Mental health care: need and value

Roanoke Times

Mental health care: need and value

From Iraq veterans to the uninsured of Western Virginia, the need for and financial benefits of treatment are evident. Yet funding is a challenge.

Sometimes, the evidence in support of improved access to mental health care is like mental illness itself: starkly real, devastating in effect and largely unseen or disregarded by the unaffected majority.

The evidence mounts all the same. With it grows the need for funding from state and federal governments, health insurers, charitable foundations and private citizens. Though mental illness can afflict anyone, the most compelling recent warning addressed a specific group. According to the secretary of veterans affairs, the brutal guerrilla war in Iraq will cause many U.S. troops long-term mental health problems. Some will be disabled for life, Anthony Principi said, after long tours of duty under constant threat of ambushes, bombings and mortar attacks.

The effects are already seen in returning veterans. Twenty percent of their requests for VA care are mental-health related. Principi expects far more, especially post-traumatic stress disorder. PTSD already accounts for a third of cases, and its debilitating effects – flashbacks, nightmares, anxiety, uncontrollable anger – may not emerge for years.

Civilian mental health needs may not face a similar surge, but they are undeniable. The Mental Health Association of the Roanoke Valley reported a 70 percent increase last year in requests for its free services, and for the first time it has a waiting list. It provided 25 percent more prescriptions.

In the long run, mental health care saves money. The Mental Health Association of the New River Valley estimates that it saves hospitals as much as $1 million a year in emergency room visits by its low-income, uninsured clients. They average almost five trips each to the ER in the three months before getting treatment, and less than two in the following three to 12 months. Reduced inpatient care produces further savings.

The President’s New Freedom Commission on Mental Health puts the national economic cost of mental illness at $79 billion a year – $63 billion of it lost productivity.

Yet funding is an ongoing struggle. The VA faces a battle every year for adequate money. With two wars under way, veterans and VA doctors complain of reduced services, staff cuts and long backlogs for treatment, including mental health care. Local civilian agencies do wonders with little but must constantly compete for grants to keep going. Government and private insurers still often shortchange mental health care.

The human need is great. The financial benefit is obvious. Either should be enough to persuade America.

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