Posts Tagged substance abuse
It is time once again in 2018 to refocus, converse, reevaluate, plan, and take action around mental health issues and substance abuse. While this battle rages all year, Mental Health Awareness month (every May) is a time where organizations, healthcare providers, and individuals can share their story to highlight how they fight on the front lines against these issues and for those that those who struggle with mental health issues and substance abuse every day to share their story to help spread awareness and inspire hope in those who may need it most. To look at this issue(s) objectively it is important to look at the data behind it all. Who is affected? How many are seeking care? What programs are there that exist to help those in need? These questions are not new, we ask them every day, but for those that don’t work at an organization that provides mental health services or those that may not suffer from a mental health issue themselves, the problem is a little less visible and these questions are a little more foreign. So, let’s look at, and answer, some of those questions now.
Who is affected
US General Stats:
- 1 in 25 adults are currently diagnosed with a serious mental illness; 1 in 5 are currently diagnosed with some sort mental illness
- There are a wide variety of anxiety disorders, including Post-Traumatic Stress Disorder, Obsessive-Compulsive Disorder, and specific phobias to name a few. Collectively they are among the most common mental disorders experienced by Americans.
- Approximately 10.2 million adults in the U.S. have co-occurring mental health and addiction disorders.
- Serious mental health illnesses cost people $193.2 billion in lost earnings every year in the U.S.
- Nearly 60% of adults with a mental illness did not receive care in the previous year.
- 3% are currently diagnosed with a serious mental illness; 14.3% are currently diagnosed with some sort mental illness.
- Men die from suicide at twice the rate as women.
- 6 milling men are affected by depression per year in the U.S.
- The Top 5 major mental health problems affecting men in the U.S. include Depression, Anxiety, Bipolar Disorder, Psychosis and Schizophrenia, and Eating Disorders.
- Men are significantly less likely to seek help for mental health issues than women. Causes for this include reluctance to talk, social norms, and downplaying symptoms.
- 5% are currently diagnosed with a serious mental illness; 21.2% are currently diagnosed with some sort mental illness.
- 12 million women in the U.S. experience clinical depression each year. Roughly twice the rate of men.
- Although men are more likely than women to die by suicide, women report attempting suicide approximately twice as often as men.
- Many factors in women may contribute to depression, such as developmental, reproductive, hormonal, genetic and other biological differences (e.g. premenstrual syndrome, childbirth, infertility, and menopause).
- Fewer than half of the women who experience clinical depression will ever seek care. And Depression in women is misdiagnosed approximately 30 to 50 percent of the time.
- 50% of all chronic mental illness begins by the age of 14; 75% by the age of 24.
- 20% of 8 to 13 year of age in the U.S. will be diagnosed with some sort of mental illness in their lifetime.
- Girls 14-18 years of age have consistently higher rates of depression than boys in this age group.
- Nearly 50% of kids with a mental illness did not receive care in the previous year.
- LGBTQ adolescents are twice as likely to attempt suicide than non-LGBTQ youths.
- More than 90% of children who die by suicide have a mental health condition.
Sources: click the links for more stats and infographics.
- National Alliance on Mental Health: https://goo.gl/XuFb82
- Mental Health America: https://goo.gl/vXcKkM
How many are seeking care?
The short answer to this one is “not enough.” A recent report from SAMHSA (Substance Abuse and Mental Health Administration) state that only 1 in 5 adults with a mental illness are receiving treatment. This statistic combined with an uncertain future for Medicare and mental health funding means that employers are often the only path to access help for those in need through health insurance benefits, employee assistance programs, and wellness programs. These alarming statistics also bring to light how common it is for these issues to affect the workforce, and simultaneously its productivity. So, whether someone is directly suffering from a mental health issue or not, this is a problem that affects every last person in one way or another.
Why we do what we do
If you found the above statistics surprising, you must be new to the mental health conversation because these are nothing new. Mental health is an area that struggles to retain consistent support and funding from public and private sources. Mental health programs, care providers, facilities, non-profit organizations, and even programs like MINES’ Employee Assistance Program have to constantly justify themselves and (re)prove the value it what they/we do. A combination of the invisible nature of many mental health conditions and the stigma behind talking about these issues and seeking care makes it difficult to see just how pervasive of a problem these are in the US as well as the much of the rest of the world. In some areas of the world, mental health disorders can land you in jail or worse. It is not a “sexy” topic so the media only really rallies around the topic when something happens like a mass shooting, celebrity rehab incident, or some other sensation worthy event. This is a tragedy in and of itself because if we as a nation could just remain committed to improving the support system, communication, and available resources around mental health, so much of this loss of life could be prevented. This is why we, MINES and every other care provider, organization, and individual fights this all too silent war every day.
The relationship between mental health and substance abuse
This month is also about a very closely related issue to mental health, substance abuse. A large percentage of people with mental health disorders also experience issues with substance abuse, and vise versa. In fact, according to a SAMSHA study, nearly 27% of people with a mental health disorder use illicit drugs, which is over twice as much as the rate of the general population. And of the approximately 8.7 million people that suffer from both mental health issues and substance abuse, only about 7% receive treatment for both issues and a staggering 56% don’t receive treatment for either issue at all. With these numbers, it’s easy to see that there is a huge correlation that links these devastating nationwide issues. Enter prevention week.
This year SAMHSA is spearheading Prevention Week, May 13-19, to help spread awareness of both mental health issues, as they do year around, as well as the prevailing substance use issues that are running rampant without any sign of slowing down. We encourage you to check out their site for more information on prevention week and to see how you can support them and your community in the fight. Check out these links for information on all of the above:
- More information: samhsa.gov/prevention-week/about
- Take the Prevention Challenge samhsa.gov/prevention-week/prevention-challenge
- See how you can help here: samhsa.gov/prevention-week/about/get-involved
Below is a list of other important resources that can help you if you or someone you care about is suffering from a mental health issue, depression, substance abuse, or if you just need someone to talk to. Many are free, community-based resources that won’t cost you anything but your time. And of course, as MINES and Associates provides Employee Assistance Programs, we encourage you to use one if your employer offers one. EAPs are a great free and confidential resource that can help you, and in many cases, your family/household members, get in touch with a counselor and start the journey to better mental wellbeing. EAPs can also help with a large variety of other work/life issues that may be affecting you like work/life balance, financial issues, fitness, nutrition, and more.
- Substance Abuse and Mental Health Services Administration Treatment Referral Helpline
- National Institute for Mental Health – nimh.nih.gov
- NAMI (National Alliance on Mental Illness) – nami.org
- Mental Health America – mentalhealthamerica.net
- Mental Health America of Colorado – http://www.mhacolorado.org/gethelp
- Anxiety and Depression Association of America – adaa.org
- Depression and Bipolar Support Alliance – dbsalliance.org
- National Suicide Prevention Lifeline – suicidepreventionlifeline.org
- First Responder Crisis Text Line
- Text “Badge” to 741741
- Military/Veterans Crisis Line/Resources
- Online Chat: Visit website at http://www.veteranscrisisline.net
- Call: 1-800-273-8255 (press 1)
- Text: 838255
- National Action Alliance for Suicide Prevention – actionallianceforsuicideprevention.org
- United Way- unitedway.org/local/united-states/
- Help and Treatment
- Child mental health resources
What can we do going forward? Stay loud. Keep talking. Keep writing congress about mental issues that affect you and those you love. Don’t let them wait for there to be a tragic event before the issues get put on their desk. Continue to vote for people that believe in what we do and what needs to be done. Continue to support organizations that are making strides in the right direction. Continue to demand benefits from employers that do more than just the bare minimum to support our mental health. Change is possible but it going to take more than an awareness month. It’s going to take people, all of us, coming together and making this an issue that’s bigger than a month, an issue that cannot be ignored or scapegoated. So, take the rest of this month help spread awareness, and then use next month keep marching, keep shouting, and continue to come together to push change forward because no one is going to do it for us.
To your wellbeing,
The MINES Team
Just a quick update.
Dr. Robert Mines (chairman and psychologist) and Dr. Dani Kimlinger (CEO) from the MINES Team were honored to contribute to an article by Bruce Shutan in this month’s issue of The Self-Insurer. The article is called Beyond Opioids and covers how EAPs, like MINES, and good benefit-plan design can help treat addictions and other substance use issues in an employee population as well as control overall health care spending.
The issue can be viewed here:
Check out other Self-Insurer publications here: https://goo.gl/2TjaUV
And check out other MINES publications here: www.minesandassociates.com/about_staff_publications.html
To your wellbeing,
The MINES Team
Psychology of Performance – 42: Integration of Behavioral Health and Medicine in Self-Insured Organizations
There are many conditions, both acute and chronic, which have significant psychological components to them. It is well-documented that medical costs for diabetes, asthma, cardiac events, and others are significantly higher when there is a co-morbid diagnosis of depression, post traumatic stress, or substance use disorder. As a function of this relationship and the impact of the Affordable Care Act (ACA), there is a need for integrating behavioral health services.
The integration needs to occur at the strategic/systems and tactical levels. On the tactical side, there are already case studies in the public healthcare sectors and in Kaiser Permanente of placing mental health professionals in medical clinics and offices so the doctors and nurses can just walk a patient down the hall to see them once a psychological component has been identified. At MINES we are piloting a wellness coaching model for individuals who are identified by their healthcare provider as a pre-substance use disorder patient, through a Screening, Brief Intervention, and Referral to Treatment (SBIRT) grant awarded to Peer Assistance Services.
At the strategic/systems level, integration has significant utility and challenges for self-insured organizations whether as an individual entity or a multi-employer trust. At this level, a key component is the ability for the various vendors to cross-communicate on these types of patients. This involves the ability to do data mining to identify the patients, having an intensive case management behavioral health specialist to be the point person, regular communication between the TPA, pharmaceutical vendor, medical utilization review, behavioral health utilization review and the medical/psychological personnel responsible for treatment. An obvious challenge is getting buy-in from all of these stakeholders. There is no incentive other than good patient care for any of these groups to cooperate with each other. To rectify this, incentives would need to be financial or contractual. Employers have leverage on the contractual side as it is their health benefit and their money. At the time of this blog, there are case-studies of organizations moving this direction; however, specifics are a long way from full integration due to the complexities required.
I would welcome your discussion and wisdom on this issue.
Have a day filled with extending loving kindness to all those you encounter,
Robert A. Mines, Ph.D., CEO
It may be self-evident to many of you reading this blog that alcohol use, sleep deprivation, and obesity can negatively affect performance at work or at home. If this is a correct assumption and you have all three of these areas under control, thank you. On the other hand, after 39 years of working with people and organizations on these issues it is clear to me that our society continues to miss the boat on them.
This week alone, I had client organizations call about each of these concerns. In one case a senior executive was observed to drink one bottle of wine at a company function, plus cocktails before dinner. Her behavior became problematic when she propositioned a male colleague, angrily denied she had drank too much and proceeded to accuse others on her executive team of “being out to get her.” To make this situation even sadder, the executive had done something similar three years earlier at the same company function. This became a performance issue at a number of levels. First, upon investigation, it turned out she had a number of days in the last few months where her secretary reported she left early for lunch and never returned resulting in significant loss of individual productivity. Second, she created liability for her company when she propositioned a colleague. This created a potentially hostile work environment/sexual harassment lawsuit. In addition, there was lost time for human resources, management, and legal to review the situation and interview all parties. Third, when confronted with her behavior and the company’s requirement to go to the employee assistance program for an evaluation and potential referral for treatment if indicated, she refused and resigned. This resulted in additional loss of intellectual capital and the personal long term health costs to her. This reminder for everyone in supervisor, management, or executive functions is that alcohol and other substance use disorders have not diminished despite policies, procedures,’ and education interventions. It is important to stay alert to your employees’ and colleagues’ behavior and act in a timely and compassionate manner similar to the company discussed in this paragraph.
The research on sleep deprivation is well documented. Sleep deprived individuals do not function well cognitively and their reaction times are diminished. This finding was significant enough for one researcher to say that sleep deprived drivers were more dangerous than alcohol impaired drivers. What are the costs to your organization related to sleep deprivation? We know that individuals who are sleep deprived eat more, make poorer food and exercise decisions, are more irritable with others, and make poor decisions. Many companies recognize the dangers of sleep deprivation and provide nap rooms, meditation classes, and other options so that employees can refresh themselves and perform better at work.
Obesity, wellness, and financial impact discussions are ubiquitous on the internet and in the professional literature. Our workforces are getting fatter and fatter. Recent research suggested that obesity not only has downstream health costs for the employer, there is some evidence that cognitive functions can be influenced as well. This research needs to be replicated. Then there is the subgroup of morbidly obese individuals who also have co-morbid depression. Depression affects performance in terms of diminished problem solving skills, concentration problems, social withdrawal, lowered energy which is compounded by the lower energy associated with morbid obesity, as well as other symptoms such as memory impairment. Any of these symptoms will negatively affect performance in most jobs. As an employer it will become an even heavier burden going forward to manage the workforce as the obesity incidence continues to grow. What is becoming more apparent is that the typical wellness program is unsuccessful in helping the morbidly obese. A major component that is missing is the psychological aspects of performance related to weight loss and weight gain. The research in this area has been well established for over 25 years. Coors Brewing in 1988 was one of the first companies to incorporate an intensive outpatient obesity program as part of its wellness program. It was a highly successful program. Unfortunately during that time there were many fasting programs and one of the unintended side effects of these programs was an increase in gall bladder surgeries and the corresponding cost. Due to a variety of factors beyond the scope of this blog, all weight loss programs were discontinued a few years later. There are best practice examples of successful interventions with the morbidly obese employee population which apply the psychological elements needed to lose and sustain weight loss.
Contact us if you would like to learn more:
Have a day filled with loving kindness and compassion,
Robert A. Mines, Ph.D., CEO & Psychologist
I recently attended an annual dinner/forum for a local non-profit group which focused on Drug Abuse Prevention. We’ve all heard, or experienced first-hand, the devastating effects of drug abuse on family, employment, education, and just about every other facet of human life. What we don’t always hear about are the amazing efforts by some making an incredible impact on prevention. By taking small steps to identify risk factors, especially for our youth, we can have a tremendous impact. At the forum, one of the panelists made a great point about how parents and doctors don’t ask the difficult questions, and often times because they are afraid of the answer, or maybe they are suffering themselves. Why do our doctors have no problem asking us about our diets and suggesting cholesterol screenings, but very seldom ask us a simple question like, “How are you feeling emotionally?” or, “Does your child seem to be fitting in, and participating in a healthy way?” When we look at diabetes and heart disease compared to major depression or substance abuse disorders only a small fraction of those suffering from behavioral disorders are actually being diagnosed and treated compared with their medical counterparts.
As the prescription drug epidemic continues to rise we need to do more in the area of prevention. Here are some wonderful resources for prescription drug abuse prevention from our friends at Peer Assistance Services:
Manager, Business Development
In over 35 years of working with people on making change, improving their performance, and living more fully it is still interesting to me how many people persist in doing the same self-defeating actions over and over despite saying they want to improve, grow, or change for the better (whatever that means). So the following are four questions worth asking yourself if you want to improve your performance in some area of your life.
- Situation Questions – Tell me about your life? How is it working now?
- Problem Questions – Can we be specific about what is not working? Are you concerned about your current quality of performance?
- Implication Questions – What happens if you don’t do something different?
- Need-Payoff Questions – If you act and it improves – how does that impact your life?
Take time to reflect on these questions, write down your answers, and be curious about where this may take you. If you find yourself resisting the questions or process, look more deeply into that instead.
It’s up to you….as they say “no one can do your push-ups for you.”
Exchange love and happiness with everyone you meet today.
Robert A. Mines, Ph.D.
CEO & Psychologist
The book, Spark, by John J. Ratey, M.D. is the holy grail of research applications related to the interaction of exercise, neuroplasticity, and performance. The information on brain chemistry changes in the areas of learning, addictions, anxiety, depression, women’s issues, ADHD, and aging is priceless. The essence of the book is that the data indicated the brain is able to create new neuronal connections, grow new nerve cells throughout life, manage major psychological conditions, pain conditions, and learning is significantly enhanced through exercise. Ratey stated that “exercise is the single most powerful tool you have to optimize your brain function”- based on hundreds of research studies (p.245). Ratey suggested that the more fit you get (regardless of where you start), the “ more resilient your brain becomes and the better it functions both cognitively and psychologically. If you get your body in shape, your mind will follow” (p. 247).
How much is enough? Ratey stated that walking is enough. Low-intensity exercise is at 55 to 65% of maximum heart rate, moderate is 65-75% and high intensity is 75-90%. “The process of getting fit is all about building up your aerobic base” (p.251). Ratey goes on to discuss the role of strength training and flexibility as important elements of optimizing your brain chemistry and hormone levels.
What does this have to do with optimizing your performance at work and in all areas of your life? Everything! Get started today and stick with it.
Have a day filled with optimal brain chemistry,
Robert A. Mines, Ph.D.
CEO & Psychologist
I ran across some interesting information on the role of niacin, depression, and alcoholism in performance at www.doctoryourself.com. It is well documented that depression and/or alcoholism may negatively affect performance across just about any domain one can perform in. In the treatment of depression and alcoholism there are very effective cognitive-behavioral psychotherapy interventions. In addition, exercise and medication may add additional therapeutic effects. The role of nutrition may have further potentiating influence.
According to this site, Bill W., the founder of AA, was successfully treated for depression with 3,000 mg of niacin a day. Unfortunately, this information has not been widely discussed or published in the media. I would be interested to hear from any of you who have used niacin as a means of treating depression or alcoholism and what your results were. Please let us at MINES know.
Have a day filled with mindfulness,
Robert A. Mines, Ph.D.
CEO & Psychologist
Overcoming any addiction is often a life-long journey filled with as many peaks as there are valleys. Getting support from your family, friends, and treatment providers is an important part of maintaining sobriety. If you are looking for additional support check out these free resources at http://store.samhsa.gov/home . As always, we’re here to help.
~The HealthPsych Team