Category Archives: Mental Health

Depressed? Look for help from a human, not a computer


Computer Circuit BoardBy Lynne Shallcross

Almost 8 percent of Americans 12 and older dealt with depression at some point between 2009 and 2012. With that many of us feeling blue, wouldn’t it be nice if we could simply hop on the computer in our pajamas, without any of the stigma of asking for help, and find real relief?

Online programs to fight depression are already commercially available, and while they sound efficient and cost-saving, a study out of the U.K. reports that they’re not effective, primarily because depressed patients aren’t likely to engage with them or stick with them. Continue reading


States look for help with bilingual mental health


From a string of public suicides in Alaska to assimilation anxiety among young Hispanics in Cleveland, states are faced with the need for more bilingual and culturally sensitive mental health care professionals

Illustration of the skull and brainBy Tim Henderson

The U.S. is grappling with a severe shortage of mental health professionals. But the situation is particularly dire for some minority communities, where barriers of language and culture can make it hard to seek and get help.

Most good mental health care requires subtle, intimate conversation with patients. But too often, mental health experts say, professionals lack the language skills needed to serve those who struggle with English.

The greatest mental health needs are often in remote, rural areas with scattered populations.

“It’s difficult to trust that translation will capture nuances in the soul-baring process of mental health treatment,” said Sita Diehl, director of state policy at the National Alliance on Mental Illness (NAMI).

The greatest mental health needs are often in remote, rural areas with scattered populations. Continue reading


Coping with autism and puberty

Alexander Brown, 14, sits in his living room on Thursday, May 14, 2015. He was diagnosed with autism at 18 months. Alexander is having a hard time with puberty and is lashing out physically (Photo by Heidi de Marco/KHN).

Alexander Brown, 14, sits in his living room on Thursday, May 14, 2015. He was diagnosed with autism at 18 months. Alexander is having a hard time with puberty and is lashing out physically (Photo by Heidi de Marco/KHN).

By Heidi de Marco

SHERRILL, N.Y. — Alexander Brown swings back and forth on a makeshift hammock bolted to a wooden beam in his living room. The swaying seems to soothe the otherwise uneasy 14-year-old. His mother gazes at him from the couch and their eyes briefly connect.

“I would love to be in Alexander’s head just for a few hours,” said Diane Brown, her head slumped against her hand. “He’s having a hard time going through puberty right now.”

Alexander is confused, moody and frustrated – all very typical for a teen during adolescence. But Alexander’s transition is especially difficult for the Browns, a family of six in Sherrill, N.Y., because he is severely autistic.

Puberty is causing chaos in Alexander’s once-predictable world. He can’t talk and struggles to express himself. “He’s angry and he’s sad . . . and he doesn’t understand why,” Brown said. “I truly feel for him.”

Alexander, the third of four children, rarely sleeps through the night. He gets up at all hours to wander the kitchen, take a shower or throw a tantrum. He’s begun lashing out physically.

Brown, 45, is exhausted. She averages four hours of sleep a night and powers through most days with the help of Red Bull. Continue reading


From pills to pins: Oregon is changing how it deals with back pain

kfv-oregon-pain-3-570 (1)

Doris Keene (right) at Portland’s Quest Center for Integrative Health. (Photo by Kristian Foden-Vencil/Oregon Public Broadcasting)

By Kristian Foden-Vencil
Oregon Public Broadcasting

When Portland resident Doris Keene raised her four children, she walked everywhere and stayed active. But when she turned 59, she says, everything fell apart.

“My leg started bothering me. First it was my knees.” She ignored the pain, and thinks now it was it the sciatic nerve acting up, all along. “I just tried to deal with it,” Keene says.

But eventually, she went to a doctor who prescribed Vicodin and muscle relaxants. In 2012, about one in four Oregonians received an opioid prescription – more than 900,000 people. The state currently leads the nation in nonmedical use of opioids. And about a third of the hospitalizations related to drug abuse in Oregon are because of opioids.

Keene says the drugs helped her, but only to a degree. Continue reading


Texas strives to lure mental health providers to rural counties


200px-Flag-map_of_TexasBy Lauren Silverman, KERA

In her third year of medical school, Karen Duong found herself on the other side of Texas.

She had driven 12 hours north from where she grew up on the Gulf Coast to a panhandle town called Hereford.

“Hereford is known for being the beef capital of the world,” she says, laughing. “There’s definitely more cows than people out there.”

Medical student Karen Duong worked in Hereford, Texas, with Dr. Akinyele Lovelace, an instructor with the University of North Texas Health Science Center's rural medical education program.

Medical student Karen Duong worked in Hereford, Texas, with Dr. Akinyele Lovelace, an instructor with the University of North Texas Health Science Center’s rural medical education program.

It’s even named after a breed of cattle. Out here, there aren’t many people who provide mental health care. In fact, there aren’t any psychiatrists.

That’s the reason Duong went there – she’s studying psychiatry as a medical student at the University of North Texas Health Science Center. This assignment showed her just how severe the state’s mental health care shortage is.

“You have a patient that comes in and they need immediate care or something more acute, and then you tell them that the soonest they can get in for an appointment is six months from now,” Duong says. “It’s not really what we want to tell our patients.”

Hereford is one of many areas in Texas lacking adequate access to mental health care.

Of the 254 counties in Texas, 185 have no psychiatrist, according to Travis Singleton, who tracks physician shortages for Merritt Hawkins, a Texas-based consulting firm. “That’s almost 3.2 million [people],” he says. Continue reading


When rehab might help an addict, but insurance won’t cover it – WITF-Fm


Federal law requires insurance firms to cover treatment for addiction as they do treatment for other diseases. But some families say many drug users aren’t getting the inpatient care they need.

Cris and Valerie Fiore hold one of their favorite pictures of their sons Anthony (with the dark hair) and Nick. Anthony died from a heroin overdose in May 2014 at the age of 24. Cris Fiore’s eulogy described his son’s death as a shock, but “not a surprise.” Anthony had been addicted to heroin for years.


Achieving mental health parity: Slow going even in ‘pace car’ state


Flag_of_CaliforniaBy Jenny Gold

After the state of California fined her employer $4 million in 2013 for violating the legal rights of mental health patients, Oakland psychologist Melinda Ginne expected her job — and her patients’ lives — to get better.

Instead, she said, things got worse.

Within months, Ginne, a whistleblower in the 2013 case, was back to writing her supervisors at Kaiser Permanente about what she considered unconscionable delays in care.

Patients who were debilitated or dying from physical diseases for which they were receiving regular medical treatment had to wait months for psychological help, she said.

Some patients, she said, might not live long enough to make the next available appointment.

Psychologist Melinda Ginne, 65, at her house in Oakland, California on Tuesday, May 26, 2015 (Photo by Heidi de Marco/KHN).

Psychologist Melinda Ginne, 65, at her house in Oakland, California on Tuesday, May 26, 2015 (Photo by Heidi de Marco/KHN).

“I can’t tell a family whose elderly mother is declining that I can’t provide treatment until 2014,” she wrote to her managers at the Kaiser Medical Center in Oakland in September 2013. In February, two years after assessing the second largest fine in its history, the California Department of Managed Health Care stepped in again, finding that Kaiser Foundation Health Plan had improved somewhat but still was short-changing patients on mental health care. The state is considering another fine against the health maintenance organization, which is not affiliated with Kaiser Health News.

“Every time the DMHC has an edict, Kaiser Permanente has a way around it,” said Ginne, who retired in September 2014. Continue reading


Insurers must cover residential mental-health care – Kriedler


Washington MapFrom the Office of the Insurance Commissioner

Washington State Insurance Commissioner Mike Kreidler has clarified to insurance companies in Washington that mental-health services must now be offered in parity with medical services.

The commissioner updated rules on mental-health parity in 2014 and asked insurers to review previous mental-health claims that had been denied under a blanket exclusion. He asked insurers to rectify those denials.

The need for clarification arose after a consumer filed a complaint with Office of the Insurance Commissioner after being denied for residential mental-health treatment. The individual said this violated federal laws regarding mental-health parity. Continue reading


Telephone therapy helps older people in underserved rural areas, study finds


red-telephoneBy Lisa Gillespie

Therapy provided over the phone lowered symptoms of anxiety and depression among older adults in rural areas with a lack of mental health services, a new study shows.

The option is important, one expert said, because seniors often have increased need for treatment as they cope with the effects of disease and the emotional tolls of aging and loss.

“Almost all older adults have one chronic medical condition, and most of these have been found to be significantly associated with anxiety disorder,” Eric Lenze, a psychiatrist and professor at the Washington University School of Medicine in St. Louis, said in an interview.

The study, by researchers at Wake Forest University and published Wednesday in JAMA Psychiatry, examined 141 people over the age of 60 living in rural counties in North Carolina who were experiencing excessive and uncontrollable worry that is brought on by a condition called generalized anxiety disorder.

The participants had up to 11 phone sessions between January 2011 and October, 2013. Half of them received cognitive behavioral therapy, which focused on the recognition of anxiety symptoms, relaxation techniques, problem solving and other coping techniques.

The other study participants got a less intensive phone therapy in which mental health professionals provided support for participants to discuss their feelings but offered no suggestions for coping.

The researchers found that severity of the patients’ worries declined in both groups, but the patients getting cognitive therapy had a significantly higher reduction of symptoms from generalized anxiety disorder and depressive symptoms. Continue reading


Most middle and high schools start too early – CDC


Students need adequate sleep for their health, safety, and academic success

From the US Centers for Disease Control and Prevention

school-busFewer than 1 in 5 middle and high schools in the U.S. began the school day at the recommended 8:30 AM start time or later during the 2011-2012 school year, according to data published today in the Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report.

Too-early start times can keep students from getting the sleep they need for health, safety, and academic success, according to the American Academy of Pediatrics.

CDC and U.S. Department of Education researchers reviewed data from the 2011-2012 Schools and Staffing Survey of nearly 40,000 public middle, high, and combined schools to determine school start times.

Schools that have a start time of 8:30 AM or later allow adolescent students the opportunity to get the recommended amount of sleep on school nights: about 8.5 to 9.5 hours. Continue reading


Screen pregnant women, new moms for depression – panel


Blue Pregnant BellyBy Michelle Andrews

One in seven women experience depression during pregnancy or the first year after giving birth, yet many may not realize it or report their concerns to clinicians.

new proposal by the U.S. Preventive Services Task Force could help change that. It recommends that all women who are pregnant or within a year of giving birth be screened for perinatal depression, as it’s called.

The screening proposal is included as part of a broader recommendation to screen all adults for depression that the task force released this week for public comment.

One in seven women experience depression during pregnancy or the first year after giving birth.

The task force proposal would update the current guidelines, adopted in 2009, which recommend depression screening in all adults if clinicians are available to address depression care.

In the 2009 document, the task force didn’t review depression in pregnant and postpartum women and made no screening recommendation for them. Continue reading


Sometimes a little more Minecraft may be quite all right


By Sarah Jane Tribble, WCPN

It’s family vacation time, and I’ve taken the kids back to where I grew up — a small plot of land off a dirt road in Kansas.

For my city kids, this is supposed to be heaven. There are freshly laid chicken eggs to gather, new kittens to play with and miles of pasture to explore.

But we’re not outside.


At a Minecraft camp in Shaker Heights, Ohio, kids trade secrets about making their virtual worlds come to life. (Photo by Sarah Jane Tribble/WCPN)

I’m sitting in my childhood bedroom watching my 7-year-old son and his 11-year-old-cousin stare at a screen. The older kid is teaching the younger the secrets of one of the most popular games on Earth: Minecraft.

“You can’t mine ores unless you have a pickax,” explains my nephew to my son. “You need a wooden pickax to get stone, and you need a stone pickax to get iron, and you need an iron pickax to get gold,” and so on.

Minecraft is the megapopular video game that ranges from simple to complicated. But the basics are that players enter a world that looks sort of like Legos on a screen and build anything they want. Think houses, mountains and farms. Continue reading


Calming dementia patients without powerful drugs


By Rachel Dornhelm, KQED

Diane Schoenfeld comes every Friday to the Chaparral House nursing home in Berkeley, Calif. to spend time with her aunt, Lillie Manger.

“Hi Aunt Lill!” she says, squatting down next to her aunt’s wheelchair, meeting her at eye level.

Manger is 97. She has straight white hair pulled back in a neat bun today. It’s tied with a green scarf, a stylish reminder of the dancer she used to be.

Diane Schoenfeld, left, shows a family photo to her 97-year-old aunt, Lillie Manger. (Photo by Rachel Dornhelm/KQED)

Diane Schoenfeld, left, shows a family photo to her 97-year-old aunt, Lillie Manger. (Photo by Rachel Dornhelm/KQED)

They go together to the dining room to look over family pictures. Manger needs to be reminded who is in them. Including one of herself. “That’s me?” she asks. “That’s you,” her niece confirms.

“Am I supposed to remember?” says Manger.

Schoenfeld smiles at her encouragingly: “I don’t know if you’re supposed to. It’s OK either way.”

Manger has dementia. Schoenfeld is her “surrogate decision maker” meaning that legally, she is the person who makes decisions about Manger’s health care. Continue reading