All three broadcast networks opened their Wednesday evening newscasts with coverage of newly released footage of Washington Navy Yard shooter Aaron Alexis during his killing spree. ABC World News called it “a haunting new video, a killer roaming the halls of the Washington Navy Yard looking for targets.” On NBC Nightly News, Pete Williams reported, “Cameras inside the Navy Yard building show Aaron Alexis carrying the sawed-off shotgun he used to shoot most of his victims.” TheCBS Evening News reported the FBI said Alexis “was driven by the delusional belief that he was being controlled or influenced by electromagnetic waves beamed into his body.”

The AP (9/26, Marot) reports that the National Athletic Trainers Association (NATA) “outlined a set of broad guidelines[pdf]…that it believes should be adopted in an effort to help” student “athletes cope with everything from depression to suicidal thoughts.” The group’s “recommendations include using athletic trainers and team physicians to help with early detection of potential mental illnesses, provide advice and make treatment referrals while maintaining patient confidentiality.”

Reuters (9/26, Pittman) notes that the new guidelines were published online Sept. 25 in the Journal of Athletic Training. The article also points out that, according to the US Substance Abuse and Mental Health Services Administration, approximately 30 percent of university-aged young people said they had some kind of mental illness during the years 2010 and 2011.

Related Links:

— “Trainers Group Makes Mental Health Recommendations, “Michael Marot, Associated Press, September 25, 2013.

On its front page, the Wall Street Journal (9/26, A1, Fields, Phillips, Subscription Publication) reports on the huge number of persons with mental illness incarcerated in jails and prisons, noting that the country’s largest jail systems, those of New York City, Los Angeles County, and Cook County, IL, are the de facto biggest treatment facilities for mental illness in the US. Deinstitutionalization in the 1970s, during which many state psychiatric hospitals were downsized or closed, coupled with the lack of mental healthcare in community settings, has led to this situation. Having large numbers of prisoners with serious mental health disorders poses a strain on Federal, state, and local lock-ups which lack facilities, budgets and mental healthcare professionals to provide proper treatment.

Related Links:

— “The New Asylums: Jails Swell With Mentally Ill, The Wall Street Journal, September 25, 2013.

HealthDay (9/26) reports, “Only some of the physical and mental health problems previously associated with preterm birth are actually caused by it,” according to a study published In JAMA Psychiatry. Investigators “analyzed the medical records of 3.3 million children born in Sweden between 1973 and 2008, and confirmed the strong link between preterm birth (generally classified as before 37 weeks’ gestation) and the risk of infant and young adult death, autism and attention-deficit/hyperactivity disorder (AD/HD).” But, the researchers “also concluded that many other problems that have been linked with preterm birth – such as severe mental illness, learning problems, suicide and poverty – may instead be more closely related to other factors that people share with other family members.”

Related Links:

— “Preemies’ Woes Sometimes Due to Heredity, Study Says, “Robert Preidt, HealthDay, September 25, 2013.

HealthDay (9/26, Preidt) reports that a brain scan study published Sept. 24 in the journal Frontiers in Human Neuroscience reveals why “psychopaths feel a lack of empathy when other people are in pain.” For the study, investigators “used functional MRI to observe brain activity in 121 inmates at a medium-security prison in the United States who were divided into three groups based on the levels of their psychopathy.” The inmates were shown pictures depicting physical pain and were then asked to imagine the pain happening to themselves and then to others. Scans revealed that inmates with a high level of psychopathy displayed little activity in brain regions associated with empathy for pain in others and above average activity for pain in themselves. What’s more, “when imagining other people in pain, highly psychopathic inmates showed increased activity in a brain area known to be involved in pleasure.”

Related Links:

— “Brain Scans Show Why Psychopaths Don’t Feel Your Pain, “Robert Preidt, HealthDay, September 25, 2013.

USA Today (9/26, A1, Zoroya, Hoyer) reports on its front page that, according to data released by the Pentagon in response to queries from USA Today, “post-traumatic stress disorder, substance abuse and other mental illnesses accounted for more days spent by troops in the hospital than any other medical condition in the military in 2012, including war wounds, injuries and illness.” Army Lt. Col. Catherine Wilkinson, a spokesperson for Pentagon health affairs, attributed the rise in hospitalizations for mental health reasons to the “exposure of servicemembers to stressful events” tied to deployments in Iraq and Afghanistan. However, according to Lt. Col. Christopher Ivany, Army chief of behavioral health, “days spent in mental health wards are projected to decline 15% in the Army” in 2013, partly because of better treatment through outpatient care.

Related Links:

— “Troops Flooding Into Hospitals For Mental Health Care, “Gregg Zoroya, USA Today, September 25, 2013.

The Wall Street Journal (9/25, A4, Beck, Subscription Publication) reports on a movement integrating mental healthcare into primary care practices. This movement is occurring as the US healthcare professionals anticipate seeing many more patients under the Affordable Care Act and its resulting mental health parity. At the same time, providing patients with psychiatric care in the primary care setting would be one way of addressing a US-wide shortage of psychiatrists. Finally, many physical and psychiatric conditions are linked, such as depression and anxiety in patients with heart disease or diabetes, and it makes sense to treat both conditions together. According to the Journal, the American Psychiatric Association has endorsed the integrated care concept.

Related Links:

— “Getting Mental-Health Care at the Doctor’s Office, “Melinda Beck, The Wall Street Journal, September 24, 2013.

In his column in the Washington Post (9/25), Courtland Milloy observes that misdiagnosis of “mental illness among black men has long been an acute problem – with consequences that extend beyond the Navy Yard killings to the daily gun violence throughout urban America.” Milloy quotes William Lawson, who chairs the psychiatry department at the Howard University College of Medicine. Lawson said that not only do African American males have less access to mental health treatment, but they are also “much more likely to be viewed as having a behavioral problem rather than a mental disorder.” Milloy concludes, “There is such a stigma around mental illness that black males themselves would rather be seen as ‘bad instead of mad,’ as Lawson puts it.” The end result is that more black males may end up incarcerated instead of getting needed treatment.

Related Links:

— “Navy Yard shooting underscores how mental illness can be misdiagnosed among black men, “Courtland Milloy, The Washington Post, September 24, 2013.

NBC Nightly News reported, “The mass shooting at the Washington Navy Yard is drawing new attention to the role of” the mental “health system in trying to prevent such violence.” Jeffrey Lieberman, MD, president of the American Psychiatric Association, said of Navy Yard shooter Aaron Alexis, “If mental healthcare was provided in the routine systematic way that general medical care was, ideally we would have expected that he would have been identified, diagnosed and offered treatment much earlier.” Chief medical editor Nancy Snyderman, MD, said, “While most people with mental illness never turn to violence, mental health advocates say that half or more of those responsible for mass shootings in recent years have suffered from a serious mental illness.”

The Rutland (VT) Herald (9/22, Freedman) quoted Dr. Lieberman, who said, “Historically, the US mental health care system is limited and badly fragmented.” He added, “As result of people lacking access to mental health care, not knowing what to do if loved ones are affected, not having insurance coverage for it, many go untreated.” According to Lieberman, “predicting which mental patient will be violent is less important that expanding treatment so that those with violent tendencies who fly under the radar get the help they need.”

Related Links:

— “Navy Yard tragedy spurs debate on mental health, “Dan Freedman, The Rutland Herald , September 22, 2013.

The Seattle Times (9/22) says in an editorial that a combination of Medicaid expansion and mental health parity in the ACA “has the potential to be revolutionary. For the first time, destitute childless adults, typically not eligible for Medicaid, will become eligible. Seattle’s Downtown Emergency Services Center alone has 27 staff ready to sign up homeless clients for health-care insurance.” It adds, “Imagine the savings – for businesses, for the criminal-justice system, for human potential – of true preventive mental-health care.”

Related Links:

— “Editorial: Affordable Care Act patches some holes in mental-health system, The Seattle Times, September 21, 2013.