Study: Mental health worse in R.I. than nation

Rhode Island has a new statistical tool to measure its relative wellness against such national indicators as breast cancer, obesity, access to health insurance and mental health.
The statistics are derived from the statewide 2013 Rhode Island Community Health Needs Assessment, a requirement of the Affordable Care Act, which were released on May 1 at a news conference at Women & Infants Hospital.
The major “unfavorable” finding of the new health-needs assessment was that Rhode Island has a big problem with its mental health.
The mental-health finding was compiled by Holleran Consulting, the Mountville, Penn., firm hired to conduct the health-needs assessment. Holleran’s study found that 22 percent, nearly one-fifth of Rhode Islanders, had been told that they had a depressive disorder, compared to an average of 16.8 percent nationally, according to Colleen Milligan, director of Health & Human Services at Holleran.
In a similar finding, 15.4 percent of Rhode Islanders answered that poor physical or mental health kept them for doing their usual activities between 15 and 30 days during past month.
In a follow-up, Holleran conducted in-depth telephone interviews with 49 local health and human service professionals and community leaders, who said that the top two “key health issues” were access to health care (82 percent) and mental health/suicide (47 percent), according to the report. In terms of resources needed, 23 of the 49 leaders named mental-health services.
From his position on the ground, administering a network of busy community health centers, Merrill R. Thomas, the CEO of the Providence Community Health Centers, agreed with the health-need assessment that mental health is a big issue.
The problem is not awareness or integration of services, he said, but the fact that health centers and behavioral health centers get paid in different ways. “There are two different silos in terms of insurance financial payments, with different rates, depending on what’s covered, who’s a billable provider and who is credentialed,” he said.
As a result, Thomas said, continuity of care and treatment in behavioral health has become an issue, or more precisely, an insurance issue. “A total of $500 in mental-health benefits will cover three or four visits with [a provider],” Thomas said. “Three visits are not going to amount to a cure.”
The community-health-needs project, a partnership between the Hospital Association of Rhode Island and the R.I. Department of Health, also unveiled a new website, www.rihealthmatters.org, which provides an online version of the results, translatable into 50 languages. All of the information collected from the Rhode Island comparisons to U.S. health statistics is available on the new website.
The statewide community-needs health assessment will be conducted every three years. Nonprofit hospitals in Rhode Island are required to prepare their own individual community-health-needs assessment, based upon the work done as part of the statewide assessment, and submit it to federal regulators by Sept. 30, or face a $50,000 fine.
Virginia M. Burke, president and CEO of the Rhode Island Health Care Association, offered both praise and criticism of the effort. “So much of health care policy has been the result of anecdotal information, or based on intuition. And, our intuition is often wrong. Now, we are creating a way to measure our community health needs,” she said.
Burke questioned the granularity of the initial statewide community-needs assessment, and questioned its lack of detail and analysis about the needs of Rhode Island’s aging population.
Joanne Carlson, a nurse manager at Kent Hospital’s outpatient infusion unit and Kim McDonough, program manager of The Breast Health Center at Kent Hospital, said that the new documentation and its breakdown of statistics will be “very helpful” assisting them with preparation of grants for future funding of their programs.
“We support efforts to make health-outcome information more-readily accessible to the public,” said Dr. Mack Johnston, chief medical officer for Neighborhood Health Plan of Rhode Island. “Better understanding of data and population health allows for more-targeted interventions.” •

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