Consumer Health Mental Health Care

Extent of mental health needs Practitioners Types therapy Selecting a therapist Hospital care Questionable “self-help” products

Extent of Mental Health Needs 40 million aged (22% of US pop.) Only 25% being treated 2.7% have most severe disorders Only 40% get treatment At least 1 in 5 children and adolescents aged 9 – 17 27% get treatment on health sector 20% get treatment at school 5% are extremely impaired 8.6 million aged 65+ (25% of 65+ pop.)

Healthy People 2010 and Healthy Campus 2010 Two overarching goals 28 focus areas 467 specific objectives and 178 college objectives 10 Leading Health Indicators

Leading Health Indicators Ten Major Public Health Issues 1. Physical activity 2. Overweight and obesity 3. Tobacco use 4. Substance abuse 5. Responsible sexual behavior 6. Mental health 7. Injury and violence 8. Environmental quality 9. Immunization 10. Access to health care Click to go to the 4 slides related to the Leading Health Indicator. Click on  in lower right corner of next slides to return to this slide. 

Mental Health Leading Health Indicator 7-3b6. Increase the proportion of college students who have received information on suicide prevention. Baseline 12.2%, 2010 Target 55% Reduce the rate of suicide attempts by adolescent and college students (12- month average rate). Baseline 1.5%, 2010 Target 1.0% 

Mental Health Leading Health Indicator 7-3b6. Increase the proportion of college students who received information from their college about suicide prevention. Targets: Baselines: Target setting method: National: Not applicable College: Better than the best. 351% improvement Our Campus: Better than the best. 634% improvement Data sources: National: Not applicable College: National College Health Assessment, Spring 2000 Our Campus: National College Health Assessment, Spring 2000 NationalDNCCollege12.2%Our Campus7.2% NationalDNCCollege55%Our Campus55% 

Mental Health Leading Health Indicator Reduce the rate of suicide attempts by adolescents and college students. Targets: Baselines: Target setting method: National: Better than the best. 62% improvement College: Better than the best. 66% improvement Our Campus: Better than the best. 86% improvement Data sources: National: 1999 Youth Risk Behavior Survey, CDC, NCCDPHP College: National College Health Assessment, Spring 2000 Our Campus: National College Health Assessment, Spring 2000 National2.6%College1.5%Our Campus2.8% National1.0%College0.5%Our Campus0.4% 

Mental Health Leading Health Indicator *Depression is defined as major depressive episode in the past year. **Treatment is defined as treatment in the past year for psychological problems or emotional difficulties at a mental health clinic or by a mental health professional on an outpatient basis or treatment for psychological or emotional difficulties at a hospital overnight or longer. Source: Substance Abuse and Mental Health Services Administration, Office of Applied Studies. National Household Survey on Drug Abuse. 1994–97. 30% Recognized depression 70% (2010 Target) College students with recognized depression Adults with depression* who received treatment,** United States, 1994–97 

Substance Abuse Leading Health Indicator 7-3b4. Increase the proportion of college students who have received information on alcohol and drug abuse prevention. Baseline 19.1%, 2010 Target 55% Reduce proportion of students using marijuana in the past 30 days. Baseline 14.8%, 2010 Target 7.8% 

Substance Abuse Leading Health Indicator 7-3b1. Increase the proportion of college students who received information from their college about alcohol and other drug use prevention. Targets: Baselines: Target setting method: National: Not applicable College: Better than the best. 188% improvement Our Campus: Better than the best. 161% improvement Data sources: National: Not applicable College: National College Health Assessment, Spring 2000 Our Campus: National College Health Assessment, Spring 2000 NationalDNCCollege19.1%Our Campus21.1% NationalDNCCollege55%Our Campus55% 

Substance Abuse Leading Health Indicator 26-10b. Reduce proportion of adolescents ages and college students reporting use of marijuana during the past 30 days. Targets: Baselines: Target setting method: National: Better than the best. 92% improvement College: Better than the best. 93% improvement Our Campus: Better than the best. 87% improvement Data sources: National: 1998 National Household Survey on Drug Abuse, SAMHSA College: National College Health Assessment, Spring 2000 Our Campus: National College Health Assessment, Spring 2000 National8.3%College14.8%Our Campus7.8% National0.7%College1.0%Our Campus1.0% 

Substance Abuse Leading Health Indicator Use of alcohol and/or illicit drugs, United States, 1994–98 Source: Substance Abuse and Mental Health Services Administration, Office of the Assistant Secretary. National Household Survey on Drug Abuse. 1994–98.  39% College student binge drinking 20% (2010 Target) 18% College student illicit drug use 8% (2010 Target) 31% College students reporting no alcohol use in past 30 days 15% (2010 Target)

Major Disorders Schizophrenia Brain disease (not psychological) 2 million in US (~1%) Affective disorders Depression 6.3% of women, 3.3% of men Manic depression 1% of adults Anxiety disorders Panic, obsessive-compulsive, PTSD, phobias 19% of US pop.

Costs Direct costs $69,000,000,000 Lost productivity & disability insurance $75,000,000,000 Crime, criminal justice, property loss $6,000,000,000 Payers 53% government, 28% insurance, 19% out- of-pocket

Practitioners Psychologists Psychiatrists (MDs) Psychoanalysts Social Workers Certified Mental Health Counselors Psychiatric Nurses Marriage and Family Therapists Sex Therapists

Types of Therapy: Psychotherapy Psychodynamic treatments Supportive therapy Cognitive therapy Behavior therapy Biofeedback Group therapy Marriage Hypnosis

Frequent Therapies Psychodynamic therapy Interpersonal therapy Cognitive therapy Behavioral therapy

Types of Therapy: Drug Antianxiety Minor tranquilizers For anxiety, detox Valium, Prozac Antipsychotic Major tranquilizers For hallucination, thought disorders Risperidone, olanzapine

Types of Therapy: Drug Anti- Depressants Manic agents Obsessive-compulsive

Selecting a Therapist Sources Family physician, societies, community mental health centers Check terms of health care plan

Warning Signs of Mental Illness Marked personality change Inability to cope with problems & daily activities Strange or grandiose ideas Excessive anxieties Prolonged depression and apathy Marked changes in eating or sleeping patterns Thinking/talking about suicide or harming self Extreme mood swings, high or low Abuse of alcohol or drugs Excessive anger, hostility, or violent behavior

Hospital Care Danger to self Suicidal Eating disorder Dangerous to others Not functional in community

Questionable “Self-Help” Products Subliminal tapes Personal biofeedback equipment Self-help instruction programs Brain wave synchronizers Bach Remedies Dietary supplements, herbs, hormones Sensitivity training Meditation Megavitamins Feingold diet

Mental Health System in the Next Century Human rights will be established as fundamental in our health care system Consumers and family members will seek and be given more responsibility for health and health care Technology will become a primary vehicle for delivering health care Genetic treatments for biologically based disorders will become routine

Summary Extent of mental health needs Practitioners Types therapy Selecting a therapist Hospital care Questionable “self-help” products