Week of April 24–28, 2023

Week of April 24–28, 2023

General Articles 

• Certain work conditions – including inflexible or late-night schedules and lack of paid sick leave – can have a significant effect on mental health, according to a new report from the US Centers for Disease Control and Prevention. In 2021, about 1 in every 37 working adults experienced serious psychological distress, or negative feelings that were severe enough to impair social and occupational functioning and to require treatment, the report shows.  Read more here.
• After a two-year decline, U.S. suicide rates spiked again in 2021, according to a new report from the Centers for Disease Control and Prevention (CDC). Suicide is now the 11th leading cause of death in the country — and the second among people between 10 and 35 years of age and fifth among those aged 35 to 54, per the report.  As the need for mental health care escalates, the U.S. is struggling with a shortage of providers. Read more here.
• As the world of artificial intelligence blooms, some players in the health care industry are looking to make a major difference in public health. HMNC Brain Health — a Munich, Germany-based health tech company — is one of those. It's attempting to use novel AI-powered technologies to address mental health issues. The company has developed what's described as a "precision psychiatry" diagnostic tool that uses artificial intelligence to predict, diagnose and even treat depression. Read more here.
• Ketamine use is surging as veterans and people with persistent depression look for alternative treatments. But the industry that's sprung up around that demand is showing signs of buckling, leaving some patients stranded without support. The big picture: The shutdown of some brick-and-mortar ketamine clinics has injected more uncertainty into an industry fueled by the broader psychedelics boom that has no oversight or standardized treatment protocols. Read more here.

 Youth Mental Health

• In 2021, 1 in 5 high school students said they witnessed violence in their communities, and 3.5 percent said they carried a gun. Nearly 9 percent of students said they’d been forced into sex in their life. A third of female students said they had considered suicide in the past year, and over 13 percent said they’d attempted suicide. A sweeping series of surveys of U.S. high school students released Thursday by the Centers for Disease Control and Prevention have an urgent message for parents and policymakers: America’s kids are in crisis. Read more here.

Gun Violence

• In May 2022, hours after 19 children were murdered at Robb Elementary in Uvalde, Texas, Republican Gov. Greg Abbott swatted back suggestions that the state could save lives by implementing tougher gun laws by proclaiming “Chicago and L.A. and New York disprove that thesis.” In reality, the region the Big Apple comprises most of is far and away the safest part of the U.S. mainland when it comes to gun violence, while the regions Florida and Texas belong to have per capita firearm death rates (homicides and suicides) three to four times higher than New York’s. Read more here.
• Sen. Rick Scott on Tuesday took action in response to the recent Nashville school shooting that looks a lot like what he did as Florida governor after the mass shooting at Marjory Stoneman Douglas High School in 2018. Five years ago, he led an effort to provide armed police officers in every public school in Florida. Now he wants to do the same across the nation with his new "School Guardian Act." Read more here.

Older Adult Mental Health

• Issues with memory and thinking are more common as you get older, but it’s not a given that everyone will experience them. With that, it’s understandable to want to do what you can to get better if you find you’re suddenly being forgetful or struggling to think clearly. Now, a new study published in JAMA Open Network suggests that positive thinking about aging may help people better recover from mild cognitive impairment than those who don’t have as sunny an outlook. Read more here.

The Opioid Crisis

• U.S. officials say they've identified and infiltrated the Mexican drug organization that's largely responsible for the fentanyl crisis killing tens of thousands of Americans every year. In a sweeping series of indictments targeting two dozen leaders and kingpins, the Justice Department blamed much of the carnage on the Chapitos network, a faction of the Sinaloa drug cartel. Read more here.
• At age 93, struggling with the effects of a stroke, heart failure and recurrent cancer, Teri Sheridan was ready to end her life using New Jersey’s law that allows medically assisted suicide -- but she was bedbound, too sick to travel. So last Nov. 17, surrounded by three of her children, Sheridan drank a lethal dose of drugs prescribed by a doctor she had never met in person, only online. She died within minutes. Soon, others who seek Sheridan’s final option may find it out of reach, the unintended result of a federal move to roll back online prescribing of potentially addictive drugs allowed during the COVID-19 pandemic. Read more here.
• Families are trying to raise awareness of the dangers of fentanyl by putting up billboards around Oklahoma City. It is a new way to remember loved ones who have died from a fentanyl overdose. For just a few seconds at the billboards across the city, you can see just 11 of the many people who have died from a fentanyl overdose. Families said this will be a success if it saves just one life. Read more here.
• The outbreak of Covid-19 presented many dangers for children, and a new study suggests increased illicit substance ingestions were among them. In the first month of the pandemic in 2020, a 25% increase in overall ingestions occurred among children under 6 years old in the United States, according to the study published Friday in JAMA Network Open.Those numbers grew by 1.8% more per month than they did before the pandemic, the study said. Read more here.
• Over the past year, the U.S. Treasury Department has used its sanctions powers to impose wide-ranging financial penalties on Russia in response to its invasion of Ukraine — turning Russia into the most sanctioned country in the world. Now, the federal agency is facing increasing pressure, including from legislation introduced Tuesday in the Senate, to use those tools with similar vigor against the people, financial institutions and companies that have participated in the explosion of fentanyl use and distribution in the U.S. Read more here.  
• I am neither a medical professional nor a trained EMT. Anyone can reverse an overdose in an emergency, along with calling 911 and giving rescue breaths. We could all be carrying this miracle drug in our purses and back pockets. The FDA made that easier last month by approving Emergent BioSolutions’ Narcan nasal spray for over-the-counter (OTC) sale. As an expert in harm reduction, I know that although finally authorizing one OTC naloxone product is a step in the right direction, it does not go far enough. Read more here.

Climate Change and Mental Health

• Calderón-Garcidueñas went on to study the brains of 203 human residents of Mexico City, only one of which did not show signs of neurodegeneration. That led to the conclusion that chronic exposure to air pollution can negatively affect people’s olfactory systems at a young age and may make them more susceptible to neurodegenerative diseases such as Alzheimer’s and Parkinson’s. The pollutant that plays the “big role” is particulate matter, said Calderón-Garcidueñas. Read more here.

Social Determinants

• More than 1 in 5 U.S. adults without access to a vehicle or public transportation missed or skipped a medical appointment in the previous year, according to a new study that sheds light on a key social driver of health equity. Why it matters: While telehealth may have reduced transportation barriers for mental health, primary care and some other services, it's not accessible to all and can't substitute for in-person care for some medical needs, the Urban Institute researchers wrote. Read more here.
• Hunger rates were highest among Black and Latino households, women and adults with disabilities in a snapshot of the COVID-19 pandemic, according to new Centers for Disease Control and Prevention data. Why it matters: The detailed look at who is most vulnerable to food insecurity comes at a time when a long-standing congressional fight over food stamps has become a central issue in the debt limit debate. Read more here.
• Food banks across the United States are straining to meet spiking demand as high food costs and shrinking federal benefits drive scores of Americans to depend on free groceries, just as Republicans seek to narrow access to food assistance. President Joe Biden, who this week criticized Republicans' proposals to further cut benefits in order to shrink the country's deficit, pledged last year to end hunger in the U.S. by 2030. Read more here.

Gender-Affirming Care Bills and Related Issues

• Oregon lawmakers are expected to pass a bill that would further expand insurance coverage for gender-affirming care to include things like facial hair removal and Adam’s apple reduction surgery, procedures currently considered cosmetic by insurers but seen as critical to the mental health of transitioning women. The wide-ranging bill is part of a wave of legislation this year in Democratic-led states intended to carve out safe havens amid a conservative movement that seeks to ban or limit gender-affirming care elsewhere, eliminate some rights and protections for transgender people and even bar discussion of their existence in settings such as classrooms. Read more here.  
• As a third grader in Utah, mandolin-playing math whiz Elle Palmer said aloud what she had only before sensed, telling a friend she planned to transfer schools the following year and hoped her new classmates would see her as a girl. Several states northeast, Asher Wilcox-Broekemeier listened to punk rock in his room, longing to join the shirtless boys from the neighborhood playing beneath the South Dakota sunshine. It wasn’t until menstruation started, and the disconnect with his body grew, that he knew he was one of them. Both kids’ realizations started their families on a yearslong path of doctors, therapists and other experts in transgender medicine. Now teenagers, their journeys have hit a roadblock. Read more here.
• Boston Children’s Hospital has received several bomb threats. The gender clinic at Seattle Children’s Hospital has installed panic buttons and hired a full-time security guard. Doctors who treat transgender children are receiving death threats, debating whether to buy guns, scouring the internet to see if they’ve been doxxed and trying to get their addresses removed from property records. The impact of gender-affirming care bans — inflamed by the rhetoric on the right about “child grooming” — is rippling beyond Republican-controlled states, making it harder everywhere for transgender youth to receive care and physicians to provide it, eight doctors who provide gender-affirming care to transgender youth told POLITICO. The Human Rights Campaign and the Southern Poverty Law Center, which have been tracking attacks against doctors, report similar findings. Read more here.
• Chelsea Freels has spent a good bit of time in 2023 trying to convince Missouri lawmakers to not vote for legislation barring what's known as gender-affirming care for transgender youth like her. Over and over, the 17-year-old from suburban St. Louis has heard GOP lawmakers talking about how they need to pass legislation to protect people like her. Despite Freels testifying that gender-affirming care has made her feel much happier and has helped her heal from depression and suicidal thoughts, Missouri lawmakers seem poised to approve legislation that bars puberty blockers, hormone therapy and gender transition surgery for minors. Read more here.

Federal and State Policy

• The Federal “No Surprises Act” may have shielded patients from unexpected medical bills, but it's left a bureaucratic mess, with providers and insurers fighting over who'll cover the costs and Congress weighing whether to step back in. The big picture: Almost a year and a half after it was enacted, the law is tied up in multiple court cases as providers push to change the process it set up to resolve billing disputes. Cases in arbitration are piling up, with more than 164,000 disputes filed from April through early December 2022. Read more here.
•  About 600,000 people would become uninsured under the House Republican debt bill's plan to impose Medicaid work requirements, the Congressional Budget Office estimated Tuesday. Why it matters: The estimate from Congress' nonpartisan scorekeeper gives a sense of the coverage loss from the proposal, while also highlighting the federal savings. The federal government would save $109 billion over a decade by making Medicaid recipients work 80 hours a month, CBO estimated. Read more here.  
• As many as 21 million Americans could be at risk of losing their Medicaid coverage under the House GOP’s work requirement proposal, according to a new Biden administration analysis shared exclusively with Vox. The projections are both a warning about the potential consequences of the strict reporting requirements Republicans are contemplating and ammunition for Democrats in the upcoming negotiations over raising the federal debt limit. Read more here.
• House Republicans are using the debt ceiling standoff to advocate for one of their longstanding goals – requiring more low-income Americans to work in order to receive government benefits, particularly food stamps and Medicaid. They see work requirements as a twofer, allowing them to reduce government spending, while bolstering the nation’s labor force at a time when many businesses are still struggling to staff up. Read more here.
• The Centers for Medicare and Medicaid Services on Thursday proposed new reporting rules for Medicaid and the Children's Health Insurance Programs health plans, that would, among other things, set national standards for appointment wait times and require disclosure of provider payment rates. Why it matters: The moves add transparency and accountability requirements for Medicaid managed care plans that serve the majority of program beneficiaries. They come as states begin a sweeping redetermination of Medicaid eligibility accompanying the end of the COVID public health emergency. Read more here.
• House lawmakers are kick-starting the legislative process for a number of health care bills at the same time their Senate counterparts are shaping their own package on drug pricing, and members appear to be finding common ground on pharmacy benefit managers. Senate Majority Leader Charles E. Schumer, D-N.Y., is aiming to put a drug pricing package on the floor this year. While the parameters of the legislation are still fluid, several committees across the Capitol have approved or are on the verge of marking up bills addressing PBMs, the drug pricing middlemen many members blame for high costs and drug access issues.  Read more here.