Hi Shelly
Since I detected so much emotion in you last post here I thought I would address this post to you. Often times, addictive behaviour is a symptom of an underlying mental illness. I was under the care of a Psychologist one time that said that he would not even bother trying to treat people
for addictions because the addiction was allmost never the root cause of the problem.
As time goes by, more and more studies are proving this to be the case. Here is an example of some of the latest research being done on duel diagnosis disorders.
Home > News > Features & Commentary
Features & Commentary
IOM Report Endorses Treatment Improvement, Integration, and Parity
12/2/2005
Email
Print
Subscribe
Most Emailed
News Feature
By Bob Curley
The addiction and mental-health treatment systems should be better integrated with general healthcare and included in broader national efforts to improve healthcare quality, the National Academy of Sciences says in a new report that endorses parity coverage of behavioral-health services as a key component of meeting both goals.
"The report is an excellent prescription of principles, some of which have been reflected in earlier reports but never acted upon, others of which provide a greater vision of a 21st-century system of care," said Michael J. Fitzpatrick, executive director of the National Alliance on Mental Illness. "We know what must be done. The challenge now is to make sure that the report does not end up simply gathering dust on shelves in the White House, the Library of Congress, or state medical libraries."
In 2001, the Academy's Institute of Medicine (IOM) outlined an influential plan for improving healthcare in a report entitled "Crossing the Quality Chasm: A New Health System for the 21st Century." While the blueprint was widely praised and adopted in many corners of the health system, some questioned whether behavioral healthcare -- with its distinct delivery systems, marketplaces, and quality standards -- could or should follow the same path to improvement.
The answer in the latest IOM report, "Improving the Quality of Health Care for Mental and Substance-Use Conditions," is a resounding "yes" -- news that will hearten addiction and mental-health advocates who want to see better integration between the behavioral and general medical systems.
"The recommendations set forth in Crossing the Quality Chasm for the redesign of health care are as applicable to [addiction and mental health] care as to general health care," states the report, prepared by a Quality Chasm committee chaired by Mary Jane England, M.D., a former Robert Wood Johnson Foundation health fellow, past president of the Washington Business Group on Health, and currently president of Regis College.
However, the IOM panel says that quality-improvement efforts in the behavioral-health field need to take into account the fact that consumers of these services "face a number of obstacles that generally are not encountered by consumers of general health care," including shame, stigma, and discrimination, and insurance coverage that is far less comprehensive (and accessible) than that for general health care.
To address these differences, the committee recommends that treatment providers incorporate "incorporate informed, patient-centric decisionmaking throughout their practices," such as involving patients in developing treatment and recovery plans, giving patients more say in the use of medications, peer-support programs, and other elements of their care. Providers also are encouraged to "maintain effective, formal linkages with community resources to support patient illness self-management and recovery."
Health plans and other payers are encouraged to pay for peer support and illness self-management programs that meet evidence-based standards, provide consumers with comparative information on treatment providers to aid in purchasing decisions, and to "remove barriers to and restrictions on effective and appropriate treatment that may be created by co-payments, service exclusions, benefit limits, and other coverage policies."
Quality Measurement Needs Work
Noting that the infrastructure needed to measure, analyze, report on and improve treatment quality is "less well developed" in the behavioral-health field compared to the general health field, the IOM report calls for:
more coordination in filling gaps in the evidence base
a stronger, more coordinated, and evidence-based approach to disseminating evidence to clinicians
improved diagnosis and assessment strategies
a stronger infrastructure for measuring and reporting the quality of addiction and mental-health care, and
support for quality-improvement practices at treatment sites
"We appreciate the emphasis on establishing models for benchmarking and quality improvement at the sites of care delivery and the development of strategies to reduce the burden of variable billing and reporting requirements," said Linda Rosenberg, MSW, CSW, president and CEO of the National Council for Community Behavioral Healthcare. "The authors recognize that providers need supports and incentives that enable the delivery of quality care."
The report also makes recommendations regarding better integration between the addiction and mental-health treatment systems, noting the high occurrence of co-occurring disorders, and for increased collaboration between primary-care and behavioral-care providers "to achieve evidence-based screening and care of their patients."
Finally, the IOM committee addresses the constellation of professions currently providing addiction and mental-health treatment services, noting that the behavioral health workforce "is not uniformly equipped with respect to the knowledge and skills needed to provide high-quality services." In response, the report calls for a "long-term, sustained commitment" to developing the workforce, following models previously used to improve the nation's physician and nursing professions.
Elizabeth F. Howell, M.D., president of the American Society of Addiction Medicine, cheered the report's findings. "We are prepared to follow with specific responses and contributions on its recommendations," she said.
However, Rosenberg stressed that "there can be no improvement without adequate resources," pointing to potential cuts in Medicaid funding and program rules that favor institutional care over community-based services.
"Many of the recommendations in the report are practices that community providers already embrace," she said. "However, without adequate funding and support, these effective initiatives will not be sustained or taken to scale."
More Features & Commentary
Mental Health And Political Forums http://community.adlandpro.com/forumShow.aspx?ForumID=10129 http://community.adlandpro.com/forumShow.aspx?ForumID=9637 http://community.adlandpro.com/forumShow.aspx?ForumID=8212 http://community.adlandpro.com/forumShow.aspx?ForumID=7420 http://community.adlandpro.com/forumShow.aspx?ForumID=8259
Lifetime web building and hosting for under $40. One time payment
http://www.superpayline.com/p002859
The most advanced VOIP system there is anywhere.
https://wv0079721.betteruniverse.com/members/index.php?action=buy_miphone
Better Universe. The People Helping People Company
http://wv0079721.betteruniverse.com
|