Psychiatrists in High Demand
The physician search firm Merritt Hawkins & Associates says that from April 2009 to March 2010, requests for psychiatrists jumped 47% over the previous year, and 121% from 3 years ago. The Irving, Tex.–based company said that the increased demand is attributable to the recession and its accompanying rise in stress-related conditions. And as the population ages and more Afghanistan and Iraq war veterans need mental health services, the supply of psychiatrists is dwindling, said Merritt Hawkins. “The shortage of psychiatrists may be a silent one, but it is real nonetheless,” said company president Mark Smith in a statement. The company also reported that more physicians are choosing to work as hospital employees. Four years ago, 23% of physician searches were for positions in hospitals, but in the latest survey, that portion jumped to 51%.
Prescription Narcotic Treatment Up
Almost 10% of substance abuse treatment admissions in 2008 involved prescription narcotic painkiller abuse, quadruple the proportion in 1998, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). The increase touched all age groups, both sexes, and all levels of education and employment. However, slightly more prescription abuse occurred among women and people with higher-than–high school educations, with 13% and 12% of their abuse admissions involving prescription narcotics, respectively. “The nonmedical use of prescription pain relievers is now the second most prevalent form of illicit dug use in the nation,” said the agency's administrator, Pamela S. Hyde, in a statement. It is also the fastest-growing problem, according to the White House Office of National Drug Control Policy. A SAMHSA study released in June found that emergency department visits for nonmedical use of painkillers had doubled between 2004 and 2008.
Millions Get Urgent Mental Care
One in eight (or 12 million) of the nation's 95 million emergency department visits in 2007 was for a mental disorder, substance abuse problem, or both, according to the Agency for Healthcare Research and Quality. Of those 12 million visits, 43% were for depression, 26% for anxiety, and 23% for alcohol-related problems. Two-thirds were for a mental disorder alone, 25% for substance abuse alone, and the remainder for both issues, said the agency. Hospitalizations resulted from 41% of these visits, a rate that's 2.5 times higher than that for emergency department visits not related to mental disorders or substance abuse. The data are in the report “Mental Health and Substance Abuse–Related Emergency Department Visits Among Adults, 2007,” available at
www.hcup-us.ahrq.gov/reports/statbriefs/sb92.pdf
313 Drugs Are in the Pipeline
The Pharmaceutical Research and Manufacturers of America said that there are 313 medications in development to treat mental illness. Of these, 90 (the largest group) are being developed to treat dementias. Two of those–both in phase III testing–are imaging agents intended to be used to diagnose Alzheimer's disease. The next largest category of agents would treat depression, with 71 such products in development. Some 54 drugs are being investigated for schizophrenia, 33 for addiction disorders, 38 for anxiety disorders, 33 for eating disorders (primarily obesity, but also anorexia and bulimia), 21 for sleep disorders, and a handful of drugs for fragile X syndrome and autism. The manufacturers' trade group said that mental illness costs the United States more than $317 billion a year in lost wages, health costs, and disability benefits.
Teen Smoking Leveled Off
The long decline in teen smoking slowed from 2003 to 2009, according to data published in the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report (2010;59:797-801). The CDC analyzed data from the biennial Youth Risk Behavior Survey for trends from 1991 to 2009, and found that the prevalence of teens who said they'd ever smoked cigarettes declined from 70% in 1991 to 58% in 2003, but had dropped no farther than 46% in 2009. The proportion that had smoked least 1 day of the 30 days before the survey declined from 36% in 1997 to 22% in 2003 and to 19% in 2009. Current frequent smokers dropped from 17% in 1999 to 10% in 2003 and to 7% in 2009. “The slow progress since 2003 tells us that much more needs to be done to reduce youth smoking,” said CDC Director Thomas R. Frieden in a statement.
Bill Seeks Federal Safety Net
A congressional proposal would establish a network of federally qualified behavioral health centers to provide mental health and substance abuse services to low-income Americans. The Community Mental Health and Addictions Safety Net Equity Act (H.R. 5636) was introduced by Rep. Doris Matsui (D-Calif.) and Rep. Eliot Engel (D-N.Y.). It would reimburse the federally qualified centers through Medicaid. “Investing in mental health and addictions treatment can save our economy the many billions we now spend” on emergency department visits, incarceration, and lost productivity, said Rep. Matsui in a statement. The legislation is supported by the National Alliance on Mental Illness and the National Council for Community Behavioral Healthcare, among other organizations.