Could common mental illnesses such as depression and anxiety be compromising patient healing after discharge? A recent study conducted by the Mental Health Research Network found that patients with comorbid psychiatric illness are at higher risk for 30-day all cause readmissions than those without mental health disorders.
The study, which encompassed 11 major U.S. healthcare systems, followed patients admitted for congestive heart failure (CHF), myocardial infarction (MI, or heart attack), and pneumonia – three conditions targeted by the Centers for Medicare and Medicaid Services through their Readmissions Reduction Program. Researchers found that when they looked at those patients who also had been previously diagnosed with a psychiatric condition (e.g., depression, anxiety, bipolar, substance abuse, dementia), they were 5 percent more likely to be readmitted to the hospital within 30 days than those who did not have a psychiatric diagnosis.
Another systemic review published last month found that patients with coronary artery disease (CAD) and comorbid mental disorders also had both higher rates of 30-day readmissions and increased overall and outpatient healthcare costs.
What does all this mean for hospitals? First of all, screening inpatients for depression, anxiety, substance abuse, and other common mental illnesses may be a cost effective way to find the undiagnosed and put them on the path to appropriate care. This is particularly important for patients with health conditions associated with a high incidence of associated mental illness; for example, heart disease, diabetes, and cancer patients are at higher risk of depression.
It also highlights the need for integrated mind-body care of patients entering the hospital. Mental illness doesn’t stay in the waiting room until discharge. Managing patient stress through relaxation programming, maintaining a healing environment, providing appropriate pain relief options, and involving caregivers in home care education are just a few strategies to help improve outcomes in this population.
 Ahmedani BK, et al. Psychiatric comorbidity and 30-day readmissions after hospitalization for heart failure, AMI, and pneumonia. Psychiatr Serv. 2015 Feb 1;66(2):134-40.
 Baumeister H, et al. Inpatient and outpatient costs in patients with coronary artery disease and mental disorders: a systematic review. Biopsychosoc Med. 2015 Apr 17;9:11.