RESEARCH WEEKLY: July Research Roundup
By Elizabeth Hancq
Research Roundup is a monthly public service of the Office of Research and Public Affairs. Each edition describes a striking new data point about severe mental illness and summarizes recently published research reports or developments.
DATAPOINT of the month
Schizophrenia is #7 most costly condition for inpatient stays for Medicaid beneficiaries.
The Agency for Healthcare Research and Quality released this month the costliest conditions for inpatient hospital stays in 2017, by payer. Schizophrenia and other associated disorders, such as schizoaffective disorder, is in the top 10 (#7) of costly conditions for inpatient hospital stays for Medicaid beneficiaries, costing an estimated $1.5 billion in 2017. Schizophrenia does not appear in the top 20 costly conditions for other payers, including Medicare, private insurance or self-pay. Three of the top 20 most costly conditions for Medicaid include mental health or substance use disorders, with schizophrenia at #7, depressive disorders at #15 and alcohol disorders at #20.
RESEARCH of the month
Availability of mental health services impacts police officer actions.
The role of police in ensuring public safety is a topical issue for policy debates in today’s society. Concerns around the appropriateness of law enforcement in responding to mental health crisis calls are chief among these policy discussions. New research published this month in the Journal of Police and Criminal Psychology suggests that the availability of mental health services has an impact on police officers’ actions in response to a mental health call for service, such as their choice to arrest, divert to mental health treatment or informally resolve on the scene.
The authors of the study surveyed 141 law enforcement officers across the United States to test the hypothesis that outcomes of mental health calls may be more related to available resources in the area than the officer’s previous training. The authors tested officer behavior by providing the survey respondent with a scenario depicted in a vignette and asking the officer questions around their likelihood of acting in different ways in response to the vignette. The researchers found that officers who had more area resources, such as a larger number of outpatient mental health facilities, were significantly less likely to respond by arresting an individual in a given scenario.
While this study has significant limitations in sample size and the lack of randomization, the findings have important implications: “The biggest policy implication that can be drawn from the study is the importance of having adequate resources available for police officers when they respond to calls for service in which the person has a mental health disorder,” the authors write. “To shift accountability from police officers to the mental health system, as originally designed, both systems need to be well-equipped to handle the change."
Cannabis use causes negative outcomes in young adults with early psychosis.
Previous research has shown that cannabis use in individuals with severe mental illness can impact
the person’s treatment course and outcomes. Because cannabis use is especially high in young adults, researchers wanted to examine how cannabis impacts outcomes in individuals with early psychosis in a real clinical setting.
In a recently published study in Schizophrenia Research, researchers examined how persistent cannabis use impacted clinical outcomes for individuals with early psychosis who are enrolled in coordinated specialty care programs in New York State. Approximately 1/3 (32.8%) of the 938 individuals with early psychosis were persistent cannabis users. The researchers found that those who had persistent cannabis use had worse psychosis symptoms compared to those who were not users. In addition, individuals who stopped using cannabis saw significant symptom improvements, according to the results. The findings highlight the potential benefits of cannabis use prevention programs for individuals with early
psychosis.
Reducing emergency department visits for people with serious mental illness with primary care.
People with serious mental illness have high rates of emergency department visits, with more than 2.2 million visits to community emergency departments in 2014, according to the Agency for Healthcare Research and Quality. Due to the high comorbidity of physical health conditions such as diabetes and heart disease, previous research has shown that people with serious mental illness also
have a 25-year lower life expectancy than the general population.
Integrated mental health and primary care services hold promise for improving outcomes for people
with serious mental illness. A new model based at the University of North Carolina was evaluated recently with the results published in the Community Mental Health Journal. The enhanced primary care service model integrated in a mental health clinic was found to result in a decrease in emergency department utilization in individuals with serious mental illness after three years of enrollment in the services, reducing the number of emergency department visits per person per year by almost half (from 3.2 to 1.8 visits/person/year). The results of this study further support the importance of primary care services for individuals with serious mental illness.
