Editorial
The Lancet
Volume 380, Issue 9858, Page 1968
Last week, Australia's National Mental Health Commission released A Contributing Life: the 2012 National Report Card on Mental Health and Suicide Prevention, its first such publication. The report card takes a whole-of-life approach, recognising that, like everyone else, people who have a mental illness need a stable home, a decent education, a job, good physical health, and a support network, as well as access to high-quality treatment and services.
There is a special focus on the first Australians, the Aboriginal and Torres Strait Islanders, who still face enormous disadvantages when compared with the general population. This disadvantage starts before birth. For example, three in ten Aboriginal and Torres Strait Islanders, including pregnant women, report barriers to accessing health services. 50% of pregnant Aboriginal and Torres Strait Islander women smoke. And one in seven new Indigenous mothers have postnatal depression. As the report notes, a child born into these circumstances does not have an auspicious start in life. Furthermore, an Indigenous child is two and a half times more likely to be born into the lowest income group, and has a one in two chance of living in a one-parent household when compared with the general population. All these factors play into adolescence and adulthood, and increase the risk of mental health problems and associated issues such as substance misuse in the Indigenous population. Up to 15% of the 10-year life expectancy gap compared with non-Indigenous Australians has been attributed to mental health disorders.
The report recommends the development and implementation of an Aboriginal and Torres Strait Islander Mental Health and Social and Emotional Wellbeing Plan to commence in 2013 as well as training and employment of more Indigenous people in mental health services. This must be a national government priority, as should addressing the deep health and social inequalities faced by Aboriginal and Torres Strait Islanders. Australia's Indigenous population should have the opportunity to thrive, not just survive.
doi:10.1016/S0140-6736(12)62139-4
Sunday, December 16, 2012
Saturday, December 15, 2012
Court: Off-Label Drug Marketing Is 'Free Speech'
By John Fauber, Reporter
Milwaukee Journal Sentinel/MedPage Today
Originally Published: December 04, 2012
A decision by a federal appeals court this week could have a dramatic impact on the marketing of prescription drugs in America, potentially affecting patient care and everything from TV advertising to future government prosecutions which, in the past, had yielded billions of dollars in settlements, doctors and attorneys said Tuesday.
"This risks taking us back to an era when people could promote snake oil without restrictions – a situation I would hate to see," said Richard Deyo, MD, a professor of family medicine at Oregon Health and Science University.
Citizens United Redux
However, others say the ruling by a three-judge panel of the Court of Appeals for the Second Circuit in Manhattan is a victory for free speech, one that could become the drug industry equivalent of Citizens United, the 2010 U.S. Supreme Court decision that gave corporations and unions the right to spend unlimited sums on political ads.
Like the Citizens United case, the ruling Tuesday by the prestigious U.S. Court of Appeals for the Second Circuit in New York, involved the right of commercial free speech, applying it to the complicated world of pharmaceutical industry promotion of prescription drugs.
How wide-ranging the decision becomes likely will depend on whether it gets to the U.S. Supreme Court, attorneys said.
Once the Food and Drug Administration approves a drug, physicians are free to prescribe that drug as they wish -- but the drug makers can only market the drug for the FDA-approved marketing indication.
The case involves Alfred Caronia, a sales representative with Orphan Medical who was criminally prosecuted for making off-label promotional statements about Xyrem, a drug approved in 2002 to treat narcolepsy patients with a condition known as cataplexy. Cataplexy involves weak or paralyzed muscles.
The FDA required a black box warning on the drug stating that its safety and effectiveness had not been established in people under the age of 16. The active ingredient in Xyrem is GHB, is a powerful medication that acts on the central nervous system and also is known as the "date rape" drug.
The entire story is here.
Friday, December 14, 2012
48 countries join forces against online child abuse
By Associated Press
Originally Published: December 5
Forty-eight countries united Wednesday in a global alliance to fight child sexual abuse online, a cross-border crime that experts say is increasing at alarming rates.
By conservative estimates, 1 million photographs of child pornography are on the Internet, with an additional 50,000 being posted every year, said Cecilia Malmstrom, the European Union’s commissioner for home affairs who was one of sponsors of the conference in Brussels.
“Behind each of these images there is an abused child, an exploited and helpless victim,” Malmstrom said at a news conference. “And every time someone looks at these pictures, that child is exploited and violated again and again and again.”
The alliance will focus on identifying and helping victims, prosecuting offenders, increasing public awareness and reducing the availability of child pornography online, according to a joint declaration.
The entire story is here.
Originally Published: December 5
Forty-eight countries united Wednesday in a global alliance to fight child sexual abuse online, a cross-border crime that experts say is increasing at alarming rates.
By conservative estimates, 1 million photographs of child pornography are on the Internet, with an additional 50,000 being posted every year, said Cecilia Malmstrom, the European Union’s commissioner for home affairs who was one of sponsors of the conference in Brussels.
“Behind each of these images there is an abused child, an exploited and helpless victim,” Malmstrom said at a news conference. “And every time someone looks at these pictures, that child is exploited and violated again and again and again.”
The alliance will focus on identifying and helping victims, prosecuting offenders, increasing public awareness and reducing the availability of child pornography online, according to a joint declaration.
The entire story is here.
Greater awareness and funding approved to address internship imbalance
APA Access | December 11, 2012
The Education Directorate and the American Psychological Association of Graduate Students worked to raise awareness of and make strides toward solving the internship imbalance.
The Education Directorate and the American Psychological Association of Graduate Students (APAGS) worked extensively over the past year to promote more quality internship positions for psychology graduate students. The effort paid off when the APA Council of Representatives approved the allocation of up to $3 million over three years for a small grant program to assist internship sites with the accreditation process. This program will potentially add up to 500 APA-accredited slots to promote quality assurance in training.
Thursday, December 13, 2012
Justice Dept. recovers record $5 billion under False Claims Act
By Peter Finn
The Washington Post
Originally published: December 4, 2012
The Justice Department’s civil division recovered a record $5 billion in the past fiscal year from companies that defrauded taxpayers, with much of the abuse occurring in the health-care and mortgage industries.
The department pursued settlements and judgments under the False Claims Act, which Acting Associate Attorney General Tony West described Tuesday as “quite simply, the most powerful tool we have to deter and redress fraud.”
“Vigorous enforcement of the act allows us to protect not only taxpayer dollars but also the integrity of important government programs on which so many Americans rely,” West said.
The amount of money recovered in 2012 is up from $3.2 billion last year, and two-thirds of it was secured through the act’s whistleblower provisions.
“Many of these cases would not be possible without the whistleblowers . . . who have come forward to report fraud, often at great personal risk,” said Stuart Delery, the principal deputy assistant attorney general for the civil division.
The entire story is here.
The Washington Post
Originally published: December 4, 2012
The Justice Department’s civil division recovered a record $5 billion in the past fiscal year from companies that defrauded taxpayers, with much of the abuse occurring in the health-care and mortgage industries.
The department pursued settlements and judgments under the False Claims Act, which Acting Associate Attorney General Tony West described Tuesday as “quite simply, the most powerful tool we have to deter and redress fraud.”
“Vigorous enforcement of the act allows us to protect not only taxpayer dollars but also the integrity of important government programs on which so many Americans rely,” West said.
The amount of money recovered in 2012 is up from $3.2 billion last year, and two-thirds of it was secured through the act’s whistleblower provisions.
“Many of these cases would not be possible without the whistleblowers . . . who have come forward to report fraud, often at great personal risk,” said Stuart Delery, the principal deputy assistant attorney general for the civil division.
The entire story is here.
APA Practice Organization safeguards Medicare reimbursements for psychologists
APA Access | December 11, 2012
Editorial note: APAPO dollars working for you!
Advocates also targeted managed care rate cuts as a violation of federal parity rules.
APAPO made ensuring appropriate Medicare reimbursement for psychologists its top legislative advocacy priority in 2012. Along with grassroots psychologists, APAPO lobbyists called for alteration of the Medicare payment formula with letters and visits to officials in the Centers for Medicare and Medicaid Services and members of key health-related congressional committees. The current flawed formula reimburses expensive technology-based specialty services at a higher rate than lower-cost mental health and primary care services.
APA’s Practice Directorate continued its multi-year initiative to evaluate the psychotherapy billing codes and recommend “work relative value units” for the new set of psychotherapy codes that take effect Jan. 1, 2013.
The entire story is here.
Editorial note: APAPO dollars working for you!
Advocates also targeted managed care rate cuts as a violation of federal parity rules.
APAPO made ensuring appropriate Medicare reimbursement for psychologists its top legislative advocacy priority in 2012. Along with grassroots psychologists, APAPO lobbyists called for alteration of the Medicare payment formula with letters and visits to officials in the Centers for Medicare and Medicaid Services and members of key health-related congressional committees. The current flawed formula reimburses expensive technology-based specialty services at a higher rate than lower-cost mental health and primary care services.
APA’s Practice Directorate continued its multi-year initiative to evaluate the psychotherapy billing codes and recommend “work relative value units” for the new set of psychotherapy codes that take effect Jan. 1, 2013.
The entire story is here.
Wednesday, December 12, 2012
Parity for Behavioral Health Coverage Delayed by Lack of Federal Rules
By Michael Ollove
Stateline/Kaiser Health News
Originally published on December 2, 2012
Here are some excerpts:
A Law but No Rules
Congress recognized that equivalence in 2008 when it passed the Mental Health Parity and Addiction Act, which requires insurers to cover mental illness and substance abuse treatment on an equal basis with physical ailments. The law, which passed with substantial bipartisan support, was supposed to eliminate two-tiered systems for co-pays, deductibles or treatment limitations.
The Obama administration's Affordable Care Act will vastly extend the reach of the 2008 law. The older law does not require health insurance plans to offer behavioral health coverage, although if they do it must be on par with benefits provided for medical and surgical care. But the ACA does require that all health plans sold on the soon-to-be-created state health insurance exchanges eventually offer mental health coverage. Those plans, then, will all be required to observe the federal parity act.
The problem, behavioral health advocates say, is that more than four years after President George W. Bush signed the parity bill into law, the Obama administration has yet to complete the federal rules that would enable states to enforce it.
As a result, behavioral health may actually have fallen further behind since passage of the law. In May, the U.S. Government Accountability Office released a report showing that health insurance plans have actually increased the number of exclusions for mental health and addiction treatments since the law was enacted. In 2010 and 2011, for example, 15 percent of the plans surveyed by the GAO were excluding residential mental health, a significant increase from 2008.
"Hundreds of thousands of Americans are being denied their rights under the federal parity law," says James Ramstad, a former Republican congressman who originally introduced the House version of the bill in 1996 at the request of his friend and fellow Minnesotan, the late Democratic Senator Paul Wellstone, whose name is memorialized on the law. Wellstone was killed in a plane crash in 2002. "It took 12 years to pass that parity act and four years later, we still have no rules and therefore no enforcement," says Ramstad. "It’s unconscionable."
The entire article is here.
Stateline/Kaiser Health News
Originally published on December 2, 2012
Here are some excerpts:
A Law but No Rules
Congress recognized that equivalence in 2008 when it passed the Mental Health Parity and Addiction Act, which requires insurers to cover mental illness and substance abuse treatment on an equal basis with physical ailments. The law, which passed with substantial bipartisan support, was supposed to eliminate two-tiered systems for co-pays, deductibles or treatment limitations.
The Obama administration's Affordable Care Act will vastly extend the reach of the 2008 law. The older law does not require health insurance plans to offer behavioral health coverage, although if they do it must be on par with benefits provided for medical and surgical care. But the ACA does require that all health plans sold on the soon-to-be-created state health insurance exchanges eventually offer mental health coverage. Those plans, then, will all be required to observe the federal parity act.
The problem, behavioral health advocates say, is that more than four years after President George W. Bush signed the parity bill into law, the Obama administration has yet to complete the federal rules that would enable states to enforce it.
As a result, behavioral health may actually have fallen further behind since passage of the law. In May, the U.S. Government Accountability Office released a report showing that health insurance plans have actually increased the number of exclusions for mental health and addiction treatments since the law was enacted. In 2010 and 2011, for example, 15 percent of the plans surveyed by the GAO were excluding residential mental health, a significant increase from 2008.
"Hundreds of thousands of Americans are being denied their rights under the federal parity law," says James Ramstad, a former Republican congressman who originally introduced the House version of the bill in 1996 at the request of his friend and fellow Minnesotan, the late Democratic Senator Paul Wellstone, whose name is memorialized on the law. Wellstone was killed in a plane crash in 2002. "It took 12 years to pass that parity act and four years later, we still have no rules and therefore no enforcement," says Ramstad. "It’s unconscionable."
The entire article is here.
Tuesday, December 11, 2012
Gay 'Conversion Therapy' Faces Test in Courts
by Erik Eckholm
The New York Times
Originally published November 27, 2012
Gay "conversion therapy," which claims to help men overcome unwanted same-sex attractions but has been widely attacked as unscientific and harmful, is facing its first tests in the courtroom.
In New Jersey on Tuesday, four gay men who tried the therapy filed a civil suit against a prominent counseling group, charging it with deceptive practices under the state's Consumer Fraud Act.
The former clients said they were emotionally scarred by false promises of inner transformation and humiliating techniques that included stripping naked in front of the counselor and beating effigies of their mothers.
They paid thousands of dollars in fees over time, they said, only to be told that the lack of change in their sexual feelings was their own fault.
In California, so-called ex-gay therapists have gone to court to argue for the other side.
They are seeking to block a new state law, signed by Gov. Jerry Brown in September and celebrated as a milestone by advocates for gay rights, that bans conversion therapy for minors.
In Sacramento on Friday, a federal judge will hear the first of two legal challenges brought by conservative law groups claiming that the ban is an unconstitutional infringement on speech, religion and privacy.
Since the 1970s, when mainstream mental health associations stopped branding homosexuality as a disorder, a small network of renegade therapists, conservative religious leaders and self-identified "life coaches" has continued to argue that it is not inborn, but an aberration rooted in childhood trauma.
The entire article is here.
The New York Times
Originally published November 27, 2012
Gay "conversion therapy," which claims to help men overcome unwanted same-sex attractions but has been widely attacked as unscientific and harmful, is facing its first tests in the courtroom.
In New Jersey on Tuesday, four gay men who tried the therapy filed a civil suit against a prominent counseling group, charging it with deceptive practices under the state's Consumer Fraud Act.
The former clients said they were emotionally scarred by false promises of inner transformation and humiliating techniques that included stripping naked in front of the counselor and beating effigies of their mothers.
They paid thousands of dollars in fees over time, they said, only to be told that the lack of change in their sexual feelings was their own fault.
In California, so-called ex-gay therapists have gone to court to argue for the other side.
They are seeking to block a new state law, signed by Gov. Jerry Brown in September and celebrated as a milestone by advocates for gay rights, that bans conversion therapy for minors.
In Sacramento on Friday, a federal judge will hear the first of two legal challenges brought by conservative law groups claiming that the ban is an unconstitutional infringement on speech, religion and privacy.
Since the 1970s, when mainstream mental health associations stopped branding homosexuality as a disorder, a small network of renegade therapists, conservative religious leaders and self-identified "life coaches" has continued to argue that it is not inborn, but an aberration rooted in childhood trauma.
The entire article is here.
SPLC files groundbreaking lawsuit accusing conversion therapy organization of fraud
Press Release
November 27, 2012
The Southern Poverty Law Center filed a first-of-its-kind lawsuit today accusing a New Jersey organization of consumer fraud for offering conversion therapy services – a dangerous and discredited practice that claims to convert people from gay to straight.
The lawsuit, filed in the Superior Court of New Jersey, charges that Jews Offering New Alternatives for Healing (JONAH), its founder, Arthur Goldberg, and counselor Alan Downing violated New Jersey’s Consumer Fraud Act by providing conversion therapy claiming to cure clients of being gay.
It is the first time a conversion therapy provider has been sued for fraudulent business practices. The lawsuit describes how the plaintiffs – four young men and two of their parents – were lured into JONAH’s services through deceptive practices.
“JONAH profits off of shameful and dangerous attempts to fix something that isn’t broken,” said Christine P. Sun, deputy legal director for the SPLC. “Despite the consensus of mainstream professional organizations that conversion therapy doesn’t work, this racket continues to scam vulnerable gay men and lesbians out of thousands of dollars and inflicts significant harm on them.”
The lawsuit describes how the underlying premise of conversion therapy – that a person can “convert” to heterosexuality – has no basis in scientific fact. Conversion therapy has been discredited or highly criticized by all major American medical, psychiatric, psychological and professional counseling organizations. It is the longstanding consensus of the behavioral and social sciences that homosexuality is a normal and positive variation of human sexual orientation.
Customers of JONAH’s services typically pay a minimum of $100 for weekly individual counseling sessions and another $60 for group therapy sessions. The lawsuit describes sessions that involved clients undressing in front of a mirror and even a group session where young men were instructed to remove their clothing and stand naked in a circle with the counselor, Downing, who was also undressed. Another session involved a subject attempting to wrest away two oranges, which were used to represent testicles, from another individual.
“Sadly, there is no accountability for those who practice conversion therapy,” said Michael Ferguson, a conversion therapy survivor and plaintiff in the lawsuit. “They play blindly with deep emotions and create an immense amount of self-doubt for the client. They seize on your personal vulnerability, and tell you that being gay is synonymous with being less of a man. They further misrepresent themselves as having the key to your new orientation.”
Thanks to Gary Schoener for this information.
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