Category Mental Health Reform

Congress Strengthens Mental Health Parity

Carol Rickard

Carol Rickard, Community Education and Outreach
Depression and Bipolar Support Alliance

With the stroke of his pen on December 13, 2016, as he signed the 21st Century Cures Act, President Obama moved our nation one step closer to treating the whole person and ensuring equal access to health care for individuals living with a mental health condition. This law addresses a wide range of health issues, including a major emphasis on mental health issues. In signing the legislation, the President put into motion critical provisions to improve implementation and enforcement of the 2008 parity law.

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What Is the Future of Obamacare?

Depression and Bipolar Support Alliance

With Republicans moving into the White House and controlling both houses of Congress, what can the American people expect to happen to “Obamacare” and what impact will that have for those of us living with a mood disorder and our families? If Obamacare collapses, will we have access to mental health care?

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Decision Aids Can Be Developed to Successfully Support Shared Decision Making in Clinical Encounters

Juan P. Brito Campana, M.D, MSc. Photo

Care For Your Mind acknowledges and appreciates the collaboration of the National Network of Depression Centers in developing this post.

Juan P. Brito Campana, M.D, MSc.
Annie LeBlanc, Ph.D.
Mayo Clinic Knowledge and Evaluation Research Unit (KER)

As recent CFYM posts have indicated, shared decision making (SDM) is good for patients, doctors, and the system itself. But if we want SDM to become the norm in exam rooms nationwide, we have to support clinicians by giving them the means to make it happen.

We can do this by providing tools that allow physicians to communicate effectively and engage in meaningful conversations about their patients’ preferences, needs, and values.

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Patients Need to Be Involved in Policy-Making

Photo of Tony Coelho

Tony Coelho, former Member of Congress, author of the Americans with Disabilities Act, and lifetime disability advocate

Since the age of 16, I’ve suffered from seizures. I’m now 74 and six decades of experience as a patient has taught me a lot about the healthcare system. I’ve seen firsthand how it’s evolved to suit the financial interests of the most powerful players and often ignore the needs of patients.

Unfortunately, many of the decisions that affect patient care are made at the policy level, often by bureaucrats with little or no clinical experience. When decision-makers ignore the patient perspective — including individual exam room experiences — care can become sterile, mechanized, and ineffective.

In order to create a system that better treats patients, we need legislators and decision-makers to create laws and regulations that value and support patient input. By bringing patients to the policymaking table, we can create a stronger healthcare system that addresses the needs of the individual and ensures more effective care for everyone as we move forward.

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Why Shared Decision Making Should Apply to Informed Consent

Erica Spatz Photo

Based on an interview with Erica S. Spatz, MD, MHS,
Assistant Professor of Medicine, Yale School of Medicine

Imagine that you’re about to be wheeled into surgery. You’ve fasted for 24 hours, you’re in a hospital gown, and you’re awaiting the doctor’s arrival. Then the nurse brings in some paperwork, and you’re asked to sign a form acknowledging the risks of the procedure. You see some potential side effects or consequences that concern you—but at that point, how likely are you to refuse the procedure?

For many patients, that last-minute signature is the only experience they have with informed consent. Legally, however, informed consent is defined as the process in which a patient learns about and understands the purpose, benefits, and potential risks of a medical or surgical intervention.

In my view, that discussion should begin long before surgery day, so a patient has time to balance the risks and benefits before moving forward with a decision.

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Shared Decision Making – with Families – Yields Better Treatment Outcomes

Alison M. Heru, M.D.
Professor of Psychiatry, University of Colorado Denver

In the NES Program at University of Colorado Health, a six-month program combining neurology and psychiatry treatment for non-epileptic or non-electrical seizures, psychiatrist Dr. Alison Heru makes shared decision making an integral part of practice.

In my experience, shared decision making yields the best results in treatment. When patients feel like they have participated in choosing the treatment and are able to ask questions and weigh alternatives, they are more likely to feel they have selected the treatment that is the best for them and have a stronger stake in the outcome.

At the NES program (addressing non-electrical seizures), there’s not clear evidence for which treatment approach will be best for each patient. It’s my role, then, to make sure we make the correct diagnosis, provide information about the treatment modalities available, and decide together with the patient (and the patient’s family, unless not available) on the treatment plan. I won’t tell the patient what to do or to force a choice on them, but I will offer my opinion.

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How Can Parents Help in Shared Decision Making?

Families for Depression Awareness for Care for Your Mind

Your teenager has been diagnosed with a mood disorder and the clinician is talking with her or him about treatment. What is your role as a parent in the shared decision making model? How can you participate?

At Families for Depression Awareness, we believe that parents can play an essential role in recognizing and addressing mood disorders in their children. When you’re worried about a teen in your life, you might need to take crucial actions in a crisis situation, convince a reluctant teen to go to a mental health provider, or be supportive in finding and accessing mental health care.

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How Peer Specialists Enhance Shared Decision Making

Tom Lane, Certified Recovery Support Specialist

Much has been written about patient-centered care. Proof that this model is gaining acceptance is the evolution to shared decision making (SDM). The National Learning Consortium defines SDM as a “process in which clinicians and patients work together to make decisions and select tests, treatments and care plans based on clinical evidence that balances risks and expected outcomes with patient preferences and values.”

In a recent CFYM post John Williams, M.D., writes that there are several tools that clinicians can use to step through the shared decision making process. Dr. Williams opines that when there are many different treatment options, SDM takes on added importance. As a result, a major step in the SDM process must be for clinicians to understand the desired outcomes of their patients.

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