Welcome to Week 7! Can you believe we are over halfway through the course, already?

This week we turn to evidence based nursing practice and evidence based legislation. Consider laws that have been enacted in your area. What were the catalysts for those laws? Was it based in science and research or was the bill introduced because of some emotional reaction to an event. My first thought, as I consider this week’s prompt, is the vaccine debate. There is lots of scientific evidence to support vaccines, and there are some true, deep-rooted, emotional responses, as well. Does one outweigh the other? Should elected officials value science over feelings and beliefs?

CLICK HERE to view a video on the vaccination debate from both an emotional and a scientific perspective. If the link doesn’t work, copy and paste the following url into your browser window.

What is the health policy issue you chose this week? Does it have support from the evidence, why or why not?

Here’s to another great week of discussion!

Dr. Mooring

For this discussion, I selected the Mental Health Services for Students Act of 2020 as my proposed health care policy. If passed, this bill would grant authority for the Project AWARE (Advancing Wellness and Resiliency in Education) program to provide mental health services in schools. This program is run by the Substance Abuse and Mental Health Services Administration SAMHSA) and would provide care to students dealing with trauma such as grief, suicidal ideations, and violence (Congress.gov, 2020). Project AWARE would advance mental health awareness and staff training to identify and handle these types of students correctly. Behavioral interventions and family involvement in preventing mental illness and alleviating trauma would also be components of this program. Lastly, this program would also establish a way for children to report incidents.

Because children are at school almost as much as at home, school is an excellent place to intervene, prevent, and detect mental health problems. Students commonly experience mental health problems such as anxiety, depression, substance abuse, grief, bullying, and stress (NASP, 2021). Providing mental health services in schools can aid in removing the stigma around mental illness and encourage more students to seek help when they need it. Assisting these types of students will promote better learning and safety for the children. Early detection of mental illness is also a benefit of providing services within the school because staff will be able to collaborate with the family to discuss what they see at school versus what the parents notice.

I believe that there is an evidence base to support the Mental Health Services for Students Act because multiple studies have been conducted on the subject. For instance, in North Carolina, a tier prevention model called Positive Behavioral Interventions and Supports (PBIS) was placed in an effort to triage students’ needs (Schultz et al., 2020). In Tier 1 of this model, all students are screened for mental or behavioral health issues that may require intervention. Tier 2 involves students whose interventions from Tier 1 did not work or could be improved. Lastly, Tier 3 focuses more specifically on each individual’s needs, potentially involving one-on-one therapy. I found this strategy to be exceptionally organized and systematic in helping the students who need mental health services. Aside from this strategy, many other methods exist for implementing mental health care in the school system. The Mental Health Services for Students Act could be very beneficial in changing the lives of many students, especially those whose issues may otherwise go unaddressed.

References

Congress.gov. (2020, September 30). H.R.1109 – Mental Health Services for Students Act of 2020. Congress.gov. Retrieved December 10, 2021, from https://www.congress.gov/bill/116th-congress/house-bill/1109/text.

National Association of School Psychologists. (2021). Comprehensive school-based mental and Behavioral Health Services and school psychologists. National Association of School Psychologists. Retrieved December 10, 2021, from https://www.nasponline.org/resources-and-publications/resources-and-podcasts/mental-health/school-psychology-and-mental-health/comprehensive-school-based-mental-and-behavioral-health-services-and-school-psychologists.

Schultz, B. K., Al-Hammori, D., Mirabelli, K., & Gaither, L. (2020). Mental Health Services in North Carolina’s Public Schools. North Carolina Medical Journal, 81(2), 111–115. https://doi.org/10.18043/ncm.81.2.111

I lived in NC for most of my life. I remember years ago when the two largest inpatient mental health facilities down-sized, one closing all together. Patients who had not lived outside the facility for years were suddenly thrust into communities they were completely unfamiliar with. For some outpatient treatment worked well, for others, though, outpatient treatment was not enough. As you mention, rural areas are often lacking in access to mental health care, however, many nurses in urban areas that have larger numbers of mental health professionals feel access is still subpar. As you consider this bill, do you feel it goes far enough to help improve access and affordability for all patients who may need it?

Dr. Mooring

Hello Marissa,

This act is a very useful one because it allows us to help students with their mental health, which is very important in ensuring we get adults who are more stable and more prepared to appropriately handle their mental health. According to the website of the congresswoman that introduced this bill, It has been implemented in Congresswoman Napolitano’s congressional district (in 35 schools) since 2001 and has been very successful (Napolitano, n.d.). My hope is that with the introduction of this bill, we will begin to see a decrease in suicide rates because the children this bill covers would finally be receiving the help they desperately need to process things. Currently in Congresswoman Napolitano’s district (32nd district in California), there are 17 firearm suicides on average which is pretty low compared to some of the surrounding districts, which are in the 30s-40s, which could serve as further proof that this bill is in need of being implemented in schools everywhere (Everytown Research & Policy, 2020).

References

Napolitano, G. (n.d.) Facts on the mental health services for students act. https://napolitano.house.gov/issues/hr-721-mental-health-services-students-act/facts-mental-health-services-students-act

Everytown Research & Policy. (2020, Oct. 2). Firearm suicide by congressional district. https://everytownresearch.org/report/firearm-suicide-by-congressional-district/ 

Hi Marissa, I enjoyed reading your post, very informative and such a great topic. Mental health is so real and so overlooked, especially amongst our youth. This act will be very useful in early detection of mental issues/concerns such as depression, suicide, anxiety or hopelessness. I try to do “mental health checks” with our kids and my husband, just a way to keep track of what we are all facing everyday and offer support.

References

Congress.gov. (2020, September 30). H.R.1109 – Mental Health Services for Students Act of 2020. Congress.gov. Retrieved December 10, 2021, from https://www.congress.gov/bill/116th-congress/house-bill/1109/text.

National Association of School Psychologists. (2021). Comprehensive school-based mental and Behavioral Health Services and school psychologists. National Association of School Psychologists. Retrieved December 10, 2021, from https://www.nasponline.org/resources-and-publications/resources-and-podcasts/mental-health/school-psychology-and-mental-health/comprehensive-school-based-mental-and-behavioral-health-services-and-school-psychologists.

The mental health state of everyone, including students is very important. Many students experience some anxiety, depression, etc. while continuing on their educational journey.(Heim, 2021). I do believe that the expectation is that everyone completes their educational journey yet many experience when things do not go as planned. I am currently in the ER with my husband which is stressful.

A journal of Social and Behavioral sciences article also discussed this topic and explained that street, anxiety, depression, etc. were found in many students. (Kratt, 2020). In the end, there are many rewards at the end of the journey. If one is experiencing challenges that are affecting their life, it is important for them to recognize and reach out for help. For many, asking for help may not be common but it is necessary.

Resources:

Heim, C., & Heim, C. (2021). Facilitating a supportive learning experience: The lecturer’s role in addressing mental health issues of university students during COVID-19. Journal of University Teaching & Learning Practice, 18(6), 68–79. https://doi.org/10.53761/1.18.6.06

“Kratt, D., & Houdyshell, M. (2020). Student Teachers and Mental Health: A Qualitative Study on Students’ Experiences Living With a Mental Health Condition. Journal of Social, Behavioral, and Health Sciences”

Response

Hi Marissa, thanks for your post, I like your topic very much. Mental health is something that is usually overlooked, much attention is not given to it as it is given to other health problems; However, just like DM, cardiac problems and other health problems, mental health is also a disease of the brain and should receive the same recognition and care as any other disease. There are also so many stigmatizations associated with mental health which prevent people with mental health from seeking for help. According to an article, “People with lived experience of mental illness commonly report feeling devalued, dismissed, and dehumanized by many of the health professionals with whom they come into contact”(Knaak, et al., 2017). The fear of being prejudiced and discriminated against prevents people with mental health to go for treatment when they are sick which leads to psychiatric emergencies (Silva, et al., 2020). I am always happy about anything that protects people with mental health and this bill you talked about will surely be beneficial to the students and will protect their safety.

References

Knaak, S., Mantler, E., & Szeto, A. (2017). Mental illness-related stigma in healthcare. Healthcare management forum. Healthc manage forum. 2017 Mar; 30(2): 111-116. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347358/

Silva, A. G. D., Baldacara, L., Cavalcante, D. A., Fasanella, N. A., & Palha, A. P. (2020). The impact of mental illness stigma on psychiatric emergencies. Frontiers in psychiatry. Front psychiatry. 2020; 11: 573. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7319091/

As someone who has worked in mental health care, it really is an aspect of overall bodily health that is heavily overlooked. I completely agree that providing mental health services at school for students could be very beneficial in regards to early detection and removing stigma. Having school-aged children myself, there are many concerns that young children may not share with parents so having a resource at school that can help provide professional guidance is a great asset. With COVID regulations and some schools going partially or fully virtual do you think students staying home 24/7 has an impact on their mental health and how would you combat this?

References:

Congress.gov. (2020, September 30). H.R.1109 – Mental Health Services for Students Act of 2020. Congress.gov. Retrieved December 10, 2021, from https://www.congress.gov/bill/116th-congress/house-bill/1109/text.

National Association of School Psychologists. (2021). Comprehensive school-based mental and Behavioral Health Services and school psychologists. National Association of School Psychologists. Retrieved December 10, 2021, from https://www.nasponline.org/resources-and-publications/resources-and-podcasts/mental-health/school-psychology-and-mental-health/comprehensive-school-based-mental-and-behavioral-health-services-and-school-psychologists.

Author: CHRIS – PAUL BLAIR Date: Sunday, January 16, 2022 9:41:26 PM EST Subject: RE: Discussion – Week 7

As someone who has worked in mental health care, it really is an aspect of overall bodily health that is heavily overlooked. I completely agree that providing mental health services at school for students could be very beneficial in regards to early detection and removing stigma. Having school-aged children myself, there are many concerns that young children may not share with parents so having a resource at school that can help provide professional guidance is a great asset. With COVID regulations and some schools going partially or fully virtual do you think students staying home 24/7 has an impact on their mental health and how would you combat this?

References:

Congress.gov. (2020, September 30). H.R.1109 – Mental Health Services for Students Act of 2020. Congress.gov. Retrieved December 10, 2021, from https://www.congress.gov/bill/116th-congress/house-bill/1109/text.

National Association of School Psychologists. (2021). Comprehensive school-based mental and Behavioral Health Services and school psychologists. National Association of School Psychologists. Retrieved December 10, 2021, from https://www.nasponline.org/resources-and-publications/resources-and-podcasts/mental-health/school-psychology-and-mental-health/comprehensive-school-based-mental-and-behavioral-health-services-and-school-psychologists.

Response to Marissa

Marissa,

Thank you for your informative post. I have many friends who work in the ER in Murphy, NC, they have told stories of how pediatric patients have spent long wait times waiting on placement. I remember one instance where they said a teen waited 35 days for placement in a facility. As you and Dr. Mooring mentioned, rural areas lack access to care, this bill sounds like it is paving a road to help bridge the gap in access to mental health care in rural communities. My husband, a deputy in NC told me that many times because there is no placement available, people are held in the jail or juvenile system until they can be transferred. That is not a suitable alternative in my opinion and changes need to be made. This bill could do that.

 “In today’s world and political climate, it is imperative that healthcare providers, administrators, and educators be knowledgeable about and active in the policy process, particularly as it relates to professional work” (Milstead & Short , 2019, pg. 87) The health policy I chose to discuss is the Dr. Lorna Breen Health care Provider Protection Act, Bill H.R. 1667. This bill was introduced in the House March 8, 2021 and passed December 8, 2021; sponsored by Representative Susan Wild (Dr. Lorna Breen Health Care Provider Protection Act, 2021). Dr. Lorna Breen was an emergency room Physician who died by suicide on April 26, 2020. “In a period of three weeks, Lorna treated confirmed COVID patients, contracted COVID herself, and returned to an overwhelming, relentless number of incredibly sick patients” (Dr. Lorna Breen Heroes’ Foundation, 2021). Dr. Breen had no history of mental illness but became overworked during the pandemic. She was also afraid to seek help fearing it would end her career.

The Dr. Lorna Breen Health care Provider Protection Act establishes grants and other requirements to improve mental and behavioral health and prevent burnout among health care providers. Furthermore, the Department of Health and Human Services (HHS) must award grants to train health care providers on suicide prevention, other mental health issues, and strategies to promote well-being; and establish or expand programs to promote mental and behavioral health among health care providers dealing with COVID-19 response efforts (Dr. Lorna Breen Health Care Provider Protection Act, 2021). The HHS must also do the following (Dr. Lorna Breen Health Care Provider Protection Act, 2021):

• study and develop policy recommendations on burnout prevention and improving mental health among health care providers
• work to removing barriers to accessing mental health care and treatment
• work to identify strategies to promote resiliency

The Centers for Disease Control and Prevention must also conduct a campaign to encourage health care providers to seek support and treatment for mental and behavioral health concerns ((Dr. Lorna Breen Health Care Protection Act, 2021).

I believe this bill is extremely necessary and overdue. The pandemic has been a tremendous strain on the health care industry and health care workers. There is evidence-based practice to support the need for legislature. In the United States, 400 physicians die each year by suicide and emergency medicine has one of the highest suicide rates of all medical specialties (Dr. Lorna Breen Heroes’ Foundation, 2021). Recent studies show health care workers in a variety of fields, positions, and exposure risks are reporting anxiety, depression, distress, and sleep problems during the pandemic (Muller et. al, 2020). It is imperative that legislative agendas should continue to be geared towards mental health support for health care workers, not only during the pandemic, but post pandemic as well.

References

Congress.gov. (n.d.). https://www.congress.gov/bill/117th-congress/house-bill/1667?r=4&s=4

Dr. Lorna Breen Health Care Provider Protection Act, H.R. 1667, 117th Cong., (2021).https://www.congress.gov/bill/117th-congress/house-bill/1667?r=4&s=4

Dr. Lorna Breen Heroes’ Foundation (2021). About. https://drlornabreen.org/about-lorna/

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

Muller, A. E., Hafstad, E. V., Himmels, J., Smedslund, G., Flottorp, S., Stensland, S. Ø., Stroobants, S., Vande Velde, S., & Vist, G. E. (2020). The mental health impact of the covid-19 pandemic on healthcare           workers, and interventions to help them: A rapid systematic review. Psychiatry research, 293(113441), https://doi.org/10.1016/j.psychres.2020.113441

I lived in NC for most of my life. I remember years ago when the two largest inpatient mental health facilities down-sized, one closing all together. Patients who had not lived outside the facility for years were suddenly thrust into communities they were completely unfamiliar with. For some outpatient treatment worked well, for others, though, outpatient treatment was not enough. As you mention, rural areas are often lacking in access to mental health care, however, many nurses in urban areas that have larger numbers of mental health professionals feel access is still subpar. As you consider this bill, do you feel it goes far enough to help improve access and affordability for all patients who may need it?

Dr. Mooring

Hi Dr. Mooring,

I agree also that there are barriers for access to mental health regardless of what area of the country an individual lives in. There has been an increase in legislative action geared towards mental health in recent years but there is still more work to be done. I believe adequate mental health access for healthcare workers directly correlates with quality patient care and availability. If we do not have healthcare providers available due to burnout, turnover, etc., then communities will have fewer options for treatment. I believe H.R. 1667 is a step in the right direction for mental healthcare for providers but we need more legislature geared towards healthcare workers. Health care providers are also particularly vulnerable to emotional distress in the current pandemic, with their risk of exposure to the virus, concern regarding infecting and caring for loved ones, shortages of PPE, longer work hours, and involvement in emotionally and ethically burdened resource-allocation decisions (Pfefferbaum & North, 2020). With the continuance of the pandemic, mental health initiatives should take precedent.

Reference

Pfefferbaum, B., North, C. (2020, August 6). Mental Health and the Covid-19 Pandemic. The New England Journal of Medicine. (383)6, 510-512.  https://www.nejm.org/doi/full/10.1056/nejmp2008017

Yes! It is very reassuring that legislators are taking action to help those with mental illness.

Hello Tamisha, I enjoyed your insightful post. I believe Dr. Lorna Breen Health Care Provider Protection Act could not have been passed at a better time than in 2021 when healthcare workers confronted major staffing challenges associated with significant consequences (American College of Radiology, 2021). I like that the bipartisan legislation will authorize grants to create programs that offer behavioral health services for front-line health care workers. Besides, it mandates the Department of Health and Human Services to study and recommend strategies to address health care provider burnout and facilitate resiliency; launch a campaign encouraging health care workers to seek assistance when needed; and require the Government Accountability Office to report to Congress on the extent to which federal substance use disorder and mental health grant programs address SUD and mental health conditions among health professionals (American Hospital Association, 2021). The successful advocacy for the passage of the bill by Dr. Lorna Breen highlight our possible role of advocating for our needs both at state and national levels. What do you think?

References

American College of Radiology. (2021, December 9). House passes Dr. Lorna Breen Health Care Provider Protection Act. https://www.acr.org/Advocacy-and-Economics/Advocacy-News/Advocacy-News-Issues/In-the-Dec-11-2021-Issue/House-Passes-Dr-Lorna-Breen-Health-Care-Provider-Protection-Act

American Hospital Association. (2021, November 17). Dr. Lorna Breen Health Care Provider Protection Act advances in House. https://www.aha.org/news/headline/2021-11-17-dr-lorna-breen-health-care-provider-protection-act-advances-house

Hi Janelle,

Thank you for your response. I completely agree with you the Lorna Breen bill should help to push more advocacy for mental health assistance for healthcare workers. We, as nurses, should continue to advocate at both the state and national level. According to an article in by Christopher Cheney in Healthleaders, “Younger nurses are leaving the profession—there are turnover rates between 30% and 60% in new graduates” (Cheney, 2021). If we do not increase mental healthcare needs among nurses, we will continue to have a shortage in the profession. The time to act is now.

Reference

Cheney, C. (2021, December 15). EXPERT: HEALTHCARE WORKER BURNOUT TRENDING IN ALARMING DIRECTION. Healthleaders. https://www.healthleadersmedia.com/clinical-care/expert-healthcare-worker-burnout-trending-alarming-direction

Hi Tamisha,

I enjoyed reading your post about The Dr. Lorna Breen Health Care Provider Protection Act. Mental health and burnout are such a big topic in the lives of healthcare professionals, especially recently in the times of COVID. During the pandemic, studies have shown that 21.7% of healthcare professionals suffer from depression, 22.1% suffer from anxiety, and 21.5% suffer from PTSD (Søvold et al., 2021). Healthcare professionals must not only care for their patients’ well-being but also their own. Self-care and finding ways to manage stress are essential in preventing burnout (MDH, n.d.). I believe that this act proposed could be beneficial in providing resources and education to those who need help.

References

Minnesota Dept. of Health. (n.d.). Mental health and resiliency tools for Health Care Workers: Covid-19. Minnesota Dept. of Health. Retrieved January 15, 2022, from https://www.health.state.mn.us/diseases/coronavirus/hcp/mh.html

Søvold, L. E., Naslund, J. A., Kousoulis, A. A., Saxena, S., Qoronfleh, M. W., Grobler, C., & Münter, L. (2021). Prioritizing the mental health and well-being of healthcare workers: An Urgent Global Public Health Priority. Frontiers in Public Health, 9. https://doi.org/10.3389/fpubh.2021.679397

Hi Tamisha,

I enjoyed reading your post, very insightful and informative. I have been working doing covid contracts since the very beginning and the stress is real. This bill is necessary and overdue, as healthcare providers we need this bill to protect us and provide an outlet to promote self-care, counseling, burnout prevention. Dr Lorna Breen Health Care Provider Protection Act came at the right time, while we are facing extreme burnout, staffing shortages and working in unsafe environments.

References

Dr. Lorna Breen Health Care Provider Protection Act, H.R. 1667, 117th Cong., (2021).https://www.congress.gov/bill/117th-congress/house-bill/1667?r=4&s=4

Dr. Lorna Breen Heroes’ Foundation (2021). About. https://drlornabreen.org/about-lorna/

Minnesota Dept. of Health. (n.d.). Mental health and resiliency tools for Health Care Workers: Covid-19. Minnesota Dept. of Health. Retrieved January 15, 2022, from https://www.health.state.mn.us/diseases/coronavirus/hcp/mh.html

Week 7 Discussion Post

Precious Dixon

Walden University

NURS 6050

Dr. Mooring

01/12/2021

Week 7 Discussion Post

The Global Health Security Act 2021 directs the US to strengthen global health security. The bill also requires the president to develop the Global Health Security Agenda Interagency Review Council to apply the Global Health Security Agenda (GHSA). The Council’s duties include offering policy suggestions on agenda-linked objectives and other global efforts to reinforce pandemic response and preparedness (Congress.gov). It also helps federal agencies with policy implementation and examines progress and issues in attaining US commitment to global health security.

Background and Development of the Health Policy

This health policy adheres to the GHSA’s objective and reinforces global partnerships between the US and 30 other countries to introduce health security plans. Its development strengthens existing bureaucracy, ensuring that various agencies respond to a worldwide health crisis. The policy also establishes a global fund for Global Health Security and Pandemic Preparedness. The challenges experienced during the Covid-19 pandemic made it possible to reinforce this policy and ensure that future global health crises get managed efficiently. Nurses should understand that health policies shape and reshape healthcare access, quality, and cost (Milstead & Short, 2019). Therefore, they need to know how this health policy impacts their practice.

Description of the Health Policy

The health policy authorizes a comprehensive and strategic approach for the US to help emerging nations strengthens global health security and makes investments towards pandemic preparedness. This strategy ensures the US cooperates with other countries to discover and mitigate outbreaks early to avert the spread of infections. The policy’s reinforcement considers animal and human health and their ability to fight the growing threat of antimicrobial resistance. During the policy implementation, the US government should consider the willingness of the public to implement this policy (Tummers & Bekkers, 2014). In this regard, the bill ensures developing countries can respond efficiently to a global health crisis and partner with the US to enhance their healthcare strategies.

Conclusion

I believe there is an evidence base supporting the proposed policy, especially after the Ebola virus disease (EVD) and Covid-19 outbreak. These infections led to the global health crisis, indicating the need for international partnerships to enhance pandemic preparedness and response. Therefore, the health policy’s reinforcement is necessary to ensure both developed and developing countries are prepared for future health concerns.

References

Congress.gov. (n.d.). H.R.391-Global Health Security Act of 2021. https://www.congress.gov/bill/117th-congress/house-bill/391?q=%7B%22search%22%3A%5B%22health+policy%22%2C%22health%22%2C%22policy%22%5D%7D&s=1&r=46

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

Tummers, L., & Bekkers, V. (2014). Policy implementation, street-level bureaucracy, and the importance of discretion. Public Management Review, 16(4), 527-547.

We are taking a top down look at legislation, but often times, bills start from the bottom-up with grassroots efforts. It is so important for the stakeholders to have a voice in how legislation is written. Do you think the community played a part in how this bill was written? If so, do you think the bill meets their needs?

Hi Precious!

Global health consists of new microbes and the spread of microbes, travel and trade, drug resistance and risks, and the potential of creating new diseases (Centers for Disease Control & Prevention).

Global Health Security is one of the most essential things to uphold right now. The hospitals are at capacity, this is the worst epidemic many have ever witnessed. The whole world has collaborated and is effected by the risks of Covid-19. This has been the worst global pandemic of the 21st century (Yimer et al., 2020).

Centers for Disease Control and Prevention. (n.d.). Why global health security matters. U.S. Department of Health & Human   

            Services. https://www.cdc.gov/globalhealth/security/why.htm

Yimer, B., Ashebir, W., Wolde, A., Teshome, A. (2020). Covid-19 and global health security: Overview of the global health security alliance, Covid-

19 response, African countries approaches, and ethics. Disaster Med Public Health Prep. 1-5. doi: 10.1017/dmp.2020.360

President Biden’s focus on getting Americans vaccinated against the ongoing COVID-19 pandemic has seen 70% of adult Americans fully vaccinated by November 2021 (The White House, 2021). This is significant progress, made possible by a vaccinations program that made shots free and convenient for months, but more vaccinations are needed to save lives, protect the economy, and accelerate the path out of the pandemic. Numerous COVID-19 vaccine-related policies have been proposed and passed by the Congress since the FDA approvals of various vaccines. One such law is the H.R. 3860 that prohibits any requirement that a member of the armed forces receives a vaccination against the virus (H.R.3860 – 117th Congress (2021-2022): To Prohibit Any Requirement That a Member of the Armed Forces Receive a Vaccination against COVID-19., 2021). The bill was introduced to the floor of the House by Representative Massie Thomas on June 14^th 2021 and referred to the House of the House Committee on Armed Services. It also seeks to outlaw adverse action, such as punishment, retaliation, a requirement to wear a mask, a requirement to live in a substandard housing, or unfair treatment, being taken against a member of the Armed Forces because the member refuses to receive a COVID-19 vaccination (H.R.3860 – 117th Congress (2021-2022): To Prohibit Any Requirement That a Member of the Armed Forces Receive a Vaccination against COVID-19., 2021). The bill was sponsored by Rep. Billy Long and co-sponsored by 55 Congress members. The latest action on the bill is that the House passed the motion to discharge committee filed by Mr. Long from consideration of the bill on 1^st Nov. 2021 (U.S. House of Representatives, 2021).

In my view, there is enough empirical evidence supporting informing the bill. Like other Americans, members of the Armed Forces have the right for informed consent, including the free will to choose whether or not to receive COVID-19 vaccination (Henao et al., 2020). The above authors explain that a safe and effective vaccine was urgently needed to prevent further COVID-19 transmission, complications, and deaths; however, the adherence to ethical principles required by clinical research is mandatory and closer supervision is also essential (Henao et al., 2020). The military frequently adopts paternalistic practices that restrict the individual choice of service members, and senior military leaders could choose to restrict individual autonomy utilizing the harm principle as justification in relation to harming other individuals as well as the whole organization of the military. However, military service members, in general, are not a high-risk population for morbidity and/or mortality from COVID-19 illness (albeit the increased prevalence of the Delta variant has shown this population to be more at risk for long-term medical complications than with prior strains (Krick & Reese, 2021). A paternalistic justification of mandating vaccination for this population would, therefore, be weak, as they are less likely to suffer significant health consequences from infection. Similarly, both the legal-moral and offense principles would be inappropriate justifications for mandating the vaccine, as it would be overly subjective to claim that an individual’s choice to refuse vaccination is either offensive or immoral (Krick & Reese, 2021).

References

Henao, S. O., Mora, A. M., Solano, F. C., & Ávila-Aguero, M. L. (2020). Bioethical implications in vaccine development, a COVID-19 challenge. Cureus, 12(9). https://doi.org/10.7759/CUREUS.10530

Krick, J., & Reese, T. (2021). Mandating the COVID-19 Vaccine for U . S . service members : An exploration of ethical arguments. Military Medical Research, 00, 1–4.

H.R.3860 – 117th Congress (2021-2022): To prohibit any requirement that a member of the Armed Forces receive a vaccination against COVID-19., (2021) (testimony of Thomas Massie). https://www.congress.gov/bill/117th-congress/house-bill/3860

The White House. (2021, November 4). Fact sheet: Biden administration announces details of two major vaccination policies. https://www.whitehouse.gov/briefing-room/statements-releases/2021/11/04/fact-sheet-biden-administration-announces-details-of-two-major-vaccination-policies/

U.S. House of Representatives. (2021, November 1). Motion to discharge a committee from the consideration of a bill. Office of the Clerk. https://clerk.house.gov/DischargePetition/20211101?CongressNum=117

We are taking a top down look at legislation, but often times, bills start from the bottom-up with grassroots efforts. It is so important for the stakeholders to have a voice in how legislation is written. Do you think the community played a part in how this bill was written? If so, do you think the bill meets their needs?

Military procedure has a very different set of rules when it comes to implementing policy. In my experience, and as you mention, there is very little bottom up for service members.

Jannelle,

On September 14, 2021 the US Army announced that all soldiers must be vaccinated (U.S. Army Public Affairs, 2021). This

mandate was one that came from the Secretary of Defense to vaccinate all service members against Covid-19. This is not the first time

that vaccines have been mandated for the military. Under Force Health Protection some treatments and vaccines are required for

duty. There was a similar issue in 1997 with the mandate for the anthrax vaccine for soldiers (Black, 2007). A large group of soldiers

were forced to get this vaccine which had little testing. It caused adverse side effects in 85% of the troops (Roos, 2002).  This vaccine

continues to be mandatory for some of the military. While I believe that everyone should have the freedom to make their own

decisions when it comes to vaccines, the military has always made their own rules. I can only speculate that by allowing choice for the

covid vaccine, could raise question about the compliance for other vaccines or treatments that may be required.

References

Black, L. (2007, October). Informed consent in the military and the anthrax vaccination case. AMA Journal Of

                 Ethics. https://journalofethics.ama-assn.org/article/informed-consent-military-anthrax-vaccination-case/2007-10

Roos, R. (2002, November 8). GAO: Military anthrax shots caused many reactions, prompted some pilots to quit. Center for Infectious

              Disease Research and Policy. https://journalofethics.ama-assn.org/article/informed-consent-military-anthrax-vaccination-

case/2007-10

U.S. Army Affairs. (2021 September, 14). Army announces implementation of mandatory vaccines for

soldiers. https://www.army.mil/article/250277/army_announces_implementation_of_mandatory_vaccines_for_soldiers

Janelle,

I also read this bill, H.R. 3860, regarding the members of that armed force being exempt from the mandatory vaccination of Covid 19 (Congress, 2021). Having served in the Armed Forces, by history, soldiers are always at the forefront of any mandatory vaccination or trial of medications frequently before it is released to the public. Our armed forces members travel worldwide and are subject to many different settings and environments. The risk factor for the members contracting and transmitting the virus is high.  The bill is an injustice to service member and their families. They have the duty appointed to them as a United States military member representative to uphold and set the example for the general populations/communities. To say that it is violating their rights by mandating that they take the vaccine is insane (Henao, 2020). Suppose President Biden can require health care workers to receive the vaccination to protect the population and guard against transmission. In that case, our military armed forces members should have the same focus to protect.  After all, ensuring that providers take steps to avoid transmitting a dangerous virus to their patients is consistent with the fundamental principle of the medical profession: first, not harm,” per the Supreme Court. The same day that the Occupational Safety and Health Administration (OSHA) announced its policy on Nov 4, 2021, The US Centers for Medicare and Medicaid Services (CMS) issued a vaccine mandate for employees of healthcare facilities and companies the agency pays to treat Medicare or Medicaid beneficiaries. To participate in both government programs, Employers must require their staff to be vaccinated, including those who do not have direct contact with patients. Staff members can decline the vaccine for medical or religious reasons. But unlike the OSHA rule, a weekly testing option and paid time off are not provided (Grymes, 2022). If the object is to provide herd immunity, then all members of society should be required to receive the vaccination.

Congress (2021). To prohibit any requirement that a member of the Armed Forces receive vaccination against COVID-19.https://www.congress.gov/bill/117th-congress/house-bill/3860

Grymes, A. (2022). Supreme Court Blocks president Biden’s vaccine-or-test rule for businesses. CBS New York.

https://newyork.cbslocal.com/2022/01/13/supreme-court-blocks-president-bidens-vaccine-or-test-rule-for-businesses/

Henao, S. O., Mora, A. M., Solano, F. C., & Ávila-Aguero, M. L. (2020). Bioethical implications in vaccine development, a COVID-19 challenge. Cureus, 12(9). https://doi.org/10.7759/CUREUS.10530

            S.2779- TRIUMPH for New Moms Act of 2021 was introduced to the Senate in September 2021 and sent for review to the Committee on Health, Education, Labor, and Pensions (Congress.gov). A 2019 case study revealed that mental health concerns pose physical risks to mom and baby. Counseling at-risk mothers showed a significant turnaround in having successful births and decreased postpartum depression (O’Connor et al., 2019).

Maternal mental health issues have not disappeared but maybe overlooked amid a pandemic. As of 2020, one in five mothers experiences mental health issues that may pose adverse health risks to themselves and their babies (California Department of Public Health, 2020). It is documented that mothers have more mental hardship when they lack social support, hormonal imbalances, food intake, sleep cycles, and exercise. There are many risk factors that we can control to decrease the dangers of postpartum depression. Simply adding vitamins to one’s daily intake, incorporating bike rides, a planned pregnancy, and quality obstetric care can make a big difference (Ghaedrahamti et al., 2017).

References

California Department of Public Health. (2020). Maternal, child and adolescent health division.

Retrieved on January 12, 2022, from

https://www.cdph.ca.gov/Programs/CFH/DMCAH/Pages/Communications/Maternal-

Mental-Health.aspx

Congress.gov. (n.d.). Retrieved January 11, 2022, from https://www.congress.gov/bill/117th-

congress/senate-

bill/2779/committees?q=%7B%22search%22%3A%5B%22health+policy%2

2%2C%22health%22%2C%22policy%22%5D%7D&r=7&s=4

Ghaedrahmati, M., Kazemi, A., Kheirabadi, G., Ebrahimi, A., Bahrami, M. (2017)/ Postpartum

depression risk factors: A narrative review. J Educ Health Promot. 6:60. doi:

10.4103/jehp.jehp_9_16

O’Connor, E., Senger, C., Henninger, M., Gaynes, B., Coppola, E., Weyrich, M. (2019).

Interventions to prevent perinatal depression: A systematic evidence review for the U.S.

preventative services task force. Agency for healthcare research and quality. 172.

PMID: 30807060

Hello Jamie, I concur with you that maternal issues might have been overlooked during the fight against pandemic, but thank God, such organizations as the American Medical Association (AMA) (2021) have come in support the advocacy for maternal health.  The AMA understands that there are a multitude of considerations necessary to address this epidemic, including lack of insurance or inadequate coverage prior to, during, and after pregnancy; closures of maternity units in many rural and urban communities; and a lack of inter-professional teams trained in best practice. AMA urges policy makers to: expand Medicaid and CHIP coverage to 12-months post-partum; increase support for Maternal Mortality Review Committees; implement equitable standardized data collection methods; expand access to medical and mental health care and social services for post-partum women; continue to develop a health care workforce that is diverse in background and experience; address shortcomings in our institutions; and adopt standards to ensure respectful, safe, and quality care before, during, and after delivery (AMA, 2021). Thus, the S.2779 – 117th Congress (2021-2022): Triumph for New Moms Act of 2021 (2021) is not only timely but pertinent in reducing maternal mortality in the U.S.

References

American Medical Association. (2021). AMA advocacy to improve maternal health. https://www.ama-assn.org/system/files/ama-advocacy-to-improve-maternal-health.pdf

S.2779 – 117th Congress (2021-2022): Triumph for New Moms Act of 2021, (2021) (testimony of Hassan Wood). https://www.congress.gov/bill/117th-congress/senate-bill/2779

Hi Jamie,

After reading your post, I did some research and read more about the TRIUMPH for New Moms Act of 2021. I found this act a significant step forward in creating awareness for maternal mental health. The development of a mental disorder is one of the most common complications of pregnancy (MMHLA, 2022). I believe that this act could be beneficial in expanding the screening and access to treatment for mothers who have mental conditions. Although approximately 1 in 5 mothers suffers from mental disorders, less than 15% of women actually receive treatment for it (20/20 Mom, n.d.). I, too, believe that there is an extensive evidence base to support this bill.

References

20/20 Mom. (n.d.). Maternal Mental Health Disorders. 20/20 Mom. Retrieved January 14, 2022, from https://www.2020mom.org/mmh-disorders

Congress.gov. (n.d.). Retrieved January 11, 2022, from https://www.congress.gov/bill/117th-congress/senate-bill/2779?q=%7B%22search%22%3A%5B%22s2779%22%2C%22s2779%22%5D%7D&s=1&r=1

Maternal Mental Health Leadership Alliance. (2022, January 12). Maternal Mental Health Conditions. MMHLA. Retrieved January 14, 2022, from https://www.mmhla.org/

Jamie,

Mental Health for new mothers with depression or anxiety is common and treatable (CDC, 2021).  During the pandemic there

were many different mental health concerns that went overlooked. The availability to see a psychiatrist or speak with a

physician was also more difficult. Not only was it harder to get treatment but, 2020 also brought on an unwanted to isolation for

many Americans. The Triumph of New Moms Act of 2021, will create a national to strategic plan to address maternal mental

health disorders (Wickramatilake, 2021). This is the first step to getting our mothers the support that they need during these trying

times and keep our children safe and healthy.

References

Center for Disease Control. (2021). Depression during and after pregnancy.  Depression During and After Pregnancy (cdc.gov)

Wickramatilake, S. (2021, September 24) Triumph for new moms act introduced in the senate. TRIUMPH for New Moms Act Introduced in the Senate (2020mom.org)

We are taking a top down look at legislation, but often times, bills start from the bottom-up with grassroots efforts. It is so important for the stakeholders to have a voice in how legislation is written. Do you think the community played a part in how this bill was written? If so, do you think the bill meets their needs?

Dr. Mooring,

In the case of a bill like H.R. 945 advocating for culturally congruent maternal care, grassroots efforts are usually behind the bill’s design because the people are advocating for a particular, marginalized group. H.R. 945 is supported by the St. Louis-based nonprofit organization Generate Health whose goal is to address healthcare disparities for minority mothers  (Generate Health, 2021). This leads me to believe that advocacy groups such as Generate Health played a part in getting this bill passed. The Passage of H.R. 945 would represent a step forward in addressing racial disparities in maternal-fetal medicine (Congressional Research Service, n.d.).

References:

Congressional Research Service. (n.d.). H.R. 945. Congress.Gov. https://www.congress.gov/bill/117th-congress/house-bill/945?q=%7B%22search%22%3A%5B%22health+care%22%2C%22health%22%2C%22care%22%5D%7D&s=1&r=1

Generate Health. (2021). Infant & Maternal Health. GenerateHealth-Champions of Family and Community. https://generatehealthstl.org/advocacy/legislative-tracking/infant-maternal-health/

Absolutely! There are lots of organizations lobbying and speaking out about maternal mortality for women of color.

Health policies proposed normally address a common issue among the general public that influences health and safety of the population. This can be statewide or nationwide. With the introduction of COVID-19, we as a society have been paying close attention to bills put forth by politicians. Implementation of these policies can be difficult especially with the numerous divisive opinions on COVID. Implementation by definition “ is the process of gaining targeted organizational members’ appropriate and committed use of an innovation” (Klein, 1996). Proper implementation of a health policy is crucial to the success of the policy itself.

During this pandemic there have been proposed bills and mandates to handle the spread of COVID as well as manage its effects. In the state I reside, Florida, there is more of a focus on handling the effects of the pandemic on daily life rather than strict mandates to slow the prevalence rate. At the beginning of the pandemic schools and non essential businesses were closed with many going virtual either via contactless deliveries or Zoom for online schooling. Having three school-aged children, the regulations for schooling have affected me directly. Policies regarding wearing a mask and vaccination are received differently based on people’s beliefs, not based on fact put forth by health organizations like the CDC.

Executive-Order-21-175 signed by Florida’s governor, Ron DeSantis regulates mandates on masks in schools and autonomy of students as well as parents. The main statute that the order states is that COVID regulations in Florida schools cannot “violate Floridians’ constitutional freedoms, violate parents’ rights under Florida law to make healthcare decisions for their minor children, [and must] protect children with disabilities or health conditions who would be harmed by certain protocols such as face masking” (Executive-Order-21-175, 2021). It reinforces the “Parents Bill of Rights” which leaves the choice of whether a child wears a mask at school wholly up to parents.

The CDC recommends that children over the age of 2 should wear masks properly in an indoor setting especially in large crowds (CDC, 2021). If a school decides to require masks, this is technically a violation of the student’s and parent’s right to autonomy and the state can choose to take action, withholding state funding from non compliant school boards. The policy gives the parents the freedom to choose what they believe is best for their child. Although this is a good thing in regards to the right to choose, many parents do choose to send their children to school without masks. This can be harmful to student health as they go into crowded areas with little to no protection. Throughout the country I have seen students complain about the dangers of attending in person classes during the pandemic with students from a Brooklyn school walking out during low temperatures to protest not being virtual during the surgence of a new variant. There is not enough evidence to support sending kids to school without a mask. Schools should be allowed to determine what is best for the safety of their students while the children are in their care.

References:

Centers for Disease Control and Prevention (CDC). (2021). COVID-19 and Your Health. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html

Executive-Order-21-175.pdf. (2021). Retrieved from https://www.flgov.com/wp-content/uploads/2021/07/Executive-Order-21-175.pdf

Klein, K. J., & Sorra, J. S. (1996). The challenge of innovation implementation. Academy of Management Review, 21(4), 1055–1080.

Vaccinations have been a hot topic recently, and anti-vaccination groups have emerged from all walks of life. Much of the research they cite as evidence against vaccines was based on faulty research or no scientific research at all. One argument I heard recently said that vaccines shouldn’t be given because the injection causes pain to the infant who can’t really consent to the procedure. What strategies would you recommend to convince those who are adamantly against a policy, particularly when their argument is not evidence-based?

Dr. Mooring

Sometimes, even when presented with factual evidence from others, those that have a certain view especially in regards to anti-vaccination arguments still are set in their opinion. So to combat this I would provide some background information and reliable sources so that they can carry out their own research in a constructive way and come to understand how vaccines function as well as why they are important.

I agree. Education and information are key to changing perception.

Chris,

I enjoyed reading your post this week. As a Florida resident with a child in public school, I can understand the struggles parents and students face in states where an anti-mask, anti-vaccine mentality is prevalent. For me, this dilemma has really arisen out of an emergence of misinformation on social media and throughout the internet. As of 2021, the World Health Organization named vaccine hesitancy one of the top 10 threats to global health (Garett & Young, 2021). Even the CDC recommends masking in indoor settings like schools, yet it seems the public in certain states is unwilling to listen (CDC, 2020). What steps do you think Florida nurses, or other concerned citizens, could take to combat the spread of misinformation and reckless public behavior?

References:

CDC. (2020). How to protect yourself & others. Centers for Disease Control and Prevention.

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html 

Garett, R., & Young, S. D. (2021). Online misinformation and vaccine hesitancy. Translational Behavioral Medicine, 11(12), 2194–2199. https://doi.org/10.1093/tbm/ibab128 

On January 20, 2021, an executive mask mandate order was enacted for all federal workers (The White House, 2021). This mandate was enacted to ensure safety for workers and to help slow or stop the spread of the Covid-19 virus. The CDC had initially placed social distancing, as well as required mask mandate recommendations, for all Americans. While some states elected to enforce their own rules when it came to mask mandates, the Federal government continued to enforce wearing them regardless of vaccination status.  In June 2021, the CDC lifted mask mandate for fully vaccinated persons indoors; although, they do continue to support the use for face masks among federal workers (CDC, 2021). While the numbers for covid continued to rise, the CDC stated that the risk for death was low when fully vaccinated. In Florida, our Governor Rick Dasante’s, implemented a policy of his own. He Signed legislation in November 2021, that prohibited mask policies Florida schools as well as mandated vaccines.

Who is right? The US federal administration look directly to the CDC for guidance on American’s health. However, even the CDC can’t seem to decide what Americans should do when it comes to masking. In December of 2021, the CDC stated that the Omicron variant of Covid -19 was now spreading (CDC,2021). The latest update from the CDC supports the wearing of masks again for all Americans, regardless of vaccination status. This update came only months after the previous revision for mask mandates. I also read a study that was published by the Southern Medical Journal, that supported the idea that masks did not lower covid rates, hospital rates, or deaths (Miltimore, 2021). While I’m reluctant to believe this evidence right away, more studies should be conducted. What is the death rate for states without mask mandates vs states with masking mandates? Overall, there is by far more evidence that supports the wearing of masks at this time, to decrease the spread of Covid.

References

Center for Disease Control. (2021, April 9) Morbidity and mortality weekly report. Provisional Mortality  Data — United States, 2020 | MMWR (cdc.gov)

Center for Disease Control. (2021, October 24). Your guide to masks. Your Guide to Masks | CDC

Center for disease Control. (2021, December 20). Omicron variant: what you need to know. Omicron Variant: What You Need to Know | CDC

Miltmore, J. (2021, September 10). New mask mandate failed to reduce Covid effects. Intellectual

Takeout. New Study Finds Mask Mandate Failed to Reduce COVID Effects | Intellectual Takeout

The White House. (2021, January 20) Executive order on protecting the federal workforce and requiring

mask-wearing. Executive Order on Protecting the Federal Workforce and Requiring Mask Wearing | The White House

Vaccinations have been a hot topic recently, and anti-vaccination groups have emerged from all walks of life. Much of the research they cite as evidence against vaccines was based on faulty research or no scientific research at all. One argument I heard recently said that vaccines shouldn’t be given because the injection causes pain to the infant who can’t really consent to the procedure. What strategies would you recommend to convince those who are adamantly against a policy, particularly when their argument is not evidence-based?

Dr. Mooring

Dr. Mooring,

When trying to find strategies to convince someone to get a vaccine, its most important to understand their reason for not wanting one. I thought that when the vaccine came out, people would rush to get them. It seemed like the only answer to help stop the spread and decrease the death toll. It would have brought us all back to the life that we previously knew before the virus came into our lives. While I felt lucky to be one of the very first people to get the vaccine, my family did not see it that way. It was at that moment, I realized how many people were totally against this vaccine and how strongly they felt about me not getting it. My wife was angry with me for getting it and threatened to “put me in a home if I stroked out,” (luckily I didn’t).

Fear is a major factor for most who are, or were, reluctant to receive the vaccine. When the vaccine was first available, it was difficult to pursued most that it was a safe and necessary element. The Vaccine Adverse Event Reporting System or VAERS, reports up-to-date adverse health effects (Brumfiel, 2021). Although, this can be a useful tool, it can also continue to instill fear in many people who may still be afraid to receive the vaccine.  Due to the high number of people getting vaccinated in the same time frame, the adverse events reported appear much higher than they they would be otherwise.

The truth is the only way to combat fear. A study by the Texas Department of State Health Services (2021), reported that the 85.5% of Covid-19 deaths were unvaccinated individuals. This was a study conducted from January 15, 2021 to October 1, 2021. While there are many reasons for individuals to decline the vaccine, for those who are just afraid, we must give facts. This will help others to make informed decisions and truly make the best decisions about their health.

References

Brumfiel, G. (2021, June 14).  Anti-Vaccine activists use a federal database to spread fear about Covid vaccines.  Anti-Vaccine

Activists Spread Fear About COVID Vaccines With Selective Data : Shots – Health News : NPR

Texas Department of State Services. (2021, November 8) Covid-19 Cases and Deaths by Vaccination Status.  COVID-19 Cases

and Deaths by Vaccination Status (texas.gov)

Many States have taken it upon themselves to decide whether to adhere to the mask mandate or not. In Florida, Governor Ron DeSantis has given parents the choice of whether they want to send their kids to school with a mask or not and some parents agreed with this decision because they feel that co-parenting with the government is not an option.

Not every person agrees with wearing a mask. You can observe that every time you go out somewhere. Since the introduction of the vaccine, face masks have now become optional. But studies show that wearing a mask decreases the chance of getting covid-19, death, and hospitalizations (Adjodah et al., 2021, p.13).

In the beginning of the pandemic, there was a nation wide shut down because of the increase in cases. There was a significant drop in the economy, so some States decided to open up again and continue to work. As people returned back to work, the rise in covid-19 infections rose but when mask mandates were ordered, those infections decreased (Zhang & Warner, 2020, p.1). Governor Ron DeSantis did not impose a mask mandate in Florida and in August 2020, we were in the top five of most covid-19 cases (Zhang & Warner, 2020, p.2).

References

Adjodah, D., Dinakar, K., Chinazzi, M., Fraiberger, S. P., Pentland, A., Bates, S., Staller, K., Vespignani, A., & Bhatt, D. L. (2021). Association between COVID-19 outcomes and mask mandates, adherence, and attitudes. PloS One, 16(6), e0252315. https://doi.org/10.1371/journal.pone.0252315

Zhang, X., & Warner, M. E. (2020). COVID-19 Policy Differences across US States: Shutdowns, Reopening, and Mask Mandates. International Journal of Environmental Research and Public Health, 17(24). https://doi.org/10.3390/ijerph17249520

Charity,

I completely agree and understand. My own state is grappling with mask mandates and vaccinations. In my own opinion, I believe the CDC does feel the pressure from citizens as well as politicians each with a different view on what is best for the country right now. At the start of the pandemic the CDC was supporting full shutdowns, social distancing, and masks but now that many want to go back to a semblance of “normal” living and the economy is struggling they have changed these claims slightly to cater to these complaints. Do you think that the CDC may be slightly influenced by public opinion?

References:

Centers for Disease Control and Prevention (CDC). (2021). COVID-19 and Your Health. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html

Zhang, X., & Warner, M. E. (2020). COVID-19 Policy Differences across US States: Shutdowns, Reopening, and Mask Mandates. International Journal of Environmental Research and Public Health, 17(24). https://doi.org/10.3390/ijerph17249520

Charity,

I appreciate your post this week on this topic. The masking and vaccination mandates have affected everyone on a large scale. I am from St.  Louis, MO, and people are now required to get a Covid Test Prior to attending certain functions like an NHL Blues Game. The restrictions or freedoms do vary from state to state. What has been observed is that some people will do whatever they believe is necessary to enjoy some of the activities that they love. A PLoS ONE article discussed how people are more vocal about the mandates and adhere to some of the mandates based on their beliefs (Adjodah, 2021).  On a personal level,  I am on the front line, have experienced indents in my face, breaking out, burnout, etc, yet continue to mask up and save lives. It is important that we continue to present people with information so that they can make informed decisions.  A Science Reports article mentioned how many places of employment and leisure require people to adhere to the policies in place or they may risk losing their jobs (Yan, 2021).  This current Pandemic has truly affected us all.

References:

Adjodah, D., Dinakar, K., Chinazzi, M., Fraiberger, S. P., Pentland, A., Bates, S., Staller, K., Vespignani, A., & Bhatt, D. L. (2021). Association between COVID-19 outcomes

and mask mandates, adherence, and attitudes. PLoS ONE, 16(6), 1–26. https://doi.org/10.1371/journal.pone.0252315

Yan, Y. Bayham, J. Richter, A. & Fenichel,. E.  (2021). Risk compensation and face mask mandates during the COVID-19 pandemic. Scientific Reports, 11(1), 1–

11. https://doi.org/10.1038/s41598-021-82574-w

Main Post Discussion

I chose to introduce a discussion regarding the legislation of the Dr. Lorna Breen Healthcare Provider Protection Act H.R. 1667. This bill was originally introduced to the legislative process on March 8, 2021. This bill passed the house and was presented to the Senate on December 9, 2021; it was read twice and referred to the Committee on Health, Education, Labor, and Pensions. This bill establishes grants and requires other activities to improve mental and behavioral health and prevent burnout among health care providers (Congress, 2021).

Dr. Lorna Breen had 21 years of experience as a physician and worked at the epicenter of the COVID-19 pandemic as an emergency medicine physician at New York-Presbyterian Hospital in Manhattan. She had become consumed, overwhelmed, and left with feelings of hopelessness and completed suicide on April 26, 2020. Dr. Breen treated COVID 19 patients for days in the emergency room and then fell sick with COVID 19. Dr. Breen returned to work but was hindered by her behavior, speech, and cognition changes. Dr. Breen was afraid to seek help due to the stigma surrounding health care professionals seeking mental health assistance. She was in fear of her career and the possibility of her medical license being revoked (Moutier et al., 2021). Most people are unaware that many states are reinforced by regulations that mandate disclosure of mental health treatment. The American Medical Association completed a survey in 2019 that showed nearly 40 percent of surveyed physicians are wary concerning seeking mental health counseling, while another 12 percent indicate that they would only do so in secret (Jennifer B. Feist, 2020). The plethora of burdens is many that face our health care workers and clinicians. Lack of available personal protective equipment (PPE), anxiety and fear of the infectious COVID 19 patient, the risk of exposure to themselves and families, short-staffed and overcrowded facilities, it is not surprising that the suicide rate is on the rise for health care workers. The work environment fosters depression, isolation, physical and mental fatigue, lack of access to mental health treatment, and provides little support to the clinicians.  Doctors and Nurses should not be ashamed to seek mental health treatment nor be  afraid of their mental health records being accessed and repercussions being mounted against them or their  license.  Health care workers deserve the opportunity to care for themselves like we deliver care to the public.  Resources and funds should be allocated and disbursed to assist any health care worker with mental health counseling and  substance abuse treatment as a direct impact resulting from COVID 19 pandemic. As the pandemic approaches the 2-year mark, nurses report they are still experiencing negative impacts of COVID-19 on their mental health and well-being, and the adverse side effects have increased significantly over the past year. Among nurses who said they intend to leave their position in the next six months, close to half cited work negatively affecting their health and well-being (48%) as a top reason, followed closely by insufficient staffing (41%) (ANA, 2021).

This legislation will mandate the Department of Health and Human Resources (HHS) to train and educate providers on suicide prevention and strategies and techniques to improve well-being. In conjunction with introducing and expanding programs for mental and behavioral health care providers involved with COVID 19. Furthermore, HHS must develop policy recommendations regarding burnout amongst health care workers and provide accessible care to health care providers (Congress, 2021).

Health care workers are subject to continuous high-stress levels, emotional trauma, fatigue, depression, depersonalization, anxiety, suicidal thoughts, and high burnout. Many health care providers also suffer from substance abuse and other mental health conditions. The daily exhaustive emotional personal trauma is often overlooked and ignored by our communities and leaders. The COVID 19 pandemic has wholly exhausted the health care workforce, and there is no relief in sight at this time.  This legislation is imperative and past due for the health care workforce. Regulatory guidelines and policies must address suicide prevention and mental health treatment for health care providers, education/training to target all health care workers with incorporating strategies from evidence-based research.

Reference 

American Nurses Association (ANA). (2021). Nurses are still stressed, frustrated, and overwhelmed almost 2 years into COVID-19. https://www.nursingworld.org/news/news-releases/2021/new-survey-data-thousands-of-nurses-are-still-stressed-frustrated-and-overwhelmed-almost-2-years-into-the-pandemic

Congress (2021). Dr. Lorna Breen Health Care Provider Protection Act, 2021. https://www.congress.gov/bill/117th-congress/house-bill/1667

Feist, J., C. Feist, and P. Cipriano (2020). Stigma Compounds the Consequences of Clinician Burnout During COVID-19: A Call to Action to Break the Culture of Silence. National Academy of Medicine, Washington, DC.

https://doi.org/10.31478/202008b

Moutier, Christine Yu MD; Myers, Michael F. MD; Feist, Jennifer Breen JD; Feist, J. Corey JD, MBA; Zisook, Sidney MD Preventing Clinician Suicide: A Call to Action During the COVID-19 Pandemic and Beyond (2021). Academic Medicine: 96(5), 624-628

doi: 10.1097/ACM.0000000000003972