NIMH Releases Strategic Research Priorities Update

To keep pace with rapid developments in research on mental illnesses, the National Institute of Mental Health (NIMH) recently released updates to its Strategic Research Priorities. These priorities serve as guidance to NIMH grantees, potential grant applicants, and staff for the design and implementation of future research.

Developed and reviewed by NIMH subject matter experts and leaders, these updates are designed to ensure that the NIMH’s priorities continue to advance research across the Institute’s four Strategic Objectives outlined in its 2015 Strategic Plan for Research, reflect the current state of the science, address gaps in research areas, and promote scientific discovery and service delivery.

The updated Strategic Research Priorities continue to emphasize the importance of research approaches that include the role of the environment, focus on prevention via early intervention, consider sex as a biological variable, address mental health disparities, and recognize global perspectives on mental health.

The Strategic Research Priorities continue to highlight NIMH’s ongoing commitment to data sharing, the use of common data elements, and priorities including the Research Domain Criteria(RDoC) project, the Brain Research through Advancing Innovative Neurotechnologies  (BRAIN) Initiative, and the Institute’s experimental therapeutics approach.

NIMH updates its Strategic Research Priorities on an annual basis to provide timely guidance to investigators and promote rapid acceleration of scientific discovery.

Understanding Different Types of Therapy

There are several different types of therapy available for psychological health concerns. The type of therapy you receive depends on the severity of your concern. It is also affected by who else will be attending and what type of tactics the therapist uses. Therapists may be available at your military treatment facility (MTF). Otherwise, find a therapist through TRICARE.

Often, therapy is conducted in an outpatient setting. There are a few different kinds, depending on your needs. It may be confusing to understand which type will best fit what you need. This article describes four, basic outpatient therapies.

Types of Outpatient Therapy

You may find the following types of therapy at your MTF or be referred by a TRICARE-approved provider:

  1. Individual Therapy: The most common type of treatment. It provides a supportive, neutral environment to discuss your concerns.
    • You will work one-on-one with a licensed therapist on a regular basis. During your session, you will talk through your concerns to change current thoughts and behavior patterns.
    • Frequency and treatment plan depends on your situation and goals. This will be determined by your therapist.
  2. Group Therapy: Treatment experienced in a group setting, with anywhere from five to 15 members total. Hearing the strategies others use to work through their concerns may help you learn new ways to help yourself.
    • Usually focused on one type of concern. For example, eating disorders, depression or substance misuse.
    • Group members and the therapist can encourage you to make the positive changes you may need.
  3. Couples Therapy: Therapists help you and your partner work through any concerns affecting your relationship.
    • It may be beneficial for couples coping with psychological health concerns that can be hard on relationships with loved ones.
    • Many times the treatment is focused on learning ways to improve communication with your partner.
  4. Family Therapy: Treatment intended to help family members resolve conflicts that affect the functioning of the family. It provides a safe environment for family members to communicate with each other. The goal is to strengthen the overall family relationship.
    • This type of therapy may include the entire family or just certain family members.
    • A specific treatment plan will depend on your family’s unique situation.

Always check with TRICARE to see if your specific treatment may be covered. Depending on where you are located, your service options may vary with both MHS and TRICARE providers.

Remember, reaching out is a sign of strength. If you or a loved one needs additional support, you can contact the DCoE Outreach Center to confidentially speak with a trained health resource consultant 24/7, call 866-966-1020 or use the Real Warriors Live Chat. You can also visit our “Seek Help, Find Care” page to see a list of key psychological health resources.

Source: http://www.realwarriors.net/active/treatment/types-of-therapy.php

 

New Antipsychotic Effective With Placebo-like Side Effects

The first phase 3 study of an investigational new drug, ITI-007, corroborates findings from an earlier large phase 2b trial in which the first-in-class novel antipsychotic was found to provide rapid and clinically significant reductions in acute psychosis at 4 weeks while having virtually no side effects in comparison with placebo.

The pooled results from the phase 2b and the phase 3 study were presented here at the Institute of Psychiatric Services (IPS): The Mental Health Services 2016 Conference.

However, in a second phase 3 study of the same drug, which was not presented at the meeting, there was no difference in efficacy in comparison with placebo, although the drug was again extremely well tolerated.

“Generally, the dopamine blockers that we have available work in acutely ill patients. In the phase 2b study, the drug behaved like risperidone (Risperdal, Janssen Pharmaceuticals), so ITI-007 was not different from risperidone efficacy-wise,” investigator Christoph Correll, MD, professor of psychiatry, Hofstra Northwell School of Medicine, Hempstead, New York, told Medscape Medical News.

“But the uniqueness of this medication is that it actually has placebo-like tolerability except for a bit of sedation, and even in the most recent phase 3 study, where the 60-mg dose of ITI-007 did not separate from placebo, there was again a placebo-level side effect profile and significantly fewer side effects than risperidone.”

To read more, please click here.

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Schizophrenia and Diabetes: Same roots?

There is a link between first-episode psychosis and insulin resistance/impaired glucose tolerance, according to the first meta-analytic review on the topic.

Investigators found that biochemical markers of both prediabetic states were more common in antipsychotic-naive patients with first-episode psychosis than in healthy peers.

“Our results suggest that there might be an intrinsic link between abnormal glycemic control and psychosis, beneath the effects of diet, medication, and reduced access to healthcare that are all known causes for those with schizophrenia to suffer from diabetes,” first author Benjamin Ian Perry, MBBS, of Coventry and Warwickshire Partnership NHS Trust, United Kingdom, told Medscape Medical News.

“People with schizophrenia are known to die younger than the general population, with a greater burden of physical comorbidity. If schizophrenia patients are intrinsically susceptible to abnormal glycemic indices, in addition to the known environmental risk factors they may be exposed to, we as clinicians must show increased vigilance to the physical health of our patients,” Dr Perry said.

The study was published online October 5 in the Lancet Psychiatry.

To read more, please click here.

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Mental Health and Substance Use Disorder Parity Task Force

The Task Force is pleased to offer its Final Report – PDF, which highlights the progress to date on parity implementation, summarizes comments from stakeholders and actions taken during the Task Force’s tenure, and offers recommendations on how to:

  • Support consumers,
  • Improve parity implementation, and
  • Enhance parity compliance and enforcement.

Other Task Force activities are being announced along with the release of the Final Report:

  • We are unveiling the beta version of the new Mental Health and Addiction Insurance Help Consumer Portal! The Portal is a web site designed to help consumers find the appropriate Federal or State agency to assist with their parity complaints, appeals, or other actions. We’re currently taking public comments on how to improve the portal, so please let us know your ideas!
  • The Centers for Medicare & Medicaid Services (CMS) is awarding $9.3 million to States to help insurance regulators monitor compliance with the mental health and substance use disorder parity protections.
  • The Substance Abuse and Mental Health Services Administration (SAMHSA) and DOL are releasing a Consumer Guide to Disclosure Rights: Making the Most of Your Mental Health and Substance Use Disorder Benefits – PDF to help consumers understand what type of information to ask for when inquiring about a plan’s compliance with parity and to explain the various Federal disclosure laws that also require disclosure of information related to parity.
  • DOL, HHS and the Department of Treasury (Treasury) are issuing guidance on parity and opioid use disorder treatment – PDF to address specific questions the Departments have received related to issues such as the application of parity to opioid treatment access and coverage of court-ordered treatment. The guidance also solicits feedback on how the disclosure document request process can be improved. In addition, a new Parity Compliance Assistance Materials Index – PDF to assist with navigating the available FAQ.
  • SAMHSA is announcing that it will host two State Policy Academies on Parity Implementation for State Officials in Fiscal Year 2017, including one focused on the commercial market and one on parity in Medicaid and the Children’s Health Insurance Program.

To read more, please click here.

Emergency Departments a ‘Dumping Ground’ for Psych Patients

 

Dwindling mental health resources are turning the nation’s emergency departments (EDs) into a “dumping ground” for psychiatric emergencies, including those involving children.

Results of a poll of more than 1700 emergency physicians conducted by the American College of Emergency Physicians (ACEP) reveals that almost one quarter of ED physicians (21%) reported they have psychiatric patients waiting in the ED for 2 to 5 days for in-patient beds.

In addition, more than half (52%) of respondents reported that the mental health system in their communities had worsened during the past year

These “extremely troubling” findings reflect the experience of Rebecca Parker, MD, an emergency physician at West Suburban Medical Center in Oak Park, Illinois, who is the incoming president of the ACEP.

“Psychiatric patients wait in the emergency department for hours and even days for a bed, which delays the psychiatric care they so desperately need. It also leads to delays in care and diminished resources for other emergency patients. The emergency department has become the dumping ground for these vulnerable patients who have been abandoned by every other part of the healthcare system,” Dr Parker said in a press release.

“State and national policy makers need to make it a priority to address this,” Dr Parker told reporters attending a press briefing here at the ACEP 2016 Scientific Assembly, where the poll results were released.

To read more, please click here.

KSOC-TV: Altering the Course: First Episode Psychosis Intervention

The September 2016 Knowledge Network for Systems of Care TV (KSOC-TV) webcast explored ways to support youth and young adults who may be in the early phase of psychosis, or experiencing first episode psychosis (FEP). Behavioral health experts discussed evidence-based strategies to address both the prodromal phase and FEP, and shared available resources to help children, youth, families, and caregivers.

Outreach Partnership 2016 Meeting

Preventing and Treating Psychosis

An area of particular importance to NIMH is the prevention, early identification, and treatment of psychosis, which was covered during three sessions at the annual meeting. Dr. Kristin Cadenhead from University of California San Diego presented the opening plenary about NIMH’s North American Prodromal Longitudinal Study, a consortium of eight research programs working to identify predictors and mechanisms of conversion to psychosis among individuals ascertained to be in a clinical high risk or prodromal clinical state, a critical first step in early identification leading to prevention of psychosis onset.

On day two of the meeting, two grantees funded under NIMH’s initiative to shorten the duration of untreated psychosis described their public health research approaches to address the critical need for interventions to get individuals with psychosis into treatment early on in their illness. Dr. Steven Lopez from the University of Southern California discussed his research project, LA CLAve, designed to increase psychosis literacy in Spanish-speaking communities. He was joined by Dr. Vinod Srihari from Yale School of Medicine who described the Specialized Treatment Early in Psychosis Program (STEP), a populationbased early intervention for psychosis

SARDAA is a NIMH National Outreach Partner and shared a display of the Brain Campaign and Schizophrenia App

 

Identifying, Engaging Patients With First-Episode Psychosis Remains Public Health Challenge

Early identification and appropriate engagement of patients experiencing first-episode symptoms of schizophrenia remains a major public health challenge, said John Kane, M.D. (left), winner of the APA Foundation’s 2016 Alexander Gralnick, M.D., Award for Research in Schizophrenia. He received the award on Saturday in Washington, D.C., at APA’s fall conference, IPS: The Mental Health Services Conference. During his award lecture, Kane outlined the importance of duration-

During his award lecture, Kane outlined the importance of duration-of untreated psychosis as a moderator of response to treatment for first-episode psychosis, the impact of nonadherence to medication on the course of psychosis, and the unrealized potential of long-acting injectable (LAI) antipsychotics.

Kane said he believes that LAI antipsychotics are an effective but underutilized answer to nonadherence. “I think we have enough data to show that this is a very effective option we are not taking advantage of,” he told meeting attendees. Emerging technologies can also be used to improve treatment adherence, he explained. He and colleagues at Zucker Hillside Hospital and Massachusetts General Hospital have studied the use of an “an ingestible event marker”—a pill embedded with a tiny sensing device that emits a signal when it comes into contact with gastric contents after being swallowed; the signal is picked up by a receiver in a patch worn by the patient, which in turns transmits the signal to caregivers and clinicians indicating that the medication has been ingested. “New technologies, such as smartphones and other monitoring tools, should be systematically developed, tested, and applied,” Kane said. Kane also addressed how pharmacogenetics can help individualize treatment, the importance of managing metabolic symptoms in patients treated with second-generation antipsychotics, the unique value of clozapine for refractory schizophrenia, and the findings from the Recovery After an Initial Schizophrenia Episode (RAISE) project, on which Kane was a principal investigator.

Emerging technologies can also be used to improve treatment adherence, he explained. He and colleagues at Zucker Hillside Hospital and Massachusetts General Hospital have studied the use of an “an ingestible event marker”—a pill embedded with a tiny sensing device that emits a signal when it comes into contact with gastric contents after being swallowed; the signal is picked up by a receiver in a patch worn by the patient, which in turns transmits the signal to caregivers and clinicians indicating that the medication has been ingested. “New technologies, such as smartphones and other monitoring tools, should be systematically developed, tested, and applied,” Kane said. Kane also addressed how pharmacogenetics can help individualize treatment, the importance of managing metabolic symptoms in patients treated with second-generation antipsychotics, the unique value of clozapine for refractory schizophrenia, and the findings from the Recovery After an Initial Schizophrenia Episode (RAISE) project, on which Kane was a principal investigator.

“New technologies, such as smartphones and other monitoring tools, should be systematically developed, tested, and applied,” Kane said. Kane also addressed how pharmacogenetics can help individualize treatment, the importance of managing metabolic symptoms in patients treated with second-generation antipsychotics, the unique value of clozapine for refractory schizophrenia, and the findings from the Recovery After an Initial Schizophrenia Episode (RAISE) project, on which Kane was a principal investigator.

Kane also addressed how pharmacogenetics can help individualize treatment, the importance of managing metabolic symptoms in patients treated with second-generation antipsychotics, the unique value of clozapine for refractory schizophrenia, and the findings from the Recovery After an Initial Schizophrenia Episode (RAISE) project, on which Kane was a principal investigator.

 

Help for people with Schizophrenia and Related Disorders

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Now it is easy to record details and specifics about symptoms, medication, moods, and more. Choose what you want to track, and see all the information you need to help you or your loved one who is living with schizophrenia and related disorders.

Get the Schizophrenia Health Storylines™ Mobile App Today! The mobile app is FREE for all users on iOS and Android devices. There is also a web version available, accessible through the browser of any desktop computer or mobile device.

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  • Reflect holistically on your self­care activities with the Self­Care Reflection Tool
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