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Studies in the News for

California Department of Mental Health

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Studies in the News is a service provided to the Legislature and Governor's Office by the State Library's Research Bureau. Weekly lists of current articles related to legislative issues will be supplemented by monthly lists focusing on a specific area of public policy. Prior lists can be viewed from the California State Library's Web site at www.library.ca.gov/CRB/SITN.cfm.

This service works as before:

• In addition to our regular Studies in the News, you may request any of our five monthly "Supplements" in the following areas by sending a reply to this e-mail (Please mark your choices).

• _____ Education Policy

• _____ Health Care Policy

• _____ Children and Family Policy

• _____ Environment, Growth Management and Transportation Policy

• _____ Employment, Training, Vocational Education, and Welfare to Work

• You may get copies of these studies by e-mailing a request to <chenningfeld@library.ca.gov> (Christie Henningfeld oversees the State Library's Capitol office), by calling 319-2691, or by stopping by room 5210 in the Capitol.

• If you would like us to try to get other studies, please e-mail information about each study you want to <chenningfeld@library.ca.gov>.

• Please use the same avenues if you want to be off the distribution lists.

• The list which follows shows only current additions to the collection. If you would like a cumulative list, or a cumulative list for only selected topics, please e-mail <chenningfeld@library.ca.gov>.

HEALTH

MENTAL HEALTH

On the MOVE: Helping Young Adults with Serious Mental Health Needs Transition into Adulthood. By Partnerships for Youth Transition Initiative (PYT). (National Center on Youth Transition, Tampa, Florida) June 2007. 10 p.

Full Text at: http://rs6.net/tn.jsp?t=haonyacab.0.gd6gzacab.4aek4xbab.16723&ts=S0253&p=http%3A%2F%2Fwww.connectforkids.org%2FPYT_brief.pdf

[“On the MOVE: Helping Young Adults with Serious Mental Health Needs Transition into Adulthood presents findings and future directions from an initiative to develop and implement transition programs for adolescents with mental and emotional difficulties as they enter adulthood. The brief, produced by the Substance Abuse and Mental Health Services Administration's Partnership for Youth Transition (PYT) Initiative, provides a snapshot of five PYT-funded sites in Maine, Minnesota, Pennsylvania, Utah, and Washington. Topics include the unique challenges of moving from adolescence to adulthood for adolescents and young adults diagnosed with a serious emotional disturbance or serious mental illness, matching services to the needs of adolescents and young adults, and the Transition to Independence Process Model. Data and preliminary findings from cross-sectional analyses of the PYT projects are presented. Federal and state policy recommendations and lists of resources and contacts are also included.”]

June 30, 2007 Issue

[Request #S607108]

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Services for Youth with Co-Occurring Mental Health and Substance Abuse Disorders and Their Families. Prepared by Beth A. Stroul, University of South Florida. Summary of the Special Forum Health at 2006 Georgetown University Training Institute. (National Technical Assistance Center for Children’s Mental Health, Washington, DC) July 2006. 7 p.

Full Text at: http://gucchd.georgetown.edu/programs/ta_center/TrainingInstitutes/SpecialForums/Services%20for%20Youth%20with%20Co-Occurring%20Mental%20Health%20and%20Substance%20Abuse%20Disorders%20and%20their%20Families.pdf

[“A series of Special Forums were held at the Georgetown University Training Institutes in July 2006 to provide opportunities for dialogue about critical issues in order to contribute to the development of future policy and technical assistance. The Special forums were designed as interactive discussions about communities and populations with unique service needs, requiring specialized planning and service delivery approaches within systems of care…. This paper presents the issues and recommendation from the Special Forum on Services for Children with Co-Occurring Mental Health and Substance Abuse Disorders and their Families.”]

June 30, 2007

[Request #S607109]

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Under One Roof: Primary Care Models That Work for Adolescents. By Marian Sandmaier, Incenter Strategies, and others. Report No. 1 (Incenter Strategies, Washington, DC) May 2007. 19 p.

Full Text at: http://www.incenterstrategies.org/jan07/Report1.pdf

[“America’s adolescents face serious, unaddressed health risks with lifelong consequences. However, adolescents, and particularly racial and ethnic minority adolescents, too often slip through the cracks of our health care delivery system. This issue brief profiles three adolescent health programs in different settings – Mount Sinai Adolescent Health Center in New York City ( a hospital-based model), Wake Teen Medical Services in Raleigh, NC (an office-based model), and Erie Teen Health Center in Chicago ( a community health center model) -- that offer comprehensive, interdisciplinary physical, behavioral, and reproductive health care to teen patients. These exemplary programs tail their services to adolescents’ unique needs through multidisciplinary staffing, team-based approaches, staff sensitivity, teen-friendly environments, and a focus on positive youth development.”]

June 30, 2007 Issue

[Request #S607110]

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Mental Health Screens for Corrections. By Julian Ford, University of Connecticut Health Center, and others. (National Institute of Justice, Washington, DC) May 2007. 24 p.

Full Text at: http://www.ncjrs.gov/pdffiles1/nij/216152.pdf

[“Identifying entering inmates’ mental health needs when they first enter an institution is critical to providing necessary services and enhancing safety in corrections settings. The purpose of the two projects discussed in this report was to create and validate mental health screening instruments corrections staff can use during the intake. The researchers created short questionnaires that accurately identify inmates who require mental health interventions. One mental health screen was found to be effective for men and is being adapted for women; the other has effective versions for both men and women.”]

June 30, 2007 Issue

[Request #S607111]

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“Depression in Cancer Patients: A Critical Review.” By Massimo Pasquini and Massimo Biondi, University “La Sapienza” Rome, Italy. IN: Clinical Practice and Epidemiology in Mental Health, vol. 3, no. 2 (February 8, 2007) pp. 1-9.

Full Text at: http://www.cpementalhealth.com/content/pdf/1745-0179-3-2.pdf

[“Cancer patients experience several stressors and emotional upheavals. Fear of death, interruption of life plans, changes in body image and self-esteem, changes in social role and lifestyle are all important issues to be based. Moreover, Depressive Disorders may impact the course of the disease and compliance. The cost and prevalence, the impairment caused, and the diagnostic and therapeutic uncertainty surrounding depressive symptoms among cancer patients make these conditions a priority for research. In this article, we discuss recent data, focusing on detection of Depressive Disorders, biological correlated, treatments and unmet needs of depressed cancer patients.”]

June 30, 2007 Issue

[Request #S607112]

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Health Insurance Coverage and Access to Care for Low-Income Non-Citizen Adults. By Karyn Schwartz and Samantha Artiga. Kaiser Commission on Medicaid and the Uninsured. Policy Brief. No.7651. (The Henry J. Kaiser Family Foundation, Washington, DC) June 2007. 7 p.

Full Text at: http://www.kff.org/uninsured/upload/7651.pdf

["This brief analyzes health insurance coverage and access for low-income non-citizen adults and provides insight into the obstacles they face in obtaining coverage and receiving care. It finds that, largely due to their high uninsured rate, low-income non-citizen adults have very poor access to care. Having insurance significantly improves their access to care and increases their likelihood of receiving preventive care, but, even with insurance, they continue to face access barriers. Although they have more limited access to care, low-income non-citizen adults are not relying on the emergency room for their care. Instead, many rely on clinics and health centers."]

June 30, 2007 Issue

[Request #S607113]

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"Functional Status and Quality of Life in Patients with First-Episode Major Depression." By I. Skarsater, Institute of Nursing, Goteborg, Sweden, and others. IN: Journal of Psychiatric and Mental Health Nursing, vol. 13, no. 2 (April 2006) pp. 205-213.

Full Text at: http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=20069285&site=ehost-live

[“The aim of this study was to analyse the level of severity of major depression and its relation to functioning and health-related quality of life over time in patients treated for their first episode of major depression. Thirty-three adult patients who fulfilled the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for major depression were included in the study. Semi-structured interviews and self-assessment questionnaires were used at baseline and at 6-monthly intervals in a 2-year follow-up, in order to measure the level of severity of depression, functioning and quality of life. The results showed that the first episode of major depression was rated as severe in 43% of cases. Multiple domains of functioning as well as quality of life were strongly affected in patients at baseline, although the level of functioning increased significantly over the study period, as did quality of life, but not concurrently with the decrease in the level of severity of the depression. Psychosocial functioning is an important outcome measure related to major depression, which underlines the importance of separate evaluations initiated and conducted by mental health nurses in order to determine whether or not patients have actually achieved a state of health.”]

Found in Academic Search Premier June 30, 2007 Issue

[Request #S607114]

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"Patient Characteristics, Service Use, and Hospital Costs in a Defined Catchment Area." By Karen Goldberg, Douglas Hospital Research Center, and others. IN: Canadian Journal of Psychiatry, vol. 51, no. 14 (December 2006) pp. 895-903.

Full Text at: http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=23538627&site=ehost-live

["Objective was to evaluate the impact of a new early intervention service for first-episode psychosis on patient characteristics, service use, and hospital costs. Method: We examined clinical records of all first admissions to hospitals of patients diagnosed with first-episode psychoses (nonaffective) over a 3-year period before and after the introduction of an early intervention service, the Prevention and Early Intervention Program for Psychosis (PEPP), in a defined catchment area. We examined demographic, clinical, and service use indices covering a 2-year period subsequent to the index admission for each patient. Results: Patients in the post-PEPP phase were significantly younger (P < 0.01), were more often male (P < 0.05), and were less likely to be admitted to hospital with an involuntary status (P < 0.05) or with injuries (P < 0.05) at the time of their first hospital admission. Over the 2 years following the initial admission, post-PEPP patients had significantly fewer admissions to a regular psychiatric service (P < 0.001) and made significantly fewer visits to the hospital emergency department (P < 0.01). There was a significant mean reduction in costs per case of regular hospital bed use ($1028.49, SD 528.02, compared with $792.28, SD 528.02; P < 0.01) and emergency visits ($519.18, SD 353.79, compared with $353.79, SD 345.0; P < 0.01). Time series analyses followed by Chow tests failed to confirm that these cost changes could be attributed specifically to the introduction of an early intervention service. Conclusion: Introduction of a specialized early intervention program may be beneficial to patients and to the health care system. To evaluate the cost-benefit ratio of early intervention services, longer term and more detailed data may be required.”]

Found in Academic Search Premier-June 30, 2007 Issue

[Request #S607115]

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“Understanding Immigrants' Reluctance to Use Mental Health Services: A Qualitative Study from Montreal.” By Rob Whitley, New Hampshire-Dartmouth Psychiatric Research Center, and others. IN: Canadian Journal of Psychiatry, vol. 51, no. 4 (March 2006) pp. 205-209.

Full Text at: http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=20316931&site=ehost-live

[“Studies suggest that non-European immigrants to Canada tend to under use mental health services, compared with Canadian-born people. Social, cultural, religious, linguistic, geographic, and economic variables may contribute to this underuse. This paper explores the reasons for underuse of conventional mental health services in a community sample of immigrants with identified emotional and somatic symptoms. Method: Fifteen West Indian immigrants in Montreal with somatic symptoms and (or) emotional distress, not currently using mental health services, participated in a face-to-face in-depth interview exploring health care use. Interviews were analyzed thematically to discern common factors explaining reluctance to use services.

Results: Across participants' narratives, we identified 3 significant factors explaining their reluctance to use mental health services. First, there was a perceived over willingness of doctors to rely on pharmaceutical medications as interventions. Second, participants perceived a dismissive attitude and lack of time from physicians in previous encounters that deterred their use of current health service. Third, many participants reported a belief in the curative power of nonmedical interventions, most notably God and to a lesser extent, traditional folk medicine. Conclusion: The above factors may highlight important areas for intervention to reduce disparities in immigrant use of mental health care. We present our framework as a model, grounded in empirical data, that further research can explore.”]

Found in Academic Search Premier-June 30, 2007 Issue

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Coordinated State Leadership for Better Mental Health: Funded by The John D. and Catherine T. MacArthur Foundation. By the National Conference of State Legislatures. Mental Health NewsFlash. (NCSL, Washington, DC) May 1, 2007. 3 p.

Full Text at: http://www.ncsl.org/programs/health/Mental.htm

[“Think that mental health care can be handled simply by your state’s mental health agency or by your Legislature’s health committee? Maybe, maybe not.

Adults and children with mental health needs rarely contact their state’s mental health department for initial help. Instead, they are more likely to first come into contact with state services when they become involved with child welfare, criminal justice or educational agencies. But those departments are often unable to provide adequate mental health care, or to coordinate with those who can….

Through a grant from The John D. and Catherine T. MacArthur Foundation, the NCSL’s Forum for State Health Policy leadership has launched a new initiative designed to improve collaboration between legislative committees and executive branch agencies in the mental health care arena.”]

June 30, 2007 Issue

[Request #S607117]

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“Dating Violence, Sexual Assault, and Suicide Attempts Among Urban Teenagers.” By Elyse Olshen, Columbia University Medical Center, and others. IN: Archives of Pediatrics & Adolescent Medicine, vol. 161, no. 6 (June 2007) pp. 539-545.

Full Text at: http://archpedi.ama-assn.org/cgi/content/full/161/6/539

[“Suicide is the third leading cause of death in adolescents. Although rates of adolescent suicide declined from 1991 to 2002, they remain unacceptably high. In 2003, 6.5 per 100 000 US teenagers aged 14 to 19 years committed suicide. Completion rates in this age group varied significantly by sex and race. Risk factors for adolescent suicide include prior suicide attempts, depression, and substance abuse. Research to identify adolescents at risk for suicide attempts has been specified, by the Institute of Medicine, as a priority for preventing adolescent suicide. Objective of this paper is to evaluate the relationship between dating violence, sexual assault, and suicide attempts among urban adolescents….Respondents were 50% female and primarily black (36.0%) or Hispanic (40.1%). In the past year, 11.7 % of females and 7.2% of males reported 1 or more suicide attempts. Lifetime history of sexual assault was reported by 9.6% of females and 5.4% of males. Dating violence in the past year was reported by 10.6% of females and 9.5% of males…. In this population of urban youth, recent dating violence among females and lifetime history of sexual assault among males were significantly associated with suicide attempts. Clinicians and educators should be trained to routinely screen adolescents for violence victimization and should have a low threshold for referring these at-risk teenagers for mental health services.”]

June 30, 2007 Issue

[Request #S607118]

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“Suicide Risk in Schizophrenia: Learning from the Past to Change the Future.” By Maurizio Pompili, “Sapienza” University, Rome, Italy, and others. IN: Annals of General Psychiatry, vol. 6, no. 10 (March 16, 2007) pp. 1-22.

Full Text at: http://www.annals-general-psychiatry.com/content/pdf/1744-859X-6-10.pdf

[“Suicide is a major cause of death among patients with schizophrenia. Research indicates that at least 5-13% of schizophrenic patients die by suicide, and it is likely that the higher end of range is the most accurate estimate. There is almost total agreement that the schizophrenic patient who is more likely to commit suicide is a young, male, white and never married, with good premorbid function, post-psychotic depression and a history of substance abuse and suicide attempts. Hopelessness, social isolation, hospitalization, deteriorating health after a high level of premorbid functioning, recent loss or rejection, limited external support, and family stress or instability are risk factors for suicide in patients with schizophrenia.

Suicidal schizophrenics usually fear further mental deterioration, and they experience either excessive treatment dependence or loss of faith in treatment. Awareness of illness has been reported as a major issue among suicidal schizophrenic patients, yet some researchers argue that insight into the illness does not increase suicide risk. Protective factors play also an important role in assessing suicide risk and should also be carefully evaluated. The neurobiological perspective offers a new approach for understanding self-destructive behavior among patients with schizophrenia and may improve the accuracy of screening schizophrenics for suicide. Although, there is a general consensus on the risk factors, accurate knowledge as well as early recognition of patients at risk is still lacking in everyday clinical practice.

This review paper is the result of a joint effort between researchers in the filed of suicide in schizophrenia. Each expert provided a brief essay on one specific aspect of the problem. This is the first attempt to present a consensus report as well as the development of a set of guidelines for reducing suicide risk among schizophrenia patients.”]

June 30, 2007 Issue

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"Post-traumatic Stress Disorder and Depression in Health Care Providers Returning From Deployment to Iraq and Afghanistan." By Tonia Kolkow, Naval Medical Center San Diego, and others. IN: Military Medicine, vol. 172, no. 5 (May 2007) pp. 451-455.

Full Text at: http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=25222992&site=ehost-live

["Objective: This study examines risk factors for post-traumatic stress disorder (PTSD), depression, and mental health care use among health care workers deployed to combat settings. Methods: Anonymous surveys were administered to previously deployed workers at a military hospital. PTSD and depression were assessed by using the PTSD Checklist and the Patient Health Questionnaire depression scale, respectively. Deployment exposures and perceived threats during deployment were also assessed. Results: There were 102 respondents (36% response rate). Nine percent (n = 9) met the criteria for PTSD and 5% (n - 5) met the criteria for depression. Direct and perceived threats of personal harm were risk factors for PTSD; exposure to wounded or dead patients did not increase risk. Those who met the criteria for PTSD were more likely to seek mental health care after but not before their deployment. Conclusions: For health care workers returning from a warfare environment, threat of personal harm may be the most predictive factor in determining those with subsequent PTSD."]

Found in Academic Search Premier-June 30, 2007 Issue

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Trauma among Youth in the Juvenile Justice System: Critical Issues and New Directions. By Julian D. Ford, University of Connecticut School of Medicine, and others. Research and Program Brief. (National Center for Mental Health and Juvenile Justice, Del Mar, New York) June 2007. 8 p.

Full Text at: http://www.ncmhjj.com/pdfs/Trauma_and_Youth.pdf

["Child traumatic stress occurs when children and adolescents are exposed to traumatic events or situations, and this exposure overwhelms their ability to cope with what they have experienced. Traumatic events can include physical abuse, sexual abuse, domestic violence, community violence, and/or disasters. Although estimates vary, it is believed that the prevalence of trauma among children and youth in the general population is substantial. In one nationally representative survey of 9-16 year olds, 25% reported experiencing at least one traumatic event, 6% in the past 3 months. The National Center on Child Abuse and Neglect reports that more than 2% of all children are victims of maltreatment, 13% are victims of neglect, and 11% are victims of physical, sexual, or emotional abuse.

For youth involved with the juvenile justice system, the prevalence of youth exposed to trauma is believed to be higher than that of community samples of similarly aged youths. Studies report varying rates of Post-Traumatic Stress Disorder (PTSD) among youth in the juvenile justice system, with estimates ranging from a low of 3% to a high of 50%. One study found that over 90% of juvenile detainees reported having experienced at least one traumatic incident. While few studies have focused exclusively on girls, PTSD has been found to be equally or more common among juvenile justice-involved girls than boys."]

June 30, 2007 Issue

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"Veterans Seeking Treatment for Posttraumatic Stress Disorder: What about Comorbid Chronic Pain?" By Jillian C. Shipherd, Boston Health Care System, and others. IN: Journal of Rehabilitation Research & Development, vol. 44, no. 2 (March 2007) pp. 153-165.

Full Text at: http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=25246841&site=ehost-live

[“Our primary aim was to document the rate of comorbidity of physician-diagnosed chronic pain conditions in veterans who were seeking treatment for posttraumatic stress disorder (PTSD). Chronic pain diagnoses (e.g., chronic lowback pain and osteoarthritis) were examined with retrospective chart review. Of the patients with PTSD, 66% had chronic pain diagnoses at pretreatment. These findings are consistent with previous studies that documented the high comorbidity of chronic pain and PTSD using samples of pain patients. Our secondary aim was to examine pain ratings before, during, and after PTSD treatment. Using data that were a part of clinical practice, we found that patients with more pain before treatment reported reductions in pain over the course of PTSD treatment and in the 4 months following treatment. While our results must be interpreted cautiously because of multiple confounding factors and the absence of experimental manipulation, they highlight the importance of PTSD and pain comorbidity.”]

Found in Academic Search Premier-June 30, 2007 Issue

[Request #S607122]

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