October 18, 2022

By Courtney Wise

Good morning, MindSite News readers. In today’s edition: Coming out about bipolar disorder to combat stigma. Follow-up care for youth lags after psychiatric discharges. Why federal mental health policy is so crucial. Plus: A Charleston-based organization to improve mental wellness in female veterans.

“Coming out” about bipolar disorder: Former Acting Surgeon General of California seeks to destigmatize mental illness 

via Twitter

Earlier this year, longtime pediatrician and California’s recent acting surgeon general Devika Bhushan showed considerable bravery: She shared her own bipolar diagnosis with the public to help destigmatize mental illness. Once fearful that revealing her bipolar disorder would derail her career, Bhushan told NPR that the disclosure instead gifted her with an entirely new community of people, many of whom loved her transparency. They told her that her revelation was “life-saving” and helped them feel “less alone, ashamed and hopeless” about their own mental health struggles. 

That was her biggest hope, Bhushan said. “The reason I chose to ‘come out’ had been precisely to reach those still finding their paths to recovery,” she told NPR “To help them know that there is a way forward. That a difficult diagnosis or a long period of struggle does not preclude living out their dreams — to hold out hope that with the right treatments, a full life is possible,” 

This year was an ideal time to speak out, Bhushan added, as the world adjusts to life with COVID after the pandemic. Data from the NIMH shows that more than one in five American adults lives with mental illness, and according to testimony from Bhushan’s medical colleagues, mental illness is highly stigmatized in the field—even among mental health professionals and even when well-controlled. “I daily hear people look down and shame those who have this disorder, even coworkers, people who I learn from in my clinical training,” wrote one mental health professional about why they’d kept their diagnosis hidden. Still, Bhushan is hopeful that her choice to speak out will help usher in a shift that ends mental health stigma and discrmimination, while achieving “lasting change in the limiting and incomplete ways many currently view those of us with mental illness.”

From Kennedy to Biden, federal policy lays the groundwork for the country’s mental health: Op-ed

We know certain things contribute to mental wellness, including friendship networks, regular sleep and exercise, and spending time  in nature. But Fletcher McClellan, a professor at Pennsylvania’s Elizabethtown College, wants us to remember that mental health policy contributes to mental health, too. In an op-ed for the Pennsylvania Capital-Star, McClellan suggests that solid groundwork for good mental health policy may have been laid out in the early 1960s, when then President John F. Kennedy signed the Community Mental Health Act (CMHA) into law. 

Imagined as an alternative to long term institutionalization, the CMHA was meant to enable patients to work and receive treatment at local centers while living at home. We don’t see the impact of that vision today, though—because less than half of the 1500 centers JFK projected were built, and many other state-supported mental health facilities are now closed. Partly as a result, significant numbers of people with serious mental illness are now unhoused or living within prison facilities.

“Mental health depends on healthy lifestyles, vigorous politics, and responsive policies,” wrote McClellan. He hailed a 1999 decision by the US Supreme Court that ruled unjustified segregation of mentally disabled persons unconstitutional and a move from the Obama Administration that began offering mental health clinics full reimbursement for providing care under Medicaid. But he said, it’s the Biden Administration’s new plan, announced earlier this year that’s offered the issue of mental health the most significant federal attention since President Jimmy Carter was in office.  

The new 988 crisis hotline is one part of Biden’s policy plan in action, as is the call for health insurers to cover mental health needs. In addition, the policy seeks to make funding for community mental health centers permanent, emphasizes a need for a pipeline of qualified mental health providers to avoid future severe shortages like the one we’re experiencing now, and spotlights children’s mental health, which has suffered from the pandemic and overexposure to social media. 

Follow-up care for youth lags after psychiatric discharges


An alarming number of youth fail to receive follow-up psychiatric care after visiting the emergency room for a mental health crisis, according to a recent study from researchers at the University of Massachusetts that was published in the journal Psychiatric Services. “For people, discharging folks after a psychiatric crisis, whether it be in a hospital or in an emergency room setting, connecting with their outpatient provider to ensure there is a transfer of care and some continuity is vitally important to reduce risk for this population,” study co-author Brian Skehan told US News & World Report

Only 29% of privately insured youth and young adults who visited an emergency room for a mental health reason received follow-up care within seven days, and just 46% were followed within 30 days, according to the study in Psychiatric Services. The equivalent statistics for people who were hospitalized for a major mental health disorder: 43% received follow-up care within seven days of discharge, rising to 67% in 30 days.

People who had harmed themselves, thought about suicide or attempted it were most ly to receive follow-up within 7 days. Follow-up rates were lower for those who had also had substance use disorders. Not surprisingly, the people most likely to get timely follow-up care had an established mental health care or primary care provider they’d seen during the previous six months. 

Authors of the study, which was based on the records of nearly 200,000 patients aged 12 to 27, dryly concluded that follow-up rates were “suboptimal.” They recommended better integration of primary and mental health care and urged ER staff to give special attention to young patients who also used drugs or showed signs of self-harm or suicidal tendencies. The lack of follow-up care after a serious psychiatric emergency “is extremely worrisome and calls for increased investment in mental health and further study to understand its causes,” Lisa Dixon, the editor of the journal, said in a press release. – Don Sapatkin

In other news…

South Carolina’s WCBD highlighed the nonprofit group She’s the Veteran, a Charleston-based organization that works to help women veterans improve their mental wellness and perspective on what it is to be a woman and a military vet through social and nature-based activities. “They’re often not given a break,” said founder Brooke Jackson Khan. “So when they come back from either deployment or some of these mobilizations, they’re just thrust back into the same things they were doing prior to doing that. They’re not given the mental health break of checking in with themselves to see what they’ve experienced, kind of processing, versus men when they come back, they’re given their space.”

Mental health in the developing world, headlines edition: Reversing the suicide and mental health crisis in Africa (IOL/Independent Online, South Africa) … Suicide is not an option (World Health Organization regional office for Africa, Republic of Congo…Years of war cause explosion of mental illness in Yemen (TRT World, Turkey)… Israel still keeps mentally-ill young Palestinian in solitary confinement (MEMO/Middle East Monitor, United Kingdom). – Don Sapatkin

Hobby Rx for mental health: Physician and author Ken Duckworth told Yahoo News that after conducting 130 interviews of people with mental health conditions for his new book, he found that hobbies are a good way to keep calm and manage one’s mental health. “Engaging in activities, particularly ones that help you feel connected to something—a mission, community, a belief system—are really valuable for people’s mental health overall,” Duckworth said.

Benjamin Cole, an Oklahoma prisoner with severe mental illness, may be put to death. Eyes are turned toward Oklahoma this week as Benjamin Cole, a prisoner on death row, awaits execution on October 20. Though Cole’s crime is a terrible one—he murdered his young daughter—law professor Andrea Digilio Miller argues in a guest column for The Oklahoman that he should not be put to death. Why? Cole lives with a mental illness so severe, it’s unlikely he even has an understanding of why he’s been sentenced to die. However, the Oklahoma State Penitentiary’s warden has refused to order a competency evaluation, saying that a state-funded doctor already determined Cole “to be perfectly fine.”

If you or someone you know is in crisis or experiencing suicidal thoughts, call or text 988 to reach the 988 Suicide & Crisis Lifeline and connect in English or Spanish. If you’re a veteran press 1. If you’re deaf or hard of hearing dial 711, then 988. Services are free and available 24/7.

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Courtney Wise

Courtney Wise Randolph is a writer and creative based in Detroit, Michigan.