Use of Services by Persons With Mental and Addictive Disorders

Narrow, William E.; Regier, Darrel A.; Rae, Donald S.; Manderscheid, Ronald W.; Locke, Ben Z.

doi:10.1001/archpsyc.1993.01820140017002

Cited by 362 publications

(44 citation statements)

References 31 publications

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“…Thus, for the majority of ambulatory utilizers, regardless of clinical status, treatment ends after a small number of visits (10 or fewer), a finding consistent with U.S. trends (e.g., Narrow et al 1993;Taube et al 1988).…”

Section: Myth #2: Any Use Leads To High Usesupporting

confidence: 52%

Ambulatory Mental Health Treatment under Universal Coverage: Policy Insights from Israel

et al. 1997

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Untested assumptions concerning ambulatory treatment have shaped mental health policies for decades. Three opinions prevail: (1) all use is alike; (2) any use leads to high use; and (3) all high use is discretionary and therefore excessive. These assumptions were tested, using data from a nationwide survey of ambulatory utilizers in Israel, a country that has universal coverage. The findings, based on detailed clinical and treatment records, challenge all three assumptions. Moreover, they document a diversity of clinical needs while also verifying substantial variations in the type, frequency, and duration of treatment provided to meet those needs. In brief, Israeli data do not confirm continuing concerns by policy makers about uncontrollable use of services with expanded mental health coverage. Special policy limitations on mental health treatment should be reconsidered in light of empirical evidence from a system without the restrictions that exist in the United States.

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Section: Myth #2: Any Use Leads To High Usesupporting

confidence: 52%

Ambulatory Mental Health Treatment under Universal Coverage: Policy Insights from Israel

et al. 1997

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“…(Medication management was an integral part of each supportive therapy session provided by the nurses.) Although supportive therapy sessions were less frequent than personal therapy sessions, the 21 annual visits of supportive therapy recipients exceeded the 16 annual visits that are customary in outpatient mental health facilities (42). Actual session frequency approximated the intended frequency: weekly sessions for personal therapy recipients over 3 years, with less contact in year 3 for those who completed treatment objectives; biweekly family sessions for family therapy recipients in year 1, with biweekly to monthly sessions thereafter; and biweekly sessions for supportive therapy recipients in all years.…”

Section: Definitions Of Treatmentmentioning

confidence: 89%

Three-Year Trials of Personal Therapy Among Schizophrenic Patients Living With or Independent of Family, I: Description of Study and Effects on Relapse Rates

Hogarty¹,

Kornblith²,

Greenwald³

et al. 1997

AJP

251

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“…Women are consistently found to have rates of depression twice as high as men. Depression is conventionally viewed as a ‘medical illness’ and drugs appear to be the most commonly delivered treatment for depression in the USA [4]. Antidepressant prescriptions have risen steadily since 1980 and are now prescribed in over 30% of all visits to psychiatrists [5].…”

Section: Introductionmentioning

confidence: 99%

Raising Questions about Antidepressants

Antonuccio

Danton

DeNelsky

et al. 1999

Psychother Psychosom

104

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Antidepressant medication has apparently become the most popular treatment for depression in the USA. Several beliefs about the efficacy of antidepressant medications prevail among mental health professionals and the public. This paper explores relevant research data and raises questions about these beliefs. Many of the common beliefs about these medications are not adequately supported by scientific data. The following issues are raised: (1) industry-funded research studies which result in negative findings sometimes do not get published; (2) placebo washout procedures may bias results in some studies; (3) there are serious questions about the integrity of the double-blind procedure; (4) the ‘true’ antidepressant drug effect in adults appears to be relatively small; (5) there is minimal evidence of antidepressant efficacy in children; (6) side effects are fairly common even with the newer antidepressants; (7) combining medications raises the risk for more serious complications; (8) all antidepressants can cause withdrawal symptoms; (9) genetic influences on unipolar depression appear to be weaker than environmental influences; (10) biochemical theories of depression are as yet unproven; (11) biological markers specific for depression have been elusive; (12) dosage and plasma levels of antidepressants have been minimally related to treatment outcome; (13) preliminary evidence suggests that patients who improve with cognitive-behavioral psychotherapy show similar biological changes as those who respond to medication, and (14) the evidence suggests that psychological interventions are at least as effective as pharmacotherapy in treating depression, even if severe, especially when patient-rated measures are used and long-term follow-up is considered.

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Use of Services by Persons With Mental and Addictive Disorders

Cited by 362 publications

References 31 publications

Ambulatory Mental Health Treatment under Universal Coverage: Policy Insights from Israel

Ambulatory Mental Health Treatment under Universal Coverage: Policy Insights from Israel

Three-Year Trials of Personal Therapy Among Schizophrenic Patients Living With or Independent of Family, I: Description of Study and Effects on Relapse Rates

Raising Questions about Antidepressants

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