U.S. Mental Health Spending Rises, But Many Still Left Out

May 6 -- TUESDAY, May 5 (HealthDay News) -- Mental health spending in the United States increased 65 percent in the past decade, and many more Americans are using mental health services, but there's still a big difference between access to care and quality of mental health care received, new research shows.

In a special edition of the May/June issue of Health Affairs focusing on mental health care in the United States, one study found that about half of Americans suffering from mental illness in a given year don't receive treatment, and another 25 percent receive treatment that's not consistent with evidence-based guidelines.

Some patients may receive inappropriate treatments, simply because doctors lack the evidence to make an informed decision about appropriate care, noted Philip Wang, acting deputy director of the National Institute of Mental Health, and colleagues.

Another study suggested that even when doctors have information about best practices, patients don't always receive the correct treatments. That's because financial incentives, regulations, the quality of the mental health workforce, and drug company marketing strategies have a major impact on doctors' treatment decisions, said Marcela Horvitz-Lennon, of the Western Psychiatric Institute and Clinic in Pittsburgh, and colleagues.

They said underuse of effective treatments and overuse of ineffective treatments undermine the quality of care and lead to poor patient outcomes. For people with severe mental illness, that can result in increasing isolation, repeated hospitalizations, inability to get or hold a job, and even suicide.

Another study found that the number of seniors receiving psychotropic drugs to treat Alzheimer's and other mental health disorders doubled between 1996 and 2006, and the number of adults and children using the drugs increased by 73 percent and 50 percent, respectively.

The use of psychotropic drugs has increased, because primary-care doctors have become more familiar with these types of drugs and lower-cost drugs have become more available, said Sherry Glied, chair of health policy and management at the Mailman School of Public Health at Columbia University, and colleague Richard Frank.