Tuesday, October 19, 2004

Website of patients' experiences launches new module on depression
British Medical Journal news story - " An internet health resource that draws on the experiences of patients to inform others has launched a new module on depression, its first mental health condition. The Database of Individual Patient Experiences (DIPEx) already provides information on 13 conditions, including breast cancer, heart disease, and epilepsy, and distinguishes itself from other sites by relating people’s personal experiences of an illness. For the depression module researchers interviewed 38 men and women between the ages of 16 and 57 from all over the United Kingdom with various types and degrees of depression. They talk about their personal anxieties and, sometimes, despair; which treatments helped them; and how they recovered from their illness. Their stories are available on the website in video, audio, or written format and are backed up with general information about depression and how it is treated..." See also the depression section of the DIPEx web site.  
  

Bush vs. the Laureates: How Science Became a Partisan Issue
New York Times article - "Why is science seemingly at war with President Bush? For nearly four years, and with rising intensity, scientists in and out of government have criticized the Bush administration, saying it has selected or suppressed research findings to suit preset policies, skewed advisory panels or ignored unwelcome advice, and quashed discussion within federal research agencies. Administration officials see some of the criticism as partisan, and some perhaps a function of unrealistic expectations on the part of scientists about their role in policy debates..." [Viewing New York Times resources requires registration, which is free].  
  

Mental Health Treatment for Youth in the Juvenile Justice System: A Compendium of Promising Practices
A September 2004 report, in Adobe Acrobat format, from the National Mental Health Association - "This document lays out what is currently known to be effective practices through evidence-based research, and what promises to be effective practices. It starts with a review of the basic values and principles that are the foundation of effective practices, as well as the essential components of the mental health services array. Then, evidence-based treatment programs are highlighted, as well as treatment approaches that show promise but require more research. Finally, examples of successful services exemplify how communities across the country are addressing the mental health needs of children and adolescents involved in the justice system..."  
  

Ontario begins review of community treatment orders (Canada)
Item in Mental Health Notes, published by CMHA-Ontario - "The Ontario government has asked mental health professionals, patients, family members and other stakeholders to provide feedback on the use and effectiveness of community treatment orders (CTOs). Community treatment orders were introduced through Brian’s Law in 2000, which amended the provincial Mental Health Act. According to the Act, community treatment orders are designed to provide people with serious mental illness with a comprehensive plan of community treatment that is less restrictive than treatment in a psychiatric facility. The legislation requires the Ministry of Health and Long-Term Care to conduct a review of CTOs during the third year after they came into use. The review will examine the reasons that CTOs were or were not used, the effectiveness of CTOs, and the methods used to evaluate any treatment delivered under CTOs. The ministry’s final report is due in July 2005..." See also the Community Treatment Orders: Ontario Legislated Review web site and the page on the CMHA web site on CTO's.  
  

A Patient's Suicide, a Psychiatrist's Pain
Feature article in the New York Times by Dr. Richard A. Friedman, written after one of his patients committed suicide - " In a random survey of psychiatrists, conducted over a decade ago, roughly half reported having had a patient commit suicide. Younger, less experienced clinicians were more affected by a patient's suicide than more experienced colleagues, the survey found. Despite this, psychiatry residency programs put very little emphasis on this sometimes career-defining event. In a 2004 study by the American Foundation for Suicide Prevention, published in The American Journal of Psychiatry, Dr. Herbert Hendin reported that over one-third of 34 therapists who experienced a patient's suicide suffered severe distress..." "nyt"  
  

Over $35 Million Awarded to Increase Local Substance Abuse Treatment
SAMHSA press release - "HHS Secretary Tommy Thompson today announced 24 grants to expand or enhance access to substance abuse treatment services in communities facing serious, emerging substance abuse problems. The three-year grants total $35 million and are administered through HHS’ Substance Abuse and Mental Health Services Administration (SAMHSA). ... Grants are being awarded in four categories: Innovative Approaches, Minority Populations, Rural Areas, and Methamphetamine Treatment." The press release also details recipients of the grants.  
  

APA Responds to New FDA Warning on Antidepressants
Press release, in Adobe Acrobat format, from the APA - "The American Psychiatric Association believes antidepressants save lives. As part of a comprehensive treatment plan, antidepressants can be extremely helpful for many young people struggling with depression, an illness with significant long-term consequences, including an increased risk for suicide. We believe the biggest threat to a depressed child’s well-being is to receive no care at all. We restate our continued deep concern that a 'black box' warning on antidepressants may have a chilling effect on appropriate prescribing for patients. This would put seriously ill patients at grave risk..."  
  

Congress Hammers FDA Over Handling of SSRIs
Psychiatric News story - "Officials of the U.S. Food and Drug Administration (FDA) first suspected an increase in suicidal thoughts and behaviors linked to antidepressant use in children and adolescents in March 1996—eight and a half years ago. Yet no apparent action was taken by the agency until a pattern seemed to emerge in the first half of 2003. During a dramatic pair of hearings before the House Energy and Commerce Committee's Subcommittee on Investigations and Oversight last month, FDA officials were repeatedly put on the defensive as to whether there existed a conspiracy to cover up the link between the drugs and harmful behaviors. Unsatisfied with answers and explanations from agency officials during the second hearing, at least two committee members, Rep. Diana DeGette (D-Colo.) and Rep. Bart Stupak (D-Mich.), threatened to introduce legislation banning the prescribing of antidepressants to anyone under age 18 'if the FDA didn't act forcefully and swiftly to protect America's children.' "  
  

Psychiatrists Link Racism, Poor Mental Health
Psychiatric News story - "Two prominent African-American psychiatrists explain to the Congressional Black Caucus the toll that centuries of racism continue to exact on the mental and physical health of black people in the United States. Deep-seated racism in the United States sets in motion a 'vicious cycle' whose psychological and biological consequences have a crushing impact on health status. Depression and all its sequelae are an inevitable and particularly devastating part of this cycle, Annelle Primm, M.D., told a special meeting of the Congressional Black Caucus in September."  
  

SSRI Prescriptions to Youth On Decline Since February
Psychiatric News story - "Conflicting emotions, combined with uncertain data, led to the FDA advisory committees' arriving at a split vote recommending black-box warnings for antidepressants. Now concerns about the drugs' safety could make a difficult situation worse. It did not take long for the data on prescriptions of antidepressants to children and adolescents to reflect shifting patterns as physicians reacted last spring to the potential connection between SSRIs and suicidal thoughts and behaviors. Now, serious concerns are being expressed about the probable impact of a "black-box" warning, jointly recommended last month by two Food and Drug Administration (FDA) advisory committees..."  
  

Access and eligibility are big hurdles (Michigan)
Story in the South Bend Tribune (Indiana) - "How many children could be greatly helped by early, ample mental health care is anybody's guess. But experts agree the needs far outpace what's available. ... with no single entry route into the system, pervasive budget woes and insufficient insurance coverage, hundreds of Michigan children instead end up in detention facilities or as wards of the state. Thousands of others receive inadequate or no mental health care. Access to services is confusing, and eligibility requirements often discourage early intervention, meaning it often takes a crisis to get help.  
  

New research needed to reduce suicide in our young people
Story in Medical News Today (UK) - "Youth suicide is a major global public health issue and consistently ranks as one of the leading cause of death for adolescents aged 15 -19. Suicide accounts for 30% of deaths in the 15-24 year age group. Studies have shown that many young people that die by suicide or who make a serious attempt have a recognisable psychiatric disorder such as depression, anxiety, conduct disorder and substance abuse at the time of their attempt. Youth suicide prevention, is a joint initiative between the Health Development Agency, the Institute of Public Health in Ireland and Programme for Action in Ireland. It aims to identify all systematic reviews in this field and to analyse and combine the evidence to highlight what measures work to prevent youth suicide. "  
  

Opposition to South Vancouver drug rehab centre continues (Canada)
Vancouver Sun story - "A proposed centre for people suffering from both mental-health problems and drug addiction has divided a south Vancouver neighbourhood. Many have vowed to stop the facility any way they can, and came out in force to speak against the project at a packed community meeting Monday night. More than 500 people attended the meeting..."  
  

Plight of patients who are denied their rights (UK)
Feature story in The Times - "Many thousands of people who are given psychiatric hospital treatment they do not fully understand have had their plight highlighted by a ruling in the European Court of Human Rights. Each year up to 50,000 people with mental incapacity are given such treatment without their consent or statutory safeguards. This month the European court found that “HL”, a man in his fifties with autism and severe learning disability who had been admitted to hospital, kept under sedation, and not allowed to see the carers he normally lived with, had been deprived of human rights protections against unlawful detention and treatment in hospital. Those protections are provided via the Mental Health Act. No one can be compulsorily treated in hospital unless two doctors have agreed in writing that statutory conditions defining the disorder and the need for compulsory care have been met."  
  

Mental health care strain weighs on providers (Texas)
Houston Business Journal story - "The number of mental health patients seeking treatment at Ben Taub General Hospital has nearly doubled since 2002 and is steadily climbing, leaving hospital officials strained in the way of financial and human resources. And the recent decision by the Department of State Health Services to allow the Mental Health and Mental Retardation Authority of Harris County to serve 430 fewer patients this year is expected to only make matters worse, says Ben Taub Chief of Psychiatry Dr. John Burruss. The cutback, coupled with the likelihood that the agency will not be accepting new patients, has Burruss and other local mental health professionals concerned..."