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Crossing state lines of chronic mental illness
A P Schinnar1, A B Rothbard, R Kanter
1Department of Public Policy and Management, Wharton School, University of Pennsylvania, Philadelphia 19104.
Hospital & Community Psychiatry
|July 1, 1990
Summary
State definitions for chronic mental illness vary widely, making national patient counts unreliable. This study found prevalence estimates ranging from 38% to 72% depending on the definition used.
Area of Science:
- Public Health
- Mental Health Services Research
- Health Policy Analysis
Background:
- Federal legislation in 1986 mandated state-specific definitions for chronic mental illness.
- These definitions were intended for state service plans but raised questions about comparability.
Purpose of the Study:
- To assess if state definitions of chronic mental illness yield comparable patient populations.
- To determine the feasibility of obtaining a meaningful national estimate of chronically mentally ill patients.
Main Methods:
- Applied definitions from ten states to a West Philadelphia public mental health service user sample.
- Analyzed a two-year period of patient data to calculate prevalence estimates.
Main Results:
- Prevalence estimates varied significantly, from 38% (Hawaii definition) to 72% (Ohio definition).
- The National Institute of Mental Health definition yielded a 55% prevalence estimate.
- Considerable variance in estimates indicates limitations in summing state-level data.
Conclusions:
- State-specific definitions of chronic mental illness lead to substantial differences in prevalence.
- The aggregation of state counts for chronic mental illness is of limited utility for national estimates.
- Need for standardized definitions or methodologies to improve national mental health statistics.