• E-mail
• Print
• Comment
• Font Size
• Digg
• del.icio.us
• Discuss article

U.S. Substance Abuse, Mental Health Treatment Lacking

Posted on: Tuesday, 21 February 2006, 15:01 CST

By Anonymous

IMPROVING the quality of health care for people with mental disorders and alcohol or drug problems is key to improving the nation's overall health system, according to a recent Institute of Medicine report.

Released in November, the report said the country needs a broad strategy to improve the quality of care and treatment for mental health and alcohol and drug problems.

"America will not have a high quality health system if equal attention is not given to mental health issues and substance use problems," said Mary Jane England, MD, president of Regis College in Weston, Mass., and chair of the report's authoring committee. "Mental health is inextricably linked with health and well-being, but treatment for mental conditions and inappropriate use of substances is often separated from other health care."

The report pointed out that health services for mental health and substance abuse concerns have been isolated not only from other components in the health system, but also from each other - even though many people have both mental illnesses as well as problems with alcohol, drugs or both.

In order to improve collaboration and better coordinate mental health and substance abuse services, the report said, service providers should link relevant areas of their own organizations and form ties with other providers. Also, government agencies, purchasers, health plans and accrediting groups should create incentives to encourage collaboration among all health providers.

Charles Curie, MA, ACSW, administrator of the Substance Abuse and Mental Health Services Administration, said in a statement that the report will be a key tool for his agency to address the needs of people with mental and substance use disorders.

"The IoM has affirmed once again that treatment is effective for mental and substance use disorders when it is evidence-based," Curie wrote. "We intend to work closely with other entities within the Department of Health and Human Services and other agencies and organizations to expand capacity for treatment that is science- based, responsive to the individual needs of consumers and culturally relevant."

Each year, more than 33 million Americans use health care services for mental health problems and illnesses or substance abuse, according to the report. Treatment can be highly effective, yet problems with quality of care hinder both the effectiveness of treatment and the likelihood of recovery. The report cited many studies that have documented a discrepancy between mental health and substance abuse treatment that is known to be effective and the care that is actually delivered. A review of studies published from 1992- 2000 assessing the quality of care for many different mental and substance abuse problems including alcohol and bipolar disorder found that only 27 percent of the studies reported adequate adherence rates to established clinical practice guidelines.

Problems with poor quality care can have serious consequences for people seeking treatment. The report cited one review of the charts of 31 randomly selected patients in a state psychiatric hospital. The review found 2,194 medication errors during the patients' collective 1,448 inpatient days. Of the errors, 58 percent had the potential to cause severe harm. Another study cited in the report concluded the use of seclusion and restraints in inpatient mental health facilities is linked to 150 deaths in the United States each year.

In addition to the harrowing personal consequences of inadequate care for mental health and substance abuse problems, such a shortfall directly affects the work place, the education, welfare and justice systems and the U.S. economy. Unipolar major depression and drug and alcohol use and dependence are the leading causes of death of American women and the second-highest for men behind heart disease, according to the report. Mental health problems that often accompany other health ills have a devastating impact. For example, about one-fifth of patients hospitalized for heart attacks suffer from major depression, and post-heart attack depression triples a person's risk of dying from a future heart attack or other heart condition.

The report included many recommendations for improving care for mental health problems and substance abuse, including the need for federal, state and local involvement in the issue. And the authors pointed to quality recommendations from a 2001 IoM study that outlined ways to improve the nation's health system through efforts such as shared knowledge and the free flow of information and cooperation among clinicians.

For more information on "Improving the Quality of Health Care for Mental and Substance-Use Conditions" or a copy of the report, visit .

Copyright American Public Health Association Jan/Feb 2006

Source: Nation's Health, The

More News in this Category