Study highlights lack of access to mental health care

By Arshya Vahabzadeh,MD 
 @VahabzadehMD

A new study from the CDC’s National Center for Health Statistics once again highlights that too many people living with mental health conditions are not getting needed care.

Study authors Laura A. Pratt, PhD, and Debra J. Brody, MPH, found that nearly 8% of Americans aged 12 and up had depression (moderate or severe depressive symptoms in the past 2 weeks). The rate of depression was twice as high among people living below the poverty level, 15%.

 Far more alarming, the study showed yet again that people with depression are going untreated. While nearly 90% of people with severe depressive symptoms reported difficulty with work, home, or social activities related to their symptoms, only about one-third (35.3%) had seen a mental health professional in the past year, according to the study. Among those with moderate depressive symptoms, only 1 in 5 had seen a mental health professional.

While there are many reasons people don’t get needed mental health care, including mental health stigma and lack of access, discrimination in mental health coverage by insurance companies shouldn’t be among the reasons. Federal law now requires that insurers cover mental health illnesses the same as physical ailments, such as heart disease, diabetes and cancer.


However, many people don’t know their rights when it comes to getting mental health treatment. To address this glaring problem, the American Psychiatric Association has released a new poster --
available to mental health professionals -- that explains in simple terms your rights under the law and what to do if you think your rights are being denied. Download a copy at www.psychiatry.org/parity.

World AIDS Day

By Annelle Primm, MD, MPH

World AIDS Day
December 1, 2014

Focus, Partner, Achieve:  An AIDS-Free Generation

World AIDS Day is a key opportunity to raise awareness and to commemorate those who lost their lives to this often deadly disease. But, today, we can also be hopeful about achieving an AIDS-free generation.  Increased access to treatment, new and better prevention services and care, and advances in treatment are all reasons for hopefulness.  And that amounts to greater peace of mind.

 

An estimated 35 million people worldwide have HIV and more than 39 million people have died from the virus since the first cases in 1981. In the U.S., more than 1.2 million people live with HIV, but nearly 1 in 7 of those don’t know they have the virus.

An estimated 50,000 people in the U.S. are newly infected each year.  It’s why I continue to tell people the importance of getting tested.  There’s no shame, just a need for information.

What is the Connection Between HIV and Mental Health?

Mental and neurological disorders have an intertwined and often complex relationship with HIV and AIDS. Yet mental health issues are often overlooked in HIV interventions and treatment.

• About 60% of people with HIV also have depression.  Sometimes one may be tempted to “blame” depression on their HIV status, but the reality is that depression can happen to anyone and treatment works
• Pre-existing mental disorders (including substance use) can complicate HIV-related illness.  It’s important for physicians to know all they need to know about your health, and for you to be comfortable sharing  
• Nearly 50% of people with HIV experience impaired motor skills, trouble with memory and poor concentration.  If you experience such changes, those are important to inform your doctor about
• Mental illness can make it more difficult for people to adhere to HIV-medication regimens
• New antiretroviral treatments and combination therapies can affect the central nervous system and/or have psychiatric side effects
• Mental illnesses can be especially challenging to recognize and diagnose in people with HIV/AIDS.  That’s why the APA works to educate and provide tools and training to physicians.

Unfortunately, both HIV and mental illness still carry a significant burden of stigma and discrimination.

As HIV/AIDS increasingly becomes a chronic disorder with the improvement of treatments, the need for mental health care and services is rising.  World AIDS Day is also a day to recognize the many psychiatrists and other mental health clinicians working with HIV patients who also have complicated psychiatric or substance use comorbidities.


Looking for ways to take action?  Here are a few simple, powerful, and engaging ways you can take action:

• Know your HIV status. Use and share the HIV Testing Sites & Care Services Locator  
• Share your message on social media using #FacingAIDS or  in the Facing AIDS gallery
• Learn about HIV/AIDS with the HIV/AIDS Basics. Ask questions. Get help.
• Take a quiz:  Are you HIV Aware? 

Annelle Primm, MD, MPH is the Deputy Medical Director of the American Psychiatric Association