Nearly three quarters of all people who visit hospitals frequently with physical ailments also struggle with mental health disorders or substance abuse or both. That’s according to a surprising new study. Right now, New Jersey requires behavioral health care centers to be separate from medical healthcare centers. But the study suggests the two intersect and their treatment should intersect as well. Center For State Health Policy Director Joel Cantor told NJTV News Anchor Mary Alice Williams that physical and metal health issues need to be treated together.
Cantor said that there were a couple of surprising things found in the study. He said that one is the high magnitude of behavioral health conditions among people who are high users of hospital care and that is people who had an in-patient stay at last once a year over a four year period. Another surprising finding, Cantor said is that it is a phenomenon that is seen pretty much across the entire population, so it is not just low-income areas or Medicade, it is private insurance and Medicare, it is widespread.
“What we can tell you is that sometimes the hospital stays are caused by mental health or substance abuse problems, sometimes they are not. The people who are in the hospital also have these behavioral health conditions. In either case, having serious mental health or substance use disorders can really get in the way of taking care of yourself, of adhering to the prescriptions the doctors give you. Very often, people with frequent hospital stays have multiple chronic conditions. They may have diabetes and hypertension and heart failure, very hard to manage conditions and having behavioral health involved can make taking care of yourself with those conditions that much harder,” said Cantor.
When asked how of the relating issues relate to rising healthcare costs, Cantor said that it is a big part of the healthcare costs. He said that roughly 5 percent of the population accounts for fully half of healthcare spending and the people that were studied were in that top 5 percent. He said that helping patients manage their conditions better can lead to very large scale savings throughout the whole system.
Cantor has said that frequent hospital users “are often people for whom the healthcare system has failed.” Cantor said that physical and mental health issues are treated separately and are under different healthcare providers and have different institutions and organizations treating them. He said that the whole person needs to be treated, with the mental health providers talking with the physicians and the nurse, to come up with a plan together to work together to address both problems.
“There are a number of states that have been working to integrate behavioral health and physical health services and there are some really promising models, Missouri is one. New Jersey is pursuing within the Medicade program, some changes that are promising. They are not quite implemented yet. Having providers be responsible for the total care of the patients is really the key,” said Cantor.