Shooting Unfairly Links Violence With Mental Illness — Again

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With the Army’s disclosure that Army Spc. Ivan Lopez was being evaluated for post-traumatic stress disorder before he went on a shooting rampage Wednesday, there were once again questions about whether the Army could have prevented the violence at Fort Hood.

Experts in mental health say (even as more facts about Lopez emerge) that it’s highly unlikely the violence could have been predicted. Just raising that question, psychologists and psychiatrists say, shows how much Americans misunderstand the link between mental illness and violence.

One national survey in 2006 found that most Americans — 60 percent — believed people with schizophrenia were likely to be violent. But the vast majority of people with psychiatric disorders are not violent. In fact, another study found they are far more likely to be the victims of violence, and that 1 in 4 experience violence every year.

by Joseph Shapiro, NPR

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KU Wichita Clinical Trial Seeking Adults with Schizophrenia

Researchers at the KU School of Medicine–Wichita are seeking adults, age 18-40, with schizophrenia to participate in a study of cognitive impairment associated with schizophrenia (CIAS).

The study is aimed at testing the theory that a virus is the cause of CIAS and is testing an anti-infective agent for this component of the disease.

Participants who qualify will receive study-related medications and procedures at no cost and will receive compensation for each visit.

Those interested in learning more about the study may call 316-293-1833.

Schizophrenics and Home Care

Home treatment for schizophrenics overseen by local health workers is more effective than institutionalization, a recent large study in India has found.

The study — a clinical trial involving 282 patients at three sites in India — found that supervised home treatment, with limited hospitalization available, was somewhat better at reducing patients’ disability and much better at getting them to stay on their medications.

In poor countries with doctors overwhelmed by the struggle against physical diseases, mental disease is often ignored. In extreme cases, those with mental illness are simply kept in chains.

Many effective anti-psychotic drugs are too old to patent, so if they were available, even the poorest countries could offer some treatment, the study suggested. The health workers needed only six weeks of training.

Still, in the India study, home care was about $150 per patient more expensive than hospitalization or psychiatric care. Travel costs for the workers was a major factor.

by Donald G. McNEIL Jr., The New York Times

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Value-Based Financially Sustainable Behavioral Health Components in Patient-Centered Medical Homes

Because a high percentage of primary care patients have behavioral problems, patient-centered medical homes (PCMHs) that wish to attain true comprehensive whole-person care will find ways to integrate behavioral health services into their structure. Yet in today’s health care environment, the incorporation of behavioral services into primary care is exceptional rather than usual practice. In this article, we discuss the components considered necessary to provide sustainable, value added integrated behavioral health care in the PCMH. These components are to:(1) combine medical and behavioral benefits into one payment pool; (2) target complex patients for priority behavioral health care; (3) use proactive onsite behavioral “teams;” (4) match behavioral professional expertise to the need for treatment escalation inherent in stepped care; (5) define, measure, and systematically pursue desired outcomes; (6) apply evidence-based behavioral treatments; and (7) use cross-disciplinary care managers in assisting the most complicated and vulnerable. By adopting these 7 components, PCHMs will augment their ability to achieve improved health in their patients at lower cost in a setting that enhances ease of access to commonly needed services.

Roger G. Kathol, MD1,2

Frank deGruy, MD3

Bruce L. Rollman, MD, MPH4

Published in the Annals of Family Medicine

Full Article (PDF)

Video — Integrating Mental and Physical Healthcare: Roger Kathol

How would your healthcare experience be different if you could obtain best-practices mental healthcare and physical healthcare in one place? This topic has been pretty buzzworthy in recent mental health advocacy. For example, Mary Palafox’s essay from IMHRO’s 2013 Brainstorm Essay Contest, Reclassify All Organic Brain Diseases Under Medicine, explores some of the reasons why integrating healthcare might benefit people with severe mental illness. Now, with the provisions of the Affordable Care Act, this integration is gaining steam. One doctor who has dedicated much of his career to this integration process is Roger Kathol, M.D., C.P.E. He joins us on this month’s Brain Waves segment to discuss the whys and hows of healthcare integration, as well as why some stakeholders oppose it.

View Video

–International Mental Health Research Organization

Inclusion of Excellence Act in Medicare “Doc Fix” — $900 Million Dedicated to Mental Health Services

Washington, DC (March 26, 2014) — Congressional negotiators released a final Medicare SGR Repeal bill today that includes $900 million to fund the bipartisan Excellence in Mental Health Act. The Excellence Act, sponsored by Senators Stabenow (D-MI) and Blunt (R-MO) along with Representatives Matsui (D-CA) and Lance (R-NJ), would improve quality and expand access to mental health care and substance use treatment through community behavioral health clinics. The legislation would establish a two year demonstration program in eight states to offer a broad range of mental health and substance abuse services like 24-hour crisis psychiatric services while setting new high standards for providers. The legislation now moves to both chambers for consideration.

“After decades of devastating state and federal budget cuts, the time has come to reinvest in mental health and substance abuse services. The Excellence Act does just that.” said Linda Rosenberg, President and CEO of the National Council for Behavioral Health.  “As many as 240,000 people will be able to receive critical mental and behavioral health services as a result of Excellence Act funding.  When people receive the quality mental health and substance abuse services they need, the benefits of treatment extend far beyond the individual – to their families, their professional colleagues and their community at large. We are all better off when quality mental health and substance abuse services are available.  This is an historic day and it would not have been possible without the tireless work of Senator Debbie Stabenow and the bill’s bipartisan sponsors.”

The National Council for Behavioral Health has long been a champion of the Excellence Act, which expands access to evidenced-based community health care for children and adults with serious and persistent mental illnesses. If enacted, the legislation will reduce high hospital emergency room utilization among persons living with behavioral health conditions while easing the burden on hard-pressed law enforcement agencies in urban and rural areas.  Additionally, the Excellence Act demonstration will assist the Veterans Administration (VA) with serving the young men and women returning from Iraq and Afghanistan with service connected mental disorders including clinical depression and PTSD.

The National Council for Behavioral Health is the unifying voice of America’s community mental health and addictions treatment organizations. Together with our 2,000 member organizations, we serve our nation’s most vulnerable citizens — the more than 8 million adults and children living with mental illnesses and addiction disorders. We are committed to ensuring all Americans have access to comprehensive, high-quality care that affords every opportunity for recovery and full participation in community life. The National Council pioneered Mental Health First Aid in the U.S. and has trained nearly 150,000 individuals to connect youth and adults in need to mental health and addictions care in their communities. Learn more at www.TheNationalCouncil.org.

May 4th Mental Health and Dignity Day: Organizing Events in Communities Near You

Mental Health and Dignity DayEvery year communities across the country recognize mental health awareness in the month of May. This year a group of advocates are organizing to proclaim May 4th as Mental Health and Dignity Day. They are using the power of social media and grass roots organizing as a way of encouraging others to organize events in their local community on this day. The idea started with one person, which lead to a logo design and now a group on facebook that is quickly growing by the 100’s. The purpose is as follows: This group was started to organize local events where we honor all members of our community, recognize that mental health is something that deserves positive support and continue the fight against stigma towards mental illness.

As many as 60 million Americans struggle with mental health concerns and this is a public health issue that has come to the forefront through numerous events that have made international headlines. From gun control to healthcare, mental health is on the minds of many citizens and part of wide spread debate. What matters most is that mental health is a part of whole health. Every person struggles with their mental health at some point in life and many may experience significant life interruptions as a result of it. What research and practice has taught us in recent years is that people can and do recover. This day is meant to promote the dignity of every person and recognize that mental health is something we all have in common and can celebrate the positives that come from experiencing wellness. We also must recognize that many who suffer from life circumstances that have a negative impact on mental health such as poverty, trauma and abuse, stigma and lack of access to adequate care, do not have a voice and need to be supported as equal members of society.

As the movement continues to grow, this group intends to support communities in organizing events, raising funds to produce t-shirts, gain support from national organizations, media and key leaders in the community. To find out more about how to get involved, visit their group on facebook: https://www.facebook.com/groups/marchformentalhealthanddignity/ and their fundraising campaign for the purchase of t-shirts with logo below and support for local events: http://www.gofundme.com/72szak

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April 8th Webinar: “Brain Plasticity: What Is It and Why Is It Important?”

Meet the Scientist logo

Tuesday, April 8, 2:00 p.m.–3:00 p.m. Eastern Time

Speaker: Bruce S. McEwen, Ph.D.

Alfred E. Mirsky Professor

Head, Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology
The Rockefeller University
Dr. McEwen’s research has contributed significantly to elucidating the impact of stress and sex hormones on the brain’s chemistry and structure. Dr. McEwen’s emphasis is on the mechanisms underlying adaptive structural plasticity. Estrogens and androgens induce new synaptic connections in the brain. They also modulate, for better or worse, damage from stroke, head trauma and seizure, as well as age-related changes in brain function. In studying both stress and sex hormones as regulators of structural plasticity in the adult brain, Dr. McEwen and his team examine sex differences and how they develop, along with the influence of early life experiences, in affecting learning, memory and predisposition towards disease.

Dr. McEwen was an assistant professor at Rockefeller in 1966 and was named Alfred E. Mirsky Professor in 1999.

More Info and Registration

Video of the AEI Event, “Fixing the mental health care system: What Congress can do”

More than 9 million Americans have a serious mental illness, more than 3 million do not have treatment, and between 20 and 50 percent of all US inmates have a mental illness. How can we attempt to combat these challenges? On Friday, AEI’s Sally Satel hosted Representative Tim Murphy (R-PA) to discuss flaws in current mental health policy and the changes he hopes to enact via his Helping Families in Mental Health Crisis Act. Rep. Murphy identified key areas that require significant change, such as addressing shortage in inpatient treatment, looking to alternatives to institutionalization, and proactively providing quick and fair treatment to all mental health patients.

See video and more information