November 2, 2021

Hello MindSite News readers. In today’s newsletter you’ll read about the life of Dr. Aaron Beck, who as a young trailblazer in psychiatry took the discipline in a different direction from Sigmund Freud. Beck, who died Monday, was the father of cognitive behavior therapy. And speaking of therapy, California Gov. Gavin Newsom just signed into law a bill that will help remedy what the San Diego city attorney called “ghost networks” of mental health therapists. You’ll also read the maddening story of how our mental health system failed a 29-year-old Latino man with schizophrenia who has been bounced back and forth between detention in Immigration and Customs Enforcement detention and prison for more than a decade.

Military suicides keep climbing – especially at high-profile bases

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Nine military bases in the United States were plagued by suicides in the double digits in 2020, prompting members of Congress to initiate an independent panel to review the military’s suicide prevention programs, according to an article in USA Today. Five hundred eighty troops died by suicide in 2020, compared to 504 the previous year – an uptick of 15%. “Every loss of one of our brave service members or members of our military families is a tragedy that demands the attention of leaders,” said Representative Jackie Speier, D-Calif., who chairs the personnel subcommittee of the Armed Services Committee. “I expect base commanders to take action to improve suicide prevention efforts.” Fort Bragg and Camp Lejeune, both in North Carolina, saw 21 suicides. The Pentagon, which released the figures, said that both bases have large populations, with 38,000 soldiers at Lejeune and 50,000 at Fort Bragg. But even some smaller bases, such as Joint Base Langley-Eustis, had suicides on par with the larger ones, Speier noted. The joint base also reported a high incidence of sexual assaults, she added, which indicated to her that leadership was lacking.

Cognitive Therapy Founder Aaron Beck Dies at 100

Dr. Aaron Beck shifted the focus of therapy from exploring the roots of adult depression to challenging patients’ “inner critic” that held patients back from a more fulfilling life. The father of cognitive behavioral therapy (CBT), Beck died on Monday at the age of 100. In the late 1950s, he began encouraging his patients to contest their distorted beliefs about themselves that would give rise to despair, self-criticism and self-destructive behavior to compensate for perceived shortcomings. If, for example, patients drank heavily to compensate for a belief they were socially inept, he’d encourage them to test their assumption by attending a party without drinking alcohol to see what happened. His research showed that over time his patients could gather evidence to disprove their negative assumptions and become more positive about themselves, which would substantially improve their mood. Along with the work of psychologist Albert Ellis, PhD, Beck’s research led to the framework for CBT, which researchers have adapted to treat patients with such challenges as panic attacks, insomnia, obsessive compulsive disorder and addiction. His work continues through his influence and through the training efforts of the Beck Institute for Cognitive Behavioral Therapy, which he founded with his daughter, psychiatrist Dr. Judith Beck. Steven Hollon, a psychologist at Vanderbilt University, said of Aaron Beck: “He basically saved psychotherapy from itself.”

Man diagnosed with schizophrenia trapped in ICE custody

Marlon Campos-Osuna, 29, had big dreams of becoming famous as a 13-year-old, when he and his family relocated to Phoenix, Arizona from Sonora, Mexico. He played the bass drum in his school marching band and idolized an uncle who was a rock musician, his mother Claudia Osuna said. But instead, Campos-Osuna, an undocumented immigrant, began experiencing mental health problems, which led to his arrest. At 19, while in Immigration and Customs Enforcement custody, Campos-Osuna was diagnosed with schizophrenia and bipolar disorder, according to an article in the Arizona Republic. He has spent the last decade being shuttled back and forth between immigration and criminal courts, as his mother tried and failed to get him mental health support. A year ago, Campos-Osuna was transferred from an immigration detention center in Eloy, Arizona, to La Palma Correctional Center, where he allegedly assaulted a worker. A judge ruled in early August 2021 that Campos-Osuna was incompetent to stand trial but “restorable,” – giving corrections officials 21 months to provide psychiatric treatment and medication and get him to a state where he can participate in his own defense. If he’s still declared incompetent, he could be transferred back to ICE detention, where it’s anyone’s guess what will happen next.

New California Law Requires Timely Mental Health Follow-up Appointments

Few things are more frustrating – or disruptive of healing – than finally getting an appointment to see a therapist and then having to wait weeks for a second visit. Now a new law, SB 221, that goes into effect next July in California, will require that patients with substance use and mental health problems receive follow-up therapy appointments no more than 10 days after their initial session, according to a column in Kaiser Health News. The legislation, sponsored by the National Union of Health Care Workers, stems from a $4 million fine that state regulators levied against Kaiser Permanente in 2013 for not providing timely mental health care. Kaiser Permanente had subcontracted services out to other mental health providers, but patients found it hard to find anyone who would take new patients. Mara Elliott, San Diego’s city attorney, sued Kaiser Permanente in June for what it called “ghost networks” of therapists, along with Molina Healthcare and Health Net. Kaiser Permanente’s Dr. Yener Balan, who heads behavioral health and specialty services for Kaiser Permanente Northern California, agreed the health plan could do better, but maintained that it meets its own follow-up appointment recommendations 84% of the time.

New Mexico Program Aims to Divert Addicts to Treatment Instead of Jail

A new program in Hobbs, New Mexico, is working to circumvent the problem of repeatedly arresting people for drug use. “We have to shift our resources from the things that we think are important like arresting a person to treating the person,” said Ibukun Adepoju, a public defender for New Mexico’s Fifth and Ninth Judicial Districts. Otherwise, she told US News & World Report, “we have not solved anything at all.” The Law Enforcement Assisted Diversion Program (LEAD) will offer a harm reduction approach to those who are eligible for it, offering them counseling and a peer mentor. To be eligible, a person must be 18 years old, want to participate, possess less than six grams of a substance, and not be suspected of dealing drugs. Will the program work? Hobbs Police Chief John Ortolano is apparently a believer. “In policing, for decades and decades, we have tried to arrest our way out of problems. Unfortunately, a lot of the problems with addiction are mental health problems. There is a whole lot of misconceptions about programs like these and (people) think it’s soft on crime… It is the exact opposite.”

In the US, if you or anyone you know is considering suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255.

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Laurie Udesky reports on mental health, social welfare, health equity and public policy issues from her home in the San Francisco Bay Area.