Care for Your Mind’s 2013 Best Of List: Mental Health Policy Advancements

It’s that time of year again when the “Best Lists” come out. The mission at CFYM is to facilitate discussion by sharing the views of experts in the community. In that spirit, we are summarizing the “Ten Best” list from the National Institute of Mental Health to create our own “Five Best List.” We want to hear from you. Read the post and tell us what you believe are the best advances in policy and advocacy during 2013.

Mental Health Advocacy Begins with Science

Director Thomas Insel of the National Institute of Mental Health makes the argument that science leads to better policy. We are encouraged that scientific advances shift the conversation towards more self-directed treatment plans. It is the empowerment of treatment ownership that fosters advocacy and ultimately leads to a life of thriving, not just surviving.  We’ve compiled our top five list below, with the corresponding NIMH rank in parenthesis.

5. (10 on the NIMH List):  “Nobel Prize—This year’s Nobel Prize in Physiology or Medicine (and Lasker Award) recognized NIMH grantee Thomas Südhof for his discoveries of how neurotransmitters are released from the pre-synaptic terminal.”

This research includes better understanding on how neurons in the brain communicate. We don’t know where the research will lead, but better knowledge about how molecules translate bio-chemical messages, give us reason to hope for advances in treatment options.

4. (9 on the NIMH List): “Beyond Magic Bullets—Several important new trends emerged this year in non-pharmacological treatments, sometimes from pharmaceutical companies. In April, a Nature commentary that included authors from the pharmaceutical giant GSK described “electroceuticals,” heralding a new era in treatment development focusing on devices to deliver electric signals rather than drugs to alter the activity of neurotransmitters in the brain.”

Many peers have reported successful outcomes with this type treatment. We are encouraged that pharmaceuticals are exploring options outside of strict pharmacology protocols.

3. (8 on the NIMH List): “Organoids—According to a team from the Austrian Academy of Sciences in Vienna, when neurons are grown in a dish, they self-assemble into circuits that resemble the normal cortex. These “organoids” are not “mini-brains” capable of consciousness but they are functional enough to permit the study of connections. It now appears that iPSCs could be a powerful tool to study circuit disorders 1,2,3

These advances come on the heels of work done in 2012 in which the researchers were awarded a Nobel Prize. Two Nobel Prizes in two consecutive years in the areas of mental health research gives advocates reason to be encouraged that the scientific community is serious about unlocking its mysteries.

Policies We Can All Celebrate

2. (2 on the NIHM List): “BRAIN—On April 2nd, President Obama in the East Room announced the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) initiative.”

NIMH encourages everyone involved with brain research or brain disorders to read the speech. In delivering the speech, President Obama compared the BRAIN project to President’s Kennedy’s challenge to the scientific community to explore space. Obama called on the global scientific community to work together citing research activities already underway in the European Union, Israel, China and Japan. The project will launch 2014 with $110M in funding.

1. (1 on the NIHM List) “Parity—My guess is that in terms of mental health issues, history will remember 2013 not for a scientific finding but for a long overdue policy change: mental health parity.”

Much has been written in CFYM over the past few months on mental health parity. The final ruling on parity was delivered by the Obama Administration in November. It clarified the law passed in October of 2008 and makes it illegal for private insurance companies to discriminate in their coverage plans between physical conditions and mental health conditions. Just as important the Affordable Care Act makes mental health coverage one of the essential benefits that private insurance packages must offer to subscribers. There’s no getting around it for private insurance companies any more. They must offer mental health services as part of their package and they must offer coverage that is comparable to other medical disorders.

So there you have it—CFYM’s top 5 list. Looking back it’s been a year of both progress and setbacks. We hope that the launch of CFYM, a forum for people to engage in conversation with the leading policy, scientific and legislative leaders in the areas of mental health care, has made it on to your top 5 list for 2013.

Your Turn

What do you think was the most important policy and legislative actions surrounding mental health care?

  • Mental Health Parity Final Ruling
  • Mental Health Care Included as an Essential Benefit under the ACA
  • White House Conference on Mental Health
  • Other

References

1 Shcheglovitov A et al. SHANK3 and IGF1 restore synaptic deficits in neurons from 22q13 deletion syndrome patients. Nature. 2013 Nov 14;503(7475):267-71. doi: 10.1038/nature12618. Epub 2013 Oct 16.

2 Krev JF et al. Timothy syndrome is associated with activity-dependent dendritic retraction in rodent and human neurons. Nat Neurosci. 2013 Feb;16(2):201-9. doi: 10.1038/nn.3307. Epub 2013 Jan 13.

3 Lancaster et al. Cerebral organoids model human brain development and microcephaly. Nature. 2013 Sep 19;501(7467):373-9. doi: 10.1038/nature12517. Epub 2013 Aug 28.

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