Challenge 13

Mental Health

Mental Health and the lack of access to acute psychiatric beds refers to an inadequacy of psychiatric beds in hospitals and makes for a deficiency in a patients overall mental health treatment. This lack not only leads to a higher rate of suicide and a lower quality of life for patients in desperate need of mental health treatment but can also create greater expenses for the public health system if patients are not properly treated.

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Sub-Challenges

Statistics

In one study, about 74% of patients with major depression achieved a 50% reduction in depression symptoms under collaborative care compared to 44% for patients receiving usual care.1
1.

Katon, W., Von Korff, M., Lin, E., Walker, E., Simon, G. E., Bush, T., . . . Russo, J. (1995). Collaborative Management to Achieve Treatment Guidelines: Impact on Depression in Primary Care. JAMA, 273(13), 1026. doi:10.1001/jama.1995.03520370068039

A few studies on the effects of collaborative care suggest that it is more effective than usual care in improving anxiety for up to 2 years.2
2.

Archer J, Bower P, Gilbody S, Lovell K, Richards D, Gask L, Dickens C, Coventry P. Collaborative care for depression and anxiety problems. Cochrane Database of Systematic Reviews 2012, Issue 10. Art. No.: CD006525. DOI: 10.1002/14651858.CD006525.pub2.

Collaborative care for anxiety and depression is one of the most well-evaluated interventions in mental health in primary care.3
3.

Archer J, Bower P, Gilbody S, Lovell K, Richards D, Gask L, Dickens C, Coventry P. Collaborative care for depression and anxiety problems. Cochrane Database of Systematic Reviews 2012, Issue 10. Art. No.: CD006525. DOI: 10.1002/14651858.CD006525.pub2.

Collaborative care programs have been shown to be both clinically-effective and cost-effective for a variety of mental health conditions, in a variety of settings, using several different payment mechanisms.4
4.

Unützer, J., Harbin, H., Schoenbaum, M., & Druss, B. (2013). The Collaborative Care Model: An Approach for Integrating Physical and Mental Health Care in Medicaid Health Homes. Health Home.

11.7 beds remain per 100,000 people. This means there are fewer state hospital beds per capita than at any time since before the nation stopped criminalizing mental illness in the 1850s.5
5.

Fuller, D. A., & Sinclair, E. G. J., Quanbeck, C., & Snook, J.(2016). Going, going, gone: Trends & consequences of eliminating state psychiatric beds, 2016. Treatment Advocacy Center.

Nearly 20% of the hospital beds for the nation’s most severely ill and dangerous psychiatric patients were eliminated in the last 5 years.6
6.

Dieleman, J. L., Baral, R., Birger, M., Bui, A. L., Bulchis, A., Chapin, A., … & Lavado, R. (2016). US spending on personal health care and public health, 1996-2013. JAMA, 316(24), 2627-2646.

Adults living with serious mental illness die on average 25 years earlier than other Americans, largely due to treatable medical conditions.7
7.

National Association of State Mental Health Program Directors Council. (2006). Morbidity and Mortality in People with Serious Mental Illness. Alexandria, VA: Parks, J., et al. – See more at: http://www.nami.org/Learn-More/Mental-Health-By-the-Numbers#sthash.emQpo9jn.dpuf

Mood disorders such as depression are the 3rd most common cause of hospitalization in the U.S. for both youth and adults ages 18 to 44.8
8.

Wier, LM (Thompson Reuters), et al. HCUP facts and figures: statistics on hospital-based care in the United States, 2009. Web. Rockville, Md. Agency for Healthcare Research and Quality, 2011. Retrieved March 5, 2013, from http://www.hcup-us.ahrq.gov/reports.jsp.

Serious mental illness costs America $193.2 billion in lost earning per year.9
9.

Insel, T.R. (2008). Assessing the Economic Costs of Serious Mental Illness. The American Journal of Psychiatry. 165(6), 663-665 – See more at: http://www.nami.org/Learn-More/Mental-Health-By-the-Numbers – sthash.F0CmiSZV.dpuf

Approximately 60% of adults and almost ½ of youth ages 8 to 15 with a mental illness received no mental health services in the previous year.10
10.

National Institutes of Health, National Institute of Mental Health. (n.d.). Statistics: Any Disorder Among Adults. Retrieved March 5, 2013, from: http://www.nimh.nih.gov/statistics/1ANYDIS_ADULT.shtml

Approximately 20% of youth ages 13 to 18 experience severe mental disorders in a given year.11
11.

National Institutes of Health, National Institute of Mental Health. (n.d.). Statistics: Any Disorder Among Adults. Retrieved March 5, 2013, from: http://www.nimh.nih.gov/statistics/1ANYDIS_ADULT.shtml

1 in 4 adults, approximately 61.5 Americans, experiences mental illness in a given year.12
12.

National Institutes of Health, National Institute of Mental Health. (n.d.). Statistics: Any Disorder Among Adults. Retrieved March 5, 2013, from: http://www.nimh.nih.gov/statistics/1ANYDIS_ADULT.shtml

25% of Americans experience mental illness in a given year.13
13.

Centers for Disease Control and Prevention. (2011). CDC Report: Mental Illness Surveillance Among Adults in the United States. Retrieved from https://www.cdc.gov/mentalhealthsurveillance/fact_sheet.html

In 2005, there were 17 public psychiatric beds available per 100,000 population compared to 340 per 100,000 in 1955. Thus, 95 percent of the beds available in 1955 were no longer available in 2005.14
14.

Torrey, E. F., Estsminger, K., Geller, J., Stanley, J., & Jaffe, D. J. (2015). The shortage of public hospital beds for mentally ill persons. 2008. The Treatment Advocacy Center. Arlington, VA.