Don Sapatkin
Philly.com
Originally posted July 19, 2017
Here is an excerpt:
Previous studies have found that increasing cost-sharing causes consumers to skip medical care somewhat indiscriminately. The Dutch research was the first to examine the impact of cost-sharing changes on specialty mental health-care, the authors wrote.
Jalpa A. Doshi, a researcher at the University of Pennsylvania’s Leonard Davis Institute of Health Economics, has examined how Americans with commercial insurance respond to cost-sharing for antidepressants.
“Because Medicaid is the largest insurer of low-income individuals with serious mental illnesses such as schizophrenia and bipolar disorder in the United States, lawmakers should be cautious on whether an increase in cost sharing for such a vulnerable group may be a penny-wise, pound-foolish policy,” Doshi said in an email after reading the new study.
Michael Brody, president and CEO of Mental Health Partnerships, formerly the Mental Health Association of Southeastern Pennsylvania, had an even stronger reaction about the possible implications for Medicaid patients.
The article is here.
Showing posts with label Mental Health Policy. Show all posts
Showing posts with label Mental Health Policy. Show all posts
Monday, August 7, 2017
Monday, December 29, 2014
Why We Need to Abandon the Disease-Model of Mental Health Care
By Peter Kinderman
Scientific American Blog
Originally published on November 17, 2014
Here is an excerpt:
Some neuroscientists have asserted that all emotional distress can ultimately be explained in terms of the functioning of our neural synapses and their neurotransmitter signalers. But this logic applies to all human behavior and every human emotion and it doesn’t differentiate between distress — explained as a product of chemical “imbalances” — and “normal” emotions. Moreover, while it is clear that medication (like many other substances, including drugs and alcohol) has an effect on our neurotransmitters, and therefore on our emotions and behavior, this is a long way from supporting the idea that distressing experiences are caused by imbalances in those neurotransmitters.
Many people continue to assume that serious problems such as hallucinations and delusional beliefs are quintessentially biological in origin, but we now have considerable evidence that traumatic childhood experiences (poverty, abuse, etc.) are associated with later psychotic experiences. There is an almost knee-jerk assumption that suicide, for instance, is a consequence of an underlying illness, explicable only in biological terms.
The entire blog post is here.
Scientific American Blog
Originally published on November 17, 2014
Here is an excerpt:
Some neuroscientists have asserted that all emotional distress can ultimately be explained in terms of the functioning of our neural synapses and their neurotransmitter signalers. But this logic applies to all human behavior and every human emotion and it doesn’t differentiate between distress — explained as a product of chemical “imbalances” — and “normal” emotions. Moreover, while it is clear that medication (like many other substances, including drugs and alcohol) has an effect on our neurotransmitters, and therefore on our emotions and behavior, this is a long way from supporting the idea that distressing experiences are caused by imbalances in those neurotransmitters.
Many people continue to assume that serious problems such as hallucinations and delusional beliefs are quintessentially biological in origin, but we now have considerable evidence that traumatic childhood experiences (poverty, abuse, etc.) are associated with later psychotic experiences. There is an almost knee-jerk assumption that suicide, for instance, is a consequence of an underlying illness, explicable only in biological terms.
The entire blog post is here.
Wednesday, September 17, 2014
Expansion of Mental Health Care Hits Obstacles
By Abby Goodnough
The New York Times
Originally published August 28, 2014
Here is an excerpt:
The new law is a big opportunity for mental health providers to reach more people of all income levels. But in Kentucky and the 25 other states that chose to expand Medicaid, the biggest expansion of mental health care has been for poor people who may have never had such treatment before.
Still, private providers face considerable headaches in taking on Medicaid patients, beyond the long-term deterrent of low reimbursement. Ms. Wright, for instance, is still waiting to be approved by some of the managed care companies that provide benefits to Medicaid recipients. Eager to build her client base, Ms. Wright has taken on a handful of new Medicaid enrollees for free while she waits for those companies to approve her paperwork.
“It’s been months and months,” she said. “It’s always there in my mind: Am I going to make it?”
The entire article is here.
The New York Times
Originally published August 28, 2014
Here is an excerpt:
The new law is a big opportunity for mental health providers to reach more people of all income levels. But in Kentucky and the 25 other states that chose to expand Medicaid, the biggest expansion of mental health care has been for poor people who may have never had such treatment before.
Still, private providers face considerable headaches in taking on Medicaid patients, beyond the long-term deterrent of low reimbursement. Ms. Wright, for instance, is still waiting to be approved by some of the managed care companies that provide benefits to Medicaid recipients. Eager to build her client base, Ms. Wright has taken on a handful of new Medicaid enrollees for free while she waits for those companies to approve her paperwork.
“It’s been months and months,” she said. “It’s always there in my mind: Am I going to make it?”
The entire article is here.
Wednesday, July 31, 2013
Most U.S. Health Spending Is Exploding — but Not for Mental Health
By Catherine Rampell
The New York Times Blog - Economix
Originally published July 2, 2013
Here is an excerpt:
Mental health spending, both public and private, was about $150 billion in 2009, more than double its level in inflation-adjusted terms in 1986, according to a recent article in Health Affairs. But the overall economy also about doubled during that time. As a result, direct mental health spending has remained roughly 1 percent of the economy since 1986, while total health spending climbed from about 10 percent of gross domestic product in 1986 to nearly 17 percent in 2009.
Thanks to Vince Bellwoar for this story.
Tuesday, April 30, 2013
U.S. Spurns California Move for Greater Say on Prisons
By Norimitsu Onishi
The New York Times
Originally published April 5, 2013
A federal judge on Friday rejected California’s motion to regain control of mental health care in its prisons, ruling that the quality of care failed to meet standards required by the Constitution. The move dealt a blow to Gov. Jerry Brown’s broader efforts to bring the prisons back under the state’s authority.
In a ruling handed down about 90 days after the state first argued that enough improvements had been made to mental health care after 18 years of outside control, Judge Lawrence K. Karlton of United States District Court in Sacramento wrote that there were “ongoing constitutional violations” and that court oversight “remains necessary to remedy those violations.”
In a statement, Deborah Hoffman, a spokeswoman for the California Department of Corrections and Rehabilitation, said that the judge had not given enough weight to experts and evidence showing that mental health care in the prisons was “a model for the nation.” She said that the state will appeal.
The entire story is here.
The New York Times
Originally published April 5, 2013
A federal judge on Friday rejected California’s motion to regain control of mental health care in its prisons, ruling that the quality of care failed to meet standards required by the Constitution. The move dealt a blow to Gov. Jerry Brown’s broader efforts to bring the prisons back under the state’s authority.
In a ruling handed down about 90 days after the state first argued that enough improvements had been made to mental health care after 18 years of outside control, Judge Lawrence K. Karlton of United States District Court in Sacramento wrote that there were “ongoing constitutional violations” and that court oversight “remains necessary to remedy those violations.”
In a statement, Deborah Hoffman, a spokeswoman for the California Department of Corrections and Rehabilitation, said that the judge had not given enough weight to experts and evidence showing that mental health care in the prisons was “a model for the nation.” She said that the state will appeal.
The entire story is here.
Wednesday, April 24, 2013
Diagnosis: Human
By Ted Gup
The New York Times Op-Ed
Originally published on April 2, 2013
Here are some excerpts:
The New York Times Op-Ed
Originally published on April 2, 2013
Here are some excerpts:
No one made him take the heroin and alcohol, and yet I cannot help but hold myself and others to account. I had unknowingly colluded with a system that devalues talking therapy and rushes to medicate, inadvertently sending a message that self-medication, too, is perfectly acceptable.
My son was no angel (though he was to us) and he was known to trade in Adderall, to create a submarket in the drug among his classmates who were themselves all too eager to get their hands on it. What he did cannot be excused, but it should be understood. What he did was to create a market that perfectly mirrored the society in which he grew up, a culture where Big Pharma itself prospers from the off-label uses of drugs, often not tested in children and not approved for the many uses to which they are put.
And so a generation of students, raised in an environment that encourages medication, are emulating the professionals by using drugs in the classroom as performance enhancers.
And we wonder why it is that they use drugs with such abandon. As all parents learn — at times to their chagrin — our children go to school not only in the classroom but also at home, and the culture they construct for themselves as teenagers and young adults is but a tiny village imitating that to which they were introduced as children.
The issue of permissive drug use and over-diagnosis goes well beyond hyperactivity. In May, the American Psychiatric Association will publish its D.S.M. 5, the Diagnostic and Statistical Manual of Mental Disorders. It is called the bible of the profession. Its latest iteration, like those before, is not merely a window on the profession but on the culture it serves, both reflecting and shaping societal norms. (For instance, until the 1970s, it categorized homosexuality as a mental illness.)
Friday, March 22, 2013
New Hampshire's mental health system: From leader to failure
By Annmarie Timmins
The Concord Monitor
Originally published March 10, 2013
During his 1971 inaugural address, then-Gov. Walter Peterson identified seven goals for his next term. First on the Republican’s list was improving mental health care.
Peterson wanted to stop warehousing people with mental illness at the state’s psychiatric hospital and begin treating them in local communities. “A state mental institution,” Peterson told lawmakers 42 years ago, “is, more than anything else, a symbol of failure to help people in time.”
Two decades later, the state had become a national leader in mental health care by beginning what Peterson had envisioned. Lawmakers had established 10 community mental health centers and put money into local housing and local treatment. And under the leadership of then-Gov. John H. Sununu, the state had opened a modern 316-bed state hospital in place of the 19th-century-era institution, once called the New Hampshire Asylum for the Insane, that had housed nearly 2,000 people.
At the time, Donald Shumway, then director of the state’s Division of Mental Health, said the national recognition showed “our plan is really heading in the right direction.”
The acclaim would be short-lived.
Today, everyone from mental health advocates to lawmakers to Gov. Maggie Hassan describe the state’s mental health system as broken.
In a scathing 2011 critique, the federal government said mental health care here is “in crisis.” Federal officials accused the state of violating the Americans with Disabilities Act by starving the community care system in favor of unnecessary hospitalization. Last year, several patients made the same allegation in a federal lawsuit against the state that the federal government has joined.
Meanwhile, people in crisis languish in emergency rooms, sometimes for days, waiting for a hospital bed. The state’s jails and prisons have become the new mental health “‘asylum,” with an estimated 65 percent of the state prison population having a mental illness, according to a prison spokesman.
The entire article is here.
The Concord Monitor
Originally published March 10, 2013
During his 1971 inaugural address, then-Gov. Walter Peterson identified seven goals for his next term. First on the Republican’s list was improving mental health care.
Peterson wanted to stop warehousing people with mental illness at the state’s psychiatric hospital and begin treating them in local communities. “A state mental institution,” Peterson told lawmakers 42 years ago, “is, more than anything else, a symbol of failure to help people in time.”
Two decades later, the state had become a national leader in mental health care by beginning what Peterson had envisioned. Lawmakers had established 10 community mental health centers and put money into local housing and local treatment. And under the leadership of then-Gov. John H. Sununu, the state had opened a modern 316-bed state hospital in place of the 19th-century-era institution, once called the New Hampshire Asylum for the Insane, that had housed nearly 2,000 people.
At the time, Donald Shumway, then director of the state’s Division of Mental Health, said the national recognition showed “our plan is really heading in the right direction.”
The acclaim would be short-lived.
Today, everyone from mental health advocates to lawmakers to Gov. Maggie Hassan describe the state’s mental health system as broken.
In a scathing 2011 critique, the federal government said mental health care here is “in crisis.” Federal officials accused the state of violating the Americans with Disabilities Act by starving the community care system in favor of unnecessary hospitalization. Last year, several patients made the same allegation in a federal lawsuit against the state that the federal government has joined.
Meanwhile, people in crisis languish in emergency rooms, sometimes for days, waiting for a hospital bed. The state’s jails and prisons have become the new mental health “‘asylum,” with an estimated 65 percent of the state prison population having a mental illness, according to a prison spokesman.
The entire article is here.
Friday, March 1, 2013
Changes to mentally ill law could mean fewer opt for treatment: B.C. review board
Allan Schoenborn, the B.C. father found not criminally responsible for killing his three children, has been the poster boy for federal reforms
By Dene Moore
The Canadian Press
February 14, 2013
It was a horrific crime, so grotesque that Allan Schoenborn, the B.C. father found not criminally responsible for killing his three children, became the poster boy for reforming the federal law to keep mentally ill offenders in detention for longer periods of time.
But Schoenborn is still entitled to an annual hearing before the B.C. Review Board, a hearing scheduled to take place Friday at the Forensic Psychiatric Hospital he now calls home.
And some wonder if the amendments announced last week won’t actually have the opposite of the desired effect, by discouraging plea bargains that see mentally ill offenders opt for treatment.
“You’re going to have a lot more mentally disordered people who have gone to jail for a period of time, have been untreated, and are back on the street untreated. So in that sense it doesn’t really make people much safer,” said Bernd Walter, chairman of the B.C. Review Board.
Policy decisions are the purview of the federal government but the Not Criminally Responsible Reform Act is “quite unclear in terms of how it will work,” said Walter, who is also the chairman of the B.C. Human Rights Tribunal.
Walter said many of the approximately 260 cases under the jurisdiction of the board were resolved by agreement between the defence and the Crown that the offender is so mentally ill that they did not understand their actions to be criminal.
The entire article is here.
By Dene Moore
The Canadian Press
February 14, 2013
It was a horrific crime, so grotesque that Allan Schoenborn, the B.C. father found not criminally responsible for killing his three children, became the poster boy for reforming the federal law to keep mentally ill offenders in detention for longer periods of time.
But Schoenborn is still entitled to an annual hearing before the B.C. Review Board, a hearing scheduled to take place Friday at the Forensic Psychiatric Hospital he now calls home.
And some wonder if the amendments announced last week won’t actually have the opposite of the desired effect, by discouraging plea bargains that see mentally ill offenders opt for treatment.
“You’re going to have a lot more mentally disordered people who have gone to jail for a period of time, have been untreated, and are back on the street untreated. So in that sense it doesn’t really make people much safer,” said Bernd Walter, chairman of the B.C. Review Board.
Policy decisions are the purview of the federal government but the Not Criminally Responsible Reform Act is “quite unclear in terms of how it will work,” said Walter, who is also the chairman of the B.C. Human Rights Tribunal.
Walter said many of the approximately 260 cases under the jurisdiction of the board were resolved by agreement between the defence and the Crown that the offender is so mentally ill that they did not understand their actions to be criminal.
The entire article is here.
Monday, February 25, 2013
New Federal Rule Requires Insurers to Offer Mental Health Coverage
By ROBERT PEAR
The New York Times
Published: February 20, 2013
The Obama administration issued a final rule on Wednesday defining “essential health benefits” that must be offered by most health insurance plans next year, and it said that 32 million people would gain access to coverage of mental health care as a result.
The federal rule requires insurers to cover treatment of mental illnesses, behavioral disorders, drug addiction and alcohol abuse, and other conditions.
Kathleen Sebelius, the secretary of health and human services, said that in addition to the millions who would gain access to mental health care, 30 million people who already have some mental health coverage will see improvements in benefits.
White House officials described the rule as a major expansion of coverage. In the past, they said, nearly 20 percent of people buying insurance on their own did not have coverage for mental health services, and nearly one-third had no coverage for treatment of substance abuse.
The entire story is here.
The New York Times
Published: February 20, 2013
The Obama administration issued a final rule on Wednesday defining “essential health benefits” that must be offered by most health insurance plans next year, and it said that 32 million people would gain access to coverage of mental health care as a result.
The federal rule requires insurers to cover treatment of mental illnesses, behavioral disorders, drug addiction and alcohol abuse, and other conditions.
Kathleen Sebelius, the secretary of health and human services, said that in addition to the millions who would gain access to mental health care, 30 million people who already have some mental health coverage will see improvements in benefits.
White House officials described the rule as a major expansion of coverage. In the past, they said, nearly 20 percent of people buying insurance on their own did not have coverage for mental health services, and nearly one-third had no coverage for treatment of substance abuse.
The entire story is here.
Tuesday, November 6, 2012
China passes mental health law to curb unnecessary hospitalizations
CBS News
Originally posted October 26, 2012
China's legislature on Friday passed a long-awaited mental health law that aims to prevent people from being involuntarily held and unnecessarily treated in psychiatric facilities - abuses that have been used against government critics and triggered public outrage.
The law standardizes mental health care services, requiring general hospitals to set up special outpatient clinics or provide counseling, and calls for the training of more doctors.
Debated for years, the law attempts to address an imbalance in Chinese society -- a lack of mental health care services for a population that has grown more prosperous but also more aware of modern-day stresses and the need for treatment. Psychiatrists who helped draft and improve the legislation welcomed its passage.
The entire story is here.
Originally posted October 26, 2012
China's legislature on Friday passed a long-awaited mental health law that aims to prevent people from being involuntarily held and unnecessarily treated in psychiatric facilities - abuses that have been used against government critics and triggered public outrage.
The law standardizes mental health care services, requiring general hospitals to set up special outpatient clinics or provide counseling, and calls for the training of more doctors.
Debated for years, the law attempts to address an imbalance in Chinese society -- a lack of mental health care services for a population that has grown more prosperous but also more aware of modern-day stresses and the need for treatment. Psychiatrists who helped draft and improve the legislation welcomed its passage.
The entire story is here.
Sunday, August 19, 2012
War Wounds
By Nicholas D. Kristof
The New York Times - Sunday Review
Originally published on August 10, 2012
The New York Times - Sunday Review
Originally published on August 10, 2012
IT would be so much easier, Maj. Ben Richards says, if he had just lost a leg in Iraq.
Instead, he finds himself losing his mind, or at least a part of it. And if you want to understand how America is failing its soldiers and veterans, honoring them with lip service and ceremonies but breaking faith with them on all that matters most, listen to the story of Major Richards.
For starters, he’s brilliant. (Or at least he was.) He speaks Chinese and taught at West Point, and his medical evaluations suggest that until his recent problems he had an I.Q. of about 148. After he graduated from West Point, in 2000, he received glowing reviews.
(cut)
Military suicides are the starkest gauge of our nation’s failure to care adequately for those who served in uniform. With America’s wars winding down, the United States is now losing more soldiers to suicide than to the enemy. Include veterans, and the tragedy is even more sweeping. For every soldier killed in war this year, about 25 veterans now take their own lives.
President Obama said recently that it was an “outrage” that some service members and veterans sought help but couldn’t get it: “We’ve got to do better. This has to be all hands on deck.” Admirable words, but so far they’ve neither made much impact nor offered consolation to those who call the suicide prevention hot line and end up on hold.
The military’s problems with mental health services go far beyond suicide or the occasional murders committed by soldiers and veterans. Far more common are people like Richards, who does not contemplate violence of any kind but is still profoundly disabled.
Thursday, August 16, 2012
Life in a Mental Hospital
"Erasing the Past at the Ghost Hospital"
By Lawrence Downes
The New York Times
Originally published on August 4, 2012
Engineers and earth movers have now joined nature and vandals in the slow dismantling of the Kings Park Psychiatric Center, an all-but-abandoned city of the sick on the North Shore of Long Island, on thickly wooded bluffs above Long Island Sound.
This article is here.
----------------------------------------------------
A Letter to the Editor by Lucy Winer about this story is here.
I was committed to Kings Park Psychiatric Center on Long Island as a teenager in the 1960s after a series of suicide attempts. Having experienced the abuses of institutional life, I expected to rejoice at news of the hospital’s bulldozing. Instead, I feel grief.
(cut)
State hospitals were closed to save money. The promise was that savings would be invested in community mental health care. This never happened, and we are living with the fallout from this broken social contract.
By Lawrence Downes
The New York Times
Originally published on August 4, 2012
Engineers and earth movers have now joined nature and vandals in the slow dismantling of the Kings Park Psychiatric Center, an all-but-abandoned city of the sick on the North Shore of Long Island, on thickly wooded bluffs above Long Island Sound.
Kings Park was one of the island’s four giant state mental institutions — part farm, part warehouse — that treated hundreds of thousands of patients from New York City. It began in the 1880s and kept growing into the 1960s and ’70s until, like its counterparts on the island and across the country, it was made obsolete by new drug therapies and a new understanding of the rights of the mentally ill.
(cut)
New York State has largely abandoned its comprehensive commitment to caring for the mentally ill and disabled. When the hospitals emptied out, patients were sent to group homes to be better cared for; many were forsaken there, too. A recent series of articles in The Times found that abuse and neglect plague the mental-health system to this day. It would be wonderful if someday profitable redevelopment of Kings Park led to a surge in financing for care of the mentally ill. I’m not counting on it.
This article is here.
----------------------------------------------------
A Letter to the Editor by Lucy Winer about this story is here.
I was committed to Kings Park Psychiatric Center on Long Island as a teenager in the 1960s after a series of suicide attempts. Having experienced the abuses of institutional life, I expected to rejoice at news of the hospital’s bulldozing. Instead, I feel grief.
(cut)
State hospitals were closed to save money. The promise was that savings would be invested in community mental health care. This never happened, and we are living with the fallout from this broken social contract.
Saturday, May 19, 2012
Maryland becomes 13th state to mandate telehealth services coverage
Law may be part of a growing trend toward reimbursement for telehealth services
By Legal & Regulatory Affairs staff
May 10, 2012—On October 1, 2012, Maryland will become the 13th state to require private sector insurance companies to pay for telehealth services. Maryland joins California, Colorado, Georgia, Hawaii, Kentucky, Louisiana, Maine, New Hampshire, Oklahoma, Oregon, Texas and Virginia in mandating that private payers cover telehealth services that are considered medically necessary and would otherwise be covered when provided face-to-face.
While reimbursement varies by insurer and state, this latest legislation seems to be part of a growing trend toward reimbursement for telehealth services.
The entire release is here.
Wednesday, May 16, 2012
Addiction Diagnoses May Rise Under Guideline Changes
By Ian Urbina
The New York Times
Originally published May 11, 2012
In what could prove to be one of their most far-reaching decisions, psychiatrists and other specialists who are rewriting the manual that serves as the nation’s arbiter of mental illness have agreed to revise the definition of addiction, which could result in millions more people being diagnosed as addicts and pose huge consequences for health insurers and taxpayers.
The revision to the manual, known as the Diagnostic and Statistical Manual of Mental Disorders, or D.S.M., would expand the list of recognized symptoms for drug and alcohol addiction, while also reducing the number of symptoms required for a diagnosis, according to proposed changes posted on the Web site of the American Psychiatric Association, which produces the book.
The New York Times
Originally published May 11, 2012
In what could prove to be one of their most far-reaching decisions, psychiatrists and other specialists who are rewriting the manual that serves as the nation’s arbiter of mental illness have agreed to revise the definition of addiction, which could result in millions more people being diagnosed as addicts and pose huge consequences for health insurers and taxpayers.
The revision to the manual, known as the Diagnostic and Statistical Manual of Mental Disorders, or D.S.M., would expand the list of recognized symptoms for drug and alcohol addiction, while also reducing the number of symptoms required for a diagnosis, according to proposed changes posted on the Web site of the American Psychiatric Association, which produces the book.
In addition, the manual for the first time would include gambling as an addiction, and it might introduce a catchall category — “behavioral addiction — not otherwise specified” — that some public health experts warn would be too readily used by doctors, despite a dearth of research, to diagnose addictions to shopping, sex, using the Internet or playing video games.
Wednesday, May 9, 2012
NY Fines 15 Insurers over Mental Health Notices
Associated Press
The Wall Street Journal
Originally published May 9, 2012
ALBANY, N.Y. — New York regulators have fined 15 insurers $2.7 million for failing to notify small businesses they were eligible to buy special coverage for mental illnesses and children with serious emotional disturbances.
Superintendent of Financial Services Benjamin Lawsky says they are the first fines under Timothy's Law, named for a teen who committed suicide after his parents were unable to obtain needed mental health treatment. The law took effect in 2007.
The rest of the story is here.
More information on Timothy's Law is here.
The Wall Street Journal
Originally published May 9, 2012
ALBANY, N.Y. — New York regulators have fined 15 insurers $2.7 million for failing to notify small businesses they were eligible to buy special coverage for mental illnesses and children with serious emotional disturbances.
Superintendent of Financial Services Benjamin Lawsky says they are the first fines under Timothy's Law, named for a teen who committed suicide after his parents were unable to obtain needed mental health treatment. The law took effect in 2007.
The rest of the story is here.
More information on Timothy's Law is here.
Tuesday, April 24, 2012
Should 'Mental Health Checkups' Be Made Part Of Health Care In Schools?
Medical News Today
Originally published April 16, 2012
"The early detection of children who are showing psychiatric symptoms or are at the risk of a mental disorder is crucial, but introducing "mental health checkups" as part of health care in schools is not altogether simple," says David Gyllenberg, MD, whose doctoral dissertation "Childhood Predictors of Later Psychotropic Medication Use and Psychiatric Hospital Treatment - Findings from the Finnish Nationwide 1981 Birth Cohort Study" was publically examined at the University of Helsinki on 13 April 2012.
In Gyllenberg's study, the mental wellbeing of nearly 6,000 Finnish children of the age of eight was charted through a survey carried out in 1989. After this, the use of psychotropic medication and psychiatric hospital periods of the same children from the age of 12 to 25 was followed up.
The entire story is here.
Originally published April 16, 2012
"The early detection of children who are showing psychiatric symptoms or are at the risk of a mental disorder is crucial, but introducing "mental health checkups" as part of health care in schools is not altogether simple," says David Gyllenberg, MD, whose doctoral dissertation "Childhood Predictors of Later Psychotropic Medication Use and Psychiatric Hospital Treatment - Findings from the Finnish Nationwide 1981 Birth Cohort Study" was publically examined at the University of Helsinki on 13 April 2012. In Gyllenberg's study, the mental wellbeing of nearly 6,000 Finnish children of the age of eight was charted through a survey carried out in 1989. After this, the use of psychotropic medication and psychiatric hospital periods of the same children from the age of 12 to 25 was followed up.
The entire story is here.
Monday, April 16, 2012
Court Upends 9-Year Fight on Housing Mentally Ill
By Mosi Secret
The New York Times
Originally published April 6, 2012
A federal appeals court, ruling on procedural grounds, struck down on Friday a judge’s order that New York State transfer thousands of mentally ill adults in New York City from institutional group homes into their own homes and apartments. In doing so, the court brought a nine-year legal battle to an abrupt end without resolving the underlying issues of how the state cares for such patients.
Though the lower court judge had ruled the current system violated federal law by warehousing people with mental illness in far more restrictive conditions than necessary, the appellate panel said the nonprofit organization that began the litigation, Disability Advocates, did not have legal standing to sue.
The panel, comprising three judges of the United States Court of Appeals for the Second Circuit, acknowledged that its decision essentially reset the long-running battle to its starting point.
Wednesday, December 28, 2011
Mentally Ill flood ERs as States Cut Services
By Julie
Steenhuysen and Jilian Mincer
Reuters
Originally published December 26, 2011
On a recent
shift at a Chicago emergency department, Dr. William Sullivan treated a newly
homeless patient who was threatening to kill himself.
"He had
been homeless for about two weeks. He hadn't showered or eaten a lot. He asked
if we had a meal tray," said Sullivan, a physician at the University of
Illinois Medical Center at Chicago and a past president of the Illinois College
of Emergency Physicians.
Sullivan said
the man kept repeating that he wanted to kill himself. "It seemed almost
as if he was interested in being admitted."
Across the
country, doctors like Sullivan are facing a spike in psychiatric emergencies -
attempted suicide, severe depression, psychosis - as states slash mental health
services and the country's worst economic crisis since the Great Depression
takes its toll.
This trend is
taxing emergency rooms already overburdened by uninsured patients who wait
until ailments become acute before seeking treatment.
"These are
people without a previous psychiatric history who are coming in and telling us
they've lost their jobs, they've lost sometimes their homes, they can't provide
for their families, and they are becoming severely depressed," said Dr. Felicia
Smith, director of the acute psychiatric service at Massachusetts General
Hospital in Boston.
Visits to the
hospital's psychiatric emergency department have climbed 20 percent in the past
three years.
The entire story
is here.
Monday, November 28, 2011
Editorial: Ricky Wyatt
By Lawrence Downes
 |
| Ricky Wyatt |
The journey was Wyatt v. Stickney, the federal class-action lawsuit filed in 1970 against an Alabama state hospital and later expanded to other facilities. It was the first and most consequential of the legal challenges to the abuse and neglect that had doomed hundreds of thousands of patients to hellish lives in public psychiatric hospitals. It threw open the doors to treatment and to new homes in the community and, for the first time, established standards of adequate care and patients’ rights to receive it.
The whole editorial is here.
Another more detailed article on Ricky Wyatt is here.
A summary of Wyatt v. Stickney is here.
Sunday, October 9, 2011
Mental-health cuts: Experts fear long-term costs
By Mary Reinhart
The Arizona Republic
azcentral.com
Arizona taxpayers are providing fewer services to fewer people with serious mental illnesses than they were last year, for annual savings of roughly $50 million.
But the short-term savings from state budget cuts threaten to have long-term consequences for patients, providers and the community, mental-health experts say.
The budget reductions eliminated services for about 12,000 Arizonans who don't qualify for Medicaid, removing the foundation of a system intended to keep the seriously mentally ill healthy and out of emergency rooms, hospitals, jails and prisons.
State lawmakers instead provided money for generic medication and additional funding to beef up a statewide crisis-response system to help prevent people from falling through the cracks. But in the 15 months since this population lost case management, brand-name prescription drugs, therapy, transportation and other benefits, more than 2,000 people have stopped receiving any state-funded services and are unaccounted for.
Local and county jails, emergency responders and hospitals often shoulder the costs when people with untreated serious mental illness, such as schizophrenia and bipolar disorder, fall into crisis.
The precise financial costs to those entities are unknown, but health professionals do know that it's far more expensive to treat people who have spiraled into crisis than to keep them stable. And once in crisis, health professionals say, it's more difficult for people to rebound, which means those higher costs continue to recur.
"It's a penny-wise and pound-foolish approach," said Bill Kennard, former executive director of the National Alliance on Mental Illness' office in Phoenix. "More people in jail and prison with mental illness, more time that law enforcement spends dealing with a health issue as opposed to a public-safety issue."
The costs
The state has not conducted an analysis that compares ongoing treatment with crisis costs.
But a March 2011 study that examined proposed mental-health cuts in Texas put the average daily cost of services at $12 for adults, compared with $401 a day in the state's mental hospital, $137 a day for a jail inmate with mental illness and $986 for an emergency-room visit.
The study, by Health Management Associates for the Texas Conference of Urban Counties, also showed that gaps in services put those discharged from psychiatric hospitals and jail at greater risk of relapse, readmission and recidivism.
Janey Durham, who is in charge of a workshop program at Mesa's Marc Center, said she lost 120 people to the budget cuts, including a man diagnosed with schizophrenia who deteriorated almost before her eyes. The non-profit agency center provides job training and other services to the mentally ill and developmentally disabled.
Durham said the man, a former alcoholic in his 50s, worked hard at his job in the manufacturing warehouse, at maintaining his sobriety and in treating his mental illness. But soon after the budget cuts forced him to switch to a generic medication, Durham said, he stopped taking his medication, started drinking again and grew increasingly paranoid, plagued by voices in his head.
Over the past year his erratic, disruptive behavior led Marc Center employees to call Mesa police at least once. He is believed to be homeless, she said, but contact with him has been sporadic since last winter.
Read the entire story here.
The Arizona Republic
azcentral.com
But the short-term savings from state budget cuts threaten to have long-term consequences for patients, providers and the community, mental-health experts say.
The budget reductions eliminated services for about 12,000 Arizonans who don't qualify for Medicaid, removing the foundation of a system intended to keep the seriously mentally ill healthy and out of emergency rooms, hospitals, jails and prisons.
State lawmakers instead provided money for generic medication and additional funding to beef up a statewide crisis-response system to help prevent people from falling through the cracks. But in the 15 months since this population lost case management, brand-name prescription drugs, therapy, transportation and other benefits, more than 2,000 people have stopped receiving any state-funded services and are unaccounted for.
Local and county jails, emergency responders and hospitals often shoulder the costs when people with untreated serious mental illness, such as schizophrenia and bipolar disorder, fall into crisis.
The precise financial costs to those entities are unknown, but health professionals do know that it's far more expensive to treat people who have spiraled into crisis than to keep them stable. And once in crisis, health professionals say, it's more difficult for people to rebound, which means those higher costs continue to recur.
"It's a penny-wise and pound-foolish approach," said Bill Kennard, former executive director of the National Alliance on Mental Illness' office in Phoenix. "More people in jail and prison with mental illness, more time that law enforcement spends dealing with a health issue as opposed to a public-safety issue."
The costs
The state has not conducted an analysis that compares ongoing treatment with crisis costs.
But a March 2011 study that examined proposed mental-health cuts in Texas put the average daily cost of services at $12 for adults, compared with $401 a day in the state's mental hospital, $137 a day for a jail inmate with mental illness and $986 for an emergency-room visit.
The study, by Health Management Associates for the Texas Conference of Urban Counties, also showed that gaps in services put those discharged from psychiatric hospitals and jail at greater risk of relapse, readmission and recidivism.
Janey Durham, who is in charge of a workshop program at Mesa's Marc Center, said she lost 120 people to the budget cuts, including a man diagnosed with schizophrenia who deteriorated almost before her eyes. The non-profit agency center provides job training and other services to the mentally ill and developmentally disabled.
Durham said the man, a former alcoholic in his 50s, worked hard at his job in the manufacturing warehouse, at maintaining his sobriety and in treating his mental illness. But soon after the budget cuts forced him to switch to a generic medication, Durham said, he stopped taking his medication, started drinking again and grew increasingly paranoid, plagued by voices in his head.
Over the past year his erratic, disruptive behavior led Marc Center employees to call Mesa police at least once. He is believed to be homeless, she said, but contact with him has been sporadic since last winter.
Read the entire story here.
Subscribe to:
Posts (Atom)