A couple of years ago, we paused this newsletter—and yet, new subscribers continue to find us. While we don’t plan to restart The Mental Health Digest at this time, we’re excited to share something new.

If you're a mental health professional—or just someone interested in staying informed about cutting-edge mental health research—we’d love to introduce you to our new project: PsychVox

As therapists, staying on top of the latest research can feel impossible. With hundreds of new studies published each month, how can anyone keep up and focus on client care?

That’s where PsychVox comes in. Each month, we’ll comb through dozens of top-tier mental health journals to find the most relevant and practice-changing studies. Then we’ll deliver:

• Concise and accessible summaries of important new research

• Contextual insights into what each study means for your work

• Audio and podcast versions for listening on the go

We aim to publish around 8 new summaries each month. While we hope to eventually cover every major study as they’re released, we’re starting with the most impactful ones.

There will be a free version with select content each month and a paid version for full access to everything we publish. If you’re curious, we’d love for you to join the free version and see what we’re building.

Thanks for your continued support. If you have thoughts or feedback, feel free to reply directly to our emails—or reach out anytime at support@psychvox.com.

Subscribe at: Psychvox.com
Instagram: @thepsychvox

Hope to see you there,
Manny

And Happy Sunday!

Over the past year and a half, we’ve been publishing this newsletter a few times every month. The original goal was to give social workers a way to read up on the most relevant happenings in the field, while also exposing them to the burgeoning tech and entrepreneurship scene that was revolutionizing the field.

About one year into the project, however, we realized that we had many subscribers who were interested in mental health and who were not social workers. At that point, we rebranded into the Mental Health Digest.

The goal was always to expand the newsletter and to hire people who work in mental health to help with writing and researching the newsletter. Unfortunately, we were unable to figure out a way to do that successfully. At this point, we are discontinuing the newsletter. Thanks to everyone who stuck with us from the beginning, and thanks to everyone who joined thereafter.

Cheers,

The Mental Health Digest (Social Work Newsletter) Team ☺️

And Happy Sunday!

On this day in 1968, the US Supreme Court, in Epperson v. Arkansas, declared an Arkansas law banning evolution in public schools unconstitutional. The court “held that the First Amendment to the United States Constitution prohibits a state from requiring, in the words of the majority opinion, ‘that teaching and learning must be tailored to the principles or prohibitions of any religious sect or dogma’”. (link)

This was a win for science and a win for the separation of church and state.

In today’s newsletter:

• An AI startup that raised $40 million to help therapists decrease their administrative burden

• Lawsuit alleges Mark Zuckerberg ignored warnings around Instagram affecting youth mental health

• New research on Alcohol Use Disorder and more

Question: How many people ages 12 and older had Alcohol Use Disorder in the United States in 2021?

AI Documentation Startup Raises $40 Million

Administrative burdens are common throughout healthcare. In their work, providers may spend time writing documentation, billing, and dealing with insurers. These administrative tasks create burdens that make health care more burdensome and inefficient for both patients and providers. Some studies have found that physicians spend twice as much time on paperwork as with patients and that these administrative burdens can be a primary cause for burnout. (link)

The field of mental health is no exception. One survey of 500 therapists found that most therapists see around 20 clients per week and spend about 7 minutes per note, for a total of 140 minutes or 2 hours and 20 minutes of notes per week (link). That’s over 10% of a therapist’s time being spent on notes, which doesn’t include time spent on other administrative tasks.

With that context in mind, Artificial Intelligence (AI) documentation startup Eleos Health, which turns behavioral health conversations into documentation and other insights, has raised a $40 million Series B round. The company was founded in 2020, has over 3 million minutes of therapy sessions in 2023 alone, and employs 95 people in Boston and Tel Aviv. The goal of the company is to eradicate administrative barriers faced by clinicians.

Other News

• Experts highlight that a combination of workforce shortages and a lack of community resources make it difficult for people to find appropriate and timely mental health care in Maine, leading to tragedies such as the mass shooting in the state. Student loan forgiveness, tuition assistance, paid internships, and sign on bonuses can help bring professionals to the field, and walk-in crisis centers can allow people to receive timely care during crises (link)

• Mental health evacuations and hospitalizations for deployed US troops are on the rise. According to survey data from the U.S. military’s Medical Surveillance Monthly, “Mental health disorders topped the list of reasons for hospitalization for every year in the survey data” (link)

• In response to recent controversies, the Federal Aviation Administration is naming a pilot mental health committee to “provide recommendations to address barriers preventing pilots from reporting mental health issues” (link)

• A new lawsuit filed against Meta claims that Mark Zuckerberg ignored warnings about Instagram's impact on the mental health of young users. For example, mental health experts raised concerns about plastic surgery filters “encouraging … body dysmorphia”, but Zuckerberg allowed the filters because there was “clear demand” and that he had seen “no data” about their being harmful (link)

• Cities such as Philadelphia are assigning 911 calls to crisis response teams which pair police officers with mental health professionals in “co-responder programs”. There’s no standard, golden model for these programs, leaving many cities to find their own way and create their own methods (link)

Reads on research

• Paradoxically, one study found that fathers with mild anxious or depressive symptoms correlated with fewer behavioral health issues and higher IQ scores in young children (link)

• Accountable Care Organizations (ACO), Medicare’s dominant care model, are groups of doctors, hospitals, and/or other health care providers who work together to improve the quality and experience of patients. A longitudinal study found that ACOs did not contribute to improvements in mental health treatment or patient-reported outcomes (link)

• Data from 118 clinical trials and 20,976 participants showed that oral naltrexone, an opiate antagonist used to treat opioid and alcohol use disorder, at 50 mg/d and acamprosate, another medication used to treat alcohol use disorder, in conjunction with psychosocial interventions, is a first line pharmacotherapy treatment for alcohol use disorder (link)

Reads on policy

• The suicide rate of farmers is 3.5 times higher than that of the general population. To combat this crisis, Congress is seeking to pass a bill that would expand mental health services in rural communities. The bill would increase the funding of the Farm and Ranch Assistance Network (FRSAN) to $15 million over a period of five years. The organization provides behavioral health counseling and other mental health resources to agricultural workers (link)

• Sen. Tammy Duckworth’s HOPE Act would allow “would allow nonviolent, deported immigrant veterans to temporarily return to the U.S. for treatment at a VA facility on a case-by-case basis.” Veteran immigrants may struggle with mental health, but may face deportation if convicted of a criminal offense. The U.S. has “deported tens of thousands of immigrant veterans since the 1996 Illegal Immigration Reform and Immigrant Responsibility Act” (link)

• Governor Kathy Hochul today announced an additional $5 million to the $9 million Community Mental Health Loan Repayment Program. The $14 million program was created to recruit and retain mental health professionals through repayment (link)

Tech, business, and interesting reads 😎

• Forum, a marketplace for peer support groups, raised $5.3 million in funding. The company seeks to create support groups led by experienced facilitators on various topics like grief, loneliness, and caregiving (link)

• Oula, a modern maternity care center, has raised over $20 million to help deliver evidence-based and personalized pregnancy experiences (link)

Answer: According to the 2021 National Survey on Drug Use and Health, 29.5 million people ages 12 and older (10.6% in this age group) had Alcohol Use Disorder in 2021. Sixteen million of these people were males, 18.7 million were white people, and 5.1 million were Hispanic or Latino (link)

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Thanks for signing up for the paid edition and supporting the Mental Health Digest!

In today’s newsletter:

• Could the tragedy in Maine have been prevented?

• Research shows that early humans interbred with ancient human cousins, and that this enhanced cold adaptation but impacted mental health 🧠

• Psychiatrists have begun to prescribe Ozempic, a diabetes drug, to patients ⚕️

Question: How many mass shootings have occurred in the United States in 2023?

Could the tragedy in Maine have been prevented?

Last week, a mass shooter killed 18 people and wounded 13 others in Lewiston, Maine’s second largest city. There were clear signs that this person posed a risk: He spent time at a psychiatric facility for troubling behavior; a fellow soldier expressed concern that he would “snap and do a mass shooting”; and he threatened to shoot up places like the Army reserve drill center in Saco, Maine.

Another troubling finding is that Maine’s “yellow flag law”, which is supposed to prevent this kind of incident, failed. The “yellow flag law” requires that a law enforcement officer report a weapon confiscation to a judge and that a medical professional complete a mental health evaluation. Yet this law, say critics, makes it extremely difficult to take away guns from someone who should not have access to them.

Unfortunately, the clear signs, troubling reports from colleagues and family members, and laws that were meant to prevent this from happening were not enough. Although there are many reasons for this, including difficult-to-implement yellow flag laws and siloed agencies, at the core we have a person who was clearly mentally ill. And as we have written previously, our mental health system functions as a band-aid and does not provide long-term treatment.

Read more

And Happy Sunday!

Quick plug 🔌 If you’re interested in weekly programming, you can sign up below for our paid edition. Our bi-weekly newsletter will always be free!

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On another note, if you are interested in more mental health content, check out this newsletter ➡ Mental: Fighting the fragmentation of mental health one policy at a time

In today’s newsletter:

• 41 states + Washington DC sue Meta, claiming that its platforms harmed children’s mental health 🖥️

• Research found a relationship between Adult ADHD & Dementia 🧠

• Insurers push back on Biden's proposal to ease mental health care access ✋

Question: How many hours a day do children use social media? 📱

40+ states sue Meta over mental health

Meta, the parent of social media platforms Facebook and Instagram, is being sued by a group of more than 40 states for designing products that are “deliberately addictive and fuel the youth mental health crisis”. The states allege that Meta has deceived the public about the harms of social media, with some comparing this lawsuit to the one against Big Tobacco in the 1990s.

The lawsuit aims to create financial penalties for addictive features and to force the company to create safer platforms for young people.

Is social media detrimental to mental health? We don’t really know because studies have provided inconclusive claims. A 2022 review of the research highlighted that:

• There is research linking higher social media use to lower well-being. Some attribute this to social media-induced isolation, while others argue it substitutes meaningful in-person relationships with less satisfying online connections.

• Other research shows that social media is associated with higher well-being for certain people. For example, online communication may benefit people who are socially anxious and isolated, helping them to feel more at ease online and to create or bolster relationships that they would have trouble nurturing off-line.

Other News

• Kaiser Foundation Health Plan, run by Kaiser Permanente, will pay a $200 million settlement due to violations and deficiencies in its provision of behavioral healthcare services. The investigation found that Kaiser Permanente “canceled behavioral health appointments and, in many cases, did not provide enrollees with behavioral health appointments that met timely access and clinical standards that were still required, regardless of a strike by mental health clinicians that was initiated in August of 2022” (link)

• A few months ago, we briefly covered Clubhouses: Community-based locations that offer people with mental illness a community, along with opportunities to live, work, and learn. New York announced a $30 million investment into new clubhouses, which will allow an additional 3,700 people to take part in the programs. Governments are hopeful that the Clubhouse model can be a part of the systemic solution to helping people with serious mental illness (link)

• In Los Angeles, a “real estate agency for the unhoused” is helping unhoused people move more quickly into homes. Brilliant Corners, the nonprofit which serves as a sort of real estate agency, finds and persuades landlords to take unhoused people with vouchers. Their secret sauce? Financial strength. The nonprofit convinces landlords to accept housing vouchers by paying rent before a tenant moves in and providing over 1 month rent for a security deposit. The program places around 200 people into housing each month and has a budget of $200 million (link)

Reads on research

• A study analyzed an Israeli cohort of over 100,000 members born between 1933 and 1952 and found that adult ADHD was associated with a 2.77-fold increased risk of dementia, while people with adult ADHD treated with stimulant medication did not display this increased risk for dementia (link)

• Exercise and mental health 🚴🧘

  • A study found that many children who took part in a middle school cycling program improved their psychosocial well-being. The study also found that males, white students, those from high socioeconomic status families, those who get adequate sleep, those who are more active, those who have reduced screentime, and those who are involved in school activities were less at risk of developing a psychosocial disorder, as measured by the WHO-5 Well Being Index and the Pediatric Symptom Checklist (link)

  • Another study found that approximately 1 heated yoga session per week was associated with significantly greater reduction in depression symptoms than a waitlist control (link)

Reads on policy

• A few weeks ago, we spoke about how the Biden administration sought to strengthen access to mental health by implementing policies that pushed back on restrictive prior authorizations and narrow provider network that make it harder for people to access mental health care. Insurers pushed back on the proposal, blaming workforce shortages as the main driver of barriers to care and claiming that there could be ‘unintended consequences’ such as a lower-quality of providers (link)

• Governor Kathy Hochul announced that the state Office of Mental Health has received two federal grants totaling $13.5 million to expand access to mental and behavioral health services in primary care practices for youth and to implement the ‘Zero Suicide’ model at 13 certified community behavioral health clinics across the state (link)

Tech, business, and interesting reads 😎

• Hero Journey Club, a startup that offers mental health support to individuals playing video games, has landed $14.6 million in funding. The startup allows members to join virtual mental health support sessions while gaming (link)

• Waymark, which provides community-based services for people receiving Medicaid, has secured $42 million in fresh funding that will be used to hire new community care teams, among other things. The company currently manages care for about 50,000 Medicaid enrollees in Washington state and Virginia (link)

• Sonar Mental Health, started by a Stanford MBA candidate, is using AI to analyze the online activity of young people and to provide notifications and support recommendations should it detect concerning behavior. The goal is to help identify people who are at risk, and to help them to obtain care (link)

• Take a deep and poignant dive into the mental health complex with “How Washington State’s mental health labyrinth claimed a life” (link)

Answer: On average, 8- to 12-year-olds use about 5.5 hours of screen media per day, while 13- to 18-year-olds use about 8.5 hours of screen media per day ❗ (link)

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And Happy Sunday!

Today, we cover the Drug Enforcement Administration’s (DEA) rule allowing controlled substances to continue to be prescribed through telehealth, new research around mental health and light exposure, and California’s push towards greater flexibility around involuntary hospitalization.

Question: Which are best states and worst states for mental health?

Controlled Medications Prescribed through Telehealth

Controlled medications are drugs or chemicals whose manufacture, possession and use is regulated by a government. Among these are stimulants for attention-deficit hyperactivity disorder, benzodiazepines for anxiety, and drugs for opioid use disorder.

The United States Drug Enforcement Administration (DEA) has, for the second time, “extended temporary rules” that allow controlled medications to be prescribed via telehealth (link). These rules were established during the COVID-19 pandemic as an exception to the Ryan Haight Act, which requires “at least one in-person medical examination before a doctor can prescribe a controlled medicine.”

The flexibilities will now be extended through December 31, 2024 while the DEA and Department of Health and Human Services consider further public comments and revisions.

Other mental health-related news

• New York Gov. Kathy Hochul threatened to fine hospitals that did not quickly reopen psychiatric wards that were closed at the height of the pandemic. She has accused hospitals of refusing to open their psychiatric wards due to concerns around the wards generating less revenue than other “lines of service” (link)

• Due to a surge of demand, some 988 state crisis hotlines have had to limit services for frequent users (link)

Reads on research

• A study in the JAMA Health Forum reviewed about 1 million overdose deaths with education information about the deceased. The study found that lower educational attainment is associated with higher growth in overdose deaths and that overdose deaths have become more prevalent in groups with lower socioeconomic status (link)

• A report by the Commonwealth Fund sought to understand why the United States “spends twice as much per person on health as the average of peer nations” by understanding where “excess” spend was going. The report found that the excess was a result of higher administrative costs, higher salaries and wages for physicians and nurses, and high prescription drug prices (link)

• The largest study on light exposure and psychiatric disorders found that greater night-time light exposure was associated with increased risk for many psychiatric disorders including major depressive disorder, PTSD, and psychosis (link)

Reads on policy

• Gavin Newsom signed “the first of a series of bills that aim to transform California’s mental health system”. (link) These controversial bills loosen rules on involuntary treatment set by the Lanterman-Petris-Short Act, allowing for greater flexibility when involuntarily hospitalizing people who are mentally ill.

Answer: Soliant’s report on the “Best States for Mental Health” reviewed different factors including the frequency of “bad mental health days” reported by the existing population, access to mental health providers, suicide rate of 15-24 age group, unemployment rates and violent crime rates. The report found that the top three states for mental health are:

1. Nebraska

2. Connecticut

3. Massachusets

And the worst states for mental health are:

1. West Virginia

2. Alabama

3. Arkansas

Notably, the report also found that there is a significant correlation between disconnected youth (youth who do not work or go to school) and states’ overall ranking.

You can read the entire report here (link)

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And Happy Sunday!

Today we cover some interesting (and controversial) research on thought suppression, California’s Community Assistance, Recovery, and Empowerment (CARE) Court, and more.

Question: What percent of people ages 65+ report having symptoms of anxiety or depression?

Suppressing thoughts and mental health

Conventional wisdom has it that suppressing thoughts can be dangerous as it can lead to a “bubbling up” later of thoughts with greater frequency and intensity, worsening mental health. In therapy, clinicians teach clients to identify and reframe challenging thoughts, as in cognitive behavioral therapy, or to approach thoughts with acceptance and neutrality, as in mindfulness-based therapy.

New research, however, is challenging this conventional wisdom.

While witnessing the breakdown of people and families in “political education” camps and prisons for Uighurs, Zulkayda Mamat noticed that “the most resilient Uighurs” coped with their trauma by pushing “the distressing memories out of their mind” (link). Given her observations, she sought to use research to figure out if her intuition about thought suppression was correct. In her study, Zulkayda trained 120 adults from 16 countries to suppress their thoughts, showing that thought suppression led to “enduring mental health gains.”

It’s important to note that this line of research is new and that further research must be completed before coming to broader conclusions on the efficacy of thought suppression. Furthermore, some psychologists warn that people should not “practice suppressing memories of a recent traumatic event” as research indicates this could “increase their risk of developing PTSD”.

You can read the research article here (link)

Other mental health-related news

• California’s Community Assistance, Recovery, and Empowerment (CARE) Court will launch in 8 counties by December. The program enables judges to “order people with untreated psychotic disorders, such as schizophrenia, to get help, with counties required to provide the aid.“ Critics of the program continue to denounce forced treatment, seeing it “as a pipeline to conservatorship and the deprivation of civil liberties“ (link)

• Ozempic, an injectable drug approved for type 2 diabetes, is being used by many for weight loss, despite not being approved by the Food and Drug Administration for this purpose. Recent reports, however, have showed that people taking the drug experience symptoms of anxiety, depression or suicidal thoughts (link)

• Starting this month, city shelters in New York have to identify and hire mental health professionals to work on site at the 30 largest family shelters in the city (link)

• We previously covered the backlash against requiring law students and bar candidates to disclose mental health concerns. In response to this, the Supreme Court of New Jersey will revise the question to one where candidates need not disclose effectively treated mental health concerns. They will still need to disclose “whether they currently have a substance abuse or mental health issue that affects their ability to practice law in a competent and ethical manner” (link)

• Applicants are suing the Peace Corps of discriminating against applicants with disabilities. This is in response to people who were denied application due to mental health concerns such as being in therapy for treatment of anxiety (link)

Reads on research

• A study looked into the correlation between seasonal patterns and temperatures and substance-related disorders in New York State during 1995-2014. The research found that “an increase in temperature 0–6 days before hospital visits was associated with higher hospital visit rates for both alcohol- and substance-related disorders” up to a certain point (link)

Reads on policy

• The Biden-Harris Administration will provide a $206 million grant to support youth mental health (link). This includes:

  • $131.7 million in grant programs that connect youth and families to behavioral health services

  • $55 million to expand access to mental health care for young people, including access to mental health care in schools

  • $20 million to improve the quality of mental health services provided to children involved in the child welfare system

• A bipartisan behavioral health bill is aimed at integrating behavioral health in primary care settings for Medicare beneficiaries (link). The bill will:

  • Increase specific Medicare reimbursement rates that will offset costs of bringing mental health care into doctors’ offices

  • Create reporting requirements that outline the integration of behavioral health within primary care

Tech, business & mental health 😎

• Cartwheel, a startup that partners with school districts to provide virtual mental health services, raised $20 million in Series A funds (link)

• 🍕 & Therapy? Costco is broadening its reach into healthcare through a partnership with Sesame, a New York-based medical care marketplace startup that connects consumers directly with primary care and mental health clinicians for appointments online and in-person without insurance (link)

• Former Tinder CEO Renate Nyborg’s startup Meeno, which aims to fight loneliness through an AI-powered chatbot, announced that it has raised a $3.9 million seed round led by Sequoia (link)

• Being, a Delaware-based startup, is on a mission to scale its mental health app, which aims to help users create a map of their concerns to better navigate their everyday issues (link)

Answer: 20%, according to a 2023 Kaiser Family Foundation survey (link)

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And Happy Sunday!

On this day 236 years ago, the U.S. Constitution was signed by delegates at Independence Hall in Philadelphia, Pennsylvania. Thirty-nine of the 55 delegates signed the new document, with many of those who refused to sign objecting to the lack of a bill of rights. At least one delegate refused to sign because the Constitution codified and protected slavery and the slave trade.

Question: How much money was invested in digital health companies in 2022?

Yale's Mental Health Reforms

In 2015, Yale sophomore Luchang Wang posted a desperate message on Facebook, saying she “couldn’t bear the thought of having to leave for a full year, or of leaving and never being readmitted.” She proceeded to take her own life.

Yale’s mental health policies had left many students considering mental health leave with a difficult choice: They could leave and obtain treatment, but in turn, they would withdraw from the prestigious university without guarantee of readmission. They would also be stripped of their health insurance and excluded from campus.

Following another student suicide in 2021, a group of strangers began to meet on Zoom, sharing their struggles and issuing a complaint, which resulted in a legal settlement “that considerably eases the process of taking a medical leave of absence.”

Under the new policy, students taking mental health leave may extend their insurance coverage for a year. They will also no longer be banned from campus or lose their campus jobs, and their return from leave will be more simple, with the health care provider playing a pivotal role in the decision.

The full article can be found here

Other mental health-related news

• The Biden administration is imposing fines on insurers for loopholes that are denying mental health care. These loopholes include "requirements that doctors seek insurers’ approval before delivering care, lower reimbursement rates for providers who treat mental illness and deliberate efforts to limit the number of in-network physicians available to patients.” The insurers, on the other hand, complain that the lack of qualified providers is the real issue (link)

• Judge Lina Hidalgo, of Harris County, Texas, announced that she will return to work on Oct. 2, extending her temporary leave of absence while receiving treatment for clinical depression. Other elected officials such as U.S. Sen. John Fetterman have also spoke about their own mental health struggles. Are we seeing the effects of de-stigmatization in mental health? (link)

• A report by Gallup and the Walton Family Foundation highlights the experiences and perspectives of Gen Z (born between 1997 and 2012) youth in America. Here are some of the highlights:

  • 47% of Gen Z are thriving in their lives -- among the lowest across all generations in the U.S. today and at a much lower rate than millennials at the same age.

  • 65% of Gen Z students with fair or poor mental health have missed school in the past month, compared with 41% of those with excellent mental health.

You can find the full report here (link)

Reads on research

• A study that looked at data from 93,263 people aged 65 or over found that having a hobby is linked to fewer depressive symptoms and higher levels of happiness, self-reported health and life satisfaction (link)

• A sense of purpose, or the feeling that one’s life is goal-oriented and has direction, is an important factor of good health. A recent study showed that a “person’s sense of purpose declines leading up to and following a diagnosis of dementia or cognitive decline.” By the same token, “the opposite of purpose in life — apathy is a significant problem in dementia.” Caregivers should strive to help involve the person with cognitive impairment by bringing them into activities and taking time to connect with them on a deeper level (link)

• Use of mental health care increased substantially during the coronavirus pandemic, as teletherapy lowered barriers to regular visits, according to a large study of insurance claims published Friday in JAMA Health Forum (link)

Reads on policy

• In California, a dispute is taking place over a $6 billion mental health bond which removed language that the money would not be used for involuntary confinement. Critics of this change argue that “all forced treatment” causes long-term psychiatric harm and that “people are not progressing with their recovery when it’s against their will” (link)

• A disability-rights advocate pleaded with Missouri mental health officials Thursday not to implement a policy change that could freeze pay rates for at-home caregivers relied upon by more than 3,000 individuals around the state (link)

Tech, mental health, and resources 😎

• London-based Beckley Waves, which creates and invests in psychedelic startups, obtained $3.3 million in seed funding (link)

• New York-based Caraway announced that it has acquired Sesh, a digital group therapy platform, allowing the Gen Z women’s health-focused company to integrate group support and therapy into its offerings (link)

• Dallas-based Spark Biomedical disclosed raising $16.2 million of a $21.8 million funding round. The company offers a neurostimulation device that the Food and Drug Administration has cleared to relieve the symptoms of opioid withdrawal. Patients wear a device around their ear for up to 24 hours a day” (link)

• In November, the Drug Enforcement Administration (DEA) will issue it’s proposed rule on telehealth and controlled substance prescribing. This rule will create regulations “that will shape the future of telehealth within behavioral health in the post-COVID era“ (link)

Answer: $15.3 billion. A significant amount, but down from $29.3 billion in 2021 (link)

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And happy Sunday!

We’re taking a break this week, but will be back in two weeks.

See you soon! ✌️

And Happy Sunday!

Last week, The Food and Drug Administration (FDA) approved the first oral pill specifically targeted to treat postpartum depression. The pill will be sold under the brand name Zurzuvae and should be taken as a once-daily pill for 14 days. This is an important breakthrough given that:

• One in seven women who have given birth experience postpartum depression, but roughly half with the condition do not receive treatment

• Maternal deaths from suicide account for about 20% of all deaths that occur postpartum

The two studies on Zurzuvae found it effective for reducing symptoms of depression, but there is concern given that the research was completed in only 45 days. In other words, the research did not study the effects of the medication on women for longer than 45 days after they gave birth.

News

• The Department of the Air Force has now implemented a law that enables Airmen and Space Force Guardians to request a mental health referral from their superiors and to be connected with a medical professional within one day, regardless of where they are deployed. The law, officially called the Brandon Act, was enacted after a 21-year-old sailor, Brandon Caserta, died from suicide after being bullied by a supervisor. Prior to the law, the referral had to be initiated by the superior, thereby creating a barrier to care.

• The American Psychological Association (APA) has joined the American Bar Association in advocating for an end to disclosure of personal mental health by individuals applying to become lawyers. Regarding this requirement, the APA states: “Statistical data reveal that there is no connection between bar application questions about mental health and attorney misconduct and that such questions have not been empirically shown to work as a successful screening tool for who can and cannot practice law in a competent manner".

• The National Association of Social Workers will mark it’s 27th anniversary with Social Work Pioneer Inductions in Washington D.C. The inductions will recognize the “outstanding achievements of social work pioneers who have truly elevated the profession” and will include the posthumous induction of NAACP co-founder W.E.B DuBois

• An article in the New York Times highlights how “hot weather can destabilize mood, exacerbate mental health disorders and complicate drug treatment.” Research has shown that high temperatures are strongly associated with an increase in suicides and a rise in violent crime, aggression, emergency room visits, and hospitalizations for mental health disorders

Reads on research

• A new study which included over 150,000 respondents from 32 surveys in 29 countries showed that about half of the world's population "can expect to develop" at least one type of mental health disorder by the time they are 75 years old

• Adverse Childhood Experiences (ACEs) and experiences of traumatic events as adults were associated with significantly increased risks of anxiety, depression, and severe stress

Reads on policy

• Proposition 63, passed by California voters in 2004, created a “millionaire’s tax”, which has since brought in an estimated $26 billion. California Gov. Newsom is advocating that $1 billion per year of this tax is spent on housing those with serious mental illness, addiction, or both

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And Happy Sunday!

In case you missed it, The Social Work Newsletter is now The Mental Health Digest.

Question: In 2021, what percent of Americans did not have health insurance?

News

The Mental Health Parity and Addiction Equity Act (MHPAEA), passed in 2008, called for mental health care benefits covered by health plans to be provided at the same level as physical health care benefits. Yet many people in the United States continue to have difficulties with finding and affording mental health care. For example, some research has shown that “of the 21% of adults who had any mental illness in 2020, less than half received mental health care.” This number is halved to 10% for those with a substance use disorder.

One of the reasons for this gap is the obstacles insurers create for those seeking care. Because of these obstacles, people are forced to seek more expensive out-of-network care or to forego treatment altogether. In response, this week, president Biden announced new rules to strengthen care. These proposed changes include:

1. Requiring health plans to track the outcomes of their coverage to make sure that there is equivalent access between mental health and medical benefits

2. Outlining what insurers can and cannot do. For example, they cannot use more restrictive prior authorization or restricted networks to make care harder to access

3. Closing loopholes which will require more than 200 health plans who are not currently compliant with MHPAEA to be compliant with the law

Other social work-related news

• In every state, people who are a threat to themselves or others can be ordered to receive treatment. Yet Mississippi appears to be the only state where people are routinely jailed without charges for days or weeks during this process. Since 2006, at least 13 people have died in Mississippi county jails while they waited for this treatment

• The “first-ever comprehensive view” into maternal mental health in America showed that “the U.S. is failing mothers”. The U.S. received a “D” rating on it’s maternal mental health score card.

• Bridget Narsh’s son, a teen with autism, ADHD, and PTSD, had stared destroying furniture and running away, but the family couldn’t afford the $1,338 a day psychiatric bed at their local hospital. Although a representative offered a discounted rate of less than $60 a day and her son was hospitalized for more than 100 days, the bill came out to over $100,000, over 15 times the expected amount

• A Kaiser Family Foundation report found that 5 states had “in-state answer rates” of between 55% and 69% when people called the 988 suicide and crises hotline. The in-state answer rate measures the percentage of calls answered within that state’s borders. This means that D.C., Alaska, Arkansas, Alabama, and South Carolina failed to answer 25% to 50% of all of the calls that they received.

  

Reads on research

• A Spanish research study on superagers, or people ages 80+ with the memory function of people decades younger than them, showed that these superagers had more gray matter in their brain relative to others their age. They also had better general mental health and mobility. Scientists don’t know exactly why superagers outperform their peers, but it could be due to their genetics

• According to the Census Bureau, the estimated revenue of independent mental health clinicians increased 104.0% from $7.9 billion in 2015 to $16.2 billion in 2021. This increase in revenue may be a result of factors such as need due to COVID-19 and the Opioid Crisis and the expansion of telehealth

• Nationally, contacts to the 988 Suicide & Crisis Lifeline, which encompasses calls, texts and messages through the network’s chat line that are routed to a crisis center or counselor, were up 38% from 277,407 in June 2022 to 382,650 in June 2023

Reads on policy

• U.S. Sen. Alex Padilla (D-Calif.) introduced The Mental Health for Latinos Act, a bill which seeks to lift barriers to mental health care among Latinos by reducing stigma and “encouraging people to reach out for help”

• Nearly a third of transgender students ages 13-17 now live in states that ban them from playing on sports teams aligning with their gender identities

• Massachusetts lawmakers are hearing testimonies from people as they consider implementing laws that will allow children and young adults in the state who are without a legal immigration status to access healthcare

Tech, mental health, and resources 😎

• UpLift, a technology-driven behavioral health company, raised an $11M Series A round. The company “partners with leading national and regional health insurance plans to deliver high-quality, virtual-first psychotherapy and psychiatry”

• UK's thymia raised $2.7 million to expand its AI approach to diagnosing mental health struggles through gamification. The company uses video games design embedded in neuropsychology, linguistics, and machine learning to detect signs of mental illness

Answer: In 2021, 8.3 percent of people, or 27.2 million, did not have health insurance at any point during the year

If you enjoyed this newsletter, consider sharing it with a friend or colleague. You can directly forward the newsletter, or use the button below to get rewards for referrals. The goal is to be able to hire support staff to run and sustain the newsletter. Thank you for your support 🙏

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And happy Hump Day! 🐪🐪

As discussed during our last post, we are rebranding the newsletter in order to be more inclusive of our wider audience. Our subscribers are not only social workers but other types of mental health professionals, business leaders, and students.

Given this, The Social Work Newsletter is now The Mental Health Digest. Although the name, URL, and logo are changing, the content will not. We will continue to cover the most important news, research, and policy changes in mental health (and social work).

See you on Sunday 😎

And Happy Sunday!

A quick note: Given that most of the content we share is more broadly related to mental health and social services, not necessarily just social work, we will be rebranding The Social Work Newsletter. The content and distribution won’t change: Instead, we will be renaming the newsletter and redesigning it to make it more readable and relevant.

Question: Last week, the 9th U.S. Circuit Court of Appeals, the most powerful federal appeals court in the Western United States, issued a significant ruling that will have a widespread impact on homelessness. What did the court rule?

New mental health research

In a recent clinical study, scientists tried to figure out what parts of cognitive-behavioral therapy actually led to reduced symptoms. Was it self-compassion training, thought challenging, relaxation, or something else responsible for the improvement in symptoms?

The study found that only the absorption component of cognitive behavioral therapy had a significant effect on depressive symptoms. What is absorption? We had a hard time wrapping our heads around this term, so we reached out to the author of the study. This was his response:

”If activity scheduling is about increasing the number of positive activities that people do to reduce their depression, absorption is about trying to increase the direct contact and experience people have when they do those positive activities. We often find that patients with depression might do something they previously found enjoyable but not get much benefit from it – and when this is explored further, the patients might be having a running commentary on what they are doing like “this is much harder than before” and “why can’t I do this as well?”, and be somewhat detached from the activity.

The goal of absorption is thus to help patients be more directly immersed in what they are doing. This has quite a few parallels with the literature on flow states. Practically, this means that in therapy, we don’t only ask people to schedule positive activities but positive activities they find absorbing and can get immersed in, we also try and plan scheduling to maximize the likelihood of being absorbed (e.g., not doing when in a rush or when lots of distractions around). It’s also important that we practice detailed holistic imagery of re-experiencing times when the person was absorbed in a positive activity, both as a mental warm-up to make it easier to get absorbed in the activity or task they are going to do, and to help identify what circumstances help and hinder absorption for that person.

This allows people to be “in the experience” of doing positive activities and not “thinking about” what they are doing, and thus maximizes the benefit for mood and reduces rumination.”

Other social work-related news

• Mount Sinai Health System, in what is the “largest private investment in behavioral health services,” opened its $140-million behavioral health facility in New York City. Along similar lines, in New Hampshire, SolutionHealth and Acadia Healthcare are building a 144-bed mental health hospital. This is good news. A federal report from earlier in the year highlighted that there are simply not enough beds for mental health care in our communities

• On the international stage: In Australia, psychiatrists will be able to prescribe psilocybin 🍄 for treatment-resistant depression and MDMA for post-traumatic stress disorder. In Japan, gender inequality is contributing to a mental health crisis

• Mental health respite facilities such as Rhonda’s House, “a rural peer respite program that offers a short-term, homelike, nurturing environment for people who are experiencing a mental health crisis but don’t need immediate medical attention are filling care gaps in over a dozen states

• A federal judge fined Washington state officials $100 million for failing to provide adequate mental health services to individuals with severe mental illnesses in the state’s jails.

Reads on research

• A groundbreaking, large-scale research study of over 6 million Dutch people, published on May 2023, found an association between mental illness and cannabis use disorder. More specifically, the study found that Cannabis Use Disorder, a disorder where a person is unable to stop using marijuana despite health and social problems, was associated with an increased risk of various types of depression and bipolar disorder. Here are some mixed reactions from scientists in the field

• Among the world’s high-income countries, the U.S. has the highest maternal mortality rate. A new research study found that things have gotten worse. Maternal death rates are highest among Black women, with these rates doubling over the last 20 years

Reads on policy

• The Oregon legislature passed laws and proposals that will expand access to opioid overdose reversal medication and create a 40-cent monthly phone tax to pay for a new crisis hotline. The legislature also formed a task force to look into raising a beer and wine tax to pay for recovery programs

• Medicare will now cover Leqembi, the first drug on the market that slowed cognitive decline in people who are in the early stages of Alzheimer’s

Tech, mental health, and resources 😎

• 2023 may be a transformative year for autism treatment providers. The big providers in the space were The Center for Autism and Related Disorders (CARD) and Invo Healthcare, but CARD filed for bankruptcy last month and Invo Healthcare has closed its in-office and in-home applied behavioral analysis branches

• Twenty-seven global investors managing $2.1 trillion are collaborating to help companies reduce the potential negative impacts of technology on the mental health of their customers. The goal is to develop " action plans to protect the mental health well-being of consumers”

• Gaggle, a company that creates software to monitor student activity on school-provided devices for concerning content, launched a new 24/7 Student Crisis Line

Answer: The 9th Circuit Court ruled that cities and towns cannot force homeless people off the streets unless communities can provide shelter for them. Cities across the west coast had tried, and failed, to overturn the ruling for years

If you enjoyed this newsletter, consider sharing it with a friend or colleague. You can directly forward the newsletter, or use the button below to get rewards for referrals. The goal is to be able to hire support staff to run and sustain the newsletter. Thank you for your support 🙏

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And Happy Sunday!

The Supreme Court had an active week. What were its rulings? Among other important rulings over the past few weeks, this week, the Supreme Court:

1. Killed Biden’s $400 billion plan to cancel or reduce federal student loan debts

2. “Sided on Friday with a web designer in Colorado who said she had a First Amendment right to refuse to design wedding websites for same-sex couples despite a state law that forbids discrimination against gay people”

3. Rejected a controversial Republican-led legal theory that would have reshaped how elections are conducted

In addition, the Supreme Court struck down “race-conscious admission programs at colleges and universities across the country.” In other words, it dealt a death blow to affirmative action (You can read the 237-page affirmative action opinion here).

Here are some of the justices’ quotes about the affirmative action ruling:

Chief Justice John Roberts: "Many universities have for too long...concluded, wrongly, that the touchstone of an individual's identity is not challenges bested, skills built, or lessons learned but the color of their skin," he wrote. "Our constitutional history does not tolerate that choice."

Justice Sonia Sotomayor: "The Court subverts the constitutional guarantee of equal protection by further entrenching racial inequality in education, the very foundation of our democratic government and pluralistic society."

Justice Ketanji Brown Jackson: "With let-them-eat-cake obliviousness, today, the majority pulls the ripcord and announces 'colorblindness for all' by legal fiat. But deeming race irrelevant in law does not make it so in life."

Justice Clarence Thomas, arguing against the use of the policies, described them as “rudderless, race-based preferences designed to ensure a particular racial mix in their entering classes.”

Justice Brett Kavanaugh: “To be clear, although progress has been made since [previous decisions by the court allowing race-conscious admissions], racial discrimination still occurs and the effects of past racial discrimination still persist. Federal and state civil rights laws serve to deter and provide remedies for current acts of racial discrimination. And governments and universities still ‘can, of course, act to undo the effects of past discrimination in many permissible ways that do not involve classification by race.’”

Question: When was the term “affirmative action” first used?

News

The U.S. Food and Drug Administration & Psychedelics

A bit of context: Psychedelics are drugs that include psilocybin (a substance found in certain types of mushrooms) and lysergic acid diethylamide (LSD). These drugs act as psychoactive substances that create changes in perception and mood, and induce psychedelic experiences, such as the ones conveyed by the following emojis:

✨(☯‿☯)(❂‿❂)(⬤‿⬤) | 🍄💊🧠🌌

The Food and Drug Administration (FDA) released it’s first ever draft guidance that provides considerations to “sponsors developing psychedelic drugs for treatment of medical conditions (e.g., psychiatric disorders, substance use disorders)”. The draft guidances basically represent the Agency’s current thinking around a particular subject. This is big news as shows a greater openness by the government around psychedelic research for medical purposes.

The FDA writes: “Psychedelic drugs show initial promise as potential treatments for mood, anxiety and substance use disorders. However, these are still investigational products…By publishing this draft guidance, the FDA hopes to outline the challenges inherent in designing psychedelic drug development programs and provide information on how to address these challenges. The goal is to help researchers design studies that will yield interpretable results that will be capable of supporting future drug applications.”

Some interesting context about it is that an analysis in JAMA Psychiatry, a research journal, estimated that most states will legalize psychedelics over the next 15 years and that “at least 25 states have considered legislation” in the space. Currently, Oregon and Colorado are the only states that have decriminalized the supervised use of psychedelics.

You can read the draft guidance here, or an overview of the guidance here.

Other social work-related news

• The White House met with representatives from 10 drug firm companies to address the cost of overdose-reversal drugs such as Narcan. Emergent BioSolutions, the company behind naloxone, has been criticized for plans at pricing the drug at $50 for a two-dose kit. The goal is to ensure that the cost of these life-saving drugs does not reach a point where they become inaccessible

• A new guaranteed income program in Washington DC is providing no-strings-attached monthly cash assistance to Black mothers with children involved in the child welfare system. The mothers are eligible to receive $500 for up to three years

• The Pittsburgh synagogue gunman who shot worshippers at Pittsburgh’s Tree of Life synagogue in 2018, the deadliest attack on Jewish people in the United States, is undergoing trial. His defense attorneys state that he “acted irrationally due to mental health problems” while prosecutors mention that he had undergone '“extensive planning”. These arguments will ultimately decide whether he is sentenced to life in prison or death

• On the international stage: Some claim that “Australia’s mental health system transforms people into ‘things’” by forcing treatment and seclusion'. In Hong Kong, mental health is “in the spotlight” after a series of violent attacks. Some reasons for the increase in mental illness in Hong Kong are attributed to COVID-19, chaos due to anti-government protests, high cost of living, and what are called coffin cubicles (see pictures of the cubicles here)

• The American Hospital Association (AHA) is lobbying Congress to address several systemic behavioral health issues

Reads on research

• Childhood housing insecurity was associated with short- and long-term mental health outcomes after adjustment for childhood poverty, suggesting that efforts to increase housing security through social policies and other methods may be protective for mental health

• Some experts think that Botox may be effective for mental health; Others are not so sure. A 2021 review of the research supported the claim that Botox may be an effective treatment for depression

Reads on policy

• “A federal judge in Little Rock struck down Arkansas’ first-in-the-nation ban on gender-affirming healthcare treatments for minors as unconstitutional on Tuesday, saying the law violates the Constitutional rights of transgender youth, their parents, and their medical providers”

Tech, social work, and other resources 😎

• Lyssn, a platform that uses artifical intelligence to analyze and review recordings of behavioral health encounters in an effort to “improve fidelity to evidence-based practices,” and Protocol Services, the nation’s leading crises hotline, were awarded a $2 million grant from the National Institute of Mental Health to “adapt the tech for use in crisis calls” (article here)

• Do you know of a leader who is shaping the future of palliative and end-of-life care? If so, you can nominate them for the Circle of Life Award

• How the field of social work is adapting to modern technologies like virtual reality and A.I.

• Prescription Digital Therapeutics For Mental Health: What It Means For Doctors And Their Patients

• Behavioral Health Tech Conference, the largest conference focused on expanding access to mental health and substance use services through technology and innovation, announced the launch of its inaugural awards program, the Young Innovators in Behavioral Health Awards

• Author Health, a health care platform for Medicare Advantage recipients, launched with $115 million in financing

Answer: Affirmative action was first used in the United States by President John F. Kennedy on March 6, 1961. The term was used in the president’s Executive Order, which stipulated that government contractors “take affirmative action to ensure that applicants are employed, and employees are treated [fairly] during employment, without regard to their race, creed, color, or national origin.”

P.S. If you found this interesting or informative, please share it with a colleague or friend.

And Happy Sunday!

Today, instead of our usual question, we honor the remarkable legacy of Marian Wright Edelman, an 84-year-old champion of civil rights and the rights of children.

Marian was born in 1939 and became involved in the Civil Rights Movement in 1959. In 1960, she and 77 other students were arrested during a sit-in at a segregated Atlanta restaurant. Following this, she went on to study law at Yale, eventually becoming the first African-American woman admitted to the Mississippi Bar in 1964.

During her lifetime of work and service, she has been intimately involved in civil rights issues; helped establish the Head Start program, which provides early childhood education, health, nutrition, and parent involvement service to low-income children and families; helped organize the Poor People’s Campaign in an effort to gain economic justice for poor people; and eventually founded the Children’s Defense Fund “as a voice for poor children, children of color, and children with disabilities”.

Marian’s life shows us that while “social worker” is a professional title that is earned through education, there are individuals in our society who do not hold the title but who do embody the essence of social work—promoting justice and advocating for the marginalized.

Her portrait, shown below, is currently displayed at the National Portrait Gallery in Washington DC.

News

Lifesaving fentanyl strips are still illegal in some states

“At Cleveland's Urban Kutz Barbershop, customers can flip through magazines as they wait, or help themselves to drug screening tests left out in a box on a table with a somber message: “Your drugs could contain fentanyl. Please take free test strips.”

Fentanyl is a synthetic opioid that is 50 to 100 times more potent than morphine. It was the cause of 75,000 of the over 100,000 drug deaths in 2022. Yet fentanyl test strips, small trips of paper that detect the presence of fentanyl in all types of different drugs, are still illegal to possess in many states due to drug paraphernalia laws dating back to the 1970s War on Drugs.

Fortunately, states have started to recognize the importance of fentanyl test strips in preventing overdoses. Kansas recently signed a bill decriminalizing the strips and Gov. Greg Abbott of Texas stopped his opposition to using the strips after a “better understanding” of their role in preventing overdose. Montana and other states are considering similar legislation.

The idea behind providing fentanyl strips is harm reduction, an approach aimed at reducing negative consequences associated with drug use. In other words, not everyone is ready or able to stop using drugs; In the meantime, we must use strategies for reducing the harm associated with use.

Other social work-related news

• Medical professionals are warning people on antidepressants to use caution when venturing outside over the coming months, as certain antidepressants can cause heat exhaustion to come quickly. 

• Bills that would ban conversion therapy in Michigan have been passed to the full body of the state Senate after being voted on by the Housing and Human Services Committee. 

• Social worker and artist Lisa Botti uses art to bring attention to human rights issues in Montana and the world

• Idaho has a higher incarceration rate than any democratic nation, and it incarcerates more women than any other state. Here’s how nonprofits and state programs there reintegrate people into society after incarceration

Reads on research

• When asked serious public health questions related to abuse, suicide, or other medical crises, the online chatbot tool ChatGPT provided critical resources – such as what 1-800 lifeline number to call for help – only about 22% of the time

• A report from Evernorth shows that:

  • 22% of people have a diagnosed behavioral condition. They account for 41% of healthcare spending. An effective behavioral health treatment (adherence to antidepressant medication and/or 3+ behavioral outpatient visits), however, can reduce this spend

  • Among patients with a behavioral condition, the research finds that 87% also have one or more medical conditions, such as a circulatory, endocrine, or musculoskeletal disorder or disease

• Gut Biome and Mental Health: Do Probiotics Work? Research suggests that probiotics may be effective in treating mental health disorders, but most studies “lack power and have weak study designs”, meaning that the evidence behind probiotics and mental health “remains inconclusive”

Reads on policy

• Arkansas is more than a third of the way through its six-month plan for redetermining whether people who remained on Medicaid during the pandemic should be able to keep their health insurance. More than 140,000 people have already lost their coverage — mostly because they have missed letters or have been snarled in paperwork problems and not because they earn too much

• 4 state policies that were introduced during the COVID-19 pandemic were led to expansion of telehealth availability for mental health care throughout the United States. Despite these policies, telehealth services were less likely to be offered in counties with a greater proportion of Black residents and in facilities that accepted Medicaid and CHIP

• A federal judge temporarily blocked portions of a new Florida law championed by Republican Gov. Ron DeSantis that bans transgender minors from receiving puberty blockers. In the United Kingdom (UK), the UK Health Service will limit puberty blockers to clinical trials. And Sen. Tammy Baldwin, a Democrat from Wisconsin, is reintroducing legislation that will include questions of sexual orientation and gender identity in government surveys to get a better sense of how the healthcare crisis is affecting LGBTQ groups

Tech, social work, and other resources 😎

• Sign up for NASW Legislative Alerts

• Last day to apply: Get Credentialed as an Emotional Fitness Instructor in order to teach online classes in resilience, burnout, etc.

P.S. If you found this interesting or informative, please share it with a colleague or friend.

And Happy Sunday!

We’re piloting a (small) newsletter program for mental health professionals with the goal of making new mental health research accessible. We’ll be sending out concise and interesting summaries of the latest mental health research weekly, and strategies for using this research in your practice. In return, we will ask for some feedback. If you’re interested, just reply to this email with “interested”. We’re looking for around 5-10 people.

—

That being said, this week, we asked DALL-E (not to be confused with Wall-E), an artificial intelligence system that generates images and art from a prompt, to create a few paintings about “social workers in 21st century America”. These are the 4 paintings it generated. Let us know what you think!

Question: Today, a more practical question - What is the most common insurance reimbursement rate per session for a clinician working in private practice?

News

The Government’s (New-ish) Plan to Targeting Homelessness

The most recent estimate of the homeless population in the United States is between 580,000 and 1.3 million people. You’ll notice that there’s quite a gap in that estimate: The reasons are that people cycle through homelessness and that different measures lead to different estimates.

In December 2022, the Biden-Harris administration set a plan to reduce homelessness by 25%. This plan is “built around three foundational pillars and three solutions pillars”. The foundational pillars are:

• Leading with equity

• Focusing on data and evidence

• Increasing collaboration across public and private sectors

The solutions pillars are:

• Preventing people from losing homes in the first place

• Improving crises response when people lose their homes

• Scaling up housing and services for people who are exiting homelessness

In addition to this, the plan is rooted in a “housing first” model, a homeless assistance approach that prioritizes offering homeless people permanent and unconditional housing, as opposed to an approach offering services first and housing later. The housing first approach has already been adopted in other countries including Finland.

For more information on this initiative, you can read through this recent interview featuring Jeff Olivet, the executive director of the U.S. Interagency Council on Homelessness, or this review the fact sheet by the Biden-Harris Administration.

Other social work-related news

• When should social workers separate families? A federal lawsuit was filed by Sarah Perkins and Joshua Sabey, parents of two young children who were briefly taken by the State of Massachusetts after a hospital visit uncovered that the child had a rib fracture. The lawsuit attempts to set a legal precedent nationwide that there should be a “neutral judge in child removal decisions unless there is an emergency situation”

• “The parents of a 22-year-old Colorado man in a mental health crisis killed by police are to receive $19m from government state and local agencies.” The unfortunate reality is that these kinds of incidents will continue to occur because we don’t have adequate support for people with severe mental illness (SMI). One type of support for people with SMI which is quite unknown but seemingly effective is the clubhouse model (not the social app), a community-based location designed to support the recovery of people living with serious mental illness

• Georgia, Arkansas, and Missouri enacted anti-trans policies that made it more difficult for people with autism and those with mental health conditions to obtain gender-affirming care. The enacted policies “suggest that the provision of such care should be withheld from autistic people, require doctors to determine whether a patient seeking gender-affirming care has autism, or require doctors to ensure that symptoms of lifelong mental health issues are ‘resolved’ prior to treatment”

• California has spent over $1 billion to fight the opioid crisis, but things keep getting worse. The main problem is fentanyl, a powerful man-made drug that's 100 times stronger than Morphine. In California, more people die from drug overdoses than car accidents, homicides, diabetes, or lung cancer

Reads on research

• A recent report on youth mental health examined the usage of mental health services by children and young people between 2016 and 2022. The findings revealed a significant rise of over 200% in the number of hospital admissions for anxiety and fear-related disorders, as well as for feeding and eating disorders among children and young adults

• An analysis of more than 175,000 individuals suggests that poor physical health scores could be a better indicator of mental illness than changes detected on brain scans. People with schizohprenia, for example, are three times more likely to develop diabetes

Reads on policy

• A bill in New Jersey was signed into law a few weeks ago which enabled mental health professionals such as psychiatrists, psychologists, clinical social workers and marriage and family therapists to help people in emergency shelters on a part-time or full-time basis. Apparently, red tape made it really difficult for people in shelters to obtain access to mental health care previously. The bill can be found here

• In Nebraska, a bill was passed that will expand access to mental health services and substance use treatment through the creation of new community behavioral health clinics

Tech, social work, and other resources 😎

• WearNet, a new deep-learning model (a technique used in Artificial Intelligence), uses Fitbit data to “gain insights into an individual’s risk for depression and anxiety.” The goal is to conduct research that would allow us to better detect mental health issues through wearables

• An NASW podcast episode on preventing fetal alcohol spectrum disorders

• Two weeks ago, we shared an article on Pear Therapuetics, the company that created digital therapeutics as a treatment for mental health disorders. The company had a valuation of $1.6 billion two years ago, but was “sold for parts” recently for $6 million after failing to secure reimbursement for its treatments

Answer: This answer comes from a report by Heard, which found that the most common “typical reimbursement rate” for a therapist in private practice who takes insurance is between $100 and $125.

The report also found that the biggest expense for these clinicians was rent and that most had business expenses of under $25,000 in 2022.

P.S. If you found this interesting or informative, please share it with a colleague or friend.

And sorry for the long hiatus 😅 I may be going back to school and was studying for a standardized test these past 5+ months.

Moving forward, you can expect this newsletter to arrive in your email inbox on a bi-weekly basis. Also, feel free to reply here or fill out the survey at the bottom and let me know what you want to see in here moving forward.

Question: How many drug overdoses occurred in 2022 and how does this number compare to that in 2015?

News

Former Social Work Students Sue the University of Southern California

“Former University of Southern California (USC) Master of Social Work (MSW) students are suing the university over claims that it did not provide students in the online program with the education promised.”

The University of Southern California has been working alongside 2U, a for-profit company which, according to its website, helps “deliver high-quality digital education at scale.” In other words, 2U works with universities and colleges to deliver online degree programs.

The former students engaged in the lawsuit claim that the University of Southern California “delivered an inferior experience to online students” compared to the in-person program, despite the university’s marketing that the two programs were similar in quality. Furthermore, the alleged lawsuit claims that the university offered an extremely expensive degree which left the former students with “one of the worst debt-to-earnings ratios in the country.”

The median student loan to pay for the degree was $112,000 😞

Other social work-related news

• Keith Doolin, an inmate on Death Row at San Quentin State Prison, California’s oldest correctional institution, has been locked inside a solitary cell for 27 years, often for 23 hours of the day. In that time, he’s never walked without a guard escort; moved without his hands shackled; used a cellphone or laptop; stepped on grass; or eaten a meal with a group of people. But this may change as Governor Gavin Newson announced that he would be transforming San Quentin “into a ‘rehabilitation center’ modeled after facilities in Norway”

• Did you know that there is a mental health hotline for new and expectant parents? It received 12,000 calls and texts in its first year. Share this with someone who may benefit from it.

• After her doctor failed to ask her about a history of sexual assault, Adrienne Baldwin-White, a member of the School of Social Work at Virginia Commonwealth University, created an app to help medical professionals better understand how to provide trauma-informed care for survivors of sexual assault

Reads on research

• A study published a few months ago found that, in a small sample of 30 adolescents which analyzed 22,000 messages sent across various platforms, self-focused language which included first-person pronouns such as “I” or “me”, language associated with the present and future, rather than the past, and a greater amount of text, were all indicators of a lower-than-usual mood. This could lead to implementing smart design such as a reminder to go for a walk or stop scrolling when it captures certain patterns.

• Some critics claim that naloxene, a medicine that rapidly reverses an opioid overdose, may promote high-risk substance abuse behaviors among adolescents. A new study shows that the opposite may be true, and that naloxene distribution is more consistently related to decreases in heroine and injection drug use among adolescents.

• Young men who use potent marijuana frequently have an increased risk of developing schizophrenia. The study also estimated that 15% of schizophrenia cases in men, and 4% of cases in women, could be averted if the person avoided cannabis

Other reads on policy

• The Washington State Legislature increased penalties for drug possession, but granted defendants access to diversion programs such as drug treatment. This law balanced different interests: Police officers and prosecutors felt that they had been unable to control open drug use and sales effectively, business owners complained that drug use in their communities scared aware customers and left it to them to clean up the residue, and Democrats fought for treatment instead of jail time

• Colorado passed HB23-1133 to make all prison calls free across state prisons and connect families. Colorado is now the 3rd state to do so

• Legislation to require courts to send mental health and intellectual disability information to the government agency that does criminal background checks for gun purchasers has cleared both houses of the Texas Legislature and is on its way to Gov. Greg Abbott for final approval

Tech, social work, and cool opportunities 😎

• “In the past few years, 10,000 to 20,000 apps have stampeded into the mental health space, offering to ‘disrupt’ traditional therapy.” Yet evidence for their efficacy is lacking.

• New treatments for conditions such as opioid addiction, ADHD and insomnia exist on your smartphone in the form of digital therapeutics. Unfortunately, the government won’t pay for them. This leads to a lack of innovation in a field that must work better if we are to deal with the mental health challenges in today’s society

• Can digital psychiatry fill the mental health gaps associated with a lack of mental health professionals? One line of thinking is that apps can never replace the therapeutic relationship. Another is that digital psychiatry can worsen care by providing cheap and ineffective treatments to those “who can’t afford traditional care”. Yet despite this, the movement is not slowing down and we will continue to see an explosion in virtual care apps and businesses.

• Therapists in Tech, a Houston-based nonprofit organization, has published a new database, which allows behavioral health clinicians to review and rate digital mental health companies.

Answer: An estimated 109,680 overdose deaths occurred last year. In 2015, there were an estimated 53,000 overdose deaths.

And Happy November! We will be taking a break for the next few weeks. Expect our next newsletter to go out in early 2023.

See you soon!

The Social Work Newsletter Team

And Happy Sunday! 172 years ago, on this date, suffragists held the first-ever National Women’s Rights Convention in Massachusetts. Durin the convention, Lucy Stone, one of the speakers, said “We want that [women] should attain to the development of her nature and womanhood; we want that when she dies, it may not be written on her gravestone that she was the [widow] of somebody.” The suffrage movement succeeded in their cause when the 19th amendment was ratified on August 18, 1920. It granted women the right to vote.

Question: What was the first institution of higher learning in the United States?

News

Universal Pre-K in New Mexico

New Mexico voters are set to vote a ballot measure that would make the state the “first in the country to guarantee a constitutional right to early childhood education”. In other words, constituents of the state will be voting on whether or not to make pre-kindergarten (pre-K) a universal right.

The measure would be funded by the state’s sovereign wealth fund, a “batch of money” that belongs to the state and which the state invests. The fund was originally created through the Land Grant Permanent Fund in 1912 and was financed by state oil and gas revenue, in addition to interest through investments.

Currently, the state requires 5 percent of the fund to be withdrawn annually and distributed to support schools, hoospitals, and universities. If the amendement passes, it would authorize an additional 1.25 percent annually for education, which translates to around $250 million.

Currently, only three states, Vermont, Oklahoma, and Florida, in addition to the District of Columbia, offer univesal Pre-K. There are many arguments for and against universal pre-K. Proponents point out that high-quality early childhood may reduce teen pregnancy, improve graduation rates, and reduce incarceration rates. On the other hand, detractors argue that the effects of pre-K are mixed and that the money should instead be spent on expanding other programs such as the federal child tax credit or direct subsidies for parents.

Other social work-related news

• Since licensed social worker Karla McDay founded Harmony House in 2014, she has been working to assist young adults experiencing homelessness in Summit County

• Millions of Americans will find out soon how much their health insurance premiums will increase next year — and eat into their paychecks

• Paying for mental health care is leaving families in debt and isolated. This is exacerbated by the difficulty of finding a mental health provider who accepts insurance

• Colorado, Florida, and Idaho will not participate in a key part of the Centers for Disease Control and Prevention’s Youth Risk Behavior surveys that reach more than 80,000 students. Over the past 30 years, the state-level surveys, conducted anonymously during each odd-numbered year, have helped elucidate the mental health stressors and safety risks for high school students

Reads on research

• Children who were randomly placed out of institutional care and into well-supported foster care before the age of 3 had changes in areas of the brain that support higher-order problem-solving years later when the children were 16. In addition, children placed into high-quality foster care before 3 years old saw typical brain development from 9 to 16 years, in areas related to emotional reactivity, language and executive function, but this pattern was altered in children who were deprived of family care

Other reads on policy

• The government announced plans on Tuesday to award millions of dollars in grants to expand all-hours mental health and substance abuse care in more communities around the country

• The federal government is pumping millions more into an effort to expand the United States' network of community mental health centers

Tech, social work, and cool opportunities 😎

• Take a peek at the recent investments in behavioral health

• How Covid prompted Asian startups to use tech in revolutionizing mental health support

• Credentialing Manager at Equip, a company helping families recover from eating disorders

• Senior Manager at Carbon health

Answer: Harvard University

We’ve previously written about the insufficient level of healthcare in the United States. A recent report by March of Dimes, a nonprofit organization that works to improve the health of mothers and babies, covered one part of our healthcare system: maternity care. The report specifically covered maternity care deserts, which are “counties where there is a lack of maternity care resources, where there are no hospitals or birth centers offering obstetric care and no obstetric providers.”

The research found that these deserts have expanded over the past few years and that nearly “7 million American women of childbearing age now live in a county with either no maternity care services or limited services”.

Question: How does the maternal mortality rate in the United States compare to the maternal mortality rate in other wealthy countries?

News

Advanced Directives in Mental Health

Advance directives are legal documents that allow a person to spell out their wishes about end-of-life care ahead of time. An example of this is the “do not resuscitate” order, which instructs providers that the person does not want to be resuscitated when there is an emergency.

Yet advance directives may also be used in a new context: In “helping people with severe mental illness to manage their own care.” These advance directives in mental health may be used in different situations. For example, if someone has a degenerative disease such as dementia where they are unable to make responsible decisions, or in an episodic and repetitive mental illness such as bipolar disorder or one where psychosis arises.

One of the ways in which these directives can be helpful is in relaying information about treatments that have been helpful or harmful in the past. People who undergo mental illness have gained experience and insight into their condition that allows them to make better decisions about their care. For instance, someone who struggles with bipolar disorder may want to share with a future provider that in case of an emergency, a specific medication or dosage is less effective or more effective, thereby leading to a higher level of care.

There are other ways in which advance directives may be beneficial in helping us care for those who are mentally ill. And while this idea is relatively new, it has been gaining traction. In 2014, the United Nations Committee on the Rights of Persons with Disabilities acknowledged the necessity of advance planning, and countries such as India and Australia have incorporated advance directives into their mental health laws.

In conclusion, advance directives may be an effective way to support people who have a serious mental illness. Moving forward, we must continue to conduct research, spread awareness, and integrate the use of advance directives into our laws and practice.

Other social work-related news

• The Healing Through Justice project, a youth-led movement for mental healing in Chicago, is receiving a $10 million grant to expand its activism and leadership training

• California’s food assistance program is experiencing high staff vacancy rates while applications for the food benefits continue to increase

• A new report by Mental Health America (MHA) ranked states by mental health access and prevalence of mental health issues. It found that Wisconsin, Pennsylvania and Massachusetts rank at the top, while Arizona, Oregon and Kansas round out the bottom

• Connecticut's foster care population has dropped by a third since 2019 due to strong leadership, efforts to keep families together, and “benevolent” lawsuits that pressured the child welfare system in the state to work more effectively

Reads on research

• A new AI model from the University of Washington’s medical school was able to accurately identify potential signs of worsening mental illness after being trained to sift through everyday text messages

• Men who belonged to unions their entire career made up to $1.3 million more on average than men who never joined one

Other reads on policy

• Nearly 1 million additional Americans will have access to ObamaCare subsidies next year under a final rule issued Tuesday by the Biden administration. The new rule will cover the so-called “family glitch”, a loophole which has obstructed 5.1 million families with dependents in obtaining ObamaCare subsidies

Tech, social work, and cool opportunities 😎

• Brave Health, the largest virtual mental health provider and engagement platform focused on serving Medicaid populations, announced a $40M Series C funding round

• Lynchburg, Virginia-based Thriveworks has opened new youth mental health services in 18 sites across 12 states. The new offering, called TherapyLand, will provide services to children ages 12 and younger for developmental disabilities, autism spectrum disorders, ADHD, parental divorce, grief and loss, defiance and bullying, among others.

• Boston-based InStride Health has launched with $26 million in new capital to expand its virtual pediatric behavioral health company.

Answer: The United States has a higher maternal mortality rate than other wealthy countries