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CNN and Oprah had an interesting question for the ladies this morning: Are you secretly sad?
The article, found here, goes on to describe a few examples of some women who describe their daily lives as if they were navigating a car with a dirty windshield. It was tolerable, sure, and they were certainly capable of it. Get up, go to work, go home. Do it all over. Sometimes happiness disappeared so gradually, they didn’t even notice. Or, maybe a certain period of stress descended on them like sadness-saturated fog. Not quite as strong as a storm cloud, but enough to dampen what would normally be good feelings. The worst part? A good day for these women was “not feeling really bad.” Maybe they would laugh occasionally. Perhaps even have a bit of fun. Eventually, though, “not feeling really bad” may only be ascertainable via alcohol, drugs, or sex.
It’s not exactly a national secret that about one in four adults suffer from some diagnosable mental disorder or another. That’s almost sixty million adults in the U.S. alone who are seeking (or should be) seeking treatment for a mental disorder. As organizations, the media, and even celebrities work to break down the stigma surrounding mental illness and all of the related, complicated areas – be it race, ethnicity, class and accessibility- CNN brought a new factor to light that is beginning to gain more and more attention and acceptance: Age, and the increasing diagnosis rates of mental illness, specifically mood disorders like bipolar disorder, in children.
I have been working in the mental health field for the entire period of time in which North Carolina has
been “reforming” its public mental health care system. I will continue to put the word “reform” in
quotes because I have come to believe that the only “reform” that has been seriously contemplated
at the highest levels in North Carolina is to seriously reduce the amount of money being paid for
treatment. Period. Without regard for the effects of such on the people of North Carolina who need
help.
Because of skyrocketing health insurance costs [NOT skyrocketing health care costs – there is a difference], some people are worried that employers may be increasingly unwilling to provide coverage for mental health care to employees. However, most experts agree that this is unlikely because of the huge “offset” benefits to Employers who allow or encourage access to good psychiatric and psychological care for their workers.
People in North Carolina who are unable to afford their medicines can now get some of them for free. The NC MedAssist program has created a mail-order central pharmacy to provide medications for free. Both generics and brand name drugs are covered. With a shout-out to Big Pharma for donating the pharmaceuticals in the first place! In 2009, the state rolled out a pilot program to give low-income North Carolinians access to needed prescription drugs. Now that program has been expanded state-wide, so I guess it has been a success thus far. The project was developed as a partnership between the NC Attorney General’s Office, NC Association of Free Clinics, and NC MedAssist. Among other medications available under NC MedAssist, low-income patients will have access to: Antipsychotics: Zyprexa, Haldol, and Seroquel; Antidepressants: Cymbalta, Prozac, Nortioptyline, and Trazadone Others: Lithium, Depakote, Clonidine, and Hydroxyzine. This program is available to North Carolinians, both adults and children, living at or below 200% of the federal poverty line; adults and children who do not qualify for Medicaid, VA, or private insurance; and/or Medicare Part D participants who fall in the infamous “Donut Hole.” One can enroll in NC MedAssist by downloading an enrollment packet at www.medassist.org, or by calling 1-866-331-1348. If one is in Forsyth, Stokes, Davie or Yadkin counties, enrollment is possible by called MedAid at 336-714-2359. Even better, if one enrolls in NC MedAssist, there is only one application form for all the participating drug companies instead of the current one form for each company process. Participating pharmaceutical companies include Novartis, Eli Lilly and AstraZeneca. These companies will ship medicines in bulk to NC MedAssist’s central pharmacy that will ship medications directly to people’s homes. It promises to be quick and easy. Once again, I say we as psychiatrists, psychologists and mental health therapists give a round of applause to these drug companies. Even if we believe that the major motivation for them to donate medications is PR, the fact is that low-income people in North Carolina are going to be able to obtain their medicine for nothing!
A group of managed care organizations, cynically called the Coalition for Parity Inc., has filed suit in U.S. District Court to delay the implementation of the federal mental health parity bill. The Coalition claims its members were not given enough time to comment on the parity rules before they became final.
The Mental Health Parity law, simply put, prohibits health insurers from placing special limits on mental health coverage that don’t exist for other medical specialties. We can absolutely understand why this would be supremely threatening to a certain industry called the behavioral health managed care industry. The only reason behavioral health companies [i.e. “managed care companies”], or mental health “carve-outs” exist is to place special limits on mental health care. This is what they are selling to the companies that pay them – mostly big insurance companies, but also some large self-employed insurers.
Attention Psychiatrists, Psychologists and Counselors: The Teenaged Mind is Different!
A study coming out of Children’s Hospital in Boston has a startling conclusion: teenagers’ brains are different from other brains! Boy, I never would have guessed it – I wonder what tipped them off? Perhaps the chief investigator made some observations in her own kitchen and living room where she may have encountered the wild beast we have named, The American Teenager?
The University of North Carolina has taken stewardship of one of only fifteen sites, nationally, for the Caring Across Communities Program. Caring Across Communities is a program whose aim is to bring direct access to mental health and psychotherapy services for underserved children in our school systems.
The idea is that school children spend a lot of their time in, you guessed it!, school. Therefore, if one wanted to identify mental illness in children and start education and treatment for them, school would be the ideal place in which to do that. Under the Caring Across Communities umbrella, UNC and Chatham County schools started a program called Confianza to target the Latino population in Chatham County.
Let’s do the numbers. How many people in the USA are suffering from a diagnosable mental illness at any given time? Below, I’ve taken the liberty of borrowing some statistics from the National Institute of Mental Health [NIMH] and the numbers are staggering. According to NIMH, about 26% of American adults over 18 – about one in four - suffer from a diagnosable mental health disorder in a given year. That doesn’t count the millions of children with mental illness and it doesn’t count the large number of people who have a mental illness, but do not seek care for it. In other words, the actual number is surely much higher than the reported one.
I knew there was something I liked about First Lady Rosalyn Carter. Ms. Carter has been working on improving mental health care in America for the past forty years and has just written a book called, Within Our Reach: Ending the Mental Health Crisis. In an article this week in Time Magazine, Ms. Carter talks about the book and her opinions on the subject of mental health in general.
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