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Childhood Poverty, Stress Induce Mental Disorders in Adolescence

Posted: August 14, 2012

How we spend our childhood and the experiences we gain at a tender age stay with us for the rest of our lives. A new study has linked childhood adversity to chronic stress during teenage years, which could cause many a physical and mental health issues. According to the study, the more time spent during childhood in poverty, the greater the risks the children are exposed to and this is linked to increased markers of chronic stress by the time the children are 17. The study is titled Poverty and Health The Mediating Role of Perceived Discrimination and was published online in July in Psychological Science.

For the study, the researchers quizzed 173 children about their family income and exposure to such risks as housing conditions, family turmoil and violence. Children's blood pressure, overnight levels of stress hormones and body mass index were measured to assess physiological changes, known as allostatic load, which are associated with chronic stress.

"While prior work has shown that childhood poverty is linked to elevated chronic stress, as indicated by allostatic load, this study adds two critical ingredients: We demonstrate this in a prospective, longitudinal design which makes the evidence stronger, and we show that the poverty-allostatic load link is explained in part by low-income children's exposure to cumulative risk factors," said lead author Gary W. Evans, the Elizabeth Lee Vincent Professor of Human Ecology in Cornell's College of Human Ecology in the press release. "In other words, one reason why poverty leads to chronic stress is because of the confluence of risk factors poor children encounter," Evans said. 

According to the authors, all the risk factors put together can add up to levels of stress which could cause damage to the developing brain of the children. Along with physiological damage this can cause disorders in children later in life. "Poverty often leads to chaotic circumstances that make it more difficult for children to get what they need to develop optimally," Evans said. "Chaos makes it difficult to sustain predictable and increasingly complex exchanges between caregivers and the growing child. Furthermore, this chaos occurs across many of the settings in which the children's lives are embedded, such as neighborhoods and schools."

Read more on the Counsel & Heal website. Read the abstract of the study.

Celebrating Two Decades of Progress in the Behavioral Health Field: SAMHSA turns 20!

Posted: August 13, 2012

This year, SAMHSA is celebrating its 20th anniversary and two decades of progress in the behavioral health field. Since SAMHSA was created in 1992, people with mental and substance use disorders have seen many improvements in their lives. The rise of the consumer and recovery movements has made it possible for individuals to be active participants in their own care and recovery. The development of community coalitions, trauma-informed care, treatment drug courts, and offender re-entry programs has helped communities and families build resilience and helped people get the assistance they need. Additionally, legislative milestones such as the Mental Health Parity and Addiction Equity Act and the Affordable Care Act will expand access to prevention, treatment, and recovery support services.

The last 20 years have seen massive changes in behavioral health financing trends. According to SAMHSA's National Expenditures for Mental Health Services and Substance Abuse Treatment reports, these changes include the shift from inpatient to outpatient care; the growing use of medications to treat conditions such as depression, opioid dependence, and other problems; and Medicaid's ever-increasing role in funding behavioral health.

Two legislative developments are also having a major impact on the funding of such services. The first is the Mental Health Parity and Addiction Equity Act of 2008. Designed to end discrimination in insurance coverage, the law prevents group health plans covering more than 50 people from imposing financial and treatment limitations for behavioral health services that are more restrictive than those for medical and surgical services.

SAMHSA played a key behind-the-scenes role in getting the legislation passed. Drawing on SAMHSA's expenditures report and written by SAMHSA staffers and others, an influential article in the journal Health Affairs showed a drop in private insurance spending on services for substance use disorders and highlighted the problem of unequal funding for behavioral and medical and surgical services. Additionally, SAMHSA's analysis of parity within the Federal Employees Health Benefits program, which adopted parity in 2001, showed that parity resulted in expanded access to behavioral health services, with most plans experiencing modest increases in benefit costs and no added administrative costs.

The Patient Protection and Affordable Care Act of 2010 is another recent milestone. For providers, the Affordable Care Act means a shift to new models of integrated care, such as health homes that coordinate care for people with chronic conditions and accountable care organizations that base reimbursement on outcomes. Providers will also face new payment mechanisms such as capitation, episode rates, and team based payments focused on outcomes achieved rather than services provided.

Read more on the SAMHSA website. Download the full report Two Decades of Progress for Behavioral Health Care and SAMHSA (pdf).

Mental Health Screening Application Adapted for Spanish-speaking Users

Posted: August 13, 2012

The National Resource Center for Hispanic Mental Health has partnered with M3 to release a Spanish language version of WhatsMyM3, a quick and anonymous tool that screens for depression, anxiety, bipolar disorder and posttraumatic stress disorder. The release coincides with the partnership’s recognition and support of National Minority Mental Health Awareness Month.

Henry Acosta, former NAMI Board member and executive director of the National Resource Center for Hispanic Mental Health (NRCHMH) says that the adapted WhatsMyM3 tool is incredibly valuable for the Latino community due to trends of misconceptions, barriers to quality care and general underutilization of mental health services within this population.

The new application, available to iPhone and Android users, will allow individuals to self-assess and receive information for free in the privacy and comfort of chosen space and may ultimately lead to earlier detection, more informed discussions with service providers and ultimately improved mental health outcomes among Latinos.

Find out more on the NRCHMH website. Read more on the National Alliance for Mental Illness website.

Young Alaska Native Men at High Risk for Suicide

Posted: August 11, 2012

Young Alaska Native men between the ages of 20 and 29 are at extremely high risk for suicide, killing themselves at a rate more than 13 times the overall national average. The study by the state Department of Health and Social Services, which tracked records from 2003 to 2008 and examined a myriad of demographic groups, said that lack of opportunity and identity issues may be among factors contributing to the phenomenon. The study is titled Characteristics of Suicide Among Alaska Native and Alaska non-Native People, 2003–2008.

The study said psychosocial factors which may contribute to the higher suicide rate include "confusion around identity and purpose resulting from perceived discordance between traditional and contemporary values, and a low sense of agency to control their own life or to fulfill their ambitions due to lack of jobs and training infrastructure in rural communities." Overall, the suicide rate in Alaska was 17.7 per 100,000 for the study period, compared with a national rate of 11.6 per 100,000 recorded in 2008, the report said. For Alaska Natives as a whole, the suicide rate during the period was nearly four times the national rate. For Alaska Native men aged 20-29, the rate was 155.3 per 100,000, according to the study.

Suicide rates for Alaska Native men were three times the rate for Alaska Native women, according to the statistics compiled in the study. Researchers believe vulnerable Native women were more likely to use suicide-prevention services, said Deborah Hull-Jilly, a public-health specialist with the department's Alaska Section of Epidemiology.

Common threads for the recorded suicides were alcohol abuse, mental health problems and geographic isolation, according to the study. Residents of small villages appeared particularly vulnerable, with suicide rates in remote villages more than twice those in larger rural hub communities. "That was eye-opening," Hull-Jilly said, adding that follow-up studies with data from more recent years were planned. One positive sign researchers found was that Native suicide rates had leveled off overall after growing dramatically in the past decades, she said.

Read more on the Reuters website. Read the complete study (pdf).

Survey: Do Outreach Strategies on the Affordable Care Act Work for the African Heritage Community?

Posted: August 10, 2012

The National Leadership Council on African American Behavioral Health is interested in learning about outreach and engagement strategies related to affordable healthcare to better inform the Department of Health and Human Services (HHS). They have been charged with gathering information specifically about the African Heritage community. Take a few minutes to take their survey online and help inform better practice as the healthcare machine rolls out.

Click here to take survey!

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