Week of July 10–14, 2023

General Articles

• Hospitals across the country are stretched beyond capacity caring for more patients with mental illness than ever before. The ongoing closure of crisis services has left many people without access to therapeutic support, making emergency departments (ED) their first point of contact during a mental health crisis. EDs are designed to treat physical traumas and are ill-equipped to provide regular care for people with mental illnesses. The resulting overflow of patients creates a potentially dangerous environment for both patients and staff. Read more here.
•  A federal judge has found Washington state in contempt and ordered it to pay more than $100 million in fines for failing to provide timely psychiatric services to mentally ill people who are forced to wait in jails for weeks or months. In her order released late Friday, U.S. District Judge Marsha Pechman said the Washington Department of Social and Health Services has been violating the constitutional rights of these people since 2015 due to a “lack of foresight, creativity, planning and timely response to a crisis of its own making.” Read more here.
• As little as 20 minutes of moderate activity a day for five days a week can significantly lower the risk of depressive symptoms for people over 50 who have conditions often linked to depression, such as diabetes, heart disease and chronic pain, a new study found. People with diabetes have twice the risk for depression, according to Diabetes UK, and a 2017 study found heart disease patients are twice as likely to die if they develop depression after their diagnosis. Read more here.
• But don’t get too worried, experts say. Such a shift is known as a “lexical innovation,” says Andrea Beltrama, a linguistics researcher at the University of Pennsylvania. He and others say that while it might be jarring for non-TikTokkers to hear suicide and sexual assault discussed so euphemistically, it doesn’t necessarily remove the seriousness from the conversation. “Whoever says ‘unalive’ intends to communicate something about suicide, and knows that, and assumes that whoever is on the other end will be able to retrieve that intention,” Beltrama says. Read more here.

Youth Mental Health

• A new study in JAMA Psychiatry shows emergency department (ED) visits and stays for mental health needs soared for adolescent females in the United States in the second year of the COVID-19 pandemic, rising by 22% when compared to the year before the pandemic. In general, the authors of the study also found a significant increase (72%) in the percentage of youth in EDs with long onboarding (waiting in an ED or medical inpatient unit) times. Read more here.
• More than a year after lawmakers passed broad legislation meant to expand access and boost resources for children’s mental health in Connecticut, a group of health care providers, advocates, legislators and residents affected by the issue convened to begin examining the availability and efficacy of services. The panel was formed as part of the legislation passed in 2022 but only began its work on Monday. Read more here. 
• Mental health services for children and teens continue to be a pressing need in New Hampshire in the wake of the pandemic, according to providers and advocates who spoke at a roundtable in Manchester Monday. Depression and anxiety among youth rose during the pandemic, and services have struggled to keep up. The speakers – who included advocates, representatives of mental health providers and the head of the state’s behavioral health division – described various ways they’re trying to meet that need, supported by recent infusions of federal funding. Read more here.
• Every day brings more evidence that our nation’s youth are facing a mental health crisis: rates of depression, anxiety and suicidal thoughts among young people are on the rise, and so are adolescent deaths from drug poisoning. By late 2021, the number of adolescents dying from drug poisoning each month had more than doubled, with 84% of these deaths involving illicit fentanyl, including fake prescription pills. Two out of every 5 of these young people also had mental health issues. Read more here.
• In March 2022, John called the police to his home in Mecklenburg County because his 16-year-old son Paul was experiencing a violent behavioral health episode. John and his wife began fostering Paul and his two younger siblings when Paul was 12 and later adopted all three children. John said child welfare services had been involved in Paul’s life from a young age, and the boy had several behavioral health diagnoses, including ADHD, a disruptive behavior disorder and an attachment disorder. Read more here.
• To say Americans have a toxic view of aging would be an understatement. Research shows that a cultural fixation on appearing and acting young has led to political, economic, and social ramifications for older individuals. However, ageism, or bias and discrimination against older people, doesn’t simply come from those who are younger. Increasingly, self-directed ageism is causing negative health effects—both mental and physical—for those who have decades of life under their belts. Read more here.

Workforce Issues

• A study found Latinos are still underrepresented among certain health care professions and obstacles to advanced education may be to blame. The study, published Wednesday in Health Affairs, comes a week after the recent Supreme Court decision to strike down affirmative action policies that helped diversify medical schools across the country for decades. Read more here. 

The Opioid Crisis and Addiction Issues

• The Biden administration on Tuesday released a national plan targeting the spread of xylazine, an animal tranquilizer that's increasingly laced with fentanyl and is rapidly spreading through the illegal drug trade. Why it matters: Overdose death rates involving xylazine have skyrocketed in the past five years, but a federal strategy to fight the emerging drug threat hasn’t existed until now, leaving the response largely to a patchwork of local efforts. Read more here.

988 Hotline

• As it hits the one-year mark, most Americans still are unaware the 988 national suicide prevention and mental health hotline exists — and only a few states have established long-term funding commitments to sustain it. Why it matters: Without more federal outreach and resources, the three-digit number could languish as the nation continues to grapple with its mental health crisis. Read more here.
• Minnesota joined the nation in introducing the phone number 988 as a mental health crisis hotline one year ago, localizing and easing access to the service that was before only reachable at 1-800-273-TALK (8255). While the longer number still functions, call center operators said state support for raising awareness of the shorter line contributed to an increase in engagement over the past year. According to most recent data from the Minnesota Department of Health, or MDH, the month of May saw a 74 percent increase in calls statewide compared to the year before. Read more here.

Health Insurance

• President Biden on Friday rolled out a new set of initiatives to reduce health care costs: a crackdown on what he called “junk” insurance plans that play consumers as ‘suckers,’ new guidance to prevent surprise medical bills and an effort to reduce medical debt tied to credit cards. Read more here.

Medicaid Redetermination

• If you care about women’s health, or the health of the U.S. economy for that matter, you should be paying attention to Medicaid. Medicaid, the publicly funded health insurance program designed to provide a safety net for low-income and disabled Americans, is unraveling at an alarming pace — and that’s bad news for women, families, communities and the nation as a whole. Read more here.
• More than 87,000 Idahoans – so far – are being removed from Medicaid coverage after expanded coverage from the pandemic has lapsed. A little more than half of Medicaid recipients who lost coverage — 48,857 — were removed because the Idaho Department of Health and Welfare either could not contact them or the Medicaid enrollees didn’t give the agency the information to prove their eligibility, department spokesperson Greg Stahl told the Idaho Capital Sun in an email. Another 38,682 people removed from Medicaid were determined ineligible, Stahl said, while 27,537 were deemed eligible. Read more here.
• Georgia has removed another 95,000 adults and kids from state insurance rolls as it continues to review who is eligible for coverage now that the federal government has ended a pandemic public health emergency, state officials announced Wednesday. The removals from Medicaid and Children’s Health Insurance represent a little under half of the roughly 217,000 people who were due for renewal in June, the Georgia Department of Community Health said in a news release. Read more here.
• Mississippi has removed more than 29,000 people from Medicaid as the program starts reviewing who is eligible to keep coverage now that the federal government has ended a pandemic public health emergency. That is just over 3% of people who were enrolled in the state’s program in June. The Mississippi Division of Medicaid said in a statement Monday that it expects enrollment to further decrease in the coming months as officials continue reviewing eligibility. Read more here.

State Bans on Gender-Affirming Care

• Transgender people in Florida are facing more restrictions to their medical care, even after two recent court rulings lambasted the state's approach to gender-affirming health care regulation. Driving the news: The state boards of medicine and osteopathic medicine issued new rules last week for trans adults to undergo hormone replacement therapy and surgery. The guidance is part of an informed consent process required by Senate Bill 254, which went into effect in May. Read more here.
• Five families of transgender youth in Texas, plus three health care workers, are suing the state in an attempt to block its ban on gender-affirming care for minors from taking effect at the start of September. The American Civil Liberties Union of Texas and national legal groups are leading the lawsuit, which was filed late on Wednesday and names the state, the Texas attorney general and state medical board. Although the law has not gone into effect, transgender youth and their families have already been suffering, said Brian Klosterboer, a staff attorney at the ACLU of Texas. Read more here.
•  Tennessee’s ban on gender-affirming care for transgender youth can go into effect — at least for now — after a federal appeals court on Saturday temporarily reversed a lower court ruling. Last month, a district court judge in Tennessee found that the state’s new law banning transgender therapies like hormone blockers and surgeries for transgender youth was unconstitutional because it discriminated on the basis of sex. Read more here.
• On an early morning in June, Flower Nichols and her mother set off on an expedition to Chicago from their home in Indianapolis. The family was determined to make it feel like an adventure in the city, though that wasn’t the primary purpose of the trip. The following afternoon, Flower and Jennilyn Nichols would see a doctor at the University of Chicago to learn whether they could keep Flower, 11, on puberty blockers. Read more here.
• Transgender people, more specifically transgender people of color, are considered a marginalized group in the US and are most impacted by state legislation being considered and passed to ban gender-affirming care. These bans will exacerbate existing challenges and further negatively impact the health and well-being of transgender youth of color as they are more likely to experience greater social, mental health, and economic issues compared to their cisgender and White transgender peers. Read more here.

Federal and State Policy

• North Carolina’s planned managed care program for Medicaid enrollees who also need services for behavioral health or intellectual or developmental disabilities is being delayed again by state officials. The start date for these “tailored plans” that will cover roughly 160,000 people had been last Dec. 1. The state Department of Health and Human Services then pushed back its implementation to April 1, then to this coming Oct. 1. DHHS announced Tuesday that it wouldn’t meet the October start date either, but this time didn’t give a new date, saying it was “still to be determined.” Read more here.