Treatment lags for teens with mental health conditions

Less than half of American teens with mental health disorders receive treatment, and those who do get help rarely see a mental health specialist, a new study indicates, reports Reuters today.

“The findings underscore the need for better mental health services for teens, said study author E. Jane Costello, associate director of the Duke Center for Child and Family Policy in Durham, N.C.

“It’s still the case in this country that people don’t take psychiatric conditions as seriously as they should,” Costello said in a Duke news release. This remains so, despite a wave of mass shootings in which mental illness may have played a role, she and her colleagues noted.

“The analysis of data from more than 10,000 teens aged 13 to 17 across the United States also showed that treatment rates varied greatly for different types of mental health problems. For example, teens with attention-deficit/hyperactivity disorder, conduct disorder oppositional defiant disorder received mental health care more than 70 percent of the time, while those with phobias or anxiety disorders were least likely to be treated. The researchers also found that blacks were much less likely than whites to be treated for mental disorders, according to the study, published online Nov. 15 in the journal Psychiatric Services. In many cases, teens received treatment from pediatricians, school counselors or probation officers, rather than mental health specialists. This is because there are not enough qualified child mental health professionals to handle the demand, said Costello, who is also a professor of psychology and epidemiology at Duke University. Continue reading “Treatment lags for teens with mental health conditions”

Stunning findings about addiction treatment

Intensive drug and alcohol treatment may be no more effective than a single appointment, according to a new study reported today in Journal of the American Medical Association.

WebMD reports that “Results of the year-long study are likely to disappoint those who believe treating addiction more like a chronic disease — with a systematic approach and follow-up — is the better way to go.

“We were completely surprised by the result,” said lead researcher Dr. Richard Saitz, a Boston University professor of medicine and epidemiology. “We put everything into this, and we were surprised that even doing that didn’t lead to differences compared to not doing any of it.”

“In the study of nearly 600 adult substance abusers, those receiving chronic care management got intensive medical care at a primary-care clinic plus relapse-prevention counseling and addiction and psychiatric treatment. Others in the study had one medical visit at which they received a list of addiction-treatment resources.

“After 12 months, 44 percent of those in the chronic care management group had stopped drinking or using drugs, as did 42 percent of those not receiving intensive care, the researchers said. Despite these similar findings, Saitz said he still believes chronic care management can be useful for some addictions. However, “we don’t want people to assume that it’s going to be effective when applied everywhere for every person,” he said. More work is needed to determine the best way to use chronic care management and to identify those who will benefit most from the approach, he said.

“We have to recognize that people with drug or alcohol addictions may be different and it’s not one monolithic disorder,” Saitz said. “I do think that integrated chronic care management, in the future, is going to be efficacious for people with addictions.”The report was published in the Sept. 18 issue of the Journal of the American Medical Association. Advocates of chronic care management point out that many substance abusers suffer serious health consequences but receive poor care. By addressing medical, emotional and dependence issues in a coordinated manner, patients would achieve better results, the thinking goes. One expert thinks motivation is the key to any program to treat addiction. People who are motivated are most likely to start and stick with a program or join a clinical trial, said Dr. James Garbutt, a professor of psychiatry at the University of North Carolina at Chapel Hill. “That’s an important point because that’s saying they already wanted to make some changes,” Garbutt said. “That’s a huge step in substance-abuse treatment.” Continue reading “Stunning findings about addiction treatment”

Continuing value of ECT

The idea of treating a psychiatric illness by passing a jolt of electricity through the brain was one of the most controversial in 20th Century medicine. So why are we still using a procedure described by its critics as barbaric and ineffective?The BBC ran a story today discussion the continuing benefits of this controversial procedure:

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“Sixty-four-year-old John Wattie says his breakdown in the late 1990s was triggered by the collapse of his marriage and stress at work.

“We had a nice house and a nice lifestyle, but it was all just crumbling away. My depression was starting to overwhelm me. I lost control, I became violent,” he explains. John likens the feeling to being in a hole, a hole he could not get out of despite courses of pills and talking therapies. But now, he says, all of that has changed thanks to what is one of the least understood treatments in psychiatry – electroconvulsive therapy (ECT).

“Before ECT I was the walking dead. I had no interest in life, I just wanted to disappear. After ECT I felt like there was a way out of it. I felt dramatically better.” The use of electricity to treat mental illness started out as an experiment. In the 1930s psychiatrists noticed some heavily distressed patients would suddenly improve after an epileptic fit. John Wattie on why he feels he needs ECT to keep severe depression at bay

“Passing a strong electric current through the brain could trigger a similar seizure and – they hoped – a similar response. By the 1960s it was being widely used to treat a variety of conditions, notably severe depression. But as the old mental asylums closed down and aggressive physical interventions like lobotomies fell out of favour, so too did electroshock treatment, as ECT was previously known. The infamous ECT scene in One Flew Over the Cuckoo’s Nest cemented the idea in the public’s mind of a brutal treatment, although by the time the film was released in 1975 it was very rarely given without a general anaesthetic. Continue reading “Continuing value of ECT”

Veterans’ PTSD options are lacking

The Department of Veterans Affairs is being criticized for the shortfall in care for almost a million veterans who can’t get timely compensation and have been waiting hundreds of days for help, often to no avail, reports NPR today.images

“Frustration with the agency came to a head last Thursday when VA Secretary Eric Shinseki was called before a closed-door meeting of the House Appropriations Committee.”We are aggressively executing a plan that we have put together to fix this decades-old problem and eliminate the backlog, as we have indicated, in 2015,” Shinseki said after the meeting.“So this is a challenge [and] we’re making tough decisions that make it possible for more people to apply for and receive benefits.

“Glenn Smith, a 28-year-old Army veteran from St. Louis, joined the military in 2004.”I joined because I loved tanks, believe it or not,” Smith tells Jacki Lyden, host of weekends on All Things Considered.Smith was deployed to Iraq twice between 2006 and 2010; he spent most of four years in combat. He now has an irregular heartbeat, and attributes it to one of the many IED blasts he went through. The irregular heartbeat, discovered during a routine training exercise, led to him being discharged last spring.

“Smith described an anxiety attack in March in which “things just [closed] in” on him. It’s even happened while he was driving.”I didn’t feel like I had any release or way to break free of it,” he says. “I’ve had memories and nightmares of my experiences while I was in Iraq. Any all that just came rushing to the surface.”Smith also says he has a bad case of PTSD. His PTSD has been so debilitating, he needs help navigating the VA. He submitted his initial claim about a year ago, but still lacks regular treatment for the disorder. Continue reading “Veterans’ PTSD options are lacking”

Obama budget: Jail before drug treatment

The Obama administration budget released Wednesday emphasizes drug abuse punishment and interdiction over treatment and prevention, despite recent rhetoric from the Office of National Drug Control Policy on a “21st century” approach, reports Huffington Post

“The White House budget proposal for fiscal 2014 devotes 58 percent of drug-control spending to punishment and interdiction, compared with 42 percent to treatment and prevention. The drug control spending ratio in this year’s budget is even more lopsided, 62 percent to 38 percent.

“The administration deserves some credit for moving this ratio slightly in the right direction over the years, but a drug control budget that increases funding for the DEA and the Bureau of Prisons is simply not the kind of strategy we need in the 21st century,” said Marijuana Majority spokesman Tom Angell. “At a time when a majority of Americans support legalizing marijuana, and states are moving to end prohibition, this president should be spending less of our money paying narcs to send people to prison, not more. If, as administration officials say, ‘We can’t arrest our way out of the drug problem,’ then why are they continuing to devote so many resources to arresting people for drug problems?” Continue reading “Obama budget: Jail before drug treatment”

Treatment rather than jail for addiction

It’s widely acknowledged that when it come to drug addiction, treatment is more efficient and effective than jail or other punitive measures. Rather than punishing a human being who is already suffering, society should move to more therapeutic and restorative strategies.imgres

Federal judges around the country are teaming up with prosecutors to create special treatment programs for drug-addicted defendants who would otherwise face significant prison time, an effort intended to sidestep drug laws widely seen as inflexible and overly punitive, reports today’s New York Times. Continue reading “Treatment rather than jail for addiction”