Mental Health in the Headlines: Week of June 20, 2011

MENTAL HEALTH IN THE HEADLINES

Week of June 20, 2011

Mental Health in the Headlines is a weekly newsletter produced by Mental Health America, providing the latest developments at Mental Health America and summaries of news, views and research in the mental health field. Coverage of news items in this publication does not represent Mental Health America’s support for or opposition to the stories summarized or the views they express.

TODAY’S HEADLINE

Children on Medicaid are much more likely than kids with private health insurance to be denied appointments with medical specialists and wait longer on average to be seen…more

IN THE NEWS

White House Releases National Prevention Strategy

Declaring a goal of changing America's "sick-care system to a health-care system," the Obama administration announced a sweeping strategy to emphasize prevention in all walks of life. The National Prevention Strategy, which is required under the health care reform law, aims to reduce leading causes of death and illness, such as smoking, bad eating habits and drug use. It requires a range of federal agencies to consider prevention in everything they do—and asks the rest of the country to think of health care as something that goes well beyond drugs and scans to include safer streets, cleaner water, and easier access to healthy foods. (Philadelphia Inquirer, 6/17/11)

IN FOCUS: MEDICAID

Medicaid Seen as a Target in Deficit Talks: The Medicaid program may be a likely target for cuts in bipartisan budget talks. The program is seen as politically easier to reduce because its constituency—the poor and disabled—lacks clout. One possible change is relaxing a requirement that currently stops states from limiting Medicaid enrollment. Republican governors are also renewing a push for more flexibility in running Medicaid. But 41 Senators sent a letter to President Obama opposing major changes to the program. (MHH Reporting, 6/20/11)

Services Facing Cuts despite Rise in Number of Beneficiaries: States are cutting Medicaid payments to doctors and hospitals, limiting benefits for Medicaid recipients, reducing the scope of covered services, requiring beneficiaries to pay larger co-payments and expanding the use of managed care. The moves come as $90 billion in extra funds originally authorized in stimulus legislation will run out in July. At the same time, the number of beneficiaries is higher now than when Congress approved the aid. The Congressional Budget Office estimates that federal Medicaid spending will decline in 2012 for only the second time in the 46-year history of the program. The cuts are likely to increase costs in other parts of the health care system. Doctors will be less likely to accept Medicaid patients if they receive lower payments, which will cause people to turn to hospital emergency rooms for care. Hospitals and other health care providers often try to make up for the loss of Medicaid revenue by increasing charges to other patients, including those with private insurance, experts say. (The New York Times, 6/15/11)

Better Medicaid Coordination Would Cut Costs: Health policy experts say one of the best ways to reduce costs for Medicaid without sacrificing care would be better care coordination for “dual eligibles.” These are the people who qualify for Medicare and Medicaid because they require hospital and long-term care. Although they represent only 15 percent of Medicaid’s beneficiaries, they account for 40 percent of the program’s spending. If their cases were coordinated better, costs would be reduced and people would be healthier. But enacting better care coordination can be difficult. (The Washington Post, 6/16/11)

Children on Medicaid More Likely to Wait for Care: Children on Medicaid are much more likely than kids with private health insurance to be denied appointments with medical specialists and wait longer on average to be seen, according to a new study.  Research assistants posing as mothers of sick children called to make appointments for specialty care at 273 clinics in Cook County, Illinois, one month apart. In one call, they told the clinic they had public insurance. In the other, they said they were privately insured. Two-thirds of fictitious Medicaid patients were denied appointments compared to 11 percent of privately insured patients, researchers reported in New England Journal of Medicine. In 89 clinics that accepted both types of insurance, children with public insurance also waited 22 days longer on average for an appointment with a specialist. And in more than half of the phone calls, the caller was asked what kind of insurance their child had before an appointment could be scheduled. Low reimbursement rates, payment delays and hassles associated with the payment process were cited by the study’s authors as likely reasons for doctors’ reluctance to see Medicaid patients. (The New York Times, 6/15/11)

New Rule Proposed for Community Mental Health Centers

The federal Centers for Medicare and Medicaid Services (CMS) issued a proposed rule last week that would establish conditions of participation for community mental health centers (CMHCs). “This rule proposes new provisions that will protect the tens of thousands of Medicare beneficiaries who receive care from a CMHC every year,” said CMS Administrator Donald Berwick in a statement. Medicare is accepting public comments until Aug. 16 and will respond with a final rule "in the coming months." The centers would have to meet the standards to enroll as a Medicare provider and to continue participating in the program. (The Hill, 6/16/11)

Rise in Drug-Related Suicide Attempts among Men

Emergency room visits by men ages 21 to 34 involving drug-related suicide attempts increased 55 percent from 2005 to 2009, according to a government report. The Substance Abuse and Mental Health Services Administration found that in 2009, men aged 21 to 34 made more than 29,000 emergency room visits for medication-related suicide attempts compared to just over 19,000 visits in 2005. Drug-related suicide attempts by males of all ages accounted for almost 78,000 emergency department visits nationwide in 2009. (HealthDay News, 6/17/11)

Depressed, Pregnant Women Receive Inconsistent Treatment

Pregnant women who screen positive for depression are unlikely to receive consistent treatment, according to a new study. The may lead to women spending more time in the hospital before their babies are born. Researchers, whose findings are published in General Hospital Psychiatry, tracked 20 health care providers in six Michigan clinics and revealed a lack of uniformity in addressing perinatal depression. (ScienceDaily, 6/16/11)

IN DEPTH

The New York Times examines the death of a mental health worker at a state-financed group home in Massachusetts.

VOICES AND VIEWPOINTS

A Huffington Post contributor writes on “The Future of Psychiatry.”

In Newsweek, a psychiatrist argues that thousands of children in the U.S. have been wrongly diagnosed with bipolar disorder.

Latest Research

Depression Not a Barrier to Weight-Loss Surgery: Being depressed doesn't reduce the effectiveness of weight loss surgery, a new study finds. University of Michigan researchers analyzed data from more than 25,469 patients who had weight loss surgery and found that patients who were depressed or depression-free before the surgery all lost nearly 60 percent of their excess weight within one year. They also reported an average 30 percent improvement in quality of life, including greater mobility, social interactions, family life and independent living. Patients with depression did have a higher rate of minor complications (4 percent versus 3.3 percent), but there were no significant differences in major complications between the two groups. (HealthDay News, 6/15/11)

Eating Disorders, History of Abuse Raise Risk of Depression among Pregnant Women: Women who have suffered from eating disorders or have been abused in the past may be at an increased risk of developing depression during and soon after pregnancy, the results of a new study indicate. Researchers surveyed 158 women who were pregnant or had recently given birth. All were undergoing treatment for depression. They found that one-third had a history of eating disorders, while many had a history of physical or sexual abuse. The researchers say that mental health screening tools, which include questions about eating disorders and abuse, should be incorporated into routine prenatal care. (PsychCentral.com, 6/17/11)

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