Mira King, who graduated with a master's in Health Administration this spring, recently won first place in the American College of Healthcare Executives' 2017 Richard J. Stull Essay Competition in Healthcare Management. Her paper, "The PII Solution to Mental Health Care Delivery: Prevention, Intervention & Integration,” will be published this July in the Journal of Healthcare Management.
King’s interest in mental health was sparked last fall when she and some three colleagues Khang Vuong, Javin Peterson and first-year observer Daniela Junco Fiehn competed in the Everett V. Fox Student Case Competition sponsored by the National Association of Health Services Executives (NAHSE). Participants were tasked with creating a new integrated model of care that enhances the provision of mental health services. King's team came in second place, and, based on the depth of their research, she realized that mental health, “is a deep-rooted problem that needs a multi-faceted solution.” King also revealed that she was exposed to the reality of mental illnesses when her childhood friend was diagnosed with schizophrenia.
When the essay competition came around, King saw an opportunity to expand on her mental health prerogatives. Her paper focused on serious mental illnesses and encounters with law enforcement. In her research, King found that the largest mental health facilities in America are not hospitals, but rather prisons and jails. In 2015, almost a quarter of people killed by law enforcement officers were mentally ill, according to data compiled by The Washington Post. These findings highlight the scarcity of mental health resources in this country as well as the contentious ways in which mental illness can often be handled.
In her paper, King proposes a PII solution, which stands for prevention, intervention and integration. It is a holistic model that takes a three-pronged, community-centered approach and leverages existing programs in concert with new approaches to meet the diverse needs of patients with a full spectrum of mental health disorders, ranging from low risk to high risk.
First off, the prevention aspect targets those who have not had an encounter with hospitals or prisons. This public-private sector collaboration effort includes outreach in communities, schools, etc., as well as private-employer involvement, to combat stigma and self-denial of mental illness so that future issues can be reduced.
Next, the intervention facet works with those who have had encounters with law enforcement or have had frequent hospital admissions. Often law enforcement officers don’t know how to handle those in mental crisis, so this program helps train them for such situations. The intervention strategies are intended to reduce the arrest and incarceration rates among mentally ill people, as well as providing law enforcement officials with the training and support needed to effectively triage these hard-to-decipher mental health cases.
Lastly, the integration model is for people who have been detained for mental illness. King wanted to find a solution to prevent the revolving door effect, which keeps people returning to prison or the hospital as a result of mental illness. She proposed leveraging telehealth and case management strategies with the aim of getting family members and the community involved and embed those struggling in a circle of personal and professional caretakers.
“There needs to be more federal attention” paid to mental health, King said. In order to improve care and treatment for all, there has to be partnership between the private and public sectors, and we must recognize that the issue is not solely those dealing with a mental illness, but also those around them.