Nursing Homes Are Turning Away Patients with Mental Health Issues

Daniel D. Sewell Photo

Daniel D. Sewell, MD, Director, Senior Behavioral Health, UC San Diego Medical Center

Care For Your Mind acknowledges and appreciates the collaboration of the National Network of Depression Centers and the American Association for Geriatric Psychiatry in developing this post.

Chemical restraint is a serious problem in nursing homes. History has shown that psychotropic medications tend to be overused in order to keep residents with problem behaviors such as wandering or combativeness subdued or “under control.”

In other words, there are documented instances when serious psychiatric drugs are given to people who might not have needed them.

To address this and other nursing home quality issues, the Centers for Medicare & Medicaid Services (CMS) created a Five-Star Quality Rating System. One of the rating criteria is the number of residents at the facility who are receiving antipsychotic medications: the larger the number, the lower the score the facility receives.

Read More

Putting Profits Over Patients: Medicare Part D Changes Mean Disaster for People with Depression

Daniel D. Sewell Photo

Care For Your Mind acknowledges and appreciates the collaboration of the National Network of Depression Centers and the American Association for Geriatric Psychiatry in developing this post.

Putting Profits Over Patients: Medicare Part D Changes Mean Disaster for People with Depression
Daniel D. Sewell, MD, Director, Senior Behavioral Health, UC San Diego Medical Center

In older adults, depression can have severe consequences. It’s associated with an increased risk of suicide; decreased physical, cognitive and social functioning; and greater self-neglect; all of which are associated with increased mortality. This is a vulnerable population that needs effective, affordable access to mental health care.

Unfortunately, proposed changes to the Medicare Part D drug program would put older patients living with depression at even greater risk.

Read More

Older Adults Are Being Overlooked When it Comes to Mental Health Care

Daniel D. Sewell Photo

Care For Your Mind acknowledges and appreciates the collaboration of the National Network of Depression Centers and the American Association for Geriatric Psychiatry in developing this post.

Daniel D. Sewell, MD, Director, Senior Behavioral Health, UC San Diego Medical Center

For most individuals in the U.S., accessing mental health care is a struggle, but older adults may have it worst of all. Due to stigma, misinformation, and false beliefs about aging, they frequently go without adequate care for depression and other psychiatric illnesses and psychological problems. Too often, doctors offer prescription drugs as a cure-all solution, and fail to address the overall mental health and well-being of the older patient.

The truth is, addressing mental health issues in older populations requires paying more attention, not less. In aging adults, depressive symptoms can point to a physical illness, while physical pain or other physical complaints can often be a sign of mental health issues.

Read More

My Mental Health Care on Base: A Perfect Storm

Sarah Davies Photo

Sarah Davies, Families for Depression Awareness Volunteer

I like to think that my issues with the mental health care on our Army post are the result of a perfect storm. I live with Bipolar II, which I know how to self-regulate for the most part. There are times, however, where either I know I need to check in or my primary care manager (PCM) recommends a visit. At our current duty station, I have seen both a psychiatrist and psychologist at the recommendation of my PCM. Both visits have left me wanting better care. The psychiatrist put me on an anti-depressant, which is contra-indicated for Bipolar as it can spin me into a manic state (which it did). I stopped taking the meds and asked to be seen by a psychiatrist to figure out a self-care plan without medication. I saw him one time—during which he allowed me to speak for maybe five minutes out of an hour. He asked for my background—during which I mentioned my college education—and he went off on a tangent about a woman he dated that went to my alma mater and how attractive the women there seem to be. My lack of confidence in his ability to listen to me, his one job, kept me from returning.

I mention all of this because I believed my bad experiences were just a result of those doctors not listening to me; like I said, a perfect storm of incompetence that I was unlucky enough to be part of. When I said that to my husband, he countered my assessment. It’s just a regular storm. It’s what too many spouses and service members face when they go to mental health [services].

Read More

In Honor of Veterans Day, Here’s How Our Servicemen and Women Can Get the Mental Health Help They Need

Michelle Kees Photo

Care For Your Mind acknowledges and appreciates the collaboration of the National Network of Depression Centers in developing this post.

Michelle R. Kees, Ph.D., University of Michigan

On November 11th, our country will pause to celebrate a courageous, resilient group of men and women—our nation’s Veterans. In the words of the U.S. Department of Veterans Affairs, Veterans Day is a day to honor these heroes for “their patriotism, love of country, and willingness to serve and sacrifice for the common good.”

As they return home from foreign conflict, these men and women deserve to succeed and thrive in their civilian lives, but may need physical, mental, and/or emotional support in order to do so.

On this important holiday, we wanted to share information about some of the challenges Veterans are facing as they make the transition to life at home—and the programs that are in place to help them.

Read More

Decision Aids Can Be Developed to Successfully Support Shared Decision Making in Clinical Encounters

Juan P. Brito Campana, M.D, MSc. Photo

Care For Your Mind acknowledges and appreciates the collaboration of the National Network of Depression Centers in developing this post.

Juan P. Brito Campana, M.D, MSc.
Annie LeBlanc, Ph.D.
Mayo Clinic Knowledge and Evaluation Research Unit (KER)

As recent CFYM posts have indicated, shared decision making (SDM) is good for patients, doctors, and the system itself. But if we want SDM to become the norm in exam rooms nationwide, we have to support clinicians by giving them the means to make it happen.

We can do this by providing tools that allow physicians to communicate effectively and engage in meaningful conversations about their patients’ preferences, needs, and values.

Read More

Patients Need to Be Involved in Policy-Making

Photo of Tony Coelho

Tony Coelho, former Member of Congress, author of the Americans with Disabilities Act, and lifetime disability advocate

Since the age of 16, I’ve suffered from seizures. I’m now 74 and six decades of experience as a patient has taught me a lot about the healthcare system. I’ve seen firsthand how it’s evolved to suit the financial interests of the most powerful players and often ignore the needs of patients.

Unfortunately, many of the decisions that affect patient care are made at the policy level, often by bureaucrats with little or no clinical experience. When decision-makers ignore the patient perspective — including individual exam room experiences — care can become sterile, mechanized, and ineffective.

In order to create a system that better treats patients, we need legislators and decision-makers to create laws and regulations that value and support patient input. By bringing patients to the policymaking table, we can create a stronger healthcare system that addresses the needs of the individual and ensures more effective care for everyone as we move forward.

Read More

Mental Health and the Presidential Election

Photo of Julie Kornack

Julie Kornack

Editor’s note: We received this post from an author who supports Hillary Clinton for President. CFYM extended an invitation to the Donald J. Trump for President campaign to submit a statement of the candidate’s positions on mental health care, but received none. Please see the note below the article for more information.

Mental health should be a nonpartisan issue; it affects nearly one of every five adults across all demographics. Each of us surely knows someone struggling with depression, schizophrenia, addiction, or another all-too-common condition. Why would there be two sides to the proposal to give people access to mental health services?

In my job, I have spent years working with both Republicans and Democrats to increase access to treatment for individuals diagnosed with autism spectrum disorder, and I have been fortunate to experience a great deal of bipartisanship. Ever since the passage of the Affordable Care Act (ACA) in 2010, though, access to health care has become a hotly-politicized issue, with the very people who are most helped by the ACA often being the most vocal opponents of it, duped by the Republican Party to act against their own self-interest. When presidential candidates float health care proposals, they get my attention because – in a world with few sure things – this is what I know for sure: this election will change your health care.

Read More