Medicaid Changes Could Cripple Community Mental Health

Just received this email alert from the Bazelon Center for Mental Health Law.

Comments Needed on Revised Medicaid Rules
Changes Could Cripple Community Mental Health

August 20, 2007--Changes in the rules proposed by the Centers for Medicare and Medicaid (CMS) to govern Medicaid’s rehabilitation service category could restrict access to intensive community mental health services needed by children and adults with disabilities who rely on Medicaid for their healthcare. (See the Bazelon Center’s August 16th Information Alert.) The proposed regulations were published in the Federal Register on August 13, 2007 (Vol. 72, No. 155, 45201-45213).

As the single most significant source of financing for the public mental health system, Medicaid provides needed access to community-based care through the rehabilitative services option to help children and adults avoid institutionalization. The new rules could also have a profound effect on Medicaid services needed by other vulnerable populations, including people with physical and developmental disabilities.
Stakeholders’ Comments Can Make a Difference

If final regulations as later promulgated include many of the proposed changes, they will have a devastating affect on the availability of vital services, potentially crippling the community mental health service delivery system. A high volume of comments is often influential, so it is vital that CMS hear from large numbers of consumers, advocates, providers and other stakeholders about the threats posed by the proposed rules.
What You Can Do
Send your comments to CMS by the October 12, 2007 deadline. This is a critical opportunity to call upon CMS to make changes in a number of key areas and to influence the final rules. All public comments will be considered.

See sample comments and details on how to submit yours in the full text of this Action Alert at http://www.bazelon.org/takeaction/2007/RehabRules9-20-07.htm.

If It's Not Broken (Op Ed)

If it's not broken, - Viewpoint

Came across this, it's from an Illinois State University student newspaper. It rankled me. You would think college journalists would be a little less "simplistic". Someone who didn't give a shit had a deadline to meet.

How Best to Treat Preschoolers With ADHD?

How Best to Treat Preschoolers With ADHD? The Harvard Mental Health Letter Discusses the Options

Preschoolers? 3 to 5 years old, being diagnosed with ADHD, and treated with Ritalin? How do they get an accurate diagnosis on a 3 year old? And is anyone else scared to death with the thought of prescribing psych medications to a 3 year old?

Ripped From The Headlines

Another visit to the wonderful world of psych headlines.

Pregnancy and Birth Spur Anxiety Dreams in Mom
What? Giving birth could be a cause of anxiety?

PETA Calls for Ban on Owning Animals, Psychiatric Intervention if Alleged Animal Abusers, Killers Are Convicted
Psychiatric intervention? PETA members are LONG overdue for their own "psychiatric intervention".

Children stressed about starting school
Ya think?

Tropical Depression Moving Away From Fla.
I would imagine moving from Florida to, say, North Dakota might cure "tropical depression". (Rimshot!)

Cannibal suspect in psychiatric care
"A census taker once tried to test me. I ate his liver with some fava beans and a nice chianti."

Psychological Torture and the Bush Administration
Oh, this headline provides an endless source of material. Suffice it to say that the Bush administration is "psychological torture" to ALL of us.

And the award for the most inane headline of the day goes to...
Late-Night Teen Cell Phone Use a Threat to Sleep

Joey's Triumph Over Bipolar Disorder Is Remarkable: Psychiatrist

Joey's triumph over bipolar disorder is remarkable: psychiatrist

A little background here.

Andrew "Joey" Johns is a rugby legend in Australia, one of the best to ever play the game, and a national hero in that country. On a recent trip to Europe, they lost his luggage containing his medication, and he went 6 days without it. This, understandably, sent him into a mania, resulting in an alcohol binge, and arrest for drug possession.

But the reason for this post, is a quote by his psychiatrist:

Andrew Johns' psychiatrist says he has been astounded at his ability to perform while suffering bipolar disorder and taking drugs to treat the condition...

..."I think when the story comes out that Andrew did these things with the bipolar condition – was able to reach the height of sporting success and was able to do it on medication - I think that’s a very positive aspect" he said.

Now this pisses me off. I have NEVER felt there was something I couldn't do because of bipolar disorder. I watch for triggers and try to be cognizant of potential problems, but I have never felt limited by this condition. If it's important to me, I'll figure out a way to accomplish it. Period.

Discussion:

1. Do people out there feel limited by this condition?
2. If limited, is it a factor of the disorder itself? Or of the meds used to treat the disorder?
3. Is this post a function of my current hypomanic / potentially manic frame of mind? Will I feel the same way after I crash?

Schering-Plough Defends Suits Over Marketing of 'Off-Label' Drug Uses

Schering-Plough Defends Suits Over Marketing of 'Off-Label' Drug Uses

While this particular suit is not targeting psychiatric medications, their aggressive sales staff is offering cash kickbacks for off-label drug prescriptions. This has become an epidemic in the industry.

Why am I not surprised?

New Orleans Mental Health Crisis

I really had no idea it was this bad...

New Orleans Suffers Crisis in Mental Health Care

It's a lengthy NPR audio piece, and prepare to be disturbed.

I should expect this by now, especially in post-Katrina New Orleans. But it's still enough to bring tears to your eyes.

New Orleans has gone from 240 mental health beds to 30. 240 beds was not enough pre-Katrina, as they were fully used and rarely had openings. Patients being brought in by emergency workers are met with open hostility by ER personnel, and are often turned away before being seen. One story involved being turned away by an angry doctor before even getting on the ramp at the ER.

This is a story that needs to be heard by all with even a passing interest in mental health issues.

Church response to the mentally ill

An excellent article I found via Liz Spikol's blog.

Church response to the mentally ill

By Peter Andres

Are people of faith with a mental illness different from those who have a physical illness? Much about mental illness still remains a mystery. That's one of the reasons people are tempted to spiritualize the problem. They hope that the person with mental illness would be able to gain spiritual strength and thus gain victory over the illness.

What remains hard for many to understand is that having a mental illness and being a strong person of faith is no different than having a serious physical illness and being a strong person of faith.

How can church leaders encourage support of people with a mental illness? What does a person with a mental illness need to help him or her feel accepted and part of the congregation? How does the Christian message and experience take on meaning under these circumstances? What exactly is mental illness, anyway?

Marja Bergen, in her book Riding the Roller Coaster (Northstone, 1999), describes her experiences living with bipolar disorder. She talks about the many important factors that helped make her life with this illness tolerable and manageable. Having a supportive husband, friends, and service systems were critical, but she also acknowledges the importance of a spiritual home.

Her church friends learned to understand her illness and provided spiritual nurture, especially during difficult times. She speaks about friendships which include a common belief as being the most valuable ones she'll have. But she also admits that she was fortunate in this regard.

Sadly, many people with mental illness who look for spiritual help during difficult times face ignorance, stigma, avoidance, and judgment. The spiritual counsel and prayer these people receive frankly do more harm than good.

Understanding mental illness, even from the professional, scientific perspective, is still very much a work in progress. Schizophrenia and its related disorders, bipolar disorder (also known as manic depression), major depression, panic and obsessive-compulsive disorders, are all considered mental illnesses. It is estimated that between 15 percent to 20 percent of North Americans will, at some time in their lives, experience a mental illness. Most of these will suffer debilitating depression.

Evidence suggests there are probably organic (biochemical) reasons for the illness, or psycho-social origins -- or a combination of the two. Treatments that deal with the symptoms include medications, psychotherapy or a blend of both.

What is clear to people working in the field is that the experience of the illness goes far beyond living with the symptoms. While a person who has a physical illness -- even cancer -- suffers discomfort and anxiety related to the illness, those who have a mental illness suffer from a constellation of additional issues. These all affect their ability to return to wellness. One of them is stigma, both internally and externally imposed. There's also the loss of self-worth and self-efficacy that might come with a loss of job, friends, marriage and the feelings of being separated from God.

How can the church assist someone in a situation as devastating as this?

1. Church leaders and church members need to know that a mental illness is not the same as a spiritual crisis. Nor is the absence of healing, especially after fervent prayer, a sign of judgment or lack of faith.

2. There should be no judgment about the use of mood altering medications. Medications are commonly needed to treat the bio-chemical causes for the disorder and radically help many keep their symptoms under control.

3. Quality of life for a person suffering from mental illness does not depend on a complete remission from the illness.

What church members need to know is that many experience a recovery which allows them to return to an active and fulfilling life -- but still continue to experience times that are difficult. Recovery from mental illness means: the return of a positive sense of self, usually through meaningful endeavour (work, vocation), a circle of meaningful relationships, a place to live that the person can call his or her own, and a spiritual life that feels a reconnection with God.

The recovering person can be experiencing personal brokenness and limitations, yet have valuable gifts to offer to the church community.

Peter Andres is a regional director for MCC Supportive Care Services, a non-profit charitable organization which supports people with disabilities -- including people with mental health issues. He can be contacted at peter@mccscs.com.

Psych News Headlines

It's been a while since I've perused the world of Psych headlines, and I needed a good laugh today. So here we go...

Facial Expressions May Confuse

A new Northwestern University study of electrical activity in the brain supports this ibelief confirming that deciphering the facial expressions of a person who is trying to conceal fear or other emotions is tricky business.

Ah yes, a well funded study that confirms what every married man knows - when you think you've read her correctly, you're usually wrong.


Breast Implants and Suicide

A recent study suggests the risk of suicide is tripled for women who have undergone cosmetic breast implant surgery.

C'mon - is this trying to tell us that implants really aren't the key to true happiness?


A Mouth Full Of Stress

Experts in the field of periodontology have discovered a strong association between stress and poor oral health.

Smile, and show those pearly whites!


How Women Perceive Men
Do we REALLY want to know?


Hostility Puts Men's Hearts at Risk

Ten years of frequent hostility and depression may harm men's immune systems and put them at risk for heart disease, a U.S. study found.

So it's not a stereotype, the high-strung, hostile men really are at higher risk for heart attack? How much did this study cost?

This Is A Health Central Top Site!

I'm stoked right now. I received a Top Site award from The Health Central Network. The Health Central Network is one of the world's premier health information web destinations. I've been writing for them for over a year, but had no clue this was coming, or that they even knew of my personal blog. From their site:

Bipolar Top Sites
Below are the web’s very best sites dedicated to bipolar disorder and depression as determined by our team of experts. These sites include small websites and individual blogs and were chosen based on their candid and informative content.  In giving these awards, we hope to recognize the individuals and organizations who share our vision in providing comprehensive, interactive and personal healthcare advice.  HealthCentral.com would like to congratulate our 2007 winners and sincerely thank them for producing high-quality, influential sites in the Bipolar and Depression community!

The Trouble with Spikol
Liz Spikol, managing editor and columnist for the Philadelphia Inquirer, has translated her award-winning column into a blog humorously highlighting everything from struggling with mental illness to how to use a mop.

Dr. Deb
Dr. Deb posts fresh, interesting, and current issues and articles that impact the human psyche.  

McMan's Depression and Bipolar Web
Health Central expert John McManamy devotes McMan's Bipolar Web to helping intelligently manage depression and bipolar disorder.

Wing of Madness
A current and informative Web site and news blog on mental health topics by site creator and HealthCentral Depression Expert Deborah Gray.

Bipolar World
Providing a friendly, interactive environment for members to obtain information, news and support.

Depression Fallout
Anne Sheffield's wisdom, support and compassion helps spread her vision of knowledge as power.

PsychEducation.org
Dedicated primarily to Bipolar II, PsychEducation.org provides, "quality education on topics where information on the Internet is scattered or non-existent".

Mood Garden
Secure, interactive community providing "Information, Support and Fun" 

Living with a Purple Dog
Patient Expert G.J. Gregory's site covers everything from living with bipolar disorder and raising a bipolar son to musing on current events, music, technology and pop culture.

Nassir Ghaemi
Psychiatrist and writer Nassir Ghaemi's blog is a mix of literary exerpts and current news commentaries written from a philosophical, psychiatric, and mental health perspective.

Slippery Slope

I know this isn’t uncommon, but unfortunately we often don’t pay attention until it happens in our backyard.

Omaha psychiatrist attacked at Lincoln Regional Center dies

Dr. Louis Martin spent the last 18 years examining the minds of the criminally insane.

Thursday, he died from the severe brain injuries that authorities say he suffered at the hands of one of those patients.

Dr. Y. Scott Moore, a fellow clinical director at the regional center, said Martin was tirelessly dedicated to his patients...

"He was very concerned for his patients," Moore said. "He leaned over backwards to make sure he had made an honest evaluation of a patient.

"He was extremely careful — and very empathetic with his patients. This was his life."

Ultimately, it was his death, too.

Eric F. Lewis, 35, had been charged with first-degree assault in the attack on Martin. Lewis, one of Martin's patients at the regional center, had made several vows that he would not be force-fed medication for paranoid schizophrenia.

After Martin testified at a hearing two weeks ago, a Douglas County district judge ordered that Lewis be forcibly medicated so he could regain his competency to stand trial on charges that he sexually assaulted two Omaha women.

Upon his return to the regional center, Lewis wrote an 11-page letter saying he wouldn't take his medicine.

The morning of July 22, a State Patrol investigator said, Lewis then piled his belongings at the front door — and ambushed Martin as he walked inside.

It was an attack that regional center officials say they couldn't have predicted or prevented — despite a history of threats and assaults by Lewis. That history included two assaults on patients at the regional center and a third assault in which he is alleged to have jumped and attacked a Douglas County inmate.

Society has the right to not fear an attack by a person with a history of schizophrenia, who has exhibited violent behavior in the past. But the person suffering from schizophrenia has the right not to be forced into a medicated state against his will. Where on this slippery slope do you draw the line? Or do you?

Cannabis Use Increases Risk Of Psychotic Illness?

Cannabis use increases risk of psychotic illness - 27 July 2007 - New Scientist

I'm not sure what to think of this. My first thought was "Duh! - they smoke BECAUSE of the mental condition", but they cover this in the study. I guess I wouldn't be surprised if there was a worsening of a condition due to heavy marijuana usage. And if it was proven that heavy marijuana use actually CAUSED a mood disorder I wouldn't be too surprised. But there's too many axes to grind where illegal drug studies are concerned. Too much grant money to prove things one way or the other. But it does get a person thinking.

Night Owl Behavior Harmful to Preteens

Night Owl Behavior Harmful to Preteens - Psych Central News

An interesting article. I have 5 children, and have seen this behavior in some of them. Kyle was the worst about going to bed. When Kyle was a pre-teen my wife worked nights. I made sure I put him to bed every night, but when my wife got home at 2:00 AM, Kyle was waiting up for her, fully awake, every night. I don't know if this was a contributer to, or a result of, his bipolar disorder.

I now see this behavior in my oldest daughter, now 12. I don't think she has bipolar disorder, she's entirely different from Kyle at that age, but these sleep patterns still bother me.

Damn War

My 19 year old son’s best friend joined the Air Force right out of high school. He was promised a mechanic’s slot, which is his career goal. He made a choice between trade school and the service, feeling the education he got in the service would be superior to trade school. The sonsabitches yanked his mechanic job and made him an MP. He just got orders – while he can’t officially acknowledge it, he’ll be accompanying truck convoys from Kuwait to Iraq.

Fuckers.

Antidepressants Not A Suicide Risk?

Antidepressants Not A Suicide Risk - Psych Central News

We hear people scream about the dangers of SSRI's, then this. So which is it?

Death Penalty for Schizophrenic Murderer Blocked

Death Penalty for Delusional Murderer Blocked - New York Times

HOUSTON, June 28 — Enforcing its edict against execution of the insane, a split United States Supreme Court today overturned the death sentence of a delusional Texas murderer who insisted he was being punished for preaching the gospel.

In a sharp rebuke to lower courts, the justices ruled 5 to 4 that the defendant, Scott Louis Panetti, was not shown to possess sufficient understanding of why he was to be put to death for gunning down his wife’s parents in 1992...

In a harsh dissent, Justice Clarence Thomas called the ruling "a half-baked holding that leaves the details of the insanity standard for the District Court to work out." He was joined in the minority by Chief Justice John G. Roberts Jr. and Justices Antonin Scalia, and Samuel A. Alito Jr...

In an interview with The New York Times last November, Mr. Panetti, clutching verses from scripture, declared, "The devil has been trying to rub me out to keep me from preaching." Until restrained by a guard, he started to strip off his prison uniform to show scars from burns he said were inflicted by demons and healed by President John F. Kennedy with coconut milk after the sinking of his torpedo boat in World War II.

Folks, this is scary. Even for Texas it's obvious this guy shouldn't be executed. Look at the vote - a 5 to 4 vote with the dissents coming entirely from the conservative side.

We often don't fully realize the long-term impact a president can have. The nominations of radically conservative justices almost allowed this man to die. It would have been a criminal act, and as Americans in our system we would all have been complicit in his death.

Get active. Be an advocate. Demand compassion and tolerance in our elected officials and their appointees. As individuals we CAN make a difference.

The Right Stuff

I don't usually get political, but couldn't resist this. This next generation seems to have the "Right Stuff".

From the Omaha World Herald:

When a group of the country's brightest young people visited the White House this week, President Bush talked about how important it is to make hard choices, to step up and lead.

The young scholars couldn't have agreed more.

One stepped right up and handed the president a folded piece of paper.

It was a handwritten letter signed by 50 of the scholars, urging the president to stop human rights violations relating to detainees such as those held at Guantánamo Bay.

"If nothing else, it was an opportunity to show the president that we had taken to heart what he said about conviction and making the tough decisions," said one of the presidential scholars who signed the letter.

From MSNBC:

The handwritten letter said the students "believe we have a responsibility to voice our convictions."

"We do not want America to represent torture. We urge you to do all in your power to stop violations of the human rights of detainees, to cease illegal renditions, and to apply the Geneva Convention to all detainees, including those designated enemy combatants," the letter said.

CBS Ad

Was halfway watching the TV show "Without A Trace" tonight, and an ad came on about Bipolar Disorder. Mark Harmon is doing a public service announcement for cbs_cares.com and says it takes an average of 10 years to diagnosis bipolar disorder. He says that's 10 years of needless suffering.

Here's a link:
http://www.cbs.com/cbs_cares/depression/bipolar.shtml

A tasteful ad, I was glad to see it.

In The News

I don’t like to get political on this blog, but today's headlines are just too inviting. I’m not going to publish a stance one way or another, but I may comment:

Obama’s My Space Controversy

US Soldiers Can’t Blog or Email Without Approval
"Mother Hen, this is the rooster. I am in the sandbox. I repeat..."

Joan Baez Banned By Walter Reed Hospital
Who says the public has a short memory?

FDA Seeks Anti Depressant Warning
We’ve known it was coming…

Vatican Calls Comedian's Verbal Attack On Pope 'Terrorism'
This Italian comedian will REALLY be heckled.

Rally Ends With Clash Between Marchers, Police

"There is evidence that officers knocked reporters to the ground, used batons on photographers and damaged cameras, possibly motivated by anger over journalists photographing efforts by officers to control the movements of marchers," an RTNA (Radio and Television News Association of Southern California) statement said.

And video.

HD-DVD Key Posted - Digg Readers in Full Riot Over Pulled Story

"Digg deleted my hard drive for posting the HD-DVD KEY! Now my hard drive refuses to write in binary. I get Error Code: 09-F9-11-02-9D-74-E3-5B-D8-41-56-C5-63-56-88-C0 . Oh, noz."

The Marketing of 'Wristcutters: A Love Story'

From Mental Health America, via Liz Spikol's blog.

Dear friends,

We need your help. AfterDark Films plans to release a Lionsgate Entertainment movie this summer called Wristcutters: A Love Story. The film premiered at the Sundance Film Festival last year to some acclaim. Mental Health America and its national partners have not yet been able to view the film and cannot yet share any detail on the content.

This month, however, AfterDark will launch an alarming “shock and awe” advertising campaign featuring cutouts of the movie characters in the states in which they kill themselves (e.g., jumping off bridges and electrocuting and hanging themselves). These signs will hang from telephone poles and trees in communities nationwide.

Interestingly enough, recent outrage around the advertising campaign of another one of the companies’ films, Captivity, forced AfterDark to remove billboards that showed graphic images of women, being kidnapped, confined, tortured and killed.

Go to The Trouble With Spikol for information on how you can contact AfterDark and try to stop this highly offensive Wristcutters' marketing blitz.