In continuing coverage, the Los Angeles Times (3/15, Gorman) reports that “California will receive funds to expand emergency psychiatric care, part of a national push to get mentally ill patients out of hospital emergency rooms and into psychiatric facilities, the federal government announced this week.” The Times quotes Marilyn Tavenner, acting administrator of the Centers for Medicare & Medicaid Services, as saying that “treating psychiatric patients in ERs is not an ‘efficient use of healthcare dollars, and may be detrimental to vulnerable patients.'”

The Bangor Daily News (3/15, Cuda) reports that “the Centers for Medicare and Medicaid Services (CMS) today announced that 11 states — including Maine — and the District of Columbia will participate in the Medicaid Emergency Psychiatric Demonstration.” The Daily News quotes Tavenner as saying that “this new demonstration will help ensure patients receive appropriate, high quality care when they need it most and save states money.”

MedPage Today (3/15, Walker) reports that “the Centers for Medicare and Medicaid Services (CMS) has announced a new demonstration project aimed at Medicaid beneficiaries who experience psychiatric emergencies.” The story adds that the new program is part of the Affordable Care Act and “will test whether Medicaid beneficiaries receive faster, more appropriate care when psychiatric institutions receive Medicaid reimbursement.”

Related Links:

— “California to get funds for emergency psychiatric care, “Anna Gorman, Los Angeles Times, March 14, 2012.

In continuing coverage, the Atlantic (3/10, Entin) reported, “A follow-up study to 2004 research, which had noted an increased risk of suicide among people taking certain antidepressants, particularly children and adolescents, has now reached a different conclusion. Contrary to earlier results, the new study,” published in the Archives of General Psychiatry, “found that when the antidepressant prescribed is a good fit for the individual, there’s a lower risk of suicide. The new study’s results were especially strong for adults and the elderly. Though there was no decrease in suicide risk among children and adolescents, there was also no increase.”

Related Links:

— “Can Antidepressants Actually Make Us More Likely to Commit Suicide? The Atlantic, March 9, 2012.

Bloomberg News (3/11, Ratnam, Cortez) reported, “Some in the military have questioned whether the name ‘post-traumatic stress disorder,’ designated by the American Psychiatric Association in 1980, carries its own stigma that discourages service members from seeking help and brands them as unstable.” Now, “as an alternative to changing the name, the psychiatric association is considering creating a separate category for PTSD that results from combat stress, said John Oldham, the group’s president and chief of staff at the Menninger Clinic in Houston. The new combat category may be included next year in the fifth edition of the association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5).”

Related Links:

— “Pentagon tries Walmart therapy to combat PTSD, “Gopal Ratnam, The Bulletin, March 11, 2012.

In continuing coverage, CNN Newsroom (3/11, 6:23 p.m. ET) broadcast, “Lawmakers are putting pressure on…VA to improve” its mental healthcare services for veterans like Paul Raines, who returned from Iraq with post-traumatic stress disorder (PTSD). Raines told CNN that he is getting more help from VA now than he did after first learning he had PTSD. At that time, according to Raines, he only received medication and had to wait more than two weeks to see a specialist. CNN showed footage of US Sen. Patty Murray (D-WA) saying, “When a veteran has the courage to stand up and ask for help, VA must be there with not only timely access to care but also the right type of care.” CNN added, “VA says it’s reviewing mental health services at all its facilities.”

MedWire (3/14, Cowen) reports, “Around one-third of patients with bipolar disorder stop taking their medications against doctors’ advice within 1 year of starting treatment,” according to a study in the Journal of Affective Disorders. Researchers “studied 275 patients (65.1% women), aged an average of 39 years, with bipolar I or II disorder who received maintenance treatment” and “found that dropout rates at 1, 3, 6, 12, 24, and 36 months after starting treatment were 10.9%, 20.4%, 24.7%, 33.8%, 44.0%, and 50.2%, respectively, with rates increasing rapidly over the first 3 months. … The most common reasons for dropout were “denial of therapeutic need” (34.8%), “lack of treatment efficacy” (23.2%), and “adverse drug events” (13.0%).”

Related Links:

— “Treatment dropout rates high in bipolar disorder patients,”Mark Cowen, MedWire News, March 14, 2012.

Though the identity of the US soldier suspected of killing at least 16 Afghan civilians has yet to be disclosed, many news outlets provided what details are available in efforts to provide a “portrait” of the shooter in efforts to determine a possible motive for the killing. For example, NBC Nightly News (3/12, lead story, 3:40, Williams) briefly broadcast that the US military is looking into whether a brain injury the suspect “suffered while in Iraq” may have contributed to his actions.

ABC World News (3/12, story 2, 2:40, Sawyer) broadcast that the suspect was stationed “at a troubled army base” in Washington State, the Joint Base Lewis-McChord, and had “four deployments to war zones” since the September 11 terrorist attacks. The soldier had reportedly passed multiple health and mental screenings and “suffered a mild brain injury after hitting his head, but was treated successfully.”

The CBS Evening News (3/12, story 3, 2:20, Pelley) aired an in-depth look at the Joint Base Lewis-McChord in Tacoma, Washington, and said, “Troops from that base have been involved in other unjustified attacks recently.” CBS News detailed the troubling incidents related to the base and noted, “Since 2010, 26 Lewis-McChord soldiers have committed suicide.” The network cited a veteran soldier who suggested the toll of multiple tours in combat was too much for soldiers to endure, arguing, “They’re finally going to just hit the wall and explode.”

The Time (3/13, Thompson) “Battleland” blog reports, “The homeland of the Taliban, where Sunday’s apparent civilian massacre took place, is a ‘pressure cooker'” for US soldiers “assigned there. Their nearly daily contact with bloodshed could push an unstable soldier to lash out by killing innocent Afghans, says an Army psychiatrist just back from an assignment near where the killings took place. The Army psychiatrist, who declined to be named, spoke of the 38-year old US Army staff sergeant from Washington state’s Fort Lewis who allegedly left his base and killed 16 Afghan civilians, including women and children, early Sunday outside Kandahar in southern Afghanistan.”

The AP (3/13, Vogt, Khan) notes, “There was no available indication about the extent” of the suspect’s brain injury, or whether that “injury could be linked to any abnormal behavior afterward.”

The suspect’s brain injury is also mentioned by the Wall Street Journal (3/13, A7, Trofimov, Entous, Millman, Subscription Publication), which takes note of troubles at the Lewis-McChord base and says the non-profit group GI Voice has called for a congressional investigation into “systemic failures.”

Army Investigating Claims Madigan Psychiatrists Failed To Diagnose PTSD In Soldiers. The AP (3/13, Johnson) reports in a related story, “In the past five years, about 300 patients at Madigan Army Medical Center at the base had their PTSD diagnoses reversed by a forensic psychiatry team, The Seattle Times reported this month.” According to the AP, the “Army is reviewing whether those doctors were influenced by how much a PTSD diagnosis can cost, in terms of a pension and other benefits.”

The Los Angeles Times (3/13, Murphy, Parsons) notes, “GI Voice, a local anti-war veterans support group outside Lewis-McChord that has campaigned for better mental health services, on Sunday called for a congressional investigation into the ‘multiple crises coming from this rogue base.’ ‘In 10 years of war, JBLM has produced a Kill Team, suicide epidemic, denials of PTSD treatment, denials of human rights in the brig, spousal abuse and a waterboarded daughter, murders of civilians (including a park ranger), increased sex crimes, substance abuse… and much more,'” said a statement from “GI Voice’s executive director, Jorge Gonzalez, an Iraq war veteran from Lewis-McChord.”

The Seattle Times (3/13, Doughton) notes that the 32-year-old Gonzalez was “diagnosed with post-traumatic stress disorder (PTSD) after he returned home” from serving in Iraq. Gonzalez “said he was surprised that the shooter gunned down women and children, but that the incident itself was not a shock. ‘This is what happens when you have 10 years of war,’ he said.”

The Washington Times (3/13, Waterman) reports, “The soldier suspected in a shooting rampage in Afghanistan was deployed from a US base where medical personnel are being investigated for misdiagnosing post-traumatic stress disorder (PTSD).” Now, “the Army is investigating claims that psychiatrists at the Madigan Medical Center on the Joint Base Lewis-McChord military base near Tacoma, Wash., failed to diagnose PTSD in hundreds of soldiers.” Approximately “1,500 cases have been reviewed, and 285 of the soldiers will be offered re-evaluations, according to the Western Regional Medical Command, which runs Madigan — the largest military hospital on the West Coast.”

The Huffington Post (3/13, Wood) reports, “The link between combat stress and outbursts of violence was well documented even before troops began routinely serving three, four or more combat deployments in Iraq and Afghanistan over the past decade.” However, “PTSD and violence among veterans has become more prevalent. A study conducted at the Puget Sound Veterans Affairs hospital in Washington, for instance, demonstrated high levels of anger and hostility among returning combat veterans screening positive” for PTSD.

The CBS News (3/13, Tracy) website reports that it is “unknown what, if any, role PTSD played in the actions” of the Sunday killings in Afghanistan.

In a separate story, the CBS News (3/13, Tracy) website notes, “Members of Congress are now looking into allegations of how PTSD cases were handled” at Lewis-McChord. Reuters (3/13, Alexander) also covers the story.

Studies: Mental Illness Growing Problem For US Military Members In Afghanistan. The Los Angeles Times (3/13, Alpert) “World Now” blog reports that “mental illness has been a persistent and growing problem for members of the military in Afghanistan, according to several recent studies.” A study last year found that “psychological problems recently reached a five-year high among Marines in Afghanistan,” with “nearly 20% of the Marines surveyed in Afghanistan [reporting] psychological problems such as severe stress and depression in 2010, twice the rate as in 2005.” Yet “another recent study found that mental disorders and suicide rates in the military surged up between 2004 and 2008. Mental illness rates nearly doubled after troops were sent to Iraq and Afghanistan, the Army Public Health Command found.”

Related Links:

— “Battlefield Stress Could Have Triggered Afghan Massacre,”Mark Thompson, TIME U.S., March 12, 2012.

In continuing coverage, the Military Times (2/29, McMichael) “Scoop Deck” blog reports that a “welcome compromise was reached Monday in federal court in Roanoke, Va., when prosecutors agreed that a Navy veteran of the Persian Gulf War who called a suicide hotline last year and threatened to kill himself with a homemade gun would not be prosecuted if he completes mandatory counseling.”

Under the “agreement, Sean Duvall will be admitted to a state Veterans Treatment Court. The concept, akin to drug treatment courts, offers vets with war-related mental health conditions counseling and treatment alternatives in the context of a highly disciplined environment.”

Related Links:

— “Deal avoids prosecution for former sailor who threatened suicide with homemade gun,”Bill McMichael , MilitaryTimes, February 28, 2012.

In continuing coverage, the ABC News (3/9, Gann) website notes, “Since the start of the Iraq War in 2003, the rate of Suicide among US Army soldiers has soared, according to a new study” from the US Army Public Health Command published online March 7 in the journal Injury Prevention.

The “study, an analysis of data from the Army Behavioral Health Integrated Data Environment, shows a striking 80 percent increase in suicides among Army personnel between 2004 and 2008.”

ABC News added, “Based on the data and the timing of the increase in suicide rates, the authors” of the study calculated that approximately “40 percent of the Army’s suicides in 2008 could be associated with the US military escalation in Iraq.”

The Atlantic (3/9, Walton) reports, “A new report from the Substance Abuse and Mental Health Services Administration (SAMHSA) finds that 20 percent of Americans adults suffered from a mental illness last year.” In other words, “this translates to 45.9 million people. Almost 30 percent of Americans between the ages of 18 and 25 suffered from a mental health disorder.” What’s more, “among all adults, women were more likely to suffer than men (23 percent vs. almost 17 percent, respectively).”

Related Links:

— “45.9 Million Americans Suffered From Mental Illness Last Year,”Alice G. Walton, The Atlantic, March 8, 2012.

The Huffington Post (3/9, Wood) reports that VA’s “free and confidential Veterans Crisis Line…is intended to bridge the gap between the vast number of veterans who need help, and the broad array of veterans services offered by the VA. In the four years of its existence, the Veterans Crisis Line operators, or ‘responders,’ as they are called, have initiated 18,600 ‘saves’ of veterans who vowed to kill themselves.” Because “thousands of war-weary men and women are expected to leave military service” in the years ahead “and face the stresses of civilian life, strained family relationships and a sagging economy,” VA “is adding more lines and call stations” to the Veterans Crisis Line.

Related Links:

— “Veterans Crisis Line Seeks To Help Those Struggling With Civilian Life, Unemployment, Post-Combat Stress,”David Wood, Huff Post World, March 8, 2012.