The opening Monday of two short-term treatment mental- health programs in Richland Township are seen as much-needed alternatives that local advocates and caregivers have been seeking.

“These are the pieces that were missing,” said Cynthia McLaughlin, chief executive officer for Behavioral Health of Cambria County.

Her agency provided startup funding for Footsteps Psychological Services to introduce the Crisis Diversion Acute Stabilization and Acute Partial Hospitalization programs at 114 and 118 Carwyn Drive in part of the former Richland Inn complex.

Learn more about these programs. 

Since 1971, CONTACT Pittsburgh has provided 24-hour hot lines staffed by volunteers offering help to people calling anonymously about suicide, hate crimes, anxieties and other mental health issues.

But because of changes over how mental health crises are handled, shrinking foundation support and the growing difficulty of recruiting volunteers, the nonprofit organization may have to close.

The agency sent letters to its network of volunteers last week.

Read more about this situation.

[Christa] Best is one of nearly 18,000 people statewide who are waiting for community-based mental retardation services. Of those waiting for services, 3,160 are considered to have emergency needs, meaning they could have to move to a state institution if they cannot gain access to community-based services.

Gov. Ed Rendell proposed an increase to the community mental retardation waiver program that would help the state Department of Public Welfare add 150 people, including 100 special-education high school graduates, to the program.

The program provides services such as home or vehicle accessibility adaptations, therapy, nursing, educational support and transportation to about 24,500 people, according to the department.

Lawmakers and advocates for those with disabilities expressed disappointment at a recent budget hearing that the increase was not large enough to accommodate even more people. The mental retardation waiver program is primarily federally funded but received about $623 million in state money this year.

Find out much more.

The symptoms of adult attention-deficit hyperactivity disorder seem to describe half the people in New York City: restlessness, impatience, impulsivity, procrastination, chronic lateness, and difficulty getting organized, focusing and finishing tasks.

How do you know you have ADHD, which experts compare to having a mind like a pinball, with thoughts flitting in multiple directions. Maybe you’re just overcaffeinated and overworked? And if you do have it, will there be a stigma? Should you try medication? Will it work?

Parents of children with suspected ADHD face a myriad of similar questions. But the concerns can be just as troubling for adults, whose ADHD often goes unrecognized.

An estimated 8% of U.S. children have ADHD, which is also known as ADD, for attention-deficit disorder, and some 50% of them outgrow it, according to government data. About 4.4% of U.S. adults—some 10 million people—also have ADHD and less than one-quarter of them are aware of it.

That’s because while ADHD always starts in childhood, according to official diagnostic criteria, many adults with the disorder went unnoticed when they were young. And it’s only been since the 1980s that therapists even recognized the disorder could persist in adults.

Even now, getting an accurate diagnosis is tricky. Some experts think that too many adults—and children—are being put on medications for ADHD, often by doctors with little experience with the disorder. Others think that many more people could benefit from ADHD drugs and behavioral therapy.

Read more.

Denise Burne-Fein and H. Reese Butler tragically have something in common – they each lost a loved one to suicide.

And the bond is stronger because both Burne-Fein’s brother, Matt, and Butler’s wife, Kristin Brooks, died by hanging themselves while they were patients in psychiatric facilities.

Now the two have joined together for the inaugural “PickUpThePhone Tour for Suicide Prevention.” The national tour opened at Burne Honda in Scranton Monday and will continue on to 17 cities and will feature the band Blue October.

There are three keys to the tour: suicide prevention, awareness and education. Matt Burne Honda, Wyoming Avenue, Scranton, is providing a Honda Pilot for the tour. The vehicle is a traveling message board for suicide prevention and resource information.

Butler said Justin Furstenfeld, lead singer of the platinum-selling rock group Blue October, suffered a debilitating anxiety attack in a Minneapolis airport a few months ago. Furstenfeld, who suffers from bi-polar disorder, will speak on Capitol Hill to encourage Congressional funding for alternative forms of mental health treatment programs including creative writing and art therapy programs.

U.S. Rep. Chris Carney, D-Dimock Township, said he will do what he can to fund programs aimed at suicide prevention and helping those with mental disorders. Carney drove the Burne Honda Pilot the first mile of the national tour.

“There’s an epidemic of suicides among our veterans,” Carney said. “I will do whatever I can to draw attention to this issue and to combat this preventable epidemic.”

Furstenfeld, Burne-Fein, Butler and others are calling for reforms in how mental health patients are treated in locked down psychiatric facilities. It is estimated that as many as 2,000 people die by suicide in these facilities each year.

As a state House committee prepares for hearings this week on overhauling mental health laws, those most affected are debating whether the proposal would be effective or fair.

Backers say a bill in both the House and Senate would make it easier to compel those suffering from the worst mental illness to get treatment.

Opponents counter that the proposal tramples rights in a way that would never be tolerated for physical illness — and would ultimately make it harder for people to recover.

Still others question if a change in the law that doesn’t create new programs or inject more money could accomplish much of anything.

The proposal would lower the threshold for a judge to order a person to receive assisted outpatient treatment, potentially including case management, medication, therapy, substance abuse treatment, vocational training and supervised housing.

For that to happen under the current law, a person must be a clear and present danger to themselves or others — on the verge of suicide, with a plan and the means to carry it out, for example. That is the same standard required to have a person committed to a mental hospital.

Because of that, comprehensive outpatient treatment is rarely used in Pennsylvania, said Aileen Kroll, the legislative and policy counsel for the Treatment Advocacy Center, a Virginia-based group that pushes to change mental health laws across the country.

Read more of the above article, and check out a related one, also in the YDR:

Backers of a proposal that would make it easier for a judge to order people living with severe mental illness to undergo outpatient treatment say an overhaul of Pennsylvania law would affect about 470 people a year.

That’s about seven people per county.

Steve Warren, the director of mental health services for York and Adams counties, estimates about 100 people in the two counties would qualify for involuntary assisted outpatient treatment if bills before the state House and Senate were passed as written.

That’s quite a difference.

And with some of the proposal’s critics worried that a new law could be used broadly to force many people into treatment, the discrepancy represents the potential for the system to take a step backward.

Bill backers base their estimate of 470 on the percentage of people that are treated annually in New York, which passed a similar law a decade ago.

But, said Marvin Swartz, a doctor at the Duke University School of Medicine who studied New York’s law, it’s very hard to compare states.

“It depends on the implementation of the law,” Swartz said.

About 80 percent of New Yorkers committed to involuntary treatment live in New York City or its immediate suburbs, Swartz found. Those communities really embraced the idea, while most of upstate New York did not.

Even still, advocate Jeannette Castello — who backs the bill — said estimates like Warren’s are based on the number of people who could qualify, not the number that actually will wind up in the program.

“That’s what they said in New York and it didn’t happen there,” said Castello, noting original New York estimates said 10,000 people would be ordered to receive treatment; actually about 800 people actually are.

It may be a subtle choice over time, or so sudden it leaves families with tainted memories of loved ones who have taken their own lives.

Following a recent health study of Wayne and Pike county residents that identified high suicide rates compared to other rural counties in the state, two local residents want to open the discussion by forming a support group this year to address the issue head on. It will be the first of its kind in the area.

…

Jack Dennis, who manages grants and development for Wayne Memorial Hospital, which commissioned the $65,000 two-year study by HMS Associates of Buffalo, said the findings of high suicide rates in Wayne and Pike counties were a big surprise.

“It was an eye-opener,” Mr. Dennis said. “We really had no idea. It just kind of came out of the woodwork.”

Culling statistics from government agencies and from interviews, the study found that at least 17 of 915 deaths in Pike County in 2004 were suicides. In Wayne County, 26 of 1,169 deaths that year were attributed to suicide.

These rates are much higher than suicide rates in other rural counties when comparing the number of suicides per number of residents. Wayne and Pike’ s suicide rates, for example, rank in the bottom 20 percent out of 48 rural Pennsylvania counties included in the study.

Find out more.

Scream at the boss? Snap at a colleague? Throw your cell phone into your @#$%%&* computer monitor? If so, you may find yourself headed to anger-management classes, which have become an all-purpose antidote for fit-throwing celebrities, chair-throwing coaches, vandals, road ragers, delinquent teens, disruptive airline passengers, and obstreperous employees.

Demand for such programs is coming from courts seeking alternatives to jail sentences and companies hoping to avoid lawsuits and office blowups. Aware that high-pressure jobs can make for hot tempers, some professions offer pre-emptive anger management. A few state bar associations now require “civility” training for lawyers renewing their licenses. And as of last year, hospitals must have programs for “disruptive” physicians as a condition of accreditation.

Programs run the gamut from $300-an-hour private therapists to one-day intensive seminars, weekly group sessions or online courses with no human interaction. Many advertise that they satisfy court requirements—even if all they offer is six CDs and a certificate of completion.

It’s not clear if the programs work, as few studies have analyzed their effectiveness. There are no licensing requirements for anger-management trainers—anyone can open a business. And since participants don’t usually sign up voluntarily, trainers say it’s possible to complete a program without actually changing one’s behavior.

Find out more.

Those who provide and need mental health services now have some parity in the new year, yet loopholes remain in the coverage.

The Mental Health and Addictions Parity Act of 2008 went into effect Jan. 1, sponsored by the late Sen. Paul Wellstone, of Minnesota and former New Mexico Sen. Pete Domenici.

It was signed into law by former President George W. Bush, as part of the Troubled Asset Relief Program.

In essence, the act states that if a U.S. health insurance company provides coverage for mental health and substance abuse, then the coverage must be equal for psychological disorders, alcoholism and drug addiction. This also goes for those covered by self-insured plans.

“What it says is that if you are an employer who has more than 50 employees and you have a health insurance plan with a mental health and substance abuse benefit to it, you are required to provide mental health coverage at parity with other medical conditions,” said Dr. Frank Sergi, of IntroSpect of BuxMont in Colmar, a private mental health practice. “That means deductibles are the same, co-payments are the same and out-of-pockets are the same. Traditionally, those are higher for mental health.”

…

“Now parity says, if you can go out of the network for medical reasons and have 80 percent coverage, then you will be able to see someone for mental health care and have the same 80 percent coverage,” Sergi said. “It gives them more choices. The insurance company must provide parity and they can no longer discriminate.”

However, loopholes exist in the act.

First, realize it is about parity and not about having coverage.

“Employers decide if they want this or don’t want it; they don’t have to provide mental health coverage,” Sergi said. “If an employer opts in with health care benefits that include mental health, then they must provide parity.”

It’s a heavier burden on a small business versus a big business to provide insurance. And if they have fewer than 50 employees, they are exempt from the parity law.

Find out more.

Far fewer children would get a diagnosis of bipolar disorder. “Binge eating disorder” and “hypersexuality” might become part of the everyday language. And the way many mental disorders are diagnosed and treated would be sharply revised.

These are a few of the changes proposed on Tuesday by doctors charged with revising psychiatry’s encyclopedia of mental disorders, the guidebook that largely determines where society draws the line between normal and not normal, between eccentricity and illness, between self-indulgence and self-destruction — and, by extension, when and how patients should be treated.

The eagerly awaited revisions — to be published, if adopted, in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, due in 2013 — would be the first in a decade.

For months they have been the subject of intense speculation and lobbying by advocacy groups, and some proposed changes have already been widely discussed — including folding the diagnosis of Asperger’s syndrome into a broader category, autism spectrum disorder.

But others, including a proposed alternative for bipolar disorder in many children, were unveiled on Tuesday. Experts said the recommendations, posted online at DSM5.org for public comment, could bring rapid change in several areas.

Learn more.