Assignment 3: Critical Analysis of Healthcare Policy

Over the last few weeks, we have examined many issues in healthcare policy and politics. Some of them were unique to the US and some of them impacted the world\’s populations. For this assignment, you will research and write about an issue and country outside of the US. As you learned in Epidemiology, to be able to diagnose the health of one’s country/community and its people, there is a need to understand the demographics and social variables affecting a population which may cause health issues. Healthy People 2020 identifies this as the social determinants of health. As you write about your selected country and issue, you will describe some of those social determinants.

COUNTRY: FRANCE
ISSUE: MENTAL HEALTH

When you examine this issue, you should identify the following items:

What country did you choose and what are some of the social determinants of health? (You do not need to write out the social determinants of health in complete sentences, you may bullet them)
What is the healthcare policy issue you chose and how and why do the identified social determinants of health contribute to the issue you selected?
What are the healthcare politics of your country and how do they drive your chosen country\’s response to the healthcare policy issue?
How does the healthcare policy issue you chose affect the common citizen of your chosen country on a local basis?
How does the healthcare policy issue you chose affect the US and the international community as a whole?
Provide conclusions (worth 30 points, needs to be substantive) which can be drawn from your research about the healthcare policy issue and include projections that can be made about the future of this issue in your country over the next 5 years.
Note the conclusion bullets and requirements and what it should contain.

Guidelines:

The length of the paper is 5 – 6 pages, not including the cover page and reference list. (Points will be deducted for papers that exceed the page limit).
All references must be less than 5 years old, unless they are classics. If you are in doubt, ask your course professor.
The paper must be prepared in APA 7th edition format. That includes a title page, body of the paper, and references.

Critical Analysis of Healthcare Policy

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Critical Analysis of Healthcare Policy

Introduction

The prevalence of mental health remains a concern in many countries worldwide. According to 6, mental illness contributes to approximately one-third of the global disability resulting from adult health problems. Mental disorders are closely associated with discrimination, poverty, humanitarian disasters, and others. Common mental illnesses include bipolar disorder, major depressive disorder, schizophrenia, and substance abuse disorder, among others (Jacquet et al., 2018). Mental illnesses occur in all age groups and countries, including the United States, the European Union countries, Canada, and other developed and developing countries. In that regard, this paper provides a robust discussion of mental health issues in France.

Country of Choice and Social Determinants of Health

The chosen country of choice for the focus and completion of this assignment in France. Like other countries, French citizens experience myriads of social determinants that negatively impact their health status (European Commission, 2019). Social determinants of health in France include

• Discrimination
• Physical environment
• Access to healthcare
• Employment
• Homelessness
• Socioeconomic factors (education, income, poverty, and occupation
• Gender differences

Policy Issue and Associated Social Determinants of Health

The selected policy issue is mental health in France. For decades, mental health issues have existed in France; however, such incidences have escalated tremendously due to the COVID-19 pandemic. It caused mental health problems such as sleep disorders, anxiety, and depression. COVID-19, alongside the other social determinants of health discussed in the previous paragraphs, has a significant influence on the mental health of individuals in France. The social determinants of health are primarily responsible for mental health inequalities in populations (European Commission, 2019). Discrimination affects more than a general medical condition. Discrimination is tied to mental health conditions such as post-traumatic stress disorder, generalized anxiety disorder, major depressive disorder, and other related mental issues. It might trigger other determinants such as homelessness and income inequalities.

According to Jacquet et al. (2018), mental disorders in France are common in individuals of low socioeconomic status. These individuals face hash or unfavorable situations psychological and behavioral factors. A good example is that increasing income disparities in society often lead to people on the lower side experiencing stress, shame, and maladaptive coping responses. These psychological disturbances occur when low socioeconomic individuals develop a sense of relative deprivation. People who share low income do not seek prevention and early treatment services (European Commission, 2019). They cannot pay for extra hospital bills making their mental condition worse than people who have achieved economic stability. French residents with low income are frustrated and psychologically disturbed for lack of food.

According to European Commission (2019), about 20% of French people faced difficulty in 2018 feeding themselves. About 5.5 million people used food aid, and only 1.2% of them managed to consume the required five portions of fruits and vegetables daily. The frustrations of lack of food lead to anxiety, depression, and post-traumatic stress disorder. Poverty goes hand in hand with low income and poor education. Gender differences have also contributed to the risk of mental issues differently. Jacquet et al. (2018) found out that educational inequalities were higher among women than men in the French population.

Additionally, income inequalities were more robust in men than women. All in all, both situations lead to some level of individual’s sense of deprivation, which leads to mental or psychological problems. Additionally, there is a higher risk of alcohol addiction and substance use disorder among the disadvantaged socioeconomic positions (European Commission, 2019). Women earn an average of 24% less than men and occupy less well-paid jobs. Also, there are higher insecurities for women than men in France. All the inequalities have significant disruptions to the psychological functioning of women. Therefore, socioeconomic factors ((education, income, and perceived financial status) have a considerable impact on the mental health of individuals in France and everywhere else.

Healthcare Policy in France

In 2011, France enacted the most recent mental health law regarding involuntary psychiatric treatment that was meant to harmonize the need for treatment and protect the patient’s rights. The law was also amended in 2013 for improvement (Michaud & Prat, 2018). The law provides three types of involuntary treatments in France; by decision of a hospital director in case of extreme urgency, at the request of a third party, or without a third party’s request. The second one is by the request of psychiatric of a state representative, and the third is involuntary outpatient treatment (Michaud & Prat, 2018). The decision of a hospital director is used when the patient is diagnosed with a mental illness that needs psychiatric intervention associated with the entire hospitalization. It only takes effect when the patient cannot consent to treatment due to the mental disorder. However, the standard procedure is used to determine who can make decisions on behalf of the patient (Michaud & Prat, 2018). When no third party is available, the hospital director decides.

Regarding involuntary treatment by request of a state representative, some conditions must be met. There must be a certificate from a psychiatrist who is not from within the hospital where the patient is to be hospitalized (Michaud & Prat, 2018). The certificate must describe the mental disorder and provide sufficient evidence that it threatens the individual’s safety and public order. Regarding involuntary outpatient treatment, the attending psychiatrist proposes the treatment of a mentally ill patient. The plan provides detailed modalities of treatment and their frequency. It should not include unduly burdensome commitments to the treatment team (Michaud & Prat, 2018). The use of force to administer or give drugs is not permitted.

This policy plays a significant role in enabling France to respond to mental health issues. For example, it provides a solution to treat patients who have mental illnesses but cannot make rational decisions without violating their rights (Michaud & Prat, 2018). Patients with mental illnesses cannot often consent to psychiatric treatment; hence, they need to be assisted legally. This law helps reduce damages associated with mental health in workplaces, at home, and in society. It also enhances access to psychiatric healthcare among the vulnerable. Therefore, this law helps France to respond to mental health problems effectively.

 

Impact of Mental Health Problems On France

Mental disorders have several detrimental impacts on French people at the local level. The disease is associated with devastating symptoms such as delusions, disorganized behaviors, hallucinations, and others (Michaud & Prat, 2018). Mental disorders impair the individuals’ cognitive functioning, especially judgmental and reasoning skills. Tikkanen et al. (2020) state that in 2016, France had 21% of its population experiencing emotional distress from different related cases. Several millions of people received mental treatment in France in 2019. Over 928 thousand women and 477 thousand men experienced a mental disorder. The most common mental health problems were mood and neurotic disorders (Tikkanen et al., 2020). Addictive disorders were the second-highest prevalent among French people.

Impact of Mental Health Problems On the U.S. And Other Countries

Mental health has a significant impact on the United States and other countries across the globe. Approximately one-quarter of the United States adults experience mental health diagnoses such as depression, anxiety, and other emotional distress (Tikkanen et al., 2020). The U.S. is one of the countries experiencing the highest rate of mental illnesses. Compared to other developed countries, the United States reports the highest number of patients diagnosed with depression, anxiety, and other mental disorders. Canada is the second, and Sweden is the third after the U.S. regarding mental health diagnoses. Self-reported emotional distress in 2016 was 27% and 24% of people in Canada and Sweden, respectively (Tikkanen et al., 2020). Only 7% and 12% of German and French adults reported emotional distress. Therefore, the U.S. still needs to improve mental health services and outcomes.

 

Conclusion

Mental health is a serious concern across the globe. Mental health problems are associated with specific social determinants of health, which may vary from one region to another. Some health determinants of health include discrimination and socioeconomic factors such as education, income, poverty, and occupation. Others have gender differences and homelessness. France generally experiences lower rates of mental disorders than the Unites States. One important mental health policy in France is the psychiatric involuntary treatment law. It provides conditions under which patients may receive cognitive treatment involuntary without violating their rights. Mental health has detrimental impacts on all nations across the world. However, based on the trends, mental disorders will reduce to insignificant levels in the U.S. and other developed countries in the future. The struggle against mental problems is promising in countries where access to healthcare is enhanced. Developing countries still need to do much to win against this enemy.

 

 

References

European Commission. (2019). State of Health in the EU-France: Country Health Profile 2019. https://www.oecdilibrary.org/docserver/d74dbbdaen.pdf?expires=1646251525&id=id&accname=guest&checksum=FBD2C45274558A1598620C9AA48D0DCB

Jacquet, E., Robert, S., Chauvin, P., Menvielle, G., Melchior, M., & Ibanez, G. (2018). Social inequalities in health and mental health in France. The results of a 2010 population-based survey in Paris Metropolitan Area. PLoS One, 13(9), e0203676. https://doi.org/10.1371/journal.pone.0203676

Michaud, C., & Prat, S. (2018). Involuntary Hospitalisation in France: Major Evolution of Legal Aspects. Psychiatry, Psychology and Law, 25(1), 124-130. https://doi.org/10.1080/13218719.2017.1387849

Tikkanen, R., Fields, K., Reginald D., Abrams, M. (2020). Mental Health Conditions and Substance Use: Comparing U.S. Needs and Treatment Capacity with Those in Other High-Income Countries. https://www.commonwealthfund.org/publications/issue-briefs/2020/may/mental-health-conditions-substance-use-comparing-us-other-countries