NAPHS - News Releases

We are pleased to respond to the challenge laid out by Surgeon General David Satcher, M.D., in his landmark report on mental health. Mind and body are inseparable, and we present this fact sheet to help healthcare providers, policymakers, and community leaders work to build bridges between behavioral and general health care.

Ø Mental illness, addiction, family stress, and violence are among top concerns community members frequently identify as issues in their daily lives [in community needs assessments].

Ø Of the 10 leading causes of disability worldwide, measured in years lived with a disability, five were psychiatric or addictive conditions: unipolar depression, alcohol use, bipolar affective disorder or manic depression, schizophrenia, and obsessive-compulsive disorder. Mental disorders collectively account for more than 15% of the overall burden of disease from all causes and slightly more than the burden associated with all forms of cancer. (Global Burden of Disease study conducted by the World Health Organization, World Bank, and Harvard University. Murray & Lopez, 1996. Reported in Mental Health: A Report of the Surgeon General. 1999.)

* Disability-adjusted life year (DALY) is a measure that expresses years of life lost to premature death and years lived with a disability of specified severity and duration.

Ø Major depression alone ranked second only to ischemic heart disease in magnitude of disease burden. (Global Burden of Disease study. Reported in Mental Health: A Report of the Surgeon General. 1999.)

Behavioral disorders affect millions of Americans of all ages and all backgrounds.

o All types of mental disorders—from severe to relatively mild—affect a full 22% of the adult population in any given year. For comparison, physical disorders affect comparably large numbers of adults. For example, 50% of adults have respiratory disorders and 20% have cardiovascular diseases. (National Advisory Mental Health Council on the Cost and Treatment of Severe Mental Illness, 1993.)

o Severe mental disorders – that is, schizophrenia, manic depressive illness and severe forms of depression, panic disorder, and obsessive compulsive disorder—affect 2.8% of the adult population, or approximately five million people. (Regier, et al., 1993.)

o Between 9% and 13% of children aged 9 to 17 years of age experience serious emotional disturbances. From 5% to 9% of this age group experience “extreme functional impairment.” (Center for Mental Health Services. Mental Health, United States, 1998. 1999.)

o An estimated 5.6 million adults (or 3.03% of those 18 and older) meet the standard diagnostic criteria for alcohol abuse in a given year. Another 8.1 million adults (or 4.38% of those 18 and older) suffer from alcohol dependence. (National Institute on Alcohol Abuse and Alcoholism)

Ø An estimated 6.1% of all adults will experience a drug problem during the course of their lifetime. (National Institute on Drug Abuse)

Ø Employers are looking for ways to reduce the operational and financial impact of absenteeism, accidents, low morale, and other problems associated with mental and addictive disorders in the workplace. Depression and high stress have the greatest impact on worker healthcare costs, according to a study of more than 46,000 employees from six nationwide organizations who were tracked for up to three years. (Goetzel et al., “The Relationship Between Modifiable Health Risks and Health Care Expenditures: An Analysis of the Multi-Employer HERO Health Risk and Cost Database,” Journal of Occupational and Environmental Medicine, October 1998, Vol 40:10: pp.843-854)

Ø Major depressive disorder, among the most common of all clinical problems in primary care, can be treated successfully by antidepressant medications or psychotherapy in 65% of cases. The rate of treatment response increases to more than 80% when alternative or adjunctive medications are used or psychotherapy is combined with medications in accordance with science-based practice guidelines. (Coalition for Fairness in Mental Illness Coverage Fact Sheet)

Ø Panic disorder is a major source of visits to hospital emergency rooms or to the physician's office. Positive response rates of 70% - 90% are reported for treatment of this disabling disorder with antidepressant medications. (Coalition for Fairness in Mental Illness Coverage Fact Sheet)

Ø Identification and treatment of depression among patients with a history of high medical expenditures improved depression and increased work productivity and quality of life. Service use decreased with treatment. (Katzelnick et al., “Effect of Primary Care Treatment of Depression on Service Use by Patients With High Medical Expenditures,” Psychiatric Services, Vol. 48, No. 1, January 1997.)

Ø Health-services research has demonstrated that comprehensive community-based mental health services for children and adolescents can cut public hospital admissions and lengths of stay and reduce average days of detention by approximately 40%. (Coalition for Fairness in Mental Illness Coverage Fact Sheet)

Ø A 10-year study of more than 600 patients found those treated for their depression reduced their use of medical services over the long term. (Kimerling et al., Annals of Behavioral Medicine. 2000.)

Ø Studies have shown that panic disorder patients can visit the ER nine times before they are referred for appropriate treatment for their problem. (“Behavioral Healthcare Risk-Sharing and Medical Cost Offset,” Medical Offset, Fall 1996.)

Ø Appropriately delivered treatment is tremendously cost-effective, with each $1 invested in treatment returning $4 to $7 in savings on crime and criminal justice costs alone. (National Institute on Drug Abuse. Principles of Drug Addiction Treatment: A Research-Based Guide. 1999.)

Ø Antidepressant treatment reduces overall healthcare costs not only for persons with depression alone, but also for persons with depression and comorbid medical illnesses such as cancer and heart disease. Researchers used claims data for 1,661 patients from a large health insurer to compare healthcare costs one year before and one year after initiation of antidepressant treatment. Those remaining on antidepressants for at least six months were 74% more likely to experience a large reduction in medical care costs, and patients with depression and heart disease who were taking antidepressants were 72% more likely to have a large reduction in medical care costs. (Thompson et al., “Predictors of a Medical-Offset Effect Among Patients Receiving Antidepressant Therapy,” American Journal of Psychiatry, 155:6, June 1998.)

Ø Collaborative mental health and primary care programs have shown success in encouraging patient compliance with treatment. A Group Health study showed significantly more patients treated in the collaborative setting than those treated in a traditional model adhered to their prescription for anti-depressant medication, rated the quality of care they received for depression as good to excellent, and had a significantly greater decrease in depression severity over time. (“A Multifaceted Intervention to Improve Treatment of Depression in Primary Care,” Archives of General Psychiatry, October 1996.)

Ø Patients maintained on a regimen of lithium for bipolar (manic depressive) illness are 28 times less likely to relapse than those not taking the medication. Lithium alone has been estimated to have saved the U.S. economy more than $145 billion since 1970. This is more than 200 times the entire current research budget for the National Institute of Mental Health. (Coalition for Fairness in Mental Illness Coverage Fact Sheet)

Ø Providing support to patients with chronic illnesses (such as heart disease or diabetes) helps improve satisfaction with overall care.

Ø New and emerging technologies are making it increasingly possible for researchers to demonstrate the extent to which mental disorders and their treatment – both with medication and with psychotherapy – are reflected in physical changes in the brain. (U.S. Surgeon General David Satcher, M.D., Ph.D. Mental Health: A Report of the Surgeon General. 1999.)

Ø “More than half of the patients admitted to general hospitals with serious psychiatric illnesses have concurrent medical problems, said Stuart L. Keill, M.D., professor of psychiatry at the University of Maryland School of Medicine, Baltimore. (Modern Healthcare, April 23, 1990, p. 28.)

Ø The prevalence of clinically significant depression in later life is estimated to be highest – approximately 25% -- among those with chronic illness, especially with ischemic heart disease, stroke, cancer, chronic lung disease, arthritis, Alzheimer’s disease, and Parkinson’s disease. (Reported in Mental Health: A Report of the Surgeon General. 1999. From reports by Borson et al., 1986; Blazer, 1989; Oxman et al, 1990; Callahan et al, 1994; Beekman et al., 1995; Borson, 1995.)

Ø In the United States today, the highest rate of suicide – an all-too-common consequence of unrecognized or inappropriately treated depression – is found in older males. This fact underscores the urgency of ensuring that healthcare provider training properly emphasizes skills required to differentiate accurately the causes of cognitive, emotional, and behavioral symptoms that may, in some instances, rise to the level of mental disorders, and in other instances be expressions of unmet general medical needs. (Mental Health: A Report of the Surgeon General. 1999.)

Ø The journey ahead must firmly establish mental health as a cornerstone of health; place mental illness treatment in the mainstream of health care services; and ensure consumers of mental health services access to respectful, evidenced-based, and reimbursable care. (U.S. Surgeon General David Satcher, M.D., Ph.D., Mental Health: A Report of the Surgeon General. 1999.)

National Association of Psychiatric Health Systems
701 13th Street, N.W., Suite 950, Washington, DC 20005-3903
Phone: 202/393-6700
Fax: 202/783-6041
Web: www.naphs.org
E-mail: naphs@naphs.org

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Marketing | Joining NAPHS | Talk to Us | Members Only | News | Home