Wednesday, January 26, 2005

Custody Relinquishment: An Avoidable TragedyA policy update from the National Association for the Dually Diagnosed - "Every year many parents of children who have both developmental and emotional disorders are faced with an impossible situation. They must either deny their children the intensive services they desperately need or relinquish custody to state authorities. This tragic choice typically arises when a child requires very costly and specialized care but community-based programs are inadequate. It is not unusual for private medical insurance to severely restrict mental health care as well as habilitation for developmental disabilities. If a family exhausts all available resources, they may be forced to transfer custody of their child to state authorities in order to access intensive treatment. The son or daughter is often sent far from home and the parents lose their ability to monitor the quality of the care their child receives. This is certainly not a new problem for the developmental disability community, but it is completely avoidable..."  
  

Teen Suicide Attempters Benefit From Outpatient Treatment Reuters story at Medscape - "For adolescents who attempt suicide, suicidal ideation is reduced and mood improves when outpatient psychotherapy is maintained over 6 months, according to the results of a pilot trial conducted by researchers at Brown Medical School in Providence, Rhode Island. Dr. Deidre Donaldson and colleagues compared two individual-based treatments for adolescent suicide attempters -- a skills-based, cognitive-behavioral treatment designed to teach problem solving and affect-management skills (SBT), and a nondirective, supportive relationship treatment (SRT). Their findings are published in the February issue of the Journal of the American Academy of Child and Adolescent Psychiatry." "med"  
  

Mental Illness Increases Risk of Obstetric Complications Reuters story at Medscape - "Women with schizophrenia or a major affective disorder have increased risks of pregnancy, birth and neonatal complications, according to a study in the American Journal of Psychiatry for January. ... There is also some evidence that maternal obstetric complications are associated with offspring's risk of schizophrenia in adulthood, they add." [Viewing Medscape resources requires registration, which is free].  
  

Studies linking Ritalin and depression highlight risk of overdiagnosing ADHDAP story reprinted at PsycPORT - "New research is raising questions about the long-term effects of Ritalin and other drugs widely used to treat attention-deficit hyperactivity disorder. While most people agree that Ritalin and similar drugs can dramatically improve the lives of kids suffering from ADHD, doctors and parents have long been concerned about how the drugs might affect a child's developing brain. Now, new studies in rats suggest that methylphenidate, the generic name for Ritalin, may permanently alter the brain and may lead to depression in adulthood. While the studies have limits - a rat's brain is obviously very different than a child's - the research nonetheless highlights the need to be sure of an ADHD diagnosis before putting a child on medication..."  
  

Understanding The Recent Growth In Medicaid Spending, 2000–2003Article in Health Affairs - "Growth in Medicaid spending averaged 10.2 percent per year between 2000 and 2003, resulting in a one-third increase in program spending. Spending growth was lower from 2002 to 2003 because of slower growth in enrollment and in spending per enrollee, particularly for acute care services, and declines in disproportionate-share hospital (DSH) payments and upper payment limit (UPL) programs. For the entire 2000–2003 period, Medicaid spending increases were largely driven by enrollment growth, much of which was attributable to the economic downturn. Increases in spending per enrollee over the period were faster than inflation but slower than increases in private insurance spending..." The article is also available in Adobe Acrobat format. See also the related press release from the Kaiser Commission on Medicaid and the Uninsured.  
  

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..."  
  

Almost 500,000 face mental health woes in Indonesia's tsunami-hit AcehAFP story reprinted at Yahoo - "Almost 500,000 tsunami survivors are facing mental health problems in Indonesia's Aceh province, the World Health Organisation expert Benedetto Saraceno said, calling for support for those at risk. ... Saraceno said the WHO alongside the Indonesian health ministry would help establish community centres across Aceh, but local counsellors needed to be trained to give the necessary support to traumatised adults and children..."  
  

Fresh path to mental health (New York)Democrat & Chronicle story on "...a pilot project aimed at transforming how community mental health centers, hospitals and day programs serve adults — and it's saving some money at the same time. ... The buzzword at the downtown Rochester offices of Care Coordination is 'person-centered planning.'" The story notes that "several hundred mental health professionals in the six participating counties who have received this training, which emphasizes empowering patients by asking them what they want, rather than telling them what to do. ... Care Coordination also tailors services to each client and monitors their progress. The end goal is to move clients from sheltered day programs to greater independence and to fuller integration into the community."  
  

Mental-health official backs hospital closing (Pennsylvania)Patriot News story - "Pennsylvania's top mental-health official says there's no 'agenda' behind closing Harrisburg State Hospital other than providing better treatment for the mentally ill and improving community-based services. ... But at a public hearing tomorrow, Erney is likely to hear people demand that the state address shortages of community-based services before attempting to place more patients in the community. A recent assessment of the seven counties affected by the closing -- done before the state announced it would close Harrisburg State Hospital -- concluded that the waiting list for housing services is nearly equal to the number of people receiving such services..."