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Mental Health System 'Close to Fracture'

Joe Cantlupe, for HealthLeaders Media, July 7, 2011

In the wake of healthcare reform, Mark Newton, CEO of Swedish Covenant Hospital, in Chicago, IL, points out in HealthLeaders Media's June intelligence report, Better Care and the Bottom Line, that the country's mental health delivery system is "close to fracture."

For the American public, the January 8 shooting of Rep. Gabrielle Giffords, (D-AZ) and the killing of six people at a Safeway supermarket in Phoenix, where she was meeting constituents, focused attention on the mental health system in Arizona and elsewhere in the states. Her alleged shooter, a 22-year-old college dropout, was declared by a federal judge incompetent to stand trial. Mental health experts say he suffers from schizophrenia.

Community-based mental health service providers are reducing services, and relying more on hospitals to provide psychiatric care. The National Alliance of Mental Illness (NAMI) notes in a statement that economic conditions in the U.S. have "dramatically impacted an already inadequate public mental health system." From 2009 to 2011, "massive cuts" to non-Medicaid state mental health spending totaled nearly $1.6 billion, with deeper cuts anticipated through next year, which also impacts community and hospital-based psychiatric care and patient access to medication, according to NAMI.

Newton says dealing with mental health is among the "deeper, more fundamental issues" at play for healthcare leaders as they address other issues, such as accountable care organizations, physician integration, and overall planning for healthcare facilities.

 "We see a lot of mental health issues involved with patients coming through the emergency rooms, and then there are co-existing conditions as well," Newton told me. "I actually think that mental health is underplayed."

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