Category Archives: Mental Health

Beach Town Tries To Reverse Runaway Growth Of ‘Sober Homes’

Source: Greg Allen, NPR, Morning Edition, August 10, 2017

Some local and state officials in South Florida are calling for more regulation of addiction recovery residences to help combat insurance scams.
Related:
Sober Homes Task Force Report 2017
Source: Palm Beach County, Sober Homes Task Force Report, January 1, 2017

Grand Jury Report
Source: State Attorney for the 15th Judicial Circuit, Palm Beach County, December 8, 2016

Delray Beach Principles to Guide Zoning for Community Residences for People with Disabilities
Source: Daniel Lauber, prepared for the City of Delray Beach Florida, May 2017

Taking Care of the Mentally Ill

Source: B.L. Sloan, D.E. Efeti, Corrections Today, Vol. 79 no. 3, May/June 2017
(subscription required)

A training opportunity for correctional professionals. …. Across the nation, individuals with a serious mental illness are three times more likely to be incarcerated than placed in a mental health facility. … Because of this ever-growing population, the challenges facing correctional staff regarding custody, supervision and treatment of mentally ill offenders have never been greater. Therefore, it is not only necessary for the treatment staff to address then needs of the mentally ill offender, but it is critical for security staff members to understand and recognize problems faced by this special population and be better equipped to manage it. ….

Costs and Outcomes of Mental Health and Substance Use Disorders in the US

Source: Rabah Kamal, Cynthia Cox, David Rousseau, et al for the Kaiser Family Foundation, JAMA Infographic, Visualizing Health Policy, August 1, 2017

This Visualizing Health Policy infographic looks at costs and outcomes of mental health and substance use disorders in the United States (US). Nearly 18% of adults reported having a mental, behavioral, or emotional disorder in 2015, including more than 1 in 5 women. Furthermore, nearly 3% of people aged 12 years or older reported addiction to or misuse of an illicit drug in 2015, including more than 7% of people aged 18 to 25 years. However, 1 in 5 people say they or a family member had to forego needed mental health services because they couldn’t afford the cost, their insurance wouldn’t cover it, they were afraid or embarrassed, or they didn’t know where to go. Mental illness treatment accounted for $89 billion, or 5%, of total medical services spending in 2013, behind checkups/prevention and circulatory disorders. Mental health and substance use disorders together were the leading cause of disease burden in 2015, surpassing cancer and cardiovascular disease, among others. Relative to countries of similar size and wealth, the US has had higher rates of death from unintentional poisonings, the majority of which were due to drug overdoses. In 2013 the age-standardized rate of death from unintentional poisonings per 100 000 population was 12.4 in the US compared with 2.5 on average in comparable countries.

Costs and Outcomes of Mental Health and Substance Use Disorders in the US

How killing the ACA could lead to more opioid deaths in West Virginia and other Trump states

Source: Simon Haeder, The Conversation, July 24, 2017

…. While the exact nature of Republican repeal-and-replace efforts remains unclear at this moment, all proposals made public so far would pose enormous challenges for states like West Virginia to turn the tide on the devastating opioid epidemic.

One of the most essential tools in fighting the epidemic, the expansion of Medicaid, would be rolled back either immediately or over several years. Furthermore, the entire Medicaid program, the backbone of states’ efforts to provide treatment and services for opioid addiction treatment, would be further curtailed by per capita caps.

Moreover, all proposals would either outright eliminate or allow states to waive the crucial Essential Health Benefit provisions. These provisions require insurers to provide coverage for certain specified conditions, such as pregnancy, addiction treatment and emergency room care, that they might otherwise refuse to cover because of their costs.

Under certain proposals, lifetime and annual limits could also affect those covered by employer-provided insurance to lose access to crucial treatment options. ….

Mental Disorders Among Criminal Offenders: A Review of the Literature

Source: Emily D. Gottfried, Sheresa C. Christopher, Journal of Correctional Health Care, Vol. 23 Issue 3, July 2017
(subscription required)

From the abstract:
This article examines mental illness among adult, juvenile, male, female, jail, and prison inmates. It also explores the way in which mental health diagnoses impact offending and violent behavior. A review of literature pertaining to differences between the genders and age of offenders suggests that psychiatric disorders are more common among criminal offenders than the population at large. Furthermore, it appears that many mentally ill offenders do not receive sufficient treatment during their incarcerations and that barriers inherent to incarceration prevent adequate treatment of mental illnesses.

‘Giving Help and Not Asking for It’: Inside the Mental Health of First Responders

Source: Katherine Barrett & Richard Greene, Governing, July 7, 2017

Teaching cops, firefighters and prison workers to recognize and know how to handle people with mental illness is a big part of the efforts to reduce suffering and death at the hands of law enforcement. Less talked about is the mental health of the cops, firefighters and prison workers themselves. ….

Saving Lives in the Stacks How libraries are handling the opioid crisis

Source: Anne Ford, American Libraries, June 21, 2017

…..What Simon didn’t say—but what librarians far and wide know—is that the McPherson Square branch is just one of many American libraries struggling with opioid-related issues such as discarded, contaminated needles; drug use in the library itself; and even on-site overdoses and fatalities. Libraries from California to Colorado, Pennsylvania to Missouri, are finding themselves on the front lines of a battle they never anticipated fighting. Of course, opiate use isn’t limited to libraries. Neither is anyone claiming that the problem is more severe in libraries than it is anywhere else. Still, the fact that libraries are open to all, offer relative anonymity, and generally allow patrons to stay as long as they like make them uniquely vulnerable to those seeking a place to use drugs…..

The opioid epidemic is so bad that librarians are learning how to treat overdoses
Source: Darran Simon, CNN, June 24, 2017

…..Long viewed as guardians of safe spaces for children, library staff members like Kowalski have begun taking on the role of first responder in drug overdoses. In at least three major cities — Philadelphia, Denver and San Francisco — library employees now know, or are set to learn, how to use the drug naloxone, usually known by its brand name Narcan, to help reverse overdoses.

Their training tracks with the disastrous national rise in opioid use and an apparent uptick of overdoses in libraries, which often serve as daytime havens for homeless people and hubs of services in impoverished communities.

In the past two years, libraries in Denver, San Francisco, suburban Chicago and Reading, Pennsylvania have become the site of fatal overdoses…..
Related:
Librarians In Philadelphia Train To Thwart Drug Overdoses
NPR, Weekend Edition, June 3, 2017

The McPherson Branch of the Free Public Library sees almost daily heroin overdoses. NPR’s Scott Simon talks to Mike Newall of the Philadelphia Inquirer and librarian Chera Kowolski about the response.

For these Philly librarians, drug tourists and overdose drills are part of the job
Source: Mike Newall, Philadelphia Inquirer, June 1, 2017

I visited the century-old library that sits atop Needle Park in Kensington because I’d heard its staff was the first in the city to learn how to administer the lifesaving overdose antidote Narcan.

They have been using the spray so often that they can tell the type of overdose simply by the sound coming from the lavatory: Heroin victims slide sluggishly into unconsciousness, the librarians have found, while victims of deadly fentanyl collapse instantly, with a thud that resonates through the entire building, which is called the McPherson Square Branch….

Salt Lake County librarians trained to respond to drug overdoses
Source: Deseret News, June 29, 2017

Salt Lake County Library Services, partnering with the Salt Lake County Health Department, has trained librarians on how to administer Narcan and has distributed naloxone kits to their branches….

Denver Public Library staff equipped with opioid overdose antidote
Source: KDVR, March 17, 2017

Staff at Denver Public Library’s central library are now carrying narcan, an opioid overdose antidote, in response to an increase in people overdosing at the library. …. Fewell said since the library started tracking the incidents in February, staff have counted six overdoses. ….

Indicators of Mental Health Problems Reported by Prisoners and Jail Inmates, 2011-12

Source: Jennifer Bronson and Marcus Berzofsky, Bureau of Justice Statistics, NCJ 250612, June 2017

From the press release:
The Bureau of Justice Statistics (BJS) released a study today that revealed 14 percent of state and federal prisoners and 26 percent of jail inmates reported experiences that met the threshold for serious psychological distress (SPD). In comparison, the BJS study found that one in 20 persons (5 percent) in the U.S. general population with similar sex, age, race and Hispanic origin characteristics met the threshold for SPD.

The data on the prison and jail inmates are from the BJS’s 2011-12 National Inmate Survey and the general population data are from the National Survey on Drug Use and Health (NSDUH), conducted by the Substance Abuse and Mental Health Services Administration. The NSDUH data were standardized to match the sex, age, race and Hispanic origin of the prison and jail populations.

The report examined the prevalence of mental health problems among inmates based on two indicators: self-reported experiences that met the threshold for SPD in the 30 days prior to the survey and having been told at any time in the past by a mental health professional that they had a mental health disorder.

Among the incarcerated population, the study also found that females in state and federal prisons reported experiencing feelings that met the threshold for SPD at higher rates (20 percent) than males (14 percent). In jails, 32 percent of females and 26 percent of males met the threshold for SPD. Similar to the pattern for SPD, two-thirds of female inmates in both prisons (66 percent) and jails (68 percent) had been told by a mental health professional that they had a mental health disorder, compared to around a third (33 percent) of male prisoners and 41 percent of male jail inmates.

Thirty-seven percent of state and federal prisoners had been told by a mental health professional in the past that they had a mental health disorder. The most common disorder was a major depressive disorder (24 percent), followed by a bipolar disorder (18 percent), post-traumatic stress or personality disorder (13 percent) and schizophrenia or another psychotic disorder (9 percent).

Among jail inmates, 44 percent had been told in the past that they had a mental health disorder. Nearly a third had been told that they had major depressive disorder and a quarter had been told they had bipolar disorder.

Among inmates who met the threshold for SPD, more than half (54 percent) of prisoners and a third (35 percent) of jail inmates had received mental health treatment since admission to their current facility. About three-quarters of prisoners (74 percent) and jail inmates (73 percent) who met the threshold for SPD said they had received mental health treatment at some time in their life. Treatment included prescription medication, counseling or therapy, or both…..

Cost-Benefit Analysis of a Support Program for Nursing Staff

Source: Dane Moran; Albert W Wu; Cheryl Connors; Meera R Chappidi; Sushama K Sreedhara; Jessica H Selter; William V Padula, Journal of Patient Safety, Published Ahead-of-Print, April 27, 2017
(subscription required)

From the abstract:
OBJECTIVES
A peer-support program called Resilience In Stressful Events (RISE) was designed to help hospital staff cope with stressful patient-related events. The aim of this study was to evaluate the impact of the RISE program by conducting an economic evaluation of its cost benefit.

METHODS
A Markov model with a 1-year time horizon was developed to compare the cost benefit with and without the RISE program from a provider (hospital) perspective. Nursing staff who used the RISE program between 2015 and 2016 at a 1000-bed, private hospital in the United States were included in the analysis. The cost of running the RISE program, nurse turnover, and nurse time off were modeled. Data on costs were obtained from literature review and hospital data. Probabilities of quitting or taking time off with or without the RISE program were estimated using survey data. Net monetary benefit (NMB) and budget impact of having the RISE program were computed to determine cost benefit to the hospital.

RESULTS
Expected model results of the RISE program found a net monetary benefit savings of US $22,576.05 per nurse who initiated a RISE call. These savings were determined to be 99.9% consistent on the basis of a probabilistic sensitivity analysis. The budget impact analysis revealed that a hospital could save US $1.81 million each year because of the RISE program.

CONCLUSIONS
The RISE program resulted in substantial cost savings to the hospital. Hospitals should be encouraged by these findings to implement institution-wide support programs for medical staff, based on a high demand for this type of service and the potential for cost savings.

Happiness is Flextime

Source: Adam Okulicz-Kozaryn, Lonnie Golden, Applied Research in Quality of Life, Forthcoming, Posted: 11 May 2017

From the abstract:
We study how working schedule flexibility (flextime) affects happiness. We use a US General Social Survey (GSS) pooled dataset containing the Quality of Worklife and Work Orientations modules for 1998, 2002, 2006, 2010, and 2014. We retain only respondents who are either full-time or part-time employees on payrolls. For flextime to be associated with greater happiness, it has to be more than just sometimes flexible or slight input into one’s work schedule, that is, little flextime does not increase happiness. But substantial flextime has large effect on happiness–the size effect is about as large as that of household income, or about as large as one-step increase in self-reported health, such as up from good to excellent health. Our findings provide support for both public and organizational policies that would promote greater work schedule flexibility or control for employees.