Wednesday, February 18, 2004

Rewarding Results: Improving the Quality of Treatment for People With Alcohol and Drug Problems
A December 2002 report (in Adobe Acrobat format) now available at the Join Together web site - " In December 2002, Join Together convened a national, non-partisan panel of experts and asked them to develop specific recommendations to improve the treatment of substance use disorders. The panel's primary recommendation is that purchasers of treatment services should reward results -- an idea that is very consistent with other leading edge efforts to improve the quality of health care for other diseases. The report outlines the reasoning behind this recommendation and the changes in measurement and accountability that will need to be established to implement a results-based reimbursement system. The panel also makes specific recommendations to payers and providers about the steps they should take to shift to a system that recognizes and rewards the providers who consistently deliver better treatment outcomes."  
  

Panel rejects proposal to close, downsize VA hospitals
Gannett News Service story reprinted at the NAMI web site - "A federal commission formally rejected Friday Bush administration proposals to close the veterans hospital at Canandaigua and consolidate services at hospitals in Westchester and Dutchess counties. But the panel studying an overhaul of veterans health care nationwide also recommended that inpatient psychiatric units -- specialties at the VA's Canandaigua and Montrose hospitals -- be transferred to other facilities in their regions. Such action, however, should be delayed until the VA completes more studies on veterans' mental health needs, the commission said in a report to VA Secretary Anthony Principi..."  
  

Annual Report of the Office of the Provincial Auditor of Ontario: Children’s Mental Health Services
This report (in Adobe Acrobat format) is available at the Open Minds web site. The report notes that "Our audit objectives were to assess whether the Ministry’s administrative procedures were adequate to ensure that: the quality and outcome of services provided by the community-based agencies wasmonitored and assessed; and that transfer payments to agencies were reasonable and satisfactorily controlled. The scope of our audit included a review and analyses of ministry files and administrativeprocedures, as well as interviews with appropriate staff at the Ministry’s head office and threeregional offices. We also visited a number of agency sites and interviewed staff there..."  
  

Early Treatment May Prevent High-Risk Patients From Progressing to Psychosis
Medscape Medical News story - "Early treatment may prevent high-risk patients with subthreshold symptoms from progressing to the first episode of psychosis (FEP), according to a presentation at the International Congress on Biological Psychiatry meeting held in Sydney, Australia, from Feb. 9-13. The results of this randomized controlled trial also were published in 2002 in the Archives of General Psychiatry..." "med"  
  

Erasing Racial Data Erased Report's Truth
Opinion column in the Los Angeles Times by M. Gregg Bloche, who teaches law and health policy at Georgetown and Johns Hopkins universities - "Do black Americans receive poorer healthcare than whites? Two years ago, a National Academy of Sciences panel on which I served concluded that the answer was yes. At the behest of Congress, we had reviewed hundreds of research studies, gathered diverse views and issued a report documenting widespread racial disparity in dispensing medical care. ... But this report was never published. In its place, the Department of Health and Human Services issued a cheery rewrite touting administration successes and asserting that claims of minority groups receiving worse care than whites were unproved." [Viewing Los Angeles Times stories requires registration, which is free].  
  

Antidepressants found ineffective on teenagers (Canada)
Story in the Globe and Mail (Toronto) - "Widely used antidepressant drugs prescribed to tens of thousands of Canadian teens and children are barely more effective than placebos in treating adolescent depression, according to a leading Canadian expert in the field. The assertion by psychiatrist Jane Garland follows a recent cascade of critical information questioning the risk and effectiveness of prescribing antidepressant medication for troubled young patients..." See also Garland's article in the Canadian Medical Association Journal, Facing the evidence: antidepressant treatment in children and adolescents (also available in Adobe Acrobat format).   
  

New Options for Dual Diagnosis Patients
NIAA press release at the About Mental Health web site - " Individuals who have co-existing alcohol-use and psychiatric disorders must overcome a number of significant hurdles on their way to recovery: multiple health and social problems, double the stigma, a poor response to traditional treatments, a lack of joint treatment options, and a chronic cycle of treatment entry and re-entry. Symposium proceedings published in the February 2004 issue of Alcoholism: Clinical & Experimental Research examine treatment options for this group, with a focus on four major psychiatric disorders: social anxiety disorder, depression, bipolar disorder, and schizophrenia."  
  

Mental health reform called a challenge (North Carolina)
Fayetteville Observer story - "Cumberland County Mental Health Board members were told Monday that the county's mental health program may have a harder time implementing state reform than other counties. Janet Schanzenbach spoke to members of the Mental Health Board during a training retreat Monday. She is the deputy director for the N.C. Council of Community Programs, a private trade group. She said the county's mental health program will be responsible for monitoring all mental health service providers in the county when the reform plan goes into effect July 1. The county will be responsible for monitoring when a complaint is filed against the providers. In the past, the county has been responsible for monitoring only facilities with contracts with the Mental Health Center. Schanzenbach said the reform plan would quadruple the number of facilities monitored by the Mental Health Center."  
  

Mental health agency makes cuts, is trying to save services (Maryland)
Baltimore Sun story - "... Howard County's Mental Health Authority was created in 1997 to bring more local control to the delivery of mental health services to county residents. Similar organizations serve residents throughout Maryland. The agencies, which receive most of their funding from the state Mental Hygiene Administration, are managed in different ways. Typically, they do not provide clinical services but direct public and private funds to an array of providers and programs for the mentally ill. "  
  

Mental health issues said to cost economy $33 billion a year (Canada)
Vancouver Sun story - "Mental health is the leading cause of worker disability and it is striking the most productive members of the labour force, according to key business leaders who met Tuesday to warn corporate directors that they ignore the problem at their peril. The Global Business and Economic Roundtable on Addiction and Mental Health issued its Board of Directors Guideline on Mental Health and Safety, an initiative spearheaded by John Evans, a physician and chairman of the board at Torstar Corporation."  
  

Court Upholds Judges' Right to Compel Medication (New York)
New York Times story - "The state's highest court on Tuesday upheld the constitutionality of a law that gives judges authority to force mentally ill people to comply with treatment. The statute, commonly known as Kendra's Law, was originally passed in 1999 after Kendra Webdale, 32, was killed when she was thrown in front of an oncoming subway train. The assailant was a man who had been found to be schizophrenic and prone to violence, but who did not take his antipsychotic medicine.  By passing the law, New York joined nearly 40 other states that had similar statutes, the state's Court of Appeals said in its decision..." [Viewing New York Times resources requires registration, which is free].