Monthly Archives: May 2014

Living — Successfully — with Mental Illness

Esme Wang, an award-winning writer, lives with bipolar disorder. (Nora Elmeligy/KQED)

Esme Wang, an award-winning writer, lives with bipolar disorder. (Nora Elmeligy/KQED)

By Nora Elmeligy

It’s been a week since the deadly shooting rampage near Santa Barbara. Much attention has been paid to the apparent perpetrator’s mental health status.

“It is still possible to live a really exciting, thriving, magnificent life, even with those limitations.”
Horrific events — and the intense media attention paid to them — feed a false perception that people with mental illness are violent. They are not. They may be more likely to be victims of violence than to cause it.

For people who live with mental illness, the timeliness of the Isla Vista rampage is especially wrenching — May is Mental Health Month, a time when community groups are trying to stress the importance of protecting and promoting mental health.

The Mental Health Association of San Francisco (MHASF) works together with its umbrella organization Mental Health America in working to change attitudes towards mental health and mental health care. They group says believing people who are mentally ill are likely to be violent is just one of three major stigmas they encounter. The others are the perception that people with mental illness are childlike or incompetent.

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Doctors Say They Would Forego Aggressive Treatment When Near Death

(Getty Images)

(Getty Images)

By Katherine Hobson, NPR

Everybody dies.

But when doctors’ time is up, they are different from the rest of us. They “go gently” rather than opt for aggressive end-of-life treatments, as one physician wrote a few years ago. They have seen the suffering of their patients at the end of life and want no part of it.

In fact, nearly 9 in 10 young physicians just finishing up their residencies or fellowships wouldn’t want to receive life-prolonging CPR or cardiac life support if they were terminally ill and their heart or breathing stopped, a Stanford University School of Medicine survey finds.

The report, published Wednesday in the journal PLOS ONE, notes the disconnect between the aggressive care the average person receives — an average of about $7,000 worth for Medicare beneficiaries in their last month of life — and what doctors would want for themselves. Continue reading

Lawmakers Push for More Mental Health Spending

(seliaymiwell/flickr)

(seliaymiwell/flickr)

California lawmakers announced a series of budget proposals Wednesday calling for more training of law enforcement officers on how to handle people with mental illness. While lawmakers have been working on the proposals for weeks, there is renewed emphasis on them in the aftermath of a gun rampage that left seven people dead near UC Santa Barbara last weekend.

“How do we stop this before it happens?” said Sen. Hannah-Beth Jackson (D-Santa Barbara).

Jackson said police officers who visited the shooter before the violence erupted failed to investigate him thoroughly and failed to recognize warning signs of mental health problems. “This is a young man whose mental illness was right out there on YouTube, right out there on Facebook, and in screeds that he posted on blogs,” Jackson said. “And yet no one did or was able to recognize the potential for violence that resulted in this mass set of murders.”

Sen. Loni Hancock (D-Berkeley) says the problem continues inside the state’s jails and prisons, where nearly half the inmates suffer from mental illness. She cited incidents where mentally ill inmates were improperly pepper sprayed. Continue reading

Insurance Commissioner Defends Health Insurance Initiative

Dave Jones leads the California Department of Insurance. (Courtesy: Department of Insurance)

Dave Jones leads the California Department of Insurance. (Courtesy: Department of Insurance)

In this lull between the end of the first open enrollment for Covered California and the release of rates for next year — expected to be made public in July — San Francisco’s Commonwealth Club invited the state’s Commissioner of Insurance Dave Jones to talk about the state of the health care overhaul in California.

The commissioner closed his remarks by pitching for the rate review ballot initiative coming up in November. As moderator of the discussion following, I fielded several questions from the audience about the upcoming initiative. To recap the basics: If passed, the initiative would give the insurance commissioner the authority to reject excessive health insurance rate increases.

The insurance commissioner already has that authority over auto, homeowner, property and casualty insurance — via voter-passed Proposition 103 back in 1988. Many voters are surprised, Jones said, to find out he cannot also reject health insurance premium increases.  He called this lack of explicit authority a “major missing piece of the Affordable Care Act.” Continue reading

Two California Counties Sue Narcotics Makers in Deceptive Marketing

Two California counties – Orange and Santa Clara — joined forces and filed a lawsuit this week against five of the largest prescription narcotics manufacturers. The Los Angeles Times summarized the case this way:

(T)he lawsuit alleges the drug companies have reaped blockbuster profits by manipulating doctors into believing the benefits of narcotic painkillers outweighed the risks, despite “a wealth of scientific evidence to the contrary.” The effort “opened the floodgates” for such drugs and “the result has been catastrophic,” the lawsuit contends.

Thursday on KQED News, Tara Siler spoke with Robert Bohrer, a professor at the California Western School of Law in San Diego. The lawsuit does not challenge the FDA approval of these drugs. Instead the case alleges that the companies broke state laws against false advertising, unfair business practices and creating a public nuisance.

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Adequacy of Doctor Networks Key Issue for Covered California

Screenshot from CoveredCA.com, the website of Covered California.

Screenshot from CoveredCA.com, the website of Covered California.

Contract negotiations are about to begin for health insurance companies that want to sell plans next year through the state marketplace, Covered California. One area of scrutiny by the agency is sure to be adequacy of provider networks offered by insurers. 

“Insurers have gotten the message that there’s some consumer dissatisfaction out there.”
Last year, in order to keep premium costs down, insurance companies sold plans with a narrowed list of doctors for customers to choose from. The goal was to offer doctors and other providers more patients in exchange for a lower cost of providing services.

But many more people signed up for Covered California plans than had been anticipated, leaving perhaps too few doctors to see the patients. Many people scrambled to find a doctor. Complaints to the state show that some people were forced to leave a trusted specialist; some women in their third trimester of pregnancy found they’d have to switch to an unknown obstetrician for their birth. 

“It’s unfair and unrealistic,” said Betsy Imholz, an advocate with Consumers’ Union.
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Patent Reform Plunged Into Deep Freeze

(Saul Loeb/AFP/Getty Images)

(Saul Loeb/AFP/Getty Images)

Patent reform is a big deal in California, and not just to Silicon Valley tech companies. Any company that makes money off a patented idea or technology is keenly interested in what happens at the federal level – or doesn’t. 

“This news is devastating to the welfare of startups who will continue to face the threat of patent trolls.”

Senator Patrick Leahy, the Vermont Democrat who chairs the Judiciary Committee, has taken the patent reform bill off the agenda, lamenting in a statement the various industries that rely on patents could not come to terms “on how to combat the scourge of patent trolls.”

“I have said all along that we needed broad bipartisan support to get a bill through the Senate. Regrettably, competing companies on both sides of this issue refused to come to agreement on how to achieve that goal.” Continue reading

Key Drivers of the Rise in Double Mastectomies: Anxiety and MRIs

(Getty Images)

(Getty Images)

By Nancy Shute, NPR

The number of women getting double mastectomies after a breast cancer diagnosis has been rising in the past 10 years, even though most of them don’t face a higher risk of getting cancer in the other breast.

More than two-thirds of the women who had the double mastectomy had no risk factors that would make it more likely that they would get breast cancer again.

That has cancer doctors troubled, because for those women having the other breast removed doesn’t reduce their risk of getting breast cancer again or increase their odds of survival. And they don’t know why women are making this choice.

Worry about the cancer coming back is one of the biggest reasons, according to a study of women in California and Michigan that tried to figure out which women decided on a double mastectomy, and why.

Women who had a breast MRI were more likely to decide on a double mastectomy, even if the scan didn’t show more cancer. Continue reading

Alameda County School for Teen Parents Faces Funding Uncertainty

One of the nurseries at Fruitvale Academy,, an education program for pregnant and parenting teens and their children. (Brittany Patterson/KQED)

An unusual sight at a high school: a nursery. But Fruitvale Academy is an education program for pregnant and parenting teens — their children are cared for on campus at a nursery like this.  (Brittany Patterson/KQED)

By Brittany Patterson

When Jennifer Martinez found out she was pregnant when she was 14, she says that the support systems in her life abruptly changed. She lost all of her friends, she couldn’t reach out to her family, and suddenly she felt alone.

She had run away from home and spent time in and out of jail. When she got pregnant, she was living with her boyfriend’s parents. Just a year after her son, Vincent, was born, Martinez learned she was pregnant again.

Choosing to have this second child, a daughter, was a turning point in her life, she said.

“As soon as I had my daughter, I finished my last jail time,” Martinez said. “I told my probation officer, ‘I promise I’m not going to come back here again.’” Continue reading

Study: Steps to Save Lives in a Flu Pandemic

A nurse introduces the front desk for the negative pressure isolation rooms section, which will be used to treat potential H7N9 avian influenza patients, at a Taipei hospital on April 6, 2013, just after the H7N9 virus emerged on China's mainland. (Sam Yeh/AFP/Getty Images)

A nurse introduces the front desk for the negative pressure isolation rooms section, which will be used to treat potential H7N9 avian influenza patients, at a Taipei hospital on April 6, 2013, just after the H7N9 virus emerged on China’s mainland. (Sam Yeh/AFP/Getty Images)

By Brian Lau

In a new analysis, Stanford researchers, in collaboration with others across the country, suggest changes policy makers could address now to save thousands of lives and billions of dollars in the event of a pandemic, such as the one the world saw in 2009 when H1N1 swept around the world.

A new bird flu strain — H7N9 — emerged in March, 2013, World Health Organization report 400 deaths since last April, most of them in Asia.

Researchers used data from the 2009 pandemic and the virus characteristics of the H7N9 bird flu in a model to estimate the health and economic consequences. They studied the effect of both vaccination programs and public health initiatives, using different time points during the first 12 months of a simulated severe pandemic in a densely populated metropolitan area.

In 2009, a vaccine was developed and became available 9 months into the pandemic. Researchers found that a shorter time to vaccination — 6 months instead of 9 –  would avert nearly 6,000 deaths and save $1.9 billion in treatment costs. The study was published in the Annals of Internal Medicine this week. Continue reading