Preventable physical illness in people with mental illness
University of Western Australia School of Population Health - "This unique study has examined the health experience of 240,000 Western Australians who have used mental health services during 1980-98 (representing about 8% of the population at any one time). Using de-identified data, their hospital admission rates, cancer incidence rates and death rates have been examined. People with mental illness are among the most marginalized people in our community. The consequences of mental illness often extend beyond the direct symptoms of the illness to affect people’s social and economic well being and all aspects of their lives. The aim of this study was to examine the physical health of people with mental illness. The purpose was to provide data that can be used to improve health services and design health promotion activities that can be specifically targeted at people with mental illness." There are three documents that can be downloaded and may be slow depending on the speed of your connection. We suggest that you read the two summaries first. If you have any comments, you can contact one of the authors at D'Arcy Holman [darcy@dph.uwa.edu.au]
Monday, October 04, 2004
Safe and Effective Approaches to Lowering State Prescription Drug Costs: Best Practices Among State Medicaid Drug Programs
A September Centers for Medicare and Medicare Service report in Adobe Acrobat format, available at the Open Minds web site - "As a result of increasing prescription drug costs, State Medicaid programs have implemented a variety of cost-containment mechanisms in their drug programs over the past few years. These mechanisms have allowed states to reduce their pharmacy expenditures and maintain beneficiary access to a vital part of their overall healthcare. This paper describes some of these cost-containment mechanisms and highlights several states that have achieved reduced costs with each technique. In general, states have not yet taken advantage of all of these approaches. CMS can provide consultation and support to assist states in using these and other methods to lower their drug costs without compromising quality of care..."
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A September Centers for Medicare and Medicare Service report in Adobe Acrobat format, available at the Open Minds web site - "As a result of increasing prescription drug costs, State Medicaid programs have implemented a variety of cost-containment mechanisms in their drug programs over the past few years. These mechanisms have allowed states to reduce their pharmacy expenditures and maintain beneficiary access to a vital part of their overall healthcare. This paper describes some of these cost-containment mechanisms and highlights several states that have achieved reduced costs with each technique. In general, states have not yet taken advantage of all of these approaches. CMS can provide consultation and support to assist states in using these and other methods to lower their drug costs without compromising quality of care..."
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NAMI blasts CBS for television malpractice
Press release at the NAMI web site - "NAMI (National Alliance for the Mentally Ill) today charged CBS Television with gross irresponsibility and potential endangerment of the lives of children with mental illness as a result of its September 22 broadcast of the Dr. Phil Primetime Special: Family First. 'Not only did the show represent a breach of professional ethics, but also, in the opinion of many, malpractice,' declared NAMI executive director Michael J. Fitzpatrick, in a letter to CBS Chairman & CEO Leslie Moonves, co-signed by Suzanne Vogel-Scibilia, MD, a child psychiatrist who chairs the Child & Adolescent Policy Subcommittee of NAMI’s national board. In the September 22 program, parents essentially were blamed for 'what may very well be the severe mental illness of their child.' "
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Press release at the NAMI web site - "NAMI (National Alliance for the Mentally Ill) today charged CBS Television with gross irresponsibility and potential endangerment of the lives of children with mental illness as a result of its September 22 broadcast of the Dr. Phil Primetime Special: Family First. 'Not only did the show represent a breach of professional ethics, but also, in the opinion of many, malpractice,' declared NAMI executive director Michael J. Fitzpatrick, in a letter to CBS Chairman & CEO Leslie Moonves, co-signed by Suzanne Vogel-Scibilia, MD, a child psychiatrist who chairs the Child & Adolescent Policy Subcommittee of NAMI’s national board. In the September 22 program, parents essentially were blamed for 'what may very well be the severe mental illness of their child.' "
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Many More People Seeking Mental Health Treatment Since 1980s
Psychiatric News story - "An increase in the number of people receiving mental health care reflects the public's growing awareness of more and better treatment options and the decline of stigma. Mental illness was among the top five conditions accounting for rising health care costs between 1987 and 2000, and most of that spending stemmed from an increase in the prevalence with which these disorders were treated. Total health care spending increased by $199 billion (in real 2000 dollars) during that period, and mental illness accounted for approximately 7.4 percent of that increase, according to a report in the August Health Affairs."
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Psychiatric News story - "An increase in the number of people receiving mental health care reflects the public's growing awareness of more and better treatment options and the decline of stigma. Mental illness was among the top five conditions accounting for rising health care costs between 1987 and 2000, and most of that spending stemmed from an increase in the prevalence with which these disorders were treated. Total health care spending increased by $199 billion (in real 2000 dollars) during that period, and mental illness accounted for approximately 7.4 percent of that increase, according to a report in the August Health Affairs."
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Proposed Drug Guidelines Get Negative APA Review
Psychiatric News story - "Draft model guidelines for Medicare Part D drug formularies do not adequately address clinical heterogeneity in patients with mental illness, APA says. APA added its voice to a wide-ranging chorus of dissatisfaction at a public hearing last month on the proposed framework of drug categories and classes to be covered by the new Medicare Part D prescription drug benefit that starts in 2006. The framework, said APA and others, is wholly inadequate to address the diverse clinical needs of a heterogeneous patient population, such as those with mental illness..."
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Psychiatric News story - "Draft model guidelines for Medicare Part D drug formularies do not adequately address clinical heterogeneity in patients with mental illness, APA says. APA added its voice to a wide-ranging chorus of dissatisfaction at a public hearing last month on the proposed framework of drug categories and classes to be covered by the new Medicare Part D prescription drug benefit that starts in 2006. The framework, said APA and others, is wholly inadequate to address the diverse clinical needs of a heterogeneous patient population, such as those with mental illness..."
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Depression drug data leave many questions
Philadelphia Enquirer story reprinted at PsycPORT - "Sixteen years after the approval of Prozac - the first of a new generation of antidepressants - doctors who treat kids still have many questions: Which drug should they use? How long should a child take it? Do the medicines really cause suicides and, if so, who is most at risk? The list goes on and on. No matter how the Food and Drug Administration responds to a recommendation to issue stronger warnings about the drugs, many of those questions likely will remain unanswered for years. The crux of the problem, doctors say, is that pharmaceutical companies fund studies aimed at FDA approval for specific uses for their drugs, not at giving doctors the facts they need..." See also Mysteries of the mind, a Washington Post story reprinted at the same site - "many of those who have been involved in the effort to get the word out are undoubtedly wondering why it took so long. Psychiatric researchers first reported that the antidepressants known as SSRIs could spark suicidal thoughts and actions in young patients back in 1990, just three years after the first major SSRI, Prozac, hit the market. Since then, there have been thousands of scientific papers published on these medications. You'd think the psychiatric research community would have noticed that the drugs can be dangerous for some patients -- particularly kids -- and may not be terribly effective for most. The fact is, many academic psychiatrists did notice, and some spoke up, but practically nobody listened."
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Philadelphia Enquirer story reprinted at PsycPORT - "Sixteen years after the approval of Prozac - the first of a new generation of antidepressants - doctors who treat kids still have many questions: Which drug should they use? How long should a child take it? Do the medicines really cause suicides and, if so, who is most at risk? The list goes on and on. No matter how the Food and Drug Administration responds to a recommendation to issue stronger warnings about the drugs, many of those questions likely will remain unanswered for years. The crux of the problem, doctors say, is that pharmaceutical companies fund studies aimed at FDA approval for specific uses for their drugs, not at giving doctors the facts they need..." See also Mysteries of the mind, a Washington Post story reprinted at the same site - "many of those who have been involved in the effort to get the word out are undoubtedly wondering why it took so long. Psychiatric researchers first reported that the antidepressants known as SSRIs could spark suicidal thoughts and actions in young patients back in 1990, just three years after the first major SSRI, Prozac, hit the market. Since then, there have been thousands of scientific papers published on these medications. You'd think the psychiatric research community would have noticed that the drugs can be dangerous for some patients -- particularly kids -- and may not be terribly effective for most. The fact is, many academic psychiatrists did notice, and some spoke up, but practically nobody listened."
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Job Protection Sought for Social Workers
AP story at Yahoo on Matt Zenner, whose wife, a Kansas social worker, was killed in August. Zenner is now "...fighting for more protection for social workers. He wants them equipped with pagers that can call 911 and global-positioning satellite locator devices. He wants to make sure caseworkers have clients' criminal records. And he wants hospitals to make more room for mental patients. ... Professor Virginia Yribia, director of field education for the University of Denver's Graduate School of Social Work, said many mental health centers around the country would probably be willing to make such changes, but could not afford to. ... A 1999 University of Michigan study of 1,600 social workers found 3 percent had been assaulted by a client and 23 percent had been threatened with assault. One in four social workers said they had a colleague who was assaulted by a client."
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AP story at Yahoo on Matt Zenner, whose wife, a Kansas social worker, was killed in August. Zenner is now "...fighting for more protection for social workers. He wants them equipped with pagers that can call 911 and global-positioning satellite locator devices. He wants to make sure caseworkers have clients' criminal records. And he wants hospitals to make more room for mental patients. ... Professor Virginia Yribia, director of field education for the University of Denver's Graduate School of Social Work, said many mental health centers around the country would probably be willing to make such changes, but could not afford to. ... A 1999 University of Michigan study of 1,600 social workers found 3 percent had been assaulted by a client and 23 percent had been threatened with assault. One in four social workers said they had a colleague who was assaulted by a client."
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The looming national benefit crisis
USA Today feature story - "The long-term economic health of the United States is threatened by $53 trillion in government debts and liabilities that start to come due in four years when baby boomers begin to retire. ... The 'Greatest Generation' and its baby-boom children have promised themselves benefits unprecedented in size and scope. Many leading economists say that even the world's most prosperous economy cannot fulfill these promises without a crushing increase in taxes — and perhaps not even then. Neither President Bush nor John Kerry is addressing the issue in detail as they campaign for the White House. A USA TODAY analysis found that the nation's hidden debt — Americans' obligation today as taxpayers — is more than five times the $9.5 trillion they owe on mortgages, car loans, credit cards and other personaldebt. This hidden debt equals $473,456 per household, dwarfing the $84,454 each household owes in personal debt..."
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USA Today feature story - "The long-term economic health of the United States is threatened by $53 trillion in government debts and liabilities that start to come due in four years when baby boomers begin to retire. ... The 'Greatest Generation' and its baby-boom children have promised themselves benefits unprecedented in size and scope. Many leading economists say that even the world's most prosperous economy cannot fulfill these promises without a crushing increase in taxes — and perhaps not even then. Neither President Bush nor John Kerry is addressing the issue in detail as they campaign for the White House. A USA TODAY analysis found that the nation's hidden debt — Americans' obligation today as taxpayers — is more than five times the $9.5 trillion they owe on mortgages, car loans, credit cards and other personaldebt. This hidden debt equals $473,456 per household, dwarfing the $84,454 each household owes in personal debt..."
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Blue Cross Blue Shield of Michigan Program Aims to Reduce Untreated Depression
PR Newswire story at Yahoo - "Health care data show major depression is one of the top causes of worker disability in the United States. Some studies estimate the total cost of depression at $43 billion annually, primarily from lost work time or disability. Depression is also one of the leading chronic disorders seen by primary care physicians. Blue Cross Blue Shield of Michigan focuses on depression as part of its care management program called BlueHealthConnection. The program includes screening for depression by nurse 'health coaches' who talk over the phone to members with chronic diseases, such as diabetes, who are at higher risk for depression. The health coaches are trained to ask questions that show whether a member should talk to a physician about depression."
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PR Newswire story at Yahoo - "Health care data show major depression is one of the top causes of worker disability in the United States. Some studies estimate the total cost of depression at $43 billion annually, primarily from lost work time or disability. Depression is also one of the leading chronic disorders seen by primary care physicians. Blue Cross Blue Shield of Michigan focuses on depression as part of its care management program called BlueHealthConnection. The program includes screening for depression by nurse 'health coaches' who talk over the phone to members with chronic diseases, such as diabetes, who are at higher risk for depression. The health coaches are trained to ask questions that show whether a member should talk to a physician about depression."
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Ruling Due in Mental Health Case (UK)
Story at Scotsman.com - "Human rights judges will rule tomorrow in the case of a Surrey man who claims he was kept in a psychiatric hospital against his wishes and in breach of his legal right liberty. The 55-year old man, named only in court as 'H.L.', was held as an 'informal patient' in July 1997 and was not allowed to leave for five months."
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Story at Scotsman.com - "Human rights judges will rule tomorrow in the case of a Surrey man who claims he was kept in a psychiatric hospital against his wishes and in breach of his legal right liberty. The 55-year old man, named only in court as 'H.L.', was held as an 'informal patient' in July 1997 and was not allowed to leave for five months."
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Political Analysts Expect Little Investment in Mental Health Care
Psychiatric News story - " 'Extreme elements' in Congress coupled with skyrocketing federal deficits may impede progress on legislation that would increase access to mental health services in the United States. The chances are that regardless of who wins the presidential election in November, looming fiscal deficits will prevent federal spending to improve mental health services for Americans, political analysts told attendees at the Opening Plenary of the 2004 conference of the National Alliance for the Mentally Ill in Washington, D.C., last month. "
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Psychiatric News story - " 'Extreme elements' in Congress coupled with skyrocketing federal deficits may impede progress on legislation that would increase access to mental health services in the United States. The chances are that regardless of who wins the presidential election in November, looming fiscal deficits will prevent federal spending to improve mental health services for Americans, political analysts told attendees at the Opening Plenary of the 2004 conference of the National Alliance for the Mentally Ill in Washington, D.C., last month. "
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Consumer Reports Readers Rate Mental-Health Care for Depression and Anxiety
Kansas City InfoZine - "In one of the largest surveys of its kind, 3,079 Consumer Reports (CR) readers rate the mental-health care they received for depression and anxiety. The survey results, plus CR's interviews with patients and experts, offer a compelling snapshot of how people fared given the mental-health care choices they made." See also Antidepressants and adolescent suicide, which is available at the Consumer Reports web site during October.
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Kansas City InfoZine - "In one of the largest surveys of its kind, 3,079 Consumer Reports (CR) readers rate the mental-health care they received for depression and anxiety. The survey results, plus CR's interviews with patients and experts, offer a compelling snapshot of how people fared given the mental-health care choices they made." See also Antidepressants and adolescent suicide, which is available at the Consumer Reports web site during October.
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Copyright 2003 © Bill Davis.
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