Letter to the Editor- Population Health Policy Advocacy
Current State of the Quality of Care and Outcomes
Depressive disorder is a clinically significant disorder and is increasingly becoming a public health issue. Depressive disorders are common occurrences in primary healthcare and remain one of the leading causes of disability globally. The chronic nature of these disorders confers considerable strain on their management. Major depression remains the leading type of depressive disorder encountered in more than half of the patients presenting with depressive disorders. In the United States alone, the lifetime risk of any depressive disorder stands at 30%. Suicides attributable to depression now account for more than half of all the reported cases (“Depression in the Primary Care Setting,” 2019). These statistics indicate a tilt in paradigm towards abnormal and warrant interventions to preserve the lives of individuals at risk.
Healthcare interventions have, however, evolved to offset this paradigm shift. Pharmacotherapeutic and psychotherapeutic interventions have been developed that greatly improve the prognosis of these disorders and enhance their clinical outcomes. Pharmacotherapy with antidepressant drugs in conjunction with psychotherapy has produced favorable clinical outcomes and remains the first line in managing these disorders (Kassianos, 2018). However, these interventions have not been adequate in managing these disorders and reducing significant morbidity and mortality attributable to these disorders. There still exists a gap in care processes for depressive disorders. Access to care remains a challenge for many patients presenting with these disorders. Improving access may provide beneficial effects in diagnosing and treating these disorders.
Most benchmarks on depressive disorders and their management indicate the need for early diagnosis and timely initiation of therapy to prevent significant morbidity and mortality resulting from these disorders. However, this has not been the case in the majority of the care systems globally. Several factors hamper the timely diagnosis and treatment of depressive disorders. Socio-cultural factors, gender, and access to healthcare are the most implicated factors in low rates of diagnosis and treatment of these disorders (Bogren et al., 2017). With these gaps still existing within the healthcare system, significant morbidity and mortality are still being realized in these groups, and suicides attributable to depression are rising.
Health Policy Development and Advocacy
An exponential increase in the incidence of depressive disorders has been seen in the recent past. Morbidity and mortality resulting from depression have also increased. The impact of these increases is being felt by the healthcare system. Therefore, innovative approaches are necessary to curtail these increases and effectively manage these patients. Policies targeted at preserving the lives of individuals with these disorders and those that enable the creation of awareness of these disorders are necessary. These policies will allow increased access to care for patients presenting with these disorders and also enable early identification and timely treatment of these disorders.
Healthcare policies provide a framework for managing a specific health issue and its effects on the population curtailed. Policy frameworks on depression have been targeted at raising community awareness of depression, enabling early detection and treatment of these disorders. Additionally, policies on depression have been targeted at enhancing the effectiveness of care processes by providing screening, effective treatment modalities, and psychosocial support to patients presenting with these disorders. The overall effect of these policy provisions has been evident in increased quality of life for most people with these disorders (Cho et al., 2019). This is because of enhanced access to care and the availability of effective modalities of treating these disorders in the conventional healthcare system. Therefore, health policy advocacy remains a valuable tool in which improvements in the management and care processes for the depressed can be achieved. These policies will enable enhanced access to care, availability of resources utilized to diagnose and treat these disorders, and availability of required personnel to handle patients presenting with these disorders.
Justification of the Policy Development
In as much as depression remains a common occurrence in primary healthcare, its management is often carried out in higher levels of care. Therefore, a policy to colocate mental health specialists to the primary level of care is necessary. Mental health professionals such as psychiatrists and psychologists are necessary for diagnosing and designing an effective therapeutic plan for patients presenting with depression. Colocating them to the lower levels of care enhances their accessibility to patients presenting at these levels of care. Primary healthcare accounts for more than half of all hospital visitations. It, therefore, provides a site in which the majority of depressive disorders can be detected in patients and diagnoses made. The presence of mental health specialists at this level of care will significantly optimize the care provided to these patients. As a result, it will potentially reduce morbidity and mortality attributable to late diagnosis of these disorders. According to Unützer & Park (2018), the colocation of mental health specialists to the primary level of healthcare may produce considerable benefits in care optimization for depressed patients and may prevent the development of chronicity common in this diagnosis. This reinforces the need to collocate care providers to the lower levels.
Advocating for Policy Changes in Other Care Settings
Despite enhanced efforts in the therapeutic management of depressive disorders, not much success has been achieved, as evident in the rising cases of mortalities. A gap in care processes still exists and can only be bridged by enhancing access to care processes. Gaps also exist in public awareness of depressive disorders and their implication for the health of individuals and communities. Health policies should, therefore, be developed to bridge these gaps.
Access to healthcare, for instance, is key in managing depressive disorders. Access to healthcare can be improved by increasing the number of healthcare facilities providing mental health management services, increasing the number of healthcare professionals providing specialty care on various mental health disorders, and increasing insurance coverage for community members. Policy changes addressing these issues will benefit the management of these disorders. Community awareness programs are also necessary in this regard: these programs are valuable tools for preventing the development of these disorders. Therefore, this intervention remains essential in preserving the lives of community members by encouraging positive living and refraining from behaviors that predispose an individual to these disorders.
Policies on depression handling and management and the handling of other mental health illnesses are all targeted at preserving the lives of vulnerable individuals and improving the quality of life of already affected individuals. These policies have been evident in the enhanced quality of life of these individuals and an increase in the number of individuals seeking treatment for these disorders. Community awareness programs have been lauded for their impact on improving the healthcare-seeking behavior of many community members. Optimized care provision has also improved the quality of life of people living with these disorders.
Interprofessional Support to the Policy
The effectiveness of this policy provision is dependent on the utilization of a collaborative paradigm in its approach. This approach draws multiple professionals and converges their care provision practices to ensure optimal clinical outcomes for the patient (Vlasveld et al., 2017). These professionals work collaboratively in interdisciplinary healthcare teams. These healthcare teams comprise psychologists, psychiatrists, doctors, nurses, pharmacists, social workers, and physical therapists. These teams are dynamic and are often adequate in addressing all areas of care for patients presenting with depression. These care areas include psychosocial support, pharmacotherapy with drugs, and functional support. Their combined efforts ensure an effective care process and the realization of better clinical outcomes. Additionally, collaborations and complementary relationships between the members of these healthcare teams enhance their work efficiency, enhancing care outcomes.
References
Bogren, M., Brådvik, L., Holmstrand, C., Nöbbelin, L., & Mattisson, C. (2017). Gender differences in subtypes of depression by first incidence and age of onset: a follow-up of the Lundby population. European Archives of Psychiatry and Clinical Neuroscience, 268(2), 179-189. https://doi.org/10.1007/s00406-017-0778-x
Cho, Y., Lee, J., Kim, D., Park, J., Choi, M., & Kim, H. et al. (2019). Factors associated with quality of life in patients with depression: A nationwide population-based study. PLOS ONE, 14(7), e0219455. https://doi.org/10.1371/journal.pone.0219455
Depression in the Primary Care Setting. (2019), 380(23), 2278-2280. https://doi.org/10.1056/nejmc1903259
Kassianos, G. (2018). Improving practice – Major depressive disorder. Drugs In Context. https://doi.org/10.7573/dic.212238
Unützer, J., & Park, M. (2018). Strategies to Improve the Management of Depression in Primary Care. Primary Care: Clinics in Office Practice, 39(2), 415-431. https://doi.org/10.1016/j.pop.2012.03.010
Vlasveld, M., Anema, J., Beekman, A., van Mechelen, W., Hoedeman, R., & van Marwijk, H. et al. (2017). Multidisciplinary Collaborative Care for Depressive Disorder in the Occupational Health Setting: design of a randomized controlled trial and cost-effectiveness study. BMC Health Services Research, 8(1). https://doi.org/10.1186/1472-6963-8-99
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Assessment 3 Instructions: Letter to the Editor: Population Health Policy Advocacy
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Write a letter to the editor of an academic or professional journal. Your choice of journal dictates the length and format of the letter.
Letter to the Editor- Population Health Policy Advocacy
Introduction
Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented.
Advocating for new policies is an essential aspect of the master’s-prepared nurse. For new policies to be compelling, they need to be supported by evidence. Supporting data can be used to illustrate why new policies and interventions are needed to help address a specific health issue. Compelling data can help sway the stakeholders and gain support for your policy.
Another aspect of advocacy is disseminating new policies and interventions outside of the immediate care environment. This can be done by reaching out to professional organizations as well as academic and professional journals. A letter to the editor is one strategy for disseminating information to a wider audience, and to potentially enlist support throughout the wider professional community.
Preparations
As you complete this assessment, you may want to consider other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a professional community member. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment. For additional assistance, you may use the Locating Letter Submission Guidelines for Journals library guide.