The Mental Health Minute

Articles and news about mental health issues

UCLA: Little or no treatment for 2 million Californians with mental health problems

One and Other-Mental Health

Image by Feggy Art via Flickr

 

Here’s an article that describes just how poorly we, as a society, are doing in helping those who have a mental illness or are having emotional/psychological issues that are situational.  California leads the nation in the healthcare field.  This article is based on a study funded by the California Department of Mental Health.

 

The statistics in this article are certainly eye-opening.  If we continue to ignore this problem, it obviously is not going to go away.  Many people are suffering unnecessarily because of stigma, money, lack of availability of care, or just lack of knowledge about mental illness.

 

Do we really want to be ostriches with regard to the issue of mental health?  It seems we do.  Please read this article from the Central Valley Business Times and then let me know your opinion on this topic, won’t you?

 

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LOS ANGELES
December 5, 2011 10:42am

 

Serious psychological distress, event difficulty functioning, are commonplace

 

•  ‘There is a huge gap between needing help and getting help’

 
Nearly two million California adults need mental health treatment, but most receive no services or inadequate services, says a new report by the UCLA Center for Health Policy Research.

 

The lack of treatment is in spite of a state law mandating that health insurance providers include mental health treatment in their coverage options, the report says.

 

 

How bad are the problems? The UCLA researchers say one in 12 Californians reported symptoms consistent with serious psychological distress and experienced difficulty functioning at home or at work.

 

 

Over half of these adults reported receiving no treatment for their disorders, and about one-quarter received “inadequate” treatment, defined as less than four visits with a health professional over the past 12 months or using prescription drugs to manage mental health needs.

 

 

The study draws on data from the 2007 California Health Interview Survey (CHIS), which is conducted by the Center.

 

 

“There is a huge gap between needing help and getting help,” says David Grant, the study’s lead author and director of CHIS. “The data also shows large disparities in mental health status and treatment by demographic, economic and social factors. These findings can help direct the state’s limited resources to those in greatest need of help.”

 

 

Unsurprisingly, says the report, uninsured adults had the highest rate of unmet needs (87 percent), which includes receiving no treatment or receiving less than minimally adequate treatment; 66 percent of these adults received no treatment.

 

 

By contrast, 77 percent of privately insured and 65 percent of publicly insured Californians reported unmet needs. Although poverty and mental health needs are strongly correlated, the lower rate of unmet needs by public program participants suggests that these programs are more likely to effectively offer mental health services than even private insurance policies.

 

 

Other findings include:

 

 

• Single adults with children had more than double the rate of mental health needs (17 percent) when compared with all adults (8 percent). Single adults without children had the next highest rate (11 percent). Married adults with or without children had the lowest rates of mental health needs (6 percent and 5 percent, respectively.)

 

 

• Nearly 12 percent of Hispanics born in the U.S. needed mental health treatment, almost twice the level of Hispantic immigrants.

 

 

• Approximately 17 percent of American Indians and Alaska Natives had mental health needs, the highest of all racial and ethnic groups. Native Hawaiian, Pacific Islander and multi-racial groups had the next highest rate, at 13 percent.

 

 

• Nearly 20 percent of these adults needed mental health treatment — more than double the statewide rate.

 

 

• Compared to the general adult population, those with mental health needs had higher rates of chronic diseases such as high blood pressure, heart disease, diabetes and asthma. They were more than twice as likely to report fair or poor health status and five times more likely to report poor health.

 

 

The report was supported by a grant from the California Department of Mental Health.

 

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December 6, 2011 Posted by | Mental Health | , , , | 1 Comment

Obsessive compulsive disorder commonly coupled with depression and bipolar disorder

Person washing his hands

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Here’s an interesting article I found on DailyRx about research investigating the incidence of two or more disorders being present at one time.  I have often wondered about OCD and Bipolar in my 20 years of psychiatric nursing.  They seem to share common characteristics.  Although with a bipolar, the OCD may not express itself quite as obviously as it does in someone who only has OCD; there are, however, many similarities to the behaviors expressed by both groups.

Please read this article and visit the site for more interesting articles.  Let me know your views on the topic if you care to.  I am always open to hearing other people’s ideas about mental health issues.

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The prevalence of mental health disorders along with a recent increase in mental health awareness is beginning to help researchers understand how these disorders develop.

Considering the rarity of mental health diseases such as obsessive compulsive disorder (OCD) and bipolar disorder, one would think it would be quite uncommon for such diseases to occur concurrently in an individual. However, a new study shows very high rates of comorbidity in mental health disorders, increasing the severity of some diseases.

Inform your therapist if you have more than one health issue.

A recent study, available through the Anxiety Disorders Association of America’s journal Depression and Anxiety, investigated the role of comorbidity in the expression of OCD. Kiara Timpano, Ph.D., an assistant professor of psychology at the University of Miami, led the study.

The Structured Clinical Review for DSM-IV was used to evaluate 605 OCD patients. Split into three groups, 13.1% of the group was bipolar, 64.1% were largely depressed, and 22.8% had OCD alone.

Comparisons among the groups analyzed comorbidity patterns, OCD symptoms, and impairments in order to determine the severity of their ailments.

Bipolar disorder patients revealed the most severe symptoms, followed by depression, and finally those with OCD alone. Fortunately, bipolar comorbidty represents a smaller segment.

Timpano explains, “those individuals with comorbid affective disorders, particularly BPD (bipolar disorder), represent a clinically severe group compared to those without such comorbidity.”

Treatments are available for obsessive compulsive disorder, bipolar disorder, and major depression and show great results to many sufferers.

Talk with your doctor if suffering from a mental health disorder.

All information on this site is provided “as-is” for informational purposes only and is not a substitute for medical advice or treatment. You should consult with a medical professional if you have any questions about your health. The use of any information on this site is solely at your own risk.

Copyright © 2008-2011 Patient Conversation Media, inc. All Rights Reserved.

Comments, questions or concerns, please email: info@patientConversation.com

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December 5, 2011 Posted by | Mental Health | , , , , , , , | 3 Comments

It is beginning…….

Here is an article from NBC Los Angeles that show the beginning of the end.  We should all be paying attention to this event, as the rest of the nation’s health care usually follows California’s lead.  Where will these people go?  How will these people get any help?  This is so sad.

Please go to the site and read this article in full, then come back here and leave me a comment about your thoughts on this topic, won’t you?

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Psych Care at Risk in Cedars Shutdown

Cedars Sinai says it will to close most of its mental health services, worrying providers and patients.

By Sharon Bernstein
|  Thursday, Dec 1, 2011  |  Updated 4:21 PM PST

The decision by Cedars Sinai Medical Center to phase out most of its mental health services will rip a hole an already tenuous network of care, rattled providers said Thursday.

The news that within a year the non-profit hospital system would shut down its 51 psychiatric beds and release the 1,800 people who come for outpatient counseling and medication ripped through the region’s mental health community.

Free clinics braced for an onslaught of new patients, and doctors in nearby neighborhoods wondered where they would refer people in need of care.

“It’s devastating news,” said Sheila Forman, who practices in Santa Monica and is also a spokeswoman for the Los Angeles County Psychological Association. “The idea that a big facility like Cedars Sinai would close its doors is a very big deal. A lot of people are in crisis right now, and they need services.”

The hospital is a major player in the region, Forman and others said. Its medical school trained hundreds of psychiatrists, and its facilities have provided internship opportunities for therapists and other professionals.

The institution accepted both Medi-Cal and most health insurance, and also offered a sliding scale for payment. That’s significant in the mental health care today, because many clinicians do not accept insurance, instead expecting patients to pay cash.

Cedars’ policy meant that not only the poor but middle class families as well were able to get in to see a psychiatrist or psychologist when they needed one.

The medical center has said that it will phase out all services not directly related to another specialty, such as cancer treatment or veterans services, within a year.

Hospital officials said the shutdown was prompted by changes in the health care system – including recent reductions in reimbursements for care provided to people who rely on Medi-Cal and Medicaid.

“At a time when the healthcare delivery system in our country is undergoing a massive transformation, every medical center has a responsibility to examine what it should focus on to ensure that it is strong over the long term to serve the community,” said Thomas M. Priselac, Cedars-Sinai’s president and CEO. “In looking at where our core strengths are in a variety of clinical and research areas, how we can best serve the community … this difficult decision needed to be made.”

The cutbacks at one of the region’s premiere medical centers can be seen against a backdrop of difficulties faced by hospitals throughout the state, said Jan Emerson-Shea, spokeswoman for the California Hospital Assn.

Earlier this fall, the administration of Gov. Jerry Brown said it would slash payments for many services covered by Medi-Cal by 10 percent. That move comes on top of expected multi-billion-dollar cuts in Medicare and Medicaid at the federal level once health reform kicks in. At the same time, many employers and insurance companies have been reducing the amount that they are willing to pay for medical services – particularly those provided by mental health professionals.

“Hospitals across California are having to really make some difficult decisions about what types of services they’re going to be able to offer in the future,” Emerson-Shea said.

In Los Angeles County, the clinics that serve the poorest residents are bracing…[read more]

 

December 2, 2011 Posted by | Uncategorized | 2 Comments

Man sentenced to psychiatric hospital still waiting for bed

Here’s an article from the Bangor Daily News that is just unbelieveable!  I found this article while reading a Squidoo lens called Lunatic Asylums which I recommend to anyone who has any interest in the history of mental health care in the world.  Sad story, I have to say.  Not much improved today; just more humane.

Please read the article but do visit the Squidoo lens and read about the history of mental health care globally.

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By Nok-Noi Ricker, BDN Staff
Posted Oct. 25, 2011, at 2:18 p.m.
Last modified Oct. 25, 2011, at 6:57 p.m.Clinton E. Grubbs.
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Courtesy of Penobscot County Jail
Clinton E. Grubbs.

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BANGOR, Maine — Several people called police Tuesday to report a possible escapee after seeing a man who was sentenced on Monday to time at the Riverview Psychiatric Hospital in Augusta for his involvement in a stabbing nearly two years ago.

Clinton Grubbs, 49, of Bangor went to the library at University of Maine at Augusta, Bangor campus, just before noon and to other locations where people recognized his picture from a Bangor Daily News story about his sentencing Monday by Superior Court Justice William Anderson.

“People had read [the] article and seen the picture and saw this guy walking around,” Michael Roberts, deputy district attorney for Penobscot County, said Tuesday. “They were wondering, ‘Did he escape?’”

Bangor had a murder suspect who escaped from Dorothea Dix Psychiatric Center in June and was on the lam for a day before he was caught after he swam to Brewer.

Grubbs, who has been out on bail since shortly after his arrest in January 2010, was sentenced to time at Riverview Monday after Anderson found him not guilty by reason of insanity in the stabbing of a man who lived in the same Essex Street boarding house.

Roberts said he was told at court on Monday that “Riverview did not have a bed for him” and the decision was made to send him to the facility in two weeks.

“He’s suffered from this mental illness since the early ’90s at least and this was the one instance” when he reportedly caused harm to another, Roberts said.

Riverview Superintendent Mary Louise McEwen said Tuesday that she couldn’t talk specifically about patients, but added, “We do have a bed.” She noted that “NCR (not criminally responsible) patients are our top priority for a bed.”

When criminal defendants are sentenced to Riverview, a judge must sign an order that is sent to the State Forensic Service, which then coordinates with Riverview about setting a date for admission.

“We have had no referral for NCR clients in the last few days,” McEwen said. “We do have a bed today. If we had received the appropriate paperwork, we would have been able to coordinate an admission.”

Grubbs has not been involved in any known crimes in the nearly two years he has been out on bail, Roberts said.

Grubbs was accused of stabbing a 57-year-old man in the side of his abdomen and his right hand with a 4-to-5-inch chopping-style knife on Jan. 6, 2010. Frederick Pond of Bangor underwent emergency surgery that same day. He died on April 27, 2010, according to an obituary published in the Bangor Daily News.

Grubbs entered a no contest plea to elevated aggravated assault at the hearing Monday at the Penobscot Judicial Center.

“I know he is out on bail. We don’t have a hold on him,” Penobscot County Sheriff Glenn Ross said Tuesday.

While McEwen said Riverview had a bed available on Tuesday, Ross noted “capacity is a big issue. Capacity is something I’m very concerned about,” especially with recent talks about closing Dorothea Dix, one of three facilities that can take Penobscot County Jail inmates who are mentally ill.

The jail and Riverview have an agreement to have one bed on hand if needed. “It’s almost never available,” Ross said.

It’s easy to blame facilities when the spotlight should be placed on the rules, the sheriff said.

“Let’s look at the system,” he said, adding that without fundamental changes, “I don’t see it getting better. I only see us digging the hole deeper.”

A librarian at UMA Bangor called security at about noon Tuesday to say Grubbs was in the library. Campus security then called Bangor police to investigate.

“I can confirm we went to the library and that Mr. Grubbs was there and that no criminal action was taken and we cleared,” Bangor police Sgt. Paul Edwards said in a statement.

Grubbs also was seen at other locations by people who called police, Roberts said.

BDN writer Judy Harrison contributed to this report.

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October 27, 2011 Posted by | Mental Health | , , , , , | Leave a comment

Mentally ill behind bars

This was an article I found in the Springfield News-Leader.  It eloquently portrays the tasks facing the prison system in Missouri.  It is almost as if the prison system has become the “new” mental health system.

This trend is continuing at an alarming rate.  Prison is not equipped to help mentally ill people.  There is no treatment except medications there.  They have no one to help them hook up with services when they are released.  Granted, there are many mentally ill people in prison who need to be because they are too dangerous to leave unattended in the population.  But the majority of the mental patients in our jails have been unlucky enough to have fallen through the cracks of a seriously cracked mental health system.

Please read this entire article, even though it is long.  It is worth the time and effort and will give you some insight into what the prison employees are having to deal with daily without any prior or special education.

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Melissa Ussery, mental health coordinator at the Greene County Jail, interviews an inmate. / Bob Linder / News-Leader

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Written by
Jess Rollins
News-Leader
Missouri State Hospital No. 3 at Nevada, shown in May 1925, housed 1,200 at its peak. / File photo, 1925

//

A slender young man in glasses sits at a small plastic table in the observation wing of the Greene County Jail.

Across from him, Melissa Ussery, mental health coordinator at the jail, asks if he is doing better.

Last week, he surprised Ussery by handing her something in a handkerchief. He had pulled out all 10 of his toenails.

“I’m actually content now. I’ve just been in there reading,” he says, pointing to his cell.

A few questions later, Ussery asks how often he thinks of harming himself or hurting guards. He says he wouldn’t but he sometimes has “the urge to do it all over again.”

This young man, who has borderline personality disorder, is one of about 50 inmates in the jail at any given time diagnosed with a serious mental illness like schizophrenia, bipolar or major depression.

Many involved in the area’s mental health system say the Greene County Jail has become the largest mental health care facility in southwest Missouri — the de facto mental hospital.

Meanwhile, the cost to house someone with a mental illness is nearly double the cost of housing a healthy inmate. According to officials and advocates, it’s an expensive, frustrating, dangerous problem.

Although mentally ill inmates receive some services in jail, they are often released without a path to continue treatment. With what many perceive as a lack of community resources, the cycle continues.

As cuts to programs for those most at risk persist, many see no end in sight.

Nowhere else to go

Every day, Ussery, the only licensed psychologist at the jail, makes her rounds.

In the female pod, Ussery talks to a young woman with straight blond hair.

“Have you thought of hurting yourself?”

“Are you seeing anything?”

“What year is it?”

At each question, the young woman pauses. She looks to the left, then to the ceiling, to the right, back to the left.

“We think she is hearing voices,” Ussery explains later.

The long pauses and wandering eyes are a type of screening of what the woman hears, according to Ussery; that’s common among those diagnosed with schizophrenia…[read more]

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October 21, 2011 Posted by | Mental Health | , , , , , | 1 Comment

Police training addresses suicide, domestic violence, road rage, DWI

Calgary police brutality cover-up?

Image by thivierr via Flickr

Here is an article from the Poughkeepsie Journal that illustrates the frustration felt by ill-equiped police when faced with a mentally ill person.  In the past, that person was either ignored or thrown in jail.  Current trends are to train the police in more “politically correct” treatment for the mentally ill.

While I wholeheartedly agree that police could stand to learn more about dealing with the mentally ill since they do it regularly, I doubt that the training is going to change anything in a major way.  The problem is that police have a totally different mindset than that of a social worker or psychiatric nurse.  They have no patience for hand-holding people who are endangering the lives and livelihood of others.  Their initial police training is in containment and arresting.

I applaud the Poughkeepsie police for their forward thinking and willingness to extend themselves.  I think there is some aspect of self-defense involved also, because, as this article states the police are frequently the first line in dealing with a mentally ill person; and with budget cut-backs, there doesn’t look to be any relief for quite some time.

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Written by
Shantal Parris Riley
Poughkeepsie Journal

They’re often the first to arrive on the scene in a mental health crisis.

Police and other law enforcement serve as public protectors — but, at a moment’s notice, when confronted with a situation involving a mentally disturbed person, they become social workers.

“Mental health issues are prevalent on the job,” Town of Poughkeepsie Police Chief Thomas Mauro said. “They occur with regular frequency.”

Regional police are preparing for an upcoming training series, titled “Responding to Situations Involving Emotionally Disturbed People: An In-Service Curriculum Orientation,” to be held in Orange County in February.

The curriculum, offered through the state Division of Criminal Justice Services and Office of Mental Health, will provide police with training on suicide assessment and intervention and a host of topics covering mental illness. The training course is designed to supplement the mandated training provided to police recruits.

From incidents of road rage and driving while intoxicated, to emotionally charged incidents of domestic abuse, police are faced with issues of mental health daily, Mauro said.

“Sometimes, there’s a conflict between our role as law-enforcement officers and the secondary social work aspect of law enforcement,” he said. “You’re trying to draw a balance between your responsibilities to maintain public safety and trying to do what is in the best interest of the person you’re dealing with.

“The difficulty can often be with communication.”

Mauro, who has decades of training in suicide intervention, crisis negotiation and stress management, said “talk tactics” often involve putting time into a conversation to calm or slow a person down.

Town of Poughkeepsie police had training in 2010 on “de-escalation techniques” to include listening with empathy and focusing on behavior, not the person.

This and other training was put to critical use in August 2010 when a 22-year-old man threatened to jump from a ledge of the sixth floor parking lot at Saint Francis Hospital after escaping from family members who drove him there for a mental health evaluation…[read more]

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October 19, 2011 Posted by | Mental Health | , , , , , , , , | 4 Comments

Global Study Tracks Pediatric Mental Illness Incidence, Treatment

The Lancet

Image via Wikipedia

Here is an article from Clinical Psychiatry News  showing that mental illness is a global concern and we, as a people, are doing miserably at attending to the needs of this population globally.  Children, especially, are vulnerable to in-utero exposure to toxins, and can end up with mental illness from that exposure.

Environmental toxins, major health outbreaks, poor nutrition all contribute to the number of mentally ill people across the globe.  But this article goes on to say that there are interventions that are effective if put in place early enough, but because some country is poor or moderately poor, they have no funds to implement these easy fixes.  Their citizens then are left unprotected and untreated, for the most part.

This article is an attempt to show that we are neglecting the needs of the mentally ill at an alarming rate.  Please go to the original site and read not only this article, but others similar to educate and enlighten yourself on the plight of the mentally ill globally.

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By: JENNIE SMITH, Clinical Psychiatry News Digital Network

 

Up to one in five children and adolescents worldwide has a mental health disorder, according to a broad-ranging new study, yet mental health interventions, and the research to support them, are neglected in low- and middle-income countries.

While 90% of the world’s 2.2 billion children and adolescents live in low- and middle-income countries, researchers found, only 10% of mental health trials for this population are conducted in these countries.

A dearth of research expertise in low- and middle-income countries is one contributing factor, said Atif Rahman, Ph.D., of the University of Liverpool and Alder Hey Children’s NHS Foundation Trust, in Liverpool, U.K., the corresponding author of the study.

“In most developing countries, the universities are not really geared up for research,” Dr. Rahman said in an interview. “If there’s not enough research infrastructure and no career structure for researchers, it’s not really going to be possible to do the research on the types of psychological and psychosocial interventions that work in these countries,” he said. And less than a third of low- and middle-income countries have a national policy that deals with mental health among children and adolescents.

The findings were published Oct 17 in the Lancet ([2011 [doi:10.1016/S0140-6736[11]60827-1]) as part of a global mental health series that explored disparities in mental health prevention and treatment worldwide.

Another article in the series (Lancet 2011 [doi:10.1016/S0140-6736[11]61093-3]) found that trained mental health clinicians can be surprisingly scarce in developing countries, because of emigration: Sri Lanka, for example, had only 25 psychiatrists living there in 2007, while 142 who trained there had emigrated. A third paper, led by another group of international researchers (Lancet 2011 [doi:10.1016/S0140- 6736[11]60891-X]), found that children were not alone in getting inadequate mental health attention – that while 1 in 3 people with a mental health problem in wealthy nations receives treatment, in developing countries, it can be as few as 1 in 50.

For their research, Dr. Rahman and his colleagues analyzed epidemiologic studies to determine the prevalence of child and adolescent mental health problems in low- and middle-income countries. They also looked at randomized controlled trials evaluating preventative and treatment strategies.

They identified a number of effective interventions – particularly school- and community-based programs, in such diverse countries as China, Mauritius, and Iran – that were shown to successfully address behavioral problems, drug use initiation, and anxiety.

Maternal and child nutritional supplementation, immunization programs, reduction of exposure to toxins, maternal health interventions, malaria prevention, and early stimulation programs were all found to prevent cognitive deficits in low- and middle-income countries.

While there are a number of trials for preventative interventions in low- and middle-income countries, “There are only a handful of treatment trials,” Dr. Rahman said. Of the more than 670 treatment trials the investigators identified for the study, 58 came from middle-income countries and only 1 was from a low-income country.

The researchers decided to include in their analysis some treatment trials done in low-income populations in higher-income countries, such as those enrolling African-American children in the United States, noting that many mental health risk factors for children and adolescents were found to be similar across higher- and lower-income countries.

But Dr. Rahman noted that interventions developed in the West might not be feasible in lower-income settings where, for example, mental health specialists may be few and far between.

“Mental health problems in children in high- and low-income countries may share similar risk factors, especially in poor and disadvantaged communities. How you treat them will be very different depending on the health, social, and community-based systems available. There is the issue of who is there to deliver them – in a low-income setting you might have to adapt your interventions or develop new ones so that nonspecialists can deliver them,” he said.

“This is why the 90-10 research gap is so important,” Dr. Rahman continued. “You can’t just implement a strategy developed in the West. You have to find the right one, which is culturally appropriate and feasible, and requires research, trials, and cost-effectiveness analyses.”

In addition to calling for more randomized controlled trials, Dr. Rahman and his colleagues made several recommendations, based on their findings, for child and adolescent mental health programming in low- and middle-income countries.

Integration with existing, community-based systems is feasible, they wrote.

Early interventions and rehabilitative or curative interventions “need to develop side by side, which can be made efficient by task sharing,” they wrote, and advised partnering with physical health programs and agencies outside the health sector – in education, social care, and criminal justice. And finally, they wrote, “awareness programs and mobilization of potential stakeholders should be considered as part of any child and adolescent mental health service development.”

The researchers noted as a limitation of their study a heterogeneity in the prevalence studies that prevented either direct comparisons between countries or meta-analytic approaches. Two of Dr. Rahman’s coauthors reported disclosures: Dr. Christian Kieling took part in meetings sponsored by Novartis, Shire, and Deva. Dr. Luis Augusto Rohde acted as speaker or consultant for Eli Lilly, Janssen-Cilag, Novartis, and Shire, and received program funding and research support from those companies.

There was no external funding, and each of the researchers contributed their time to the study.

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October 17, 2011 Posted by | Mental Health | , , , , , | Leave a comment

Friday Videos!

Here are some videos to enlighten, entertain and educate us all.

October 14, 2011 Posted by | Uncategorized | Leave a comment

Mental First Aid: How To Help In An Emotional Crisis

Werner Erhard and Associates v. Christopher Co...

Image via Wikipedia

Here is an article that denotes a personal struggle with OCD, an anxiety disorder.  She is one of the lucky ones who got help and then went out to find a way to help others.  OCD is a terrifying illness and I am so happy she was able to overcome it enough to participate in learning to help others with this and other mental illnesses.

Mental illness is an equal opportunity player.  No one is excused or exempt from playing in this game.

Learning the skills to help a mentally ill person is fairly easy to do.  What is hard is challenging your own beliefs about the mentally ill and making changes in your own behavior toward them.

I am reposting this article for NPR in its entirety because I believe the more people that are exposed to this message the better.  Please do click over and leave them a comment at the original site.

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by Kelley Weiss

October 10, 2011

When Nikki Perez was in her 20s, she had a job as a lab tech at a hospital in Sacramento, Calif. She said everything was going well until one day, when something changed.

“I worked in a very sterile environment, and so part of the procedure was to wash your hands,” she said. “I found myself washing my hands more and more, to the point where they were raw, and sometimes they would bleed.”

Perez went to the doctor and was diagnosed with something she had never even heard of — obsessive-compulsive disorder. At the time she was living with her parents. She quit her job and went on short-term disability.

Researchers say 1 in 4 adults has a mental disorder. But while many Americans are trained in first aid and CPR to respond to medical emergencies, few are prepared to help others experiencing a mental health crisis.

Perez said her illness turned her life upside down. She would sit in her parents’ room watching TV on the floor, afraid to move. She didn’t want to get caught up in the obsessive routines around the house.

“You check locks, check the washer, check the doors, check the window — I did a lot of checking,” she said.

Overall, it was profoundly isolating. Her family, like many people, didn’t know how to handle mental illness.

Finally, she got treatment, but her experience made her want to learn more about mental health issues so she could help others in crisis.

Emotional Crises More Common Than Heart Attacks

She found just the right class, called Mental Health First Aid. Bryan Gibb is the director of public education for the National Council for Community Behavioral Healthcare, which runs the course.

“We often train to know CPR or the Heimlich maneuver or first aid. But the reality is, it’s much more likely that we’re going to come in contact with someone suffering from an emotional crisis than someone suffering a heart attack or choking in a restaurant,” he said.

In a 12-hour course, Gibb teaches people how to identify different types of mental illness: depression, anxiety disorders, psychosis, eating disorders and substance abuse.

Part of the learning process involves group exercises. Nikki Perez participated in one that simulated what it’s like for people who hear voices. She tried to have a conversation while someone whispered in her ear “don’t trust him,” “you’re a failure,” and “is he looking at you?”

After the class, members who get this firsthand perspective of the different symptoms of mental illness then learn how to approach someone who’s having a psychotic episode. They’re told to speak calmly and clearly, and not to dismiss or challenge the person about their hallucinations.

Direct Questions For The Suicidal

As with any first-aid course, there’s an Action Plan for what to do if someone’s in crisis: assess the person for risk of harm or suicide, listen non-judgmentally, give reassurance, and encourage the person to seek professional help.

Gibb says that for this to work, people need to force themselves to ask direct questions: Are you thinking of killing yourself? Do you have a plan? Do you have the things you need to complete that plan?

Gibb told the class to never leave an actively suicidal person alone and to call the police if the person has a weapon or is acting aggressively.

Longtime mental health advocates with the National Alliance on Mental Illness, or NAMI, say courses like this raise awareness about mental illness. Jessica Cruz, executive director of NAMI California, said this reduces the stigma around getting help.

“If people know that others are trained in how to deal with a crisis situation, they may even reach out for help before they even get to that crisis point,” she said.

Cruz is so impressed with the course, her own staff is going to be trained next month.

“It seems like it could be just universally applied, just like CPR,” Cruz said.

That’s already under way at schools, the workplace and churches. Since it started three years ago, more than 30,000 people have been trained around the country; another 20,000 are expected to get training by the end of the year.

Perez says she would recommend this course to anyone.

“I think it’s one of the best things that I’ve ever done for myself so far,” she said.

The National Council for Community Behavioral Healthcare said thousands of people like Perez now have the skills to help those experiencing a mental health crisis. But the group emphasized that this is first-aid training and should be used to keep someone safe and stabilized until the professional help arrives, just like if you’re responding to someone having a heart attack.

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October 12, 2011 Posted by | Mental Health | , , , , , | 2 Comments

Patients suffer when reimbursements for mental health care are reduced

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Here is an article written by a nurse about the way an insurance company manipulates the coverage and prevents payouts.  The targeted population for this tactic is the mentally ill, who cannot advocate for themselves and require nurses and mental health professionals to do so for them.

This article is from the OregonLive.com, and is a guest post by Susan King.  She speaks eloquently and obviously from her heart.  Please read this article and let your elected officials know that this type of behavior by insurance companies is totally unacceptable to you.

Please visit the site for other articles that may interest you, too.  Don’t forget to leave a comment!

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By Susan E. King

Your editorial “Sick, insured, and nowhere to turn” (Oct. 2) exposed tactics that Blue Cross Blue Shield of Massachusetts has used to decrease the financial impact of their insured customers with mental illness on the company’s bottom line. Such tactics clearly discriminate against people trying to maintain their health and further stigmatize those struggling with diagnoses of mental illness.

Unfortunately, Massachusetts isn’t the only state in which health insurance companies try to evade the intent of mental health parity laws. In 2009, many mental health professionals across Oregon received notice from Regence Blue Cross Blue Shield that their reimbursement rates for provision of mental health services would be reduced by 25 percent. Why? According to Regence, these providers were not physicians and, as a result, they were being paid “above the market” for their services. Nurse practitioners who had a large number of patients covered by Regence and who were treating the exact same diagnoses (and billing under the exact same codes as psychiatrists) were subjected to this arbitrary decrease in reimbursement rates.

The result? According to a recent survey of mental health nurse practitioners from across the state, the 25 percent reduction in reimbursement has had a serious impact on the financial viability of many NP practices. NPs report that the reduced reimbursements have led to reduced capacity to provide care to mental health clients, significantly longer wait times for appointments, limitations in the types of services available, and some have even reported they are considering clinic closure.

In a state that is already experiencing serious challenges in the provision of mental health services, Regence’s unilateral decision to reduce reimbursement rates simply exacerbates this problem, putting even more pressure on an already stressed system.

Those of us who provide health know that if patients are unable to access care in a clinic or non-hospital setting, some of them will seek care when their illness is much more expensive to treat such as when they are in crisis or, in the case of mental illness, when their behavior intersects with law enforcement. Providing care in the ER or when a patient is in crisis is dramatically more expensive.

Insurers should help ensure that those they cover seek care in the most appropriate and most cost effective setting. Reducing reimbursement for nurse practitioners, creating more barriers to access for patients and refusing to pay the same fee for the same service, is not the way to support patients or to reduce costs.

Susan E. King is the director of the Oregon Nurses Association.

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October 9, 2011 Posted by | Mental Health | , , , , , , , , , , | 1 Comment