Before we introduce this week’s post about important disparities in 988 utilization, by Lindsey Dawson and Heather Saunders and originally published in KFF Health News, we wanted to highlight an upcoming Symposium on Responding to Behavioral Health Emergencies being held by the Medical Care section of the American Public Health Association (among others). The need… Read More »
Every older adult should have the opportunity to age successfully. And the growing older LGBTQ+ population is no exception. This group is diverse, with unique health and social needs. On average, LGBTQ+ older adults experience poorer physical and mental health, but this is by no means the case for all LGBTQ+ older adults. The adversity… Read More »
Suicide prevention and intervention programs and services are vital. Mental health services are essential to support individuals, families, and communities struggling with mental health, suicide, and after suicide loss. But we must also recognize that preventing suicide requires a larger collective, systemic response. Suicide deaths are rising steadily every year, with a record high of… Read More »
The postpartum period, recognized as the fourth trimester or the 12 weeks after birth, is often overlooked. In 2021, 52% of all maternal deaths occurred during the postpartum period. And mental health was the top underlying cause, accounting for 23% of all deaths (mostly suicides and overdoses related to substance use disorder). More than 60%… Read More »
What if there was a public health problem so big that even public health leaders were too enmeshed in its grip to be able to warn against its perils? I worry that we are in that very conundrum with regard to our relationship with technology. It has accelerated from being part of our world to… Read More »
The ACA marketplaces continue to be an important source of health insurance for millions of Americans. Achieving health equity for these enrollees may require more than simply providing coverage. The number of individuals who selected a Affordable Care Act (ACA) marketplace plan increased from 8 million [PDF] in 2014 to 16 million [PDF] in 2023.… Read More »
The way we’re addressing substance use and overdoses in the United States isn’t working. Let’s be perfectly clear: the “war on drugs” isn’t, and never was, really a war on drugs. It’s been a war waged on communities who are Black, Indigenous, and People of Color (BIPOC). The war on drugs started well before President… Read More »
The rapid transition from in-person to care to telemedicine visits at the start of the COVID‑19 pandemic did not adversely affect the quality of care – and even improved some aspects of care – for patients with major depression in a major integrated health system, according to a new report. The study appears as part of… Read More »
An Opportunity to Get Ahead of the Overdose Crisis For many Americans, drug use ‘prevention’ conjures memories of early public health campaigns using fearsome imagery and catchy slogans to deter substance use. Campaigns implored youth to “just say no” to drugs, and the public received stark warnings: “this is your brain on drugs.”
More than 150,000 avoidable deaths occur each year due to mental, emotional, and behavioral health problems. This includes nearly 50,000 suicide deaths and 100,000 overdose deaths. People with chronic persistent mental illness suffer a 20-year shorter life expectancy. This country urgently needs to address how we pay for mental health services. Medicaid is a major… Read More »
Front-line workers are always at risk. It’s in the name. The COVID-19 pandemic has made this reality more salient for everyone. Risks of sickness from COVID-19 include death and morbidity. Front-line workers may also have lost more friends and co-workers than the average person. Healthcare workers have also been subject to violence and see the… Read More »
Homelessness persists in the US, and across the world, despite decades of recognition and longstanding efforts to end the condition. There have been major successes in our understanding of what policies and programs work to prevent and end homelessness. However, the work must and will find new ways to adapt and improve if we are… Read More »
We have reached a 30-year high in the rate of suicide in the United States. Suicide risk and prevention efforts among women are the focus of a recent Medical Care supplemental issue. Efforts at prevention and recovery have been especially important for the Departments of Defense and Veterans Affairs. As mentioned in the introduction to… Read More »
Behavioral health — counseling, mental health care, and care for substance use issues — is one of the basic benefits associated with health insurance and healthcare delivery. The COVID-19 pandemic has reminded us of the gross inadequacy of current behavioral health to deliver high quality care to most Americans. The past 30 years of health… Read More »
The COVID-19 pandemic and the killing of George Floyd are further stressing the already strained U.S. mental health care system. Primary care doctors train to treat common mental health problems, and they can help alleviate this strain on the system. Mental health issues on the rise In a national survey [pdf] of primary care patients… Read More »
Postpartum depression is common, preventable, and treatable. The Agency for Healthcare Research and Quality (AHRQ) challenge competition, “Cross-Sectional Innovation to Improve Rural Postpartum Mental Health,” identifies what communities are doing to improve access to mental healthcare for rural women. Furthermore, the challenge seeks new solutions to ensure that more women and families receive the help… Read More »
COVID-19 has revealed many vulnerabilities in our societal structure. One particular vulnerability is the risk inherent in our use of congregate institutions to house and treat people. This includes the risks of inpatient psychiatric facilities. Inadvertently, the pandemic has surfaced critical questions that we should seek to answer even when the virus is under control: What is the right… Read More »
This year, teachers striking across the country have found common ground on a priority outside of typical debates around salaries or pensions. Educators in three major cities–Los Angeles, Oakland, and Chicago–among others, have been calling for more school counselors, librarians, nurses, psychologists, and social workers to support their students’ development beyond academic benchmarks. These public… Read More »
Inappropriate antipsychotic medication use among older adults with dementia is associated with increased risk [pdf] of hospitalization and death. In 2017, the rate of potentially inappropriate use was 16%, having fallen from 24% in 2011. While this decline has been substantial, further decreasing the rate is an important goal to protect the health and wellbeing… Read More »
Mass incarceration is a true epidemic. It is also one fueled by social determinants, including race. Over the past four decades of “war on drugs” and “tough on crime” policies, the US incarceration rate has increased by over 500% [pdf]. There are over 2 million men and women in jails and prisons across the country… Read More »
How happy are you? That’s a tricky question and there’s a lot that can impact your answer. According to a 2016 article in The Economist, these include factors like your financial status, health, relationships and education. One factor that might also have a big influence on your answer is your age. As a society, we… Read More »
Individuals experiencing homelessness are among the most medically, socially, economically, and politically vulnerable in our society. Because of this, patterns of service use by these individuals can often serve as indicators of the safety net capacity and overall wellness of the systems of care we have in place – like “canaries in the coal mine.”… Read More »
Do you use social media? If so, how many social media platforms (e.g., Facebook, Twitter, Instagram, Pinterest, LinkedIn) are you a member of? With about 40% of the world’s population already on some form of online social media, even if you don’t use it, you’ve probably heard of it. Devoting several hours each day to… Read More »
In many situations, randomized controlled trials are infeasible and one must draw conclusions from observational data. Certain quasi-experimental designs – for example, interrupted time series analyses – strengthen the conclusions that can be drawn from observational data. However, particularly when the intervention evaluated is important, either clinically or from a health policy perspective, implied or… Read More »
Growing up we were encouraged to learn how to manage our time. Many of us were told that time management was the key to successful careers, personal lives, and finding the balance between the two. A cursory search online of time management brings you to a world of articles, blog posts, and books on time… Read More »
What role does mental health play in preventable hospitalizations? In a new article in the January 2018 issue of Medical Care, Dr. Laura Medford-Davis and colleagues report that in Texas, mental illnesses were associated with higher odds of preventable hospitalizations. Using an administrative database of all Texas hospital admissions from 2005-2008, the authors found that 13% of… Read More »
Enrollment in Medicaid has been shown to enhance access to health care for our nation’s most vulnerable citizens. Yet despite these benefits, a substantial number of beneficiaries lose coverage at the time of renewal. An article by Xu Ji and colleagues, published in this month’s issue of Medical Care, demonstrates how critical maintaining continuous Medicaid coverage… Read More »
Violence against women and girls is an international concern that cuts across all sectors of society. The United Nations defines violence against women as “any act of gender-based violence that results in, or is likely to result in, physical, sexual or psychological harm or suffering to women, including threats of such acts, coercion or arbitrary… Read More »
Paying for value, rewarding high-value care, pay-for-performance—all are examples of terminology used to describe aligning financial incentives with clinical goals and processes. Essentially, these policies and programs seek to link quality to payment and their influence is growing, extending even to Medicare. While these concepts have been discussed repeatedly by many in healthcare, including the… Read More »
In 2013, there were 10.7 million people enrolled [PDF] in both Medicare and Medicaid. Dual eligibility depends on age, income, and disability. Dually enrolled beneficiaries are also responsible for a large share of program costs overall; 31% of Medicare fee-for-services spending for 18% of beneficiaries [PDF] who are dually enrolled. Given the additional health challenges [PDF] faced by dual eligibles, this… Read More »