Burden of medical co-morbidity in men and women with serious mental illness

Research shows that persons with serious mental illness (SMI) are at greater risk for chronic medical conditions and lower life expectancies because of health risks associated with atypical antipsychotics and lifestyles (Chang et al., 2011) This analysis uses administrative data from Medicaid claims data linked to the Connecticut Department of Mental Health and Addiction Services data system to examine service use, medical co-morbidities and Medicaid costs for individuals with schizophrenia, bi-polar disorder, major depressive disorder and other psychoses. Some health conditions show higher prevalence among the SMI population--such as cancer (7.4% vs 6.6% p=0.000) and diabetes (16.5% vs 6.5% p=0.000). The average medical Medicaid costs for individuals with SMI for these conditions are $5,306 and $2,336 respectively - both lower than expenditures for individuals without SMI. This is consistent with differential access and treatment for an SMI population with co-morbid health conditions compared to the rest of the population. As states rethink systems of care with the implementation of the Affordable Care Act, the differential health burden for disadvantaged populations, such as those with SMI, needs to be considered. To the extent possible, disparities of access and need should be addressed with mechanisms such as patient-centered medical homes that provide for the integration of behavioral and medical treatment.

Reference: Chang CK, Hayes RD, Perera G, Broadbent MT, Fernandes AC, Lee WE, Hotopf M, Stewart, (2011) 'Life expectancy at birth for people with serious mental illness and other major disorders from a secondary mental health care case register in London'. R.PLoS One; 6(5).