[NYAPRS Enews] Forbes: Access To MH Care Improves, But Many Still Left Out

[Matt Canuteson]

U.S. Mental Health Spending Rises, But Many Still Left Out 

Access To Care Improves, Studies Find, But Treatment Quality Lags For
Elderly, Vets

Forbes May 6, 2009

 

TUESDAY, May 5 (HealthDay News) -- Mental health spending in the United
States increased 65 percent in the past decade, and many more Americans
are using mental health services, but there's still a big difference
between access to care and quality of mental health care
<http://topics.forbes.com/health%20care>  received, new research shows. 

In a special edition of the May/June issue of Health Affairs focusing on
mental health care in the United States, one study found that about half
of Americans suffering from mental illness in a given year don't receive
treatment, and another 25 percent receive treatment that's not
consistent with evidence-based guidelines.

Some patients may receive inappropriate treatments, simply because
doctors lack the evidence to make an informed decision about appropriate
care, noted Philip Wang, acting deputy director of the National
Institute of Mental Health, and colleagues.

Another study suggested that even when doctors have information about
best practices, patients don't always receive the correct treatments.
That's because financial incentives, regulations, the quality of the
mental health workforce, and drug company marketing strategies have a
major impact on doctors' treatment decisions, said Marcela
Horvitz-Lennon, of the Western Psychiatric Institute and Clinic in
Pittsburgh, and colleagues.

They said underuse of effective treatments and overuse of ineffective
treatments undermine the quality of care and lead to poor patient
outcomes. For people with severe mental illness, that can result in
increasing isolation, repeated hospitalizations, inability to get or
hold a job, and even suicide.

Another study found that the number of seniors receiving psychotropic
drugs to treat Alzheimer's and other mental health disorders doubled
between 1996 and 2006, and the number of adults and children using the
drugs increased by 73 percent and 50 percent, respectively.

The use of psychotropic drugs has increased, because primary-care
doctors have become more familiar with these types of drugs and
lower-cost drugs have become more available, said Sherry Glied, chair of
health policy and management at the Mailman School of Public Health at
Columbia University <http://topics.forbes.com/Columbia%20University> ,
and colleague Richard Frank.

The researchers also found that access to mental health care has
improved for many Americans, but challenges persist for many groups of
people. Between 1996 and 2006, treatment declined for elderly people
with mental limitations that make it difficult for them to do daily
living tasks such as dressing, eating and bathing without assistance.

Glied and Frank also found that more people with serious mental
illnesses are being imprisoned or incarcerated. About 7 percent of
people with persistent mental illnesses are put in jail or prison every
year.

Another study found that many members of the military and veterans get
inadequate treatment or no care at all for post-traumatic stress
disorder (PTSD) and depression. The Rand Corp. researchers said more
needs to be done to better prepare community health providers to help
veterans with mental health problems when they return home.

In addition, the Department of Defense needs to reduce institutional and
cultural barriers to seeking mental health care, especially for
active-duty military personnel.

A study by Robert Drake, a psychiatry professor at Dartmouth Medical
School, and colleagues concluded that a national program to help
mentally ill people on Social Security disability programs find jobs
could save the federal government $368 million a year.

The researchers noted that about 27 percent of people receiving Social
Security Disability Insurance benefits are mentally ill, and that up to
70 percent of people with mental illnesses want to work.

"Giving people with mental disabilities the power to build financial
security will help improve their quality of life significantly by
encouraging self-sufficiency and building self-esteem, which can
ultimately help move their treatment forward as well," Drake said.

http://www.forbes.com/feeds/hscout/2009/05/05/hscout626791.html

 

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