Category Archives: Behavioral/mental health care
A new American Public Health Association (APHA) Press book, “Veteran Suicide: A Public Health Imperative,” addresses the critical and growing issue of suicide among military veterans. The book is a collaboration between the APHA and the Department of Veterans Affairs. Both organizations previously partnered on a supplement to the American Journal of Public Health on suicide risks among veterans.
Topics addressed by the book include
- suicide prevention,
- substance abuse, and
- suicide surveillance.
The new book includes very recent research on suicide among veterans. "The research represented by the collection of manuscripts included in this volume is an important step towards addressing the national problem of suicide and a reminder that even one death by suicide is too many," said Janet Kemp, RN, PhD, Department of Veterans Affairs National Mental Health Program Director for Suicide Prevention.
“Veteran Suicide: A Public Health Imperative” is available for purchase online.
>>Bonus Link: This week the Huffington Post published an article by Kimberly Williams, Director of the Center for Policy, Advocacy, and Education of the Mental Health Association of New York City, pointing out that the connectedness members of the military feel with each other often disappears when they return to their communities, which may be a factor in the rising suicide rates among veterans.
Each year, the March of Dimes National Communications Advisory Council, which includes journalists from many websites and magazines that cover pregnancy and early childhood, holds a reporters’ luncheon to share information that can lead to healthier births, babies and mothers. This year’s luncheon, being held tomorrow, focuses on treating mental health conditions in mothers during and after pregnancy. The issue is important for many reasons, in particular because many women have been taking prescription medications for depression, anxiety, panic attacks, ADHD, and other mental health issues since adolescence and may need to change or stop the medicines in order to have a healthy baby, yet run the risk of a relapse or worsening of their health condition.
NewPublicHealth recently spoke with, Siobhan Dolan, MD, a consultant to the March of Dimes and an obstetrician gynecologist and clinical geneticist at Montefiore Medical Center/Albert Einstein College of Medicine about communicating information about treating mental health during pregnancy to both mothers and health care professionals.
NPH: For the upcoming luncheon, the March of Dimes has singled out mental health medications. Why that area of health?
Dr. Dolan: There is a huge overlap between women of reproductive age who are dealing with becoming pregnant and having families and caring for families and women who have mental health issues and may be entering their reproductive years already on medication.
And we know that bonding and creating a family and getting your family life off to a good start in the early postpartum period is much, much better when a woman is in a balanced mental health state. So if there’s either a preexisting depression or a postpartum depression, we need to pay attention to that.
CDC Issues First Comprehensive Report on Children’s Mental Health in the United States
As many as one in five American children under the age of 17 has a diagnosable mental disorder according to a new report from the Centers for Disease Control and Prevention. The report is the first expansive report on children's mental health ever done by the U.S. government and looked at six conditions:
- attention-deficit/hyperactivity disorder (ADHD)
- behavioral or conduct disorders
- mood and anxiety disorders
- autism spectrum disorders
- substance abuse
- Tourette syndrome
The most common disorder for children age 3 through 17 is ADHD (7 percent) followed by behavioral or conduct problems (3.5 percent), anxiety (3 percent), depression (2 percent), and autism spectrum disorders (1 percent).
Five percent of teens reported abusing or being dependent on illegal drugs, 4 percent abused alcohol and 3 percent reported smoking cigarettes regularly. Boys were more likely than girls to have the disorders. Read more on mental health.
New PSAs Help Parents Talk to Younger Kids about the Dangers of Underage Drinking
“Talk. They Hear You,” is a new national public service announcement (PSA) campaign from the Substance Abuse and Mental Health Services Administration (SAMHSA) to empower parents to talk to children as young as nine about the dangers of underage drinking. SAMHSA research shows that more than a quarter of American youth engage in underage drinking, and though there has been progress in reducing the extent of underage drinking in recent years, particularly among those aged 17 and younger, the rates of underage drinking are still unacceptably high, according to SAMHSA. A report from late last year shows that 26.6 percent of 12-20 year-olds report drinking in the month before they were surveyed and 8.7 percent of them purchased their own alcohol the last time they drank, despite the fact that all fifty states and the District of Columbia currently have laws prohibiting the purchase and use of alcoholic beverages by anyone under age 21.
“Even though drinking is often glamorized, the truth is that underage drinking can lead to poor academic performance, sexual assault, injury, and even death,” said said SAMHSA Administrator Pamela S. Hyde.
The goal of the new PSA is to help parents start a conversation about alcohol before their children become teenagers. Read more on addiction.
Advocacy Groups Petition FDA to Ban Menthol Flavored Cigarettes
In response to a Citizen Petition by close to twenty health and tobacco control advocacy groups, the Food and Drug Administration has opened a docket for public comment on banning menthol in cigarettes. In 2009, according to the Tobacco Control Legal Consortium, the lead group on the petition, Congress banned all flavors in cigarettes except menthol, and directed the FDA to decide whether continued sale of menthol cigarettes is “appropriate for public health." According to the petition, menthol cigarettes are the source of addiction for nearly half of all teen smokers. Read more on tobacco.
Immediately after the explosions at the Boston Marathon yesterday, both the U.S. Centers for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA) updated their crisis management resources and moved the information to the top of their home pages.
Yesterday, NPR reported that business owners near the blast site are beginning to return and reopen their doors.
"They fled in a panic last week and returned both eager and anxious," said NPR reporter Tovia Smith. The piece describes how business owners returned to find food left half-eaten and rotting, because so many left in such a hurry, and blood splattered in some spots from those who were injured.
To help make sure businesses get the help they need to reopen safely, public health inspectors played a role in visiting every building on every block. "They also stood ready with trauma counselors, pro-bono attorneys and clean-up crews," said Smith.
But the public health response to any disaster goes beyond helping to restore normalcy in the immediate aftermath. An earlier interview with John Lumpkin, director of the Health Care Group at the Robert Wood Johnson Foundation, about the sustained response to Hurricane Sandy also applies here:
We saw with Katrina and are seeing again now with Sandy, [public health officials] are not only concerned with food, air, and water during and immediately after an emergency, but also with ensuring that services related to health care delivery and mental health are provided when and where they’re needed. It’s an interesting statistic, for instance, that the demand for mental health services was higher five years after Hurricane Katrina than it was immediately after the hurricane hit.
The Boston Public Health Commission announced this week, for example, that the organization has opened a new drop-in center to continue to provide emotional support to anyone affected by the Boston Marathon attack.
"While the physical injuries and destruction that resulted from the bombings might be the most visible signs of trauma, many people experience serious emotional distress based on what they saw, heard, and felt during and after the attack. Sometimes these symptoms do not surface immediately," according to the Commission release. "Understanding the deep impacts of this emotional distress, city officials opened the drop-in center as a safe place for people to come together and talk about their experiences over the past week."
>>Read more about building community resilience to recover from disaster.
Mental health has become a more prominent topic since the recent shooting in Newtown, Conn., that claimed 26 lives, 20 of them children. The Alliance for Health Reform, a non-profit group based in Washington, D.C., that provides information to journalists and Congressional staff on health reform issues, released some key numbers on mental health issues recently that can be useful in moving the discussion forward:
- An estimated 45.9 million adults in the United States age 18 or older had any mental illness in 2010 (one out of five people in this age group).
- In 2010, an estimated 31.3 million adults received any kind of mental health service during the past year.
- Among adults with severe mental illness, 60.8 percent received mental health services during the past year.
- An estimated 11.1 million adults reported an unmet need for mental health care in the past year. Of those, 5.2 million had not received any mental health care at all in the past year.
- People who are out of work are four times as likely as those with jobs to report symptoms consistent with severe mental illness.
- The cost of care is the reason most often given by people who recognize that they need mental health treatment but don’t get it.
According to research by the Alliance, mental illnesses range from occasionally troubling to life-consuming. To cope with temporary problems, such as depression following illness or a traumatic event, many people need only a short-term intervention. But others experience more debilitating and long-lasting conditions that interfere with routine activities such as work, school and family, and can require lifelong treatment.
Effective, well-documented treatments for mental illness and substance abuse have been developed and widely disseminated, including psychotherapy, psychosocial treatment and prescription medications. But a significant number of Americans do not have adequate access to mental health treatment or do not take advantage of available help.
A recent article in the Washington Post looks at ongoing clinical trials that have researchers studying the potential effects of transcendental meditation as a treatment for post-traumatic stress disorder (PTSD). As many as 10 percent of returning veterans suffer from PTSD and both internal military reports and outside reviews show an insufficient and too-slow response for veterans seeking mental health help. Military spokespeople say they know many returning veteran with mental health concerns who aren’t accessing the help at all. The results of the trials won’t be available for at least a year, but two small pilot studies show a reduction of symptoms by 50 percent in participants just two months after beginning the meditation.
- Read an interview with Jonathan Woodson, MD, assistant secretary for health at the Department of Defense (DOD) on the DOD's emphasis on wellness and suicide prevention.
- Read the full Washington Post article.
- Read a blog post from the Department of Veterans Affairs on maintaining military benefits for veterans displaced by Hurricane Sandy.
Idea Gallery is a recurring editorial series on NewPublicHealth in which guest authors provide their perspective on issues affecting public health. In this Idea Gallery, Jane Isaacs Lowe, Team Director for the Vulnerable Populations Portfolio at the Robert Wood Johnson Foundation, provided her perspective on the critical impact of public policies on the mental health of urban populations.
Recently I attended and spoke at the Social Determinants of Urban Mental Health conference hosted by the Adler School of Professional Psychology. Lynn Todman, the Executive Director of Adler’s Institute on Social Exclusion and the conference’s organizer, has been doing groundbreaking work on the link between public policies and the mental health of urban communities, including the Institute’s Mental Health Impact Assessment, which was developed in part through support from the Robert Wood Johnson Foundation.
It’s been exciting to see the field of health impact assessments grow so rapidly. But, of course, physical health is not the only outcome that matters; equally important is our mental health and its integral connection to physical health, especially for the most vulnerable among us. This is reflected in many of the organizations and models in which we’ve invested and which we’re helping to scale for greater impact. You’ll see it, for instance, in a video we just released on Child First, a psychotherapeutic home-visiting program that works with families with very young children who are showing signs of severe developmental, emotional, and behavioral problems. Child First partners with providers all across the community who touch these families’ lives — including doctors, day care providers, teachers, and social workers. If a provider sees a problem, she makes a referral to Child First, which then arranges a comprehensive assessment and home visit with a team of trained specialists, including a masters-level mental health clinician. That team works on the relationship between the child and parent or caregiver and on environmental factors, such as depression, substance use, domestic violence, food insecurity or homelessness that are detrimental to the child and family.
Ultimately, the goal is to foster strong, stable, nurturing relationships between parents and children and also create a safer and healthier overall environment for the child. In so doing, Child First effectively helps to buffer the developing brains of these young children from the damage caused by repeated exposure to toxic stress, and sets the families on a course toward stability and better health.
As Lynn Todman explains it, effective interventions for addressing the social determinants’ impact on mental health exist along a continuum — from trying to “fix” the individual within the clinical setting to structural reforms that create a social environment that will lead to better mental health outcomes. This is demonstrated in the Child First model, which goes beyond the clinical setting to engage individuals and institutions from across the community united by a common goal. The Adler School wants their students to be able to operate along that continuum, and to understand that, to improve outcomes, change will need to happen outside of the clinical setting, in the context of people’s lives and where they live, learn, work and play. This also must include the realm of policy change. Being able to contribute to this goal was well worth my time.
The other speakers at the conference reflected this belief in the need for interventions along a continuum and which engage individuals and institutions from multiple sectors. Lynn Todman’s background is as an urban planner, which is inherently a multi-disciplinary role. As an urban planner, she needed to understand housing, transportation, social services delivery, fiscal policy, and more. And she needed to be able to apply a lens that allowed her to see the connections between all of these seemingly different issues. It’s worth noting that it’s a lens through which Risa Lavizzo-Mourey is also looking in her recent chapter, “Why Health, Poverty, and Community Development Are Inseparable,” in the book, Investing in What Works for America's Communities. She makes a forceful case that, “community development and health must be partners in planning and building communities.”
We’ve pulled together some of the highlights from the conference, including resources that were shared by speakers. I hope you’ll take a look and, more importantly, put them to use in your own work.
Several mental health organizations and government agencies have announced online or telephone resources to help citizens and professionals cope with worry, fear, anxiety and stress in the aftermath of the Colorado shooting at a movie theater early this morning that has taken at least 12 lives and injured dozens more:
- The Centers for Disease Control and Prevention has a web portal dedicated to disaster response with resources for direct victims and the larger community.
- Mental Health America, a national advocacy and education group on mental health issues, has developed guidelines and a fact sheet to help facilitate discussions about the tragedy.
- The Disaster Distress Helpline (800-985-5990) of the Substance Abuse and Mental Health Administration provides immediate crisis counseling and help to people in the US coping with the shooting incident in Colorado, or any other disaster. The helpline operates 24/7 and connects callers with trained professionals from the closest crisis counseling center in the nationwide network of centers. The helpline can also be accessed by text (Text: TalkWithUs to 66746).
- The Department of Veterans Affairs has a helpful fact sheet on post traumatic stress disorder after a disaster.
- UPDATE: One of our commenters shared resources from the National Child Traumatic Stress Network, which is funded by SAMHSA. See the comment below for more details.
>>Weigh In: Do you have a response system ready for local and national disasters?
The recent spate of severe storms around the country is a driving catalyst behind the decision by the Substance Abuse and Mental Health Administration (SAMHSA) to change the status of its formerly as-needed helpline available after disasters, into a permanent program—the Disaster Distress Helpline.
Brad Stone, a SAMHSA spokesperson, says previously the agency would engage the 24/7 helpline (1-800 985-5990, text 66746) after disasters such as hurricanes to help people in need of mental health counseling and referral. Stone says SAMHSA found the disasters were occurring frequently enough that having it continually available was the best way to help people as soon as a crisis strikes.
The helpline immediately connects callers to trained professionals from the closest crisis counseling center who can provide confidential counseling, referrals and other support services.
“When disaster strikes, people react with increased anxiety, worry and anger. With community and family support, most of us bounce back. Some may need extra assistance to cope with unfolding events and uncertainties,” says SAMHSA Administrator Pamela S. Hyde.
Multilingual help is available and the helpline is intended for anyone experiencing psychological distress as a result of natural or man-made disasters, incidents of mass violence or any other tragedy affecting America's communities.
A recent Reuters in-depth report finds that slashes to state mental health budgets as well as job and home losses from the economic downturn of the last few years have led to an increase in people seeking care for mental illness at emergency rooms. Physicians say the increase has caught them unprepared, with too few social workers to handle cases, too few facilities that can accept patients and ER staff often not trained to handle needs of mental health patients beyond emergency measures.