Thursday, February 10, 2005

Medicolegal Considerations in the Treatment of Psychosis With Second-Generation Antipsychotics Psychiatric Times article - "Are the metabolic side effects of the atypical antipsychotics fueling the next round of malpractice suits being filed against psychiatrists? Guidelines are being created, but how can clinicians protect themselves and their patients, while continuing to give their patients the best care available?"  
  

Maintenance and Long-Term Treatment Issues in Selected Special Populations: Schizophrenia  CME unit at Psychiatric Times - "What special issues do psychiatrists face when treating women, children and adolescents, and elderly people with schizophrenia? Are there recommendations for care and monitoring strategies to maintain patients on effective, long-term treatment regimens? "  
  

FY 2006 Budget Hurts Mental Illness Programs Alert at the NAMI web site - "As a federal entitlement, Medicaid is not subject to the same annual appropriation by Congress that discretionary programs are. Nonetheless, the President's budget does include a number of recommended reductions for Medicaid that Congress is likely to consider as part of a budget "reconciliation" bill that will be taken up later this year. Overall, these reductions are projected to reduce federal Medicaid spending (i.e. federal matching funds for the states) by $20 billion over the next 5 years and $60 billion over the next decade. While full details of these reductions are not available yet, they appear to target reforms aimed at curbing methods that states have used to maximize federal matching funds..."  
  

DHEA May Be Effective for Midlife-Onset Minor and Major Depression A new Medscape Medical News CME unit - "Dehydroepiandrosterone (DHEA) can be effective for midlife-onset minor and major depression, according to the results of a placebo-controlled, randomized trial published in the February issue of the Archives of General Psychiatry." [Viewing Medscape resources requires registration, which is free].  
  

NICE guidelines for the management of depression (UK) Editorial in the British Medical Journal - " Guidelines from the National Institute for Clinical Excellence (NICE) focus on clinical conditions that have a substantial impact on public health and aim to improve standards of care and reduce variations in provision. Depression is a common condition, contributing 12% of the total burden of nonfatal global disease. Variations in its treatment within the NHS are striking and perplexing.We welcome these guidelines and recent advice from the Medicines and Healthcare products Regulatory Agency (MHRA) concerning the prescription of antidepressants. The methods underpinning the guidelines were rigorous and produced a definitive summary of current evidence. However, the uncertainty of many recommendations is disappointing. The guidelines advocate a stepped care approach, but the weakness of evidence supporting structured interventions for mild to moderate depression limits the value of recommendations referring to initial steps." See also the NICE Guidelines (Adobe Acrobat format).  
  

Making Medicaid a Block Grant Program: An Analysis of the Implications of Past Proposals A report, in Adobe Acrobat format, by Jeanne Lambrew of George Washington University commissioned by the Kaiser Commission on Medicaid and the Uninsured - "In 2003, President Bush proposed converting Medicaid from an entitlement to a block grant program. Similar ideas from President Reagan in 1981 and Congress in 1995 were introduced but not enacted. Block grants aim to provide greater federal budget certainty and a stronger state incentive to contain program costs. This paper compares the preestablished funding levels proposed in 1981 and 1995 with what actually happened to federal Medicaid spending. Its results show that previous block grant proposals’ funding levels at the national and state levels were quite different from what was anticipated and what occurred. As a result, Medicaid probably could not—and cannot—maintain existing health coverage under a block grant financing structure."  
  

Healthcare Costs Take Big Bite From Economy Los Angeles Times story - "Increased spending for healthcare is gobbling up about one-quarter of the growth in the economy, and health-related items now amount to more than three times the defense budget and twice what the nation devotes to education, a report released today concludes. The study by researchers at the Boston University School of Public Health comes as the Bush administration and lawmakers of both parties cautiously are trying to restart a national debate on how to rein in costs and cover an estimated 45 million Americans who lack health insurance." [Viewing Los Angeles Times stories requires registration, which is free]. See also the full report (Adobe Acrobat format, 56 pages).  
  

Agencies forge partnership (California) Eureka Reporter story - "Mental health counseling, child abuse prevention, dental care and parent education are just a few of the services that could be enhanced by a new partnership being formed between the Department of Health and Human Services and Community and Family Resource Centers. Agency representatives met recently in the first step to strengthen relationships and connections that will eventually help all of the agencies provide improved services to the community. The Department of Health and Human Services has received funds to restructure the Child Welfare Services program. In addition, the department is in the process of applying for several grants and has committed $300,000 to Community or Family Resource Centers..."  
  

Mental health program advocates rally against budget cuts (Maine) Story at MaineToday.com - "Sign-carrying supporters of mental health programs around Maine jammed State House corridors Tuesday, voicing opposition to cutbacks proposed in Gov. John Baldacci´s $5.7 billion budget package. Health and Human Services Commissioner John Nicholas, presenting details to two legislative committees for a second day, took pains to stress what he called enduring state support for social services."  
  

Mental Health Care In Texas Is “Broken,” Group Says  KWTX story - "The Mental Health Association in Texas called on state legislators Tuesday to restore millions of dollars cut from mental health funding in 2003, saying mental illness is costing the state as much as $16.6 billion a year." See also the Association's report, Turning the Corner (Adobe Acrobat format) - " Texas is turning the corner, and we have it within our reach to combine our economic opportunity with our moral obligation. Will we do the right thing? Or will Texans with mental illness continue to face closed doors in their quest for care? State government's ability to reflect our common values and most positive impulses is at stake. Surely, in a land with such wide horizons, where independence is so prized and fairness so fundamental, we can find the will to include everyone as we turn the corner toward a future of progress and prosperity." See also the related story from News 8 Austin, Cuts to mental health services cost billions in long run.  
  

Mental-health parity: Is it justified? (Washington) A brief introduction in the Seattle Times - "State lawmakers are weighing legislation this session that would require health insurance to cover psychiatric disorders on an equal basis with other illnesses..." - and two opposing points of view, Pro: End discrimination against the mentally ill and Con: Why waste money, endanger civil liberties?.  
  

Redefining mental health (UK) BBC story Harplands Hospital in north Staffordshire - "Health chiefs explain how they aim to break the mould and become one of the first mental health trusts to achieve foundation status.  ...  The hospital, sandwiched in between two schools, replaced a Victorian asylum situated 10 miles away in a small rural community three years ago. North Staffordshire medical director Dr Roger Bloor said the trust purposely cited the hospital in a residential area to show the local community that mental health was not something that needed to be hidden away. "