What You Need to Know About Vision & Mental Health. Vincent Young, M.D.

Transcription

1 The Eye/Brain Connection: What You Need to Know About Vision & Mental Health Vincent Young, M.D.

2 Vincent Young, M.D. Board certified ophthalmologist since 1985 Chairman, Division of Ophthalmology at Albert Einstein Medical Center, Philadelphia President, American Association of Dispensing Ophthalmologists Member AAO, American Medical Association, Philadelphia County Medical Society

3 What Our Eyes Reveal About Us

4 How Our Mood Affects Our Vision Mood impacts how much we see Good mood = more brain activity, take in more visual info Bad mood = tunnel vision 2009 Univ. of Toronto study

5 Today s Discussion Scope of mental health problems Mental health in the national spotlight Connection between vision and mental health Role of vision plan in improving mental health Detection Treatment Prevention Role of vision and benefits industries

6 What Is Mental Health? Cognitive/emotional well-being; the absence of a mental disorder

7 Mental Health Issues Poor mental state Depressed, disengaged, stressed Mental disorders Mood disorders Depression Bipolar disorder Personality disorders Schizophrenia Anxiety disorders Eating disorders ADHD Autism Image Credit: NIMH

8 Scope of Mental Health Problems 1i in 4US U.S. adults suffer from a diagnosable mental disorder every year 6% have a serious mental illness Leading cause of disability in ages 15-44

9 Scope of Mental Health Problems Mental illness accounts for over 10% of national disease burden National Economic Burden of Chronic Disease

10 Toll on Workplace Annual lost workdays per worker 65.5 bipolar disorder major depressive disorderd Impact on earnings Mean reduction $16,306 (serious mental illness) $317 billion estimated economic burden of serious mental illness alone

11 Mental Health in the National Spotlight

12 Mental Health Coverage Trends Parity laws have shortened gap between mental, general healthcare coverage Still barriers to care E.g. availability through healthcare plans, pre-existing existing conditions, limits on treatment Resources are tight States pulling back mental health spending

13 Patient Protection and Affordable Care Act Part of Obama healthcare reform Intended to allow more people access to health insurance Has provisions to ensure mental health coverage on par with medical Mental health defined as essential Mental health defined as essential benefit

14 Mandated Changes for Employers If offer mental health coverage, must Have same allowances / restrictions as health plan Include prescription drugs, mental health / addictions treatment, rehabilitation Not exclude pre-existing conditions Taxes for non-compliance Exemption for companies < 50 ees Most employers keeping mental health coverage

15 National Spotlight: Influence of Recession Financial stress linked to rise in mental health problems 50% Americans report irritability, anger, fatigue or sleeplessness Unemployed = 4 x risk for severe mental illness Pay cuts or reduced hours = 2 x risk

16 Role of a Vision Plan in Improving Mental Health Detection ~ Treatment ~ Prevention

17 Detecting Mental Health Issues Through Eye Care

18 Preventive Role of Eye Exams We already know comprehensive exams can detect Vision problems Eye diseases Systemic diseases Diabetes Hypertension Cancers but the eyes can also provide clues to mental illness

19 Bipolar Disorder 2.6% of U.S. adults Slower to switch gaze from one image to another ERG shows reduced G s o s educed adaptation to darkly lit settings in bipolar disorder / schizophrenia

20 Schizophrenia 1 in 100 U.S. adults Abnormalities in eye movements may identify risk Rate and smoothness of tracking objects with eyes

21 Alzheimer s More than 5.3 million Americans Prevalence doubled since th leading cause of death Detection with brain scans costly Clues present in eyes Cataract Thinning of nerves in retina Drusen Unusually sensitive to pupil dilation drug Future eye test measuring cell death

22 Treating and Preventing Mental Health Issues With Vision Care / Vision Wear

23 Visual / Mental Health Cycle How We See How We Feel

24 Visual / Mental Health Cycle Poor Visual Health More likely to have a poor mental state, which h can contribute to mental health issues Poor Mental Health More likely to have vision issues, and take medications that make them worse

25 Thoughts of Vision Loss Distressing Americans fear vision i loss more than memory loss, heart disease Quality of life implications Societal stigma

26 Those With Vision Problems More Likely to Have Mental Health Issues Link between vision loss, depression 22% feel depressed at time of eye disease diagnosis Depressed patients 3 x more likely not to follow treatment potentially worsening vision loss or disease progression. 2.3 x greater risk for clinical i l depression Photo Credit: NIMH

27 Those With Vision Problems More Likely to Have Mental Health Issues Untreated poor vision in elderly linked to dementia Seniors with poor vision 5 x more likely to develop cognitive decline Seniors with poor vision without ih intervention i 10 x risk for Alzheimer s

28 Those With Mental Health Issues More Likely to Have Vision i Problems Depressed people have lower contrast sensitivity See world in shades of grey Depressed AMD patients have worse vision than nondepressed AMD patients People with schizophrenia, bipolar disorder may have perceptual problems (from retinal deficits)

29 Those With Mental Health Issues More Likely to Have Vision i Problems Medications can cause: Blurry vision Sensitivity to light/glare l Susceptibility to UV damage Increase in certain eye diseases Higher risk of cataract in older adults taking antidepressants 6 of 20 most prescribed meds are pain or depression related

30 Vision Problems Tied to Behavioral Problems Undiagnosed vision problems common in problem children 80% of those diagnosed with learning problems 50% of delinquents Vision i problems impact social abilities Increases risk for depression anxiety, aggression

31 Overall Takeaways for Managed Vision Care Channel

32 Why Vision Coverage Is Important for Mental lhealth lh Important for employees with (or at-risk for) mental health issues Early detection Mental health conditions Vision problems/eye disease that may contribute

33 Why Vision Coverage Is Important for Mental lhealth lh Vision wear for prevention and treatment Corrected vision associated with fewer problems, enhanced mood Glare protection (photochromics/ar) to enhance contrast, address light sensitivity from medications UV blockage to prevent damage

34 Education and Leadership Ensure HR clients have updated info on quality vision i plans Use mental health angle to show link between eye/overall health Promote vision care for prevention AND disease management Address emotional impact of vision loss by offering diagnosed employees support materials Steps to treat eye disease, improve sight Consider extra coverage for patients diagnosed with mental health issues.

35 Opportunities for Inter-Plan Referrals Those diagnosed with eye disease referred for mental health counseling Those diagnosed with mental health issue referred for eye exam, offered premium eyewear

36 Questions