3. August 6, 2012 Mental Health Weekly
3
Mental Health Weekly DOI: 10.1002/mhw A Wiley Periodicals, Inc. publication. View this newsletter online at wileyonlinelibrary.com
to make sure that when they are
ready to leave the hospital they are
able to be stepped down to less in-
tensive levels of care,” said Covall.
CMHCs provide many of those less
intensive/aftercare services, includ-
ing case management and rehabili-
tation services, he said.
Covall added that it’s important
for community mental health pro-
viders and providers of psychiatric,
residential and inpatient treatment
facilities to improve coordination so
that patients get the services they
need in a timely manner. “We have
to be proactive as providers in work-
ing with all stakeholders to manage
the process and ensure patients get
the care they need,” he said.
Hospital trends
Occupancy rates have also in-
creased in inpatient psychiatric fa-
cilities by more than 5 percent be-
tween 2009 and 2010, despite addi-
tional beds being added to existing
facilities. Outpatient facilities have
shown even greater growth with the
average number of outpatient visits
in 2010 increasing by more than 25
percent since the prior year.
Trend analysis shows that aver-
age total days of inpatient hospital
care increased 7.3 percent from
24,531 days in 2009 to 26,333 days
in 2010. The increase in inpatient
days of care in 2010 was driven by
increased admissions, as the average
inpatient hospital length of stay re-
mained approximately the same
from 2009 to 2010.
The average inpatient hospital
admissions increased 7.1 percent,
from 2,692 admissions in 2009 to
2,883 admissions in 2010. The aver-
age inpatient hospital length of stay
was unchanged at 9.1 days for 2009
and 2010.
Although the length of stay re-
mained unchanged, this year’s re-
sults show that a greater number of
patients utilized psychiatric services
provided by NAPHS member facili-
ties in 2010 compared to the previ-
ous year, according to the survey.
“The length of stay in inpatient hos-
pital care has been very steady for
close to a decade now,” said Covall.
The treatment approach in inpatient
psychiatric facilities is very stable —
it’s about crisis stabilization and
short-term treatment.”
Residential, outpatient
trends
The hospital-based and free-
standing residential treatment centers
reported data for both 2009 and 2010
which showed that the average facil-
ity residential days of care increased
5.5 percent from 21,850 days to
23,058 days. Average residential ad-
missions in these facilities increased
16.4 percent from 166 admissions in
2009 to 193 admissions in 2010.
As with inpatient hospitals, in-
creases in days of care in residential
treatment centers were driven by in-
creased admissions from 2009 to
2010, the survey stated. Average oc-
cupancy in residential treatment
centers rose in 2010 compared to
2009, despite average length of stay
decreasing during this time. These
trends are largely due to a 16.4 per-
cent increase in average residential
treatment admissions in 2010.
In the trend analysis examining
data from hospital-based outpatient
visits between 2009 and 2010,
NAPHS found that the average out-
patient visits increased 25.8 percent
‘We have to be
proactive as
providers in working
with all stakeholders
to manage the
process and ensure
patients get the care
they need.’
Mark Covall
from 13,866 visits in 2009 to 17,448
visits in 2010, with significant growth
in both regular and intensive outpa-
tient visits. The average partial hos-
pitalization visits increased 3.3 per-
cent from 5,270 visits in 2009 to
5,443 visits in 2010.
2010 snapshot
In the examination of all survey
respondents’ experiences in the year
2010, NAPHS found that 79.8 per-
cent of respondents offered inpa-
tient hospital care and 44.3 percent
offered residential psychiatric care.
In addition, 56.8 percent offered
partial hospitalization and 47.5 per-
cent offered outpatient psychiatric
services (see graph on page 2).
NAPHS found that about three-
quarters of its-member organizations
responding to the survey provide in-
patient care to adolescents (71.6
percent) and adults (72.1 percent) in
inpatient hospital settings. Residen-
tial treatment provided by respon-
dents predominately treats adoles-
cents (41 percent of facilities). About
half of partial care and outpatient
facilities responding to the survey
treat adults (in 49.2 percent and 47
percent of facilities, respectively), al-
though care to older adults and ado-
lescents is provided by more than 30
percent of facilities in these settings.
The 2010 snapshot showed
some differences in average length
of stay by hospital population
served. While length of stay in adult
programs averaged 8.5 days, the av-
erages were 9.7 days in adolescent
programs and 14.5 days in older-
adult programs.
“There’s an increased amount
of need out there,” said Covall. “We
have to be able to put in place pro-
grams that are able to address the
various needs.” •
The 2010 Annual Survey is avail-
able at a prepaid cost of $400 from
the National Association of Psychiat-
ric Health Systems, 900 17th Street
NW, Suite 420, Washington D.C.
20006-2507 or call 202-393-6700,
ext. 101 or visit www.naphs.org.
4. Mental Health Weekly August 6, 2012
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Continues on page 6
States have new reason to expand Medicaid: Lower death rates
As states consider whether or
not they want to expand Medicaid
under the Affordable Care Act (ACA),
the results of a new study from
Harvard School of Public Health
researchers found that Medicaid
expansions were associated with a
significant reduction in mortality as
well as improved coverage, access
to care and self-reported health.
The study, “Mortality and Access
to Care among Adults after State
Medicaid Expansions,” was pub-
lished online July 25 and will appear
in the September 13 issue of the
New England Journal of Medicine.
Medicaid currently insures 60
million people, and the ACA will
extend Medicaid eligibility to mil-
lions more starting in 2014. The Su-
preme Court ruling enables states to
choose whether to expand Medic-
aid under the ACA, and many states
facing budget pressures are consid-
ering cutbacks instead, according to
the study.
Traditionally, Medicaid covers
low-income children, parents, preg-
nant women and disabled persons;
however, over the past decade sev-
eral states expanded Medicaid to
cover nondisabled adults without
dependent children, a group that is
similar to the population gaining eli-
gibility under the ACA.
Researchers noted that evidence
regarding Medicaid’s effect on health
remains surprisingly sparse, particu-
larly for adults. “To our knowledge,
this is the first study that has looked
specifically at the effect of state
‘Our study suggests that expanding Medicaid
enables people to access the care they need,
and their health improves, even to the
point of potentially saving lives.’
Benjamin D. Sommers, M.D., Ph.D.
Medicaid expansions on mortality in
this group of low-income adults,”
Benjamin D. Sommers, M.D., Ph.D.,
assistant professor of health policy
and economics at the Harvard
School of Public Health and lead au-
thor, told MHW.
Sommers added, “Previous re-
search in the 1980s and 1990s
looked at the impact of prior expan-
sions [impacting] children and preg-
nant women.”
Study methods
Researchers compared three
states (Arizona, Maine and New
York) that substantially expanded
their Medicaid programs to childless
adults, ages 20 to 64, between 2000
and 2005. They compared those
states to four neighboring states
without expansions: Nevada and
New Mexico (for Arizona), New
Hampshire (for Maine), and Penn-
sylvania (for New York).
Researchers observed the popu-
lation sample for five years before the
expansions, from 1997 through 2007.
According to the study, the pri-
mary outcome was annual county-
level all-cause mortality per 100,000
adults between the ages of 20 and 64
years obtained from the Compressed
Mortality File of the Centers for Dis-
ease Control and Prevention (CDC)
from 1997 through 2007, totaling
68,012 observations specific to an
age group, sex, year and county.
Secondary outcomes were the
percentages of persons with Medic-
aid, without any health insurance,
and in “excellent” or “very good”
health (from the Current Population
Survey, a total of 169,124 persons)
and the percentage unable to obtain
needed care in the past year be-
cause of cost (from the Behavioral
Risk Factor Surveillance System, a
total of 192,148 persons).
Mortality reductions
Medicaid expansions in the three
states were associated with a signifi-
cant reduction in mortality of 6.1
percent, or 19.6 deaths per 100,000
adults, compared with neighboring
states that did not expand Medicaid,
according to the study. The study
found mortality reductions greatest
among adults between the ages of
35 and 64 years, minorities and
residents of poorer counties. These
groups have traditionally had higher
mortality rates and faced greater bar-
riers to care, said researchers.
The expansions were also asso-
ciated with increased Medicaid cov-
erage (24.7 percent), decreased rates
of uninsurance (14.7 percent), de-
creased rates of delayed care be-
cause of costs (21.3 percent) and in-
creased rates of self-reported health
status of “excellent” or “very good”
(3.4 percent).
Researchers say the results cor-
respond to 2,840 deaths prevented
per year for every 500,000 adults
gaining Medicaid coverage. This
finding suggests that 176 additional
adults would need to be covered by
Medicaid in order to prevent one
death per year.
The study noted that increases
in Medicaid coverage in the expan-
Bottom Line …
A new study provides further
information that policymakers should
be aware of: Major changes in
Medicaid — either expansions or
reductions in coverage — may have
significant effects on the health of
vulnerable populations.
5. August 6, 2012 Mental Health Weekly
5
Mental Health Weekly DOI: 10.1002/mhw A Wiley Periodicals, Inc. publication. View this newsletter online at wileyonlinelibrary.com
ABHW pledges support for Million Hearts Campaign
by Coral Ellis
T
The Association for Behavioral Health and Wellness
(ABHW) and its member companies pledged support in
May 2012 for the Million Hearts Campaign, organized
to prevent one million heart attacks and strokes over
five years. The campaign is a national initiative
launched by the U.S. Department of Health and Human
Services (HHS) in September 2011.
This national initiative brings together individuals,
federal agencies, state, county and local health officials,
health care providers, pharmacies and pharmacists
communities and patient organizations. ABHW joins
other partners from across public and private health
sectors, including the Substance Abuse and Mental
Health Services Administration (SAMHSA), the Centers
for Medicare & Medicaid (CMS), and the Centers for
Disease Control and Prevention (CDC).
ABHW distributed a newsletter article about the
campaign to our members in order to help educate the
consumers they serve, the providers in their networks
and their own staff. In addition, ABHW is providing
awareness about the campaign to a ABHW member’s
biometric screening notification process. Biometric
screenings are short health exams that can identify any
sign of cardiovascular problem or certain other medical
conditions.
Heart disease is the leading cause of death in the
U.S. for adults of all races. Following a heart attack,
approximately one in four women and one in five men
will die within the first year. It is especially important
for ABHW and other organizations interested in
behavioral health to support this initiative because
people with heart disease are more likely to suffer from
depression than otherwise healthy people.
The burden from heart disease and stroke
significantly impacts the behavioral health community.
Persons with serious mental illness (SMI) die younger,
on average 25 years earlier, than the general
population. The increased morbidity and mortality are
caused by risk factors such as smoking, obesity,
substance abuse, and inadequate access to medical
care. Data has also shown that psychological distress,
which includes anxiety, depression, sleeping problems
and loss of confidence, is associated with a higher risk
of death from stroke. People who suffer from
psychological distress have a 66 percent greater risk of
death from cerebrovascular disease and a 59 percent
greater risk of death from ischemic heart disease
compared with people with no symptoms of mental
distress.
Over the past few years, evidence has mounted
that depression should be added to the list of risk
factors for cardiovascular disease. According to
SAMHSA, in 2009, 45.1 million adults (19.9 percent) in
the U.S. had a mental illness. Adults with SMI are more
likely than adults without SMI to have high blood
pressure and experience strokes. In a SAMHSA national
survey in 2008 and 2009, 21.9 percent of adults who
experienced any mental illness in the past year had
hypertension, compared to 18.3 percent of adults
without any mental illness who had hypertension in
the past year. That same survey found that adults with
any mental illness had a 5.9 percent chance of heart
disease and 2.3 percent chance of stroke, compared to
adults without mental illness who had a 4.2 percent
chance of heart disease and only a 0.9 percent chance
of stroke. Additionally, up to 83 percent of people with
SMI are overweight or obese, another risk factor to
heart attacks and stroke.
The data clearly indicate why it is essential for the
behavioral health community to pay attention to the
risk factors associated with heart attacks and strokes.
One way behavioral health providers can do this is to
recognize the importance of the “ABCS” — Aspirin for
people at risk, Blood pressure control, Cholesterol
management, and Smoking cessation— in their
patients. They can also encourage physicians or other
health care providers to promote a team-based
approach to health care services in order to improve
the quality of care in patients. Providers can help
improve a person’s health and possibly decrease their
visits to the doctor by encouraging, where appropriate,
participation in smoking cessation programs and
nutrition efforts aimed to reduce sodium and eliminate
trans-fats in the diet.
By signing the Million Hearts pledge, ABHW is
helping to raise awareness about the close connection
between mental illness and heart disease and work to
help prevent heart attacks and strokes. We hope that
other organizations will also sign the pledge and be
part of the campaign to prevent one million heart
attacks and strokes over the next five years. ABHW
continues to look for more ways to be involved in the
Million Hearts campaign and new partnership
opportunities.
To learn more about the campaign and sign the
pledge go to: http://millionhearts.hhs.gov/index.html.
Coral Ellis is an intern for the Association for
Behavioral Health and Wellness (ABHW).
FromtheField...
6. Mental Health Weekly August 6, 2012
6
It is illegal under federal copyright law to reproduce this publication or any portion of it without the publisher’s permission. Mental Health Weekly DOI: 10.1002/mhw
sion states were concentrated among
low-income adults, whereas reduc-
tions in uninsured rates were signifi-
cant for both lower- and higher-
income groups. Reductions in cost-
related delays in care were signifi-
cant for all subgroups.
New Medicaid enrollees
New Medicaid enrollees were
older than the general population
(mean age, 40.6 vs. 40 years), dispro-
portionately male (57 percent vs. 49
percent), nonwhite (27 percent vs. 20
percent) and in fair or poor health
(20 percent vs. 11 percent), the study
stated.
Researchers used a differences-in-
differences quasi-experimental design
that incorporated data before and af-
ter Medicaid expansions in the expan-
sion states and the control states. Re-
searchers tested their quasi-experi-
mental design among adults 65 years
or older whose Medicaid eligibility
was not affected by the expansions.
Among this population, Medic-
aid was associated with a small but
significant reduction in the unin-
sured rate (0.4 percent), a significant
decline in cost-related delays in care
(2.3 percent) and a significant re-
duction in absolute mortality (by
127 deaths per 100,000, for a relative
reduction of 2.6 percent).
Sommers said the overall study
results were pretty straightforward.
“Giving people health insurance im-
proves access to care and, ultimate-
ly, health,” he said. “But on the other
hand, there really has been a lack of
solid evidence on this issue for
adults in Medicaid.”
Observations were not made
specific to Medicaid recipients with
mental health or behavioral health
disorders, Sommers said. “The study
didn’t have that level of detail to de-
scribe findings specific to people
with particular conditions,” he said.
According to the study, rates of
insurance coverage and access to
care increased in expansion states
for both high-income persons and
the elderly even though the Medic-
aid eligibility expansions did not ap-
ply to them directly, researchers
noted. “Some of this may present a
spillover effect from a large expan-
sion of coverage,” said Sommers.
Sommers added, “If these ex-
pansions brought more money into
the health care system, especially for
the safety net providers and public
hospitals, this could have helped im-
prove access even for those who
were not on Medicaid.”
It’s also possible that other
trends were going on in these states
at the same time, unrelated to Med-
icaid, he said. “This is why we
looked to see what happened to
mortality for these groups,” said
Sommers. “While mortality did de-
cline somewhat for elderly adults
and adults in higher-income areas,
the biggest effects were where we’d
expect them for Medicaid — adults
under 65, and for those living in
poor areas.”
Policy implications
One consideration for states de-
termining whether or not they in-
tend to expand Medicaid is cost,
though the federal government is
paying for 100 percent of the costs
of the expansion for the first three
years and 90 percent in the long run,
Sommers said.
“Another key consideration is
what impact the program has on the
people it covers,” he said. “Our study
suggests that expanding Medicaid
enables people to access the care
they need, and their health im-
proves, even to the point of poten-
tially saving lives.”
Sommers added, “While states
have many factors to weigh in decid-
ing whether to expand Medicaid, it
should be clear from our study and
others — including an ongoing ran-
domized trial of an expansion of
Medicaid in Oregon that showed sig-
nificant improvements in self-report-
ed care in the first year — that this is
a program that succeeds in its goal of
helping improve healthcare and
health for poor Americans. We will
be eagerly watching to see what hap-
pens with the Medicaid expansion
under the Affordable Care Act.” •
Continued from page 4
SAMHSA report finds depression rates triple for adolescent girls
Adolescent girls ages 12 to 17 are
three times more likely to have expe-
rienced a major depressive episode
(MDE) in the past year than their
male counterparts (12 percent versus
4.5 percent), according to a new re-
port from the Substance Abuse and
Mental Health Services Administra-
tion (SAMSHA) National Survey on
Drug Use and Health (NSDUH).
The percentage of girls who
experienced MDE in the past year
triples between the ages of 12 and
15 (5.1 percent to 15.2 percent re-
spectively), according to the report.
The report also found that an an-
nual average of 1.4 million adoles-
cent girls ages 12 to 17 experienced
a major depressive episode in the
past year.
According to the report, “Data
Spotlight: Depression Triples be-
tween the Ages of 12 and 15 among
Adolescent Girls,” older adolescent
girls experiencing major depressive
episodes were more likely to receive
treatment than younger ones —
about two-fifths ages 15 to 17 re-
ceived treatment as opposed to only
one-third of the girls ages 12 to 14
(see graph on page 7).
The onset of puberty is associ-
ated with an increase in depression
among adolescents, particularly
among adolescent girls, according to
SAMHSA. “It is crucial that we pro-
vide adolescent girls the coping
skills and social supports they need
to avoid the onset of depression, and
to offer behavioral health services
that foster resiliency and recovery if
they experience it,” said Pamela S.
7. August 6, 2012 Mental Health Weekly
7
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Continues on next page
Hyde, SAMHSA administrator.
Given the young age at which
MDE begins to increase among girls,
prevention and intervention efforts
targeting adolescents in middle school
may help ameliorate depression on-
set, as well as reduce depression re-
currence through the life course, ac-
cording to SAMHSA officials. •
For a copy of the new SAMHSA
report visit http://1.usa.gov/N2ChFU.
For more information about ad-
dressing the mental health needs of
adolescent girls and women, please
visit http://bit.ly/vQe98a.
performance — families can con-
nect with that piece,” Winston said.
“We’re not just saying to them,
‘Something is wrong with your kid.’”
Partners in initiative
The organizations working to-
gether to bring this middle school
initiative to fruition are the Seattle
Public Schools, Sound Mental
Health, Seattle Children’s Hospital/
University of Washington and the
Nesholm Family Foundation. Sound
Mental Health program manager
Terry Richardson told MHW that the
mental health organization has ex-
perience with providing services in
schools since the 1990s, when it
held a contract with the school dis-
trict for about five years and then
formed individual relationships with
schools after the contract expired.
This latest project targeting mid-
dle schools grew out of the Nesholm
Family Foundation’s work on a lit-
eracy program called “Kids in the
Middle,” in which the sponsors were
identifying numerous barriers to
learning for some students. This
eventually would lead to the part-
nership that would give the mental
health organization a direct pres-
ence in middle schools in some of
Seattle’s most disadvantaged com-
munities. The support project was
launched in the fall of 2006.
Sound Mental Health’s lead care
coordinator, David Lewis, told MHW
that a young person’s move from be-
ing in the oldest age group in elemen-
tary school to being in the youngest at
middle school can amount to a diffi-
cult transition, as the child now deals
with a team of teachers instead of one
classroom teacher, adjustments in re-
lationships with peers and higher
stakes academically.
The structure of a middle school
environment is not always condu-
cive to easy solutions for students
who are struggling. “When one
teacher builds the relationship [in el-
ementary school], the teacher can
structure the classroom to let the
student be successful,” Lewis said.
It is at this stage that previously
undiagnosed issues such as anxiety,
post-traumatic stress or symptoms of
depression also might surface, often
manifesting in behaviors that for
some could involve angry outbursts
and for others could appear as with-
drawal and isolation.
Lewis, a master’s-level licensed
clinician, says the students at his
school see him as a counselor, fully
a part of the school community. His
work at the school involves meeting
with and assessing students referred
by school personnel, as well as re-
sponding to emerging crises that
could identify a student in need of
assistance.
Lewis said he also is conducting
weekly motivational group sessions
with 10 to 12 struggling young males
in grades 7 and 8. The groups offer
a safe environment for the students
to discuss goals and the barriers
they might be facing, such as an un-
stable home or comments from oth-
ers that they should not strive to be
successful.
In all communications with young
people and their family members,
program workers seek to emphasize
the youths’ strengths, and to highlight
successes even when small. “Family
involvement has grown to be very
good,” Lewis said. “The parents are
pretty open to doing what it takes.”
School from page 1
32.4
12
32.9
13
33.6
14
40.7
15
41.7
16
42.0
17
50
40
30
20
10
0
Age
Percent
Treatment for depression in the past year among
girls ages 12-17 with past year major depressive
episode: 2008 to 2010
Source: SAMHSA’s National Survey on Drug Use and Health (NSDUH), 2008 to 2010.
If you need additional copies of
Mental Health Weekly for associates,
please contact Customer Service at
888-378-2537 or jbsubs@wiley.com
for special rates.
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Coming up…
The Mental Health Association in Tulsa and Mental Health America will present
the 2012 National Zarrow Mental Health Symposium & MHA Annual Conference,
“From Housing to Recovery: Building Community, Building Lives,” September 19-21
in Tulsa, Okla. Visit www.fromhousingtorecovery.org for more information.
The Center for School Mental Health and the IDEA Partnership are hosting the
17th Annual Conference on Advancing School Mental Health October 25-27 in Salt
Lake City, Utah. The theme is “School Mental Health: Promoting Positive Outcomes
for Students, Families, Schools, and Communities.” For more information visit
http://csmh.umaryland.edu/Conferences/AnnualConference/index.html.
The U.S. Psychiatric and Mental Health Congress will hold its 25th Annual
Conference and Exhibition November 8-11 in San Diego, Calif. For more
information, visit www.psychcongress.com.
State News
Florida resumes assertive
community treatment program
An intensive treatment program
for people who have been hospital-
ized for mental health problems is
returning to Panama City, four years
after it closed due to lack of funding.
Life Management Center of North-
west Florida told the News Herald
last week that it’s receiving $680,000
in funding from the state legislature
to resume its Florida Assertive Com-
munity Treatment Team (FACT),
Congratulations Mental Health Weekly!
Mental Health Weekly has received the 2012 ASBPE (American Society
of Business Press Editors) Azbee Award of Excellence. MHW’s online pub-
lication, mentalhealthweeklynews.com was also recognized by industry
peers with an APEX 2012 Award of Excellence in the websites category.
Continued from previous page
In case you haven’t heard…
Following NFL player Junior Seau’s suicide and numerous subsequent lawsuits
over brain injuries, the NFL on July 26 announced its launch of a comprehensive
wellness program for current and retired players, including a confidential mental
health phone line, the Associated Press reported last month. An outside agency
will run NFL Life Line, a free consultation service to inform players and family
members about the signs of crisis, symptoms of common mental health problems,
and where to get help. The announcement came as many training camps are
getting under way. More than 2,400 NFL veterans suing the league claim the NFL
did not do enough to shield them from the long-term effects of repeated hits to
the head.
which provides intensive, communi-
ty-based treatment, rehabilitation
and support services for adults with
severe and persistent mental illness.
The program was in use from 2004-
2008 but ended due to budget cuts.
Tricia Pearce, community relations
for the center, said the program
would also benefit the local econo-
my. Hiring will happen in November
and December and the program will
begin in January.
It is important in these communi-
cations with families to link unre-
solved behavioral health problems
with school achievement. “You have
to have clinicians who understand
how mental health issues can impair
academic performance,” Winston said.
Lewis said that each Sound Men-
tal Health care coordinator will typi-
cally refer about 100 students a year
for services in the community. In ad-
dition, each school maintains a “case-
load” of about 30 high-need students
who require ongoing support be-
cause they are experiencing multiple
barriers to achieving their potential.
Producing results
Sound Mental Health officials
believe their efforts are having an
impact on youths’ academic perfor-
mance at the participating schools.
Over the past two years, they said,
the three schools’ overall improve-
ment in reading and math achieve-
ment has outpaced the average im-
provement rate district-wide.
The principal at one of the par-
ticipating schools, Aki Kurose Middle
School, told MHW that close com-
munication between the school’s as-
signed care coordinator and school
administration has proven critical to
the effort’s success. Principal Mia
Williams said the program maintains a
focus on the impact of students’ chal-
lenges on what she calls the “ABCs”:
attendance, behavior and coursework.
“When a child gets to middle
school, he might not have received
any services for 11 years,” Williams
said. “This might be the first place
where they’ve seen wraparound
services.”
Other students might have re-
ceived community services in the
past, but possibly their families did
not have positive experiences in the
service system, Lewis pointed out.
Williams added that her school
will be establishing a counseling
and student support suite within the
building, and the Sound Mental
Health care coordinator will serve as
an integral part of that operation. •
Visit our website:
www.mentalhealthweeklynews.com
![Mental Health Weekly August 6, 2012
2
It is illegal under federal copyright law to reproduce this publication or any portion of it without the publisher’s permission. Mental Health Weekly DOI: 10.1002/mhw
hospitals, behavioral healthcare
units and divisions within general
healthcare systems, residential treat-
ment centers, youth services organi-
zations, and outpatient services
throughout the country.
According to the NAPHS survey,
trends showing increased demand
for psychiatric care in this survey are
consistent with national trends. A
2010 report by the Health Care Cost
Institute displayed a 5 percent in-
crease in utilization of all psychiatric
services between 2009 and 2010.
Additionally, data from the Agency
for Healthcare Research and Quality
show that between 1996 and 2006
the number of Americans paying for
mental health services increased
87.6 percent and total expenditures
on mental health services increased
63.4 percent.
“One reason we’re seeing an in-
crease in demand is the reduction in
stigma, even though there is still a
long way to go,” Mark Covall,
NAPHS president and CEO, told
MHW. “There are much more ac-
ceptable forms of treatment for
mental illness and addictions treat-
ment than ever before, including
better diagnostic techniques and im-
proved medications.”
“Even though there’s more room
for implementation, parity has been
a game changer,” said Covall. “Parity
79.8
Inpatient
hospital
psychiatric
44.3
Residential
psychiatric
56.8
Partial
psychiatric
47.5
Outpatient
psychiatric
100
80
60
40
20
0
Percent
Percent of respondents offering each level
of psychiatric care, 2010
Source: NAPHS survey of members 2009/2010.
© National Association of Psychiatric Health Systems, 2012.
NAPHS from page 1
is like a civil rights law — it’s really
changed people’s perception of
mental illness and addiction disor-
ders and put it on par with medical
disorders; that’s critical.”
However, many people with se-
rious mental illnesses are still not re-
ceiving treatment, said Covall. The
NAPHS survey pointed out that the
need for treatment is only partially
met by the existing treatment system.
Only 4 in 10 adults (39.2 percent) ex-
periencing any mental illness in the
past year and only about 60.8 per-
cent of those experiencing serious
mental illness received any mental
health services during that period.
The closing of state hospitals
and moving more consumers back
into the community is another rea-
son for an increased demand for ser-
vices, said Covall. “While it’s a good
thing that people are moving back
into the community, it results in
some individuals not getting the
care they need early on,” he said.
“That’s led to increases on the hospi-
tal side as well.”
Patients with a serious mental
illness need a range of services from
acute care to long-term supports,
said Covall. “Our members can pro-
vide only so much,” he said. “CMHCs
[Community Mental Health Centers]
prove to be a valuable part of that
continuum.”
“What is most important for pa-
tients with serious mental illness is
Executive Managing Editor Karienne Stovell
Managing Editor Valerie A. Canady
Contributing Editor Gary Enos
Editorial Assistant Elizabeth Phillips
Production Editor Douglas Devaux
Executive Editor Isabelle Cohen-DeAngelis
Publisher Sue Lewis
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