The Meadows Mental Health Policy Institute believes that education is the key to creating a healthier Texas. Below you will find basic information and links to further reading for some topics that have been central to our work.
A recovery-oriented program helped Margaret learn how to manage her schizophrenia after her first psychotic episode.
First Episode Psychosis Care
Each year, 4,000 Texas adolescents and young adults first experience a psychotic episode. Most have health insurance through their parents, but they do not typically receive care and treatment until five years after first onset. Studies show that the longer treatment is delayed, the worse the outcome, both for the individual and for society.
A new approach called First Episode Psychosis (FEP) Care starts treatment as early after initial psychosis as possible, and helps people remain on their developmental trajectories. A team of specialists provides FEP care, including a psychiatrist, employment/education specialist, nurse, substance abuse counselor, peer coach, and outreach specialist.
FIRST EPISODE PSYCHOSIS CARE IS EFFECTIVE
The American Journal of Psychiatry reported that, especially when receiving FEP care within the first 17 months of psychosis onset, participants achieve better quality of life and are more involved in work and school. FEP care is better than care-as-usual at helping people remain on a normal developmental path.
FEP care is cost-effective as well. On average FEP care costs less than $9,000 per person per year. That’s less than two-thirds the cost of providing intensive care when it is typically provided—after years of suffering.
WHAT CAN TEXAS DO?
FEP care is currently being tested by pioneering providers in Dallas and Houston, and in 2016 eight new FEP care sites were being funded statewide by the Texas Department of State Health Services. Texas needs to take steps to bring FEP care “to scale.” Suggested steps include:
- Implement policies that ensure health plans can work with providers to pay for the early detection and treatment of psychosis.
- Develop a forum through which FEP care providers can hone increasingly cost-effective approaches by sharing their findings and innovative strategies.
- Better track the success of FEP care statewide including more precise estimates of new cases of psychosis annually, the number of people receiving early care, and the related outcomes and costs of care.
First Episode Psychosis Care for Texans
Best Practices and Challenges in First Episode Psychosis Care
SAMHSA’s National Inventory of Best Practices in First Episode Psychosis Care
RAISE: Recovery After an Initial Schizophrenia Episode
PREP: Prevention and Recovery in Early Psychosis
NASMHPD’s Guidance Manual on Peer Involvement in FEP Care
Three combat vets, each injured in a different war, heal inside and out through fly fishing.
Posttraumatic stress (PTS), also known as Posttraumatic Stress Disorder (PTSD), is a mental health issue that can develop after witnessing or experiencing a traumatic, or life-threatening event. Traumatic events can take many forms, but car accidents, combat, natural disasters and sexual assaults are all examples of events that might lead to PTS. While it is normal to have disturbing memories, feelings of being on edge and difficulties doing normal daily activities after such an event, most people will begin to feel better within a few months. If your symptoms persist longer than that, or are disrupting your life, you may have PTS.
There are four main symptoms of PTS, however, each person experiences PTS in their own way. PTS symptoms will not be the same for everyone.
- Reliving the event
- Avoiding things that remind you of the event
- Having more negative thoughts and feelings than before
- Feeling on Edge
There are a range of options including different talk therapies and medications. Recovery from PTS is possible, with many who follow through with treatment getting rid of symptoms all together, and many other reporting less intense, or fewer symptoms. Treatment can help even if your trauma was experienced years ago. Review the information below to learn more about the treatment options available.
While anyone can develop PTS, due to the high rates among veterans, the U.S. Department of Veterans Affairs has developed comprehensive and reliable resources on this topic.
With a highly structured schedule, Jinneh helps her son manage his ADHD and gives him the tools to cope with mental health challenges the future may bring.
The prevention of mental disorders includes interventions targeting an array of groups, including the general population, those at high risk for developing behavioral health conditions, and those just beginning to display symptoms that are precursors to behavioral health disorders.
Prevention is particularly important for children and families, as half of all mental health conditions begin by age 14. In Texas, there are more than 300,000 children living in poverty with a severe emotional disturbance. Of those, 1 in 10 are at high risk for out of home placement or exclusionary discipline, and will require intensive services. Prevention could be instrumental in curbing these numbers, however, both nationally and in Texas it has not received sufficient funding.
DOES PREVENTION WORK?
Many effective evidence-based prevention programs exist, and prevention has been the subject of over 30 years of research highlighting positive results in many community settings. By making a “turn toward prevention,” Texas could set a standard for other states to follow.
Using an integrated care model, this clinic addresses clients physical, mental, and emotional needs together for better outcomes and longer lives.
The Cost of Depression
In the United States, one in five adults (20%) will experience a clinically significant form of depression in their lifetime. About 7.5% of the US workforce has depression in any year. The impact of an employee’s depression extends beyond the suffering of the individual to impact family, friends, coworkers, and eventually, the bottom line.
THE PERSONAL COST
Untreated depression can increase the chances that someone will experience another medical condition. Individuals with depression and a medical condition experience greater distress, increased functional impairment, and are less able to follow medical regimens. As a result, depression can increase medical costs and negatively affect treatment outcomes.
THE BUSINESS COST
Depression costs U.S. employers approximately $187.8 billion a year. This includes $134 billion in health care (health and mental health combined), $20.9 billion in absenteeism, and $32.9 billion in lost productivity. Research shows that untreated depression is a significant contributor to workplace disability costs, reduced work performance and “presenteeism,” absenteeism, safety issues, employee turnover, and legal costs.
BARRIERS TO EFFECTIVE CARE
Effective depression treatment can improve medical outcomes, reduce medical costs and decrease associated business costs. Nearly 74% of Americans who seek help for symptoms of depression go to a primary care physician (PCP) rather than a mental health professional, and a diagnosis of depression is missed 50% of the time in a primary care setting.
REMOVING BARRIERS: THE COLLABORATIVE CARE MODEL
Collaborative Care can significantly improve outcomes by increasing the number of individuals who access and successfully complete treatment for depression. Collaborative Care implements specific interventions that promote the detection of depression, “in-place” treatment (no referral needed), and treatment adherence.
Research on the cost-effectiveness of Collaborative Care interventions, compared to that of treatment for depression on its own, is relatively new but the results are positive. Several studies evaluating Collaborative Care interventions relative to routine care in primary care settings demonstrated healthcare savings over time.