Published 12:00 am Thursday, May 17, 2007
By Joseph F. Damore
For the Salisbury Post
The scene was a focus group of young adults in western North Carolina, part of a community assessment of local health needs conducted more than a year ago. Of the many issues discussed, the gaps in mental health services drew some of the most passionate comments.
Theres a lot of depression on campus and some people commit suicide, said one of the young participants. People arent open about their problems and need to know theyre not alone.
In the wake of the tragedy at Virginia Tech, these words seem hauntingly prophetic. Its time to examine what we must do at the national level and here in North Carolina to address the fatal flaws in the way we deliver mental health services.
A number of trends have converged to push the problem to the point of crisis. Rising numbers of our citizens lack health insurance. In North Carolina, 20 percent of people between 18 and 64 years are uninsured. Even for those who have insurance, mental health benefits are typically inadequate. Meanwhile, efforts to reform mental health care in North Carolina and elsewhere have foundered. The laudable goal of deinstitutionalization has sadly led to reduced access, as funding for community-based mental health services has not kept pace with the needs.
The result: too many people suffering from mental health problems are not getting help. The good news is that treatment works. Mental illness need not be an unsolvable medical riddle or a lost cause. A recent U.S. Surgeon General analysis reaffirmed the efficacy of mental health treatment. One example: with proper diagnosis, treatment and monitoring, 80 percent of people suffering from depression will make a full recovery.
The solutions, then, lie in the direction of increasing access to the treatments we know can help these patients. Two paths hold particular promise.
The first is to integrate mental health services in primary and specialty medical care settings. Mission Childrens Hospital in Asheville has adopted an integrated care model in which two mental health therapists are available to provide counseling to children undergoing chemotherapy and other treatment modalities for physical disease. By weaving counseling as another form of help in a continuum of care, we not only make services more accessible but also avoid the stigma that unfortunately remains attached to the phrase mental health services.
The second path to increasing access is to convince health insurers, employers and policymakers that quality mental health services are a smart investment. We must begin to recognize the true cost of our broken mental health system. That cost is measured not only in the tragedy that occurred at Virginia Tech, but also in a host of societal ills from homelessness to increased law enforcement challenges. For employers, untreated mental illness is a significant drain on productivity. For society as a whole, failure to address mental health problems in todays children, adolescents and young adults tomorrows leaders promises a heavy cost indeed. When patients receive quality mental health care, evidence shows there is a corresponding decline in hospitalizations, length of hospital stays and emergency room visits leading to lower costs.
We can help people suffering from mental illness return to being productive and vital community members. We can reduce the heavy cost burden our society is now carrying, but these things will happen only if we give this issue the attention it clearly deserves. The time to lead is now.
Joseph F. Damore is president and CEO of Mission Health and Hospitals in Asheville.