Tuesday, February 22, 2005

Integrating Behavioral Health and Primary Care Services: Opportunities and Challenges for State Mental Health Authorities  A 53 page January 2005 report (in Adobe Acrobat format) from the National Association of State Mental Health Program Directors Medical Directors Council - "The work group reviewed current literature, consulted with leading researchers and provider organizations that are successfully implementing integration models for “safety net” populations, and shared examples of efforts underway at state and local levels. There is ongoing research regarding the medical cost offsets that may accrue through provision of Behavioral Health (mental health and substance abuse) as well as Behavioral Medicine services to the primary care population, including early screening for and delivery of Substance Abuse (SA) services in Primary Care (PC)—thus, the report generally references Behavioral Health (BH) services rather than solely Mental Health (MH) services. The discussion considered both population-based and person-centered approaches to care. Recognizing that the emphasis and level of activity will vary from state to state, the report focuses separately on the need for overall system coordination, the needs of persons with serious mental illness, and needs of populations served in primary care. The report integrates two conceptual models that assist in thinking about populationbased and systemic responses..."  
  

A Host of Anxiety Drugs, Begat by Valium New York Times story - "...Valium reached the height of its popularity in 1978, a year when Americans consumed 2.3 billion of the little yellow pills. But by the 1980's its reputation for creating abuse and withdrawal problems was well known, and the new selective serotonin reuptake inhibitors like Prozac were widely considered better treatments for anxiety and panic disorders. Still, the benzodiazepines - there are now more than a dozen others available besides Valium - never disappeared. They are still widely prescribed and, in the view of many doctors, extremely effective in treating not only anxiety and panic disorder, but bipolar illness, insomnia, catatonia and alcohol and drug withdrawal. 'The key is to use them correctly,' said Dr. Eric Hollander, director of clinical psychopharmacology at Mount Sinai School of Medicine in New York. Using them correctly is not so simple. Benzodiazepines cause sedation, which can be either therapeutic or a side effect, depending on the patient's ailment. " [Viewing New York Times resources requires registration, which is free].  
  

Scientists Criticize Bush Administration for Allegedly 'Stifling' Advancements Item in the outstanding Kaiser Daily Health Policy Report - "The 'voice of science is being stifled' by the Bush administration, which includes few scientists in policy discussions and has proposed reductions in funds for research and education programs, according to speakers at a meeting of the American Association for Advancement of Science on Sunday, the AP/Atlanta Journal-Constitution reports. According to the AP/Journal-Constitution, speakers said that some scientists in federal agencies are 'being ignored or even pressured' to revise study conclusions when they do not agree with administration policies..."  
  

National Governors Association Analyzes President's Budget, Medicaid Proposals NGA press release at their web site - "President Bush's $2.5 trillion fiscal 2006 budget includes a 1 percent decrease in non-defense discretionary spending less homeland security. The health care changes include a $60 billion reduction in Medicaid spending over 10 years; $16.5 billion Medicaid and SCHIP spending increases; and several health care-related federal tax incentive provisions totaling about $125 billion over 10 years to expand insurance coverage." See also NGA's Analysis of the Proposed FY 2006 Budget (Adobe Acrobat format) and the San Francisco News Chronicle story, Governors Oppose Bush's Medicaid Cuts.  
  

Mental illness targeted (California) San Bernadino Sun story - "Half a million more people are expected to settle in San Bernardino County by 2010 a population surge that will undoubtedly strain the county's health-care system. West End areas, such as Ontario, Chino and Rancho Cucamonga, as well as Fontana, already are experiencing the growth. As a way to combat the influx of children and adolescents suffering from mild to severe behavioral disorders in that area, Kaiser Permanente Medical Center in Fontana recently opened the Ontario Mental Health Offices."  
  

Fighting drugs with drugs is latest addiction therapy KRT wire story at the Grand Forks Herald (and many other papers around the US) - "The weapon of the future in the war on drugs will likely be ... drugs. Researchers are optimistic about a host of new medications that target the chemical cycle of addiction. Some block the intense pleasure that makes drugs such as heroin so seductive while others calm the brain during withdrawal. Long-acting versions of two drugs already approved - naltrexone for heroin addicts and alcoholics, and buprenorphine for opiate addicts - are on the horizon. They should combat one of the biggest treatment problems: Addicts often dislike taking anything that prevents getting high. Other researchers are taking a different tack, testing vaccines that teach the body to treat illicit drugs like invading microbes..."  
  

Housing projects under way (Michigan) Traverse Record-Eagle story on an apartment project that is "one of two 'special needs supportive housing' developments pushed ahead by Foundation for Mental Health Grand Traverse/Leelanau. The $2.6 million project will offer more permanent housing options for the low-income and homeless, said Carol Moorman, the foundation's executive director."  
  

House Speaker Chopp's sister testifies in support of mental health parity bill (Washington) Seattle Post-Intelligencer story - "The sister of House Speaker Frank Chopp told lawmakers Monday that they need to end insurance discrimination and pass a bill that would force health insurance companies to cover mental health the same way they cover physical health. Jo-Anne Wilson, 60, told the Senate Health & Long-Term Care Committee that after she was diagnosed with bipolar disorder in 1986, she had to pay significant out-of-pocket costs for many items associated with her treatment, including most prescriptions..." See also the related news story, Legislation would make insurers treat mental illness like other health problems and the commentary piece, Parity in health care, in the same source.  
  

Medicaid cuts threaten mental health services (Washington) King County Journal story - "King County could lose about $10 million and hundreds of mentally ill people in the county could end up on the streets July 1, unless the state Legislature comes up with $82 million to restore federal Medicaid cuts statewide. The loss of the federal funds will affect thousands of people across the state. Already, hundreds of mentally ill people have been turned away from community services. Experts say many of them will end up in jail, on the streets or in emergency rooms if they can't get help anywhere else. The state has already cut its funding for the mentally ill in King County, lopping off $40 million in six years..."