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Biomedical subjects

Ronald W Manderscheid

Publications and source records attributed to Ronald W Manderscheid.

16 recordsLinked to original sources
PubMed2006

Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states.

INTRODUCTION: Mortality rates are used as global measures of a population's health status and as indicators for public health efforts and medical treatments. Elevated mortality rates among individuals with mental illness have been reported in various studies, but very little focus has been placed on interstate comparisons and congruency of mortality and causes of death among public mental health clients. METHODS: Using age-adjusted death rates, standardized mortality ratios, and years of potential life lost, we compared the mortality of public mental health clients in eight states with the mortality of their state general populations. The data used in our study were submitted by public mental health agencies in eight states (Arizona, Missouri, Oklahoma, Rhode Island, Texas, Utah, Vermont, and Virginia) for 1997 through 2000 during the Sixteen-State Study on Mental Health Performance Measures, a multistate study federally funded by the Center for Mental Health Services in collaboration with the National Association of State Mental Health Program Directors. RESULTS: In all eight states, we found that public mental health clients had a higher relative risk of death than the general populations of their states. Deceased public mental health clients had died at much younger ages and lost decades of potential life when compared with their living cohorts nationwide. Clients with major mental illness diagnoses died at younger ages and lost more years of life than people with non-major mental illness diagnoses. Most mental health clients died of natural causes similar to the leading causes of death found nationwide, including heart disease, cancer, and cerebrovascular, respiratory, and lung diseases. CONCLUSION: Mental health and physical health are intertwined; both types of care should be provided and linked together within health care delivery systems. Research to track mortality and primary care should be increased to provide information for additional action, treatment modification, diagnosis-specific risk, and evidence-based practices.

Accidents↗
PubMed2006

National estimates for mental health mutual support groups, self-help organizations, and consumer-operated services.

The authors report on a 2002 national survey of mental health mutual support groups (MSG) and self-help organizations (SHO) run by and for mental health consumers and/or family members, and consumer-operated services (COS). They found 7,467 of these groups and organizations-3,315 MSGs, 3,019 SHOs, and 1,133 COSs-greatly eclipsing the number of traditional mental health organizations (4,546). MSGs reported that 41,363 people attended their last meetings. SHOs reported a total of 1,005,400 members. COSs reported serving 534,551 clients/members in 1 year. The array of services and supports provided within each of these types (MSG, SHO, COS) is reported, and implications for the President's New Freedom Commission on Mental Health recommendations are explicated.

Health Care Surveys↗
PubMed2006

A neuroscientist-consumer alliance to transform mental health care.

The field of mental health has long suffered from a lack of convergence of disciplines that deal with the mind, the brain, and behavior. This mind-brain dualism has been particularly detrimental for consumers and their families who daily face stigma and discrimination. The understanding of the brain and its dysfunctions has benefited from the study of the human genome and, in particular, of the mutations and variations in its code. This analysis permits a better understanding of the biological basis of mental disease and will soon inform a generation of new diagnostic tools and individualized pharmacological therapies. A biological perspective on mental illness will be complemented by the analysis of the social factors influencing people's behavior and their impact on brain biology and gene function. Neurobiology has progressed to a level for which the knowledge that is generated, even if still colored with uncertainty, could represent a catalyst for the creation of an alliance between neuroscientists and consumers. This partnership has the potential to benefit both parties but will require some concrete steps that might be outside of the usual courses of action for both consumers and scientists. It is by building collaborations based on personal contact and information sharing that a transformation of the mental health care system can occur.

Community Participation↗
PubMed2006

Convergence of service, policy, and science toward consumer-driven mental health care.

BACKGROUND: A common theme is emerging in sentinel reports on the United States health care system. Consumer relevance and demands on service systems and practices are influencing how mental health care is delivered and how systems will be shaped in the future. AIMS OF THE STUDY: The present report seeks to assemble a confluence of consumer-driven themes from noteworthy reports on the state of the mental health system in the U.S. It also explores innovative efforts, promising practices, collaborative efforts, as well as identification of barriers to consumer-directed care, with possible solutions. METHOD: The report reviews the relevant public mental health policy and data used in published work. RESULTS: The findings indicate an increasing public and private interest in promoting consumer-driven care, even though historical systems of care predominate, and often create, barriers to wide-spread redesign of a consumer-centered mental health care system. Innovative consumer-driven practices are increasing as quality, choice, and self-determination become integral parts of a redesigned U.S. mental health care system. DISCUSSION AND LIMITATIONS: The use of consumer-driven approaches in mental health is limited at best. These programs challenge industry norms and traditional practices. Limitations include the need for additional and thorough evaluations of effectiveness (cost and clinical) and replicability of consumer-directed programs. IMPLICATIONS FOR HEALTH CARE PROVISION AND USE: Consumer-driven services indicate that mental health consumers are expecting to be more participative in their mental health care. This expectation will influence how traditional mental health services and providers become more consumer-centric and meet the demand. IMPLICATIONS FOR HEALTH POLICIES: Public and private interest in consumer-driven health care range from creating cost-conscious consumers to individualized control of recovery. The health care sector should seek to invest more resources in the provision of consumer-driven health care programs. The results of this study have implications and are informative for other countries where consumer-directed care is delivered in either the private or public health care systems. IMPLICATIONS FOR FURTHER RESEARCH: More research is needed to obtain further evidence on the use of consumer-driven services and their overall effectiveness.

Community Participation↗
PubMed2005

Quality of care measures for the treatment of bipolar disorder.

The staff of the American Psychiatric Association (APA), the American Psychiatric Institute for Research and Education (APIRE), and a national panel of experts in bipolar disorder and practice guideline development have collaborated to generate a set of quality of care indicators for the pharmacologic and psychosocial treatment of bipolar disorder. The indicators were derived from APA's evidence-based Practice Guideline for the Treatment of Patients with Bipolar Disorder, 2002 (1) and the Expert Consensus Guideline Series: Medication Treatment of Bipolar Disorder, 2000 (2) These quality indicators can be used for quality monitoring, benchmarking, and quality improvement efforts across health plans, systems of care, and health care providers to improve quality and outcomes of care for patients with bipolar disorder.

Bipolar Disorder↗
PubMed2004

Growth of mental health services in state adult correctional facilities, 1988 to 2000.

OBJECTIVE: This study examined trends in the availability and use of mental health services in state adult correctional facilities. METHODS: Results from the 1988 Inventory of Mental Health Services in State Adult Correctional Facilities of the Center for Mental Health Services were compared with those from the 2000 Census of State and Federal Adult Correctional Facilities survey of the Bureau of Justice Statistics. The two surveys were chosen because they occurred more than a decade apart, had a reasonable amount of data, and could be made comparable. RESULTS: This analysis used data from 757 state adult correctional facilities that were sampled in 1988. The number of such facilities increased to 1,097 in 2000, a 44.9 percent increase. A dramatic increase was also seen in the prison population, from 505,712 in 1988 to 1,084,625 in 2000, a 114.5 percent increase. Mental health services were offered in significantly more facilities in 2000 than in 1988. However, the relative percentage of facilities that offered mental health services decreased overall. Simultaneously, the percentage of inmates who used these services increased overall. CONCLUSIONS: The growth in prison facilities and the growth in prisoner populations are outstripping the more meager growth in mental health services. These results suggest that mental health services are becoming less available to the prison population, and service populations are becoming more concentrated in the facilities that do offer such services.

Adult↗
PubMed2003

Screening for serious mental illness in the general population.

BACKGROUND: Public Law 102-321 established a block grant for adults with "serious mental illness" (SMI) and required the Substance Abuse and Mental Health Services Administration (SAMHSA) to develop a method to estimate the prevalence of SMI. METHODS: Three SMI screening scales were developed for possible use in the SAMHSA National Household Survey on Drug Abuse: the Composite International Diagnostic Interview Short-Form (CIDI-SF) scale, the K10/K6 nonspecific distress scales, and the World Health Organization Disability Assessment Schedule (WHO-DAS). An enriched convenience sample of 155 respondents was administered all screening scales followed by the 12-month Structured Clinical Interview for DSM-IV and the Global Assessment of Functioning (GAF). We defined SMI as any 12-month DSM-IV disorder, other than a substance use disorder, with a GAF score of less than 60. RESULTS: All screening scales were significantly related to SMI. However, neither the CIDI-SF nor the WHO-DAS improved prediction significantly over the K10 or K6 scales. The area under the receiver operating characteristic curve of SMI was 0.854 for K10 and 0.865 for K6. The most efficient screening scale, K6, had a sensitivity (SE) of 0.36 (0.08) and a specificity of 0.96 (0.02) in predicting SMI. CONCLUSIONS: The brevity and accuracy of the K6 and K10 scales make them attractive screens for SMI. Routine inclusion of either scale in clinical studies would create an important, and heretofore missing, crosswalk between community and clinical epidemiology.

Health Surveys↗