Tuesday, August 22, 2023

By Courtney Wise

Good morning, MindSite News readers. People used to shy away from mentioning cancer or AIDS in death notices. When those terms were used, it marked a turning point. Can the same now occur with suicide? Plus: New school year starts amid stimulant shortage. Offering treatment instead of jail in Miami. Anxiety mounts as Hollywood strike rolls on. And more.

Shortage of ADHD med’s causing worry as students start a new school year

For 11-year-old Madison Robinson, pretty much the only thing that slows down the racing in his brain – “from 100 miles per hour…to 70 miles per hour,” he told the New York Times – is Adderall. For decades, physicians have prescribed it, along with Ritalin, Concerta and other stimulants, to treat patients with ADHD. But now, kids like Robinson and people of all ages find they must often do without it, due to a nationwide shortage. Indeed, the shortage is so severe that the Drug Enforcement Administration and the Food and Drug Administration issued a joint public letter earlier this month explaining the challenge and asking drug makers to increase production. 

Many factors explain the current shortage, but interestingly, the DEA’s limit on the production of controlled substances including stimulants isn’t one of them. The joint FDA-DEA public letter notes that last year, amphetamine manufacturers made 1 billion fewer doses than they were allowed to – and didn’t meet production quotas in 2021 or 2020 either. According to the FDA’s online drug database, manufacturers offer the following reasons for the existing shortage: regulatory delay, shortage of active ingredient, increased demand, and ‘other.’ “The fact that there’s no information is just that much more frustrating,” said Michael Ganio, an expert in drug shortages at the American Society of Health-System Pharmacists.

At the same time, demand has surged. From 2012 to 2021, dispensing of prescribed stimulants increased by 46% in the U.S., according to the FDA-DEA letter. And in the first year of the pandemic, the number of people with prescriptions for stimulants rose 10%, the Times reported. Ilisa Bernstein, senior vice president at the American Pharmacists Association, says the $21 billion opioid settlement signed by three big pharma distributors and most states placed checks on distribution strategies. As a result, Bernstein said, “There is a higher level of scrutiny on all controlled-substance ordering by pharmacies. It’s created a perfect storm.”

Meanwhile, Madison Robinson’s mother has been trying to help him through by rationing his on-hand summer supply to save some for the start of classes. She’s also trying other strategies to help him regulate his behavior and emotions. “We try to manage with a couple of caffeine drinks during the day and soccer in the afternoons,” she said.

Sad sign of change: More obituaries list suicide as cause of death

After losing their 16-year-old daughter to suicide in November 2021, it didn’t occur to Deborah and Warren Blum not to be forthcoming about her cause of death. “Esther’s whole thing was that people should know and talk about mental health and it shouldn’t be a secret,” Deborah Blum told KFF Health News. “The least I could do was to be honest and tell people. I think being embarrassed just makes it worse.” 

The Blum’s decision might have sent shockwaves through their community a few years ago, but things are changing, said Dan Reidenberg of the National Council for Suicide Prevention. Suicides of high-profile celebrities, along with advertisements for depression and anxiety medications have make the conversation around suicide less of a taboo. “The stigma is changing,” Reidenberg said. “There is still some, but it’s less than it used to be, and that’s increasing people’s willingness to include it in an obituary.”

Some advocates have worried that news reports about someone taking their own life can act as a “suicide contagion” – and is a reason not to acknowledge suicide in death notices. But Reidenberg contends they can be phrsaed in a way that honors the deceased and avoids encouraging others to end their lives, while helping to ease the stigma attached to the act. “We don’t ever want to normalize suicide, but we don’t want to normalize that people can’t have a conversation about suicide,” Reidenberg said. “Being honest can lead to information and awareness, whereas if we keep it shrouded in this big mystery it doesn’t help.” 

Conversation is an important step in the grief process, said Holly Prigerson, a professor of sociology in medicine at Weill Cornell Medical College in New York and an expert in prolonged grief disorder. “Part of adjusting to the loss of someone is coming up with a story of what happened and why,” she said. If people can’t be honest, “that will complicate, if not impede, your ability to fully and accurately process your loss.”

Miami-Dade County Jail to open new treatment center as alternative to incarceration 

As in many large cities, Florida’s largest mental instituion is a jail: Miami-Dade County Jail. Soon though, some of its residents will have access to something different – a residential recovery center for people with mental illness. After 16 years of planning, the Miami Center for Mental Health and Recovery is expected to open within six months. “The illnesses are complex, but the solutions are not. We just have not offered them,” the center’s founder, Florida judge Steve Leifman, told CBS News. “It’s about relationships. It’s about helping people reconnect and once you are able to do that, it really helps them in their own recovery.” 

Leifman has long been an advocate for decriminalizing mental illness, which he sees as harmful to the individual – as well as expensive and ineffective. According to Liefman, the county now spends $232 million per year, or $636,000 per day, to house 2,400 people with mental illness.

Once open, the center will offer transitional housing, outpatient mental health support, primary care, job training and employment services, as well as  legal and social services. “We can gently reintegrate people with these very serious illnesses back to the community, in recovery and hook them up with the support they need to maintain their recovery,” Leifman said. “Plus they will have job skills and they’ll have reason to get up every morning.”

In other news…

“Anxiety. Anger. Frustration. As the WGA and SAG-AFTRA strikes roll on, folks in Hollywood are feeling it all.” So writes the Hollywood Reporter in a story about the toll the ongoing work stoppage is taking on writers, actors and other workers employed in Tinseltown’s cottage industry. Therapists interviewed by the Reporter say their patients are unsettled and triggered – but they urge people to use the time effectively and seek help where they need it. In a town often focused on individuality and hype, mental health professionals say people now need to pivot. “Be vulnerable with your support system,” says Beverly Hills psychologist Jeff Blume. “Let people know if you have a need, whether it’s financial or emotional.”

The Detroit Police Department recently expanded its unit of specially-trained police officers to respond to calls for mental health. Take a look at how they work with citizens and patrol the street, in this video from NBC News

Do seasonal allergies worsen mental health? Perhaps. Research suggests that people with seasonal allergies experience inflammation in the immune system, which, in turn, is linked to mood disorders. Plus dealing with an endless cough, congestion and watery nose is stressful just by itself. “If environmental allergy symptoms are making a person miserable every day, and they can’t stop sneezing and going through boxes of tissues, it inevitably impacts how one lives their life, how they sleep, how rested they are, being able to show up to work, being able to pay attention in school,” allergist and immunologist Farah Khan told US News and World Report

Kids who are physically assaulted are twice as likely to develop a mental illness as their peers – and three times as likely in the year immediately following the attack, according to a study in JAMA Network Open covered by The Washington Post. The study was based on health records of more than 27,000 children in Ontario, Canada. 

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:

Courtney Wise Randolph is a native Detroiter and freelance writer. She is the host of COVID Diaries: Stories of Resilience, a 2020 project between WDET and Documenting Detroit which won an Edward R. Murrow...