This is a blog for the Mental Health Policy Class at the George Warren Brown School of Social Work.

December 17, 2007

Nation's Hospital Bill

A handful of high-cost and high-volume conditions helped drive the national hospital bill up 7% in 2005, to $873 billion, a record high and nearly double 1997 spending adjusted for inflation, a federal agency reported. The report, from the federal Agency for Health Care Research and Quality, analyzed figures from the most recent year available and found in part that triple-digit percentage growth in the amount charged for blood infections, nonspecific chest pain, respiratory failure, back pain and arthritis over the past decade contributed to the increase.
The 20 costliest conditions accounted for 52% of hospital charges, and the five costliest accounted for a fifth of all charges. Medicare and Medicaid, the government health plans for the elderly, disabled and poor, accounted for nearly two-thirds of total charges. The five costliest categories were coronary-artery disease, pregnancy and delivery, newborn-infant care, heart attack and congestive heart failure, followed by pneumonia and arthritis.

December 14, 2007

Point Counterpoint Essays on HR 2640 (Gun Control Law)

About 3%-5% of all violence in the United States is perpetrated by individuals with mental illness. But the risk of violence is much higher with “rampage killers,” those who go into schools, malls, and other public places and shoot. About 50% have a history of mental illness and 8% have been committed. Legislation recently passed in the House of Representatives is a good idea if even one life is saved. The bill, H.R. 2640 (the National Instant Criminal Background Check System Improvement Amendments Act of 2007), would require the states to update the NICS with the names and other identifying information of people committed to mental institutions so that they could not buy firearms.

BUT

We still have no data to show that this approach would be effective. Guns are widely available from legal and illegal sources in the United States. Federal purchase restrictions only apply to purchases from a dealer. They do not affect those who already own guns, obtain a gun from another person, or buy one at a gun show. If even a single life could be saved by stopping gun purchase by mentally ill patients, why not do it? Because the costs would vastly outweigh a small likelihood of benefit. The financial impact will be enormous. The federal bill offers states $1 billion to participate in a national database. Think of what else we could do with that money to combat gun violence.

December 13, 2007

Health care challenges fire up U.S. students

One measure of the troubled state of U.S. health care is the hordes of idealistic young people lining up to fix it. . . . students are pouring into health policy classes in economics, political science, history, and public health departments. Many plan on making health policy their career.
"I tell some of my friends that are a few years younger then me, if they are interested in politics and what is going on -- take policy courses. Health policy is something that affects us and it's going to affect us in the long run," said Chang, who hopes to attend law school.

World 'must do more' for children

More must be done more quickly to make the world fit for children by 2015, the UN children's agency, UNICEF, has said. In a report it noted considerable strides had been made to meet pledges in education and areas of health care. But it stressed that "much more must be done" in order to meet the 2015 Millennium Development Goals deadline.

Marketing hype or a miracle cure?

A costly drug cocktail touted as the first pharmacological treatment for cocaine and methamphetamine addiction is at the center of a raging national debate.The treatment, called Prometa, is not approved by the Food and Drug Administration as an addiction therapy, nor has it undergone extensive scientific testing. But officials at Los Angeles-based Hythiam Inc., the company that sells the treatment protocol, say it can work miracles for people struggling to break their addiction.

December 11, 2007

Ranking America's Mental Health: An Analysis of Depression Across the States (Missouri Ranks #45)

Depression is a chronic illness that exacts a significant toll on America's health and productivity. It affects more than 21 million American children and adults annually and is the leading cause of disability in the United States for individuals ages 15 to 44.
Lost productive time among U.S. workers due to depression is estimated to be in excess of $31 billion per year. Depression frequently co-occurs with a variety of medical illnesses such as heart disease, cancer, and chronic pain and is associated with poorer health status and prognosis. It is also the principal cause of the 30,000 suicides in the U.S. each year. In 2004, suicide was the 11th leading cause of death in the United States, third among individuals 15-24.
Despite significant gains in the availability of effective depression treatment over the past decade, the level of unmet need for treatment remains high. On average, people living with depression go for nearly a decade before receiving treatment, and less than one-third of people who seek help receive minimally adequate care.
"Ranking the States: An Analysis of Depression Across the States" was researched and written by Mental Health America and Thomson Healthcare. It looks at data from 2002-2006 and was conducted from July to November 2007. The report compares depression levels and suicide rates in all 50 states and the District of Columbia and uses the information to highlight solutions to improve states' mental health status.

December 6, 2007

Doctors don't report colleagues, errors

Nearly half of doctors surveyed say they have failed to report an impaired or incompetent colleague or a serious medical error, and more than one-third say they would order an unneeded MRI scan for an insistent patient - though these actions conflict with what the physicians consider the heart of their professional obligations.

The survey is the first broad attempt to measure the success of a new movement called "medical professionalism." Arguing that government regulation, financial incentives, and public reporting alone will not improve the quality and efficiency of medical care, physicians groups in the past several years have been promoting a new code of professional values, meant to modernize the ancient Hippocratic Oath.

Exercise pill hope for depression?

Yale University experts say that experiments on mice could show why regular exercise can help people suffering from depression. Writing in the journal Nature Medicine, they say it could lead to more effective drugs. Mental Health charities in the UK already back exercise programmes as a way of lifting depression. While the link between exercise and improved mood is well known, the reasons behind it are not fully understood. The latest research focuses on an area of the brain called the hippocampus, which is already established as a target for antidepressant drugs.