Mental health

Ohio Medicaid announces care management organizations for OhioRISE program

The Ohio Department of Medicaid announced this week the 20 organizations that would launch OhioRISE, a new Medicaid program for children with severe behavioral and mental problems (Source: “Parents have given up custody to get care for children with severe needs. Ohio Medicaid is closer to ending that,” Columbus Dispatch, Feb. 17).

OhioRISE, short for Resilience through Integrated Systems and Excellence, is scheduled to roll out in July with the goal of addressing situations where parents are at risk of giving up custody of their children to the state in order to get the required, unaffordable mental health and residential care needed by a child with severe behavioral and mental health problems. 

Aetna will be the health insurance company overseeing the program, which the department expects to cover up to 60,000 children by the end of the first year. The organizations, called care management entities, will be responsible for coordinating care for a child: Bringing together schools, behavioral health providers, juvenile services and other systems to provide help for complex needs. 

The $1 billion program is partly paid for by savings from other planned Medicaid reforms, such as centralized credentialing and billing systems. Around $19.5 million will be given to the entities to help them start up.


Study: Many who attempted suicide can’t find mental health care

A new study has found that although suicide attempts in the United States have increased substantially over the last decade, the number of people who had recently attempted suicide and said they were not receiving mental health services has remained constant at about 40 percent (Source: “Survey of Americans Who Attempted Suicide Finds Many Aren’t Getting Care," New York Times, Jan. 19).

The study, published in JAMA Psychiatry on Wednesday, traces a rise in the incidence of suicide attempts, defined as “self-reported attempts to kill one’s self in the last 12 months,” from 2008 to 2019. During that period, the incidence rose to 564 in every 100,000 adults from 481.­ Among the major findings was that there was no significant change in the use of mental health services by people who had tried suicide, despite the passage of the Affordable Care Act in 2010 and receding stigma around mental health care.

The Affordable Care Act, which took effect fully in 2014, required all health plans to cover mental health and substance abuse services, and also sharply reduced the number of uninsured people in the U.S. Still, many respondents to the survey in the new report said the cost of mental health care was prohibitive; others said they were uncertain where to go for treatment or had no transportation.

Dr. Paul Nestadt, an assistant professor of psychology at Johns Hopkins who has researched the epidemiology of suicide but was not involved in the study, said the new data points, once again, to the scarcity of psychiatric beds or mental health professionals who take insurance, factors that have prevented medical science from bringing down the country’s suicide rates.

“The bottom line is, our treatments really work,” he said. “But people have to be able to access care. When they can’t, they’re left with less choices.”


Answers sought for rise in suicide attempts among Black teens

Legislators and academics are pushing for better research to understand why self-reported suicide attempts have dramatically risen among Black adolescents over the past three decades (Source: “Why Are More Black Kids Suicidal? A Search for Answers.,” New York Times, Nov. 18).

A study published this summer in the Journal of the American Medical Association found that self-reported suicide attempts rose nearly 80% among Black adolescents from 1991 to 2019, while the prevalence of attempts did not change significantly among those of other races and ethnicities.

One study of high school students, published in September, found that the Black teenagers surveyed were more likely than the white teenagers to have attempted suicide without first having suicidal thoughts or plans. Because suicide screening questionnaires typically ask whether people are having suicidal thoughts or have made plans to hurt themselves, the authors speculated that the questionnaires might fail to identify some Black youths who are at risk of suicide, or that there could be additional factors that might indicate a need for intervention.

More research is needed, but a government study conducted last year suggested that Black children and adolescents who died by suicide were more likely than white youths to have experienced a crisis in the two weeks before they died. They were also more likely to have had a family relationship problem, argument or conflict, or a history of suicide attempts.


Nearly 1 in 4 Ohioans has mental health issues, report finds

A new national report found that nearly 25% of Ohio adults are experiencing mental health issues (Source: “Mental health issues affect nearly 25% of Ohio adults,” Axios Columbus, Nov. 9).

According to nonprofit Mental Health America’s annual mental health rankings, Ohio slid from 11th to 25th in the nation, meaning the situation dramatically worsened year-over-year. In fact, Ohio had the third-worst decline in mental health rankings in the nation. The report measures the prevalence of issues as well as access to health care.

"We should be concerned that Ohio had one of the largest negative changes in overall ranking from year-to-year," Mental Health America of Ohio executive director Kenton Beachy said in a statement. "... we need to do much better in getting mental health services to youth with depressive disorder and reaching adults with serious thoughts of suicide.”


COVID-related depression and anxiety are improving, still higher than pre-pandemic

While Americans reported heightened symptoms of anxiety and depression during the pandemic peaking last winter, their symptoms had improved by this past June, according to a new CDC study (Source: “COVID nearly doubled self-reported anxiety symptoms,” Axios, Oct. 6).

Still, Americans reported their anxiety and depression symptoms are still higher than they were before the pandemic. The average anxiety severity score increased 13% from late August to December 2020 and then decreased nearly 27% from December to late May and early June this year.

About a fifth of U.S. adults still experience high levels of psychological distress, per the Pew Research Center, especially adults under 29, those with lower income or adults with a disability or health conditions.


Ohio study finds Black children twice as likely to die by suicide

Black children ages 5 to 12 are twice as likely to die by suicide as their white counterparts, a new study from Nationwide Children's Hospital in Columbus shows (Source: “Black children are twice as likely to die by suicide, Nationwide Children's study finds,” Columbus Dispatch, Sept. 9).

Research on suicide by Black youths is extremely limited and this study sought to identify the circumstances that arise when young Black people take their own lives.

"[W]e wanted to look specifically within Black youth only to get a clear understanding of what is happening within this population,” said Dr. Arielle Sheftall, principal investigator in the Center for Suicide Prevention and Research and the Abigail Wexner Research Institute at Nationwide Children’s.

Black girls, the study found, were more likely to experience a crisis with a boyfriend or girlfriend prior to death and died by suicide within 24 hours of an argument. Black boys were more likely to have experienced a recent legal problem and when compared with Black girls were less likely to have received prior mental health treatment, the study found.

Younger children who died by suicide, especially those 5 to 11 years of age, were more likely than older children to have experienced family and school problems. If Black children ages 5 to 11 were diagnosed with a mental health concern, it was more likely to be attention deficit disorder (ADD) or attention deficit hyperactive disorder (ADHD), according to Nationwide Children's.

“When implementing suicide prevention with Black youth, you have to start from ground zero," Sheftall said. "You have to figure out what the risk factors are for Black youth and then evaluate which prevention programs are beneficial or if adaptation of the prevention programs are needed."


Organizations aim to connect patients, therapists of color

A number of new organizations aim to digitally connect patients with mental health providers who value and understand different cultures (Source: “It’s Hard to Search for a Therapist of Color. These Websites Want to Change That.,” New York Times, July 16).

In recent years there has been an expanding number of digital companies and nonprofits created to help people of color find a therapist they can trust — someone who is not only skilled in the best evidence-based treatments but also culturally competent. In other words, a provider who is aware of their own world views, knowledgeable about diversity and trained to connect with different types of clients.

The founders of these organizations say there has always been a need for such services, and even more so now that people are coping with the stressors of the pandemic and the racial reckoning that followed the killing of George Floyd by the Minneapolis police.

Studies have shown that mental health treatments can be more effective when a client feels that their therapist values culture.

It can be difficult for people of color to locate a therapist with a shared cultural background.  An American Psychological Association report found that only 5% of psychologists are Hispanic and 4% are Black — 86% are white. A similar disparity exists among the country’s social workers and psychiatrists.


States not ready to meet mental health needs of students this fall, report finds

A report released this week from advocacy group Mental Health America found that a majority of states are not ready to address youth mental health as schools prepare to reopen for in-person learning in the fall (Source: “Analysis: Most states not ready to tackle youth mental health ahead of fall,” The Hill, July 20). 

The analysis reports that just 14 states have fully expanded Medicaid to cover mental health services in schools, and only a handful have legislation requiring mental health education. The lack of access and education make states unprepared to deal with mental health issues among children, which were exacerbated by the pandemic, the report said. 

Children of color are more likely to receive school-based mental health services than white children, so limited resources can also lead to disparities in who is getting care. And although Black and Latino children are less likely than white children to get mental health treatment for depression, they made up the largest increases in the proportion of youth experiencing suicidal ideation between 2019 and 2020, the report said.

Advocates say the coronavirus pandemic worsened an already existing mental health crisis devastating young people. The percentage of 12- to 17-year-olds who reported a past-year major depressive episode doubled over the past 10 years, according to the National Survey on Drug Use and Health. 


Feds consider adding text option to new 988 suicide hotline

Recognizing that many Americans rely on texting, U.S. regulators are weighing whether to require that phone companies allow people to text the new 988 suicide hotline (Source: “Texting option weighed for upcoming ’988′ suicide hotline,” Associated Press, April 22).

The Federal Communications Commission (FCC) last summer voted to require a new “988” number for people to call to reach a suicide-prevention hotline. Phone companies have until July 2022 to implement it. Once it’s in place, people will be able to dial 988 to seek help, similar to how 911 is used for emergencies. Currently, the National Suicide Prevention Lifeline uses a 10-digit number, 800-273-TALK (8255), which routes calls to about 170 crisis centers across the country.

Crisis counselors began responding to texts sent to the Lifeline last August, the FCC said. On Thursday, the agency voted unanimously to start a process that would also require phone companies to let people text 988. The agency noted the importance of texting for young people and those who are deaf, hard of hearing or have speech disabilities.

“While a voice hotline has its benefits, traditional telephone calls are no longer native communications for many young people. Texting is where they turn first,” said FCC Acting Chairwoman Jessica Rosenworcel in a statement. “So it’s time to make the suicide prevention hotline text accessible with 988.”


Ohio to create statewide support system for child and adolescent behavioral health

Ohio state agencies have announced plans to create a statewide center that will offer support to child and adolescent behavioral health programs and agencies, including providing services to keep children out of foster care (Source: “Ohio looks to form new statewide support system for child and adolescent behavioral health,” Cleveland Plain Dealer, March 12).

Ohio’s Child and Adolescent Behavioral Health “Center of Excellence” will offer training and technology and administrative services, including increased access to government support through telehealth. Multiple departments, including the Ohio Department of Job and Family Services and the Ohio Department of Mental Health and Addiction Services, created the request for qualified contractors to help develop the center.

Case Western Reserve University’s Center for Innovative Practices, through a two-year, $3.6 million contract, will organize the creation and operations.