Category Archives: Psychology & Psychiatry

California to broaden autism coverage for kids through Medicaid

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This KHN story also ran in the .

Maria Cruz had never heard the word autism until her daughter, Shirley, was diagnosed as a toddler.

“I felt a knot in my brain. I didn’t know where to turn,” recalled Cruz, a Mexican immigrant who speaks only Spanish. “I didn’t have any idea how to help her.”

No one in her low-income South Los Angeles neighborhood seemed to know anything about autism spectrum disorder, a developmental condition that can impair language, learning and social interaction.

Starting Monday, Sept. 15, thousands of children in California from low-income families who are on the autism spectrum will be eligible for behavioral therapy under the state’s health plan for the poor.

Years passed as Shirley struggled through school, where she was bullied and beaten up. Now 9, Shirley aces math tests but can barely dress herself, brush her teeth or eat with utensils.

Shirley is like many autistic children from poor families: She hasn’t gotten much outside help. The parents often lack the know-how and means of middle-class families to advocate for their children at schools and state regional centers for the developmentally disabled.

A new initiative seeks to help level the playing field. Starting Monday, Sept. 15, thousands of children from low-income families who are on the autism spectrum will be eligible for behavioral therapy under Medi-Cal, the state’s health plan for the poor. Continue reading

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Urgent care centers opening for people with mental illness

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BrainBy Anna Gorman
KHN / 
AUGUST 28TH, 2014

LOS ANGELES, Calif. — Hoping to keep more people with mental illness out of jails and emergency rooms, county health officials opened a mental health urgent care center Wednesday in South Los Angeles.

The goal of The Martin Luther King, Jr. Mental Health Urgent Care Center is to stabilize and treat people in immediate crisis while connecting them to ongoing care.

Run by Exodus Recovery, it will be open 24 hours a day, seven days a week and can serve up to 16 adults and six adolescents.

During their stay of up to one day, patients will undergo a psychiatric evaluation, receive on-the-spot care such as counseling and medication and be referred for longer-term treatment. Continue reading

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Federal officials order Medicaid to cover autism services

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Photo: Willi Heidelbach

When Yuri Maldonado’s 6-year-old son was diagnosed with autism four years ago, she learned that getting him the therapy he needed from California’s Medicaid plan for low-income children was going to be tough.

Medi-Cal, as California’s plan is called, does provide coverage of autism services for some children who are severely disabled by the disorder, in contrast to many states which offer no autism coverage.

But Maldonado’s son was approved for 30 hours a week of applied behavioral analysis (ABA), a type of behavior modification therapy that has been shown to be effective with autistic children, and she was worried that wasn’t enough.

So she and her husband, neither of whose jobs offered health insurance, bought an individual private policy for their son, with a $900 monthly price tag, to get him more of the comprehensive therapy.

“I don’t know any family that can really afford that,” says Maldonado. “We made some sacrifices.”

That should be changing soon. In July, the Centers for Medicare & Medicaid Services announced that comprehensive autism services must be covered for children under all state Medicaid and Children’s Health Insurance Program plans, another federal-state program that provide health coverage to lower-income children. Continue reading

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‘Pastoral counselors’ help fill mental health gap in rural states

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Mental health therapists most often leave issues of faith outside their office doors, even for patients who are religious. But one class of counselors believes a nonsectarian model doesn’t serve everyone equally well.

“On a feeling level, people want a safe, respectful place, to ponder the tons of questions that come begging in hard times,” said Glenn Williams, a pastoral counselor in Kentucky and chair of the Kentucky Association of Pastoral Counselors. “Where is God?  Why did this happen?  Is it karma, sowing-reaping, happenstance?  What purpose does this suffering serve?”

Six states allow these counselors – who include faith and spirituality in their work – to be licensed mental health counselors, which can make it easier for them to get health insurance reimbursements.

Williams, who works at the St. Matthews Pastoral Counseling Center outside Louisville, said many of his patients are quite “intentional” about their preference for pastoral counselors over other mental health professionals.

Kentucky recently became the sixth state (joining Arkansas, Maine, New Hampshire, North Carolina and Tennessee) to allow pastoral counselors to become licensed mental health counselors. Continue reading

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San Antonio police take radical approach to mental illness — Treat It

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Officers Ned Bandoske, left, and Ernest Stevens  (Photo by Jenny Gold/KHN).

This KHN story also ran on NPR.

SAN ANTONIO — It’s almost 4 p.m., and Officers Ernest Stevens and Ned Bandoske have been driving around town in their black unmarked SUV since early this morning.

When it first came out, I was very skeptical. I thought, well this is ridiculous.

The officers are part of San Antonio’s mental health squad – a six-person unit that answers the frequent emergency calls where mental illness may be an issue.

The officers spot a call for help on their laptop from a group home across town.

“A male individual put a blanket on fire this morning, he’s arguing with them, and is a danger to himself and others, he’s off his medications,” Stevens reads from the blotter.

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Officer Stevens talks to a young man named Mason, who has set his blanket on fire and says he is hearing voices (Photo by Jenny Gold/KHN)

A few minutes later, the SUV pulls up in front of the group home in a run-down part of the city.  A thin 24-year-old sits on a wooden bench in a concrete lot out back, wearing a black hoodie. His bangs hang in damp curls over his forehead.

“You’re Mason?” asks Bandoske. “What happened to your blanket?”

Eight years ago, a person like Mason would have been heading to the emergency room or jail next. Continue reading

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Six tips for college health and safety – CDC

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Tips for the US Centers for Disease Control and Prevention

BooksGoing to college is an exciting time in a young person’s life. It’s the end of one chapter and the beginning of another. College is a great time for new experiences, both inside and outside the classroom. Here are a few pointers for college students on staying safe and healthy. Continue reading

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Washington’s high court says psychiatric boarding is unlawful – Puget Sound Business Journal

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GavelPsychiatric boarding – the practice of detaining patients with mental health problems without treatment because of limited psychiatric beds – is unlawful, according to a unanimous opinion the Washington state Supreme Court issued Wednesday.

via Washington’s high court says psychiatric boarding is unlawful – Puget Sound Business Journal.

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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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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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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.

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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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