Princeton University Library Catalog

The Earlier The Better: Prevention and Early Diagnosis for Mental Illness

Daly, Deborah [Browse]
Senior thesis
Fiske, Susan T. [Browse]
Woodrow Wilson School of Public and International Affairs [Browse]
Class year:
Summary note:
Health care is currently a contentious issue in the United States primarily due to the high and rising costs of care, and the need to improve the health of the population. In efforts to both reduce costs and improve health, policymakers have turned to preventive care as a method of accomplishing these dual goals. Preventive care includes a wide range of services such as annual primary care visits, vaccines, and screenings for specific conditions, as well as diagnosing individuals early in condition development. Research shows that this type of care is cost saving, can improve an individual’s quality of life by averting illness, and can increase the overall health of a population. Given this, current policies work to incentivize prevention via coverage mandates and economic incentives. Though mental health is often considered to be independent of medicine, prevention and early diagnosis have the same benefits as for general medicine, and are incentivized by policy as well. In addition to wide-sweeping prevention methods, there is promise of improvement of diagnostic procedures for mental illnesses. Traditionally, physicians make diagnoses based on behavioral observation after symptom onset; however, current research may allow diagnoses to be made prior to the onset of symptoms. Such diagnostic methods are based on risk evaluations and objective, quantifiable behavioral tests, as well as potential biologically-based tests. With the development of early diagnostics, it is also important to determine if and when patients would be interested in engaging in these types of procedures. An exploratory study of parental attitudes toward early diagnostics of mental illness reveals that, generally, parents would want to use these types of tests for their children. Of the three variables tested, a greater chance of developing a mental illness, greater severity of the illness, and the possibility of prevention each increased the likelihood that parents would want to know test results. These effects were increased when there was both a high chance of development and a high severity, as well as when there was a high severity and possibility of prevention. These results indicate that, overall, parents would utilize these tests if they were offered. Parents’ desire to utilize early diagnostic tests, as well as the benefits of such tests and overall push for preventive care leads to two main policy implications. First, physicians should offer early diagnostics for mental illness s. This can be promoted using economic incentives (such as bundled payments), increased coordinated care, and education for physicians. Second, these services should be covered by insurance so that patients’ finances do not limit access. For this to occur, further research will be necessary to validate and improve testing methods. This in turn, will require that regulations for human subjects research facilitate increased behavioral science research. All in all, while health care reform in the US is currently in a turbulent state, improving prevention and early diagnostics should remain central goals for both mental health and medicine in general.