Just how many people are mentally ill?

                                                                                         

States and those responsible for administering the healthcare service have to make long term plans. With the population rising, they need to predict how many hospitals and doctors we are going to need in ten years time. This allows time to draw up plans and build. It also allows time to increase the number of places in universities to train the doctors. And that’s before we get to all the other people who are needed to run hospitals like nurses. And then who’s going to pay for it all. Taxes may have to be raised to pay for the public services, or insurance companies may have to increase their premiums to pay for all the new treatments required. Either way, there could be some big bills coming and plans should be drawn up. Except how do you estimate the number of patients? With something like broken bones, this is reasonably easy. You count how many people break their bones now and, as a percentage of the population, estimate how many will do the same in ten years time. But when it comes to anxiety and depression, how do you produce reliable estimates?

Conventional wisdom says that, at any one time, about 20% of the population has some level of mental disorder. This can be anxiety, panic or depressive disorders. Or it may include alcoholics and drug addicts as well. It’s appropriate to ask the question now because psychiatrists are debating how to diagnose the different conditions. The idea is to produce national standards so that all health professionals use the same tests to diagnose the disorders. Like broken bones, this will make it easier to count how many people are affected. By coincidence, we also have new research published in Psychological Science that finds, among young adults up to the age of 32, 41% suffering clinical depression, 50% with an anxiety disorder and 33% with alcohol dependence. The idea that conventional wisdom is underestimating the scale of the problem by half is a worrying possibility.

There’s no doubt that many people do not report their illnesses because, without insurance coverage, they cannot afford to pay for treatment. Even if they do seek treatment, they often “forget” past behavior. This lack of reliable information from many patients makes diagnosis more difficult than it should be. Of course doctors and psychiatrists could fall back on the default approach. Xanax is the first response drug of choice for anxiety and panic disorders. Used responsibly in combination with counseling and therapy, there’s a very high rate of success with about 80% of patients finding vastly improved quality of life. Unfortunately, many doctors and their patients simply rely on xanax. This increases the risk of dependence — withdrawal symptoms are unpleasant and the forced cost of continuing to take the drug runs down savings. It’s time for the medical profession to start training for counselors and behavioral therapists to deal with mental health problems. There are not enough trained people to deal with the current number of patients. We need a better count of how many people to treat so that buildings and trained staff can be put in place over the next ten and more years.

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