Publications on Mental Health Topics

When Teens Visit Doctors, Increasingly the Subject is Mental Health, by Matt Richtel, The New York Times, Mar 7 2024.

“Increasingly, doctor visits by adolescents and young adults involve mental health diagnoses, along with the prescription of psychiatric medications. That was the conclusion of a new study that found that in 2019, 17 percent of outpatient doctor visits for patients ages 13 to 24 in the United States involved a behavioral or mental health condition, including anxiety, depression, suicidal ideation, self-harm or other issues. That figure rose sharply from 2006, when just 9 percent of doctor’s visits involved psychiatric illnesses. The study, published Thursday in JAMA Network Open, also found a sharp increase in the proportion of visits involving psychiatric medications. In 2019, 22.4 percent of outpatient visits by the 13-24 age group involved the prescription of at least one psychiatric drug, up from 13 percent in 2006. The latest study does not posit a reason for the shift. But the pandemic alone was not to blame, it noted. “These findings suggest the increase in mental health conditions seen among youth during the pandemic occurred in the setting of already increasing rates of psychiatric illness,” wrote the authors, a pediatrician and psychiatrist at Harvard Medical School. “Treatment and prevention strategies will need to account for factors beyond the direct and indirect effects of the pandemic.” ”

One Twin Was Hurt, the Other Was Not. Their Adult Mental Health Diverged., by Ellen Barry, The New York Times, Mar 6 2024.

“Why do twins, who share so many genetic and environmental inputs, diverge as adults in their experience of mental illness? On Wednesday, a team of researchers from the University of Iceland and Karolinska Institutet in Sweden reported new findings on the role played by childhood trauma. Their study of 25,252 adult twins in Sweden, published in JAMA Psychiatry, found that those who reported one or more trauma in childhood — physical or emotional neglect or abuse, rape, sexual abuse, hate crimes or witnessing domestic violence — were 2.4 times as likely to be diagnosed with a psychiatric illness as those who did not. If a person reported one or more of these experiences, the odds of being diagnosed with a mental illness climbed sharply, by 52 percent for each additional adverse experience. Among participants who reported three or more adverse experiences, nearly a quarter had a psychiatric diagnosis of depressive disorder, anxiety disorder, substance abuse disorder or stress disorder. To disentangle the effects of these traumas from genetic or environmental factors, the researchers narrowed the pool to “discordant” pairs, in which only one twin reported maltreatment in childhood. An analysis of 6,852 twins from these discordant pairs found that childhood maltreatment was still linked with adult mental illness, though not as strongly as in the full cohort. A twin who reported maltreatment was 1.2 times as likely to suffer from a mental illness as the unaffected twin in identical twin pairs, and 1.7 times as likely in fraternal twin pairs. This effect was especially pronounced among subjects who reported experiencing sexual abuse, rape and physical neglect. ”

Maternal mental health conditions drive climbing death rate in US, research says, by Mira Cheng, CNN, Feb 23 2024.

“Maternal mental illness is the leading cause of pregnancy-related deaths in the US, according to a new evidence review, but national initiatives developed to combat the issue often fail to prioritize mental health. The maternal mortality rate in the US is two- to threefold greater than in other high-income countries, and it has only increased in recent years, according to the review, which was published Wednesday in the journal JAMA Psychiatry. More than 80% of pregnancy-related deaths in the US are preventable, the US Centers for Disease Control and Prevention says. The new review examined 30 recent studies and 15 historical references to highlight the underrecognized contribution of mental illness to maternal mortality. The researchers determined that mental health disorders such as suicide and opioid overdose are responsible for nearly 1 in 4 maternal deaths in the US. That’s almost double the rate of maternal death from postpartum hemorrhage, the second leading cause of pregnancy-related death, according to the reports from three dozen maternal morbidity and mortality review committees, state-based organizations that review maternal deaths. ”

A pandemic legacy: Majority of mental health appointments stay remote, by Linda Searing, The Washington Post, Feb 12 2024.

“More than half of mental health appointments — 55 percent — are being conducted remotely, mainly via videoconferencing rather than in-person visits, according to a brief research report in the journal Annals of Internal Medicine. Telemedicine, also known as telehealth, enables patients to obtain care via technology, most often a cellphone, video chat, computer or tablet. ”

Life in the Throes of Postpartum Depression, by Catherine Pearson, The New York Times, Jun 23 2023.

“The condition, which can arise at any point during the first year postpartum — and is distinct from the relatively short-lived “baby blues” most women experience soon after delivery — is now recognized as one of the most common complications of childbirth. It affects one in eight new moms, and mental health struggles are a leading cause of pregnancy-related death in the United States, primarily from suicide and drug overdose.  There are more treatment options for postpartum depression now than ever before, including the first medication designed specifically to treat it. But factors like stigma and inadequate screening keep many mothers from getting help. The Centers for Disease Control and Prevention estimates that about 20 percent of women were not asked about depression during a prenatal visit, and more than half of women with postpartum depression continue to go untreated. ”

All adults under 65 should be screened for anxiety, health panel says, by Erika Edwards, NBC News, Jun 20 2023.

“All young and middle-age adults should be screened regularly for anxiety and depression, even if they don't have symptoms, an influential public health group said Tuesday.  While the U.S. Preventive Services Task Force has recommended doctors assess patients for depression since 2002, it is the first time the group has advocated for routine screening of anxiety in adults. Pregnant women and those who gave birth within the past year were highlighted as people who should be screened.  "This is a call to action," Dr. Wanda Nicholson, vice chair of the task force and a professor of prevention and community health at the George Washington Milken Institute of Public Health in Washington, D.C., said in an interview. The guidance comes as emotional stress has skyrocketed in recent years, increasing demands on the limited number of counselors and therapists nationwide. ”

Suicide and homicide rates among young Americans increased sharply in last several years, CDC reports, CBS News, Jun 15 2023.

“Homicide and suicide rates among groups of young Americans have risen sharply in the last few years, new data from the Centers for Disease Control and Prevention shows, shining a light on the state of mental health and violence in the U.S. The study, which was published by the CDC on Thursday, gathered data over a 20-year period, from 2001 to 2021, on young Americans ages 10 to 24.  The report found a general upward trend in suicide and homicide rates in this age group, which were the second and third leading causes of death, respectively, in 2021. Experts believe the increases in both suicide and homicide rates are a result of several factors, including stress, social media, the COVID-19 pandemic, higher rates of depression, limited access to mental health services and increased access to guns. About 54% of gun-related deaths in 2021 were suicides, while 43% of gun-related deaths in the same year were homicides, according to data from the Pew Research Center. ”

People who are gay, lesbian or bi have more mental health and substance use problems, survey finds, by Jen Christensen, CNN, Jun 13 2023.

“Despite increasing acceptance of the LGBTQ+ community, at least in some circles, adults who identify as gay, lesbian or bisexual are more likely than those who identify as straight to have serious thoughts of suicide and mental health conditions including major depressive episodes, and they are more likely to misuse substances like alcohol or drugs, according to a new US government report. The report, published Tuesday, comes from the annual National Survey on Drug Use and Health, sponsored by the US Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration. It’s included a question about how the participant identifies their sexual orientation since 2015. The data in the report, which focuses on LGB adults, comes from 2021 and 2022. ”

An eating disorders chatbot offered dieting advice, raising fears about AI in health, by Kate Wells, NPR, Jun 9 2023.

“A few weeks ago, Sharon Maxwell heard the National Eating Disorders Association (NEDA) was shutting down its long-running national helpline and promoting a chatbot called Tessa as a "a meaningful prevention resource" for those struggling with eating disorders. She decided to try out the chatbot herself.  Maxwell, who is based in San Diego, had struggled for years with an eating disorder that began in childhood. She now works as a consultant in the eating disorder field. "Hi, Tessa," she typed into the online text box. "How do you support folks with eating disorders?"  Tessa rattled off a list of ideas, including some resources for "healthy eating habits." Alarm bells immediately went off in Maxwell's head. She asked Tessa for more details. Before long, the chatbot was giving her tips on losing weight - ones that sounded an awful lot like what she'd been told when she was put on Weight Watchers at age 10. "The recommendations that Tessa gave me was that I could lose 1 to 2 pounds per week, that I should eat no more than 2,000 calories in a day, that I should have a calorie deficit of 500-1,000 calories per day," Maxwell says. "All of which might sound benign to the general listener. However, to an individual with an eating disorder, the focus of weight loss really fuels the eating disorder." In October 2022, NEDA passed along screenshots from Monika Ostroff, executive director of the Multi-Service Eating Disorders Association (MEDA) in Massachusetts. They showed Tessa telling Ostroff to avoid "unhealthy" foods and only eat "healthy" snacks, like fruit. "It's really important that you find what healthy snacks you like the most, so if it's not a fruit, try something else!" Tessa told Ostroff. "So the next time you're hungry between meals, try to go for that instead of an unhealthy snack like a bag of chips. Think you can do that?" In a recent interview, Ostroff says this was a clear example of the chatbot encouraging "diet culture" mentality. "That meant that they [NEDA] either wrote these scripts themselves, they got the chatbot and didn't bother to make sure it was safe and didn't test it, or released it and didn't test it," she says. The healthy snack language was quickly removed after Ostroff reported it.  ”

Maternity’s Most Dangerous Time: After New Mothers Come Home, by Roni Caryn Rabin, The New York Times, May 28 2023.

“Most people think of labor and birth as the most dangerous part of pregnancy. But new scientific research is challenging this assumption, finding that substantial risks persist for a full year after birth itself. The deadliest time for mothers is actually after the baby is born. And for each woman who dies, an estimated 50 to 100 women experience severe complications that may leave them with lifelong health problems. The numbers are growing as more American women become heavier, and hypertension and diabetes become more common. More women are also postponing childbearing until later in life, so they are more likely to start pregnancy with chronic medical conditions that can lead to complications. The new figures come amid a troubling rise in deaths of pregnant women and new mothers in the United States, which has the highest maternal mortality rate in the industrialized world. The figures soared during the pandemic, to 32.9 deaths for every 100,000 live births in 2021, up from 20.1 per 100,000 in 2019. Rates for Black and Native American women are two to three times higher than those for white women. But those figures reflect a traditional definition of maternal mortality, deaths that occur during gestation or up to six weeks after birth. A fuller extent of the problem came to light in September, when the Centers for Disease Control and Prevention took a more expansive look at mothers’ deaths, analyzing them for a full year after childbirth and including deaths resulting from mental health conditions. The leading causes of maternal mortality among white and Hispanic women are mental health conditions that lead to suicide or fatal overdoses. Among Asian women, the leading cause is hemorrhage. ”

A lifetime of racism makes Alzheimer’s more common in Black Americans, by Kat Stafford, Associated Press, May 23 2023.

“Black people are more likely to develop Alzheimer’s than white people in the United States. They are less likely to be correctly diagnosed, and their families often struggle to get treatment from a medical system filled with bias against them. About 14% of Black people in America over the age of 65 have Alzheimer’s, compared with 10% of white people, according to the Centers for Disease Control and Prevention. The disparity is likely even more, because many Black people aren’t correctly diagnosed. And by 2060, cases are expected to increase fourfold among Black Americans. While some risk factors may differ by race, the large disparities among racial groups can’t be explained just by genetics. The problems start much earlier in life. Health conditions like heart disease and diabetes are known risk factors. Both are more common among Black populations, because of where they live in relation to polluting industries, lack of healthy food choices, and other factors. Depression, high blood pressure, obesity and chronic stress can also raise the likelihood of developing Alzheimer’s. So can poverty. Across the board, Black people don’t receive the same quality of health care throughout life as white people. So they don’t get high quality treatment — or any treatment — for all those conditions that are risk factors. Then, at the end, they’re less likely to get medication to ease the symptoms of Alzheimer’s and dementia-related disorders. And there’s the insidious impact of a life experiencing racism. Racism is trauma that can lead to increased stress, which can in turn cause health problems like inflammation, which is a risk factor for cognitive decline, said Dr. Carl V. Hill, of the Alzheimer’s Association. ”

Students are increasingly refusing to go to school. It’s becoming a mental health crisis., by Adrianna Rodriguez, USA Today, May 15 2023.

“School avoidant behavior, also called school refusal, is when a school-age child refuses to attend school or has difficulty being in school for the entire day. Several mental health experts told USA TODAY it has become a crisis that has gotten worse since the COVID-19 pandemic. "There's no book on this, it's not spoken about," said Demsky, whose son declined to be interviewed by USA TODAY but gave his mother permission to share their story. "It's very scary and parents feel a sense of helplessness." The two continued to struggle with school avoidance for four years with little guidance. In 2014, she created a website to offer families the help and support she couldn't find. The site eventually turned into the School Avoidance Alliance, which spreads awareness and educates learning facilities and families of school avoidant children.  School avoidance is not a concrete diagnosis and looks different in every child. Some students consistently miss a couple of days a week, while others may leave during the day or escape to the nurse or counselor’s office. In some extreme cases, students don't step foot in a school for months or years at a time. Half a dozen family members and students told USA TODAY that school avoidance has affected not only their mental health, often leading to anxiety and depression, but also their family dynamics, relationships with fellow students, and grades. It has threatened their prospects of graduation and a thriving future. ”

Does weed help with anxiety or cause it? Here’s what experts say., by Teddy Amenabar, The Washington Post, May 3 2023.

“Cannabis has different effects at lower doses than high doses. Generally, low doses of THC are well-tolerated, stimulating a release of dopamine, and higher doses of THC can cause people to feel anxious, said Peter Grinspoon, a primary care physician at Massachusetts General Hospital and the author of “Seeing Through The Smoke,” a book reviewing the latest medical research on cannabis.  “The main way you can get into mischief with cannabis is by using too high a dose and becoming very, very anxious,” said Grinspoon, who’s also an instructor at Harvard Medical School. “There are some patients who can’t use it at all, even a teeny bit, because any little bit makes them anxious.” Cannabis affects virtually every neural connection in the brain, even more so than stimulants such as cocaine and opioids, said Judy Grisel, a professor of psychology at Bucknell University and the author of “Never Enough: The Neuroscience and Experience of Addiction.” This, in turn, means cannabis can cause a wide array of reactions, depending on the person, she said.    Decades of clinical research has found THC can negatively effect the developing brain, and regular cannabis use in the teen years is associated with a higher likelihood of developing anxiety and depression later in life.  “Smoking early can catalyze anxiety and depression,” Grisel said. “It’s not exactly clear how that happens but the evidence for it is very strong.” ”

One-third of US teen girls seriously considered attempting suicide in 2021: CDC, by Mary Kekatos and Youri Benadjaoud, ABC News, Apr 27 2023.

“The number of teenage girls experiencing suicidal thoughts and behaviors increased during the second year of the pandemic, new federal data showed.  The percentage of high school female students who seriously considered attempting suicide rose from 24.1% to about one-third, or 30%, between 2019 and 2021, according to the latest results of the Youth Risk Behavior Survey, published Thursday by the Centers for Disease Control and Prevention.  The percentage of those who made a suicide plan increased from 19.9% to 23.6% and there was also an increase in suicide attempts from 11.0% to 13.3%, according to the CDC survey. ”

Kids’ Declining Mental Health Is the ‘Crisis of Our Time,’ Surgeon General Says, by Caitlynn Peetz , EducationWeek, Apr 25 2023.

“In a conversation with Vermont Sen. Bernie Sanders livestreamed on Twitter, Murthy called the increase in youth mental health needs “the defining public health crisis of our time,” and underscored that kids’ mental health has taken a hit as they turn to social media more often and at younger ages. The increased use has led to more feelings of isolation, stress, and inadequacy as they constantly compare themselves to others, he said. It also keeps kids awake well into the night when they should be getting much-needed rest and makes it harder for young people to focus.  The most recent results of the Centers for Disease Control and Prevention’s Youth Risk Behavior Survey showed an alarming increase of self-reported mental health challenges, most notably among girls and children who identify as LGBTQ+. The survey was conducted in 2021, when many schools were still in remote or hybrid learning, but illustrates how sharply children’s mental health needs have increased in recent years. In 2021, for example, 42 percent of high school students said they experienced persistent feelings of sadness or hopelessness during the past year, according to the report. This was a 13.5 percent increase from 2019 and a 50 percent increase from 2011. Nearly one in five high school students had seriously considered attempting suicide during the previous year, while 18 percent made a suicide plan, and 10 percent attempted suicide. The CDC’s report does not explore what is driving the increased challenges. The rates were higher among girls and students who identify as LGBTQ+. ”