1. An Innovative Mental Health Center

2. Reasons for HOPE: Advances in Mental Health Care Presented by Paul E. Keck, Jr., M.D. President and Chief Executive Officer, Lindner Center of HOPE Professor, University of Cincinnati College of Medicine

3. Prevalence of Mental Illness By the numbers: Mental illness – depression, bipolar disorder, schizophrenia, addictions, anxiety and eating disorders – constitute the #1 public health problem facing Americans. 1 out of 4 people are affected by mental illness in their lifetime. Less than half receive adequate treatment. (Reports from the Surgeon General)

4. Prevalence of Mental Illness By the numbers: 26.2%, approximately 60 million, adult Americans suffer from a diagnosable mental disorder in any given year. Depression alone affects up to 14.8 million American adults (The National Institute of Mental Health (NIMH), 2009)

5. Lifetime Prevalence Adults 510 1520 Eating Disorders PTSD ADHD Mood Disorders Anxiety Disorders Cancer (All) Percentage of US Population Coronary Heart Disease Diabetes (NIMH, 2009; Am. Cancer Society 2006; Am. Diabetes Assn, 2008; Am. Heart Assn, 2006) 8% 5.6% 3.7% 9.5% 4.1 % 15% 3.5% 1-3%

6. Leading Causes of Disability in the World CausesTotal (millions)Percent of total 1 Unipolar major depression50.810.7 2 Anemia22.04.7 3 Falls22.04.6 4 Alcohol Use15.83.3 5 Chronic obstructive pulmonary disease 14.73.1 6 Bipolar disorder14.13.0 7 Congenital anomalies13.52.9 8 Osteoarthritis13.32.8 9 Schizophrenia12.12.6 10 Obsessive-compulsive disorders10.22.2 (World Health Organization 1990)

7. The Good News Remission and recovery is the achievable goal for most psychiatric illnesses Vast improvements in diagnostic accuracy over the last 25 years Enormous advances in efficacy and safety of treatments (over 25 new medicines and 2 new devices FDA approved since 1988) 5 new time-limited, focused, illness-specific forms of counseling established from sound research

8. Recent Advances in Treatment Medicines Asenapine Iloperidone Paloperidone Lisdexamfetamine Guanfacine Research Medicines that work in new ways for depression

9. Recent Advances in Therapy Dialectical Behavioral Therapy Resilience Therapy for PTSD Specific therapies for skills and cognitive problems in schizophrenia

10. Recent Advances Transcranial Magnetic Stimulation Proven effectiveness for depression Potential benefit for bipolar disorder, PTSD, migraine, eating disorders Deep Brain Stimulation Effective for severe, treatment-refractory depression Potential benefit for severe, treatment- refractory OCD

11. Current Research at Lindner Center of HOPE Genetics of bipolar disorder study (with Mayo Clinic) New medicines for Bipolar II depression Bipolar I depression Depression Binge eating and bulimia nervosa Bipolar disorder with anxiety symptoms

12. Gene to Jean Long-term research needs Linking genetic risk to brain imaging to treatment development and outcome Understanding genetic factors contributing to medication response and side effects New medicines that work in more specific and novel ways compared with currently available medicines (a 3 rd generation of progress)

13. The Problem: Access to Quality Care Only about one-fifth of the 60 million Americans suffering from a diagnosable mental disorder will receive adequate care. At least three-fifths will seek medical treatment instead of mental health care. An estimated 60 percent of all primary care visits are to some extent related to depression or anxiety. (NIMH, 2009)

14. Real Productivity Costs Illness Related Disability (US) 0%4%8%12%16%20%24% Alcohol/Drug Use Diabetes Cancer Infectious Diseases Arthritis Cardiovascular Diseases Mental Health Conditions Alcohol/Drug Use (Mental Health America 2009)

15. Add It Up The cost of untreated mental illness in 2008 = $338.9 billion in lost productivity Cost of mental illness treatment = $9.03 billion (Kessler et al. Am J Psychiatry 2008)

16. Why the Huge Gap? Reluctance to recognize the legitimacy of mental health parity Reluctance to pay for quality mental healthcare Failure to recognize the real costs

17. Psychiatric Healthcare: “The most significant untapped source of health care cost savings”

18. The Bottom Line Together we can make a paradigm shift happen. Some of the work is already being done. Cincinnati has a tremendous opportunity to be a national leader.

19. Thank You Thank you for all that NAMI does.

20. 888-536-HOPE (4673) lindnercenterofhope.org