Need someone to add to my already completed project. I need information on why The Russian Federation changed their healthcare policy for mental health and what was going on politically at the time of that change. I need more information on Medicaid and the mental health coverage. I need graphs comparing Medicaid to the Russian Federation mental health coverage. Lastly focus on the APA just fixing it. I will attach the rubric it’s in two parts and power point
- Got mental health access?
Improving access to mental health care to help address problems such as suicide in Russia.Comparing access of mental health care in the United states for those covered under Medicare.
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A review of The Russian Federation’s health care system
Healthcare in Russia is provided by the government through the Federal Compulsory Medical Insurance Fund and regulated through the Ministry of Health (Popovich, 2011).
The Constitution of the Russian Federation provides all citizens the right to free health care.
Mental health is covered by law, under the Law of the Russian Federation “On Psychiatric Care and Guarantees of Citizens’ Rights during Its Provision“ (Popovich, 2011).
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Lack of Access to mental health
The Law of the Russian Federation’s basic legal act that regulates psychiatric care in the Russian Federation that applies to all the those citizens seeking mental health services.
In 2001, the state guarantee of “providing for high-quality mental health care” was abolished. Moreover, the Psychiatric Assistance Act does not provide any guarantees or sanctions for failure to comply, up to 90% of inpatients do not receive accurate information about their diagnosis or treatment, nor do they have access to their own medical records (Savenko, 2014).
Need for improving access to mental healthcare
The psychiatric care system is based on two main types of facility: the territorial psychiatric out-patient clinics, termed ‘dispensaries’ (in rural areas these are units located by general hospitals), which provide care for the population residing in a specific territory; and the psychiatric hospitals, which generally provide in-patient treatment for the community within a particular areas (Krasvo, 2010).
Only about 30–35% of all patients with a mental illness apply for psychiatric assistance in the dispensary (Krasvo, 2010).
the problem of mental disorders in primary care is becoming more and more serious, such that, at present, some 25–30% of primary care patients need a psychiatric consultation. (Krasvo, 2010).
Mental health reform
The Russian Federation’s mental healthcare has gone under reform several times. The major reform was in 1992 decision to develop a law on mental health was made by senior officials, guaranteed the rights of individuals with mental health problems( WHO, 2020).
The Law on Psychiatric Care, was adopted in 1992.
Provisions of the Law and reforms were to endure that the rights are being met while meeting the psychiatric care demands of the public.
Suicide rate
There is a need for this particular regulation in mental health services because of the high rates of suicide in the Russian Federation.
The suicide rate in 2017 was 13.8 per 100 000 population (WHO, 2020).
There is a continuous in the Russian Federation’s history of sustainable high suicide rates.
The suicide rate peaked in the mid-1990s, when for men aged 50–54 years this was over six times that seen in the United States of America: 139 and 22.5 deaths per 100 000 population, respectively. In 2002, Russian men had the second-highest rates of suicide in WHO European Region, with rates of 69.3 per 100 000 males and 97.2 per 100 000 in the 45–54 year old age group (WHO, 2020).
Measuring up The similarities
In comparison with the United States regarding access to mental health with Medicare, both the most utilized services for mental health are provided, outpatient. In the united states, providers are mostly private (nonprofit and for-profit), with some public providers, including public mental health hospitals (Tikkanen, 2020).
Funding for mental health services is provided through the government. The United States, the federal Substance Abuse and Mental Health Services Administration, provides states with grants, including Mental Health Block Grants, that fund community mental health services. State and local governments offer additional funding (Tikkanen, 2020).
Measuring up The differences
Russian Federation
The Russian Federation’s mental health services are free and provided by the government to all citizens( Popovich,2011).
Funding is provided by general budgetary revenues, with federal level developing the legal and regulatory framework and policy guidelines (Popovich, 2011) .
Long term for psychiatric care is mandated through acute psychiatric beds, long term care is cover by the Social Protection system. Funding is adequate which allows hospitals to perform important social functions like providing shelter for those consider vulnerable and unable to care for self with residential care homes (Popovich, 2011).
United States
The United States’ mental health services are not free. They are paid through insurance or private pay. There are income based healthcare for low income families to help aid in access to mental health services. Insurance such as Medicaid are offered for older(Tikkanen, 2020).
The United States government doesn’t policy guidelines the insurance companies do, however government can hold insurance companies to certain standards to mandate care standards are met. Under the ACA mandated that marketplace insurers provide coverage of mental health and substance use conditions as an essential health benefit (Tikkanen, 2020).
Long term care in the United States is maintained through multiple services outpatient such as clinics, acute in patient hospitalizations, long term such as state hospitals, and group homes.All which can be covered through public and private insurances (Tikkanen, 2020).
The legislative process
Like the United States, before a policy goes into effect, specific steps must occur before the policy can be implemented. There are two chambers of the Federal Assembly: the State Duma and the Federal Council (Government of the Russian Federation, 2020).
The Federal Council is the upper house of the Federal Assembly
The legislative process requires a two-thirds vote of the total number of members of both chambers. The process includes three hearings in the State Duma approved by the Federation Council and signed into law by the President (Government of the Russian Federation, 2020).
Draft laws may originate in either legislative chamber. The president may submit them, the Government, local legislatures and the Supreme Court, the Constitutional Court, or the Superior Court of Arbitration within their respective competences. Draft laws are first considered in the State Duma. Upon adoption by a majority of the full State Duma membership, a draft law is considered by the Federation Council, which has fourteen days to place the bill on its calendar (Government of the Russian Federation, 2020).
Stakeholders for change
Those stakeholders supporting the reform are The World Psychiatric Association, Independent Psychiatric Association of Russia, and The Russian Society of Psychiatrists.
All three organizations are professional human rights organizations that advocates for the rights of the psychiatric patient population.
In the community/society, there is still a stigma surrounding mental health in the Russian Federation.
Law enforcement may result in increased in involvement in the detainment of psychotic patients in public areas.
Summing it all up
Long term implications of lack of access to mental health care in the Russian Federation can lead to a further increase in the suicide rate. Lack of awareness further contributes to society’s misconceptions and the continuous stigmatization of mental health.
If an increase in access to mental health care, the long-term implication is an improvement in the healthcare provided to patients, a decrease in suicides, increased awareness in the community allowing for possible treatment regarding when to seek care.
Adjustments in funding would need to be discussed and re-evaluated.
References
(n.d.). Retrieved September 22, 2020, from http://government.ru/en/search/?q=State+duma
Jenkins, R., Lancashire, S., Mcdaid, D., Samyshkin, Y., Green, S., Watkins, J., . . . Atun, R. (2007). Mental health reform in the Russian Federation: An integrated approach to achieve social inclusion and recovery. Bulletin of the World Health Organization, 85(11), 858-866. doi:10.2471/blt.06.039156
Julia Zur, M. (2019, August 12). Medicaid’s Role in Financing Behavioral Health Services for Low-Income Individuals. Retrieved September 22, 2020, from https://www.kff.org/medicaid/issue-brief/medicaids-role-in-financing-behavioral-health-services-for-low-income-individuals/
Krasnov, V., Gurovich, I., & Bobrov, A. (2010). Russian Federation: Mental healthcare and reform. International Psychiatry, 7(2), 39-41. doi:10.1192/s1749367600005725
Popovich, L (2011). Russian Federation: Health system review. Health Systems in Transition, 13 (7): 133-135. Retrieved from https:// rm.coe.int /168097e38a
The National Council for Soviet and East European Research: Retrieved September 20th 2020.
Mental health reform in the Russian Federation: An integrated approach to achieve social inclusion and recovery. (2011, March 04). Retrieved September 22, 2020, from https://www.who.int/bulletin/volumes/85/11/06-039156/en/
Tikkanen, R. (2020, June 05). United States. Retrieved September 22, 2020, from https:// www.commonwealthfund.org /international-health-policy-center/countries/united-states
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