Mental health issues affect approximately 20 percent of the kids in the United States, according to a first-of-its-kind report from the Centers for Disease Control (CDC). The CDC, which partnered with several other federal agencies to study data on childhood mental illness between 2005 and 2011, say they expect that rate to increase even further in the coming years.

The mental health issues that affect children include attention-deficit/hyperactivity disorder (ADHD), autism, mood and anxiety disorders, behavioral disorders, substance abuse, and Tourette Syndrome. The CDC found that ADHD was the most commonly reported mental disorder, affecting about 4.2 million children between the ages of 3 and 17. About 1.2 million children in that age group are battling depression, and about 678,000 fall somewhere on the autism spectrum. And an estimated 40 percent of children who have been diagnosed with a disorder actually suffer from multiple different mental health issues.

The CDC estimates that treating those mental health issues costs the U.S. about $247 billion each year. But that actually represents just a fraction of what the nation should be spending, since less than a quarter of the children living with mental disorders are receiving the treatment they need:

Although the prevalence, early onset and effect on society make childhood mental problems a major public health issue, only 21 percent of affected children get treatment because of a shortage of pediatric sub-specialists and child and adolescent psychiatrists, according to the American Academy of Child & Adolescent Psychiatry.

“Our current health care system does not meet the needs of these children,” Martin J. Drell, the group’s president, said last week in a statement about the problem.

Making matters worse, fewer medical students are opting for careers in children’s mental health, while the current crop of professionals is aging out of the workforce. The dearth of providers means troubled youngsters in underserved rural and urban areas are less likely to get timely care.

“Children with serious medical conditions should not have where they live determine what kind of health care services they receive,” said Thomas K. McInerny, president of the American Academy of Pediatrics.

Researchers say their new report represents the first comprehensive look at mental health issues among children. “This report is a reflection of what’s happening in the nation as a whole,” one of the report’s authors, Dr. Ruth Perou, told the Daily Beast. “We’re finally opening a dialogue on mental health.”

After a series of recent mass shootings, there has been renewed interest in these kind of national discussions regarding mental health issues. Indeed, the U.S. has a long way to go in this area. Half of mentally ill Americans are currently skipping out on treatment because they can’t afford it, partly because mental health care providers don’t always accept private insurance. This problem was exacerbated by the recent economic downturn, which led many states to slash billions of dollars in funding from their mental health programs. Predictably, as those mental health services have disappeared, the prison population has skyrocketed. A recent survey of Texas’ juvenile detention facilities found that the rate of mental illness exceeds the rate of gang membership among teen prisoners there.

Fortunately, there has been some legislative movement in this area. At the beginning of this year, Sen. Al Franken (D-MN) held a series of hearings on the dire state of youth’s mental health services, and introduced a measure to strengthen school’s resources for identifying and treating kids’ mental disorders.

Unintended pregnancy doesn’t just take a physical and financial toll on a woman; according to a new study published on Wednesday, it also has emotional consequences.

Researchers at the University of North Carolina spoke with 680 women — 433 who had an intended pregnancy, 207 who said their pregnancy was mistimed, and 40 with an unwanted pregnancy — to gauge the impact of an unintended pregnancy on a woman’s mental health. They found that a women who didn’t mean to get pregnant were much more likely to suffer from postpartum depression, and more likely to risk long-term mental health issues:

Results show that postpartum depression was more likely in women with unintended pregnancies at both three months (11% vs. 5%) and twelve months (12% vs. 3%). The increased risk was highest at 12 months and indicates that this group of women have a long term risk of depression. When age, education level and poverty status were factored into the results, women with unintended pregnancy were still twice as likely to have postpartum depression at twelve months.

The research offers yet another reason why it’s important for women to have readily available access to contraception. Access to birth control would lower rates of unintended pregnancy — and therefore both abortion and, as this study indicates, maternal depression.

Rates of unintended or mistimed pregnancy are particularly high among low-income women, who struggle to find access to affordable contraception. Unfortunately, there is little being done to increase access to family planning that would ultimately be beneficial to preventing such pregnancies. Instead, states are continually pushing to make it more difficult for all women, and particularly low-income women, to access this type of reproductive care.

(HT: Kay Steiger)

The Diagnostic and Statistical Manual of Mental Disorders (DSM), which is published by the American Psychiatric Association (APA), has been around in one form or another since the 1950s. It contains standardized definitions and a common language for the treatment of mental disorders, and it’s set to release its fifth edition — the first updated issue of the tome since 1994 — later this month. Count the National Institute of Mental Health (NIMH) as one group that’s canceling its subscription.

The DSM is sometimes described as the “bible” of the mental health field. It can take at least a decade to produce updates to the manual that incorporate shifts in medical research. But in a blog post on the NIMH website, the federal organization argues that, when it comes to the well-being of mental health patients, the DSM simply isn’t cutting it:

The goal of this new manual, as with all previous editions, is to provide a common language for describing psychopathology. While DSM has been described as a “Bible” for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been “reliability” – each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. [...]

Patients with mental disorders deserve better. NIMH has launched the Research Domain Criteria (RDoC) project to transform diagnosis by incorporating genetics, imaging, cognitive science, and other levels of information to lay the foundation for a new classification system.

The case against using the DSM boils down to the APA’s lack of clinical and longitudinal studies in crafting it — a major shortcoming that mental health advocates argue relegates the DSM to a semantics-based publication, with little connection to the needs and realities of actual mental health patients. Consequently, many updates to the DSM are more reflective of changes in sociopolitical thinking, rather than underlying scientific realities. For instance, one of the “updates” included in the DSM-V strikes kinky sex habits and queer behaviors such as S&M, fetishism, and transvestism from being considered “mental disorders of abnormal or unusual attraction.”

NIMH instead calls for a holistic — and scientific — approach to constructing an alternate diagnostic “Bible” that is “based on the biology as well as the symptoms” and maps the “cognitive, circuit, and genetic aspects of mental disorders [to] yield new and better targets for treatment.”

The Great Recession led to the biggest cuts to mental health services in this nation’s history. According to a report from the National Alliance on Mental Illness, states slashed more than $1.8 billion from their mental health services between 2009 and 2011. That funding decision has had some serious consequences — such as fewer beds in mental health institutions for American adults, creating a situation in which mentally ill people often end up in prison when they can’t access the treatment they need.

But this trend wasn’t initiated by the recession’s budget cuts; it was simply worsened by it. As evidenced by the following graph from Mother Jones (which relies on the National Alliance on Mental Illness’ data), it’s been happening over the past several decades. Since the 1970s, a rapid rise in the nation’s prison population has directly corresponded with a sharp decline in the number of Americans institutionalized at mental health hospitals:

Patients are often pushed into the prison system when they don’t have access to the mental health treatment that helps keep them stable. Without the medication, counseling, and support they need, mentally ill Americans can exhibit behavior that results in an encounter with law enforcement. But another part of the issue is that American society continues to criminalize mental illness rather than recognizing and treating it effectively.

This issue doesn’t just affect adults. A recent survey of Texas’ juvenile detention facilities found that the rate of mental illness exceeds the rate of gang membership among teen prisoners there.

Federal officials have a clear message for Nevada’s Rawson-Neal mental health facility: Stop mistreating patients, or see your federal Medicare dollars disappear. In a curt letter distributed by the Center for Medicare and Medicaid Services (CMS), the federal agency that oversees major entitlement spending warned the hospital — which has been accused of unceremoniously dumping its homeless patients onto buses — that “If we do not receive an acceptable, timely submission, or if a resurvey finds that the hospital is not complying with any [conditions of participation], we will notify you that we are initiating action to terminate the facility’s Medicare provider agreement.”

The beleaguered hospital gained national attention after reports surfaced that it had systematically been dumping homeless patients with serious mental illnesses onto buses to other states. Doctors allegedly told the patients this was necessary due to a dearth of funding for housing and mental health services in the state, suggesting that they would be better off elsewhere. Rawson-Neal allegedly bused at least 100 patients to California in just one year, despite the fact that Golden State is only marginally better at funding mental health care than Nevada is.

Primary reports focused on a schizophrenic patient named James Flavy Coy Brown, who was discharged and placed onto a Greyhound to California with nothing but light snacks and three days’ medication. A follow-up investigation by the San Francisco Bee found that the behavior was nothing new, leading state and federal officials to slam the alleged patient mistreatment:

The Bee followed with an investigative report that said Rawson-Neal had purchased one-way bus tickets for 1,500 discharged patients over five years, some of whom had been sent to locations where they had no contacts.

The revelations prompted the city attorneys of Los Angeles and San Francisco to announce probes into the matter earlier this week. Rawson-Neal patients were bused to both cities, according to the Bee’s findings.

Nevada Gov. Brian Sandoval said in a statement that his office had launched three separate investigations and that disciplinary actions had been taken. The governor’s office determined that policies were not followed in at least one instance. The new policy, he said, provides “additional oversight” to ensure the hospital follows proper discharge procedures.

“I take the concerns regarding Rawson-Neal Psychiatric Hospital very seriously and it is not the policy of the state of Nevada to engage in ‘patient dumping,’” he said in a statement.

State officials have also claimed that the problem is limited to Rawson-Neal, and not reflected through other state-operated facilities.

Now that Rawson-Neal’s Medicare dollars are in jeopardy, doctors and hospital administrators might be more eager to take action. But if the facility buckles under the weight of losing its federal funding — in addition to Nevada’s steep cuts to mental health services through its Medicaid program — then other public facilities in the state would be forced to absorb its patient load. Considering the multiple barriers to providing the homeless with mental health treatment, that could end up being a tall order.

This Friday, House Republican Tim Murphy is holding a hearing on whether the Health Insurance Portability and Accountability Act (HIPAA) “helps or hinders patient care and public safety” in the context of mentally ill patients. The hearing, a followup to his hearing last month in which he reiterated false claims about mental illness and violence, will notably not include a single mentally ill witness. Why not? Because, according to Tim Murphy, mentally ill people are not “competent” to testify about how a relaxation of HIPAA rules would affect their own lives.

Instead, the hearing will revolve around family members, psychiatric professionals, and public health representatives, making decisions with potentially very serious implications about medical privacy for mentally ill people.  This event is occurring in a larger context of national panic about mental health and violence — with few public figures brave enough to stand against the tide, as Al Franken recently did, and warn against continued stereotyping and stigma of mentally ill people.

Rep. Murphy’s claim is that HIPAA “may interfere with the timely and continuous flow of health information between health care providers, patients, and families, thereby impeding patient care, and in some cases, public safety.” In other words: mentally health patients shouldn’t receive patient confidentiality, because mentally ill people are violent, and it’s in the best interest of society overall to lift privacy restrictions that limit the disclosure of their health information. This is part of a larger attack on HIPAA rights for mentally ill people with potentially grave implications that’s wrongheaded from a number of perspectives.

Despite the public perception that mentally ill people are violent and dangerous — one fostered by dangerous pop culture depictions, scaremongering media, and public comments by politicians and other leaders — it’s just not the reality. In fact, the link between mental illness and violence goes the other way round; mentally ill people are far more likely to be the victims than the perpetrators of violence. They also experience sexual assault, financial exploitation, and discrimination at very high rates because they’re viewed as easy victims. Of those who do commit violence, the vast majority engage in acts of self-harm like suicide, not violence against others.

The vast majority of violent crimes are perpetrated by people without mental health conditions. And, in unsurprising news, the largest factors involved in a violent crime that does involve a mentally ill person are lack of access to treatment (a perennial problem in the US) and drugs, which some patients may turn to for self-medication when they cannot get care through other means.

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Our guest blogger is s.e. smith, a writer and editor based in Northern California with a journalistic focus on social issues, particularly gender, prison reform, disability rights, environmental justice, queerness, and class.

22-year-old Chris Reed of Algonquin wants to give young former addicts a place to indulge in some R&R — recovery and recreation, that is. The former heroin addict and president of the recovery nonprofit New Directions Addiction Recovery Services has — with the help of some fellow recovery patients — led the charge in creating “The Other Side,” a completely volunteer-funded “sober bar” set to open in Crystal Lake, Illinois at the end of the month.

Although alcohol and substance abuse are often stratified in everyday conversation, they are rooted in similar dependencies and have a fair amount of interplay. Substance abusers are much more likely to have an alcohol dependency than vice versa, and young people between the ages of 18 and 24 are at the highest risk of having co-occurring alcohol and substance abuse problems. That’s why The Other Side aims to be a space in which young Americans recovering from a drug habit can take a breather — without the temptation of booze and its potential to cause a relapse. “If you’re choosing a sober lifestyle, this will be a healthy atmosphere. It’s an important place for people in recovery,” Reed told the Daily Herald. “We’re still young, and we want to hang out. You can’t hang out with 40 people at your house.”

The whole effort is not-for-profit, intertwined with other recovery groups, and will hopefully become an additional therapeutic resource for recovering addicts:

The Other Side is not a business — everyone involved is keeping a day job, and it’s only open four nights a week, Thursdays through Sundays. Any money raised will fund drug education and treatment initiatives by their nonprofit and others, including Wake the Nation, a Facebook-based drug awareness group led by New Directions board member Cassandra Wingert, 23, of Western Springs. [...]

Falling somewhere between “nightclub” and “rec center,” The Other Side is opening in the warehouse loft space behind Reed’s construction company on Berkshire Drive. It has room for people to relax on couches, watch TV, play pool or video games, listen to live bands, or dance along with a disc jockey. There will be security, and people will be carded at the door to make sure they’re at least 18 years old — and sober. [...]

The Other Side’s creators hope their bar will help people in various stages of recovery by providing them a place to go, and a place to be with others who understand the struggle of addiction.

The space also features photographs of late addicts who succumbed to their struggles with drugs — a solemn reminder of what can happen without a robust support system for Americans who are trying to get clean. Social exclusion, loneliness, and isolation are all significant risk factors for both mental illness and substance abuse, making group-based recovery efforts particularly important. What makes efforts such as The Other Side promising is that they close the gap between the social and therapeutic spheres of recovery, giving former addicts a place to be with both non-addict and addict friends.