Category Archives: Mental health

Homelessness may drive extended hospitalizations among people with severe mental illness

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.

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

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.

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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U.S. prepares to launch 3-digit mental health crisis hotline with a text option

About Kerry Dooley Young

Kerry Dooley Young (@kdooleyyoung) is AHCJ's core topic leader on patient safety. She has written extensively about the Food and Drug Administration, medical research, health policy and quality measurements. Her work has appeared in Medscape Medical News, Congressional Quarterly/CQ Roll Call and Bloomberg News.

A tweet from Miriam E. Delphin-Rittmon, Ph.D.

Federal officials and telecommunications companies have been working to meet a July 2022 deadline for a switch to a new three-digit hotline number for people experiencing mental health crises.

The new 988 dialing code will operate through the infrastructure of the existing National Suicide Prevention Lifeline, 800- 273-TALK. 

In covering the creation of the 988 code, journalists should consider the advice that a member of the Federal Communications Commission (FCC) gave in a 2020 statement. Michael O’Rielly warned against “giving a false promise to the public that 988 is already operational.”

Instead, it’s important to note how much effort establishing the 988 code will require. Deploying 988 “isn’t a matter of simply pulling a proverbial switch,” O’Rielly said. Instead, it will require telecommunications companies to replace, update, or otherwise alter their systems, as well as changes in dialing, he said.

“Even in the best of circumstances, such transitions can be challenging and lengthy, requiring consumer education, end user equipment upgrades by enterprise and government entities, and coordination with state public utility commissions, among other challenges,” O’Rielly said. “Acknowledging the work ahead doesn’t diminish the extensive work that’s been done to arrive at this point; it just reflects the reality of the transition.”  

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Researchers and organizations addressing prevention of gun suicides as they surge

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.

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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Managing reporter burnout during the pandemic

About Bara Vaida

Bara Vaida (@barav) is AHCJ's core topic leader on infectious diseases. An independent journalist, she has written extensively about health policy and infectious diseases. Her work has appeared in the National Journal, Agence France-Presse, Bloomberg News, McClatchy News Service, MSNBC, NPR, Politico, The Washington Post and other outlets.

Chelsea Cirruzzo

Since the beginning of the pandemic, almost every health reporter I’ve talked with has experienced both the professional thrill of writing about an unfolding science story and the personal feelings of fear, anxiety and grief about the virus. The energy that it takes to stay on top of this relentlessly evolving story and manage our own emotions has led to reporter burnout. For this “How I Did It,” one journalist, newer to the health care beat, shares how she’s been coping.

Chelsea Cirruzzo, a health and local news reporter for Axios, began utilizing social media in college to elevate her voice as a journalist. She used Twitter to help find sources and gained a following of almost 15,000. But as the pandemic has worn on, Cirruzzo has decided that for her own well-being, she needed to limit her activity on Twitter. Finding that boundary, among other decisions, is helping her manage burnout. 

You made reference on social media to burnout in covering the pandemic. I think a lot of journalists share this feeling. How did you manage these emotions while covering this story? 

I think it just kind of came in waves, where it was like, ‘Oh, no, this is really scary.’ And then, ‘Vaccines are coming! This is exciting.’ And then, you’re seeing that these same iterations of inequities [and people] who are not getting what they need just based on where they live, how old they are, and what race they are. The story [repeated] itself over and over again. But [at the same time], I think it’s so important and I wanted to do these stories. It was a lot to write about and a lot to handle. On top of that, we all had our own things going on. I live with a teacher, and I have health concerns and was worried about my family. So, it was tough.

In March of this year, I wrote about the challenges health reporters have faced during the pandemic for Nieman Reports and found out many of my colleagues had similar feelings of exhaustion and burnout. But also, some were dealing with challenges I haven’t faced: Some of them lost loved ones to COVID-19. Asian American reporters, not just health reporters, faced racist attacks because of anti-Asian rhetoric being pushed by the former president. It’s hard for health reporters to remove themselves from the story right now because the pandemic has hurt everyone, so how do you continuously cover something that has become so personal?

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