Patients with serious mental illness have a right to treatment and a right to get better. That’s what Rep. Tim Murphy (R-Pa.) said in an address this morning to the APA Assembly, in which he discussed the bill he is sponsoring in Congress titled the “Helping Families in Mental Health Crisis Act” (HR 3717).
The congressman received a standing ovation following an impassioned talk in which he discussed the need to fix this country’s broken mental health system. Prior to his address, Assembly members viewed a brief video of Murphy grilling an official with the Centers for Medicare and Medicaid Services about the administration’s proposal earlier this year to eliminate antidepressants and antipsychotics from the Medicare Part D prescription drug program’s six protected classes of clinical concern. That proposal was rescinded after vigorous protests from Murphy, APA, and other medical and mental health organizations (psychiatric news, March 6, 2014).
A licensed clinical psychologist, Murphy described his own experience working as a volunteer at Walter Reed Medical Center with veterans with PTSD. He also recounted case examples from his home state of Pennsylvania of individuals with serious mental illness, unable to access treatment, who later killed themselves or others.
In January 2013, not long after the Newtown, Conn., shooting, the Energy and Commerce Subcommittee on Oversight and Investigations (of which Murphy is chair) launched a top-to-bottom review of the country’s mental health system. The investigation revealed that the approach by the federal government to mental health is a chaotic patchwork of antiquated programs and ineffective policies across numerous agencies.
In response, Murphy wrote the Helping Families in Mental Health Crisis Act.
–Psychiatric News Update
I first came to understand mental illness through my brother’s experience.
Never understanding what mental illness was until years later, I came to know my brother’s diagnosis as severe bipolar disorder. Watching my brother struggle is similar to observing a roller coaster: he will have manic episodes where he speaks quickly and paces up and down hallways. Then he will have depressed episodes in which he will lie in bed for days with a curtain drawn. There was one incident in which my brother stole my car and disappeared for two weeks and I did not know where he was.
Current HIPPA laws kept me from trying to help him. The HIPAA privacy rule kept me completely locked out of his care and I was powerless to help him. The first time I encountered this roadblock was when my brother was admitted to the psychiatric hospital a few years ago. I went to visit him but he was gone. The nurse told me that she couldn’t give me any information about my sick brother’s whereabouts because of the privacy rule. So I was left to worry about where he was and what he might be doing. It was a wake-up call to realize that to help my brother, I could only count on myself and not the system.
For years I have been told by mental health professionals that my brother is an adult and can take care of himself. However, the truth of the matter is that he is not mentally capable of taking care of himself as I am now finally his caregiver.
I am my brother’s keeper.
–The Treatment Advocacy Center
Our neighbor Maryland has long been among the very worst states in the union for those who cannot seek or agree to essential treatment for their severe mental illness. Marylanders in this condition (and the families who love them) currently face a tragic triple whammy:
1. A hospital commitment standard requiring a finding of “danger to life or safety,” which is often interpreted to slam the hospital doors on anyone who doesn’t appear imminently violent or suicidal;
2. The notorious “Kelly Decision” of 2007, in which the Maryland Court of Appeals ruled that a patient committed to a mental hospital who refuses medication cannot be medicated over objection without evidence that the person poses a danger while in the hospital, irrespective of the danger the person would pose in the community if released in his or her current unmedicated state;
3. The lack of an assisted outpatient treatment (AOT) law to help those caught in the revolving doors of the mental health and criminal justice systems to survive safely in the community. (Only four other states share this dubious distinction.)
With the strokes of several pens yesterday morning, Maryland Governor Martin O’Malley gave hope for a brighter day ahead. The governor signed two bills championed in this year’s legislative session by the Treatment Advocacy Center and our indefatigable partners in NAMI-Maryland.
One bill, HB 592/SB 620, nullifies the Kelly decision (effective October 1) by amending the state law interpreted by the court. The new language makes explicit that a committed patient may be medicated over objection if a review panel finds the patient’s mental illness symptoms cause dangerousness in the hospital, caused the dangerousness that led to commitment, or would cause dangerousness if the person were released.
The second bill, HB1267/SB882, represents progress towards addressing the two other glaring flaws in Maryland’s treatment laws. It directs the state’s Department of Health and Mental Hygiene (DHMH) to convene a work group to examine AOT and deliver to the legislature by November 1, 2014 “a proposal for a program that … best serves individuals with mental illness who are at high risk for disruptions in the continuity of care.” It further directs DHMH to “evaluate the dangerousness standard for involuntary admissions and emergency evaluations of individuals with mental disorders, including … how the standard should be clarified[.]” (DHMH is already on record acknowledging the state’s need for both AOT and a consistent, more flexible interpretation of “danger to life or safety.”)
For now, we’ll say “one down, two to go,” with optimism that by this time next year, Maryland will stand proudly among the best states in meeting the needs of those whose anosognosia puts voluntary mental health care out of reach. We offer heartfelt thanks and kudos to the Maryland lawmakers who this year carried the mantle of this too-often-voiceless population: Senator Dolores Kelly and Delegate Dan Morhaim of Baltimore County, and Senator Mac Middleton and Delegate Peter Murphy of Charles County.
–The Treatment Advocacy Center
Congressman Scott Peters (CA-52) introduced bipartisan legislation, as part of his efforts to promote wellness, to designate the first full week of May each year as “National Mental Health No Stigma Week.” As of introduction, 54 Members of Congress have signed on as supporting co-sponsors of the bill, and 34 medical, academic, and professional associations have stated their support.
“Our mental health is often something we take for granted, but millions of our neighbors, friends, family members, and colleagues are working through mental illness issues every day,” Rep. Peters said. “It’s time to work together to end the stigma attached to mental illness and focus in on increasing awareness and prevention. A National Mental Health No Stigma Week would give this effort the recognition it deserves and would save lives.”
Mental illness affects millions of Americans each year, including 20% of teenagers, but stigmas around mental health often prevent treatment – only half of young adults believe that treatment can help return those with a mental illness back to a healthy life. Given that more than 300,000 Americans attempt suicide each year, with fear of stigmatization listed as among the top factors for preventing the mentally ill from seeking help, there is clearly much work to be done toward acknowledging this problem.
Read Full Press Release by Rep. Scott Peters
Support Letter signed by SARDAA and other organizations
Last Thursday, some of the world’s top mental illness researchers and advocates gathered at the Johns Hopkins University School of Medicine to celebrate the many achievements of Dr. E. Fuller Torrey and to applaud him towards his continuing career with a Festschrift.
Colleagues offered moving reflections on their relationships with Dr. Torrey, who has inspired, encouraged them to venture into new research and advocacy territory. Among the many topics they discussed were the accomplishments they and their teams have made as a direct result of Dr. Torrey’s leadership.
One such example is the “revolutionary” brain bank at the Stanley Medical Research Institute which has created unprecedented availability of a rare sample for brain research on schizophrenia. Another is his stature as a modern leader in investigating viral implication in schizophrenia’s cause and course, one of the most exciting and well-followed theoretical paths in studying the nature of the disease.
Dr. Torrey’s persistent questioning of traditional beliefs about schizophrenia has led to greater acknowledgment of epidemiology as an important avenue for investigating the causes and nature of the disease, said Dr. Dr. Preben Mortensen of University of Aarhaus and Sir Robin Murray of King’s College, London.
Dr. Steven Sharfstein of Sheppard Pratt Health System and others recounted the ways Dr. Torrey’s dedication to putting severe mental illness on the agendas of policy makers and service agencies has changed the landscape of mental health in the United States for the better.
Many things are clear about Dr. Torrey’s career: he has demonstrated compassion, principle, ingenuity and courage to so many – and he has mobilized a true movement towards a world where severe mental illnesses can one day be treated effectively, allowing individuals and their families and communities the resources they deserve to live free of these diseases.
But as Dr. Torrey humbly said at the event, “Our work is not done. We aren’t where we need to be,” and so onward we all must go.
–The Treatment Advocacy Center
Using marijuana a few times a week is enough to physically alter critical brain structures, according to a new study published Tuesday in The Journal of Neuroscience.
….The study found volume, shape and density changes in two crucial brain areas — the nucleus accumbens and the amygdala — involved with emotion and motivation and some types of mental illness. “This is a part of the brain you do not want to mess around with,” Breiter said.
by Karen Weintraub, USA Today
94% of the population experiences unwanted, intrusive thoughts. So, if you are one to check whether your hands are clean, imagine your house might be on fire, or worry that the gas or propane has not been turned off, you are not alone.
Researchers clarify that the often devastating diagnosis of OCD is not a result of the thoughts, but the actions that follow or result from the thought.
by Nick Nauert, PhD, Psych Central
The architecture of the autistic brain is speckled with patches of abnormal neurons, according to research partially funded by the National Institute of Mental Health (NIMH), part of the National Institutes of Health. Published in the New England Journal of Medicine on March 27, 2014, this study suggests that brain irregularities in children with autism can be traced back to prenatal development.
“While autism is generally considered a developmental brain disorder, research has not identified a consistent or causative lesion,” said Thomas R. Insel, M.D., director of NIMH. “If this new report of disorganized architecture in the brains of some children with autism is replicated, we can presume this reflects a process occurring long before birth. This reinforces the importance of early identification and intervention.”
–National Institute of Mental Health
Games like Flappy Bird and Candy Crush have helped many of us de-stress during long waits at the doctor’s office and crowded Metro rides. But what if an app could actually help with mental health?
….”What this game is doing is trying to train your attention toward the positive,” says Tracy Dennis, a professor of psychology at Hunter and the lead researcher behind the game. It’s modeled after a cognitive treatment for anxiety called attention-bias modification training, Dennis tells Shots. The idea is that if people can learn to ignore threatening stimuli and focus on the good, they’ll feel less anxious in stressful situations.
by Maanvi Singh, NPR