Week of June 12–16, 2023

General Articles

• The idea that trauma can be transmitted across generations — originating with long-dead relatives and passed down to future great-grandchildren — can be a difficult concept to grasp. But with regular news of mass shootings, covid deaths, police killings and climate disasters, a growing number of therapists and their patients, particularly among the millennial and Gen Z cohorts, are turning their attention to the far-reaching impact of trauma, past and present. Read more here.
•  A study from researchers at the University of Kansas shows Southern states may have carried the brunt of mental health troubles during the COVID-19 pandemic, with people in that region most consistently worried about finances throughout COVID-19 lockdowns and the emergence of new strains of the virus. The findings were published yesterday in PLOS One. The study focused on rates of anxiety, depression, and financial worries as stand-ins for mental health during the pandemic and relied on survey repossess gathered via the Delphi Group at Carnegie Mellon University. Read more here.
• First responders and 911 call takers facing the stress and challenges of the job in Fairfax County, Virginia, will now have a new place to connect with mental health professionals. The Fairfax County Public Safety Wellness Center held its grand opening on Monday. Police and firefighters have higher rates than the general public of stress, depression and suicide, according to the Substance Abuse and Mental Health Services Administration, and there’s often a stigma among public safety officers in seeking out mental health services. Read more here.
• Unfortunately, in January 2018, Hilinski tragically took his own life at the age of 21. His untimely passing shocked the WSU community and left a void in the hearts of his loved ones. The devastating loss sparked important conversations about mental health, the pressures faced by student-athletes, and the need for increased support and resources in the sporting world. Hilinski’s Hope was started by Kym and Mark Hilinski, Tyler's parents, shortly after his death in 2018. Read more here.

Youth Mental Health

• This country faces a longstanding mental health crisis, exacerbated by the isolation, fears and uncertainties of the pandemic. This crisis affects all generations, but has been especially devastating for young people. In America today, 40% of parents report being either extremely or very worried that their child is struggling with anxiety or depression. And they are right to be worried. According to a recent survey by the Centers for Disease Control and Prevention, nearly one out of every three teenagers in America reported that the state of their mental health was poor. Read more here.
•  The homicide rate for older U.S. teenagers rose to its highest point in nearly 25 years during the COVID-19 pandemic, and the suicide rate for adults in their early 20s was the worst in more than 50 years, government researchers said Thursday. The Centers for Disease Control and Prevention report examined the homicide and suicide rates among 10- to 24-year-olds from 2001 to 2021. Experts cited several possible reasons for the increases, including higher rates of depression, limited availability of mental health services and the number of guns in U.S. homes. Read more here.
•  Nearly 15% of children in the United States were recently treated for mental health disorders in 2021, according to new research from the US Centers for Disease Control and Prevention. The finding, released Tuesday by the CDC’s National Center for Health Statistics, suggests that mental health disorders – such as attention-deficit/hyperactivity disorder or anxiety – are common among school-age children. For the research, statisticians analyzed data from the 2021 National Health Interview Survey to find the percentage of children who received mental health treatment in the past year. Read more here.
•  To address the student mental health crisis, colleges and universities have implemented a swath of resources and services targeting mental well-being and resilience. Evaluating the effectiveness of each measure, however, remains a challenge for leaders. A May Student Voice survey by Inside Higher Ed and College Pulse found students, when evaluating a prospective college or university, consider mental health supports above other wellness offerings. Around 30 percent of students ranked mental health supports as their No. 1 priority among wellness services offered by the institution. Read more here.
•  In this video, Jeremy Faust, MD, editor-in-chief of MedPage Today, sits down with Jessi Gold, MD, MSopens in a new tab or window, an assistant professor in the department of psychiatry at Washington University School of Medicine in St. Louis, and Amanda Calhoun, MD, MPHopens in a new tab or window, a psychiatry resident at the Yale Child Study Center in New Haven, Connecticut, to discuss the state of youth mental health in the U.S. The following is a transcript of their remarks. Read more here.

Older Adult Mental Health

• Loneliness and social isolation are increasingly being recognized as a nationwide epidemic. The U.S. Surgeon General’s office, headed by Vivek Murthy, MD, MBA, released an 81-page report earlier this year detailing the scourge of loneliness and social isolation, and also laid out a national strategy for addressing it, following recommendations from both national and global organizations. Loneliness refers to the subjective experience that results from feeling isolated or having inadequate connections with others, while social isolation is objectively having few relationships, social roles or group memberships and infrequent social interaction. Read more here.

Workforce Issues and Burnout

• Two new studies illustrate the mental toll COVID-19 took on healthcare workers (HCWs), with the first documenting high rates of burnout among HCWs and the second describing harassment on social media platforms suffered by physicians and scientists during the pandemic. The first study, published in the Journal of Interprofessional Education & Practice, included surveys and interviews of HCWs in Massachusetts who were asked about their experiences with burnout during the pandemic. Forty percent of those interviewed said the pandemic, and subsequent burnout, meant it was likely they would leave their jobs within 5 years. Read more here.
• Burnout in the health care industry is a widespread problem that long predates the covid-19 pandemic, though the chaos introduced by the coronavirus’s spread made things worse, physicians and psychologists said. Health systems across the country are trying to boost morale and keep clinicians from quitting or retiring early, but the stakes are higher than workforce shortages. Rates of physician suicide, partly fueled by burnout, have been a concern for decades. And while burnout occurs across medical specialties, some studies have shown that primary care doctors, such as pediatricians and family physicians, may run a higher risk. Read more here.

The Opioid Crisis and Addiction Issues

• More than 109,000 Americans died from drug overdoses in the 12-month period ending January 2023, a slight increase from the previous year, according to provisional data from the U.S. Centers for Disease Control and Prevention (CDC) released on Wednesday. The figure is up 0.7% from 108,825 overdoses recorded in the 12-month period ending January 2022, according to U.S. data. Read more here.
• Thousands of local governments nationwide are receiving settlement money from companies that made, sold, or distributed opioid painkillers, like Johnson & Johnson, AmerisourceBergen, and Walmart. The companies are shelling out more than $50 billion total in settlements from national lawsuits. But finding out the precise amount each city or county is receiving has been nearly impossible because the firm administering the settlement hasn’t made the information public. Until now. Read more here.
• The clinic exemplifies an ongoing shift in the nation’s approach to stemming overdose deaths, which surged during the pandemic to unprecedented heights as the potent synthetic opioid fentanyl replaced heroin in drug markets across the country. The so-called harm reduction model, which has received endorsement and funding from the Biden administration, offers potentially life-saving services to opioid users, without requiring abstinence in return. Advocates say it acknowledges the importance of keeping people alive, first and foremost, while they confront the sometimes insurmountable challenges associated with recovery. Critics argue it enables illegal activity. Read more here.
•  The state of Minnesota is pumping $200 million over the next four years into fighting the substance abuse crisis. The big picture: Supporters say the changes, which include a slate of new policies, are aimed at reducing overdose deaths and taking a more comprehensive public health approach to addressing substance use disorder and recovery. Details: Laws passed in the recent legislative session will require overdose reversal medication for schools, jails, and law enforcement; dedicate $10 million to housing for people struggling with substance abuse; and allow the sale of fentanyl test strips at liquor stores. Read more here.
• The average American drinks 60 percent more hard liquor now than in the mid-1990s, an unheralded surge in spirit consumption that signals changing tastes in alcohol. Americans are drinking more wine, too: 50 percent more per person since 1995. Overall, the average American consumed 2.51 gallons of ethanol, the alcohol in wine, beer and spirits, in 2021, compared to 2.15 gallons in 1995, according to the National Institute on Alcohol Abuse and Alcoholism. If 2.5 gallons in a year sounds low, consider that the figure covers only alcohol, not water and other ingredients in an alcoholic drink. Read more here.
•  About 1 in 8 Americans over 50 struggle with an unhealthy relationship with highly processed food that goes well beyond the occasional binge or midnight snack, according to a recent poll. Known as food addiction, the condition isn’t limited to older adults — previous food addiction data had primarily centered around young- to middle-age adults up to around 50, said Ashley Gearhardt, lead author of the latest research by Michigan Medicine and a pioneer in the field of food addiction studies. Read more here.

988 Hotline

• Only 13% of adults in the U.S. have heard of the 988 Suicide and Crisis Lifeline and know its purpose nine months after its launch, according to a nationally representative survey conducted for The Pew Charitable Trusts. In July 2022, the U.S. launched 988, a service established by Congress to connect with a trained counselor the growing number of people experiencing mental health or substance use crises. The effectiveness of a standard number, such as the emergency 911 number or 988, relies on people being aware both of its existence and of when to call. Read more here.
• Almost a year after the launch of the 988 Suicide and Crisis Lifeline, only 13% of U.S. residents know the line exists and what it’s for – and many of those who do know are afraid that calling it will summon the police, according to a new survey. Even with the relatively low levels of awareness, the number of calls, on-line chats, and texts to the lifeline each increased considerably in April 2023 compared to the year before and, if this rate of increase continues, is on pace to roughly double the 2.4 million calls received annually from 2017 to 2021.  Read more here.

Health Insurance and Health Care Spending

• Two bills recently signed into law greatly enhance the ability of Oklahomans to access mental health care. Oklahoma Senate Bills 442 and 254 address high patient costs and excessive wait times for appointments by ensuring more transparency from commercial health insurance plans and capping out-of-pocket costs when a timely appointment with an in-network provider isn’t available. The bills address key findings of Healthy Minds Policy Initiative’s 2023 research report on Oklahoma private insurance plans’ coverage of behavioral health services. Read more here.
• A surge of Medicare spending on hospitals and other services later this decade will help U.S. health care expenditures outpace inflation and top $7.2 trillion by 2031, federal actuaries said on Wednesday. Why it matters: The new projections show medical spending across all categories rebounding from the pandemic doldrums, with hospitals being the biggest cost-driver. That likely will make health care become a larger part of household spending. Read more here.

Medicaid Redetermination

• The Biden administration on Monday urged states to slow down their purge of Medicaid rolls, citing concerns that large numbers of lower-income people are losing health care coverage due to administrative reasons. The nation’s Medicaid rolls swelled during the coronavirus pandemic as states were prohibited from ending people’s coverage. But that came to a halt in April, and states now must re-evaluate recipients’ eligibility — just as they had been regularly required to do before the pandemic. In some states, about half of those whose Medicaid renewal cases were decided in April or May have lost their coverage. Read more here.
• Another 68,838 residents lost Medicaid coverage in May, in addition to the 72,802 who were kicked off the state and federally funded insurance program in April, the Arkansas Department of Human Services reported Thursday. State of play: Of the more than 141,000 Medicaid closures over the past two months, about 18% were because recipients made too much money to qualify or requested to no longer receive the benefits. Most (66%) failed to return renewal forms or supply other requested information, according to DHS. Others couldn't be found. Read more here.

Protections and Bans on Gender Affirming Care and LGBTQ Issues

• Nevada Gov. Joe Lombardo has signed two bills related to transgender rights and vetoed another, bucking trends from other Republican governors across the country who have pushed anti-transgender policies. Lombardo’s signing of a bill Monday requiring health insurance companies including Medicaid cover all gender-affirming surgeries was the third major bill related to transgender health and rights to reach his desk. Another bill he signed earlier this month requires the state’s Department of Corrections to adopt mental and medical health standards for transgender and gender-nonconforming people inside the state’s prisons, including cultural competency training for guards. Read more here.
• Trans girls playing in girls sports, Nikki Haley has said for months on the campaign trail, is “the women’s issue of our time.” In Iowa, on the first day of his presidential campaign last week, Mike Pence said he would support a national ban on “radical gender ideology” and gender-affirming health care for transgender kids. Florida Gov. Ron DeSantis has promised to take his Florida policies national; those include a slate of laws that restrict how schools can talk about gender and sexuality, including pronouns. The current leader of the Republican presidential field, former President Donald Trump, released a campaign video that suggested his campaign was a war against trans identity. Read more here.
• How should the American Medical Association (AMA) respond to the rapidly increasing number of state prohibitions on gender-affirming care for adolescents? Delegates considered the topic during committee discussions at the AMA House of Delegates meeting Saturday. The AMA already has a policy in place for gender-affirming care, and a new draft resolution moves the policy forward from "passively supporting" gender affirming care to "proactively protecting it," according to Charles "Charlie" Adams, a draft resolution co-author. Read more here. (Free registration is required to read this article.)
• Despite increasing acceptance of the LGBTQ+ community, at least in some circles, adults who identify as gay, lesbian or bisexual are more likely than those who identify as straight to have serious thoughts of suicide and mental health conditions including major depressive episodes, and they are more likely to misuse substances like alcohol or drugs, according to a new US government report. The data in the report, which focuses on LGB adults, comes from 2021 and 2022. Next year’s survey will also aim to identify people who are transgender or nonbinary. Read more here.

Federal Policy

• A mandate that U.S. health insurers cover preventive care like, depression screening, cancer screenings and HIV-preventing medication at no extra cost to patients could remain in place while the Biden administration appeals a court order striking it down, following a tentative agreement announced on Friday.  Read more here.