Overview of mental health disparities Flashcards
Define health disparity
differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the US.
health equity
the attainment of the highest level of health for all people
Health inequality
differences between individuals or groups
Health inequity
differences that are avoidable, unfair, unjust
Healthcare disparity
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
Prevalence of any mental illness among US adults (2017)
Any adult: 18.9 % , Female>male, highest in 18-25 year old age group, highest in those with > 1 race/ethnicity
Mental health services received in the past year (2017)
Overall 42.6%, Female> male, greatest in 50+, least in the Asian population, and the most in white population
Prevalence of serious mental illness (2017)
Overall 4.5%, highest in those with >1 race/ethnicity, greatest in those 18-25 years
Mental health services in those with serious mental illness
Overall 66.7%, female> males, greatest in whites and those 50+
Adults who received healthcare for major depressive episode in the last year : epidemiology
Female: ~72%, male: ~60% overall: ~70%
Race: white: 69%, black: 58%
Adolescents who received have received treatment for major depressive episode in the last year
females: 40% and males: 36%
whites: 41% > than all other races
10th leading cause of death for Americans
suicide
% of suicides that had a mental health diagnoses
50% , the other 50% did not
2nd leading cause of death between the ages of 10-34
suicide
Highest rate of suicide by age
greatest in those 85 and older, closely followed by 55-64 age group
T or F : female suicide has been trending up
true
Suicide rate by gender
Male: 20/100,000 Female: 5/100,000
Suicide rate by ethnicity
Whites highest, lowest in blacks and Asian/pacific islander
Suicide deaths by method
50.6% by firearm, suffocation 27%, poisoning 13%
Top reasons not seeking mental health treatment
could not afford cost, thought could handle on their own, did not know where to go for services
Barriers to high quality mental health treatment
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
Mental health parity act of 1996
- 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
Health Parity Act in the FEHB
- applied in 2001
- only to federal employees
- Parity related to: cost sharing, number of visits, length of treatment limits
Mental health parity and addiction equity act
- 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
ACA and mental health
- 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
Stigma
devaluing, disgracing, and disfavoring by the general public of individuals with mental illness , can lead to discrimination, can be significant barrier to seeking care
Influence of culture and society
- may present differently with dizziness and fatigue, meaning different across cultures, coping style ( suppression and avoidance vs. head on)
WHO mental health action plan
- 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
