The New York Times recently reported that rates of ADHD diagnosis among school-aged children has risen to 11 percent — a record high. That number is partially a consequence of more accurate ADHD diagnoses — but it presents a stark choice for parents debating the best treatment options for their kids. Medications such as Adderall and Ritalin are a common choice — but a new analysis of previous ADHD studies suggests behavior training “that teaches parents to understand their children’s needs” might be a better long-term care option for young children.

The new study, led by Dr. Alice Charach of the Hospital for Sick Children in Toronto, examined eight past analyses on the effect that parental behavior training “which consists of about 10 to 12 sessions that teach parents how to better understand their child” had on preschoolers with ADHD. Those studies found that the parent-oriented treatment led to about the same behavioral improvement in children as medication, but without causing the negative side effects associated with ADHD drug use by young kids:

“The main thing is really helping the parent understand their child and read their child,” [Charach] said.

For example, the sessions may help parents understand their child acts up after an hour of being at a birthday party, and that they should leave earlier.

Only one “good” study evaluated Ritalin use in preschoolers. That study showed a similar improvement in behavior, but the preschoolers were at risk for side effects, including irritability and slowed growth.

“For whatever reason children in this age group are more sensitive to the Ritalin side effects,” said Charach.

Questions surrounding the long-term efficacy of ADHD medications have stirred debate among pediatricians and psychiatrists. In a 2012 editorial for the New York Times, a professor emeritus of psychology at the University of Minnesota’s Institute of Child Development argued that there is considerable evidence showing that medication was effective in the short-term, but “after three years, these effects had faded, and by eight years there was no evidence that medication produced any academic or behavioral benefits.”

Early intervention by parents trained to approach their children in an appropriate way could end up being more beneficial in the long term, and could be particularly effective in a regimen that also includes medications if necessary. That’s particularly important considering that ADHD has lingering long-term effects well past childhood and is a strong indicator of co-occurring mental illness in both adults and children.

Still, beneficial or not, the question of costs will weigh heavily on parents considering the potentially high out-of-pocket costs associated with the personalized training sessions. A combination of factors — including poor reimbursement rates by government insurance programs and private insurers to mental health care providers, as well as a lack of school-based resources for treating mental health — could price out parents looking to take advantage of this treatment approach.

According to a recent New York City Health Department analysis of city preteens’ mental health, over 145,000 children between the ages of six and 12 suffer from mental illness or other emotional problems — constituting one in five NYC children, the New York Post reports.

The report also found that city preteens’ mental health demographics approximately tracked national trends, with ADHD being the most commonly diagnosed mental illness, young boys much more likely to be diagnosed with a problem than young girls, and adverse physical effects such as sleep deprivation affecting kids with a behavioral disorder. But the report’s most disturbing findings have to do with these children’s access to appropriate care:

The study pointed to lapses in treatment. Only two-thirds of kids with a mental-disorder diagnosis received medical help in the prior year, including 36 percent who received medication. Only 17 percent of kids whose parents identified them as having behavioral problems got assistance. [...]

The Health Department insisted the city rates were in line with national figures. The department also said it offers extensive mental services through its Family Resource Centers and public-school clinics.

It encourages families to call the 24-hour hot line LifeNet (1-800-543-3638) to connect to services.

“Over 400 schools offer mental-health services, either as part of school-based health centers or via dedicated mental-health clinics,” said a Health Department spokesman, Sam Miller.

To be fair to the city, New York actually has a fairly robust public mental health system. A 2003 study finds that unmet mental health care needs for New York children and their families was almost eight percentage points lower than the national average. Still, as the paltry numbers in the city’s own analysis demonstrate, there’s still a long way to go — particularly since mental health problems that take root in youth tend to do long-lasting damage to kids’ mental and physical health.

The findings suggest that schools — which are children’s primary access points to mental health care — have to do a better job at actually utilizing those resources by identifying mental and behavioral problems in kids, and engage with parents who might be dissuaded by the societal stigma surrounding mental health care. Less than 20 percent of parents in New York City who suspect their child to have behavioral health issues decide to pursue care.

Go ahead — check those notifications. According to a new pilot study conducted by Dr. Alice Good of the University of Portsmouth, the vast majority of Facebook users use the social network to lift their spirits when they’re feeling down by navigating their old photos and wall posts in which they’ve interacted with family and friends — a “self-soothing” coping mechanism somewhat akin to flipping through a photo album or watching old home videos.

Researchers argue that that could be a big boost for users who are prone to anxiety or depression by providing a healthy emotional conduit for reminiscing about the good times in one’s life. The findings also shed new light into what, exactly, users are looking to achieve when they use social media to share their feelings and experiences:

Psychologist Dr Clare Wilson, also of the University of Portsmouth, said: “Although this is a pilot study, these findings are fascinating.

“Facebook is marketed as a means of communicating with others. Yet this research shows we are more likely to use it to connect with our past selves, perhaps when our present selves need reassuring.

“The pictures we often post are reminders of a positive past event. When in the grip of a negative mood, it is too easy to forget how good we often feel. Our positive posts can remind us of this.”

Dr Good’s study has concluded that looking at comforting photos, known as reminiscent therapy, could be an effective method of treating mental health. [...]

The act of self-soothing is an essential tool in helping people to calm down, especially if they have an existing mental health condition.

The findings are particularly interesting given past studies that have indicated that Facebook users end up feeling depressed after a browsing session. For instance, one German study found that “one in three people felt worse after visiting the site and more dissatisfied with their lives, while people who browsed without contributing were affected the most.”

But those findings derived from users’ envy at their friends’ vacations, life milestones, and various successes. The new preliminary data from Dr. Good’s study suggests that, used in a different way — i.e., actively “self-soothing” rather than passively sulking — browsing through one’s Facebook history could be a net benefit. And that could be very good news from a global mental health perspective for the social network, which has over a billion users worldwide and counting.

Faced with a Veterans’ Affairs Department (VA) overwhelmed by medical claims and more and more American soldiers returning from the war in Afghanistan, the state of New Mexico has decided to provide recently-discharged veterans of the Iraq and Afghanistan wars with a critical resource: one year of free mental health services.

As per New Mexico Department of Veterans’ Services Secretary Timothy Hale, “This is the first collaborative effort between private and state agencies in the country to provide statewide pro-bono mental health counseling for Iraq and Afghanistan war veterans. This means nearly 500 veterans in the state can receive the immediate help they need now rather than waiting for any veterans’ benefits paperwork to be filled out and processed – which can take awhile to be completed.”

That’s crucial for the soldiers returning home from recent conflicts, considering that the VA has a backlog of over 900,000 unprocessed medical claims — and that’s just from current veterans. As the war in Afghanistan winds down, that problem will be exacerbated further, particularly for mental health care claims. By the VA’s own estimates, at least 15 percent of Iraq and Afghanistan war veterans suffer from Post-Traumatic Stress Syndrome (PTSD) — and that number could potentially be much higher considering the sky-high rates of suicide and homelessness among Iraq and Afghanistan veterans.

The program is being sponsored by a combination of state and federal Access To Recovery (ATR) programs, as well as local providers and nonprofits. On the webpage for the new program, New Mexico ATR specifically cites VA backlogs and waiting periods associated with claims-processing as a major reason that New Mexican veterans might want to consider the program, along with “previous failures accessing and navigating the system,” transportation barriers, and “the stigma related with mental health care.”

While the collaborative public-private partnership will relieve a major burden for New Mexican veterans by enhancing access to care and shielding them from the high costs of mental health treatment, such efforts aren’t necessarily fiscally feasible in other states. New Mexico’s ATR program — which is funded substantially through the federal Substance Abuse and Mental Health Services Administration (SAMHSA) — is one of the best in the nation, and therefore receives enhanced federal funding. So while New Mexico may be shielded from the effects of looming federal budget cuts to departments such as the SAMHSA and the VA, veterans in other states might not be so lucky.

During a hearing before the House Military Personnel Subcommittee Wednesday, American civilian and military leaders issued lawmakers a stark warning: federal budget cutbacks under the so-called “sequester” will leave veterans with Post-Traumatic Stress Disorder (PTSD) and other mental illnesses without access to the health care that they desperately need.

The sequester cuts will force multiple governmental departments to cut back on programs or eliminate them entirely. Charged with taking care of the staggering percentage of Iraq and Afghanistan war veterans with PTSD, the Defense Department has had to increasingly rely on civilian mental health specialists to address the backlog. In fact, out of the 2,118 psychologists, 809 psychiatrists, and 2,533 social workers now employed by the military — a substantial increase over past years — over half are civilians. But under sequestration, the Department has been bracing for massive cuts to this civilian workforce, and is preparing to send notices to “more than 800,000 Defense Department civilian workers telling them that once-a-week unpaid furloughs will begin in April and continue for 22 weeks.”

As Military.com reports, that is particularly problematic for the military when it comes to these civilian mental health specialists because “they have options to seek employment elsewhere” and might be tempted to do so seeing as they are not exempt from the furloughs:

Lt. Gen. Patricia Horoho, the Army’s surgeon general, has lobbied to exempt the mental health specialists from furloughs to retain them for treating PTSD. The Pentagon has said that 20 percent of the civilian workforce will be exempt from furloughs. However, it did not look like the mental health specialists would receive that exemption, said Col. Rebecca Porter, the chief of Behavioral Health in Horoho’s office.

“We value these individuals greatly,” Porter said of the mental health workers. “If they start to go out the door, it’s going to take a lot longer for us to rebuild that” mental health workforce, Porter told a defense writers breakfast Tuesday.

“We have in the past offered retention bonuses, but that’s not specifically on the table now,” said Porter, a former military police officer and now a clinical psychologist whose main task is treating PTSD in the Army.

Her comments echoed those of Gen. Ray Odierno, the Army’s chief of staff, who told a Senate hearing last month that “before sequestration, we allocated the dollars and positions to increase military and civilian mental health providers.”

“The problem is there are not enough out there,” Odierno said. “Now what’s going to happen is we’re going to have to reduce the number we already have.”

The officials’ testimony is a clear-cut demonstration of the real world consequences brought on by budget cuts that lawmakers and the media tend to discuss in rather shallow terms. Budget cuts to military health care programs are also particularly cruel considering the already-massive backlog of over 900,000 veterans’ benefit claims — a problem that will be exacerbated as more military personnel return home from the waning Afghan war. Those veterans will already be plagued by poverty and a bleak economic outlook when they return home — and under sequestration, their mental health care outlook is even worse.

A group of Iowa state lawmakers, consisting of five Democrats and one Republican, have sent Gov. Terry Branstad (R) a letter urging him to rethink his decision to shut down a prison mental health care ward in the state.

According to the San Francisco Chronicle, the lawmakers argue that the ward’s closure will be disruptive to inmates’ care, and that Branstad’s fiscal argument for closing the unit comes up short:

The proposed budget that Branstad put forward in February calls for closure of the $26 million, 200-bed facility in 2014. Prisoners would be transferred to prison medical units in Clarinda and Coralville and the new state penitentiary in Fort Madison. [...]

Tim Albrecht, a spokesman for the governor, said closing the facility and dispersing its inmates “more effectively utilizes the department’s resources” and inmates with mental health needs “will receive similar, if not greater, mental health care under this new plan.”

The lawmakers who sent the letter expressed concern that prisoners with mental health needs don’t acclimate well to change and by mixing them with the general inmate population it could stimulate behaviors that create an unsafe the working environment for corrections staff.

The lawmakers also say the building should be given a longer lifespan since the Legislature recently invested $18 million to upgrade the facility.

Branstad’s state budget director also stated that the projected savings from closing the mental health unit is $8 million — a drop in the bucket compared to Branstad’s $6.2 billion budget for fiscal year 2013.

Mental health care issues take a particularly harsh toll on the incarcerated population, and the lawmakers raising concerns to Branstad are correct in stating that abruptly removing them from their treatment centers will have a negative effect on their care and well-being. State budget cuts to mental health care programs have already encouraged a trend where prisons become de-facto asylums, and Branstad’s closure of the Iowa jail’s mental health ward will only exacerbate that problem by denying and disrupting inmates’ care.

A new University of Cambridge study featuring input from doctors around the globe concludes that every person should get their mental health status checked just as regularly as they do their physical health status.

As the Detroit Free Press reports, doctors assert that making mental health checkups just as routine as physicals would spare patients from developing more disruptive and costly ailments in the future, and reduce the societal stigmas associated with receiving such care:

“Unfortunately, most people don’t address mental health issues until they are drastically interfering with their lives,” said Dr. Nizar El-Khalili, medical director of Alpine Clinic in Lafayette, Ind. “If they were just more aware of mental health from the start, problems could be avoided long before it complicates their lives and costs them thousands of dollars.”

Mental health screenings can be administered during most annual checkups. Some doctors always screen their patient’s mental health, but El-Khalili recommends that all patients, no matter their age or family medical history, ask for a screening during their checkup. [...]

Along with improving quality of life and saving money, health professionals say annual mental checkups would help reduce the stigma attached to mental illness.

The doctors’ calls for more regular mental health screenings echo that of mental health advocacy organizations such as the National Alliance on Mental Illness (NAMI). Vulnerable populations such as the poor and LGBT Americans are disproportionately affected by mental health problems, and the combined effects of stigmatizing mental health care and the high transaction costs of pursuing such care keeps the vast majority of Americans — including those with serious mental illnesses — from getting treatment.

Insurance benefits for physical and mental health issues technically have legal parity, thanks to the Mental Health Parity and Addiction Equity Act of 2008. But the implementation of the law has been messy and poorly enforced, with many basic questions regarding its provisions left unanswered.

A new study on mental health in war-ravaged Afghanistan conducted by researchers at the Washington University in St. Louis comes to a jarring conclusion: socioeconomic indicators such as poverty and social vulnerability are more telling risk factors for mental illness than even exposure to warfare. While the study in question is centered on Afghans’ mental health outlooks in the waning years of the Afghan war, its lessons — and implications — are just as applicable to another group in the region that has been living with a decade’s worth of violent and traumatic experiences: the enlisted men and women of the United States military.

The report is quick to point out that it’s not claiming that warfare isn’t a significant contributor to mental health concerns. But as an issue of systemic public health risk, underlying socioeconomic insecurity in the Afghan people was found to be a more significant and lasting indicator of mental wellness:

“War exposure is undisputedly a factor of mental distress and anxiety, but other predictors, such as poverty and vulnerability, are stronger and probably more persistent risk factors that have not received deserved attention in policy decisions,” says Jean-Francois Trani, PhD, assistant professor at the Brown School at Washington University and lead author of a new study published in the online first edition of Transcultural Psychiatry.

“Political unrest and violence is fueled by despair and frustrations often associated with mental distress,” Trani says. “A lack of resources or inability to find work make it impossible to assume one’s social status. That, in turn, leads to distress that can conduct to young men choosing a path of violent opposition to authorities and an international presence.”

The study… shows that even in a time of war, mental health is influenced by a combination of demographic and socioeconomic characteristics linked to social exclusion mechanisms — factors that were in place before war began.

“The conflict magnifies factors that were already in place,” Trani says, “and are redefined in relation to the changing social, cultural and economic contexts.”

To state the obvious, the report was done in the context of Afghanistan, a country with a high level of unrest and generally weak institutions. But the trends outlined in the study may also resonate with Afghanistan war veterans — a group that skews younger and more racially diverse than the general population — considering the socioeconomic exclusions and insecurities that they face here in the U.S. after returning home from combat:

The National Coalition for Homeless Veterans estimates that some 1.5 million veterans are at risk of homelessness due to poverty, lack of support networks and dismal, overcrowded, living conditions. Veterans are much more likely than the population at large to suffer from homelessness, comprising 23 percent of the homeless population even though only 8 percent of the population at large can claim veteran status.

Afghanistan War veterans are particularly at risk because of their young age and their exposure to combat with its psychological effects. Some seventy percent of Iraq and Afghanistan veterans had exposure to combat. About 30,700 are expected to leave the military in each of the next four years as the military reduces its ranks. About 13 percent of homeless Afghan and Iraq war veterans are women, and almost 50 percent of all homeless veterans are African American.

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The Great Recession, in conjunction with states’ propensities to cut Medicaid benefits in the face of the rising cost of health care services, led to some of the biggest cuts to state mental health care services in U.S. history between 2009 and 2011. Of course, the population of Americans with mental health problems didn’t just disappear in that time. Facing a shortage of adequate medical resources, many of them are now ending up in the only place that will take them: America’s jails.

According to CBS News, a shortage of mental health facilities and adequate treatment resources — particularly in large states like Illinois and California — has produced an untenable status quo in which the prison system serves as an alternate pipeline to funnel through sick Americans, who have nowhere else to go:

Police logs in twelve cities revealed that mental health crisis calls have increased an average of 37.5 percent over the last four years.

Los Angeles County Sheriff Lee Baca says more mentally-ill people end up in jail when they’re not getting the medications they need. [...]

”I believe it is, I think that medication is the stabilizer for most mentally-ill people,” said Baca. ”The money for that dried up with our California economy going south and when they go off their meds, they go back to the behavior that leads to a law enforcement solution.”

Kathryn Wooten of Los Angeles called 911 for help when her 23-year-old son Terrence suffered a mental breakdown in October 2011.

”The police came and I thought they were going to take him to the hospital but he wind up in county jail,” said Wooten.

Police say with few mental health beds available at state facilities, they have no choice but to leave the fate of people like Terrence Wooten to the criminal justice system.

”They have a mental ward in county but he wasn’t really getting the counseling and the therapy that he needed,” said Wooten.

To state the obvious, prisons are not treatment facilities, and guards are not professionally trained medical personnel — a fact that law enforcement authorities understand all too well. ”This is something that happens all the time here and the heart of it is, we’re not a mental health facility. These people should not be here,” said Cook County Sheriff Tom Dart. “These people by and large are not criminals. They’re people with mental illness but when they act out they end up in the jails because it’s the only place that’ll take them.”

California could serve as the poster child for what happens when slashes to mental health care funding — particularly through cuts to public insurance programs such as Medicaid — meets a sprawling industrial prison complex bursting at the seams. Patients become prisoners, reminiscent of a time when ignorance regarding mental illnesses perpetuated a system of asylums and involuntary commitment that public health advocates spent decades fighting, as it treated mentally ill Americans as dangerous vagrants to be locked up rather than patients to be cured. In fact, the mentally ill are not predisposed to violence, and are more likely to be the victims of violent acts than anything else.

But now, poor access to facilities in the face of states’ budget cuts have left the mentally ill — particularly the low-income mentally ill, who have access to even fewer resources than their wealthier counterparts — with few places to go. It’s a particularly devastating dynamic considering that states’ spending on prisons is the fastest growing budgetary item behind Medicaid. However, while Medicaid costs have risen due to the general rise of health care costs, states’ decisions to invest more in prisons in order to incarcerate — rather then rehabilitate — increasing numbers of Americans is a conscious and deliberate choice.