Friday, April 29, 2005

Patient-Centered Care and Communication: An Expert Interview With Tom Delbanco, MD Interview in Medscape Psychiatry and Mental Health - "I don't much like the phrase, 'patient-centered care.' I guess we were among the first to use it the mid-1980s when we developed an effort supported by the Commonwealth Fund to learn from patients. I never liked it. It offends everyone, because each health professional thinks he or she is patient-centered. The basic notion to me is trying to see through the eyes of the patient and understand patients' expectations, perceptions, and experiences, rather than just seeing through our professional eyes. The expression has come to mean an awful lot of different things, as it's become shop talk. The minute that happens, words take on many different meanings." [Viewing Medscape resources requires registration, which is free].  
  

Treatment-Resistant Schizophrenia: An Expert Interview With Ralph Hoffman, MD Interview in Medscape Psychiatry and Mental Health - " Treatment resistance used to refer more to the positive symptoms, like hallucinations and delusions, that would persist despite reasonable trials of antipsychotic medicine. And incomplete recovery is, for schizophrenia, kind of a misnomer, because basically schizophrenia in essence is almost defined by the incompleteness of recovery. So if people go into full remission of all of their symptoms, it actually raises questions about the diagnosis. But the typical hoped-for course these days is that the medication, and whatever other treatments they're given, result in the patient's positive symptoms going into relatively full remission. But in general, for these patients, they continue to have residual negative symptoms. So their concentration may be somewhat off and they may continue to be somewhat more socially isolated and withdrawn, less able to engage in work or school kinds of activity. That's really more the norm, unfortunately. There are different levels of incompleteness of recovery, so that oftentimes we'll see patients who have a temporary remission, but then the symptoms quickly come back within a year or so, and the negative symptoms get worse, so the patient becomes even more progressively withdrawn. And so those are the kinds of trajectories of incomplete recovery." [Viewing Medscape resources requires registration, which is free].  
  

NAMI is a National Sponsor of Cover the Uninsured Week, May 1-8 Announcement at the NAMI web site - "There is a desperate need to help uninsured Americans. The number of uninsured in the U.S. is staggering -- currently, there are 45 million Americans without health insurance. People with mental illness are at a particular risk of being uninsured because of high medical costs due to their illness. Furthermore, a lack of insurance can lead to or exacerbate mental health conditions. Without insurance, it is difficult for people to access necessary medical and mental health care, and conditions may worsen significantly as a result." See also the new web site, covertheunisuredweek.org.   
  

Judge bars TennCare cuts again Story in The Tennessean - "A federal judge has halted TennCare cuts — again — saying the state's policies and procedures for ending health-care coverage for 323,000 people would violate their constitutional rights. State lawyers said they would immediately file an emergency appeal with the 6th U.S. Circuit Court of Appeals in Cincinnati. The ruling by U.S. District Court Judge William J. Haynes throws into question once more the fate of TennCare enrollees and Gov. Phil Bredesen's plans to overhaul the financially troubled program. It also may have an impact on the state budget process, which the governor has said hinges on keeping the TennCare budget in check."  
  

Congress Passes Budget That Cuts Medicaid Las Vegas Sun story - "A $2.6 trillion budget outline barely approved by Congress will cut projected spending on Medicaid for the poor, lock in tax cuts and - Republicans claim - put the country on a path toward lower federal deficits. Democrats unanimously opposed the spending outline passed late Thursday. They said the budget reflects the president's misplaced priorities by freezing or trimming health, education and agriculture programs while cutting taxes by as much as $106 billion over five years. The vote was 214-211 in the House and 52-47 in the Senate. The budget resolution is nonbinding, but it sets critical guidelines for lawmakers as they make decisions on taxes and specific spending programs for the 2006 fiscal year that begins October 1."  
  

New Veterans Health Clinic For Women (Iowa) KWWL story - "A new outpatient clinic for women vets opened this week in Coralville. The new clinic offers medical, mental health, and other services specifically for female veterans. Carrol Roy served three years in the U.S. Air Force Medical Corps. Starting now, she goes to the new, comprehensive V.A. Health Clinic in Coralville, instead of the V.A. Hospital in Iowa City. Medical and office supplies are still being unpacked. In fact, doctors are just now starting to see patients. Doctors say a woman's experience in the military can be much different than a mans. Dr. Susan Goodner says women can face different health and mental problems when they return to civilian life and they get special care in Coralville."  
  

Mental-health agenda wins significant gains (Washington) Seattle Times story - "Advocates began spring worried budgets for state mental-health programs would be slashed by $82 million due to federal Medicaid cuts, but this week they are celebrating big gains. Not only were the cuts replaced during the state legislative session that ended Sunday, but $18 million in new money was granted to bolster addiction treatment. Mental-health advocates also won long-sought 'parity' for insurance coverage. It adds up to what some describe as the most significant legislative session for mental health in more than a decade..."  
  

Forum tackles migrant mental health issues (New Zealand) Auckland University of Technology press release - "Growing concern over mental health issues for migrant and refugee communities was the driver behind today’s workshop co-organised by the West Auckland Shared Vision and AUT’s Centre for Asia and Migrant Health Research. The objective of the forum was to highlight the issues that mental health services need to be aware of when working with migrants and refugees, says co-organiser Ruth DeSouza, Coordinator of AUT’s Asia and Migrant Health Research Centre. However, the focus was not only on challenges but also emphasised the skills and strengths that migrants and refugees bring to their new homeland, she said."