(May 30, 2018) Research Roundup is a monthly public service of the Office of Research and Public Affairs. Each edition describes a striking new data point about serious mental illness and summarizes recently published research reports or developments. This roundup marks the last of the series for Mental Health Awareness Month to bring awareness to research into the impacts of the most severe of psychiatric diseases, which are often ignored by national media campaigns.
DATAPOINT of the Month
- 2.12% of state expenditures spent towards public mental health care
In Fiscal Year 2016, on average State Mental Health Authority expenditures represented 2.12% of the total states budget. This ranged from below 0.75% in Indiana, Arkansas and Kentucky to more than 4% in Pennsylvania, Arizona and Maine. To see your state's data, click here.
RESEARCH of the Month
- The role of serious mental illness in superutilization after Medicaid expansion
The expansion of Medicaid coverage in the states that adopted it through the Affordable Care Act significantly improved insurance coverage for millions of low-income single adults. This includes providing coverage for individuals who are superutilizers of health care and social service systems, a population known to have high rates of serious mental illness, substance use disorders. As we reported in our 2017 report, A Crisis in Search of Data, serious mental illness and superutilization includes the societal consequences for not treating these diseases including homelessness and criminal justice involvement.
New research published this month in Health Affairs finds that individuals covered under Medicaid expansion in Hennepin County, Minnesota, who are high utilizers of health care services incurred expenses more than four times higher than other Medicaid expansion enrollees. Almost 90% of the Medicaid expansion enrollees who were high utilizers had a mental illness, 48% were homeless and 70% had criminal justice system involvement. The authors echo our findings, concluding that the significant cross-system service use among these individuals suggests that collaborations across siloes are needed to improve care and reduce costs.
Diaz Vickery, K. (2018, January). "Cross-sector service among high health care utilizers in Minnesota after Medicaid expansion." Health Affairs. - Psychotropic medication use among individuals with schizophrenia and schizoaffective disorder
Antipsychotic medications are the keystone treatment for schizophrenia and other psychotic disorders but are rarely used alone to address all the symptoms and needs of individuals with these disorders. Oftentimes other psychotropic medications, including mood stabilizers, antidepressants and sedative drugs are also used despite the limited evidence about their safety when individuals simultaneously use these and other drugs.
In a new article published in Psychiatric Services, authors conducted a review of Medicaid claims from 45 state Medicaid programs to determine the filled prescriptions for psychotropic medications for individuals with schizophrenia or schizoaffective disorder. The authors found that in 2010, 86% of patients with schizoaffective disorder and 70% of patients with schizophrenia were treated with both antipsychotics and other psychotropic drugs such as a mood stabilizer or antidepressants.
The authors conclude that due to the widespread use of psychotropic medications for individuals with schizophrenia and schizoaffective disorder, more research is needed to determine the efficacy and safety of these medications for appropriate usage in mental illness treatment.
Scott Stroup, T. et al. (2018, May). "Psychotropic medication use among adults with schizophrenia and schizoaffective disorder in the United States." Psychiatric Services. - Federal watchdog investigates state Protection and Advocacy programs for Individuals with Mental Illness
The United States Government Accountability Office (GAO) serves as Congress' watchdog investigating how the federal government spends taxpayer dollars. As part of the 21st Century Cures Act signed into law by President Obama in 2016, the GAO was mandated to review state Protection and Advocacy for Individuals with Mental Illness (PAIMI) programs to review their activities and compliance with statutory and regulatory requirements. PAIMI programs are designed to safeguard rights of individuals with serious mental illness, who are at higher risk of abuse and neglect due to their illness.
The GAO found that in the eight states they reviewed, 74% of PAIMI cases were resolved in the client's favor. In most states reviewed, the majority of cases filed to PAIMI were for rights complaints, except in Georgia and Texas, in which more than 50% of cases reported by the state PAIMI programs were complaints of neglect.
United States Government Accountability Office. (2018, May). Report to Congressional committees: Federal procedures to oversee protection and advocacy programs could be further improved.
Elizabeth Sinclair
Director of Research
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Research Weekly is a summary published as a public service of the Treatment Advocacy Center and does not necessarily reflect the findings or positions of the organization or its staff. Full access to research summarized may require a fee or paid subscription to the publications.
The Treatment Advocacy Center does not solicit or accept funds from pharmaceutical companies.