Mental Illness, Substance Use Care Needs Outpacing Services
By Beth Potier, Media Relations
May 21, 2008
A new policy brief from the UNH Institute on Disability indicates that although
demand for hospital services among people with mental illness or substance
use conditions is rising, services to treat and pay for such care may not be
keeping pace.
“National research tells us that over the course of their lives, nearly
half of all New Hampshire residents are likely to require some kind of treatment
for mental illness or substance use,” said report author Peter Antal,
research associate at the Institute on Disability (IOD). “Based on our
research and other New Hampshire-based research, it does not appear that the
system of care is prepared to effectively meet this rising demand, let alone
provide a continuum of care. We need to address this gap now rather than ten
years from now.”
For the brief, “The Changing Dynamics of Hospital Care for Mental Illness & Substance
Use in New Hampshire – Implications for Supporting Continuums of Care,” researchers
reviewed 1997-2006 New Hampshire ambulatory, inpatient, and specialty hospital
records involving patients presenting either mental illness or substance use
conditions. The policy brief suggests a range of action steps needed to ensure
that the state can meet the growing demand for mental health and substance
use services.
Among the report’s key findings:
- Demand for emergency department and ambulatory care among people
with mental illness or substance abuse conditions is rising, particularly among
younger residents. Between 1997 and 2006, mental illness hospitalizations increased
55 percent among 15 – 29 year-olds.
- Private insurance is less likely to pay for the care of people with
mental illness or substance use conditions. For patients who are repeatedly
hospitalized, private insurance is no longer the majority payor source.
- There are no inpatient (acute care) medical facilities with dedicated
resources for the integrated treatment of mental illness or substance use conditions
in key areas of New Hampshire. Many towns in the North Country as well as in
central and eastern New Hampshire rank in the top 20 percent of towns with
the highest rates of hospitalization for mental illness or substance use but
have no acute care medical facilities to provide resources dedicated to these
issues.
- Among patients who are frequently hospitalized (at least 10 times
over 10 years) with a primary condition of mental illness, 75 percent had a
co-occurring diagnosis of substance use in a quarter of their visits, accounting
for a disproportionate share of charges.
- Individuals with mental illness or substance use conditions experience
a wide variety of additional physical conditions that impact their overall
health and should impact their treatment plans.
- Although the hospital system of care for patients with mental illness
or substance use conditions demonstrates an increased ability to identify underlying
conditions of mental illness or substance use, patients with primary diagnoses
of these conditions were five to nine times more likely to be discharged from
inpatient care against the medical advice of the attending physician than all
patients.
The brief makes a range of recommendations, including continued assessment
of the state’s mental health system, improved treatment solutions for
patients who have both mental illness and substance use conditions, improved
availability of community resources in some rural regions of the state that
experience higher need and limited facilities, and ongoing education in best
practices for health care providers to ensure integrated care.
“If we don’t do something now and renew our focus on prevention
or long-term support-based strategies, things are going to get far worse and
New Hampshire taxpayers – families, employers, and the community at large
-- are going to shoulder an increased burden while the residents who need effective
care get bounced from one system to another,” said Antal.
The report is the second in the Access New Hampshire series, which is a collaborative
led by the Institute on Disability/UCED, a University Center for Excellence
on Disability.
The Institute on Disability was established in 1987 to provide a coherent
university-based focus for the improvement of knowledge, policies, and practices
related to the lives of persons with disabilities and their families. Its mission
is to advance policies and systems changes, promising practices, education,
and research that strengthen communities to ensure full access, equal opportunities,
and participation for all persons. For more information, go to www.iod.unh.edu.
Home |
Archive |
Subscribe/Unsubscribe
Contact
