Monday, December 27, 2004

To Treat Autism, Parents Take a Leap of Faith
New York Times story - "esperate parents of autistic children have tried almost everything - hormone injections, exotic diets, faith healing - in the hope of finding a cure. But more than 60 years after it was first identified, autism remains mystifying and stubbornly difficult to treat. About the only thing parents, doctors and policy makers agree on is that the best chance for autistic children to develop social and language skills is to enroll them in some type of intensive behavioral therapy. ... Yet the science behind behavioral treatments is modest at best. Researchers have published very few rigorously controlled studies of the therapies, and the results of those studies have been mixed..." [Viewing New York Times resources requires registration, which is free].  
  

Correctional Psychiatry Needs More Clinicians
December 17 Psychiatric News story - "The field of child and adolescent psychiatry is not the only practice area enduring a serious shortage of trained clinicians. A similar chasm between supply and demand is a constant concern in correctional psychiatry as well, pointed out Cassandra Newkirk, M.D., at an APA Assembly session devoted to workforce issues. Newkirk, director of mental health programs at New York's huge Riker's Island prison, described the dimension of the need for psychiatrists in correctional systems by noting that of the 4 million Americans in prison or on parole in 2003, about 25 percent had a psychiatric disorder. She pointed out that inmates are the only population in the United States who have a constitutional right to mental health care. But clinicians have to be available to provide it, of course..."  
  

Recent drug warnings may spur major overhaul of FDA safety procedures
Boston Globe story reprinted at PsycPORT - "Just as the Enron scandal triggered an overhaul of corporate accounting practices, the nation's prescription drug crisis may prompt a sweeping revamp of the way the Food and Drug Administration ensures drug safety, some say. The momentum for FDA reform is driven by the recent parade of drug problems dominating the nation's front pages, including antidepressants that heighten suicidal thoughts and behaviors among children, and the painkillers naproxen, Bextra, Celebrex, and Vioxx increasing the risk of heart attacks or strokes..."  
  

Treating Childhood Anxiety Prevents Adult Disorders
Reuters Health story at Yahoo - "Panic disorders, phobias and other childhood anxiety conditions should be treated during childhood so that they won't be carried over into adulthood, according to advice in the latest Harvard Mental Health Letter. Various studies show that anxiety disorders are among the most common psychiatric conditions present during childhood. In many instances, adults with anxiety disorders experienced their first symptoms during their early childhood years. Yet many parents may not be aware that their child is experiencing such symptoms..."  
  

The Dictionary of Disorder
New Yorker feature on Robert Spitzer - "Robert Spitzer isn’t widely known outside the field of mental health, but he is, without question, one of the most influential psychiatrists of the twentieth century. It was Spitzer who took the Diagnostic and Statistical Manual of Mental Disorders—the official listing of all mental diseases recognized by the American Psychiatric Association (A.P.A.)—and established it as a scientific instrument of enormous power. Because insurance companies now require a DSM diagnosis for reimbursement, the manual is mandatory for any mental-health professional seeking compensation. It’s also used by the court system to help determine insanity, by social-services agencies, schools, prisons, governments, and, occasionally, as a plot device on “The Sopranos.” This magnitude of cultural authority, however, is a relatively recent phenomenon."  
  

Court decision on mental illness may free some patients (Oregon)
Statesman Journal story - "Oregon taxpayers have shelled out about $300,000 to keep Richard Laing locked up on crowded psychiatric wards for the criminally insane. Laing says that’s crazy. ... He could have a good case. Hospital records indicate Laing hasn’t shown symptoms of mental illness since he was committed to Oregon State Hospital’s forensic program for the criminally insane nearly three years ago. Now, the fiery mental patient is at the center of a legal controversy due to come before the Oregon Supreme Court in early January. At issue is the legal definition of mental illness, and whether people diagnosed solely with alcohol or drug dependency belong at the psychiatric hospital."  
  

Michigan renews focus on mental health crisis
Detroit News opinion column - "For decades, Michigan has suffered attention deficit disorder on the issue of mental health. It's now getting overdue focus in Lansing. Especially tragic, after wholesale closings of mental hospitals, is how the severely mentally ill end up in prisons without proper psychiatric care. The State Bar of Michigan correctly calls it "an out of control crisis." In 1960, the number of those in mental hospitals totaled more than 19,000. It fell to about 1,600 by 1995 after the deinstitutionalization craze closed most of the state hospitals. Initially, the craze seemed sensible: Community mental health services were supposed to fill the gap and provide a safety net of much less costly outpatient treatment and support services..."  
  

Don't abandon mental health (Pennsylvania)
Editorial in The Sentinel - "The word is out: Gov. Ed Rendell's administration is considering a plant to shut down the oldest state mental hospital in Harrisburg. It isn't any news that government doesn't want to run institutions for the mentally ill or retarded. That message has been sent out for several decades. The Associated Press attributes falling demand for services for institutional care has closed 11 of the 20 state hospitals that were in operation 25 years ago. The original idea was to provide care closer to home — meaning the community would provide... What? How? Oh yes, letting patients out of these hospitals also gave them back their rights. To do what? Many had no place to go, but the community was supposed to take care of that. There was an initial burst of funding which didn't last. And funding for such services then fell into a horrible rut marked 'Irrevocably insufficient.' "  
  

Mental health unit to reopen (Massachusetts)
Story in The Republican - "The Hampden County House of Correction in Ludlow is poised to reopen its unit for inmates with acute mental health problems after a three-year hiatus. The jail's Evaluation and Stabilization Unit had been a model for providing mental-health care behind bars before it lost its funding in 2002. With some lobbying by Sheriff Michael J. Ashe Jr., the Legislature has appropriated $1 million to fund the program in 2005, according to Dr. Thomas J. Conklin, director of mental health services at the Hampden County Jail and House of Corrections and Correctional Center at Stony Brook. It will serve all four Western Massachusetts counties."