RESPONSES FOR REVIEW
Daniela Gomez Vasquez
Apr 21 8:35pm
Manage Discussion by Daniela Gomez Vasquez
Reply from Daniela Gomez Vasquez
Main Post
Evaluation of Mental Health Program and Policy
In 2022, the 988 Suicide and Crisis Lifeline program was launched in the US, designed to prevent suicide and assist people experiencing emotional distress through a simple three-digit phone call, text message, or online chat (Stephanie et al., 2023). At the start of this program, many questions arose regarding whether these centers were truly prepared for the launch, prompting several researchers to conduct studies to assess their readiness (Matthews et al., 2023).
The results indicated that while some centers were prepared, many still lacked the necessary resources to operate effectively (Matthews et al., 2023). Insufficient funding and a shortage of trained personnel, such as mental health professionals, were the primary causes of this lack of preparedness (Stephanie et al., 2023). Research also showed that some facilities in certain regions did not receive the same level of training as others, or there were not enough mental health care facilities available to transfer people for treatment in specific rural areas. Additionally, some facilities in locations with Hispanic or Latino residents did not report effective preparation, while remote towns benefited from telehealth (Matthews et al., 2023).
A lack of staff and resources was believed to lead to missed calls and a low quality of service (Stephanie et al., 2023). Despite these challenges, the program continues. In 2022, 79% of calls were answered, but this figure rose to 89% in 2024, and so far in 2025, 92% of calls have been answered (Substance Abuse and Mental Health Services Administration [SAMHSA], 2023a). Each state has its own policies regarding funding for the 988 Lifeline program (Stephanie et al., 2023). In states with legislation supporting the 988 Lifeline program, every county has at least one center, and those that have funded this program have seen positive growth in care and development, unlike states that rejected this proposal (Burns et al., 2024). The Tennessee government has allocated $5 million for the development and continuation of this program (Substance Abuse and Mental Health Services Administration [SAMHSA], 2023b). Nursing advocacy for the 988 Lifeline can also benefit the population by sharing these programs within the community (Glodstein, 2023).
References
Burns, A., Nir M., Olena M., Salyers, M. P., & Yeager, V. A. (2024). State Policies Associated with Availability of Mobile Crisis Teams.
Administration and Policy in Mental Health and Mental Health Services Research.
to an external site.
Glodstein, S. L. (2023). The lifeline and advanced practice nursing/intervention prevention perspective.
Archives of Psychiatric Nursing,
47, 47–49.
to an external site.
Matthews, S., Cantor, J. H., Brooks Holliday, S., Bialas, A., Eberhart, N. K., Breslau, J., & McBain, R. K. (2023). National preparedness for 988-the new mental health emergency hotline in the United States.
Preventive medicine reports,
33, 102208.
to an external site.
Stephanie, B. H., Matthews, S., Bialas, A., McBain, R. K., Cantor, J. H., Eberhart, N. K., & Breslau, J. (2023).
A Qualitative Investigation of Preparedness for the Launch of 988: Implications for the Continuum of Emergency Mental Health Care.
50(4), 616–629.
to an external site.
Substance Abuse and Mental Health Services Administration (SAMHSA). (2023). 988 Lifeline Performance Metrics.
to an external site.
Substance Abuse and Mental Health Services Administration (SAMHSA). (2023, May 11).
Cooperative Agreements for 988 Suicide and Crisis Lifeline Crisis Center Follow-Up Programs.
to an external site.
Apr 22 10:37am| Last reply Apr 22 12:20pm
Manage Discussion by Carlos R Astacio
Reply from Carlos R Astacio
Policy & Advocacy for Pop Hlth
Carlos Astacio
Walden University
Dr. Bob
April 22, 2025.
Evaluation of Medicaid Expansion Program under the Affordable Care Act
Within the framework of the Affordable Care Act, the Medicaid expansion policy stands as one of the most far-reaching public health policy measures introduced in the last decade across the United States (Fox & Kahn-Troster, 2022). The main objective of this policy has been to expand access to health services for adults whose incomes fall within 138% of the federal poverty thresholds because they lack affordable health coverage. Evaluation studies of this policy demonstrate several positive effects, including reduced uninsured rates and increased preventive care, reduced uncompensated hospital expenditures, and improved detection and treatment of chronic diseases (Donohue et al., 2022). Follow-up has revealed improvements in certain health outcomes, such as diabetes control and accessibility to mental health services, while minorities see reductions in preventable deaths (Donohue et al., 2022).
Evaluating the effectiveness of Medicaid expansion requires a thorough understanding of the broader framework of the social determinants of health. The social determinants, namely economic stability and educational attainment, along with the physical environment and geographic access to health care, along with the social context, directly determine how people are able to take full advantage of their health coverage (Parzuchowski et al., 2023). People living in rural areas and underserved urban neighborhoods have difficulty obtaining medical services because their communities lack medical providers who accept Medicaid coverage. The combination of limited health literacy and low educational attainment makes it difficult for these individuals to process their health entitlements and effectively use the health system to obtain authorized services (Parzuchowski et al., 2023).
In addition to food insecurity and unemployment and inadequate housing and lack of transportation help determine patients’ ability to follow treatment guidelines and maintain disease prevention measures. Both the quality of medical treatment as well as patient willingness to access medical services must include the study of structural racism and discriminatory practices (Shao & Stoecker, 2022). The health care expansion of Medicaid does not eliminate the systematic obstacles which force African Americans along with Hispanics and Native Americans and other oppressed groups to maintain unequal health standards (Shao & Stoecker, 2022).
The provision of care services remains essential but nursing professionals assume a vital duty to examine and execute as well as make improvements to public health policies. Healthcare professionals can be equity advocates and social situation experts to find disparities while supporting evidence-driven initiatives for social determinants reform. Through the combination of clinical judgment and social justice perspective nursing establishes itself as a fundamental force that drives change in healthcare policies like Medicaid expansion to achieve equal benefits outcomes for the population (Fox & Kahn-Troster, 2022).
References
Fox, K. S., & Kahn-Troster, S. (2022). Advancing health equity in health care coverage: a public-private partnership to engage underserved communities in medicaid expansion.
Journal of Health Care for the Poor and Underserved,
33(4S), 44–60.
to an external site.
Donohue, J. M., Cole, E. S., James, C. V., Jarlenski, M., Michener, J. D., & Roberts, E. T. (2022). The US medicaid program: coverage, financing, reforms, and implications for health equity.
JAMA, 328(11), 1085–1099.
to an external site.
Kaiser Family Foundation. (2023).
Status of
State Medicaid Expansion Decisions: Interactive Map
.
to an external site.
Parzuchowski, A., Oronce, C., Guo, R., Tseng, C. H., Fendrick, A. M., & Mafi, J. N. (2023). Evaluating the accessibility and value of U.S. ambulatory care among Medicaid expansion states and non-expansion states, 2012-2015.
BMC Health Services Research,
23(1), 723.
Shao, Y., & Stoecker, C. (2022). The effect of louisiana medicaid expansion on affordability of health care.
Public Health Reports (Washington, D.C. : 1974),
137(5), 912–920.
