Tuesday, January 13, 2004

Juvenile detention overused?
UPI story reprinted at the NAMI web site - "On any given day nearly 28,000 children, most under 15 years old, are incarcerated in a secure detention facility in the United States -- a 72-percent increase since 1993 despite two decades of declining juvenile crime rates. There's no argument detention is needed for offenders likely to commit another crime or fail to appear in court if released. Today's violent offenders are not the juvenile delinquents of old. But what should be done with non-violent boys and girls, most not convicted of any crime, who pose minimal danger to themselves or others? ... A study by Northwestern University psychiatry Professor Linda Teplin found more than 60 percent of boys and more than 70 percent of girls in juvenile detention centers had one or more emotional disorders. About 60 percent had behavioral or mental health issues; nearly seven in 10 substance abuse problems."  
  

Social Network Key to Teen Suicide Risk
Health Day News story at Yahoo - "When it comes to preventing teen suicide, understanding the social world of adolescent girls may provide a key to predicting potential risk, says a new study.  Researchers found girls were twice as likely to think about suicide if they had few friends. The risk of suicide attempts also rose among girls whose social life was fragmented among different groups of friends. While one suicide expert says the research offers nothing new, study co-author Peter Bearman contends the findings should help guide communities as they try to prevent suicide..."  
  

Foundation Aims At Taking Consumer-Directed Service Model For Medicaid To National Level
A press release from the Robert Wood Johnson Foundation - "When Medicaid beneficiaries of various ages and disabilities have the option to direct their own supportive services, their quality of life is improved, satisfaction with services is increased, unmet needs for care are reduced, access to home care is increased, and nursing home usage is reduced - without compromising the beneficiaries' health or safety. Further, the option costs Medicaid no more than traditional agency services. The Robert Wood Johnson Foundation (RWJF) announced today that the model Cash & Counseling program that achieved these results will be expanded with a new $7 million authorization approved by the Foundation."  
  

Prescription Drug Access Disparities Among Working-Age Americans
A December Issue Brief from the Center for Studying Health System Change - "Working-age African Americans and Latinos are much more likely than white Americans to report they cannot afford all of their prescription drugs, according to a new study by the Center for Studying Health System Change (HSC). In 2001, nearly one in five blacks and one in six Latinos 18 to 64 years old did not purchase all of their prescriptions because of cost, compared with slightly more than one in 10 whites. Cost-related prescription drug access problems are considerably higher for people with chronic conditions,1 particularly African Americans. Regardless of race or ethnicity, uninsured working-age people with chronic conditions are at particular risk for not being able to afford all of their prescriptions, with about half reporting cost-related prescription access problems. Increased patient cost sharing for prescription drugs will likely increase prescription drug access disparities for insured African Americans and Latinos, especially those with chronic conditions."  
  

Dealing With Depression and the Perils of Pregnancy
New York Times story - "... For some women, especially those with a history of significant depression, the risks of abandoning antidepressants during pregnancy may be far greater to the mother and the fetus than taking the drugs themselves. Those who abruptly stop taking their medications, often on the advice of their obstetricians, put themselves in danger of a relapse. Others who switch to lower dosages may still suffer depressive symptoms. Although there are known risks to taking antidepressants in pregnancy, and there may be unknown risks, mental health experts do not advise all pregnant women or those planning to conceive to stop their drug regimens." [Viewing New York Times resources requires registration, which is free].  
  

Supreme Court to Hear Key Disability Rights Case; Advocates Call for 'Access to Justice' in Tennessee vs. Lane and Jones
US Newswire story at PsycPORT - "The Supreme Court will hear oral arguments tomorrow in State of Tennessee vs. George Lane and Beverly Jones, a case that could severely limit enforcement of key provisions in the Americans with Disabilities Act (ADA) that protect millions of people with disabilities from discrimination by public entities in courtrooms, schools, health care and other areas. ... At issue in the case is whether Congress had the authority to allow state and local governments to be sued for money damages for violating Title II of the ADA. Title II protects millions of Americans with disabilities from discrimination in access to public facilities and the provision of public services. Advocates fear that a negative ruling might diminish the ability of people with disabilities to enforce their civil rights in court and that the Court's ruling might further weaken the ADA, which has faced numerous challenges in recent years."  
  

NIH to defend dozens of disputed studies Critics says some are a waste of money
USA Today story reprinted at PsycPORT - "The director of the National Institutes of Health plans this week to issue a letter resolutely defending dozens of AIDS, sexual behavior and addiction studies that have been challenged by conservative critics as a waste of taxpayers' money, officials said Monday. After ordering his staff to review about 190 studies that were under fire, NIH director Elias Zerhouni says he has concluded that they address ''major'' public health issues that deserve scientific attention."  
  

Payments Go Under a Microscope
Washington Post story on "the growing concern among private and government health insurers about the accuracy of physicians' claims and the system for calculating reimbursements. The largest insurer of all, the federal government, recently estimated that the Medicare program overpaid doctors, hospitals and other health-care providers by $11.6 billion in 2002, according to an audit of 128,000 claims. The audit found many providers submitted insufficient documentation (45 percent), billed for medically unnecessary services (22 percent) and used incorrect codes to describe patient visits (12 percent). A larger audit is planned this year."  
  

Funding for boards at issue in suit (Alaska)
Anchorage Daily News story - "Just as lawmakers opened their annual session in Juneau on Monday, the state was sued to ensure oversight of services for people with mental illness and other conditions. The Law Project for Psychiatric Rights, an Anchorage-based private organization, sued in Anchorage Superior Court concerning a key provision of the 1994 Mental Health Lands Trust settlement. The settlement ended a divisive and complicated lawsuit that stretched over a dozen years and clouded title to 1 million acres in Alaska. That lawsuit contended the state had botched the original mental health trust set up in territorial days to pay for mental health programs. ... If it is, and if lawmakers then fail to provide adequate funding, that would be a breach of the settlement and would reopen the whole thorny issue..."  
  

Better screening needed to head off suicides, experts say (Canada)
Montreal Gazette story - " Over the last eight years, at least 50 people killed themselves in Quebec hospitals, most of them struggling with mental health problems...Quebec has the highest suicide rate in Canada - about 1,500 every year, twice the number of car-accident fatalities. Suicide experts have long called for provincial standards for assessing, treating and tracking people with suicidal tendencies. ... What's missing is a uniform, standard procedure for assessing risk, said Brian Mishara, director of Centre for Research and Intervention on Suicide and Euthanasia at the Université du Québec à Montréal."  
  

Consolidation likely for county mental health, addiction service plans (Oregon)
Story in the News-Review - "In an effort to cut costs and fuse administrative services, a state agency is mandating change at the Douglas County Health & Social Services Department. Officials from the organization will conduct four meetings across the county to share and gather information from the public about consolidation of mental health, prevention, addiction treatment and problem gambling services plans. The Oregon Department of Human Services Office of Health is requiring counties submit one plan that covers all services instead of individual plans, as it had previously done. The new planning framework will include the health department's mental health division, ADAPT, Commission on Children and Families and the Department of Human Services..."  
  

Polk prepares for switch to new mental health system (North Carolina)
Tryon Daily Bulletin story, focused on Polk County on the state's "...sweeping reform aimed at consolidating administrative functions and standardizing services. The 39 area authorities that have supplied mental health, development disability and substance abuse services across the state are being divested, and 20 new local managing entities (LMEs) are being formed in their place. Under the new, more privatized system, the LMEs will take an administrative role, rather than directly providing services. The LMEs will coordinate services through private providers in each local area...."