Monday, May 16, 2005

Mother's Serious Mental Illness and Substance Use among Youths New report from SAMHSA - "Although substance use and serious mental illness (SMI) tend to occur together among adults and parental substance use is associated with an increased risk of substance use in the offspring,research findings are not conclusive about whether substance use among youths is associated with parental mental illness.This report focuses on the association between mother's SMI and substance use among youths aged 12 to 17." Principal findings include: "In 2002 and 2003, an annual average of 2 million (12 percent) mothers living with youths aged 12 to 17 had serious mental illness (SMI) during the past year; among youths aged 12 to 17, 3 million (12.1 percent) youths lived with a mother who had SMI; youths living with a mother who had SMI had an increased risk of past month alcohol or illicit drug use compared with youths living with a mother who did not have SMI." See also the page at the SAMHSA site linking to related resources.   
  

Taking Aim Together (Schizophrenia Digest) Article reprinted from Schizophrenia Digest at the NAMI web site - "The relationship between a physician and patient is, inevitably, as fragile and complicated as a cobweb. When problems in the body arise there is, in one corner, a doctor in a starched lab coat, bolstered by academic credentials and the medical community. In the other corner is the patient, naked beneath a paper gown, feeling vulnerable as he or she is poked, prodded and examined. When illness involves the brain, the dynamics between physician and patient become even more complex. A person's most private thoughts, beliefs and life goals are being scrutinized, and ultimately judged, by a psychiatrist. With a prescription pad, the doctor can try to rewrite the script in their patient's mind and-while they’re at it-bring on a cornucopia of side effects that may change the patient's life just as profoundly. The lack of balance in the doctor-patient relationship is particularly acute in schizophrenia, often characterized by a consumer's lack of insight into his or her condition..."  
  

The long road home: Families key to caring and recovery in first episode psychosis Article in the Spring 2005 issue of Cross Currents, published by Toronto's Centre for Addiction and Mental Health - "Early intervention is crucial to getting youth experiencing a first episode of psychosis on the path to recovery. A first psychotic episode (FPE) typically occurs in a person's teens or early 20s and may develop into bipolar disorder or schizophrenia. The incidence rate of FPE is estimated to be 15-20 cases per 100,000, according to the Canadian Mental Health Association. A large body of research has found that early intervention brings about timely treatment, accelerates recovery, preserves psychosocial skills and lowers the risk of relapse. Families play a key role in facilitating these positive outcomes..."  
  

Caring for the caregiver: Concurrent disorders pose unique challenges for families Article in the Spring 2005 issue of Cross Currents, published by Toronto's Centre for Addiction and Mental Health - "...A 2002 study in the Community Mental Health Journal found that people with concurrent disorders have more difficulty managing daily living tasks than people with a single disorder and that their caregivers spend more time in direct care, crisis intervention, creating structured activities and providing financial support. They also reported greater dissatisfaction with their family relationships, compared to people with a single diagnosis. What this translates into is a strong need for support for caregivers. This gaping necessity is exactly why the Centre for Addiction and Mental Health (CAMH) in Toronto in partnership with Elmgrove Services at Brockville Psychiatric Hospital in Brockville, Ontario, is running the first study in Canada to examine how to best support these families in a group environment."  
  

Recognition and Treatment of Bipolar Disorder in Children and Adolescents  A new CME unit from Medscape - "Pediatric bipolar topics covered during this talk include diagnosis, differential diagnosis, comorbidity, a short case presentation, and treatment options, including behavioral, mood stabilizers, and atypical antipsychotics." See also Children and Bipolar Disorder: Recognizing Early Onset, another CME unit at the same source. [Viewing Medscape resources requires registration, which is free].  
  

Vilsack signs state Medicaid reform bill (Iowa)Quad City Times story - "Gov. Tom Vilsack signed into law an unprecedented reform of the state’s Medicaid program Thursday, an overhaul that will make scores more Iowans eligible for health-care coverage under the program. Iowa is the first in the nation to attempt such reforms, and state officials are optimistic the changes to the health-care program for the poor and disabled will be successful. ... State officials were forced to take a look at the program when they faced a loss of close to $65 million each year in federal funding, as officials cracked down on an accounting practice used by Iowa and other states to qualify for more federal dollars. To keep from losing that money, the reforms would qualify Iowans getting health care at state expense for Medicaid. That would mean a share of the cost for their care would picked up by the federal government. Vilsack said the new program will help take some of the burden of charity care off Iowa hospitals and clinics that provide it. "  
  

States face "meltdown" over Medicaid American Medical News story - "Lawmakers' resolution to shave $10 billion in savings from Medicaid likely means that further cuts to physician reimbursement, patient rolls and benefits are ahead. The recently passed fiscal year 2006 budget resolution calls for a $10 billion reduction in projected Medicaid spending over five years. While a significant sign of congressional intent, the measure is only a blueprint for the final budget. Now lawmakers in various committees must fill in the details of how budget targets will be reached. The Bush administration has proposed finding Medicaid savings by curbing what it sees as inappropriate use of state cost-shifting mechanisms and cracking down on waste, fraud and abuse. It's hard to believe that the government will be able to find $2 billion in savings a year through those measures alone, said Stephen Edwards, MD, past president of the American Academy of Pediatrics and chair of AAP's access subcommittee..."  
  

A Hospital Stay Can Make An Older Person More Likely To Commit Suicide Science Daily story - "A study in the May edition of the Journal of the American Geriatrics Society indicates that suicide in persons age 80 and older is more prevalent among those who have been hospitalized than in those who have not. A review of data on nearly 1.8 million people age 52 and older revealed that about two-thirds of the oldest subjects who committed suicide had been hospitalized for an illness in the previous two years. This is the first study to examine this type of association between hospitalization and suicide in older adults."  
  

Mental health court to get trial run (Maine) Kennebec Journal story - "A special new court geared to steer mentally-ill criminal defendants to treatment rather than jail will debut in Maine's capital city by early June if lawmakers support the concept next week. Supreme Court Chief Justice Leigh Saufley will appear before the Legislature's Judiciary Committee Monday to ask for support of the project, which has been led by Superior Court Justice Nancy D. Mills and District Attorney Evert Fowle. If the effort -- known as mental-health court -- is a success, Saufley hopes it would expand."  
  

A Public Health Crisis: Children and Adolescents with Mental Disorders Kansas City Infozine story - "A school superintendent whose daughter once attempted suicide, a, college student, a social worker, a board-certified child psychiatrist, and a member of President Bush's New Freedom Commission on Mental Health warned today that children's lives will be lost without programs for early identification, evaluation and treatment of mental disorders. In briefings for the U.S. Senate and House of Representatives, the Campaign for Mental Health Reform (CMHR) addressed misinformation and distortions surrounding a critical need identified by the Surgeon General and the President's Commission-as well as by the medical and public health communities."  
  

DHS to be audited for mental health service (Arizona) Arizona Republic story - "The Arizona Department of Health Services will undergo a state audit to determine how it is providing public mental health services in the Valley. DHS hires contractors around the state to provide care for people with mental illnesses who are indigent or needy. But the agency is ultimately responsible for how that care is delivered. DHS has been under fire the past year because of a critical report revealing inadequate patient treatment and two publicized suicides of people enrolled in the Valley's mental health system. The problems have drawn scrutiny from the Governor's Office and a Maricopa County judge overseeing a lawsuit to improve care for people with serious mental illnesses."  
  

Research - no easy answers to tackling suicide (New Zealand) Scoop story - "There are no quick fix programmes that can be implemented to significantly cut the suicide rate, says Associate Health Minister, Jim Anderton, following the release of two reports that review the latest research on suicide prevention. There are no quick fix programmes that can be implemented to significantly cut the suicide rate, says Associate Health Minister, Jim Anderton. Releasing two reports that review the latest research on suicide prevention, Mr Anderton said the reasons why people take their own lives are complex." See also the reports, available from the Ministry of Health web site - Suicide Prevention in New Zealand: A contemporary perspective - Social explanations for suicide in New Zealand and Suicide Prevention - A review of evidence of risk and protective factors, and points of effective intervention.  
  

Substance-abuse funds cut, hiked (Utah) Deseret News story - "A new bidding process coupled with state and federal funding shortfalls has some Salt Lake County substance abuse treatment providers absorbing big financial hits and others rolling in new money. The cutbacks and windfalls take effect July 1, the start of the new fiscal year, and affect 17 nonprofit providers, including Salt Lake County's own Division of Youth Services. ... this year, with three-year contracts now open to negotiation, the county decided to embrace a new approach, dropping entrenched providers to a zero-based budget and putting everything out to bid for five-year contracts, starting from ground zero."  
  

Integrated chemical-dependency and mental-health treatment best for adolescents Story at Medical News Today (UK) - "Adolescents with alcohol- and drug-use disorders often have co-occurring mental-health disorders. 'Dual-diagnosis' patients - those with co-occurring substance-abuse and mental-health problems - tend to have less successful chemical-dependency (CD) treatment outcomes. Findings indicate that dual-diagnosis adolescents in private, managed-care CD treatment who receive psychiatric services have better CD-treatment outcomes than those not receiving these services. Adolescents with alcohol- and drug-use disorders often have co-occurring mental-health disorders. Furthermore, patients with co-occurring substance-abuse and mental-health problems tend to have less successful chemical-dependency (CD) treatment outcomes. A recent study of adolescent patients in private, managed-care CD treatment has found that those individuals who receive needed psychiatric services are more likely to be abstinent from both alcohol and drugs than those not receiving these services. Results are published in the May issue of Alcoholism: Clinical & Experimental Research."