The high risks of homophobia

A new study published in the December 29 online edition of Pediatrics adds further evidence that parental attitudes toward their gay, lesbian, bisexual and transgendered children can have deleterious effects on the youth.
Based on their sample of 224 gay, lesbian, bisexual and transgendered adults in California, researchers found that teens rejected by their families were eight times more likely to attempt suicide, six times more likely to struggle with depression, and three time more likely to engage in high risk drug and sexual behaviors.
Two additional notes of interest: First, gay Latinos encountered the most negative reactions from their families and had the highest risk factors for HIV and mental health problems.
Second, the study found that forbidding a gay teen from socializing with their gay peers carried the same risk as physical or verbal abuse.
You can read more about the study at Discover.Sphere: Related Content
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Defining mental illness again

As the American Psychiatric Association prepares the fifth edition of the Diagnostic and Statistical Manual (DSM), a chorus of criticism about the closed-door process continues to crescendo. The Los Angeles Times ran a story on December 29 titled “DSM psychiatry manual's secrecy criticized” detailing the arguments of Dr. Robert Spitzer and others in favor of publicly airing the decision-making process of what qualifies as mental illness.
The venerable Dr. Spitzer, who edited the third edition of the DSM, widely considered the version to beat, argues for l’gealite as a prophylactic against big pharmaceutical interests who may want to pathologize and ultimately medicate the most trivial of human behavior. Although psychiatrists working on the DSM V are limited to $10,000 annually from big pharma, such a restriction may be too little, too late.
Dr. David Kupfer, who is overseeing the newest edition, told the Times that he wants to reduce the number of diagnoses.
Let’s hope he can hold this ground.Sphere: Related Content
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72-Hour Observations

Weekend News

Army to establish mental health board
Since 2003, 15 Army recuiters have committed suicide, prompting the armed service to form a suicide prevention board. Their task will be to study the mental health of recruiters, one of the Army's most stressed-out job classes. Read more about it at The Fayetteville Observer.

Insurance and mental health
A study published in the December 24/31 issue of the Journal of the American Medical Association found that psychiatric patients who insurance with a lower share of cost tended to get treatment more frequently. Read more about it the Washington Post.

But if they were in Afghanistan...
Mental health patients in that country are numerous, according to experts, but treatment is hard to come by. So Afghanistan sends its mentally ill to feed on bread, water and pepper at shrines, or chains them to trees. Read more at UPI.com.Sphere: Related Content
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Some mental health patients remain invisible

Violations of the human rights of psychiatric patients may not be as uncommon as I'd like to imagine them. On December 23, the Associated Press ran an item "Mental patients isolated for years despite laws" on the MSNBC web site. Virginia, Connecticut, Florida, California, Pennsylvania, Oregon, Massachusetts and Maryland were among the states listed to have put patients into long-term seclusion for lack of any other treatment alternatives.
Typically the patients are chronically violent. For instance, the story refers to Cesar Chumil, who has been in a three-room "containment suite" since 1993. He had 300 incidents of assaulting staff and another 100 of assaulting patients before going into confinement.
Simple isolation was not the most egregious encroachment on patients’ rights cited. Others involved long-term restraint: one man strapped to a bed for 2½ years in Florida, another tied to a bed for over a year in Connecticut.
The AP story opens up a Pandora’s Box of questions about behavioral management, staff biases, and physician perception.Sphere: Related Content
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Missouri shows how it's done

Probably every one of us in the mental health profession can produce a (hopefully) short roster of psychiatrists whose prescribing practices are flawed. Some of them would like to squeeze their patient’s symptom presentations into formulaic drug regimens whereas others would under- or overprescribe.
Five years ago, the state of Missouri’s Behavioral Pharmacy Management Program began an ambitious educational outreach to those physicians operating on the edges of psychiatry. The program paid off well this year when the Substance Abuse and Mental Health Services Administration (SAMHSA) awarded them one of their highly-regarded Science and Service Awards for 2008.
This innovative and voluntary program provides physicians with suggested prescribing strategies as well as clinical considerations. Physicians who continue to experience the same issues are offered per consultation.
"This is a model on how states can increase the quality of care that Medicaid residents with severe mental illnesses receive while encouraging more efficient use of taxpayer dollars," said Joseph Parks, M.D., Medical Director of Missouri's Department of Mental Health. "Through this project, many opportunities for coordination of care have been identified, resulting in improved quality of care and enhanced quality of life for persons with mental illness."
You can read more about this innovative program on the SAMHSA website.Sphere: Related Content
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