April 11, 2007

04-11-2007 Media Madness

Many things to link to today.

First, the New Yorks Times' Bob Herbert on a misbehaving six-year-old in Florida being carted off to jail by the police. The girl was having outbursts in class and in an office. She happens to be African-American. Very reminiscent of another case of a black girl who acted out in school and was arrested last year. Also an elementary school kid. This is bizarre and I'll say more about it tomorrow. (Via CL Psych.)

CL Psych also picks up on The Last Psychiatrist's recent post on atypicals replacing anti-depressants. Go the end of CL's post for a brief history of diagnoses and meds. I wrote about this last week. I continue to be fascinated by the unjustified emergence of atypicals for long-term use in mainstream culture. Mother's little helper. Psych Central has a slightly different take on The Last's posting.

Also, Psych Central has thoughts about the AstraZeneca sales manager being blunt about how sales reps should view doctors' offices.

An op-ed in the New York Times claiming that the mental health parity bill in Congress will discourage use of evidence-based treatments. Advocates for evidence-based treatments that have been shown to work. What evidence base would that be? Pharma-sponsored clinical trials? CATIE, STAR*D and STEP-BD? The corrupt Texas Medication Algorithm Project?

Pharmalot on Big Pharma's bad reputation with the public.

Man jumps off bridge in Seattle, knocks out power to neighborhood.

One of the Bipolar Chicks Blogging crew writes of a nasty bout of depression.

A blogger outs herself as having bipolar disorder. Welcome to the show.

A bipolar ditches as many meds as possible, including Cymbalta. I hope she's doing this under some form of doctor supervision.

Patient goes off meds. Will confess to doc today.

The Canadian government continues to go after the makers of True Hope. I don't know enough about Canada's drug laws to say much, but it strikes me that the True Hope people aren't saying anything more bizarre than Big Pharma does every day.

Guns in homes leads to higher rates of suicide. Apparently independent of a mental illness. Not sure I completely buy this. Will be used by anti-gun lobby.

Patient has one year of ups and downs on Cymbalta.

Posted by Philip Dawdy at April 11, 2007 11:50 AM
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Comments

She's a female with anger issues. Clearly, she's suffering from borderline personality disorder. There's no other explanation.

Posted by: Lisa at April 11, 2007 04:01 PM

Re Suicide link. Uh I'm kind of uncomfortable about the information given out there. If everyone knew the "success" rate it could increase the death rate when a suicider picks another method.

Posted by: Mark at April 11, 2007 04:07 PM

Re: True hope. Canada has been going after that for years. I know someone who has a teen son successfully using EmPower [basically same thing], which has very low mg. of Li in it. [like microdose].With therapy, a supportive family, and a doctor who is an out of box thinker--this young man was able to ditch psychiatric medications and though life is not perfect[what life is?] He is managing quite well on a basic vitamin mix.
In my opinion, the only reason EmPower or True Hope don't get the attention and positive comments is because doctors are medication based thinkers.
Unless a person goes to a naturopath or elsewhere, they will come out with an Rx for psych meds, which has a boatload of money backing it[duh].
Considering that this person's child is about my daughter's age, and they took the EmPower route, and I didn't...well I cannot speak for this mom, but she should be commended for being against mainstream medications these last 6 years. She's a Harvard graduate, and I am sure her son will be as well.
Just something to think about. I wonder what the CABF board thinks now "about her little experiment." Rock on.

Posted by: Stephany at April 11, 2007 07:10 PM

Back to this mental health parity thing. I've gone back and forth on this issue. But, the way things are now...I just can't support it. Before I would be willing to support mental health parity, there has to be some check on the bullshit that passes for treatment. Some therapy is okay (cognitive behavioral, etc) but some of it is just plain sick and weird. It's not just psychiatry that needs to clean up some problems, psychology and the other mental health professions have some work to do also. Insurance companies should not be expected to cover the get-in-touch-with-your-inner-child crap. The way things stand now as long as the professional has the credentials, e.g. PhD in psychology, insurance will usually cover some sessions of therapy no matter how sick or weird it is. The fact that this could go on indefinitely scares the bejesus out of me. At least if it's paid out of pocket, there's somewhat of a limit to it. My former therapist had the appropriate credentials. He also encouraged me to bring a stuffed animal to my therapy sessions. I'm an adult woman. That to me is incredibly sick and twisted, yet insurance covers his "therapy." Why?

Until there is some massive clean-up, then I can't support mental health parity. Get rid of the crackpots, then we'll talk.

Posted by: Lisa at April 11, 2007 08:44 PM

I don't have any money for out of pocket.


It's all on credit cards now, and most likely, unless I can pay a 20.00 co-pay; I'm shit outta luck. I take the free Pharma rep samples of Lamictal. go team.

Posted by: Stephany at April 11, 2007 10:24 PM

The school District threatened me with police pick up of my daughter; if I did not arrive within 7 minutes.
Lucky for them; I worked in a school kitchen and could drive with an apron.
[lucky for my daughter, and not for a friend's son who was arrested, hauled off, as his mother answered the school telephone as a secretary].
This is not so uncommon. Police haul was written into my daughter's IEP plan until I had it removed. Wake up people.

Posted by: Stephany at April 11, 2007 10:31 PM

Stephany, it's strange that Lamictal isn't covered but my stuffed animal therapy was. That's when you know things are seriously mixed up.

Posted by: Lisa at April 12, 2007 08:14 AM

Liz Spikol speaks about parity and comments on the lifetime cap of inpatient hospital days; which is exactly what ran out with my 19 year old. She has no insurance coverage left for that, and personally, I pay up front to my pdoc who will not bill insurance. Each month, between my daughter and I; I have to be able to pay 260.00. I use a credit card for it. My daughter is too young to have a lifetime cap on her insurance run out. She's only 19. What happens if she cracked and brain malformation isn't the reason she is ill? what if she is permanently psychotic? runs down a road one too many more times, and gets sent to live in the state hospital?
I found one therapist who said she would talk with me, and help sort things out, and she told me she would bill insurance for me, and she would be covered 100%. Why isnt everything else that way?
My daughter will have full coverage for brain MRI, etc. but not if she has mental illness. That is flat out discriminatory practices by insurance companies, and in my opinion, intolerable, and placing those in need of psych care at risk for not receiving the treatment if it is necessary.


Liz on parity.

Posted by: Stephany at April 12, 2007 10:00 AM

Stephany, I see your point. I guess my concern is that there be some check on what passes for treatment and on what will be covered. I know it's wishful thinking, but if this mental health parity thing passes they should have some definition for what qualifies as "therapy." My insurance company would cover anyone with the proper credentials but had no concern for what took place past that point. It didn't matter if it was cognitive behavioral therapy or primal/regressive therapy. It absolutely should matter. Insurance should not cover regressive therapy or dream work or a therapist's own special made-up therapy. If people want to pay out of pocket for that, okay. I also think there has to be some indication that treatment is actually helping the patient, not making them worse.

Posted by: Lisa at April 14, 2007 09:31 AM

Lisa, I think my head is clearing off of the Seroquel, because now I get your point you have been trying to make. You know I have a friend who has massages paid for by her insurance? the doc wrote out an rx for stress and insurance pays. Now that I could use. I find it interesting, that was under therapy and I forgot about that.

My main concern is one-sided worry, that my daughter may need a psych hospital again. She will end up in county [at least here]or shipped down to the state hospital. No insurance left for me to find her a place any one would want to reside.
Another comment about that: when she was being transported from Childrens to the state hospital I was in a major conference with the Chief of Staff asking him what other alternatives were there?[they were not going to sign a release to home, due to the 800mg.of Seroquel manic /psychosis she was having at the time]

This pdoc told me and my other daughter in a meeting:

"No where. Unless you had 500-600,000 $$ and then I'm not so sure the care would be any better. She would also be out of state."

I also wish I could have a 20.00 co-pay for the psychiatrist that prescribes the same medications that my PCP does for a co-pay.
I want co-pays and equal coverage for my mental health.

I really like your take on the mental health stuff Lisa, and being based on personal experience is the best. Thanks.

Posted by: Stephany at April 14, 2007 11:34 AM

Stephany, I don't think I'm probably the best person to give an opinion. I haven't chosen well. My first therapist lost his license. My former psychiatrist couldn't stay out of jail. His PA couldn't stay out of jail, either. There seems to be an abundant supply of crackpots in this field. I think if I had not encountered therapist # 3 I would have joined the anti-psychiatry group a long time ago. I certainly can identify with their anger. I know what the problems are in the mental health field, but I am a whole lot less clear on how to fix them.

When I think about your daughter and what she's going through it brings it all back. I know that pain. I know it well. Sadly, I think what the doctor told you is correct. I wasn't in a state hospital, but the walls were still gray. I remember watching a t.v. special about Jane Pauley's experience, and it showed her in a nice, bright sunny hospital room painting. I remember thinking, please don't kid the public. That's not the experience for most people who end up in a psych hospital.

Posted by: Lisa at April 14, 2007 07:09 PM

Lisa,
That is exactly why you are the best one to comment about this...because you could did not choose to have those doc/therapists end up being creeps. You went for help, like any one of us does, and found out the hard way. Lord have mercy, look at the pdoc that told my daughter no meds were needed; then loaded her up on 11 in 13 weeks at mega doses to boot. We are "supposed" to trust docs at face value, and unfortunately it is hard to find one we can trust.
I also find it offensive that places are portrayed in the media as warm, and nice therapeutic hospital settings [like Jane P.'s].I never would have ever believed psych wards could be so frightening, dirty, degrading and unhealing places, if I didn't see it for myself.
The only psych hospital I ever saw [5]in 2 states, that was in my opinion clean, and appeared like a hospital, had a sunny relaxing area for the patients: in Montana.

Posted by: Stephany at April 15, 2007 10:02 AM

11 drugs in 13 weeks. My god. That puts all my drug cocktails to shame. I can't even imagine that.

You're right, trust is that key component coupled with the fact that the people seeking help are vulnerable. You just sort of have to hope that they have integrity. Unfortunately, some don't.

Posted by: Lisa at April 15, 2007 11:12 PM

Thank you for the link... now that I know other people are reading, I will have to update more often :)

Posted by: Miette at April 22, 2007 03:09 PM

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