December 9, 2021

Good morning, MindSite News readers. The US Surgeon General has released a sobering report on the crisis in youth mental health. A British health agency says therapy should come before medication when treating people for depression. And a soaring mental health start-up adds to its valuation.

Surgeon General warns of youth mental health crisis

US Surgeon General Vivek H Murthy visiting the Montefiore addiction treatment center in New York in 2016. Photo: a katz, Shutterstock

The COVID-19 pandemic has worsened an already grave mental health crisis among youth, US Surgeon General Vivek H. Murthy said as he released a report yesterday calling for urgent action on what he called a “moral obligation.” The pandemic triggered “alarming increases” in mental health conditions for young people, Murthy wrote, citing data from the Centers for Disease Control and Prevention that, in 2019, one in three high school students experienced sadness or hopelessness so severe they couldn’t participate in regular activities, a 40% increase since 2009.

“Mental health challenges in children, adolescents, and young adults are real, and they are widespread,” Murthy wrote in an introduction to the report. “But most importantly, they are treatable, and often preventable.” (You can read the rest of our news story here – and read the full text of Murthy’s introduction here in the Guest Essays section of MindSite News.)

UK healthcare agency’s new guidelines call for therapy before depression medication 

Medication should not be the first go-to treatment for people suffering mild depression – at least according to new preliminary guidelines issued by the United Kingdom’s National Institute for Health and Care Excellence. In its first new guidelines in a dozen years for depression in adults, it recommends instead that health care providers advise adult patients with “less severe depression” to exercise, go to therapy, and learn mindfulness and meditation, according to an article in The Guardian. 

For “more severe depression,” the guidelines advise combining medication, if necessary, with alternative approaches. The draft recommendations override current guidelines that recommend antidepressant medication to people suffering mild symptoms of depression. Approximately 20 million antidepressants in the UK were prescribed from October to December of 2020, 6% more than in the same period of 2019, according to the National Health Service. 

Digital mental health start-up Cerebral now worth $4.8 billion 

The mental health startup Cerebral Inc. pulled in $300 million in a new round of equity funding to push its valuation to $4.8 billion, according to a story in Bloomberg News. On paper, that makes them one of the highest value companies in the digital mental health space. Cerebral  recently announced gymnast Simone Biles, an investor, as its chief impact officer and very public face of the company. Biles famously opened up about her own mental health challenges when she pulled out of most events at the summer Olympics in Tokyo and the company clearly hopes that her story will draw attention and customers. “Her story resonates with tens of millions of Americans,” Cerebral CEO Kyle Robertson told Bloomberg.

Robertson says the startup, launched at the beginning of 2020, has built a culturally competent workforce with half of its 2,300 clinicians identifying as people of color. Wait times for seeing a therapist on its “instant live” sessions with clinicians have dropped to a little over 5 minutes from 23 minutes earlier this year. The company, which has served more than 200,000 clients, offers medication and therapy for depression and other disorders and plans to offer treatment for schizophrenia in 2022.  

Health care analyst pinpoints gaps and solutions in Minnesota’s mental health workforce

Substance use is a burning problem in Minnesota’s rural areas but there is an extreme shortage of people trained to help, including licensed alcohol and drug counselors (LADCs). “When you get to the frontier areas of the state or even the small towns, there is only one LADC for every 13,576 people,” Lance Egley, staff development coordinator at Red Lake Nation Tribal Chemical Health Program, told MinnPost. That statistic was drawn from research by Teri Fritsma, the lead health care workforce analyst with the Minnesota Department of Health. 

Why such a shortage? Fritsma found that tuition costs and students forced alcohol and drug counselors to leave the area after graduation or retrain for jobs with better earnings. The state legislature recently adopted her proposed solution: In exchange for student loan forgiveness, LADCs will be asked to serve for a minimum of three years in a rural area and will receive annual awards of more than $9,000 for their work. For her work examining mental health workforce gaps, the Minnesota’s National Alliance for the Mentally Ill gave Fritsma a public service award. “My hope is that this will move the needle and fundamentally change the dialogue – maybe even the way we compensate mental health providers,” she said in her acceptance speech. “Obviously NAMI has always known this, but perhaps it’s taking a global pandemic for the rest of us to realize that without mental health, there isn’t health.”

California passes new law to ease aid-in-dying for terminally ill

Kaiser Health News columnist Bernard Wolfson recalls the wrenching pain his wife endured in 2003 as a breast cancer recurrence slowly but surely drained her life away. Although his wife elected to stay alive as long as possible for their two young children, he found himself back in that dark time while writing about a revision to the End-of LIfe Option Act, signed into law in October by California Governor Gavin Newsom. The revision makes it easier to choose to die, eliminating some of the hoops in the previous legislation. 

Before, someone who wanted to end their life and had six months or less to live – as determined by medical providers – was required to make two verbal requests to take lethal medication 15 days apart and then sign a written confirmation 48 hours before taking the medication. The new law will reduce the waiting period to two days and no longer requires a final written note. The provisions in the original law were intended to protect the dying from coercive family members who regard their care as a burden or who were seeking “a potential financial bonanza,” Wolfson wrote. But some of those provisions were so strict they prevented terminally ill people from taking advantage of the law.

Wolfson advises talking early about such wishes with doctors. In his wife’s final days, he recalls, “She would often sink into a semiconscious state, far out of our reach for days on end. Then, just when we thought she wasn’t coming back, she would suddenly open her eyes and ask for the children. She’d get into her wheelchair and join us at the dinner table.” His kids, he said, treasured those moments. “Though I’ll never know for sure,” he says, “I suspect Leslie would not have wanted to foreclose on such moments.”

If you or anyone you know is considering suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255. And if you’re a veteran, press 1.

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