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Mental Health Care Big Business

Once hidden from view, mental illness and treatment continues to evolve. Improved understanding, new medications and insurance coverage have prompted millions to seek help. Outpatient treatment has largely replaced costly hospitalization. In the second part of a three part series, WOSU examines the funding behind the treatment. Mental health is a booming business. With the stigma of mental illness fading, researchers developing new treatment methods and insurance companies covering the bills, mental healthcare has become a 113 billion dollar industry. About a third of that is spent on prescription drugs. Helping fuel the boom: TV advertisements. TV adds for drugs like Cymbalta offer help for depression. They’re also on the radio and in magazines. The ads make drug companies a lot of money, but they’ve also brought mental illness into the mainstream, prompting people to seek treatment. The meds have allowed doctors to care for the mentally ill without putting them in a hospital. While many argue drugs are over prescribed, better medications with fewer side effects helped reduce hospitalization for mental illness. “Many people who had been hospitalized for a number of years were able to go into the community, be successful in the community and actually become productive members of our society. To be employed, to live independently and to contribute in many ways that of course would be impossible if they were hospitalized," said Dr. Mark Hurst, Ohio Department of Mental Health Medical Director. As Outpatient care became standard, public funding has changed. Hurst said states have diverted money from hospitals to local-level mental health boards, like ADAMH. “So the boards then had the discretion about using that money for hospital bed days or for OTHER services to try to avoid hospitalization.â€? The number of state hospitals declined sharply from 17 to six. And the state is spending less money on mental health services. Since the late 80s, Ohio’s funding has been on a downward trend even as demand for services has risen with the recession. OSU Harding Hospital Executive Director Amanda Lucas said when clinics see a cut in state funding, programs limit care or close. And that costs more in the long run' “A downside of that is, aside from the patient not having care, is you’ll see an uptick in [emergency department] visits for emergent psychiatric issues and an increase of in-patient stays because people aren’t getting the day-to-day care they need to allow them to adequate address their mental health concerns and live without being in crisis," Lucas said. Admissions to state hospitals increased 18 percent last year. Many patients have had multiple stays. The revolving door effect. “I see a whole lot of it," said Thomas Hayes. Hayes helps patients at Twin Valley Behavioral Health on Columbus’ Near East Side. He suffers from paranoid schizophrenia. Hayes a good example of how outpatient treatment works. He was hospitalized once but never again thanks to medication and therapy. He has a job and takes classes at Columbus State. “I’m able to live a fulfilling life with the medication," he said. "And that’s one thing that I like to tell the patients, the new admissions, that, you know, staying on your medication is vital. Mental health professions are hopeful of seeing expanded public funding for mental health services. Governor Kasich’s plan to expand Medicaid would mean more money. But so far Republican lawmakers have balked at the plan which is a major part of President Obama’s new health care law. Tune in Wednesday for the final installment of this three part series when WOSU takes a look at what is in store for mental health care.