The NIMH global mental health research community and COVID-19

Havoc caused by the pandemic and the impending impact on economies, social structures, and health systems, has resulted in a global mental health crisis. The Director-General of the UN stated “The mental health and wellbeing of whole societies have been severely impacted by this crisis and are a priority to be addressed urgently.” Three critical actions were recommended: apply a whole-of-society approach to promote, protect, and care for mental health; ensure widespread availability of emergency mental health and psychosocial support; and support recovery from COVID-19 by developing mental health services for the future. The National Institute of Mental Health (NIMH) supports a network of global research Hubs designed to address questions that arise as low-income and middle-income countries (LMICs) widely implement sustainable, evidence-based mental health services. [Read More] Source: Lancet Psychiatry...

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New study highlights best practices for delivering care via telehealth

The Substance Abuse and Mental Health Services Administration (SAMHSA) has developed six principles of trauma-informed care: safety, trustworthiness and transparency, peer support, collaboration and mutuality, empowerment, voice and choice, and sensitivity to cultural, historical and gender issues. Researchers from Boston University School of Medicine (BUSM) describe ways in which these concepts can be used during telehealth encounters in primary care and other specialties to help mitigate the isolating, traumatic effects of COVID-19. “COVID-19 has created stressors that are unprecedented in our modern era, prompting health care systems to adapt rapidly. Demand for telehealth has skyrocketed, and clinicians, many of whom had planned to adopt virtual practices in the future, have been pressured to do so immediately. The Centers for Medicare and Medicaid Services (CMS) in March 2020, expanded telehealth services, removing many barriers to virtual care. By the time the pandemic was underway in the US, telehealth was already in widespread use across the  Veterans Health Administration (VHA)  In late March 2020, VHA released a COVID-19 Response Plan, in which telehealth played a critical role in safe, uninterrupted delivery of services. According to the researchers from BUSM, trauma-informed virtual care during the COVID-19 pandemic has the potential to ensure and even expand continuity of medical care, offer connection and support to trauma survivors, and enhance patient and clinician resilience in this time of need. “Clinicians have a unique opportunity during this pandemic to apply trauma-informed care principles early on and to envision how telehealth may contribute to a more meaningful care experience for all and a more equitable future for those we care for,” said Gerber, associate professor of medicine at BUSM. [Read More] Source: Gerber MR, et al. Fed Pract. 2020 July;37(7):302-308    ...

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Not a Normal Mental-Health Disaster

According to the Atlantic, the psychological effects of the novel coronavirus will long outlast the pandemic itself. Looking at history and the SARS pandemic, in Hong Kong, only three months separated the first infection, in March 2003, from the last, in June. However the suffering did not end when the case count hit zero. Over the next four years, scientists at the Chinese University of Hong Kong discovered something worrisome. More than 40 percent of SARS survivors had an active psychiatric illness, most commonly PTSD or depression. Some felt frequent psychosomatic pain. Others were obsessive-compulsive. The findings, the researchers said, were “alarming.” Looking at COVID-19, a recent poll by the Kaiser Family Foundation found that the pandemic had negatively affected the mental health of 56 percent of adults. In April, texts to a federal emergency mental-health line were up 1,000 percent from the year before. The situation is particularly dire for certain vulnerable groups—health-care workers, COVID-19 patients with severe cases, people who have lost loved ones—who face a significant risk of post-traumatic stress disorder. In overburdened intensive-care units, delirious patients are seeing chilling hallucinations. At least two overwhelmed emergency medical workers have taken their own life. According to Steven Taylor, a psychiatrist at the University of British Columbia and the author of The 2019 book ‘Psychology of Pandemics’, “the sorts of mental-health challenges associated with COVID-19 are not necessarily the same as, say, generic stress management or the interventions from wildfires. And in a nation where, even under ordinary circumstances, fewer than half of the millions of adults with a mental illness receive treatment, those large numbers are a serious problem. A wave of psychological stress unique in its nature and proportions is bearing down on an already-ramshackle American mental-health-care system, and at the moment, Taylor told me, “I don’t think we’re very well prepared at all.” According to Joe Ruzek, a longtime PTSD researcher at Stanford University and Palo Alto University, “most disasters affect cities or states, occasionally regions. Even after a catastrophic hurricane, for example, normalcy resumes a few hundred miles away. Not so in a pandemic. In essence, there are no safe zones any more.” [Read More] Source: Jacob S. The Atlantic. July 7, 2020 Related stories worth reading: The Coming Mental Health Crisis Is Everyone Depressed? Why your Shrink Wasn’t Offering Virtual Therapy Until...

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HHS Awards $20.3 Million to Expand the Addiction Workforce in Underserved Communities

June 2020. The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), awarded $20.3 million to 44 recipients to increase the number of fellows at accredited addiction medicine and addiction psychiatry fellowship programs. The awardees will train addiction specialists at facilities in high need communities that integrate behavioral and primary care services. “The need for physicians with the expertise and skills to provide substance use prevention, treatment and recovery services is essential,” said HRSA Administrator Tom Engels. “Addiction specialists can respond to patients’ specific behavioral health needs and help communities that are hit hardest by the opioid epidemic.” [Read more] Links to Addiction Psychiatry Addiction...

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FDA Approves First Device for Treatment of ADHD

The Food and Drug Administration (FDA) announced that it is permitting the marketing of the first medical device for the treatment of attention-deficit/hyperactivity disorder (ADHD). The device is the Trigeminal Nerve Stimulation (eTNS) System by Monarch. It will be available by prescription only and is indicated for children aged 7 to 12 years who are not taking ADHD medications. The Monarch eTNS System delivers low-level electrical pulses to a child’s trigeminal nerve via wires and a small patch adhered to the child’s forehead while the child sleeps. The exact mechanism of eTNS is not yet known, but neuroimaging studies have shown that the trigeminal nerve connects to brain regions that are important in regulating attention, emotion, and behavior. The efficacy of the Monarch system was shown in a recently published clinical trial of 62 children with ADHD. The participants randomly received either eTNS or sham nerve stimulation nightly for four weeks. At the study’s completion, the children using the eTNS device had a statistically significant improvement in their ADHD symptoms compared with the sham group, as measured with the clinician-administered ADHD Rating Scale. The device was well tolerated; the most common side effects observed with eTNS were drowsiness, increased appetite, trouble sleeping, teeth clenching, headache, and fatigue. Source: Psychiatric News (APA)...

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The World Health Organization adds gaming addiction as a new mental health disorder

As of today, gaming disorder will appear in a new draft of the World Health Organization’s International Classification of Diseases, the highly regarded compendium of medical conditions. According to the New York Times, “Concerns about the influence of video games are dovetailing with increasing scrutiny over the harmful aspects of technology, as consumers look for ways to scale back consumption of social media and online entertainment. The W.H.O. designation may help legitimize worries about video game fans who neglect other parts of their lives. It could also make gamers more willing to seek treatment, encourage more therapists to provide it and increase the chances that insurance companies would cover it.” Sources: NY Times WHO...

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