The Columbus (OH) Dispatch (12/29, Rowland, Candisky) detailed efforts to improve the US mental healthcare system in the past year since the Newtown, CT school shootings. In a webcast, American Psychiatric Association president Jeffrey Lieberman, MD, of Columbia University, said that the combination of the Mental Health Parity Act and the Affordable Care Act “will have tremendous impact of historic significance.” The article also examined measures passed in Ohio to improve mental healthcare, including “Gov. John Kasich’s initiative to expand Medicaid, which will provide health coverage to tens of thousands of adults in need of treatment for mental illness and substance abuse, and provide additional state aid for community-based services.”

Related Links:

— “‘Broken’ mental-health system made a few improvements this year, “Darrel Rowland, The Columbus Dispatch, December 29, 2013.

In an opinion piece in the Baltimore Sun (12/29), psychiatrist John J. Boronow, MD, of the Sheppard Pratt Health System, and psychiatrist Steven S. Sharfstein, MD, president and CEO of the Sheppard Pratt Health System, called for passage in Maryland of an “‘assisted outpatient treatment’ (AOT) law, also called Outpatient Civil Commitment.” According to the two psychiatrists, “many AOT programs in other states have been the subject of studies – most exhaustively in North Carolina and New York – and have been shown to reduce hospitalization, homelessness, incarceration and, not the least, the costs of care for individuals with major mental illness.”

Related Links:

— “Close the mental health revolving door [Commentary], “John J. Boronow, The Baltimore Sun, December 29, 2013.

In continuing coverage, Reuters (12/28, Huggins) reported that research published online in Stroke suggests that greater levels of anxiety may be associated with a higher risk of stroke.

On its website, TIME (12/28, Nicks) reported that investigators looked at data on more than 6,000 “men and women over about 16 years.” The researchers found that “anxiety is responsible for a relatively small uptick, 14 percent, in the risk of suffering a stroke.”

The Huffington Post (12/28) reported that although the research “does not show that anxiety causes stroke,” study author Maya Lambiase, PhD, “noted that people with greater anxiety levels might be more likely to engage in unhealthy behaviors such as sedentary activity or smoking, which are known stroke risk factors.” Meanwhile, “other potential factors could include higher blood pressure or stress hormone levels.”

Related Links:

— “Anxiety linked to stroke risk, “C.E. Huggins, Reuters, December 27, 2013.

On its front page, the New York Times (12/26, A1, Creswell, Subscription Publication) reported that an experiment in Raleigh, NC, in which paramedics take people with severe mental illnesses directly to a psychiatric facility and not to the emergency department (ED) “is being closely watched by other cities desperate to find a way to help” those with mental illnesses get the help they need without overcrowding EDs. Across the US in the year 2010, more than 6.4 million ED visits, “or about five percent of total visits, involved patients whose primary diagnosis was a mental health condition or substance abuse.” What’s more, “spending by general hospitals to care for these patients is expected to nearly double to $38.5 billion in 2014, from $20.3 billion in 2003,” according to one estimate by the Federal government.

Related Links:

— “E.R. Costs for Mentally Ill Soar, and Hospitals Seek Better Way, “Julie Creswell, The New York Times, December 25, 2013.

On its “All Things Considered” program and in its “Shots” blog, NPR (12/24, Hamilton) reported on “growing evidence that pot can affect brain circuits involved in” post-traumatic stress disorder (PTSD). According to Andrew Holmes, a researcher at the National Institute on Alcohol Abuse and Alcoholism, experiments using animals indicate that “tetrahydrocannabinol [THC], the chemical that gives marijuana its feel-good qualities, acts on a system in the brain that is ‘critical for fear and anxiety modulation.’” However, Holmes “and other brain scientists caution that marijuana has serious drawbacks as a potential treatment for PTSD.” The effects of THC are not lasting, and marijuana has side effects including impairment of motor skills and short-term memory loss.

Related Links:

— “Could Pot Help Veterans With PTSD? Brain Scientists Say Maybe, “Jon Hamilton, NPR, December 24, 2013.

USA Today (12/27, Weintraub) reports, “Having a serious concussion could be a risk factor for developing Alzheimer’s decades later – though not everyone with head trauma will lose their memory,” according to a study published Dec. 26 in the journal Neurology.

The Los Angeles Times (12/27, Mohan) reports that “elderly people who have both mild cognitive impairment [MCI] and a history of serious concussion showed higher amounts of the protein deposits associated with Alzheimer’s disease.” For the study, researchers “enlisted 589 elderly residents of surrounding Olmsted County, beginning in 2004, and administered a battery of cognitive and memory tests, along with brain scans that reveal both structure and metabolic function.”

Related Links:

— “Alzheimer’s risk tied to concussions in some, “Karen Weintraub, USA Today, December 27, 2013.

The Washington Post (12/24, Searing) reports that according to a study published Dec. 17 in the Annals of Internal Medicine, “at least for men, taking multivitamins doesn’t seem to benefit the brain.” The 12-year study, which involved some 5,947 aged 65 and older who were randomized either to a multivitamin or placebo, revealed “no difference…in the average cognitive ability or rate of cognitive decline between men who were taking a multivitamin and those who were not.”

Related Links:

— “Study asks: Do multivitamins help stave off cognitive problems in older men?, “Linda Searing, , December 23, 2013.

In print and in the New York Times (12/23, D3) “Well” blog, psychiatrist Richard A. Friedman, MD, of the Weill Cornell Medical College, observes, “Of all the major illnesses, mental or physical, depression has been one of the toughest to subdue.” Now, “at a time when federal research funds are shrinking and major drug companies have all but shuttered their brain research programs, enlightened philanthropists and entrepreneurs are helping to open a promising new pathway for neuroscience research: collaboration among researchers willing and able to take thoughtful risks and solve big problems.” Dr. Friedman also quotes Huda Akil, psychiatry professor at the University of Michigan, who points out that the strength behind the Hope for Depression Research Foundation is the fact that scientists there “‘can think about big ideas and take risks without worrying about what grant reviewers’ – like the National Institute of Mental Health, the major source of federal funding for psychiatric research – ‘might think.’”

Related Links:

— “A New Focus on Depression, “Richard A. Friedman, The New York Times, December 23, 2013.

In a cover piece for the Atlantic (12/23, Stossel) in which he describes his long-life struggle with anxiety, Scott Stossel, editor of the Atlantic and author of the upcoming book, “My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind,” writes, “According to the National Institute of Mental Health, some 40 million American adults, about one in six, are suffering from some kind of anxiety disorder at any given time; based on the most recent data from the Department of Health and Human Services, their treatment accounts for more than a quarter of all spending on mental-health care.” He adds, “Today, the American Psychiatric Association’s Diagnostic and Statistical Manual (now in its just-published fifth edition, DSM-5) defines hundreds of mental disorders,” including anxiety. After recounting his difficulties with treatments and medication, Stossel looks at the bright side of the matter, noting that “anxiety is productive mainly when it is not so strong as to be debilitating,” improving job performance, for example.

Related Links:

— “Surviving Anxiety, “Scott Stossel , The Atlantic, December 22, 2013.

On its front page, the New York Times (12/22, A1, Luo, McIntire, Subscription Publication) reported that a case in Connecticut “highlights a central, unresolved issue in the debate over balancing public safety and the Second Amendment right to bear arms: just how powerless law enforcement can be when it comes to keeping firearms out of the hands of people who are mentally ill.” Under Connecticut law, police have “broad leeway to seize and hold guns for up to a year” in such cases, but even “police often find themselves grappling with legal ambiguities when they encounter mentally unstable people with guns…in particular, how they should respond when the owners want them back.” The Connecticut case involves Mark Russo, who has had problems adhering to medication for paranoid schizophrenia. Police confiscated his firearms after he threatened to shoot his mother. However, Russo is due to have his guns returned to him in the spring under Connecticut law.

Related Links:

— “When the Right to Bear Arms Includes the Mentally Ill, “Michael Luo, The New York Times, December 21, 2013.