Tuesday, March 09, 2004

Companies Facing Ethical Issue as Drugs Are Tested Overseas
March 5 New York Times story - "As companies increasingly test new drugs in other countries, they are struggling to decide what, if anything, they owe the patients who served as test subjects. Some companies have chosen not to sell their drugs in the countries where they were tested; others have marketed their drugs there, but few patients in those countries can afford them. ... Ethicists say that they, too, are troubled but that their field has reached no consensus on what companies should do." [Viewing New York Times resources requires registration, which is free].  
  

The Potential of 'Brain Pacemakers'
Washington Post story reprinted at PsycPORT - " A handful of scientists around the world have begun cautiously experimenting with devices implanted in patients' bodies to deliver precisely targeted electrical stimulation to the brain in hopes of treating otherwise hopeless behavioral, neurological and psychiatric disorders. While stressing that the ethically sensitive research with 'brain pacemakers' has just begun, the scientists say the results so far have been so promising that it could mark the beginning of a new era in treating often intractable cases. The approach builds on rapid recent advances in understanding how the brain works, on high-tech imaging technologies that allow surgeons to pinpoint targets with unprecedented precision, and on the miniaturization of computerized electronic devices that can safely be inserted under the skin."  
  

Twin study finds possible connection between depression, heart disease
Emory University press release at EurekAlert - "Depression is a recognized risk factor for coronary heart disease (CHD) and, by studying pairs of twins, researchers from Emory and Yale believe they have found a mechanism that explains this link. In research announced today at the American College of Cardiology's 53rd Scientific Sessions in New Orleans, the scientists say they found a decrease in heart rate variability (HRV) in those twins who were depressed as compared to their non-depressed siblings."  
  

Drug Maker Alters Procedure In Medical Study After Participant Commits Suicide
AP story at InteliHealth - "Eli Lilly and Co. said Friday that it will lengthen the withdrawal period used to wean participants in a drug study off an experimental medication after the suicide of a 19-year-old woman who was taking part in the tests. Lilly required mental-health evaluations of test subjects after the Feb. 7 suicide of Indiana college student Traci Johnson. Some participants complained of sleeplessness, anxiety or nervousness during their withdrawal from duloxetine, a drug Lilly is testing for two uses: depression and stress urinary incontinence. But the company has said none reported symptoms that suggested a suicide risk. Indianapolis-based Lilly has now doubled the tapering period for the drug from four days to eight days."  
  

Administration Sets Forth a Limited View on Privacy
March 5 New York Times story - "In a sharp departure from its past insistence on the sanctity of medical records, the Bush administration has set forth a new, more limited view of privacy rights as it tries to force hospitals and clinics to turn over records of hundreds and perhaps thousands of abortions. Federal law 'does not recognize a physician-patient privilege,' the Justice Department said last month in court papers that sought abortion records from Planned Parenthood clinics in California, Kansas, Missouri, Pennsylvania, New York City and Washington. Moreover, the department said in another abortion case, patients 'no longer possess a reasonable expectation that their histories will remain completely confidential.' Health lawyers and privacy experts said that position reflected a significant shift after six years in which Bush and Clinton administration officials had promised to strengthen the confidentiality of medical records." [Viewing New York Times resources requires registration, which is free].  
  

Helping the homeless solutions, not shelters
St. Louis Post Dispatch story - "...Getting people out of shelters and into supported housing makes economic as well as moral sense, said Philip Mangano, executive director of the U.S. Interagency Council on Homelessness. The agency is creating the federal plan to end chronic homelessness. Mangano points to a nine-year study that tracked nearly 10,000 mentally ill homeless people. Researchers from the University of Pennsylvania's Center for Mental Health Policy and Services found that a mentally ill homeless person annually used about $41,000 worth of publicly funded services. When half of these people were placed into permanent housing with a variety of social services provided, the costs were reduced by more than $16,000 a year. That's because the need to rely on tax-supported programs and shelters dramatically decreased, as did incidents of incarceration, hospitalizations and other services."  
  

More Mentally Ill Incarcerated
A Pacific News Service commentary piece - "In the 19th century, many mentally ill patients were locked up in their homes by families embarrassed by their conduct and ignorant about the illness. But with more medical knowledge about the nature of mental illness, this was seen as barbaric and mental hospitals were created to care for these patients. As problems surfaced with these mental hospitals in the latter half of the 20th century, many were closed with the understanding that community treatment facilities would be put in place for their former patients. But these community-based services were never adequately funded so today instead of locking our mentally ill up in our homes, it seems we have opted to lock them in prisons and jails. "  
  

New UConn poll reflects prison reform support (Connecticut)
Middletown Press story - "The University of Connecticut’s Center for Survey Research & Analysis found that 89 percent of those surveyed support sending mentally ill offenders to mental health facilities as a way to reduce prison overcrowding, an issue under consideration this session by the General Assembly’s Judiciary and Appropriations committees. At the same time, 84 percent answered in favor of sending drug abusers to substance abuse treatment instead of prison, and 76 percent said education, counseling and transitional services need to be provided for parolees..."  
  

Ohio strapped for cash again
Cincinatti Enquirer story - "Ohio is once again short on cash, eight months after lawmakers and Gov. Bob Taft raised taxes to balance the state budget. Taft's budget office reported Monday that sluggish income tax collections will sink the state's finances $300 million in the red by June 30, 2005. Officials linked the new deficit to the lingering effects of the national recession, which has cost thousands of Ohio manufacturing jobs. ... The state's prison, mental health and mental retardation programs will lose 1 percent of their funding over the next four months and 2 percent in the fiscal year starting July 1."  
  

Missouri picks vendor to recover Medicaid, mental health costs
St. Louis Business Journal story - "The state of Missouri has contracted with New York-based Health Management Systems Inc. to help recover costs from Medicaid and the state's mental health care system. Financial terms were not disclosed. It is the first time the state's Department of Mental Health has contracted with a third-party vendor. Health Management Systems (HMS) helps Medicaid and other government health-care programs recover costs from third-party sources of health insurance..."  
  

Mental health association asserts that mandatory insurance actually saves (New York)
Albany Business Review story - "Passing 'Timothy's Law' - which mandates full insurance coverage for all mental health and chemical dependency treatment - would save New York taxpayers $218 million annually, according to the Mental Health Association of New York State Inc. The tax savings, said Mental Health Association President Joseph Glazer, would offset any increases in insurance premiums that employers would see if the new mandate were added."  
  

California Mental Health Agency Is in Financial Straitjacket
Knight Ridder wire service story in the Miami Herald - "An outpatient mental health clinic system operated by three cities filed for Chapter 9 bankruptcy protection Feb. 13 in U.S. Federal Court, Central District in Los Angeles. It is the first bankruptcy of a California public mental health agency in at least 10 years, a state official said. Tri-City Mental Health is a municipal joint powers authority serving Claremont, La Verne, Pomona and surrounding communities with three clinics and 70 offsite locations and schools, according to its Web site. The organization claimed a budget of nearly $28.5 million for fiscal 2002-2003, funded by more than 30 sources, the agency said on its site."