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Catherine Hoffman and Karyn Schwartz, Eroding Access Among Nonelderly U.S. Adults With Chronic Conditions: Ten Years Of Change, Health Affairs Web Exclusive, July 22, 2008 [Abstract] [PDF] [Technical Appendix] [Reprints & Permissions]

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Chronic Diseases Exclude Mental Health

Samuel L. Kent, MD   ( 14 August 2008 )

Looking For A Source Of Data That Includes Chronic Mental Conditions

Catherine B. Hoffman, Karyn Schwartz   ( 28 August 2008 )

Chronic Diseases Exclude Mental Health 14 August 2008
Samuel L. Kent, MD, Psychiatrist Unaffiliated Send comment to journal: Re: Chronic Diseases Exclude Mental Health samuelkent2{at}mac.com Samuel L. Kent, MD	I read this paper with great interest. I was struck, possibly for parochial reasons, at your omission of all chronic psychiatric conditions from these data. Recurrent major depression, bipolar disorder, and anxiety disorders are certainly significant among chronic illnesses suffered by working and disabled Amercans, and are too often relegated to the category of "not significant enough to cover" by insurers. In otherwise significant and revealing research on the effectiveness of our health care non-system, psychiatric disorders should not be excluded.
Looking For A Source Of Data That Includes Chronic Mental Conditions 28 August 2008
Catherine B. Hoffman, Assoc. Director/Sr. Researcher Kaiser Commission on Medicaid and the Uninsured, Karyn Schwartz Send comment to journal: Re: Looking For A Source Of Data That Includes Chronic Mental Conditions choffman{at}kff.org Catherine B. Hoffman, et al.	We want to thank Dr. Kent for his letter, pointing out that in our trend analysis of access to health care among those with chronic conditions we did not include persons with chronic mental health problems. Our analysis was based solely on data from the National Health Interview Survey (NHIS). The survey asks adults if they have been told by a doctor or other health professional that they have certain chronic conditions, all of which are physical in nature. However, in the same section of the questionnaire, the NHIS asks respondents if in the past 30 days they have experienced several symptoms associated with poor mental health, e.g., sadness, nervousness, restlessness, hopelessness, etc. Regrettably, the survey does not ask directly whether the person has ever been told by a health professional if he or she has a specific chronic mental health condition. Dr. Kent, your inquiry challenges us to find a survey source or other methods to examine trends in access to care among those with chronic mental conditions--and we thank you for that.