The National Prevention Strategy and Behavioral Health Care: Prevention Is Now

RADM Peter J. Delany, Ph.D., LCSW-CSubstance Abuse and Mental Health Services Administration

2012 USPHS Scientific and Training SymposiumCollege Park, MD • June 21, 2012

SAMHSA’s Vision

• Behavioral health is essential to health.

• Prevention works.• Treatment is effective.• People recover.

America is a nation that understands and acts on the knowledge that …

What the Vision Looks Like

• Primary care providers monitor:– Blood pressure, body mass index,

vaccines– Depression, alcohol/tobacco use

• School/community presentations focus on:– Emotional health– Substance use and mental illness

• Partnering at all levels

Daily Disaster of Unprevented and Untreated Mental and Substance Use Disorders

Any Mental Illness

45.9 million

Substance Use Disorder 23.1 million

Diabetes 25.8 million

Heart Disease 81.1 million

Hypertension 74.5 million

39.2 % receiving treatment

11.2 % receiving treatment

84 % receiving treatment

74.6 % receiving screenings

70.4 % receiving treatment

What Do Americans Believe About Addiction?

… and about one in three think less of someone currently addicted

… and three-quarters think recovery is possible

Yet, two-thirds think addiction can be prevented…

Only one in five think less of a friend/relative in recovery from an addiction …

What Do Americans Believe About Mental Illness?

The majority, two out of three, think treatment and support can help people with mental illness lead normal lives.

And,

Only one in five think people with a mental illness are dangerous to others.

• Up to half of people with a serious mental illness will develop a substance abuse disorder at some time in their lives.

• Alcohol dependence is four times more likely to occur among adults with mental illness than among adults with no mental illness.

• One in five people with a diagnosable mental health disorder also suffer from a substance abuse disorder.

Substance Abuse and Mental Illness Are Linked

Substance abuse and mental illness share risk and protective factors.

• Mental health problems increase risk for physical health problems.

• Substance use disorders increase risk for chronic disease, HIV/AIDS, STDs.

• Cost of treating common diseases higher with untreated behavioral health problems• Hypertension – 2X the cost• Coronary heart disease – 3X the cost• Diabetes – 4X the cost

$0$50,000,000

$100,000,000$150,000,000$200,000,000$250,000,000$300,000,000

With behavioral health problems and diabetes

With diabetes alone

Individual Costs of Diabetes Treatment for Patients Per Year

Impact of Behavioral Healthon Physical Health

Changing the Conversation:Behavioral Health Is Part of Overall Health

• Americans know risk factors for chronic conditions such as diabetes, hypertension, and cardiovascular disease.

• However, many people do not know the warning signs for suicide, addiction, or mental illness.

… Nor do they know what to do to help themselves or others.

A National Call to Action

Health Reform: A Defining Moment for Prevention

• More people covered• Prevent diseases, promote wellness,

whole health needs• New opportunities for behavioral

health: • Parity: Mental Health Parity and Addiction

Equality Act and within Affordable Care Act• Tribal Law and Order Act• National Action Alliance for Suicide

Prevention

• Medicare and Medicaid changes

Cancer screenings such as mammograms & colonoscopies Vaccinations such as flu, mumps & measles Blood pressure screening Cholesterol screening Tobacco cessation counseling and interventions Birth control Depression screening And more…

Visit www.healthcare.gov/prevention for a full list.

The Law Increases Access to Affordable Care

In many cases, you can get preventive services for free:

Everyone Has a Part: Communities

• Develop comprehensive prevention systems.

• Establish linkages.• Conduct education,

outreach, and training.

Everyone Has a Part:Health Systems, Insurers, Physicians

• ID and screen patients for excessive drinking.

• ID, track, and prevent inappropriate patterns of prescribing.

• Develop and adopt evidence-based guidelines for prescribing opiates.

• State prescription drug monitoring plans.

Collaboration is Key! Center for Substance Abuse Prevention

Center for Mental Health Services

Center for Substance Abuse Treatment

Center for Behavioral Health Statistics and Quality

http://www.samhsa.gov