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Mental Health Medications Used for Adolescents The National Juvenile Defender Center has published on its web site a chart of medications commonly used to treat mental health disorders in children and adolescents. The information here includes type of medication, generic name, approved age, what it is intended to treat, and common side effects. A good bit of information to have at hand. ++++++++++ School Based Mental Health Education Program The Tarrant County Texas MHA is developing a mental health education curriculum based on a public health model and fully integrated into the general school curriculum. The curriculum is being piloted in six schools in the county. It is designed to supplement traditional classroom materials, rather than being taught separately. Click above to read an interview with the project’s leader. +++++++++ Oklahoma’s Task Force on Mental Health, Substance Abuse and Domestic Violence A blue-ribbon panel convened by Oklahoma’s governor and attorney general has put on paper what advocates have been telling policymakers for years: investing in addiction, mental health, and domestic violence services can save taxpayers billions of dollars a year. The report makes five key recommendations: Making prevention, early intervention, treatment, and recovery-support services available to those in need. Identifying people in the criminal justice system with addictions and major mental illnesses soon after their entry, with referrals to more cost effective programs to treat, monitor, rehabilitate, and supervise these populations. Establishing minimum state standards for mandatory training of addiction, mental health, and domestic violence service providers. Further study of the needs of offenders and others in custody that need addiction and mental health services, as well as improved data collection on sexual assault.
The reported noted that addiction, mental health, and domestic violence account for half of all state expenditures on criminal justice, and 11% of health care costs. Click here to read this 31 page report. ++++++++++ GAO Report: Special Education – Children with Autism This newly released report from the Government Accounting Office finds: - The number of children diagnosed with autism served under IDEA (Individuals with Disabilities Education Act) has increased by more than 500 percent in the past decade.
- It is estimated than more than 1.5 million Americans live with some form of autism, including more than 100,000 children served under IDEA.
- Intervention at an early age is a key feature of successful approaches to educating children with autism.
- Characteristics of ASD (Autism Spectrum Disorders) are generally present by age 3 and include deficits in social interaction, deficits in verbal and nonverbal communication, and repetitive behaviors or interests. Often children with ASD have unusual responses to sensory stimulation.
This is an unusually readable GAO report. 38 page pdf file. ++++++++++ A Map of My Mind On the Youth Radio web site a teen describes the onset of bi-polar disorder in her freshman year of high school, the mood swings, hyper behavior and dark moods, and her decision to go on anti-depressants and mood stabilizers. This is a short, single page essay that introduces the reader to an unfamiliar mental landscape. ++++++++++ National Center for PTSD This web site offers all sorts of information and assistance dealing with the variety of ways in which PTSD manifests. Here is a fact sheet on PTSD in Children and Adolescents. It states that studies indicate that 15 to 43% of girls and 14 to 43% of boys have experienced at least one traumatic event in their lifetime. ++++++++++ Rural Mental Health Links SAMHSA’s National Mental Health Information Center includes this site with information for rural communities on mental health services, resources, and research pertinent to their needs. ++++++++++ Washington State’s Family Integrated Transitions program for Juvenile Offenders: Outcome Evaluation and Benefit-Cost Analysis. WSIPP evaluated the Washington State FIT program and found: - FIT reduces recidivism rates – In the FIT program recidivism dropped to 27%. Without FIT 40.6% of offenders were re-convicted for a new felony within 1`8 months of release.
- FIT generates more benefits than costs - FIT is an intensive treatment program that begins in the juvenile institution and continues for four to six months in the community. WSIPP found that FIT achieves $3.15 in benefits per each dollar of program cost.
FIT is based on components from four programs: Multi-Systemic Therapy, Motivational Enhancement Therapy, Relapse Prevention, and Dialectical Behavior Therapy. +++++++++ San Francisco’s Youth Treatment and Education Court (YTEC) (Sometimes this link works. Sometimes it doesn't. If it doesn't, get in touch with me and I'll get you to it.) The court is a community-based juvenile drug court collaborative founded in 1997. YTEC’s model is unique among youth drug courts nationwide. It integrates treatment with education to support court and drug involved youth in addressing their academic, emotional, substance abuse and delinquency issues in the least restrictive environment. To graduate from treatment a participant must, at minimum, achieve six months clean and sober. The court is noted for an outstanding creative arts program too. +++++++++++ Interview with Lisa Boesky on Juveniles and Mental Health The Corrections.com web site has added an interview with Dr. Lisa Boesky about mental health issues among juveniles involved with the justice system to its Archived Programs section. Go to the link above to listen to the interview on your computer. ++++++++++ Support in Congress for Children's Mental Health Needs The American Psychological Association reports on legislation and proposed legislation to ensure that children's mental health has a place in federal legislation and policy. This report provides information on recently enacted legislation and promising bills that will come before Congress in 2005. ++++++++++ NMHA Compendium of Promising Practices in Mental Health Treatment for Youth in the Juvenile Justice System According to the NMHA: - from one-quarter to one-third of incarcerated youth have anxiety or mood disorder diagnoses,
- nearly half of incarcerated girls meet criteria for post-traumatic stress disorder (PTSD), and
- up to 19% of incarcerated youth may be suicidal.
In addition, up to two-thirds of children who have mental illnesses and are involved with the juvenile justice system have co-occurring substance abuse disorders, making their diagnosis and treatment needs more complex. Recidivism rates among those youth who received treatment are as much as 25% lower than the rates of those children and teens in untreated control groups. The best, research-based treatment programs can reduce recidivism rates even more – from 25 to 80%. The compendium reports on best programs, examines special populations in the juvenile justice system – youth with co-occurring disorders, adolescent girls, and youth of color. The report provides descriptions of exemplary service providers that incorporate promising practices and lists measures that are widely used, but have been shown to be ineffective in reducing recidivism or addressing the root causes of juvenile crime. 23 page pdf file. ++++++++++ Mental Health Resource Kit The National Center for Mental Health and Juvenile Justice (NCMHJJ) has prepared a resource kit with information about screening and assessment, treatment, diversion, e-entry and related topics. Each of the topics comes with readings, resource, and reference information. See also Online training opportunities, including Training Curriculum for Working With Girls Involved with the Juvenile Justice System and the GAINS Center's Juvenile Cross Training Curriculum. ++++++++++ The Right Drug – Check your DNA Psychiatrists at the Mayo Clinic have come up with a new way to help people avoid some of the nasty side effects of antidepressants and other drugs. They’re using genetic tests to predict which patients are likely to get headaches, nausea, or experience other problems from medications such as Prozac and Paxil. The tests identify what drugs don’t work and thus help reduce side effects and failure rates. They are the first in a new wave of genetic tools that will transform the way doctors make decisions about treating their patients. ++++++++++ Parents in Va. Relinquish Children to Foster Care to Get Mental Health Services A report commissioned by the Virginia General Assembly says that almost one of every four children in Virginia’s foster care system is there because parents want the child to have mental health treatment. The cost of treating children with schizophrenia, severe depression or bipolar disorder is so high that private insurers and HMOs don’t fully cover it. Parents are often ineligible for Medicaid. But if children are in foster care or special ed programs they can get needed services through the state. The State of Virginia estimates that 62,000 young people suffering from mental illness, behavioral disorders and emotional problems are not being served adequately by the commonwealth. ++++++++++ Report Addresses the Shortage of Qualified Providers to Address Children’s Mental Disorders An Issue Brief published by the National Health Policy Forum examines children’s unmet needs for mental health care and the shortage of mental health providers to meet those needs. The paper introduces what is known about evidence-based care in children’s mental health, the extent to which it is taught and practiced. 18 page pdf file. ++++++++++ The Role of Specialty Mental Health Courts in Meeting the Needs of Juvenile Offenders This document aims to help inform an ongoing debate about the wisdom of specialty courts for youth. Juvenile mental health courts raise many of the same concerns posed by similar adult courts, but have additional concerns because of the nature of the Juvenile Justice system and the young people who are subject to its jurisdiction. This article addresses those concerns. ++++++++++ The Wild Child: Coping with a Bipolar Youth This radio documentary special produced by WFCR in Amherst, Mass. Interviews three young people with bipolar disorder, their parents, doctors, and teachers as they navigate puberty and adolescence with a serious mood disorder. The kids are 17, 15, and 10. The program is an hour in length and can be listened to on line by clicking on a link at the site. It is also available on CD. The site includes a lengthy list of organizations and resources too. I listened to the program and was struck by the courage of these three kids whose lives, and the lives of their families, are difficult, to say the least. ++++++++++ A Death in the Box The most recent New York Times Sunday Magazine (October 31) features a lengthy article on prison housing, or the lack of it, for mentally ill inmates. This article examines the life and prison experience of 21-year-old Jessica Lee Roger, who successfully hung herself in “the box,” an isolation cell, in 2002. The box is the most severe punishment in prison. It is a small barren chamber set apart from the general prison population with a concrete floor, a steel door and no clock. It is particularly difficult for mentally ill inmates to handle. ++++++++++ More Information about the Mentally Ill Offender Treatment and Crime Reduction Act and the Keeping Families Together Act The Mentally Ill Offender Treatment and Crime Reduction Act has passed both the House and the Senate and is expected to be signed into law by President Bush. It would authorize $50 million in federal funding for grants to states that would include programs to divert individuals with serious mental illness from going to jail. The Keeping Families Together Act, still pending in Congress, aims to eliminate the pressure that leads some parents to give up legal custody of their emotionally disturbed children to get them mental health services. More details on both acts along with sidebar information available in this lengthy article from Connect for Kids that includes an interview with Laurel Stine, the director of federal relations with the Bazelon Center for Mental Health Law. ++++++++++ Mentally Ill Offender Treatment and Crime Reduction Act Passes The Mentally Ill Offender Treatment and Crime Reduction Act (S.1194) introduced by Representative Ted Strickland (D-OH) and Senator Mike DeWine (R-OH) was approved unanimously by the Senate after House lawmakers also unanimously approved the bill last week. S-1194 would authorize $50 million in federal funding for grants to states to support pre- and post-booking interventions, including crisis intervention teams and law enforcement training, mental health courts and other court-based approaches, re-entry and transitional programs. The bill establishes one-year planning grants and five-year implementation grants that would require states to increase their share of funding for the program in later grant years. S.1194 will now be sent to the White House, where advocates believe President Bush will sign it into law. (Source: Bazelon Update, email newsletter, 10/12/2004) ++++++++++ Fascination with Fire – Juvenile Arson More than half of all arsons nationwide are committed by children. Each year, youths start more than 70,000 fires, cause at least 300 deaths, 2,000 injuries and more than $300 million in damage, according to the National Fire Data Center. The Scranton Times (Penn.) looks at juvenile arson arrests in the community which are up 42% since 1999. One part of a four part series. ++++++++++ Children’s Mental Health Fact Sheets The Bazelon Center for Mental Health Law offers key facts and statistics on children’s mental health issues in a series of fact sheets. They are available in pdf or html formats. - Facts on Children’s Mental Health
- Facts on Co-Occurring Mental Illness and Substance Abuse Disorders in Children and Adolescents
- Facts on Transitional Services for Youth with Mental Illnesses
- Fast Facts on Insurance Coverage and Access to Service for Children with Serious Mental Health Needs
++++++++++ Community-based Drug Treatment Programs Help Youth Curb Drug Use and Improve Mental Health A RAND study finds that teen probationers enrolled in a drug treatment program that follows a widely used care model were more likely to curb their drug use and have better psychological health than their peers who received other probation services. ++++++++++ Using Outcome Management to Guide practice in the Treatment of Mentally Ill juvenile Offenders: Lessons learned at Project Empower This article came to me via its author, a Brevity subscriber. Project Empower provides intensive outpatient treatment services to serious juvenile offenders and their families through collaborative programming between the Utah State 2nd District Juvenile Court and the local mental health authority. The project’s early stages identified tools that both assess mental health symptoms and provide outcome measures to help guide treatment and programming decisions. The article was published in APPA’s journal, Perspectives. ++++++++++ Adolescents and Anti-depressants Antidepressant Study Seen to Back Expert – A government scientist who concluded last year that most antidepressants are too dangerous for children because of a suicide risk writes that a new study confirms his findings. (NYTimes. Link good through 8/27) Boy’s Murder Case Entangled in Fight Over Antidepressants – Christopher Pittman faces charges of first-degree murder. His defense is that he killed his grandparents in a reaction to the antidepressant Zoloft, a drug he had started taking for depression not long before the slayings. (NYTimes. Link good through 8/30) Combination Treatment Most Effective in Adolescents with Depression – The National Institutes of Health (NIH) says that a combination of medication and psychotherapy is the most effective treatment. ++++++++++ Michigan’s Mental Health Reforms for Young Offenders Reviews the work of the state’s special mental health commission, its conclusions, and looks at what is working in other states. One of the things the commission has done is to look at the shortage of child psychiatrists and to see what can be done to change things. ++++++++++ Assessing the Mental Health Status of Youth in Juvenile Justice Settings A timely and useful new report looks at the use of the Voice DISC-IV in juvenile justice settings and how it was received by youths and their parents as well as the agency/institutional staff who administered it. 8 page pdf file. ++++++++++ Trauma Among Youth in the Juvenile Justice System The National Child Traumatic Stress Network (NCTSNet) has just published four new fact sheets on youth in the juvenile justice system. They are: The fact sheets are the work of the University of Connecticut School of Medicine, the Yale/UConn Center for Children Exposed to Violence, and the Juvenile Justice Working Group. ++++++++++ Therapeutic Foster Care A CDC Task Force on Community Preventive Services review reports research shows that therapeutic foster care programs reduced violent crimes among adolescents ages 12-18 with a history of chronic delinquency an average of 70% compared with programs for youth in standard group residential treatment facilities. Therapeutic foster care programs place troubled youth with trained foster families. During the program adolescents live for 6-7 months in a structured environment where they are rewarded for positive social behavior and penalized for disruptive and aggressive behavior. ++++++++++ New Juvenile Mental Health Court in Cincinnati Last November a group of local mental health workers went to San Jose, Calif., to study the juvenile mental health court there. When they returned to Cincinnati they combined pieces of the Santa Clara County court with a home-based treatment program developed in North Carolina to create the Hamilton County court. Children diagnosed with major depression or post traumatic stress or who are bipolar are eligible to have their criminal case transferred to the juvenile mental health court. The new Hamilton County Juvenile Mental Health Court started up in January. ++++++++++ Incarceration of Youth Who Are Waiting for Community Mental Health Services in the United States In the House and in the Senate this past week at hearings conducted by Representative Henry Waxman and Senator Susan Collins the results of a survey in which every juvenile detention facility in the United States was surveyed. Waxman’s staff heard back from more than 500 administrators in 49 states, a response rate over 75%. Key findings: - Two-thirds of juvenile detention facilities in the United States lock up mentally ill youth because there is no place else for them to go.
- Every day, about 2,000 youth are incarcerated simply because community mental health services are unavailable. This represents about 7% of all youth in juvenile detention.
- In 33 states, juvenile detention centers hold youth with mental illness who have no charges against them of any kind.
- Over 160 detention centers report that youth held unnecessarily have attempted suicide.
- Children as young as seven years of age are incarcerated because they do not have access to care.
Below are documents with more information about the survey and the hearing: ++++++++++ Psychotropic Drugs and Children: Use, Trends and Implications for Schools This fact sheet from The Center for health and Health Care in Schools summarizes recent research and suggesting implications for school-based health care. Should be of particular interest to detention workers. ++++++++++ Screening & Assessing Mental Health and Substance Use Disorders Among Youth in the Juvenile Justice System: A Resource Guide for Practitioners Written by Thomas Grisso and Lee Underwood, the contents should be of interest to juvenile justice practitioners around the country. The Resource Guide includes an overview and three major sections: - Selecting Screening and Assessment Instruments in Juvenile Justice
- A Menu of Screening and Assessment Instruments
- Best Practice Selections.
The final chapter includes these recommendations for screening and assessment: - Screening should be performed on all youth at the earliest point of contact with the juvenile justice system.
- Assessment should be performed on those youth requiring further evaluation.
- Care should be taken to identify the most appropriate instruments for juvenile justice involved youth.
- Contextual Factors – taking situational factors into consideration when selecting instruments.
- Psychometric properties and Adequacies – consider these when selecting instruments.
- Need and risk levels need to be appropriately balanced.
- There is no one best way to provide mental health screening and assessment to youth in the juvenile justice system.
It is 90 pages in length, a comprehensive, thorough treatment of the subject and a good resource to have on hand. ++++++++++ Kids with Mental Health Problems without Help, Without Treatment Two newspapers describe conditions for children with mental disorders in communities throughout the country. Mentally ill kids adrift in system – USA TODAY series of articles that detail the failings of services to children and youth with mental health disorders. They include: - Sparse research
- Failure to offer children proven treatments
- Insurance coverage limits
- Struggle to obtain care
- Severe shortage of child and adolescent psychiatrists
- The need for equal treatment for all illnesses
- In the sidebar for this article you will see links to three associated articles on the subject:
- Treatment varies by location, insurance;
- An orphaned area of science; and
- Diagnosis, medicine turn young man’s life around.
A perilous prescription The Atlanta Journal-Constitution examines the Georgia mental health system, a system that places children with serious mental disorders behind bars. Many seriously disturbed children wait for months for mental health care. Only two people work at the state level to oversee mental health programs for children. The story profiles J. R., a 9 year old child with mental illness. ++++++++++ Teens REALLY ARE Different New brain research has found strong evidence that when it comes to maturity, organization and control, key parts of the brain related to emotions, judgment and “thinking ahead” are the last to arrive. Until recently brain experts thought the human command center was pretty much set for life by age 3. Instead, the brain has a final growth spurt around the ages of 11 to 13 in the frontal lobes of the brain, the regions that guide human intellect and planning. It seems to take most of the teen years for kids to link these new cells to the rest of their brains, allowing them to think and act like adults. As a result, teens look at things differently than adults. The graphics for the TIME Magazine cover article “Secrets of the Teen Brain,” May 10, 2004 issue, are available to look at online. If you want to read the entire article there is a fee. ++++++++++ Update on the Nation’s First Juvenile Mental Health Court (Scroll to First Monday #12, May 2004) In this month’s First Monday, the newsletter of NCJFCJ’s Juvenile Sanctions Center , San Jose , Calif. , is the featured demonstration site. The Santa Clara County juvenile mental health court, the subject of this newsletter, is now in its third year of operation. It reviews the experience of the court, the changes it has made along the way, and discusses the protocol under which the court operates. Notable as well is the section on the relationships among the members of the court’s Multi-Disciplinary Team who have learned to work with and understand each other despite professional points of view, professional cultures and vocabularies that are often poles apart. ++++++++++ Neurologically Based Social Disorders That Isolate Will be available to read for one week. Autistic Spectrum Disorders are a new group of disorders believed to encompass a wide spectrum on impairment and intelligence. People with this group of disorders are intelligent functioning people with a wide gap between their intellectual and social skills. They lack the ability to read cues like body language, to intuit what other people are thinking, and they have profound difficulty navigating basic social interactions. They are what autism researchers call “mind blind.” For the Aspies (who have named themselves after Asperger’s syndrome) and their families, the relief in learning that their difficulties are neurologically based is coupled with disappointment that there is no cure for the disorder and no drug to treat it. Their families are relieved to know that their condition is not the result of bad parenting or a fundamental character flaw. Fascinating article. ++++++++++ APT (Adolescent Portable Therapy) APT, a project of the Vera Institute of Justice, is an intensive, outpatient, family-based service for youth who are arrested and detained in New York City. By beginning treatment a soon as the adolescents enter detention and providing treatment without interruption from institutionalization through return to the community the project aims to reduce substance abuse and recidivism, and improve the physical, mental, social, and educational well-being of the youth and families served. Downloadable overview of APT – five pages, including findings about the program’s effectiveness. ++++++++++ Why Girls Cut and Burn Themselves This article from women'senews addresses self-mutilation by teenage women from a different point of view. Female teens are logging on the the internet to talk about why they injure themselves, pointing toward a culture in which it is acceptable to talk about it. Among professionals working with teens, most are aware that cutting is a particularly female affliction. Dr. Wendy Lader, director of a self-injury program, says that while boys traditionally express anger outwardly and more directly, girls live in a more body-focused culture. "Skin is a bulletin board. They're saying, 'Can you see how much pain I'm in?'" ++++++++++ Troubled Minds, Chaotic Care The Cincinnati Enquirer published this special report on mentally ill children in Ohio . It examines the plight of Ohio parents who have run out of insurance or money and have given up custody of as many as 1,800 children so the government will pay to treat their mental illness. Even then, kids don’t always get the help they need. This is a lengthy report. If you’d like a hard copy send me an email with your USPO address and I’ll mail you a copy. It will take a couple of weeks because I (and most of our department’s staff) will be leaving for Las Vegas over the weekend to conduct the 31st National Conference on Juvenile Justice there. With about 1,500 people already registered to attend and more anticipated, we’ll be dealing with about 2,000 attendees, making this the largest JJ Conference yet. We have a number of ‘firsts’ at this year’s conference, including a live horse in the exhibit center. ++++++++++ Rural Mental Health Provider Work Group – Final Report This report underscores the need for mental health services in rural areas and includes sets of recommendations in two categories: - to improve access to mental health services for rural residents, and
- to enhance the supply of rural mental health providers in rural areas.
++++++++++ The Police Pocket Guide to Responding to Youths With Mental Health Needs I already may have included this in Brevity, but it is such a dandy little tool, I’m bringing it to you attention again. The pocket guide is 15 pages in length and was written by mothers of youths with mental health disorders in Massachusetts. The contents cover, briefly, clearly, and succinctly, mental health disorders, assessment on the scene, clinical recommendations, and points to remember. Includes a glossary of terms and a list of Massachusetts resources. The listing for Borderline Personality Disorder (BPD), for instance, tells you that youths with BPD are impulsive and unstable in their moods, personal relationships, and self-image. They have a high risk for self harm. They drive or spend recklessly; binge on food, alcohol or drugs; or engage in impulsive sexual activity. They may have very low self esteem and seek approval and acceptance from others. With thanks to my friend Lili at the National PACER Center for sending me this link. ++++++++++ Medicaid dollars for Children with Mental Health Needs
The latest Bazelon Health Policy Reporter features an article on the effectiveness of Medicaid in serving children with mental health needs. Indiana has just become the fourth state granted a waiver to its state Medicaid plan to allow use of Medicaid dollars to fund home- and community-based services for children with mental health needs. Kansas , New York and Vermont have increased access to service and reduced traumatic out-of-home placements while cutting the cost of serving children. +++++++++++ Antidepressants and Youth Suicide
The FDA says antidepressants such as Prozac, Paxil and Zoloft show a greater risk of suicide among children taking the drugs compared with those taking dummy pills. Only one of these drugs has been approved for the treatment of children with depression, but doctors are prescribing them to hundreds of thousands of American children every year. The FDA analysis was identical to a British analysis that led Britain in December to prohibit use of most antidepressants in children. ++++++++++ Apply to Attend Improving Services for Youth with Mental Health and Co-Occurring substance Use Disorders Involved with the Juvenile Justice System The National Center for Mental Health and Juvenile Justice is accepting applications for the June 2004 National Policy Academy. The event is designed to provide select jurisdictions with the opportunity to develop improved and collaborative strategies to identify and respond to youth with mental health and co-occurring substance use disorders in contact with the juvenile justice system. Particular emphasis will be placed on community-based efforts to successfully divert and reintegrate these youth. Up to eight jurisdictions will be selected to participate. Completed applications are due March 1. Travel and lodging costs are covered for the core team members. Details are available at the NCMHJJ web site. ++++++++++ Teaming Up: Using the IDEA and Medicaid to Secure Comprehensive Mental Health Services for Children and Youth This recent report from the Bazelon Center for Mental Health Law is designed to inform practitioners – attorneys and advocates who are not familiar with using either IDEA or Medicaid – how to obtain the services and supports needed by children with emotional and behavioral disorders. Downloadable. 30 pages. ++++++++++ Family Guidance Home-based Services Program Research out of Eastern Michigan University shows that this program gets better results than any other state-funded children’s mental health program. The program: - lets parents choose the therapist
- is available 24 hours a day
- conducts therapy sessions at the child’s home, and
- looks for situations where the child succeeds and seeks to duplicate them.
Most of the children in the program have serious mental illnesses such as schizophrenia or bipolar disorder. Some cut themselves with knives. Others are suicidal. Others are violent. Therapists go to the family home. They help families set up crisis plans and provide respite care to give the parents a break. They only rely on psychiatric hospitals when all else fails. Insurance Parity for Mental Health and Alcohol Treatment A policy brief from Ensuring Solutions to Alcohol Problems includes this information on parity for alcohol treatment: - An analysis of 11 state studies on parity shows that its cost to insurers is negligible and raises annual premiums just 0.2 percent.
- The State of Oregon found that it saves $5.62 in tax-supported health, corrections and welfare costs for every state dollar spent on people who complete treatment.
- Parity increases the number of people who receive treatment, there by reducing their long-term costs to the state.
- A North Carolina legislative report concluded: “Studies from several states have consistently shown that appropriate treatment of chemical dependency results in a significant reduction in medical claims, absenteeism, and disability; an increase in productivity; and a healthier and safer environment for all employees.”
- A 2001 study by the national Center on Addiction and Substance Abuses (CASA) on the impact of substance abuse nationally found that each American pays $227 per year in state taxes to deal with the burden of substance abuse and addiction. The CASA report said “The brunt of failure to prevent and treat substance abuse and the cost of coping with the wreckage of this problem falls most heavily on the backs of governors and state legislatures across America .”
Implementing Mental Health Parity in Vermont The Vermont Parity Act is the most comprehensive parity law in the nation, covering both mental health and substance abuse services. A study by Mathematica that looked at the first two to three years of parity in the state concludes that parity was achieved. Use of managed care help make parity affordable but may have reduced access and utilization for some services and beneficiaries and did not appear to have an effect on the insurance market. The report can be read in detail at the link above. ++++++++++ A Dad Crusades for Mental Health Parity in New York Tom O’Clair and his wife Donna have criss-crossed the state of New York for the past nine months on behalf of “Timothy’s law,” named after their 12-year-old son who hanged himself in his bedroom closet. Timothy’s Law would eliminate limits on mental-health treatment and require insurance plans to cover the care of mental illnesses the same way they cover physical illnesses. ++++++++++ Missouri Juvenile Justice MH Screening Results The only way I can get you to this article is this: Click on the link above. At the search bar type in "Test reveals mental woes of delinquents" Thanks to Jim Richardson for bringing this article to my attention. Three-fourths of the youths at the front door of the juvenile justice system in Missouri are showing warning signs of mental health problems ranging from depression to suicidal tendencies or thought disturbance. A two year period in which a screening instrument was used at the point of entry into the juvenile justice system showed that 81% of those screened had symptoms of mental health problems. But these rates don’t necessarily mean that the majority of juvenile delinquents are mentally ill. The MAYSI (Massachusetts Youth Screening Instrument) screening instrument, according to its developer Thomas Grisso, was not designed to diagnose mental illness, but to alert workers that a youth may need further attention. 26 states have adopted the MAYSI statewide. It consists of 52 yes-no questions that need not be administered by a mental health expert. The Missouri results are consistent with research that points to pervasive mental illness among the nation’s juvenile detainees. Read about the MAYSI. ++++++++++ Losing Joshua A feature article from the Village VOICE about a 17-year-old’s suicide. Joshua had been diagnosed with ADHD when very young and re-diagnosed as bi-polar four months before his death. He suffered from severe chronic depression. This article is a very thorough treatment of a complex and difficult subject. ++++++++++ Ulifeline.org This link to college and university mental health centers for information, counseling or to schedule appointments offers depressed students the anonymity of the Internet to seek mental health counseling. It was created by the Jed Foundation, established by the parents of 20-year-old Jed Satow who took his own life in 1998 by hanging himself. Jed’s father says the Internet is the perfect medium to teach this generation of students about the signs of depression. Suicide among 15-to 24-year-olds has tripled since the 1950s. ++++++++++ Children with Mental Health Problems in Residential Care Programs in the U.S. This is a brief two-page review about children and youth in mental health facilities, among the most troubled children in the country. Nearly 66,000 of them live in residential care programs. The first page of this report is all about facts. The second page answers key policy questions about the subject. This report is from a series of short, nonpartisan bulletins for policymakers, advocates, clinicians and the community of all those who care about the well being of children. To see 2002 issues, click here. (Scroll down the page.) ++++++++++ Mental Illness in Children (Scroll down to Editor's Picks and click on Mental Illness Children) A new series running on NPR examines worrisome issues in the treatment of children with mental health problems. At the end of each program page you’ll find good internet resources for subjects addressed in each day’s program too. - Part I deals with the use of psychiatric drugs developed for adults for children and associated safety and effectiveness questions.
- Part II deals with the occurrence of bipolar disorder (once known as manic depression) in children as young as five. I found this one particularly interesting because it includes the most recent studies of children with bipolar disorder and the way it shows up in kids.
- Part III aired today (Wednesday, September 24). It deals with what scientists say are unique aspects of mental illness in children. As an example, bipolar disorder in children is very different from bipolar disorder in adults. It needs to be diagnosed treated early because, untreated; the disease causes biological damage to the brain.
- If I heard correctly this morning, Part IV, set to air tomorrow morning (Thursday, September 25) will deal with ADHD issues.
++++++++++ Transitional Services Article The Education Development Center, Inc. (EDC) website has this article available for download at the site: Improving Transitional Services for Young People with Mental Health Disorders- How state systems of mental health and special education can better prepare vulnerable young people for adulthood. Also available on the same page, links to a series of resources. ++++++++++ Mental Health: Culture, Race, and Ethnicity This series of fact sheets is a supplement to the Surgeon General’s Mental Health Report. Each Fact Sheet presents cultural and demographic information on each of the groups shown below and attempts to define the mental health needs of each. Unfortunately, much of this information is unknown at this point. And, here is a policy position statement from the National Mental Health Association: Cultural Competency in Mental Health Systems. ++++++++++ Suspending Disbelief: Moving Beyond Punishment to Promote Effective Interventions for Children with Mental or Emotional Disorders This report from the Bazelon Center for Mental Health Law examines the use of Functional Behavioral Assessments (FBAs) and Positive Behavioral Interventions and Supports (PBIS) in the national’s schools. These targeted services and supports for children and youth with emotional and behavioral problems are two important tools mandated in the IDEA ’97 amendments. Parents and advocates report that implementation of the new provisions is erratic and often perfunctory and that schools are increasingly using zero-tolerance and other disciplinary policies to make it easier to remove students who exhibit problem behaviors. The report is about 30 pages long. The report is basically a blueprint for establishing legally sufficient FBAs and SBISs. ++++++++++ Final Report of the President’s New Freedom Commission on Mental Health Including appendices, the report is about 100 pages in length. The Executive Summary, about 15 pages in all, would be a good place to start with this report. The commission found that the current system focuses on managing the disabilities associated with mental illness rather than promoting recovery. It recommends a focus on promoting recovery and building resilience. The Commission identified these goals as the foundation for transforming mental health care: - Understanding that mental health is integral to overall health, and that mental illnesses must be addressed with the same urgency as other medical problems.
- Shifting mental health care toward consumer and family-driven services.
- Eliminating disparities in mental health care and making a commitment to providing services that are “culturally competent” – services that are acceptable and effective for people of varied backgrounds.
- Moving care toward a model that emphasizes early intervention and disability prevention.
- Developing a more effective process that would make “evidence-based practices” the bedrock of service delivery.
- Harnessing the power of communications and computer technology to improve access to information and care, in improving quality and accountability.
The FDA . Only one of these drugs has been approved for the treatment of children with depression, but doctors are prescribing them to hundreds of thousands of American children every year. ++++++++++ The National Center for Mental Health and Juvenile Justice is P . The event is Particular emphasis will be placed on . Up . Completed applications are due March 1. Travel and lodging costs are covered for the core team members. ++++++++++ This recent report from the is Downloadable. 30 pages. ++++++++++ Research out of Eastern Michigan University shows that this program gets better results than any other state-funded children’s mental health program. The program: Most of the children in the program have serious mental illnesses such as schizophrenia or bipolar disorder. Some cut themselves with knives. Others are suicidal. Others are violent. Therapists go to the family home. They help families set up crisis plans and provide respite care to give the parents a break. They only rely on psychiatric hospitals when all else fails. The is , covering . A study by Mathematica that looked at the first two to three years of parity in the state concludes that parity was achieved. . The report can be read in detail at the link above. ++++++++++ Tom O’Clair and his wife Donna have criss-crossed the state of New York for the past nine months on behalf of ++++++++++ Thanks to Jim Richardson for bringing this article to my attention. . A two year period in which a screening instrument was used at the point of entry into the juvenile justice system showed that . But . The MAYSI (Massachusetts Youth Screening Instrument) screening instrument, according to its developer Thomas Grisso, . 26 states have adopted the MAYSI statewide. It consists of 52 yes-no questions that need not be administered by a mental health expert. The Missouri results are consistent with research that points to pervasive mental illness among the nation’s juvenile detainees. A feature article from the Village VOICE about a 17-year-old’s suicide. This article is a very thorough treatment of a complex and difficult subject. ++++++++++ . It was created by the Jed Foundation, established by the parents of 20-year-old Jed Satow who took his own life in 1998 by hanging himself. Jed’s father says the Internet is the perfect medium to teach this generation of students about the signs of depression. This is among the most troubled children in the country. The first page of this report is all about facts. The second page answers key A new series running on NPR . At the end of each program page you’ll find good internet resources for subjects addressed in each day’s program too. ++++++++++ The Education Development Center, Inc. (EDC) website has this article available for download at the site: - How state systems of mental health and special education can better prepare vulnerable young people for adulthood. Also available on the same page, links to a series of resources. This series of fact sheets is a supplement to the Surgeon General’s Mental Health Report. Each Fact Sheet presents cultural and demographic information on each of the groups shown below and attempts to define the mental health needs of each. Unfortunately, much of this information is unknown at this point. And, here is a policy position statement from the National Mental Health Association: This report from the Bazelon Center for Mental Health Law These targeted services and supports for children and youth with emotional and behavioral problems are two important tools mandated in the IDEA ’97 amendments. and that schools are increasingly using zero-tolerance and other . The report is about 30 pages long. The report is basically a blueprint for establishing legally sufficient FBAs and SBISs. ++++++++++ Including appendices, the report is about 100 pages in length. The Executive Summary, about 15 pages in all, would be a good place to start with this report. The commission found that the current system focuses on managing the disabilities associated with mental illness rather than promoting recovery. It recommends a focus on promoting recovery and building resilience. The Commission identified these goals as the foundation for transforming mental health care: |
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