CHAPTER 11
family, educational and vocational settings.23 The
most prevalent treatment for mental health problems
among adults in 2004 was prescription medication,
which was taken by nearly 11 percent of
Americans.24
Treatment-resistant patients are the focus of a major
federal research effort known as the Sequenced
Treatment Alternatives to Relieve Depression trial,
or STAR*D. The trial is focusing on patients who did
not experience remission of symptoms with their
initial treatments. One in four patients who
participated in the trial became symptom-free after
switching to a different antidepressant.25 These
findings and the results of other studies have the
potential to improve treatment for people seeking
services through a range of settings, including
hospitals, through their physicians, and in clinics.
But the care that many adults are currently receiving
through state public mental health care systems
remains poor. In 2005, the National Alliance on
Mental Illness (NAMI), an advocacy group,
conducted a comprehensive survey that gave states
an overall grade of D+ for care. Only five states
received a B: Connecticut, Maine, Ohio, South
Carolina, and Wisconsin. Eight states received an
F.26 (For more information, see www.nami.org/
gtstemplate.cfm?section=grading_the_states&lstid=
679.)
In the area of substance abuse, recent research shows
that providing effective outpatient services can
decrease the need for other health care services, and
reduce health care costs. For example, a 2005 study
of Medicaid beneficiaries conducted by Kaiser
Permanente found that providing outpatient
addiction treatment reduced overall medical costs –
for services such as emergency room visits and
hospital stays – by 30 percent over three years.27
Such findings, however, may not yet be widely
recognized by all policymakers overseeing publicly
financed programs. Between FY 2004 and FY 2006,
the addiction prevention and treatment budget of the
Substance Abuse and Mental Health Services
Administration (SAMSHA) for was reduced by
about 2 percent, from $2.40 billion to $2.35 billion.
This includes a $20 million reduction in the
Substance Abuse Prevention and Treatment Block
Grant, a principal source of federal funding for more
than 10,500 community-based organizations. Further
www.allhealth.org
COVERING HEALTH ISSUES, 2006
Major Categories of Mental Illness
Anxiety disorders
These disorders - Generalized Anxiety Disorder,
Obsessive-Compulsive Disorder, Panic Disorder,
Post-Traumatic Stress Disorder (PTSD) and Social
Phobia - cause overwhelming anxiety and fear. They
are chronic, and can grow progressively worse if
not treated.
Depression and Bipolar Disorder
These mood disorders' symptoms may include
mood swings such as extreme sadness or elation,
sleep and eating disturbances and changes in
activity and energy levels. People with bipolar
disorder, also known as manic-depressive illness,
have mood swings, going from severe highs
(mania) to lows (depression).
Schizophrenia
Schizophrenia affects how a person thinks, feels
and acts. Someone with schizophrenia may have
difficulty distinguishing between what is real and
what is imaginary; may be unresponsive or
withdrawn; and may have difficulty expressing
normal emotions in social situations.
Dementias
These disorders includes diseases like Alzheimer's
which leads to loss of mental functions, including
memory loss and ability to carry out daily
activities.
Eating Disorders
People with anorexia nervosa and bulimia nervosa,
the two main types of eating disorders, have a
preoccupation with food and an irrational fear of
being fat. Women are much more likely than men
to develop an eating disorder, which can include
self-starvation (anorexia) or cycles of bingeing and
purging (bulimia).
11
Sources:
National Mental Health Association:
(www.nmha.org/infoctr/factsheets/index.cfm)
National Institute of Mental Health:
(www.nimh.nih.gov/healthinformation/index.cfm)
reductions are proposed in the Bush administration’s
FY 2007 budget, along with larger cuts in funding
for addiction prevention and treatment services
offered by the Departments of Justice and
Education.28
For all individuals with mental illness and substance
abuse disorders, the success of long-term recovery
depends on effective treatment regimens – which in
turn are based on plans of care that are tailored to the
needs of both individuals and their family members.
Alliance for Health Reform
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