Mental Health Association of Nebraska

NE HHS: Psychiatric Regional Center Readmission Rate Low

According to Regional Center Discharge Follow-up Services Project Report, 1,225 adults have been discharged from selected units of the State Regional Centers between January 1, 2005 and December 31, 2008.  Nebraska began behavioral health reform in 2004 with the passage of LB 1083, which called for the closure of adult mental health services at 2 of the 3 state hospitals.  According to the report, 78 percent of those discharged have not been readmitted to any state mental health facilities.  Unfortunately, 28 former patients (2.3%) who were discharged during that time have since died, and with an average age of 47 years at the time of death (state average: 75 years), reflects the national trend that has found that people living with severe mental illness die 25 years sooner than the general population.

The report also includes community and emergency services use by former patients, as well as Medicaid, Social Security and other forms of economic assistance use.  For a copy of the report, click here.

To read Nancy Hicks' article in the Lincoln Journal Star, click here.

Bazelon Center for Mental Health Law on Electronic Medical Records

In acknowledging the importance of effective communication between medical care providers and consumers, especially given the co-morbidity of mental illness and physical illnesses like diabetes and cancer, the Bazelon Center believes that mental health consumers need to have access to and control of their medical records.  "The Bazelon Center . . .strongly believes that consumers with mental illness should  be able to access all of their health and mental health information.  Access to this information is not only fundamental to a person's sense of autonomy, it is also critical to health care improvement efforts that focus on involving patients in their own care and their learning to self-manage aspects of their health. Also, for consent to be fully informed, the consumer must have confidence that the information is accurate and complete and thus may want to know exactly what is being shared."  To learn more, visit the Bazelon Center for Mental Health Law.

Elyn Saks on Forced Treatment, Seclusion and Restraint

Elyn Saks, Associated Dean and Orrin B. Evans Professor of Law, Psychology, Psychiatry and Behavioral Health Sciences at the University of Southern California Gould Law School, is considered an expert in mental health law.  In 2009, Saks was awarded the MacArthur Fellowship for her work as a "mental health lawyer expanding the options for those suffering from severe mental illness through scholarship, practice, and policy informed by a life that adds uncommon depth and insight." 

Saks was recently interviewed by Alysa Solomon, Ph.D, of the Los Angles County Department of Mental Health, where she speaks about her experiences growing up with mental illness, including in-patient psychiatric care and the use of restraints.To hear her interview, click here.

In the Introduction of Refusing Care: Forced Treatment and the Rights of the Mentally Ill, Saks writes that "it has been said that how a society treats its least well-off members says a lot about its humanity.  Our treatment of the mentally ill says that American society is inhumane." 

In her book she asks, "when should we treat those who don't want treatment, and when should we respect their choices?"  According to Saks, determining competence is an exercise in "value choices," where societal norms dominate when defining competence.  Saks believes that the standard for competence should be the same for those living with mental health issues as for the healthy, thus in determining incompetence, as in requiring forced medication or seclusion and restraint, standards should be the same for those living with and/or living without mental illness.  "Nobody would dream of authorizing, say a doctor, to force treatment of some kind on a perfectly competent, unimpaired person solely because that would be in his best interests."  Although the book isn't in our city library, you can read excerpts and order it through Amazon.com.

Strategies to Avoid Burnout in Professional Practice

According to Psychiatric Times, professional burnout (a.k.a. compassion fatigue) is characterized by emotional exhaustion, cynicism and "a sense of personal inefficiency or impeded accomplishment."  Although Strategies to Avoid Burnout in Professional Practice focuses on mental health professionals, many of the suggestions can be applied to everyone experiencing "an erosion of soul."  The key to  avoiding burnout is to identify areas where you have control, stay connected to others, and practice self-care.

"Although external stressors themselves cannot always be changed, healthy approaches to lessen the stresses . . . and avoid burnout can be learned at any age." 

To learn more . . .

Federal Government Launches New and Improved National Resource Directory for Military and Veteran Communities

The U.S. Departments of Defense, Labor and Veterans Affairs have launched a new and improved National Resource Directory (NRD) that provides access to services and resources at the national, state and local levels that support recovery, rehabilitation and community reintegration.  Information that is accessible through the website includes:  benefits and compensation, education and training, employment, family and caregiver support, health, homeless assistance, housing, transportation and travel. and other services and resources.  Learn more by visiting the National Resource Directory.

Tai Chi Linked to Improvements in Psychological Well-Being

Tai Chi, the Chinese low impact mind-body exercise, has been practiced for centuries for health and fitness in the East and is currently gaining popularity in the West.  According to Chenchen Wang, from Tufts Medical Center in Boston, "it is believed to improve mood and enhance overall psychological well being, but convincing evidence has so far been lacking."  Researchers searched 8 English-language and 3 Chinese-language databases and were able to identify 40 studies evolving 3,817 participants and reporting on a total of 29 psychological measurements.  Of 33 randomized and non-randomized trials, 21 reported significant improvements in psychological well-being, including reduced stress, anxiety, depression, mood disturbance and increased self-esteem, with 1 hour to 1 year of regular Tai Chi.  To read more . . .

To learn more about Tai Chi, visit the National Center for Complementary and Alternative Medicine.

Patient Voices: A.D.H.D.

NY Times' Patient Voices provides first person accounts of the changes, challenges and rewards patients face as they cope with various health issues.  This week we're featuring the voices of those living with this condition.  To hear their stories, click here.

Patient Voices: Bipolar Disorder

NY Times' Patient Voices provides "first person accounts of the changes, challenges and rewards patients face as they cope with various health issues," including ADHD, AIDS/HIV, autism, epilepsy, cancer and migraines.  This week we're featuring the segment on bipolar disorder, what it's like to have the disorder, to be labeled "crazy," and how to balance the ups and downs.  To hear their stories, click here.

Disability Nondiscrimination Law Advisor now available

The US Department of Labor (DOL) now hosts a new tool to help employers ensure their employment policies and practices do not discriminate against qualified individuals with dis-abilities.  The interactive, online Disability Nondiscrimination Law Advisor helps employers quickly determine which federal disability nondiscrimination laws apply to their business or organization and their responsibilities under them.

The DOL hosts a series of "elaws" (Employment Laws Assistance for Workers and Small Businesses) to help employers and employees understand federal employment laws.  To access it, visit elaws web site.  To learn more about DOL's efforts to increase employment opportunities for people with dis-abilities, visit the Office of Disability Employment Policy Web site.

Pfizer found guilty of racketeering

In a followup to last week's post When drug maker' profits outweigh penalties, the federal court in Boston found Pfizer guilty of racketeering for marketing its epilepsy drug Neurontin for unapproved use in treating aliments including bipolar disorder and migraines. Under federal racketeering law, the $47 million penalty automatically triples to $141 million (US jury's Neurontin ruling cost Pfizer $141 million, Reuters, March 25, 2010).  The suit was brought to court by HMO Kaiser Permanente, who claimed they were "wrongfully manipulated" into spending "more that one hundred million dollars on a very expensive drug that we now know is no more effective than a placebo for pain, bipolar. and many other conditions it was promoted to relieve" (Kaiser Pernanente Statement on Verdict in Neurontin Case, FierceBiotech.com, March 26, 2010).

To learn more about the prescription medications you are taking, and whether they are approved for the uses they were approved for, check out:

MedWatch

DailyMed

MedLine Plus