Recovery Michigan

The politics of Obamacare have produced a geographic divide in mental health care. Uninsured, low-income Americans in the east, mid-Atlantic and Pacific are receiving more treatment through the Medicaid expansion, while those in the south and central U.S. are not, according to a new report.

Nearly 568,000 uninsured people who have been diagnosed with a serious mental health condition would have received treatment in 2014 if their states had chosen to expand Medicaid, according to the American Mental Health Counselors Association, a professional organization that does advocacy and education. That’s one in five of the nearly 3 million uninsured adults with serious mental health conditions who live in the 24 states that did not expand Medicaid last year. That treatment would have been fully paid for by the federal government.

Obamacare extended Medicaid to anyone whose income is below 138 percent of the federal poverty line ($15,521 for an individual last year), with the federal government paying 100 percent of the cost of insuring new enrollees for three years. But after a 2012 Supreme Court ruling gave states the option of not expanding Medicaid eligibility, some states elected to continue receiving “traditional” Medicaid, rather than accept the expanded funds. In 2014, 24 states went this route. The report accuses those states of rejecting Medicaid coverage “based on ideological intransigence – not health or fiscal interests.”

"Smoking is a real problem for people with schizophrenia," said Stéphane Potvin, a researcher at the Institut universitaire en santé mentale de Montréal and lead author of the study. "Their health and life expectancy are often undermined by this addiction, whose brain mechanisms were until now largely unknown," said the associate professor at the University of Montreal's Faculty of Medicine.

Essentially, the research team observed greater neuronal activation of a specific region of the brain (vmPFC) in schizophrenia smokers compared with healthy subjects when presented with appetitive cigarette images. At the behavioural level, the researchers also found that schizophrenia smokers had more depressive symptoms than did participants in the control group.

"These observations suggest that smoking has a greater rewarding effect in schizophrenia smokers. This corroborates the hypothesis already formulated of their increased vulnerability to this addiction but also demonstrates the great difficulty for them when it comes to quitting smoking," said Potvin.

The prevalence of smoking in people with schizophrenia is high, and cessation rates are low. Schizophrenia smokers are twelve more times likely to die from heart disease related to smoking than are those who do not smoke. "It is necessary to explore avenues that will help people in their efforts to free themselves from smoking," said Potvin. "That is why we want to continue our research into whether this activation of the ventro-medial prefrontal cortex (vmPFC) is caused by the disease itself or by the effects of antipsychotics," concluded the researcher.

Then the lecturer said something that made me stop and think. She said that people with Asperger Syndrome experience a great deal of fatigue, because they are always conciously processing things with their intellect, as their brain doesn’t do it automatically.

Now, in all the books and articles I’d read about Asperger Syndrome, none of them had mentioned fatigue. Many had talked about the act of processing things by intellect, but none had talked about this causing fatigue. But now this lecturer mentioned it, it made so much sense – and explained so much.

Fatigue became a huge part of my life when I lived in Canada for a few years. I went there at age 21, after completing my first undergraduate degree. Before that, I’d been a very solitary person, not really having a lot of awareness of what was going on around me, and not really needing to. I spent my time reading, in a world of my own. But when I was doing my undergraduate degree I started to realise that I wouldn’t survive in the world if I continued like this. I needed to learn social skills. So this is one reason I went to Canada, so I could have a new start, in a different country, and try to learn how to be social there.

I found it fascinating and fun, but after a while I noticed something strange started to happen. I would get incredibly tired throughout the day. I’d go out with friends and find myself falling asleep instead of chatting. If ever I went to anyone’s house, I would invariably fall asleep on the sofa.

The tiredness only lessened when I spent a lot of time alone. I observed the same when I returned to England. The jobs I chose were all working with people – because I wanted to learn how to do this – and whenever I had days off work, I would spend the time alone at home, completely exhausted, sleeping a lot. I made myself do overtime a lot, to save money, and would get even more exhausted, and often have to take time off sick, because I would become dizzy and unwell from the mental overload.

Adolescent gang members in the U.S. experience much higher rates of depression and suicidality than the general population, according to a new study that appears in the journalCriminal Justice and Behavior. While those who join gangs are typically seen as highly problematic individuals, this research at least sheds some light on what motivates them to do so, suggesting that gang membership is often seen as a coping strategy by youngsters suffering from psychological disorders.

Moreover, the study authors assert that involvement in street gangs rarely has the desired effect, and appears to exacerbate rather than alleviate mental suffering.

To conduct the study, researchers examined data collected as part of the National Longitudinal Study of Adolescent to Adult Health, a survey of around 15,000 middle school and high school students conducted over two years in the mid-1990s. As part of the survey, participants were asked a number of questions designed to evaluate their levels of depression, suicidality, and several other makers of mental health.

New research reveals the severe mental health problems experienced by men and women trafficked to the UK for sexual exploitation, domestic servitude and forced labour, including high levels of depression, anxiety and post-traumatic stress disorder (PTSD).

The study, led by King's College London and the London School of Hygiene & Tropical Medicine, found that of 150 people trafficked to the UK from more than 30 different countries, nearly 80 per cent of women and 40 per cent of men reported high levels of depression, anxiety or PTSD.

Human trafficking is the recruitment and movement of people, by deception and coercion, for the purposes of exploitation. The UK Home Office has estimated that in 2013 there were between 10,000 and 13,000 trafficked people in the UK, including people trafficked for forced sex work, domestic servitude, and labour exploitation. Recent estimates suggest that almost 21 million people worldwide are in situations of forced labour as a result of human trafficking.

The present study was specifically designed to investigate the prevalence of auditory verbal hallucinations (AVH) in the general population, and sought to compare similarities and differences regarding socio‐demographics, mental health and severe life events between individuals who have never experienced AVH with those who had. The study also aimed to compare those who sought professional help for their experience of AVHwith those who had not sought help. 

Through a postal questionnaire, 2,533 participants ages 18 and over from a national survey completed the Launay‐Slade Hallucinations Scale and other measures examining AVH characteristics and other areas related to AVH. In total, 7.3% of the sample reported a life‐time prevalence ofAVH. 

Those with AVH were more likely to be single and unemployed, reported higher levels of depression and anxiety, and experienced a higher number of severe life events compared with those without AVH. Only 16% of those who experienced AVH in the general population sought professional help for these experiences. Compared to those who did not seek professional help, participants that had were more likely to experience AVH with a negative content, experience them on a daily basis, undergo negative reactions when experiencing AVH, and resist AVH. 

In conclusion, the prevalence of AVH was found to be relatively high. The results also revealed higher levels of reduced mental health for individuals who sought professional help, followed by those who did not, compared with those who had never experienced AVH.

A University of California, Berkeley, study of homeless youth living on the streets of San Francisco found that they have a 10 times higher mortality rate than their peers, mostly due to suicide and substance abuse.

"This population is highly stigmatized. That stigma leads to neglect and, in turn, to increased mortality. All the deaths in this cohort were preventable," said the study's main author, Colette Auerswald, a pediatrician and adolescent medicine specialist who is an associate professor of public health at UC Berkeley. "Stigma kills."

The study appears online April 14 in the open-access journal PeerJ. Auerswald, co-founder of I4Y, the UC Berkeley School of Public Health's center for adolescent population health, co-authored the study with Jessica Lin of UC Berkeley's School of Public Health and Andrea Parriott of UCSF's Phillip R. Lee Institute for Health Policy Studies.

"These sobering data provide evidence of what homeless youth face when their only option is life on the streets," added Sherilyn Adams, executive director of Larkin Street Youth Services in San Francisco. "We must not ignore or underestimate the gravity of homelessness or its tragic impact on young lives cut short. No young person deserves to die a preventable death because they didn't get the help they needed."

The majority of people with post-traumatic stress disorder (PTSD) recover after early treatment—but a substantial number still suffer for years after a traumatic event even with early clinical interventions, according to a study publishing online April 12, 2016 in The Journal of Clinical Psychiatry.

Over a 12-week period, researchers looked at several groups of non-military individuals suffering from PTSD (a total study cohort of 232 individuals) after a single traumatic event. All participants received either prolonged exposure therapy; cognitive therapy; treatment with selective serotonin reuptake inhibitors (SSRIs); or a placebo pill one month after the traumatic event. They also followed individuals who declined treatment. All were reassessed at five months and at 36 months.

While the groups receiving prolonged exposure and cognitive therapy showed a significant reduction of symptoms by five months (61% better than the other groups), and their symptoms remained low for three years, the other groups, including those who declined treatment, reached the same level of low symptoms by three years. In that sense, early-prolonged exposure andcognitive therapy significantly shortened the time to recovery, but did not reduce a three-year prevalence of PTSD.

Depression may compound the risk of developing type 2 diabetes in people with such early warning signs of metabolic disease as obesity, high blood pressure and unhealthy cholesterol levels, according to researchers from McGill University, l'Université de Montréal, the Institut de recherches cliniques de Montréal and the University of Calgary.

While previous studies have pointed to a link between depression and diabetes, the new findings, published in the journalMolecular Psychiatry, suggest that when depression combines with metabolic risk factors the risk of developing diabetes rises to a level beyond the sum of its parts.

"Emerging evidence suggests that not depression, per se, but depression in combination with behavioral and metabolic risk factors increases the risk of developing type 2 diabetes and cardiovascular conditions," said lead author Norbert Schmitz, an Associate Professor in McGill's Department of Psychiatry and a researcher at its affiliated Douglas Mental Health University Institute. "The aim of our study was to evaluate characteristics of individuals with both depressive symptoms and metabolic risk factors."