The Washington Post (11/21, Holley, Larimer) “Post Nation” blog reported that in wake of Thursday morning’s shooting at the Florida State University library, experts are once again debating the fairness of the connection between gun violence and serious mental illness. Earlier this year, in a piece run by Psychiatric News, a publication of the American Psychiatric Association, Thomas Insel, MD, director of the National Institute of Mental Health, discussed that very issue in a keynote address at a workshop on mental health and violence conducted by the Institute of Medicine, putting the issue in perspective and reiterating that the vast majority of people with mental illnesses are not violent, nor are most violent acts perpetrated by people with mental illnesses.

Related Links:

— “In wake of Florida State shooting, spotlight returns to mental health issues and violence,” Peter Holley and Sarah Larimer, Washington Post, November 21, 2014.

Pew Charitable Trusts (11/19) reports on a new Federal rule that “will require states to ensure that long-term care alternatives to nursing homes work with residents and their families to develop individual care plans specifying the services and setting each resident wants,” with the goal of creating a “home-like atmosphere” within assisted living facilities. However, “the rule could make it difficult for [physicians] to fulfill increasing demand for long-term care outside of nursing homes,” and “could limit the availability of services for elders,” while bringing unintended consequences, according to Pew. For example, patients with dementia who are not likely to wander off should not face constraints such as locked doors under the new rule, but this guideline becomes complicated when multiple dementia patients share living space and some are at risk for wandering and some are not.

Related Links:

— “New Medicaid Rule Could Challenge State Shift Away From Nursing Homes,” Christine Vestal, Pew Charitable Trusts, November 19, 2014.

HealthDay (11/21, Preidt) reports that according to a report issued by the Substance Abuse and Mental Health Services Administration (SAMHSA) and based on the agency’s annual National Survey on Drug Use and Health, “nearly one in five American adults – 43.8 million people – had a diagnosable mental illness in 2013.” In addition, the report revealed “10 million adults had a serious mental illness, 15.7 million had major depressive episodes, 9.3 million had serious thoughts of suicide, 2.7 million made suicide plans and 1.3 million attempted suicide.” In a news release, SAMHSA Administrator Pamela Hyde said, “It is a serious issue that millions of Americans are needlessly affected by mental illness when they can get effective treatment to restore their well-being.” Hyde emphasized the importance of seeking help.

Related Links:

— “1 in 5 U.S. Adults Dealt With a Mental Illness in 2013,” Robert Preidt, HealthDay, November 20, 2014.

The New York Times (11/21, Parker-Pope) “Well” blog reports that according to a report released Nov. 20 by the Centers for Disease Control and Prevention and the Substance Abuse and Mental Health Services Administration in the CDC’s Preventing Chronic Disease journal, the majority of “people who drink to get drunk are not alcoholics.” The conclusions of “a government survey of 138,100 adults counters the conventional wisdom that every ‘falling-down drunk’” has an addiction to alcohol. Rather, “the results from the National Survey on Drug Use and Health show that nine out of 10 people who drink too much are not addicts, and can change their behavior with a little – or perhaps a lot of – prompting.”

Related Links:

— “Most Heavy Drinkers Are Not Alcoholics,” Tara Parker-Pope, New York Times, November 20, 2014.

Medscape (11/20, Cassels) reports that according to a study published online Nov. 19 in JAMA Psychiatry, “collaborative care delivered via telemedicine may offer a viable and effective way of treating veterans with severe posttraumatic stress disorder (PTSD) who live in rural and remote areas.” The “results of a multisite, randomized effectiveness trial” including 265 veterans with PTSD “showed that Telemedicine Outreach for PTSD (TOP), an off-site intervention in which a multidisciplinary PTSD care team uses telemedicine tools, such as telephone calls, interactive videos, and shared electronic medical records, to support on-site [healthcare professionals] significantly improved clinical outcomes in veterans compared with usual care.”

Related Links:

— Medscape (requires login and subscription)

USA Today (11/20, Crutchfield) reports that at a meeting of the Senate Veterans’ Affairs Committee yesterday, senators concluded that “veterans at risk of suicide have to wait too long to get mental health treatment from the Department of Veterans Affairs.” Each day, “about 22 veterans commit suicide…VA records show, and they remain a higher risk of suicide than members of the general population.” Sen. Patty Murray (D-WA) told representatives of the VA, “We cannot have someone call in for an appointment and have to wait five weeks to get help.”

Related Links:

— “At-risk veterans need help on suicide, senators say,” Charmaine Crutchfield, USA Today, November 19, 2014.

The Higher Education Mental Health Alliance (HEMHA) has published Postvention: A Guide for Response to Suicide on College Campuses. From its introduction:

This resource is intended for use by colleges and universities that are affected by and/or want to be prepared for campus crises and campus deaths. Suicide postvention efforts address the need for predetermined strategies to effectively and sensitively respond to campus deaths after they occur and also contribute to improved prevention efforts….While our hope is that schools will use this guide to help with planning so that systems are in place to respond, we have tried to make this guide sufficiently concise to be valuable also when a school has not engaged in planning but is faced with a student suicide and needs to rapidly develop and implement a response plan.

The guide specifically looks at facilitating the grieving process, stabilizing environments, reducing negative behaviors, and limiting further suicides through contagion.

Another resource for learning about depression associated with college life is the Maryland Foundation for Psychiatry’s own Love, From Depression site.

The Colorado Daily (11/18, Brennan) reported that a University of Colorado study funded by the National Institute of Mental Health and the National Institute of Biomedical Imaging and Bioengineering suggests that “physical pain and social pain are processed by distinct neural circuits, which could help direct scientists and clinicians toward prevention and treatment options that work best for emotional suffering.” While “neuroscientists in the past decade had largely come to think that physical and social pain are processed by the brain in the same way.” Now, “a new study led by CU graduate student Choong-Wan Woo shows the two types of pain actually use separate neural circuits.”

Related Links:

— “CU-Boulder study shows differences in brain’s processing of emotional, physical pain,” Charlie Brennan, The Colorado Daily, November , 2014.

HealthDay (11/19, Haelle) reports that according to a study published in the December issue of the journal Anesthesiology, “the proportion of women dependent on drugs such as narcotic painkillers or heroin during pregnancy has more than doubled in the past decade and a half.” The research “covers a class of drugs known as opioids, which include prescription painkillers such as oxycodone (Oxycontin) and Vicodin; morphine and methadone; as well as illegal drugs such as heroin.” Researchers arrived at the study’s conclusion after analyzing “national hospitalization data on nearly 57 million deliveries between 1998 and 2011.”

Bloomberg News (11/18, Edney) reports that, according to a study released by the Tufts Center for the Study of Drug Development, “it costs drugmakers $2.56 billion to bring a new medicine to market, on average,” which is “more than double the price of 11 years ago,” according to a study released today. The researchers say the higher cost “comes from clinical trials that are larger and more complex, as well as more drugs that fail in development.” Joseph DiMasi, director of economic analysis at the Boston-based center, said in a statement, “Drug development remains a costly undertaking despite ongoing efforts across the full spectrum of pharmaceutical and biotech companies to rein in growing R&D costs.”

The Boston Globe (11/19, Weisman) outlines what the researchers said has driven up the cost of developing medication within recent years. According to Tufts officials, one “reason for surging development costs is that scientists are seeking to develop medicines for more complex and difficult-to-treat diseases, ranging from Alzheimer’s to brain and pancreatic cancers.” Other factors cited by Tufts officials include “regulatory requirements mandating clinical trials with more patients and longer time frames, and the expense of studies to demonstrate the cost-effectiveness of new [medicines],” and they factored in “rising costs of those [medication] candidates that prove unsuccessful in the laboratory or do not win regulatory approval.” Those medicines “account for the vast majority of experimental treatments.” Data included in the study showed that “only 11.8 percent of drug compounds entering clinical testing are eventually approved.”

Related Links:

— “Scientists close in on non-addictive opioid painkillers,” Laura Ungar, USA Today, November 17, 2014.

The New York Times (11/18, Gross) “The New Old Age” blog reports that according to an article published March 12 in the Journal of the American Medical Association, physicians may overlook the needs of caregivers, ignoring the needs of people who care for “an elderly family member with dementia or a heart condition or diabetes — or all of the above.”

Recently, the author of that article, Ronald D. Adelman, MD, co-chief of geriatrics and palliative medicine at Weill Cornell Medical College in New York City, gave a talk on that very subject in which he detailed “the risk factors for caregiver burden that should ‘trigger assessment,’” such as “being a woman; the number of hours of care provided; the complexity of medical tasks” being performed; “transitions from one kind and location of care to another,” stress caused by finances; lack of caregiver education; presence of cognitive impairment in the patient; whether the caregiver actually lives with the patient, and finally, whether the caregiver had any choice in taking on that role.

Related Links:

— “Seeing the ‘Invisible Patient’,” Jane Gross, New York Times, November 17, 2014.