Texas Department of State Health Services, Term Paper Example

Introduction

 The Mental Health Services for Children and Adolescents Service Delivery System mission is to provide quality family focused community-based mental health services and supports to children and their families. Their vision is to provide emotional wellness for youth, families, and communities in Texas. DSHS Children’s Mental Health serves children between the ages of 3 and 17 who have been diagnosed with mental illness, but cannot include diagnosis of substance abuse, mental retardation, autism, or pervasive development disorder. The adolescents may have a serious functional impairment, be at risk of disruption preferred living due to psychiatric disorder, or be enrolled in their school system’s special education department under emotional disturbance exceptionality. DSHS partners with local schools, health departments, and physicians clinics to ensure that adolescents and parents are aware of the services they provide. They also provide informational workshops in conjunction with local school systems. One way they connect with the local communities is by what they term the clearinghouse: “The Clearinghouse is a resource designed to help Local Mental Health Authorities and other behavioral health providers, consumers, family members and interested stakeholders find information about practical approaches for improving mental health service systems that have demonstrated effectiveness, with emphasis on practices that are working in Texas. There is also a Texas Behavioral Health Clearinghouse focused on clinical practices that is maintained by the University of Texas” (http://www.dshs.state.tx.us/)

Services

 Potential clients are screened by staff personnel. A member of the staff will talk directly to the child face to face or by phone. This information will determine if the child needs a detailed mental health assessment. The parent or legal guardian will be informed of the findings. If an assessment is needed, several steps will be followed. First, the child must be eligible for services from DSHS. The child must meet what is called priority population. In order to be considered a priority population, the child must be between the ages of 13 and 17 and have a diagnosis of mental illness with characteristics of emotional, behavioral, or mental disorders. After the child has meet eligibility requirements, a licensed professional will meet you the parent and child to ask questions about the child’s behavior at home, school, and with friends. DSHS also provides crisis services. They term a crisis situation as: “Crisis: A situation in which because of a mental health condition; the child/adolescent presents an immediate danger to self or others; or the child/adolescent’s mental or physical health is at risk of serious deterioration; or a child/adolescent believes that he/she presents an immediate danger to self or others; or that his/her mental or physical health is at risk of serious deterioration”(http://www.dshs.state.tx.us/). A crisis hotline is available 24 hours a day, seven days a week. Callers can get information, support, and referrals to help the client or the parent of the child who is experiencing the crisis.

Safety monitoring is also provided to the clients served. Ongoing observation to ensure that the adolescent is safe is maintained. The monitoring includes the child’s mental and physical status. Rapid response will be taken if the child is suspected to be in a dangerous situation.

Transportation is provided for clients receiving crisis intervention of follow-up services. This transportation service is provided in accordance with state laws and regulations and may be carried out by law enforcement, ambulance, or other qualified staff.

Training is also provided to primary care givers to assist with coping and handling a child with emotional disturbance. This training includes basic parenting skills and other forms of guidance. The parents and primary caregivers of children with emotional disturbance suffer emotional disorders as well, due to the strain of being a primary caregiver. Child and family members may participate in group therapy sessions to reduce emotional strain.

Adolescent Development-Sexual Identity

 Adolescents struggle with sexual identity during this time frame This article conveys the importance that  parental acceptance and support plays in furthering the psychological well-being of gay, lesbian, and bisexual individuals. Parents, Families, and Friends of Lesbians and Gays (PFLAG),  is an organization dedicated to this goal, has as its mission the support for family members, education of the public, and advocacy for equal rights for lesbians, gay men, and bisexuals.

According to this article, the U.S. Department of Health and Human Services reported that lesbian and gay youth are more likely to attempt suicide than are straight youth. Although that is a little under one third of actual suicides which were committed by someone who was gay. For example:

“During early to mid-adolescence, youths’ understanding of gender is quite rigid and stereotyped” (Goldfried, Anita & Marvin, 2001).

Nonetheless, it is important to note that one’s sexual orientation does not contribute to his/her likelihood to commit suicide, but rather the depression and hopelessness resulting from the rejection of family members and others does. This article is written from the perspective of parents who have discovered that their son is gay. The parents are professional clinicians, and are abreast of LGBTQ studies. They note that they have been aware of the possibility of their child being gay for some time, but were waiting for him to “come out” to them. “It has been estimated that between 3 and 6% of the population in this country are gay or lesbian, resulting in a figure of 7.5 to 15 million” (Goldfried, Anita & Marvin, 2001).

Upon learning that a daughter or son is gay, parents typically react in a negative manner. They often experience the conflict between their love for their son or daughter  and their own negative feelings toward homosexuality. They may feel anger and resentment. They may blame themselves-wondering how and where they went wrong. They may worry what friends, relatives, and neighbors will think if they learned their child is a LGBTQ. This article was very well written. It was most interesting because it is written from the parents’ perspective. I have not experienced this type of situation in my immediate family. Nonetheless, I do have some LGBTQ members in my extended family and other members of the family are not very understanding of their lifestyles. He could give his perspective of what it was like for him to “come out” to his parents.

For years, researchers have known that body image was something that adolescent females struggled with. However, researchers have found that this problem may follow adolescents into adulthood.  The researchers examined the belief that body image is an important part of a person’s self-concept. The researchers have linked body dissatisfaction to various psychopathologies. The researchers conducted this research because they noticed that the majority of literature to date had focused on adolescents and college-aged samples. Very little attention was paid to body image and eating disorders throughout life span prior to their research. They found that concerns about body image represent a source of distress for a majority of African-American women. Their study revealed that approximately 50% of the samples they interviewed were highly dissatisfied with their current physical appearance. Body dissatisfaction is also evident in older women (Nickel, A., Rogers, Wood & Petrie, Trent, 2010).

Body dissatisfaction, regardless of age, has a number of potentially negative consequences. They found that body image is highly correlated with one’s overall self-concept in both men and women. Consequently, persons who are dissatisfied with their bodies are likely to be at risk for psychological dysfunction. These dysfunctions can lead to eating disorders-anorexia and bulimia. They also discovered that those who suffered from eating disorders early in life were more likely to struggle with those same disorders later in life. Likewise, those who had not developed eating disorders in early years were less likely to develop them later in life. Nonetheless, the research seems to indicate that women experience body dissatisfaction throughout their lives, but the extent of negative impact that body dissatisfaction has on self-concept lessens with age. As women age, they seem to become more realistic about body image. They are more accepting of the physical changes the body goes through that can lead to a less appealing appearance (childbirth, medical issues, menopause, etc) (Nickel, A., Rogers, Wood & Petrie, Trent, 2010)..

Critique

According to the site, Texas spends a great deal of money (Texas was awarded 92.5 million dollars in 2005 for mental health services) on the mentally ill. The services are very proactive because they collaborate with other organizations to reach out to persons who may need help. They provide weekly support meetings for the families of those caring for patients suffering from mental illness. One aspect of the service that I found extremely helpful was the fact that they provided transportation to those who needed it.  The site was very beneficial because it outlined the services that they provided, which would help any person seeking their services. It was easy to maneuver and provided the information in both English and Spanish. There were also many links that led clients to other resources that DHSS did not provide. The information was in large font and there were no annoying pop ups. There were links to handbooks that caregivers could print out free of charge. Adolescents who are LGBT are bullied more than normal adolescents.  DHSS does not address handling this situation as much as they discuss mental illness in general. There were no specific plans to handle LGBT adolescents. Overall, I believe the services that are provided by DHSS for mental illness are great.

Suggestions

I believe the fact that the DHSS provides transportation effectively breaks the physical access barriers. Many mental health patients are Medicare recipients and Medicare does not cover non-emergency transportation.  Another way that this problem could be remedied is by having mental health clinicians conduct their treatments in the patient’s home, independent practitioners’ offices, or nursing home facilities. This would allow clients to come to whatever location is closest to them. To ensure that DHSS has adequate workers, strategies may be used to recruit workers in great need areas. Most areas have adopted the National Health Service Corps, which is a federal repayment system for academic expenses of mental health clinicians. By advertising this incentive, DHSS will be able to effectively recruit workers for high need areas.

Telehealth provides beneficial outcomes to the patient and his/her family, healthcare providers, community organizations, healthcare facility, and the government. First, telehealth improves the way patients and their families gain access to healthcare services. This is especially important to families who do not have adequate transportation or live in rural areas that are long distances from healthcare facilities. Having access to remote services will decrease hospitalizations and re-admissions to hospital. With access to remote services, they can address issues before they require hospitalization.  If patients are being served remotely, having adequate transportation will no longer be a barrier to access. Finally, there are great economic benefits. Most importantly, the patient is not placed in such a financial strain because they are not worried about transportation costs, extended stay costs, and large co-pay premiums if they have to be admitted to the hospital for a preventable issue.

Gay Straight Alliances are a great asset for LGBT adolescents. DHSS could partner with school clubs to provide safe environments to support LGBT adolescents. By partnering with schools DHSS can help to reduce homophobic behavior by other students. When teachers, students, and other staff members understand LGBT they are more likely to intervene when they witness LGBT students been bullied. This alliance can also prevent a potential problem. LGBT adolescents are more likely to abuse drugs and alcohol. Having support from family members can help reduce chances of suicide, depression, and drug use.

References

Goldfried, Anita & Marvin (2001). The importance of parental support in the lives of gay, lesbian, and bisexual individuals. JCLP/In Session: Psychotherapy in Practice, 57(5), 681–693

Nickel, A., Rogers, Wood & Petrie, Trent. (2010). Body Dissatisfaction, Ethnic Identity, and Disordered eating among African American Women. Journal of Counseling Psychology, 57(2), 141-153