Wednesday, July 16, 2003
Consensus on Treatments for Aggression in Youth Article in the July
Psychiatric Times - "One of the more difficult aspects of treating children and adolescents is the issue of aggression. An expert consensus panel convened by the Center for the Advancement of Children's Mental Health at Columbia University and the New York State Office of Mental Health has released a new set of treatment guidelines that should help physicians give the best care possible."
The Efficient Use of Pharmaceuticals: Does Europe Have Any Lessons for a Medicare Drug Benefit?
Health Affairs article at
Medscape - "Managing drug use in a way that maximizes the value obtained from total health care spending faces obstacles; hence, payers and policymakers tend to look at pharmaceutical expenditures in isolation from the rest of health care spending. Currently there are both regulatory and putative market-based approaches to containing pharmaceutical spending worldwide. But evidence suggests that regulatory efforts in Europe and elsewhere have not proved effective in containing costs or improving efficiency or access, and supposedly market-based solutions now in vogue, such as reference pricing, pose their own set of challenges and may in practice violate market principles. In the end, silo-based budgeting is short-sighted; the emphasis in Europe and in the United States should be on measures that achieve efficient health care rather than the containment of drug spending." [Viewing
Medscape resources requires registration, which is free].
Stopping Antidepressants for Bipolar Illness to Avoid Inducing Mania May Cause Depression Relapse
Medscape Medical News article - "After successful treatment of bipolar depression, guidelines recommend discontinuing antidepressant therapy to prevent inducing mania. However, results of a prospective comparison trial reported in the July issue of the
American Journal of Psychiatry suggest that patients who discontinue treatment are no less likely to develop mania, but much more likely to relapse into depression, than those who continue antidepressant therapy." [Viewing
Medscape resources requires registration, which is free].
NAMI is grateful to Senator Collins (R-ME) for her leadership in addressing the tragedy of custody relinquishment At the NAMI web site - "The Senate Committee on Governmental Affairs -- chaired by Senator Collins (R-ME) -- is holding two days of hearings on July 15 and 17 to address custody relinquishment – the national tragedy of states forcing families to turn custody of their child over to the state to secure mental health services. NAMI applauds Senator Collins for her leadership on this issue that has long been of great concern to NAMI. Senator Collins is not new to this issue; she joined Representatives Patrick Kennedy (D-RI) and Pete Stark (D-CA), in requesting that the General Accounting Office (GAO) investigate and report on this unthinkable practice."
Study identifies factors increasing risk of psychosocial problems among disabled children Massachusetts General Hospital press release - "Whether or not children with disabilities experience psychosocial problems is associated with the type of disability and the impact of the disability on the child's family, a new study finds. The report from a Massachusetts General Hospital (MGH) researcher and her colleagues found that children whose disabilities involve learning or communication impairments were significantly more likely to experience poor psychosocial adjustment. In addition, family stressors – such as poverty and the impact of the disability on the family – increased the risk of poor psychosocial adjustment. The study appears in the July 2003 issue of
Archives of Pediatric and Adolescent Medicine." Please note that the journal makes an
abstract available free of charge, but that full text is only available for a fee (from the same page).
Individual Treatment Gains Favor
Washington Post story on Multidimensional Treatment Foster Care, a program developed 20 years ago by Patricia Chamberlain, which is now spreading nationwide to 15 cities that have adopted her model for juveniles, many with the assistance of federal grants. The story focuses on Central Virginia Community Services, a government-chartered mental health agency in Lynchburg, and the application of the core principles of Chamberlain's program: instead of sending teens to group homes and residential treatment centers, "the 54-year-old clinical psychologist came up with a novel idea: Separate the children, put them with highly trained foster families and closely monitor them."
Commission for Health Improvement: NHS Star Ratings (UK) The CHI is the independent regulator of NHS performance, and this web page indexes Performance ratings for NHS trusts in England, covering the year ending March 2003. These are the first ratings produced and published by CHI, and are the first set of ratings in which primary care trusts and mental health trusts have received full star ratings. See, especially, the
overview of mental health trusts, the
results (in the form of a table with links to summaries and reports for each trust rated) and the page indexing
indicators and results for each indicator. See also the related BBC story,
Row over NHS star ratings ("This year's NHS star ratings have sparked a furious row between the government, doctors and opposition MPs. Ministers say the ratings show that NHS services are improving across England. But doctors and opposition parties have dismissed the claim, saying the ratings are 'ludicrous', 'pathetic' and 'unfair.' ") and the
Guardian story,
Mental health campaigners attack grades ("Mental health campaigners have branded the NHS performance ratings as 'astonishingly unrealistic' for failing to reflect the poor standards of care experienced by many patients. The number of top rated mental health trusts has more than trebled, according to the latest health service league table.").
Teens cut their bodies as way to cope Story at
CentreDaily.com (Ohio) - "Doctors and mental health experts are seeing a troubling rise in the number of teenagers who deliberately cut themselves to relieve emotional pain. It's difficult to determine how many teens cut, they say, because the behavior is hidden and a symptom of a mental health problem, rather than an independent diagnosis. But they agree that the practice has been increasing in the past few years."
Some fear mental facility closings (Alabama) Birmingham News story on plans by the state Department of Mental Health and Mental Retardation to close J.S. Tarwater Developmental Center and other places like it, "citing patient populations that have declined to the dozens while institution budgets remain in the millions."
