Monday, February 6, 2023

Happy Monday, MindSite News readers. Thanks to George Santos, pathological lying, long recognized but never elevated to the importance of a psychiatric diagnosis, is finally getting attention as a mental health disorder, CNN reports.

Getting our attention today: Therapists at a mental health startup vote to unionize. Memphis is struggling to cope with its latest trauma. Despite mixed evidence that marijuana helps with anxiety, the condition has come to dominate sanctioned cannabis use in Pennsylvania. And Miami prosecutors want to keep a schizophrenic homeless man in prison for 150 years for public possession of pornography.

Long-term exposure to even low levels of air pollution linked to depression and anxiety

Air pollution isn’t just bad for your physical health, according to a new study covered by the Washington Post, it’s also bad for your mental health. Researchers tracked exposure to four common pollutants caused by the burning of fossil fuels ­– particulate matter under 2.5 microns (PM2.5) plus nitrogen dioxide and nitric oxide – among 390,000 people for an average of 11 years. The findings, published in JAMA Psychiatry, showed depression diagnoses were 16% more likely and anxiety 11% more likely among people with the highest levels of exposure compared to those with the lowest levels.

Cybele Dey, a child and adolescent psychiatrist who serves as co-chair of Doctors for the Environment Australia, told the Post there has been “consistent evidence” linking air pollution to problems with learning, attention and focus among children. The effect on mental health can also be indirect, she said. Air pollution has been linked to lower birthweight, premature births, heart disease, lung disease, shorter life spans and other factors that could negatively impact a community’s mental health, she said.

How do we know depression and anxiety are increasing?

Via Twitter

There’s no shortage of reasons for the drumbeat of statistics that show our mental health getting worse: social media algorithms that keep us angry and distracted, the hyperactive 24/7 news cycle, overwork, isolation, climate change, racism and transphobia – you name it. But identifying the causes of a collective deterioration in mental health is different than understanding how we know mental health problems have increased, writes Laura Newberry, a Los Angeles Times reporter who is also earning a masters degree in social work, in her weekly Group Therapy newsletter.

Americans are increasingly open about it, with friends and with survey-takers whose data create the official estimates. (Perhaps the jump bears some resemblance to the dramatic increase in U.S. autism prevalence from 1 in 150 children in 2000 to 1 in 88 in 2008 and 1 in 44 today, a trend that experts now believe is substantially due to rising public awareness, new insurance mandates and other factors rather than a true increase in the disorder.)

“We know that reports of anxiety and depression are going up, and we suspect that some part of that is real, and some part of it is due to greater awareness and willingness to talk,” Harvard sociologist and mental health researcher Ronald Kessler told Newberry. But, really, he added: “Who cares?” Kessler said the pandemic made clear that lots of people are suffering from mental disorders and have been for years, often out of sight. The real crisis, he said, is the number of people who aren’t getting adequate care. “We know how to treat people,” he said, “but the great majority who need it aren’t getting help.” He sees a silver lining. The grim statistics are so grim and people are finally talking about mental health, she writes, there’s heightened pressure on state and federal governments to provide access to care, and hopefully to fund related research.

‘We are in trauma’: Memphis struggles to cope

Keedran Franklin, 36, runs a South Memphis food truck called “The Check-in.” The  community organizer and activist not only feeds people, he checks in on how residents of one of the poorest and most dangerous large American cities are faring, emotionally and spiritually. “It’s a combustion chamber of trauma — that’s what Memphis is,” he told the New York Times. “We push it down and push it down, until it explodes. That’s what happened with Tyre.”

Via Twitter

Last week’s funeral for Tyre Nichols, a 29-year-old FedEx employee who died from a beating inflicted by Memphis police officers, triggered a national moment of mourning. The incident took its place on a roster of events that have shaped the story of Memphis as much as its 20th-century musical innovations. Memphis has always had a front seat to the brutal consequences of slavery and organized racism, tangibly reflected in its 27% poverty rate for Black residents and the 1968 assassination of Dr. Martin Luther King Jr. on a balcony of the Lorraine Motel.

As an ice storm paralyzed much of the city heading into the weekend, Memphians seemed to be taking stock, amid their rage and grief, of how far they have come and how far they must still go. Many in the majority-Black city are fearful of both gun violence and of the police: The city of 630,000 people reported 302 homicides last year, compared with 433 in New York City, population 8.5 million. The fact that the first five officers charged in Nichols’s death were Black was painful for Black Memphis, the Times reported.

But it also underscored how well represented Black people are in Memphis government, with a Black police chief and Blacks holding an 8-5 majority on the City Council. Indeed, the image that modern-day Memphis often projects to the world is one in which Black genius, entrepreneurship and culture take center stage. Memphians, however, are also having a conversation about the extent to which their wounds are self-inflicted. Some say the city overemphasized building luxury housing and flashy amenities downtown at the expense of supporting poorer neighborhoods.

Right now, though, people are just trying to process the latest tragedy. “I think it is a perfect way to describe Memphis right now: We are in trauma,” said Otis Sanford, a longtime newspaper columnist and historian of Memphis.

Therapists at mental health startup vote to unionize

Photo: Shutterstock

In one of the first successful organizing efforts at a digital health company, social workers and mental health counselors at Resilience Lab, a New York-based startup that matches therapists with clients for virtual and in-person sessions, voted 79 to 13 to unionize last week, Forbes reported. Employees elected to be represented by District Council 37 AFSCME, a union that generally represents public sector employees. About 13% of the 1.3 million U.S. health care workers were members of unions in 2022, down half a percentage point from the year before.

The vote followed growing concerns among employees after the company fired 12 of its 200 therapists (and three administrative workers) last fall, gave them three days to transition 271 patients, changed the way the rest were paid, and placed increasing emphasis on technology and software, according to five current and former employees who spoke to Forbes. They said most of the terminated employees were people of color, queer or trans, and people with disabilities – despite the company’s claim to have the “largest and most diverse collective of New York-based therapists.”

Forbes said the company’s co-founders and top executives didn’t respond to multiple requests for comment.

How anxiety became Pennsylvania’s No. 1 qualifying condition for medical marijuana

Chronic pain used to be the overwhelming reason people in Pennsylvania were issued medical marijuana cards. But the state approved anxiety disorder as an eligible condition three years ago – despite limited evidence that cannabis is actually effective in treating it, according to an investigation by Spotlight PA, an independent nonprofit newsroom. Spotlight found that anxiety disorders were a factor in 60% of the program’s 385,000 medical marijuana certifications in 2021 – and the sole qualifying condition in 40%.  

Supporters of Pennsylvania’s decision say it has given patients another treatment option at a time when more people are suffering from anxiety. Still, a wide range of medical professionals told Spotlight PA that they were concerned about the medical marijuana certification process, and question whether most of the state’s 1,800 medical marijuana doctors thoroughly assess patients before certifying them and note that some patients schedule appointments through third-party certification companies that the state cannot regulate. Some of those companies have been alleged to tie physicians’ payments to medical marijuana approvals.

Medical marijuana physician Stephen Evans worries that some doctors and medical card companies aren’t doing enough “to try to screen out people who really don’t have anything wrong with them — they just want to use marijuana as a recreational drug.”

In other news…

Los Angeles County will offer virtual therapy for K-12 students, the LAist reported. The announcement followed by one week New York Mayor Eric Adams’s pledge to provide telehealth-based mental health services to high school students. Supported in part by state funds, the county Office of Education will partner with health insurers, the county’s mental health agency and school-based telehealth company Hazel Health to deliver mental health support via telehealth for all students, it said in a press release.

Florida prosecutors want to incarcerate for 150 years a homeless man with schizophrenia who was arrested for possessing pornography in public, the Miami Herald reported. The 32-year-old, whose severe mental illness went untreated for years, had visited a Best Buy in Miami-Dade County, declared “Look, I have child pornography!” and sat on the floor perusing it on his laptop. When he rejected prosecutors’ offer of a three-year sentence in return for a guilty plea, they added more charges and a judge sentenced him to a term 129 years longer than prosecutors recommended. Last week, they told a judge they want to keep that sentence in place.

CVS Health is expanding its new telehealth mental health care service to include appointments with licensed therapists and psychiatrists, Fierce Healthcare reported. The retail drugstore chain announced CVS Virtual Primary Care last spring to give consumers access to primary care, on-demand care, chronic condition management and mental health services.  

The mysterious day-long outage of the 988 national suicide hotline in December was caused by a cyberattack, federal officials told the Associated Press.

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...