Monday, January 24, 2005

The Treatment of Panic Disorder Current Opinion in Psychiatry article at Medscape - " Purpose of Review: The aim of this article is to provide an updated review of studies and recommendations published from August 2003 to August 2004 on the treatment of panic disorder. Recent Findings: Cognitive-behavioral psychotherapy remains the treatment of choice for panic disorder. Recent studies confirm selective serotonin reuptake inhibitors as the first-choice drugs in treating panic disorder. Recommendations for (adjunctive) high-potency benzodiazepines have been published. Psychoeducation and combined pharmacotherapy/psychotherapy improve treatment response. Optimal long-term treatment of panic disorder involves adequate medication and duration of treatment, since relapse is frequent. Summary: Recent studies confirm that cognitive-behavioral therapy, alone or in combination with drug therapy, remains the treatment of choice for panic disorder. Long-term treatment is often necessary due to the chronicity of the illness." [Viewing Medscape resources requires registration, which is free].  
  

Integrated models play vital role Article in BHT Newswire that originally appeared in Mental Health Weekly - "A report released last month by the actuary and healthcare consulting firm Milliman makes the case that integrated care needs to be a driving force behind the transformation of mental health care in the United States. The report, authored by Stephen P. Melek, an actuary and healthcare consultant with Milliman, and entitled "Spending on Mental Illness, the Need for Creative Innovation, and Improving the Bottom Line," examines the current mental health system and fragmentation of care; mental health spending trends in private insurance; increased costs for physical healthcare associated with mental health conditions; innovations in mental health care and the need for incremental change..." The full report, Spending on Mental Illness, the need for Creative Innovation and Improving the Bottom Line, is available in Adobe Acrobat format at no charge from the Milliman web site.  
  

A Pilot Study of Interpersonal Psychotherapy for Posttraumatic Stress Disorder American Journal of Psychiatry article at Mental Help Net - "This article describes pilot testing of interpersonal psychotherapy adapted for posttraumatic stress disorder (PTSD). Unlike most psychotherapies for PTSD, interpersonal psychotherapy is not exposure-based, focusing instead on interpersonal sequelae of trauma. ... Treating interpersonal sequelae of PTSD appears to improve other symptom clusters. Interpersonal psychotherapy may be an efficacious alternative for patients who refuse repeated exposure to past trauma. This represents an exciting extension of interpersonal psychotherapy to an anxiety disorder."  
  

The Key Assistance ReportA publication (in Adobe Acrobat format) from the National Mental Health Consumers' Self-Help Clearinghouse that has been recently added to the NMHCSC web site. Published quarterly, the Key Assistance Report is a technical assistance product designed to help consumers get what they need. Please note that the issue now online was first published in summer 2004.  
  

The Treatment Gap in Mental Health Care Red Nova article - "If disability is to be reduced, a bridging of the 'treatment gap' must occur. The treatment gap represents the absolute difference between the true prevalence of a disorder and the treated proportion of individuals affected by the disorder. Alternatively, the treatment gap may be expressed as the percentage of individuals who require care but do not receive treatment. Estimating the treatment gap in a population depends on the prevalence period of the disorder, the time frame of the examination of service utilization, and the demographic representativeness of the study sample with reference to the target population. The objective of this report is to examine the extent of the treatment gap for selected mental disorders. "  
  

2001-2002 Survey Finds That Many Recover From AlcoholismNational Institute of Health press release - "More than one-third (35.9 percent) of U.S. adults with alcohol dependence (alcoholism) that began more than one year ago are now in full recovery, according to an article in the current issue of Addiction. The fully recovered individuals show symptoms of neither alcohol dependence nor alcohol abuse and either abstain or drink at levels below those known to increase relapse risk. They include roughly equal proportions of abstainers (18.2 percent) and low-risk drinkers (17.7 percent). The analysis is based on data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a project of the National Institutes of Health’s National Institute on Alcohol Abuse and Alcoholism (NIAAA)."  
  

Relatives of mentally ill support expanding community program (Montana) Story in the Montana Standard - "Scores of people who might otherwise be institutionalized at Montana State Hospital testified before legislators Wednesday in support of expanding a community-based mental health program that has helped them lead more ordinary lives. The Program of Assertive Community Treatment, which began in Billings and Helena in 1999, helps high-risk patients with severe mental illness to live in their own homes while they receive psychiatric care. ... The Helena and Billings programs can currently accept 70 patients, but with the program expanding to Missoula, Kalispell and Great Falls, the state needs additional funding, said Joyce DeCunzo, director of the state's Addictive and Mental Disorders Division. The goal is to reach 350 patients through assertive treatment by 2007, but 80 percent of those slots are for Medicaid patients."  
  

From the Street into Homes: A Strategy to Assist Homeless Persons Find Permanent Housing (Canada) A report (in Adobe Acrobat format) from the Chief Administrative Officer of Toronto's Commissioner of Community and Neighbourhood Services. A related item in CMHA/Ontario's Mental Health Notes summarizing the report notes that it "...includes recommendations specifically to help people with mental illness and addictions who are homeless, such as increasing supportive housing units, developing a pilot multidisciplinary outreach team, improving discharge planning for those released from hospital or correctional facilities and supporting more mental health services. Funding for these services would come from existing federal and city funds, as well as through collaboration with the provincial government. "  
  

Outpatient Commitment Garners Broad Support Psychiatric News story - "Michigan has joined 24 other states in giving courts, police officers, psychiatrists, mental health professionals, and families with a means of forcing people with mental illness into treatment rather than jail. ... Since the nationwide closing of psychiatric hospitals beginning in the 1970s, states have had little power to mandate mental health care, unless someone is dangerous or convicted of a crime. Family members and advocates for mentally ill individuals in Michigan have pushed for Kevin's Law since 2001. Public awareness that the state's mental health care system is broken helped create a consensus for the bill this year."  
  

Why Are Mental Illness Rates Lower in Some Immigrants?  Psychiatric News story - "Close-knit family and social supports that Mexican Americans bring when they immigrate appear to help them ward off aspects of U.S. culture that raise risks of psychiatric disorders. Mexican-American and non-Hispanic white immigrants both have a lower prevalence of psychiatric disorders than their U.S.-born counterparts, but Mexican Americans born in the United States retain that advantage over non-Hispanic whites born here, according to a study by researchers at the National Institute on Alcohol Abuse and Alcoholism (NIAAA). "  
  

Mental health system may see more changes (Texas) Houston Chronicle story - "House Bill 2292 has changed the way mental health services are delivered in Harris County. But it's just the beginning. State Rep. John Davis, R-Houston, has filed a bill that would regionalize state-funded programs for mental health, mental retardation, substance abuse, aging and services for the disabled. Among other things, it would prohibit agencies from both overseeing services and providing them, as the Mental Health and Mental Retardation Authority of Harris County now does." See also the related story at the same source, In the shadow of a crisis.  
  

A cry for help from those with mental illnesses (Florida) News-Press story - "Demand overwhelms Lee's only psychiatric treatment facility... Ruth Cooper Center for Behavioral Health in Fort Myers operates the only program for people in urgent need of psychiatric treatment. Its crisis stabilization unit, which can treat 30 adults and 10 children at a time, stays constantly full. The county has been without a psychiatric hospital since 2000, when Charter Glade closed after its parent company ran to financial problems."  
  

Study: Bay Area Counties Rank Low in Mental Health (California) Daily Californian story - "Residents of Alameda and San Francisco counties show the greatest need for mental health services in the state, according to a report released by four UC Berkeley professors last week. Alameda and San Francisco counties ranked lowest in the state, receiving a score of 3 on a 1 to 10 scale devised to test overall well-being. Questions included limitations on activity or work due to emotional problems, sadness, anxiety, binge drinking and perceived need for mental health services..."