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Health Promotion Final Paper: Mental Health Population of Delaware

Taylor White

RN to BSN Nursing Program, Delaware Technical Community College

NUR 330: Population and Community Health

Mrs. Furlong

April 11, 2023

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Current Data

Mental illness can be acute or chronic problems and are normally diagnoses that can

affect the patients emotional, psychological, and social well-being (Orgera & Panchal, 2021).

Examples of these illnesses can be depression, anxiety, schizophrenia, mood/personality disorder

and substance abuse. Mental health disorders in the state of Delaware and all around the country

have increased since the COVID19 pandemic and forcing people into

isolation. Approximately 1 in 10 adults have reported symptoms of anxiety and/or depression

due to isolation and forced away from loved ones (Orgera & Panchal, 2021). There was a

reported 26.6% of people in the state of Delaware that reported symptoms of anxiety or

depression compared to 31.6% of adults in the United States. Also compared to before the

pandemic there was a reported 20.9% or people that reported mental illness in the state of

Delaware. Substance abuse has also increased in the last 3 years due to the pandemic. In 2020

15.1% of adults reported new or increased substance use due to stress caused from the pandemic,

deaths related to substance abuse increased from 72,000 in 2019 to 93,000 in 2020 (Orgera &

Panchal, 2021). 

Needs and Problems

In 2021 it was reported that 16.9% of the mental health population in Delaware was not

able to get the mental health resources and counseling they needed to deal with their diagnoses

(NAMI, 2021). This is due to two things, not having health insurance or the health insurance

they are provided with did not support or cover visits for mental health issues (NAMI, 2021).

6.6% of the mental health population did not receive help for their mental health issues because
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they were uninsured and could not cover the costs. While other Delawareans were 3x more likely

to be forced out of network to get help for their mental health issues causing them increased

costs and in return not receiving any medical care (NAMI, 2021). 88,697 of the population

in Delaware do not have enough medical professionals working in mental health as well, causing

delayed care and inability to supply care (NAMI, 2021). So along with the decreased visits due

to health insurance related issues, when this is not the cause there is also problems with getting

medical professionals to see the patients as well. 

Background and Population/Community Information

High school students in the state of Delaware are 2x more likely to drop out

more than their peers and ages 12-17 45.5% of them did not receive any care in the last year

(NAMI, 2021). Of the mental health population 1,165 of the people are homeless and 1 in 10 are

living with a serious mental health problem. Looking at a nationwide perspective 1 person in the

US dies because of suicide every 11 minutes, and 113 of those lives were lost to suicide and

38,000 adults had thoughts of the same (NAMI, 2021). Majority of the population in jail are

suffering from mental health issues as well, 1 in 4 of the people with a serious mental health

issue have been arrested by the police at some point in their life and 7 in 10 of the youth in the

juvenile system are suffering from mental health illness as well (NAMI, 2021). 

SMART Goals and Interventions

Health Insurance is a main problem for the mental health population and not being able to

receive the care that they need. When there are not enough health care providers in the

geographic area to support the needs of the mental health population (Bogusz, 2020). Then the

health insurance company will deny the coverage for the visit. This requires the patients to wait

long periods of time to receive care, drive long distances, and be forced to see a professional that
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is outside of their medical coverage increasing the costs (Bogusz, 2020). It was found in a study

in 2019 that a mental health visit was found to be five times more likely to be out of network

then a primary care physician. Mental health providers and advocators need to work together to

come up with a better system for these patients. If they are being forced to see providers that are

out of their network, then visits should be given at the same rate that they would be to in network

patients (Bogusz, 2020). Also, when the providers are out of network like stated previously then

they are also at a greater driving distance then other provider. Therefore, transportation should be

provided for these patients as well to help them get their appointments. Most of the mental health

population is homeless, which is why things like money and transportation is a problem.

Another problem is the living situation for most of these clients as well, they often are

homeless and have very little resources available. Most of them fall to addiction and other

methods of coping when they are left with nothing. Housing is very limited and hard to obtain

due to the high percentage of people that require it. It was reported that in January of 2020 there

was a reported 1,165 people who experienced homelessness (Jedra, 2020). Of these numbers

about 20% of this population of people were diagnosed with a mental illness, who are not being

treated due to limited resources (Jedra, 2020). Case management and behavioral health services

need to do a better job at community outreach and offering these services to this population of

people. We can also create more group homes and halfway houses, while finds may be limited

we can do more fundraising and nonprofits to help with building these services. For now, some

examples of resources available for this population is the Salvation Army, once here this service

can also provide with services for other things that you may need like clothes and food.

The lack of mental health providers is what leads many to limited treatment as well,

many providers stay clear of mental health clients and services because of the insurance issues as
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stated before. According to an article written by Joyce Frieden with Medpage Today, there are

75 million children in the country and 20% of them require mental health support but there are

not enough providers to supply the care (Frieden, 2022). We can work with the federal

government and provide training programs for providers and pay them once they are trained

(Frieden, 2022). This would provide them with the incentive to want to provide these services

and improve suicide and mental health prevalence in the state of Delaware. While this may not

be specifically related to the state of Delaware there are mental health crisis hotlines available for

people who may not be able to find a provider right away. You can text “HOME” to 741741 or

call 1-800-273-TALK to talk with a mental health specialist or support person while waiting for

other services.

Mental Health Promotion Plan

I. Health Insurance:

a. Supporting patients without the appropriate health insurance due to

geographical issues or lack of providers

b. Creating programs that allow services with out of network providers to be

given at a lower cost

c. Work with legislation to create better health insurance guidelines

d. Provide transportation to and from mental health visits when they are with

out of network providers who are long distances away from the home or

provide inhouse treatment options for patients who are unable to leave the

home

II. Living Issues

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a. More community outreach for this population, seeking more of the

homeless and getting them the housing, they need

b. Finding areas that lack shelters, and working with fundraisers and

nonprofits to make more shelter options for the population

c. Having mental health counselors at these shelters to provide treatment

while they are there or connect them with the resources they need

III. Increasing Mental Health Providers

a. Work with legislation and the state to increase and mandate mental health

training for providers

b. Provide the incentive needed to get the providers to participate, give the

pay wanted after the training has been completed

c. Narrow down which area is most needed based off number of patients

versus physicians and requirements by health insurance

Nurses Role

A nurse is a major advocate for the mental health population, they work very closely with

these patients and are their voice when they are not being heard. I am doing my clinical rotation

with the behavioral health department at Beebe Medical Center. I can say first-hand how hard the

nurses fight for these patients to get them the care that they need. There is only one in-house

psychiatrist here, so as you can imagine time spent with the patients is very limited. But that is

when the amazing nurses come into play. They set up housing, addiction clinic appointments,

inpatient recovery, call family members, and just sit and listen to the patients and their concerns.

They are a nurse, social worker, support person, and friend all in one job, without this resource

for many of these patients they would be left with nothing and no help. Nurses wear many hats in
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the mental health population, but without them the patients would truly suffer more than they

already are.

Summary

Mental health is becoming an increasing problem in the state of Delaware and in the

youth of Delaware as well. Especially with the new covid19 pandemic mental health is an

increasing problem in the population due to isolation from loved ones and the fear of getting ill.

Then the people who are seeking help for their mental illness are struggling with things like

insurance and costs of the mental health resources deterring them from seeking the help they

need. This in return is increasing mental health issues and suicide rates. There is also limited

mental health professionals, making the resources available to the population limited. This factor

also in return can increase the previously discussed rates as well. As a state we need to work on

getting this population the help and resources they need to in return decrease the amount of

people suffering and suicide rates. Mental health is a growing problem, and covid19 pandemic is

not a illness that will be going away any time soon, so this means the increase in mental health

will not be stopping anytime soon. We need to make mental health resources cheaper and

increase mental health professionals in the state of Delaware. 

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Resources

Bogusz, G. (2020) Health insurers still don’t adequately cover mental health treatment. National

alliance on mental illness. Retreieved from

https://www.nami.org/blogs/nami-blog/march-2020/health-insurers-still-don-t-

adequately-cover-mental-health-treatment

Frieden, J. (2022) Mental health providers need better incentives to accept insurance, lawmakers

told. Medpage today. Retrieved from

https://www.medpagetoday.com/psychiatry/generalpsychiatry/100024

Jedra, C. (2020) The truth about homelessness in Delaware. Delaware online. Retreived from

https://www.delawareonline.com/story/news/2018/12/26/truth-homelessness-delaware/

2316572002/

Orgera, K., & Panchal, N. (2021). Mental health in delaware. Kaiser family foundation.

NAMI. (2021). Mental health in delaware. Retrieved from DelawareStateFactSheet.pdf

(nami.org)