Can We Reduce Youth Suicides by Understanding and Identifying Risk factors?

Coryell,WilliamWilliam Coryell, MD
George Winokur Professor of Psychiatry at the University of Iowa Carver College of Medicine

Today we begin a five part series on youth suicide prevention. Guest perspectives come from National Network of Depression Centers and the Active Minds, Inc., as well as personal stories from both a peer and family member.

In the United States, someone dies from suicide every 13.7 minutes. As a physician, I understand that the vast majority of people who die by suicide have a mental disorder at the time of their deaths, and that both attempted and completed suicide take a great emotional toll on family members. As a research scientist, I recognize that studying the characteristics of individuals who attempt and complete suicide will help us better understand who is most at risk. This knowledge can empower clinicians, family members and peers to seek emergency care for those in need.

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Can You Thrive with a Mood Disorder?

dr_greg_simonGregory Simon, MD, MPH
Investigator, Center for Health Studies Group Health Cooperative

Can You Thrive with a Mood Disorder?

The Depression and Bipolar Support Alliance has designated 2014 as the Year of Thriving. Throughout the year, they are challenging the organization and the mental health community to set higher goals, to shift the conversation from “surviving” or “managing” a mood disorder to truly thriving.

In a recent DBSA podcast, Dr. Joseph Calabrese and I discuss the limitations of current treatment options for mood disorders and the need within the clinical and patient communities to shift expectations and raise treatment goals to complete remission of symptoms and sustained wellness.

We are challenging our entire field—clinicians, researchers, administrators, and policy makers—to set higher goals for mental health treatment. Our goal is not simply to control or reduce symptoms, but to eliminate them.

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Target Zero: Redefining the Clinical Definition of Success

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The first priority in treating a mood disorder is ensuring that the person is out of immediate crisis. But should this be the end goal? Too often researchers, providers, family members, and peers consider a stable mood as a measurement of a successful outcome.

On April 1, the Depression and Bipolar Support Alliance (DBSA) kicked off a month-long program challenging the mental health community to raise expectations from fewer symptoms to zero symptoms. “Target Zero to Thrive” is a campaign to insist on new standards for research and treatment that raise the bar from stability to lives of wellness.

Twenty-one million people in the U.S. live with mood disorders, and persisting symptoms increase the likelihood of:

  • relapse
  • functional impairment that increases the challenges of work, family, and day-to-day living
  • life-threatening co-occurring conditions such as heart disease, diabetes, hypertension
  • death by suicide

According to Allen Doederlein, president of DBSA, “Living with a mood disorder can damage hope and lower expectations so a person may not expect or think they deserve a full life. We as peers, clinicians, researchers, and family need to help them expect and achieve more.”

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Working to Dispel Stigma Among Asian Americans

PataSuyemotoPata Suyemoto
Working to Dispel Stigma Among Asian Americans

Cultural stigma and language barriers result in extremely low utilization of mental health services among Asian Americans (8.6 percent versus nearly 18 percent of general population). But individuals and organizations are working to narrow the gap between the need for services and the use of services. Pata Suyemoto is a Massachusetts-based mental health activist and educator. Mood disorders are present in both of her parents’ families, and she lives with treatment-resistant depression.

How was depression addressed in your own family?
My father, who is Japanese American, did not acknowledge mental health issues in his family, including those with my mother or me. The denial and sense of shame about mental health issues were unavoidable, and I still see that in other Asian Americans today.

What is the key issue and what are you doing to create change among Asian Americans?

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Criminalizing Mental Health in the United States

Melody_MoezziMelody Moezzi

More than 60 percent of the population in U.S. prisons are minorities, and by some accounts, the three largest mental health facilities in the country are prisons. CFYM continues its interview with attorney, author and mental health activist Melody Moezzi as she points to educating ourselves and the public about our legal rights as a means to righting these injustices.

Criminalizing Mental Health in the United States

CFYM: Melody, in addition to being an award-winning author, you are a public speaker, attorney and an advocate, you also have a Masters in public health. What changes would you like to see in public health policy with respect to mental health care?

MM: First, we need to stop criminalizing mental illness in the US. The three largest mental health facilities in this country are prisons. That’s beyond unacceptable, and it needs to change, particularly in a country that imprisons more of its citizens than any other on the planet. Furthermore, the use of solitary confinement—both in prisons and hospitals—needs to end. I feel very strongly about this because I’ve experienced “isolation,” and I have no doubt that it is cruel, unusual and downright inhuman. No human being is meant to live like that, even for a short period of time. We are social creatures. We need contact with others; we need compassion; we need connection—especially when we’re going through a crisis. That’s just human nature.

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Does Cultural Bipolarity Create Barriers to the Delivery of Quality Mental Health Care?

Melody Moezzi

Melody_MoezziWhat would it be like if your clinician didn’t understand your culture or treated you as something other than “normal” because of your ethnicity, religion, or gender?  Would you receive appropriate, effective treatment? Attorney, author and mental health activist Melody Moezzi talks with Care For Your Mind about how her religion influences her mental health and why the mental health care system should become more culturally competent.

Does Cultural Bipolarity Create Barriers to the Delivery of Quality Mental Health Care?

CFYM:  In your book, Hadol and Hyacinths: A Bipolar Life, you write about your experience living with and recovering from both clinical and cultural bipolarity. Can you expand on how you experienced cultural bipolarity?

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Tackling Disparities, Achieving Equity

vivianVivian H. Jackson, Ph.D.
National Center for Cultural Competence, National TA Center for Children’s Mental Health
Georgetown University Center for Child and Human Development

We are a nation of immigrants, but you wouldn’t know it by looking at our mental health care system. It’s hard enough to access quality mental health care services, but the challenge is even greater when cultural, racial, linguistic, or other demographic factors come into play. Today, Dr. Vivian Jackson blogs about what is being done to reduce the barriers to quality care and to promote culturally and linguistically appropriate services in mental health.

Tackling Disparities, Achieving Equity
How You Can Help Eliminate Disparities in Mental Health Care

What’s the problem?
As a society we claim to value fairness, yet every day there is evidence that we are a nation operating with significant disparities in mental health care. Is this fair? Are we offering services in a manner that meets the definition of fair: “not exhibiting any bias, and therefore reasonable and impartial”­?

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Say Hello to the National Network of Depression Centers: Part II

Dr. John Greden. M.D.greden
Executive Director of the University of Michigan Comprehensive Depression Center

Today we continue our interview with John Greden of the National Network of Depression Centers. NNDC is a 21 member institution representing the top academic medical centers in the country focused on providing excellence in the advancement of treatment for depression and bipolar disorder. We ended our previous post with Dr. Greden identifying issues that can be barriers to innovation.

Say Hello to the National Network of Depression Centers: Part II

CFYM: Dr. Greden, you’ve shared with us some pretty radical ideas on how to shake up the way mental health services are delivered. However you also explained that current methods of research and funding can be barriers to implementing these ideas. How does the existence of NNDC help address these issues?

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Say Hello to the National Network of Depression Centers

gredenDr. John Greden. M.D.
Executive Director of the University of Michigan Comprehensive Depression Center

Can you imagine 21 leading institutions collaborating on diagnosis and treatment of mood disorders? That’s the National Network of Depression Centers, affecting and advocating for mental health care. What does the NNDC mean for people living with depression or bipolar disorder and their families? Dr. John Greden met with CFYM to talk about the NNDC’s role, concerns, and impacts.

Say Hello to the National Network of Depression Centers

CFYM: Tell us about the NNDC and why it was formed.

JG: The NNDC is a national network of mood disorder specialists from psychiatry, psychology, social work, nursing, etc. To make real progress in the understanding and successful, sustainable treatment of mood disorders, we must

  • initiate a more robust approach on how we diagnose, study and treat patients and,
  • influence the policies put in place on researching and treating mood disorders

To do all that, a national collaborative network with the resources for widespread, longitudinal follow-up that has the ability to bring research findings into the community is required. At the NNDC we seek to model the collaborative networks for cancer, heart disease, and diabetes care, and emphasize why the same level of effort and funding is necessary to improve the lives of people living with mood disorders.

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You Did It! CMS Rescinds Proposed Protected Classes Rule!

Over the past two months, Care for Your Mind has closely followed the Centers for Medicare and Medicaid Services’ (CMS) proposed ruling around Medicare Part D’s six protected classes. Thanks in large part to the combination of the mental health community’s expert and peer perspectives as well as your insightful comments and willingness to take action to oppose this rule, CMS Administrator Marilyn Tavenner announced yesterday that the agency would not move forward to remove antidepressants and immunosuppresants from Medicare Part D’s six protected classes at this time.

Yesterday’s decision marks a monumental victory for the mental health community and proves that the Administration is appropriately listening to our concerns. In addition to bringing three of our peers to Washington, D.C., to visit with influential members of Congress, the CFYM community worked together to make our voices heard through the forum and beyond. The Partnership for Part D Access, a coalition comprised of patient groups and pharmaceutical companies alike, was able to generate more than 1,000 comments sent to CMS during their open comment period and we know many of those comments started right here on CFYM.

CMS’ announcement shows that grassroots-based advocacy works! Thank you again for coming together to voice your thoughts and concerns – you had a direct hand in protecting our Nation’s seniors and disabled, and the mental health community as a whole, making it known that appropriate treatment is not “one size fits all.”

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