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The Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances

July 16, 2015 Comments off

The Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances
Source: Substance Abuse and Mental Health Services Administration

Presents 2012-2013 findings from a federally funded program that supports community-based mental health services for children with serious emotional disturbances. Reports on the system of care approach, service characteristics and use, and child outcomes.

One Nation, Under Sedation: Medicare Paid for Nearly 40 Million Tranquilizer Prescriptions in 2013

July 15, 2015 Comments off

One Nation, Under Sedation: Medicare Paid for Nearly 40 Million Tranquilizer Prescriptions in 2013
Source: Pro Publica

In 2012, Medicare’s massive prescription drug program didn’t spend a penny on popular tranquilizers such as Valium, Xanax and Ativan.

The following year, it doled out more than $377 million for the drugs.

While it might appear that an epidemic of anxiety swept the nation’s Medicare enrollees, the spike actually reflects a failed policy initiative by Congress.

More than a decade ago, when lawmakers created Medicare’s drug program, called Part D, they decided not to pay for anti-anxiety medications. Some of these drugs, known as benzodiazepines, had been linked to abuse and an increased risk of falls and fractures among the elderly, who make up most of the Medicare population.

But doctors didn’t stop prescribing the drugs to Medicare enrollees. Patients just found other ways to pay for them. When Congress later reversed the payment policy under pressure from patient groups and medical societies, it swiftly became clear that a huge swath of Medicare’s patients were already using the drugs despite the lack of coverage.

In 2013, the year Medicare started covering benzodiazepines, it paid for nearly 40 million prescriptions, a ProPublica analysis of recently released federal data shows. Generic versions of the drugs — alprazolam (which goes by the trade name of Xanax), lorazepam (Ativan) and clonazepam (Klonopin) — were among the top 32 most-prescribed medications in Medicare Part D that year.

Effects of Hormone Therapy on Cognition and Mood in Recently Postmenopausal Women: Findings from the Randomized, Controlled KEEPS–Cognitive and Affective Study

July 14, 2015 Comments off

Effects of Hormone Therapy on Cognition and Mood in Recently Postmenopausal Women: Findings from the Randomized, Controlled KEEPS–Cognitive and Affective Study
Source: PLoS Medicine

In the KEEPS-Cog trial, 220 healthy recently postmenopausal women took an estrogen pill every day and a progesterone pill for the first 12 days of each month, 211 women wore an estradiol patch (transdermal estradiol) and took a progesterone pill for the first 12 days of each month, and 262 women received placebo patches and pills for up to four years (the average follow-up was a little less than three years). The researchers assessed the trial participants for their overall cognitive health using an instrument called the Modified Mini-Mental State Examination, for four specific cognitive functions using several established instruments, for depression symptoms using the Beck Depression Inventory, and for mood using the Profile of Mood States instrument at baseline and at 18, 36, and 48 months. Statistical analysis of the data collected indicates that, during the trial, there were no treatment-related effects on cognition or depression symptoms. However, women treated with estrogen pills and progesterone (but not those treated with estradiol patches and progesterone) showed improvements in some mood symptoms compared to women in the placebo group.

CRS — The Mental Health Workforce: A Primer (April 16, 2015)

July 8, 2015 Comments off

The Mental Health Workforce: A Primer (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

Congress has held hearings and introduced legislation addressing the interrelated topics of the quality of mental health care, access to mental health care, and the cost of mental health care. The mental health workforce is a key component of each of these topics. The quality of mental health care depends partially on the skills of the people providing the care. Access to mental health care relies on, among other things, the number of appropriately skilled providers available to provide care. The cost of mental health care depends in part on the wages of the people providing care. Thus an understanding of the mental health workforce may be helpful in crafting policy and conducting oversight. This report aims to provide such an understanding as a foundation for further discussion of mental health policy.

Characteristics of people dying by suicide after job loss, financial difficulties and other economic stressors during a period of recession (2010–2011): A review of coroners’ records

July 7, 2015 Comments off

Characteristics of people dying by suicide after job loss, financial difficulties and other economic stressors during a period of recession (2010–2011): A review of coroners’ records
Source: Journal of Affective Disorders

Background
Suicide rates increase during periods of economic recession, but little is known about the characteristics of people whose deaths are related to recession, the timing of risk in relation to job loss, the nature of financial stresses and the sources of help individuals used.

Methods
We extracted information on the social and economic circumstances, mental health and help-seeking from the coroners’ records of 286 people who died by suicide in 2010 and 2011 in four areas of England. We graded each death on a 5-point scale of ‘recession-relatedness’, measuring the extent to which recession, employment and financial problems contributed to the death.

Results
Financial and employment-related issues contributed substantially to 38 (13%) of the deaths and were thought to be the key contributing factor in 11 (4%). Individuals whose deaths were thought to be related to the recession were less likely to have previously self-harmed but were more likely to be employed, have financial difficulties (76% vs. 23%) and financial dependents (55% vs. 23%). Amongst the subset of 11 people where financial/employment issues were the key contributory factor, only two (18%) had ever had contact with psychiatric services.

Limitations
Details on finances and employment were not systematically recorded by coroners. We found richer information was usually available for people who were living with other people.

Conclusions
Financial difficulties, little past psychiatric history, low levels of service contact and having financial dependents were more common in ‘recession-related’ deaths. This suggests that interventions to prevent recession-related rises in suicide should be focused on non-clinical agencies and initiatives.

Characteristics of Social Network Gamers: in between Social Networking and Online Role-Playing Games

July 6, 2015 Comments off

Characteristics of Social Network Gamers: in between Social Networking and Online Role-Playing Games
Source: Frontiers in Psychiatry

Current research on internet addiction (IA) reported moderate to high prevalence rates of IA and comorbid psychiatric symptoms in users of social networking sites (SNS) and online role-playing games. The aim of this study was to characterise adult users of an internet multiplayer strategy game within a SNS. Therefore, we conducted an exploratory study using an online survey to assess sociodemographic variables, psychopathology and the rate of IA in a sample of adult social network gamers by Young´s Internet Addiction Test (IAT), the Toronto Alexithymia Scale (TAS), the Beck Depression Inventory II (BDI-II), the Symptom Checklist-90-R (SCL-90-R) and the WHO Quality of Life-BREF (WHOQOL-BREF). All participants were listed gamers of “combat zone” in the SNS “Facebook”. In the IAT analysis, 16.2 % of the participants (n = 60) were categorized as subjects with IA and 19.5 % (n = 72) fulfilled the criteria for alexithymia. Comparing study participants with and without IA, the IA group had significantly more subjects with alexithymia, reported more depressive symptoms, and showed poorer quality of life. These findings suggest that social network gaming might also be associated with maladaptive patterns of internet use. Furthermore, a relationship between IA, alexithymia and depressive symptoms was found that needs to be elucidated by future studies.

Home Foreclosure, Health, and Mental Health: A Systematic Review of Individual, Aggregate, and Contextual Associations

July 1, 2015 Comments off

Home Foreclosure, Health, and Mental Health: A Systematic Review of Individual, Aggregate, and Contextual Associations
Source: PLoS ONE

Background
The U.S. foreclosure crisis intensified markedly during the Great Recession of 2007-09, and currently an estimated five percent of U.S. residential properties are more than 90 days past due or in the process of foreclosure. Yet there has been no systematic assessment of the effects of foreclosure on health and mental health.

Methods and Findings
I applied systematic search terms to PubMed and PsycINFO to identify quantitative or qualitative studies about the relationship between home foreclosure and health or mental health. After screening the titles and abstracts of 930 publications and reviewing the full text of 76 articles, dissertations, and other reports, I identified 42 publications representing 35 unique studies about foreclosure, health, and mental health. The majority of studies (32 [91%]) concluded that foreclosure had adverse effects on health or mental health, while three studies yielded null or mixed findings. Only two studies examined the extent to which foreclosure may have disproportionate impacts on ethnic or racial minority populations.

Conclusions
Home foreclosure adversely affects health and mental health through channels operating at multiple levels: at the individual level, the stress of personally experiencing foreclosure was associated with worsened mental health and adverse health behaviors, which were in turn linked to poorer health status; at the community level, increasing degradation of the neighborhood environment had indirect, cross-level adverse effects on health and mental health. Early intervention may be able to prevent acute economic shocks from eventually developing into the chronic stress of foreclosure, with all of the attendant benefits this implies for health and mental health status. Programs designed to encourage early return of foreclosed properties back into productive use may have similar health and mental health benefits.

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