Category Archives: Psychology & Psychiatry

Helping the mentally ill join the workforce

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Photo courtesy of Sanja Gjenero

Photo courtesy of Sanja Gjenero

By Michael Ollove
Stateline

By his own admission, for many years Cyrus Napolitano’s mental illness—bipolar disorder—did not make him an ideal employee.

Perhaps the worst moment came when he walked into the Brooklyn McDonald’s he was managing to discover some now-forgotten worker infractions.

“Whatever it was,” he said last week, “it triggered an explosion where I was screaming at the top of my lungs and beating a path of destruction all the way to the back, knocking everything off shelves and kicking the back door with my boot.”

He left the job at McDonald’s, as he did various other jobs over the decades—as a waiter, a bartender, a concierge at a luxury condo building. During one eight-year period in the 2000s, after his third suicide attempt, he could barely work at all.

But that was some time ago. Thanks to his eventual involvement with Fountain House, a community mental health center in Manhattan, Napolitano, now 53, is in his fourth year of steady, part-time employment as the “scanning clerk” at an international law firm, a stress-free job he credits with helping him manage his illness. Continue reading

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Unemployment high among adults with serious mental illness

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Jigsaw puzzle with one piece to add

Photo: Willi Heidelbach

By Jenny Gold
KHN / JULY 10TH

Employment rates for people with a serious mental illness are dismally low and getting worse, according to a report from the National Alliance on Mental Illness.

Just 17.8 percent of people receiving public mental health services were employed in 2012 – down from 23 percent in 2003.

Most adults with mental illness want to work, and six in 10 can succeed with the right supports, according to the report.

That’s an unemployment rate of more than 80 percent.

“It isn’t surprising,” says Sita Diehl, director of state policy at NAMI and author of the report.  The problem has less to with the workers themselves, she says, and more with the organizations that provide services for people with serious mental illness. Continue reading

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Medicaid tailored to those with mental health problems

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Jigsaw puzzle with one piece to add

This KHN story also ran in .

Studies show that enrollees with mental illness, who also have chronic physical conditions, account for a large share of Medicaid spending.

Seeking to improve care and lower costs, Florida this month became the first state to offer a Medicaid health plan designed exclusively for people with serious mental illnesses, such as schizophrenia, major depression or bipolar conditions. Continue reading

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‘Telepsychiatry’ helps bring mental health care to rural areas

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telepsych

Ed Spencer, director of South Carolina’s telepsychiatry program, (seated) and Ralph Strickland, program coordinator, (on screen) conduct a simulation of a typical emergency room telepsychiatry consultation at their offices in Columbia.

By Christine Vestal
Stateline

When emergency room patients are deemed “a danger to themselves or others,” every state requires hospitals to hold them until a psychiatrist conducts a face-to-face evaluation to decide whether it is safe to let them leave. In rural hospitals across the country, it can take days for a psychiatrist to show up and perform the exam.

Five years ago, rural hospitals in South Carolina illustrated the problem. On a typical morning, more than 60 people were waiting in the state’s emergency rooms for psychiatric exams so they could either be discharged or admitted for treatment.

Today the scene is quite different, thanks to a “telepsychiatry” program that allows psychiatrists to examine South Carolina patients through videoconferencing, reducing the average wait time from four days to less than 10 hours.

In 2010, North Carolina began rolling out a similar program, and a dozen other states, including Alabama, Kentucky and Wisconsin, plan to follow suit. Continue reading

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Obamacare boosts hospital mental healthcare for young adults

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teen-in-shadow-lightBy Jay Hancock
JUNE 11TH, 2014, 5:00 AM

Expanded coverage for young adults under the Affordable Care Act substantially raised inpatient hospital visits related to mental health, finds a new study by researchers at Indiana and Purdue universities.

That looks like good news: Better access to care for a population with higher-than-average levels of mental illness that too often endangers them and people nearby.

But it might not be the best result, said Kosali Simon, an economist at Indiana University and one of the authors.

Greater hospital use by the newly insured might be caused by inadequate outpatient resources to treat mental-health patients earlier and less expensively, she said. Continue reading

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Should mental illness mean you lose your kid?

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Mindi has never harmed her daughter and is capably raising a son, but authorities took her daughter under a concept sometimes called “predictive neglect.”

Mindi’s daughter was taken by authorities after Mindi had a mental health crisis. Mindi has never been able to get her daughter back, even though she’s now capably raising a son. (Steve Herbert for ProPublica)

This story was co-published with The Daily Beast.

In August 2009, Mindi, a 25-year-old struggling new parent, experienced what doctors later concluded was a psychotic episode. She had been staying in a cousin’s spare basement room in De Soto, Kansas, while trying get on her feet after an unexpected pregnancy and an abusive relationship. She’d been depressed since her daughter was born and was becoming increasingly distrustful of her relatives.

Isolated, broke and scared, one Saturday morning, she cracked. She woke to change her 5-month-old daughter’s diaper. When Mindi looked down, she believed the baby’s genitals had been torn.

Mindi’s mind raced for an explanation. The one she came to? That her baby had been raped the night before; that someone—she did not know who—had put sedatives in the air vents.

Mindi called her pediatrician’s office. A receptionist told her to take her daughter to a children’s hospital in nearby in Kansas City, Missouri. Doctors there found no evidence that the girl had been harmed or that any of what Mindi claimed had actually happened.

After Mindi started arguing, medical staff sent her for a psychological evaluation and notified local child welfare authorities, according to court records.

Continue reading

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Privacy law frustrates parents of mentally ill adult children

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Even if parents are providing health insurance, they often can’t find out about what’s happening when their adult children suffer from severe mental illnesses.

HIPPA 300

Mark, a minister who lives in Northern California, has not been able to communicate with doctors for his son, Scott, since Scott became an adult (Photo by Jenny Gold/ KHN).

By Jenny Gold
KHN Staff Writer

This story was produced in collaboration with NPR

Among the many questions brought up by the horrifying killings in Isla Vista, Calif., last month were what could have parents have done to prevent the tragedy, if anything? And what did they actually know about their son’s mental illness?

Some parents of adult children with mental illnesses fear that their child will go untreated, suffer, or, at worst, become violent.

And often, as the people who care the most about them, many parents want the doctors, social workers and other providers to share protected patient information.

The 1996 privacy law HIPAA (The Health Insurance Portability and Accountability Act) was created in part to protect patients’ information, but it also presents a dilemma for families of people with serious mental illnesses like schizophrenia.

Family members wonder how they can protect their loved one if they won’t share treatment details. Continue reading

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Women’s Health – Week 38: Post-Traumatic Stress Disorder (PTSD)

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From the Office of Research on Women’s Health

tacuin womenPost-Traumatic Stress Disorder (PTSD) is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which death or grave physical harm occurred or was threatened.

Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat.

Untreated, PTSD can lead to additional problems, such as depression and drug use, marital problems, unemployment, and even suicide.

The disorder is also associated with several other physical health problems, underscoring the importance of treatment. Continue reading

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Training police to handle those with mental illnesses

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Officer Lance Newkirchen on his way to visit the family of a man who, two days earlier, considered suicide (Photo by Jeff Cohen/WNPR).

By Jeff Cohen, WNPR

How do you tell the difference between someone who needs to be taken to jail and someone who needs to be taken to the hospital?

That’s a big concern in Connecticut, where the intersection of law enforcement and mental health has been a huge issue since the Sandy Hook Elementary School shootings in Newtown in 2012.

Lance Newkirchen is a regular patrol officer in the nearby town of Fairfield. But he’s also an officer who is specifically trained to respond to mental health calls.

On a recent weekday, he headed in his patrol car on a follow-up call.

“We’re going to go meet with a father whose 21-year-old son, two days earlier, at three o’clock in the morning, through his depressive disorder, was having suicidal thoughts,” Newkirchen explains. Continue reading

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Alzheimer’s support model could save states millions

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And younger man's hand holds an elderly man's handBy Lisa Gillespie

As states eye strategies to control the costs of caring for Alzheimer’s patients, a New York model is drawing interest, and findings from a study of Minnesota’s effort to replicate it shows it could lead to significant savings and improved services.  Continue reading

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Jails house 10 times more mentally ill than state hospitals, report

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Screen Shot 2014-04-08 at 7.26.27 AMBy Jenny Gold
KHN

April 8, 2014 – In 44 states and the District of Columbia, at least one prison or jail holds more people with serious mental illnesses than the largest state psychiatric hospital, according to a report released Tuesday by the Treatment Advocacy Center and the National Sheriffs’ Association. Continue reading

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Drug company agrees to pay $27.6 million to settle allegations involving Chicago psychiatrist

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ProPublica Logoby Kara Brandeisky
ProPublica, March 12, 2014

Teva Pharmaceutical Industries Ltd. has agreed to pay more than $27.6 million to settle state and federal allegations that it induced Chicago psychiatrist Michael Reinstein to overprescribe clozapine, a powerful antipsychotic drug.

Reinstein has twice figured into ProPublica investigations.

Four years ago, ProPublica and the Chicago Tribune spotlighted Reinstein’s prescribing pattern, findingthat in 2007 he had prescribed more clozapine to patients in Medicaid’s Illinois program than all of the doctors in the Medicaid programs of Texas, Florida and North Carolina combined. Continue reading

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Why hospitals are failing civilians who get PTSD

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Gunby Lois Beckett
ProPublica, March 4, 2014

More than 20 percent of civilians with traumatic injuries may develop PTSD. Trauma surgeons explain why many hospitals aren’t doing anything about it.

Undiagnosed post-traumatic stress disorder is having a major impact on injured civilians, particularly those with violent injuries, as Propublica detailed last month.

One national study of patients with traumatic injuries found that more than 20 percent of them developed PTSD.

But many hospitals still have no systematic approach to identifying patients with PTSD or helping them get treatment.

We surveyed 21 top-level trauma centers in cities with high rates of violence. The results show that trauma surgeons across the country see PTSD as a serious problem.  Continue reading

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Childhood trauma’s affect on health throughout life – Event Feb. 25

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Dr. Anda

Dr. Anda

A national expert on child abuse, Dr. Robert Anda, will discuss how childhood trauma can have effects that last throughout life at an event being held February 25th in Lynnwood.

The event is sponsored by Ryther, a provider of behavioral health services to children and their families, the Comprehensive Health Education Foundation and Coordinated Care.

Dr. Anda’s talk will be followed with a panel discussion. The event is free but registration is required.  Continue reading

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Men, minorities and the elderly not getting treated for depression

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And younger man's hand holds an elderly man's handBy Milly Dawson
HBNS Contributing Writer

A leading cause of disability, depression rates are increasing in the U.S. and under-treatment is widespread, especially among certain groups including men, the poor, the elderly and ethnic minorities, finds a new study in General Hospital PsychiatryContinue reading

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