High Anxiety: Political Turmoil, Health Reform Take Their Toll

Alicia Ault

May 23, 2017

SAN DIEGO, California – The political turmoil in the United States, as well as concerns about healthcare and health reform, are raising anxiety levels among Americans, new research shows.

Poll results released here at the American Psychiatric Association (APA) 2017 showed that two thirds of Americans reported that they were somewhat or extremely anxious about their own health and safety as well as those of their families, and more than one third reported being more anxious overall now compared to 2016.

"Our poll findings show that health and safety are primary concerns for most Americans, and even moreso for people of color and for millennials," APA President Maria A. Oquendo, MD, PhD, said in a statement.

"Having access to quality affordable health and mental health care is important for all Americans," she added.

Fifty-one percent of respondents said they were anxious about the impact of politics on their daily life; 49% said the political climate was not a concern.

Anxiety is hitting Democrats harder, with 62% saying they are somewhat or extremely anxious about politics compared to 44% of Republicans.

Rising anxiety levels are not surprising, especially given the fact that anxiety disorders are the most prevalent psychiatric condition in the United States, said Harsh Trivedi, MD, CEO of the Sheppard Pratt Health System, Baltimore, Maryland.

"With the amount of change that is happening across the world, but also within our political system, as well as with healthcare reform, it's understandable that people are getting more anxious about what that will mean for their health coverage, but also what they may be experiencing in their lives," Dr Trivedi, who is also chair of the American Psychiatric Association's Health Care Systems and Finance Committee, told Medscape Medical News.

The poll also showed that men and women were equally anxious and that blacks and Hispanics reported higher levels of anxiety than whites. Only 15% of whites reported being extremely anxious about their health, compared to 38% of blacks and 31% of Hispanics.

Those receiving Medicaid were more anxious than those with private health insurance. Among poll participants, 52% had insurance through an employer or union, 10% had private insurance they bought themselves, 7% had private insurance purchased through the Affordable Care Act exchanges, 22% had Medicare, and 12% had Medicaid.

Overall, 30% of those polled said they were more anxious in general than last year; 40% said their level of anxiety was the same. Forty-one percent of millennials were more anxious, compared to 32% of baby boomers.

Impact of Climate Change

The APA also asked participants about another anxiety-provoking issue – climate change. When given a true/false choice, 63% said it was true that climate change is having an impact on health. Twenty-three percent said it was false, and 15% were unsure. Millennials were most likely to say climate change was having an impact on health.

More than half of those polled said their mental health insurance coverage was adequate; almost a third said they weren't sure. Just over half of those surveyed said they thought mental health should be covered by all types of insurance. Fifty-two percent said they had not ever sought mental health care.

It's a paradoxical picture, but not surprising, said Dr Trivedi.

"People don't have a good idea of what their mental health benefits are, and the first time they find out is when they need to access services, and they realize how inadequate or how noncomprehensive they might be," he said.

"Because of the stigma associated with mental health, there's also a perception that 'this isn't going to affect me,' " he said. The problem is, "If you don't feel like it's something you'll necessarily need, you're more likely to say 'okay' if I don't have coverage," Dr Trivedi added.

The APA doesn't want lawmakers thinking people are satisfied with mental health coverage as it stands. Less than half of adults said they know how to access mental health care if they need it. The poll also found that 69% think mental health is a low priority or is not a priority among Washington policy makers.

"We've made progress in recent years with improving and expanding mental health coverage, but the American Health Care Act [AHCA] passed by the House will reverse much of that progress," said APA CEO and Medical Director Saul Levin, MD, MPA, in a statement.

"The AHCA will remove insurance coverage from millions of Americans and roll back Medicaid expansion that occurred under the Affordable Care Act, potentially reducing access to care for the 1.3 million Americans with serious mental illness and the 2.8 million Americans with substance use disorders."

The majority of those polled said the country is going in the wrong direction when it comes to dealing with the opioid crisis. Almost 60% said that policy makers should prioritize access to treatment over stricter punishment (26%). The figure held when self-identified party affiliation was taken into account. Just more than half of Republicans and 67% of Democrats said treatment should be the priority.

More than twice the number of Republicans (34%), however, said punishment should be a priority.

Poll participants said they understood how people could accidentally become addicted to opioids, and a quarter said they knew someone who had become addicted. Millennials were closer to the epidemic, with a third saying they knew someone who had become addicted. Almost half reported that it was extremely or somewhat easy to access illegal opioids in their community.

Although most of those surveyed said it was not a good idea to take a prescription that had not been written for them, 18% of millennials said it wasn't so bad (compared to 10% of baby boomers). "The number of young people, 1 in 5, who believe it's okay to share prescriptions is troubling," said Dr Levin.

Most of those polled said they believed that recovery was possible. The belief in recovery was stronger in those who knew someone who had been addicted.

"Our poll findings show that Americans are aware of the problem of opioid addiction, believe people can recover, and want to see an emphasis on making treatment available," said Dr Levin.

The poll was conducted online from April 20 to April 23. It was a nationally representative sample of 1019 adults. The margin of error was ±3.1 percentage points.

Dr Trivedi has disclosed no relevant financial relationships.

American Psychiatric Association (APA) 2017 Annual Meeting. Released May 22, 2017.

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