Individuals with depression and
limited access to treatment incurred an average of nearly three times the
annual out-of-pocket costs for medication, psychotherapy and other
treatment costs than individuals with less restricted access ($4,312 versus
$1,496), according to results of a new survey. Credit card debt and other
negative social consequences attributable to depression further contributed
more than $13,500 in out-of-pocket costs. However, results reveal that the
costs of depression are not just financial, but social, given that as few
as one-third of those with limited access to treatment reported being
satisfied in either their job or relationship with a spouse or partner.
This survey, sponsored by the National Alliance on Mental Illness
(NAMI) and funded by Wyeth Pharmaceuticals, is part of a nationwide effort
to examine access to mental health services for those living with
depression in five large bellwether states (California, Florida, New York,
Ohio and Texas). Findings from this effort suggest that among these five
states, there are individual budget and workforce challenges that may
hinder access to appropriate care.
"This survey pinpoints exactly how lack of access to treatment harms
the job prospects, financial situation and personal relationships of people
living with depression," said Dr. Ken Duckworth, NAMI Medical Director.
"Clearly, a person's family, employer, creditors, and society as a whole
also suffer. These findings should provide new impetus for all stakeholders
impacted by this disease to ensure that those who suffer from depression
have access to optimal treatment."
Among the 662 respondents who participated in the national sample of
the survey, those with limited access to treatment were more than four
times as likely to quit their job (27 percent versus 6 percent) and twice
as likely to be fired from their job (20 percent versus 10 percent) because
of their depression.
Additionally, limited-access respondents were more likely to report
that, during the last 30 days, they had unpaid bills more than 60 days
overdue (34 versus 12 percent), were afraid they couldn't make their
rent/mortgage payment (22 percent versus 8 percent), and were unable to
afford the necessities of life (30 percent versus 11 percent).
"This survey illustrates the depths of this disease and the important
need for treatment and support," said Dr. Duckworth. "With proper
diagnosis, access to treatment and adequate support, recovery is possible.
We hope these findings will encourage the ongoing efforts of the
individual, their families and their communities to ensure adequate access
to care."
Individual State Findings
To gain an understanding of the personal and economic costs of
depression in the five states, Harris Interactive administered an online
survey to respondents in the five key states, as well as to a national
sample. Respondents answered questions about the social and economic impact
of their depression symptoms on their lives, access to appropriate
treatments, as well as symptomology and treatment efficacy. Findings from
this research indicate that:
-- People with depression are not being fully diagnosed
Results revealed that many Americans living with depression have
symptoms of other related conditions, such as bipolar disorder or
generalized anxiety disorder (GAD), that have not yet been officially
diagnosed. In fact, while 70 percent of respondents indicated the
presence of symptoms of generalized anxiety disorder -- a disease that
often coexists with depression -- only 20 percent of those respondents
had been officially diagnosed.
-- Only a small minority of people with depression are receiving dual
therapy (prescription medication and talk therapy)
Survey results also showed that many Americans living with depression
are under-treated. While studies demonstrate that a combination of
prescription medication and psychotherapy enable the most effective
treatment of depression symptoms, less than 15 percent of Americans
living with depression are currently receiving both treatments. Among
the five states, Floridians were the most likely to be receiving both
treatments, but at 27 percent, there is clearly room for improvement.
-- The shortage of mental health care professionals is impacting care
Texas, in particular, is suffering a tremendous shortage of mental
health care workers. Although the economic burden of depression on the
state tops $16.6 billion, Texas ranks 38th out of 50 states in the
number of psychiatrists per 100,000 people, 40th in psychologists and
45th in social workers. Survey results underscore the impact of this
shortage, as a higher percentage of survey respondents in Texas with
health insurance who have been diagnosed with depression reported that
they have not seen a particular physician because they were out of
their health insurance provider network (32 percent versus 18 percent
of the national average).
-- People with depression who live in states with no mental health parity
law may have more limited access to treatment
Ohio and New York are two of only 13 states that do not have a state
mental health parity law in place -- which increases access to
treatment without increasing costs by providing mental health benefits
that are equal to physical health benefits. For residents in these
states with limited access to treatment, the impact is clear. In Ohio,
residents with limited access have higher out-of-pocket medication
costs than those with less restricted access (35 percent versus 9
percent who pay more than $50 per month). Similarly, New Yorkers with
limited access pay more than six times the out-of-pocket costs for
medication, psychotherapy, and other treatment costs than residents
with less restricted access ($6,450 versus $957).
-- Self-reported depression among minority groups may be on the rise
Studies indicate that individuals in minority groups underreport
depression and other mental illnesses. However, data from this survey
revealed that minorities were just as likely as Caucasians to
self-report their depression diagnosis. Additionally, Hispanics and
African-Americans experienced more severe depression symptoms than
Caucasians. These findings may reflect either an increased awareness of
depression within minority communities or gross disparities in the
availability of treatment for minority groups versus Caucasians.
About the Survey
This survey was conducted online by Harris Interactive(R) among 2,880
people in five state samples (California, Florida, New York, Ohio, and
Texas) and among 662 people from a national sample, for a total of 3,542
respondents (aged 18 and older) between March 28, 2006 and April 17, 2006.
In this survey, limited or low access was defined as either having no
health insurance, being in a health savings account-qualified health plan
where costs are not reimbursed until a high minimum deductible is met (at
least $1,050 for individuals and at least $2,100 for a family), being
enrolled in a pharmacy benefit plan that provides no coverage for certain
brand-name pharmaceutical agents (self-reported data), or being enrolled in
a health plan which, respondents claim, either provides no coverage for
physician visits, or no coverage for prescription medication.
Figures for age, sex, race/ethnicity, education, region (for the
national sample) and household income were weighted where necessary to
bring them into line with their actual proportions in the population.
Propensity score weighting also was used to adjust for respondents'
propensity to be online. With a pure probability sample of 662 adults one
could say with a ninety-five percent probability that the overall results
have a sampling error of +/-4 percentage points. Sampling error for sub
sample results is higher and varies, however, that does not take other
sources of error into account. This online survey is not based on a
probability sample and therefore no theoretical sampling error can be
calculated.
Harris Interactive designed and fielded the survey, analyzed the data
and wrote an initial report, which was subsequently reviewed by Booz Allen
Hamilton.
About NAMI
The National Alliance on Mental Illness (NAMI) is the nation's largest
nonprofit, grassroots, self-help, support and advocacy organization of
consumers, families, and friends of people with severe mental illnesses.
Through its affiliates and volunteer members, NAMI works to achieve
equitable services and treatment for the millions of Americans living with
severe mental illnesses and their families.
Access to mental health services is significantly impacted by public
policy decisions made by the state legislature and state government
agencies. For a discussion of the current mental health public policy
environment in each of the individual states, including a discussion of
needed public policy improvements, visit nami/grades .
- Based on the data from the Harris Interactive survey, Booz Allen
Hamilton provided an aggregate estimate of the individual cost of
depression for treatment and other health-related expenditures. This
estimate includes the annual deductible and annual costs of prescription
medication and psychotherapy.
National Alliance on Mental Illness
nami/grades
Комментариев нет:
Отправить комментарий