DR KENT: May is Mental Health Month

DR. KENT MERCADO JD

U.S. CONGRESS 11th DISTRICT – ILLINOIS

IMMEDIATE PRESS RELEASE / Policy Statement: Medical Executive-Post

Date Line: May 26, 2023

Contact: http://www.ElectDrKent.com

May is Mental Health Month and we have to be acutely aware of the seen and unseen symptoms of related disorders. We need access to mental health care providers to foster appropriate treatment.  Whether it is post traumatic stress disorder from a non consensual encounter, clinical depression from isolation, or the stress of everyday living, urgent and long term care is needed. Also, normalizing it in terms of the prevalence of mental health issues and ranges in the way mental health needs surface is vital. Trying to help people to not feel alone, or engage in self critical thinking for their own mental health needs is paramount. There is still much stigma around mental health issues. Getting more information is one part of the solution equation – education can help with this change by decreasing one’s internal barriers around seeking care. 

Access to resources and services is another issue with different meanings to those addressed and their situation. There are too many barriers to accessing mental health care services. And, the idea that mental health is an important part of physical health in general, as well as the quality of life, must be accentuated.

TO WHIT:

  • Federal Regulations — The United States healthcare system is guided by programs such as those established under the Centers for Medicare and Medicaid (in the case of county mental health programs, Medicaid is especially important), Americans with Disabilities Act (ADA), Occupational Safety and Health Administration (OSHA), Health Insurance Portability and Accountability Act (HIPAA), and others.
  • State Regulations — These include general legislative guidelines, state management of benefits and reimbursement of the Medicaid program, and state allocations of budgets, which impact the centers’ operations.
  • County Regulations — Each county defines its own County Mental Health Program and decides which services will be provided or excluded.

We need to do our part and recognize the importance of mental health care.

Finally, by way of contemporary breaking news and all accounts, America’s youth are currently experiencing a mental health Social Media crisis. For example:

  • The number of teens and young adults with clinical depression doubled between 2011 and 2021, according to San Diego State University psychology professor Dr. Jean Twenge.
  • In 2021, the CDC found that nearly 25% of teenage girls had made a suicide plan.

So, we must remain vigilant on these, and related mental health emerging issues.

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NOTE: The Illinois’s 11th Congressional District is in the State of Illinois. It includes parts of Cook, DuPage, Kendall, Kane, and Will counties, and covers the southwestern suburbs of Chicago, as well as some rural areas. Regardless of your congressional district, affiliation and/or U.S. state, DR. KENT MERCADO JD is a political centrist and surely a rising new national star.

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Pediatric Mental Health Month is Also in May

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Even though timely follow-up care for self-harm or mental illness has been shown to prevent hospitalizations, reduce the chances of a repeat visit, and improve overall outcomes, less than a third of children receive follow-up care within seven days of their ED visit, and just over half (56%) receive care within a month, according to a recent study from Ann & Robert H. Lurie Children’s Hospital of Chicago.

More than a quarter of the children in the study returned to the ED within six months.

RELATED: The second-largest psychiatric facility in Washington State is looking to hire more employees after threats that it could lose its accreditation.

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PODCAST: Physician’s Mental Health

Doctor Burnout According to Specialty

By Eric Bricker MD

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SOCIAL MEDIA: Dr. Vivek Murthy Warns on Children’s Mental Health

U.S. SURGEON GENERAL ADVISORY REPORT

By Staff Reporters

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May is mental health month in the USA. US Surgeon General Dr. Vivek H. Murthy issued a powerful public advisory yesterday warning of the considerable risks that social media poses to young people’s mental health. “Nearly every teenager in America uses social media, and yet we do not have enough evidence to conclude that it is sufficiently safe for them,” Murthy wrote. He argued that kids have “become unknowing participants in a decades-long experiment.”

The surgeon general’s report focuses on the impacts of social media on teens and kids—both positive and negative—and the attendant health risks. The report outlines two types of dangers associated with social networks: content-related problems, such as negative self-image or bullying, and use-related problems, such as poor sleep and addiction.

What we know about social media and kids’ mental health

By all accounts, America’s youth are currently experiencing a mental health crisis.

  • The number of teens and young adults with clinical depression doubled between 2011 and 2021, according to San Diego State University psychology professor Dr. Jean Twenge.
  • In 2021, the CDC found that nearly 25% of teenage girls had made a suicide plan.

Many experts have pointed to social media as a potential cause since the deterioration of kids’ mental health has coincided with the rise of social media platforms over the last decade.

Still, the effect of likes, retweets, and TikTok comments on kids’ brains remains more or less a mystery. We know that social media use affects adolescents and that teens show alarming rates of anxiety and depression. But studies that have attempted to determine whether social media is a direct cause of worsening mental health have been inconclusive. Plus, not all kids are impacted by social media similarly: Some—adolescent girls, for instance—appear to be more at risk than others.

Finally, and according to Morning Brew, while researchers search for answers, some lawmakers are pushing ahead with restrictions on teens’ use of social media. In March, for example, Utah became the first state to establish a curfew for teens on social media apps and mandate that parents have access to their children’s accounts.

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RIGHTS: Mental Health in America [Georgia]

MENTAL HEATH AMERICA

By Staff Reporters

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MENTAL HEALTH PARITY ACT

Atlanta, GA – Governor Brian P. Kemp, joined by First Lady Marty Kemp and their three daughters, Lt. Governor Geoff Duncan, Speaker David Ralston, members of the House and Senate, and mental health advocates, to sign the Mental Health Parity Act (HB1013) into law.

You may view his remarks from the bill signing ceremony below, and you can watch the full ceremony here.

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Mental Health Rights

People living with mental health conditions are people. They have people they love, activities they enjoy, and dreams for their lives. As people, they deserve to be treated with dignity, and under the law they have rights and protections. 

GA MENTAL HEALTH PARITY LAW: https://gov.georgia.gov/press-releases/2022-04-04/gov-kemp-provides-remarks-and-signs-mental-health-parity-act

Unfortunately, it has long been the case that individuals with mental health conditions are among the most abused and discriminated against in our country. From leaving people to languish in overcrowded state hospitals to lobotomies and forced sterilization, the treatment of those with mental health conditions is a dark stain on our history as a nation.

While we have come a long way, abuse and discrimination continue to be serious problems today. The shackling or restraining of children, keeping people out of work, and denying access to services are just a few examples of the way we continue to fail the 1 in 5 Americans that has a diagnosable mental health disorder.

CITE: https://www.r2library.com/Resource/Title/082610254

This is not just a small issue for a small group of people: half of all Americans will experience a diagnosable mental health condition in their lifetime. If it is not us being directly impacted, it is likely that it will be our family members, friends, or loved ones– whether we know it or not. Beyond struggles in education or employment, we see the loss of human dignity and even human life for the people we love and care about when we do not work to address abuses in the system.

For Mental Health America, the fight against abuse and discrimination is essential to our history and continues to guide our work. MHA’s symbol, which sits in our national office, is the Bell of Hope cast from the chains and shackles that were used to restrain individuals in old state hospitals. As an organization, MHA is committed to the principles of human and civil rights inherent to the concept of equal justice under the law.

PROVIDERS: https://medicalexecutivepost.com/2022/10/05/a-review-of-mental-healthcare-provider-types/

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FLORENCE 2.0: A.I. Advice for a A Healthier Lifestyle And Mental Health

WHO

By Staff Reporters

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By 2030, the WHO projects that 15 million healthcare workers will be missing globally. 

Introducing Florence, the “world’s most extensive freely accessible AI health worker” is one way of tackling this issue. 
Florence is knowledgeable in key health topics, including mental health, nutrition and tobacco cessation, and provides information on COVID-19 vaccines. So, have a chat with her.

READ MORE: https://www.who.int/news/item/04-10-2022-who-and-partners-launch-world-s-most-extensive-freely-accessible-ai-health-worker?mc_cid=16b214db2e&mc_eid=40fee31c25

HIT: https://www.amazon.com/Dictionary-Health-Information-Technology-Security/dp/0826149952/ref=sr_1_5?ie=UTF8&s=books&qid=1254413315&sr=1-5

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Mental Health Entrepreneurial Start-Up Companies

Top Ten [10] Venture Capital Backed

By Dr. David Edward Marcinko MBA

By Carol Miller RN MBA

By http://www.MCOL.com

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Mental Health White Paper:

FILE: https://healthcarefinancials.files.wordpress.com/2019/05/mental-health-dr.-marcinko.pdf

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

LINK: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

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What Are the 7 Types of Mental Illnesses? Neuro-Psychiatric Hospitals

There are several types of mental illnesses, but the list below will provide an overview. These categories are also helpful in understanding a person with a particular ailment. Knowing more about these conditions will help you develop more profound empathy for those with the same condition and hope that treatment will be available. The following […]

What Are the 7 Types of Mental Illnesses? — NeuroPsychiatric Hospitals

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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.

First

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.

Second

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.

Assessment

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.

Conclusion

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Understanding the Mental Healthcare Regulatory Environment

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Appreciating the Rules

[By Carol Miller; RN, MBA]

Carol S. MillerLocal counties and municipalities are the primary providers of state mental healthcare for patients who lack private insurance coverage for such care.

Both children and adults may be eligible to receive assistance.

These counties provide a wide range of psychiatric and counseling services to the residents in their community as well as other types of assistance such as:

  • treatment services related to substance abuse;
  • housing;
  • employment services;
  • information and education service;
  • referrals;
  • consultative services to schools, courts and other agencies;
  • after-care services; and other related activities.

mental

Rules and Regulations

Accordingly, regulations from federal, state, and county governments have an impact on the day-to-day operations, procedures and processes of a county mental health center. Traditionally, there are three main types of regulations.

Federal Regulations — The United States healthcare system is guided by programs such as those established under the Centers for Medicare and Medicaid (in the case of county mental health programs, Medicaid is especially important), Americans with Disabilities Act (ADA), Occupational Safety and Health Administration (OSHA), Health Insurance Portability and Accountability Act (HIPAA), and others.

State Regulations — These include general legislative guidelines, state management of benefits and reimbursement of the Medicaid program, and state allocations of budgets, which impact the centers’ operations.

County Regulations — Each county defines its own County Mental Health Program and decides which services will be provided or excluded.

Assessment

County facilities generally include outpatient clinics, county mental health programs, short-term psychiatric facilities, day-care centers, de-toxification centers, residential rehabilitation centers for substance abuse, long-term care psychiatric facilities, and Veterans Affairs (VA) psychiatric centers. The county centers may be co-located with other county services such as social services, occupational rehabilitation services, information technology services, human resources, maintenance services, and others or may be independently located.

Conclusion

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COVID-19’s Impact on Mental Health and Workplace Well-being

Pandemic Mental Health

By NIHCM

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READ: https://nihcm.org/publications/covid-19s-impact-on-mental-health-and-workplace-well-being?utm_source=NIHCM+Foundation&utm_campaign=a03fb2164b-EMAIL_CAMPAIGN_2020_12_03_03_17&utm_medium=email&utm_term=0_6f88de9846-a03fb2164b-167744768

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Medicare Customers Say Mental Health Benefits Are Very Important

By Staff Reporters

AN eHEALTH SURVEY

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A eHealth survey of 3,800 Medicare customers aged 65 and older asked “When choosing health coverage, how important are mental health benefits?” The survey found: 
•  38% say mental health benefits are “very important” to them when choosing health insurance.
 •  34% say it’s “somewhat important” to them.
 •  22% say mental health benefits are “not so important” to them.
 •  Only 5% say it’s “not at all important.”
Source: eHealth, “Seniors Speak Out On Mental Health,” March 2022

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On the Prevalence of Mental Health Issues

 The 7 most common issues

By http://www.MCOL.com

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Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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Percent of Population Under 65 With Mental Health Disorders

By Staff Reporters

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EBRI: % of Population Under 65 With Mental Health Disorders

 •  Anxiety disorders: 8.1%
 •  Major depressive disorders: 5.3%
 •  Attention deficit hyperactivity disorder: 2.8%
 •  Other behavioral/mental health disorders: 2.2%
 •  Bipolar and manic disorders: 0.7%
 •  Post-traumatic stress disorder: 0.5%
 •  Phobic anxiety disorders: 0.4%
 •  Autistic disorder: 0.3%
 •  Obsessive-compulsive disorder: 0.2%
 •  Eating disorders: 0.2%
 •  Schizophrenic disorders: 0.1%
 •  Dissociative disorders: 0.04%
 •  Delusional disorders: 0.02%

Source: EBRI, “How Do High-Deductible Health Plans Affect Use of Health Care Services and Spending Among Enrollees With Mental Health Disorders?” March 10, 2022

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PODCAST: In-Patient Psychiatric Care

By Eric Bricker MD

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RELATED: https://medicalexecutivepost.com/2013/02/13/a-review-of-mental-healthcare-provider-types/

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Prioritizing Mental Health Care In America

By NIHCM Infographics

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Data Insights

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By the end of 2021, Americans found themselves in one of the worst nationwide mental health crises in years. Nearly 1 in 5 U.S. adults experience a mental illness each year, or more than 50 million people. Unfortunately, less than half of the people in need ever receive the mental health care they require. Due to physician burnout, a workforce shortage, and poor funding, this country has long struggled with handling the growing mental health crisis and providing equitable access to behavioral health care.

The mental health system in America may be largely broken, but conditions are ideal for transforming the system with scientific advances, improved coverage, and political consensus on the importance of mental health. Goals once thought to be long out of reach may soon be possible.

CITE: https://www.r2library.com/Resource/Title/082610254

This NIHCM infographic highlights the many challenges contributing to America’s mental health crisis as well as steps to improve and strengthen mental health care and the behavioral health industry and promote individual resiliency.

NIHCM: https://tinyurl.com/3whz69vk

ME-P: https://medicalexecutivepost.com/2022/06/02/medical-workplace-violence-prevention-guidelines/

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MENTAL HEALTH Action Day 2022

By Staff Reporters

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As part of its Mental Health initiative, MTV’s second-annual Mental Health Action Day – an open-source movement of brands, organizations, government agencies, and cultural leaders to drive culture of mental health from awareness to action – will bring together more than 1,600 organizations in cities across the country to encourage and empower people to take action for mental health on Thursday, May 19, 2022.

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LINK: https://www.mentalhealthactionday.art/

COACHING: From Chaos to Calm: https://medicalexecutivepost.com/coach/
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PODCAST: Mental Health Interview with Milton L. Mack Jr.

RIP NAOMI JUDD

[Original Rebroadcast]

The Common Bridge by Rick Helppie

Mental Health, Jury Bias, and Judicial Reform, with the Honorable Milton L. Mack Jr.
Rich brings back the Honorable Milton L. Mack, Jr. for a discussion on Mental Health, Jury Bias, and Judicial Reform. Judge Mack has been a leading voice on how mental health issues affect over half of the court cases in the US and how this needs to be addressed in judicial reform. He has also been on the forefront of bringing cutting edge technology into the courtroom.

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PODCAST: https://richardhelppie.com/podcasts/

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Does Money REALLY Buy Happiness?

Maybe IT CAN

Psychological Considerations

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Money Can Buy Happiness After All, According to New Study

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R&D 2010: https://www.pnas.org/content/107/38/16489

R&D 2021: https://www.pnas.org/content/118/4/e2016976118

DEM: https://medicalexecutivepost.com/2020/12/11/the-science-of-happiness/

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Types of Care Medical Providers Deliver Via Tele-Health

By Staff Reporters

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1
.   Conduct primary care visits (75%)
2.  
Conduct chronic care visits (72%)
3.   Order prescription refills (64%)
4.   Conduct COVID-19 screenings (39%)
5.   Conduct urgent care visits (38%)
6.  
Address mental health concerns (36%)
7.   Conduct follow-up after a procedure or surgery care (28%)

Source: Optum Via UnitedHealth Group, March 15, 2022

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The “Fair Health” Study of Private Healthcare Claims

By Staff Reporters

Three [3] Key Findings

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 •  Among patients aged 19-35, mental health conditions were the most common diagnosis associated with emergency ground ambulance in the period 2016-2020.
 •  Throughout the period 2016-2020, advanced-life-support (ALS) accounted for a larger percentage of emergency ground ambulance claim lines than basic-life-support (BLS) services. For example, in 2020, 51.5% of emergency ground ambulance claim lines were associated with ALS compared to 48.5% associated with BLS.
 •  Individuals 65 years and older were consistently the largest age group associated with emergency ground ambulance services, though their share of the distribution decreased from 37.7% in 2016 to 34% in 2020.

Source: Fair Health Via PR Newswire, “Ground Ambulance Services in the United States,” February 23, 2022

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PODCAST: Technology Enabled Behavioral Healthcare in 2022?

A Critical Strategy for Population Health Management

By Michael Vergare MD

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Value Based Care Definitions: https://www.r2library.com/Resource/Title/0826102549

High Value Care & Value-Based Care

PODCAST: https://www.healthsharetv.com/content/technology-enabled-behavioral-health-care-critical-strategy-population-health-management

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PODCAST: Mental Health Care Lowers Costs

BY ERIC BRICKER MD

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MENTAL HEALTH: https://medicalexecutivepost.com/2021/07/28/mental-health-entrepreneurial-start-up/

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PODCAST: The State of Mental Health

IN THE USA

By Eric Bricker MD

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MORE: https://medicalexecutivepost.com/2021/07/28/mental-health-entrepreneurial-start-up/

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PODCAST: Mental Health Conditions are Common

Mental Health Conditions Are Common and Complicate Co-Morbid Medical Diseases As Well.

Image result for eric bricker

By Eric Bricker MD

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7% of the US Adult Population Has Depression.

Depression is Highest Among 18-25 Year Olds at 11%.

19% of US Adults Have Anxiety and 56% of Those with Anxiety Are Impaired By Their Condition.

12% of People with Diabetes Have Associated Depression… Resulting in Missed Appointments, Poorer Diet, Decreased Medication Adherence and Increased Complications.

To Address This Problem, The Intermountain Health System Incorporated a Mental Health Provider in Their Primary Care Clinics.

Results: Improved in Diabetes Care, Decreased Hospitalizations and Decreased ER Utilization.

Treating Mental Health Not Only Improves Mental Wellbeing, But Also Lowers Overall Healthcare Costs as Well.

Disclaimer: Dr. Bricker is the Chief Medical Officer of Virtual Care Company First Stop Health.

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MARCINKO ON MENTAL HEALTH START-UPS: https://medicalexecutivepost.com/2020/09/30/mental-health-entrepreneurial-start-up/

CITE: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

Your thoughts are appreciated.

NOTE: If you or someone you know is considering suicide, please contact the National Suicide Prevention Lifeline at 1800-273-TALK (8255), text “help” to the Crisis Text Line at 741-741 or go to suicidepreventionlifeline.org.

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PODCAST: The Covid 19 Pandemic and Mental Health

Including Substance Use Issues

By Dr. David E. Marcinko MBA CMP© and staff reporters

The COVID-19 pandemic has spurred—and aggravated—a range of mental health and substance use issues in the United States.

In this episode of Critical Point, Milliman’s Stoddard Davenport discusses the rising demand for mental health services and how different populations are being affected. Stoddard also highlights recent statistics on the topic and what the road ahead may look like for mental health in America.

PODCAST LINK: https://www.healthcaretownhall.com/?p=10186

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Community Mental Health Programs and Resources: https://healthcarefinancials.files.wordpress.com/2019/05/mental-health-dr.-marcinko.pdf

Social Determinant of Health: https://www.healthsharetv.com/content/webinar-recap-social-determinants-health-turning-potential-actual-value

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PODCAST: Transgender Health [Focus on Resiliency]

Network of the National Library of Medicine [NNLM]

[By Charlene Ice]

DEFINITION: Transgender people have a gender identity or gender expression that differs from the sex that they were assigned at birth. Some transgender people who desire medical assistance to transition from one sex to another identify as transsexual.

Citation: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

Network of the National Library of Medicine

And so, the Network of the National Library of Medicine Pacific Southwest Region at the UCLA Biomedical Library and Southeastern Atlantic Region at the University of Maryland-Baltimore are excited to announce the first NNLM Transgender Health webinar series.

With approximately 1 million adults in the U.S. identifying as Transgender/Gender Non-Binary (TGNB), this series will promote awareness of the social determinants of health, health disparities, and resilience in these individuals and communities.

A pioneer in LGBTQ care, Tang takes two steps forward for ...

PODCAST LINK: https://www.youtube.com/watch?v=evs-DScvcyc&t=784s

Gay Doctors: https://medicalexecutivepost.com/2009/04/03/the-gay-physician-dilemma/

Mental Health Programs: https://medicalexecutivepost.com/2020/09/30/mental-health-entrepreneurial-start-up/

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World Bi-Polar Day 2021

By staff reporters

Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression).

When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of energy or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior and the ability to think clearly.

Episodes of mood swings may occur rarely or multiple times a year. While most people will experience some emotional symptoms between episodes, some may not experience any.

Although bipolar disorder is a lifelong condition, you can manage your mood swings and other symptoms by following a treatment plan. In most cases, bipolar disorder is treated with medications and psychological counseling (psychotherapy).

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Social Determinants of Mental Health

SDoMH

[Staff reporters]

As mental illness and chronic health conditions become more common, leaders are looking at upstream solutions that can improve overall well-being by addressing social determinants of mental and physical health.

For example, the Blue Cross Blue Shield of Michigan Foundation is providing over $125,000 in grants for community organizations working with vulnerable populations, including children and adults suffering from mental illness, homeless adults and families that are struggling financially.

And, health plans including Blue Cross Blue Shield of Tennessee and Horizon Blue Cross Blue Shield of New Jersey are integrating care to ensure people can access behavioral health treatment through their primary care providers.

Assessment

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MENTAL HEALTH WHITE PAPER

Mental Health DR. MARCINKO

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On Mental Health Gender and Racial Disparities

USA Adults in 2015

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USA Inmates and Mental Health

Prison Inmates and Mental Health [1-in-4]

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On Schizophrenia Related ER Visits

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By http://www.MCOL.com

For 2009-2011

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Diagnostic and Statistical Manual of Mental Disorders

Coding Classification

By Staff Reporters

The classification and coding systems used by mental health insurers both diagnosis-related groups (DRGs) and current procedural terminology (CPT®) are still being defined through historical methodologies and are vague compared to the medical classification coding structure.

As an example, mental health insurers classify Tourette Syndrome (TS) as a “mental disorder.” In fact, TS is an inherited, neurobiological disorder, and both neurologists and psychiatrists treat TS with the same medications. If TS were reclassified under the medical coding structure, TS would not only receive potentially a better reimbursement but public perception of TS as a “mental disorder” would be changed.

The DSM-IV

The Diagnostic and Statistical Manual of Mental Disorders (4th edition, text revision), also known as the DSM-IV-TR, is a manual published by the American Psychiatric Association (APA) that includes all currently recognized mental health disorders. The coding system utilized by the DSM-IV is designed to correspond with codes from the International Classification of Diseases, commonly referred to as the ICD. Since early versions of the DSM did not correspond with ICD codes and updates of the publications for the ICD and the DSM are not simultaneous, some distinctions in the coding systems may still be present.

Assessment

For this reason, it is recommended that users of these manuals consult the appropriate reference when accessing diagnostic codes. For more information, contact the APA at (800) 368-5777.

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Stockholder Suit Targets Troubled Mental Health Chain

Psychiatric Solutions, Inc

By Robin Fields, ProPublica – September 22, 2009 5:01 pm EDTCaduceus

Psychiatric Solutions Inc. the nation’s leading provider of inpatient mental health care is being sued by stockholders who claim the company issued “false and misleading statements” about troubles at one of its hospitals.

The Lawsuit

The lawsuit, filed Monday in U.S. District Court in Tennessee, alleges that PSI violated securities laws by downplaying problems at Riveredge Hospital near Chicago and waiting too long to tell shareholders how they had affected the company’s bottom line.

The Investigations

Investigations last year by the Chicago Tribune and ProPublica detailed violence, sexual abuse and neglect at PSI facilities from coast to coast, including Riveredge. In several instances, PSI facilities were cited for not reporting patient deaths and injuries as required, federal and state records showed. In response to the reports, the Justice Department opened an investigation and the Illinois Department of Children and Family Services froze admissions of foster children to Riveredge.

The Allegations

The lawsuit alleges that PSI’s statements – particularly those indicating the admissions hold would end soon and that other regulatory deficiencies had been fixed – inflated the company’s stock price, helping company leaders reap millions from insider sales. In early 2009, PSI announced that its 2008 results had fallen short of estimates. Its share price dropped about 35 percent on the news.

Assessment

Through a spokesman, PSI called the lawsuit “wholly without merit.” “We have at all times operated, and will continue to operate in full compliance with the rules and regulations of the Securities and Exchange Commission,” John Van Mol said in a written statement.

Note: Robin Fields is a reporter for the ProPublica news service, which first published this article.

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Health Insurance versus Mental Health Parity

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Understanding Physical Health and Mental Health Insurance

By Carol Miller; RN, MBA

Carol S. Miller

There is a difference between the benefits covered under medical insurance compared to those covered under mental health benefits.

Mental Health Parity Act

There has always been a disparity resulting in caps on the annual number of visits allowed, higher co-pays, higher deductibles, and reduction of covered benefits such as partial hospitalization and number-of-treatment limits for mental health. Congress touched on this issue in 1996 with the Mental Health Parity Act. This federal law prevented group health plans from placing annual or lifetime dollar limits on mental health benefits that are lower¾less favorable¾than annual or lifetime dollar limits for medical and surgical benefits.

Group Health Plan Exclusions

However, the law did not require group health plans and their health insurance issuers to include mental health coverage in their benefits package¾it only applied to group health plan insurances that already did include mental health benefits in their benefit package.

MHETA Attempts at Correction

In 2003, Senators Pete Domenici, Edward Kennedy, and Representatives Patrick Kennedy and Jim Ramstad introduced S. 486 and H.R. 953, called the Mental Health Equitable Treatment Act. In March 2005, the Mental Health Equitable Treatment Act [MHETA] was passed and with the passage of this bill a loophole – insurers may no longer arbitrarily limit the number of hospital days or outpatient treatment sessions for people in need of mental health care – was closed.

Assessment

Nevertheless, even though states are encouraged by the government with this new bill to enact stronger parity laws, the final decision of parity still rests with the states.  Many states have not enforced the law and therefore, insurers may still be inclined to limit

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