Health Policy

Escaping the Iron Triangle of Health Care in Mental Health

It’s been called the “Iron Triangle of Health Care,” but sometimes I call it “The Panera Pick 2 Rule ” – whereby you have to choose between sandwich, soup, and salad, but you can only have two.

I assume you are familiar with Panera Bread, so let me tell you about the Iron Triangle and how a recent article in The Lancet may provide clues on how to disentangle that nearly legendary triangle in mental health.

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The £350 million per week question: What will Brexit really mean for mental health and the NHS?

On June 23, Britain, by way of public referendum and by a 52-48% margin, became the first member state to vote to leave the European Union (EU). Nobody had planned for this.

As a tiny amount of Brexit dust begins to settle, it remains to be seen exactly what this unprecedented decision will mean for the National Health Service (NHS) and mental health services in the United Kingdom.

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Asking the Right Questions About Gun Violence

In the wake of the recent nightclub shooting in Orlando, there are voices that are again loudly touting mental illness as a key target for preventing the repetition of such horrors.

Yet, as we wrote last year, researchers have already debunked the link between mental illness and gun violence. Instead, we found access to guns increases rates of suicide, but not of homicide. However, what most people don’t know is that, underlying all of this, there is policy prohibiting research from delving further into the issue and discovering where the evidence leads us.

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Hill Update: The Uphill Battle for the Mental Health Reform Act

In the midst of an election year and a national opioid addiction crisis, mental health is finally getting the attention it’s due.

The Mental Health Reform Act, which has already been approved by the Senate HELP Committee, is one of those efforts that is trying to right the ship to balance mental and physical health care.

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2016: A Year of Promise in the Fight Against Opioid Addiction

When it comes to addressing opiate addiction, it’s all beginning to come together.

Within mere days of each other, Massachusetts Gov. Charlie Baker signed a historic law holding great promise to curb the Commonwealth’s opioid epidemic; the Centers for Disease Control and Prevention (CDC) released new guidelines for prescribing opioids; and the U.S. Senate passed the Comprehensive Addiction and Recovery Act of 2016 (CARA) by a near-unanimous vote.

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News Flash: Mental Health Funding Gets Its Due

When it comes to government funding for mental health services, there’s good news and some bad news.

The good news is that the federal government is putting its money where its mouth is. President Obama recently announced that the administration is proposing for 2017 the expenditure of $500 million for a series of two-year mental health initiatives and $1.1 billion for new addiction treatment, prevention and recovery programs.

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Integration

Integration is a buzzword in mental health care, but what does it really mean?

Such a plethora of definitions leads to a lack of clarity about what activities need to take place, where, and by whom to really make a difference in improved health for people with mental illness.

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Shake It Up!

Disruptive Health Care Technology through Strategic Academic Partnerships

In 1982, the rock band “The Cars” had a #2 hit with “Shake It Up,” a quintessential pop tune about letting go of your conventional self and dancing all night. To some, 1982 may seem like a long time ago, but defying convention remains a pop-and-rock-music staple (think Taylor Swift’s “Shake it Off”). More recently, “shaking it up” has made its way into the formerly staid world of health care under the guise of “disruptive technology” (Carnegie Mellon University, 2015).

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The Relationship: Medicine Is Both Art and Science

The Question: Questioning the value of the annual physical exam for “healthy,” or asymptomatic, adults is nothing new, but the issue assumes greater significance in the current era of limited resources and the growing status of evidence-based care. Last month, The New England Journal of Medicine’s “Perspective” was devoted to the pros and cons of eliminating this time-honored, but poorly evidenced, practice. Before discussing these pieces, it seems only fair to tip my hand and admit I am (empirically, subjectively, limbicly) in favor of the annual check in with one’s PCP – whether one “needs” it, or not. The authors of both articles agree that the lack of standardization in the annual exam makes the epidemiological research weaker, i.e., lack…

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Time to Apply Behavioral Economics to Behavioral Health Care

The term “behavioral health” is about just exactly that – human behavior and its healthy alignment with the world. However, ironically, the very industry to improve behavioral health is way behind other industries in changing behavior. Consider the advertising industry: every day we are bombarded by sales tactics. Commercials on TV, ads on public transit, billboards on highways, grocery store aisle layouts, all of these add up to an all-out assault on our minds. Sometimes the target is our pocketbooks (think about the GEICO commercials); sometimes it is our actions (“smoking kills” campaigns in the 90s and 00s). Today, though, the tactics are more specific, focused, and nuanced than ever. The old-school way of behavior change was successful because it…

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