Setting the Context

1
Setting the Context

• Ron Manderscheid, PhD
• Constella Group, LLC
• Johns Hopkins University

2
The Issue

• Mental and Substance Use Conditions
• Any
  Disabling
• Adults 25 6
• Children and Adolescents 20 9-13
• Action Issue Can we reduce these numbers through
  prevention and early care?

3
The Issue

• An Example The Window of Opportunity
• Teenage Girl
• Age 13 Age 20
• I--------------I-----------------I----------I
  
• Anxiety I Window? I Alcohol/
  
  
• Drug
  Use

4
The Effect Leading Causes of Disease Burden by
Select World Bank Regions, 2001

• High-Income Countries
  
• 3. Depression
• 4. Alzheimers and other dementias
• 9. Alcohol use
• Low and Middle Income Countries
• 4. HIV/AIDS
• 7. Depression
• Action Issue Can we reduce the level of
  disability caused by these conditions?

5
The Cost

• Specialty Care 120 Billion/Year (400 per
  American)
• States (All Departments) 100 Billion/Year
• SSI/SSDI 19 Billion/year
• Medicare 41 Billion/Year (Exclusive of
  Pharmacy)
• Action Issue Can we spend smarter?

6
The Care

• Mental and Substance Use Care
• Any
  Disabling
• Adults 50 65
• Children and Adolescents 15 25
• Action Issue Are we reaching those who are most
  in need of care?

7
Some Major Policy Concerns

• Public mental health consumers die 25 years
  younger than other Americans.
• 25 of college students are prescribed
  psychotropic medications.
• Almost 1 of Americans used methamphetamine in
  the past year.

8
Key Policy Responses

• Presidents New Freedom Commission
• Foster recovery-oriented care
• Foster consumer and family direction of care

9
Key Policy Responses

• Presidents New Freedom Commission
• Americans understand that mental health is
  essential to overall health.
• Mental health care is consumer and family driven.
• Disparities in mental health services are
  eliminated.

10

• Presidents New Freedom Commission
• Early mental health screening, assessment and
  referral to services are common practice.
• Excellent mental health care is delivered and
  research is accelerated.
• Technology is used to access mental health care
  and information.

11
Key Policy Responses

• Institute of Medicine Study
• Improve the quality of care Safe,
  Person-Centered, Efficient, Effective, Equitable,
  Timely.
• Implement collaborative care among mental health,
  substance use, and primary healthcare.
• Action Issue How can these recommendations best
  be implemented?

12
Contact

• Ron Manderscheid, Ph.D.
• Director, Mental Health and Substance Use
  Programs
• Constella Group, LLC
• 6003 Executive Boulevard, Room 416
• Rockville, Maryland 20852
• 240-514-2607 (Voice)
• 301-787-1414 (Cell)
• 240-514-2601 (Fax)
• rmanderscheid_at_constellagroup.com
• www.constellagroup.com
• Enhancing human health around the world, every day