Care notes
Jacki Scuffle, Hertfordshire Partnership NHS Trust
"Information systems in the NHS tend to reflect working practices of their time, and therefore legacy systems concentrated mainly on administrative activities, gathering data on spells, events and attendance, for export to financial systems and NHS Central Returns. However, there are now real benefits in clinicians taking advantage of technology to improve the level and quality of information available to them about their patients. The widespread use of computers amongst clinical teams requires enormous investment, not only in the supply and installation of equipment and a suitable network, but also in the training of clinical staff to become computer competent, and in the change management issues around transparency and information sharing."
Thursday, June 17, 2004
Posters & Abstracts: New Research on Bipolar Disorder
From Medscape's coverage of the American Psychiatric Association 2004 Annual Meeting - "The appropriate administration of antidepressants in patients with bipolar disorder is a challenging clinical problem. Antidepressants can, even in the presence of the administration of an adequate dose of a mood stabilizer, induce mania and cycling. Since there are now several clinical alternatives to antidepressant use in patients with cycling mood, these questions are of great clinical relevance in this difficult-to-treat population. Three studies were presented at the American Psychiatric Association 2004 Annual Meeting that attempted to address these questions..." [Viewing Medscape resources requires registration, which is free].
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From Medscape's coverage of the American Psychiatric Association 2004 Annual Meeting - "The appropriate administration of antidepressants in patients with bipolar disorder is a challenging clinical problem. Antidepressants can, even in the presence of the administration of an adequate dose of a mood stabilizer, induce mania and cycling. Since there are now several clinical alternatives to antidepressant use in patients with cycling mood, these questions are of great clinical relevance in this difficult-to-treat population. Three studies were presented at the American Psychiatric Association 2004 Annual Meeting that attempted to address these questions..." [Viewing Medscape resources requires registration, which is free].
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Therapy in America
Results of a Harris poll sponsored by Psychology Today and PacifiCare Behavioral Health and published in April, available at the Open Minds web site - " Two surveys were conducted as part of this study: 1) a telephone survey of a nationally representative cross-section of 500 adults ages 18 and over, and 2) an online survey of 1,730 members of the Harris Poll Online Panel who have needed or received treatment for a mental health problem within the past two years. The telephone data were weighted to ensure that the data accurately represent the national population of adults ages 18 and over. The data from the online survey were weighted to ensure that the data are representative of all adults who have needed or received mental-health treatment at some point within the past two years. All survey interviews were conducted between February 16 and March 5, 2004."
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Results of a Harris poll sponsored by Psychology Today and PacifiCare Behavioral Health and published in April, available at the Open Minds web site - " Two surveys were conducted as part of this study: 1) a telephone survey of a nationally representative cross-section of 500 adults ages 18 and over, and 2) an online survey of 1,730 members of the Harris Poll Online Panel who have needed or received treatment for a mental health problem within the past two years. The telephone data were weighted to ensure that the data accurately represent the national population of adults ages 18 and over. The data from the online survey were weighted to ensure that the data are representative of all adults who have needed or received mental-health treatment at some point within the past two years. All survey interviews were conducted between February 16 and March 5, 2004."
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Using Medicaid to Support Healthy Mental Development in Young Children
A report in Adobe Acrobat format from the National Academy for State Health Policy, available at the Open Minds web site - "Recent research documents how and why social-emotional development may be as important as cognitive (intellectual) development. Children who are viewed by others as "sad, mad, or bad" are far less likely to experience school success and may be unable to use preschool intervention. Recent research also documents the important role Medicaid can play in supporting young children’s healthy mental development. This report examines both why and how Medicaid can support children’s healthy mental development, including a discussion of how states can use Medicaid to better support young children’s social/emotional development even in the current economic climate."
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A report in Adobe Acrobat format from the National Academy for State Health Policy, available at the Open Minds web site - "Recent research documents how and why social-emotional development may be as important as cognitive (intellectual) development. Children who are viewed by others as "sad, mad, or bad" are far less likely to experience school success and may be unable to use preschool intervention. Recent research also documents the important role Medicaid can play in supporting young children’s healthy mental development. This report examines both why and how Medicaid can support children’s healthy mental development, including a discussion of how states can use Medicaid to better support young children’s social/emotional development even in the current economic climate."
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NAMI Taskforce Report on Children and Psychotropic Medications
A new report from NAMI (in Adobe Acrobat format) - "In 2003, NAMI’s Policy Research Institute (NPRI) convened a task force of experts and stakeholders to consider issues related to the use of psychotropic medications for children and adolescents. Since then, the issue has exploded in the nation’s headlines, but not necessarily with the kind of precision that medical issues require. Our nation is currently experiencing a public health crisis in the number of youth with mental illnesses that fail to receive any treatment or services. The U. S. Surgeon General has warned that approximately 80% of youth with mental illnesses fail to receive any treatment or services. We have made major scientific advances in understanding how to properly diagnose and treat mental illnesses in children, but more needs to be done..."
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A new report from NAMI (in Adobe Acrobat format) - "In 2003, NAMI’s Policy Research Institute (NPRI) convened a task force of experts and stakeholders to consider issues related to the use of psychotropic medications for children and adolescents. Since then, the issue has exploded in the nation’s headlines, but not necessarily with the kind of precision that medical issues require. Our nation is currently experiencing a public health crisis in the number of youth with mental illnesses that fail to receive any treatment or services. The U. S. Surgeon General has warned that approximately 80% of youth with mental illnesses fail to receive any treatment or services. We have made major scientific advances in understanding how to properly diagnose and treat mental illnesses in children, but more needs to be done..."
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NAMI Establishes New Multicultural Action Center
June 2 NAMI press release - "NAMI (National Alliance for the Mentally Ill) today announced creation of a Multicultural Action Center (MAC) in conjunction with a national forum offering multicultural perspectives on President Bush’s New Freedom Commission Report. The new center replaces the NAMI Multicultural & International Outreach (MIO) Center established in 2002."
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June 2 NAMI press release - "NAMI (National Alliance for the Mentally Ill) today announced creation of a Multicultural Action Center (MAC) in conjunction with a national forum offering multicultural perspectives on President Bush’s New Freedom Commission Report. The new center replaces the NAMI Multicultural & International Outreach (MIO) Center established in 2002."
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Medical Journals Weigh Plan for Full Drug-Trial Disclosure
June 15 New York Times story - "An organization of top medical journals is considering a proposal that would require drug makers to register clinical trials at their start in a public database in order for results, whether successful or not, to be later considered for publication, according to three people working with the group. Advertisement Pharmaceutical companies are not generally required now to disclose results of a trial or even whether one was conducted. Some academic researchers have long argued that fuller registries of drug trials are needed because companies, as well as medical journals and scientists, tend to spotlight only trials that show positive results. The plan, if adopted by the organization, the International Committee of Medical Journal Editors, is likely to put pressure on pharmaceutical makers to disclose more about the trials they run. The group includes 12 major medical journals like The Journal of the American Medical Association, The New England Journal of Medicine, The Lancet and The Annals of Internal Medicine." "nyt"
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June 15 New York Times story - "An organization of top medical journals is considering a proposal that would require drug makers to register clinical trials at their start in a public database in order for results, whether successful or not, to be later considered for publication, according to three people working with the group. Advertisement Pharmaceutical companies are not generally required now to disclose results of a trial or even whether one was conducted. Some academic researchers have long argued that fuller registries of drug trials are needed because companies, as well as medical journals and scientists, tend to spotlight only trials that show positive results. The plan, if adopted by the organization, the International Committee of Medical Journal Editors, is likely to put pressure on pharmaceutical makers to disclose more about the trials they run. The group includes 12 major medical journals like The Journal of the American Medical Association, The New England Journal of Medicine, The Lancet and The Annals of Internal Medicine." "nyt"
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FDA Panel Backs Implant To Counter Depression
Washington Post story - "A surgical implant that stimulates the brain should get government approval to treat chronic depression, an expert panel of federal experts said yesterday -- marking the first time an implanted device has been recommended for the treatment of a psychiatric disorder. Using a technique known as vagus nerve stimulation, the device uses electrodes implanted in the neck to activate brain regions that are believed to regulate mood. The decision by an expert advisory panel of the Food and Drug Administration came after a day of clashing scientific opinions about whether the data submitted by the manufacturer were adequate for approval. Proponents of the device prevailed, citing the desperate need of patients with chronic depression that does not respond to existing treatments." [Viewing Washington Post stories requires registration, which is free.]
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Washington Post story - "A surgical implant that stimulates the brain should get government approval to treat chronic depression, an expert panel of federal experts said yesterday -- marking the first time an implanted device has been recommended for the treatment of a psychiatric disorder. Using a technique known as vagus nerve stimulation, the device uses electrodes implanted in the neck to activate brain regions that are believed to regulate mood. The decision by an expert advisory panel of the Food and Drug Administration came after a day of clashing scientific opinions about whether the data submitted by the manufacturer were adequate for approval. Proponents of the device prevailed, citing the desperate need of patients with chronic depression that does not respond to existing treatments." [Viewing Washington Post stories requires registration, which is free.]
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Under Pressure Glaxo Publishes Paxil Data
Reuters Health story at Yahoo - "GlaxoSmithKline, responding to a lawsuit claiming it suppressed negative data about its antidepressant Paxil, published results of trials showing the drug is broadly ineffective in children and adolescents and could increase risks of suicidal behavior. The British drugmaker released data from nine pediatric trials on its Web Site after New York Attorney General Eliot Spitzer filed suit two weeks ago accusing Glaxo of fraudulently suppressing the information. Glaxo has denied the allegations, saying it publicized the results either in medical journals or at scientific meetings. The data released by Glaxo earlier this week showed Paxil to be mostly ineffective in treating youngsters." See also the related AP story at Yahoo, Paxil Said Ineffective for Depressed Kids.
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Reuters Health story at Yahoo - "GlaxoSmithKline, responding to a lawsuit claiming it suppressed negative data about its antidepressant Paxil, published results of trials showing the drug is broadly ineffective in children and adolescents and could increase risks of suicidal behavior. The British drugmaker released data from nine pediatric trials on its Web Site after New York Attorney General Eliot Spitzer filed suit two weeks ago accusing Glaxo of fraudulently suppressing the information. Glaxo has denied the allegations, saying it publicized the results either in medical journals or at scientific meetings. The data released by Glaxo earlier this week showed Paxil to be mostly ineffective in treating youngsters." See also the related AP story at Yahoo, Paxil Said Ineffective for Depressed Kids.
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Recovery Month Will Highlight Success of Drug Treatment: Report Shows Many Need Treatment for Substance Abuse
SAMHSA press release - "The Substance Abuse and Mental Health Services Administration (SAMHSA) today unveiled a new kit and other materials to be used as part of the 15th annual Recovery Month celebrations in September, as well as a new state report showing that overall 2.7 percent of persons 12 and older nationwide needed, but did not receive treatment for an illicit drug problem; and 7.3 percent needed but did not receive treatment for an alcohol problem. Recovery Month spotlights the need for alcohol and drug abuse treatment and recovery, and honors both those in recovery and treatment providers..." See also the Recovery Month web site and the report, State Estimates of Persons Needing But Not Receiving Substance Abuse Treatment (available in both HTML and Adobe Acrobat formats) and related materials at the Office of Applied Studies web site.
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SAMHSA press release - "The Substance Abuse and Mental Health Services Administration (SAMHSA) today unveiled a new kit and other materials to be used as part of the 15th annual Recovery Month celebrations in September, as well as a new state report showing that overall 2.7 percent of persons 12 and older nationwide needed, but did not receive treatment for an illicit drug problem; and 7.3 percent needed but did not receive treatment for an alcohol problem. Recovery Month spotlights the need for alcohol and drug abuse treatment and recovery, and honors both those in recovery and treatment providers..." See also the Recovery Month web site and the report, State Estimates of Persons Needing But Not Receiving Substance Abuse Treatment (available in both HTML and Adobe Acrobat formats) and related materials at the Office of Applied Studies web site.
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Experts concerned over children's mental health (Australia)
ABC News story - " Mental health professionals are calling for more resources to deal with young people suffering from depression. The call follows the release of a pharmaceutical company's research which shows certain anti-depressants can cause suicidal thoughts in children. Australian College of Psychiatrists spokeswoman Dr Louise Newman says it is not a new finding. However she says it highlights important issues surrounding the prescribing of anti-depressants, with thousands of teenagers currently taking them in Australia..."
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ABC News story - " Mental health professionals are calling for more resources to deal with young people suffering from depression. The call follows the release of a pharmaceutical company's research which shows certain anti-depressants can cause suicidal thoughts in children. Australian College of Psychiatrists spokeswoman Dr Louise Newman says it is not a new finding. However she says it highlights important issues surrounding the prescribing of anti-depressants, with thousands of teenagers currently taking them in Australia..."
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North Carolina overhaul of mental health services is lagging
Wilmington Star story - "Plans to change the state's mental health system, including closing wards at Dorothea Dix hospital, have fallen behind because patient demand is up and private services are refusing to take more difficult patients, officials say. Patient numbers in the geriatric ward at Dix were supposed to be cut nearly in half by July 1, but the new date to move some of the 33 patients has been pushed to next July. The child and adolescent unit was supposed to close in January, but it will remain open until Dix closes in 2007 because of an increase in patients. Dix Director Terry Stelle, in a memo about the delays, said 'community services have not come on line to serve many of these patients, and it may be several years before specialized facilities are developed.' " [Viewing Washington Post stories requires registration, which is free.]
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Wilmington Star story - "Plans to change the state's mental health system, including closing wards at Dorothea Dix hospital, have fallen behind because patient demand is up and private services are refusing to take more difficult patients, officials say. Patient numbers in the geriatric ward at Dix were supposed to be cut nearly in half by July 1, but the new date to move some of the 33 patients has been pushed to next July. The child and adolescent unit was supposed to close in January, but it will remain open until Dix closes in 2007 because of an increase in patients. Dix Director Terry Stelle, in a memo about the delays, said 'community services have not come on line to serve many of these patients, and it may be several years before specialized facilities are developed.' " [Viewing Washington Post stories requires registration, which is free.]
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Drug Firms Trying to Make Painkillers Less Abusable
June 13 Washington Post story - "Millions of Americans suffer from intense but poorly treated pain that could be helped by today's broad array of morphine-based prescription painkillers. Millions of others abuse prescription narcotics, using them to get high rather than to ease pain, and many become addicted. This dilemma -- that legal painkillers are both under-used and abused -- has become a pressing issue since the introduction in the mid-1990s of the extended-release opioid OxyContin. The drug has provided enormous relief to many pain sufferers and could help many more, but it has also become a drug of choice for many addicts, who promptly discovered how to disable the extended-release aspect of the drug to get high on the enhanced dose. With the problem now clearly identified, dozens of researchers have embarked on a difficult and high-stakes race to find ways to keep the benefits of prescription painkillers available to pain sufferers while eliminating or reducing the possibility for abuse..." [Viewing Washington Post stories requires registration, which is free.]
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June 13 Washington Post story - "Millions of Americans suffer from intense but poorly treated pain that could be helped by today's broad array of morphine-based prescription painkillers. Millions of others abuse prescription narcotics, using them to get high rather than to ease pain, and many become addicted. This dilemma -- that legal painkillers are both under-used and abused -- has become a pressing issue since the introduction in the mid-1990s of the extended-release opioid OxyContin. The drug has provided enormous relief to many pain sufferers and could help many more, but it has also become a drug of choice for many addicts, who promptly discovered how to disable the extended-release aspect of the drug to get high on the enhanced dose. With the problem now clearly identified, dozens of researchers have embarked on a difficult and high-stakes race to find ways to keep the benefits of prescription painkillers available to pain sufferers while eliminating or reducing the possibility for abuse..." [Viewing Washington Post stories requires registration, which is free.]
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Mental health courts encounter some criticism
Story in the Courier-Post (New Jersey) - "In some areas of the country, mentally ill people charged with low-level offenses are being paid attention by "mental health courts" where their needs are recognized and their cases are set aside for special consideration. But the idea, being tried in Ohio, New York, Florida and Alaska, is facing strong criticism from New Jersey mental health advocates. 'There are mixed feelings about mental health courts,' said William Waldman, former state Human Services commissioner who is writing a report on how 250 mentally ill prisoners can be better treated at the Camden County Jail. 'There's some controversy about their effectiveness,' said Waldman. 'They're not a magic bullet.' Nancy Wolff, a Rutgers University researcher, is expected to head a new state task force in New Jersey to find ways to treat and protect the mentally ill in jails and prisons throughout the state. Wolff is a critic of mental health courts, saying they effectively serve only 10 to 20 percent of the mentally ill in jails and prisons."
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Story in the Courier-Post (New Jersey) - "In some areas of the country, mentally ill people charged with low-level offenses are being paid attention by "mental health courts" where their needs are recognized and their cases are set aside for special consideration. But the idea, being tried in Ohio, New York, Florida and Alaska, is facing strong criticism from New Jersey mental health advocates. 'There are mixed feelings about mental health courts,' said William Waldman, former state Human Services commissioner who is writing a report on how 250 mentally ill prisoners can be better treated at the Camden County Jail. 'There's some controversy about their effectiveness,' said Waldman. 'They're not a magic bullet.' Nancy Wolff, a Rutgers University researcher, is expected to head a new state task force in New Jersey to find ways to treat and protect the mentally ill in jails and prisons throughout the state. Wolff is a critic of mental health courts, saying they effectively serve only 10 to 20 percent of the mentally ill in jails and prisons."
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Communities around state start teen mental health screening programs (Pennsylvania)
Wilkes-Barre Times Leader story on a 10-minute computer-assisted survey that "... could identify students who need further evaluation for depression, anxiety, substance abuse and other problems ... Based on the success of the university's TeenScreen Program at sites around the country, including in Erie, program organizers hope to expand into more high schools and recreational programs. The program is meant to identify teenagers who need a more detailed assessment. The survey asks a variety of questions about mental well-being, including how feelings of anxiety impair daily activities. Students also answers questions about suicide attempts, alcohol and drug use."
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Wilkes-Barre Times Leader story on a 10-minute computer-assisted survey that "... could identify students who need further evaluation for depression, anxiety, substance abuse and other problems ... Based on the success of the university's TeenScreen Program at sites around the country, including in Erie, program organizers hope to expand into more high schools and recreational programs. The program is meant to identify teenagers who need a more detailed assessment. The survey asks a variety of questions about mental well-being, including how feelings of anxiety impair daily activities. Students also answers questions about suicide attempts, alcohol and drug use."
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Staff reluctant to report offences by mental health patients (New Zealand)
New Zealand Herald story - "A damning internal report on Hawkes Bay District Health Board's mental health and addiction services says that if a patient committed a crime while officially or unofficially on leave from the ward, staff were reluctant to contact police. "
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New Zealand Herald story - "A damning internal report on Hawkes Bay District Health Board's mental health and addiction services says that if a patient committed a crime while officially or unofficially on leave from the ward, staff were reluctant to contact police. "
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Critical Ingredients of Consumer Run Services: Results of a National Survey
Adobe Acrobat version of a report published in the February 2004 Community Mental Health Journal - "Fidelity criteria are increasingly used in program monitoring and evaluation, but are difficult to derive for emerging models (i.e., those not based on theory or a research demonstration project). We describe steps used to develop and operationalize fidelity criteria for consumer-run (CR) mental health services: articulating and operationalizing criteria based on published literature, then revising and validating the criteria through expert judgments using a modified Delphi method. Respondents rated highest those structural and process components emphasizing the value of consumerism: consumer control, consumer choices and opportunities for decision-making, voluntary participation (and the absence of coercion), and respect for members by staff."
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Adobe Acrobat version of a report published in the February 2004 Community Mental Health Journal - "Fidelity criteria are increasingly used in program monitoring and evaluation, but are difficult to derive for emerging models (i.e., those not based on theory or a research demonstration project). We describe steps used to develop and operationalize fidelity criteria for consumer-run (CR) mental health services: articulating and operationalizing criteria based on published literature, then revising and validating the criteria through expert judgments using a modified Delphi method. Respondents rated highest those structural and process components emphasizing the value of consumerism: consumer control, consumer choices and opportunities for decision-making, voluntary participation (and the absence of coercion), and respect for members by staff."
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Copyright 2003 © Bill Davis.
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