Declining Mental Illness Stigma
A mental illness diagnosis does not result in the fear or shame that it used to, according to a recent survey by the American Psychiatric Association. Nearly 90% of the 1,000 adults surveyed said that people with mental illness could live healthy lives, and 80% said mental health treatment was effective. In addition, 70% said seeing a psychiatrist was a sign of strength, according to the APA. Despite those encouraging signs, however, there were also some disturbing results, the association noted in a statement. For instance, 20% of respondents said they would not see a psychiatrist under any circumstances, and 57% said they were not concerned that they themselves or a family member might ever having to deal with a mental illness.
Mental Health Coverage Trends
The Mental Health Parity Act of 1996 has resulted in some gains in employee mental health coverage, but inequities remain, according to a report from the U.S. Department of Labor. Since the passage of the act, which requires employers to equalize dollar benefits for mental health and physical health coverage, the incidence of employees in medical plans that impose more restrictive dollar limits on inpatient mental health care coverage has decreased from 41% in 1997 to 7% in 2002. However, employees in plans that contain tighter restrictions on the number of days of inpatient mental health care compared with inpatient medical and surgical care–a disparity allowed under the law–rose from 61% to 77% in the same period. Differences in substance abuse coverage also remained, with only 8% of employees who had coverage for alcoholism treatment receiving the same coverage for that condition as for other conditions in 2002.
Depression and Marijuana Use
The evidence for a link between marijuana use and depression is getting stronger, according to the White House Office for National Drug Control Policy. “There certainly are people who self medicate, but the danger we're talking about is the growing evidence that use itself … may be triggering and may be worsening the onset of mental health problems,” ONDCP Director John Walters said at a Washington press conference. “Now, would some of those people have mental health problems anyway? That's entirely possible. But it's also entirely possible that some of these people may not subsequently show these mental health problems, and the evidence suggests that the use of marijuana may trigger the onset of problems that would not otherwise be there.” According to the office's National Survey on Drug Use and Health, among persons aged 18 years or older, those who first used marijuana before age 12 were twice as likely to have serious mental illness in the past year as those were who first used marijuana at age 18 or older.
AMA: Ban Booze Ads at NCAA Events
The American Medical Association has asked the National Collegiate Athletic Association to eliminate alcohol advertising associated with NCAA events. “The prevalence of alcohol advertising in college sports sends a damaging message about the core values of the NCAA and higher education,” AMA President-elect J. Edward Hill, M.D., said in a statement. “Allowing aggressive alcohol advertising during its events only encourages underage consumption of alcohol.” In a national poll sponsored by the AMA, 62% of adults said the NCAA should reverse its policy and not allow beer companies to advertise during college sporting events. NCAA spokesman Erik Christianson said that the association already limits alcohol advertisements to 60 seconds per hour of any broadcast NCAA event. In addition, Mr. Christianson noted that the NCAA executive committee was already planning to discuss the idea of banning the advertisements completely at an upcoming meeting, in response to a request from one of its divisions.
Ads Influence Prescribing
Direct-to-consumer advertisements appear to have an impact on physician prescribing practices, reported Richard L. Kravitz, M.D., of the University of California, Davis (JAMA 2005;293:1995–2002). A total of 152 family physicians and general internists were recruited from solo and group practices and health maintenance organizations to participate in the study, which focused on advertising for prescription antidepressants. Standardized patients were randomly assigned to make 298 unannounced visits, presenting either with major depression or adjustment disorder with depressed mood. When the patients with depression made a general request for an antidepressant, only 3% of the physicians prescribed paroxetine (Paxil). However, when they asked for the prescription by name, 27% were given a prescription for Paxil.
E-Prescribing Standards
Medicare should adopt a program-wide system of uniform national electronic prescribing standards for its new prescription drug benefit, according to the Pharmaceutical Care Management Association (PCMA). A uniform national standard is needed to maximize the participation of private plans in the Part D benefit and to help reduce regional variations in health care delivery and outcomes, PCMA said in comments to the Centers for Medicare and Medicaid Services on its proposed rule for Medicare e-prescribing standards. “PCMA believes that Medicare e-prescribing holds the potential to transform the health care delivery system,” PCMA President Mark Merritt said in a statement. “Regrettably, a 50-state patchwork approach would increase costs, decrease efficiency, and severely undermine the promise of e-prescribing.”