Biden Administration Rule Aims To Ensure Americans With Private Health Insurance Can Access Affordable Mental Health Services

Reuters (9/9, Niasse) reports, “The Biden Administration said on Monday it had finalized a regulation to help ensure that the 175 million Americans with private health insurance have access to affordable mental health services.” The 2008 Mental Health Parity and Addiction Equity Act “requires insurers and corporate-backed health plans to provide access and payment structures for mental health care services on par with other medical services.” But, “in practice, that is often not the case.” The final rule “is aimed at closing the gaps by requiring health insurers to evaluate which mental health [professionals’]services are covered by their plans, how much those [professionals] are paid, as well as…how often they require or deny prior authorizations for coverage.”

CNN (9/9, Hassan , Gumbrecht ) reports, “Most provisions in the rule will apply to group health plans and health insurance issuers for plan years starting January 1 or after.” Under the “rule, mental health and substance use disorder care on private insurance plans should be covered at the same level as physical health benefits.” That could mean “adding more mental health and substance use professionals to their networks or reducing red tape for [professionals] to deliver care,” a White House fact sheet said.

The Hill (9/9, Weixel ) reports, “The health insurance industry is likely to challenge the rule, saying the administration did not have the authority to issue it to begin with.” The industry “argued the proposed requirements were unworkable and an unfunded government mandate that would cause employers to stop covering behavioral health services.”

Modern Healthcare (9/9, Early , Subscription Publication) reports, “The regulation also extends mental health parity requirements to state and municipal employee benefits programs, which had been exempt under the Mental Health Parity and Addiction Equity Act of 1996, and to individual market health insurance policies.” American Psychiatric Association CEO and Medical Director Marketa Wills, MD, said, “This is a big step forward to hold insurance plans accountable by ensuring the law’s intent is fulfilled and that more individuals will be able to access the mental health and substance use treatment they need.”

Psychiatric News (9/9) reports Wills also said, “APA has always been a strong advocate for mental health parity, and since its enactment, APA has worked tirelessly to advocate for compliance with and enforcement of the federal parity law.”

Related Links:

— “Biden administration finalizes rule to strengthen mental health parity law,”Amina Niasse , Reuters, September 9, 2024

Olanzapine, Perphenazine Should Be Considered First-Line Antipsychotics For Patients With Schizophrenia, Researchers Say

Psychiatric News (9/6) reported, “Along with aripiprazole and risperidone, olanzapine and perphenazine should be considered first-line antipsychotics for patients with schizophrenia, according to a clinical perspective.” According to Psychiatric News, “given its demonstrated effects on hostility, the researchers believe olanzapine is a preferred first-line choice for patients for whom aggression may be a concern, with clozapine as a second-line medication.” The perspective was published in Schizophrenia.

Related Links:

— “Researchers Propose Olanzapine and Perphenazine as First-Line Schizophrenia Treatments, Psychiatric News, September 6, 2024

Only 20% Of Ketamine Clinics Require Pregnancy Test At Least Once Prior To Or During Treatment, Study Finds

HealthDay (9/5, Thompson ) reports “ketamine is becoming a popular depression drug, but” physicians are not “keeping in mind the danger it can pose to a pregnancy, a new study warns.” Ketamine may “be very harmful to a developing fetus and should not be used during pregnancy, researchers said.” However, “only 20% of ketamine clinics require a pregnancy test at least once prior to or during treatment, according to” study results. Additionally, “only 26% of clinics discuss the potential need for contraception with” patients using ketamine, “and fewer than 15% specifically recommend or require contraception use during ketamine treatment, researchers found.” The findings were published in the Journal of Clinical Psychiatry.

Related Links:

— “Ketamine Can Fight Depression, But Pregnant Women Face Risks,”
Dennis Thompson, HealthDay, September 5, 2024

Study Finds Roughly 4% Of Individuals With Neuropsychiatric Disorder Have Serious Adverse Event After Being Given Psychedelic As Part Of Research

Psychiatric News (9/5) reports, “About 4% of individuals with a neuropsychiatric disorder had a serious adverse event – including worsening depression, suicidal behavior, psychosis, or convulsions – after being given a ‘classic’ psychedelic as part of a research study, according to a meta-analysis that spanned some 75 years.” The research “identified no such adverse events among healthy participants; at the same time, tracking of such events should be improved, the study researchers wrote.” The findings were published in JAMA Psychiatry.

Related Links:

— “Study Finds Roughly 4% Of Individuals With Neuropsychiatric Disorder Have Serious Adverse Event After Being Given Psychedelic As Part Of Research, Psychiatric News , September 5, 2024

Meta-Analysis Finds High-Dose Psilocybin Has Potential To Treat Depressive Symptoms, But Effect Size Appears Small

Healio (9/5, Mahoney) reports, “High-dose psilocybin showed the potential to treat depressive symptoms, although the effect size appeared small and comparable to that of escitalopram, according to results of a network meta-analysis.” The researchers “performed a sensitivity analysis that included only patients with major depressive disorder and found that the relative effects of escitalopram, ayahuasca and high-dose psilocybin had better responses than placebo in antidepressant trials.” The findings were published in The BMJ.

Related Links:

— “High-dose psilocybin may help treat depressive symptoms, with small effect size,”Moira Mahoney, Healio, September 5, 2024

Having Medical Condition Is Linked To Greater Risk Of Suicide In Dose-Response-Like Manner, Study Suggests

MedPage Today (9/4, DePeau-Wilson ) reports, “Having a medical condition was associated with an increased risk of suicide in a dose-response-like manner, such that the higher the burden of disability, the higher the risk of suicide, according to an observational study in Denmark.” An analysis of over “6.6 million people found that nine medical condition categories including 31 specific conditions were associated with a statistically significant increased risk of suicide, with the exception of endocrine disorders.” Researchers found “the associations were most pronounced for gastrointestinal conditions… cancers…and hematological conditions.” The findings were published in JAMA Psychiatry. “ Individuals with mental disorder requiring psychiatric hospital treatment appear to be at such elevated risk of suicide that additional disability associated with medical conditions has little impact in this regard.”

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New Studies Do Not Support Association Between GLP-1 Receptor Agonists, Signal For Suicidal Ideation

MedPage Today (9/3, Monaco ) reports, “Two new studies published in JAMA Internal Medicine do not support a previously reported association between GLP-1 receptor agonists and a signal for suicidal ideation.” In one “analysis of nearly 300,000 new users of a GLP-1 agonist or SGLT2 inhibitor in Sweden and Denmark, primarily for diabetes, rates of suicide death over 2.5 years were not significantly different between groups, reaching 0.23 and 0.18 events per 1,000 person-years, respectively.” In the second study, researchers “pooled data from several of the STEP trials that supported semaglutide’s (Wegovy) weight-loss indication.” The “analysis showed that in STEP 1, 2, and 3, depression scores on the Patient Health Questionnaire-9 were lower at study end for patients on a 2.4-mg dose of semaglutide versus placebo recipients.”

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MedPage Today (requires login and subscription)

Cannabis Use Disorder, Frequent Cannabis Use Associated With Greater Absenteeism At Work, Study Finds

Psychiatric News (9/3) reports “cannabis use disorder and frequent cannabis use are linked to greater absenteeism at work, a study” found. Study “participants who used cannabis in the past month had a mean 1.47 days of missed work because of illness or injury, compared with 0.95 days for those who never used cannabis.” The findings were published in the American Journal of Preventive Medicine.

Related Links:

— “Cannabis Use Linked to Absenteeism at Work, Psychiatric News, September 3, 2024

Investigation Finds Acadia Healthcare Improperly Detained Patients Who Seek Mental Healthcare

The New York Times (9/1, Silver-Greenberg , Thomas) reported “Acadia Healthcare is one of America’s largest chains of psychiatric hospitals,” and “since the pandemic exacerbated a national mental health crisis, the company’s revenue has soared.” However, “a New York Times investigation found that some of that success was built on a disturbing practice: Acadia has lured patients into its facilities and held them against their will, even when detaining them was not medically necessary.” According to records, “in at least 12 of the 19 states where Acadia operates psychiatric hospitals, dozens of patients, employees and police officers have alerted the authorities that the company was detaining people in ways that violated the law.” In a number of “cases, judges have intervened to force Acadia to release patients.”

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— “The New York Times (requires login and subscription)

Analysis Suggests Prevailing Neurological Hypothesis Of ASD May Not Be Accurate

Psychiatric News (8/30) reported, “A systematic analysis of brain imaging data from nearly 500 individuals suggests that a prevailing neurological hypothesis of autism spectrum disorder (ASD) – theorizing that people with ASD have poorer neural connections in certain brain regions relative to those without ASD – may not be accurate.” The researchers said, “It is important to note that we do not conclude that amygdala [connectivity] is generally typical in autism. Instead, we conclude that the evidence for atypical [connectivity] of the amygdala in autism is weak at best, and unreliable.” The findings were published in the American Journal of Psychiatry.

Related Links:

— “Study Uncovers No Strong Evidence That Autism Is Linked With Poor Amygdala Connectivity, Psychiatric News, August 30, 2024