In the wake of last Friday’s shootings in Newtown, CT, many in the US are calling for changes to gun laws. Many other Americans, however, are turning their focus to the state of mental healthcare in the US and are looking for ways to improve it to prevent similar tragedies from occurring. Improving mental healthcare will not be easy, however, due to national and state budget considerations, insurance coverage issues, and lack of access to competent care.

On an NBC Nightly News (12/19, story 6, 2:05, Williams) segment, NBC correspondent Ron Mott reported that last Friday’s tragedy and reports that shooter Adam Lanza may have been suffering from mental illness have made many Americans examine the state of mental healthcare in this country. Mott explained, “One in 17 Americans lives with a serious mental illness, and their symptoms range in severity. But fewer than a third receive professional treatment. Fewer professionals are entering the field, and rising costs have reduced the number of hospitals and clinics offering care.” Psychiatrist Harold S. Koplewicz, MD, of the Child Mind Institute, was shown saying: “We don’t treat the disorders from the neck up the way we do the rest of the body. So mental illness is not equal to physical illness and this is truly at our own peril.”

On its website, ABC News (12/20, Lupkin) reports, “Despite four shooting rampages since President Obama took office in 2009, mental health care continues to be hampered by budget cuts, closures, battles with insurers and stigma, doctors said. ‘We have very good treatments for mental illness that are highly effective,’ said Dr. Jeffrey Lieberman, president-elect of the American Psychiatric Association. ‘But they’re not widely available. People don’t have ready access to them.'”

Related Links:

— “Newtown Shooting Put Spotlight on U.S. Mental Health Care — Again, “Sidney Lupkin, abc News, December 19, 2012.

USA Today (12/20, Zoroya) reports that Command Sgt. Maj. Chris Faris, the senior non-commissioned officer for special operations says the US’ most elite fighting forces “are under more emotional strain after a decade of war than commanders realized.” Faris noted that a “tragic part of that is record suicides this year. … According to Pentagon data, there were 17 confirmed or suspected suicides this year among commandos or support personnel through Dec. 2, compared with nine suicides each of the past two years.” Faris added, however, that “despite signs of strain, this select category of troops remains capable of meeting any missions they are given.”

Related Links:

— “Stress on special operations troops ‘worse than we thought’, “Gregg Zoroya, USA Today, December 20, 2012.

The Wall Street Journal (12/20, A3, Dooren, Subscription Publication) reports the survey, conducted by the University of Michigan, found that cigarette smoking among adolescents in the US fell to record lows. Additionally, it found that a rise in marijuana use among teens appears to have leveled off. The annual report revealed that the number of teens who reported smoking cigarettes dipped to 10.6% in 2012 — down from 11.7% in 2011.

Marijuana Use Levels Off. Bloomberg News (12/20, Lopatto) reports that “marijuana use among US high school seniors is leveling off, ending four years of increases in annual prevalence,” according to the survey. Bloomberg News says that “thirty-six percent of high school seniors surveyed in 2012 said they smoked marijuana at least once in the previous year, the National Institute on Drug Abuse said.” Lloyd Johnston, a research professor at the University of Michigan who led the study, stated, “There isn’t much evidence for increasing use this year,” adding that the “use of a great many drugs are holding steady.”

Perception Of Marijuana Dangers At 20-Year Low. The AP (12/20, Yen) reports that “teenagers’ perception of the dangers of marijuana has fallen to the lowest level in more than 20 years,” the study says, “prompting federal researchers to warn that already high use of the drug could increase as more states move to legalize it.” According to the article, “the annual survey released Wednesday by the National Institutes of Health found that only 41.7 percent of eighth graders believe that occasional use of marijuana is harmful, while 66.9 percent regard it as dangerous when used regularly.” Moreover, “teens’ perception of marijuana risks diminished even more as they got older.” Approximately 20.6 percent of 12th graders indicated that occasional pot use is harmful, and about 44.1 percent thought that regular pot use was detrimental.

Related Links:

— “Teen Smoking Keeps Falling, “Jennifer Corbett Dooren, The Wall Street Journal, December 19, 2012.

On the front of its Science Times section, the New York Times (12/18, D1, Quenqua, Subscription Publication) reports, “For young people exposed to gun trauma — like the students of Sandy Hook Elementary School in Newtown, Conn. — the road to recovery can be long and torturous, marked by anxiety, nightmares, school trouble and even substance abuse. Witnessing lethal violence ruptures a child’s sense of security, psychiatrists say, leaving behind an array of emotional and social challenges that are not easily resolved.” However, Glenn Saxe, MD, chairman of child and adolescent psychiatry at NYU Langone Medical Center, stated, “The data shows that the majority of people after a trauma, including a school assault, will end up doing OK.”

Related Links:

— “Children Can Usually Recover From Emotional Trauma, “Douglas Quenqua, The New York Times, December 17, 2012.

In continuing coverage, NBC Nightly News (12/17, story 5, 1:25, Williams) reported, “This tragedy in Newtown, Connecticut has already ignited a national conversation about guns, as we have just seen.” However, mental illness has been a “component…in all the serious gun crimes we have covered. One in 17 Americans lives with a serious mental illness, that’s according to the government, and their symptoms range in severity, of course. But fewer than a third of them receive treatment.” Chief medical editor Nancy Snyderman, MD, explained, “Less than 10% of our healthcare dollars are spent on mental healthcare.” While well-to-do people can pay for care and the poor may get some care through Medicaid, other people fall through the cracks.

American Medical News (12/17, Krupa) reports, “Physicians with mental illness are at a higher risk of committing suicide than nonphysicians,” according to a study published online Nov. 5 in the journal General Hospital Psychiatry. After evaluating “data from the Centers for Disease Control and Prevention’s National Violent Death Reporting System on 31,636 adult suicide victims in 17 states,” researchers found that “the 203 physicians in the study were more likely than nonphysicians to have a known mental health disorder or to have experienced recent job-related stress.” The piece goes on to note that physicians may be reluctant to seek help for a number of reasons, including the fact that they may be required by their state medical boards to self-report any psychiatric treatment.

Related Links:

— “Doctors shun the help that could cut suicide risk, “Carolyne Krupa, American Medical News, December 17, 2012.

In “The Mind” column for the New York Times (12/18, D5, Subscription Publication), psychiatrist Richard A. Friedman, MD, writes, “In the wake of the terrible shooting at an elementary school in Newtown, Conn., national attention has turned again to the complex links between violence, mental illness and gun control.” Dr. Friedman asserts, “All the focus on the small number of people with mental illness who are violent serves to make us feel safer by displacing and limiting the threat of violence to a small, well-defined group.” However, “the sad and frightening truth is that the vast majority of homicides are carried out by outwardly normal people in the grip of all too ordinary human aggression to whom we provide nearly unfettered access to deadly force.”

Related Links:

— “In Gun Debate, a Misguided Focus on Mental Illness, “Richard Friedman, The New York Times, December 17, 2012.

The ABC News (12/16, Moisse) “Medical Unit” blog reported, “If you’ve ever felt bullied at work, you’re not alone. A study” published online Dec. 12 in BMJ open “suggests workplace bullying is common, and so is the need for medical intervention.”

MedPage Today (12/15, Neale) reported, “Middle-age, municipal employees who said they were bullied were significantly more likely to be prescribed and reimbursed for at least one psychotropic medication in the next five years (HR 1.51 for women and 2.15 for men).” The study of “6,287 workers (80% female) between the ages of 40 and 60 [who] were not using psychotropic medications at baseline” also revealed that “frequently observing a fellow worker being bullied was similarly associated with subsequent psychotropic medication use for both women (HR 1.53) and men (HR 1.92), the researchers reported.”

Related Links:

— “Workplace Bullying Tied to Psychiatric Tx, “Todd Neale, MedPage Today, December 14, 2012.

USA Today (12/17, Szabo) reports, “Families and doctors who treat the mentally ill say they hope that Friday’s tragedy in Newtown, Conn., will refocus the nation’s attention on improving mental health services.” While “police have not yet released details about the motives or mental state of shooter Adam Lanza,” the “perpetrators of similar mass murders — at Virginia Tech, Northern Illinois University and a Tucson gathering for Rep. Gabby Giffords, for example — all suffered from serious mental health conditions.” Forensic psychologist Dew Cornell, who directs the Virginia Youth Violence Project, pointed out that “schools and communities ‘have cut their mental health services to the bone.'” He added, “We’re paying a price for it as a society.”

The Arizona Republic (12/16, Sexton) reported that “mental health experts in Arizona said discussion of Lanza’s mental state is an opportunity to talk about the need for better mental health preventive services.” Jim Frost, president of National Alliance on Mental Illness for Arizona, said that “it is no surprise that mass shootings in the past two years involved young adult men.” He explained, “There is a life trigger at age 18 for some people who have trouble coping, he said. For some men, it becomes an act of aggression, an act of violence.”

Better Mental Healthcare Alone May Not Prevent Mass Killings. The Buffalo (NY) News (12/15, Zremski) pointed out that “better mental health services alone are not the [preventive] medicine for mass shootings like the one that claimed the lives of 20 school children and eight adults, including the killer, in Connecticut on Friday.” According to psychiatrists, “it’s nearly impossible to identify who among the mentally ill is truly dangerous, and that any effort to do so will only further stigmatize a category of illness where many people already shun treatment out of embarrassment and fear.” Finally, “the vast majority of mentally ill people are not prone to violence.”

Article Provides Tips On How To Discuss Newtown Shootings With Kids. HealthDay (12/15, Gardner) provided tips for parents on how to discuss the Newtown shootings with their children. Experts say youngsters “need to be able to express their feelings about what happened.” Parents “should try to inform children without overwhelming them.” Grown-ups “can also offer ‘gentle words, a hug when appropriate or sometimes just being present with [kids] and not leaving them alone,’ said” Victor Fornari, MD, “director of child/adolescent psychiatry at North Shore-LIJ Health System in New Hyde Park, NY.”

Related Links:

— “Newtown tragedy could put mental health in spotlight, “Liz Szabo, USA Today, December 17, 2012.

MedPage Today (12/14, Pittman) reports, “Most seniors said they would talk about their depression with their primary care physician, but few said [physicians] think to ask,” according to a recent survey of some 1,300 US seniors called “The Unfinished Business of Mental Health Care for Older Adults.” The survey, which was released yesterday, found that “three-quarters of respondents 65 and older (77%) said they would mention that they were feeling depressed or anxious to their doctor even if they weren’t asked,” but “only one in four said their doctor asked how they were feeling. And, 23% of those older adults who had received some form of treatment said they wished their doctor would do more to make sure the treatment was working.”

Related Links:

— “PCPs Should Treat Depression, Seniors Say, “David Pittman, Medpage Today, December 13, 2012.