Americans spend almost $23 billion for mental health care, and lost productivity from mental illness costs the nation almost as many billions of dollars at the workplace. It has become such a significant health care concern that an influential health care advisory body has stepped up its advice to all physicians in the United States to regularly screen for the the group of mental illnesses commonly known as depression. The new advice, for the first time, also underscored the importance of the screenings for women who are pregnant and who have just given birth.
Early reaction has been largely favorable to the recommendation by the U.S. Preventive Services Task Force, the independent body that recommends best practices for prevention and early detection of a whole range of serious diseases.
The USPSTF previously had suggested doctors use standard questionnaires and other diagnostic tools to detect depressive symptoms, especially if follow-up care could be provided. The task force said mental health care since has become more widely available. Its recommendation for pregnant and new moms to be screened was welcomed. As one psychologist in the Pacific Northwest told NPR: “Historically, depression in these populations has been under-recognized and under-treated.”
Women, quoted in the public radio story as well as in the Times, told of the anguish they had suffered with post-partum depression, one of several depressive disorders. A North Carolina psychiatrist told the Times that many women shy away from talking to their doctors on their own about depression, because, if a mother is “feeling so anxious [as if] you’re going to come out of your skin or feeling that you’re going to harm your baby, you may think: ‘Oh, my God, I’m having these crazy feelings and nobody’s talking about it. I must be a terrible mother.’ ”
Based on the USPSTF recommendation, depression screenings now will be covered by insurance under the Affordable Care Act. Proponents of the ACA, also known as Obamacare, long have argued that it would boost coverage for mental health care. However some research and experts question whether the administration has fallen short of the act’s stated goal of parity for mental health care compared to physical diseases.
Depression’s role, toll
In its screening recommendation, the USPSTF said that front-line, primary care physicians could be valuable in battling depression. Treatment for the ill, which includes the longer-standing approach of psychotherapy, has seen some advances, particularly with new drugs. The medications require close medical supervision, and they can be problematic for younger patients. The meds are powerful, and have not been approved for use in children, though some physicians — for reasons that defy good sense, in my view — prescribe these and other psychiatric drugs even to tots, as I have written before.
Living with depression can be a struggle; any efforts by the health care system to assist those afflicted should be welcomed. The call for broader screening recognizes that mental illnesses are becoming an even greater problem in this country. Depression and the despair it can create no doubt contributes to the surprising recent finding that American whites, both young and middle aged, are seeing shorter lifespans, as I have written lately. Further research on this topic is highlighting the contributing factors, too, of poor health and healthcare. Although popular culture slowly has caught up with the disorders’ debilitating effects and its links to many famous creative individuals, society still far too often stigmatizes those with mental illnesses. This needs to stop.
It may be science that will help change negative attitudes toward mental illness by illuminating these disorders more. And, even as lots of public attention got paid to depression, a new, large study on the causes of schizophrenia also has snagged the media spotlight. As the New York Times described it:
[The study] will not lead to new treatments soon, experts said, nor to widely available testing for individual risk. But the results provide researchers with their first biological handle on an ancient disorder whose cause has confounded modern science for generations. The finding also helps explain some other mysteries, including why the disorder often begins in adolescence or young adulthood.
Researchers delved deep, down to the molecular and genetic level to better understand the root causes of schizophrenia, a chronic and severe mental disorder that experts say affects how a person thinks, feels, and behaves, causing some patients to seem as if they have lost touch with reality. It is one of the more severe mental disorders, with symptoms most frequently starting in the teen to young adult years. Two to three million Americans have schizophrenia. Clinicians, because they don’t know schizophrenia’s causes, treat its symptoms with potent antipsychotics, psychotherapy, and individual, group, or institutional care.