Almost two years of pandemic lockdowns, re-openings, retreats from re-opening, and coronavirus variants — and another COVID-19 winter upon us — mental health challenges remain a hot topic.
Now that we’ve entered a new year, a bevy of stories already in the news cycle beg for follow-up coverage, including ones on the pros and cons of telemental health and, by extension, the future of video-conferenced and teleconferenced care.
During the pandemic, the federal Centers for Medicare and Medicaid issued waivers expanding patient access to their clinicians via Zoom, phone calls, etc. Some lauded that move, which is expected, on some level, to become permanent. Others say telehealth is far from the preferred avenue of care for everyone, including some patients with more severe diagnoses, including drug-resistant depression, bipolar disorder and schizophrenia.
Along with those looming questions and trends, there are emerging and resurfacing news topics for reporters to tackle. From that pool, here are the discussions to listen for and probe in 2022:
- There’s a renewed move afoot to change the term schizophrenia. Of 1,190 government officials, clinicians and members of the general public responding to this survey, published online in October 2021 and print in December 2021 in Schizophrenia Research, 74.1% said the term was stigmatizing; 71.4% wanted to change it to phrasing they contend might more accurately describe the symptoms of that disease. Among alternatives that those respondents preferred were “altered perception syndrome,” “psychosis spectrum syndrome” and “neuro-emotional integration disorder.” From the same journal, this 2015 paper assessed 41 previous studies, commentaries and such on whether to change the term. And this 2019 paper, “The debate about renaming schizophrenia: a new name would not resolve the stigma,” questioned whether a name change, which already exists in several Asian countries, would actually diminish stigma.
- There’s a longstanding debate over the prudence of letting internists, general practitioners and other non-psychiatrists prescribe medicines to treat mental illness. As that debate, that prescribing and a shortage of mental health clinicians continues nationwide, Emory University Hospital has launched an integrative health project where a psychiatrist oversees several primary care doctors who prescribe psychotropic medications and psychotherapists who provide counseling and do case management. “If we have a huge shortage [of psychiatrists],” said Brandon Kitay, M.D., Emory Healthcare’s director of behavioral health integration, “this is how we can scale my expertise without me having to actually see a hundred patients. Also, it’s a way of handling the overlay of psychiatric issues on diabetes” and an array of other chronic illnesses.
- With kids of color disproportionately numbered among juvenile offenders, an increasing focus of juvenile justice reformers is trauma-informed juvenile justice sentencing, including diverting youth to community-based programs. Among other services, those programs aim to provide trauma-informed mental health care. And like mental health care, generally, across the United States, there aren’t enough clinicians to serve those disproportionately poor youth. Avenues for Justice in New York City is among groups that have enlisted pro bono services of psychologists, psychiatrists, etc. Similar endeavors exist in other states and municipalities.
Also, the Treatment Advocacy Center issued its year-end list of top research on mental health in 2021, more fodder for your reporting.
The center cited, among other studies, a January 2021 analysis in JAMA revealing that people with schizophrenia who contracted COVID-19 were 2.7 times more likely to die from it than COVID patients in the general population.
The center also listed its April 2021 letter, published in Psychiatric Services, decrying what it argues is a decline in National Institute of Mental Health-funded clinical research on severe mental illness, including bipolar disorder and schizophrenia. Instead, center leaders wrote, 90% of NIMH funding recently has been going to basic research.
“Because NIMH’s primary purpose is to develop better treatments for current patients as well as future ones, the authors recommend that the ratio of basic to clinical research be readjusted to approximately 50:50,” the center wrote.
“Traditionally, the National Institute of Mental Health (NIMH) has maintained a relatively evenly divided research portfolio between basic research, for developing future treatments, and clinical research, for improving the treatment for individuals currently affected with mental illnesses.”