1. Mental Health in The U.S. Public Health Service CAPT Marc Safran, LCDR Joanette Sorkin, CDR Dana Thomas U.S. Public Health Service Physicians Category Day USPHS Scientific and Training Symposium Tuesday, June 21, 2011

2. Initial Presentation Mental Health Marc Safran, MD, MPA, DFAPA, FACPM Captain, U.S. Public Health Service Senior Psychiatrist, Centers for Disease Control & Prevention Chair, Mental Health Subcommittee U.S. Public Health Service Physicians Professional Advisory Committee

3. Prevalence of Mental Disorders a decade ago Data source: Mental Health: A Report of the Surgeon General, 1999. 1 in 5 Americans 1 in 5 Americans

4. Mental health disparities remain prevalent: In the general population In specific populations served by the U.S. Public Health Service In the way mental health is treated within the health system References: Safran MA, Mays RA; Huang LN, McCuan R, Pham PK, Fisher SK, McDuffie KY, Trachtenberg A. Mental Health Disparities. American Journal of Public Health. 2009, 99(11): 1962-1966. Safran MA. Achieving recognition that mental health is part of the mission of CDC. Psychiatric Services. 2009, 60(11): 1532-1534.

5. Our goal for this hour is to explore: Challenges faced by U.S. Public Health Service physicians in addressing mental health needs of their patients Challenges faced by U.S. Public Health Service physicians in maintaining their own resilience Potential ways to help U.S. Public Health Service physicians meet such challenges

6. This presentation is part of a larger effort by USPHS physicians: To evaluate issues potentially related to the mental health of USPHS physicians and those they serve To consider potential USPHS strategies for addressing such issues

7. Participants in this evaluation effort: All U.S. Public Health Service physicians were invited to participate via their Professional Advisory Committee list serve Response by 255 physicians, April 30 to May 17, 2010, indicates that over 25% all U.S. Public Health Service physicians participated during the allotted time period Because participation was anonymous, the identities of those who participated can not be verified Some who did not participate may not have had access to the list serve during the specified time period

8. 255 U.S. Public Health Service physicians commented anonymously via Internet on: PHS physician mental health, morale and access to care Strategies for addressing mental health of patients and populations they serve A response by 255 physicians indicates that over 25% all U.S. Public Health Service physicians chose to participate during the allowed time period, April 30 to May 17, 2010.

9. Question 1 Do you know of any situation in the past 12 months in which a mental health issue appeared to be affecting the job performance of one or more PHS medical officers?  1 = Yes102 (40%)  2 = No153 (60%) This slide contains preliminary data presented by the Mental Health Subcommittee, USPHS Physicians Professional Advisory Committee, at USPHS Medical Category Day, USPHS Scientific and Training Symposium, May 25, 2010

10. Question 2 Do you know of any situation in the past 12 months where a PHS medical officer or a family member of a PHS medical officer attempted to access mental health care? 1 = Yes 83 (33 %) 2 = No 172 (67%) This slide contains preliminary data presented by the Mental Health Subcommittee, USPHS Physicians Professional Advisory Committee, at USPHS Medical Category Day, USPHS Scientific and Training Symposium, May 25, 2010

11. Question 3 Do you know of any situation in the past 12 months where a PHS medical officer or a family member of a PHS medical officer had difficulty accessing mental health care?  1=Yes35 (14%)  2=No220 (86%) This slide contains preliminary data presented by the Mental Health Subcommittee, USPHS Physicians Professional Advisory Committee, at USPHS Medical Category Day, USPHS Scientific and Training Symposium, May 25, 2010

12. 42 % of the 83 PHS physician respondents who knew of a PHS physician or family member attempting to access mental health care in the past 12 months--ALSO knew of an instance of difficulty in accessing such care. This slide contains preliminary data presented by the Mental Health Subcommittee, USPHS Physicians Professional Advisory Committee, at USPHS Medical Category Day, USPHS Scientific and Training Symposium, May 25, 2010

13. Mental Disorders “…health conditions characterized by alterations in thinking, mood, or behavior … associated with distress and/or impaired functioning.” Reference: Mental Health: A Report of the Surgeon General, 1999.

14. But mental health is about much more…

16. Ground Rules Your comments will help inform further recommendations For sensitive topics, please avoid sharing identifiable information Statements and slides need not necessarily reflect the views of USPHS, CDC, or any other US Government agency