Just in case you've missed it, there is a bill wending its way through Congress to extend the HIT/EHR incentives that are available to all other health care provider organizations through the Stimulus (ARRA) funds to behavioral health. On April 15, 2010, Congressman Patrick J. Kennedy (D-RI) and Congressman Tim Murphy (R-PA) introduced the Health Information Technology Extension for Behavioral Health Services Act of 2010 (HR 5040). The bill adds mental health and substance abuse professionals, psychiatric hospitals, substance abuse treatment facilities, community mental health centers, psychologists and clinical social workers to those eligible for electronic health record incentive payments established under the American Recovery and Reinvestment Act of 2009 (ARRA). Psychiatrists and psychiatric nurse practitioners are already eligible for this program under existing law.
You can learn about the bill at http://patrickkennedy.house.gov/PRArticle.aspx?NewsID=1770. We'll keep you posted on the status of the bill in our coverage of breaking developments in the field.
The future of institutions as long-term residences for persons with mental illness is certainly an integral part of the discussion about mental health policy. Usually those discussions focus on state budgets and Medicaid reimbursement and compliance with Olmstead. But, I was intrigued with a recent piece on Scott Hensley's blog on npr.org “A Peaceful War on Mental Institutions”—coverage of a different chapter in the history of mental institutions.
I never realized that many conscientious objectors in World War II were assigned to mental institutions in lieu of military service. Their experiences are documented in a recent piece on NPR ("WWII Pacifists Exposed Mental Ward Horrors") and in two books—Acts of Conscience: World War II, Mental Institutions, and Religious Objectors (by Stephen Taylor and published by Syracuse University Press) and The Turning Point: How Men of Conscience Brought About Major Change in the Care of America's Mentally Ill (by Alex Sareyan and published by American Psychiatric Press).
As I read this tale of the evolution of human conditions within our mental institutions, I was first struck by how much had changed. Then my thoughts wandered to the millions of Americans with mental illness in our corrections system. If we had the same undercover reporting of conditions of these citizens, would the photos be far different?
For more information on mental health in the corrections context, check out:
“Antidepressants May Change Your Personality” was the lead story of the recent daily health news update from healthfinder.gov, the U.S. Department of Health and Human Services’ service to provide current health info to the public. My initial reaction was that this isn’t news. (I’m not making any value judgments about whether this is good or bad, by the way.)
The story cites the research of Tony Tang, an adjunct professor of psychology at Northwestern University in Evanston, which found that taking antidepressants may not only help alleviate depression, but could also make you more extraverted and less neurotic. The study, “Personality Change During Depression Treatment: A Placebo-Controlled Trial,” featured in the December 2009 issue of Archives of General Psychiatry, posits that extraversion—often associated with positive emotions—is believed to help protect from depression, while neuroticism—the tendency to experience negative emotions and emotional instability—is thought to contribute to depression.
The study revives some of the work by Peter D. Kramer (author of Listening to Prozac and Against Depression) following the introduction of Prozac (though the premise is certainly extended to all types of antidepressants) about social questions surrounding the benefits and problems of “norming” one’s personality in the name of treatment. Though this question may seem a bit passé, it is a topic that will certainly get more traction as cosmetic neurology and the concept of “normal” wends its way through the mental health field.
For more on this topic, check out:
Is Cosmetic Neurology the Behavioral Health Business of the Future? The Controversy Over Drugs That Build “Mental Muscle”
If your organization is looking at increasing its private pay services, a new study, “Money or Mental Health: The Cost of Alleviating Psychological Distress With Monetary Compensation Versus Psychological Therapy” published in Economics Policy and Law and summarized in Science Daily’s "Psychological Therapy 32 Times More Cost Effective at Increasing Happiness Than Money" provides some powerful ammunition. The study found that four months of therapy increased "happiness" (as defined by the researchers Christopher J. Boyce and Alex M. Wood at the universities of Warwick and Manchester) as much as a $40,000 raise. The researchers concluded that "The research therefore demonstrates that psychological therapy could be 32 times more cost effective at making you happy than simply obtaining more money."
Despite the happy news for psychotherapy practices and the many vagaries of calculating well-being and happiness, the study speaks to the struggle of government policymakers in determining the 'relative value' of funding health services. "The researchers further draw on two striking pieces of independent evidence to illustrate their point—over the last 50 years developed countries have not seen any increases to national happiness in spite of huge economic gains. Mental health on the other hand appears to be deteriorating worldwide. The researchers argue that resources should be directed towards the things that have the best chance of improving the health and happiness of our nations—investment in mental health care by increasing the access and availability of psychological therapy could be a more effective way of improving national well-being than the pursuit of income growth."
These cost-benefit analyses, in health care analyzed through the lens of comparative effectiveness, will become more frequent as we have more data available through inoperable EMRs and there is greater pressure to reduce health care costs.
September 9, 2009
It was inevitable, I guess. Americans want everything in a hurry. And now we've gone from speed dating to speed shrinking. The August 31 edition of The New York Times featured an article, "Answers to Life's Worries, in Three-Minute Bursts". It talks about "speed shrinking gatherings" featuring three-minute sessions for people needing fast advice—or those who find their regular professional on vacation. One interesting comment in the piece was a woman who said it was great to see multiple therapists in short order because “It was a great way to learn which of them I had the most chemistry with.”
What does this mean for the field? For a certain cohort of consumers, 'short sessions' don't seem to be a problem—and viewed as a convenience. And speaking of convenience, I can see the 'speed shrinking sessions' moving from bookstores to on-line meeting places. For professionals in private practice or looking to attract new clients, 'speed shrinking' is a marketing opportunity.
Matrix Mindset, in Australia, for instance, is already capitalizing on this new phenomenon:
Related Resources from the OPEN MINDS Circle Library:
- Consumerism in Health Care: What's Your Next Move
- Current Trends in Consumer-Directed Health Plans
- Technology as the Next Disruptive Innovation in Behavioral Health: Thoughts on How Consumerism and Technology Will Define Our Future
- Getting Your On-Line In Line: Issues & Considerations for Behavioral Health Professionals Contemplating Internet-Enabled Therapy
