The Case For Early Intervention
First, High-Cost Mental Health Patients Are Much Younger Than Other High-Cost Patients.
The authors found that 79 percent of high-cost mental health patients were under the age of 60. But only 39.7 percent of other high-cost patients were under age 60.
Chronic diseases affecting the heart, lungs, and other organs are often diseases of aging. But half of all mental illnesses begin by the age of 14, three-quarters by the age of 25. For individuals with mental illnesses, the costs often start adding up early.
Second, The Researchers Suggested That High-Cost Mental Health Patients Did Not (Yet) Manifest Other Chronic Diseases.
Their data suggested that only 10 percent of mental health high-cost patients had a hospitalization that wasn’t related to mental health needs. They explain this in part because of the young age of the high-cost mental health patients.
This disparity in utilization of non-mental health hospitalizations among high-cost mental health patients could also be due to the increased mortality rates among younger individuals with mental illness. Americans with major mental illness die on average 14-32 years earlier than the general population.
There may be another answer. Mental illnesses could precede other chronic conditions, which in turn become more costly as people age.
Third, High-Cost Mental Health Patients Were More Likely To Be Hospitalized Than Were Non-Mental Health High-Cost Patients.
The disproportionate use of hospitalizations among high-cost mental health patients is a result of our failure to act early. Not too long ago, schizophrenia was thought to be a lifetime sentence of profound disability, with little hope of being able to participate in the community. But we are learning more about schizophrenia every day, and what we are learning highlights the importance of intervening early.
Early intervention around psychosis has long-term positive effects, including a reduction in hospitalizations for five years or more. When services are offered in the community, not in a hospital setting, individuals live more independent lives. This has the added benefit of holding down costs.