What We’re Reading
By Joy Burkhard, MBA
Founder and Executive Director, 2020 Mom
In this issue of What We’re Reading, I was struck by the articles that point to continued evidence of a growing mental health and maternal mental health problem, and by the articles which highlight the path to health care system transformation. 2020 Mom has identified policy and provider practice paths forward; it’s time for the field to double down on pilot-testing solutions like embedding peers in obstetric settings and passing needed policies. (Stay tuned to read my upcoming blog post on certified peer support specialists as the next addition to Ob/PCP workforce).
MATERNAL MORTALITY / SUICIDE
Missouri Maternal Mortality Review Shows Mental Health a Main Contributor to Pregnancy-Related Death
On Aug. 2, the Missouri Department of Health and Senior Services released its maternal mortality review for 2017 through 2019.
Suicides From Firearms Prompt Movement to Address Mental Health Stigmas
When it comes to gun deaths in America, suicide is still the leading cause. William Brangham recently traveled to Colorado and Wyoming, the state with the highest suicide rate, to look at a movement to change the conversation around mental health and firearms.
TREATMENTS
Deep Brain Stimulation to Brain Area Linked to Reward and Motivation Is Potential Therapy for Treatment-Resistant Depression
Deep brain stimulation (DBS) to the superolateral branch of the medial forebrain bundle (MFB), which is linked to reward and motivation, revealed metabolic brain changes over 12 months post-DBS implantation, making it a strong potential therapy for treatment-resistant depression according to researchers.
FDA OKs First Oral NMDA Receptor Antagonist for Depression
— Dextromethorphan-bupropion (Auvelity) tablets approved for MDD
Low Serotonin Might Not Cause Depression, but Why Do SSRIs Still Work?
Depression is a highly prevalent mental illness. Treatment options for depression are individualized and may include the use of medications and therapy.
Researchers have theorized that low serotonin levels cause depression.
Data from a recent systematic umbrella review found little evidence linking serotonin levels with depression.
Association of Everyday Discrimination With Depressive Symptoms and Suicidal Ideation During the COVID-19 Pandemic in the All of Us Research Program
People facing weekly discrimination -- particularly racial discrimination -- had 18-fold higher odds of moderate-to-severe depressive symptoms and 11-fold higher odds of suicidal ideation.
COVERAGE & ACCESS
US Uninsured Rate Hits Record Low of 8 Percent
The U.S. uninsured rate fell to a record low of 8 percent in the first quarter of 2022, according to a new report from the Biden administration.
President Biden touted the number on Tuesday, saying it showed the success of his efforts to build on the Affordable Care Act (ACA).
“This progress did not happen by accident,” Biden said in a statement. “More than 35 million Americans are enrolled in Affordable Care Act related coverage – the highest total on record.”
New Safeguards May Help Those Who Are Drowning in Medical Debt
Debra Smith of Spring Hill, Tenn., sorts through her medical bills in her living room in 2021. Patient advocates and some state governments say hospitals must do more to help patients deal with medical bills before the debt winds up in collections.
Mental Health Providers Need Better Incentives to Accept Insurance, Lawmakers Told
— Participants in Delaware roundtable also decry shortage of mental health professionals
The Financial Stress of Motherhood Led Her to Postpartum Depression
When Ament found out had her son back in 2016, she and her husband were overjoyed. But, because she had to return to work just three months after giving birth, life soon began to take its toll.
While juggling work and taking care of a baby, Ament became depressed, which led to her becoming suicidal.
Shifting from Structure to Process and Outcomes in Behavioral Health
The Donabedian model provides a helpful framework for understanding the components of delivering quality care. The model consists of three main components: Structure, Process, and Outcome. It has been widely applied in general healthcare since its inception in the 1960s, and efforts have been made to apply the model to behavioral health (e.g., NCQA, efforts with PCMH with distinction in behavioral health, HEDIS, etc.) but not very broadly or effectively.
Innovations in Telehealth in Behavioral Health During COVID-19
The COVID-19 pandemic exacerbated behavioral health needs in the United States, resulting in a swift and unexpected pivot to telehealth services for mental health and substance use services to fill gaps in care. Even now, providers continue to grapple with the implications.
What works? What isn’t working? What unexpected solutions have emerged? What barriers to quality care remain and how can we continue to reduce them?
Technology Can Bridge Gap Between Physical, Mental Health
Walk into any integrated health care facility and more likely than not there’s one reception area, floor, wing and staff for behavioral health and a separate location for primary care. That’s not integration. The dividing line is even starker at the information technology level. From the perspective of the electronic health record, a psychiatric patient may be an entirely different person to their primary care provider.
HEALTH SYSTEM TRANSFORMATION
Emerging Stronger from COVID-19: Priorities for Health System Transformation
The COVID-19 pandemic has presented death and devastation—but also an unprecedented opportunity to truly transform U.S. health, health care, and health delivery.
To capitalize on this opportunity, the National Academy of Medicine gathered field leaders from across all of the major health system sectors to assess how each sector has responded to the pandemic and the opportunities that exist for health system transformation. The opportunity is now to capitalize on the hard-won lessons of COVID-19 and build a health care system that centers patients, families, and communities; cares for clinicians; supports care systems, public health, and biomedical research to perform at the best of their abilities; applies innovations from digital health and quality, safety, and standards organizations; and encourages health care payers and health product manufacturers and innovators to produce products that benefit all.
SDoH
Social Determinants of Health Data Decoded
Papa released their new guide, "SDoH Data Decoded," to help health plans improve equity with supplemental social support
Four in 10 Americans Cut Spending to Cover Healthcare Costs
Rising healthcare costs have compelled nearly four in 10 Americans in the past six months to delay or skip healthcare treatments, trim regular household expenses or borrow money. That translates into an estimated 98 million adults having to take extraordinary steps to afford healthcare.
RELATED
Maternal Instinct Is a Myth That Men Created
Ms. Conaboy is a journalist specializing in health and the author of the forthcoming book “Mother Brain: How Neuroscience Is Rewriting the Story of Parenthood,” from which this essay has been adapted.
Anosognosia: A Big Word for a Surprising Condition
When she defined anosognosia to us, I had a revelation so powerful it practically knocked me out of my chair. The basic definition: A symptom experienced by those with serious mental illness (SMI) in which a person cannot recognize that they have a mental illness.
Post-Intensive Care Syndrome
In the August issue of Health Affairs, Narrative Matters author Joanna Bayes describes her experience with post-intensive care syndrome after an accident, which you can listen to on the Narrative Matters podcast.
Women Were Already Tired. Then 2022 Happened.
These women told CNN they have more to worry about than ever.
Hundreds responded telling us they have more to worry about than ever — and more than 3,500 reacted after Roe v. Wade was overturned. School shootings, inflation, work-life imbalance and the ongoing baby formula shortage are just a few of the themes they focused on.
Patients of Color Disproportionately Subjected to Involuntary Admission to Psychiatric Hospitals
A recent study reports that compared with White patients, Black patients had 1.57 times the odds of being admitted involuntarily, and patients who identified as other race or multiracial had 2.12 times the odds of being admitted involuntarily.
Why Tween Girls Especially Are Struggling So Much
The American Academy of Pediatrics recently declared a national emergency in child and adolescent mental health, as rates of depression, anxiety, self-harm and suicidal thoughts skyrocketed during the pandemic. What gets obscured when we lump all youths together, though, is that certain demographic groups are especially vulnerable to psychological problems and may disproportionately account for the overall trend. The belief has long been that middle school is the hardest period to get through, especially for girls, but a confluence of more recent societal and biological trends has led to a perfect storm for tween girls…in the middle-school years, girls become much more depressed and somewhat more anxious, and these differences persist into adulthood. What happens during this critical period to make girls especially vulnerable?
What Role Does Social Media Use Play in the Youth Mental Health Crisis? Researchers Are Trying to Find Out
Youth mental health is at a crisis point.
In December 2021, the U.S. Surgeon General issued an advisory on youth mental health. A few months later, the chief science officer at the American Psychological Association testified before a Senate committee that America’s youth mental health system was fundamentally flawed. Not only have symptoms of mood disorders, such as depression, increased in teens and children—but manifestations of those diseases, such as emergency room visits and suicides, have as well.
SUD
We're Approaching the Overdose Crisis All Wrong
— We need more support for treatment and harm reduction interventions proven to work.
In the shadow of the COVID-19 pandemic, the drug overdose crisis has reached new tragic heights. Between 1999 and 2019, nearly 841,000 people died from an overdose, and in 2021 we passed a grim milestone of more than 100,000 people dying from a drug overdose in a 1-year period. Each one of those deaths is someone's family member, friend, or neighbor. What makes these deaths all the more devastating is that no one should die from an overdose. We have years of evidence demonstrating which public health interventions keep people safe from an overdose, we have medical interventions like naloxone to reverse the effects of an overdose, and we have effective, lifesaving treatment for opioid use disorder.
Rahul Gupta: We Have a Public Health Crisis on Our Hands
In the first of a two-part interview with TreatmentMagazine.com, the director of the White House Office of National Drug Control Policy discusses the opioid epidemic, harm reduction and a range of other topics
“[W]e know that roughly half of people who suffer from substance use disorder have co-occurring mental health disorders, and vice versa. So it’s really important for us to first recognize that fact and then, secondly, make sure that we have systems and programs in place.”
COVID May Increase the Risk of Getting Some Brain Disorders.
What to know: People were more likely to have lasting brain fog, dementia, epilepsy and psychosis two years after a coronavirus infection, according to a large study published last week.
RESEARCH
Owning a Cat While Pregnant Increases the Risk of Postpartum Depression – But Owning a Dog Reduces Mental Health Problems, Study Claims
Research has found that pregnant cat owners are more likely to have depression
However, owning a dog reduces the risk of that and other mental health issues
Over 80,000 expectant mums did questionnaires before and after childbirth
The authors claim dogs' longer history of domestication may be significant
Information Needs and Sources of Information Among People With Depression and Anxiety: A Scoping Review
Previous studies have identified substantial unmet information needs in people with depression and anxiety. Sufficient information about the disorder, treatment, available services, and strategies for self-management is essential as it may influence quality of care and patients’ quality of life. This scoping review aimed to provide a broad overview of information needs of people with depression and anxiety as well as the sources that they use to seek this information.
Another Study IDs Moms at Highest Risk of Postpartum Depression
To get more women the care they need before symptoms develop, researchers have now identified the groups at the highest risk of postpartum depression.
Postpartum Depression Risk Higher With Family Psych History
Mothers who have a family history of any psychiatric disorder have almost two times the risk of postpartum depression as do mothers without such history, according to a new study.
Mette-Marie Zacher Kjeldsen, MSc, with the National Centre for Register-based Research at Aarhus (Denmark) University, led the study, a meta-analysis that included 26 studies with information on 100,877 women.
The Importance of Managing Psychiatric Disorders During Pregnancy and Postpartum
Treating women of reproductive age who have depression can be difficult. Here’s an overview on the subject from the 2022 Annual Psychiatric Times™ World CME Conference.
What Causes Depression? The Truth Is, We Still Don't Know
“Our comprehensive review of the major strands of research on serotonin shows there is no convincing evidence that depression is associated with, or caused by, lower serotonin concentrations or activity.”