SPOTLIGHT
Impact of COVID-19 on State Mental Health Agencies Services
To understand and assess the magnitude of the impact of the COVID-19 pandemic has had on state mental health agencies services, and how these services have adapted to challenges presented by COVID-19, NRI, in collaboration with the National Association of State Mental Health Program Directors (NASMHPD), surveyed the SMHAs during the summer of 2020. This report represents the results of this survey.
This is the first of a series of 2020 State Profiles reports on the organization, services, and financing of SMHAs that NRI will be releasing over the next few months.
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The Intersection of the Opioid Crisis and Rise in Polysubstance Use
The Pew Charitable Trusts recently released a new fact sheet that addresses the opioid crisis and emerging trends in polysubstance use. The fact sheet provides data on two classes of drugs that are frequently co-used with opioids: depressants and stimulants, and notes that this has contributed to the rising number of opioid overdose deaths.
Comorbid polysubstance use and mental illnesses are common in psychiatric settings and concerning. In 2016, NRI published an article in the Journal of Psychiatric Practice, in which results indicated that the prevalence of antipsychotic polypharmacy in a sample of 86,034 discharges for adult patients that received services in state psychiatric hospitals was 12%. Antipsychotic polypharmacy continues at a high rate (23%) to affect nearly 10,000 patients with schizophrenia each year in state psychiatric hospitals. Although the research from NRI focused on antipsychotic polypharmacy to treat mental illness, substance abuse and deaths due to accidents mainly drug overdose have been identified for individuals treated in state psychiatric hospitals. The strategies from The Pew Charitable Trusts may be modified to accommodate the needs of the people served in state psychiatric hospitals, and to reduce the mortality burden in this particular population group.
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STATE AND FEDERAL
CMS Approves Georgia’s Partial Medicaid Expansion
The Centers for Medicare & Medicaid Services (CMS) approved Georgia’s Pathways to Coverage Section 1115 waiver request, allowing for a limited expansion of Medicaid that provides coverage to individuals ages 19 to 64 earning up to 100 percent of the federal poverty level (FPL). Read more.
Massachusetts State Supreme Judicial Court Expands Insanity Defense to Include Substance Use
Massachusett’s highest court unanimously vacated the murder conviction of a man who killed a fellow patient while in a psychiatric ward, saying the jury should have been given clearer instructions about the insanity defense and substance use. Read more.
NASADAD Releases Updated STR/SOR Funding Timeline
In 2018, the National Association of State Alcohol and Drug Abuse Directors developed an initial timeline of the State Targeted Response to the Opioid Crisis (STR) and State Opioid Response (SOR) grant programs. The timeline has now been updated to reflect a recent development: in August 2020, the Substance Abuse and Mental Health Services Administration (SAMHSA) announced $1.5 billion in funding to States for the third year of SOR funding. Learn more.
CMS Releases Initial Data from the Accountable Health Communities Model
As part of their focus on delivering better health care value, Centers for Medicare & Medicaid Service’s (CMS) is sharing a fact sheet with a snapshot of the data from the Accountable Health Communities (AHC) Model, reflecting the agency’s most comprehensive collection of social needs data to date. Learn more.
Commonwealth Fund Study: Outpatient Care Visits Return to Pre-Pandemic Levels, but Not for Behavioral Health Providers and Patients
A Commonwealth Fund study finds that visits for outpatient care, which had fallen nearly 60 percent in April at the beginning of the pandemic lockdowns, have returned in the past month to the levels existing prior to the COVID-19 pandemic for many providers and patients in many areas of the country, but not for behavioral health providers and patients. Read more.
Cleveland Clinic Announces Top 10 Medical Innovations for 2021
In its list of the Top 10 Medical Innovations, Cleveland Clinic included Increased Access to Telemedicine through Novel Practice & Policy Changes, noting that “COVID-19 saw increased adoption of telemedical practices. An increasingly virtual care model & increased consumer adoption came by way of fundamental shifts in policy at government & provider levels.” Read more.
SAMHSA Launches New Mental Health Mobile App
The Substance Abuse and Mental Health Services Administration (SAMHSA) has released a new mobile app, My Mental Health Crisis Plan, that allows people with serious mental illness (SMI) to guide their treatment during a mental health crisis. Learn more.
HRSA Accepting Applications for Workforce Education and Training Program
The Health Resources and Services Administration (HRSA) is now accepting applications for the fiscal year (FY) 2021 Behavioral Health Workforce Education and Training (BHWET) Program for Professionals. Learn more.
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RESEARCH
Preterm Birth Linked to Childhood Depression
Preterm birth before 28 weeks of gestation may be linked to childhood depression, suggests a study in the Journal of the American Academy of Child & Adolescent Psychiatry. Read more.
Psychotherapy Combined With Medication May Prevent Recurrence in Patients With Bipolar Disorder
When combined with pharmacotherapy, manualized psychosocial interventions were associated with a lower risk of illness recurrence in patients with bipolar disorder compared with pharmacotherapy alone, a meta-analysis in JAMA Psychiatry found. Read more.
Overwhelming Second Wave of Psychiatric Disorders Expected Due to Pandemic
Even as public health experts warn of a new tide of COVID-19 cases and deaths, another “second wave” is building in the form of mental and substance use disorders associated with social isolation, economic insecurity, and loss of family and community supports, cautioned Naomi M. Simon, M.D., M.Sc., director of the Anxiety and Complicated Grief Program at the NYU Grossman School of Medicine, and colleagues in an article published in JAMA. Read more.
Suicidal Thoughts Elevated Among Depressed Patients Reporting Anger Attacks
People with major depressive disorder (MDD) who often experience sudden bouts of anger—also known as anger attacks—may have elevated levels of suicidal ideation compared with those who do not experience anger attacks, suggests a study in Depression & Anxiety. Read more.
Fetal Exposure to Alcohol Associated With Behavioral, Psychological Problems in Offspring
Children who were exposed to any amount of alcohol in the womb are more likely to be impulsive and diagnosed with separation anxiety and oppositional defiant disorder compared with children who were not exposed to alcohol in the womb, reports a study in AJP in Advance. Read more.
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