April 18, 2022

Happy Monday, MindSite News Daily readers! Today we explore how to find a mental health app that (may) actually work for you, explore the world of tranq — the ominous likely successor to street fentanyl – and, in case you missed it in our Research Roundup, we take a look at how efforts to boost schoolkids’ mental health are being undermined by another culture war in the states. And that was before a federal panel last week recommended that all children be screened for anxiety, starting at age 8. 


A sham “grassroots” campaign targets mental health in education

Image credit: TikTok

A growing culture war is brewing over what kids are taught in public schools, and this time the focus is mental health and social-emotional learning (SEL), a decades-old and until recently non-controversial approach based on the idea that kids learn and do best when they feel safe, valued and connected. Beginning in 2021, SEL has been under attack from conservative and libertarian groups, Dr David Tuller wrote in a deeply reported piece for MindSite News last week.

The president of an organization named Purple for Parents Indiana, for example, reportedly claimed that teaching grammar school students about emotions and acceptance of LGBTQ children prepares kids for sex trafficking. A group called the Idaho Freedom Foundation excoriated that state’s education department’s SEL efforts as a stealth campaign “to hide a vehicle for critical race theory from the public.” Groups in other states are seeking to ban books associated with SEL and/or discussions of racism and sexism.

Educators are stunned. “Depression, alcohol, suicide – those things know no boundaries, and no demographic when it comes to affecting our kids,” Sherri Ybarra, Idaho’s Republican superintendent of public instruction, told a virtual symposium on school safety. “We will not tolerate being shamed or scared off of a program that prevents kids from dying.”

Tuller, a senior fellow in public health and journalism at UC Berkeley’s Center for Global Public Health, noted in his article that some conservative media reports gave the impression of parents rising up en masse to protest suicide prevention programs and social-emotional learning. In fact, he found that other, more powerful forces are driving the scattered protests, and they are anything but grassroots. Well-funded conservative organizations such as Parents Defending Education and the far-right Moms for Liberty are behind the movement, he learned. Their goals, according to some experts, are to undermine public schools and to drive conservative voters to the polls in the mid-term elections.

A recent Axios story about the SEL protests also pointed out that most states are moving in the opposite direction, strengthening mental health care in communities and schools, with at least 22 red and blue states enacting laws that support children’s mental health.

Some readers responded to the MindSite News article with stories of their own:

Image credit: Twitter


Is there a mental health app that could work for you?

With an estimated 10,000 mental health apps on the pandemic-fueled market, dubious “guides to the best” mobile apps appear almost daily. So we were excited to read a well-researched, comprehensive and appropriately skeptical New York Times review of the evidence.

“These are not stand-alone treatments,” explained Stephanie Collier, director of education in the geriatric psychiatry division at Harvard-affiliated McLean Hospital. “They can be effective when used in tandem with therapy.” They work best when people have mild illness and are motivated, Collier told the Times. “People with moderate or severe depression may not have sufficient motivation because of their illness to complete modules on a mobile app.” The vast majority of mental health apps are unregulated, and they are not covered by federal privacy laws; one study found that 29 of the 36 top-ranked apps for depression and smoking cessation shared user data to Facebook or Google.

Image credit: Shutterstock

Diana Kapp took a broad look at the field for MindSite News last fall, especially the big money behind the explosion in mental health apps. The Times focused on how to find an app that might work for you. The article says that Mind Apps, a website created by clinicians at Beth Israel Lahey Health in Massachusetts, has reviewed more than 600 apps and is updated every six months. It considers a range of factors such as cost, security and privacy concerns and whether the app is supported by research. Another site, One Mind PsyberGuide, which is affiliated with the University of California, Irvine, evaluates health apps annually for credibility, user experience and transparency of privacy practices. It reviews each of the more than 200 apps in its database annually. And if you’re looking for a mental health app, Collier and other experts have several recommendations.

Have you ever heard of tranq? You will

3-D rendition of xylazine’s molecular chemical structure Credit: Shutterstock

When illicit fentanyl first appeared on the streets in the mid-2000s, it was hard to imagine anything worse than an addictive drug that was 50 times stronger than the heroin it was occasionally used to cut. Now fentanyl is by far the nation’s No. 1 killer street drug — and the newcomer is much, much worse, the Philadelphia Inquirer reports in a story about xylazine, a drug that is well-known to law enforcement but still flying under the public radar.

Tranq, as it is known on the street, is a powerful veterinary tranquilizer. It’s not an opioid, so the emergency overdose reversal medication naloxone doesn’t work. It’s not a “scheduled” drug, so it’s perfectly legal and easy for dealers to buy. And it causes  horrific skin ulceration, leading in some cases to lost limbs. Both the Philadelphia Medical Examiner’s Office and the local division of the Drug Enforcement Administration have unusually robust overdose fatality tracking, which may explain why the rising threat of fentanyl was identified early in the city, which at the time was one of a small number of jurisdictions to test overdose victims for the drug. Now it is in the minority of places to screen for xylazine. A recent study in Drug and Alcohol Dependence found an increase over five years in xylazine-related deaths in 10 locations around the country but none more so than in Philadelphia, where the drug was detected in a quarter of overdose victims in 2020.

Longtime heroin users complained for years that fentanyl was less satisfying than their drug of choice. These days, heroin is hard to find, largely replaced with fentanyl, which increasingly is cut by xylazine and is known as tranq dope.  “Some users report that mixing xylazine with fentanyl makes the effects more similar to heroin than fentanyl. It gives you the nod a little more,” Patrick J. Trainor, a DEA special agent and public information officer for the Philadelphia division, told MindSite News. He recalled a woman whose arm had to be amputated due to tranq-caused necrotic wounds. “It’s bad. It is really, really bad.”  

Panel recommends anxiety screening for all kids 8 and over

Darren Baker/Shutterstock

All children ages 8 to 18 should be screened for anxiety and for depression starting at age 12, an influential government panel reported in a draft recommendation covered by the Miami Herald. If finalized after public comment, it would be the first time that the U.S. Preventive Services Task Force has called for screening kids that young for anxiety disorders. The panel said that children and teens who screen positive need additional evaluation to determine if they have anxiety or depression and should work with their parents or guardians and health care professionals to determine the best treatments. 

In other news … 

Frustrated night owls may function better when allowed to work – and sleep – on their own schedule, Kaiser Health News reports, citing researchers who looked at work-from-home habits during the pandemic.

Magic mushrooms, aka psilocybin, are now legal in Canada for terminally ill cancer patients to ease anxiety about death, although they must be administered in health care settings, according to SurvivorNet, a website that brings medical news to cancer patients.

Relatively small amounts of physical activity can significantly lower symptoms of depression, according to a HealthDay story in U.S. News & World Report about a JAMA Psychiatry meta-analysis of 15 prospective studies that found 4.4 hours of activity per week was associated with an 18% reduction in depression and 8.8. hours a week was linked to a 25 percent reduction. MindSite News’s Tom Insel has recently explored how, exactly, exercise might relieve depression.

How to practice “trauma-informed journalism” – understanding how trauma works, how an interview might affect someone who is traumatized and how to protect your own mental health when immersed in a victim’s traumatic past – is laid out in detail for reporters and editors by the Journalist’s Resource, a joint project of the Harvard Kennedy School and the Shorenstein Center on Media, Politics and Public Policy.

If you or anyone you know is considering suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255. And if you’re a veteran, press 1.

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Don Sapatkin

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...