GOP Govs Point To Medicaid Flexibility As Means To Reduce Spending
Kaiser Health News.jpg Cuts to Medicaid are among the GOP's strategies for bringing their state budgets under control, according to a report issued by the Republican Governor's Association. But at what cost for the nation, as cuts fall on the backs of people with disabilities and chronic illnesses, and for whom the federal program has become a lifeline to treatment, rehab and recovery? Kaiser Health News has summarized coverage of this story. []
Screening absent for Medicaid patients with psychiatric diagnosis
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Medicaid patients taking second generation anti-psychotic drugs (SGA) didn't get adequate screening for baseline serum glucose and lipids. . . []
Side effects largely untended
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Despite FDA warnings seven years ago, people taking second generation anti-psychotic (SGA) medicines are still not receiving adequate follow-up for life-shortening side effects. []
Review of psycho-social interventions for schizophrenia
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Delays in implementing recommended psycho-social services as an adjunct to medication can prolong disabilities associated with schizophrenia, write the authors of a study in the on-line Advance Access Schizophrenia Bulletin. In a comprehensive project (citing 233 references) []
Care I receive in Canada
by Lou Ross-Johns I have always lived in a separate room. I look in the window and the rest of the world is in some strange and mysterious party which I cannot understand or participate in, only watch through the window. This has always been with me and will ever be. I was a child who stayed on the edges of the playground, and who sat silently in her mind in the schoolroom. My experience with the health care system... []
Off label antipsychotic drugs increased at VA
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A study appearing in Psychiatric Services describes a hike in prescribing antipsychotic medications over a ten-year period at the Veterans Administration. Sixty percent of antipsychotic drugs were prescribed off-label . . . []
Stabenow introduces bill (S1136) to close treatment gap
Michigan's Senator Debbie Stabenow (D) introduced a bill to open the door for seriously mentally ill people, now receiving Medicaid, to get comprehensive care in 10 participating states. The Mental Illness Chronic Care Improvement Act (S 1136) is a demonstration program with the potential to close a treatment gap by linking to primary care. Diabetes and heart disease are among the chronic conditions afflicting people with a mental illness and shortening life and Stabenow's proposal recognizes the existing system has... []
British campaign against diabetes
In response to the increased numbers of people with diabetes, a new program in London announced a three-year time strategy to improve care, and raise awareness of risks. A systematic strategy includes mental health professionals as part of a comprehensive team.... []
Seroquel trial
Allegations that AstraZeneca failed to warn patients that its drug Seroquel contributed to weight gain and diabetes came to light yesterday when documents were opened as part of a lawsuit over the billion dollar anti-psychotic drug. Instructions to divert direct questions about side effects advised the sales force to "neutralize" concerns about this despite knowing it's own doctor pointed to "reasonable evidence" about impaired glucose regulation." Court documents also reveal off-label use, and the vetting of negative trials. The case... []
Premature death associated with bipolar disorder
Evidence of premature death for people diagnosed with bipolar disorder comes from a study published in Psychiatric Services (abstract available). This study adds to previous warnings discussing risk factors contributing to chronic illnesses such as heart disease and diabetes. The authors reviewed 17 published studies (between 1959 and 2007) involving more than 330,000 people.... []
Senate hearings on prevention and wellness
Congressional hearings were held last week to address prevention and wellness as the cornerstone to health reform. Bill Emmet, Campaign for Mental Health Reform, explained how mental health and substance use disorders are intertwined with preventable chronic illnesses contributing to loss of productivity and a shorter life expectancy (averaging 25 years). Emmet said: People with mental illnesses are uninsured at twice the rate of the general population: 34% of people with mental illness have no health coverage at this point.... []
Sudden death associated with anti-psychotic drugs
Researchers from Vanderbilt University say the rate of sudden cardiac death is twice as high (29 versus 14 per 10,000) for people taking anti-psychotic medication than for those who aren't. Based on analysis of 15 years of Medicaid data from Tennessee, authors of a study published in the New England Journal of Medicine (NEJM) conclude that despite expectations that they differed, first and second generation anti-psychotic drugs have similar, dose-related risks.... []
Other nations surpass US in chronic care
Depression is one of the seven illnesses included in an international comparison of how nations treat chronic conditions. Authors report that the United States stands out for "gaps in coverage, and for high cost sharing even for patients with insurance" with more people suffering complex chronic health problems despite spending twice as much on health care ($7,000 per person versus $3,500 per person). Cost figured into the decision of more than half the American respondents not to seek care, and... []
Antipsychotic meds and heart disease
An NIMH study (n=1125) comparing antipsychotic medications and cardiac heart disease found the "risk for CHD differed significantly among the medications." Risk, marked by elevated cholesterol, was highest for those taking olanzapine (Zyprexa, Zydis) and quetiapine (Seroquel). A decreased risk was noted for those taking risperidone (Risperdal) and ziprasidone (Geodon). Cardiovascular disease is a contributing factor to the shorter life span of people diagnosed with schizophrenia.... []
Nearly 70 percent of individuals with serious mental illness smoke.
Read this press release from the New York Department of Health.... []
Global mental health challenges
photo:iStock World Mental Health Day was the occasion for reports calling attention to the global marginalization of psychiatric conditions. A general assessment from the editors of The Lancet notes: "mental ill-health is likely to have been underestimated because the connection with other health conditions is often ignored. Worse still, the availability, accessibility, and quality of health services is poor and inequitable." Plans are underway for an international mental health summit next year in Athens. Ghana Officials in Ghana are joyful... []
Eli Lilly settles $62 million case; more pending
Eli Lilly announced a $62 million settlement in 32 states for the marketing of its block buster drug Zyprexa. In the 12 years it has been on the market, the company says it has been prescribed 26 million times. Zyprexa is known to cause weight gain leading to diabetes, heart disease, both of which are associated with early death. Other law suits are still outstanding. Since 2005, according to SEC filings, costs associated with Zyprexa lawsuits, including legal fees, amount... []
Linking medical and mental health services
Access to the full spectrum of health needs for people with a psychiatric diagnosis is the focus of the August issue of Psychiatric Services (subscription required). Articles address the obstacles encountered by people with a psychiatric disorder in gaining access to primary care; the screening and services available in community mental health centers; and Canadian and Norweigan programs linking mental health and physical health services. ... []
Spouses paid for caregiving
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Bone loss linked to depression
Depression should be on the list of risk factors for osteoperosis in premenopausal women, according to a National Institutes of Health study appearing in Archives of Internal Medicine (Nov. 26). Earlier reports indicated a relationship between antidepressants and bone loss in the elderly, but the recent study “showed that these medications were not linked to low bone mass in premenopausal women.” The level of bone loss was comparable to that associated with other risk factors such as smoking or diet.... []
Tobacco industry creates "self-medicating" rationale
An outstanding article in Schizophrenia Bulletin Advance Access exposes the tobacco industry's aggressive tactics to market smoking to people with schizophrenia. This includes the creation of the "self-medicating hypothesis" and in 1997 the formation of an R. J. Reynolds Tobacco Company subsidiary, Targacept, a biopharmaceutical company. The authors say the industry's success came from "suppressing research that does not support their position, and disseminating their data and interpretations to the lay press and policy makers" including family advocacy groups. They... []
Poor screening for metabolic syndrome in United Kingdom
An audit of the clinical records of 1996 patients in mental health services across the United Kingdom slammed doctors for “suboptimal” screening “for aspects of the metabolic syndrome in routine clinical practice in psychiatry.” Inadequate attention to people taking antipsychotic medications associated with metabolic syndrome was apparent in an analysis of prescriptions. Barriers to screening – confusion over who is responsible (primary care or psychiatry), and a lack of equipment (tape measures and scales) – will be addressed in an... []
Pumping up community services
A bill to bolster community mental health centers with primary care services was introduced by Sen. Jack Reed (D-RI). The Community Mental Health Services Improvement Act (S. 2182) reduces or forgives loans to professionals who serve medically under served communities, and recognizes chronic medical illnesses exist alongside mental illness. It is co-sponsored by Sen. Gordon Smith (R-OR) and is now making its way through committees, starting with the Senate Health, Education, Labor and Pensions Committee. Additional links: National Council for... []
Heart disease killing people with mental illness
An editorial in Journal of the American Medical Association (JAMA) sounds a wake up call to the medical community to address the shortened life span of untreated cardiovascular disease for people with a mental illness. On average their life-span is 25 years shorter, and the authors go beyond explaining this disparity with diet and smoking (people with mental illness consume about half of the cigarettes sold in the United States). They urge psychiatrists to begin monitoring cholesterol, blood pressure, and... []
Depression and diabetes
People with diabetes who neglect self-care are at risk for the symptoms of depression, according to a new study (N=879) conducted by Dr. Jeffrey Gonzalez, Mass. General Hospital. But the opposite is also true. People suffering from depression are more likely to miss their medication. Gonzalez told Reuters that the findings reiterate the importance of mental health providers remaining alert to diabetes as a chronic disease. ... []

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