The Policy Process: Formulation, Legislation and Implementation

Mental health issues have been a problem since the 16th century in the when many people may have been the victims of witch-hunts. Most mentally ill people or those who were judged insane were sent to work in workhouses, poorhouses, and jails. Forced confinements and restraints were used on those who people though were dangerously disturbed or could be violent to themselves, other’s or other’s property. Eventually, madhouses were created where mental ill people were housed and treated harshly but were seen as being therapeutic and helping to suppress animalistic passions. Formulation

The Vision of mental health policy is to help not only current patients with but future patients by helping to diagnose, manage, and prevent the mental health and neurological diseases. According to “Mental Health Policy, Planning & Service Development” (2014), “mental health policies can coordinate essential services and activities to ensure that treatment and care is delivered to those in need while at the same time preventing fragmentation and inefficiencies in the health system.” (“Mental Health Policy, Planning & Service Development”, 2014). A new bill or legislation may begin if there is an increase of concern regarding the health care industry especially when it comes to mental health and affects the public. Any of the above situations individually or combined engages regular media attention, therefore the information is relayed to the public. With more people dying each year from suicides due to mental health issues, the public is being concerned and wants the government to help by providing better policies to help those in need.

Sometimes the voices of the public are not enough and special interest groups such as the National Alliance on Mental Illness and Mental Health America are needed to give that extra push within Congress. Mental Health America is one of the biggest leaders in mental health policy and advocacy. This interest group helped pass the Mental Health Parity law and monitoring implementation of the Affordable Care Act. The process of policy formulation includes creating proposals, debating the information and making several drafts for the bill. If the policy is unclear or unacceptable, the writers will make revisions to outline all necessary details. The policy should identify its goals and outcomes as well as any related activities. Additional steps may include attempting to plan for any obstacles toward the wanted outcome, and identifying any progress measurements, budget needs, and necessary resources. After the policy formation, the document is ready for the legislative phase. There are twelve steps in formulation a mental health policy: 1. Asses the populations needs

Identify major roles and responsibilities of different sectors

2. Gather evidence for effective strategies
Determine the strategies and time frames

3.Consultation and negotiation
Set indicators and targets

4. Exchange with other countries
Determine major activities

5. Set out the vision, values, principles and objectives of the policy 11. Determine the cost, the available resources and the budget 6. Determine areas of action
Set up monitoring and evaluation processes
(“Mental Health Policy, Planning & Service Development”, 2014). Legislative
The official legislative process beginning when the bill is numbered, -H.R designates it a House bill and S a Senate bill, and then referred to a committee which is then printed by the Government Printing Office. (“Introduction to the Legislative and Regulatory Process”, n.d.). Once the bill has its number it then goes to a standing committee. The Committee’s Chair who can delay, block, or expedite action on the measure. The Committee’s duties include drafting the legislation and advising and counseling Committee Members and writing the report to the legislature. After the bill reaches the committee, it is put on the calendar. From here the committee can either consider the bill themselves or they can refer the bill to a subcommittee. Through the committee and subcommittee decisions about the content and language of the bill are made.

The subcommittee can call for a hearing where the bill will be examined section by section, to make changes before the bill goes back to the main committee. “Hearings provide the opportunity to put on the record the views of the executive branch, experts, other public officials, supporters and opponents of the legislation. Testimony can be given in person or submitted as a written statement.” (“Introduction to the Legislative and Regulatory Process”, n.d.). After the bill the subcommittee’s report, the full committee then votes on the recommendations before sending it to either the House or the Senate. After either the House or Senate debates the bill and it’s approved, it will then be sent to the Speaker of the house or the President of the Senate where they will approve the bill as received, revise it, reject it, or fail to take action on it. Both the House and the Senate must agree on the language in the bill before it is sent to the President. If the President approves the bill then he will sign the legislation and it will become law. If the President was to veto the bill, Congress still has the opportunity to override the veto and enact the law without the President’s signature. Implementation

“Once the legislation has been signed into law, it then goes to the appropriate agency for implementation.”(shi, 2014, p. 39). The principal agency in charge of implementing health care laws is the US Department of Health and Human Services (HHS) who’s mission is to protect the health of all American’s while providing essential human services especially those who can’t care for themselves. The HHS will then develop rules and regulations which will then be published in the Federal Register for public comment before the law is finalized. Implementation is about trying to accomplish public objectives, the process of seeing how the policy will affect societal conditions and outcomes. While in the implementation phase HHS will set detailed rules and regulations for the application of the new law. The implementation process may require many decisions involving staffing, procedures, and budgets. “During the preliminary stage of information collection and as part of the comment or negotiation period, the public—individuals and groups—may also have the opportunity to provide input on the terms of the proposed rule.” (shi, 2014, p. 39). Once all the rules
and regulations are finalized, the law making process can move forward.

Mental health services have been a huge part of medical care for several years. The issues with mental health care costs, coverage and the availability of the services the patients need. With a mental health policy, the US would be able to look and find more money in helping those who need help to get the medication and the treatment they need.

References
Introduction to the Legislative and Regulatory Process. (n.d.). Retrieved from http://www.aacn.org/wd/practice/content/publicpolicy/intro.pcms?menu= Mental health policy, planning & service development. (2014). Retrieved from http://www.who.int/mental_health/policy/services/en/ Policy and Advocacy. (n.d.). Retrieved from http://www.mentalhealthamerica.net/policy-advocacy shi, L. (2014). Introduction to Health Policy. Retrieved from The University of Phoenix eBook. STATE LAWS MANDATING OR REGULATING MENTAL HEALTH BENEFITS. (2014). Retrieved from http://www.ncsl.org/research/health/mental-health-benefits-state-mandates.aspx