Feeds:
Posts
Comments

Posts Tagged ‘criminal justice system’

I’m still amazed that a government agency is asking for our opinions – and better yet, they’re actually listening.

Check out this post for a little background. The verdict is in. The USDA is backing off on a proposal that might have inadvertently encouraged heavy drinking. They had originally proposed to ditch the daily recommendations and set weekly recommended quantities of alcohol, but the public spoke out. Since most people do their drinking only one to three nights a week, those who took the time to comment online were mostly concerned that drinkers would look at weekly guidelines and try to cram one week’s worth of drinking into one night. And that was a real possibility – most of us know how bright alcoholics are when it comes to justifying “let’s have another one!”

The USDA’s new guidelines retained a daily recommendation for alcohol consumption, and they now define heavy drinking and binge drinking as well. They admit there is evidence of health benefits of moderate drinking – apparently they’re trying extra hard not to give anyone the idea that it’s okay to drink like a fish – but they now give the stern “this is bad for your health” statement like you’ll find on a cigarette pack, listing all the health conditions that might get in your way if you drink too much.

According to Join Together, it was the online response from private citizens (both healthcare professionals and concerned consumers) that made a difference in the final policy decision. That is seriously encouraging. All government agencies should have a limited public commenting period like this every time new policies are being considered. 

Get ready to click again – someone else needs our input now. The Centers for Medicare and Medicaid Services (part of the Department for Health and Human Services) is asking what we think about Medicare covering alcohol screening and counseling in primary medical care.

This debate is about whether Medicare and Medicaid should cover alcohol abuse prevention, screening, and counseling. They already cover screening for other medical issues, but this time they’re considering doing that for something that might cross over into services that are normally performed by mental health providers.

Providing the service could mean a significant extension of prevention and early intervention services for individuals struggling with alcohol. It could also be pretty expensive, but then again so is the current drain on state and federal budgets when it comes to incarceration of drunk drivers and other alcohol-fueled criminals, child protective services, healthcare services for abused family members, emergency services for indigent people with alcohol poisoning, and anything else that relates to the public costs of excessive drinking.

A report on reducing underage drinking from the National Academy of Sciences found that government agencies, businesses, and individuals in the United States end up spending – and remember, this is just about underage drinkers – around $53 billion per year (including $29 billion due to violent crime and $19 billion from traffic crashes) because we can’t keep the alcohol away from the kids. Now that’s expensive. And that study was presented back in 2003. What are those numbers like today? And how much greater could the costs be for adults with alcohol problems?

If you want to get in on the debate, their National Coverage Analysis Tracking Sheet is open for comments until March 20, 2011. Let them know – especially if you work in healthcare – what you think about how this might work, who might coordinate the services, how often the services might be offered, or under what conditions Medicare or Medicaid might play a greater role in preventing a lot more unnecessary problems.

Advertisements

Read Full Post »

I have a special place in my heart for anyone trying to give guided instruction in current events, especially lately. For one thing, we as a country are in the middle of an incredibly interesting journey on which we’re throwing it all on the table, getting it out in the open, and hashing out some things that have been swept under the rug for a long time. For another thing, the analysis of current events always looks different a month or a year or a presidential term later, so what we first see as truth is bound to change a little eventually. But someone has to get the conversation started.

I have a friend who says he’s teaching a class in civil discourse this coming semester. I think that’s a brave thing to do – I imagine it means he’s going to try to teach young people how to communicate without using anger or irrational behaviour. The more I think about it, the more I think it should be a required class in our schools. All of them. Catch the kids with the attitude problems before they’re old enough to buy guns.

The evidence is piling up in favor of paying extra attention to our country’s educational system. And that’s normal – schools need new rules all the time in response to a changing society. Remember typing class? That changed a bit over the years, didn’t it? In the seventies, it was typing class. In the nineties, it was keyboarding class. I have no clue what they’re calling it nowadays. For all I know, they’re now teaching 5-year-olds their ABCs using the touch typing system, word processing software, and the media controls on the computer, which takes care of all three skills at once.

So I made a little list of the new classes I think ought to be added to each and every school’s curriculum, and be made a requirement for high school middle school graduation. Correct me if I’m wrong, but I think these new classes will really make a difference in the lives of the young adults we throw out into the world with questionable social skills.

– Civil Discourse: how to state opinions and discuss issues in productive ways, especially in response to angry and hateful boneheads (must earn a B or better to pass)

– Criminal Law 101: introduction to the nature of crime and punishment, the penalties for various laws in their local area, and the difference between movies and reality (unit on survival skills to be made available in certain gang-infested school systems)

– Beginning Personal Finance: everything from making change to balancing a checkbook to the joys of compound interest (or the avalanche of compound interest, in the case of credit cards), with a special section on how to avoid getting ripped off

– Fifth-Grade Ethics: why and how to act in everyone’s best interest, how to begin figuring out what that is, and when and how to speak up in the face of injustice (violators of other school rules must repeat this class with the fifth-graders, no matter how old they are)

– Introduction to Gun Safety (mandatory in TX, NM, and AZ; optional everywhere else): how to safely handle, clean, and fire a gun; with emphasis on hunting, the difference between self-defense and self-importance, and the dangers of semiautomatic weapons (prerequisite, Ethics; must be taught concurrently with the class on Civil Discourse)

Feel free to add your own, but I think these five classes could be the start of some cool new rules in school – and save lives, and save the government a heck of a lot of money down the road, and…

Read Full Post »

The Patient Protection and Affordable Care Act (PPACA) began its journey into the wild blue yonder today.

You know the laundry list of benefits that went into effect today. There’s no way some part of the media has not reached you by now. Across the board, we’re getting ready to see:

  • elimination of lifetime coverage limits
  • restrictions on or phaseouts of annual coverage limits
  • extension of dependent coverage up to age 26
  • no more policy cancellations for sick people

And these changes are also being made, but only for employer plans or new individual policies – they may not apply if your insurer chooses not to amend your existing policy:

  • no more plans that deny or cancel coverage for children with pre-existing conditions
  • free evidence-based preventive care services
  • no more out-of-network increases for medical emergencies

Now, I think that making predictions about what these changes will or won’t do is a little like predicting whether getting a new job will make you a happier, more productive person. The grass may look greener, but you don’t know until you get there. There are too many variables involved.

But I have another list for you.

According to the Bazelon Center for Mental Health Law, we have the following facts staring us in the face:

  • 26% of Americans have a diagnosable mental disorder.
  • Only 29% of those people actually receive treatment.
  • 50% of Americans with a mental disorder have problems by age 14.
  • Mental disorders are the leading cause of disability for Americans age 15-44.
  • Major mental disorders cost America at least $193 billion per year in lost wages alone. This study only focused on comparative wage levels – it didn’t include the costs of presenteeism (showing up but being unproductive) or absenteeism (calling off work) on the job.

Insurance parity is an economic issue. Mental health parity is great, but it isn’t enough. Now we need to get people into treatment and back to productivity, and cost – lack of insurance coverage – is the biggest roadblock to getting that help.

Think of the cost savings if we could get people off of public disability assistance and/or Medicaid. Think of the extra cash flow that America could experience with additional payroll tax income, sales tax income, and property tax income because so many more people would be able to work and buy things like appliances and furniture and homes. Think of what could happen if all those kids got help and became productive citizens instead of being homeless or in jail.

No matter who reacts how to the new law, we’re taking another step in the right direction for the good of our country as a whole. You can talk about bleeding hearts all you want, but the return on investment here is too great to pass up.

Read Full Post »

Just when you think nothing can surprise you anymore…

http://www.jointogether.org/news/research/summaries/2009/cocaine-vaccine-cuts-drug.html

Read Full Post »

Here’s another encouraging bit of news:  mental health is getting more funding in the form of grant money from the American Recovery and Reinvestment Act (ARRA).  The main requirement is that those funds be used for research projects that have the potential to make a difference in scientific advancement in under two years.

The National Institutes of Health (NIH), which bills itself as The Nation’s Medical Research Agency, really does sponsor a great deal of medical research, so feeding over $8 billion to the NIH was probably the best way to provide research funding to the most projects at once.  Autism research was one of the main target areas, along with opportunities for science educators and existing short-term research projects which were running out of funds.

Some of that money is going to the National Institute of Mental Health (NIMH).  On their web pages, I found a couple of interesting grant opportunities that I’d like to keep an eye on.

One priority area is developing new ways of evaluating the brain without actually cutting into it.  From what I understand, just about every other organ in the body can be biopsied and analyzed without significant damage to a person’s health.  I’ll bet there aren’t very many people who are willing to give up a chunk of their brain for the advancement of science, so this new technology (whatever it is) will be great.

They would also like to get a report card on the current system of “community re-entry programs” for prisoners in need of mental health services.  I have a hunch that they’ll find that it needs major help.  I know a guy who knows a guy who regularly steals something when he’s having a hard time coping just so he can go back to jail.  He thinks that the struggle to survive is easier there.  Most jails are now being seen as modern variations of the “funny farms”, so new information here could have an impact on quite a few areas.

The grant money will also target the nature of schizophrenia and other major mental disorders, the genetics of mental illness, how to improve services for racially and ethnically diverse populations, intervention strategies for youth and young adults, and how to develop low-risk drugs that might be better solutions for some of us, among other things.

The big news will have be the results of the “Grand Opportunities” grants.  The NIMH is going to give out money to anyone who comes up with research studies which will find out more about brain development (or which part of our brain went haywire at what point to impact our symptoms), which genes specifically affect the risk of mental illness, and – my personal favorite – “Neurodevelopmental Genomics:  Trajectories of Complex Phenotypes”.

In plain English, this means we could end up with a better understanding of how genetics, physical growth, environment, and behaviour all work together over time to make us who we are.  We could end up with a more accurate system of categorizing mental and emotional disorders, which in turn might make it easier to accurately diagnose and treat them.

Click here for the full story on what the National Institute of Mental Health is doing with their piece of the pie.  I’m really looking forward to the “How Are We Doing?” page on the federal government’s ARRA website to see how this all plays out.

Read Full Post »