Week of September 19–23, 2022

General Articles on Mental Health Issues

• U.S. doctors should regularly screen all adults under 65 for anxiety, an influential health guidelines group proposed Tuesday. It’s the first time the U.S. Preventive Services Task Force has recommended anxiety screening in primary care for adults without symptoms. The recommendations are based on a review that began before the COVID-19 pandemic, evaluating studies showing potential benefits and risks from screening. Given reports of a surge in mental health problems linked with pandemic isolation and stress, the guidance is “very timely,” said Lori Pbert, a task force member and co-author.  Read more here.
• A growing number of Americans are struggling with depression and most are not seeking treatment or are undertreated for the mental health disorder, according to a new study. A study published in the American Journal of Preventive Medicine found almost 1 in 10 Americans reported suffering from depression in 2020, with rates of the mental health disorder higher among adolescents and young adults. “The net effect of these trends suggests an accelerating public health crisis and that parity and public-service announcement efforts have not achieved equity in depression treatment.” Read more here.
• Depressed patients with prior treatment failure often face high medical costs and poor quality of life, a new survey suggested. Of 10,710 adults with self-reported major depressive disorder (MDD) who participated in the 2019 National Health and Wellness Survey, 1,077 said they experienced treatment failure requiring them to try new medications as a result of non-responsiveness, Larry Culpepper, MD, of Boston University School of Medicine, and colleagues reported. Read more here.
• Levels of stress, anxiety, worry, sadness, and anger among women worldwide are at a 10-year high, according to a new report. In one of the largest studies on women’s well-being, analytics firm Gallup and medical tech company Hologic, Inc. teamed up to survey over 66,000 women in 122 countries around the world. Read more here.
• A study published this month in Psychology and Aging by researchers at the University of California San Diego School of Medicine indicates that adults over 60 showed greater mental well-being but worse cognitive performance than younger adults. Adults in their 20s tended to have more experience with anxiety, depression, and loneliness than seniors.
• The average number of veteran suicides per day in the United States has fallen to the lowest it’s been since 2006, according to new Department of Veterans Affairs (VA) data, but those figures might not paint the whole picture. The VA’s National Veteran Suicide Prevention Annual Report, released Monday, found that there were 6,146 veteran suicide deaths in 2020, or about 16.8 a day. The new figure is 343 fewer suicides than in 2019 and 650 fewer than in 2018, appearing to reflect positive gains in efforts to give veterans and discharging service members mental health care and support, VA officials said. Read more here.
• A bill introduced in the House of Representatives would require private health insurance to cover forensic exams for sexual assault survivors in full. The legislation came after research published last week in the New England Journal of Medicine showed that nearly 18,000 out of 113,000 emergency visits related to sexual violence in 2019 resulted in out-of-pocket costs for the survivors. The average cost was $3,551 per person. Read more here.
• More adults are seeking out treatment for mental health issues. The percentage of adults getting mental health treatment increased from 19.2% in 2019 to 21.6% in 2021, the Centers for Disease Control and Prevention reported. Those more likely to have received treatment? Younger adults, those aged 18 to 44, especially women in that age group, according to findings from the National Health Interview Survey, a nationally representative household survey done by the CDC. Participants who received mental health treatment were either on prescription medication for their mental health, in counseling or therapy from a mental health professional, or both over the past 12 months. Read more here.
• Patients with post-traumatic stress disorder (PTSD) are often treated for symptoms of the condition before ever receiving a formal diagnosis, according to a retrospective analysis of U.S. commercial claims data. In the 6 months prior to PTSD diagnosis, patients often experienced multiple PTSD-related symptoms, such as mental, behavioral, or neurodevelopmental disorders (69.7%), physiological symptoms (58.1%), general health and quality of life issues (23.6%), and problems with cognitive faculties (10.0%), reported Jyoti Aggarwal, MHS, of Otsuka Pharmaceutical Development & Commercialization. Read more here.

Youth Mental Health

• Wildfires in California are becoming increasingly frequent, widespread, and devastating. Since 2015, fifteen of the state’s most destructive fires in recorded history have occurred. But as we measure each new fire by acres burned, homes destroyed, and lives lost, we’re also beginning to comprehend the toll wildfires are having on the youngest who’ve survived these extreme disasters. Health screenings of some of the state’s most underserved families are revealing tens of thousands of children who’ve lived through these fires are experiencing potentially lasting psychological trauma and other chronic health issues. Listen here.
• We’ve had multiple conversations on Insight about the rise in gun violence and firearm purchases during the pandemic. But there are many more that happen on an intimate and individual level that don’t receive the same trajectory of attention. Genoa Barrow, a senior writer at the Sacramento Observer, went beyond gun violence and learned about the overlap of domestic violence plays, an intersection with deep roots in mental health, poverty, and socioeconomic inequality. Read more here.
• Today’s kids face so much more than I did. The threat of mass shootings. The political spectacle of anti-diversity efforts. Cyber bullying on social media. The disruption of COVID. The looming calamity of climate change and a democracy that’s teetering on the edge. Add all of those on top of the stressors that have been common for kids throughout the decades. It’s no wonder a recent survey of over 20,000 Cincinnati-area kids showed that nearly one in three were exhibiting signs of mental health issues. Read more here.
• We’re Edward and Bea, the parents of two adult children. Our first-born, John, has been diagnosed with schizophrenia, a treatable brain disorder (if our county and country had a functioning mental health system and benevolent laws). For the past 23 years, we’ve prayed and fought for John to have a good independent life that we see his church and high school buddies experiencing — maybe a family, good friends, a good career (and probably a dog because he loves ours, Cody). That’s what we always imagined John having. And at first, it was an easy dream to believe in. Read more here.
• Maternal depressive symptoms were associated with an increase in the number of unhealthy adolescent behaviors, a 15-year longitudinal study showed. While unhealthy behaviors were found to be common among adolescents in general, with two out of three engaging in at least one, higher levels of maternal depressive symptoms during a child's middle childhood and adolescence were associated with engagement in more unhealthy behaviors at 16 to 17 years of age, reported Laura Bechtiger, MSc, of the Jacobs Center for Productive Youth Development in Zurich, and colleagues. Read more here.
•  The stress of a natural disaster during pregnancy may substantially increase the risk of childhood anxiety, depression, or other behavior disorders, according to a new study published Wednesday in the Journal of Child Psychology and Psychiatry. Researchers from the Icahn School of Medicine at Mount Sinai and the CUNY Graduate Center found that children who were in the womb during Hurricane Sandy in 2012 were more likely to develop psychological and behavior disorders than those who were born before or conceived after, with stark contrast. Read more here.

 Impact of the Pandemic

• People who had COVID-19 are at higher risk for a host of brain injuries a year later compared with people who were never infected by the coronavirus, a finding that could affect millions of Americans, U.S. researchers reported on Thursday. The year-long study, published in Nature Medicine, assessed brain health across 44 different disorders using medical records without patient identifiers from millions of U.S. veterans. Read more here.

Climate Change and Mental Health

• A recent study has found a link between outdoor temperatures and the prevalence of hate speech on social media, which may, in turn, impact mental health. The findings were originally published in the medical and health news outlet Medical Xpress before the study was published in the peer-reviewed journal The Lancet Planetary Health . It found that people post more hateful tweets when the temperature rises above or dips below a "feel-good" range. Read more here.

Crisis Services and 988

• For too long, there hasn’t been an easy, safe way for someone experiencing suicidal thoughts or a mental health crisis to get immediate help. Fortunately, that appears to be changing thanks to 988. The number, which became available nationwide earlier this summer, is a dedicated phone line that anyone can contact for mental health, substance use and suicidal crises. When Congress and the Federal Communications Commission designated it as an emergency line in 2020, there were questions about why the number was needed and how effective it would be. But now, we have data to support the resource.
• More than half of Colorado counties lack a “co-responder” program in which a mental health professional joins law enforcement on police calls, including Clear Creek County where local officers shot and killed a 22-year-old man as he sat in his car.  The death of Christian Glass in the small mountain town of Silver Plume, about 45 miles west of Denver, is once again raising questions about law enforcement response to 911 calls involving someone who is having a mental health crisis. Glass’ parents and their attorney revealed details of the man’s June 11 death last week. Read more here…

Social Determinants of Mental Health

• During the past decade, a growing body of research has shown that air pollution harms older adults’ brains, contributing to cognitive decline and dementia. What hasn’t been clear is whether improving air quality would benefit brain health. Two studies published this year by researchers at six universities and the National Institute on Aging provide the first evidence of such benefits in an older population. Read more here.
• Presumptive depression and post-traumatic stress disorder (PTSD) were highly prevalent among residents of Flint, Michigan, 5 years after they were exposed to contamination in their tap water, which was not declared safe until nearly 3 years later, a cross-sectional survey study showed. Of the 1,970 residents who responded to the survey, 22.1% met the DSM-5 criteria for presumptive past-year depression, 24.4% met criteria for presumptive past-year PTSD, and 14% met criteria for both. Read more here.

Refugees and Mental Health

• Refugees are arriving in the U.S. in greater numbers this year after resettlement counts reached a 40-year low under President Donald Trump. These new arrivals, like those refugees before them, are 10 times as likely as the general population to have post-traumatic stress disorder, depression, and anxiety. Many of them, like Bahige, fled their homelands because of violence or persecution. They then must deal with the mental toll of integrating into new environments that are as different as, well, Wyoming is from Central Africa. Read more here.

Workforce Issues

• Hospitals across Missouri are facing a “crisis” caring for patients in acute care settings who can’t find long-term care through the Department of Mental Health due to the agency’s chronic shortage of workers, according to hospital officials. Patty Morrow, vice president of behavioral health services for Mercy Health, testified during a legislative hearing Wednesday that “the problem is pervasive and systemic” as residents languish on waitlists for services. Read more here.
• Emotional exhaustion among U.S. healthcare workers worsened over the course of the COVID-19 pandemic and threatens to compromise patient care, according to a Sept. 21 analysis from JAMA Network Open. Read more here.

Health Insurance

• Soaring medical debt is setting U.S. adults up for higher risks of eviction, food insecurity, and bad health outcomes regardless of insurance or income, a new study found. Why it matters: Uninsured or middle-to-low-income patients are more likely to get stuck with medical debt while the rich are largely spared. But even private insurance offers little protection against unaffordable bills, according to the study published in JAMA Open Network. Read more here.
• All signs are pointing toward significantly higher health costs in the employer market next year, which will translate into larger-than-normal premium increases. Why it matters: Employers will have to choose between taking the hit or passing the added cost to their employees — a decision that's particularly difficult in a tight labor market. Read more here.

The Opioid Crisis and Addiction Issues

• April Babcock and Virginia Krieger both lost children to the powerful synthetic opioid fentanyl and have pleaded with lawmakers and officials to ramp up enforcement along the U.S.-Mexico border to stop the flow of illicit drugs. On Saturday, the mothers built a kind of wall. Fifty banners stretched for about 400 feet, nearly spanning the width of the National Mall. They featured faces of nearly 3,500 people who lost their lives to fentanyl. Read more here.
•  Knoxville, a city of about 190,000 people on the Tennessee River with a state university and downtown entertainment district, was a huge market for Endo International’s addictive opioid pain pills. Almost 1 million more of Endo’s Opana ER tablets were sold in the Knoxville area between 2007 and 2014 than in New York, Los Angeles, and Chicago combined. Read more here.
• Joy Bogese is one of four peer recovery specialists who have been working in central Virginia this year as part of “Project Recover.” The specialists are embedded with ambulance crews and police officers so they can offer guidance and resources to victims during one of the most difficult times of their lives — immediately following an overdose. Read more here.
• Federal data shows most people who need treatment for opioid use disorder don’t get it. Yet nearly every state has laws that limit access to opioid treatment programs, according to a new report from the Pew Charitable Trusts. Researchers say these state restrictions go against evidence-based practices and limit access to care. Read more here.
• September is National Recovery Month, a time to celebrate the 22 million Americans in recovery, remember those we have lost to the disease of addiction, and share solutions to prevent overdose deaths and save lives. As part of this important effort, it is critical to pass legislation to help prevent addiction before it begins by expanding access to and use of non-addictive pain management treatments.

Research

• For most of his adult life, Aaron Presley, age 34, felt like a husk of a person, a piece of "garbage." He was trapped in a reality that was so excruciatingly tedious that he had trouble getting out of bed in the morning. Then, all at once, the soul-crushing, depressive fog started to lift, and the most meaningful experience of his life began. Presley was one of 24 volunteers taking part in a small study aimed at evaluating the effectiveness of a combination of psychotherapy and psilocybin, the active ingredient in what's more commonly known as magic mushrooms, to treat depression—an approach that, should it win approval, could be the biggest advance in mental health since Prozac in the 1990s. Read more here.

Federal and State Policy

• New Senate legislation seeks to add 400 new psychiatrists a year in a bid to address a crippling shortage of mental health workers. The discussion draft released  by the Senate Finance Committee is part of a larger effort by the panel to reform mental health. The legislation would also boost bonus payments for mental health providers that offer care to underserved communities. Read more here.
• Rep. Bonnie Watson Coleman (D-N.J.) and Sen. Bill Cassidy (R-La.) expressed support on Wednesday for more mental health care investments, pointing to the tens of thousands of lives potentially saved and the billions of dollars invested in a more comprehensive federal program that would benefit the U.S. Both lawmakers spoke at the “Cost of Mental Health Inequities” event moderated by The Hill contributing editor Steve Scully. Read more here.
• North Carolina’s hospitals and hospital systems recently unveiled an offer that could shake up stalled negotiations to pass legislation that would expand Medicaid to cover hundreds of thousands of low-income adults in the state. The North Carolina Healthcare Association said the offer sent to Republican legislative leaders and Democratic Gov. Roy Cooper also contained reforms to some state laws that require regulatory approval before certain medical buildings can be constructed or services offered in a region. Read more here.