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Leading Change 2.0: Advancing the Behavioral Health of the Nation 2015-2018

October 15, 2014 Comments off

Leading Change 2.0: Advancing the Behavioral Health of the Nation 2015-2018
Source: Substance Abuse and Mental Health Services Administration

Introduces six Strategic Initiatives that will guide SAMHSA through 2018 in leading change to increase awareness and understanding of mental illness and substance use disorders, promote wellness, increase access to effective treatment, and support recovery.

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Report reveals the scope of substance use and mental illness affecting the nation

September 9, 2014 Comments off

Report reveals the scope of substance use and mental illness affecting the nation
Source: Substance Abuse and Mental Health Services Administration

A new report by the Substance Abuse and Mental Health Services Administration (SAMHSA) provides insight into the nature and scope of substance use and mental illness issues affecting America. Today, 2013 national survey data as well as information on the efforts and resources being taken to address these problems is being released in conjunction with the 25th annual observance of National Recovery Month.

The report shows that 24.6 million Americans aged 12 or older were current (past month) illicit drug users – 9.4 percent of this age group.

Marijuana was by far the most commonly used illicit drug with approximately 19.8 million current users aged 12 and older.

In terms of other illicit drugs, the report indicates that among those aged 12 and older, there were 4.5 million current nonmedical users of prescription pain relievers (1.7 percent), 1.5 million current cocaine users (0.6 percent), 595,000 methamphetamine users (0.2 percent), and 289,000 current heroin users (0.1 percent). Although an estimated 22.7 million persons aged 12 or older needed treatment for an illicit drug or alcohol use problem, only 2.5 million persons received treatment at a specialty facility.

The SAMHSA report also shows that 34.6 million adults aged 18 or older (14.6 percent of the population aged 18 or older) received mental health treatment or counseling during the past 12 months. Nearly one in five American adults (18.5 percent), or 43.8 million adults, had a mental illness in 2013. Ten million adults (4.2 percent of the adult population) had a serious mental illness in the past year. Serious mental illness is defined as mental illness that resulted in serious functional impairment, which substantially interfered with, or limited, one or more major life activities.

Emergency department visits linked to zolpidem overmedication nearly doubled

September 3, 2014 Comments off

Emergency department visits linked to zolpidem overmedication nearly doubled
Source: Substance Abuse and Mental Health Services Administration

The estimated number of emergency department visits involving zolpidem overmedication (taking more than the prescribed amount) nearly doubled from 21,824 visits in 2005-2006 to 42,274 visits in 2009-2010, according to a new study by the Substance Abuse and Mental Health Services Administration (SAMHSA).

The report also indicates that 68 percent of all zolpidem overmedication visits in 2010 involved females, the number of zolpidem overmedication emergency department visits for males increased 150 percent from 2005-2006 to 2009-2010 compared to an increase of 69 percent for females over the same time period.

In 2010 there were a total of 4,916,328 drug-related visits to emergency departments throughout the nation.

Other prescription drugs were involved in 57 percent of the emergency department visits involving zolpidem overmedication. These medications included benzodiazepines (26 percent) and narcotic pain relievers (25 percent). Alcohol was also combined with zolpidem in 14 percent of these hospital emergency department visits.

Crisis Services: Effectiveness, Cost-Effectiveness, and Funding Strategies

August 25, 2014 Comments off

Crisis Services: Effectiveness, Cost-Effectiveness, and Funding Strategies
Source: Substance Abuse and Mental Health Services Administration

Summarizes the evidence base on the clinical and cost effectiveness of different types of crisis services, and presents cases studies of different approaches states are using to coordinate, consolidate, and blend funding sources to provide robust crisis services.

Emergency department visits for drug-related suicide attempts rise over six year period

August 11, 2014 Comments off

Emergency department visits for drug-related suicide attempts rise over six year period
Source: Substance Abuse and Mental Health Services Administration

Two new reports highlight the rise in drug-related suicide attempt visits to hospital emergency departments especially among certain age groups. The reports by the Substance Abuse and Mental Health Services Administration (SAMHSA) show that overall there was a 51 percent increase for these types of visits among people 12 and older — from 151,477 visits in 2005 to 228,277 visits in 2011.

One report analyzed the increase in emergency department visits by age and found that the overall rise resulted from increases in visits by people aged 18 to 29 and people aged 45 to 64. Visits involving 18 to 29 year olds increased from 47,312 in 2005 to 75,068 — a 58 percent increase. Visits involving people aged 45 to 64 increased from 28,802 in 2005 to 58,776 visits in 2011 — a 104 percent increase. In 2011, these two age groups comprised approximately 60 percent of all drug-related emergency department visits involving suicide attempts.

The other SAMHSA report focused on the 45 to 64 age group, which had the largest increase in emergency department visits involving drug related suicide attempts, and characterized these visits. The report found that the majority (96 percent in 2011) of these visits involved the non-medical use of prescription drugs and over-the-counter-medications. In 2011, these drugs included anti-anxiety and insomnia medications (48 percent), pain relievers (29 percent) and antidepressants (22 percent).

Other substances involved in these drug-related suicide attempt emergency department visits during the same year included alcohol (39 percent) and illicit drugs (11 percent).

The report also found that these visits by patients aged 45 to 64 doubled for both men and women during this time period.

Therapies for Children With Autism Spectrum Disorder: Behavioral Interventions Update (August 6, 2014)

August 6, 2014 Comments off

Therapies for Children With Autism Spectrum Disorder: Behavioral Interventions Update (PDF)
Source: Agency for Healthcare Research and Quality

Objective
We updated a prior systematic review of interventions for children (0–12 years) with autism spectrum disorder (ASD), focusing on recent studies of behavioral interventions.

Data sources
We searched the MEDLINE® (PubMed®), PsycInfo, and Educational Resources Information Clearinghouse (ERIC) databases as well as the reference lists of included studies and recent systematic reviews. We conducted the search in December 2013.

Methods. We included comparative studies (with treatment and comparison groups) of behavioral interventions with at least 10 participants with ASD in the update, and made our conclusions based on the cumulative comparative evidence across the original report and update. Two investigators independently screened studies against predetermined inclusion criteria and independently rated the quality of included studies.

Results
We included 65 unique studies comprising 48 randomized trials and 17 nonrandomized comparative studies (19 good, 39 fair, and 7 poor quality) published since the prior review. The quality of studies improved compared with that reported in the earlier review; however, our assessment of the strength of evidence (SOE), our confidence in the stability of effects of interventions in the face of future research, remains low for many intervention/outcome pairs. Early intervention based on high-intensity applied behavior analysis over extended timeframes was associated with improvement in cognitive functioning and language skills (moderate SOE for improvements in both outcomes) relative to community controls in some groups of young children. The magnitude of these effects varied across studies, potentially reflecting poorly understood modifying characteristics related to subgroups of children. Early intensive parent training programs modified parenting behaviors during interactions; however, data were more limited about their ability to improve developmental skills beyond language gains for some children (low SOE for positive effects on language). Social skills interventions varied in scope and intensity and showed some positive effects on social behaviors for older children in small studies (low SOE for positive effects on social skills). Studies of play/interaction-based approaches reported that joint attention interventions may demonstrate positive outcomes in preschool-age children with ASD when targeting joint attention skills (moderate SOE); data on the effects of such interventions in other areas were limited (low SOE for positive effects on play skills, language, social skills). Studies examining the effects of cognitive behavioral therapy on anxiety reported positive results in older children with IQs ≥70 (high SOE for improvements in anxiety in this population). Smaller short-term studies of other interventions reported some improvements in areas such as sleep and communication, but data were too sparse to assess their overall effectiveness.

Conclusions
A growing evidence base suggests that behavioral interventions can be associated with positive outcomes for children with ASD. Despite improvements in the quality of the included literature, a need remains for studies of interventions across settings and continued improvements in methodologic rigor. Substantial scientific advances are needed to enhance our understanding of which interventions are most effective for specific children with ASD and to isolate elements or components of interventions most associated with effects.

What does the Research Tell us about Services for Children in Therapeutic/Treatment Foster Care with Behavioral Health Issues?

July 18, 2014 Comments off

What does the Research Tell us about Services for Children in Therapeutic/Treatment Foster Care with Behavioral Health Issues?
Source: Substance Abuse and Mental Health Services Administration

Reports on a technical expert panel convened to assess the research about services for foster care children in therapeutic or treatment care. Reviews the scientific evidence and expert panel input to identify actions to be taken and further research needs.

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