Nurs 6050 policy and advocacy Assignment

Nurs 6050 policy and advocacy for improving population health

  • Review the agenda priorities of the current/sitting U.S. president and the two previous presidential administrations.
  • Select an issue related to healthcare that was addressed by each of the last three U.S. presidential administrations.
  • Reflect on the focus of their respective agendas, including the allocation of financial resources for addressing the healthcare issue you selected.
  • Consider how you would communicate the importance of a healthcare issue to a legislator/policymaker or a member of their staff for inclusion on an agenda.
  • The Assignment: (1- to 2-page Comparison Grid, 1-Page Analysis, and 1-page Fact Sheet)


Agenda Comparison Grid Template


Nurs 6050 Policy and Advocacy for Improving Population Health

Part 1: Agenda Comparison Grid


Identify the Population Health concern you selected.  

Mental health

Describe the Population Health concern you selected and the factors that contribute to it. Mental disorders are common in United States. Around one in five adults in United States has a mental illness. Mental illness is connected with numerous contributing factors. Genetics along with other biological variables, (for instance brain injury and defects and neurotransmitter imbalances) and physiological issues (for instance neglect and trauma) are major factors that have a close connection with mental health. In addition, environmental numerous factors are connected with mental illness.  These factors include stressors like divorce/ separation, the demise of a loved one, financial hardships, and job loss.



Administration (President Name) President Trump President Obama President Bush
Describe the administrative agenda focus related to this issue for the current and two previous presidents.  

The  Trump administration is researching numerous initiatives aimed at improving the treatment of individuals with serious mental illnesses. These initiatives include doing research on the capability of personal technology to assist mentally ill individuals, moving the homeless to government housing, and taking away guns from seriously mentally ill individuals who are possibly violent. Other initiatives include building more psychiatric hospitals and reforming civil commitment procedures to ensure that mentally ill individuals are involuntarily commitment and confined to receive treatment and prevent them from causing harm to themselves or others (Jaffe, 2019). 






Increasing coverage for individuals with mental health coverage was a key agenda of the  Obama administration. The ACA enacted into law in 2010 expanded protection and resources for individuals with mental disorders.  In 2014, Obama passed legislation that offers finances to the SAMHSA to reinforce the establishment of programs for treating psychosis across the country. The Obama Administration also enacted the mental health parity and addiction equity act  (MHPAEA), which places behavioral healthcare in the same line with surgical and medical care. Additionally, President Obama enacted protecting access to medicare act (PAMA)  to increase access to community-based substance use and mental health disorder services for individuals under Medicaid.   In 2004, Bush unveiled a mental health federal action agenda, aimed at assisting more mentally ill patients to live within the community and eradicating the stigma of mental conditions. The president appointed the New Freedom Commission on Mental Health tasked with conducting a comprehensive study of the country’s mental health service delivery system entailing private and public providers and provides recommendations to the president.  The recommendations were to permit adults with serious mental illness and children experiencing serious emotional disturbances to learn, work, live, and fully participate within their communities (Hogan, 2003).
Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue. The Trump administration has been making cuts on financial allocation for mental health. In the 2019 fiscal year budget, trump requested 68.4 billion dollars which were a 17.9 billion decrease from the 2017 mental health budgetary allocation. Trump reduced Medicare by 500 million dollars and Medicaid by 1.4 trillion, the two biggest programs that pay for behavioral health services.



The Obama administration allocated a huge on money on mental health. in 2016, amid the growing issue of addiction and mental health issues, the administration requested a 500 million dollars for a two year initiative on mental health and a 1.1 billion dollars for addiction treatment, recovery, and prevention programs. The bush administration was keen on narrowing the substance misuse treatment gap. In 2003, president Bush requested 126 million dollars for the center for substance abuse treatment to enable 3.9 million drug users who did not access treatment.  
Explain how each of the presidential administrations approached the issue. The Trump administration recognizes that mental health plays a very important role in the wellbeing of Americans and the country.  The administration reaffirms its devotion to facilitating education and research, dispelling stigmatization of mentally ill personas, and reassuring all people with mental disorders that they are not on their own. The administration has made behavioral and mental health a major focus of its public health efforts, especially serious mental disorders and Opioid addiction (Trump, 2019).







President Obama acknowledged that mental health and general health are intertwined and identified the importance of making actual, long-lasting transformations to ensure individuals with behavioral health problems, entailing people with mental disorders, have supports and services they require.  Since he took offices, Obama made numerous major transformations in the delivery of and access to quality mental health services entailing novel opportunities for quality and coverage of care Under the Accountable Care Act (The White House, 2018).  



The administration approached mental illness as any form of illness and confirmed his support for the mental health parity legislation. The president wanted a healthcare system that could treat mental disorders with similar urgency as physical conditions.   The administration viewed that mentally ill patients must fully be integrated into the community by offering services within the community other than psychiatric institution institutions. The administration also saw the screening of the entire population as a key step that could assist address the issue of mental health in United States (Lenzer, 2004).


Part 2: Agenda Comparison Grid Analysis



Administration (President Name) President Trump President Obama President Bush
Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?


The Trump administration will be least likely to be responsible for assisting me to address mental health issues. Although the administration has implemented legislation and developed initiatives for the prevention and treatment of mental illness, achieving outcomes would not be possible with reducing funding.  Proposals on cuts to Medicare and Medicaid pose a threat to mental illness patients and significantly limit the ability of low-income individuals to seek services.




The Obama administration would most likely be responsible for assisting me to address mental health issues. The administration has enacted numerous legislations related to mental health. In addition, the administration allocated appropriate amounts of money on mental health care.     President Bush administration would be the second most likely agency responsible for assisting me to address mental health issues. This administration enacted the mental health parity act to ensure that mental health is viewed as a fundamental health benefit. The administration also supports the provision of mental health services within the community without having to confine mentally ill patients in psychiatric institutions.
How do you think your selected healthcare issue might get on the agenda for the current and two previous presidents? How does it stay there? The mental health issue can get into the agenda of President Trump through votes. Voters are  powerful and cannot be ignored The issue might get into the agenda of President Obama via the media. The media can publicize the issue and structure public debate on what needs to be done to address the issue.  The issue might get into the agenda of President Bush through political leaders who are the key initiators of a policy issue and key participants in national debates on policy.
Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents? I would champion mental health issues through campaign plans and hold the president accountable for the implementation of policies to address the issue. I would champion the issue for President Obama through public opinion.  I would influence public opinion to elicit an action from President Obama. I would champion the mental health issue through interest groups which will conduct advocacy campaigns to pressure the Bush administration to adopt the mental health issue onto its agenda.


Narrative with the Facts

Mental health is emotional, behavioral, and cognitive well-being.  It is fundamental to the well-being of an individual, interpersonal, and family relationships and the capability to contribute to society. However, millions of households in United States are affected by mental illness. In 204, about one in five or approximately forty-three adults in United States had been diagnosed with a mental disorder over the last one year, and around ten million adults in America have serious functional impairment as a result of mental illness, such as anxiety, or serious mood or psychotic disorders. Mental illnesses can disrupt careers and families and even cause death. Suicide is the tenth topmost cause of death in the country, accounting for over 41, and 000 deaths annually. Untreated mental disorders and behavioral health conditions have a serious adverse impact on the lives of individuals. Mentally ill people have a high likelihood of being absent from work, being unstably housed, lose jobs, and have poor family relationships (The White House, 2018).

Almost ten million adults who are seriously mentally ill face considerable challenges in utilizing and accessing quality mental health care.  they are among the greatest users of health service and public health support programs.  Serious mentally ill adults have a high likelihood compared with individuals without serious mental disorders to be on Medicaid and more likely to be enrolled in Medicare before they reach 65 years.  Additionally, they are at a high likelihood of depending on supplemental security income and social security disability insurance, are heavy users of the emergency room, and have serious comorbidities (The White House, 2018).   Although knowledge of where to get mental and behavioral services and societal stigma are barriers to care, reductions in mental health funding continue making it difficult for mental health patients to seek care.


Jaffe, D. (2019). The Two most important mental health reforms the Trump Administration should consider. Retrieved from

Hogan, M. (2002). New Freedom Commission Report: The President’s New Freedom Commission: Recommendations to Transform Mental Health Care in America.  Psychiatric Services, 54(11), 1480-1481

Lenzer, J. (2004). Bush Plans to Screen Whole US population for mental illness. BMJ, 328(7454), 1458.

The White House. (2018). Making Health Care Better. Retrieved from

Trump, D (May 1, 2019). Presidential Proclamation on National Mental Health Awareness Month, 2019. Retrieved from


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