Health Policy

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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Medical Marijuana: An Oxymoron?

Has public opinion trumped the rigors of the scientific method – clinically sound research that supports or negates the efficacy of marijuana for medical use? A recent issue of the Journal of the American Medical Association (JAMA) devoted two extensive clinical reviews, a research letter, an editorial and a patient page to topics related to medical marijuana. The reviews lay bare what is at the heart of the medical marijuana debate for the health care industry: Has public opinion trumped the rigors of the scientific method – clinically sound research that supports or negates the efficacy of marijuana for medical use? There are downstream effects of the legalization of medical marijuana that are not specifically related to efficacy or safety….

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A More Perfect Union: U.S. Supreme Court Decision on Gay Marriage Helps Ease Stigma and Improve Mental Health

While not the first nation to assert the rights of gay couples, last month’s U.S. Supreme Court ruling is especially historic when considered against the backdrop of the 1969 Stonewall riots, considered to be the catalyst for the gay liberation movement, and the removal of “ego-syntonic homosexuality” from the list of disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1973. For American social (and legal) policy, this ruling came at lightning speed – within the Baby Boomer lifetime. Access to health care coverage is associated with improved health and lower mortality1 – improving both the health of the nation and the financial well-being of the health care system. So what does this mean for the health…

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Don’t Bring Back the Asylum: Recovery, Not Re-institutionalization

asylum

Amid the current opioid crisis, high-profile events of mass violence and suicide, mental health parity implementation, and continued efforts to expand Medicaid for childless adults, never has behavioral health featured so prominently on policy agendas. Industry experts are scrambling for solutions, including a serious proposal to reintroduce the “asylum” as described in the Journal of the American Medical Association (JAMA) in January of this year. The JAMA article argued for the expansion of institutionalized settings for people with mental illness who cannot live alone, cannot care for themselves, or are a danger to themselves and others. Surely the solution to tackling the incredibly complex problem of mental illness and substance misuse has to involve a broader dialogue than whether or…

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