Social Work in the Public Eye (April 2013)

Barbara SmithThe Herald-Sun, in Durham, N.C., recently published a guest column by NASW member Barbara Smith titled Early intervention in youth mental health.

“Much too frequently in America, we bear witness to horrific shootings,” Smith wrote, adding that while it’s important to have stricter gun laws, the country also needs “a humane and effective mental health system that gives priority to young persons with emerging severe mental illness.”

Smith, a clinical assistant professor at the School of Social Work and the Department of Psychiatry at the University of North Carolina at Chapel Hill, has spent the last 20 years of her career working with schizophrenic patients. She states in the article that people she sees with this issue are a part of the human dynamic as a whole.

She says those with an emerging mental health issue are in distress and open to receiving treatment in a humane way, and early intervention can create better outcomes where schizophrenia is concerned. However, in the U.S. it’s almost impossible for young people with emerging severe mental health issues to get the help they need, Smith says.

“Over the past 30 years, our mental health system has suffered from fragmentation and underfunding,” Smith writes. “The resources we do have are sometimes misdirected. We have over-relied on medications hoping for the quick and simple cure for disorders that are complex.”

Smith says that people with mental illness — particularly schizophrenia and other psychotic disorders — often are viewed as monsters by their fellow citizens. This public perception of mental illness can affect what happens privately, she says, such as denial when a young person develops psychosis.

“We ignore it or call it something else,” she writes, adding that being in denial can delay treatment.

Smith offers suggestions on how to improve the U.S. mental health system:

  • Treat emerging psychosis like a true medical emergency
  • Make youth mental health a public health priority
  • Provide education to young people, their families, their teachers and their faith communities about early warning signs of mental illness and how to get help
  • Create specialized early intervention teams that can respond rapidly and humanely to persons with emerging severe mental illness
  • Strengthen the mental health workforce by developing training initiatives that focus on persons with severe mental illness
  • Broaden the dominant medical model to include psychological treatment, social interventions, psychiatric rehabilitation and peer support.
  • … Early intervention, easy access to care, the best treatment from a multidisciplinary team of professionals, shared decision-making and enough support to lead a meaningful life as a contributing member of the community. If we had those things in our mental health system, we would all be better off,” Smith says.

Joan ScullyAbout one in eight women are binge drinkers, according to an article in The Independent Florida Alligator. NASW member Joan Scully, a licensed clinical social worker and a substance abuse coordinator at the University of Florida Counseling & Wellness Center, says in the article that the first step to recognizing binge drinking as an illness is to lower the stigma that comes with addiction. Even though males are more known for binge drinking, women are catching up, the article says. About 14 million American women binge drink — which means having six or more drinks in one sitting and drinking three or more times a month.

For female binge drinkers, the chances of breast cancer, heart disease, sexually transmitted diseases and unintended pregnancy are higher, the article says.

“You can’t find that label on a bottle of vodka or a bottle of wine,” Scully says.

The Centers for Disease Control and Prevention released a statement cautioning that excessive drinking is a dangerous behavior that is under-recognized as a women’s health issue. Scully says binge drinking needs the same level of social awareness that cigarette smoking has.

Joan ScullyIn a recent article in The Topeka Capital-Journal in Kansas, NASW member Gayle Taylor discusses her skepticism about the way KanCare (the Medicaid program for the state of Kansas) handles patients with brain injuries.

The article says Kansas Gov. Sam Brownback had turned over the state’s $3.2 billion Medicaid program to United HealthCare, Sunflower State Health Plan and Amerigroup companies in January to operate a managed-care system that aims to save the state about $1 billion over five years. The system also is designed to improve care for 380,000 Kansans, the article says.

Taylor, who owns Therapy Services based in Burlington, Kan., says that as the transition took place earlier this year, she went to check on one of her Medicaid clients with traumatic brain injury to discover he had spent five days bleeding from an arm wound without having a grasp on where or how to get help.

“What I’m so afraid of is, without proper care, people are either going to end up dead, homeless, in jail or in a nursing home,” she says in the article. “They will lose their independence.”

Kari Bruffett, director of the division of health care finance at the Kansas Department of Health and Environment, says in the article that after assessing the situation with Taylor’s patient, she found that he was receiving all services he was entitled to.

Lt. Gov. Jeff Colyer says the state and federal governments will have to gradually resolve the inadequacies of Medicaid, because the system has been plagued with shortcomings for decades, the article says.

Charles IngogliaIn a recent article in The Connecticut Mirror, NASW member Charles Ingoglia expresses support for President Barack Obama after he announced an executive order to finalize the regulations of the 2008 mental health parity law in response to the shootings at Sandy Hook Elementary School in Newtown, Conn.

The article says that although the president’s announcement was perhaps not the most headline-grabbing, it meant a lot to people like Ingoglia, who is the senior vice president for public policy and practice improvement at the National Council for Community Behavioral Healthcare.

Ingoglia says in the article that the lack of a final regulation makes it hard to ensure that people get insurance coverage for mental health and addiction treatment. “We’re very thrilled that the president included this in his announcement,” Ingoglia says. “In a way, it’s long overdue.”

According to the American Psychological Association, the 2008 Mental Health Parity and Addiction Equity Act requires health insurance to cover both mental and physical health equally. APA says that under the law, insurance companies can no longer arbitrarily limit the number of hospital days or outpatient treatment sessions, or assign higher co-payments or deductibles for those in need of psychological services.