Tuesday, March 22, 2005

SAMHSA Issues Group Therapy Guide for Substance Use Disorders Treatment SAMHSA press release - "The Substance Abuse and Mental Health Services Administration (SAMHSA) today unveiled a comprehensive guide on the use of group therapy in the treatment of substance use disorders. The consensus panel that created 'Substance Abuse Treatment: Group Therapy' emphasized that group therapy is effective treatment and is a cost effective way to deliver treatment. The guide, Treatment Improvement Protocol #41 in SAMHSA’s Treatment Improvement Protocol (TIP) series, is designed to aid substance abuse counselors who employ group therapy in the treatment of substance use disorders..." Despite what the press release says, the publication is not yet available at NCADI's TIP publications order form, but readers may want to save the link and check back. Please note, however, that TIP #42, Substance Abuse Treatment for Persons With Co-Occurring Disorders (Adobe Acrobat format), announced last month, is now available online.  
  

Early Detection of Schizophrenia Story in Current Opinion in Psychiatry at Medscape - "This article will evaluate the rationale and feasibility of detecting psychosis and schizophrenia earlier than is currently the case. ... Schizophrenia incidence may vary more than has been believed previously. Early detection studies fall into two groups. Firstly, operational criteria now exist for prodromal or at risk mental states which predict transition to psychosis of 20-40% over 1 year. The first randomized trials of antipsychotic drug and psychological interventions aimed at reducing this transition rate have shown promising results. Secondly, duration of untreated psychosis in the first episode seems genuinely to be associated with clinical outcome but how much of the association is truly causal remains disputed." [Viewing Medscape resources requires registration, which is free].  
  

Strategies to Enhance Patient Adherence: Making It Simple Medscape General Medicine article - "The problem of poor patient adherence has been extensively researched, but the rates of nonadherence have not changed much in the past 3 decades. Healthcare providers play a unique and important role in assisting patients' healthy behavior changes. We conducted a narrative review of the current literature to help providers become more familiar with proven interventions that can enhance patient adherence. We then grouped the interventions into categories that can be remembered by the mnemonic "SIMPLE": 1. Simplifying regimen characteristics; 2. Imparting knowledge; 3. Modifying patient beliefs; 4. Patient communication; 5. Leaving the bias; and 6. Evaluating adherence..." [Viewing Medscape resources requires registration, which is free].  
  

Adjunctive risperidone benefits chronic PTSD patients Story at Psychiatry Matters - "Risperidone appears to be an effective adjunctive treatment for chronic combat-related post-traumatic stress disorder (PTSD), say researchers in findings that suggest atypical antipsychotic medications may have a wide therapeutic spectrum. 'In this severely ill and probably treatment-resistant group of patients, risperidone was superior to placebo in reducing PTSD as well as other symptom clusters such as anxiety, psychosis, and possible depression over the 4-month study period,' George Bartzokis (University of California School of Medicine, Los Angeles, USA) and colleagues report. For the study, 65 men with chronic combat-related PTSD were referred to a 5-week residential treatment program followed by a 3-month patient follow-up. After the first week, the participants were randomly assigned to receive either risperidone or placebo in addition to ongoing psychotropic medication."  
  

New DVD offers rare look at consumer/survivor initiatives (Canada) Laurier press release, brought to our attention by CMHA/Ontario's Mental Health Notes on From Madhouse to Our House, a new DVD "produced as a new way of introducing an emerging model for mental health care to a wide audience. Consumer/survivor initiatives (CSIs) transform in a fundamental way how people with mental health concerns are supported. They go from being consumers of services and survivors of the system to active participants who support one another and work for community change." For further information on Consumer/Survivor Initiatives in Ontario, see the related web page at the Community Mental Health Evaluation Initiative site.  
  

Study: Depression can be treated in seniors Intense treatment can forestall dependency USA Today story reprinted at PsycPORT - "Successful treatment of depression in frail older people may help slow their physical decline, which could help keep them living independently as long as possible, a new study says. The findings suggest that doctors more aggressively identify and treat seniors with depression, an illness that puts people, especially the elderly, at risk of suicide. Many doctors mistakenly believe that treatment doesn't help older people suffering from depression. Not so, says Christopher Callahan, a geriatric researcher at the Indiana University School of Medicine in Indianapolis. Depression can be harder to treat in seniors, but this study and others suggest that treatment does work for many people. And when the fog of depression lifts, they find they're better able to perform routine but crucial tasks."  
  

Mental Health Care for Veterans Disputed Los Angeles Times story - "As troops return from Iraq and Afghanistan — including thousands with combat-related mental disorders — they enter a Veterans Affairs healthcare system sharply divided about how to care for them. In the last decade, veterans hospitals across the country have sharply reduced the number of inpatient psychiatric beds, replacing them with outpatient programs and homeless services. The new offerings, officials say, cost less and are just as effective. The new offerings, officials say, cost less and are just as effective. ... But veterans' advocates and even some VA psychiatrists say the hospitals, including the massive Veterans Affairs Greater Los Angeles Healthcare System, are flirting with disaster. They say the facilities are ill-equipped to deal with veterans who need the most extensive help for psychosis, substance abuse, suicidal impulses and post-traumatic stress disorder." [Viewing Los Angeles Times stories requires registration, which is free]. See also Female GIs hard hit by war syndrome (Kansas City Star) and The effects of post-traumatic stress (Newsday).  
  

Mental-health charity helpline faces closure as grant dries up (UK) London Times story - "A leading mental health charity is making an eleventh hour appeal for funds to save its national telephone helpline. Sane, which is closing two regional call centres with the loss of 120 volunteers after government funding dried up, believes it will struggle to keep its London centre running without more funds. The crisis is the latest to befall the charity founded 19 years ago by Marjorie Wallace, a campaigner driven to create the Saneline phone service in response to the failures of the care in the community programme."  
  

Nevada mental health programs discussed Las Vegas Sun story - "An Assembly panel voted Monday to add $17.8 million to Nevada Gov. Kenny Guinn's proposed $100 million in new spending for mental health care programs. The Health and Human Services Committee voted unanimously Monday to approve AB175, a bill supporters said "fills the gaps" that are aggravating a mental health care crisis in Las Vegas. There are only 131 psychiatric beds in facilities other than general hospitals in the Las Vegas area, a shortage that led Clark County to declare an emergency last July."  
  

Senate approves insurance for mental health (Oregon) Bend.com story - "The state Senate today approved a measure to provide full parity in health care coverage for those with mental illness, with several senators calling current practices discrimination against the mentally ill. Senate Bill 1 requires health insurers to provide the same level of coverage for mental health and chemical dependency treatment as they provide for other medical treatments. It prohibits insurers from imposing treatment limitations unless similar limitations or requirements are imposed on coverage of other medical conditions."  
  

Mental-health providers relieved (Washington) Seattle Times story - " Community mental-health providers who were fearing the worst were relieved — even a little surprised — that Gov. Christine Gregoire included an extra $80 million in her budget to restore almost all of the $82 million lost in federal Medicaid cuts. ... If the Legislature goes along with Gregoire's plan, Gaylord said, the money will help keep 1,600 severely mentally ill people in residential services and help pay for mental-health services for 43,000 people with low incomes who are not on Medicaid. "  
  

Quarter of US Adults Have Received Mental Health Treatment Over Two-Year Period Medical News Today story - "A national survey of the general adult population and of adults who have needed or received some form of mental health treatment(1) find that more than a quarter (27%) of all adults have received some form of mental health treatment over a two-year period. Among those patients who have received treatment in the past two years: Approximately one-third (34%) received both therapy and drugs; approximately half (47%) of patients used prescription drugs but did not receive therapy; approximately one-fifth (19%) of patients received therapy but did not use prescription drugs..."  
  

Security risks over mental health (UK) BBC story - "Psychiatric staff are being put at risk because of inadequate training and funding, according to the Royal College of Nursing. 'Patients are frustrated because they're not getting the care they should and frustration leads to violent behaviour,' spokeswoman Ann Leedham-Smith told File On 4. More than 100,000 violent incidents occur across the NHS each year, almost half in mental health units..."