Every year during the month of May, we recognize Mental Health Awareness month. As a mental health professional, I am grateful there is a month dedicated to this issue – but quite frankly, one month a year is not enough to address what I believe to be the most pressing public health issue of our time.
Nationwide, more than 43 million Americans – one in five of all adults – suffer from a mental health condition. Washington state is no different, with over a million people affected by a mental health or substance use disorder. Even more alarming, our suicide rate is 10.5 percent higher than the national average, and here in Pierce County, the suicide rate is a shocking 46.8 percent higher. Alarmingly, suicide is the second leading cause of death among young adults in Washington.
The cost of mental health on our society is tremendous – both in lives and resources. With each life lost, literally dozens of others are affected. According to a study published in the journal “Health Affairs,” in 2013 the United States spent an estimated $201 billion on mental disorders such as anxiety and depression – making these conditions the leading drivers of escalating healthcare costs in our country. According to the World Health Organization, depression is the leading cause of disability worldwide.
What can be done to tackle this urgent challenge to our communities? The short answer: there is no quick fix. Instead, we must take a long view, recognizing that it could take many years to see real progress around mental health. First and foremost, we must rethink the way we view mental health in this country. There are still significant stigmas in our society surrounding mental illness. We need to understand that there is no health without mental health.
Further, we must recognize there is not a single solution. There must be significant collaboration between health care organizations, educational institutions, community organizations, government entities, physicians, and citizens. Only together can we begin to chip away at this widespread public health problem.
My health care organization, CHI Franciscan Health, has been out in front on this issue, leading the charge to rethink its approach to behavioral health care, implementing various strategies across the Puget Sound and the region.
- CHI Franciscan recently formed a partnership with MultiCare Health System to build a 120-bed adult Behavioral Health Hospital with the goal of addressing the critical shortage of inpatient psychiatric care in Pierce County. While the national average of psychiatric hospital beds is 26.1 per 100,000 people, Washington state has just 8.3 beds – with Pierce County having only 2.8 beds per 100,000 people. The $45 million hospital will help to alleviate the critical shortage of inpatient psychiatric care in Pierce County.
- We are also moving to integrate behavioral health services into the primary care setting. Of the people struggling with depression who receive any care at all for their depression, ninety percent receive treatment for depression from their primary care provider. It’s critical that we meet people where they are – and that means partnering with primary care clinics across the Puget Sound to ensure providers have the tools they need to effectively treat their patients who are dealing with mental health issues.
- Further, we are reaching into the community to develop partnerships with community mental health agencies. For some patients suffering from a serious mental illness, their only access to medical care is through their mental health provider. By collaborating with our community partners, we hope to narrow the life expectancy gap for people suffering from serious mental illness, and improve their overall care.
- Nearly 61,000 (about 28 percent) Medicaid members in Pierce County have been diagnosed with a mental illness. Pierce County is one of the lowest performing regions in the state for mental health and substance use treatment penetration – meaning that Medicaid enrollees with a need for care don’t always receive the services they need. In partnership with the Pierce County Accountable Community of Health, CHI Franciscan is working to integrate behavioral health services with physical medicine and reduce opioid use for Medicaid recipients in Pierce County by 2020.
- Finally, we are zeroing in on suicide prevention. CHI Franciscan is working to implement the Zero Suicide model. The foundational belief of Zero Suicide is that suicide deaths for individuals under care within health systems are preventable. This model was developed by the Henry Ford Health System in Detroit, MI, resulting in the elimination of suicides among patients seen in their system.
There is no single cure-all, but collectively these strategies are important steps in our journey to improve the health and wellness of our communities. Ultimately, the mental health challenges we are facing in communities across America will not be resolved in the near-term. But if we all work together, get involved and continue to build awareness around mental illness – we will continue to make progress. So, as we come together to observe Mental Health Awareness month – it’s imperative we remember that there truly is no health without mental health.
Dimitry Davydow, MD, MPH, is the medical director for Behavioral Health at CHI Franciscan.