Some psych patients wait days in hospital ERs

Emergency rooms, they say, have become all-purpose dumping grounds for the mentally ill, with patients routinely marooned a day or more while health care workers try to find someone to care for them. A survey of hundreds of U.S. hospitals released last month by the American College of Emergency Physicians found that 79 percent reported that they routinely "boarded" psychiatric patients in their waiting rooms for at least some period of time because of the unavailability of immediate services. One-third reported that those stays averaged at least eight hours, and 6 percent said they had average waits of more than 24 hours for the next step in a patient's care.

Major Problem Often Overlooked When Linking Violence, Illness

Public and professional attention in recent years has tended to focus on whether people with mental illness are more likely than others to commit acts of violence, but a new study suggests that violent victimization of these individuals may be the greater public health problem.
A literature review of studies published since 1990 on the perpetration of violence by, and violent victimization of, mentally ill individuals indicates that victimization is considerably more common than perpetration. The study was published in the February Psychiatric Services as part of a special issue on violence and mental illness.
Among outpatients, 2 percent to 13 percent had perpetrated violence in the prior six months to three years, compared with 20 percent to 34 percent who had been violently victimized. Studies combining outpatients and inpatients reported that 12 percent to 22 percent had perpetrated violence in the prior six to 18 months, compared with 35 percent who had been a victim in the preceding year. "Although society may regard persons with mental illness as dangerous criminals, our review of the literature shows that violent victimization of persons with severe mental illness is a greater public health concern than perpetration of violence," wrote lead author Linda Teplin, Ph.D., and colleagues in their report.

Point Counterpoint Essays on HR 2640 (Gun Control Law)

About 3%-5% of all violence in the United States is perpetrated by individuals with mental illness. But the risk of violence is much higher with “rampage killers,” those who go into schools, malls, and other public places and shoot. About 50% have a history of mental illness and 8% have been committed. Legislation recently passed in the House of Representatives is a good idea if even one life is saved. The bill, H.R. 2640 (the National Instant Criminal Background Check System Improvement Amendments Act of 2007), would require the states to update the NICS with the names and other identifying information of people committed to mental institutions so that they could not buy firearms.

BUT

We still have no data to show that this approach would be effective. Guns are widely available from legal and illegal sources in the United States. Federal purchase restrictions only apply to purchases from a dealer. They do not affect those who already own guns, obtain a gun from another person, or buy one at a gun show. If even a single life could be saved by stopping gun purchase by mentally ill patients, why not do it? Because the costs would vastly outweigh a small likelihood of benefit. The financial impact will be enormous. The federal bill offers states $1 billion to participate in a national database. Think of what else we could do with that money to combat gun violence.

Ranking America's Mental Health: An Analysis of Depression Across the States (Missouri Ranks #45)

Depression is a chronic illness that exacts a significant toll on America's health and productivity. It affects more than 21 million American children and adults annually and is the leading cause of disability in the United States for individuals ages 15 to 44.
Lost productive time among U.S. workers due to depression is estimated to be in excess of $31 billion per year. Depression frequently co-occurs with a variety of medical illnesses such as heart disease, cancer, and chronic pain and is associated with poorer health status and prognosis. It is also the principal cause of the 30,000 suicides in the U.S. each year. In 2004, suicide was the 11th leading cause of death in the United States, third among individuals 15-24.
Despite significant gains in the availability of effective depression treatment over the past decade, the level of unmet need for treatment remains high. On average, people living with depression go for nearly a decade before receiving treatment, and less than one-third of people who seek help receive minimally adequate care.
"Ranking the States: An Analysis of Depression Across the States" was researched and written by Mental Health America and Thomson Healthcare. It looks at data from 2002-2006 and was conducted from July to November 2007. The report compares depression levels and suicide rates in all 50 states and the District of Columbia and uses the information to highlight solutions to improve states' mental health status.

States Face Decisions on Who Is Mentally Fit to Vote

Rhode Island is among a growing number of states grappling with the question of who is too mentally impaired to vote. The issue is drawing attention for two major reasons: increasing efforts by the mentally ill and their advocates to secure voting rights, and mounting concern by psychiatrists and others who work with the elderly about the rights and risks of voting by people with conditions like Alzheimer’s disease and dementia.