This is a blog for the Mental Health Policy Class at the George Warren Brown School of Social Work.

February 28, 2007

The Stigma of Mental Illness

Five times he called her a "loon" or "lunatic." Each time, the peace activist reacted to Bill O'Reilly's name-calling with a shrug or smirk. But this encounter on "The O'Reilly Factor" raised the question: Who was more outrageous? Was it O'Reilly for using words that some might interpret as slurs? Or was it the activist for not taking him to task?

A Compelling Argument for Universal Health Insurance

For Want of a Dentist
Boy Dies After Bacteria From Tooth Spread to Brain
By Mary OttoWashington Post Staff WriterWednesday, February 28, 2007; Page B01
Twelve-year-old Deamonte Driver died of a toothache Sunday.
A routine, $80 tooth extraction might have saved him.
If his mother had been insured.
If his family had not lost its Medicaid.
If Medicaid dentists weren't so hard to find.

February 21, 2007

Can People with Mental Illness Receive Adequate Treatment in Prisons?

Mentally Ill Inmate Dies Alone (60 Minutes Episode). Scott Pelley looks at the case of Timothy Souders. The inmate's death was recorded on camera while he was in solitary confinement and has instigated a look at the prison's mental health care.

America's Children: Key National Indicators of Well-Being

Presents statistics about children’s economic security, health, behavior, social environment, and education. This biennial report to the Nation on the condition of children in America provides nine contextual measures describing the changing population, family, and environmental context in which children are living, and 25 indicators depict the well-being of children in the areas of economic security, health, behavior and social environment, and education. The 2005 report has special features on children with asthma, children with specified blood lead levels, and parental reports of children’s emotional and behavioral difficulties. In addition, the report includes a special section on family structure and the well-being of children. The Federal Interagency Forum on Child and Family Statistics produces this annual report, which offers the most recent available data from official sources in a nontechnical, user-friendly format.

February 20, 2007

How Do We Solve the Problem of Doctor Shortages in Rural America?

The Wall Street Journal takes a close look at physician shortages in rural areas, noting that the problem is getting worse because of "an unusual tale of two visa programs." The J-1 visa waiver program since 1994 has allowed foreign physicians to become eligible for green cards, so long as they agree to work for three years in medically underserved areas. The program "has provided more than 1,000 doctors annually to underserved areas, outperforming scholarship and loan programs designed to attract young U.S. doctors to these same places," the Journal reports. Health centers like Yakima Neighborhood Health Services, which is featured in the WSJ story, rely on the J-1 visa program for their work force. But because of an expansion of the H1-B visa waiver program enacted in 2000 to provide U.S. companies with more foreign high-tech workers, hundreds of foreign physicians "are bypassing the J-1" and "are securing an H1-B, which doesn't require the rural stint," says WSJ. Now the number of foreign physicians with J-1 visas has dropped from 11,000 in 1995-1996 to 6,000 in 2005-2006. You can read the full story here. Download wall_street_journal_article_yakima_doctors.pdf

A Local Example of Advocacy (Post Dispatch Story)

"What's really disturbing is it's the one form of mental retardation birth defect that is 100 percent preventable," says Melinda M. Ohlemiller, director of prevention and advocacy for St. Louis Arc, an agency that advocates for people with birth defects. So the fight against fetal alcohol syndrome can be won without compromise, Ohlemiller says. That's why health experts have increased their warnings about drinking while pregnant. Even that one glass of red wine at night or a couple of beers on the weekend can have consequences for your unborn child, says Dr. Mark Mengel, professor of family and community medicine at St. Louis University School of Medicine.

February 16, 2007

Drugs, Brains, and Behavior: The Science of Addiction

The National Institute on Drug Abuse (NIDA) has released a layman's guide to alcohol and other drug addiction to complement the new HBO documentary series "Addiction," which premieres in Washington, D.C., this week.
"Drugs, Brains, and Behavior: The Science of Addiction" is a 30-page booklet that provides an overview of the science supporting the concept of addiction as a brain disease. Information on prevention and treatment also is included.

February 15, 2007

What is the Prevalence of Autism in the United States?

U.S. health officials say autism rate about 1 in 150, higher than previous estimates WASHINGTON — About one in every 150 children in the United States has autism or a closely related disorder — a figure higher than most recent estimates — according to a federal survey released Thursday, the most thorough ever conducted. The new data do not mean that autism is on the rise, because the criteria and definitions used were not the same as those used in the past. But the number of children apparently affected — 560,000 nationwide if the new statistics are extrapolated to all 50 states — makes autism an "urgent public health issue" and a "major public health concern," said Marshalyn Yeargin-Allsopp, chief of the developmental disabilities branch of the Centers for Disease Control and Prevention, which conducted the survey.
Missouri democrats push for mental health program
JEFFERSON CITY — House Democrats proposed on Monday to expand funding for a mental health program that provides intensive care for the homeless, people with substance abuse problems and those who are unaware that they are ill. Supporters say the program is designed for patients who have struggled with the traditional model, which assigns patients a case worker who helps them secure a variety of health services. Jackie Lukitesch, executive director of the St. Louis office of the National Alliance on Mental Illness, said the biggest difference between the more intense treatment and traditional models is that patients who miss treatments and appointments are not automatically removed from the program. "They go out and seek out why, if they don't come in, and do not discharge them," she said.
The stepped-up care, called "assertive community treatment," has been used in several states. The Department of Mental Health asked for $5 million to fund the program in its budget requests for the next fiscal year, but Gov. Matt Blunt did not include it in his budget recommendations. A spokeswoman for Blunt said the governor had not included funding for the program "because of funding constraints."

February 14, 2007

Why Do I Need to Learn How to Set Up a Blog?

Blogging clicks with educators Chicago Tribune: "Mundelein High School social worker Julie Wheeler wanted to reach students and parents in a non-threatening way, so she took a lesson from the kids and started her own blog."

The Prescription Project Lauched

Community Catalyst and the Institute on Medicine as a Profession launched The Prescription Project on Feb 12, 2007, calling on academic medical centers, professional medical societies and public and private payers to end conflicts of interest resulting from the $12 billion spent annually on pharmaceutical marketing. Building on a series of reforms recommended last year in an article in the Journal of the American Medical Association (JAMA), the project will conduct and publicize research on conflicts of interest, advocate for policy reforms that will eliminate such conflicts, and promote prescription practices that are based on scientific evidence...

February 12, 2007

How Would Mental Health be Afffected by the President's Proposed Budget?

Significant cuts to the budgets of the Center for Substance Abuse Treatment (CSAT) and the Center for Substance Abuse Prevention (CSAP) were some of the lowlights of the Bush administration's budget for the Substance Abuse and Mental Health Services Administration (SAMHSA) -- part of an FY2008 spending plan that trims or eliminates a number of prominent federal discretionary programs.
"Bush's proposal would provide a big increase in military spending to fight the war in Iraq while squeezing federal health-care programs and cutting most domestic agencies to below fiscal 2006 levels to meet his goal of eliminating the deficit in five years," noted the
American Counseling Association.

Evolutionary Psychopathology

Evolutionary psychology sees the mind as a set of evolved mechanisms, or adaptations, that have promoted survival and reproduction. Evolutionary psychopathology — abnormal psychology through an evolutionary lens — looks at what has gone wrong. The discipline is so new that "some people would say it hasn't started yet," jokes Randolph M. Nesse, a professor of psychiatry at the University of Michigan, and one of its pioneers. No one paradigm has won universal acceptance. Evolution-based therapies rely on an eclectic mix of techniques, and their effectiveness is still being tested.

The VA, Iraq and PTSD

The Department of Veterans Affairs is facing a wave of returning veterans who are struggling with memories of a war where it's hard to distinguish innocent civilians from enemy fighters -- and where the threat of suicide attacks and roadside bombs haunts the most routine mission.
Since 2001, about 1.4 million Americans have served in Iraq, Afghanistan or other locations in the global war on terror. The VA counts post-traumatic stress disorder, or PTSD, as the most prevalent mental-health disorder -- and one of the top illnesses overall -- to emerge from the wars.

Providing Mental Health Services for Prisoners in New York

Spitzer plan aids mentally ill inmates: Governor proposes adding $60 million for improved, more humane services

ALBANY -- In response to long-standing calls for better treatment for the most vulnerable segment of the prison population, Gov. Eliot Spitzer proposes to increase state spending by $60 million over three years on services for mentally ill inmates. The proposal was praised by advocacy groups that say it signals a heightened commitment toward humane care of prisoners with severe psychiatric needs.

The Power of Advocacy

The latest Super Bowl score: Advocacy Groups 2, Advertisers 0.
In the second capitulation by a corporate behemoth in less than a week, General Motors yesterday agreed to modify a TV commercial it aired during Sunday's Super Bowl to address complaints from interest groups.
Mental health organizations had peppered GM with protests about the ad, contending that it trivialized suicide. In the commercial set to the strains of Eric Carmen's "All by Myself," a clumsy auto factory robot throws itself off a bridge in despair after being drummed off an assembly line. GM said it would edit the ad to eliminate the bridge sequence.

February 6, 2007

Is It Appropriate to Lie to Get Services for Your Clients?

In 1977, Randy Revelle says, he almost killed his two young children with a fireplace poker during a psychotic hallucination brought on by untreated bipolar disorder. But at the time, his health insurer didn't cover psychiatric treatments and his family couldn't get him hospitalized. . . . "In order to get admitted, we had to threaten the doctor with jail and lie about the diagnosis," said Revelle. He responded quickly to lithium, which he still takes today, and went on to become King County executive from 1981 to 1985.

Kids' Suicides Rise, CDC Report Finds

New government figures show a surprising increase in youth suicides after a decade of decline, and some mental health experts think a drop in use of antidepressant drugs may be to blame.
The suicide rate climbed 18 percent from 2003 to 2004 for Americans under age 20, from 1,737 deaths to 1,985. Most suicides occurred in older teens, according to the data _ the most current to date from the federal Centers for Disease Control and Prevention. By contrast, the suicide rate among 15- to 19-year-olds fell in previous years, from about 11 per 100,000 in 1990 to 7.3 per 100,000 in 2003.
Suicides were the only cause of death that increased for children through age 19 from 2003-04, according to a CDC report released Monday. "This is very disturbing news," said Dr. David Fassler, a University of Vermont psychiatry professor. He noted that the increase coincided with regulatory action by the U.S. Food and Drug Administration that led to a black box warning on prescription packages cautioning that antidepressants could cause suicidal behavior in children. Fassler testified at FDA hearings on antidepressants during 2003 and 2004 and urged caution about implementing black box warnings. The agency ordered the warnings in October 2004 and they began to appear on drug labels about six months later.

February 2, 2007

Was this Sentence Appropriate?

Okla. Woman Guilty of Harming Daughter - New York Times: "A woman who experts said has a rare mental disorder has been sentenced to more than 15 years in prison after admitting she injected fecal matter into her infant daughter. Sarena Sherrard, 31, pleaded guilty Tuesday to child abuse charges. Two mental health care providers, who have cared for Sherrard since her arrest, testified she could not resist the urge to harm her daughter. They blamed a disorder known as Munchausen syndrome by proxy, in which parents create or exaggerate injury to a child to bring attention to themselves. The cause is unknown. Sherrard was arrested in August 2005 after surveillance video showed her injecting a foreign substance into her daughter's catheter at Children's Hospital in Oklahoma City. Police had put the girl's room under surveillance because doctors suspected someone was harming her, according to court papers."