mhascreeningcdn.trustedpartner.com/docs/library/mentalhealthp... · touch –helpline and affiliate...

The Strategy for Intervention B4Stage4Paul Gionfriddo, President and CEO

Mental Health America

MHAScreening.org

Presentation Outline

• Why Screen?

• Overview of the (Ongoing) Results.

• Examining Subpopulations.

• Breakdowns by Demographic Group

• Breakdowns by Co-Occurring Condition

• Local Data.

• Call to Action.

Screening Promotes Integration.

Why Screen?

More Screening = Better Healthcare

• Screening in primary care perceived as helpful 93% of the time;

• PCPs 3 times more likely to recognize MI symptoms and follow up;

• Post-screening treatment changes were made 40% of the time;

• Positive benefits persist one year later.

Sources: Christensen, et al, 2005; Pignone et al, 2002; O’Connor et al, 2009; Duffy et al, 2009.

Screening Promotes Recovery

People who screen regularly are:

• More attuned to their symptoms;

• More knowledgeable about their conditions;

• Better able to communicate with their provider;

• Able to recognize improvement early in

treatment;

• More aware of the warning signs of relapse;

• Better able to self-manage their illness.

Prevention

Early Identification

and Intervention

Integrated Care and

Treatment

Recovery

MHA’s B4Stage4 Prevention/Recovery Model:Where Screening Fits

Intervention B4Stage 4: Why Screen?

MHA Online Screening ToolsDepression (PHQ-9)

Anxiety (GAD-7)

Bipolar

PTSD (PC-PTSD)

Youth Screen (PSC-YR)

Parent Screen (PSC)

Alcohol and Substance Use Screen (CAGE-AID)

Psychosis Screen (Ultra-High Risk) (PQ-B)

Work Health Survey

MHA Screening Links Early ID to Treatment and Recovery.

Overview of the Ongoing Results.

Overall Screening Numbers: Fast Facts

Screening Web site: www.mhascreening.org

• Number of Screening Tools Available: 9

• % of Screens Started That are Completed: 90%

Number of Screens completed: 650,000+

• % Female: 74%

• % Under Age 25: 54%

Current Monthly Average: 85,000

• % Positive or Moderate-to-Severe (all conditions): 66%

• % Never Been Diagnosed (of everyone taking a screen): 67%

10

Screenings Completed, by Screen, Yr 1

11

AnxietyScreening

BipolarScreening

DepressionScreening

PTSDScreening

17.4% 18.0%

58.9%

5.7%

Screening Summary Breakdown

Source: www.mhascreening.org

White69%

Non-White

Positive66%

Negative

Female75%

Male

Been DiagnosedNever

Been Diagnosed

65%

http://www.mhascreening.org/

Screeners, by Age

13

50%

22%

12%

9%

5% 2%

37%

28%

18%

8%

5%3%1%

"11-17"

"18-24"

"25-34"

"35-44"

"45-54"

"55-64"

"65+"

Inner Circle Apr 14-Apr 15

n= 242,204

Outer CircleMay-Jul 15n= 116,054

Screeners, by Race/Ethnicity

14

6.0%

7.2%

10.2%

4.2%

0.9%2.2%

69.2%

Asian or Pacific Islander

Black or AfricanAmerican (non-Hispanic)

Hispanic or Latino

More than one of theabove

Native American orAmerican Indian

Other

White (non-Hispanic)

White, Non-Hispanic

N=242,204

Screeners’ Income Distribution

15

0%

5%

10%

15%

20%

25%

30%

35%

Percent Positive* for Each Condition

16* “Moderate” to “Severe” = “Positive”

Moderate Anxiety

7%

Severe Anxiety

10%

Moderate Depression

19%

Moderately Severe

Depression24%

Severe Depression

25%

Positive Bipolar

9%

Positive PTSD6%

N=173,418

Almost All of Those Taking Psychosis Screening Are At Risk

95%

5%

Psychosis Risk

No/Low Risk

17

N=2517, May-August, 2015

Three-Fourths Likely for Substance Use Disorder

77%

23%

Likely

Unlikely

18N=2971, May-August, 2015

What Will Screeners Do for Follow-up?

19

0% 10% 20% 30% 40%

Discuss with a family or friend

Discuss with MH professional

Discuss with primary care doc

Take screens regularly

Do nothing

Take a screen immediately

Support After Screening: What Screeners Want

20

Online, self-help

apps/tools27%

A way to contact a

peer15%

More info about where to go for help

32%

Find providers in

my area17%

Other9%

N= 242,204

Word Cloud: What Do They Want?

21

Different Demographic Groups Yield Both Similar and Differing Results

Examining Subpopulations 1

Multi-Racial Individuals Most Positive or Moderate to Severe

23

72% 69%74%

80% 77% 75% 74%

60%72%

N=242,204

Are People Who Self-ID as LGBT More Likely to Experience MH Concerns?

20.3%

2.3%

LGBT Screeners

LGBT General Population

24N=79552, May – August 2015

Source: CDC, 2013

Children and Mental Illness: Early Warning Signs

25

Anxiety Screening

6%

Bipolar Screening

16%

Depression Screening

70%

PTSD Screening

1%

Youth Screening

7%

N=36,346 (May-July 2015). PTSD, SUD, and Parent Screens were <1% combined.

80.4% of youth taking youth screen were positive/at risk. Results of other screens not validated for youth.

Children and Mental Illness: Even Earlier Warning Signs

62%

38%

Parent Screening Results

At Risk

Not at Risk

26


Young (<25) Women Slightly More Likely to have Positive Result

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Positive Negative

Young Women Young Men

27


Caregivers are Most Frequently Positive for PTSD and Depression

28

78.4%71.3%

48.2%

81.4% 81.9%

Alcohol orSubstance Use

Screening

Anxiety Bipolar Depression PTSD

N=6,303 (2015). 30% (versus 65% of overall screeners) were under 25; 14% (versus 1% of overall screeners) were 55+.

Vets/Active Duty: More Worried About Depression, Bipolar, Anxiety than PTSD

29

0 500 1000 1500 2000

Depression

Bipolar

Anxiety

PTSD

Other

N=2855

Source: MHA Screening, May 2015-July 2015

79% Positive

49% Positive

68% Positive

79% Positive

Who Has PTSD?

30

0

200

400

600

800

1000

1200

New Moms Vets Caregivers Students

83%+

85%+

79%+

82%+

N=73,735. Note: Screeners could choose more than one category.

Race/Ethnicity: Blacks Most Likely to Do Something

31

45%

30%35%

39%35%

43%

35% 35% 36%

Percent Saying “Will Do Nothing” with Results

Screening Results: Men More Likely to do Nothing

32

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Discussresults with

family orfriend

Discussresults with

MHprofessional

Discussresults with

PCP

Take regularscreens

Do nothing Takeanotherscreen

immediately

Female

Male

Mental Illnesses Frequently Co-Occur with Other Conditions

Examining Subpopulations 2

Research Backdrop on Co-Occurring Conditions

• People with diabetes: 2x more likely to have depression.

• Adults with depression: 2x more likely to develop cardiovascular disease.

• 25% of cancer patients also have major depressive disorder.

• 50% of people with chronic pain also have depression.

• 50% with depression also have anxiety disorder.

Sources: NIH, VA, ADAA

34

14 Percent Have Other Chronic Conditions

35

Pain31%

Lung13%Diabetes

13%

Heart8%

ADD/HD3%

Cancer3%

Migraines1%

Other28%

Source: MHA Screening, May-August, 2015

No Co-Occurring

86%

Co-Occurring

14%

People Reporting Chronic Pain Who are Positive for a Mental Illness

77%

23%

Positive

Negative

36

N=10353, May-August 2015

People Reporting COPD/Lung Disease Who are Positive for a Mental Illness

80%

20%

Positive

Negative

37


People Reporting Alzheimer’s Who are Positive for a Mental Illness

75%

25%

Positive

Negative

38


People Reporting Diabetes Who Are Positive for a Mental Illness

74%

26%

Positive

Negative

39


People Reporting Cancer History Who are Positive for a Mental Illness

71%

29%

Positive

Negative

40


Note: 63% positive for depression v. 25% with MDD in earlier research data.

How Does Our Community Look?

Local Results

Palm Beach County By the Numbers

• Total Number of Screeners (through August 2015): 648

• Percent Female: 68% (versus 75% Florida and National)

• Most Common Screen: Depression (58% - Same as National)

• Roughly one in four PBC Screeners reports having at least one other chronic condition.

• 36% identify as students; 13% as LGBT; and 4% as caregivers.

42

PBC Screening Reaches a More Diverse Population

43

0% 20% 40% 60% 80%

Asian or Pacific Islander

Black or African American(non-Hispanic)

Hispanic or Latino

More than one of the above

Native American or AmericanIndian

Other

White (non-Hispanic)

PBC

Florida

National

PBC Screeners are Older

44

0%

5%

10%

15%

20%

25%

30%

35%

40%

"11-17" "18-24" "25-34" "35-44" "45-54" "55-64" "65+"

National Florida PBC

N=116054 (National), May – August, 2015

Similar in Income, Slightly Wealthier

45

0%

5%

10%

15%

20%

25%

30%

35%

National

Florida

PBC

Percent Positive, by Contribution to Total by Condition

46

0%

10%

20%

30%

40%

50%

60%

70%

80%


Positive PTSD

Positive Bipolar

Severe Depression

Moderately SevereDepression

Moderate Depression

Severe Anxiety

Moderate Anxiety

72% 73% 72%

Ever Been Diagnosed?

47

66.89% 67.49% 66.37%

33.11% 32.51% 33.63%


No Yes

People in PBC Most Likely to Report Having Co-Occurring Conditions

14%

22%

28%

National Florida Palm Beach

48

What We Can Do with the Results to Inform Policy and Practice.

Call To Action

What Young People (11-17) Say They Want

50

10% 9%

38%

46%

57%

Phone Number Referral toAffiliates

Worksheets Online MobileApps - trackand managesymptoms

AdditionalInformation

about mentalhealth

N=17969, May-July 2015

What Caregivers Say They Want

51

19%26%

54%49%

41%


Worksheets Online MobileApps - track and

managesymptoms


about mentalhealth

N=4085, May-July, 2015

What Active Duty/Veterans Say They Want

52

19%22%

48%42% 42%


Worksheets Online MobileApps - track and

managesymptoms


about mentalhealth

N=1491, May-July, 2015

Different Demo Groups Want Different Things, But Everyone Wants Online Help and Info

53

0%

5%

10%

15%

20%

25%

30%

35%

40%

Online, Self HelpApps

Contact a Peer

Info about whereto get MH help

Help FindProviders

Other (pleasespecify)

PBC Residents Want More Help Finding Treatment

54

0%

5%

10%

15%

20%

25%

30%

35%

Discussresults with

family,friend or

pro

Findadditional

informationonline

Findtreatment

Monitor myhealth

Do Nothing

National

Florida

PBC

Screeners in PBC Want a More Personal Touch – Helpline and Affiliate Connection

55

0%

10%

20%

30%

40%

50%

60%

Phone # forimmediateassistance

Referral toAffiliate

Worksheetsor Coping

Skills to useat home

OnlineMobile Apps- track and

managesymptoms

More Infoabout MH

National

Florida

PBC

MHA’s Advocacy for Screening

Mental health screening should be as commonplace as vision, hearing, dental, and blood pressure screening.

It should be conducted in clinicians’ offices, communities, schools, and workplaces.

Revision of the Free Care Rule (December 2014) makes free screening in schools reimbursable by Medicaid.

56

MHA’s Screening to Treatment and Recovery

Online Screening

S2T Apps and Interactive Web

Environment

Paid MHA apps.

Vendor Opportunities

Clinical Tools and Worksheets

Improved, Linked Web Content

Referrals to Affiliates

Helplines; Local and Peer Support

57

Using Screening Results for Education and Evaluation

Online Screening

Special URLs for

Population Tracking

Regular and

Special Reports

Informing Policy and Practice

58

Thank You!

mhascreeningcdn.trustedpartner.com/docs/library/mentalhealthp... · touch –helpline and affiliate...

Documents