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Campus Suicide Prevention: Knowledge, Facts, and Stigma in a College Student Sample

April 24, 2015 Comments off

Campus Suicide Prevention: Knowledge, Facts, and Stigma in a College Student Sample
Source: Sage Open

A public health approach to suicide prevention (SP) emphasizes using a comprehensive plan utilizing multiple strategies to address suicide in the community of interest. Universities using this approach are called to develop interventions to increase SP knowledge, reduce suicide risk factors, enhance protective factors, and examine their efforts scientifically to evaluate program effectiveness. The current study polled responding college students (N = 819) about their exposure to campus SP messaging materials, participation in SP activities, and whether they experienced having a person close to them attempt or die by suicide during the three years of a SP program funded by the Garrett Lee Smith Memorial Act (2004). Students were also queried about their perceived level of SP knowledge, knowledge of suicide facts, and the stigma associated with receiving treatment for suicidal thoughts and behaviors using the Suicide Prevention Exposure, Awareness, and Knowledge Survey (SPEAKS). Simultaneous multiple regression analyses were used to examine relationships between study variables. Results indicated that exposure to SP messaging materials predicted a higher level of self-perceived knowledge and a lower level of perceived stigma. Participating in SP activities and having someone close to you attempt or die by suicide predicted both a higher level of perceived knowledge and actual knowledge of suicide facts. Self-identifying as male predicted a higher level of stigma. Implications for campus SP programming are discussed.

A Relevant Risk Approach to Mental Health Inquiries in Question 21 of the Questionnaire for National Security Positions (SF-86)

April 24, 2015 Comments off

A Relevant Risk Approach to Mental Health Inquiries in Question 21 of the Questionnaire for National Security Positions (SF-86) (PDF)
Source: U.S. Department of Defense

Background
Individuals vetted by the government for initial or continuing eligibility to access classified information must fill out a personnel security questionnaire as part of a screening process designed to identify those who are not likely to be trustworthy, reliable , or loyal to the United States. Question 21 in the Questionnaire for National Security Positions (SF – 86) asks applicants if they have consulted with a mental health professional in the last 7 years , with certain groups exempted . This approach identifies too many individuals for investigative follow – up who do not have a mental health condition that pose s an unacceptable risk , and likely misses other at – risk individuals . Disagreements over the goal, effectiveness , and adverse consequences ( e.g., stigmatizing the use of mental health services ) associated with this question have resulted in previous Question 21 wording changes but have not significantly resolved concerns.

Highlights
A proposed “r elevant r isk ” approach to Question 21 — focusing only on standardized clinical conditions that could pose a security risk as well as mental health related hospitalizations — would not represent an obstacle to mental health care for the vast majority of personnel and would be consistent with Department of Defense ( DoD ) policy to foster a culture of support with respect to mental he alth. This approach would reduce the costs associated with unnecessary Q uestion 21 follow – up investigative work, as well as much of the stigma – related adverse consequences associated with the current Q uestion 21. At the same time , the “relevant risk” appro ach would identify more effectively the small number of individuals with mental health conditions that may pose security risks. In addition, t his report evaluates the benefits for both security and clinical care for having separate professionals conduct se curity fitness evaluations vice individuals’ mental health treatment.

Drug-poisoning Deaths Involving Heroin: United States, 2000–2013

April 23, 2015 Comments off

Drug-poisoning Deaths Involving Heroin: United States, 2000–2013
Source: National Center for Health Statistics

Key findings
Data from the National Vital Statistics System (Mortality)

  • From 2000 through 2013, the age-adjusted rate for drug-poisoning deaths involving heroin nearly quadrupled from 0.7 deaths per 100,000 in 2000 to 2.7 deaths per 100,000 in 2013. Most of the increase occurred after 2010.
  • The number of drug-poisoning deaths involving heroin was nearly four times higher for men (6,525 deaths) than women (1,732 deaths) in 2013.
  • In 2000, non-Hispanic black persons aged 45–64 had the highest rate for drug-poisoning deaths involving heroin (2.0 per 100,000). In 2013, non-Hispanic white persons aged 18–44 had the highest rate (7.0 per 100,000).
  • From 2000 through 2013, the age-adjusted rate for drug-poisoning deaths involving heroin increased for all regions of the country, with the greatest increase seen in the Midwest.

Alcohol Policy In The EU – State Of Play March 2015

April 22, 2015 Comments off

Alcohol Policy In The EU – State Of Play March 2015
Source: European Parliamentary Research Service

The 2006 EU Alcohol Strategy officially came to an end in December 2012. A report published in December 2012 evaluated the impact of this strategy and concluded that it was still very relevant and had brought about positive added value in terms of addressing alcohol-related harm.

Although the European Commission intended to present a new European Action Plan to reduce alcohol related harm for the period 2014-2017 , no new proposal has as yet been introduced. The Commission nevertheless proposed a new EU action plan on youth drinking and also included alcohol-harm preventive measures in its 2014-2020 Health Programme. Furthermore the Commission also undertook a study to examine the different practices related to labelling of alcoholic beverages.

Recently, the Latvian Presidency 2015 promised in its programme, as part of its health priorities , to “follow the work of the Committee on National Alcohol Policy and Action, and is in the process of developing a scoping paper on the vision of future actions to be taken in the area of an alcohol policy in the EU”.

By means of resolutions and questions, the European Parliament has repeatedly put pressure on the Commission to present a new European Action Plan since alcohol related harm is still a major public health concern across the EU.

New Report: Disparities in Child and Adolescent Mental Health and Mental Health Services in the U.S.

April 20, 2015 Comments off

New Report: Disparities in Child and Adolescent Mental Health and Mental Health Services in the U.S.
Source: William T. Grant Foundation

Mental health is recognized as a central determinant of individual well-being, family relationships, and engagement in society, yet there are considerable variations in mental health and mental health care according to race and ethnicity among youth in the U.S.

In their new report, Margarita Alegría and colleagues investigate disparities in mental health and mental health services for minority youth. Taking a developmental perspective, the authors explore four areas that may give rise to inequalities in mental health outcomes, highlight specific protective factors and barriers to care, and, finally, outline an agenda for future research.

The authors write, “Over the past decade, the study of inequality in health and mental health has grown rapidly, with researchers seeking to quantify the extent of the problem, identify causal mechanisms, and develop interventions to eliminate specific disparities. Even so, inequity persists, and in most areas of health care progress has been limited and incremental in nature. There is good reason to believe that a renewed focus on prevention of youth mental health problems among minorities could not only yield more rapid results, but could also drastically reduce overall inequality in the long-term.”

State Discretion Over Medicaid Coverage for Mental Health and Addiction Services

April 17, 2015 Comments off

State Discretion Over Medicaid Coverage for Mental Health and Addiction Services
Source: Psychiatric Services

Approximately one-third of adults who enroll in Medicaid because of a disability have a serious mental illness. Arguably, this population stands to benefit from insurance coverage that complies with the Mental Health Parity and Addiction Equity Act (MHPAEA). The MHPAEA and the Affordable Care Act (ACA) do not guarantee such coverage for this beneficiary group; however, they provide a variety of mechanisms by which states may provide parity-compliant coverage for mental health and substance use disorder treatment. This column explains key interactions between the MHPAEA, the ACA, and the Medicaid program that permit states to determine whether and how to provide parity-consistent coverage to beneficiaries with disabilities.

Long working hours and alcohol use: systematic review and meta-analysis of published studies and unpublished individual participant data

April 13, 2015 Comments off

Long working hours and alcohol use: systematic review and meta-analysis of published studies and unpublished individual participant data
Source: British Medical Journal

Objective
To quantify the association between long working hours and alcohol use.

Design
Systematic review and meta-analysis of published studies and unpublished individual participant data.

Data sources
A systematic search of PubMed and Embase databases in April 2014 for published studies, supplemented with manual searches. Unpublished individual participant data were obtained from 27 additional studies.

Review methods
The search strategy was designed to retrieve cross sectional and prospective studies of the association between long working hours and alcohol use. Summary estimates were obtained with random effects meta-analysis. Sources of heterogeneity were examined with meta-regression.

Results
Cross sectional analysis was based on 61 studies representing 333 693 participants from 14 countries. Prospective analysis was based on 20 studies representing 100 602 participants from nine countries. The pooled maximum adjusted odds ratio for the association between long working hours and alcohol use was 1.11 (95% confidence interval 1.05 to 1.18) in the cross sectional analysis of published and unpublished data. Odds ratio of new onset risky alcohol use was 1.12 (1.04 to 1.20) in the analysis of prospective published and unpublished data. In the 18 studies with individual participant data it was possible to assess the European Union Working Time Directive, which recommends an upper limit of 48 hours a week. Odds ratios of new onset risky alcohol use for those working 49-54 hours and ≥55 hours a week were 1.13 (1.02 to 1.26; adjusted difference in incidence 0.8 percentage points) and 1.12 (1.01 to 1.25; adjusted difference in incidence 0.7 percentage points), respectively, compared with working standard 35-40 hours (incidence of new onset risky alcohol use 6.2%). There was no difference in these associations between men and women or by age or socioeconomic groups, geographical regions, sample type (population based v occupational cohort), prevalence of risky alcohol use in the cohort, or sample attrition rate.

Conclusions
Individuals whose working hours exceed standard recommendations are more likely to increase their alcohol use to levels that pose a health risk.

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