Overview of mental health disparities

Question 1

Define health disparity

Answer 1

differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the US.

Question 2

health equity

Answer 2

the attainment of the highest level of health for all people

Question 3

Health inequality

Answer 3

differences between individuals or groups

Question 4

Health inequity

Answer 4

differences that are avoidable, unfair, unjust

Question 5

Healthcare disparity

Answer 5

racial or ethnic differences in the quality of healthcare that are not due to access related factors or clinical needs, preferences, and appropriateness of intervention

Question 6

Prevalence of any mental illness among US adults (2017)

Answer 6

Any adult: 18.9 % , Female>male, highest in 18-25 year old age group, highest in those with > 1 race/ethnicity

Question 7

Mental health services received in the past year (2017)

Answer 7

Overall 42.6%, Female> male, greatest in 50+, least in the Asian population, and the most in white population

Question 8

Prevalence of serious mental illness (2017)

Answer 8

Overall 4.5%, highest in those with >1 race/ethnicity, greatest in those 18-25 years

Question 9

Mental health services in those with serious mental illness

Answer 9

Overall 66.7%, female> males, greatest in whites and those 50+

Question 10

Adults who received healthcare for major depressive episode in the last year : epidemiology

Answer 10

Female: ~72%, male: ~60% overall: ~70%
Race: white: 69%, black: 58%

Question 11

Adolescents who received have received treatment for major depressive episode in the last year

Answer 11

females: 40% and males: 36%
whites: 41% > than all other races

Question 12

10th leading cause of death for Americans

Answer 12

suicide

Question 13

% of suicides that had a mental health diagnoses

Answer 13

50% , the other 50% did not

Question 14

2nd leading cause of death between the ages of 10-34

Answer 14

suicide

Question 15

Highest rate of suicide by age

Answer 15

greatest in those 85 and older, closely followed by 55-64 age group

Question 16

T or F : female suicide has been trending up

Answer 16

true

Question 17

Suicide rate by gender

Answer 17

Male: 20/100,000 Female: 5/100,000

Question 18

Suicide rate by ethnicity

Answer 18

Whites highest, lowest in blacks and Asian/pacific islander

Question 19

Suicide deaths by method

Answer 19

50.6% by firearm, suffocation 27%, poisoning 13%

Question 20

Top reasons not seeking mental health treatment

Answer 20

could not afford cost, thought could handle on their own, did not know where to go for services

Question 21

Barriers to high quality mental health treatment

Answer 21

Cost of care, lack of sufficient insurance for mental health services, mistrust of providers, fragmented organization of services, criminal justice involvement of individuals, limited availability of skilled care providers

Question 22

Mental health parity act of 1996

Answer 22

• prohibited lower annual or lifetime dollar limits on mental health benefits compared to medical or surgical benefits
• did not mandate coverage for mental health treatment
• did not address substance abuse
• did not address treatment limits, limitations, or types of facilities covered

Question 23

Health Parity Act in the FEHB

Answer 23

• applied in 2001
• only to federal employees
• Parity related to: cost sharing, number of visits, length of treatment limits

Question 24

Mental health parity and addiction equity act

Answer 24

• applied to large employer sponsored health plans
• prohibited differences in: cost-sharing, treatment limits, in and out of network coverage
• applied to treatment of substance abuse disorders
• did not preempt more stringent state parity laws
• did not mandate health coverage for mental health
• did not require specific conditions to be covered

Question 25

ACA and mental health

Answer 25

• defined coverage for mental health and substance abuse as one of the 10 essential benefits
• applied MHPAEA to insurers of individual market and plans offered through and exchange or marketplace

Question 26

Stigma

Answer 26

devaluing, disgracing, and disfavoring by the general public of individuals with mental illness , can lead to discrimination, can be significant barrier to seeking care

Question 27

Influence of culture and society

Answer 27

• may present differently with dizziness and fatigue, meaning different across cultures, coping style ( suppression and avoidance vs. head on)

Question 28

WHO mental health action plan

Answer 28

• limit number of mental hospitals
• build community mental health systems
• develop mental health services in general hospitals
• integrate mental health services into primary care
• build informal community mental health services
• promote self-care