Improve Detection and Treatment of Mental Health Conditions

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Brief Description

Introductory Paragraph

A national study shows that one in five americans has a mental health issue and of young adults aged 18-24, indicated that more than 61 percent of respondents who had used opioids not prescribed to them had done so primarily to relieve anxiety and stress.   Early identification, screening, accurate diagnosis and effective treatment of mental health and substance use condition can alleviate suffering for young people and their families dealing with behavioral health challenges. Providing early care can help young people to more quickly recover and benefit from their education, to develop positive relationships, to gain access to employment, and ultimately to lead more meaningful and productive lives.

Early detection and identification screenings have been in place and mandated for physical health issues such as vision and hearing screenings.  Similiary early identification of mental health and substance use issues should occur where and when young people are most likely to present concerns. These screening should occur as they do for early detection of physical conditions in venues such as schools, primary health care providers and other community arenas.  Communities should be given the tools and supports necessary to identify signs of mental health or substance use issues at the earliest possible time. This position is endorsed by the American Academy of Pediatric  (for depression in youth over age 11) and  the United States Preventive Services Task Force.  Early detection and screening will reduce the likelihood and consequences of delaying care.

Whenever warning signs are observed, resources should be available to parents or guardians to access comprehensive mental health and substance use evaluations and services needed to promote recovery.  Access to adequate care can reduce barriers to learning and improve educational, behavioral and health outcomes for our youth. The best services promote collaboration among all of the people available to help, including families, educators, child welfare case workers, health insurers, and community mental health and substance use treatment providers. Barriers should be reduced and incentives created to ensure increase collaboration across systems and funding sources.

Some of the barriers that need to be addressed to improve mental health detection and treatment outcomes also include health disparties or disadvantages of certain populations.  In order to improve early detection and treatment we need to be aware of underlying factors including biolgogical, environmental, social economic and cultural. Disparaties in communites may be a factor in early diagnonis and treatment of mental health conditions and can increase mental illness challenges in individuals, families and communities. 

 

 

Key Information

Mental Health and Drug addiction
Mental health and drug addiction are undeniably linked. According to the National Institute on Drug Abuse “Many individuals who develop substance use disorders (SUD) are also diagnosed with mental disorders, and vice versa. Multiple national population surveys have found that about half of those who experience a mental illness during their lives will also experience a substance use disorder and vice versa.”  Studies have shown that around 1 in 4 individuals that have a serious mental illness also have a substance abuse disorder. Many people attempt to use drugs to self medicate their mental illness or escape their situation. Understanding mental health is essential to any prevention or recovery effort.

The National Allinace of Mental Illness has indicated in conjunction with SAMHSA and CDC-

1 in 5 U.S. adults experience mental illness each year
1 in 20 U.S. adults experience serious mental illness each year
1 in 6 U.S. youth aged 6-17 experience a mental health disorder each year
50% of all lifetime mental illness begins by age 14, and 75% by age 24
Suicide is the 2nd leading cause of death among people aged 10-34 

Youth are Struggling with Mental Health Issues
A nationwide U.S. survey of over 1300 14- to 22-year-olds done in February and March of 2018 shows evidence of a growing mental health crisis affecting young people. The survey, sponsored by Hopelab and Well Being Trust (WBT), finds that many teens and young adults are experiencing moderate to severe symptoms of depression are turning to the internet for help. Common uses of the Internet include researching mental health issues online (90 percent), accessing other people’s health stories through blogs, podcasts, and videos (75 percent), using mobile apps related to well-being (38 percent), and connecting with health providers through digital tools such as texting and video chat (32 percent).

Depression

• Because depression is under-diagnosed and untreated, depression and opioid abuse are strongly concurrent.
• People with depression show abnormalities in the body’s release of its own opioid chemicals
• Depression tends to exacerbate pain—it makes chronic pain last longer and hurts the recovery process after surgery
• Depression nearly doubles the risk that someone already using opioids will continue to use them long-term
• Depression & Opioids
• Depressed people are about twice as likely as non-depressed people to misuse their painkillers for non-pain symptoms
• Depressed individuals were between two and three times more likely to ramp up their own doses of painkillers
• Adolescents with depression are also more likely to use prescription painkillers for non-medical reasons and to become addicted
• Depressed people are likely to keep using opioids, even when their pain has subsided and when they are more functional 

Stigma & Depression
Stigmatization of depression can reduce the likelihood of people reaching out to get the mental care they need. Instead, depressed people may ask for prescriptions for physical ailments, and use their prescription drugs to treat their emotional pain. 

Rural Areas
In particular, shortages of mental-health providers are prominent in rural areas where the opioid epidemic hit the hardest. Some have suggested that providing mental health care to those suffering from chronic pain may help detangle the relationship between pain and depression.
 

Co-Occurring Disorders
Co-occurring disorders, or dual diagnosis, refers to having a simultaneous mental health disorder and substance use disorder. It is common for people with addictions to also suffer from depression, anxiety, or more severe mental illnesses such as schizophrenia or bipolar disorder. Research shows that people who use alcohol or other drugs early in life are more likely to have mental or emotional problems. It’s also true that many people with mental illnesses “self-medicate” with alcohol or other drugs to numb emotional pain, relieve anxiety, or quiet their thoughts. In the past, the medical profession treated one disorder first, typically the substance use disorder, before addressing the other. It is now understood that treating both simultaneously leads to better outcomes. Any successful addiction treatment program will include a mental health assessment and treat co-occurring disorders at the same time.

Relevant Research

In this section, please capture any recent findings, reports, or data on the topic. Please also highlight any gaps or existing disparities. Please include references and links to the information so that we may add a footnote for the reader to find further information. Do we have any available research about discriminatory practices? Is there information about the value of access to educational opportunities?

Impactful Federal, State, and Local Policies

Please list any federal, state, or local laws, policies, or regulations that support this topic or ones that could be a possible barrier. Are there laws or policies other states should know about and replicate for success?

Available Tools and Resources

The National Institute of Mental Health
Provides resources on how to find immediate help, health care providers, how to decide if a provider is right for you, how to join a study, and resources to learn more about mental disorders.

The American Academy of Child and Adolescent Psychiatry
Provides a service that helps find child and adolescent psychiatrist throughout America.

SAMHSA Resources for Suicide and Substance Use Prevention in Youth
2017 SAMHSA Webinar on Suicide and Substance Abuse among Young People and includes best practices for prevention and intervention.

SAFE Project Wiki Site- Trauma informed Care

Mental Health America-Mental Health America (MHA)'s work is driven by its commitment to promote mental health as a critical part of overall wellness, including prevention services for all; early identification and intervention for those at risk; integrated care, services, and supports for those who need them; with recovery as the goal.

National Alliance on Mental Illness -NAMI provides advocacy, education, support and public awareness so that all individuals and families affected by mental illness can build better lives.

Promising Practices

Promising Programs
There are a growing number of promising programs for helping to identify and address mental health issues.

Virtual Reality Therapy
Dr. Skip Rizzo has been working since the 1990s to use virtual reality to treat mental illness. [15]In an "early clinical trial of the software found that "after an average of seven sessions, 45 percent of those treated no longer screened positive for PTSD and 62 percent had reliably improved."[16]

The Virtual Reality Medical Center uses simulation technologies for:

• Treating patients with anxiety disorders
• Training for both military and civilian populations
• Enhancing various educational programs
• Benefits of VR Therapy
• Faster than traditional therapy and desensitization
• Practice these skills in situations in which you previously experienced anxiety, allowing the skills to generalize more easily to real world settings
• Can do some sessions in between office session at home, cuts down on the number of sessions people need
   

M3 Checklist (Screening Tool)
M3 Information developed a mental health screen that measures outcomes based on a 27-question diagnostic checklist and a related algorithm targeted for adults aged 18 and older. The M3 Checklist accurately measures outcomes based on question responses for major depression, bipolar disorder, anxiety disorder and posttraumatic stress disorder (PTSD).
 

Project Aware
Project AWARE is a SAMHSA program that focuses on student mental health and wellness, While not specifically focused on opioid abuse prevention, much of the work that grantees are doing may also help prevent opioid misuse. Through Project AWARE, schools are implementing evidence-based, culturally appropriate prevention programs that support youth at the universal, selective, and indicated levels.
 

Communities that Care
Programs such as Communities That Care promote a range of youth mental and behavioral health outcomes, included reduced risk for opioid misuse and addiction. (Find Source)

myStrength
myStrength is a digital platform that integrates state-of-the-art technologies to support people in addressing mental and behavioral health issues. It can be integrated with a professional practice to allow them to see more patients more efficiently and better meet the needs of their patients between in-person visits. Learn more at this recorded Webinar.

Medicaid Early and Periodic Screening, Diagnosis and Treatment (EPSDT) law requires states to provide Medicaid-eligible children regular mental health screenings.