In a video commentary for Medscape (4/5), psychiatrist Jeffrey A. Lieberman, MD, of Columbia University, asserts, “What we are seeing in the context of this great recession that we are experiencing, the deficits that are occurring at the state level, and the changes in healthcare delivery that financial pressures are occasioning is a retreat from the mission of mental healthcare.” He adds, “This creates a vicious cycle where the state cuts back, putting more pressure on the nonpublic healthcare” clinicians who are “also under financial pressure. They are also looking for ways to reduce their financial vulnerability, and so they cut services. All of this leaves psychiatry and patients who need psychiatric services in the lurch and out in the cold.”

USA Today (4/5, Zoroya) reports, “As thousands of additional veterans seek mental health care every month, the Department of Veterans Affairs is short of psychiatrists, with 20% vacancy rates in much of the country served by VA hospitals, according to department data.” What’s more, “the vacancies occur at a time when the number of veterans with post-traumatic stress disorder is increasing by about 10,000 every three months, what experts say is the cumulative effect of a decade of war, VA data show.” According to internal data, “the VA has about a 20% shortfall in psychiatrists at hospitals throughout the Northwest, Deep South, and Southern California,” particularly in rural areas with smaller populations.

Sen. Murray Raises Question Whether Cost Factors Into PTSD Diagnosis Decision. In continuing coverage, the AP (4/5) reports that US Sen. Patty Murray (D-WA) “is questioning military and Veterans’ Affairs officials over concerns that cost has been a factor in reversing diagnoses of soldiers found to suffer” from post-traumatic stress disorder (PTSD). Murray’s “questioning came Wednesday at a Tacoma field hearing of the Senate Veterans’ Affairs Committee, which she chairs.” While the AP did not mention what VA officials had to say in response to the questioning, it did report that “military officials pointed out that it is not US policy to deny soldiers and veterans necessary medical care or benefits for financial reasons.” However, some soldiers who have PTSD challenged that claim at Wednesday’s hearing.

Related Links:

— “VA sees shortfall of mental health specialists,”Gregg Zoroya, USA Today, April 5, 2012.

The Washington Post (4/3, Andrews) reports that “depression often goes undiagnosed in the elderly, who feel the stigma of mental illness more acutely than younger people and are often less likely to seek help,” but “the situation may be changing,” because “in October, Medicare began to cover annual depression screening in primary-care settings with no cost sharing for beneficiaries.” The piece notes that “the landscape should change as policymakers and insurers increasingly offer incentives to primary care physicians to transform their practices into medical homes for their patients and reward [clinicians] for better disease control rather than simply running tests and doing procedures.”

Related Links:

— “Depression often goes undiagnosed, but new Medicare benefit may change that,”Michelle Andrews, The Washington Post, April 2, 2012.

The New York Times (4/3, Brody) “Well” blog points out that according to a “report being released Tuesday by Safe Horizon, a victim assistance group that operates child advocacy centers in New York City, and the Childhood Violent Trauma Center at Yale University, children who are abused or neglected are 59 percent more likely than those who were not victimized to be arrested as juveniles, 28 percent more likely to be arrested as adults, and 30 percent more likely to commit a violent crime.” What’s more, these youngsters “face much higher rates of teenage pregnancy and are likelier to abuse or neglect their own children,” the report concludes. However, a special program involving “just four to six structured sessions with trained clinicians” involving both the traumatized children and their caregivers may help ameliorate the children’s symptoms.

Related Links:

— “A Brief Therapy Heals Trauma in Children,”Jane E. Brody, The New York Times, April 2, 2012.

In “Vital Signs,” the New York Times (4/3, D6, Bakalar, Subscription Publication) reports, “Snorting and stopping breathing during sleep are associated with depression, even in people whose symptoms do not meet the criteria for a diagnosis of obstructive sleep apnea,” according to a study published in the April issue of the journal Sleep. After studying “9,714 men and women participating in an ongoing national health survey by the Centers for Disease Control and Prevention,” researchers found that “among those with a diagnosis of obstructive sleep apnea, depression was more than twice as common among men and more than five times as common among women, compared with those who did not have the condition.”

Related Links:

— “Hazards: Mild Sleep Disorders Tied to Depression,”Nicholas Bakalar, The New York Times, April 2, 2012.