The Army Times (2/29, Kime) reports, “Better data on suicide rates among veterans could be available by summer under an agreement forged between” Secretary Shinseki “and 49 states.” The rate “often noted in press reports and analyses — an average of 18 veteran suicides each day — is derived from information available from the Centers for Disease Control’s National Violent Death Reporting System, which receives input from 18 states, and other sources. VA now has a commitment from 49 state governments to furnish statistics on veterans’ deaths in their states to the department, said Jan Kemp, VA’s National Mental Health Program Director for Suicide Prevention,” who added that VA is in talks with Colorado’s governor to provide the information. While speaking at the American Legion convention in Washington, DC, on Monday, Kemp stated, “By April, hopefully, we’ll have a more realistic view of the scope” of suicides committed by veterans.

Related Links:

— “VA aims to get better data on vet suicide rates,”Patricia Kime, ArmyTimes, February 28, 2012.

Bloomberg News (2/28, Moroney) discussed “the diminishment of acute care for the mentally ill — the kind of hospitalizations sought during times of crisis. The duration of these stays has dropped to 7.8 days in 2009, the last year of available data, from 12.8 days in 1993.” Even though “stays of all kinds have been shortened by insurance plans trying to manage care, the 39 percent decline for mental illness is one of the sharpest…according to the US Agency for Healthcare Quality and Research (AHQR).” Bloomberg News adds, “The result: greater relapse and more patients released prematurely doing harm to themselves and others, according to 20 psychiatric experts interviewed by Bloomberg News.”

Related Links:

— “Son Who Hears Voices Finds Health Care Fatally Dysfunctional,”Tom Moroney , Bloomberg, February 28, 2012.

In commentary published on the CNN (2/23, Brooks) website, Adam C. Brooks, a research scientist at the Treatment Research Institute, wrote, “What makes substance abuse hard to combat is the fact that addiction plays such a central role,” but “major advances in scientific research have given us a much clearer picture of addiction — what it is, what is isn’t, and what causes it.” At present, “there is no ‘cure’ for addiction.” However, the “disease can be managed and recovery is possible. The most successful treatments are modeled after treatments for other chronic, noncurable, relapsing diseases such as diabetes, hypertension or asthma.”

Related Links:

— “Addiction is not hopeless,”Adam C. Brooks , CNN, February 22, 2012.

The Time (2/24, Thompson) “Battleland” blog points out that a “wrenching chart in a new Congressional Budget Office report on how the Department of Veterans Affairs is handling wounded troops suffering” from post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) “shows that nearly all the troops afflicted with both ailments remain under the VA’s care after four years of care. In contrast,” the chart, which does not grade VA’s work, says that “only 42% of the troops seeking VA care with neither diagnosis were still under VA care after four years’ treatment.”

Related Links:

— “They Don’t Seem to Get Better…,”Mark Thompson , Time U.S. Battleland, February 23, 2012.

The ABC News (2/24, Moisse) “Medical Unit” blog reports, “Elderly nursing home residents who take certain antipsychotic drugs for dementia have an increased risk of death,” according to a study published online Feb. 23 in the BMJ. “The study of more than 75,000 nursing home residents with dementia, all of whom were 65 or older, found that residents taking the drug Haldol [haloperidol] had double the risk of death as those taking Risperdal [risperidone],” with the risk being “highest during the first 40 days of treatment.”

“In fact, the risk of death associated with haloperidol (Haldol) is so high that its use ‘cannot be justified because of the excess harm,’ according to Krista Huybrechts, PhD, of Brigham and Women’s Hospital in Boston, and colleagues,” MedPage Today (2/24, Smith) reports. “Quetiapine (Seroquel) appeared to be the safest among six medications studied in a large cohort of people 65 and older in US nursing homes,” the study found. “While antipsychotics are not approved for people with dementia, they are widely used to help control aggression, the researchers noted.”

HealthDay (2/24, Preidt) points out, “In 2005, the US Food and Drug Administration warned that certain antipsychotic drugs are associated with an increased risk of death in elderly patients with dementia. This warning was expanded to include conventional antipsychotics in 2008, according to a journal news release.” The study authors “said that, despite the FDA action, the use of antipsychotic drugs for this patient population is likely to grow,” due to the fact that “there are a growing number of elderly patients with dementia who require some type of treatment.” Also covering the story are BBC News (2/24, Gallagher) and the UK’s Daily Mail (2/24, Hope).

Related Links:

— “Drugs Raise Death Risk in Dementia Patients,”Katie Moisse , abc News, February 23 , 2012.

Bloomberg News (2/23, Silverberg, Kazel) reports, “US states looking to balance budgets by cutting mental-health facilities and Medicaid payments risk increasing health-care costs by pushing psychiatric patients into emergency” departments. “States trimmed 9.5 percent, or more than $1.6 billion, from their mental-health spending from fiscal 2009 to 2012, according to the National Alliance on Mental Illness. The coming budget year will be worse in some states, with Illinois looking to shutter two psychiatric hospitals and Alabama planning to close all of its except for one serving the elderly and another treating criminal cases.” According to emergency department physician Dr. William Sullivan, of the University of Illinois Medical Center in Chicago, “if patients can’t find free or low-cost outpatient psychiatric care due to government cutbacks, they may swamp emergency rooms and raise health-care costs for all patients.”

Related Links:

— “Mental-Health Cuts by U.S. States Risk Boosting Health Costs,”Melissa Silverberg and Bob Kazel , Bloomberg Businessweek, February 26, 2012.

MedWire (2/22, Cowen) reports, “The presence of anxiety is associated with increased impulsivity in patients with bipolar disorder (BD) or major depressive disorder (MDD),” according to a study published online Feb. 13 in the Journal of Psychiatric Research. In 205 adult patients with BD and 105 adult patients with MDD, investigators “found that the presence of anxiety, either as a comorbidity or a symptom, was significantly associated with increased impulsivity in both groups. Specifically, BD and MDD patients with anxiety had mean” Barratt Impulsivity Scale “scores of 79.56 and 73.91, respectively, versus respective scores of 77.73 and 66.23 in those without anxiety.”

Related Links:

— “Anxiety linked to increased impulsivity in mood disorder patients,”Mark Cowen , MedWire News, February 22, 2012.

Reuters (2/18, Grens) reported that according to a study published online Feb. 6 in Archives of General Psychiatry, no association was found between suicide and antidepressants among children and adults taking fluoxetine or venlafaxine. In addition, results based on unpublished data, also found that antidepressants may decrease the risk of suicide in adults.

The New York Times (2/19, A25A, O’Shea, Subscription Publication) reported that at the Cook County Jail in Illinois, an estimated 2,000 of some 11,000 prisoners “suffer from some form of serious mental illness,” according to Tom Dart, the Cook County sheriff. “Dart said the system ‘is so screwed up that I’ve become the largest mental health provider in the state of Illinois.'” Unfortunately, “the situation is about to get worse, according to Mr. Dart and other criminal justice experts. The city” of Chicago “plans to shut down six of its 12 mental health centers by the end of April, to save an estimated $2 million, potentially leaving many patients without adequate treatment — some of them likely to engage in conduct that will lead to arrests.”

Related Links:

— “Psychiatric Patients With No Place to Go but Jail,”BRIDGET O’SHEA , The New York Times, February 18, 2012.

USA Today (2/21, Healy) reports, “Children whose activity choices, interests and pretend play don’t conform to expected gender roles face an increased risk of abuse and future trauma,” according to a study published online Feb. 20 in the journal Pediatrics. “One in 10 kids display gender non-conformity before age 11 and, on average, are more likely to experience physical, psychological and sexual abuse and experience post-traumatic stress disorder (PTSD) by early adulthood,” the study of “nearly 9,000 young adults” found, with abuse “perpetrated mostly by parents or other adults in the home,” the study authors explained.

Pointing out an opposite viewpoint, the AP (2/20, Tanner) reported, “Offering sex-changing treatment to kids younger than 18 raises ethical concerns, and their parents’ motives need to be closely examined, said Dr. Margaret Moon, a member of the American Academy of Pediatrics’ bioethics committee,” who was not involved in the study. “Some kids may get a psychiatric diagnosis when they are just hugely uncomfortable with narrowly defined gender roles; or some may be gay and are coerced into treatment by parents more comfortable with a sex change than having a homosexual child, said Moon, who teaches at the Johns Hopkins Berman Institute of Bioethics.” She stated that it’s “harmful ‘to have an irreversible treatment too early.'”

According to MedPage Today (2/21, Walsh), a second study published in the same journal found that “among children and teens evaluated for medical intervention to suppress puberty or for hormone therapy, 44% had been given a psychiatric diagnosis — most often depression — and 21% reported self-mutilation.” MedPage Today adds, “In 2009, guidelines on the treatment of adolescents with this disorder were published by the Endocrine Society, recommending delay of puberty with reversible gonadotropin-releasing hormone (GnRH) analogs at Tanner stages 1-2 in eligible adolescents.” The study authors wrote, “This fully reversible treatment allowed patients time until age 16 to decide, in consultation with health professionals and their families, whether to begin hormone treatment that would allow them to transition physically.” Also covering the story are CBS News /WebMD (2/20, Mann) and HealthDay (2/21, Esposito).

Now Chicago, before that LA where the LA County jail was the largest mental institution in the US. – TEA

Related Links:

— “Gender Uncertainty Risky for Kids,”Nancy Walsh , MedPage Today,February 20, 2012.