How can clinicians and policy makers collaborate to improve the standing of mental health in the US?
Earlier this month, Otsuka America Pharmaceutical, Inc. hosted the 2nd Annual Advancing Mental Health Policy: BetterTogether forum in Washington, DC. The event brought together leaders in healthcare, community, advocacy, and government for a day of discussion and collaboration toward the goal of bettering the policy-based solutions in place for patients with mental illness.
In an interview with MD Magazine® following the forum, Kabir Nath, chief executive officer of Otsuka North America Pharmaceuticals, recapped the forum’s biggest takeaways, and shared his own perspective on the challenges facing mental healthcare in the US.
MD Mag: What is the motivation behind the mental health policy forum?
Nath: So, we see that mental health policy is an absolutely key aspect of public policy. It involves many stakeholders with different backgrounds, different roles. And we, as Otsuka, are proud to bring together this coalition of people to discuss some of those pressing issues, and really discuss some of the actions we can all take collectively to improve the situation for those patients with serious mental illness.
MD Mag: What is the significance of hosting a multi-faceted discussion on mental health policy solutions?
Nath: We're a pharmaceutical company, but we have always acknowledged that treating patients or providing the best outcomes to patients with serious mental illness is a very complex endeavor. There's a large ecosystem around that; providing the drug is just one part of it. There are social elements, public policy elements, education elements, all these different pieces come together. And we think it's essential to have this broad-based group of stakeholders, who can actually all bring their points of view, their expertise, and their ability to help solve some of these problems.
MD Mag: How do stigma and social barriers challenge the progress of improved mental healthcare measures?
Nath: So unfortunately, stigma is still central to how we think about and talk about mental illness as a society. So there's a stigma around individuals coming forward with mental illness. And there are other elements of stigma that are pervasive, such as the causal and entirely incorrect linkage between mental illness and acts of violence. In practice, people with serious mental illness are much more likely to be victims of violence than perpetrators. And there's data, for instance, suggesting that people with untreated serious mental illness are 16 times more likely to be killed in an encounter with a police officer than people without mental illness in such a normal civilian encounter.
Similarly, only 3% of violent crime can actually be attributed to folks living with mental illness. So that stigma applies in so many different ways. And it starts here. It starts in the family, it starts in schools and starts in college and so on. And therefore collectively, we have to work very hard to break down that stigma.
MD Mag: Patient access to care is accentuated by a decreased rate of trained and available psychiatrists. How can we streamline the process to psychiatric treatment?
Nath: This is an already tough question. It's clearly the case that psychiatry is an aging profession. Something like one-third of all psychologists are over the age of 55. And we see that in many counties, something like 60% of rural counties in the US, there is actually no psychiatrist. Beyond that it's not just the lack of psychiatrists. It's also whether they are actually practicing within plans, whether they're available to new patients, and so on. Somehow, there needs to be an effort to look at the incentives across the entire healthcare system, to bring more people licensed to practice psychiatric medicine—whether that's psychiatrists, psychologists, nursing assistants, and so on. But clearly, things have to change all the way through, so that we can actually develop a much stronger base of people able to treat the people living with mental illness.
MD Mag: What are some of the most promising advancements in mental health care today? What fields need to be better addressed?
Nath: I think there are clearly areas for hope. I think first, around treatment itself, we're starting to see that there is an increasing pipeline of potential new mechanisms, new medicines. After 20 years, we're ready. We haven't had much innovation. This year alone, there have been a couple of new products, new classes improved. And we start to see a lot more interest in that, because our understanding of the basic biology is improving. I think also with the convergence of digital technology with medicine, there are opportunities in areas such as digital therapeutics where we may be able to bring much lower costs, more readily available treatments to people. Clearly, areas like telehealth, telepsychiatry are ways to try and deal with the shortage of psychiatry. It's our signs for hope.
MD Mag: What is the biggest take-home message from the AMHP forum?
Nath: The biggest message is we have to do more to break down the stigma, to break down the societal construct and framework in which serious mental illnesses are seen. And the way to do that is for us all to speak up, to share our stories. Today, I was proud to see that so many people on the stage shared their own stories. I did myself, as I had done last year, that my father died by suicide, and there's a history of schizophrenia in my family. But together, all of us have to speak up, share our stories. All of us are impacted by this level of serious mental illness in society. And by doing so, we can actually both move that narrative forward, and also encourage others to take action.