This is Prevention Week, part of Mental Health Awareness Month in the U.S. Too bad that the policies promoted by Prevention Week’s creators, the US Substance Abuse and Mental Health Services Administration (SAMHSA), make it more likely that people with the most severe psychotic disorders — schizophrenia and bipolar disorder — will remain ill.

To see the problem, just imagine that you are the parent of someone you think may be developing or already has schizophrenia. You go to the SAMHSA website because this is the well-funded U.S. agency in charge of supporting treatment for mental illnesses.

You urgently need some kind of overview about schizophrenia. Let me know if you find it.

In looking for basic information about schizophrenia, you might not think to click on ”What a Difference a Friend Makes.” This is because your son or daughter’s friends fled when the delusional behaviour started. Click on this anyway and you can see the one meager paragraph that I could find on the entire SAMHSA website that discusses schizophrenia. The random comments mention the use of medication.

You may have heard somewhere else that anti-psychotic medications have a good success rate in helping people recover from psychosis and maintain their sanity. I can’t find any of this research on SAMHSA’s site. However, there are numerous links, amidst the vast resources on recovery, to psychiatric survivor groups ready to explain why medications should be avoided. In the information on recovery, I couldn’t find any links to the informative list of strategies for managing schizophrenia that are easily found on the science based US National Institute of Mental Health website.

by Susan Inman, The Huffington Post

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Former Detroit Lions player, Titus Young, is making headlines after his father told the Free Press his son suffers from a brain disorder following a series of off-the-field incidents, including three arrests in less than a week.

The football player was released from the Lions in February following a series of “bizarre behaviors.” He was reportedly receiving periodic counseling and was prescribed to medications. “Titus wasn’t taking his medicine regularly,” the football player’s father told the Free Press.

While the details of Young’s condition remain unclear, what is clear, according to the football player’s father is that “his son suffers from a mental health disorder and desperately needs help…We just want Titus to get well.”

–The Treatment Advocacy Center

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The CIA was not spying on me. Nor were FBI agents looking to bring me down. On the other hand, I did not belong to either of these groups and was neither the President, Jesus Christ, nor Cleopatra. These, I had heard, are the content of delusions that characterize schizophrenia; its delusions are grandiose, and based (albeit flimsily) on the culture we see in the media. For example, having a radio transistor in your tooth is a common delusion of people suffering from schizophrenia — but I would assume this is just since the ubiquity of such technology. Naïve, I thought that if you were not pulled into these “standard” delusions, you could not have schizophrenia.

Given that logic, I did not consider myself to have schizophrenia. When mental health professionals labelled some of my beliefs as delusions, I was not convinced. I was worried, though: microscopic rats were eating my brain. “That’s the schizophrenia talking,” the hospital staff would say to me. “It is not real; it is a delusion.” But I was terrified of these brain-eating rodents, especially as they flooded my system via the countess forced injections I endured while certified — over 10 hospitalizations in five years.

“Erin, rats cannot even fit inside your head,” they’d all say. Furthermore, they’d expect me to use my understanding of neuroscience (I have a Master’s degree in the field) that felt like as a slap in the face. Did they not understand that the rats’ existence and constant consummation of my brain transcended science? It was of the Deep Meaning.

This “Deep Meaning” was to me the ultimate reality, while again doctors and nurses spoke of delusion. How could I expect them to understand, anyway? I reasoned. After all, this Deep Meaning was revealed only to me, the Chosen One. I had great responsibility: I was chosen to have my brain regenerate after being eaten by the rats, in order for there to be scientific study of this phenomenon. Regeneration in the brain is limited and its widespread occurrence in my brain would be an amazing breakthrough for neuroscience. Since this was, in my mind, based in science, it was obviously not a delusion.

by Erin Hawkes, The Huffington Post

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A storm is brewing over the most effective way to implement California’s Laura’s Law so that services reach those who need them most. We recently celebrated legislative efforts to amend the life-saving mental illness treatment law, but these legislative strides were halted by California Senate President Pro Tem Darrell Steinberg.

While we consider it progress that the Senate Pro Tem eliminated funding hurdles by clarifying that money from the Mental Health Services Act can be used to implement the law, this does not mean services will reach people with the most severe mental illnesses who need them the most.

The Sacramento Bee published today three letters that demonstrate how passionately people feel that Steinberg’s amendments gut the core of the law, which makes treatment possible for people who are too sick to realize they are ill.

“Steinberg’s plan will eliminate the funding hurdle but misses the opportunity to make treatment more accessible to the sickest and most vulnerable Californians by removing other barriers to implementing Laura’s Law.”

“His new proposals are for voluntary services and do not help the seriously ill who are too psychotic to know they are ill. To help people living under lice-infected clothing, who are eating out of dumpsters, screaming they are the Messiah requires implementing Laura’s Law.”

“[I]deological arguments keep getting in his way. That is the is the battle between those who believe acceptance of mental health treatment must always be through a person’s free will decision and those who recognize psychosis robs some people with mental illness of the ability to realize they are ill and need treatment.”

We commend Steinberg on his plan to make it easier to fund assisted outpatient treatment (AOT), but he is missing an opportunity remove other barriers that would make treatment more accessible for the sickest and most vulnerable Californians.

–Treatment Advocacy Center

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The last time I saw my old self, I was 27 years old and living in Boston. I was doing well in graduate school, had a tight circle of friends and was a prolific creative writer. Married to my high-school sweetheart, I had just had my first child. Back then, my best times were twirling my baby girl under the gloaming sky on a Florida beach and flopping on the bed with my husband — feet propped against the wall — and talking. The future seemed wide open.

Brain scans during memory tests might help predict which depressed patients will be helped by a fast-acting drug, a new study reports.

Major depression is marked by feelings of sadness, loss, anger or frustration that can interfere with daily life for many weeks. Symptoms can also include memory loss and trouble focusing.

Most depression-fighting drugs must be taken for several weeks before working, which can cause an agonizing wait for patients. Because different people respond to different medications, patients may need to try several drugs over a month or more before getting symptom relief.

Several years ago, NIH researchers discovered that a drug used to treat motion sickness could also rapidly reduce symptoms of depression. But the drug, called scopolamine, didn’t work in all patients.

To try to predict the drug’s effects, the researchers used MRI to track brain activity in adults with and without major depression. People with major depression are known to have unique patterns of brain activity when asked to pay attention to the emotional content of images. They also tend to remember negative information (such as sadness) better than positive or neutral information.

The researchers found that scopolamine relieved symptoms in 11 of the 15 participants who had major depression. Scopolamine’s effectiveness was linked to activity in a specific brain region when patients were asked to remember the emotions on faces that flashed by. Activity in this same brain region was also altered by infusions of scopolamine.

The findings suggest that activity in this brain region might provide early clues about how well scopolamine will work in different patients. Ongoing studies are exploring how the brain’s response to emotional images might help guide treatment strategies for major depression.

–National Institutes of Health

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Method Enables 3-D Analysis of Fine Structure and Connections – NIH-funded Study

A breakthrough method, called CLARITY, developed by National Institutes of Health-funded researchers, opens the intact postmortem brain to chemical, genetic and optical analyses that previously could only be performed using thin slices of tissue. By replacing fat that normally holds the brain’s working components in place with a clear gel, they made its normally opaque and impenetrable tissue see-through and permeable. This made it possible to image an intact mouse brain in high resolution down to the level of cells and molecules. The technique was even used successfully to study a human brain.

“CLARITY has the potential to unmask fine details of brains from people with brain disorders without losing larger-scale circuit perspective.”

–NIMH

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The physicist and mathematician Freeman Dyson once noted, “New directions in science are launched by new tools much more often than by new concepts.” This week marks the publication of a new tool that may alter the way we look at the brain. Karl Deisseroth and his colleagues at Stanford University have developed a method they call CLARITY. Yes, CLARITY is an acronym, for Clear Lipid-exchanged Anatomically Rigid Imaging/immunostaining-compatible Tissue hYdrogel.

By replacing the brain’s fat with a clear gel, CLARITY turns the opaque and impenetrable brain into a transparent and permeable structure. Most important, the hydrogel holds the brain’s anatomy intact. And because the hydrogel is permeable, the brain can be stained to localize proteins, neurotransmitters, and genes at a high resolution (see images below). Unlike other recent breakthroughs in neuroanatomy, this one can be used in human brains.

This technique is only for post-mortem tissue. And it measures structure not function. But I predict this new tool will revolutionize neuropathology, opening a new era for studying the neural basis of mental disorders. Indeed, in this initial report Deisseroth and his colleagues describe findings from a brain of someone who had died with autism 6 years earlier. With CLARITY they detected an unusual pattern of bridging connections from a particular class of inhibitory cells in this brain. Of course, this finding from a single brain needs to be replicated. The beauty of CLARITY is that other brains can now be tested, even tissue that has been stored for years.

by Thomas Insel, NIMH

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A new study showed that a weight-loss intervention can help overweight and obese people with serious mental illnesses—such as schizophrenia, bipolar disorder and major depression—lose significant weight and keep it off.

More than 80% of people with serious mental illnesses are overweight or obese—a major factor that helps lead to a death rate 3 times that of the overall population. Factors that contribute to obesity include unhealthy eating habits and lack of physical activity. Medications to help control mental illness symptoms can increase appetite and encourage weight gain. Adding to these challenges, people with serious mental illnesses may have impairments in memory and mental processes that make it more difficult for them to learn and adopt new weight loss behaviors such as counting calories.

To address the problem, researchers led by Dr. Gail L. Daumit at Johns Hopkins University tested the effectiveness of an 18-month behavioral weight-loss program tailored for adults with serious mental illnesses. The findings demonstrate that overweight and obese adults with serious mental illness can adopt healthy habits while in an outpatient psychiatric rehabilitation program. “We’re showing that serious mentally ill patients can make successful, sustained changes with proper interventions,” Daumit says. The researchers now hope to expand the program.

–National Institutes of Health (NIH)

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Behavioral health providers agree that following detention or arrest, the best place for many people with mental illness or addictions is in community treatment, not in jail or prison. Not only is it good public policy from a health perspective, but it saves money for the counties and states, since treatment in the community is far less costly than incarceration.

Most people who end up in jail who have mental illness are not dangerous and have not committed any violent crime, said Polzin. Two of every three people with a mental illness who end up in jail “are there because they have decompensated in some way, become a nuisance, trespassed, done this or that which is not socially acceptable,” said Polzin. “They commit a minor misdemeanor offense, and then they sit in jail because they are not able to post bond.”

Those with a mental illness who are fortunate enough to have benefits such as Medicaid or SSI find those benefits are suspended or terminated by federal law when they enter incarceration, even before trial when they are presumed innocent. Thus, he explains, the costs for any mental health treatment they receive – as well as the jail costs – become ‘100-percent county costs,’ he said, noting that in most cases, counties run the most of the nation’s jails. He called the costs of such treatment “a huge burden for counties.”

by Alison Knopf, Behavioral Healthcare

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