Thursday, June 23, 2005

Accurate Diagnosis and Methodical Treatment Approach Important In the Management of OCD in Children and Adolescents Drug and Therapy Perspectives article at Medscape - "Obsessive-compulsive disorder (OCD) causing clinical impairment can occur in up to 3% of children and adolescents, while a larger proportion have subthreshold symptoms that are, nevertheless, noticeable. The most common obsessions are fears of contamination and aggressive/sexual behaviour while the most common compulsions are repeating, ordering compulsions and washing rituals. In terms of pharmacological treatment, selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors (SSRIs) are currently the drugs with the greatest benefit-to-risk ratio in the treatment of childhood OCD and are the agents of first choice ..."  
  

Insurers Turn to Escalating Copays As Cost-Containment Strategy  Psychiatric News story - "Copayment increases associated with a three-tier formulary are found to lower total spending on ADHD medications and decrease the probability of their use. Three-tier pharmacy formularies, adopted by many employers and health plans to control costs, appear to be associated with a significant decrease in the probability of using medications to treat children for attention-deficit/hyperactivity disorder (ADHD). Copayment increases associated with the implementation of a three-tier formulary resulted in lower total ADHD medication spending by the employer, sizable increases in out-of-pocket expenditures for families of children with ADHD, and a significant decrease in the probability of using those medications, according to a study in the April Archives of General Psychiatry."  
  

Problem Behaviors In Teens May Signal Later Illness  Psychiatric News story based on a study in the American Journal of Psychiatry - "Adolescents who engage in problem behaviors before age 15 are at high risk of developing mental disorders by adulthood. These disorders range from substance abuse to major depression to antisocial personality. It should come as no surprise that people who smoked as adolescents often become nicotine dependent as adults, or that people who were in trouble with the police as adolescents show signs of antisocial personality disorder as adults. It may be more surprising, however, that people who engaged in specific problem behaviors as adolescents are at risk, as adults, not just for related mental disorders, but for a more generalized psychopathology."  
  

Mental Health Reform Critical to Fixing Medicaid Announcement at the New Democrats Online web site - "At the urging of President Bush, this year Congress will attempt to cut $10 billion from Medicaid. This reduction would have a devastating impact on people with mental illness, the country's leading cause of disability. In "Parity-Plus: A Third Way Approach to Fix America's Mental Health System", the new PPI report released today, Art Levine offers a bold reform plan that would make mental health coverage stronger and more cost-effective, while diminishing the financial burden on the country's strained Medicaid system." See also the full report, Parity-Plus: A Third Way Approach to Fix America's Mental Health System.  
  

Schwarzenegger Appoints Twelve to the Mental Health Services Oversight and Accountability Commission (California) California Office of the Governor press release providing detail biographies of those appointed to the commission charged with implementing Prop. 63 - "The role of the Mental Health Services Oversight and Accountability Commission (MHSOAC) is to develop strategies to overcome stigma and accomplish the objectives of the Act. The Commission will advise the Governor or the Legislature regarding actions the state may take to improve care and services for people with mental illness. The Commission is required to annually review and approve each county mental health program for expenditures. If the commission identifies a critical issue related to the performance of a county mental health program, it may refer the issue to the State Department of Mental Health."  
  

County balks at mental health contract (Iowa) Daily Gate City story - "The Lee County supervisors did not re-sign a contract with a mental health care provider on Tuesday as they continued to ponder the decreasing availability of emergency psychiatric care in the county. The current contract with ResCare, which is headquartered in Fairfield, expires June 30. At issue is a $15,000 increase ResCare wants to cover their investment in a new psychiatrist for the area, as well as access to other services via a toll-free hotline."  
  

Third key state mental health official resigns (Hawaii) Honolulu Star Bulletin story - "Dr. Thomas W. Hester, who guided the state mental health system through critical court-ordered changes the past four years, has resigned as Adult Mental Health Division chief. Hester is the third key management official to resign from the division. Others are Paul Guggenheim, Hawaii State Hospital administrator, and Dr. Alan Radke, medical director. The resignations have raised questions about how the state Health Department can finish improvements in mental services ordered under a lawsuit filed by the U.S. Justice Department in 1991."  
  

Extra aid for mental health care considered (Kansas) Kansas City Star story - "With funding tight, only those with the most severe mental health illnesses can expect to receive aid from the state of Kansas. Now it’s up to Johnson County to decide how much of the slack it wants to pick up. On the second day of budget hearings Wednesday, county commissioners informally agreed to consider adding nearly $1 million to next year’s proposed Johnson County Mental Health Center budget. If funded, the money would add 14 employees in a growing county with a growing demand for mental health services."  
  

County tries mending mental health rift (Oregon) News-Review story - "When Douglas County commissioners decided to look into the possibility of privatizing mental health services, they should have gone straight to the employees that would be affected and explained their intentions, Commissioner Marilyn Kittelman told members of the Mental Health Advisory Committee on Tuesday. Instead, they relied on officials from the county's Mental Health Division and the Health Department itself to inform workers. That, Kittelman said, led employees to believe mass layoffs would ensue and that most workers would lose their jobs within a year. Saying the commissioners are concerned with providing the best service for patients, Kittelman said Tuesday she believes that only a certain percentage of the mental health programs could be privatized. The rest, she said, would remain under the county..."