by Rhona Finkel
First posted on HealthWorks Collective on 12/8/2012
If you throw mental illness and addiction into one cesspool, take the graduated weight for that side of the equation, and then go about seeing how your second side fares, you might find yourself arguing that mental illness is more disabling even than cancer, with no uncertain rooms for margin.
Think I’ve totally lost my gourd? Well, let’s take a look at what happens when we’ve got the same sufferer staring down mental illness and addiction from one corner of the test tube, and your regular dread physical illnesses from another angle. It’s worse than you might imagine.
Researcher Joanna Frketich doesn’t sidle around the topic and would rather tell the truth about the comparison between mental and physical illness than offer false hope that all will be well. It’s all harsh, but her statements have the legs to carry them.
The study opens exactly like this:
“Mental illness and addiction steal more years of life than cancer and infectious disease but a provincial study by a McMaster researcher finds few of those patients get the help they need.
‘“The bottom line is that when you talk about burden of disease for mental health and addictions, it’s higher than virtually everything else,’” said Dr. John Cairney coauthor of the report and associate professor of family medicine, psychiatry and behavioural neurosciences at McMaster University. “When you look at the budget, much less money is allocated to mental health than it is to other disease conditions. That has been the case for some time.”
[I want to add in the next two lines, because I feel they say a lot about the state of our treatment affairs in this country. Here I go:] ”In spite of this, treatments are underutilized and prevention is lacking.
“While effective treatments exist for mental illness and addiction, only a small proportion of affected individuals receive them,” concludes the report. “Given the significant burden, there is a need to consider population-based prevention, promotion and treatment strategies.”
“The number of years of life lost is 1.5 times that of cancer and more than seven times that of infectious disease, according to the study published Wednesday by the Institute for Clinical Evaluative Sciences (ICES) and Public Health Ontario (PHO).”
Oh, but they’re not done yet. They’ve got a ‘sidebar’ which isn’t very sidebar-ry, but is very telling about how serious the situation we’re in is.
“Sidebar: THE BURDEN OF MENTAL HEALTH
• The five conditions with the highest burden are: depression, bipolar disorder, alcohol use disorders, social phobia and schizophrenia.
• Depression is the most burdensome condition — worse than lung, colorectal, breast and prostate cancers put together.
• Alcohol use disorders contributed to 88 per cent of the total number of deaths attributed to these conditions.”
It’s too big for us anymore just to close our eyes and not inhale when we’re around it. We need to face phobias, depressions, disabilities, dysfunctionalities–all, head on.
According to their ‘paper,’ there are some more facts about mental illness we should all know. For example it pays to know that
- According to the World Health Organization, unipolar depression was the third most important cause of disease burden worldwide in 2004. Unipolar depression was in “eighth place in low-income countries, but at first place in middle- and high-income countries.”
- In a nationally representative face-to-face household survey, 6.7% of U.S. adults experienced a major depressive episode in the past 12 months.
Their paper has more research on some harsh facts people would rather not be faced with:
- Anxiety disorders, which include panic disorder, generalized anxiety disorder, post-traumatic stress disorder, phobias, and separation anxiety disorder, are the most common class of mental disorders present in the general population.
- The estimated lifetime prevalence of any anxiety disorder is over 15%, while the 12-month prevalence is more than 10%.
- Prevalence estimates of anxiety disorders are generally higher in developed countries than in developing countries.
The paper continues to address other disorders, moving on to bipolar disorder:
“The National Comorbidity Study reported a lifetime prevalence of nearly 4% for bipolar disorder. Bipolar disorder is more common in women than men, with a ratio of approximately 3:2. The median age of onset for bipolar disorder is 25 years, with men having an earlier age of onset than women.”
- “In an insured population, 7.5% of all claimants with behavioral health care coverage filed a claim, of which 3.0% had bipolar disorder. Persons with bipolar disorder incurred $568 in annual out-of-pocket expenses—more than double the expenses incurred by all claimants. Annual insurance payments were greater for medical services for persons with bipolar disorder than for patients with other behavioral healthcare diagnoses.
- The inpatient hospitalization rate of bipolar patients (39.1%) was greater than the 4.5% characterizing all other patients with behavioral health care diagnoses.
- Bipolar disorder has been deemed the most expensive behavioral health care diagnosis, costing more than twice as much as depression per affected individual. Total costs largely arise from indirect costs and are attributable to lost productivity, in turn arising from absenteeism and presenteeism.
- For every dollar allocated to outpatient care for persons with bipolar disorder, $1.80 is spent on inpatient care, suggesting early intervention and improved prevention management could decrease the financial impact of this illness.
What about “frequent mental distress?”
Frequent Mental Distress is defined based on the response to the following quality of life question, ‘‘Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?’’ Frequent mental distress is identified as a report of 14 or more days of poor mental health in the past 30 days.
- 9.4% of U.S. adults experienced Frequent Mental Distress (FMD) for the combined periods 1993-2001 and 2003-2006.
- The Appalachian and the Mississippi Valley regions had high and increasing FMD prevalence, and the upper Midwest had low and decreasing FMD prevalence during this same time period.
Alzheimer’s Disease: “Alzheimer’s disease is the sixth leading cause of death in the United States and is the fifth leading cause among persons age 65 years and older.”
- Up to 5.3 million Americans currently have Alzheimer’s disease.
- By 2050, the number is expected to more than double due to the aging of the population.
So there we have it. These illnesses sap those who suffer from them, and sap our health system, and our means of dealing with them appropriately and skillfully are far from fully developed. And, in fact, we as a society don’t work as hard as we should and could to better prepare our members for dealing with emotional misalignment and addiction.
And so we pay a very great price, finding mental illness more malignant than, well, melanoma.