How Health Communicators and Journalists Can Help Replace Stigma with Science

National Institute on Drug Abuse (NIDA) Director Nora Volkow, M.D. blogs about how one can use science to counter the stigma of drug addiction. There are still people who believe addiction is a moral failing that could be solved if the person had more willpower. In fact, the science is clear: Addiction is a chronic, relapsing neurobiological disorder caused by changes in the brain that make controlling drug use extremely difficult, even when an individual knows it has terrible consequences for his or her life and health and wants to stop. Journalists can help reduce the stigma toward addiction by providing information that helps the reader understand the person suffering from addiction rather than writing stories that generate anger and disgust. Increasing the public understanding of the underlying pathology and cultural reinforcers of addiction is a critical first step for improving the way our society addresses addiction. Journalists can dig deeper and ask how everyone can facilitate a more compassionate public health-based approach to those suffering from addiction.

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NIDA: Nonmedical Treatment for Cocaine Addiction Shows Promise in Pilot Trial

Transcranial magnetic stimulation (TMS) projects electromagnetic fields into the brain and can be used to either increase or decrease neuronal responsiveness in targeted brain areas. Researchers have hypothesized that administering TMS to strengthen activity in the prefrontal cortex (PFC) and downstream brain regions can alleviate cocaine addiction (see Narrative of Discovery: Can Magnets Treat Cocaine Addiction?).

Patients who received transcranial magnetic stimulation (TMS) were more likely to abstain from cocaine than patients who received medications for symptoms associated with abstinence. NIDA researchers concluded that TMS appears to be safe and its efficacy as a treatment for cocaine addiction deserves to be evaluated in a larger clinical trial.

Previous findings that support the hypothesis include:

  • Studies in animals and people have demonstrated that exposure to cocaine weakens neuronal activity in the PFC, and have linked that decreased activity to some of the primary manifestations of addiction, such as craving and compulsive drug-seeking.
  • In a recent study, rats stopped seeking cocaine after researchers experimentally increased activity levels in their prelimbic cortex, a sub region of the rat cortex that shares functional similarities with the human dorsolateral PFC (see Prefrontal Cortex Stimulation Stops Compulsive Drug Seeking in Rats).

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Webinar: Advancing Comprehensive Community Suicide Prevention: An Overview

This event was the first in the webinar series, Advancing Community Suicide Prevention, which aims to disseminate comprehensive models of community suicide prevention based on the best existing evidence and drawing on experiences from across the globe. SAMHSA, the Public Health Agency of Canada, and the Mental Health Commission of Canada highlighted the work of the International Initiative for Mental Health Leadership and the National Action Alliance for Suicide Prevention, and introduced the webinar series.

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Webisode: Diverting to Treatment: Community Policing and Mental Illness

This webisode explores the changing role of law enforcement in addressing youth and young adults with a mental illness. The program discussed evidence-based strategies to combine efforts of police officers, mental health educators, and community advocates to resolve potentially violent situations in more positive ways. Additionally, the webisode featured presentations from states that have implemented diversion programs, a law enforcement officer and crisis intervention team trainer, and a firsthand youth perspective.

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Understanding Child Welfare and the Courts

Families involved with the child welfare system must often engage with the judicial system. This Administration for Children and Families factsheet is designed to demystify the legal process and inform families of their rights and responsibilities. It includes frequently asked questions about the different stages of court proceedings, how parents and family members can prepare for court hearings, and who and what to expect in the courtroom and throughout the process.

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The All of Us Research Program Seeks Feedback from the Community

The All of Us Research Program will create a community of one million or more people from across the U.S. to improve the future of health. Those who join the program will contribute their health, environment, and lifestyle information over an extended period of time. By gathering information from such a large group of people, researchers will be able to learn how specific factors impact an individual’s health, and disease prevention and treatment. This approach to tailoring health care for each unique individual is called, “precision medicine.”  The research program developers want to hear from everyone about their thoughts and ideas for how to make All of Us a success. Ideas on topics such as participant engagement and communications, health information data security, and the type of data to be collected are welcome from researchers, health care providers, patients, or anyone who wants to contribute to greater knowledge.

To read further, please click here.

Study Suggests Omega-3s May Not Improve Outcomes in People at High Risk of Psychosis

For years, researchers have been encouraged by evidence from a small, single-center trial that suggested omega-3 polyunsaturated fatty acids (PUFAs) might reduce the risk of onset and improve outcomes in patients at ultrahigh risk (UHR) for psychosis. The results of a multicenter study published today in JAMA Psychiatry now suggest omega-3s may be no better than placebo at preventing psychosis, reducing symptoms, or improving function in UHR patients.

“Although ω-3 PUFAs were well tolerated, they did not demonstrate an advantage over placebo in the prevention of psychosis at 6- or 12-month follow-up evaluations,” Patrick McGorry, M.D., Ph.D., of the University of Melbourne and colleagues wrote. “Secondary outcome measures of psychiatric symptoms and functioning tended to favor the placebo group.”

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Repetitive Transcranial Magnetic Stimulation Research Clinic at Yale-New Haven Psychiatric Hospital

What is Repetitive Transcranial Magnetic Stimulation?

Transcranial magnetic stimulation (TMS) utilizes an electromagnet placed on the scalp that generates magnetic field pulses roughly the strength of an MRI scan. The magnetic pulses stimulate a small area on the surface of the brain about the size of a quarter. Low frequency (once per second) TMS has been shown to induce small, sustained reductions in activity in the part the brain that has been stimulated. Currently we are conducting studies to determine whether low-frequency TMS can reduce hallucinated voices. Below are descriptions of these studies and information about how to contact us.

Transcranial Magnetic Stimulation as an Investigational Treatment for Auditory Hallucinations or “Voices”

What are “Voices”?

Auditory hallucinations are experienced by 50-80% of patients with schizophrenia and 10-15% of patients with a mood disorder. These hallucinations, referred to as voices by patients themselves, consist of spoken speech. Sometimes the voices are familiar-persons whom the patient has known. But often the voices are unrecognizable. They comment, cajole, criticize, and in some cases command the patient. Voices are often highly distressing to the patient, especially when verbal content is negative or intrusive. These experiences disrupt one’s ability to interact with others, to work, to study and even to sleep. In extreme cases they can produce suicidal behavior. In about 25% of cases, voices respond only partially or not at all to currently available drug therapy. Effective treatment alternatives for these hallucinations would therefore provide a significant benefit to patients and their communities. Our neuroimaging studies suggest that voices arise from parts of the brain that are ordinarily involved in perceiving spoken speech. These studies have led us to investigate a new treatment approach. Our strategy is to use low frequency TMS to reduce activity of brain areas appearing to generate voices. Our prediction is that reduced intensity of voices will result. These studies are described in more detail in the enclosed pdf file.

 

House Passes the 21st Century Cures Act – on to the Senate

On 11/30/2016 the House of Representatives passed the 21st Century Cures Act (H.R. 34) by a vote of 392-26. This wide-ranging, $6 billion bipartisan health legislation includes significant mental health components.

The bill incorporates elements of legislation previously put forth by Reps. Tim Murphy (R-Pa. To be honored by SARDAA with the Exceptional Legislator Award on 12/8) and Eddie Bernice Johnson (D-Texas) in the Helping Families in Mental Health Crisis Act as well as provisions in the Mental Health Reform Act of 2016, sponsored by Sens. Chris Murphy (D-Conn.) and Bill Cassidy (R-La.)

Some of the provisions included in the legislation:

* Elevates the importance of addressing mental illness and substance use within the federal government:

o Creates a Presidentially-appointed Assistant Secretary for Mental Health and SubstanceAbuse

o Establishes a Chief Medical Officer

o Makes reforms to SAMHSA, including emphasis on science and evidence based programs

* Extends the federal Assisted Outpatient Treatment (AOT) grant program,

o Greatly increases program funding authorization levels

o Authorizing AOT as an alternative to incarceration within Department of Justice programs

* Establishes a grant program for Assertive Community Treatment (ACT)

o Directs CMS to outline for states innovative opportunities to use Medicaid 1115 waivers to provide care for adults with serious mental illness.

* Requires clarification of HIPAA by:

o Directing the Health and Human Services Secretary to clarify circumstances under which a family member may receive protected health information about their loved ones with SMI

o Requiring the Secretary develop training and education to health care providers and compliance staff on these circumstances

* Establishes the National Mental Health and Substance Use Policy Laboratory to promote and disseminate evidence-based service delivery models and practices

* Provides vital new tools for law enforcement, including:

o Grants for crisis intervention teams (CIT)

o Federal mental health courts

o Creation of a National Criminal Justice and Mental Health Training Center

To read more, please click here.

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.