NEW PULSE PUBLICATION: The inaugural issue of the PULSE Quarterly Briefing was published in late June and has already received a great deal of praise ("Brilliant" - Fran Silvestri, Director: International Initiative for Mental Health Leadership; "A triumphant inaugural issue" - Paul Lefkovitz, CEO: Behavioral Pathway Systems; "Very useful..." - Elaine Alfano, Bazelon Center for Mental Health Law). The PQB comes bundled with two other services, the "PULSE Bulletin" (40 issues/year) and "Recent Resources" (10 issues /year) and organizational subscriptions include access to a set of Internet-based tools for distributing news and announcements. For details on subscriptions, please see the new PULSE Community Site.

 Wednesday, August 10, 2005

Editor's NoteMy apologies for the dearth of postings this week, as I've been down and out with a nasty summer virus. Postings will resume (and make up the lost ground) as soon as I'm back on my feet. Thanks very much for your ongoing interest in PULSE ........... Bill   
  

 Monday, August 08, 2005

Congress to Consider Major Medicaid Changes in September, Grassroots Advocacy Campaign Needed During Congressional Recess Action Alert at the NAMI web site - " This week the House and Senate began a month long summer recess, during which members of Congress will be in their states and districts across the country. One of the major issues Congress will confront upon their return to work in September is how to reduce future Medicaid expenditures by $10 billion over the next five years. These reductions to Medicaid will be considered as a part of a massive budget 'reconciliation' measure that Congress is supposed to complete sometime in the fall. This "reconciliation" legislation will include a number of programmatic changes to Medicaid that could have an enormous impact on beneficiaries (both children and adults) living with mental illness. NAMI is very concerned that these reductions to Medicaid do not adversely impact on access to treatment support services for Medicaid beneficiaries living with mental illness."  
  

FDA Responds to Criticism With New Caution August 6 New York Times article - "Stung by a series of drug safety scandals, the Food and Drug Administration has in recent months issued a blizzard of drug-safety warnings and approval times for new drugs are slower. The agency is issuing twice the number of public advisories about drug risks as it did a year ago and adding five times as many black box warnings - its most serious alert - to drug labels. And drugs approved in the first half of this year took almost twice as long to get that approval as drugs approved in the same period last year. This new conservatism, a response to fierce recent criticism from Congress that the F.D.A. has failed to protect the public against drug dangers, has upset some doctors and drug makers..." [Viewing New York Times resources requires registration, which is free].  
  

Data Behind Antidepressant Advisory Don't Give Clear-Cut Answers  Psychiatric News story - "The FDA's most recent public health advisory regarding antidepressants appears to have been based on seemingly contradictory studies published earlier this year. The FDA's June 30 public health advisory concerning antidepressants was prompted, the advisory said, by 'several recent scientific publications' that suggested 'the possibility of an increased risk for suicidal behavior in adults who are being treated with antidepressant medications.' FDA spokesperson Christine Parker told Psychiatric News that the advisory was prompted by 'two papers of particular interest.' Both appeared in the February 19 BMJ..." See also abstracts of the BMJ studies.  
  

FDA Alert Covers Cymbalta  Psychiatric News story - "In conjunction with its release of the public health advisory regarding increased risk of suicide in adults taking antidepressants, the FDA issued a separate FDA Alert involving duloxetine (Cymbalta) and suicidality in pediatric and adult patients. The alert largely echoes the language of the advisory, noting that the FDA is 'highlighting that adults being treated with any type of antidepressant medication, particularly those being treated for depression, should be watched closely for worsening of depression and for increased suicidal thinking or behavior.' "  
  

Texas Health Official Explains Effort To End Mental Illness Stigma  Psychiatric News story - "Deep in the heart of Texas, NAMI members learn about several new initiatives on destigmatization and prevention of mental illness for those living in the state. Government officials in Texas, the state that hosted the 2005 annual conference of the National Alliance for the Mentally Ill (NAMI), are setting an example for other states by taking steps to eliminate the stigma that surrounds mental illness. Part of their focus will be on implementing strategies for preventing mental illness in those at risk for these disorders."  
  

Identifying Patients' Treatment Goals Helps Overcome Noncompliance  Psychiatric News story - "Though many patients with anosognosia refuse to take psychotropic medications because they don't believe they are ill, some may take them to quell loved ones' concerns. To stem what some call an 'epidemic; of medication noncompliance for patients with serious mental illness, psychiatrists must tie treatment directly to patients' goals. This was a key message delivered to mental health consumers, family members, psychiatrists, and mental health professionals who attended the 2005 annual conference of the National Alliance for the Mentally Ill in Austin, Texas, in June."  
  

Quarter of Prop. 36 drug offenders complete treatment, UCLA finds (California) AP story at the Mercury News - "About a quarter of drug offenders diverted from prison completed their alternative treatment under a program approved by California voters nearly five years ago, with results similar to other treatment programs, according to a UCLA study released Monday. The results of the third year of independent tracking of offenders sentenced under Proposition 36 came as lawmakers debate renewing funding for the program and whether to allow judges to incarcerate offenders who refuse treatment or keep abusing drugs. Proposition 36, approved by 61 percent of voters in November 2000, requires that first-and second-time nonviolent drug offenders be sent to treatment programs instead of prison."  
  

Minorities less likely to seek mental health help: local therapists cite reasons, solutions (Arkansas) Northwest Arkansas Times story - "... Donna Van Kirk, a licensed psychologist for the Behavior Therapy & Counseling Clinic in Fayetteville, said minorities are "certainly underrepresented compared to the white population" in terms of how many seek treatment from a mental health professional. The Surgeon General’s report, a supplement on mental health issued in 1999 and drawn from numerous scientific studies, said that once differences in income and background are accounted for, minorities and whites suffer equally from mental disorders but still do not seek treatment in the same percentages. There are a variety of reasons minorities are less likely to get the mental health treatment they need, said Van Kirk, who also serves as secretary for Psychologists of Northwest Arkansas. "  
  

Latino Behavioral Health Institute to Present Eleventh Annual Conference Prime Zone press release - "Latino Behavioral Health Institute (LBHI), one of the nation's largest non-profit organizations dedicated to eliminating discrimination against Latinos in need of behavioral health services and health care, will present its eleventh annual international conference, Tuesday, Wednesday and Thursday, Sept. 20 -- 22, at the Universal Hilton Hotel in Universal City, Calif. Themed, 'Transformation: Towards Access and Quality in Latino Behavioral Health,' the event will address contemporary issues of policy, training, research, clinical practice and education related to Latino mental health, substance abuse, health and human services. Approximately 1,000 behavioral health professionals from the United States, Puerto Rico, Mexico and South American countries are expected to attend."  
  

APA Launches College Mental Health Initiative Medical News Today story - "Across the USA, students are preparing to start or return to college. This is an exciting time, though for some it's overwhelming and stressful. Depression, substance use and eating disorders are increasingly common mental health issues on college campuses. According to a recent survey, nearly half of all college students report feeling so depressed that they had trouble functioning, and 15 percent meet the criteria for clinical depression. Untreated depression can lead to suicide, which is the second leading cause of death of college students..."  
  

 Sunday, August 07, 2005

Peer Support Manual 192-page booklet in PDF format from CMHA/British Columbia = "Sometimes the simplest concepts are the most profound. The CDP strives to build relationships and treat other people and their opinions with respect. It is our fundamental belief that people can and should be encouraged to speak on their behalf. Our role is to ensure that people have opportunities and support to develop the skills to do so. The CDP has evolved to become a leader and champion in a recovery vision of service with the idea that one of the essential roles of the mental health system is to support individuals to connect with appropriate services within the mental health system as well as build supports in other areas of their lives through personal, social, environmental and spiritual connections. We strive to bring alive the concepts of the Framework for Support, CMHA’s guiding principles. A recovery vision of service is grounded in the idea that people can recover from mental illness when they play an active and empowered role in their journey. ..."  
  

What Can Communities Do? A Community Action Guide to Early Psychosis Intervention Strategies Booklet in PDF format from CMHA/Ontario - "A guide emphasizing the key role that community members can play in the early identification, treatment and recovery of young people with psychosis." The guide notes that "CMHA’s project activities have reflected this community focus by promoting 'ownership' of the issue and the capacity for action by a range of community-based constituencies. The project has:  promoted awareness and provided information to key national stakeholder organizations by preparing articles for publications in journals and newsletters; produced and widely disseminated a range of educational resource materials; developed a strategic planning framework to assist policy makers to move forward effectively; facilitated first-episode family action and mutual support; and raised awareness and improved access to services through working directly with various groups and organizations across Canada."  
  

A Sibling's Guide to Psychosis - Information, Ideas and Resources Booklet, in PDF format, from CMHA/Ontario - " guide providing information, ideas and resources to siblings of young people with psychosis, guided by the reflections and experiences of siblings themselves."  
  

Hangin' in There: Strategies for job retention by persons with a psychiatric disability (Canada) Booklet in PDF format from CMHA/Ontario - "This publication is an exciting new booklet that outlines strategies on keeping a job by people with a psychiatric disability. The reader will discover how people with a disability are overcoming the challenges faced in keeping a job. In addition, employers weigh in with their viewpoints on hiring people with psychiatric disabilities."  
  

New hope for schizophrenia sufferers Research Australia press release at EurekAlert - "Key research from the University of New South Wales (UNSW) could lead to the first early diagnostic tool for schizophrenia and bipolar disorder. 'At the moment we don't have any biological tests for these conditions,' said one of the authors, UNSW Associate Professor of Psychiatry, Philip Ward, who is based at Liverpool Hospital's Schizophrenia Research Unit. 'Our research could eventually lead to a simple, cost-effective and safe way to distinguish patients with schizophrenia from those suffering bipolar disorder. This is important because a patient can get treatment sooner and hopefully have a better outcome.' "  
  

Creating and supporting family therapists of color Brief Blackwell Publishing press release at EurekAlert - "An article published in the latest issue of Family Process describes the creation and structure of a training program designed to increase the number of family therapists of color. The authors address the first twelve years, in which the Diversity and Social Work Training Program of the Ackerman Institute for the Family trained fifty-seven graduate students of color. Of those, twenty-seven elected to remain in their program for post graduate training-- a high fifty percent retention rate as compared to other recruitment and retention efforts for professionals of color. Using a bottom-up approach, they recruited students of color while still in graduate school and provided them with mentors, financial aid, and emotional support..."  
  

Court clarifies TennCare questions (Tennessee) Story in The Tennessean - "Issuing a new order outlining what the state can and cannot do to limit TennCare benefits, a federal judge said officials now have all the information they need to decide whether about 97,000 sick people can stay in the program. State officials said last night they were encouraged by U.S. District Judge John Nixon's ruling, but remained noncommittal."  
  

Wall Street Journal Examines Eli Lilly's Tactics To Persuade Physicians To Prescribe Antidepressant Cymbalta Item in the Kaiser Daily Health Policy Review - "The Wall Street Journal on Friday examined how pharmaceutical companies' contracts with insurers and medical organizations to sell their drugs sometimes restrict 'unflattering statements about the costs and risks of drugs when they communicate with health practitioners.' For example, Indianapolis-based Eli Lilly offers health facilities a 5% discount for the antidepressant Cymbalta, but the contract states that most of the discount could be revoked if the facility engages in certain actions, including 'negative [drug utilization review] correspondence to physicians.' A drug utilization review is a type of analysis of prescription patterns often used by insurers to identify risky or inappropriate practices and to reduce expenses. Pharmaceutical industry officials have said that insurers or other groups could use DURs to encourage doctors to use lower-cost drugs that might not be as effective. The Cymbalta contract also restricts 'negative educational counterdetailing,' a practice often used by insurers to counterbalance a drug maker's sales pitch to doctors that can focus on recommending generic drugs."  
  

Faulty Biological Clocks May Influence Addiction Science Daily story - "A gene that regulates the body's circadian rhythms, including sleep and wakefulness, body temperature, hormone levels, blood pressure and heart activity, may also play a central role in drug addiction, according to a recent study published online by the Proceedings of the National Academy of Sciences (PNAS). Although expressed primarily in the brain's circadian command center, biological clock genes have also been found in areas of the brain involved in reward and addiction. A team led by researchers from the University of Texas Southwestern Medical Center at Dallas and including Northwestern University's Joseph S. Takahashi, Walter and Mary Elizabeth Glass Professor in the Life Sciences and a Howard Hughes Medical Institute investigator, used mice lacking the Clock gene to examine the possible involvement of the biological clock system in the rewarding properties of cocaine..."  
  

State plans new mental health hospital in Fergus (Minnesota) Fergus Falls Daily Journal story - "The state is readying plans to move out of the Regional Treatment Center -- by readying plans to build a new mental health hospital in Fergus Falls. The 16-bed community behavioral health hospital will be located on about 2.5 to 3.2 acres of land at the intersection of County Roads 1 and 15, just past Alcott Avenue in Fergus Falls, according to Kent Mattson, an attorney who is coordinating the RTC reuse process. Mattson said that construction of the estimated $3.4 million facility, which has been nearly three years in the making, is anticipated to begin in late September or early October and be completed by May 1, 2006."  
  

Veto worries local mental health care providers, clients (Texas) Fort Worth Star-Telegram story focusing on Paradise, a Fort Worth community center - "Paradise Center is threatened by Gov. Rick Perry's veto of a bill designed to retain local control of mental health dollars. ...The bill Perry vetoed would have slowed the transfer of decision-making ability from the state's local mental health/mental retardation centers to Austin bureaucrats. Local mental health care providers fear that groups like Paradise will be less likely to get funding from Austin than they are from the local MHMR offices. They also worry that local government won't continue to fund programs because the money would first go to regional or statewide offices instead of staying at home. Some local mental health providers could close, and others could face substantial funding cuts, said Jim McDermott, executive director of MHMR of Tarrant County. In the Fort Worth area, $24 million administered by McDermott's organization could revert to the state for distribution. MHMR centers statewide could lose more than $150 million."  
  

Mental Health Issues: The Impact of Explosive Growth (Nevada) Red Nova story on the growing need for services in Nevada - "Both private and public juvenile service providers cannot keep up with demand. Hospitals are often on divert status as a result of too many mental health patients taking up emergency room beds, resulting from too few psychiatric facilities being available to meet their needs. One-third of emergency-room beds and one-fifth of detention beds are occupied by mental health patients. And more than one-tenth of the prison beds are also occupied by mental health patients. Sound familiar? Welcome to the criminal justice system in southern Nevada. And that system is feeling the pinch of this growth in a major way. Law enforcement, the courts, prisons and all their related services, have felt the need to evaluate their roles and examine the scope of their duties in order to focus their efforts in fulfilling their respective and collective responsibilities. Legislative changes as the state has matured have impacted law enforcement, corrections and everything in between. "  
  

 Friday, August 05, 2005

One-Third of the Estimated 8.4M Uninsured Children Go Without Medical Care for Entire Year, Despite Eligibility for Public Health Insurance, Report Says Item in the Kaiser Daily Health Policy Report - "The number of uninsured U.S. children decreased by about two million to 8.4 million between 1998 and 2003, and 70% of the uninsured qualified for public health insurance programs such as Medicaid or SCHIP but were not enrolled, according to a study released on Tuesday by the Robert Wood Johnson Foundation, CQ HealthBeat reports. According to the report, released as part of the sixth annual RWJF Covering Kids and Families Back to School Campaign, 20% of Latino children lacked health insurance, compared with 9% of black children and 6% of white children... "  
  

 Thursday, August 04, 2005

Leavitt Praises Governors on Medicaid  AP story in the Las Vegas Sun - "The nation's governors likely will play an influential role in federal efforts to slow the growth of Medicaid, Health and Human Services Secretary Mike Leavitt said. Leavitt has appointed a commission that will recommend to Congress short- and long-term changes to the program, which serves about 52 million Americans. The commission's first report is due Sept. 1. It will focus on ways to slow the health insurance program's growth by $10 billion over the next five years. The commission just had its first meeting last week, raising the question of how extensive a review it can accomplish. Leavitt said in an interview Tuesday with Associated Press reporters and editors that governors have had some of the answers for a long time. .."  
  

Mental health reform back in limbo (Maine) Morning Sentinel story - "State efforts to lift a 15-year-old consent decree governing much of Maine's mental health system suffered a blow this week when a court official rejected important portions of a state reform plan. Court Master Daniel E. Wathen also approved some parts of the plan put forward by Maine Department of Health and Human Services officials in June after the Maine Supreme Court rejected Superior Court Justice Nancy D. Mills' plans to takeover some parts of the state mental health system."  
  

Mental Health Portrayals Praised (New Zealand) Story at Black Enterprise - "The Mental Health Commission has congratulated the country's print media for the way it reports mental health issues. The commission said compared with a 1998 study, reporting of mental health issues last year showed a significant improvement in how papers portrayed people with experience of mental illness. Commissioner Mary O'Hagan was heartened by that and made specific mention of the Waikato Times for the number of stories it ran with a mental health theme."  
  

Mental Health of War Survivors Ivanhoe Newswire story - "War has exposed millions of people to psychological trauma. While impunity for those responsible for the trauma is thought to be associated with the mental problems of survivors of violence, a new study finds other fears may play a role as well. The study could have important implications for determining effective intervention for traumatized war survivors in postwar countries."  
  

Northeast Health to acquire Mid-Coast (Maine) Bangor Daily News story - "The nonprofit health care umbrella company Northeast Health Inc. will take over Mid-Coast Mental Health, officials from both organizations announced Tuesday. Northeast Health runs Penobscot Bay Medical Center in Rockport, Kno-Wal-Lin Home Care and Hospice, Penobscot Bay Physicians & Associates, Quarry Hill and the Knox Center for Long-Term Care. Mid-Coast Mental Health runs outpatient and residential mental health treatment and services in nine offices and residential sites in Knox and Waldo counties."  
  

Governor appoints John Houston mental health commissioner (Alabama) Brief Dateline Alabama story - "Gov. Bob Riley selected John Houston, a veteran employee of the state mental health agency, to become its commissioner Thursday. Houston replaces Kathy Sawyer, who retired Feb. 1 after serving 28 years with the Alabama Department of Mental Health and Mental Retardation. Houston had served as acting commissioner since Sawyer's retirement..."  
  

 Tuesday, August 02, 2005

Outlining the World Health Report 2006 Announcement at the WHO web site - "In response to World Health Assembly resolution WHA57.19, the Director-General has declared the health workforce to be the theme of the World health report 2006. And for the first time, WHO is offering open consultation on the World health report via the World Wide Web and electronic mail. Broad participation is encouraged – from schools for the health professions to national and international financing institutions to the ultimate beneficiaries of health services, the general public."  
  

Terrorism, Mental Health, and September 11  44-page report in PDF format from the Century Foundation that "examines how post-traumatic stress disorder (PTSD) extended far beyond the New York population directly exposed to the September 11 attacks. Television coverage brought the disaster to a much larger audience and caused full-blown and sub-syndromal cases of PTSD throughout the nation. The report recommends increasing training for PTSD diagnosis and treatment so that primary care physicians are able to refer or assist patients suffering from the disorder. "  
  

Including behavior in health-disparities legislation APA Monitor story - "Although the adverse effects of behaviors such as limited physical activity, poor nutrition and alcohol and tobacco consumption are widely recognized as precipitators of stroke, lung disease, diabetes and other such diseases, the rising prevalence of these behaviors is still cause for national concern. As a result, psychologists have been developing effective evidence-based interventions to help modify these behavioral risk factors. APA's Public Policy Office (PPO) has been working to inform Congress and key federal health agencies of these interventions and emerging best practices in hopes that they reach more citizens to improve the nation's health status and lower the cost that unhealthy behavior inflicts on society."  
  

VA psychology conference advocates for new veterans' mental health APA Monitor story - " At the eighth annual Department of Veterans Affairs (VA) Psychology Leadership Conference, April 29–30 in Dallas, VA psychologists and top VA and APA officials met to discuss ways to promote improved psychological services for veterans, including those who have served in the Iraq and Afghanistan wars. Illustrating this year's conference theme, "Strong leadership in uncertain times," top officials including VA Deputy Secretary Gordon Mansfield and VA Under Secretary for Health Jonathan Perlin, MD, PhD--who received word while at the convention that the Senate confirmed him for a four-year term in the position--discussed mental health care's future at the VA..."  
  

Taking on policy APA Monitor story - "Adrienne Stith Butler, PhD, and Tracy Myers, PhD, have taken their psychology careers on a nontraditional path to the Institute of Medicine (IOM), where they address public policy issues ranging from ethnic inequalities in health care to psychological aspects of terrorism. As IOM program officers, they assemble and oversee interdisciplinary committees that examine policy issues related to public health. Based on their investigations, which are sometimes congressionally mandated, the committees produce reports that help to inform policy-makers and the public about health care, research and education. For example, one recent IOM report highlighted ways to increase the number of minority health-service providers."  
  

Mentally ill more likely victim than perp Science Daily story - "A Northwestern University study indicates severely mentally ill people are more likely victims rather than perpetrators of violence. Researchers at the university's Feinberg School of Medicine say more than one-fourth of individuals with severe mental illness were victims of violent crime during 2004 -- a rate nearly 12 times that of the general population. Depending on the type of violent crime, prevalence was six to 23 times greater among people with severe mental illness than among the general population, said lead author Linda Teplin, a professor of psychiatry and behavioral sciences at Feinberg..."  
  

Cognitive Therapy Reduces Repeat Suicide Attempts by 50 Percent  National Institute of Mental Health press release - "Recent suicide attempters treated with cognitive therapy were 50 percent less likely to try to kill themselves again within 18 months than those who did not receive the therapy, report researchers supported by the National Institutes of Health’s (NIH) National Institute of Mental Health (NIMH) and the Center for Disease Control and Prevention (CDC). A targeted form of cognitive therapy designed to prevent suicide proved better at lifting depression and feelings of hopelessness than the usual care available in the community, according to Gregory Brown, Ph.D., Aaron Beck, M.D., University of Pennsylvania, and colleagues, who published their findings in the August 3, 2005 Journal of the American Medical Association (JAMA). "  
  

Cambodian refugees feel stress decades later Reuters AlertNet story - "A majority of Cambodian refugees settled in the United States suffer from post-traumatic stress, deep depression or alcoholism decades after surviving their country's 1970s genocide, a study said on Tuesday. A survey of Cambodians who are representative of the 175,000 who have taken refuge in the United States found practically all had lingering effects from nearly starving to death and witnessing relatives and friends being murdered. An estimated 3 million died during the 1975-79 reign of the Khmer Rouge and in civil wars before and after. The prevalence of psychiatric illness found among Cambodian refugees is indicative of a larger crisis affecting the world's 42 million refugees, based on other reports published in this week's issue of the Journal of the American Medical Association, which focused on the subject of violence." See also the free JAMA abstract, the summary of articles on "Violence and Human Rights" in the current issue and the abstracts of other articles of note - Cognitive Therapy for the Prevention of Suicide Attempts, Psychiatric and Cognitive Effects of War in Former Yugoslavia: Association of Lack of Redress for Trauma and Posttraumatic Stress Reactions, Predisplacement and Postdisplacement Factors Associated With Mental Health of Refugees and Internally Displaced Persons: A Meta-analysis, and the free article, Adult Schizophrenia Following Famine.   
  

Mental health agencies working on proposals to privatize state hospital (Indiana) Madison Courier story - "Two mental health agencies are putting together proposals for turning over Madison State Hospital to private ownership. Terry Stawar, president and chief executive officer of LifeSpring Inc. in Jeffersonville, said he is forming a coalition of elected officials, business leaders and other nonprofits to run MSH. LifeSpring is the hospital’s largest single client, Stawar said, with 35 beds allocated to its customers. Another group is being led by Quinco Behavioral Health Systems of Columbus. Richard Williams, president and CEO of Quinco, said his agency is forming a partnership with the mental health center in Bloomington and a similar entity in Indianapolis."  
  

Geriatic pyschiatry grant recognizes growing mental health needs of seniors Medical News Today story - "The National Institute of Mental Health (NIMH) has made a $984,000 grant to the University of Rochester Medical Center to support the training of physician scientists for research careers in geriatric mental health. 'America is aging, at least one third of older people suffer from a mental disorder, and yet we have a critical, nationwide shortage of researchers trained in geriatric mental health,' said Jeffrey M. Lyness, M.D., director of the Program in Geriatrics and Neuropsychiatry at the medical center. 'Mental health problems like depression and dementias cause as much suffering as common medical conditions like heart disease and cancer, and we urgently need more researchers to identify fundamental disease mechanisms and develop the treatments of the future.' "  
  

Costly gap remains in mental health bills Op-ed column in the Raleigh News & Observer - "Medicare covers practically all other health care more generously than it covers outpatient mental health. It pays 80 percent of the cost of an outpatient doctor's visit if the visit isn't related to mental health, leaving only 20 percent for the patient to pay. Inpatient care is covered more fully still, with the patient paying a relatively small deductible after which Medicare picks up the whole tab, regardless of whether the patient is hospitalized for general medical or psychiatric causes."  
  

Mental health issues (Mississippi) Daily Journal editorial - "Mental health remains one of the most nettlesome issues in the laps of local and state governments. The available money - almost $500 million, including federal funds, in fiscal year 2006 - doesn't keep pace with the need for state-funded beds, state-paid, certified therapists/counselors, or funding for crisis centers established by the state. State funding actually has decreased by $30 million since 2000..."  
  

 Monday, August 01, 2005

Dual Eligibles: Medicaid’s Role for Low-Income Medicare Beneficiaries Fact sheet (in PDF format) from the Kaiser Family Foundation - "This fact sheet describes the over 7.5 million 'dual eligibles,' the low-income elderly and persons with disabilities who are enrolled in both Medicare and Medicaid, why this population needs Medicaid, what services they receive from Medicaid, and the current policy challenges related to dual eligibles, including the new Medicare prescription drug benefit."  
  

State of California Medi-Cal Redesign Report (in PDF format) called to our attention by Open Minds - "California’s Medi-Cal Program provides medical assistance for qualified individuals with low income under Title XIX of the Federal Social Security Act. The California Department of Health Services (DHS) administers the program with the federal government providing a matching Medicaid reimbursement rate of 50 percent. Currently, Medi-Cal provides health care services to 6.6 million Californians – just under one in five Californians receive their health coverage through the Medi-Cal program. Medi-Cal has been providing health care services to Californians since 1965. It is the health care funding source for low-income children, their parents, pregnant women, and seniors and persons with disabilities. In addition to providing those benefits that are required by federal law, California is one of eight States that provide a wide range of optional benefits. "  
  

State of Georgia Gap Analysis for Mental Health Services - Final Report  Index of the final report to the state of Georgia from APS Healthcare, called to our attention by Open Minds - "Established by a Federal mandate, Georgia’s Mental Health Planning and Advisory Council has the oversight responsibility for providing ongoing guidance to the Department of Human Resources, Division of Mental Health, Developmental Disabilities and Addictive Disease (DMHDDAD) on services and system design throughout the state. The Mental Health Planning and Advisory Council requested a Gap Analysis of the mental health delivery system that serves Georgia. This Mental Health Gap Analysis provides a comprehensive assessment of the state’s publicly funded mental health system, the system of care paid for by federal, state, and local tax dollars to support adults with Serious Mental Illness (SMI) and children and adolescents with Serious Emotional Disorders (SED)." The link above points to an HTML version. The report is also available in PDF format.  
  

Mental health courts require access to effective community mental health services  Item in CMHA/Ontario Mental Health Notes - "People who were diverted through a mental health court did not experience reductions in psychiatric symptoms, suggesting the need for more effective and adequate community mental health services, according to a recent study in Psychiatric Services. According to the authors, a variety of studies have demonstrated that diverting defendants with mental illness from the criminal justice system into mental health treatment result in increased access to treatment and better quality of life. The purpose of this study was to evaluate whether the increased access to mental health services achieved through diversion resulted in improved clinical outcomes for defendants with mental illness."  
  

Strategies for a participant-centred approach to research Item in CMHA/Ontario's Mental Health Notes - "Conducting a participant-centred research study with people with severe and persistent mental illness who are homeless or at risk of becoming homeless requires fundamental changes in research design and methods, according to an article in the Canadian Journal of Program Evaluation. The paper appears in a special issue of the journal focusing on the Community Mental Health Evaluation Initiative (CMHEI), which evaluated the effectiveness of various community mental health programs. This paper is based on research on the intensive case management (ICM) program of the Canadian Mental Health Association, Ottawa Branch, conducted jointly by CMHA and the Centre for Research on Community Services at the University of Ottawa. "  
  

Homelessness, mental illness and substance abuse increase incarceration time  Item in CMHA/Ontario's Mental Health Notes based on an article in the July Psychiatric Services - " A study published in Psychiatric Services suggests that individuals who are homeless and have severe mental disorders with co-occurring substance-related disorders stay longer in jail than others charged with similar crimes. This study was designed to assess the relationships between homelessness, mental disorder and amount of time spent incarcerated..."  
  

Securing better mental health for older adults (UK) A document from the UK Department of Health that "marks the start of a new initiative to combine forces across mental health and older people’s services to ensure that older people with mental illness do not miss out on the improved services that younger adults or those without mental illness have seen. It provides a vision for how all mainstream health and social care services, with the support of specialist services, should work together to secure better mental health for older adults, and describes how the Department of Health is aiming to help deliver this." The link above leads to an HTML version of the document, which is also available in PDF format.  
  

Magnetic Stimulation of the Brain for Depression Health News Digest story reprinted at PsycPORT - "Electroconvulsive therapy (ECT) is well established for treating depression and other psychiatric disorders. Though effective, ECT produces short-term confusion and occasionally some memory loss, and patients require general anesthesia and muscle relaxants. Now a growing body of research suggests that new techniques such as transcranial magnetic stimulation (TMS) may offer less disruptive ways to use electromagnetic energy against depression, schizophrenia, and other psychiatric disorders, reports the August issue of the Harvard Mental Health Letter."  
  

Premiums for the Poor Washington Post editorial - "The notion of asking Medicaid recipients to pay more toward their health care has a lot of intuitive appeal. Rapidly growing costs for the health care program for the poor are straining state budgets across the country, as well as the federal government's. In private insurance programs, co-payments, deductibles and other cost-sharing mechanisms have helped make patients more informed and cost-conscious consumers. It's not surprising, then, that the nation's governors are pressing for more flexibility to require Medicaid recipients to pay more for their care as well. But the evidence from states that have adopted such cost-cutting measures suggests that any changes should be made only with extreme caution. Those considering changes in the program must make certain that the payments -- even if they don't appear burdensome -- don't prevent recipients from getting needed services and don't backfire by resulting in more expensive emergency room and hospital care."  
  

Ruling leaves fate of sickest TennCare enrollees uncertain (Tennessee) Story in The Tennessean - "A federal judge's ruling yesterday afternoon leaves unclear what will happen to about 97,000 of the sickest TennCare enrollees who are due to lose access to state-paid prescription-drug coverage come Monday. Saying he was ruling as quickly as possible before those changes are to take effect, U.S. District Judge John Nixon gave the go-ahead to part of the state's plans to enact cost-saving drug-management tools. State officials have said those tools are key to overhauling TennCare — and sparing 97,000 people from cuts. However, Finance Commissioner Dave Goetz said last night that he was unsure whether yesterday's partial ruling will help avert the changes to come for the "medically needy" — a special category of TennCare enrollees whom Gov. Phil Bredesen has said are the sickest people on the program."