By Jessica Hart, NAMI State Advocacy Manager
NAMI just released a report highlighting what went on in state legislatures in 2014 across the country when it comes to mental health issues. The report, State Mental Health Legislation 2014 shows that investment in mental health services slowed from last year and that when progress was made around specific policy issues much of the legislation felt like it only skimmed the surface.
This year, only 29 states and the District of Columbia increased funding for mental health services. Overall, the mental health care system still simply needs to recover lost ground from the state budget cuts of 2009-2012. But reinvestment is unsteady. See where your state fell in investment this year below.
There were some victories this year. Minnesota, Virginia and Wisconsin were leaders in the country by passing measures that can serve as models for other states in areas such as workforce shortage, children and youth, school-based mental health, employment and criminal justice.
Our policy recommendations for states in 2015 are:
- Strengthen public mental health funding.
- Hold public and private insurers and providers accountable for appropriate, high-quality services with measurement of outcomes.
- Expand Medicaid with adequate coverage for mental health.
- Implement effective practices such as first episode psychosis (FEP), assertive community treatment (ACT) and crisis intervention team (CIT) programs.
What can you do?
Write to your Governor and State Legislators to let them know that they need to make mental health care a priority.
Connect with your local NAMI to see how you can help advocate for mental health services and supports in your community.
Psychiatric illness may contribute to higher 30-day hospital readmission rates for patients with heart failure (HF), acute myocardial infarction (AMI), and pneumonia, according to a study of 160,169 patients served by 11 U.S. health systems.
From 2009 to 2011, about 21.7% of patients with psychiatric comorbidity went back to the hospital within 30 days of discharge, compared with 15.5% of those without such diagnoses, said Brian Ahmedany, Ph.D., L.M.S.W., of the Center for Health Policy and Health Services Research at the Henry Ford Health System in Detroit and colleagues in Psychiatric Services in Advance yesterday.
“Individuals with comorbid anxiety, dementia, and depression had higher rates of readmission than persons with no psychiatric comorbidity regardless of whether the index hospitalization was for HF, AMI, or pneumonia,” the researchers found. “[H]ealth systems should consider adding elements of mental health assessment, diagnosis, monitoring, and treatment to interventions to prevent 30-day all-cause hospital readmissions.”
Those elements might include psychiatric screening and evaluation, discharge planning that includes a mental health component, and follow-up for psychiatric conditions that includes outpatient treatment.
Ahmedany and colleagues noted that the gap in readmission rates between patients with and without psychiatric comorbidities shrank from 6.0% in 2009 to 4.1% in 2011. That was an encouraging trend but might be narrowed still further by adoption of interventions specifically designed for these conditions.
For more on the interface between psychiatric and general medical conditions, see the American Psychiatric Publishing book, Integrated Care: Working at the Interface of Primary Care and Behavioral Health, edited by Lori Raney, M.D.