F.D.A. Considers Implant Device for Depression May 20 New York Times story - " The Food and Drug Administration may soon approve a medical device that would be the first new treatment option for severely depressed patients in a generation, despite the misgivings of many experts who say there is little evidence that it works. The pacemaker-like device, called a vagus nerve stimulator, is surgically implanted in the upper chest, and its wires are threaded into the neck, where it stimulates a nerve leading to the brain. It has been approved since 1997 for the treatment of some epilepsy patients, and the drug agency has told the manufacturer that it is now 'approvable' for severe depression that is resistant to other treatment. But in the only rigorously controlled trial so far in depressed patients, the stimulator was no more effective than surgery in which it was implanted but not turned on." [Viewing New York Times resources requires registration, which is free].  
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Decoding Health Insurance Opinion piece in the New York Times by Robin Cook - "...As a doctor schooled to some degree in science, I believed (and still do) that decoding the human genome might be the most important milestone in the history of medical science. To borrow Mr. Clinton's metaphor, the full genome offers researchers the sequence of all the letters of the human book of life, a monumental resource despite our imperfect understanding of the book's overarching, mind-boggling complexity. As decoding gathers speed, it promises to change just about everything we know about medicine in the form of understanding, prediction, prevention, diagnosis and the treatment of disease. And in so doing, it also offers us a remarkable opportunity to solve the huge and nettlesome problem of paying for health care in the United States..." [Viewing New York Times resources requires registration, which is free].  
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Goals Backed by Budget Requests (New Jersey) Psychiatric News story - "Acting New Jersey Gov. Richard Codey (D) told attendees at the statewide Mental Health Summit in March, 'The problems of mental illness are difficult and expensive.... I'm not going to pretend we are going to make lasting changes without new money.' He followed up that declaration with a proposed budget that includes new funding for mental health services of approximately $40 million. If all of Codey's proposals are enacted, the mental health increases would come about despite his recommended cuts of $600 million in other state programs and increases in property taxes." See also, at the same source, Firsthand Experience Spurs Codeys' Fight to End Stigma.  
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Governors Say Major Reform Only Salvation for Medicaid  Psychiatric News story - "The Medicaid program is threatening fiscal disaster for states, said Virginia Gov. Mark Warner (D), chair of the National Governors Association. In a Webcast sponsored by the Kaiser Family Foundation, Warner said rapidly escalating costs associated with the 40-year-old entitlement program were threatening states with financial ruin. He called for multiple approaches to reform, including tax credits to provide individuals and families an incentive to purchase long-term-care insurance, regulatory reform to address the problem of 'asset transfer' by which families may transfer wealth from an individual so the individual may qualify for Medicaid, widespread incorporation of information technology to improve efficiency, and drug-pricing reform..."  
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Patient Rep Reverses Position On SSRI Black-Box Warning  Psychiatric News story on Gail Griffith - "The FDA's patient representative on the advisory committee on antidepressants and suicide recounts her perspective of why she and her fellow committee members decided to support a black-box warning—and why she changed her mind... 'Trotting out members of the public to air emotionally devastating, personal, and anecdotal stories and having those stories sit as evidence for the committee amounts to a barrage that can't help but sway how you feel and how you look at the data you are seeing,' Griffith said. 'Intellectual analysis does not happen [under those circumstances],' Griffith continued. 'It is an emotional exercise. After a day's worth of personal and anecdotal accounts—some pro, some con—if the committee could then be sequestered and thereby have the opportunity to fully examine the data in light of what we'd heard, then I think you would have some confidence in the notion that a scientific effort had been made to render a decision.' "  
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Covert Drug Administration: `Win Battle, But Lose War'  Psychiatric News story - " Surreptitious administration of medications may seem like a tempting option for nonadherent patients, but the disadvantages may outweigh any benefits. Spiking a child's food or drink with medication may be an acceptable necessity when there's no other way to give a drug. Adults are another matter, even for those with severe mental illness who cannot or will not take their medicine. The practice of covertly administering drugs may seem like a minor matter, but it touches on legal and ethical issues of the patient's competence, autonomy, and insight, wrote [the authors] in the April issue of Psychiatric Services. ... Research on the extent of the practice is spotty but suggestive. Drugs were given covertly at some time in 24 of 34 residential, nursing, or inpatient units in southeast England, according to a study in the August 2000 issue of the Journal of the Royal Society of Medicine. ... Little information is available on the extent of the practice in the United States, said former APA President Paul Appelbaum, M.D., now chair of APA's Council on Psychiatry and Law, but he thinks it is rare in inpatient settings, given professional sensitization to informed consent and knowledge of how to obtain consent or what to do if the patient is not competent..."  
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Funds 'must stem suicide crisis'  BBC story - "More funding is needed to stem the 'crisis' of suicide and self harm among young people, the NI Commissioner for Children and Young People has urged. There have been at least 15 suicides in west Belfast in a three-month period this year with seven deaths occurring in one week in April. In north Belfast, 13 young men took their lives in two months last year. Nigel Williams said there was a crisis in mental health services and called for resources to tackle the problem."  
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Mental health bill "fundamentally flawed" (UK) Story at Black Information Link - "Black mental health experts said the government's new Mental Health Bill needed major changes to avoid discriminating against ethnic minorities. Labour included the bill in a packed legislative package announced in the Queens Speech. The draft Mental Health Bill, which introduced in the last parliament before the election, was widely criticised by experts and politicians. Today mental health professionals expressed hope that the new bill would be an improvement on the last effort..."  
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