Author Archives: Katti Gray

Katti Gray

About Katti Gray

Katti Gray (@kattigray) is AHCJ's core topic leader for behavioral and mental health. A former Rosalynn Carter Mental Health Journalism Fellow, Gray is providing resources to help AHCJ members expand their coverage of mental health amid ongoing efforts to de-stigmatize mental illness and to place mental health care on par with all health care.

Addressing “national emergency” in youth mental health

Photo by ketan pics via Flickr.

A pandemic-fueled surge in mental illness among children and teens, including some disorders driving youth violence and disruptions at school, has been the subject of several news headlines.

This October 2021 Washington Post article cited a string of assaults, including against school security officers, after schools reopened last fall to what educators and other experts say is an extraordinary level of mental distress among youth. (That same article cited National Association of School Resource Officers reports of 97 gun-related incidents in schools from August 1, 2020, to October 1, 2020; up from 29 such incidents during the same period in 2019.)

This June 2020 Voice of America article spotlighted a United Nations report about global spikes in online bullying, harassment and such during remote learning, and the anxiety, depression and other mental health disorders that those assaults triggered. (Conversely, this July 2021 paper, published by the Brown University Annenberg Institute for School Reform but not in a peer-reviewed journal, suggests that bullying and cyberbullying declined during COVID-19.)

The situation is so severe in the collective eyes of the American Academy of Pediatrics, American Academy of Child & Adolescent Psychiatry and Children’s Hospital Association that those organizations, in October 2021, jointly declared the worsening state of youth mental health a national emergency. They especially noted, among other realities, that “more than 140,000 children in the United States lost a primary and/or secondary caregiver, with youth of color disproportionately impacted.”

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Busting myths about people with mental illness and criminal activity

Photo by Ricky Shore via Flickr.

One of the most widespread misconceptions about people with mental illness is that they are more likely to commit crimes than people without mental illness. Several studies have shown that the opposite is true. Overall, most crimes are committed by people who have no mental illness diagnosis; and people with mental illness are more likely to be crime victims than perpetrators.

The misconceptions, policymakers, reformers and researchers in this sphere say, are at least partly driven by news headlines about crimes committed by those with mental illness, especially the severest diseases. Schizophrenia is one of those severe illnesses. And, indeed, those with schizophrenia and related psychotic disorders are the likeliest of all people with mental illness to commit crimes.

That latter reality is at the center of a recently published JAMA Psychiatry study, “Association of schizophrenia spectrum disorders and violence perpetration in adults and adolescents from 15 countries: A systematic review and meta-analysis.” It newly spotlights the complicated, complex problem of crimes perpetrated by mentally ill people, even as it cautions against stigmatizing mental illness.

Study authors contend that the psychiatric needs of people with mental illness at risk for committing crimes go unmet precisely because the medical, law enforcement, and patient advocacy sectors — and the general public — have not confronted the facts. And, they argue, that news coverage of, say, those guilty of mass shootings sometimes has overstated the role/potential role of mental illness in those crimes. 

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Homelessness may drive extended hospitalizations among people with severe mental illness

Photo by Michael Tefft via Flickr.

Recent years have seen an uptick in the nation’s count of homeless people, a population with a greater portion of people with mental illness than in the general population.

The Substance Abuse and Mental Health Services Administration’s still widely referred to 2011 estimate suggests that 26% of unsheltered persons had severe mental illness compared with roughly 5% of people with housing. And when the tally of homeless people with less debilitating mental disorders is added to that equation, the rate jumps as high as 45%.

Published online last fall in Psychiatric Services, a University of California, Los Angeles analysis concluded that homeless people in court-ordered in-patient psychiatric care wound up in psychiatric hospitals for months longer than other involuntarily admitted psychiatric patients.

Mental Health Conservatorship Among Homeless People With Serious Mental Illness,” an observational study, analyzed hospital administration data for 795 patients, 18 and older, admitted involuntarily to one Los Angeles safety-net hospital between 2016 and 2018. While involuntarily committed patients comprised 6% of the sample population, they accounted for 41% of inpatient days spent hospitalized.

In-patients without housing spent an average of 154.8 days involuntarily in the hospital, while in-patients with homes were hospitalized for an average of 25.6 days.

What’s more, researcher Kristin Choi, Ph.D., M.S., R.N., said, according to a Jan. 2 University of California, Los Angeles (UCLA) press release, “There are very few long-term housing options for people who are disabled by mental illness and in need of supportive housing in Los Angeles. When these individuals are stabilized and ready for a lower level of community-based care, there is no place for them to go.”

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Mental health topics to explore in 2022

Photo by Finn via Unsplash.

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.

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Researchers and organizations addressing prevention of gun suicides as they surge

Photo by Eduardo Vázquez’s via Unsplash.com.

Recent CDC data has revealed that roughly half of suicides nationwide are by firearms. Forty percent of respondents from a Pew Research Center June 2021 survey said they lived in a household that had guns; 30% said they owned a gun.

During a pandemic where a record number of Americans reported heightened suicidal ideation and other severe mental stress, those data are significant, at least in part, because gun sales have also surged during the past couple of years. 

A glance at research

Gun ownership heightens risks of suicide by firearm, a series of studies over the years have concluded. Among the largest and most recent of them is a Stanford University study published in June 2020 in the New England Journal of Medicine. It concluded that men who owned guns were eight times more likely to die than men who didn’t of a self-inflicted gunshot and that the rate of suicide by firearm among women who owned hand guns was 35 times the rate of women who didn’t. Tracking risks from day one of a gun purchase, the analysis examined 26 million Californians across 12 years ending in 2016.

A commentary by a Boston emergency room physician published in the JAMA Network Open cited a 59% increase in firearm suicides by teens between 2010 and 2019, outpacing a 29% spike in other forms of suicide during that period. Teen males used a firearm 51% of the time and teen females 25% of the time.

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