Suicidal Acts Using Firearms Highly Lethal Compared to Other Means

Boston, MA -- In the first nationally representative study to examine the relationship between survey measures of household firearm ownership and state level rates of suicide in the U.S., researchers at the Harvard School of Public Health (HSPH) found that suicide rates among children, women and men of all ages are higher in states where more households have guns. The study appears in the April 2007 issue of The Journal of Trauma.
"We found that where there are more guns, there are more suicides," said Matthew Miller, Assistant Professor of Health Policy and Management at HSPH and lead author of the study.
Suicide ranks as one of the 15 leading causes of death in the U.S.; among persons less than 30 years old, it is one of the top three causes of death. In 2004, more than half of the 32,439 Americans who committed suicide used a firearm.

Lawmakers urge closing gaps in federal-state gun laws

WASHINGTON -- Grappling with the deadliest shooting spree in U.S. history, lawmakers said Sunday they want to eliminate a gap between state and federal laws that can allow someone with a history of mental illness to buy guns.

Members of Congress have shown little political appetite, however, for attempting to expand federal gun control in response to the massacre at Virginia Tech.

Seung-Hui Cho, who gunned down 32 people on campus and killed himself Monday, was evaluated at a psychiatric hospital in late 2005 and deemed by a judge to present "an imminent danger to himself as a result of mental illness." That should have disqualified him from purchasing a gun under federal law, experts say.

But Virginia court officials insist that because the judge ordered only outpatient treatment -- and did not commit Cho to a psychiatric hospital -- they were not required to submit the information to be entered in the federal databases for background checks.

Lawmakers pushed Sunday to eliminate such breakdowns. They called for uniformity between state and federal reporting to make background checks more dependable.

How Should Universities Respond to Potentially Violent Students?

For the most part, universities cannot tell parents about their children’s problems without the student’s consent. They cannot release any information in a student’s medical record without consent. And they cannot put students on involuntary medical leave, just because they develop a serious mental illness.

Nor is knowing when to worry about student behavior, and what action to take, always so clear.

“They can’t really kick someone out because they’re writing papers about weird topics, even if they seem withdrawn and hostile,” said Dr. Richard Kadison, chief of mental health services at Harvard University. “Most state laws are pretty clear: you can only bring students to hospitals if there is imminent risk to themselves or someone else, so universities are in a bit of a bind that way.”

Phil Zimbardo on the Daily Show

Stanford social psychologist Philip Zimbardo discusses his book The Lucifer Effect and similarities between the Stanford Prison Experiment and Abu Ghraib.

Resisting the Drums of War

Social psychologist Roy Eideslon discusses the ways in which the Iraq war was sold to the American public by exploiting five core concerns: Vulnerability, injustice, distrust, superiority, and helplessness.

A Shock Wave of Brain Injuries

About 1,800 U.S. troops, according to the Department of Veterans Affairs, are now suffering from traumatic brain injuries (TBIs) caused by penetrating wounds. But neurologists worry that hundreds of thousands more -- at least 30 percent of the troops who've engaged in active combat for four months or longer in Iraq and Afghanistan -- are at risk of potentially disabling neurological disorders from the blast waves of IEDs and mortars, all without suffering a scratch.

How do young people manage without health insurance?

They offer insurance at Home Depot, but you’re only allowed to sign up during a two-week period and I missed it. If it’s a cut or bruise or whatever, I try to patch it up myself. I usually know what to do. I bruised a rib last winter. I just wrapped it in rags to keep it tight, and it got better after a few weeks. Also, I cut my head on a wineglass back at Halloween. I was very drunk, and there was blood all over the place. My friend wanted to call the ambulance, but I told her not to. I just cleaned it out myself. Now I’ve got a scar, but at least I’m not broke.

Confronting Confinement

On any given day, 2.2 million people are incarcerated in the United States, and over the course of a year, many millions spend time in prison or jail. 750,000 men and women work in correctional facilities. The annual cost: more than 60 billion dollars. Yet within three years, 67 percent of former prisoners will be rearrested and 52 percent will be re-incarcerated. At this moment, the effectiveness of America's approach to corrections has the attention of policy makers at all levels of government and in both political parties. The Commission and its report, Confronting Confinement, make a unique contribution to this timely national discussion by connecting the most serious problems and abuses inside jails and prisons with the health and safety of our communities.

ACLU Free Speech Victory

In one of the most important student free speech cases in decades, the ACLU joined attorneys for former student Joseph Frederick before the U.S. Supreme Court this week and urged the high court not to abandon its famous 1969 ruling that students do not “shed their constitutional rights to freedom of speech or expression at the schoolhouse gate.”

Families USA Publications

A Pound of Flesh: Hospital Billing, Debt Collection, and Patients' Rights provides an overview of some of the progressive reform measures that state policymakers have implemented to help families struggling with medical debt. [Recommend you read this document, along with any of the other publications that may interest you.]

Families USA Global Health Initiative

"With globalization, the same sea washes all of humankind. We are all in the same boat. There are no safe islands. There is no dividing line between "foreign" and "domestic" infections...There is no them: only us.” –UN Secretary General Kofi Annan

Is Genuine Health Care Reform Finally Feasible?

It has been nearly a decade and a half since the last effort to overhaul the nation's health care system. But the issue is back, driven by recent state initiatives seeking ways to provide universal health care and by the 2008 presidential campaign. . . . The phrase "universal health care" has been widely used among the Democratic presidential candidates.
Sen. Barack Obama, the Democrat from Illinois, recently told the International Association of Fire Fighters that he will make sure that everybody in the country has universal health care by the end of his first term as president.
Not to be outdone, Democrat John Edwards, the former North Carolina senator and presidential candidate, has already laid out a fully detailed plan for universal health coverage. On NPR's Talk of the Nation, Edwards pledged that he would implement his plan even faster than Clinton and Obama would: before the end of his first presidential term.

Can the Best be the Enemy of the Good?

It’s Kennedy versus Kennedy as two members of Congress from the same family face off over competing versions of legislation that would require many health insurance companies and employers to provide more generous benefits to people with mental illness.
Representative Patrick J. Kennedy, Democrat of Rhode Island and chief sponsor of the House bill, has criticized as inadequate the Senate bill introduced by his father, Senator Edward M. Kennedy, Democrat of Massachusetts. Representative Kennedy is trying to mobilize mental health advocates to lobby for what he describes as “the stronger of the two bills, the House bill.”

Do You Support Prescriptive Authority for Appropriately Trained Psychologists?

Community health centers across the state and the Hawaii Primary Care Association strongly endorse Senate Bill 1004 and House Bill 1456, which address prescriptive authority for certain psychologists. We believe that the requirements outlined in these bills regarding psychopharmacological training, supervised practice, standardized testing, board review and authorization, restrictions on what drugs can be prescribed, and practice only within community health center settings will ensure that patients will be well served rather than jeopardized.

The Best Health System in the World?

With some of the best-equipped hospitals and most highly specialized physicians in the world, it is no wonder that many people believe the U.S. health system is the best on earth. The evidence, however, suggests this confidence is misplaced.
According to the National Scorecard on U.S. Health System Performance, the United States scored just 66 out of 100 when comparing the nation's average performance on three dozen indicators against benchmarks set either within the U.S. or abroad. Given America's high standards—and high spending on health care—that is simply unacceptable.

Social Isolation Is Hazardous to Men's Health

Researchers at the Harvard School of Public Health who looked at more than 28,000 men over a period of 10 years found that those who were socially isolated were more likely than others to have died of all manner of illness, accidents and suicide. This study and others show that men who lack strong social networks are at far greater risk of developing heart disease and that those who already have heart disease are more likely to die from it. And men who are not connected with other people run a higher risk of depression and other mental health problems.

Harvard economist proposes team approach on healthcare

WASHINGTON -- A renowned Harvard economist unveiled a plan yesterday to revamp the US healthcare system by focusing on the value of care to patients, arguing that improving the quality of medical services can by itself save money and provide a road map to a national health plan. . . . The nation's healthcare system is using "21st-century technology delivered with a 19th-century system," Porter said. Medical care, he added, is "the only sector in our economy that has not undergone reconfiguration seen everywhere else."

Paying for Care Episodes and Care Coordination (Karen Davis, NEJM)

The fee-for-service system of provider payment is increasingly viewed as an obstacle to achieving effective, coordinated, and efficient care. It rewards the overuse of services, duplication of services, use of costly specialized services, and involvement of multiple physicians in the treatment of individual patients. It does not reward the prevention of hospitalization or rehospitalization, effective control of chronic conditions, or care coordination.

Price Variations for Generic Drugs

Wolf began snooping around and found that two chains, Costco and Sam’s Club, sold generics at prices far, far below the other chains. Even once you factor in the cost of buying a membership at Costco and Sam’s Club, the price differences were astounding.

[Note to Class: Will you refer your clients to Sam's Club? Do you have any ethical concerns about supporting companies like Walmart? Poke around this website and explore some of the interesting stories, and, if you have the time, read this book.]

Does Treatment Work for Sex Offenders?

Similar to aspects of Alcoholics Anonymous, relapse prevention has sex offenders own up to wrongdoing and resign themselves to a lifelong day-to-day struggle with temptation. But one of the few authoritative studies of the method, conducted in California from 1985 to 2001, found that those who entered relapse prevention treatment were slightly more likely to offend again than those who got no therapy at all.
Clinicians who work with sex offenders cling to relapse prevention nonetheless, and its durability speaks volumes about the troubled, politically fraught science of treating sex offenders. Not only is relapse prevention of questionable value, but so are the tests to gauge whether sex offenders in treatment still get inappropriately aroused, the drugs used for so-called chemical castration and the methods of predicting risk of reoffending.
Treatment methods have become particularly topical as thousands of sex offenders are confined or restricted beyond their prison terms under civil commitment laws on the books in 19 states.