Abortion Not Linked To Mental Health Risk

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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.
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Developing Nations Need Good Governance In Mental Health Research

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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)
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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.

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Mortality Risk In Patients With Chest Pains Increased By Prior Hospitalization For Mental Illness

Main Category: Mental Health
Also Included In: Psychology / Psychiatry;  Heart Disease;  Diabetes
Article Date: 02 Dec 2011 - 1:00 PST

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New research from Scotland has shown that the rate of death in men and women hospitalised for chest pain unrelated to heart disease is higher in those with a history of psychiatric illness than without.

The study published online in Europe's leading cardiology journal, the European Heart Journal [1] found that the death rate one year after hospitalisation for NCCP (non-cardiac chest pain) was higher in men and women with a previous psychiatric hospitalisation than without, with cardiovascular disease accounting for the majority of deaths among men and women with a previous psychiatric hospitalisation.

Dr Michelle Gillies, Clinical Lecturer in Epidemiology, at the University of Glasgow, Glasgow, UK, said: "We found that men and women with a prior psychiatric hospitalisation were younger, more socioeconomically deprived and more likely to be suffering from diabetes or hypertension than those without a prior psychiatric hospitalisation. Even after adjusting for these differences we found that the rate of death at one year from any cause and from cardiovascular disease was higher in men and women with a previous psychiatric hospitalisation than without, with the excess risk being greatest in younger patients."

Using routinely collected hospital admission data from the Scottish National Health Service the researchers identified over 150,000 men and women, without existing heart disease, hospitalised for the first time for NCCP between 1991 and 2006. Of these, 3514 (4.4%) men and 3136 (3.9%) women had a previous psychiatric hospitalisation in the preceding 10 years. One year after hospital discharge for NCCP, there were more deaths among patients with a previous psychiatric hospitalisation than those without: 6.3% versus 4.3% respectively in men, and 5.3% versus 3.6% in women. Cardiovascular disease was the most frequent cause of death, accounting for 28.2% and 44.1% of all deaths in men and women respectively, who had a previous psychiatric hospitalisation.

Dr Gillies said: "Our findings are consistent with previous studies that have shown that patients with psychiatric illness have a greater risk of heart-related problems and are at a greater risk of death than the general population. In our study patients with psychiatric illness were at excess risk of death relative to the rest of the study population, despite having been assessed by hospital physicians for chest pain. A hospitalisation for chest pain is a valuable opportunity to engage this difficult-to-reach population, assess cardiovascular risk and intervene to reduce risk.

"Our study highlights the need to carefully assess all patients who are admitted to hospital with chest pain and suggests that current approaches to this assessment may be less effective in patients with psychiatric illness. Further studies to understand why this is so, are required. We would urge clinicians to carefully assess cardiovascular risk in all patients with psychiatric illness, a view supported by a recent joint position statement issued by the European Psychiatric Association and European Society of Cardiology," [3], said Dr Gillies.

In an accompanying editorial [2], Bertram Pitt, Professor of Internal Medicine at the University of Michigan School of Medicine (Michigan, USA), wrote: "The initial episode of psychiatric hospitalization or possibly the diagnosis of psychiatric illness rather than the first episode of NCCP should be the time to consult a cardiologist, and the stimulus for intensive cardiac evaluation and risk factor control to prevent the development of coronary artery disease and its consequences."

He added: "While the exact mechanisms linking a prior psychiatric hospitalization and a first hospitalization for NCCP to increased cardiovascular and total mortality remain uncertain, we are indebted to Dr Gillies et al. for pointing out the increased cardiovascular risk and the need for cardiovascular evaluation of these patients. The increasing evidence that both vascular disease and psychiatric illnesses such as anxiety and depression share common mechanisms suggests challenges and opportunities for both the psychiatrist and the cardiologist to improve risk detection and to prevent cardiovascular and total mortality in patients with psychiatric illnesses both with and without NCCP. . . . This will, however, require a further understanding of the links between psychiatric illness and cardiovascular disease as well as prospective evaluation."

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. [1] "Prior psychiatric hospitalization is associated with excess mortality in patients hospitalized with non-cardiac chest pain: a data linkage study based on the full Scottish population (1991)". European Heart Journal. doi:10.1093/eurheartj/ehr401
[2] "Increased cardiovascular risk associated with non-cardiac chest pain in patients with a prior psychiatric hospitalization: an opportunity and challenge for both the psychiatrist and the cardiologist". European Heart Journal. doi:10.1093/eurheartj/ehr390
[3] "Cardiovascular disease and diabetes in people with severe mental illness position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC)". European Psychiatry (2009), doi:10.1016/j.eurpsy.2009.01.005
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posted by William Gipson on 4 Dec 2011 at 2:08 am

First Psychariatic Doctors tend to evaluate and sign you off on dosages of medicines which with any other pain management cause you to suffer and most likely place you in and under stress relief but adding to your being tired and sleepy majority of the time Then if it is not to late or you haven`t driven off the road or already had a accident they tell you to exercise and go out walking when your energy level is down and you haven`t completely understood what disease you are under and if or are you over medicated and why so many pills to take. I have been missed prognosed and evaluated to where I was almost dead or died temporary and now I have been told I have a diseased heart. With clearence for knee surery clearance and possible back l3-l4-l5 root damage with impingement at roots with diseased and narrowing of spine synosis etc. Will need evaluation for next alternative I may have, Miniscus tear and tendon tear on left knee. It has been two years with out treatment so why even do any repair because of the age and it has not been to bother some since I have taken Vitamine D 1000 Miligrams a day and small regiment of exercise etc.

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Gene Variation Predicts Rate Of Age-Related Decline In Mental Performance, Stanford Study

Main Category: Mental Health
Also Included In: Genetics;  Seniors / Aging
Article Date: 26 Oct 2011 - 0:00 PDT

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A tiny difference in the coding pattern of a single gene significantly affects the rate at which men's intellectual function drops with advancing age, investigators at the Stanford University School of Medicine and the Veterans Affairs Palo Alto Health Care System have learned.

In a study published online on Oct. 25 in Translational Psychiatry, the researchers tested the skills of experienced airplane pilots and found that having one version of the gene versus the other version doubled the rate at which the participants' performance declined over time.

The particular genetic variation, or polymorphism, implicated in the study has been linked in previous studies to several psychiatric disorders. But this is the first demonstration of its impact on skilled task performance in the healthy, aging brain, said the study's senior author, Ahmad Salehi, MD, PhD, clinical associate professor of psychiatry and behavioral sciences at Stanford.

The study also showed a significant age-related decline in the size of a key brain region called the hippocampus, which is crucial to memory and spatial reasoning, in pilots carrying this polymorphism.

"This gene-associated difference may apply not only to pilots but also to the general public, for example in the ability to operate complex machinery," said Salehi, who is also a health-science specialist at the VA-Palo Alto.

The gene in question codes for a well-studied protein called brain-derived neurotropic factor, or BDNF, which is critical to the development and maintenance of the central nervous system. BDNF levels decline gradually with age even in healthy individuals; researchers such as Salehi have suspected that this decline may be linked with age-related losses of mental function.

Genes, which are blueprints for proteins, are linear sequences of DNA composed of four different chemical units all connected like beads on a string. The most common version of the BDNF gene dictates that a particular building block for proteins, called valine, be present at a particular place on the protein. A less common - though far from rare - variation of the BDNF gene results in the substitution of another building block, methionine, in that same spot on the protein. That so-called "val/met" substitution occurs in about one in three Asians, roughly one in four Europeans and Americans, and about one in 200 sub-Saharan Africans. Such a change can affect a protein's shape, activity, level of production, or distribution within or secretion by cells in which it is made.

It appears that the alternative "met" version of BDNF doesn't work as well as the "val" version. This variant has been linked to higher likelihood of depression, stroke, anorexia nervosa, anxiety-related disorders, suicidal behavior and schizophrenia.

So Salehi and his colleagues decided to look at whether this polymorphism actually affected human cognitive function. To do this, they turned to an ongoing Stanford study of airplane pilots being conducted by two of the paper's co-authors - Joy Taylor, PhD, clinical associate professor of psychiatry and behavioral sciences, and Jerome Yesavage, MD, professor of psychiatry and behavioral sciences -examining a wide array of neurological and psychiatric questions.

For this new research, Salehi and his colleagues followed 144 pilots, all healthy Caucasian males over the age of 40, who showed up for three visits, spaced a year apart, spanning a two-year period. During each visit, participants - recreational pilots, certified flight instructors or civilian air-transport pilots - underwent an exam called the Standard Flight Simulator Score, a Federal Aviation Administration-approved flight simulator for pilots.

This test session employs a setup that simulates flying a small, single-engine aircraft. Each participant went through a half-dozen practice sessions and a three-week break before his first visit. Each annual visit consisted of morning and afternoon 75-minute "flights," during which pilots confronted flight scenarios with emergency situations, such as engine malfunctions and/or incoming air traffic. Resulting test scores pooled several variables, such as pilots' reaction times and their virtual planes' deviations from ideal altitudes, directions and speed. A pilot's score represented the overall skill with which he executed air-traffic control commands, avoided airborne traffic, detected engine emergencies and approached landing strips.

Blood and saliva samples collected on the pilots' first visits allowed the Stanford investigators to genotype all 144 pilots, of whom 55 (38.2 percent) turned out to have at least one copy of a BDNF gene that contained the "met" variant. In their analysis, the researchers also corrected for pilots' degree of experience and the presence of certain other confounding genetic influences.

Inevitably, performance dropped in both groups. But the rate of decline in the "met" group was much steeper.

"We saw a doubling of the rate of decline in performance on the exam among met carriers during the first two years of follow-up," said Salehi.

About one-third of the pilots also underwent at least one round of magnetic resonance imaging over the course of a few years, allowing the scientists to measure the size of their hippocampi. "Although we found no significant correlation between age and hippocampal size in the non-met carriers, we did detect a significant inverse relationship between age and hippocampal size in the met carriers," Salehi said.

Salehi cautioned that the research covered only two years and that the findings need to be confirmed by following participants over a multiyear period. This is now being done, he added.

No known drugs exist that mimic BDNF's action in the brain, but there is one well-established way to get around that: Stay active. "The one clearly established way to ensure increased BDNF levels in your brain is physical activity," Salehi said.

The National Institute of Aging and the U.S. Department of Veterans Affairs funded the study. First authorship was shared by Martha Millan Sanchez, MD, postdoctoral scholar in the Department of Psychiatry and Behavioral Sciences, and Devsmita Das, MD, a VA-Palo Alto visiting scholar. VA-Palo Alto health-science specialist Arthur Noda also was a co-author.

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

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Reducing The Treatment Gap For Mental, Neurological, And Substance Use Disorders

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

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In this week's PLoS Medicine, Shekhar Saxena of the WHO in Geneva, Switzerland and colleagues summarize the recent WHO Mental Health Gap Action Programme (mhGAP) intervention guide that provides evidence-based management recommendations for mental, neurological, and substance use (MNS) disorders.

This guide is aimed at reducing the treatment gap for MNS disorders, which is more than 75% in many low- and middle-income countries (LMICs). Further details and background material to the guide can be accessed on the WHO website: http://bit.ly/vKPSRF

The authors recommend that: "In the near future, further efforts should be made to introduce formal evaluations of the capability of [treatment] programs to induce relevant and persistent changes, and to generate useful insights on how implementation in [low- and middle-income countries] should be conducted to maximize benefit at sustainable costs."

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 PLoS Medicine Mental Health in Low- and Middle-Income Countries Collection, a seven-part series of articles published between October 2009 and February 2010, provides further information on mental, neurological, and substance-use disorders in LMICs.
Funding: Funding for the mhGAP Programme, under which the work reported in this manuscript was done, was provided by the following: American Psychiatric Foundation, USA; Association of Aichi Psychiatric Hospitals, Japan; Autism Speaks, USA; CBM; Government of Italy; Government of Japan; Government of The Netherlands; International Bureau for Epilepsy; International League Against Epilepsy; Medical Research Council, UK; National Institute of Mental Health, USA; Public Health Agency of Canada, Canada; Rockefeller Foundation, USA; Shirley Foundation, UK; Syngenta, Switzerland; United Nations Population Fund;World Psychiatric Association. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing Interests: JLA was paid in 2007 by Lundbeck S.A. for consultancy preparation of the research protocol for a study on the diagnostic delay in first episode of depression in contact with health care centers in Spain and was paid in 2009 by Sanofi Aventis S.A. for expert testimony on the side effects of veralapride. OO is the current President of the International Association for Child and Adolescent Psychiatry and Allied Professions (IACAPAP) (http://www.iacapap.org/). JWS served on scientific advisory boards for GlaxoSmithKline (2010), Eisai (2009), and UCB (2009); received funding for travel from UCB (2008) and Janssen (2009); serves on the editorial boards of Lancet Neurology, Epilepsia and Epileptic Disorders; served on the speaker's bureaus of UCB (2009) and GlaxoSmithKline (2009); and has received research support from UCB (grant finished 2010), Eisai (grant finished 2008), the NIH (ongoing grant), the EU FP7 (ongoing grant), the Wellcome Trust (grant finished 2009), WHO (ongoing grant), the National Epilepsy Funds of the Netherlands (ongoing grant), and the Epilepsy Society (ongoing grant). His current position is endowed by the National Society for Epilepsy (UK). SS confirms that the competing interests of JWS were declared, reviewed, and deemed acceptable by the mhGAP Guideline Development Group. All other authors have declared that no competing interests exist.
Citation: Dua T, Barbui C, Clark N, Fleischmann A, Poznyak V, et al. (2011) Evidence-Based Guidelines for Mental, Neurological, and Substance Use Disorders in Low- and Middle-Income Countries: Summary of WHO Recommendations. PLoS Med 8(11): e1001122. doi:10.1371/journal.pmed.1001122
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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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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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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.

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