Loose Screws Mental Health News

In the wake of the Newtown, CT shooting, NRA chief executive Wayne LaPierre called for a national registry of those who are mentally ill. According to the Washington Post, the federal government does not possess the constitutional authority “to require state agencies to report data.” All the federal government can do is either offer or withhold funding, as it did in the wake of the 2007 Virginia Tech Shooting when it provided additional funding for state governments that shared 90 percent of their mental health records. But it seems that 38 states already maintain an active database that “require or authorize the use of” mental health records during gun background checks. And the Gun Control Act of 1968 does not allow sales of firearms to people who have been institutionalized or considered to be mentally “defective.”

For the purpose of firearms sales, I support the idea of maintaining a database of people who have been institutionalized. This could prevent a person from being a harm to himself or to others. I speak as a person who has been institutionalized for being a harm to herself more than once. If I’d had access to a firearm, I wouldn’t be here right now. There may be many others who are in the same boat.


The New York Times reported on mental health coverage through insurance. In any given year, 26 percent of adults have a mental disorder, and 6 percent of adults have a mental illness that prevents them from functioning, according to the NIMH. In addition, 21 percent of teenagers between the ages of 13 and 18 undergo a “severe emotional disturbance.” But it seems as though 85 percent of employers offer some kind of mental health coverage through insurance, and 84 percent of employers with more than 500 employees allowed access to in-network and out-of-network mental health treatment. Beginning in 2014, insurance plans will be required to cover mental health disorders as part of President Obama’s Affordable Care Act.

The New York Times notes that many psychiatrists, however, don’t accept insurance:

Plenty of psychiatrists in private practice accept no insurance at all, though it is not clear how many; their professional organizations claim to have no recent or decent data on the percentage of people in private practice who take cash on the barrelhead, write people a receipt and send them off to their insurance company to request out-of-network reimbursement if they have any at all.

My psychiatrist does not accept insurance. He writes me a receipt, and I am to seek out-of-network reimbursement, a claim that has been repeatedly rejected by my insurance. The NYT is right on the money in this instance. But I am happy with my psychiatrist and would rather pay out of pocket for him without reimbursement than to find another psychiatrist who is in network.


According to the San Francisco Chronicle, California is ahead of every other state in covering mental health services with public money. But as always, there are critics who say California does not go far enough, even though in 2004, California voters approved Proposition 63 that funnels $1 billion annually for mental health services by taxing the state’s highest earners. But funding is being cut, not just in California but also nationally, according to NAMI.

Overall, California cut $768 million from its state mental health services outlay during the past three fiscal years, according to a November 2011 report from the National Alliance on Mental Illness. California’s 21 percent reduction in mental health funding over that period is the seventh-highest among all states.

Nationally, states cut more than $1.6 billion in general funds from their state mental health agency budgets for mental health services since 2009, according to the 2011 report by the National Alliance on Mental Illness.

I’m not sure what can be done to stop funding cuts of mental health services when state budgets are slashing services across the board.


And finally, according to NY1 News, New York City Mayor Bloomberg has announced an initiative to get mentally ill people out of jail and into treatment facilities. The mayor’s office estimates that 36 percent of inmates suffer from some kind of mental disorder. The city initiative will attempt to “reduce incarceration rates, improve jail safety, and lower crime.”

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Loose Screws Mental Health News

I could’ve been a statistic right here in this area.

suicides in PhiladelphiaPhiladelphia now boasts the sharpest increase in suicides in the country. Despite all the homicides in Philadelphia making the news, the 196 people who killed themselves in 2008 were quietly buried in the obit pages (if they made it there at all).

In light of this news, I’ve decided to place a suicide hotline web banner in the upper right-hand corner of my right sidebar. Susan of If You’re Going Through Hell Keep Going has one in her sidebar and I think it’s a wonderful idea. I’ve had a couple of people comment or send me emails about how they feel they’re on the brink of losing it so hopefully the banner — one of the first things to be seen on this page — will draw some attention and prompt someone to call for help. When I was a teen, I called 1.800.SUICIDE. I can’t remember what happened exactly but I called the hotline and someone talked me into why life was still worth living. People who are suicidal don’t really want to die; they want an escape from the pain they’re feeling and they feel the only way to alleviate that pain is through inflicting death upon themselves. I hope someone who is suicidal would be willing to pick up the phone and come to the same realization that I did at the time.


Speaking of suicide, researchers from the World Health Organization and the University of Verona, Italy have discovered that SSRIs (a class of antidepressants) may significantly reduce the risk for suicide in adults. SSRIs — which include such medications as Prozac, Paxil, and Zoloft — are not be confused with SNRIs such as Effexor, Pristiq, and Cymbalta. PsychCentral notes:

SSRIPrevious studies, including a 2007 study by the U.S. Food and Drug Administration (FDA), found the risk of suicide in adults was neutral, elevated in those under 25 and reduced in people older than 65. A subsequent black box warning was added to all antidepressants regarding increased risk of suicidal symptoms in people under 25 years of age.

Basically, this study just means antidepressants help those who are 25 years and older and hurt those 24 years and younger. I’m sure a new study will come out within the next year or so that contradicts this one. Especially since numerous previous studies on SSRIs found the risk of suicide to be neutral in ages 25-65.


Young adultAccording to the Boston Globe, a (really pathetic) new study shows that nearly half of young adults between the ages of 19 to 25 “meet the criteria for at least one psychiatric disorder.”

Whether in college or not, almost half of this country’s 19-to-25-year-olds meet standard criteria for at least one psychiatric disorder, although some of the disorders, such as phobias, are relatively mild, according to a government-funded survey of more than 5,000 young adults, published in December in the Archives of General Psychiatry.

The study, done at Columbia University and called the National Epidemiologic Study on Alcohol and Related Conditions, found more alcohol use disorders among college students, while their noncollege peers were more likely to have a drug use disorder.

But, beyond that, misery is largely an equal-opportunity affliction: Across the social spectrum, young people in America are depressed. They’re anxious. They regularly break one another’s hearts. And, all too often, they don’t get the help they need as they face life’s questions…

According to the 2005-2007 American Community Survey, the population for adults ages 18-24 is gauged to be around 30 million. Therefore if we’re going to take the study at its word, let’s chop the number by half (even though the number is just under half). That will put us at about 15 million young adults. The NIMH, however, estimates 57.7 million adults in the U.S. “suffer from a diagnosable mental disorder.” If this is the case, those 15 million young adults make up nearly 26 percent of the NIMH’s “diagnosable mental disorder” statistic. The inclusion of alcohol and drug addictions might explain why this figure might be a little high.

Loose Screws Mental Health News

The mastermind behind Stavzor is Noven Pharmaceuticals (in conjunction with Banner Pharmacaps Inc.). The new “small, easy-to-swallow soft gel capsule” is available in three strengths: 125, 250, and 500 mgs. The pills are are “up to 40% smaller than han Depakote® and Depakote ER® tablets at the 500 mg dosage strength.” From Noven’s PR:

Stavzor is approved for the treatment of manic episodes associated with bipolar disorder, as monotherapy and adjunctive therapy in the treatment of patients with complex partial seizures that occur either in isolation or in association with other types of seizures, and for prophylaxis of migraine headaches.

The drug will hit the market in mid to late August.

The hotline receives an average 250 calls each day from veterans that have fought in Iraq, Vietnam, and Afghanistan.

The issue of soldiers with mental illness has recently come to light with studies showing that 1 in 5 soldiers returning from Iraq and Afghanistan have shown symptoms of post-traumatic stress disorder. The issue of the high suicides rate has been a high priority of the VA since mental health director Ira Katz tried to hide the significant number of suicides committed by veterans.

The National Suicide Prevention Lifeline is available 24 hours a day by calling 800-273-TALK (8255); veterans should press “1” after being connected.

“We have seen a 60 per cent increase in demand for our child anxiety classes in the past six months,” said [Dr. Kimberley O’Brien, of the Quirky Kids Clinic at Woollahra in Sydney].

It sounds more like the article is speaking of children who are exposed to constant physical and emotional abuse. If that’s the case, shouldn’t there rather be an increase in parenting properly classes?

The Act and Follow-through of Suicide: Part IV

Compilation of Statistics Regarding Suicide

Scott Anderson in his NYT article weaves the grim statistics of suicide in and out of his story. Here’s the morbid list:

General

  • mental illnessThe nation’s suicide rate (11 victims per 100,000 inhabitants) is almost precisely what it was in 1965.
  • In 2005, approximately 32,000 Americans committed suicide, or nearly twice the number of those killed by homicide.
  • The National Institute of Mental Health says that 90 percent of all suicide “completers” display some form of diagnosable mental disorder.

Demographics

  • Both elderly men living in Western states and white male adolescents from divorced families are at elevated risk.

Premeditation vs. Passion

  • [T]he person who best fits the classic definition of “being suicidal” might actually be safer than one acting in the heat of the moment — at least 40 times safer in the case of someone opting for an overdose of pills over shooting himself.
  • In a 2001 University of Houston study of 153 survivors of nearly lethal attempts between the ages of 13 and 34, only 13 percent reported having contemplated their act for eight hours or longer. To the contrary, 70 percent set the interval between deciding to kill themselves and acting at less than an hour, including an astonishing 24 percent who pegged the interval at less than five minutes.
  • “Sticking one’s head in the oven” became so common in Britain that by the late 1950s it accounted for some 2,500 suicides a year, almost half the nation’s total. By the early 1970s, the amount of carbon monoxide
    running through domestic gas lines had been reduced to nearly zero. During those same years, Britain’s national suicide rate dropped by nearly a third, and it has remained close to that reduced level ever since.

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Mental health parity bill

I haven’t posted anything on legislation that relates to mental health care so it’s about time I did.

On March 6, the House approved the Paul Wellstone Mental Health and Addiction Equity Act, a mental health parity bill that will require most medical insurance companies to provide better treatment for mental illnesses akin to what they do for physical illnesses. This is a significant move considering that insurers who cover mental health treatment can currently do one of two things: make patients pay for the bulk of the cost or place limits on treatment. The Senate also passed a similar bill in September 2007. Here’s what both pieces of legislation would do:

Both bills would outlaw health insurance practices that set lower
limits on treatment or higher co-payments for mental health services
than for other medical care.

Typical annual limits include 30 visits to a doctor or 30 days of
hospital care for treatment of a mental disorder. Such limits would no
longer be allowed if the insurer had no limits on treatment of
conditions like cancer, heart disease and diabetes.

As a result, the cost of group health insurance premiums likely will go up. However, the bills do not apply to businesses with 50 employees or less or individual insurance.

According to the NYTimes, President Bush initially endorsed mental health parity but came out opposing the current bill because it “would effectively mandate coverage of a broad range of diseases.” Technically, he’s right.

Under the bill, if an insurer chooses to provide mental health
coverage, it must “include benefits” for any mental health condition
listed in the latest edition of the Diagnostic and Statistical Manual
of Mental Disorders, published by the American Psychiatric Association.

The protections of the House bill apply to people who need treatment for alcohol and drug abuse, as well as mental illness.

Covering a broad range of conditions is a step forward, but I realize if group insurers are forced to pay for all conditions listed in the DSM, I can see why premiums would go up. It wouldn’t surprise me if costs increased significantly. No one likes to hear this but if people want better mental health coverage, they need to be willing to pay for it. For those who suffer with mental illnesses, it’s certainly worth the cost.

(By the way, only 47 Republicans joined the 221 Democrats in helping to pass the measure. It has nothing to do with the overall importance of the bill but it was a little annoyance that I had to throw in here. Grr.)

Pregnancy is NOT a mental illness

I stumbled upon Yankee Cowgirl’s blog that mentioned Congress is working on the MOTHERS (Mom’s Opportunity to Access Health, Education, Research, and Support for Postpartum Depression) Act which would “strongly encourage pregnant women into mental health programs – that means drugs – to combat even mild depression during or after giving birth.”

She links to a column written by Byron J. Richards on newswithviews.com. He writes:

The Mothers Act is pending legislation that will indoctrinate hundreds of thousands of mothers into taking dangerous psych drugs.

He goes on to slam Big Pharma about how they control Congress and how mothers don’t need psych drugs for a natural birth process.

The Mothers Act (S. 1375: Mom’s Opportunity to Access Health, Education, Research, and Support for Postpartum Depression Act) has the net affect of reclassifying the natural process of pregnancy and birth as a mental disorder that requires the use of unproven and extremely dangerous psychotropic medications (which can also easily harm the child).

These are some serious accusations. I got pretty riled up myself and decided to see what Congress said in the bill.

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Schizowhat?

Today's lesson, kids: What's the difference between schizoaffective disorder and schizophrenia?

Quick background: I work in a medical field where I constantly have to look at the diagnoses of different "patients." When I see a diagnosis for schizoaffective disorder, my mind goes, "Hmm, isn't that just schizophrenia? Are they trying to name it something different these days?"

No.

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