House Panel Chair Miller Proposes Tricare Expansion To Fill Mental Care Gap.

The AP (1/30, Freking) reports on House Committee on Veterans Affairs Jeff Miller’s (R-FL) proposal, under which veterans having trouble receiving timely mental healthcare from VA hospitals and clinics would have access to Tricare’s network of psychologists and psychiatrists, a move that “allows veterans to get care closer to home, particularly those who live in rural communities.” Miller “doesn’t have an estimated price tag yet but says that whatever it is, that’s part of the cost of war. … Even a modest increase in spending could make Miller’s proposal a tough sell at a time when Congress is focused on cutting the federal debt and dealing with the threat of [sequestration].”

Related Links:

— “Rep. looks outside VA to fill mental care gap, “Kevin Freking, The Associated Press, January 29, 2013.

After Newtown Shooting, Connecticut Officials Address Systematic Issues In Mental Healthcare.

USA Today (1/29, Stoller) reports, “In the third of four hearings scheduled by a legislative task force formed to prevent gun violence and improve school safety in the wake of December’s Newtown school shooting massacre,” Connecticut’s Mental Health Services Commissioner Patricia Rehmer “said risk assessments of mental-health patients are difficult and cannot be done with complete accuracy.” Jeremy Richman, whose daughter was killed at Sandy Hook, testified along with his wife. They “have started the Avielle Foundation to honor those killed on Dec. 14 and to prevent future violent acts by enhancing mental health care and ‘fostering community.'” Rehmer, “who said she was asked to address gaps in the mental health system, alternatives to outpatient commitment and mental health first aid, said the biggest gaps are for those with private insurance.”

The Wall Street Journal (1/30, A15, De Avila, Subscription Publication) notes the commission doesn’t know whether Newtown shooter Adam Lanza was ever treated for mental illness, and privacy laws suggest that the panel may never know. Testimony from Jennifer Maksel, the mother of a Sandy Hook survivor, explained that getting help from the local schools and hospital is hard when it comes to her son, who she said had Asperger’s Syndrome, attention deficit-hyperactivity disorder, and oppositional defiant disorder.

Related Links:

— “Mental health experts talk about systemic issues, “Gary Stoller, USA Today, January 29, 2013.

Study Says “Coming Out” Has Health Benefits.

The New York Daily News (1/29, Miller) reported that according to a new study by Canadian researchers published in Psychosomatic Medicine, gays, lesbians and bisexuals who come out about their sexuality are “less anxious, depressed and burnt out than their closeted counterparts, or even than heterosexual people of similar age.” The study examined “87 men and women of varying sexual orientations, all of whom were around 25 years old,” and found that the out participants “had lower stress hormone levels and fewer symptoms of depression than those who weren’t public about their sexuality. Out gay and bisexual men also had lower stress and depressive symptoms than heterosexual men.” The study concluded that the constant stress of hiding one’s sexuality “can cause the hormone cortisol to spike, creating inflammation in the body – which in turn has been linked to increased risk of heart disease, diabetes and other chronic illness.”

NBC News (1/30, Alexander) in its “Vitals” blog reports the study’s finding “could help explain a remarkable study published last year by a group of researchers from Columbia University in the American Journal of Public Health. They found that after Massachusetts enacted its same-sex marriage law in 2003, there was a significant drop in medical and mental health care visits – and therefore costs – incurred by gay men.” The lead author of the study by McGill University and University of Montreal researchers, Robert-Paul Juster, said, “It seems to be that if you’re using more avoidance coping, and wishful thinking, then you get poorer health. If you aren’t dealing with the problem, it affects health in a negative way.”

Related Links:

— “Coming out is good for your health: Lesbians, gays, bisexuals less stressed than closeted and some hetero counterparts: study, “Tracy Miller, New York Daily News, January 29, 2013.

Some Mental Health Professionals Uneasy With Maryland Gun-Policy Proposal.

The Baltimore Sun (1/29, Rector) reports that as “law enforcement officials and politicians push new gun control measures, mental health providers say they feel caught in the middle and warn that some proposals would endanger their relationships with patients.” The Maryland General Assembly is presently, considering legislation, based on the state “task force’s work, to require mental health professionals to report patients who make verbal or physical threats of suicide or serious violence” and to allow law enforcement to use such “information to investigate and potentially seize” guns owned by the patients. But Dr. Paul Appelbaum, “past president of the American Psychiatric Association, said such efforts strip away the discretion of psychiatrists and other mental health professionals to decide the best course of action after hearing a troubling statement from a patient.”

Related Links:

— “Psychiatrists, mental health advocates uneasy with gun policy prescriptions, “Kevin Rector, The Baltimore Sun, January 28, 2013.

Childhood Adversity May Increase Comorbidity Risk In BD Patients.

Medwire (1/29, Davenport) reports, “Childhood adversity, including verbal, physical, or sexual abuse, is associated with the later development of multiple medical comorbidities in patients with bipolar disorder,” according to a study published online Jan. 18 in the Journal of Affective Disorders. The researchers from the Bipolar Collaborative Network in Bethesda, Maryland, administered questionnaires related to all types of childhood abuse, parental history of substance abuse or mood disorders, and suicidality to 904 individuals with bipolar disorder. They determined that the “most common medical conditions were allergies, migraine, headache, and head injury, which were found in 22.0%-37.2% of patients.” The results also indicated that the “prevalence of 16 medical conditions was significantly increased with increasing tCAS score, and included allergies, arthritis, asthma, chronic fatigue syndrome, chronic menstrual irregularities, fibromyalgia, head injury without loss of consciousness, hypertension, hypotension, irritable bowel syndrome and migraine headache.”

Related Links:

— “Childhood adversity raises comorbidity risk in bipolar disorder,”Liam Davenport, Medwire News, January 29, 2013.

President Obama Concerned About NCAA Football Players’ Mental Health.

Multiple sources reported on President Obama’s interview with the New Republic, where he expressed concern over the mental health of the nation’s collegiate football players in light of similar concerns being addressed by the NFL. The President expressed that, if he had a son, it would be a difficult choice to let him play football, in light of the recent evidence that a large amount of players are experiencing brain injuries as a result of the repeated collisions they endure.

USA Today (1/27, Lopresti) reports, “The president of the United States is worried about the most pressing college football issue of our time…The carnage of concussions has Barack Obama’s attention, as it should everyone.” According to USA Today, “You play the game long enough, get hit in the head hard enough, have that happen enough times, and you might not even recognize yourself one day,” due to chronic traumatic encephalopathy, or CTE, as a result of repeated blows to the head. USA Today finishes the piece by calling on the NCAA to act, saying, “Nobody should let bureaucratic malaise get in the way on this one. The president means you, NCAA.”

Related Links:

— “Concussions in football: The president is watching, “Mike Lopresti,USA Today Sports, January 27, 2013.

Experts Warn US Senators About Gaps In Children’s Mental Healthcare.

Reuters (1/26, Morgan) reported that last week, experts warned US lawmakers about the gaps in the mental health system that have prevented many kids from getting treatment that could prevent tragedies later in life. In written testimony to the Senate Health, Education, Labor and Pensions Committee, Michael Hogan, head of the President’s New Freedom Commission on Mental Health, said, “We see the results of insufficient mental healthcare in school failure and suicide.” Hogan remarked, “while the gaps in children’s mental healthcare are huge, there is also reason for hope,” adding that this is in part “because we know more about what works, and what doesn’t.” Hogan was scheduled to appear at the Senate committee’s hearing, which was prompted by the shootings at Newtown’s Sandy Hook Elementary School.

Related Links:

— “U.S. mental health experts urge focus on childhood screening,”David Morgan, Reuters, January 25, 2013.

Physicians Urged To Screen Active Military Members For Depression.

American Medical News (1/28, Fiegl) reports that “suicides by active U.S. service members exceeded the number of combat deaths in 2012, and the rate of suicide among military members has been on the rise.” The article adds, American Medical Association President Jeremy A. Lazarus, MD, a psychiatrist in Denver, said that “physicians should educate themselves and have information about mild brain injuries, postcombat depression and PTSD.” According to American Medical News, “about half of active military members and veterans with illness related to their service will seek care from a physician in private practice,” and Lazarus “said physicians should be prepared to ask questions and screen these patients for depression and anxiety.”

Related Links:

— “Doctors warned on combat link to military suicide risk,”Charles Fiegl, Amednews, January 28, 2013.

Alzheimer’s Groups Push For Brain Imaging To Be Covered By Medicare, Insurers.

Bloomberg News (1/28, Cortez) reports the Alzheimer’s Association and the Society of Nuclear Medicine and Molecular Imaging advocate that “advanced imaging that detects plaque in the brain should be covered by Medicare and private insurers for select people with dementia to help diagnose or rule out Alzheimer’s disease.” The recommendations “are the first to help govern the burgeoning field of brain imaging and may increase the use of the practice to improve care for the 5 million Americans affected with Alzheimer’s.” The article notes that “amyloid plaque is a hallmark of Alzheimer’s disease,” but not everyone who has it also is afflicted with Alzheimer’s. “PET scans require a drug injected into patients to highlight the plaque for doctors.” Eli Lilly’s Amyvid (florbetapir F 18 injection) is the “only compound currently approved for use with PET scans for this purpose,” and it is currently not covered by Medicare. The cost of the scans can vary from $1,000 to $3,000.

Related Links:

— “Insurers Urged to Cover Brain Imaging for Alzheimer’s, “Michelle Fay Cortez, Bloomberg, January 28, 2013.

Report: AD/HD Medication-Related Emergency Room Visits Up Sharply.

The Los Angeles Times (1/25, Healy) reported in its “Booster Shots” health blog that a study found that between 2005 and 2010, “ADHD medication-related emergency room visits have more than doubled – from 13,379 in 2005 to 31,244 in 2010,” with the increase being “particularly pronounced in those over 18.” The data was “reported Thursday in an issue of the DAWN (Drug Abuse Warning Network) Report, published by the Substance Abuse and Mental Health Services Administration, an office of the National Institutes of Health.” About half of the “stimulant-related emergency department visits –15,585 in 2010 – were for ‘non-medical’ use of ADHD medication: They were to treat stimulant-related effects in patients who either had not been diagnosed with ADHD and prescribed the drugs or in patients who were not taking the medication as prescribed.”

Related Links:

— “Emergency room visits for ADHD medications rise sharply, report says, “Melissa Healy, Los Angeles Times, January 25, 2013.