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Hospitals need to do more to address the rising tide of despair and resulting addictions

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Jeff Goldsmith, writing in Hospitals & Health Networks, says that U.S. hospitals need to do more to address the growing epidemic of despair as reflected in the opioid epidemic and Americans’ declining life expectancy.

Mr. Goldsmith is national adviser to Navigant Healthcare and associate professor of public health sciences at the University of Virginia.

Death rates have risen for eight of the 10 leading causes of death in America. The life-expectancy decline was entirely in the under-65 population.

The  obesity epidemic and other social factors would seem to be playing big roles.

Mr. Goldsmith writes: “It is going to take more than the ‘right incentives’ and a surge of healthcare consumerism to alleviate the despair…. While the new administration and Congress struggle with health reform issues, hospitals should directly address the ‘forgotten’ in their communities.”

Among his suggestions:

“Hook them up. A lot of the folks who end up in your emergency department for self-inflicted conditions will survive to fight another day. You may be able to save their lives, but your ED cannot fix the underlying conditions that brought them to you. What you can do is (1) listen to them, (2) gauge their readiness to address their problems, and (3) hook them up — to primary care, to Alcoholics Anonymous/Narcotics Anonymous, to weight loss programs, to rehab and recovery specialists, to mental health professionals, to churches or community agencies. Absent these connections, odds are that they will return to you with their problems unaddressed.”

“Advocate for continued coverage of mental health and substance abuse treatment.”

“Explore the psychiatric emergency services center. fast-growing, innovative form of care is an inexpensive, locked-unit, short-stay special hospital for people with acute psychiatric conditions, including drug problems. It is specifically geared to stabilization and detoxification of people in acute psychiatric distress and is often physically separate from the hospital. Such centers are proliferating and solve a significant problem: freeing up ED personnel to focus on the nonpsychiatric portion of their patient flow. Though it is still early days, some evidence from the field suggests that 80 percent or more of patients treated in PES are discharged to home. And because of the thorough workup they receive, the remaining 20 percent are matched to the right inpatient setting (acute, rehab, etc.) with much improved continuity of care.

“Lead your community’s economic development activities.

“The underlying cause of many of the health problems we have been discussing is a lack of economic opportunity. Do not rest until your hospital is not the largest employer in your community.”

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