Sunday, December 6, 2009

Therapists as financial planners?


Our seemingly never-ending recession has enabled a robust discussion of money's impact on mental health. In my own practice, understanding my clients' financial status has become as essential as knowing who lives in the household with them. After all, every one of us lives with money.
The University of Georgia and Kansas State University have escalated the conversation by studying "Financial Therapy," blending psychotherapy and financial planning. Today's story from the Associated Press provides a good overview.
It has long been a standard of care in treating couples, for instance, that the therapist at least be aware of their financial situation. So when the AP author writes that, "Experts say therapists are taught to look for mental health causes for problems, not monetary ones, and haven't traditionally learned how to help their clients budget or reduce debt," she gets it only half right. Therapists aren't financial planners and, I'm guessing, many of my colleagues would bristle at the suggestion that they become such.
Putting aside any personal aversion to math and economics, practicing these dual counseling roles, even with the requisite training and certification, could dramatically alter the therapeutic conversation to make it counter-therapeutic. How much unconditional positive regard -- the cornerstone of the therapeutic relationship -- can one experience while their spending is being cut?
Financial therapy is an interesting concept, but I think we're better off to refer our money-troubled clients out to a qualified financial planner.
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Monday, September 28, 2009

October's Mental Health Awareness Activities


October is a busy month in the field of mental health. October 4-10 is Mental Illness Awareness Week which means a variety of activities nationwide, many of them sponsored by NAMI, the National Alliance on Mental Illness. It is also the week of National Depression Screening Day on October 8, sponsored by Screening for Mental Health.
The NAMI-sponsored events include their fundraising NAMIWALKS in cities throughout the country. Some NAMI chapters such as Orange County, CA, Michigan, Pennsylvania, Minnesota, Utah, Montana, and Brown County, WI got their walks off to an early start on September 26. The vast majority are held October 3-10. NAMI publishes a complete list of Walks here.
Meanwhile, on National Depression Screening Day, members of the public can attend an event, get information on disorders such as depressin, anxiety and PTSD, and take a free assessment for depression, speak with a mental health professional and obtain referrals. For a screening site near you, visit Screening for Mental Heath's site listing.Sphere: Related Content
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Friday, September 25, 2009

Wisconsin county may create psychiatric emergency center

Faced with cuts in social services and mental health staff, Dane County in Wisconsin will be the latest to join the rising tide of localities creating psychiatric emergency centers.
According to the Wisconsin State Journal, County Executive Kathleen Falk will include a 12-bed Crisis Care Stabilization Center in her 2010 budget. The center would cost about $595,000 per year to operate, as compared to the $4.36 million in costs between two area hospitals treating individuals with mental illness.
"It's kind of comparable to the detox model in alcohol where you stabilize people for a day or several weeks," Falk said. "But the whole idea is to move them back into the community or a different care setting."
The model for the new center will likely by the successful Jackson House in Janesville, WI.
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Thursday, September 10, 2009

New York violated mental health consumers' rights, judge rules

A federal judge has ruled that the state of New York violated the Americans with Disabilities Act (ADA) by placing thousands of mentally ill consumers in nursing homes rather than community housing.
According to the Associated Press on September 8, U.S. District Judge Nicholas Garaufis of Brooklyn ruled that the state violated the rights of more than 4,300 mentally ill citizens. According to the judge, the ADA requires the state to house people "in the most integrated setting appropriate to their needs."
The judge found that the plaintiff, the nonprofit Disability Advocates, had proven that most of the mentally ill consumers could live in supportive housing.
Observers stated that some of the most key testimony came from Dr. Kenneth Duckworth, medical director of the National Alliance on Mental Illness. He testified, in essence, that nursing homes were more restrictive than mental hospitals of the past.
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Wednesday, September 2, 2009

NIMH unveils largest ever military study of suicide


Why has the suicide rate of US soldiers risen over the last few years to match that of comparable civilians? The Army has thus far pointed to the failure of marital and other significant relationships as the leading cause of service personnel suicides. That answer hasn't proven satisfactory to many observers and personnel, so the National Institute of Mental Health (NIMH) has selected four research universities to dig deeper into the causes of the climbing numbers.
The new research will be "searching for likely, but weakly linked, risk factors that in combination might create different risk states over time," according to Robert Heinssen, PhD, acting director of the Division of Services and Intervention Research at NIMH.
The project will be the largest study in history on military personnel and suicide. For more information, visit Psychiatric News or NIMH.
PHOTO: Steven Aanen
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Wednesday, August 19, 2009

Virginia Tech gunman's records point to systemic inadequacies

The mental health records of Virginia Tech gunman Seung-Hui Cho were released this afternoon to much fanfare. The records, however, revealed little in terms of clinical substance, as the Washington Post indicated today.Sphere: Related Content
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Thursday, July 9, 2009

New York's assisted outpatient treatment revisited


The publication of a Duke University Study on assisted outpatient treatment in New York, known as Kendra's Law, and the June 30 report from the New York Office of Mental Health (OMH) has put the law back in the spotlight. WSJ blogger Shirley Wang tackled the issue today, asking "Does Court-Ordered Treatment for Mental Health Work?" So does it?
The answer, from Duke Univerity researchers and New York's official report, is a resounding yes. The OMH reported that the process resulted in a "substantial reduction in the number of psychiatric hospitalizations and in days in the hospital if a person is hospitalized." Their report also found that, "AOT reduces the likelihood of being arrested."
The New York report also found, "AOT recipients are far more likely to consistently receive psychotropic medications appropriate to their psychiatric conditions. Case managers of AOT recipients also report subjective improvements in many areas of personal functioning, such as managing appointments, medications, and self-care tasks."
One emotionally charged issue has been the racial disparities between blacks and whites in court-ordered treatment. In 2005, New York Lawyers for the Public Interest presented demographic data which demonstrated that African Americans were overrepresented in the AOT program. The OMH report acknowedged this, stating, "We find that the overrepresentation of African Americans in the AOT Program is a function of African Americans’ higher likelihood of being poor, higher likelihood of being uninsured, higher likelihood of being treated by the public mental health system (rather than by private mental health professionals), and higher likelihood of having a history of psychiatric hospitalization."
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Tuesday, July 7, 2009

Feds want Medicaid money back


When needing mental health treatment, many of the nation's poor have been turned away at the door. A new move by the federal government may lock them out entirely, at least in Texas.
According to a story in today's Houston Chronicle, the feds have required the state to repay them $1.67 million in Medicaid reimbursements for inpatient psychiatric care. Medicaid does not provide for adults living in psychiatric institutions.
About 200 psychiatrists and institutions in the state received notices from the Texas Health and Human Services Commission in June requesting the return of reimbursements from 2001 to 2007. A few individual practitioners received bills for $40,000 and one medical group was hit with a $130,000 demand, according to the article.
Will other states be next?
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Friday, July 3, 2009

Münchausen mother convicted of murder


On June 19, a St. Louis circuit court jury convicted Judy Pickens of second-degree murder and five other felony counts in the poisoning of her children, underscoring that Münchausen by Proxy is, at least for now, not a viable legal defense.

The case began when Pickens' three-year-old son Mikal died in October 2004. Her lawyer sent a letter threatening to sue St. Louis Children's Hospital for his death. Ironically, Pickens' daughter Kheematah was in the hospital days after the letter was received.
Hospital workers were suspicious and an aide was assigned to the room. One staff member reported seeing Pickens putting a substance in her daughter's drink. Another reporter seeing her tamper with her intravenous tube and throw an empty syringe in the trash.
Pickens was ultimately charged with crushing her blood pressure pills and feeding them to her son and trying to poison her daughter.
A psychologist testified that her behavior fit the criteria for Münchausen by Proxy, a disorder in which someone deliberately makes another sick to command attention, often from doctors or other care providers.
Even though her actions may be the result of a mental disorder, Michael Armour, a forensic psychologist, testified that, "In my opinion, these are rational and deliberate behaviors." Münchausen by Proxy "would not exclude someone from taking responsibility for their actions."
See STLtoday.com for the full story.
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Monday, June 22, 2009

"Death in slow motion": A Scientology exposé

The death of Lisa McPherson, is the subject of today's St. Petersburg Times' series on the Church of Scientology.
Titled "Death in Slow Motion," this second in a three-part series on Scientology explores how the church's "counseling" services may have led to the death of this 36-year-old follower.Sphere: Related Content
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Monday, March 30, 2009

State settlements called into question

As covered extensively in this blog, Georgia's mental health system has been under scrutiny and finally reached an agreement with the federal government to overhaul patient care (see "Georgia reaches agreement with feds.")
According to an NPR report today, however, the Justice Department's agreement with Georgia and five other states, including Hawaii, Washington, South Carolina, Tennessee and Connecticut, are on ice. According to the NPR report, "Advocacy groups say the terms of these last-minute settlements are inexcusably weak and that the agreements don't do enough to make sure the states fix their problems."Sphere: Related Content
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Thursday, February 19, 2009

South Florida Sun-Sentinel comments on Florida's Baker Act

The South Florida Sun-Sentinel today called on the state's legislators to reform its mental health commitment law, the Baker Act, to mandate outpatient treatment and medication compliance. The full editorial is at the Baltimore Sun web site.Sphere: Related Content
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Thursday, January 29, 2009

Military suicides continue to explode

Military suicides have reached a 30-year high, according to a story published Thursday in the New York Times. In 2008, 128 soldiers killed themselves, with 15 additional deaths awaiting a final cause.
This grim picture becomes even more so when the Army declared its suicide rate has surpassed that of civilians, a macabre zenith not seen since the Vietnam war.
The reasons are myriad, from financial pressures to personal, legal and job-related difficulties.
An interesting dimension to the statistics: Thirty percent of the suicides took place during deployment and thirty-five percent afterwards. Another 35% of those who successfully suicided had never deployed.
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Tuesday, January 20, 2009

Brain imaging sheds new light on schizophrenia

Schizophrenia may blur the boundary between internal and external realities by overactivating a brain system that is involved in self-reflection, and thus causing an exaggerated focus on self, a new MIT and Harvard brain imaging study has found.
The traditional view of schizophrenia is that the disturbed thoughts, perceptions and emotions that characterize the disease are caused by disconnections among the brain regions that control these different functions.
But this study, appearing Jan. 19 in the advance online issue of the Proceedings of the National Academy of Sciences, found that schizophrenia also involves an excess of connectivity between the so-called default brain regions, which are involved in self-reflection and become active when we are thinking about nothing in particular, or thinking about ourselves.
“People normally suppress this default system when they perform challenging tasks, but we found that patients with schizophrenia don’t do this,” said John D. Gabrieli, a professor in the McGovern Institute for Brain Research at MIT and one of the study’s 13 authors. “We think this could help to explain the cognitive and psychological symptoms of schizophrenia.”
Gabrieli added that he hopes the research might lead to ways of predicting or monitoring individual patients’ response to treatments for this mental illness, which occurs in about 1 percent of the population.
Schizophrenia has a strong genetic component, and first-degree relatives of patients (who share half their genes) are 10 times more likely to develop the disease than the general population. The identities of these genes and how they affect the brain are largely unknown.
The researchers thus studied three carefully matched groups of 13 subjects each: schizophrenia patients, nonpsychotic first-degree relatives of patients and healthy controls. They selected patients who were recently diagnosed, so that differences in prior treatment or psychotic episodes would not bias the results.
The subjects were scanned by functional magnetic resonance imaging (fMRI) while resting and while performing easy or hard memory tasks. The behavioral and clinical testing were performed by Larry J. Seidman and colleagues at Harvard Medical School, and the imaging data were analyzed by first author Susan Whitfield-Gabrieli, a research scientist at the MIT Martinos Imaging Center at the McGovern Institute.
The researchers were especially interested in the default system, a network of brain regions whose activity is suppressed when people perform demanding mental tasks. This network includes the medial prefrontal cortex and the posterior cingulate cortex, regions that are associated with self-reflection and autobiographical memories and which become connected into a synchronously active network when the mind is allowed to wander.
Whitfield-Gabrieli found that in the schizophrenia patients, the default system was both hyperactive and hyperconnected during rest, and it remained so as they performed the memory tasks. In other words, the patients were less able than healthy control subjects to suppress the activity of this network during the task. Interestingly, the less the suppression and the greater the connectivity, the worse they performed on the hard memory task, and the more severe their clinical symptoms.
“We think this may reflect an inability of people with schizophrenia to direct mental resources away from internal thoughts and feelings and toward the external world in order to perform difficult tasks,” Whitfield-Gabrieli explained.
The hyperactive default system could also help to explain hallucinations and paranoia by making neutral external stimuli seem inappropriately self-relevant. For instance, if brain regions whose activity normally signifies self-focus are active while listening to a voice on television, the person may perceive that the voice is speaking directly to them.
The default system is also overactive, though to a lesser extent, in first-degree relatives of schizophrenia patients who did not themselves have the disease. This suggests that overactivation of the default system may be linked to the genetic cause of the disease rather than its consequences.
The default system is a hot topic in brain imaging, according to John Gabrieli, partly because it is easy to measure and because it is affected in different ways by different disorders.
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Saturday, January 17, 2009

72-Hour Observations

Weekend Psych News

Proposed cuts draw fire in Virginia
Virginia's Department of Mental Health wants to save $16 million by closing some of the state's psychiatric centers. But the legislature isn't going along quietly. Read about the heated debate at the Richmond Times-Dispatch.

New psych hospital focuses on moving from intensive care to community life
Fort Hamilton Hospital in Hamilton, Ohio unveiled a shiny new 15-bed psychiatric unit on Thursday. This is the first psych facility in Butler County and will focus its energy on moving its patients back into the community. Read more about it at the Oxford Press.

Cheerleader mom sent to psychiatric hospital
The Green Bay, Wisconsin mother who tried out for cheerleading under her daughter's name has been sent to a psychiatric hospital for three years in lieu of jail time for identity theft. Read more about it at MSNBC.
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Friday, January 16, 2009

Georgia reaches agreement with feds

Georgia Governor Sonny Perdue announced yesterday that his state has reached an agreement with the Justice Department to overhaul patient care seven state psychiatric hospitals.
The agreement, which still needs judicial approval, covers almost every area of patient care:
  • Incident reviews and investigations
  • Treatment planning
  • Seclusion and restraint protocols
  • Medical and nursing care
  • Discharge planning
The tentative agreement also calls for the state to develop new suicide risk assessment tools to prevent patient suicides. They are also to examine approaches to deter assaultive behavior.
As discussed on this blog, Georgia has been under intense scrutiny after an Atlanta Journal-Constitution investigation uncovered 136 deaths and nearly 200 cases of patient abuse since 2002. Recently, the state has been exploring privatizing its crumbling public psychiatric hospital system.
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Wednesday, January 14, 2009

Deep problems in the Grand Canyon State

While many of us were sleeping last night, the lines in Arizona's mental health battle were etched deeper into the sand. At issue are the number of patients being un- or under- served by the state's partially privatized system, particularly in Maricopa County. At midnight, the Arizona Republic published a story appearing today, "Audit calls county's mental care worse."

"They've really gone to hell in a handbasket."

Nancy Diggs, court-appointed monitor.

Based on an analysis by court-appointed monitor Nancy Diggs, Magellan Health Services, the company which won the contract in 2007 to manage mental health services in Maricopa County, has failed to meet the needs of 83% of the county's most seriously ill clients. If that weren't damning enough, the report also found three in five patients do not have "an adequate clinical team" and four in five don't even have a completed mental health assessment.

Magellan won their contract promising to clean up the mess left by their predecessor, Value Options .

Among the lightning rods for the current controversy is the case of Joe Gallegos, a longtime mental health client who had been court-ordered into treatment at a Glendale, Arizona clinic. He didn't receive help from Magellan and on December 23, murdered two young boys in a Southwest Phoenix park, beating them to death with a baseball bat.


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Saturday, January 10, 2009

72-Hour Observations

Weekend Psych News

Texas death row inmate moved to psych facility
If there was any doubt that 25-year-old Andre Thomas has a serious mental disorder, he made his point last month. The death row inmate gouged out his left eye and ate it, resulting in a transfer to a psychiatric facility outside Houston. The case of Mr. Thomas, who had already removed his right eye in 2004, begs the question of how the mentally ill can be sentenced to death. Read more from the Associated Press.

Help for mentally ill in Arizona comes too little, too late
Writer Laurie Roberts posted a damning entry today at the Arizona Republic about the state of mental health care in Arizona. The system has come under fire after a mentally ill man named Joe Gallegos killed two boys with a baseball bat, and presumably had attacked others as well.

More problems at Patton
A patient was found unresponsive at Patton State Hospital in San Bernardino, CA on Thursday morning in what is now being called a suicide. The patient apparently hung himself. The death, if it is ruled suicide by the coroner, would be the sixth at Patton since 2003. The state hospital is under close scrutiny as part of a deal between state officials and the US Department of Justice to improve care for the residents, including keeping them safe from suicide and assault. Read more at the Los Angeles Times.
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Friday, January 9, 2009

No Purple Hearts for soldiers with PTSD


The Department of Defense announced this week that the psychic injuries of Post-Traumatic Stress Disorder are not enough to warrant a Purple Heart.
“The Defense Department has determined that based on current Purple Heart criteria, PTSD is not a qualifying Purple Heart wound,” department spokeswoman Eileen Lainez said in a dispassionate news release on January 6. “PTSD is an anxiety disorder caused by witnessing or experiencing a traumatic event.” It is not, she said, “a wound intentionally caused by the enemy from an outside force or agent.”
Apparently, Department personnel had forgotten how serious PTSD is. The Pentagon's own experts estimate 20% of our troops in Iraq and Afghanistan are suffering PTSD. In 2007, 115 military personnel committed suicide and another 93 did so in the first eight months of 2008. For any of us who have dealt personally or professionally with traumatized soldiers, the DOD's statement was downright insulting.
They must have realized the because the Department issued another release on Thursday, this time with a little more empathy. It read, "The Defense Department is deeply committed to providing the best care possible for military members with post-traumatic stress disorder, despite the determination that the disorder does not meet the criteria for the Purple Heart."
Pentagon Press Secretary Geoff Morrell is further quoted in the release stating, “So, just because an awards committee believes this particular injury does not qualify for this award, does not in any way reflect that we don't take this problem seriously and aren't committed to doing everything we possibly can towards preventing it, towards treating it, towards taking care of those who are suffering with it."
The committee to which Mr. Morrell referred is the Pentagon Awards Advisory Group, an assembly of "awards experts" from the Office of the Secretary of Defense, the Joint Staff, the military departments, the Institute of Heraldry, and the Center for Military History. To the best of my knowledge, not one mental health expert or soldier with PTSD was invited to the conversation. If they had been, the awards committe would have gotten an earful, such as the comments at the Think Progress web site (see MSG Jack Perry's comment #17 there in particular).
What the Department of Defense refuses to acknowledge is that the damage of PTSD may never fully heal and many of our service personnel are coming home forever changed due to the psychic injuries they have suffered.
If you agree with me that the Department of Defense needs its head, and priorities, examined and that PTSD deserves a Purple Heart, follow this link to the DOD website and post your thoughts. You can also write to the following:

Dr. Robert M. Gates
Secretary of Defense

1000 Defense Pentagon
Washington, DC 20301-1000


Gordon R. England
Deputy Secretary of Defense
1010 Defense Pentagon
Washington, DC 20301-1010

David S. C. Chu
Under Secretary of Defense
(Personnel and Readiness)

4000 Defense Pentagon
Washington, DC 20301-4000
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Wednesday, January 7, 2009

Duckett's lawyers are ok with release of mental health records

Lawyers for Melinda Duckett, the young mother who committed suicide after being interviewed by CNN's Nancy Grace, will not object to releasing Ms. Duckett's mental health treatment records, according to a report posted yesterday on OrlandoSentinel.com.
As reported last weekend on this blog, Duckett's family is suing Grace and CNN for inflicting emotional distress on the young woman when her toddler went missing in August 2006. She later killed herself. Duckett is considered the prime suspect in the disappearance of her child, who was never found.
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Tuesday, January 6, 2009

Update on Georgia's Mental Health Makeover

As discussed previously on this blog, Georgia officials are considering turning their state's mental health system over to the private sector (see "Georgia Edges Toward Eliminating Public Psychiatric Hospitals," Dec. 11, 2008). Since then, Gwen Skinner, director of the state's Division of Mental Health, Developmental Disabilities and Addictive Diseases, announced she will be leaving the troubled agency come this fall.
Today's Atlanta Journal-Constitution featured a thought-provoking opinion piece authored by Dr. Branko Radulovacki, a clinical psychiatrist and Program Director of the Adult Psychiatric Partial Hospitalization Program at the Ridgeview Institute. He rightly proposes that instead of looking to for-profit companies to run Georgia's psychiatric hospitals, the state's mentally ill would be far better served if non-profit hospitals took them over instead.
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Saturday, January 3, 2009

72-Hour Observations

Weekend Psych News

CNN wants therapy records on mother
CNN host Nancy Grace and lawyers for the network are seeking the mental health treatment records of a patient to defend themselves against a wrongful death lawsuit. Melinda Duckett had reported her toddler missing in August 2006. Following news coverage about the event, the 21-year-old mother committed suicide, triggering a wrongful death lawsuit from Duckett's family against the network, who they claim "intentionally inflicted emotional distress." According to documents filed December network, records of Duckett's treatment from LifeStream Behavioral Center in Leesburg, Florida will prove relevant to the case. Read more about this developing story at Central Florida News 13 and the Orlando Sentinel.

Wyoming considers making the incompetent ready to stand trial
When Wyoming's legislature reconvenes on Janauary 13, lawmakers will consider legislation mandating serious criminal offenders take psychotropic medications if they've been declared incompetent to stand trial. Backers of the bill say it will bring state law into conformity with Supreme Court precedent. For more details, visit Montana's News Station site.

A few key mental health proponents won't be back in Congress
Some of the strongest champions of mental health legislation will be noticeably absent when the new Congress convenes on January 6. They include Rep. Jim Ramstad (R-Minn.), Sen. Pete Domenici (R-N.M.), and Sen. Gordon Smith (R-Ore.). Read more at the American Psychiatric Association's website.

Hoarding as a crime
Fifty-two-year-old Cincinnati resident Charles O'Bryan is on probation for hoarding. The Daily Gleaner reports that O'Bryan was indicted on one count of aggravated arson and three counts of arson after a small fire had to be extinguished outside his house. He may one of the city's compulsive hoarders required to undergo counseling as a condition of probation, or face jail time.
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Friday, January 2, 2009

A brighter New Year for mentally ill prisoners in Hawaii, New York

Aloha: friendly, hospitable, welcoming
According to the US Department of Justice, Hawaii has been anything but the Aloha State for the mentally ill incarcerated. After launching an investigation in 2005 of the O’ahu Community Correctional Center, the feds in 2007 declared the facility had glaring deficiencies when it came to treating mental health and later filed suit against the state.
On December 31, the Honolulu Advertiser reported that the state reached a settlement agreement with the DOJ. Among the changes to be made:
• A ban on “therapeutic lockdowns” in which inmates were routinely isolated from staff or mental health professionals.
• Mandating that inmates placed in “individualized seclusion” be assessed by an appropriate mental health professional within four hours and routinely checked afterwards.
• Improving suicide watches.
• Increasing control of psychotropic medications.

New York’s state of mind

Seeing that 10% of their prison population is diagnosed with a psychiatric illness, New York’s Office of Mental Health and the Department of Correctional Services are unveiling a new “wellness self-management” program.
Starting in February, inmates will attend seminars to learn about coping with their mental health conditions, managing medications and side effects, and how to improve communication with clinicians.
The initiative begins at Fishkill Correctional Facility in Beacon followed by the Sing Sing and Bedford Hills prisons.
Read more about this at the Poughkeepsie Journal.
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Thursday, January 1, 2009

The dopamine connection in risk-taking

News Item
For risk-takers and impulsive people, New Year’s resolutions often include being more careful, spending more frugally and cutting back on dangerous behavior, such as drug use. But new research from Vanderbilt University finds that these individuals—labeled as novelty seekers by psychologists—face an uphill battle in keeping their New Year’s resolutions due to the way their brains process dopamine. The research reveals that novelty seekers have less of a particular type of dopamine receptor, which may lead them to seek out novel and exciting experiences—such as spending lavishly, taking risks and partying like there’s no tomorrow.
The research was published Dec. 31, 2008, in the Journal of Neuroscience.
The neurotransmitter dopamine is produced by a select group of cells in the brain. These dopamine-producing cells have receptors called autoreceptors that help limit dopamine release when these cells are stimulated.
“We’ve found that the density of these dopamine autoreceptors is inversely related to an individual’s interest in and desire for novel experiences,” David Zald, associate professor of psychology and lead author of the study, said. “The fewer available dopamine autoreceptors an individual has, the less they are able to regulate how much dopamine is released when these cells are engaged. Because of this, novelty and other potentially rewarding experiences that normally induce dopamine release will produce greater dopamine release in these individuals.”
Dopamine has long been known to play an important role in how we experience rewards from a variety of natural sources, including food and sex, as well as from drugs such as cocaine and amphetamine. Previous research has shown that individuals differ in both their number of dopamine receptors and the amount of dopamine they produce, and that these differences may play a critical role in addiction. Zald and his colleagues set out to explore the connection between dopamine receptors and the novelty-seeking personality trait.
“Novelty-seeking personality traits are a major risk factor for the development of drug abuse and other unsafe behaviors,” Zald and his colleagues wrote.
“Our research suggests that in high novelty-seeking individuals, the brain is less able to regulate dopamine, and this may lead these individuals to be particularly responsive to novel and rewarding situations that normally induce dopamine release,” Zald said.
Previous research in rodents showed that some respond differently to novel environments. Those who explore novel environments more are also more likely to self-administer cocaine when given the chance. Dopamine neurons fire at a higher rate in these novelty-responsive rodents, and the animals also have weak autoreceptor control of their dopamine neurons. Zald and colleagues speculated that the same relationships would be seen in humans.
The researchers used positron emission topography to view the levels of dopamine receptors in 34 healthy humans who had taken a questionnaire that measured the novelty-seeking personality trait. The questionnaire measured things such as an individual’s preference for and response to novelty, decision-making speed, a person’s readiness to freely spend money, and the extent to which a person is spontaneous and unconstrained by rules and regulations. The higher the score, the more likely the person was to be a novelty seeker.
The researchers found that those that scored higher on the novelty-seeking scale had decreased dopamine autoreceptor availability compared to the subjects that scored lower.
The National Institute of Drug Abuse funded the research. Zald is a Vanderbilt Kennedy Center for Research on Human Development investigator and is a member of the Vanderbilt Center for Integrative and Cognitive Neuroscience. His Vanderbilt co-authors were Ronald Cowan, Ronald Baldwin, M. Sib Ansari, Rui Li, Evan Shelby, Clarence Smith, Maureen McHugo and Robert Kessler from the departments of Psychology, Psychiatry and Radiological Sciences. Patrizia Riccardi, Albert Einstein College of Medicine in Bronx, New York, was also a co-author of the paper.
PHOTO: Duchessa
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