Articles Posted in Mental Illness

Chronic_Traumatic_Encephalopathy-300x153Football players and fans, if they had doubts before, have taken yet another hit to their favorite sport, with a retrospective study of hundreds of pro players’ brains finding a damaging disorder in a startling percentage of the donated organs.

Experts reported in the Journal of the American Medical Association that 110 of 111 brains of onetime players in the National Football League, examined by neuropathologists and other experts, showed evidence of chronic traumatic encephalopathy, or CTE. It’s a degenerative disease that experts think is caused by repeated head blows. It has been linked with multiple symptoms, including memory loss, confusion, depression and dementia. The problems can crop up long after the head trauma stops.

Caution needs to be exercised with this research because the athlete-brain donors and their families were extremely self-selecting. They participated in the post-mortem study, some with guarantees of confidentiality about identities, because they had experienced or started to show likely CTE-related debilitation before their deaths.

overdose-300x225Taken from a most favorable point of view, Big Pharma and doctors tried to address a big physical problem for patients when they pushed ahead in recent years with potent painkillers. But now, it’s those troubled Americans’ mental health woes that  officials may need to deal with to better battle what has become an epidemic of opioid drug abuse.

It’s a crisis that may worsen still and claim as many as 650,000 lives in the next decade, says the online health information site, Stat, which consulted 10 leading experts to develop its forecast.

Stat and other news organizations also have reported on newly published research showing the depths of the mental health challenges of those who abuse opioid drugs, with adults with a mental illness each year receiving more than half of the 115 million opioid prescriptions in the United States.

girls-300x208It isn’t a teary topic fit only for moody young adult fiction and sudsy afternoon TV dramas: Depression afflicts as many as a third of girls, becoming a rising problem for some as early as age 11 and increasingly separating out as gender difference in the mental health between boys and girls.

The higher incidence of depression in girls—found in interview research with more than 100,000 young participants from 2009 to 2014 in the annual, statistically representative National Survey of Drug Use and Health—has raised concern among mental health experts. They note that depression can cause patients to struggle with relationships and school. It can lead some to suicide and may require sustained treatment for those with more serious cases.

Researchers could not explain why girls are more affected by depression, and they were surprised to find the earlier gender divergence, with it occurring at younger ages than had been tracked before. This tends to undercut existing psychological theories, they said, that depression in girls may be triggered by hormone changes or other significant life shifts that occur in their teens.

Medicaid-300x225Republicans have long fumed about the federal government’s role in health care, ever since Medicare for the elderly and Medicaid for the poor were both passed in 1965. Now, though, we’re at a crossroads, where a frontal assault on Medicaid could cause big damage to both programs.

The temptation for too many Americans, as I’ve written before, may be to skip over the Medicaid-related parts of the GOP proposals to repeal and replace the Affordable Care Act, aka Obamacare. That would be wrong because those parts of the American Health Care Act, aka Trumpcare, may be the most radical and will be detrimental to the poor, working poor, children, sick, disabled, and seniors. They will hit many millions more middle-class Americans than might be thought.

Opponents also say that Trumpcare and its Medicaid and health insurance changes will harm Medicare, the linchpin of health care coverage for seniors.

price-portrait-300x253The Republican-controlled Senate has launched itself in a late-night session on the path to its long-pledged repeal and replacement of the Affordable Care Act, aka Obamacare. The GOP-controlled House on  Friday the 13th followed close behind.

Lawmakers have chosen a complex parliamentary path. GOP members are expressing confusion about their way forward, even as doubts are being voiced by GOP governors in states where the ACA has expanded health care for the poor through Medicaid. The president-elect has called for swift action — insisting on not just Obamacare’s repeal but also its replacement with an undefined plan that he says will provide health care coverage that’s better than what exists now and for more Americans.

With big, many, and byzantine legislative steps needing to be taken even beyond “repeal,” can the ACA be replaced, too — and with what?

Carrie_Fisher_memorial_star-225x300Although advocates ended 2016 cheered by new legislation that increased funding and raised the priority of mental health in the nation’s health policy, the year also closed with stark reminders of how far the United States has lagged in this vital area.

Two separate news investigations have painted dire portraits of how the lack of mental health care has led to criminal violence and killings, while another media probe found disturbing signs that a major hospital chain was too quick to question patients’ mental competency and then to hold them against their will. The deaths of two of Hollywood’s elites—a mother and daughter—also brought to fore the stigma that many still bear due to mental disorders.

Neglect’s huge toll

VPJoeBiden_PresidentObamaPresident Obama is expected to sign the $6.3 billion 21st Century Cures Act, capping a rare, multi-year, bipartisan push to significantly improve the nation’s health care. The Senate, with Vice President Biden presiding and winning salutes from political colleagues and patient advocacy groupsapproved the act 94-5.

Proponents say it has many benefits to go around, as I’ve written, providing:

  • a $4.8 billion boost to the National Institutes of Health to support an array of innovative research in its facilities, as well as at universities, medical schools, academic medical centers, and major hospitals;

mdmaMental health experts aren’t suffering Sixties flashbacks. But they are seeing a new day for Molly (aka MDMA, Ecstasy, or 3,4-Methylenedioxymethamphetamine) and magic mushrooms (psilocybin). These hallucinogenic drugs are getting serious consideration in helping those with post-traumatic stress disorder (PTSD) and depression and anxiety due to cancer.

The federal Food and Drug Administration, which won’t comment on the matter, has approved Phase 3 clinical trials (large-scale human research) of MDMA for treatment of PTSD, according to  Multidisciplinary Association for Psychedelic Studies (MAPS).  

MAPS is a nonprofit research and educational organization that “develops medical, legal, and cultural contexts for people to benefit from the careful uses of psychedelics and marijuana.”

US_Congress_02It’s almost 1,000 pages,   culminates at least three years of work, and provides a $6.3 billion boost for an array of health-related agencies and initiatives. Will the U.S. Senate join the House in bipartisan passage of the 21st Century Cures Act, a sweeping measure that some say could affect American health care as much as the Affordable Care Act aka Obamacare?

After the bitterly divisive presidential campaign, House members surprised many with their swift consideration of the health funding bill, which passed 392-26. Congressional leaders then crowed about how they can work together and how the legislation will help. The act now has moved to the Senate for consideration. Senators, notably Massachusetts Democrat Elizabeth Warren, have been far more critical of components of the measure, particularly how Big Pharma and device-makers may benefit.

I’ve written how Congress, around this time last year, provided holiday cheer by approving the framework of the 21st Century Cures Act, an omnibus bill that took a year for funding details to get worked out. Because the legislation covers so many health areas and still must be acted on by the Senate and signed by the president, it still needs wary watching. Lobbyists for many different causes already have had a field day on this bill, and they will continue to do so.

commty care ncHospitals and health systems are making stark choices between offering models to assist their communities and reduce medical costs−or raking in profits, no matter how outrageous and shame-provoking their charges might be. Evidence of the extremes came this week in reports about alternative realities.

Let’s start with the positive view, recognizing exemplary efforts in the Charlotte, N.C.-area to both help patients and to sharply cut medical costs. Forward-looking health policy experts decided to dive into the highest Medicaid users of emergency services, discovering, for example, that just one patient, a homeless alcoholic man, visited the ER 223 times in 15 months and had undergone 150 redundant and needless X-rays or other scans. Many of the top 100 “frequent flyers,” poor and repeat ER patients, took an exceedingly costly route to fill prescriptions or to seek pregnancy or other routine tests; 86 of these individuals were known to have behavioral woes, including depression or bipolar disease. The experts found that these individuals visited multiple ERs on the same day, sometimes crossing a street or two to do so. They appeared on hot or cold days, suggesting their real need might not be medical but for shelter.

Community Care North Carolina — an umbrella group, with cooperation and support from hospitals, social workers, nurses, and social service agencies — searched out the heaviest using Medicaid-ER patients. They needed to comb the streets, jails, and even a strip club. They helped the patients find responsive primary care doctors, and other assistance, for example, in managing chronic illnesses and conditions. They connected them with social service agencies for assistance with existing housing, nutrition, jobs, and transportation programs. As the Charlotte Observer reports:

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