Last week I discussed factors that threaten access to mental health care. However, better access to care doesn’t always mean better quality of care. Overworked mental health professionals and overcrowded ERs are forced to expend efforts and limited resources where they have the most impact.  This forces compromises in care. We must investigate ways to enhance coordination and quality of care for the mentally ill.

Prevention/Early Treatment in Children/Young Adults

While severe and persistent mental illness has tremendous effects across all segments of the population, it is within the child/adolescent group where clinical advancements in prevention/early treatment have the potential to generate significant long term benefits. According to the National Alliance on Mental Illness (NAMI):

• 50% of all chronic mental illness begins by age 14 and 75% by age 24.
• 70% of those who are in the juvenile justice system suffer from mental illness.
• More than 50% of students aged 14 and older who have a mental illness, and are involved in special education, drop out of school - the highest dropout rate of any disability group.

In addition, the National Institute of Mental Health reports that suicide of those aged 15-24 represents the third leading cause of death for that age group.

In addition, many of those with severe mental illness often suffer from chronic physical ailments which are exacerbated by the presence of untreated mental illness. This can lead to higher long term treatment costs and the possibility of conditions becoming resistant to treatment. These combined factors contribute to a shocking result.

People with a serious and persistent mental illness have a life expectancy 25 years shorter than the non-mentally ill population.[1]

It’s important to get in front of the problem as early as possible. According to MentalHealth.gov, studies show that positively supporting the social and emotional well-being of children & adolescents also leads to improved education outcomes, reduced rates of crime and teen pregnancy[2], increased productivity and quality of family life, and even more robust economies.

Prevention/Early Treatment in Adults

Early detection and treatment within the adult mental health population also is key to enhancing quality of care for that population. The consequences of untreated adults parallel those of children and adolescents, but the risk also extends beyond the effects on the individual and their family and friends.

These populations are in many cases now parents, leaders, educators and members of the workforce that, when left untreated, can impact their social and professional environments. Untreated adult mental illness negatively affects the productivity inside the work place. Untreated adults who are also suffering from co-occurring physical conditions such as diabetes can generate unnecessary hospital admissions and health care costs due to their inability to effectively manage their physical conditions. With such a high number of adults with an undiagnosed mental illness, it is important to identify and understand the risk factors as early as possible, implement evidence-based treatment plans, and target public outreach/education campaigns for this population. Evidenced-based treatment has proven successful in helping mentally ill patients function better in their daily lives and relationships with people.

Further complicating matters, studies suggest that mentally ill people are going long periods of time without seeking treatment. NAMI indicates that the median time between onset of mental health symptoms and treatment is nearly 10 years. This kind of gap creates challenges to successful treatment and raises the possibility of other physical/sociological problems, as previously mentioned. Mentally ill adults often find themselves  in the direst of situations. An estimated 1.1 million attempted suicide[3], approximately 46% of the homeless population live with mental illness and/or substance abuse issues, and 20-21% of state/local prisoners have a history of mental illness[4].

Even in cases where mental illness is diagnosed, the use of data and associated analytic tools can prove to be extremely valuable in sustaining effective treatment plans over time. In my next post, I’ll discuss how integrating data from a variety of systems, and applying analytics, can help with prevention, detection and treatment of mental illness. If you missed the previous two entries in this series, please check out my posts on an analytic approach to improving mental health, and access to care.

[1] National Association of State Mental Health Program Directors. (October 2006). Morbidity and Mortality in People with Serious Mental Illness.

[2] Vigod SN, Dennis CL, Kurdyak PA, Cairney J, Guttmann A, Taylor VH. Fertility rate trends among adolescent girls with major mental illness: a Population-based study. Pediatrics. 2014 Mar;133(3):e585-91

[3] National Survey on Drug Use and Health (2009) Suicidal Thoughts and Behaviors Among Adults. http://archive.samhsa.gov/data/2k9/165/suicide.htm

[4] National Alliance on Mental Illness (2013) Mental Illness facts and numbers. http://www.nami.org/factsheets/mentalillness_factsheet.pdf