Week of May 1–5, 2023

Week of May 1–5, 2023

General Articles

• Over 50 million Americans have a mental illness, but more than half (55%) of adults with a mental illness don’t receive treatment. In some states, accessing mental health care may be more challenging because of high costs, too few mental health treatment centers and lack of health insurance coverage. To determine which states are worst for mental health care, Forbes Advisor compared all 50 states and Washington, D.C., across seven key metrics. We also examined two metrics to uncover the states with the highest and lowest rates of mental illness. Read more here.
•  The mental health crisis among Latinos is not letting up, and experts tell Axios it's time for political leaders and others to step up and promote seeking help in a more culturally relevant way. The big picture: The pandemic exacerbated mental health needs in the U.S., especially among Latinos, whose rates of depression, anxiety and suicide grew. But there aren't enough mental health providers. The shortage is especially acute when it comes to providers who are Latino or who can at least speak Spanish or one of the Indigenous languages from Latin America. Read more here…
• Nearly 30 percent of all work remains remote in the United States, the legacy of a workplace revolution that swept in with the COVID-19 pandemic and transformed the nation’s daily routine.   Survey after survey shows that Americans love remote work.  But that doesn’t mean remote work is good for us.   The mental health implications of telework is a relatively new field of study. And that makes sense, given that only 5 percent of American work took place remotely before the pandemic.   Read more here.
• Exercise is a powerful tool for mental health. It’s been shown to improve mood, relieve stress and depression, boost creativity and cognition, and even make therapy more effective—among other benefits. Now, a new research review suggests physical activity may also help people cut back on drug and alcohol use. Adding physical activity to traditional treatment for substance-use disorder seems to lead to better results, says review co-author Florence Piché, a doctoral candidate in physical activity at the University of Montreal. Read more here.
• Up to 60% of all stroke survivors develop memory and thinking problems within a year, and one-third go on to develop dementia within five years, according to a new American Stroke Association scientific statement. “The numbers are staggering, right?” said Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver. “This is a call to action to up our game and focus on prevention,” said Freeman, who was not part of the scientific committee who prepared the statement. Read more here.

Youth Mental Health

• Emergency room visits for young people in mental distress rose sharply over the last decade, per a report published this week in the Journal of the American Medical Association. What they found: Between 2011 to 2020, emergency department visits among children, adolescents and young adults for mental health reasons approximately doubled, a group of researchers and physicians found. This includes a five-time increase of visits for suicide-related symptoms. The greatest increase was among adolescents, and was consistent across sex, race and ethnicity. Read more here.
• Nationwide, young people are screening themselves for mental health issues, according to recently reported data from Mental Health America. Especially concerning is that half of the people who screened for depression said they frequently think about suicide. The organization also found 60% of people who screened positive or moderate to severe for a mental health condition in 2022, cited body or self-image as their primary concern. This was followed by 51% reporting relationship problems and 48% reporting loneliness or isolation. Read more here.
• Teenagers engaged in toxic, controlling dating relationships may be at risk for a variety of problems as they enter adulthood, including drug use, as well as mental and physical health struggles, new research finds. The study, published Monday in the journal Pediatrics, also showed that such teens are likely to repeat patterns of unhealthy — potentially dangerous — intimate relationships. "If an adolescent goes from one relationship to another, they are more likely to find themselves in the same situation in the future," said study author Antonio Piolanti, a post-doctoral researcher in the Institute of Psychology at the University of Klagenfurt in Austria. Read more here.
• Teen eating disorders have never been this rampant — or this severe.  Hospitalizations for eating disorders spiked during the pandemic, doubling among adolescent girls, according to the Centers for Disease Control and Prevention. While most teens have returned to a normal life of in-person school, sports and social activities, eating disorders, especially anorexia, remain at an all-time high, experts warn. Eating disorder-related health visits — which include hospital stays, pediatrician visits, telehealth talk therapy, and everything in between — more than doubled among people younger than 17 in the past five years, according to a recent report from the data company Trilliant Health. Read more here.
• A longitudinal meta-analysis today in JAMA Pediatrics surveyed studies published in 12 countries about the rates of anxiety and depression among adolescents and children before and after the pandemic and found that rates of depression increased, especially among female youth in high-income counties. In total, the studies analyzed included 40,807 subjects pre-COVID and 33,682 subjects during the COVID-19 pandemic, from a total of 53 longitudinal studies. Longitudinal studies, as opposed to cross-sectional studies, allow for a more nuanced look as to how strong of an effect the pandemic had on youth mental health, the authors argue. Read more here.
• Much like many relationships a person might have between ages 18 and 24, the relationship a young person has with social media can be complicated. No matter where they live, respondents in a new global survey said social media usage can lead to a fear of missing out (FOMO) or poor body image, but it also can help with social connections and self-expression. McKinsey Health Institute’s (MHI’s) 2022 Global Gen Z Survey asked more than 42,000 respondents in 26 countries across continents questions based on the four dimensions of health: mental, physical, social, and spiritual. Read more here.
• Parents are noticing a troubling change in their children after using social media platforms like Facebook, TikTok, and Instagram, according to a new survey. The survey of 2,035 American adults found that 50 percent of parents with children younger than 18 years old feel their child or children’s mental health has suffered in the last year because of social media use.  The survey, conducted by The Harris Poll for the Nationwide Children’s Hospital, adds to the growing body of research linking social media use among children and depression, anxiety, addiction and poor body image. Read more here.

Perinatal Mental Health

• Newly published findings from Mathematica and the Vermont Department of Health estimated that the societal costs of untreated perinatal mood and anxiety disorders (PMADs) among birthing parents in Vermont reached $48 million. Investing in the prevention and treatment of mental health conditions in pregnant and postpartum people could go a long way toward decreasing that burden. PMADs are mental health conditions that develop during pregnancy and the year after delivery. They are the most common complication of pregnancy and childbirth and include diagnoses such as depression and obsessive-compulsive disorder Read more here.
•  A Mathematica report found that for one year of childbirths in Texas, failure to treat maternal mental health conditions (MMHCs) such as postpartum depression creates an estimated $2.2 billion in societal costs from conception through five years postpartum. The calculations are based on pre-pandemic data.  The report notes there are human costs beyond the costs quantified in the analysis. As noted in the report, untreated MMHCs increase the risk of babies being born preterm, dying of SIDS, or growing up with health, emotional, or behavioral challenges. Read more here.

Behavioral Health Workforce

• New survey data from the National Council for Mental Wellbeing, conducted by The Harris Poll, finds that the vast majority (83%) of the nation’s behavioral health workforce believes that without public policy changes, provider organizations won’t be able to meet the demand for mental health or substance use treatment and care. The survey, conducted among 750 behavioral health workers and more than 2,000 U.S. adults, also warns of a potential exodus of behavioral health workers due to burnout. Read more here.

Gun Violence

• Firearm mortality in the United States has been well documented, and for good reason: far more Americans die of firearm-related causes than do residents of any other high-income country. Firearms are the leading cause of death for children in the U.S. and the weapon used most in interpersonal violence against women. The Centers for Disease Control and Prevention (CDC) estimates that nearly 49,000 Americans died from firearm-related causes in 2021, up from about 45,000 in 2020. Less publicized, however, is how gun violence burdens the health care system. Read more here…
• Governors in two states passed major gun control legislation this week and a third is poised to do the same soon. On Friday, Colorado Gov. Jared Polis signed the legislative package that included a longer waiting period for firearm sales, and an increase in the minimum age to purchase a gun. Colorado's move came three days after Washington state became the 10th state in the nation to ban assault rifles and handguns after Gov. Jay Inslee signed a gun reform package. Read more here.

The Opioid Crisis

• Colleen Ronnei didn’t know what naloxone was when her 20-year-old son fatally overdosed on opioids in 2016.  Since then she’s formed a nonprofit called Change the Outcome. And one of its major missions is to make the overdose antidote nasal spray readily available in as many places as possible, especially schools. “Versions of legislation that has passed in Minnesota’s House and Senate would require every public school building to have at least two doses of naloxone, also known by its brand name Narcon, on site. Read more here.
• The rate of drug overdose deaths linked to fentanyl in the United States has skyrocketed over the last five years, new federal data showed. The rate of overdose deaths involving fentanyl spiked by 279% between 2016 and 2021 from 5.7 per 100,000 to 21.6 per 100,000, according to a report published early Wednesday by the National Center for Health Statistics' National Vital Statistics System -- which looked at death certificate records. Read more here.
• White House officials for years warned that opioids were becoming rampant in Black communities. Then came Covid-19. In 2020, the rate of drug overdose deaths among Black Americans skyrocketed, increasing faster than that of any other racial or ethnic group in the country. Fentanyl, which had become more ubiquitous, drove the rising toll. On Wednesday, the Centers for Disease Control and Prevention released a report showing that more Black Americans died from fentanyl overdoses than from any other drug in 2021 and at far higher rates than whites or Hispanics. Read more here.
• More than a year after OxyContin maker Purdue Pharma reached a tentative settlement over the toll of opioids that was accepted nearly universally by the groups suing the company — including thousands of people injured by the drug — money is still not rolling out.
• Parties waiting to finalize the deal are waiting for a court to rule on the legality of a key detail: whether members of the Sackler family who own the company can be protected from lawsuits over OxyContin in exchange for handing over up to $6 billion in cash over time plus the company itself. Read more here.
•  Opioid painkillers have left millions of Americans addicted or dead over the past three decades. Now, state and local governments are receiving more than $50 billion in settlement funds from the companies accused of aggressively promoting those medications. Many people see the money, which will be distributed over the next 15 years, as an opportunity to transform the country’s addiction treatment landscape. But many states aren’t being transparent about where dollars are going, and others are facing contentious battles over what should be funded. Listen here.
• Wisconsin legislators decided Tuesday to accept the state’s share of a settlement stemming from another multistate lawsuit accusing drug manufacturers and distributors of contributing to the nation’s opioid crisis. A coalition of states and local governments secured settlements in November and December with opioid manufacturers Teva and Allergan as well as with pharmaceutical chains Walmart, Walgreens and CVS totaling $19.2 billion. Wisconsin is in line to receive about $324.3 million, with 30% going to the state and 70% going to county governments. Read more here.
• West Virginia has settled with Kroger for $68 million over its role in distributing highly addictive prescription painkillers into the U.S. state that has lost more lives to opioid overdoses per capita than any other. That brings West Virginia’s total opioid litigation dollars up to more than $1 billion, more than any other state per capita, Attorney General Patrick Morrisey said at a press conference at the state Capitol in Charleston. “Let this be a warning to others: We fight hard for those affected the most by the opioid epidemic and will stop at nothing in getting justice for them,” he said. Read more here.

Social Determinants

• Most doctors in the U.S. now understand that their patients cannot live healthy lives when nutritious foods, safe housing, and other basic needs are out of reach. Recognizing this, health systems and payers have spent billions of dollars on programs that address non-medical needs, such as housing instability and food insecurity. But the fundamental idea that health is primarily a function of economic, social, and environmental factors is only beginning to enter the public conversation -- and its slow dissemination may be hurting both the health of the public and the healthcare system at large. Read more here.

 Health Insurance

• Medical experts urged Congress to hold insurance companies accountable for inaccurate medical directories that can hamper access for patients seeking mental health treatments.  The problem, referred to as a “ghost network,” occurs when health insurance providers ostensibly provide coverage, but direct customers to nonexistent or unavailable doctors and providers.  “In my view, it’s a breach of contract for insurance companies to sell their plans for thousands of dollars each month, while their product is unusable due to a ghost network,” Senate Finance Committee Chair Ron Wyden (D-Ore.) said at a hearing Wednesday. Read more here.
• Minnesota officials hit Bloomington-based insurance and health care company HealthPartners with a consent order for allegedly violating laws related to mental health parity. State and federal laws prohibit health insurance companies from evaluating mental health diagnoses or treatments more stringently than they do for other forms of care. “This is one example of our commitment to enforcing mental health parity laws and making sure that Minnesotans can get access to the coverage that they've paid for,” said Commerce Commissioner Grace Arnold. “We want to make sure that people have fewer barriers, and this is a way to do that.” Read more here.

State Actions on Gender-Affirming Care and Transgender Issues 

• Across the U.S., anti-LGBTQ legislation — and especially anti-trans legislation — is limiting queer youth’s access to everything from bathrooms to gender-affirming surgery. A new national survey from the Trevor Project paints a stark picture of the mental-health toll of these forces: LGBTQ youth consider and attempt suicide at alarmingly high rates, and nearly one-third say their mental health was poor “most of the time or always” due to anti-LGBTQ policies and legislation. In the past year, 41% of LGBTQ youth seriously considered suicide, according to the online survey of more than 28,000 queer young people between the ages of 13 to 24, conducted at the end of 2022. Read more here.
• Oklahoma Gov. Kevin Stitt signed a bill into law Monday banning gender-affirming care for minors with the possibility of a felony charge for health care professionals who provide it. Senate Bill 613 bars health care professionals from providing gender-affirming care to those under the age of 18 in the form of surgeries, puberty blocking medication and hormone treatments. A health care provider accused of violating the new law could face felony charges. The ban takes effect immediately under an emergency clause and leaves certain exemptions for minors currently receiving treatment. Read more here.
• In the past two years, 19 states have banned or restricted gender-affirming care for minors, and another 12 states are considering it — a tidal wave of policy change that has emboldened many Republicans on the far right while terrifying transgender youth and their families. Gender-affirming care for transgender patients can cover pediatrics, psychiatry and endocrinology. Doctors may offer hormone treatments such as puberty blockers to patients under 18 to address gender dysphoria, which often worsens when bodies develop during adolescence. The “top” and “bottom” surgeries that have especially rankled the conservative base of the Republican Party are rarely performed on minors. Read more here.
• The Florida legislature on Thursday passed a bill that bans gender-affirming care for transgender youth and adds restrictions for adults seeking care, sending it to the desk of Gov. Ron DeSantis (R). Why it matters: The Florida Board of Medicine already barred health providers from offering this type of care to trans minors. If enacted, this bill would codify those restrictions into state law, and would also add criminal penalties for physicians who provide gender-affirming treatments. Various LGBTQ rights groups, on behalf of seven Florida parents, said that they plan to urge a federal court to block the bill as part of their pending lawsuit. Read more here.

Federal and State Policy

• More than a half million of the poorest Americans could be left without health insurance under legislation passed by House Republicans that would require people to work in exchange for health care coverage through Medicaid. It’s one of dozens of provisions tucked into a GOP bill that would allow for an increase in the debt limit but curb government spending over the next decade. The bill is unlikely to become law, though. It is being used by House Republicans to draw Democrats to the negotiating table and avoid a debt default. Read more here.
• Patients seeking mental health treatment for themselves or their families too often find their insurers' provider directories riddled with inaccurate information, filled with names of providers who aren't accepting new patients or packed with contact information for providers who aren't actually accepting that form of insurance. The problem of so-called "ghost networks" is pervasive in mental health, according to data released by Senate Finance Democrats ahead of a hearing Wednesday in which senators sharply criticized the accuracy of insurance company provider directories and called for action that would make it easier for patients to seek mental health care. Read more here.
• We have our work cut out for us. Indiana consistently ranks near the bottom of multiple national health statistics, including maternal deaths (42nd out of 51 states and Washington D.C.) and mental illness prevalence and access to care (42nd again). Where are we ranked near the top? Cigarette use among adults (11th out of 53 states, D.C. and territories), which is not a rank to be lauded. Read more here.
•  If the federal government breaches the debt ceiling, Medicare wouldn't be able to pay providers — and states wouldn't get their federal Medicaid funding, experts tell Axios.
• Why it matters: Losing out on those payments, even for a short time, could be disastrous for providers’ bottom lines — and the effects could trickle down to patients. An extended default could have broad consequences for Americans' health care, potentially reaching not just Medicare and Medicaid, but the Affordable Care Act as well — and making providers more reluctant to treat Medicare and Medicaid patients. Read more here.