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SPRING 2005 EDITION [Download PDF]
Michigan Mental Health: A Focus on Early Intervention
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According to Governor Jennifer M. Granholm, the mental health system in Michigan is “broken.” Consequently, she challenged Michigan’s Mental Health Commission to identify the most urgent mental health care concerns and propose a means for improvement. Last October, the commission submitted its final report to the governor for review. The report included a brief overview of the current status of mental health care, as well as a series of recommendations to enhance and expand the state’s public mental health system. (see www.michigan.gov/gov/0,1607,7-168--104835--,00.html) The public voiced to the commission that they feel that community-based care is necessary. However, right now the local facilities are understaffed, lack funding and structure, and the administrative process is too complex. People are getting neglected in the early stages of their illness, and are only considered for treatment when crisis hits. They need outreach programs for school-age children, better trained health care providers for the elderly, and improved judgment of mental health capacity in criminally charged individuals. Most often than not, people are not getting the quality care that they need. The commission’s report addresses all of these issues and suggests improvement on various different levels. Some main points include: · Psychiatric patients often remain untreated because of the public misconceptions of mental illness – however, through community education and awareness the stigma could be dispelled, allowing individuals to openly seek treatment. · It’s best to catch things early, so prevention and early intervention are important. By including mental health screening in standard physical health treatment, it would be easier to detect the less severe psychiatric disorders that might otherwise go by unnoticed but worsen with time. · High quality care should be both available and accessible for those who seek it. In-patient treatment should be available close to home for those in need. Specific outreach programs should be tailored to the needs of child, adult, and geriatric patients · Partnered with the Michigan Universities, the state should create incentive programs to draw psychiatrists, nurses, psychologists, social workers, and therapists across the state. College loans should be relaxed for those who agree to pursue fields involving child and adolescent mental health specialties.
· Law enforcement officials, trial attorneys, judiciaries, and correctional officers should be properly trained in mental health affairs, so they don’t wrongly charge a mentally incapacitated individual.
· Since insurance companies are stringent in regards to who they find eligible for mental health services, uniform guidelines should be developed in order to dispel any doubts regarding accountability.
· Rehabilitation services for those recovering from mental illness should be provided. This includes housing, education, employment and integrated physical and mental health care. Several barriers still exist in allowing the accomplishment of the commission’s goals. Though high quality community-based care would be ideal, there is considerable variation in administrative costs and funding from county to county. It may prove difficult to provide equal care to those in regions with lower financial support. However, with such optimistic goals in mind, Michigan’s mental health care system can only improve.
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What to do when a Mentally Ill Person is Missing: People who are mentally ill often experience disjointed, confused thoughts. They express poor judgment and can feel compelled to leave their homes and wander aimlessly for days, months, or even years. It can be difficult to locate these lost persons, so the following guidelines below are for family members to recover their loved ones.
When a mentally ill person is found:
Services for the mentally ill vary widely, and finding appropriate services at a distance will probably be a frustrating experience. Depending on the location, service may be inadequate in many areas. And as it is impossible for the police to hold individuals against their bequest, it’s important act quickly when a missing individual is found.
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What is new from the world of research Can schizophrenia be detected before it begins? Can we identify who might be at risk for schizophrenia among those with a hereditary predisposition? New research suggests that this may now be possible. According to recent studies, children and adolescents with a genetic predisposition to the disease are more likely to have emotional and neurological abnormalities than those belonging to “normal” control groups. Behavioral tests indicate that they have difficulty adjusting to social situations, experience anxiety and memory lapses, and are less prone to smile or laugh. By pinpointing early symptoms of the illness, intervention and treatment can begin before long term damage such as full-blown psychosis results In order to figure out whether symptoms could be detected at an early age, researchers from the National Public Health Institute in Helsinki, Finland studied 159 high-risk and 99 control subjects. When compared to the control group, the high-risk children showed more emotional symptoms before school age, attention deficiencies and social withdrawal at school age, and weaker neurological development throughout. If the social and neurological problems were apparent while the children were of pre-school age, schizophrenia was more likely develop later in adulthood. However, if the problems only developed in late childhood, different psychotic disorders developed. (Niemi LT Br J Psychiatry. 2005 Feb;186:108-14.) Another group of researchers from Edinburgh University in Scotland tried to tackle the same problem. In a study involving 163 high-risk young adults, those who went on to develop schizophrenia had experienced anxiety, social withdrawal and “schizotypal” thoughts at an early age. Although these symptoms didn’t have much of an effect on quality of life, parents were able to tell that their child was always “different” from other children during development. This supports researchers’ theory that schizophrenia is linked to the temporal lobe – a part of the brain which develops slowly over the years. ( Johnstone EC Br J Psychiatry. 2005 Jan;186:18-25) A third relevant study took place in Denmark over a span of several years. 250 high-risk children, ages 11-13, were evaluated in 1972. As a segment of the study designed to examine social and neuromotor skills, the subjects were videotaped while they ate lunch. Twenty years later, researchers used these tapes to compare the children’s lunch behavior with their eventual diagnosis. It was apparent that the individuals who went on to develop schizophrenia displayed more aloof, distant behavior during lunch. (Schiffman JAm J Psychiatry. 2004 Nov;161(11):2021-7).
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Pharmaceutical Assistance for Patients Though often doctors consider talking to drug representatives a waste of time, such meetings can still prove to be beneficial if the following guidelines are followed: Be specific in regards your time restraints Ask the rep to provide information only when asked Ask for coupons for patients whose medication may be lost or stolen Further patient assistance is provided by pharmaceutical companies: Solvay Pharmaceuticals 800-256-8918 Ortho McNeil Pharmaceutical 800-577-3788 Abbot Laboratories 800-222-6885 Wyeth 800-568-9938 Merck and Co. 800-994-2111 GlaxoSmithKline 800-728-4368 AstraZeneca Pharmaceuticals 800-424-3727 (www.astrazeneca-us.com/content/drugAssistance/) Bristol-Myers Squibb Co. 800-736-0003 Novartis Pharmaceuticals Corp. 800-277-2254 Forest Pharmaceuticals 800-851-0758 (www.forestpharm.com/pap/) Pfizer Inc. 800-707-8990 Cephalon 800-511-2120
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Where to Research Mental Illness Rather than looking through outdated reference books or dusty library texts, an efficient and helpful way to get information about mental health issues is to research it on the internet. However, it is also important to know that the sites that you access are providing accurate and reliable information. The following sites can be very helpful: An excellent resource, this website is easy to navigate and provides information concerning disease symptoms, possible causes, diagnostic criteria and treatment. Sponsored by the U.S. government, this site includes links to mental health and substance abuse databases and an extensive list of publications. Contains fact sheets, research news and updates, online resource guides and a powerful search engine.
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Editor : Meghana Keshavan Advisors: Matcheri Keshavan MD R P Rajarethinam MD
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