RE: EARLY DIAGNOSIS OF MENTAL ILLNESS
HOW TO REDUCE THE FINANCIAL BURDEN ON MEDICAL AIDS
Both local and international research provides powerful evidence for the argument that a correct and timely diagnosis of mental disorders such as Panic Disorder will, in the long run, cost both the patient and their medical aid considerably less. Despite this well-known fact, many sufferers often go misdiagnosed for at least two years, with the result that they waste their limited benefits and consequently cannot afford the treatment prescribed when they eventually receive an accurate diagnosis. This is, therefore a dire situation which must be addressed by medical aids, mental health care professionals and consumer advocacy groups, such as the South African Depression and Anxiety Support Group.
During the time that these patients go misdiagnosed, they draw funds from their medical aids to seek relief for the physical symptoms associated with their illness, rather than the underlying disorder. As this is a short-term symptomatic response to a deeper pathology, treatment is usually ineffective and erodes away at medical funds. Compared to a global average of 35%, 43% of South Africans sufferers only received a correct diagnosis after multiple undiagnosed visits to four or more doctors, each visit incurring noticeable expenditure on the part of the sufferer and their medical aid.
Misdiagnoses often result in referrals to specialist physicians practicing in fields vastly unrelated to the core mental disorder – including endocrinology and gastroenterology – with each referral requiring funds for specialised tests and clinical investigations. In a South African groundbreaking study, Clarence (1999) found that patients with Panic Disorder spent on average R 24 506,43 per year on inappropriate medical investigations compared to controls (R 1 288,02). This frightening figure could be considerably reduced if speedy and accurate diagnoses could be made, thus resulting in effective treatment being implemented and valuable medical funds being used in a responsible manner. Clarence claims that in most cases, “…these medical procedures are often unnecessary and make little impact on sufferer’s conditions; or worse still, can unwittingly reinforce the negative process of their condition”
In a recent four-year survey of 2558 elderly patients in a large health maintenance organisation, Dr Jurgen Unutzer of Seattle University, U.S.A, found that costs in all areas of medical care are higher for depressed patients, regardless of the severity of their physical illness. At the start of the study, the overall health-care costs of patients with significant depression symptoms averaged almost R90 000 compared to the R60 000 incurred by patients without depressive symptoms. The depressed group utilised more services in all categories of medical care, including outpatient visits, prescriptions and laboratory tests. Speciality mental health care accounted for only 1% of costs. Investigators have speculated that depression amplifies patient’s physical symptoms – including pain and medication side effects – and often leads to inadequate nutrition, all of which substantially increase both the use and cost of medical services.
By referring potential sufferers of Panic Disorder (and other anxiety and mood disorders) to professionals who are experienced in the field of treating this disorder, correct diagnoses are made early on, facilitating an effective long-term treatment process and thereby eliminating any further unnecessary expenditure. Such an early and effective treatment process represents a huge saving to both patient and medical aid. This huge saving means that the patient can afford to be on their medication for a substantially longer period of time, thereby ensuring their overcoming their illness and preventing a potential relapse of symptoms. In spite of the obvious benefits of early diagnosis and treatment, medical aid organisations continue to harbor discrimination against mental illnesses, the anxiety disorders in particular. Anxiety disorders, and depression to a lesser extent, are still not viewed as “real” illnesses by several organisations.
Realising the severe impact that misdiagnosis has on the future treatment of a patient’s Panic Disorder, the Depression and Anxiety Support Group have tirelessly implemented education programs aimed at both the public and mental health professionals, in an attempt to improve the rate of early diagnosis. Thus far, these programs have been successful, however, if they are to continue to increase the numbers of patients receiving correct treatment, then the support group are going to need the support of all those involved in the South African mental health system in the never-ending fight against anxiety and mood disorders.
I am happy to address your company on issues surrounding the speedy diagnosis and appropriate treatment of Mood Disorders. For further information on the statements in this document or to arrange for me to visit your company, kindly contact The Depression and Anxiety Support Group
For Prof. Mike Berk Telephone Number.
Prof. Mike Berk - MBBCh M Med (Psych) F F (Psych) SA Phd
Chairman of Scientific and Advisory Board.