Van kills 12 on Toronto Street. 4 dead in shooting at Nashville Waffle
House. Multiple gunshot wounds, 1 suicide at YouTube headquarters in San Bruno.
These grotesque acts are occurring almost daily and each has the hallmarks
of a perpetrator suffering from a mental health disorder. It is not merely
a coincidence that the males (and occasionally females) responsible for
these tragedies are in their early 20s. The majority of mental health
disorders begin in the teenage years, and it takes 8 years on average
to make the diagnosis. Indeed, a surprising number of individuals who
suffer from mental illness ( or “dis-ease” ) are not diagnosed
nor properly treated. In 2009, 23.5 million Americans needed treatment
for an illicit drug or alcohol problem (often self-medication for an underlying
mental problem such as anxiety, depression or bi-polar illness). Only
4.3 million people received addiction treatment. Of the 9.8 million Americans
who needed treatment for serious mental illness, only 4.1 million received
it. The numbers have been steadily rising. A significant percentage of
those with substance abuse and/or with mental health problems die prematurely,
on average 37 years sooner. Their healthcare costs throughout their lives
are substantially higher, compounding their hospital admissions for medical
issues, prolonging their lengths of stay, not to mention the impact on
unnecessary repeated admissions to emergency departments.
May is mental health awareness month. Statistics above are not meant to
simply lead to head shaking or tongue clucking. Awareness of the rising
tide of mental illness and the tremendous impact they create for individuals,
families, and healthcare systems needs resolve and more concerted action,
not just awareness. Even at Hoag, the statistics document the rapid increase
in the number of mentally ill patients. Year over year, there has been
a 47% increase in patients with psychiatric diagnoses visiting the emergency
department compared to 14% increase in such visits for all other conditions.
Up to 24% of our hospitalized inpatients for various medical conditions
suffer from mental health comorbidities. Depression is the most common
combined mental health condition, and is the number one cause of global
burden of disease in the industrial world (outdistancing heart disease,
cancer, diabetes, etc.). 1 out of 5 Americans (men, women and children)
are now on a medication for some type of mental health disorder.
Hoag has been addressing addiction disorders for well over 20 years, seeing
approximately 75 patients a day, and is now expanding its mental health
efforts to address the tsunami described above. Particularly, given the
onset of mental health in the teenage years, our after school program
for resiliency education in troubled teenagers (ASPIRE) is starting both
here and in Irvine, in cooperation with local school systems, parents,
and other community leaders. Much, much, much more is needed. We are tactically
focusing our efforts on the Hoag communities we serve. We are working
with our partners at Providence St. Joseph Health on these issues on a
more global scale. This is the toughest health struggle we face as a health
system and, some would say, as a society. Let’s roll.
Michael N. Brant-Zawadzki, M.D., F.A.C.R.
The Ron and Sandi Simon Endowed Chair,
Executive Medical Director, Pickup Family Neurosciences Institute
Kambria Hittelman, PsyD
Director of Hoag Neurobehavioral Health