I was highly struck by something Dr David Sobel said in his great speech at the Ix Therapy conference last October—he suggested some 50% of primary care office visits are the result of background mental health issues. That sounds intuitively right. After all a British GP once told me that his most frequent symptom was “TATT” (tired all the time”).

Meanwhile I’ve been getting to know a homeless childrens’ organization in San Francisco, which specializes in mental health services for those families. And not surprisingly those kids have issues that result in wide social and health problems later on (but not too much later on) in life.

Then today a reader asked me if there was any evidence on whether more care overall, and specifically more specialty care, would help those with mental illnesses? And whether providing more treatment manages to save money down the line (presumably in other areas).

Mental health has not been an area we spend much time on at THCB, other than perhaps to acknowledge that we over-medicate some populations. But Vic Fuchs did say to me once, “remember, the head is connected to the body”.

So does anyone have any data or conclusions about whether specialty mental health care is a) effective and b) a good investment? Please comment below.

Looks like CNN’s Glenn Beck won’t say what his local hospital’s CEO would like to hear when Press-Ganey call him! He accuses the staff there of not caring.

At the hospital I was often treated more like a number than a patient. At times, staff members literally turned their back on my cries of pain and pleas for help. In one case a nurse even stood by tapping his fingers as if he was bored while my tiny wife struggled to lift me off a waiting room couch.

So far he hasn’t named names, but I suspect that when it gets out, it’ll be worse for the hospital than it having a bad overall mortality rating in some obscure state report. After all when Don Berwick and David Lawrence wrote about their wife and mother respectively, they went out of the way to praise the staff, while castigating the care system. Beck is not so kind.

I’m not sure Beck’s solution is too constructive.

That’s why I don’t want to hear anymore about universal health care or HMOs or the evils of insurance companies until each and every hospital in this country can look me in the eye and tell me that they their staff is full of truly compassionate people who treat their visitors like patients, not products. Hire and train the right people, and then and only then come talk to me about everything else you need.

But his complaints are echoed in a series of videos from Health care for All in Massachusetts which also start talking about problems with care quality. I wonder if Paul Levy will name names about the hospitals in the last two videos—Both prominent Boston teaching hospitals that both screwed up big time with medical errors

Final thought: perhaps Michael Millenson is finally influencing people….while he’s even still alive!