Much to Desire

Statistics from the National Institute of Mental Health reveal that 9.6 million adults in this country suffer from a serious mental illness. If you include any mental illness, those numbers climb to 43.7 million, or 18.6% of adults.

That excludes substance abuse, but the National Institute of Drug Abuse has determined that substance abuse in this country costs over $600 billion—that’s a lot of zeroes. NIDA’s statistics also found that in 2013, 20% of eighth-graders consumed alcohol, and 15% used some form of illicit drug in the past year. The future is not looking so good.

To complicate things further, our traditional emergency-care safety net in this country is not equipped to care for those with mental illnesses. If you are in a serious car crash or have a heart attack, call 9-1-1, and our EMS systems can deliver you to the highest quality of healthcare available. If you just feel depressed and unsure what to do, those same systems that are otherwise prepared to save your life leave much to desire.

In fact, the American College of Emergency Physicians placed emergency psychiatric holds at the top of its list of issues facing emergency medicine in the U.S. Recent testimony by an emergency physician in New Jersey revealed that patients often wait in emergency departments for days until inpatient psychiatric beds become available.

Mental health practitioners have worked for years to improve access to both inpatient and outpatient services for those in need, but funding continues to fall short. It would be easier if a CT scan could show a tumor that needs to be removed or some blood test would reveal the area to attack, but mental illnesses continue to elude the best of us.

As we continue to fight the challenges facing mental health, we must focus on the patient first. Integration of services with a focus on patient navigation is the key. There are great examples of integrated healthcare delivery systems that improve care for those who suffer mental illnesses. The traditional emergency department is not the best place go for these patients.

In this issue of Integrated Healthcare Delivery, we focus on models of blending mental and behavioral healthcare with physical and primary care. We have some great articles that highlight the benefits of working together for our patients. Thinking outside the box, with nontraditional partners, can and will improve care for those with mental illnesses.

—Jeff Beeson, DO