HHS is planning to launch a national evaluation to determine how prevalent mental illness is in the United States. Its results could lead to a seismic shift in the practice of medicine, clinicians say.
The last time such an analysis was conducted was over a decade ago, according to the agency.
"The availability of timely and high-quality epidemiological data is key to supporting strategic initiatives to increase awareness and understanding of mental and substance use disorders," the agency said in a notice on the White House's Office of Management and Budget site. "Unfortunately, data on the prevalence of specific mental disorders among adults and adolescents across the United States are outdated."
Clinicians say more up-to-date data on prevalence of mental illness in the U.S. could lead to changes in the practice of medicine and increased access to care for underserved parts of the country.
"Current national psychiatric epidemiologic data are sorely needed to understand not just the prevalence of psychiatric conditions but also potentially modifiable determinants," said Dr. Philip Wang, director of research at the American Psychiatric Association.
Before launching a national evaluation, the agency is seeking permission from the OMB to launch a smaller survey in order to properly assess the feasibility of a national study on mental health disorders.
The test survey will include three parts: a screener survey targeting more than 3,000 homes, an in-person survey targeting 1,200 adults and minors, and a telephone survey targeting 200 adults and children.
HHS hopes the evaluation will shed light on the prevalence of a number of specific mental disorders including depression, social anxiety disorder, mania/bipolar disorder psychotic experiences and eating disorders along with how patients are getting care for their condition.
If approved, study efforts would begin in January with a report to follow next summer.
Updated information on mental illness could affect how providers screen and refer patients, according to Dr. David Sack, chief medical officer at Elements Behavioral Health, a provider of addiction and mental health treatment programs.
If clinicians had more data on the prevalence of dual diagnoses, they would be more inclined to screen patients for both disorders and ensure they receive integrated treatment, he said.
Those screenings have become increasingly important as more and more research shows a high correlation between physical illnesses such as diabetes or heart disease and depression, but it can often go untreated and lead to higher healthcare costs, according to Douglas Tynan, director of integrated healthcare for the American Psychological Association
"Information like this could go along way toward de-mystifying mental health conditions, getting more attention to earlier interventions and working toward recovery," said Paul Gionfriddo, president and CEO of Mental Health America. "Waiting until people are in crisis to respond is no way to build a mental health system."
A greater understanding of the prevalence of mental illness in the U.S. could also lead to states ramping up recruitment efforts to attract new behavioral health providers to underserved areas, according to Dr. Beth Salcedo, medical director at the Ross Center for Anxiety and Related Disorders.
It could also reverse an ongoing trend in which many behavioral health providers don't accept insurance due to strict prior authorization and administrative requirements as well as low reimbursement. Greater data about the need for care could lead to insurance companies easing the requirements they place on mental health providers.
"My hope is that this would legitimize mental health, which would lead to better treatment of patients," Salcedo said. "Some practices are spending 40% of their time meeting various requirements for insurance companies in order to be reimbursed and that's not sustainable."
