Category: Mental Health

Therapists and other behavioral health care providers cut hours, reduced staffs and turned away patients during the pandemic as more Americans experienced depression symptoms and drug overdoses, according to a new report from the Government Accountability Office.

The report on patient access to behavioral health care during the covid-19 crisis also casts doubt on whether insurers are abiding by federal law requiring parity in insurance coverage, which forbids health plans from passing along more of the bill for mental health care to patients than they would for medical or surgical care.

The GAO’s findings are “the tip of the iceberg” in how Americans with mental, emotional and substance use disorders are treated differently than those with physical conditions, said JoAnn Volk, a research professor at Georgetown University’s Center on Health Insurance Reforms who studies mental health coverage.

The GAO report, shared before publication exclusively with KHN, paints a picture of an already strained behavioral health system struggling after the pandemic struck to meet the treatment needs of millions of Americans with conditions like alcohol use disorder and post-traumatic stress disorder.

Up to 4 in 10 adults on average reported anxiety or depression symptoms during the pandemic, the report showed, compared with about 1 in 10 adults in early 2019.

During the first seven months of the pandemic, there were 36% more emergency room visits for drug overdoses, and 26% more visits for suicide attempts, compared with the same period in 2019.

As the need grew, already spotty access to treatment dwindled, the GAO found: A survey of members of the National Council for Behavioral Health, an organization that represents treatment providers, showed 27% reported they laid off employees during the pandemic; 35% reduced hours; and 45% said they closed programs.

Worker shortages have long been an obstacle to accessing behavioral health services, which experts attribute in large part to problems with how providers are paid. Last fall the federal government estimated that more than one-third of Americans live in an area without enough providers available.

Provider groups interviewed by GAO investigators acknowledged staff shortages and some delays in getting patients into treatment. They noted that the pandemic forced them to cut outpatient services and limit inpatient options. They also told the researchers that payment issues are a significant problem that predated the pandemic. In particular, the GAO said, most groups cited problems getting reimbursed by Medicaid more often than any other payer.

Sen. Ron Wyden (D-Ore.), who chairs the Senate Finance Committee, requested the report from GAO after hearing complaints that constituents’ insurance claims for behavioral health care were being denied.

In an interview, Wyden said he plans to embark on a “long-running project” as chairman to make care “easier to find, more affordable, with fewer people falling between the cracks.”

Spurred by how the pandemic has intensified the system’s existing problems, Wyden identified four “essential” targets for lawmakers: denied claims and other billing issues; the workforce shortage; racial inequality; and the effectiveness of existing federal law requiring coverage parity.

For Wyden, the issue is personal: The senator’s late brother had schizophrenia. “Part of this is making sure that vulnerable Americans know that somebody is on their side,” he said.

State and federal officials rely heavily on people’s complaints about delayed or denied insurance claims to alert them to potential violations of federal law. The report cited state officials who said they “routinely” uncover violations, yet they lack the data to understand how widespread the problems may be.

Congress passed legislation in December that requires that health plans provide government officials with internal analyses of their coverage for mental and physical health services upon request.

Part of the problem is that people often do not complain when their insurer refuses to pay for treatment, said Volk, who has been working with state officials on the issue. She advised that anyone who is denied a claim for behavioral care should appeal it to their insurer and report it to their state’s insurance or labor department.

Another obstacle: Shame and fear are often associated with being treated for a mental health disorder, as well as a belief among some patients that inequitable treatment is just the way the system works. “Something goes wrong, and they just expect that’s the way it’s supposed to be,” Volk said.

The GAO report noted other ways the pandemic limited access to care, including how public health guidelines encouraging physical distancing had forced some treatment facilities to cut the number of beds available.

On a positive note, the GAO also reported widespread approval for telehealth among stakeholders like state officials, providers and insurers, who told government investigators that the increased payments and use of virtual appointments had made it easier for patients to access care.

This story was produced by KHN (Kaiser Health News), a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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Addiction Recovery Bulletin

The COVID-19 pandemic has accelerated digital innovation around the globe – including spurring on a revolution in telemedicine.

Digital rehab start-up Workit Health, which offers group meetings and one-on-one counselling in the comfort of people’s homes, now helps 10,000 people through its recovery platform – and it could be the key to tackling another epidemic afflicting the US: opioids.

Between March and May 2020, the introduction of lockdown measures in the US coincided with a record rise in drug overdose deaths, with synthetic opioids the main driver, according to the Centers for Disease Control and Prevention.

Prior to the pandemic, there were barriers to receiving treatment. Your first appointment had to be in person, there was a disincentive for providing telehealth services, as doctors were paid little, and a patient could only receive a week’s supply of medication.

 

 

The post Digital Rehab is Helping Tackle America’s Opioid Crisis appeared first on Addiction/Recovery eBulletin.

Karen Butcher’s son Matthew struggled for years with an addiction to opioids. She’s convinced the pandemic made it worse.

The restaurant in Scott County, Ky., where Matthew worked as a bartender closed before the pandemic, and soon other establishments, from restaurants to stores, followed suit as states imposed lockdowns.

“One day you’re a bartender and you’re serving people and having a great time at it, and then the next day the doors are closed,” Butcher recalls. “Then COVID hits. It was the perfect storm.”

Butcher says her son was increasingly isolated, just at a time when his unemployment checks were starting to come in.

“He was lonely. He was depressed. He didn’t have a reason any more to get up and keep going,” she said. “And then, all this money flows in because of unemployment. So you’re isolated, you have lots of money, and your coping skill has always been drug use.”

Matthew died of a drug overdose, alone in his apartment, last May.

Ordinarily, a spike in unemployment doesn’t lead to a spike in overdose deaths. People who aren’t working often don’t have the money to buy drugs.

But University of Chicago economist Casey Mulligan says the COVID-19 recession is unusual. Federal relief payments put more money in people’s pockets last spring, just as many of the usual ways to spend it were closed off.

“Vacations or eating out or anything group oriented — going to a sports game, concerts, bars. And that kind of left the sort of things that you do by yourself,” Mulligan said. “Taking opioids is something that people can do by themselves.”

Mulligan, who was a White House economist in the Trump administration, argued in a recent working paper that increased isolation during the pandemic may have contributed to rising “deaths of despair” — that is, suicides, alcohol-related deaths and especially drug overdoses.

It’s an argument the Trump administration often made against government stay-at-home orders, though Mulligan admits the pandemic itself may be isolating. His paper suggests that “deaths of despair” may have increased during the pandemic.

“It’s not a happy time when you’re not with other people. Most people are social,” Mulligan said in an interview. “And the pandemic has been anti-social. Whether it’s voluntary quarantine or mandatory is a separate question. People have definitely been alone more.”

And a person who accidentally overdoses alone may be at greater risk of dying, since there’s no one else around to call for help, or administer life-saving medicine like naloxone.

The Centers for Disease Control and Prevention warned last month that the pandemic may have contributed to a rise in deadly drug overdoses.

But Princeton economist Anne Case, who co-authored a book on deaths of despair, is wary of putting too much blame on the pandemic. She notes that overdose deaths were already climbing sharply the year before the coronavirus took hold. Case suspects a bigger problem is the nationwide spread of fentanyl, a powerful synthetic opioid.

“There’s this horribly dangerous, deadly drug on the market that is responsible for this explosion of drug overdoses,” Case said.

Fentanyl used to be rare west of the Mississippi, but it’s now found throughout the country.

Chris Permoda overdosed on fentanyl in Arizona last July, just over a month after his mother drove him home from prison.

“When they found him, they found one needle out the package,” Mary Permoda recalled. “So that was the first time he had used since he got out. And he died — first dose.”

While the powerful opioid was the direct cause of her son’s death, Mary Permoda has no doubt that the pandemic was also a factor.

“Absolutely,” she said. “Oh my God, absolutely.”

Permoda says her son tried desperately to find an in-person support group last year, even suggesting he might start his own meeting in a parking lot, if necessary. Zoom counseling and online support groups just weren’t working for him.

“He craved being part of a group that understood what he was going through, in person. And it just couldn’t happen,” Permoda said. “So yes, I believe it impacted it greatly.”

Both Mary Permoda and Karen Butcher have found their own comfort and support through a group called Parents of Addicted Loved Ones, or PAL. Butcher said for her, it’s been a lifeline.

“Everybody needs a group of people who are walking a similar path,” she said. “We laugh, we cry, we pray, we learn. And we become a family who learns it’s a common language.”

Permoda says this family — united by their loved ones’ addiction — is growing all too quickly.

“This is an epidemic second to coronavirus, I’m here to tell you,” she said.

Drug overdoses, suicides and alcohol-related deaths killed 165,000 Americans in 2019. Princeton’s Case warns that while vaccines will eventually provide relief from the deadly coronavirus, finding a way to prevent these deaths may be even harder.

“Once COVID is in the rear-view mirror, we still have a lot of work to do to try to bring down the numbers of people who are dying annually in the U.S. from suicide, drug overdose, and from alcohol,” Case said.

This article was originally posted on NPR.com

Addiction Recovery Bulletin

Just weeks after working out for 24-hours solid and raising montye for Children in Need, Joe Wicks, AKA The Body Coach, shares his thoughts on movement for mental health benefits, parenthood and how meditation helps to quiet his always busy brain, on Happiful’s podcast.  On top of his mammoth televised workout and keeping the nation moving throughout 2020, Joe has written and now released a new book 30 Day Kick Start Plan. The emphasis, he shares, is slightly different from his earlier work, as he wants to drive home the mental health benefits of movement.

“It used to be all about the physical transformations for me. I’d talk about ‘lean in 15’, fat loss, getting lean and burning body fat. With my new book, I talk about the mental health benefits of exercise. I’ve realised over the years, that people mention those benefits more than the physical; sleeping better, having more energy, feeling happier, less stressed and being more patient with the kids.

“These are the things I really want to promote now,” Joe continues. Although Joe shares that he’s exhausted from a year that has seen him constantly on the move, he’s both upbeat and looking forward to the future when he speaks to Happiful. “I’m 35 years old and I really feel like I’ve only just started at what I could achieve in my lifetime.”

Joe speaks with an openness and honesty that may be harder to find in someone else who has reached his level of success and public accolade. He’s always keen to emphasise that there’s no shortcut to achieving your goals. “My work has been a ten-year ‘overnight success’, I always talk about that,” Joe shares. “I worked so hard as a personal trainer in the early days with my boot camp, and nobody would turn up but I didn’t give up. I believed in myself. “The same thing happened with YouTube, when I first posted, nobody was watching and nobody subscribed. All of these things take such a long time but if you’ve followed me from who I was on day one to who I am today, I’m exactly the same Joe. I have the same passion and the same enthusiasm. I’m just a little bit older!”

Read the complete article at Happiful.com

Addiction Recovery Bulletin

Laughing your way to sobriety –

ooking back on the darkest moments of your life isn’t something most people enjoy doing. For the folks behind recovery meme accounts, though, it’s the source of some of their funniest jokes — and the inspiration some people need to start getting clean.

There are a number of ways to recover from the trauma of substance use disorder — including 12-step programs, medication, treatment centers and counseling. Rarely does one method work without the help of another, and of course, it’s never instant. With that in mind, humor also helps.

READ MORE: This best-selling seat cushion worked absolute wonders for my back pain

Recovery meme accounts — often Instagram, Facebook or Twitter pages — poke fun at the horrors of addiction and the cliches that come along with it.

The power of ‘gallows humor’
Kat, who runs the Junkee Brewster account, told In The Know that she spends more time attending 12-step meetings and working within her community than she does making memes — and truthfully, she gets just as much joy from that hard work— but there’s something uniquely satisfying about being able to joke about the “addict lifestyle.”

“Humor allowed me to relate and feel a kinship to other people at a time when I thought I was the most uniquely flawed person on earth,” she said in an interview with In The Know. “I generally like to make memes that are inspired by the ridiculous thoughts and behaviors that I actually thought were reasonable when actively using, but highlight how outlandish and self-destructive they truly were.”

Sorry I’m late. Buying the drugs I need to function was just as convoluted and time consuming as it always is, and I was not expecting that.

— Junkee Brewster (@JunkeeBrewster) December 30, 2019
Kat also serves as an editor for Dank Recovery, one of the first recovery-centric meme pages to go viral. The account has more than 740,000 likes on Facebook and 90,000 followers on Instagram.

The man who created Dank Recovery, Timothy, said that as he was working a 12-step program, he and his friends were trying hard to be good, spiritual people — but they shared the same “messed up sense of humor” and knew they could safely make “inappropriate” jokes together in light of their recovery.

“Addiction causes a lot of trauma for a lot of people, myself included,” he told In The Know.

He said there are a number of topics that are stigmatized in the field of addiction recovery — using words like “junkie,” for instance. Sometimes, though, using politically incorrect terms and speaking frankly about the bleakness of addiction can actually help people face the stigma and shame of their current reality and move toward recovery.

“Some people say you shouldn’t make jokes about suboxone [a drug used to treat opiate addiction] because it’s a life-saving medication that shouldn’t be further stigmatized,” Timothy said. “I make 12-step memes to keep things fair and balanced. There are cliches in everything to make fun of.”

He told In The Know he recognizes that the so-called “gallows humor” of his page is not funny to everyone, but he doesn’t mind, because a lot of people relate to it. He recommended that people looking for more wholesome recovery content simply go to another page — or stay away altogether.

“It’s hard to keep a needle out of your arm. Talk to a doctor if a meme page is bothering you,” he said.

Kat, who runs the Junkee Brewster account, told In The Know that she spends more time attending 12-step meetings and working within her community than she does making memes — and truthfully, she gets just as much joy from that hard work— but there’s something uniquely satisfying about being able to joke about the “addict lifestyle.”

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