Priority Area: Mental Health/Substance Abuse - Mental Health

The Burden of Mental Illness

Mental disorders continue to be common, widespread and disabling. Every year, more than 1 in 5 New Yorkers has symptoms of a mental disorder. Moreover, in any year, 1 in 10 adults and children experience mental health challenges serious enough to affect functioning in work, family and school life. The disease burden or total cost of mental illness exceeds that caused by all cancers.

Barriers to effective care—stigma and discrimination, symptoms that reduce the ability to recognize problems, insurance limits—add up. In our nation, people enter care on average nine years after problems first appear. Mental health problems are a leading health challenge for children; half of all lifetime cases of mental illness begin by age 14, while three-quarters begin by age 24. Mental disorders that appear early on, when left untreated, are associated with disability, school failure, teenage childbearing, unstable employment, marital instability, death by suicide, and violence. Nearly $200 billion is lost each year nationwide in reduced earnings due to mental health problems. The costs of untreated or poorly treated mental illness in the disability system, in prisons, and on the streets contribute to the mental health care crisis.

The New York State Office of Mental Health (OMH) promotes the mental health and well-being of all New Yorkers. Its mission is to facilitate recovery for young to older adults receiving treatment for serious mental illness, to support children and families in their social and emotional development and early identification and treatment of serious emotional disturbances, and to improve the capacity of communities across New York to achieve these goals. OMH envisions a future when every New Yorker experiences hope and recovery and when people across New York have access to and choice among the supports and services that foster self-determination for living, working, learning and participating fully in their communities.

Objectives

  • By the year 2013, reduce the age-adjusted suicide mortality rate in New York to no more than 4.8 per 100,000. Baseline: 6.0 per 100,000, Vital Statistics, 2003-2005. (Healthy People 2010 Goal)
  • By the year 2013, reduce the percentage of adult New Yorkers reporting 14 or more days with poor mental health in the last month to no more than 7.8%. Baseline: 10.4%, BRFSS, 2003-2005. (Healthy People 2010 Goal)

Indicators for Tracking Public Health Priority Areas

Each community's progress towards reaching these Prevention Agenda Objectives will be tracked so members can see how close each community is to meeting the objectives.

Data and Statistics

  • County Mental Health Profiles
    The County Mental Health Profiles released by the New York State Office of Mental Health lists key county community characteristics, mental health services, expenditures, and outcomes. It has information on consumer demographics, services provided, and has comparative statewide statistics. Each of the seven tabs represents a different domain of information. On each pages ia a notes button that explains the data sources, and most pages have a Related Reports button that links to other websites containing additional information.
    Chartbook on Mental Health and Disability in the United States
    This easy-to-use chart book from the National Institute on Disability and Rehabilitation Research draws from national surveys and statistical research; it presents information on the prevalence of mental disorders and the extent to which mental disorders contribute to reduced participation in major life activities.
    Community Health Data Set
    The data set includes county-level data in 18 health focus areas. The focus areas are: Demographic and Socioeconomic Characteristics, Physical Activity and Fitness, Nutrition, Tobacco Use, Substance Abuse: Alcohol and Other Drugs, Family Planning, Unintentional Injuries, Oral Health, Maternal and Infant Health, Child and Adolescent Health, Heart Disease and Stroke, Cancer, Chronic Conditions, HIV Infection, Sexually Transmitted Disease, Immunization, and Infectious Diseases, and Violent and Abusive Behavior.
    Kids Well-Being Indicators Clearinghouse (KWIC) - Physical and Emotional Health
    Physical and Emotional Health is one of six life areas that make up the New York State Touchstones framework used in KWIC. Each life area has a set of goals and objectives - representing expectations about the future, and a set of indicators-reflecting the status of children and families. The Touchstones framework provides a holistic approach as it cuts across all health, education and human service sectors.
    Patient Characteristics Survey Report
    The Patient Characteristics Survey (PCS) is conducted every two years, and collects demographic, clinical, and service-related information for each person who receives a public mental health service during a specified one-week period. Results from the PCS are summarized into reports at the state, region, county, and facility levels.
    The Numbers Count Mental Disorders in America (2008)
    This publication describes national statistics about mental disorders.

Mental Health Services and Supports

The majority of people in New York who find treatment for their mental health problems do not obtain care in programs operated, funded, or regulated by OMH. They often see private therapists, rely on self-help and peer support, or simply receive medication treatment from primary care physicians. For those people whose illness is complex or results in substantial disability—or for those who lack insurance coverage or for whom mental health benefits are inadequate—more is often required. This is where the OMH "safety net" is essential.

The core mission of OMH is to sustain the safety net of programs operated by nonprofits, counties, hospitals and the State for adults living with serious mental illness and children and youth with serious emotional disturbance. In tough times, when rates of mental illness and suicide increase and private care can be less accessible, this challenge is urgently important.

Over the past 50 years, the public mental health system in New York has evolved from one dominated by large State psychiatric hospitals serving a tiny fraction of persons with serious mental illness, to a highly dispersed system of non-profit organizations, county mental hygiene departments, and State and private hospitals serving about 650,000 individuals yearly. Currently, OMH funds and/or licenses more than 2,500 mental health programs operated by local governments and private agencies. They provide outpatient, inpatient, emergency, residential, community support and vocational care and services.

Strategies – The Evidence Base for Effective Interventions

  • Best Practices Registry for Suicide Prevention
    The Suicide Prevention Resource Center's (SPRC) website defers to evidence-based programs in the National Registry of Evidence-based Programs and Practices. The SPRC stopped conducting reviews in 2005, though continue to list 12 suicide prevention programs previously identified.
    Center for Practice Innovations
    The Center supports the mission of OMH to promote the widespread availability of evidence-based practices serves as a key resource by spreading those practices identified by OMH as most important in transforming the mental health system of care.
    Dartmouth Evidence-Based Practices Center
    Since 1987, the Dartmouth Psychiatric Research Center has studied mental health services and helped providers establish programs based on evidence gained from research. The Center facilitates the implementation of Evidence- Based Practices in sustainable ways in public mental health systems and agencies across the country.
    Evidence Based Treatment Dissemination Center (EBTDC)
    A program of the OMH Division of Children and Families, the EBTDC is dedicated to increasing access to evidence-based treatments and supports through education and training of and consultation with clinicians. Information, including training offerings, may be obtained from this site.
    National Registry of Evidence-based Programs and Practices (NREPP).
    The NREPP is a searchable database with up-to-date, reliable information on the scientific basis and practicality of interventions. Users, such as community organizations and state and local officials, can perform custom searches to identify specific interventions based upon desired outcomes, target populations and service settings.
    The Community Guide - Mental Health and Mental Illness
    In the area of mental health and mental illness, the Task Force on Community Preventive Services recommends collaborative care for treatment of adults 18 years of age or older with major depression. To reduce depression among older adults, the Task Force recommends home-based depression care management, and clinic-based depression care management.

Reports and Resources

Return on Investment

  • Clinical evidence shows treatment for depression reduces workplace absenteeism.
    While these studies used different criteria for diagnosing depression, different methods of treating depression, and different treatment outcome measures, the overall results were very consistent: about a 40-55% reduction in absenteeism with treatment of depression with usual care,and 20-30% further reduction with enhanced care.1,2,3

References

  1. Greenberg PE, Kessler RC, Birnbaum HG et al. (2003). The economic burden of depression in the United States: how did it change between 1990 and 2000? J Clin Psychiatry 2003; 64(12):1465-1475.
    This economic analysis estimated the average cost of treating a depressed person using national data. Published utilization data for individuals receiving medical treatment for depression included: the National Ambulatory Medical Care Survey, Mental Health, United States, 2000, the National Hospital Discharge Survey, and the National Nursing Home Survey. Average direct costs for the treated depressed were estimated to be $3,309 per case.
  2. Lerner D, Adler DA, Chang H, Lapitsky L, Hood MY, Perissinotto C, Reed J, McLaughlin TJ, Berndt ER, Rogers WH (2004). Unemployment, Job Retention and Productivity Loss Among Employees With Depression. Psychiatric Services, 55:12, 1371-1378
    Baseline and 6-month follow-up data were collected from employees with major depression (n=75) and a control group (n=169). Those with major depression had 1.9 days missed from work during a two-week span, compared to 0.7 days for the control group. This translates to approximately 60 and 18 days per year respectively. Those with major depression reported lost productivity of 19.6%, compared to 6.6% in the control group.This paper highlights the importance of keeping a workforce healthy. Through a careful literature review and long-term thinking, the authors contend that investing in healthy human capital will pay off large dividends in the long run. This paper also cites many publications that are used in this model.
  3. Simon GE, Revicki D, Heiligenstein J, Grothaus L, VonKorff M, Katon WJ, Hylan TR, (2000).Recovery from depression, work productivity, and health care costs among primary care patients. General Hospital Psychiatry, 22, 153-62.
    This study examined 290 adults with major depression who were beginning antidepressant treatment. Patients who had improved or remitted (term implies "recovered") after 12 months reported fewer days missed from work due to illness (10.4 and 6.3 in two years) compared to patients who had not improved (16.8). Patients who were improved or remitted after 12 months had lower health care costs during the second year of follow-up ($2,345 and $2,236) compared to patients who had not improved ($6,365). The authors conclude that recovery from depression is related to significant reductions in work disability and possibly related to reductions in health care costs.

Partners

More Information

New York State Office of Mental Health
44 Holland Avenue
Albany, New York 12229
1-800-597-8481 (toll-free)

Specific contact information: http://www.omh.state.ny.us/omhweb/contact/