Better but not best: Recent trends in the well-being of the mentally ill

Health Affairs

Volumn 28, Issue 3, 2009, Pages 637-648

  Glied, Sherry A ^a   Frank, Richard G ^b  

^a Columbia University ^*  (United States)

^b HARVARD MEDICAL SCHOOL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; FINANCIAL MANAGEMENT; HEALTH CARE ACCESS; HOSPITAL CARE; HOSPITAL PATIENT; HUMAN; MENTAL DISEASE; MENTAL HEALTH; MENTAL HEALTH CARE; PATIENT CARE; PRISON; WELLBEING;

ADULT; AGED; CHILD; CROSS-SECTIONAL STUDIES; DRUG COSTS; FORECASTING; HEALTH EXPENDITURES; HEALTH POLICY; HEALTHCARE DISPARITIES; HUMANS; INSURANCE, PSYCHIATRIC; MENTAL DISORDERS; MENTAL HEALTH SERVICES; PRIMARY HEALTH CARE; PRISONS; PSYCHOTROPIC DRUGS; QUALITY ASSURANCE, HEALTH CARE; QUALITY OF LIFE; SOCIAL SECURITY; UNITED STATES;

EID: 66749159748     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.28.3.637     Document Type: Article

References (41)

1. For example, the National Comorbidity Study, first conducted in 1990-1992, included 8,098 respondents. R.C. Kessler et al., "Lifetime and Twelve-Month Prevalence of DSM-III-R Psychiatric Disorders in the United States: Results from the National Comorbidity Survey," Archives of General Psychiatry 51, no. 1 (1994):8-19.
2. It has been replicated only once, in 2001-02. R.C. Kessler et al., "Prevalence and Treatment of Mental Disorders, 1990 to 2003," New England Journal of Medicine 352, no. 24 (2005): 2515-2523.
3. R.G. Frank and S.A. Glied, Better but Not Well: Mental Health Policy in the United States since 1950 (Baltimore: Johns Hopkins University Press, 2006).
4. R.G. Frank and S.A. Glied, Better but Not Well: Mental Health Policy in the United States since 1950 (2006).Ibid.;
5. and Kessler et al., "Prevalence and Treatment of Mental Disorders."
6. See Appendix 1 for data descriptions and information on the prevalence of mental health problems as measured in these data, online at http://content.healthaffairs.org/cgi/content/full/28/3/637/DC1.
7. See Appendix 2 online for a drug classification list; ibid.
8. Frank and Glied, Better but Not Well, 112;
9. and Kessler et al., "Prevalence and Treatment of Mental Disorders."
10. Analysis of data from the Medical Expenditure Panel Survey (MEPS), 1996-2006.
11. U.S. Department of Health and Human Services, Mental Health: A Report of the Surgeon General (Rockville, Md.: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, 1999).
12. Analysis of data from the National Ambulatory Medical Care Survey (NAMCS), 1996-2006, and from the National Hospital Ambulatory Medical Care Survey (NHAMCS), 1996-2006.
13. Analysis of data from the National Health Interview Survey (NHIS), 1996-2006.
14. D. Mechanic and S. Bilder, "Treatment of People with Mental Illness: A Decade-Long Perspective," Health Affairs 23, no. 4 (2004): 84-95. (Pubitemid 38960700)
15. Frank and Glied, Better but Not Well, 80-82.
16. Analysis of data from NAMCS, 1996-2006. The share reporting that 75 percent or more of all patients were either self-pay or in Medicare has also dropped over time (currently about 13 percent).
17. Analyses of data from NAMCS, 1996-2006.
18. J.E. Wilk et al., "Access to Psychiatrists in the Public Sector and in Managed Health Plans," Psychiatric Services 56, no. 4 (2005): 408-410;
19. and Treatment Advocacy Center, "TAC Study Reveals Severe Shortage of Psychiatric Beds," 2008, http://www.psychlaws.org/documents/CatalystSUM08. pdf (accessed 19 November 2008).
20. Analyses of data from MEPS and NHAMCS, 1996-2006.
21. Analysis of data from the National Hospital Discharge Survey (NHDS), 1996-2006. Supplemental analysis of MEPS data suggests that the number of hospitalizations per user did not change systematically.
22. Frank and Glied, Better but Not Well, 74.
23. Frank and Glied, Better but Not Well, Ibid., 114-119.
24. M.M. Weissman et al., "National Survey of Psychotherapy Training in Psychiatry, Psychology, and Social Work," Archives of General Psychiatry 63, no. 8 (2006): 925-934. (Pubitemid 44188485)
25. Data on primary care and specialty care service use and prescribing practices are from NAMCS and NHAMCS, 1996-2006. Data on medication use among people with a mental health diagnosis are from MEPS, 1996-2006.
26. Data on treatment quality for depression (for 1998-2006) are from National Committee for Quality Assurance, "The State of Health Care Quality, 2007" (Washington: NCQA, 2007).
27. Analysis of data from MEPS, 1996-2006.
28. Analysis of data from the NHIS, 1996-2006, and from the NHDS, 1996-2006.
29. Analysis of data from MEPS, 1996-2006, for information on out-of-pocket payments, cost sharing, and costs as a percentage of family income. Data on family income end in 2005. Analysis of data from the NHIS, 1996-2006, for information on affordability of care among those with functional limitations. The estimated increase in 2006 in out-of-pocket payments for children remains even after an outlier with very high payments was omitted.
30. Analysis of data from MEPS, 1996-2006, and from the NHIS, 1996-2006.
31. Frank and Glied, Better but Not Well, 129.
32. Income distribution data are from the National Household Survey of Drug Abuse, 2001, and from the National Survey on Drug Use and Health, 2002-2006. Data on SSI benefit receipt are from the SSI Annual Reports, 1996-2006. Data on SSDI benefit receipt are from the SSDI Annual Reports, 2000-2006.
33. Data on housing affordability are from A. O'Hara et al., Priced Out in 2006: The Housing Crisis for People with Disabilities, 2007, http://www.tacinc.org/Docs/HH/PricedOut2006/POin2006.htm (accessed 19 November 2008).
34. Data on homelessness are from U.S. Department of Housing and Urban Development, The Annual Homeless Assessment Report to Congress, February 2007, http://www.huduser.org/Publications/pdf/ahar.pdf (accessed 3 March 2009).
35. Based on an assumption that 1.7 percent of the population have a serious and persistent mental illness (Frank and Glied, Better but Not Well, 20, 24).
36. Data on prisoners in federal and state prisons are from U.S. Department of Justice, Bureau of Justice Statistics, "Prisoners in 2006," December 2006, http://www.ojp.usdoj.gov/bjs/pub/pdf/p06.pdf (accessed 3 March 2009);
37. and "Prisoners in 2002," July 2003, http://www.ojp.usdoj.gov/ bjs/pub/pdf/p02.pdf (accessed 3 March 2009).
38. Data on prevalence rates by setting are from Bureau of Justice Statistics, "Mental Health Problems of Prison and Jail Inmates," September 2006, http://www.ojp.usdoj.gov/bjs/pub/pdf/mhppji.pdf (accessed 3 March 2009);
39. and Bureau of Justice Statistics, "Mental Health and Treatment of Inmates and Probationers," July 1999, http://www.ojp.usdoj.gov/bjs/pub/pdf/ mhtip.pdf (accessed 3 March 2009). Based on these data, we conservatively assumed that 7 percent of all incarcerated people have a serious mental illness.
40. Based on analyses in Frank and Glied, Better but Not Well, 123-128;
41. and BJS data described in Note 30.