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Hazelden, a nonprofit organization, and the Dartmouth Psychiatric Research Center (PRC) both leaders in the research and development of evidencebased practices have announced a partnership to develop a variety of resources for the mental health and addiction treatment industries. These resources, including curricula, books, multimedia tools, and staffdevelopment trainings, will be published under a new “Dartmouth PRCHazelden” imprint.

This groundbreaking collaboration between Hazelden and the Dartmouth PRC was born from the success of a project between Hazelden and Dartmouth Medical School the 2008 publication of the Cooccurring Disorders Program, the first comprehensive, evidencebased program for the treatment of nonsevere cooccurring disorders. This exceptional program has been adopted by several organizations, including the U.S. Navy and the Adult Mental Health Division of the Minnesota Department of Human Services.

The new joint venture between Hazelden and the Dartmouth PRC will launch with the fall 2009 release of A Guide for Living with PTSD Perspectives for Professionals and Their Clients, a video on the treatment of posttraumatic stress disorder. Future products will compose a continuum of evidencebased resources for working with those who have a mental health disorder or cooccurring addiction and mental health disorders, including an updated, expanded, and serviceable version of the Integrated Dual Disorder Treatment program, which will feature a new relapse prevention component. These products and trainings will be designed to serve a broad range of professionals, including counselors, social workers, nurses and psychiatrists who work in mental health agencies, the military, treatment centers, corrections departments, state governments, and industry associations.

“The partnership between Hazelden and Dartmouth Psychiatric Research Center is a milestone for the mental health and addiction communities,” says Robert E. Drake, M.D., Ph.D., director of the Dartmouth PRC. “With our combined expertise, we are able to bring professionals in a wide variety of settings relevant, researchbased resources for treating clients with mental health and addiction disorders. Together, we are committed to providing comprehensive programs and evidencebased tools for helping people identify their disorders, get the help they need, and sustain healthy, fulfilling lives.”

Source
David Corriveau

“What many people say they fear most from an overhaul of the health care system [is] the prospect of the federal governments limiting the medical care they receive,” the New York Times reports. Policy experts say people are right to worry about health care costs, but this fear of rationing is unrealistic. “[T]here is nothing in the current proposals in Washington to suggest that the country is likely to embark on a system of medical rationing anytime soon,” the Times reports (Abelson, 8/24).

A variation of this fear stems from proposals that would affect endoflife care. A Veterans Affairs guide to writing living wills, “Your Life, Your Choices,” spurred controversy last week when a former Bush administration official dinged it in a Wall Street Journal oped, NPR reports. The document asks veterans to choose in advance when they would say their lives are no longer worth continuing, based on criteria like relying on a wheelchair, living in a nursing home or being sad all the time. Jim Towey, the former leader of the White House Office of FaithBased Initiatives, said, “That makes them feel their life is a burden not a gift.” NPR notes that Dave Autry, a spokesman for Disabled Veterans of America, said “Its a tempest in a teapot as far as Im concerned, personally,” and adds “He says although health care is on the minds of veterans at the convention, the VA guide has gotten almost no attention. And then, mainly from veterans who worry that its being used to undermine attempts to change health care” (Shapiro, 8/24).

To critics of reform, Ezekiel Emanuel, a bioethicist and physician who advises the White House on health care issues, has become the object of many of these fears, the New York Times reports. Betsy McCaughey, the former lieutenant governor of New York, called him a “deadly” doctor who seeks to restrict care for the disabled, “a false assertion” gleaned from quoting his writing “out of context” and then repeated on the House floor by Rep. Michele Bachmann, RMinn. However, the Times reports, “The level of vitriol against him has led even some conservative opponents to defend Dr. Emanuel while expressing concern that it is overtaking what they say are more vital realworld critiques” (Rutenberg, 8/24).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.

© Henry J. Kaiser Family Foundation. All rights reserved.

Today leading mental health charity Mind has helped to redraw the boundaries in our understanding of psychiatric medication, with the launch of new book Psychiatric Drugs (1). Drawing heavily on individuals experiences, it is the first book of its kind to explore what it is like to take antidepressants and other drugs from the viewpoint of the patient, and it contains new and provocative material about peoples relationships with some of the most debated and controversial medications around.

From the launch of wonder drug Prozac in the 1980s to the scandals around sideeffects and drug trials in recent times, psychiatric drugs have been surrounded in controversy since they first came on the market. Over 60 million prescriptions are written for mental health medications every year (2), a figure that is rising year on year, with over 36 million prescriptions for antidepressants issued in 2008 alone (3). Despite their popularity with prescribers, weighing up benefits versus side effects can be a constant battle for patients shockingly, its estimated that 1.9 million people get no benefit from medication at all (4). Psychiatric Drugs aims to give professionals and patients alike an insiders view to the issues people face on a daily basis.

The author, Jim Read, whose work is informed by his own experiences of medication, said

For every person who says their lives have been ruined by psychiatric drugs there is someone who believes they have been saved by them, and many more who just dont know, and wonder what their lives would have been like without them. The prescribing and taking of psychiatric drugs is always about more than a chemical and a brain. Everyones relationship with their medication is unique and personal, and is affected by their beliefs and modified by their experience.

The inspiration for Psychiatric Drugs came after research by Mind found that many people struggle to come off medication, and can find their doctors unhelpful and unsupportive in the withdrawal process (5). This prompted debate over how much is really known about the patient experience, and the need for an inside view of how peoples lives are really affected by drug treatments.

Minds chief executive, Paul Farmer, said

Psychiatric medication and the impact it has on peoples lives is a vitally important issue for anyone who has been prescribed drug treatments, or knows someone on medication. Even within this one book there are themes that crop up again and again hope, fear, indifference, adverse affects, ignorance about coming off them, and insecurity about managing without them.

Although we know a lot about the effects of psychiatric medication, the lists of benefits and adverse effects do not describe what it is actually like to take them. This book is designed to give that insight, so patients know they are not alone, and professionals realise that for patients, coming off medication can be a tough process that is also about taking control of their own destiny.

1. Psychiatric Drugs, Mind, 2009. Published by Palgrave Macmillan. Writer and mental health consultant Jim Read was commissioned by Mind to author the book to help address lack of awareness around patient experiences of taking and coming off psychiatric medication.

2. NHS information Centre, Prescription Cost Analysis, 2008
3. NHS information Centre, Prescription Cost Analysis, 2008
4. Psychiatric Drugs, Mind, 2009

Around one in five young people in the U.S. have a current mental, emotional, or behavioral disorder. About half of all adults with mental disorders recalled that their disorders began by their midteens and threequarters by their mid20s. Early onset of mental health problems have been associated with poor outcomes such as failure to complete high school, increased risk for psychiatric and substance problems, and teen pregnancy.

A new article by Mary E. Evans, RN, PhD, FAAN, published in the Journal of Child and Adolescent Psychiatric Nursing assesses the recently released government report on preventing these disorders among young people. Dr. Evans paper concludes that using certain interventional programs in schools, communities and health care settings, risk for mental illness can be better identified and treated.

The article highlights the fact that specific risk and protective factors have been identified for many disorders. For example, certain thinking and behavioral patterns are risks for the development of depression. Nonspecific factors that increase risk for developing disorders also include poverty, marital conflict, poor peer relations, and community violence. Also, certain neurobiological factors contribute to the development of disorders in youth, but this is also influenced by environmental factors.

A key risk factor for externalizing disorders is aggressive social behavior that begins in early childhood. A number of interventions have been developed to provide training in parenting skills to prevent the development of aggressive and antisocial behavior. In addition, some preventive interventions have targeted specific disorders such as depression and schizophrenia. Cognitive behavioral treatment for highrisk adolescents has lowered the rate of major depressive symptoms. Also, a number of communitybased programs have been shown to be effective in promoting healthy behaviors.

“For all nurses, this report will increase our understanding of risk and protective factors related to the healthy development of children and youth,” Evans concludes.

Mary E. Evans, RN, PhD, FAAN, is affiliated with the College of Nursing, University of South Florida & Institute of Medicine.

Source
Amy Molnar

It would make sense that teenage mothers have a lot of psychological stress in their lives, but a new study shows that the distress comes before the pregnancy, not because of it.

“Psychological distress does not appear to be caused by teen childbearing, nor does it cause teen childbearing, except apparently among girls from poor households,” said Stefanie Mollborn, Ph.D., an assistant professor of sociology at the Institute of Behavioral Science of the University of Colorado at Boulder.

The study, published in the September issue of the Journal of Health and Social Behavior, used data from two large longterm U.S. surveys that followed thousands of teen girls and women. Participants responded to items on symptoms associated with depression, such as how often they found things that did not usually bother them to be bothersome, how easily they could shake off feeling blue or whether they had trouble concentrating. The researchers did not use the term “depression,” which is a clinical diagnosis.

Only the combination of poverty and existing distress was a good predictor of teen pregnancy.

Previous studies had shown high levels of depression among teen mothers, but nationally representative studies had not examined if distress was present before the pregnancy and stresses of young motherhood.

“Psychologically distressed girls are at risk for teen childbearing and vice versa, even if the two things usually do not cause each other,” Mollborn said. “This could help educators and clinicians identify atrisk adolescents.”

Looking for symptoms of depression or distress should be part of normal health screening for all teenagers, said Diane Merritt, M.D., director of Pediatric and Adolescent Gynecology at the Washington University School of Medicine in St. Louis. “Talking to teenagers about their sexuality and responsible behavior is key,” she said. Responsible behavior would include the use of birth control if the teenager were sexually active.

One of the best ways to prevent teen pregnancy is for teens to have longterm goals and good selfesteem, Merritt added.

High levels of depression have longterm negative consequences for both mothers and children, Mollborn said. The higher levels of psychological distress in women who had teenage pregnancies continued well into adulthood, she added.

A powerful new research facility at the heart of Kings Health Partners Academic Health Sciences Centre has been launched by Professor Dame Sally C Davies, Director General of Research and Development and Chief Scientific Adviser, Department of Health. The Biomedical Research Centre (BRC) Nucleus is funded by a £3M infrastructure grant from South London and Maudsley Charitable Funds (£1.8M) and Guys and St Thomas Charity (£1.2M) to create a unique centre housing key translational initiatives to support the development of novel therapies and treatments for mental health and related disorders.

Part of the National Institute for Health Research funded specialist BRC for Mental Health at South London and Maudsley NHS Foundation Trust (SLaM) and Kings College London, the BRC Nucleus will bring together expertise in epidemiological, biological and biostatistical research to power the collection, linkage, integration and analysis of complex data in a way not previously possible; to develop new biomarkerled approaches to treating mental health and improving service provision for patients in the local community.

The BRC Nucleus will house groundbreaking research initiatives designed to accelerate improvements in healthcare, such as

The Case Register Interactive Search (CRIS) tool a computer programme capable of anonymising data from SLaM clinical records offering researchers opportunities to ask questions which they havent been able to answer before. For example Is there a test for those with Alzheimers disease that can show if drugs would be the best treatment? Do some drugs for schizophrenia affect physical health, e.g. diabetes? Do peoples home living arrangements affect how long they spend as inpatients, receiving care in hospital wards?

OPCRIT+ a unique software programme designed to standardise diagnosis of psychiatric illnesses and collect quality data to support research for patient benefit. Together CRIS and OPCRIT+ offer the potential to exploit the previously untapped resource of patient records for patient benefit.

The BRC Community Survey of households in South East London and the BRC Care Home Study which aim to improve understanding of the needs of the population served by SLaM and other health partners and allow SLaM to improve and tailor the quality of its service provision to meet local needs and support research.

Professor Matthew Hotopf, Director of the BRC Nucleus and Chair of the BRC Analytical Methods Theme said “The BRC Nucleus is unparalleled in the comprehensive data it will offer researchers. We are delighted this exciting facility is now open for business and the BRC for Mental Health can accelerate translational medicine in pursuit of personalised mental health care.”

Professor Simon Lovestone, Director of the BRC for Mental Health adds “The BRC Nucleus has the potential to bring the power of modern, biomedical science to transform the diagnosis, assessment and ultimately treatment, of people with mental health problems.”

Source
Louise Pratt

Help is available and essential for teenagers struggling with depression and suicidal thoughts.

In the wake of two recent teen suicides in Palo Alto, Calif., child and adolescent psychiatrist Frances Wren, MD, is working to raise community awareness of mentalhealth resources for young people. Wren, who directs the Child and Adolescent Depression Clinic at Lucile Packard Childrens Hospital at Stanford, hopes to clarify the warning signs of teen depression and counteract the stigma teens or families may feel about seeking treatment.

Recognizing the link between depression and suicidal thoughts is an important first step in preventing teen suicides.

“A very large majority of people who die by suicide are suffering a psychiatric illness. About twothirds are depressed, and often that depression has been present a year or longer,” said Wren, who is also an assistant professor of psychiatry and of pediatrics at the Stanford University School of Medicine. Teenage depression is common, she noted, with 15 percent of teens experiencing an episode of clinical depression before they reach adulthood. Though teen suicides are rare, suicide attempts are more widespread, and all cases of depression should be taken seriously.

Parents of teens who notice depression warning signs such as sustained changes in mood, deterioration in grades, withdrawal from friends or loss of interest in usual activities should seek help, Wren said. “Depression is not just sadness,” she said. “Patterns of irritability, anger and acting withdrawn can also signal depression.”

The good news is that effective treatments for depression are available; the challenge is that, because depression sufferers feel hopeless, its often necessary for another person to take the initiative in seeking treatment.

The first step in getting help is to talk to your child. “Many of us feel some sense of discomfort about this, but its important to ask, How are you doing?” Wren said. “Dont be afraid to ask if theyre feeling sad or down, and dont be afraid to ask if your child is having suicidal thoughts.” Such a question does not increase the risk that a teen will make a suicide attempt, and will send the message that its OK to talk about the problem.

“Then, if you believe your teen is depressed, its very important that they have an evaluation, ideally by a licensed mental health professional,” Wren said. Some high school counseling centers have the right resources for such an evaluation. Parents can also approach their primary care physician or minister for guidance to a mental health professional. Even if the teen does not want to be evaluated, mental health professionals can meet with the parent to discuss his or her concerns about their child, added Wren, who has extensive experience treating teens for depression and suicidal thoughts.

Its also important for parents to play a supportive role when their son or daughter is part of a community where a suicide has occurred. “You can say, I find myself thinking about this,” Wren said. “Knowing you want to talk to them opens the door for discussion with your children.” Friends can also provide important support in such circumstances, especially by getting help from an adult if they suspect a teen they know is contemplating suicide. “Young people may worry that seeking help from an adult would be disloyal to their friend, but it is vital to get depression sufferers effective help,” Wren said.

Finally, Wren emphasized the importance of dispelling myths about teen suicide. “Every individual suicide is complicated,” she said. “There is never a single event or a single thing said that fully explains a suicide.”

More information about Child and Adolescent Psychiatry services at Lucile Packard Childrens Hospital is available by calling (650) 7235511 or online at psychiatry.lpch.org.

In addition to seeking a mental health professional, parents and others concerned about a teens mental state can get information and help from the resources below tinyurl.com/lpchresources

Resources for the media on responsible reporting about suicide are also available at the above link.

Source

“Although the number of mentally ill immigration detainees” at the La Mesa, Calif.based private psychiatric hospital Alvarado Parkway Institute “at any one time seems to range from as few as two to only five or so, their situation needs to be addressed quickly,” a San Diego Tribune editorial states (San Diego Tribune, 5/19). Some disability rights lawyers and advocates for the mentally ill say that conditions at many of the private facilities, including API, violate state and federal laws governing treatment of mentally ill people. Ann Menasche, a lawyer with the legal advocacy group Disability Rights California, last month sent a letter to the U.S. Immigration and Customs Enforcement claiming that after visiting API and interviewing detainees, she found that the conditions are “excessive, unjustifiable and punitive” (

A new study conducted by SANE Australia finds almost half of all Australians still have a very limited understanding of schizophrenia and the everyday reality of living with the illness.

The study (conducted in conjunction with Virtual Medical Centre), surveyed nearly 900 people with 49 per cent admitting to having a poor understanding of schizophrenia and its impact.

The findings are disappointing but not surprising, says SANE Australias Executive Director Barbara Hocking. A lot of education is still needed about the realities of schizophrenia the fact is, with treatment, the majority of those affected lead full lives and participate in the community.

Unfortunately there is still a lot of stigma and discrimination towards those with schizophrenia, which is not helped by persistent myths about the illness. The most common myth confuses schizophrenia with socalled split personality, which is not the case.

Another myth is that people affected by schizophrenia are violent, when in fact research shows that they are more likely to be victims of violence than to commit violent acts themselves.

One in a hundred people will develop schizophrenia during their lives. More males than females are affected and 75% develop the illness between 16 and 25 years.

Schizophrenia is an illness which influences the normal functioning of the brain, affecting its ability to interpret information and make sense of the world. Symptoms can include confused thinking, delusions, hallucinations, difficulty expressing emotions and withdrawal from others. There is no cure for schizophrenia but treatment, which includes medication, psychological therapy and community support and accommodation programs, can do much to reduce and even eliminate the symptoms.

Through events such as Schizophrenia Awareness Week we can hope to break down the stigma surrounding the illness by encouraging conversation and helpseeking behaviour, says Ms Hocking.

SANE produces a number of education resources about schizophrenia to help people understand and make sense of the illness, as a first step to coping with its effects. SANE also operates a StigmaWatch program, which works with the community to monitor media portrayals of mental illness and suicide, advocating for an end to misrepresentations of schizophrenia.

Schizophrenia Awareness Week runs from May 17 23 2009.

The AMA says tonights budget does nothing to provide Australians with confidence that their health needs will be met in the face of the recession. There is nothing to cushion Australians from the ravages of the recession.

AMA President, Dr Rosanna Capolingua, said the budget will mean many Australians will pay more for health adding to their anxiety when they are already stressed about job security and the future.

“More detailed analysis is needed, but one thing is clear the governments broken promises and lack of understanding will mean sick Australians will wait longer or pay more for health.

“Estimates are that we will have one million people unemployed and we fear the ravages of this will hit the health system harder than the government realises. Many of these Australians will be forced to rely on our crumbling public health system. They will need help with a broad range of health issues including stress related illness and mental health.”

Dr Capolingua said the AMA will examine the budget more closely to see if health funding has been maintained as a proportion of total government outlays.

“But my first impression is that it has not.

“Changes to the 30 % Private Health Insurance Rebate mean many Australian singles and families will pay a lot more for health insurance, and if you dont keep your private health insurance youll be slugged with an increased Medicare Levy surcharge. They get you both ways.

“Changes to the Medicare Safety Net will hit couples having babies. Were particularly worried about anyone relying on IVF to have children. This measure could make IVF simply unaffordable to all but the most well off.

“We needed infrastructure spending on health, we needed to boost our capacity to help people struggling with the health impacts of hard times. What we got was broken promises, recycled funding, and a hole in health that the next generation will have to fix.

“Our patients will have difficulty understanding how a government that can spend $52 billion on stimulus packages cant afford to even maintain the status quo health let alone provide the additional support needed in time of recession.