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Archive for the ‘mental health and substance abuse’ Category

New From the GAO

January 30, 2015 Comments off

New GAO Reports
Source: Government Accountability Office

1. Defense Health Care: Additional Information Needed about Mental Health Provider Staffing Needs. GAO-15-184, January 30.
http://www.gao.gov/products/GAO-15-184
Highlights – http://www.gao.gov/assets/670/668209.pdf

2. Federal Workforce: OPM and Agencies Need to Strengthen Efforts to Identify and Close Mission-Critical Skills Gaps. GAO-15-223, January 30.
http://www.gao.gov/products/GAO-15-223
Highlights – http://www.gao.gov/assets/670/668203.pdf

Improving Long-term Psychiatric Care: Bring Back the Asylum

January 29, 2015 Comments off

Improving Long-term Psychiatric Care: Bring Back the Asylum
Source: Journal of the American Medical Association

During the past half century, the supply of inpatient psychiatric beds in the United States has largely vanished. In 1955, 560 000 patients were cared for in state psychiatric facilities; today there are fewer than one-tenth that number: 45 000. Given the doubling of the US population, this represents a 95% decline, bringing the per capita public psychiatric bed count to about the same as it was in 1850—14 per 100 000 people.1 A much smaller number of private psychiatric beds has fluctuated since the 1970s in response to policy and regulatory shifts that create varying financial incentives.

As a result, few high-quality, accessible long-term care options are available for a significant segment of the approximately 10 million US residents with serious mental illness. This population includes adults who are assessed as lacking insight and chronically psychotic, unable to care for themselves, and potentially dangerous to themselves and the public. These persons frequently have refractory schizophrenia and bipolar disorder. The void is both ethically unacceptable and financially costly.

Trauma, Grief and the Social Model: Practice Guidelines for Working with Adults with Intellectual Disabilities in the Wake of Disasters

January 27, 2015 Comments off

Trauma, Grief and the Social Model: Practice Guidelines for Working with Adults with Intellectual Disabilities in the Wake of Disasters
Source: Review of Disability Studies: An International Journal

Formulating personal needs assessments and plans for self-protection have been the recent focus of disaster preparedness manuals for individuals with intellectual disabilities and their caregivers. Interventions to address the minimization of psychological ill effects of trauma and grief in the aftermath of disasters for this population, however, remain largely unexplored. In the wake of such events, persons with intellectual disabilities require trained mental health professionals to assist them in identifying and coping with trauma exposure and its associated, often sudden losses. Intervention should be based on the unique needs of this population within the context of disaster and each individual’s cognitive strengths and capacities. Coupled with reviews of research and practice in the area of disaster mental health, the social model of disability served as a foundation for the formulation of best practice guidelines for tertiary interventions with adults with intellectual disabilities. The guidelines suggest approaches that will enable professionals to identify and minimize acute and chronic responses to disasters as well as foster resilience and enhance the valuable contributions of adults with intellectual disabilities in disaster-affected communities.

DoD Releases 2013 Annual Report on Suicide

January 21, 2015 Comments off

DoD Releases 2013 Annual Report on Suicide
Source: U.S. Department of Defense

Today, the Department of Defense (DoD) released its 2013 calendar year Suicide Event Report (DoDSER), which details the number of suicide attempts and deaths for U.S. service members.

The DoDSER also includes detailed assessments of demographic information, behavioral health history, and deployment history for each suicide event. This comprehensive information informs DoD senior leaders as they make policy decisions to improve suicide prevention efforts.

In calendar year 2013, active component suicide totals and rates declined over 2012, while reserve components had a slight increase. There were 229 deaths by suicide among active component service members and 220 deaths by suicide among selected reserve component service members (87in the reserve and 133 in the National Guard).

The suicide rate per 100,000 in 2013 was 18.7 for active component service members, 23.4 for reserve component and 28.9 for National Guard.

Guide to Cigarette Litter Prevention

January 19, 2015 Comments off

Guide to Cigarette Litter Prevention
Source: Keep America Beautiful

A cigarette butt or cigar tip dropped to the ground seems insignificant. But follow that butt as it’s carried off by rain into storm drains and eventually to streams and rivers. It now adds up to a big impact on the places we live: In fact, 32% of litter at storm drains is tobacco products.

Cigarette butt litter creates blight. It accumulates in gutters, and outside doorways and bus shelters. It’s the number one most littered item anywhere. Increasing amounts of litter in a business district, along riverfronts, or recreation areas create a sense that no one cares, leading to more community disorder and crime.

Cigarette butts and cigar tips don’t disappear. About 95% of cigarette filters are composed of cellulose acetate, a form of plastic which does not quickly degrade and can persist in the environment. Cigar tips, too, are predominantly plastic.

Filters are harmful to waterways and wildlife. Litter traveling through storm drains and water systems, ends up in local streams, rivers, and waterways. Nearly 80% of marine debris comes from land-based sources. Cigarette butt litter can also pose a hazard to animals and marine life when they mistake filters for food.

Impacts of Emerging Contaminants on Surrounding Aquatic Environment from a Youth Festival

January 16, 2015 Comments off

Impacts of Emerging Contaminants on Surrounding Aquatic Environment from a Youth Festival
Source: Environmental Science & Technology

The youth festival as we refer to Spring Scream, a large-scale pop music festival, is notorious for the problems of drug abuse and addiction. The origin, temporal magnitudes, potential risks and mass inputs of emerging contaminants (ECs) were investigated. Thirty targeted ECs were analyzed by solid-phase extraction and liquid chromatography coupled to tandem mass spectrometry (SPE-LC-MS/MS). Sampling strategy was designed to characterize EC behavior in different stages (before and after the youth festival), based on multivariate data analysis to explore the contributions of contaminants from normal condition to the youth festival. Wastewater influents and effluents were collected during the youth festival (approximately 600 000 pop music fans and youth participated). Surrounding river waters are also sampled to illustrate the touristic impacts during peak season and off-season. Seasonal variations were observed, with the highest concentrations in April (Spring Scream) and the lowest in October (off-season). Acetaminophen, diclofenac, codeine, ampicillin, tetracycline, erythromycin-H2O, and gemfibrozil have significant pollution risk quotients (RQs > 1), indicating ecotoxicological concerns. Principal component analysis (PCA) and weekly patterns provide a perspective in assessing the touristic impacts and address the dramatic changes in visitor population and drug consumption. The highest mass loads discharged into the aquatic ecosystem corresponded to illicit drugs/controlled substances such as ketamine and MDMA, indicating the high consumption of ecstasy during Spring Scream.

Major Depression in the National Comorbidity Survey–Adolescent Supplement: Prevalence, Correlates, and Treatment

January 8, 2015 Comments off

Major Depression in the National Comorbidity Survey–Adolescent Supplement: Prevalence, Correlates, and Treatment (PDF)
Source: Journal of the American Academy of Child & Adolescent Psychiatry

Objective
To present the 12-month prevalence of DSM-IV major depressive disorder (MDD) and severe MDD; to examine sociodemographic correlates and comorbidity; and to describe impairment and service use.

Method
Data are from the National Comorbidity Survey–Adolescent Supplement (NCS-A), a nationally representative survey of 10,123 adolescents aged 13 to 18 years that assesses DSM-IV disorders using the Composite International Diagnostic Interview (CIDI) Version 3.0. One parent or surrogate of each participating adolescent was also asked to complete a self-administered questionnaire.

Results
Lifetime and 12-month prevalence of MDD were 11.0% and 7.5%, respectively. The corresponding rates of severe MDD were 3.0% and 2.3%. The prevalence of MDD increased significantly across adolescence, with markedly greater increases among females than among males. Most cases of MDD were associated with psychiatric comorbidity and severe role impairment, and a substantial minority reported suicidality. The prevalence of severe MDD was about one-fourth of that of all MDD cases; estimates of impairment and clinical correlates were of 2- to 5-fold greater magnitude for severe versus mild/moderate depression, with markedly higher rates for suicidal thoughts and behaviors. Treatment in any form was received by the majority of adolescents with 12-month DSM-IV MDD (60.4%), but only a minority received treatment that was disorder-specific or from the mental health sector.

Conclusion
Findings underscore the important public health significance of depression among US adolescents and the urgent need to improve screening and treatment access in this population.

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