Director’s Blog When the Mental Health Parity and Addiction Equity Act was signed into law in 2008, after decades of debate, advocates for mental health celebrated what was arguably their most important legislative achievement in 50 years. The new law, with the cumbersome acronym of MHPAEA, had a simple, ambitious goal: treatment for mental illness and substance abuse disorders would be on a par with treatment for all other medical disorders. If insurance companies covered treatments for depression and diabetes, they could not have different requirements or different deductibles or different reimbursement schedules for the two conditions.

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Importance In 2011, an estimated 26.8 million US adults used prescription medications for mental illness. Objective To estimate the numbers and rates of adverse drug event (ADE) emergency department (ED) visits involving psychiatric medications among US adults between January 1, 2009, and December 31, 2011.

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Abstract: Objective: To examine primary care clinician actions following positive suicide risk assessments administered to Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans.Methods: We identified OEF/OIF veterans with positive templated suicide risk assessments administered in primary care settings of three VA Medical Centers. National VA datasets and manual record review were used to identify and code clinician discussions and actions following positive assessments. Bivariate analyses were used to examine relationships between patient characteristics and discussions of firearms access and alcohol/drug use.Results: Primary care clinicians documented awareness of suicide risk assessment results for 157 of 199 (79%) patients with positive assessments.

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It’s time again for the year’s ten best from NIMH. A year that included a 16-day government shutdown and a 5.2 percent sequester also saw some outstanding scientific breakthroughs and historic changes in policy.

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Neuroscientist Robert Ferrante stands accused of poisoning his neurologist wife, Autumn Klein, both from the University of Pittsburgh. Medscape Medical News

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Abstract: Objective: To examine the associations between depressive/anxiety disorders (DAs), perceived health-related quality of life (HRQOL) and mortality in dialysis patients.Methods: Patients were assessed for depressive and DAs with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders. The HRQOL was assessed with the Medical Outcome Short Form 36 (MOS SF-36), and the Beck Depression Inventory and Hospital Anxiety and Depression Scale were also applied. Sociodemographic, clinical and laboratory data were also collected.Results: Patients with depressive disorders reported more impaired HRQOL on four of the eight subscales, while those with a depressive disorder comorbid with DA reported more impairment on all MOS SF-36 subscales compared to those without any psychiatric disorder.

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New guidelines have been developed by the Physicians Committee for Responsible Medicine. Outside experts say a healthy diet and exercise is always good advice, but evidence that this will reduce Alzheimer’s risk is lacking. Medscape Medical News

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Decreased brain reactivity in response to eye contact may denote social disability in children with autism — and may eventually lead to clinical benefits, according to preliminary research. Medscape Medical News

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A novel study provides “incontrovertible” evidence that prenatal tobacco smoke exposure contributes significantly to conduct problems in children, one researcher says. Medscape Medical News

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While the Alzheimer’s Association is disappointed with the CMS draft decision not to allow wider reimbursement, some experts agree with the CMS that more data are needed before expanded use of the test is funded. Medscape Medical News

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