A new report shows that one-fourth of all stays in U.S. community hospitals are for mental health disorders.
These included depression, bipolar disorder, schizophrenia, Anxiety Disorders, other mental health disorders, or substance use related disorders.
The study was made from an analysis of hospital data from 2004. It comes from the Health and Human Services Agency of the federal Agency for Healthcare Research and Quality (AHRQ).
The study is the first documentation of the full impact of mental health and substance abuse disorders on U.S. community hospitals. According to the report, about 1.9 million of the 7.6 million stays were for patients who were hospitalized primarily because of a mental health or substance abuse problem. Of the 5.7 million other stays for other conditions, many were also diagnosed as having a mental disorder.
One-third of the stays for mental health issues were for uninsured patients. The remaining two-thirds were paid by Medicare, Medicaid and private insurers.
Sources of the report
All non-federal hospitals were included
The report is based on 2004 data, the latest currently available. They are from the AHRQ’s Healthcare Cost and Utilization Project Nationwide Inpatient Sample, a database of hospital inpatient stays that is nationally representative of all short-term, non-federal hospitals. The data are drawn from hospitals that comprise 90 percent of all discharges in the United States and include all patients, regardless of insurance type, as well as the uninsured.
AHRQ Director Carolyn M. Clancy said,
Community hospitals play an important role in the treatment of people with mental health and substance abuse disorders. This report gives health care policymakers an in-depth look at the impact of mental health and substance abuse care on the health care system
The report found that, of those 8 million hospital stays for mental health and/or substance abuse problems:
- A large portion of patients were older. Although people over 80 represent only 5 percent of the population, nearly 21 percent of the stays were for these problems — mostly dementia.
- Of those younger than 80, the most common diagnosis was mood disorders. Overall, 11 percent of these stays were people 18-44 years of age, 13 percent for those 45-64, and 8 percent for those 65-79.
- Women were admitted most frequently for mood disorders.
- Men were mostly admitted for substance abuse.
- Dual diagnoses — those with both mental health and substance abuse problems — accounted for 1 million of the 8 million stays. Half of these involved drug abuse, one-third alcohol abuse, and one in five both drug and alcohol abuse.
- 240,000 women hospitalized for childbirth or pregnancy also had mental heal or substance abuse problems. Four of 10 of these patients were between 18 and 24 years old.
- Suicide attempts accounted for nearly 179,000 stays. Of these, 93 percent involved a mental health condition. Nearly three-quarters of these patients were between the ages 18 and 44, with more than half being women.
Report signals the need for early intervention
Early intervention is essential
Over and over we see calls from the medical community for early intervention into mental health care issues. These calls have gone largely unheeded. Insurance companies still do not pay as much for mental health services as for medical or surgical services. Many companies have a lifetime cap on the amounts paid.
The public still labors under the twin burdens of stigma and scapegoating. This causes less than one-third of the public voluntarily seeking treatment for mental health issues. The remaining two-thirds only receive treatment when a crisis strikes.
Terry Cline, Substance Abuse and Mental Health Services Administration Administrator, said,
The significant number of hospital stays related to mental health and substance use disorders signals the need for an increased national effort to identify and intervene early before the conditions require a hospital stay. Too often because of social stigma or lack of understanding, individuals and health care providers don’t recognize the signs or treat mental health or substance use disorders with the same urgency as other medical conditions.
What do you think?
I don’t know about you, but the results of this report surprised me. The magnitude of the mental health problem in the U.S. today staggers the imagination, yet little is being done about it.
- What do you think about the report? Does it surprise you?
- What do you think about mental health care in America?
- Have you ever been hospitalized for mental health reasons?
- Have you ever been hospitalized for a physical reason and were then diagnosed with a mental health problem?
As always, your comments are welcome!
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Resources used in this post:
Nauert, Rick. (2007, April 12). A Quarter of Hospital Stays for Mental Health. Retrieved June 1, 2008 from Psych Central Web site: http://psychcentral.com/news/2007/04/12/a-quarter-of-hospital-stays-for-mental-health/748.html
Owens, Pamela; Myers, Megan; Elixhauser, Anne; Brach, Cindy. Care of Adults With Mental Health and Substance Abuse Disorders in U.S. Community Hospitals, 2004—HCUP Fact Book No. 10. Retrieved August 14, 2008 from Agency for Healthcare Research and Quality Web site: http://www.ahrq.gov/data/hcup/factbk10/