Mental Disorders & Medical Comorbidity

In the wake of national health reform, tens of millions of Americans will become newly insured. Given the high rates of uninsurance among people with mental illness, as well as the high rates of comorbidity between mental and medical conditions, the nation’s policy-makers will soon be confronted with how to best serve this newly insured population. To improve quality and reduce the growth of health spending, policy-makers must focus on particular subgroups most at-risk for high cost and poor quality—among them—those with mental health and medical comorbidities.

A new report from the Robert Wood Johnson Foundation’s Synthesis Project provides an overview of medical and mental comorbidity, with an eye toward current federal health reform efforts.
The Synthesis report includes the following key findings:

• Comorbidity is the rule rather than the exception. When mental and medical conditions co-occur, the combination is associated with elevated symptom burden, functional impairment, decreased length and quality of life, and increased costs.
• The pathways causing comorbidity of mental and medical disorders are complex and bidirectional. Medical disorders may lead to mental ones, mental conditions may place a person at risk for medical disorders, and mental and medical disorders may share common risk factors.
• Models that integrate care to treat people with mental health and medical comorbidities have proven effective. Despite their effectiveness, these models are not in widespread use.

Read the report and related materials.
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