Monday May 29, 2023

By Don Sapatkin

Good post-Memorial Day Tuesday morning! In today’s Daily: The L.A. Times sits in on a graduation for mentally ill offenders who got treatment instead of prison. Elon Musk’s brain chip implant company is a go for its first human clinical trial (!). Could teen mental health awareness campaigns be backfiring?

Plus, illicit ketamine seizures are increasing − and so is evidence of the anesthetic’s benefit for depression. And two new MindSite News Originals look at #DisabledJoy and the slow progress of 988 awareness campaigns.

Few People Know About the 988 Lifeline – and Many Who Do Fear Calling it Will Summon Police

Almost a year after the launch of the 988 Suicide and Crisis Lifeline, only 13% of U.S. residents know the line exists and what it’s for – and many of those who do know are afraid that calling it will summon the police. Read the full story here.

Revisiting #DisabledJoy Five Years Later: How a Hashtag of Pride Continues to Resonate

This festive hashtag has become the go-to place for disabled people to affirm and celebrate their lives – something that for many means tapping their creativity in music, writing and art. While mental health studies that include chronically ill and disabled subjects are limited, one small study found that cortisol levels decreased in most of the 39 subjects following 45 minutes of making art. Read the full story here.

Diverting mentally ill criminal offenders from prosecution to treatment in L.A.

The defendant talked about her struggle overcoming anger and accepting her need for mental health treatment. When she was done, the judge led the courtroom in applause, stepping down from the bench and posing with her for photos.

So begins a story in the Los Angeles Times about a county diversion program that is chipping away, albeit slowly, at the huge number of mentally ill offenders in jail. The story continues:

Five times that day, Judge Theresa R. McGonigle and two colleagues repeated that ritual, offering personal salutes to accused lawbreakers who had chosen to go through treatment for their mental illness rather than face prosecution.

Each one walked out free, having completed their court-ordered mental health program. Their charges were dismissed, criminal cases expunged from their records. They had just graduated the Rapid Diversion Program, an initiative of  LA County’s Criminal Court.

The program tries to spot candidates for mental health diversion as soon as possible after their arrest and shift them into community care without long stays in jail that often lead to further deterioration. In less than four years, Rapid Diversion has released more than 1,500 people from detention. So far, 350 have graduated.

FDA clears way for human trial of a brain implant from an Elon Musk company under investigation

In one of the more mysterious announcements we’ve seen in a while, the medical device company Neuralink, owned by Elon Musk, announced on Twitter (where else?) that it was “excited to share that we have received the FDA’s approval to launch our first-in-human clinical study!” The agency confirmed in a statement that it had “cleared Neuralink to use its brain implant and surgical robot for trials on patients,” Reuters reported. Twitter users had some fun with the announcement:

According to its website, Neuralink’s mission is to “create a generalized brain interface to restore autonomy to those with unmet medical needs today and unlock human potential tomorrow.” Musk co-founded the company six years ago with prominent neuroscientists. The trial isn’t listed on the comprehensive database, and Reuters said that neither the company nor Musk responded to its requests for comment.

Neuralink has been facing increasing federal scrutiny. Employees told Reuters last year that “the company was rushing and botching surgeries on monkeys, pigs and sheep, resulting in more animal deaths than necessary, as Musk pressured staff to receive FDA approval.” The news service reported earlier this month on potential financial conflicts involving members of a panel overseeing animal testing, prompting lawmakers to ask the U.S. Department of Agriculture to expand its ongoing investigation of Neuralink.

U.S. Department of Transportation investigators also are examining allegations of “unlawful transport of dangerous pathogens on chips removed from monkey brains without proper containment measures,” Reuters said, and the USDA’ Inspector General has opened an investigation into potential animal-welfare violations.

“What if we’re talking about teens’ mental health too much?”

That provocative headline topped an opinion piece in Stat by Lucy Foulkes, an  academic psychologist at the University of Oxford and author of “Losing Our Minds: The Challenge of Defining Mental Illness.” She was referring to awareness campaigns.

“From the data we have so far, these campaigns don’t seem to be resulting in more people actually getting help. At a population level, rates of mental health problems certainly aren’t decreasing; quite the opposite,” Foulkes wrote.

“It’s one thing if mental health awareness efforts are simply ineffective. But as an academic psychologist who researches mental health in teenagers in particular, I’ve started to ask a tricky question: What if these well-intentioned campaigns are actually contributing to the problem? What if the more we encourage people − especially young people − to talk about their mental health, the worse they end up feeling?”

She says this is only a hypothesis. But it’s an interesting one.

Illicit ketamine seizures rise sharply. And a study finds ketamine eases hard-to-treat depression

Ketamine usage for the treatment of mental health conditions has increased sharply in recent years, along with celebrity mentions. Another thing that has surged: Seizures of illicit supplies of the anesthetic that has been used in medicine for a half-century, the Washington Post reported.

Seizures by law enforcement increased nearly 350% from 2017 to 2022, according to a research letter in JAMA Psychiatry, and the total weight of ketamine seized was up more than 12-fold.

Meanwhile, encouraging news about ketamine’s effectiveness as a treatment for serious depression was published in another research article that same day, Stat reported. Because severely depressed patients who don’t respond to antidepressants are often given electroconvulsive therapy (ECT), the study compared ECT and ketamine head-to-head. The study, published in the New England Journal of Medicine, found that intravenous ketamine performed at least as well. The surprise findings contradicted three smaller studies that focused on patients who were arguably less sick.

The study was designed to see whether ketamine is “noninferior” to ECT and it findings suggest that it is: 55% of the 195 patients randomly assigned to ketamine infusions experienced an improvement in their symptoms, compared to 41% of the 170 who had ECT. Still, ketamine hasn’t been used for depression for very long and the risks of long-term use – possibly including addiction – aren’t clear. For individual patients, it would likely need to be weighed against the known risk of memory loss from ECT, according to Stat.

In other news…

American workers’ mental health fell sharply in just six months, according to a poll by The Conference Board that was covered by Yahoo! Finance. About 34% of the 1,100 workers surveyed in late February reported that their mental health was poorer than the half-year before, and that they felt overwhelmed and unable to take a break. Of those with declining mental health, 48% said they work 50 or more hours a week and 69% said that they are applying more effort than is expected at their job occasionally or consistently compared to six months ago, according to a press release from The Conference Board, a nonprofit think tank for business.

The FDA approved a new nasal spray for reversing opioid overdoses from fentanyl and other synthetic opioids, NPR reported. It will work similarly to naloxone, the drug in Narcan nasal spray, a version of which was recently approved for over-the-counter sale. Narcan reverses most overdoses involving fentanyl but sometimes requires two doses. Opvee, which was approved specifically for the highly potent synthetic opioids, contains nalmefene and its effects are stronger and more durable − which means that using it may trigger longer-lasting withdrawal symptoms. The manufacturer, Indivior, is aiming to make Opvee available by October but has not yet announced a price or agreements to supply treatment organizations and government agencies.

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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Type of work:

Don Sapatkin is an independent journalist who reports on science and health care. His primary focus for nearly two decades has been public health, especially policy, access to care, health disparities...