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Mental Health and Hospital Care

Written by

G.J. Gregory

G.J. Gregory

Mon, June 04, 2007

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According to a new study released by the Agency for Healthcare Research And Quality, in 2004, adults with a mental health and/or substance abuse diagnosis accounted for 1 out of 4 stays at U.S. community hospitals, or 7.6 million hospital stays.

The study examined community hospital (not including specialty psychiatric or substance abuse treatment facilities) care for adults 18 years of age and older with MHSA (mental health and substance abuse) diagnoses.  

Interesting facts/figures:

"The top 5 MHSA diagnoses seen in the hospitals were mood disorders (including bipolar disorder), substance-related disorders, delirium/dementia, anxiety disorders, and schizophrenia.  The most common principal MHSA diagnosis—mood disorders—had the highest aggregate in-patient hospital costs of all MHSA diagnoses at $3.4 billion nationally in 2004.

A large proportion of stays for the uninsured and for patients covered by Medicaid and Medicare were related to MHSA disorders. About 33 percent of all uninsured stays, 29 percent of Medicaid stays, and 26 percent of Medicare stays were related to MHSA disorders. On the other hand, only 16 percent of privately insured stays were related to MHSA disorders. 

Over 66 percent of adult hospital stays with MHSA diagnoses were billed to the government in 2004. Medicaid was billed for 18 percent of all MHSA-related stays and Medicare was billed for 49 percent of all MHSA stays. In comparison, 57 percent of hospital stays with non-MHSA diagnoses were billed to the government.  Only about 23 percent of stays with MHSA diagnoses were billed to private health insurance compared with about 37 percent of stays with non-MHSA diagnoses."

This information literally blows me away.  I knew the prevalence of  mood disorders was high, but I had no idea MHSA made up 25% of all hospital stays.  And the cost to taxpayers?  66 percent of  those stays were billed to the government.  Not surprising is the number of uninsured MHSA patients.  Adults with MHSA diagnoses were 36 percent more likely to be uninsured than those without MHSA diagnoses.  I know first-hand how devastating medical care costs can be when the family doesn’t have insurance.  I’ve walked many miles in those shoes.  

This is not a political statement by any means, but we really need to figure something out with respect to our mental health care.  I don’t claim to know that that answer is, but I do know a problem when I see one.  Think how much these figures could improve with preventative care.  Early screening.  Affordable medication.  Available therapy and counseling.  And a public that recognizes these benefits and is understanding of those who seek the benefits.

6/ 4/07 5:00pm

Teach/train those with mood disorder the life skills necessary to cope. It is called MBSR+ It is really the skills to handle their emotions ...Buddhism in its secular guise. The + are the hygiene factors - exercise, good diet, plenty of water etc.


MBSR (Mindfulness Based Stress Reduction) takes 8 weeks of 2hours + one full day - a worldwide standardised course. However, it takes a lot of committment - 45 minutes 6 days a week for meditation - quietening of the mind. Hard work but rewarding when you are able to cope with the stresses thrown at you.


 

6/ 5/07 12:11pm
Is there a specific web site where I can find out who can provide this training? I have done some (informal) mindfulness training with my psychologist, and meditation training, and found both to be quite helpful. A great book on the subject is called "Peace Is Every Step - The Path of Mindfulness in Everyday Life" by Thich Nhat Hanh.
6/ 5/07 1:53pm

The book on the course is "Full Catastrophe Living" by Jon Kabat-Zinn.


http://www.umassmed.edu/cfm/mbsr/

6/ 5/07 4:04pm

No practioner in my area, but thanks anyways. I've heard good things about the book in the past & will have to check it out.



6/ 5/07 4:47pm
The book has a companion set of CDs which, in my view, it is worth getting as well. If you use the book, I will be interested in how it works out for you.
6/ 5/07 12:07pm

He is featured on today's Oprah, regarding his new movie, called "Sicko".


http://www2.oprah.com/tows/slide/200706/20070605/slide_20070605_350_101.jhtml

6/ 5/07 5:02pm

- In 1999/2000, 1.5 million hospital days in Canada were due to mental illness & suicidal behavior.


- People with mental illness, as a group, represent the most frequest category of billings by general practitioners.


- In B.C., Canada, mental illness-related hospital stays account for more than twice the number of bed days as cancer does.


- Mental illness represents one of the top categories of "frequent users" of emergency room services.

6/ 7/07 10:50pm
Thanks to all for taking the time to stop by, for the great information left, and for your insightful comments.

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