Drugs and County Mental Health Programs

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On Medication and Pharmaceutical Direction

[By Carol S. Miller BSN, MBA, PMP]

Two issues related to medication have an impact on county mental health programs. The first is the new emphasis on drug therapy and the second is targeted marketing by pharmaceutical companies of newer, more costly drugs.


In the past, psychiatrists focused on identifying the “cause of the problem” and developing associated treatment plans to treat the cause. With the increasing number of mental health patients, especially those with chronic mental illness conditions, psychiatrists do not have the time to focus solely on the treatment plan and the underlying cause of the mental illness. Instead, their focus has had to become intake evaluations, case coordination, and medication checks. Use of medication has replaced the treatment plan, and continues to play a much larger and more primary role in the treatment of most, if not all, patients.


The second major issue is advertising. The Food and Drug Administration (FDA) lifted restrictions against direct pharmaceutical advertising several years ago, enabling the representatives of these firms to market and advertise their drugs. Advertisers target both medical and mental-related problems, including everything from depression, anxiety, attention deficit disorder, acid reflux disease, high cholesterol, erectile dysfunction, arthritis, allergies, over-active bladder, to asthma. With the advent of marketing, many drugs are now being over-prescribed and are becoming a component of spiraling healthcare costs.


In summary, both of these pharmaceutical issues are having an impact on county mental health centers — first, as a cost issue, second because of the change-in-direction treatment modality, and third from the perspective of potential ethical issues involved in provider/pharmaceutical company ties and relationships.


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6 Responses

  1. Supreme Court Overturns State Law Restrictions on Data-Mining

    On June 23th, 2011, the U.S. Supreme Court in a 6-3 decision overturned a 2007 Vermont law that restricted data-mining companies from using and selling individual doctor’s Rx prescribing patterns without the physician’s permission.

    This ruling will have significant effects on states’ approach to the pharmaceutical industry and healthcare expenditures.

    Click to access supreme.pdf



  2. Investigating how mentally disabled people are housed

    Rosemary Hoban, a reporter with North Carolina Public Radio/WUNC, compared North Carolina’s system for treating the mentally ill with those in place in other states and how cuts have affected the systems of care.

    She found that people with mental health issues ended up living in ‘adult care homes,’ facilities that weren’t required to have expertise in mental health issues. Essentially, adult care homes were classic “three hots and a cot” facilities with provision of medications thrown in.




  3. The selling of ADHD

    Attention Deficit Hyperactivity Disorder is a serious problem in kids. And, this author has been funded in the past, and published on the results, for a trial to improve physician diagnosis and management of the condition.


    That said, the NYT had a long piece yesterday on how it’s being oversold these days:


    Ann Miller RN MHA


  4. Aimee Picchi [5 Reasons Why Americans Pay So Much For Drugs]

    1.Lack of bargaining – Other governments bargain on behalf of their citizens, which helps to keep costs down

    2.High marketing costs – The U.S. allows drug companies to market directly to consumers, which isn’t legal in Europe. That means pharmaceutical firms in America typically spend much more on marketing

    3.No caps on costs – When you cap costs a pharmaceutical company can’t easily copy what Turing Pharmaceuticals did this year when it jacked up the price of a 62-year-old drug some 5,000 percent

    4.Opaque pricing – Figuring out how much a prescription medication costs can be difficult because there is no database or other sources of information that track increases in drug prices

    5.Lack of rationing or denials – Americans want medical treatment, regardless of the cost or outcome but other countries will reject paying for medications if they believe the drugs aren’t worth it

    Source: CBS News


  5. F You!

    The DEA has seized a lot of Fentanyl. The Drug Enforcement Agency said it confiscated more than 379 million doses of the synthetic opioid this year—enough to kill every person in the US. The number of fentanyl-laced pills it seized was double that of last year, the DEA said, pinning the blame on two Mexican drug cartels for driving the influx. The powerful drug was involved in the deaths of more than 70,000 Americans in 2021, according to the CDC.



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