Free Research Proposal On Private Health Care Of Psychiatric Disorders Is Ill Suited To Serve The Public And Social Policy

Type of paper: Research Proposal

Topic: Health, Health Care, Psychology, Public, Information, Mental Health, Confidentiality, Study

Pages: 9

Words: 2475

Published: 2020/09/25

Should be Designed to have Access to Public Funds

Abstract
The rate of mental disability is double that caused by cancer of all types. However, there have not been enough efforts by the US or other governments to tackle the mental health issues using public funds. Most patients with psychotic disorders are treated by private health care units in the USA and other countries, creating enormous impacts in healthcare, economic burden, and social life of individuals. The purpose of the current study is to investigate the extent, scope, and impacts of private healthcare in the treatment of psychotic illnesses in the USA. Conducting the research in the form of data collection from existing sources such as the published information and hospital patient records, we will determine the extent of and the factors that have an impact on public health care and social policy in the USA due to increasing usage of private health care for psychotic disorders. Mentally ill people going through private health care are ill served in our society, so social policy should be designed to permit them access to public funds. The practical implications of this study include potential changes to public policy regarding in treating psychotic disorders and wide spread awareness of the problem. Healthcare professionals, general population, policy makers, and mental health patients are the potential beneficiaries of this study.

Introduction

Mental health issues result from different sets of emotions, behaviors, and thoughts that cause various levels of distress among people. The mental issues are considered a consequence of interactions between biological, social, genetic, and economic factors (MHCC, 2010). Psychotic disorders have intense effects on an individual’s health. Though there are quite a many ways to describe the reasons for any medical situation of patients, the customary way of evaluating mental health disorders is not satisfactory. It has been projected that psychotic disorders are responsible for about 15% of overall disability globally in 2000 which is very alarming (Thornicroft & Tansella, 2003). The rate of mental disability is double that of the disability caused by cancer of all types. However, there have not been enough efforts by the governments to tackle the mental health issues. It is critical that both private and governmental bodies address the mental health issues actively and in a coordinated manner. There have been some reforms done in few countries where public health care facilities are provided to the patients. However, a large number of patients with psychotic disorder are treated by private health care units in a majority of the countries. It creates enormous impacts on public health care and social life of individuals. Patients are forced to get treatment in private health care units that can be expensive. A study of the underlying impacts of private health care of mental disorders on public health care and social policy is the main research problem (Thornicroft & Tansella, 2003). The position of the current study is that mentally ill people who had gone through private health care are ill served in our society and social policy should be modified such that people have access to public funds.

Problem Statement:

What are the documentable extent and impacts of private health care in US on the treatment of psychotic illnesses? How are the impacts reflected in community health care and social policy?

Statement of Purpose:

The purpose of the study is to investigate and highlight the extent, effects, and perceptions of private healthcare in the treatment of psychotic illnesses in the USA. The study is also intended to foster public awareness to the problems faced by mental health patients.

Literature Review

The worldwide burden of disease linked to psychotic disorders is on the rise, with the World Health Organization (WHO) reckoning that more than 450 million people are suffering from mental disorders worldwide. The Mental Health Global Action Program (MHGAP) was initiated by the WHO in 2002 in order to solve the spreading gap in access to psychological healthcare in low-income states. Regardless of these struggles, access to mental healthcare in under developed countries remains inadequate, incompetent, and unbalanced. It is estimated that the gap in poor countries for mental healthcare facilities in public hospital is about 85% which is alarming. In a recent article, Marangu, et al., (2014) has argued that incorporating mental health facilities into key healthcare locations through capability building is essential with respect to attaining the goals set by WHO. It is suggested that the combination of both the multiethnic and competencies methods as a collective strategy for dealing with capacity building in heterogeneous settings is the best solution to solve the issues related to mental healthcare (Marangu, et al., 2014).
The impact of private health care on public health care and society has been studied by De Menil, Knapp, McDaid, and Njenga (2014). It analyzes the understanding of public health care and about treatment of mental health disorders among adult patients. The pilot scheme was planned to improve the treatment of patients in public health facilities. The results indicate positive link between social and primary health care of the patients. Managed patient’s health care can affect structures that generate gaps concerning primary health care. The research did not include any comparison between public and private health care which could have offered better understanding of improvement in patient’s healthcare. The result depicts only from a pilot project and does not depict the true picture of the whole state (Upshur, 2005).
Mental disorders like schizophrenia guzzle up a major chunk of healthcare resources in both developed and developing countries (Uwakwe, Modebe, Njelita & Ezeama, 2012). The patients admitted in private health care units were analyzed by a using a Brief Psychiatric Rating Scale. All other costs incurred in private clinics were also incorporated for assessment. The results indicate that the cost of treatment in private health clinics is very high. There is a need to formulate cost saving public health facilities for the patients suffering from mental illness. The sample size of the data used for the research was subtle and might not represent the true picture of the whole population. Apart from that, the study did not incorporate indirect cost associated with the treatment. The drawback of this study is that it does not incorporate qualitative analysis to have a better understanding to the population under study (Uwakwe, Modebe, Njelita & Ezeama, 2012).
Psychotic disorders are becoming a serious concern internationally. However, all countries including the developed, developing and underdeveloped countries are resisting to give more attention to psychotic health needs of their suffering citizens. A research study conducted by Fournier (2011) evaluated the conditions of mental care facilities available to the public. For this study, the data was gathered through both primary and secondary resources. The results indicate that the public health care facilities in are very limited, and most countries face shortage of health care professionals. There have not been any changes in the policy implemented three decades ago. The administration does not have sufficient resources to expand public health care facilities in the country. There are several organizations working to help the people in order to deal with mental health issues. The private health care units are very expensive, and everyone cannot afford it. It creates an inequality in a society that can create unrest among the people in the long run. The state should take action to minimize the gap between the quality of treatment in government funded and private health care units. This study gives a complete picture of the problem that and all aspects have been covered very comprehensively in it (Fournier, 2011). Such research studies on US healthcare facilities for mental health disorders are lacking and there is an urgent need for similar studies.
Another study was conducted on mental health care issues by Ofori-Atta (2010). A quantitative method of conducting a survey was used in this research. World health organization’s instruments to assess mental health was used in the survey. Apart from that, informal interviews were conducted from the people directly involved in the healthcare system of the country. The sample used for the study was 122. It was found that the country needs legislation in public health care for mental disorders. The lack of funds and distribution of psychotic health experts needed to be organized in such a manner that everyone can have easy access to health care. For that purpose, the government should promote community-based health care units in the country. This study provides a more conclusive picture of the shortcomings with respect to basic public health facilities for mental illness.
Martins (2008) conducted a study to analyze the involvement of homeless individuals with the public health care system. The research design used for this purpose was descriptive in nature. Interviews were conducted on a sample of 15 homeless individuals. The result of the research stressed that the displaced people do not have the same access to mental health care as other individuals in society do. They face discriminatory behavior from the public and private health care units. Because of it, they try to delay the treatment unless it became extremely severe. It can lead to a feeling of social inequality among the poor people. The research was accompanied with a subtle sample size of homeless people that might not represent the actual scenario. The large sample size of homeless people along with the point of view of the representatives from the public health care organizations can present the exact outcome desired in this research.
A research study was conducted to analyze the access of mental health care facilities to women living in rural areas (Chemali, et al., 2013). For this purpose, medical records of public healthcare institutions were studied. A total of 226 psychiatric charts were studied. After analysis, it was found that none of the charts contained medication status of the female patients. The hospital medical staff was found careless in treatment of females patients. Appropriate psychotic health care for women needs concentrated efforts by various stakeholders. It has been suggested that public mental health care structure needs to be reactive, consenting for change initiating with equal rights for both male and female patients, so that women living in the rural areas of the country have access to basic mental healthcare facilities (Chemali, et al., 2013).
In developing countries of the third world, it has been estimated that about 16.1% of the adults in the country were suffering from some type of mental illness (Ahmed,et al., 2011). However, the ratio of qualified doctors with respect to population is very low in the country and is distributed unequally across the country. There is no legislative structure of public health care for psychotic disorders in the county. Majority of the population get treatments of its mental disorders from private sector health care units. It has been suggested that countries require a new management framework for treatment of mental health issues of the residents. However, this research does not provide any conclusive suggestions for the solution of mental health care issues prevailing in the country (Ahmed, et al., 2011).
Pelzang (2012) evaluated and highlighted the social beneficial policy and problems with the mental health systems. The study emphasizes on mental health care system with respect to services, policies, and problems to support improved system of psychotic disorders’ treatment. The reason behind these problems includes the lack of understanding and bad management of mental disorders by the health authorities and residents. In order to reinforce mental healthcare in the country, there should be awareness about the mental illness in every aspect of health and social policy (Pelzang, 2012).
In US, a majority of mental illnesses including the psychotic disorders is treated through private health care units and the impacts of such treatment public health care and society are not completely clear. An analysis of mental health care system operating in two of the most developed countries, that is, United States and Switzerland was conducted by Trotta, Lang and Schneeberger (2013). In both U.S. and Switzerland, the majority of the mental health illness are covered through private health care system operating in these countries. The private health care system of Switzerland has been more effective in delivering the outcomes as compared to that of the U.S. The researchers have suggested that not everyone can afford to have treatment from private health care centers. Both of the governments should do proper legislation to formulate an effective public health care system that can satisfy the general public to a large extent. In this way, the gaps among different social classes can be reduced to promote equality in the societies.

Research Methodology

The methodology used for this research study was a blend of both qualitative and quantitative methods. The research will be conducted in the form of data collection from published sources and hospital records. The data collection would focus on adult individuals that have undergone or under treatment for mental health issues at a local healthcare facility in the USA. The sample data intended to be collected is presented below in Table 1.
The use of combination of methods in research is also termed as triangulation. This method has certain advantages associated to it. It makes the researcher mode confident of his results, encourages growth of creative ways of gathering data, helps in collecting a richer and reliable data, and discloses any contradictions (Jick, 1979). The use of mixed research methods neutralize the weaknesses of one methodology and support the benefits of the other in order to achieve better quality research outcome. The use of both qualitative and quantitative methods increases the aptitude to rule out conflicting explanation of observed data and minimizes doubts about data reliability (Hussein, 2009). The use of triangulation methodology in this case will provide more convincing outcomes. Besides, for justifying the influence of private health care for the treatment of mental disorders on public health care and social policy. The used of mixed method will also confiscate the restriction of dependence only on either qualitative or quantitative methods. De Lisle (2011) stated that complicated social issues have a tendency to be challenging for the rigid investigations by traditional researchers. The complexity of issues have forced the researchers to demand multiple tools for investigation. It has steered to the advancement of mixed research methods.
The reason behind using data collection from the existing source methods is to try and get the maximum information about the issue. A data collection template was designed for collecting information on the patients who have used public and private health care for psychotic disorders. While it will be feasible to collect the same data using short questions, we believe the existing data is the best way to get the information we are seeking.

Objectives

Determine what extent and factors can have an impact on public health care and social policy in the USA due to increasing usage of private health care for psychotic disorders.

Analyze the data associated with psychotic disorders treatments in private health care facilities

Explanation of Research Framework
As stated before that both qualitative and quantitative methods are used in conducting this research. The following framework outlines the basic methodologies employed for conducting and concluding each segment of this study. Literature review was performed to analyze the impact of private health care for psychotic disorders on public health care and social policy. Concurrent to the literature review, a set of indicators will be developed to measure the concepts through a framework based on a data collection from existing sources. Content analysis was performed to set a base for collecting research information. This method allows logical, quantitative and objective research to capture stresses on filtering the information from the content and data significant to the concept being analyzed (Altheide, 1996). Data collection will be conducted with representative private and government health care sector facilities and community institutions. Ofori-Atta (2010) and Fournier (2011) has used both qualitative and quantitative set of techniques to analyze the mental health care issues in Ghana. The data will be collected through random sampling. The information will be gathered in two phases. In first phase data collection of qualitative technique will take place followed by the quantitative data. The methods of collecting the data will include individual searches for existing data for the qualitative part. For the quantitative data, methods of collection will also include existing data collection methods.

Data Collection Methods

A study on this subject has been done by using both primary and secondary research. Primary research encompasses existing data collection from published as well as hospital records. The data for the research will be carried out by using the two sources primary and secondary. Published primary sources, where available, will be the questionnaires distributed among the respondents and the combined results will be analyzed quantitatively through the use of graphical presentations. The chosen existing sources of the questionnaire will be the people who have suffered from psychotic disorders. It will help us to understand the problems they have faced during treatments from either public or private healthcare facilities. Published interviews and the data will be selected to include people associated with healthcare professions and government policy makers to understand their point of view with respect to this issue. Secondary research will be performed through articles from known journals, reports, and cases. The literature and evidence will be gathered, analyzed, and extracted to form opinion and support our research questions and objectives. The factors that impact the public health care and social policy will be researched through the secondary literature. More than 30 articles for.’’ renowned journals along with Harvard business review articles and cases will be studied for the research. This approach is called the case study approach through which the data will be studied.

Intended Audience

The audience of the research study consists of organizations, employees of health organizations and professionals that are directly linked with mental health. All of them will be engaged in research work and information will be collected from them through semi-structured interviews. The viewers of research will include people from both private and government mental health institutions in order to analyze the differences between their performances. The data will be gathered from primary and secondary resources. The analysis will help to cover every aspect necessary in this research and achieving underlying objectives of the research.

Limitations

There are certain limitations to the research work in the present study. These include:
Reporting biases on the part of respondents of the questionnaire.
Time limitation can restrict the scope of the study and sample size
The sample size and distribution of gender might have an influence on the consequence of the results.
Schedule
In order to complete the research, the work will be divided into different sections and each section would be completed in an appropriate time. The schedule for this research will be as follows:

Projected Results

We expect to analyze the results in terms of differences, if any, between race, sex, and age demographics for using mental health services. We also analyze how different populations view the private health care services for mental health disorders. We will tabulate the quantitative results and make summaries of the interviews.
We anticipate to find that economic factors have the highest impact on in private healthcare. We also anticipate that public health care and social policy change in the USA will be highly sought and desired by patients currently seeking help in private health care for psychotic disorders. Overall, we expect our results to provide reasonable answers to our research questions.

Learning Experiences

As a healthcare professional, I believe that I am immensely benefitted in going through this research study. I understand how evidence based research is conducted and can be used to shape public policy and help patients. I also believe that this research project improved my understanding of medicine practice and provoked further interest in research. The research program helped me understand various issues patients encounter in seeking healthcare in US and the need for public institutions, particularly for mental disorders.

Human Subjects

The proposed study does involve human subjects as volunteers in a survey. An IRB form with details is enclosed.

Mentoring

Peggy Tally had been by mentor throughout the research project. We had three meetings and she had been very supportive. Her role as y supervisor and mentor is negligible. The designing of the questionnaire would not have been possible without her guide and I could not have accomplished this far.

References

Ahmed, H. U., Mullick, M., Alam, F., Nahar, J. S., Chowdhury, N. F., Hamid, M. A., & Rabbani, G. (2011). Management of Psychotic Depression in Bangladesh. BMRC Bulletin, 46-50.
Altheide, D. L. (1996). Qualitative Media Analysis. Thousand Oaks: SAGE publications.
Berelson, B. (1952). Content analysis in communication research.
Burgess, R. G. (2002). In the field: An introduction to field research.
Chapman, A. (2014). The Impact of Reliance on Private Sector Health Services on the Right to Health. Health and Human Rights Journal, 122-134.
De Menil, V. P., Knapp, M., McDaid, D., &Njenga, F. G. (2014). Service use, charge, and access to mental healthcare in a private Kenyan inpatient setting: the effects of insurance. PLOS One, 1-7.
De Lisle, J. (2011). The Benefits And Challenges Of Mixing Methods And Methodologies:Lessons Learnt From Implementing Qualitatively Led Mixed Methods Research Designs In Trinidad And Tobago. Carribean Curriculum, 87-120.
Fournier, O. (2011). The Status of Mental Health Care in Ghana, West Africa and Signs of Progress in the Greater Accra Region. Berkeley Undergraduate Journal, 9-34.
Holsti, O. (1969). Content analysis for the social sciences and humanities.
Hussein, A. (2009). The use of Triangulation in Social Sciences Research: Can qualitative and quantitative methods be combined? Journal of Comparative Social Work, 1-12.
Jick, T. D. (1979). Mixing qualitative and quantitative methods: Triangulation in action. Administrative Science Quarterly , 602-611.
Kabanoff, B., Waldersee, R., & Cohen, M. (1995). Espoused values and organizational change themes. Academy of Management Journal, 1075-1104.
Martins, D. C. (2008). Experiences of Homeless People in the Health Care Delivery System: A Descriptive Phenomenological Study. Public Health Nursing, 420-430.
MHCC. (2010). Making the Case for Investing in Mental Health in Canada. Mental Health Care Commission of Canada.
Ofori-Atta, A. (2010). A situation analysis of mental health services and legislation in Ghana: challenges for transformation .African Journal of Psychiatry, 99-108.
Pelzang, R. (2012). Mental health care in Bhutan: policy and issues. WHO South-East Asia Journal of Public Health , 339-346.
Rasiah, R., Abdullah, R. N., &Tumin, M. (2011). Markets and Healthcare Services in Malaysia: Critical Issues. International Journal of Institutions and Economies , 476-486.
Scandura, T. A., & Williams, E. A. (2000). Research methodology in management: Current practices, trends, and implications for future research. Academy of Management journal, 1248-1264.
Thornicroft, G., &Tansella, M. (2003). What are the arguments for community-based mental health care? Copenhagen: World Health Organization.
Trotta, C., Lang, U. E., &Schneeberger, A. R. (2013). Mental health care across two nations – Switzerland and the United States of America. Swiss Archives of Neurology and Psychiatry, 165-169.
Upshur, C. C. (2005). Crossing The Divide: Primary Care and Mental Health Integration. Administration and Policy in Mental Health, 341-355.
Uwakwe, R., Modebe, I., Njelita, I., &Ezeama, N. (2012). Direct Cost of Treating Acute Psychotic Episodes in Nnewi, South-East Nigeria .Orient Journal of Medicine, 10-17.

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