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The Stigma of Mental Illness
As a society, how do we view mental illness? Often with disdain, discomfort, or fear. Often we ridicule people with mental health disorders. Our culture fosters negative views of mental illness by using terms such as “crazy”, “nuts”, “psycho”, and the media perpetuates these concepts by depicting people with mental illness as scary, silly, stupid, or defective.
The policy issue that most affects my professional, as well as, personal life is Disability. I am a psychiatric nurse who also happens to have a mental health issues. Mental illness discrimination and access to healthcare are protections meant to be provided under the law. According to the Americans with Disabilities Act (ADA), it is illegal to revoke licensure or otherwise prevent a healthcare provider from working due to mental disorders. The conditions included are illnesses such as depression, bipolar disorder, and schizophrenia. Another form of discrimination the ADA protects is “employment tests or other selection criteria that screen out or tend to screen out an individual with a disability or a class of individuals with disabilities” (Samuel, L, 2017). However, professional licensing boards still actively engage in discriminatory actions every single day. “Boards’ hands are often tied in terms of what state legislatures will let them do” (Dyrbye, 2017). According, to Dyrbye, at the state level, the quandary is between protecting the public from impaired healthcare workers and the provider’s right to make a living. New studies have shown that nearly 40% of physicians and an even higher percentage of nurses reported that they would be reluctant to seek formal medical care for treatment of a mental health condition because of concerns about repercussions to their licensure.
In the Kingdon’s Model the problem is having special protections under the American Disabilities Act (ADA) to prevent increased discrimination for licensed professional healthcare workers suffering from mental illness who are far more susceptible to bias related to the nature of their professions as providers of patient care.
A policy stream can easily be defined as a think tank. The primary objective is to collaborate to refine the problem to best address the proposed policy. In the case of disabilities related to mental illness in healthcare professionals this may be difficult because it is a narrowly defined subset of both the mentally ill and the disabled populations. However, because the subset can pull from two communities for support it may be easier gain support. Ultimately, the goal is to put policy into law that forces all healthcare licensure boards and healthcare employers from gathering mental health information and that employers will face serious penalties for discrimination and/or wrongful termination. The burden of proof is then on the employer rather than the employee to prove rational for separation.
Engaging members from all facets of the healthcare community, as well as, the American Psychiatric Association (ADA) to serve as experts is paramount in generating political support. Having political connections foster influence from organizations such as NAMI, MHA, Congressman LaHood from IL, Representative Tim Murphy from PA, Linda Rosenberg, CEO of the National Council for Behavioral Health, Executive Director of Mental Illness Policy Org DJ Jaffe, ANA, AMA, and EEOC. Finally, identifying successful lobbyists to push policy forward is fundamentally crucial if any bill is to become law. Eliciting the support of a successful lobbyist can help to identify windows of opportunity and to approach legislators at the right time and under the best circumstance to have a bill well received.
Dyrbye, L., West C., Synsky, C., goders, L., Satele, D., Shanafelt, T. (2017). Medical Licensure Questions and Physician Reluctance to Seek Care for Mental Health Conditions. Mayo Clinic Proceedings. 92, 10, p1463-1604, e133-e153. DOI: https://doi.org/10.1016/j.mayocp.2017.06.020
Farmer, J., (2011, May 16). Disclosing a Mental Health Problem to an Employer. The Guardian. Retrieved by https://www.theguardian.com/careers/careers-blog/mental-health-at-work
John Kingdon, Agendas, Alternatives, and Public Politics, 2nd ed. (New York: Harper Collins, 1995). p. 19.
Samuel, L; (2017, October 16). Stat. Doctors Fear Mental Health Disclosure Could Jeopardize Their Licenses. Retrieved from https://www.statnews.com/2017/10/16/doctors-mental-health-licenses/