New York to Move Many With Mental Illness to Community Housing

Yesterday, the state of New York agreed to settle a decade-long lawsuit allowing 4,000 people with mental illness the opportunity to move out of adult group homes and into their own apartments “in the most integrated setting appropriate to their needs.” The consent decree requires that New York set up at least 2,000 supported-housing units and hire staff to advise the residents. The state will also provide coordination of psychiatric and general medical care, employment services, assertive community treatment, and crisis services, among other services.

….The lawsuit was filed after the New York Times reported that operators of the for-profit group homes provided poor care or needless medical treatment to the residents.

–Psychiatric News Alert

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Scientists Warn of Overwhelming Costs of Mental Illness

Health systems could be “overwhelmed” by the costs of coping with mental illnesses such as dementia, depression and addiction if nothing is done now to boost investment in research, leading neuroscientists said on Thursday.

Publishing a study that put the estimated costs of brain disorders in Britain alone at more than 112 billion pounds ($172 billion) a year, they said mental illness research needed to attract the same funding levels as illnesses such as cancer and heart diseases to be able to reduce the burden.

“No group of chronic diseases costs the world more than brain disorders,” said Barbara Sahakian, a professor at Cambridge University and president of the British Association of Psychopharmacology.

by Kate Kelland, Reuters

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L.A. Supervisors Agree to Act on Billion-Dollar Jail Renovation

Concerned about possible federal intervention into the operation of Los Angeles County’s system of jails, the Board of Supervisors agreed Tuesday to take a significant step toward replacing the Men’s Central Jail and renovating other facilities to reduce crowding and increase mental-health services for prisoners.

The five-member board voted unanimously to accept a report from consultants who outlined five options. All included tearing down and replacing the Men’s Central Jail and reconfiguring other existing facilities.

The number of jail beds would be unchanged, but the design changes would decrease crowding, while increasing access to care for the mentally ill and drug and alcohol addicts. Design changes would also create safer facilities, with guards better able to monitor the inmates, said Rob Nash, an architect with Vanir Construction Management.

By Seema Mehta and Abby Sewell, LA Times

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Wipe Out The Stigma of Mental Illness

Shouldn’t all Americans be afforded equal rights and equal opportunities?

Sadly, when it comes to the treatment of people with mental illness, addiction and brain injury, equality remains unattained.

In America in 2013, thousands of our fellow citizens are still marginalized. They are still discriminated against. They face stigma every day. Today, too many Americans are told that they’re less entitled to health care than those who have diseases like diabetes or cancer or asthma, just because the origin of their illness is in their brain. Without equality, or parity, insurers can refuse to cover mental illnesses at the same level as other physical illnesses, making it harder for people to get well and often further isolating them in their struggle. Together, we must change that.

Eliminating the stigma of mental illness — and finally achieving parity for its treatment — is the next chapter in America’s civil rights movement.

by Patrick J. Kennedy, CNN

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Finding Simple Tests For Brain Disorders Turns Out To Be Complex

If you’re having chest pain, your doctor can test you for a heart attack. If you’re having hip pain, your doctor could test for osteoarthritis.

But what if you’re depressed? Or anxious? Currently there are no physical tests for most disorders that affect the mind. Lab tests like these could transform the field of mental illness. So far efforts to come up with biomarkers for common mental health disorders have proved largely fruitless.

That doesn’t stop people from trying. Doctors are looking to create them, and patients are taking them, too, even though they know that existing biomarkers — for Alzheimer’s disease, for instance — have serious limitations.

by Amy Standen, NPR

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Long Term Effects of Ecstasy

Ecstasy primarily affects the brain’s serotonin center. Serotonin is a neurotransmitter that is related to your mood and feelings of well-being. In the short term, ecstasy increases serotonin levels to make you feel happy and euphoric. The long term effects of ecstasy on the serotonin center, however, can be permanent and result in feelings that are quite the opposite.

Long term ecstasy use can result in irreversible damage to the brain that can affect all the ways serotonin functions. Essentially, it can limit the amount of serotonin your body produces and block serotonin from doing its job. It can negatively impact our ability to sleep, remember things, and be happy. Long term effects of ecstasy include memory loss, difficulty sleeping, difficulty concentrating, depression, anxiety, mood swings, and even psychosis.

There are studies that suggest long term ecstasy use can also result in other types of brain damage, including the reduction of overall brain mass.


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NIH Funds Industry Collaborations to Identify New Uses for Existing Compounds

Drug discovery still entails a matter of luck. The average length of time from discovery of a possible compound to its approval is more than 13 years, and the failure rate exceeds 95 percent. And yet these are the odds for the compounds that enter the drug pipeline. For each compound that enters the drug discovery path– a costly venture averaging more than $1 billion per successful drug–there are of thousands of compounds that remain partially developed. Hoping to increase the chances of success for these underdeveloped compounds, the National Institutes of Health has funded $12.7 million to match nine academic research groups with a selection of pharmaceutical industry compounds to explore new treatments for patients in eight disease areas including Alzheimer’s disease, alcohol and nicotine dependence, and schizophrenia. The collaborative pilot initiative, called Discovering New Therapeutic Uses for Existing Molecules, is led by the National Center for Advancing Translational Sciences (NCATS) and funded by the NIH Common Fund.

–National Institutes of Health (NIH)

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Brain Scan May Predict Best Depression Treatment

A brain imaging technique may help predict whether people with major depression will respond best to treatment with psychotherapy or a commonly prescribed drug. The approach might eventually be used as a tool to identify treatments that are most likely to succeed.

People with major depressive disorder, or major depression, have feelings of sadness, loss, anger or frustration that interfere with daily life for weeks or longer. Symptoms can also include memory loss and trouble focusing.

Major depression is most commonly treated with medication, psychotherapy or a combination. Unfortunately, less than 40% of patients typically respond well to initial treatment. They may need to try several treatments over many weeks or months before finally getting symptom relief.

–National Institutes of Health (NIH)

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RESEARCH: Mental Illness Behind Bars – and Under the Rug

We all know the criminal justice system is bursting with individuals who have severe mental illness.

We didn’t know the role of their mental illness was being minimized.

According to a new report in The Journal of the American Academy of Psychiatry and the Law, researchers have begun de-emphasizing the link between mental illness and the risk for criminal behavior in favor of factors such as antisocial attitudes and a lack of problem-solving and self-control skills.

While such characteristics “may be present and contribute to criminal behavior,” it is the lack of “adequate treatment, structure, social control, and, when necessary, 24-hour care in the mental health system” that results in the behaviors that typically land individuals with severe mental illness behind bars (“Some perspectives on criminalization,” 2013).

Authors H. Richard Lamb and Linda E. Weinberger estimate that slightly fewer than 378,000 people with serious mental illness are in jails and state and federal prisons. The growing “underemphasis” of the role lack of treatment plays in their incarceration diverts attention and resources from getting them the care they need to avoid criminal behavior and thus “greatly impedes” the efforts to reverse criminalization.

“The importance of psychiatric treatment must not be underestimated,” they warn. The mental health system “needs to be given more funding and to take more responsibility for these challenging individuals.”

The authors conclude with a question: “Is that not our mission: to help those persons with mental illness, especially those who are at most need, in a humane, therapeutic, and dignified manner?”

With their actions, too many mental health systems say, “No.” There’s little chance of that changing to “Yes!” if the link between illness and criminal behavior is swept under the rug.

–The Treatment Advocacy Center

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Laura’s Law Gains Momentum in California

Laura’s Law, California’s assisted outpatient treatment (AOT) law, will be implemented in Yolo County after its Board of Supervisors earlier this week unanimously approved the launch of a one-year pilot program for qualifying people with severe mental illness.

The court-ordered outpatient treatment law enacted in 2002 only operates in counties where the county board of supervisors, by resolution, authorizes its use. Until Monday morning, only two California counties – Nevada and Los Angeles – had done so.

“Without assisted outpatient treatment…these individuals are simply part of a revolving door system, where they decompensate to the point where they are hospitalized or jailed, then are released, stop taking any medication they were on, and decompensate again,” Nevada County’s program director, Carol Stanchfield told the Yolo County supervisors.

The pilot program in Los Angeles County has already produced impressive outcomes, including a 78% reduction in incarceration and a 77% reduction in hospitalization among participants. The law also cut LA County taxpayer costs by 40%. Meanwhile, Nevada County estimates it saves taxpayers $1.82 for every $1 it spends on its program.

For individuals too ill to seek treatment themselves, mandatory community treatment is an essential boost onto the road to recovery. We can only hope the remaining 55 counties in California – and all the counties around the country that are under-using their state AOT laws – will follow Yolo’s example and implement this treatment option for the benefit of their most vulnerable citizens and their communities.

–The Treatment Advocacy Center

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