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Filling the Demand for Mental Health Specialists

Cheryl Clark, for HealthLeaders Media, August 4, 2010

Yet only one in three of those who reported these mental health issues actually visited a mental health professional for treatment, in part because of fear of stigma, and in part because of lack of insurance coverage, the survey said. The problem is especially severe among Latino and Asian immigrants.

Additionally, this was the survey's snapshot for 2005, several years before the recession and the historic rise in the number of unemployed, which created economic pressures that have undoubtedly made the problem much worse.

"In the U.S., mental illness accounts for approximately 25% of disability and is a leading cause of premature death," the UCLA report says. "Aside from reducing overall year and quality of life, untreated mental illness has been associated with suicide, substance abuse, homicide, heart disease and other medical conditions, work or school problems, family conflicts, relationship difficulties, social isolation, poverty and homelessness."

Aguilar-Gaxiola says that in many cases, people who have mental health issues often seek care because they are having symptoms and know something is wrong, "but they don't know they have a mental disorder and don't describe what they're feeling or their symptoms like that. Instead, they describe it as a physical condition."

There is emerging evidence, he continues, "that the coexistence of mental conditions with physical conditions is the rule rather than the exception. When these patients come to the emergency room, they present with specific aches and pains, and it is up to the emergency room specialists to sort that out."

He adds, "If we had more behavioral health providers co-located in these emergency rooms, more often these patients would be appropriately triaged and treated more appropriately. But that is not the case.  Unfortunately, this tends to be very expensive, and now, providers are in budget cutting mode."

Stephen Mayberg, director of the California Department of Mental Health which funded the UCLA study, notes that "Some people with mental illness are not taken seriously by physicians when they have a physical complaint because they have mental illness. Other people with a mental illness who do not have access to medical care often develop chronic health conditions."

Aguilar-Gaxiola also indicated that medical training needs to improve the way it trains future doctors by better equipping them to recognize these subtle distinctions and treat patients' physical and mental health issues more effectively.

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