PsyDPsyD Clinical Clinical

PsyDPsyD School School

CAGS SchoolCAGS School

MA MA Forensic Forensic

MA MA CounselingCounseling

MA MA OrganizationalOrganizational

Certificate Executive CoachingCertificate Executive Coaching Certificate Latino Mental HealthCertificate Latino Mental Health

Massachusetts School of Professional PsychologyMassachusetts School of Professional Psychology

Founded in 1974 Accredited by NEASC, APA, NASP

Mission StatementMission Statement

““MSPP strives to be a preeminent school of psychology that MSPP strives to be a preeminent school of psychology that integrates rigorous academic instruction with extensive integrates rigorous academic instruction with extensive field education and close attention to professional development. field education and close attention to professional development. We assume an ongoing social responsibility to create programs We assume an ongoing social responsibility to create programs to educate specialists of many disciplines to meet the evolving to educate specialists of many disciplines to meet the evolving mental health needs of society.”mental health needs of society.”

Access to Access to Mental HealthMental Health

“Mental illness, including suicide, accounts for over 15 percent of the burden of disease in established market economies, such as the United States. This is more than the disease burden caused by all cancers.”

National Institute of Health, 2004

Mental Illness: PrevalenceMental Illness: PrevalenceKessler et al., 2005Kessler et al., 2005

World Mental Health Survey Initiative (WHO)

Nationally Representative Sample, English speaking adults(N = 9, 282)

12 month Prevalence EstimatesAnxiety (18%)Mood (9.5%) Impulse (9%)Drugs (4%) Other (26%)

Mental Illness: FactsMental Illness: FactsKessler et al., 2005; Satcher, 2001Kessler et al., 2005; Satcher, 2001

30 % of US adults have a serious mental disorder

Fewer than 50% of those in need are treated Independent of insurance, language, trust, relational style,

prejudice are barriers to care Culturally sensitive services show superior patient

compliance

Global Burden of Disease 2004 Global Burden of Disease 2004 Update: Update:

Selected figures and tablesSelected figures and tables

Health Statistics and Informatics DepartmentHealth Statistics and Informatics Department

Health Statistics and Informatics

Global Burden of Disease: DALYWorld Health Organization

“The overall burden of disease is assessed using the disability-adjusted life year (DALY), a time-based measure that combines years of life lost due to premature mortality and years of life lost due to time lived in states of less than full health.”

Health Statistics and Informatics

Leading Causes of Mortality and Burden of DiseaseWorld, 2004

%1. Ischaemic heart disease 12.22. Cerebrovascular disease 9.73. Lower respiratory infections 7.14. COPD 5.15. Diarrhoeal diseases 3.76. HIV/AIDS 3.57. Tuberculosis 2.58. Throat, bronchus, lung cancer 2.39. Road traffic accidents 2.210. Prematurity, low birth weight 2.0

%

1. Lower respiratory infections 6.2

2. Diarrhoeal diseases 4.8

3. Depression 4.3

4. Ischaemic heart disease 4.1

5. HIV/AIDS 3.8

6. Cerebrovascular disease 3.1

7. Prematurity, low birth weight 2.9

8. Birth asphyxia, birth trauma 2.7

9. Road traffic accidents 2.7

10. Neonatal infections and other 2.7

Mortality DALYs

Health Statistics and Informatics

Leading causes of disease burden for women aged 15–44 years, high-income countries, and low-

and middle-income countries, 2004

Health Statistics and Informatics

Ten leading causes of burden of diseaseWorld, 2004 and 2030

Access to Access to Mental HealthMental Health

“Depression makes a large contribution to the burden of disease, being at third place worldwide and eighth place in low-income countries, but at first place in middle- and high-income countries. Effective treatments for depression are available, suggesting that this burden could be reduced.”

National Institute of Health, 2004

Substance AbuseSubstance Abuse

“ The Committee has concerns that people who are seeking substance abuse treatment are unable to access services due to the lack of an adequate clinical workforce. People seeking treatment often have to wait for weeks or months before they are accepted into a treatment facility ."

Report of the Department of Health and Human Services and the House Committee on Appropriations (2006)

Substance AbuseSubstance Abuse

23.5 million need drug or alcohol treatment 1.2 million report an inability to access care

67,000 practitioners nationwide35% increased need for practitioners by 2010

“There is a workforce crisis in substance abuse care.”

Report of the National Survey of Drug Use and Health (2005)

ChildrenChildren

Living in MassachusettsLiving in Massachusetts 1, 464, 198 1, 464, 198In need of mental health services: 146, 419In need of mental health services: 146, 419Who need but will not receive: 102, 493Who need but will not receive: 102, 493

““70% of children in Massachusetts who need mental health care will not receive it.” 70% of children in Massachusetts who need mental health care will not receive it.”

MSPCC & Children’s Hospital (2006) MSPCC & Children’s Hospital (2006)

Children’s Mental Health in the Commonwealth: The Children’s Mental Health in the Commonwealth: The time is now.time is now.

ChildrenChildren

ChildrenChildren

Combat duty in Iraq and AfghanistanCombat duty in Iraq and Afghanistan Barriers to Care Barriers to Care

• Veterans of Iraq, Afghanistan War Veterans of Iraq, Afghanistan War 1.7 M 1.7 M• % who report being shot at or near explosions% who report being shot at or near explosions 90 90• % In need of mental health services % In need of mental health services 33 33• % victims of Traumatic Brain Injury% victims of Traumatic Brain Injury 20 20• % diagnosed with PTSD% diagnosed with PTSD 17 17

““There is a significant risk of mental health problems and subjects report There is a significant risk of mental health problems and subjects report important barriers to care.” important barriers to care.” Hodge et al. (2000)Hodge et al. (2000)

Mental Health AccessMental Health Access

Racial and Cultural MinoritiesRacial and Cultural Minorities

Four main ethnic groups are projected to account for 40% Four main ethnic groups are projected to account for 40% of the U.S. population by 2025 then continue to growof the U.S. population by 2025 then continue to grow

2008 2008 2050 2050 Non-Hispanic whites Non-Hispanic whites 66 % 66 % 46 % 46 % Hispanics Hispanics 15 % 15 % 30 % 30 % African Americans African Americans 14 % 14 % 15 % 15 % Asian Americans Asian Americans 5 % 5 % 9 % 9 %

U.S. Census Bureau, 2008U.S. Census Bureau, 2008

Race, Culture and Mental HealthRace, Culture and Mental Health

The prevalence of mental disorders for racial and ethnic The prevalence of mental disorders for racial and ethnic minorities in the United States is equal to or less than that minorities in the United States is equal to or less than that of whites of whites (Satcher, 2001; Miranda et al., 2008)(Satcher, 2001; Miranda et al., 2008)

Minorities have less access to, and availability of, mental Minorities have less access to, and availability of, mental health services health services (Neighbors et al., 2007)(Neighbors et al., 2007) Mental Health Mental Health Disparities (33%) are worse than those for Medical Health Disparities (33%) are worse than those for Medical Health (17%) and they have declined in recent years (17%) and they have declined in recent years (Cook et al., (Cook et al., 2007)2007)

Insurance coverage does not explain difference in access to Insurance coverage does not explain difference in access to care care (Padgett et al., 1995; Snowden & Thomas, 2000) (Padgett et al., 1995; Snowden & Thomas, 2000) Prejudice, Prejudice, attitudes towards spirituality, lack of trust, stigma are attitudes towards spirituality, lack of trust, stigma are offered as explanations offered as explanations (Keith, 2000; Cooper-Patrick et al.,1997) (Keith, 2000; Cooper-Patrick et al.,1997)

Mental Health AccessMental Health AccessRacial and Cultural MinoritiesRacial and Cultural Minorities

African Americans are over diagnosed with Schizophrenia and African Americans are over diagnosed with Schizophrenia and under diagnosed for Depression. under diagnosed for Depression. (Snowden & Cheung 1990)(Snowden & Cheung 1990) Seventeen percent of African Americans with mental Seventeen percent of African Americans with mental illnesses are treated for them illnesses are treated for them (Satcher, 2001)(Satcher, 2001)

Minority subjects and issues are underrepresented in mental Minority subjects and issues are underrepresented in mental health research health research (Hall, 2001; Hogg Foundation for Mental Health, 2006; Satcher, (Hall, 2001; Hogg Foundation for Mental Health, 2006; Satcher, 2001) 2001)

Some evidence supports ethnic matching to improve Some evidence supports ethnic matching to improve compliance and extend the length of treatment. compliance and extend the length of treatment. (Sue, 1998; (Sue, 1998; Ziguras et al., 2003)Ziguras et al., 2003)

Less than 2% of psychologists and mental health providers are Less than 2% of psychologists and mental health providers are capable of offering cultural and language competent care to capable of offering cultural and language competent care to racially and culturally diverse persons racially and culturally diverse persons (Holzer et al., 1998)(Holzer et al., 1998)

Mental Health AccessMental Health AccessRacial and Cultural MinoritiesRacial and Cultural Minorities

““American Indians, Alaska Natives, African Americans, Asian Americans, Pacific Islanders, and Hispanic Americans bear a disproportionately high burden of disability from mental disorders. This higher burden does not arise from a greater prevalence or severity of illnesses in these populations. Rather it stems from receiving less care and poorer quality of care.”

Achieving the Promise: Transforming Mental Health Care in AmericaAchieving the Promise: Transforming Mental Health Care in AmericaNew Freedom Commission on Mental Health (2003)New Freedom Commission on Mental Health (2003)