Week of Feb. 27–March 3, 2023

Week of Feb. 27–March 3, 2023

General Articles 

• The majority of Americans surveyed in the new Axios-Ipsos American Health Index say businesses and the government don't make citizens' health and well-being a priority. The big picture: Mental health is a top concern for Americans — as parents, employers and leaders. They're spending more money on mental health services, while the federal government has allocated new funds for states to expand community behavioral health centers. Read more here.
• Black Americans are nearly twice as likely as white Americans to go to hospital emergency departments for mental health care, the Centers for Disease Control and Prevention said in a new report based largely on pre-pandemic data. The big picture: While the Biden administration has made tackling disparities in mental health a priority, it's running up against long standing inequities in care, housing and income. Read more here.
• More people in California could be detained against their will because of a mental illness under a new bill backed Wednesday by the mayors of some of the nation’s largest cities, who say they are struggling to care for the bulk of the country’s homeless population. Federal data shows nearly one-third of the country’s homeless population lives in California, crowding the densely populated coastal cities of the nation’s most populous state. Read more here.
• New Hampshire’s practice of temporarily boarding mental health patients in hospital emergency departments is an illegal seizure of the hospitals’ property that disrupts care for other patients in need, a federal judge has ruled. In an order issued Feb. 23, U.S. District Judge Landya McCafferty did not immediately require the practice to end, but told hospitals and the New Hampshire Department of Health and Human Services to come up with a timeline for proposing a court order to permanently resolve the issue. Read more here.
• Mental health patients in need of admission to state-run psychiatric hospitals across North Carolina might spend hours, days or even weeks in an emergency department, waiting for an open bed in a facility that is better staffed and equipped for their needs. The state Department of Health and Human Services created a monitoring system over the past year that provides a quick report about the location of open mental health care beds available across the state. What it shows can be disturbing. Read more here.
• "Dementia thoroughly altered my dad—and our family—and taught me just how hard it can be to care for someone with dementia. When I don’t understand something, my impulse as a photojournalist is to do a story about it. That instinct, by way of a Facebook group for caregivers of people with dementia, connected me with Leandra and George Manos, whose lives I have been chronicling since the spring of 2021." Read more here.
• It's almost hard to remember a time before people could turn to “Dr. Google” for medical advice. Some of the information was wrong. Much of it was terrifying. But it helped empower patients who could, for the first time, research their own symptoms and learn more about their conditions. Now, ChatGPT and similar language processing tools promise to upend medical care again, providing patients with more data than a simple online search and explaining conditions and treatments in language nonexperts can understand. Read more here. 

Youth Mental Health

• Young people who identify as LGBTQ+ were less likely to report symptoms of depression when they had general support from their parents, according to a study. Previous research has examined parental support directly tied to a person’s LGBTQ+ identity, but the study, which was published by the University of Texas at Austin researchers in the Child Development journal, asked LGBTQ+ youth to answer how often their parents did things like say how proud they were of them or assisted them with activities. Read more here. 

Impact of the Pandemic

• In better times, the U.S. has, with some humility, owned up to its failures. Commissions have investigated tragedies such as Pearl Harbor and 9 /11. Three years into the COVID pandemic, more than 1.1 million people are dead, and millions more are living with long COVID. How did the nation judged most prepared for an epidemic or pandemic in 2019 suffer a death rate so much worse than peers such as Canada, Germany, or Japan? Read more here.
• Structural changes in the brain may explain the persistent fatigue and neuropsychiatric complications associated with long COVID, finds an observational study published in eClinicalMedicine. Universitatsmedizin Berlin researchers in Germany enrolled 47 adults aged 18 to 69 years who had moderate to severe fatigue and visited post-COVID neurologic outpatient clinics from Apr 15 to Nov 30, 2021; 83% were women. MRI revealed abnormal structural changes in the thalamus, the part of the brain responsible for relaying motor and sensory signals and regulating sleep and wakefulness. Read more here. 

Older Adults and Mental Health

• There’s no cure, yet, for Alzheimer’s disease. But dozens of programs developed in the past 20 years can improve the lives of both people living with dementia and their caregivers. Unlike support groups, these programs teach caregivers concrete skills such as how to cope with stress, make home environments safe, communicate effectively with someone who’s confused, or solve problems that arise as this devastating illness progresses. Unfortunately, despite a significant body of research documenting their effectiveness, these programs aren’t broadly available or widely known. Read more here. 

The Opioid Crisis and Addiction Issues

• Doctors, public health experts, and even Democratic members of Congress are sounding the alarm on a new Biden administration proposal to restrict access to a key addiction-treatment medication. The proposal would curtail access via telehealth to buprenorphine, a common and highly effective drug used to treat opioid use disorder. While doctors can currently give out both new buprenorphine prescriptions and refills after telemedicine visits, the new rule would require an in-person examination for telehealth patients who want to stay on the medication for longer than 30 days. Read more here.
• A federal crackdown on overprescribing controlled substances via telehealth is causing confusion and consternation in the behavioral health community over an in-person prescribing requirement for drugs used to treat pain and opioid use disorder. Why it matters: Child care, transportation and other hurdles can make in-person requirements "an extremely high hurdle" for patients with opioid use disorder, said David Deyhimy, medical director of an addiction treatment clinic in Orange County, California. Read more here.
• A series of settlements from lawsuits related to the opioid crisis have flooded billions into the United States. This influx of money, advocates say, presents a unique opportunity for the U.S. to fund treatment solutions for substance use disorder and the overdose epidemic. The settlement money comes from a number of legal battles around the nation and the world. Read more here.
• Despite an overdose epidemic that killed 107,000 people last year, nearly 9 in 10 Americans who need medication to treat their addiction to deadly opioids aren’t receiving it. Surprising new results from a first-of-its-kind study in Rhode Island could hold a key to getting addiction medication to more people who need it: allowing patients to get prescriptions at their local pharmacy rather than a doctor’s office. The change would particularly help those with low incomes who lack housing and transportation, the study found. Read more here.
• There’s a dangerous new drug out there that’s been devastating U.S. cities for the past year and it does not respond to the lifesaving anti-opioid drug Narcan. It’s a veterinary tranquilizer called Xylazine (pronounced ZIE-la-zeen) and it’s been wreaking havoc from Philadelphia to Los Angeles as a substitute for heroin and other opioids. Veterinarians legitimately use drug products containing Xylazine to sedate cattle, horses and deer, but it is not safe for use in people and may cause serious and life-threatening side effects. Read more here.
• As the U.S. continues to contend with an opioid epidemic that has led to surge in accidental deaths among teens — largely due to fentanyl — some teachers are now being educated on the use of Narcan, a drug that reverses opioid overdoses. In January, a 14-year-old died after a suspected opioid overdose in the bathroom of a high school in Arlington, Virginia. Arlington Public Schools immediately took action, with the rare step of requiring all secondary school teachers to learn how to use naloxone, which is sold under the brand name Narcan. Read more here.
• An influx of fentanyl into Alaska in the last two years has vexed law enforcement, overwhelmed health systems and deeply affected struggling Native communities.  In 2020 and 2021, the synthetic opioid was a major contributor in a spike in overdoses – the nation's largest, according to Alaska's public health department. In 2021, overdose deaths jumped by 74% in one year, with fentanyl deaths spiking by 150%, the report said. Read more here. 

Social Determinants

• The temporary boost to the Supplemental Nutrition Assistance Program (SNAP) benefits put into place during the COVID-19 pandemic will end this week. The big picture: The end of the emergency allotments aimed at combating food insecurity will impact more than 41 million Americans who received the increased benefit last year alone. What they are: SNAP is a monthly benefit for eligible low-income people to purchase food. Read more here.
• Anti-hunger advocates fear the newly reduced SNAP benefits will drive millions of people to a “hunger cliff” and deeper into poverty as they search for ways to pay for food. The cut in SNAP funds will also have harsh economic consequences, advocates warn. Every $1 in SNAP benefits distributed during an economic downturn generate between $1.50 and $1.80 in economic activity, according to the Food Research and Action Center, a Washington D.C.-based anti-hunger nonprofit. Read more here. 

Federal and State Policy

• Millions of people who rely on Medicaid coverage may be removed from the program over the next year. The big picture: Under the COVID public health emergency, the federal government required state Medicaid agencies to provide coverage, even if an individual's eligibility changed. Enrollment in Medicaid and the Children's Health Insurance Program increased in every state since the start of the pandemic, per the Kaiser Family Foundation. Before the provision took effect, individuals could be booted from the program if they did not report a change in family status or if their income was too high, among other things. What's happening: Ineligible Medicaid recipients could be removed as early as April, when some states begin checking individuals' Medicaid eligibility, AP reports. Read more here.
• Almost 7 million children and teens are at risk of losing their health coverage when the public health emergency ends, new estimates from the Georgetown University Health Policy Institute show. Why it matters: States in April will begin redetermining Medicaid eligibility as pandemic-inspired coverage requirements lapse and enhanced federal matching funds dry up. Kids will fall off program rolls even though upward of 70% will remain technically eligible, per federal estimates. Read more here.
• Republicans and Democrats alike have declared the marquee safety-net programs of Medicare and Social Security off-limits for cuts as a divided Washington heads for a showdown over the national debt and government spending. Health programs for lower-income Americans, though, have gotten no such bipartisan assurances. More than 20 million people gained Medicaid coverage in the past three years after Congress expanded access to the entitlement program during the covid-19 pandemic, swelling Medicaid’s population by about 30%. Read more here.
• The high-speed effort in Arkansas, where more than a third of the state’s 3 million people are on Medicaid, offers an early glimpse at the potential disruption in store for the country as states comb through their Medicaid rolls for the first time in three years. These verifications, once routine, were suspended during the pandemic, and their resumption nationwide could lead to as many as 15 million people, including 5.3 million children, losing their health insurance. Read more here.
• Three million Pennsylvanians on Medicaid during the pandemic will have to reapply for continued coverage beginning April 1. As KDKA-TV money editor Jon Delano explains, it could also mean loss of health coverage for some. During the pandemic, those on Medicaid – state-provided health care coverage for lower income Pennsylvanians – did not have to reapply each year to determine their eligibility, but that comes to an end on April 1. Read more here.
• North Carolina legislative leaders announced Thursday an agreement to expand Medicaid to hundreds of thousands of additional low-income adults through the Affordable Care Act. The deal, which likely won’t be voted on until later this month at the earliest, marks a milestone for Republican lawmakers, most of whom opposed expansion for a decade until recently, and for hospitals and patient advocates who sought it all that time. Read more here.