psych&neuro
An Economic Evaluation
of Severe Mental Health Disorder Treatment Options
Gillian Arleth Mental illnesses are more common than cancer, heart disease, and diabetes.1 Although they affect nearly one in five adults in the US, the question remains: are those suffering from mental illness effectively treated?2 Many researchers are evaluating the success of mental health treatment options, including UNC-Chapel Hill professor, Dr. Domino. Working in the Department of Health Policy and Management, Dr. Domino investigates the efficacy of healthcare policies that focus on low income and disabled populations. It wasn’t until college that she found her interest in health policy. Originally a piano performance major, she began taking courses in health policy and realized her true interests. In graduate school, Dr. Domino worked with mental health policies and economics. She has continued researching mental health economics and recently investigated the efficacy of primary care based medical homes in her article titled Through the Looking Glass: Estimating Effects of Medical Homes for People with Severe Mental Illness. Her review analyzes the impact of enhancements added to primary care facilities on those with severe mental illnesses. Dr. Domino states “In a primary care based medical home, a team maintains overall responsibility for an individual’s health care, including any coordination needed with specialty providers”.3 Medical homes have the potential to improve outcomes for patients with severe mental illness. These facilities are characterized by more communication between physicians and mental health care
providers, the development of understanding and trusting relationships between patients and caregivers, and patients are more likely to adhere to medication recommendations. Dr. Domino saw the need for more research to determine if these are actual advantages especially because of the Dr. Marisa Domino diversity in responses to treatment. She also recognized the significance of this research because mental illness disproportionately impacts people on Medicaid. Attentively monitoring treatment options could have far reaching impacts on the large portion of the population affected by mental disorders. The study focused on the effect of medical homes on patients enrolled in Medicaid and diagnosed with one of three different severe mental illnesses: schizophrenia, bipolar disorder, and major depressive disorder. Dr. Domino chose both schizophrenia and bipolar disorder because of their characterization as severe mental health disorders. However, opinions differ in regards to major depressive disorder’s similar categorization. Dr. Domino chose to investigate major depressive disorder because of the abundant evidence relating
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