Horticulture Improves Heart Rate, Stress Levels Of Mentally Challenged Adults

Main Category: Rehabilitation / Physical Therapy
Also Included In: Anxiety / Stress;  Mental Health
Article Date: 14 Dec 2011 - 1:00 PST

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Participation in horticultural activities can improve confidence and social skills, cultivate a positive attitude, and rejuvenate the mind and body. Many studies have emphasized the effects of horticultural activities in relation to physical and psychological rehabilitation, but few have considered the influence of these types of activities on mentally challenged people's autonomic nervous system (ANS) and on the stress hormone cortisol. A new study examined how activities such as pressing flowers, planting, creating flower arrangements, and making topiaries affect stress relief for patients who are mentally challenged.

In the first experiment of the study, the heart rate variation (HRV) was measured in 30 mentally challenged people at a rehabilitation center in Daegu, South Korea. Researchers in the second experiment measured the cortisol levels of 20 mentally challenged people from a residential home in Yeongcheon, South Korea. Min-Jung Lee from the Department of Horticultural Therapy at the Catholic University of Daegu (South Korea) published the results of both experiments in a report in HortTechnology.

For the first experiment, subjects participated in four indoor horticultural activities: a pressed flower activity, flower planting, flower arranging, and topiary crafting. Participants' heart rate variation was measured five minutes before and five minutes after each horticultural activity was performed. The pressed flower group and the planting group showed a significant improvement in the standard deviation of the normal-normal (SDNN) interval heart rate variation measurements. The planting group's SDNN and low frequency (LF) significantly improved; a significant improvement in total power (TP) and high frequency was also observed. The flower arrangement group displayed a significant difference in LF, while the topiary group showed a significant difference in TP.

The second experiment used the same four horticultural activities, but collected participants' saliva in order to analyze their cortisol levels. Compared with the baseline measurement, the pressed flower group displayed a significant decrease in cortisol density from the first to the seventh day of testing, however no significant difference was observed on the fourth day. The planting group showed a significantly decreasing difference in cortisol density on day seven compared with day four. The topiary group continued to show a significant decrease in cortisol density at each cortisol collection after the first day of topiary activities.

Interestingly, the participants in the flower arrangement group showed increased stress (as measured by low frequency), and showed no great change in cortisol density. "We inferred that activities such as cutting stems with shears and arranging the cut stems in the exact location are difficult jobs for mentally challenged people", Lee said.

The topiary group exhibited a significant difference in total power, and not only had the most significant difference in TP but also had the largest significant decrease in cortisol density among the four indoor horticultural activities. Lee noted that topiary activities are thought to be fairly valuable in aiding emotional stability and vocational rehabilitation for mentally challenged people.

The research supports previous studies that show that touching and mixing soil affects the activity of the autonomic nervous system (ANS) and relieves stress. Planting activities resulted not only in the greatest change in mentally challenged people's ANS but also in a significant gradual decrease in cortisol density.

Lee concluded that planting activities are the most effective horticultural activity for stress relief and added that the extension of indoor planting activities to outdoor planting activities targeted for mentally challenged individuals will have a greater effect not only on vocational rehabilitation, but also on emotional stability.

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Abortion Not Linked To Mental Health Risk

Editor's Choice
Main Category: Abortion
Also Included In: Mental Health;  Psychology / Psychiatry;  Women's Health / Gynecology
Article Date: 11 Dec 2011 - 4:00 PST

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Having an induced abortion in itself does not raise a female's chances of developing mental health problems, says a report, claimed to be the largest and most comprehensive ever, published by the Academy of Medical Royal Colleges (AOMRC), UK. The authors added that whether the pregnant woman decides to have an abortion or proceed with her pregnancy has no impact on health subsequent mental health.

The review, carried out by the NCCMH (National Collaborating Centre for Mental Health, part of the Royal College of Psychiatrists), was commissioned by the Academy of Medical Royal Colleges.

The Steering Group sifted through 180 potential published studies from 1990 to 2011 and eventually included 44.

The Review concluded that: When a woman has an unwanted pregnancy, her chances of developing mental health problems are increased.Terminating an unwanted pregnancy with abortion does not result in a higher risk of mental health problems, compared to seeing that (unwanted) pregnancy to full term.What does have an impact on whether a woman who has an induced abortion subsequently might have mental health problems is her mental health history, i.e. a woman with a history of mental health problems has a greater risk of developing mental health problems after an abortion compared to a woman with no history of mental health problems who has an abortion.If a woman has a negative overall attitude to abortions, and then has one, there is a greater risk of her having mental health problems afterwards.Women who are under pressure from their partners to have an abortion are more likely to have mental health problems, compared to women who abort without such pressure.The review added that some other stressful life events may increase a woman's risk of having mental health problems after an abortion.The authors stressed that it is not the abortion itself that is the predictor of mental health problems, but rather, other factors.

The authors say future practice and research should concentrate on providing support for all females who have an unplanned or unwanted pregnancy.

Chair of the Steering Group, Dr Roch Cantwell, a consultant perinatal psychiatrist, said:

"Our review shows that abortion is not associated with an increase in mental health problems. Women who are carrying an unwanted pregnancy should be reassured that current evidence shows they are no more likely to experience mental health problems if they decide to have an abortion than if they decide to give birth."

NCCMH Director, Professor Tim Kendall, who is also a member of the Steering Group, said:

"This review has attempted to address the limitations of previous reviews of the relationship between abortion and mental health. We believe that we have used the best quality evidence available, and that this is the most comprehensive and detailed review of the mental health outcomes of induced abortion to date worldwide."

AOMRC Chairman, Professor Sir Neil Douglas, said:

"The Academy recognizes that this is a complex and controversial area, where there have been many conflicting research findings. We welcome this extremely high-quality review from the NCCMH, and endorse its findings."

The Family Planning Association (FPA) and Brook said they welcomed the review. They both stated that there is now compelling evidence that when a woman has had, or is wondering whether to have an abortion, that the procedure is safe and does not have a direct impact on her mental health.

They went on to say that forcing women who are having an abortion to have counseling is both "unnecessary" and "patronizing".

The FPA and Brook jointly wrote:

"Giving women accurate and honest information about abortion is essential and is something that FPA and Brook take extremely seriously. However, we know that misinformation about mental health can be used as a scare tactic by third parties, to try and deter women from considering abortion.

"We hope this new report will prevent this type of scaremongering and ensure women receive the non-judgemental support and information they need."

Dr Kate Guthrie, a spokesperson from the Royal College of Obstetricians and Gynaecologists (RCOG) said that this latest Review is welcomed. They have revised their own guidelines regarding the care for females seeking induced abortion according to its findings, which include informing the women of what possible emotional responses are possible during and after an abortion.

Dr. Guthrie said:

"It is important that all women, and particularly those with a history of previous mental health problems, are offered appropriate support and if needed follow-up.

It is essential that healthcare workers identify women that are vulnerable in any way and offer the appropriate aftercare.

Abortion including aftercare is an essential part of women's healthcare services, alongside access to contraception and family planning information."

In a published response placed on its website, SPUC mentioned the following points, which are from stories told by a large number of women. The charity adds that several studies with empirical findings demonstrate that there are psychological consequences from having an abortion: After an abortion, a woman experiences a wide range of negative emotions, such as shame, regret, doubt, grief, guilt, loneliness and sadness.Some women who experience relief after undergoing an abortion, subsequently experience negative emotions.Some females may experience PTSD (post-traumatic stress disorder), triggered by an abortion.Even though a history of mental health problems may impact on the risk of having mental health problems following an abortion - it in no way accounts for all of the effect.The following risk factors increase the chances of a woman suffering psychological harm after an abortion: no social and emotional support, uncertainty and ambivalence about whether to have an abortion, partner violence, and a history of mental health problems.Abortion raises the risk of developing bipolar disorder, depressive psychosis, schizophrenia, neurotic depression, anxiety, and depression.Abortion raises the risk of subsequent substance abuse and self harm, especially when a woman who had an abortion gets pregnant again.Women who have an abortion because of a fetal disability are especially susceptible to psychological damage.A list of studies supporting the negative consequences of abortion for the woman are listed on this page.

Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our abortion section for the latest news on this subject. Induced Abortion and Mental Health
"A Systematic Review of the Mental Health Outcomes of Induced Abortion, Including Their Prevalence and Associated Factors. December 2011" (PDF, 252 pages)
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posted by Dr. Spock on 11 Dec 2011 at 5:09 am

This is about the dumbest study out there. Honestly, you people should be shot!

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posted by Amanda Gonzalez on 11 Dec 2011 at 5:31 am

I am American and have lived in the UK. I am grateful for this study. In my country, the land of polarized views, knee-jerk sound-bites, extreme atheists and bible-bashers, and niche politics, such a study would never be done. If if it were, I would doubt its impartiality.

Thank you.

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posted by John Ambery on 11 Dec 2011 at 5:32 am

In the eyes of God, abortion is a sin. The focus should not be on the mother, she is the vehicle for new life. The new life needs a chance, everything else is irrelevant.

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posted by Father of Two on 11 Dec 2011 at 5:56 am

Based on what I read here, this was less a "study" than a selective survey of other studies. While the article calls this a "review," other commenters and the media are undoubtedly giving this headline more due than it's worth.

And it seems difficult to imagine that deciding to terminate a pregnancy does not carry with it significant prospects for future emotional turmoil. The pro-abortion groups' use of such "data" to promote these procedures soft-pedals what is and should be an extremely grave moral decision to terminate another life.

This fundamental, ethical decision should be the focus of concern. If people can be desensitized to its magnitude, as this review suggests, it says something quite tragic about our world and its throwaway and convenience-based priorities.

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posted by kww on 11 Dec 2011 at 6:03 am

Their are studies that show a link between women that have had abortions and higher rates of certain cancers like breast.

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posted by Dave on 11 Dec 2011 at 6:11 am

That's a great and hopefully healthy attitude / belief for you. However, not everyone believes as you do and as I'm sure you wouldn't want other people or cultures or religions expecting you to adopt their personal beliefs I hope ask that you don't push your personal or religious beliefs on others.

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posted by Ranger on 11 Dec 2011 at 6:11 am

I know two women personally that have suffered depression and years long guilt as a result of abortion. Perhaps some do not. But I am witness to the problems it can cause.

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Dealing With Aggressive Young Offenders With Psychiatric Disorders

Main Category: Psychology / Psychiatry
Also Included In: Mental Health;  Pediatrics / Children's Health
Article Date: 05 Nov 2011 - 0:00 PDT

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Seclusion should always be the last resort when it comes to dealing with aggressive episodes involving young offenders with psychiatric disorders, according to staff who took part in a four-country study published in the November issue of the Journal of Psychiatric and Mental Health Nursing.

Researchers led by the Universities of Turku and Tampere, Finland, report that the multi-disciplinary teams they spoke to said that verbal intervention was their first choice. Putting adolescents in a bare, locked room was viewed as the least favoured option in the three countries where seclusion remains legal.

The research team also found that countries with a longer history of treating adolescents in medium to high security units tended to use less physical restraints on fewer occasions.

"Adolescent aggressive behaviour poses a challenge for staff working in forensic units, which cater for 12 to 18 year-olds who have been in trouble with the law, because it occurs so frequently" says lead author Johanna Berg from the Department of Nursing Science at the University of Turku.

"Our study of units in Belgium, Finland, the Netherlands and UK found that while the principles of dealing with aggression were fairly similar, there were some differences in the practical solutions."

The study comprised forensic units ranging from eight to 12 beds, treating young offenders with a range of problems, including: severe mental health disorders, delinquent, violent and non-compliant behaviour and impulse control problems. One unit was established in the 1980s (UK), two in the 1990s (Belgium and the Netherlands) and one in the 2000s (Finland).

The 58 staff, including nurses, doctors, psychologists, social workers, educators, support workers, occupational, art and family therapists and sports instructors, had an average age of 36.

Key findings from the one-to-one interviews included: Verbal intervention was the favoured technique and was most effective when it was clear, structured and used in the early stages of aggression. Talking about the incident afterwards was also very important, so that both the adolescent and staff could reflect on why it happened and how it could be prevented in future. Staff planned daily routines and worked together so that risks were minimised. Being able to respond quickly and call on colleagues for support, including staff from other units, was vital. Isolation techniques ranged from separating the aggressor from other adolescents for five to 15 minutes, to give them a chance to calm down, to seclusion, which was only used when less restrictive interventions had failed. It was not used in Finland, where it is banned by legislation. Duveting, where the adolescent is swathed in blankets to prevent violent acts and enable staff to transfer them to the seclusion room was not used in the UK unit. Restraint beds with straps were only used in Finland, for intensive care and for as short a time as possible. If medication was needed it was jointly decided between the staff and adolescent, if possible. Forced medication was rarely used and only in major incidents where safety was seriously compromised. Key factors that determined the level of response included the level of aggression involved, how well staff knew the individual adolescent's behaviour and what had proved helpful in the past. Teamwork was important and all members of the multi-disciplinary team needed to be committed to therapeutic aggression management. "Staff in all four units displayed high ethical standards when it came to the use of restrictive treatment measures" says Johanna Berg. "They endeavoured to cooperate with the adolescent as long as possible and avoid coercive measures, while still maintaining the safety of others." The research team have come up with a number of key recommendations for clinical practice as a result of their research: Continuous education is necessary to ensure that staff know how to evaluate incidents and implement the safest and most effective practices when intervening in aggressive situations. Sufficient resources should be available so that the needs of adolescents can be met without compromising the occupation safety and well-being of the staff that care for them. This will help to retain qualified staff in this challenging working environment. Further studies are needed to identify current practices, measure how effective they are and suggest how they could be improved. Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our psychology / psychiatry section for the latest news on this subject. The full paper includes further details of the different approaches employed by the four units, together with quotes from various participants.
Management of aggressive behaviour among adolescents in forensic units: a four-country perspective. Berg et al. Journal of Psychiatric and Mental Health Nursing. 18, pp776-785. (November 2011). doi: 10.1111/j.1365-2850.2011.01726.x
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Good Governance Required In Mental Health Research

Main Category: Mental Health
Article Date: 25 Nov 2011 - 0:00 PST

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In this week's PLoS Medicine Taghi Yasamy from the WHO, Geneva, Switzerland and colleagues identify challenges facing good mental health research governance in low- and middle-income countries and provide suggestions for a way forward.

The authors recognize the need to establish the general orientation of mental health research to deal with problems such as organizational structure, research prioritization and relatively limited capacity and resources, and to balance expensive research with assessment of services and resources using low-cost methods.

The authors state: "Low resource countries face a range of challenges that leads to little or inappropriate research. They need to use their limited financial and human resources for mental health research as effectively as possible. They need sound governance of their mental health research to achieve this."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our mental health section for the latest news on this subject. Funding: No specific funding was received for this article.
Competing Interests: The authors have declared that no competing interests exist. MTY, MVO, and SS are WHO employees, they are responsible for the views expressed in this publication, and they do not necessarily represent the decisions, policy, or views of the World Health Organization.
Citation: Yasamy MT, Maulik PK, Tomlinson M, Lund C, Van Ommeren M, et al. (2011) Responsible Governance for Mental Health Research in Low Resource Countries. PLoS Med 8(11): e1001126. doi:10.1371/journal. pmed.1001126
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Teen Suicide Prevention

Main Category: Mental Health
Also Included In: Pediatrics / Children's Health;  Psychology / Psychiatry;  Preventive Medicine
Article Date: 04 Nov 2011 - 2:00 PDT

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Roughly 1 million people die by suicide each year. In the U.S., where nearly 36,000 people take their own lives annually, more than 4,600 victims are between the ages of 10 and 24, making suicide the third leading cause of death in this age group.

Youths treated at hospital emergency rooms for suicidal behavior remain at very high risk for future suicide attempts. But despite the urgent need to provide them with mental health follow-up care, many don't receive any such care after their discharge. Consequently, a major goal of the U.S. Department of Health and Human Service's National Strategy for Suicide Prevention has been to increase rates of follow-up care after discharge for patients who come to the emergency department (ED) due to suicidal behavior.

Now, a new study by UCLA researchers shows that a specialized mental health intervention for suicidal youth can help. Reporting in the November issue of the journal Psychiatric Services, Joan Asarnow, a professor of psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA, and colleagues show that a family-based intervention conducted while troubled youths were still being treated in the ED led to dramatic improvements in linking these youths to outpatient treatment following their discharge.

"Youths who are treated for suicidal behavior in emergency departments are at very high risk for future attempts," said Asarnow, the study's first author. "Because a large proportion of youths seen in the ED for suicide don't receive outpatient treatment after discharge, the United States National Strategy for Suicide Prevention identifies the ED as an important suicide prevention site. So, a national objective is to increase the rates of mental health follow-up treatment for suicidal patients coming out of EDs."

But how to encourage this with youths when they are at their most vulnerable? The study involved 181 suicidal youths at two EDs in Los Angeles County, with a mean age of 15. Sixty-nine percent were female, and 67 percent were from racial or ethnic minority groups. For 53 percent of the participants, their emergency department visit was due to a suicide attempt. The remainder were seen because they had thoughts of suicide.

The youths were randomly assigned to either the usual ED treatment or an enhanced mental health intervention that involved a family-based crisis-therapy session designed to increase motivation for outpatient follow-up treatment and improve the youths' safety, supplemented by telephone contacts aimed at supporting families in linking to further outpatient treatment.

The results of the study show that the enhanced mental health intervention was associated with higher rates of follow-up treatment. Of the participants in the enhanced intervention, 92 percent received follow-up treatment after discharge, compared with 76 percent in the standard ED treatment arm - a clinically significant difference.

While the results are positive, the study is only a first step, according to Asarnow, who also directs UCLA's Youth Stress and Mood Program.

"The results underscore the urgent need for improved community outpatient treatment for suicidal youths," she said. "Unfortunately, the follow-up data collected at about two months after discharge did not indicate clinical or functioning differences among youths who received community outpatient treatment and those who did not."

Still, Asarnow said, the data from the new study underscores the critical importance of this work. To address the need for effective follow-up treatment for troubled youths, the UCLA Youth Stress and Mood Program has major research trials in progress aimed at evaluating outpatient treatments for preventing suicide and suicide attempts.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our mental health section for the latest news on this subject. Funding for the study was provided by the Centers for Disease Control and Prevention, the National Institute of Mental Health and the American Foundation for Suicide Prevention.
Other authors included Larry Baraff, Robert Suddath, John Piacentini, Mary Jane Rotheram-Borus and Lingqi Tang, all of UCLA; Michele Berk and Charles Grob of Harbor–UCLA Medical Center, Los Angeles Biomedical Research Institute; Mona Devich-Navarro of Santa Monica College; and Daniel Cohen of Johns Hopkins University.
Asarnow reports receiving honoraria from Hathaways-Sycamores, Casa Pacifica, the California Institute of Mental Health and the Melissa Institute. Piacentini has received royalties from Oxford University Press for treatment manuals and from Guilford Press and the American Psychological Association Press for books on child mental health. In addition, he has received a consultancy fee from Bayer Schering Pharma. The other authors report no competing interests.
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Early Diagnosis Of Psychotic Disorders

Main Category: Mental Health
Also Included In: Psychology / Psychiatry;  Depression
Article Date: 04 Nov 2011 - 0:00 PDT

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Functional psychosis can be diagnosed from the first indications of the patient, thanks to affective symptomatology. Depressive moods, hyperactivity and lack of concentration are affective symptoms that can present themselves during the first psychotic episodes, and the presence or absence of any of them may contribute to differentiating, at an early stage, between the different variations of the mental disease. Thus concludes researcher Ms Marta Arrasate, who also pointed to the symptoms belonging to the activation dimension (verborrhea, lack of concentration, hyperactivity, etc.) as the best indicators. Her thesis, defended at the UPV/EHU, was entitled Valor predictivo de la sintomatología afectiva en primeros episodios psicóticos (Predictive value of affective symptomatology during the first psychotic episodes).

This is the first European PhD undertaken at the Alava/Araba Unit of the Faculty of Medicine of the UPV/EHU, and was codirected by Ana González-Pinto, 2010 National Award winner of the Spanish Society for Biological Psychiatry. According to Ms González-Pinto, the relevance of the research lies in that "affective symptoms can help not only in telling future prognosis but also in contributing to diagnosis - something difficult in psychiatry because diagnostic tests equivalent to a radiograph, an analysis or a scanner do not exist. This is why, if a test were found, however simple, or rudimentary, it would be of great use".

Evaluation in three stages

Ms Arrasate undertook the study based on a sample of 112 hospitalised patients with a first psychotic episode, and analysed the predictive value of the affective symptoms that present themselves in three concrete moments: initial hospital admission, the third year and the fifth year. In order to evaluate the results, the different affective symptoms were grouped according to dimensions (these classifications being based on a previous study of patients with bipolar disorders), and associated with variables such as the number of relapses, hospital or health centre admissions, suicide attempts, etc.

The results show that the activation dimension (involving symptoms of hyperactivity, lack of concentration and verborrhea, amongst others) can be an especially useful tool for early distinguishing between the various types of psychotic symptoms. This is what has been deduced from the data obtained from a study of one of the principal diseases in this field: bipolar disorder. According to Ms Arrasate's research, the activation and manic dimensions are those which best characterise bipolar disorder. Nevertheless, the manic dimension is absent in the first episodes; moreover, that which is present during these first episodes is the depressive dimension, thus possibly giving rise to confusion and inability in making an early and correct diagnosis. Thus, the results point to the activation dimension as the reliable path to follow: it is a useful predictive factor in the early diagnosis of bipolar disorder with psychotic symptoms.

These results open a new line of research as they prove that affective symptoms are able to discriminate between different psychoses, and contribute to an early diagnosis during its course. In fact, the evaluating panel for Ms Arrasate's thesis have made a point of informing those experts responsible for reviewing diagnostic criteria of mental diseases worldwide of these findings.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our mental health section for the latest news on this subject. Marta Arrasate Gil (Bilbao, 1969) is a medical graduate who specialised in psychiatry. She carried out her PhD thesis under the direction of Ms Ana González-Pinto Arrillaga (Head of the Psychiatric Research Service at the Hospital Santiago Apóstol in the Basque Country capital of Vitoria-Gasteiz) and Mr Miguel Gutiérrez Fraile (Head of the Psychiatry Service at the same hospital and Professor of Psychiatry). Both are members of the Department of Neurosciences at the Faculty of Medicine and Odontology (UPV/EHU), where Ms Arrasate defended her thesis. The research was undertaken at the Psychiatric Research Service of the Hospital Santiago Apóstol. Ms Arrasate is currently working at the Psychiatric Service at Basurto Hospital, near the Basque city of Bilbao.
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Higher Minimum Legal Drinking Ages Linked To Lower Rates Of Suicides And Homicides Later In Life

Main Category: Alcohol / Addiction / Illegal Drugs
Also Included In: Public Health;  Mental Health
Article Date: 17 Nov 2011 - 0:00 PST

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Prior to the 1984 passage of a uniform drinking-age limit of 21 years in the U.S., many states permitted the legal purchase of alcohol at age 18. These lower drinking ages have been associated with several adverse outcomes such as higher rates of suicide and homicide among youth. A new study of individuals who were legally permitted to drink before the age of 21 has found they remain at elevated risk for suicide and homicide as adults, particularly women born after 1960.

Results will be published in the February 2012 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

"After prohibition, most states had a drinking age of 21," explained Richard A. Grucza, an epidemiologist at Washington University School of Medicine, and corresponding author for the study. "In the late 1960s and early 1970s, as voting rights were extended to people as young as 18, and people of that age were also being drafted to serve in Viet Nam, a lot of states lowered their drinking ages. But by the late 1970s, we saw spikes in DUI-related deaths among young people and states began to revert to a drinking age of 21. The 1984 federal act was really just a completion of change that was already underway."

"Alcohol-control policies are always controversial, as many people are generally in opposition to laws which seem to govern individual choices and behavior," observed Katherine M. Keyes, a post-doctoral fellow in epidemiology at Columbia University. "However, this study and other data make the case for minimum legal drinking age (MLDA) laws as a public health benefit incredibly clear: MLDA laws save lives, both among young people and as currently demonstrated, throughout the life course."

Grucza added that he and his colleagues had earlier observed higher rates of alcohol and drug use disorders among adults - both men and women - who were born in states that allowed alcohol sales to youth under age 21. Furthermore, other shorter-term studies had found higher rates of DUI accidents, other drinking behaviors, suicides, and homicides in states with lower drinking ages during the time those laws were in effect. "So studying the longer-term effects of drinking ages on suicide and homicide was a logical next step," he said.

Grucza and his co-authors used data from the U.S. Multiple Cause of Death files, 1990-2004, along with data on living populations from the U.S. Census and American Community Survey. The combined data contained records on more than 200,000 suicides and 130,000 homicides for individuals who turned 18 between the years 1967 and 1989, the years during which legal drinking ages were in flux.

"A number of adverse consequences were associated with lower drinking ages during the time periods that those laws were in effect, including elevated rates of suicide and homicide," said Grucza. "In this study we found that youth who lived in states with lower drinking ages remain at elevated risk for suicide and homicide as adults. The effect seems to be specific for women."

"This study is an incredibly important documentation of the long-term impact of alcohol-control policies," said Keyes. "These findings indicate that populations among whom alcohol was restricted until age 21 experience health benefits of that restriction throughout adulthood, with significantly reduced risk of homicide and suicide among women in more recently born cohorts." More specifically, study authors estimated that the national drinking age of 21 years may be preventing approximately 600 suicides and 600 homicides annually.

"Suicide and homicide are very different phenomena," observed Grucza. "For homicide, females are victimized by acquaintances in 92 percent of the cases. If lower drinking ages result in elevated rates of alcohol problems, this could contribute to alcohol-fueled domestic violence. Alcohol use by both women and their partners could contribute to domestic-violence situations. For suicide, it may be that alcohol contributes to the severity of suicide attempts. In general, women attempt suicide more often than men, but men complete - or die from - suicide more often than women. Alcohol problems may tip the balance by turning attempts into completions more often, and this would be particularly risky for women because of the higher number of attempts."

"While women are less likely overall to drink and develop alcohol use disorders compared to men, the consequences of drinking are often more harmful for women," added Keyes. "This study adds important evidence to the literature, indicating that exposure to alcohol during a critical period of development in young adulthood may have long ranging health consequences for women, increasing the risk of suicide and homicide throughout the life course."

"Many scientists believe the adolescent brain is especially vulnerable to the effects of drugs, including alcohol," said Grucza. "But a lot of the findings supporting that idea come from animal experiments that can't be extended to humans. We saw drinking-age changes as a 'natural experiment' to see what happens to young people who have easy access to alcohol compared to those whose access is restricted: if early drinking was a true risk factor for subsequent alcoholism, then we should see multiple adverse long-term consequences among people who lived under more permissive drinking age laws as youth. Our results help to solidify the case for drinking age laws."

Keyes concurred. "Grucza and colleagues have elegantly demonstrated that individuals who were young adults during a time in which they could legally drink between the ages of 18 and 21 have far-reaching health consequences in adulthood," she said. "Given that debate over the MLDA in the U.S. continues to persist, especially in light of the Amethyst Initiative supported by many college presidents which advocates returning to an age 18 MLDA, this study is an important reminder of the public-health effectiveness of controlling alcohol at the population level during a very critical time in development. These data underscore that, especially for young women, drinking during young adulthood can lead to a wide range of consequences throughout the life course."

"The 21 MLDA was initially adopted to reduce the number of DUI related accidents and other social consequences of drinking involving young people," added Grucza. "The finding that it may also save lives and reduce problems during adulthood shows the importance of maintaining these laws, and developing other interventions aimed toward reducing drinking among young people."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our alcohol / addiction / illegal drugs section for the latest news on this subject. Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, "The Legacy of Minimum Legal Drinking Age Law Changes: Long-Term Effects on Suicide and Homicide Deaths among Women," were: Pamela R Hipp, Laura Rundell, Anastasia Evanoff, Patricia Cavazos-Rehg, and Laura J. Bierut of the Department of Psychiatry at Washington University School of Medicine; and Karen E. Norberg of the Department of Psychiatry at Washington University School of Medicine, and the National Bureau of Economic Research, Cambridge, MA. The study was funded by the National Institutes of Health. This release is supported by the Addiction Technology Transfer Center Network at http://www.attcnetwork.org/.
Washington University School of Medicine
Columbia University
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Little Or No Help For Two Million Californians Reporting Mental Health Needs

Main Category: Mental Health
Also Included In: Health Insurance / Medical Insurance
Article Date: 02 Dec 2011 - 0:00 PST

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Nearly 2 million adults in California, about 8 percent of the population, need mental health treatment, but the majority receive no services or inadequate services, despite a state law mandating that health insurance providers include mental health treatment in their coverage options, a new report by the UCLA Center for Health Policy Research shows.

The report, which provides some of the first comprehensive data ever collected on the mental health of California's adult population, found that one in 12 Californians reported symptoms consistent with serious psychological distress and experienced difficulty functioning at home or at work.

Over half of these adults reported receiving no treatment for their disorders, and about one-quarter received "inadequate" treatment, defined as less than four visits with a health professional over the past 12 months or using prescription drugs to manage mental health needs.

The study draws on data from the 2007 California Health Interview Survey (CHIS), which is conducted by the center.

"There is a huge gap between needing help and getting help," said David Grant, the study's lead author and director of CHIS. "The data also shows large disparities in mental health status and treatment by demographic, economic and social factors. These findings can help direct the state's limited resources to those in greatest need of help."

Among the findings: Insurance

Unsurprisingly, uninsured adults had the highest rate of unmet needs (87 percent), which includes receiving no treatment or receiving less than minimally adequate treatment; 66 percent of these adults received no treatment. By contrast, 77 percent of privately insured and 65 percent of publically insured Californians reported unmet needs. Although poverty and mental health needs are strongly correlated, the lower rate of unmet needs by public program participants suggests that these programs are more likely to effectively offer mental health services than even private insurance policies.

Single parents under stress

Single adults with children had more than double the rate of mental health needs (17 percent) when compared with all adults (8 percent). Single adults without children had the next highest rate (11 percent). Married adults with or without children had the lowest rates of mental health needs (6 percent and 5 percent, respectively.)

U.S.-born Latinos have greater need than immigrants

Nearly 12 percent of Latinos born in the U.S. needed mental health treatment, almost twice the level of Latino immigrants.

Racial groups

Approximately 17 percent of American Indians and Alaska Natives had mental health needs, the highest of all racial and ethnic groups. Native Hawaiian, Pacific Islander and multi-racial groups had the next highest rate, at 13 percent.

Lesbian, gay and bisexual adults

Nearly 20 percent of these adults needed mental health treatment - more than double the statewide rate.

Link to chronic health conditions

Compared to the general adult population, those with mental health needs had higher rates of chronic diseases such as high blood pressure, heart disease, diabetes and asthma. They were more than twice as likely to report fair or poor health status and five times more likely to report poor health.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our mental health section for the latest news on this subject. The report was supported by a grant from the California Department of Mental Health Services.
Report and related fact sheet: "Adult Mental Health Needs in California."
The California Department of Mental Health Services has oversight of the state's public mental health budget, provides leadership for local county mental health departments. and evaluates and monitors public programs, among its many duties.
The California Health Interview Survey (CHIS) is the nation's largest state health survey and one of the largest health surveys in the United States.
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Foster Kids Get More Psychiatric Drugs

Editor's Choice
Main Category: Pediatrics / Children's Health
Also Included In: Psychology / Psychiatry;  Mental Health
Article Date: 03 Dec 2011 - 11:00 PST

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A Government Accountability Report released this Thursday showed America's foster children being prescribed powerful psychotropic drugs, at doses beyond what the Food and Drug Administration has approved. At a congressional hearing the same day, Thursday saw lawmakers discussing both the problems and possible solutions.

Obviously, those in foster care are more likely to have had elements of abuse or traumatic experiences during their upbringing, thus they are more likely to end up on medication, especially once they are labeled as problem children, hopping from one home to the next.

By way of example, three-quarters of the children who enter Maryhurst's program, a nonprofit agency for neglected or abused children in Kentucky, are on psychotropic drugs, but by the time they leave, well over half are on reduced or no medication at all.

Maryhurst president and CEO Judy Lambeth continued :

"Our children come to us on many medications, but over time we want to reduce the medication as much as possible and hopefully, to where they wouldn't need any at all. That's a fine balance, but we want them to be able to participate in the treatment and if they're overmedicated, they can't do that."

Medicaid, administered by individual states and overseen by the Department of Health and Human Services (HHS), provides prescription drug coverage to foster children, so medication is clearly the easy way out a lot of the time.

A part of it also has to do with simplifying and streamlining care to hundreds or thousands of children at a time, who have ended up without official parents or guardians and thus in foster care.

However, the results are more shocking than simply a slight overuse of psychotropic drugs on foster kids, even if just for expediency.

Government Accountability Office (GAO) experts say there is more evidence of misuse, overuse and potential health risks than simply a statistic showing foster kids are on medication more than those with regular homes.

They examined five states Florida, Maryland, Massachusetts, Michigan, Oregon, and Texas; cases include : The concomitant use of five or more psychotropic drugs for which there is no established benefitChildren prescribed doses higher than the maximum levels cited in guidelines developed by Texas based on FDA-approved labels.Children under 1 year old were prescribed psychotropic drugs.The GAO state that there are no established usages for mental health conditions in infants; providing them these drugs could result in serious adverse effects. Using higher than recommended doses exposes children to the risks of side effects and serious health problems.

Putting aside the creation of wanton costs for Medicaid, there is no medical precedent for using five or more psychotropic drugs on the same patient.

Selected states' monitoring programs for psychotropic drugs provided to foster children, seem to fall short of the guidelines published by the American Academy of Child and Adolescent Psychiatry (AACAP). The guidelines, which states are not required to follow, cover four categories : (1) Consent: Each state has some practices consistent with AACAP consent guidelines, such as identifying caregivers empowered to give consent. (2) Oversight: Each state has procedures consistent with some but not all oversight guidelines, which include monitoring rates of prescriptions. (3) Consultation: Five states have implemented some but not all guidelines, which include providing consultations by child psychiatrists by request. (4) Information: Four states have created websites about psychotropic drugs for clinicians, foster parents, and other caregivers. GAO recommended that The Department of Health and Human Service (HHS) begin endorsing guidance for states on best practices for overseeing psychotropic prescriptions for foster children. HHS agreed with the recommendation. Agency comments will be incorporated and addressed in a written report that will be issued in December 2011.

Written by Rupert Shepherd
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posted by Richard Wexler on 4 Dec 2011 at 1:53 am

Yes, foster children may have more mental health problems - some of them caused by being moved from foster home to foster home. But several factors suggest all those drugs are *not* needed:

--While all of the studied states use these meds on a shocking proportion of foster children, some are a lot more shocking than others. The range is from 19.7 percent in Oregon to 39.1 percent in Massachusetts. It is unlikely that Massachusetts foster children are twice as likely to have problems requiring medication as Oregon foster children.

--A Florida pilot project, discussed in the trade journal Youth Today had dramatic results, albeit among one subgroup reducing the use of meds 75 percent. Did the children in that subgroup suddenly get 75 percent healthier?

--But the “smoking gun” on these issues comes from some findings in Florida that are not in the study. Florida officials found that when a child is placed with a grandmother or other relative he is dramatically less likely to wind up on meds than when that child is placed in an institution, a group home, or even a foster home with a stranger.

It’s not hard to figure out why. Unlike the strangers, grandparents typically love the children they’re caring for – so they’ll put up with a lot more instead of rushing to seek a prescription to make a child docile and easier to manage.

In contrast, when it comes to doping up children the worst offenders are residential treatment centers. So the notion that a place like Maryhurst is a solution is ludicrous. Institutionalizing children is a major part of the problem.

You can’t fix this with another regulation because you can’t legislate love. Large numbers of children never needed to be taken from their parents in the first place – they are taken when, for example, family poverty is confused with “neglect.” The only way to significantly reduce the use of psychiatric medication in foster care is to significantly reduce foster care.

Richard Wexler
Executive Director
National Coalition for Child Protection Reform

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posted by Shirley on 4 Dec 2011 at 6:54 am

A drop in the bucket. Look and you will find that most Special Needs populations are on the same meds, need or no need. They are called "The drugs of choice" and Developmentally Delayed folks of all ages are routinely given these drugs, whether called for or not. Our doctor calls them "staff in a bottle". He does not prescribe this stuff, himself.
Another feature of giving these drugs might possibly be any profits that providers and down-the-line caregivers might receive for their parts in this sharing of the meds so widely. Who regulates this sort of thing? Anybody??

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posted by Dennis Knicely on 4 Dec 2011 at 12:45 pm

After decades of research, many realize side effects from use of psychotropic drugs can often lead to many more problems than simply using common sense, like giving children needed attention, love and non sexual affection.

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posted by Brandon on 5 Dec 2011 at 1:12 am

I just got out of Foster care and the medicine they put me on made me do worse...when I got out of Foster care and got off the medicine I did much better so the medicine is not helping
..go get on it yourself if you think it does

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