The impact of telemental health use on healthcare costs among commercially insured adults with mental health conditions

Abstract Background Parental mental health conditions have been associated with increased morbidity and use of healthcare services in offspring. Existing studies have not examined different severities of parental mental health conditions, and the impact of paternal mental health has been overlooked. We examined the association between two severities of parental mental health conditions and use of healthcare services for children during the first year of life and explored the impact of both maternal and paternal mental health conditions. Methods This register-based cohort study included all live-born children born in Denmark from 2000 to 2016. Information on socioeconomics, diagnoses, drug prescriptions, and healthcare contacts was extracted from nationwide public registries. Parents were grouped according to severity of mental condition based on the place of treatment of the mental health condition. Negative binominal regression analyses were performed to estimate the incidence rate ratio (IRR) of contacts to general practice (GP), out-of-hour medical service, emergency room (ER), and out- and inpatient hospital contacts during the first 12 months of the child’s life. Results The analyses included 964,395 children. Twenty percent of the mothers and 12 % of the fathers were identified with mental health conditions. Paternal mental health conditions were independently associated with increased risk of infant healthcare contacts (GP IRR 1.05 (CI95% 1.04–1.06) and out-of-hour IRR 1.20 (CI95% 1.18–1.22)). Risks were higher for maternal mental health conditions (GP IRR 1.18 (CI95% 1.17–1.19) and out-of-hour IRR 1.39 (CI95% 1.37–1.41)). The risks were even higher if both parents were classified with a mental health condition (GP IRR 1.25 (CI95% 1.23–1.27) and out-of-hour contacts IRR 1.49 (CI95% 1.45–1.54)), including minor mental health condition (GP IRR 1.22 (CI95% 1.21–1.24) and out-of-hour IRR 1.37 (CI95% 1.34–1.41)). This pattern was the same for all types of healthcare contacts. Conclusions Both maternal and paternal mental health conditions, including minor mental health conditions, were associated with increased utilization of healthcare services. Focus on both parents’ mental health conditions (even if minor) may be warranted in service planning.

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Experiences of living with mental health problems during the COVID-19 pandemic in the UK: a coproduced, participatory qualitative interview study

10.1101/2020.11.03.20225169 ◽

2020 ◽

Author(s):

Steven Gillard ◽

Ceri Dare ◽

Jackie Hardy ◽

Patrick Nyikavaranda ◽

Rachel Rowan Olive ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Social Connectedness ◽

Mental Health Problems ◽

Qualitative Interviews ◽

Health Conditions ◽

Mental Health Conditions ◽

Qualitative Interview Study ◽

The Impact

AbstractPurposeResearch is beginning to quantify the impact of COVID-19 on people with pre-existing mental health conditions. Our paper addresses a lack of in-depth qualitative research exploring their experiences and perceptions of how life has changed at this time.MethodsWe used qualitative interviews (N=49) to explore experiences of the pandemic for people with pre-existing mental health conditions. In a participatory, coproduced approach, researchers with lived experiences of mental health conditions conducted interviews and analysed data as part of a multi-disciplinary research team.ResultsExisting mental health difficulties were exacerbated for many people. People experienced specific psychological impacts of the pandemic, struggles with social connectedness, and inadequate access to mental health services, while some found new ways to cope and connect to community. New remote ways to access mental health care, including digital solutions, provided continuity of care for some but presented substantial barriers for others. People from black and ethnic minority (BAME) communities experienced heightened anxiety, stigma and racism associated with the pandemic, further impacting their mental health.ConclusionThere is a need for evidence-based solutions to achieve accessible and effective mental health care in response to the pandemic, especially remote approaches to care. Further research should explore the long-term impacts of COVID-19 on people with pre-existing mental health conditions. Particular attention should be paid to understanding inequalities of impact on mental health, especially for people from BAME communities.

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Higher Education Completion Rates for Domestic Undergraduate Students Who Access Mental Health Services Using A Multi-Agency Matched Population Cohort

International Journal for Population Data Science ◽

10.23889/ijpds.v5i5.1502 ◽

2020 ◽

Vol 5 (5) ◽

Author(s):

Lewis Cowie ◽

Luke Hendrickson

Keyword(s):

Mental Health ◽

Health Condition ◽

Health Conditions ◽

Mental Health Service Use ◽

Randomised Control Trial ◽

Completion Rates ◽

Mental Health Condition ◽

Mental Health Conditions ◽

Wide Range ◽

The Impact

By linking Education, Health, and Welfare data in the Multi-Agency Data Integration Project (MADIP), our analysis looked at the impact of poor mental health on the likelihood of completing an undergraduate degree in Australia. IntroductionCompletion of a bachelor degree is important to both the student and the government, as it provides lifelong benefits and prevents investment loss. Previous research has reported conflicting findings regarding whether students with mental ill health are less likely to complete a degree, with an estimated 25 per cent of young adult university students experiencing mental ill-health each year. Objectives and ApproachOur research analysed national mental health service use and related pharmaceutical prescriptions linked with education data to determine the extent and effect of known mental health conditions on undergraduate student six-year completion rates. We followed a de-identified cohort of 120,000 students who commenced an undergraduate degree for the first time in 2011 for six years. Summary statistics and a binomial logit was used on a matched sample to confirm significance. ResultsWe found that students with a known mental health condition had a significantly lower six-year completion rate (58 per cent) than those students with no known mental health condition (71 per cent). By simulating a randomised control trial controlling for a wide range of demographics, we showed that these results held and that completion rates worsened with increasing severity of mental health conditions, as measured by usage of psychiatric services. ConclusionIntegrated data assets such as MADIP help us better understand the interaction between student success and mental health conditions which in turn will help us improve policy and better evaluate programs.

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Systematic review of healthcare costs related to mental health conditions among cancer survivors

Expert Review of Pharmacoeconomics & Outcomes Research ◽

10.1080/14737167.2018.1485097 ◽

2018 ◽

Vol 18 (5) ◽

pp. 505-517 ◽

Cited By ~ 5

Author(s):

Jaya S. Khushalani ◽

Jin Qin ◽

John Cyrus ◽

Natasha Buchanan Lunsford ◽

Sun Hee Rim ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Cancer Survivors ◽

Healthcare Costs ◽

Health Conditions ◽

Mental Health Conditions

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Parental mental health conditions and use of healthcare services in children the first year of life – a register-based, nationwide study

10.21203/rs.3.rs-26572/v2 ◽

2020 ◽

Author(s):

Signe Heuckendorff ◽

Martin Nygård Johansen ◽

Søren Paaske Johnsen ◽

Charlotte Overgaard ◽

Kirsten Fonager

Keyword(s):

Mental Health ◽

Healthcare Services ◽

Health Condition ◽

Health Conditions ◽

Mental Health Condition ◽

Parental Mental Health ◽

Mental Health Conditions ◽

First Year Of Life ◽

Paternal Mental Health ◽

The Impact

Abstract Background Parental mental health conditions have been associated with increased morbidity and use of healthcare services in offspring. Existing studies have not examined different severities of parental mental health conditions, and the impact of paternal mental health has been overlooked.We examined the association between two severities of parental mental health conditions and use of healthcare services for children during the first year of life and explored the impact of both maternal and paternal mental health conditions. Methods This register-based cohort study included all live-born children born in Denmark from 2000-2016. Information on socioeconomics, diagnoses, drug prescriptions, and healthcare contacts was extracted from nationwide public registries. Parents were grouped according to severity of mental condition based on the place of treatment of the mental health condition. Poisson regression analyses were performed to estimate the incidence rate ratio (IRR) of contacts to general practice (GP), out-of-hour medical service, emergency room (ER), and out- and inpatient hospital contacts during the first 12 months of the child’s life.Results The analyses included 964395 children. Twenty percent of the mothers and twelve percent of the fathers were identified with mental health conditions. Paternal mental health conditions were independently associated with increased risk of infant healthcare contacts (GP IRR 1.05 (CI95% 1.04-1.05) and out-of-hour IRR 1.20 (CI95% 1.18-1.21)). Risks were higher for maternal mental health conditions (GP IRR 1.17 (CI95% 1.17-1.18) and out-of-hour IRR 1.38 (CI95% 1.37-1.37)). The risks were even higher if both parents were classified with a mental health condition (GP IRR 1.24 (CI95% 1.23-1.25) and out-of-hour contacts IRR 1.48 (CI95% 1.45-1.51)), including minor mental health condition (GP IRR 1.22 (CI95% 1.22-1.23) and out-of-hour IRR 1.37 (CI95% 1.35-1.39)). This pattern was the same for all types of healthcare contacts.Conclusions Both maternal and paternal mental health conditions, including minor mental health conditions, were associated with increased utilization of healthcare services. Focus on both parents’ mental health conditions (even if minor) may be warranted in service planning.

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Motivation to Improve Mental Wellbeing via Community Physical Activity Initiatives and the Associated Impacts—A Cross-Sectional Survey of UK parkrun Participants

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182413072 ◽

2021 ◽

Vol 18 (24) ◽

pp. 13072

Author(s):

Allison Dunne ◽

Steve Haake ◽

Helen Quirk ◽

Alice Bullas

Keyword(s):

Mental Health ◽

Physical Activity ◽

Physical Health ◽

Online Survey ◽

Local Community ◽

Health Conditions ◽

Mental Wellbeing ◽

Health Improvement ◽

Mental Health Conditions ◽

The Impact

Participation in regular physical activity is a well-established strategy to support good mental wellbeing in adults with, and without, mental health conditions. The physical activity initiative parkrun is a free, weekly, timed, running and walking event which is attended by people from the local community of all abilities. The purpose of this study was to investigate the mental wellbeing of UK parkrun participants along with their motives for taking part and the impact of participation. Mental health conditions were self-reported in 2.5% of 60,000 respondents to an online survey of parkrunners, with the most prevalent being depression and anxiety. Those with mental health conditions were more motivated than those without to first participate in parkrun to manage their health conditions and improve their mental health. Those with mental health conditions were equally motivated to improve their physical health when compared to those without, and reported similar levels of improvement. Mental wellbeing scores for those with mental health conditions were close to the normal range, suggesting that engagement in parkrun may have had a role in limiting the effect of their illness. Community initiatives could replicate parkrun’s model, and use the potential for both mental and physical health improvement, as well as health condition management, as a motivation for participation.

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Outcomes of mental health pharmacist-managed electronic consults at a Veterans Affairs health care system

Mental Health Clinician ◽

10.9740/mhc.2017.05.131 ◽

2017 ◽

Vol 7 (3) ◽

pp. 131-136 ◽

Cited By ~ 2

Author(s):

Christina Herbert ◽

Holly Winkler ◽

Troy A. Moore

Keyword(s):

Mental Health ◽

Primary Care ◽

Health Care ◽

Health Care System ◽

Health Conditions ◽

Veterans Health ◽

Improvement Project ◽

Mental Health Conditions ◽

The Impact ◽

Care System

Abstract Introduction: The demand for mental health services has increased as more veterans have been diagnosed with—and sought care for—one or more mental health conditions. Within the South Texas Veterans Health Care System (STVHCS), providers may submit electronic consults (e-consults) to mental health clinical pharmacy specialists for medication review and recommendations. These consults aim to manage veterans with uncomplicated mental health conditions in primary care, making specialty mental health providers more available for those who need such services. Pharmacists have improved outcomes and access to care for conditions such as diabetes and hypertension, but currently, there is limited evidence demonstrating the impact of pharmacists in mental health. Methods: This quality improvement project assessed the effectiveness of the e-consult service. Information was collected through a retrospective chart review of STVHCS veterans with the corresponding consult note placed in their chart from May 2014 through December 2015. Numbers of recommendations implemented and veterans maintained in primary care were analyzed as markers of effectiveness. Time and cost savings were secondarily explored. Results: A total of 361 consults were submitted for 353 unique patients. Of the 322 patients included in analyses, a total of 301 unique patients (93.5%) were maintained in primary care for at least 3 months. Of the 21 not maintained in primary care, 15 recommendations were implemented; of those maintained in primary care, 271 recommendations were implemented. Discussion: This service improves mental health care—and patient access—by promoting successful management and maintenance of less complicated patients in primary care.

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The impact of adverse childhood experiences (ACEs) and combat exposure on mental health conditions among new post-9/11 veterans.

Psychological Trauma Theory Research Practice and Policy ◽

10.1037/tra0000614 ◽

2020 ◽

Vol 12 (7) ◽

pp. 698-706 ◽

Cited By ~ 1

Author(s):

Keith R. Aronson ◽

Daniel F. Perkins ◽

Nicole R. Morgan ◽

Julia A. Bleser ◽

Dawne Vogt ◽

...

Keyword(s):

Mental Health ◽

Adverse Childhood Experiences ◽

Combat Exposure ◽

Health Conditions ◽

Childhood Experiences ◽

Mental Health Conditions ◽

Adverse Childhood ◽

The Impact

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Prevalence of mental health conditions amongst people living with human immunodeficiency virus in one of the most deprived localities in England

International Journal of STD & AIDS ◽

10.1177/0956462420904299 ◽

2020 ◽

Vol 31 (7) ◽

pp. 619-626

Author(s):

A Gill ◽

AWIP Ranasinghe ◽

A Sumathipala ◽

KA Fernando

Keyword(s):

Mental Health ◽

Human Immunodeficiency Virus ◽

Service Evaluation ◽

Poor Quality ◽

Health Conditions ◽

Cross Sectional ◽

White Ethnicity ◽

Mental Health Conditions ◽

Immunodeficiency Virus ◽

The Impact

Mental health conditions (MHCs) are often unrecognised which can result in detrimental physical health outcomes and poor quality of life. This can be compounded by the impact of deprivation. People living with human immunodeficiency virus (PLWH) are more likely to be affected by MHCs which if untreated, may result in both clinical and psychosocial adversities. To ascertain the prevalence of and factors associated with MHCs in the human immunodeficiency virus cohort of Stoke-on-Trent, which is the 13th most deprived locality in England, we conducted a cross-sectional service evaluation using electronic records of 302 PLWH attending the service between October 2018 and January 2019. The prevalence of MHCs amongst PLWH was 33.4% (101/302). Depression was the most prevalent MHC affecting 17.2% (52/302). Those of white ethnicity were at higher risk (odds ratio [OR] = 3.14; p < 0.01) of MHCs compared to black Asian and minority ethnic groups. Women were at higher risk of having an MHC (OR = 3.15; p < 0.01), and recreational drug use was also a significant factor (OR = 16.18; p = 0.01) associated with MHCs. There is sub-optimal access and heterogeneity in the modes of referral to mental health support services. Commissioning constraints will further detrimentally affect our ability to provide support in an already deprived area, thus widening health inequalities affecting the most vulnerable.

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Experiences of living with mental health problems during the COVID-19 pandemic in the UK: a coproduced, participatory qualitative interview study

Social Psychiatry and Psychiatric Epidemiology ◽

10.1007/s00127-021-02051-7 ◽

2021 ◽

Author(s):

Steven Gillard ◽

◽

Ceri Dare ◽

Jackie Hardy ◽

Patrick Nyikavaranda ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Social Connectedness ◽

Mental Health Problems ◽

Qualitative Interviews ◽

Health Conditions ◽

Mental Health Conditions ◽

Qualitative Interview Study ◽

The Impact

Abstract Purpose Research is beginning to quantify the impact of COVID-19 on people with pre-existing mental health conditions. Our paper addresses a lack of in-depth qualitative research exploring their experiences and perceptions of how life has changed at this time. Methods We used qualitative interviews (N = 49) to explore experiences of the pandemic for people with pre-existing mental health conditions. In a participatory, coproduced approach, researchers with lived experiences of mental health conditions conducted interviews and analysed data as part of a multi-disciplinary research team. Results Existing mental health difficulties were exacerbated for many people. People experienced specific psychological impacts of the pandemic, struggles with social connectedness, and inadequate access to mental health services, while some found new ways to cope and connect to the community. New remote ways to access mental health care, including digital solutions, provided continuity of care for some but presented substantial barriers for others. People from black and ethnic minority (BAME) communities experienced heightened anxiety, stigma and racism associated with the pandemic, further impacting their mental health. Conclusion There is a need for evidence-based solutions to achieve accessible and effective mental health care in response to the pandemic, especially remote approaches to care. Further research should explore the long-term impacts of COVID-19 on people with pre-existing mental health conditions. Particular attention should be paid to understanding inequalities of impact on mental health, especially for people from BAME communities.

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