Mental Health: Change Perception–Change Reality

Reprinted from the SAMHSA blog:

Changing the Story about Mental Health in America

blog.samhsa.gov · by SAMHSA · March 9, 2015

Today, in support of her Joining Forces initiative, the First Lady spoke at the launch of The Campaign to Change Direction, a nation-wide effort to raise awareness around mental health in America. Spearheaded by Give an Hour and co-sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), the campaign is designed to change the story of mental health across the nation by urging all Americans to learn the five signs that someone might be in distress.

While there has been much media attention on mental health in the military and veteran community, it is incredibly important to understand that mental health isn’t just a military issue — it is a human issue. Mental health conditions impact our children, our grandparents, and our neighbors. Every year, roughly one in five adults — or more than 40 million Americans — experience a diagnosable mental health condition like depression or anxiety.

"I want to encourage everyone in this country to go to http://t.co/MBYHHV44EY." —The First Lady on learning the five signs of mental illness

— The First Lady (@FLOTUS) March 4, 2015

It’s up to all of us to change the conversation by encouraging everyone to reach out when a friend, co-worker, veteran, or loved one might be struggling, and to ask for help when we need it for ourselves.

As the First Lady said today at the Newseum in Washington, D.C.:

It’s time to tell everyone who’s dealing with a mental health issue that they’re not alone, and that getting support and treatment isn’t a sign of weakness, it’s a sign of strength. That’s something that my husband believes strongly as President. Because in this country, when you’re fighting an illness — whether that’s mental or physical — you should be able to get the help you need, end of story.

Rory Brosius is the Deputy Director of Joining Forces.

Campaign to Change Direction, First Lady of the United States of America, FLOTUS, Joining Forces, Michelle Obama, The First Lady

Cheers,
  ~ Sparky

Mental Illness Is A Community Disease

For those Pub patrons interested in being kept informed on happenings affecting the futureneeding-mental-health-care of mental health policy in the US. the Substance Abuse and Mental Health Services Administration (SAMHSA) will be holding a public listening session next Wednesday, November 12th, to solicit input and feedback on the establishment of criteria for  the Certified Community Behavioral Health Clinics (CCBHC) Demonstration Program, as outlined in Protecting Access to Medicare Act (P.L. 113-93, Section 223).

    The demonstration program was originally introduced as the Excellence in Mental Health Act by Senators Stabenow (D-MI) and Blunt (R-MO) and U.S. Representatives Matsui (D-CA) and Lance (R-NJ) and is an effort to strengthen community mental health systems by establishing higher standards of care and better coordination and communication across individuals, organizations and agencies that provide assistance and care to individuals in their communities. 

Under provisions of the Act, which was an extender bill used to delay until March of next year pending cuts to Medicare, a maximum of eight states will be selected to participate in a two-year demonstration program whereby the federal government will pay a matching percentage to those states for providing medical assistance for mental health services equal to what Federally Qualified Health Centers (FQHCs) currently receive for primary care services. This is strictly an outpatient clinic initiative (i.e., no funding for inpatient care, boarding, residential treatment).

Example services to be provided by CCBHC’s under the demonstration program include 24-hour crisis management, screening assessments and diagnostic services, outpatient mental health and substance-abuse services, primary care screening and peer support and counseling. The HHS secretary is to determine criteria for a clinic to be certified by a state as a CCBHC no later than September of next year. Next week’s session will solicit input on criteria such as,

  • staffing requirements: e.g., qualifications, areas of experience & expertise, licensing and credentialing, recruiting;
  • availability, scope and accessibility of services: e.g., looking beyond crisis management, determining basis of financial responsibility, evidencing service and referral relationships;
  • care coordination: e.g., relationships with other providers, integration into and with community services and agencies, enabling technical requirements;
  • governance, accountability & reporting: e.g., organizational authority, measuring outcomes, evidential reporting.
  • The secretary is also directed to provide guidance for the establishment of a prospective payment system for this demonstration program, no later than Sept. 1, 2015.

    As I have shared in this space numerous times before, mental and behavioral health services are underfunded and inadequately available to meet the growing needs across the country. We are learning more every day of the evidentiary benefits – to the individual and society – of taking a holistic approach to individual health and welfare. I am hoping to learn more next week whether and how this demonstration program might lead to addressing this critical concern – and I will report back what I learn.

    Cheers,
      Sparky

Mental Health Realities

As mentioned here before, WordPress allows me to track blog visits based upon search strings that were used to refer visitors to the PolicyPub.  I have noted recently a prevalence of searches on Mental Health, likely owing to the national discussion and debate on Gun Control now taking place in lieu of the Sandy Hook Elementary shooting in December.

I recently wrote a post (Obama’s Opportunity Missed) explaining why I feel the President missed a golden opportunity to raise the level of social awareness and consciousness concerning the difficult and growing challenges that mental and behavioral health present to our society.  As a follow up to that, I wanted to share with Pub visitors information that was recently presented by Pamela Hyde, the Administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA), at the Third Annual Public Health Law Research Meeting in New Orleans on January 18th.

According to Ms. Hyde, “people are just beginning to wake up to the knowledge that behavioral health issues are so common . . . “ yet among the eight million people worldwide in the past year who had a mental illness or substance abuse disorder, only 6.9% received treatment.  She added that, “the country has to spend as much time helping children develop their emotional skills as they do their soccer skills.” 

Links to Ms. Hyde’s slide presentation, data cites, and meeting Q&A can be found at the bottom of this post.  Provided below are a few snippets taken directly from her presentation that I found particularly impactful.

Prevalence & Incidence
Approximately one-half of all Americans will meet criteria for mental illness at some point in their lives

Mental and Substance Use Disorders rank among the top 5 diagnoses associated with 30-day readmissions, accounting for about one in five of all Medicaid readmissions (12.4 percent for Mental Disorders and 9.3 percent for Substance Use Disorders)

Comorbidity
7% of the adult population (34 million people), have co-morbid mental and physical conditions within a given year

Co-morbid depression or anxiety increases physical and mental health care expenditures

Impact on Physical Health
24 percent of pediatric primary care office visits and ¼ of all adult stays in community hospitals involve Mental or Substance Use Disorders

Adults who had any mental illness, serious mental illness, or major depressive episodes in the past year had increased rates of hypertension, asthma, diabetes, heart disease, and stroke

Cost of Care
Average monthly expenditure for a person with a chronic disease and depression is $560 dollars more than for a person without depression

General medical costs were 40% higher for people treated with bipolar disorder than those without it

Perception of Value
Mental illnesses account for 15.4% of total burden of disease, yet mental health expenditures in the U.S. account for only 6.2%

The public is less willing to pay to avoid mental illnesses compared to paying for treatment of medical conditions

Top reasons for not receiving treatment include:
     • Inability to afford care (50.1%)
     • Problem can be handled without care (28.8%)
     • Not knowing where to go for care (16.2%)
     • Not having the time (15.1%)

The SAMHSA Web site referenced above includes a large knowledgebase of useful, understandable resources and information on mental/behavioral health and substance abuse.  If you are interested in learning more about the very difficult public policy issues surrounding Mental Health, I invite you to check it out.

Cheers,
  Sparky

Link to Slides: Click …
                                    

Link to Q&A: Click …
                                   

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