Primary Care Practices Integrating Mental Healthcare.

The Wall Street Journal (9/25, A4, Beck, Subscription Publication) reports on a movement integrating mental healthcare into primary care practices. This movement is occurring as the US healthcare professionals anticipate seeing many more patients under the Affordable Care Act and its resulting mental health parity. At the same time, providing patients with psychiatric care in the primary care setting would be one way of addressing a US-wide shortage of psychiatrists. Finally, many physical and psychiatric conditions are linked, such as depression and anxiety in patients with heart disease or diabetes, and it makes sense to treat both conditions together. According to the Journal, the American Psychiatric Association has endorsed the integrated care concept.

Related Links:

— “Getting Mental-Health Care at the Doctor’s Office, “Melinda Beck, The Wall Street Journal, September 24, 2013.

Columnist: Stigma Surrounds Mental Illness Among Black Men.

In his column in the Washington Post (9/25), Courtland Milloy observes that misdiagnosis of “mental illness among black men has long been an acute problem – with consequences that extend beyond the Navy Yard killings to the daily gun violence throughout urban America.” Milloy quotes William Lawson, who chairs the psychiatry department at the Howard University College of Medicine. Lawson said that not only do African American males have less access to mental health treatment, but they are also “much more likely to be viewed as having a behavioral problem rather than a mental disorder.” Milloy concludes, “There is such a stigma around mental illness that black males themselves would rather be seen as ‘bad instead of mad,’ as Lawson puts it.” The end result is that more black males may end up incarcerated instead of getting needed treatment.

Related Links:

— “Navy Yard shooting underscores how mental illness can be misdiagnosed among black men, “Courtland Milloy, The Washington Post, September 24, 2013.

Lieberman: Navy Yard Shootings Reflect Failing Of US Mental Health System.

NBC Nightly News reported, “The mass shooting at the Washington Navy Yard is drawing new attention to the role of” the mental “health system in trying to prevent such violence.” Jeffrey Lieberman, MD, president of the American Psychiatric Association, said of Navy Yard shooter Aaron Alexis, “If mental healthcare was provided in the routine systematic way that general medical care was, ideally we would have expected that he would have been identified, diagnosed and offered treatment much earlier.” Chief medical editor Nancy Snyderman, MD, said, “While most people with mental illness never turn to violence, mental health advocates say that half or more of those responsible for mass shootings in recent years have suffered from a serious mental illness.”

The Rutland (VT) Herald (9/22, Freedman) quoted Dr. Lieberman, who said, “Historically, the US mental health care system is limited and badly fragmented.” He added, “As result of people lacking access to mental health care, not knowing what to do if loved ones are affected, not having insurance coverage for it, many go untreated.” According to Lieberman, “predicting which mental patient will be violent is less important that expanding treatment so that those with violent tendencies who fly under the radar get the help they need.”

Related Links:

— “Navy Yard tragedy spurs debate on mental health, “Dan Freedman, The Rutland Herald , September 22, 2013.

Editorial: Affordable Care Act Patches Some Holes In Mental-Health System

The Seattle Times (9/22) says in an editorial that a combination of Medicaid expansion and mental health parity in the ACA “has the potential to be revolutionary. For the first time, destitute childless adults, typically not eligible for Medicaid, will become eligible. Seattle’s Downtown Emergency Services Center alone has 27 staff ready to sign up homeless clients for health-care insurance.” It adds, “Imagine the savings – for businesses, for the criminal-justice system, for human potential – of true preventive mental-health care.”

Related Links:

— “Editorial: Affordable Care Act patches some holes in mental-health system, The Seattle Times, September 21, 2013.

ACA Will Require Parity Coverage For Mental Health.

The Louisville (KY) Courier-Journal (9/23, Kenning, Ungar) reports that across the US, “access to insurance and limits on services, therapy visits and hospital stays have left those with mental illness feeling treated like second-class citizens in a health system built to handle physical ailments, according to patients, providers and advocates.” Now, however, under the Affordable Care Act, health “insurers will soon be required to give mental illness coverage equal to that for physical ailments.” Beginning in 2014, “the ACA calls for one of the largest expansions of mental health and substance abuse coverage in a generation, requiring that all new small-group and individual market plans offer mental health services and cover them at a par with medical benefits.”

Related Links:

— “Obamacare pushes for parity in mental health coverage, “Chris Kenning, The Louisville Courier-Journal, September 22, 2013.

Kids Victimized By Racism May Have Poor Mental Health, Depression.

HealthDay (9/23, Preidt) reports that research published in Social Science & Medicine suggests that children and teens who have been victimized by racism may have “poor mental health, depression and anxiety.” Researchers came to this conclusion after studying “461 cases of links between racism and the health and well-being of youngsters.”

Related Links:

— “Racism Takes a Toll on Kids’ Mental Health, Research Shows, “Robert Preidt, HealthDay, September 23, 2013.

Mental Health Bill Gaining Support.

Modern Healthcare (9/19, Zigmond, Subscription Publication) reports that the Excellence in Mental Health Act, introduced in February by Sens. Debbie Stabenow (D-MI) and Roy Blunt (R-MO), “now has the support of 19 other senators and more than 50 mental health, veterans and law enforcement organizations, such as the American Psychiatric Association, the National Sheriffs Association, the National Council for Behavioral Healthcare, the National Association of Psychiatric Health Systems, and Iraq and Afghanistan Veterans of America.” Among its provisions, the measure “would establish criteria for federally qualified community behavioral health centers based on evidence-based quality standards and reporting measures to make sure that those facilities cover a broad range of outpatient and crisis services.”

Related Links:

— “In wake of Navy Yard tragedy, advocates push for improved mental health services, Modern Healthcare, September 19, 2013.

Mental Health Legislation Not Expected To Pass.

The Atlantic Wire (9/20, Jones) provides an overview of mental health legislation currently pending in Congress. Bills that would train teachers to recognize and deal with mental illness, provide more services and care for the mentally ill, and provide mental health background checks for would-be gun purchasers are not expected to pass because “there is little momentum to fix the system.”

Related Links:

— “Three Things Congress Could Actually Do About Mental Health, “Allie Jones, The Atlantic Wire, September 19, 2013.

Murphy To Introduce Bill Boosting Mental Health Treatment Options.

CQ (9/20, Attias, Subscription Publication) reports that yesterday, Rep. Tim Murphy (R-PA), chairman of the Energy and Commerce Oversight Subcommittee, announced “he will be introducing legislation soon to boost treatment options and address other challenges, saying that Monday’s deadly shooting” at the Washington Navy Yard “again ‘raised the issues of how we are handling mental health to stop this terrible violence.’” Murphy’s proposal, which is “expected to be introduced in a couple of weeks, appears to offer a different approach to mental health than the legislation (S 689) that was approved by the Senate Health, Education, Labor and Pensions Committee and incorporated into a gun control package (S 649) by a vote of 95-2.” Murphy “said his bill will increase the options available for individuals who need inpatient and outpatient treatment.”

Childhood Cancer Survivors May Be More Likely To Be Treated For Later Mental Health Disorder.

Reuters (9/20, Raven) reports that research published in The Lancet Oncology suggests that individuals who had cancer when they were children may have a higher likelihood of being treated for a mental health disorder later on. The study included more than 7,000 individuals who had been treated for cancer as children.

Related Links:

— “Mental disorder treatment common after childhood cancer, “Kathleen Raven, Reuters, September 19, 2013.