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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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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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.
University of California - Los Angeles Please use one of the following formats to cite this article in your essay, paper or report:

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University of California - Los Angeles. "Little Or No Help For Two Million Californians Reporting Mental Health Needs." Medical News Today. MediLexicon, Intl., 2 Dec. 2011. Web.
9 Dec. 2011. APA

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Developing Nations Need Good Governance In Mental Health Research

Editor's Choice
Academic Journal
Main Category: Mental Health
Article Date: 25 Nov 2011 - 7:00 PST

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Taghi Yasamy, from the World Health Organization (WHO), Geneva, Switzerland, and colleagues pointed out the difficulties good mental health research governance in low- and middle-income countries face in this week's PLoS Medicine.

In addition, Yasamy and colleagues offer suggestions on how good mental health research can move forward.

The team acknowledge the need to organize the general direction of mental health research in order to deal with issues, such as research prioritization, organizational structure, relatively limited capacity and resource, as well as to balance costly investigations with evaluation of resources and services using inexpensive techniques.

The researchers, explain:

"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."

Written by Grace Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our mental health section for the latest news on this subject. ”Responsible Governance for Mental Health Research in Low Resource Countries.”
Yasamy MT, Maulik PK, Tomlinson M, Lund C, Van Ommeren M, et al. (2011)
PLoS Med 8(11): e1001126. doi:10.1371/journal. pmed.1001126 Please use one of the following formats to cite this article in your essay, paper or report:

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Grace Rattue. "Developing Nations Need Good Governance In Mental Health Research." Medical News Today. MediLexicon, Intl., 25 Nov. 2011. Web.
9 Dec. 2011. APA

Please note: If no author information is provided, the source is cited instead.

posted by Dalpay on 26 Nov 2011 at 6:45 am

Mental hygiene is situational to cultural expectations and even then the Caste or Class to which an individual belongs. With international migration of medical personnel, the professional opine may be called into question. Ethical conduct of a Polynesian can not be adequately assessed by an Eskimo. A Catholic can not usually comment on the motive for behavior of a Hindu. While developing nations may need to explore a new Malleus Maleficarum of social expectations, it is not required they participate in Inquisition. The legacy of Behavioral Science is footnoted with witch hunts combining honest research with personal patterns of belief.

| post followup | alert a moderator |

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View the original article here

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

email to a friend   printer friendly   opinions  

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.
University of California - Los Angeles Please use one of the following formats to cite this article in your essay, paper or report:

MLA

University of California - Los Angeles. "Little Or No Help For Two Million Californians Reporting Mental Health Needs." Medical News Today. MediLexicon, Intl., 2 Dec. 2011. Web.
8 Dec. 2011. APA

Please note: If no author information is provided, the source is cited instead.

Please note that we publish your name, but we do not publish your email address. It is only used to let you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

If you write about specific medications or operations, please do not name health care professionals by name.

All opinions are moderated before being included (to stop spam)

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional. For more information, please read our terms and conditions.

View the original article here

Developing Nations Need Good Governance In Mental Health Research

Editor's Choice
Academic Journal
Main Category: Mental Health
Article Date: 25 Nov 2011 - 7:00 PST

email to a friend   printer friendly   opinions  

Taghi Yasamy, from the World Health Organization (WHO), Geneva, Switzerland, and colleagues pointed out the difficulties good mental health research governance in low- and middle-income countries face in this week's PLoS Medicine.

In addition, Yasamy and colleagues offer suggestions on how good mental health research can move forward.

The team acknowledge the need to organize the general direction of mental health research in order to deal with issues, such as research prioritization, organizational structure, relatively limited capacity and resource, as well as to balance costly investigations with evaluation of resources and services using inexpensive techniques.

The researchers, explain:

"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."

Written by Grace Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our mental health section for the latest news on this subject. ”Responsible Governance for Mental Health Research in Low Resource Countries.”
Yasamy MT, Maulik PK, Tomlinson M, Lund C, Van Ommeren M, et al. (2011)
PLoS Med 8(11): e1001126. doi:10.1371/journal. pmed.1001126 Please use one of the following formats to cite this article in your essay, paper or report:

MLA

Grace Rattue. "Developing Nations Need Good Governance In Mental Health Research." Medical News Today. MediLexicon, Intl., 25 Nov. 2011. Web.
8 Dec. 2011. APA

Please note: If no author information is provided, the source is cited instead.

posted by Dalpay on 26 Nov 2011 at 6:45 am

Mental hygiene is situational to cultural expectations and even then the Caste or Class to which an individual belongs. With international migration of medical personnel, the professional opine may be called into question. Ethical conduct of a Polynesian can not be adequately assessed by an Eskimo. A Catholic can not usually comment on the motive for behavior of a Hindu. While developing nations may need to explore a new Malleus Maleficarum of social expectations, it is not required they participate in Inquisition. The legacy of Behavioral Science is footnoted with witch hunts combining honest research with personal patterns of belief.

| post followup | alert a moderator |

Please note that we publish your name, but we do not publish your email address. It is only used to let you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

If you write about specific medications or operations, please do not name health care professionals by name.

All opinions are moderated before being included (to stop spam)

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Please send any medical news or health news press releases to:

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional. For more information, please read our terms and conditions.

View the original article here

In Wake Of Disasters Mental Health Relief Efforts Often Overlooked

Main Category: Aid / Disasters
Also Included In: Mental Health;  Psychology / Psychiatry
Article Date: 21 Oct 2011 - 1:00 PDT

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Recent events such as the ten-year commemoration of September 11th just weeks ago, Hurricane Irene striking the east coast this past summer, three months of oil spills off of the Gulf Coast a year ago, and the tragic earthquakes that struck Chile and Haiti in early 2010, are constant reminders that tragedy and catastrophe can occur at any moment. But what kind of effects do these devastating disasters have on those involved and what can counselors and psychologists do to help them?

A new issue of The Counseling Psychologist (published by SAGE) titled "Counseling Psychology and Large-Scale Disasters, Catastrophes, and Traumas: Opportunities for Growth," discusses past efforts by mental health professionals in responding to international disasters, current research endeavors, and training and intervention programs that can be implemented at a global level in the future.

"Disasters affect individuals, families, communities, work places, and disaster responders. Thus, they require a multisystem analysis and response, which counseling psychologists can provide," wrote Sue C. Jacobs, Mark M. Leach, and Lawrence H. Gerstein, authors of the introductory article, "Introduction and Overview: Counseling Psychologists' Roles, Training, and Research Contributions to Large-Scale Disasters." "

Following Hurricane Katrina's destructive assault on the Gulf Coast in 2005, a group of psychologists came together to form the Special Task Group (STG) in order to encourage and support students and faculty from counseling psychology programs in their efforts to organize mental health relief efforts for those affected by the disaster. After the effects of the hurricane lessened, members of the STG found that they needed a way to discuss what they learned from the experience as well as what they could do to improve their services when disasters occurred in the future.

Defining disasters as natural disasters, human made disasters, and war and genocide, the November 2011 edition of The Counseling Psychologist reflects this proactive and systematic attempt to organize and prepare psychologists as they help those affected by traumatic events on their long road to recovery.

Jacobs, Leach, and Gerstein wrote, "As we discussed this contribution it became blatantly clear that Hurricane Katrina was just the latest in a series of disasters that had widespread effects. We decided, therefore, to invite other counseling psychologists with appropriate expertise to be part of this major contribution"

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our aid / disasters section for the latest news on this subject. Please use one of the following formats to cite this article in your essay, paper or report:

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SAGE Publications. "In Wake Of Disasters Mental Health Relief Efforts Often Overlooked." Medical News Today. MediLexicon, Intl., 21 Oct. 2011. Web.
8 Dec. 2011. APA

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View the original article here

Study Finds Care For Mentally Ill Veterans Is As Good Or Better Than In Other Health Systems

Main Category: Veterans / Ex-Servicemen
Also Included In: Mental Health;  Alcohol / Addiction / Illegal Drugs
Article Date: 21 Oct 2011 - 0:00 PDT

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Treating U.S. veterans with mental illness and substance use disorders is more expensive than caring for veterans with other medical conditions, costing more than $12 billion in 2007, according to a new RAND Corporation study.

The study found that while the proportion of veterans who received the care recommended for their mental illness varied widely, the overall quality of mental health care offered by the U.S. Department of Veterans Affairs was as good as or better than that reported by privately insured, Medicare or Medicaid populations. The findings are published online by the journal Health Affairs and will also will appear in its November edition.

"While the VA does a better job at providing mental health services than other health care systems, there is still substantial room for improvement," said Dr. Katherine Watkins, lead author of the study and a senior natural scientist with RAND, a nonprofit research organization. "With some changes, the VA could provide even better and more cost-effective care for the nation's veterans, as well as serve as a model for other health care systems."

Researchers say the VA already has undertaken several mental health-specific initiatives that may increase the proportion of veterans receiving evidence-based treatments.

The RAND study is the first comprehensive look at the full spectrum of clinical services provided to veterans with mental health issues, from assessment to treatment to chronic care management. It also examines variations in care for veterans across different regions of the United States and for different diagnoses.

Between fiscal years 2004 and 2008, the number of veterans diagnosed with mental illness and substance-use disorders increased 38 percent to 906,394, with the greatest increase seen among those with post-traumatic stress disorder. While the veterans in the RAND study represent only 15.4 percent of those who used VA services in fiscal year 2007, they accounted for 32.9 percent of the total health care costs because of higher use of both inpatient and outpatient physical and mental health care services.

In 2006, the VA commissioned RAND and the Altarum Institute to do a comprehensive evaluation of its mental and substance-use treatment system. The evaluation took place during the implementation of the VA's five- year Mental Health Strategic Plan, a large initiative to expand and improve care for mental and substance abuse disorders.

The study included 836,699 veterans who received services from the VA in fiscal year 2007 for treatment of at least one of five diagnoses: schizophrenia, bipolar I disorder, post-traumatic stress disorder, major depression and substance-use disorders. To be included, veterans had to have had at least one inpatient episode or two outpatient visits.

Veterans in the RAND study had four times as many acute inpatient discharges as non-study veterans and three times as many outpatient encounters. The average cost per non-study veteran was $4,579, while the average cost for a study veteran was $12,337, or nearly three times as much.

The kind of care the veterans received varied widely, although none of the individual facilities stood out as consistently performing above or below the network average. Watkins and her colleagues identified 23 performance indicators to track the kind of care veterans got, such as whether veterans with post-traumatic stress disorder were given cognitive behavioral therapy as recommended. Of those indicators, three had rates about 75 percent, and nine were below 25 percent.

For example, among the assessment indicators, 82 percent of the study veterans were assessed for suicidal thoughts, but only 23 percent were assessed for response to psychotherapy. Use of medication varied from a high of 60 percent for the acute treatment of depression to a low of 16 percent for drug therapy for alcohol dependence. Less than a third of the veterans diagnosed with schizophrenia or bipolar disorder received continuous maintenance treatment with antipsychotics or mood stabilizers.

The study data does not reflect instances when a service or medication was recommended by a provider, but refused by a patient, or prescriptions that were written by the doctor, but never filled by the patient.

In addition to VA's ongoing improvement efforts, researchers say efforts are needed to better understand what underlines the quality differences and strategies should be developed to address the differences in the future.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our veterans / ex-servicemen section for the latest news on this subject. Coauthors of the study are Harold Pincus, Susan Paddock, Carrie Farmer, Melonie Sorbero, Marcela Horvitz-Lennon, Kimberly Hepner, and Jacob Solomon, all of RAND; and Brad Smith, Abigail Woodroffe, and Cathy Call, of the Altarum Institute; and Thomas Mannle, Jr., with Pilot Consulting Services.
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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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View the original article here