IST Gets Ranked as a “Top Pharmacy” Blog

The Blogmeister firmly believes in the old adage that says something to the effect of “you have to say good things about yourself, because no one else will.” So, in that vain (pun intended)…

We are happy to report nursingdegreeguide.org writer Joel West has ranked INdiana Systemic Thinking as number 33 on his top pharmacist blogs. He writes:

33. Indiana Systematic Thinking: Posts related to mental health pharmacology, as well as other pharmacology-related posts are available through Indiana Systematic Thinking.

While we don’t feel our primary focus is pharmacology related posts, it does appear we do our fair share of it. Thanks so much to nursingdegreeguide.org and Joel…we appreciate it!

Complicated Grief Just Got More Complicated

Newsweek’s online edition carried an interesting story recently on new research focusing on complicated grief.  According to Newsweek:

In a paper in the journal Neuroimage, O’Connor and her colleagues describe using an fMRI machine to probe the neurological basis for complicated grief among a small sample of women who had lost a close relative to breast cancer. Ordinary grief is apparent on a brain scan: show a bereaved daughter a picture of her mother, and areas of the brain that process emotional pain are activated. The women with complicated grief showed that pattern, but something else as well: activity in the nucleus accumbens, a brain region associated with pleasure, rewards and addiction. “When the women came out of the scanner, the complicated-grief group rated themselves as feeling more negative than the others,” O’Connor said. “But they also said things like, ‘Oh, it was so nice to see my mom again.’ These are the ones who pore over picture albums, talk about the person all the time, almost as if she was still here.” The women in that situation were unconsciously prolonging their grief, she concluded, because memories of the person they missed gave them pleasure—as well as pain.

Interesting, but it causes one to wonder…  As practicing clinicians what are we to do to treat these patients?  Do we encourage them not to look at pictures, etc, or do we encourage it.  Perhaps further studies will give us some direction, but the basic research provided here gives a good explaination of what is going on with these grief stricken individuals.

GlaxoSmithKline Pays out big on Paxil… …Again!

The Wall Street Journal’s Health Blog is reporting GlaxoSmithKline is paying out another 40 million in ongoing litigation regarding the antidepressant, Paxil.

GlaxoSmithKline is shelling out another $40 million to deal with the fallout over the use of its antidepressant Paxil in kids. This time, the money is going to insurers who paid for the drug to be used in children and adolescents.

A class-action lawsuit argued that Glaxo had promoted the drug for use in children, while withholding evidence that the drug was neither safe nor effective in kids. Glaxo denied those charges and told the WSJ it settled to “avoid the costs, burdens and uncertainties of ongoing litigation.”

Mental Health Parity Passes as part of Bailout Bill

As I reported here early Friday morning, Mental Health Parity was attached to the bailout bill passed by the Senate last Wednesday.  It went to the House of Representatives on Friday, and was passed.  I recieved a confirmation of this yesterday from the American Association of Marriage and Family Therapists, which I would like to post, but my email server is currently down, so I can’t paste it into this post.  However, CNN has a story here that explains, as well as confirms passage.

All I can say is it’s about damn time, and to all those who worked tirelessly for this cause, I applaud and thank-you.  Sometimes we get all wrapped up in how “pork” should be left out of bills, but in this case, parity is something that should have happened a long time ago and everyone will benefit.

Big Insurance and “The Sentinal Effect”

Dr. Benjamin Brewer had a great article on the Wall Street Journal site about insurance companies requiring preauthorization for medications and services.  Most people don’t know, as mental health professionals, we almost always face the same unjust scrutiny by big insurance.  As this quote points out, insurance companies, in an effort to save money, hope that by making the preauthorization process as difficult as possible, we will all just give up, saving them money.

“They want me to incur the overhead and frustration that comes with trying to prove to a non-doctor that I know my patient and what I’m talking about. They want to cut costs, and they don’t really care about how it affects my patients or my practice. If they make the process hard enough, they hope I’ll just give up. There is even a term in the managed care literature for that kind of deterrence: the “sentinel effect.”

Just so you don’t have to click over, the Sentinal effect:

deters utilization by requiring the administrative effort necessary to authorize the procedure. “Studies have shown the sentinel effect to be persuasive

This “administrative effort” transfers over to big money, in my practice at least a third.  Of course this is passed on to our patients, but not the one’s who have insurance, as the insurance companies won’t pay us for the time it takes to cut through their red tape.  Instead, we have to charge higher rates, and pass the costs on to our private pay clients.

Just another example of how Big Insurance IS the problem in healthcare…  Not the answer.

The Bailout AND Mental Health Parity???

Wow, this was a shocker when it came across the news feed. Apparently Senate proponents of mental health parity had only one legislative vehicle left to carry their bill this year…the mortgage industry bailout bill! What is mental health parity you ask??? Well, according to the Associated Press:

“Currently, insurance plans routinely require mental health patients to pick up more of the initial costs of their care through higher deductibles and co-payments. Other times, insurance plans have stricter limits on how often patients with mental problems can see their doctors.”

Specifically, the bill would make coverage the same whether the patient had a mental or physical problem and…

“…apply to health plans that cover more than 50 employees – potentially reaching 113 million people nationwide.”

Parity is a good idea for many reasons. First, a more mentally healthy workforce is a better workforce. Second, it will help put mental health care on a par with physical health care and reduce some of the stigma still prevelant in the population. Still, it had it’s detractors. Anyone know who??? Of course, our friends at big insurance who successfully lobbied so the

legislation does not mandate that group health plans cover mental health or addiction treatment. But if they do, the coverage must be equitable with other medical coverage.

Now, according to the AP, they (insurance companies) support the legislation.

For those not following all this drama, the legislation has been negotiated and renegotiated for almost seven years. It even came up for a vote a time or two. Now that all sides agree, it should pass, but the authors lacked a way to get it in front of the entire Senate. So, in a common strategic move, they have tacked it on to the mortgage bailout bill, which passed the Senate on Wednesday, and is up for a House vote today. So, despite how one may feel about the current mortgage mess, if you are a supporter of parity, you may want to support the bailout bill and encourage your Representative to as well.

Post updated here.

State Sen. Marvin Riegsecker Loses Cancer Battle

From the AP, via the Fort Wayne Journal Gazette:

State Sen. Marvin Riegsecker, a Goshen Republican who helped push statewide adoption of daylight saving time during his two decades in the Indiana General Assembly, died Tuesday at age 71.

Riegsecker died of cancer at the Indiana University Medical Center in Indianapolis, where he was surrounded by his wife, Norma, and immediate family members, according to the Senate Republican caucus. Riegsecker was diagnosed this year with lymphoma and decided not to seek re-election.

Riegsecker, a retired pharmacist who was first elected to the Senate in 1988, was a longtime supporter of statewide daylight saving time and helped usher the contentious proposal through the legislature in 2005.

“I just want to get this over with,” Riegsecker said on the day when the daylight time bill won final approval. “I guarantee if it’s not over with, it will come back to haunt us again.”

Riegsecker represented Senate District 12, which covers most of Elkhart County in northern Indiana. He worked to protect consumers from counterfeit prescription drugs and championed causes such as providing services to those with developmental disabilities.

“In my four years in state government, I never met a kinder or more decent person than Marvin Riegsecker,” Gov. Mitch Daniels said. “Plus, he was brave in helping us tackle tough issues, always caring more about Indiana’s future than his own political future.”

Riegsecker was hospitalized for parts of the last legislative session.

“Legislative colleagues will always remember Sen. Riegsecker’s intelligence, passion and commitment,” said Senate President Pro Tem David Long, R-Fort Wayne. “We will all miss Marvin greatly.”

The Blogmeister wishes Sen. Reigsecker’s family well in their time of sorrow.

Matt Lauer Screws up on “Today” Show

This morning I’m sitting in my favorite chair, drinking a cup of coffee, and watching the “Today” show. They announce Robert Kennedy Jr. Is going to be interviewed by Matt Lauer. Here is the clip:

I just about spit coffee all over myself! For those who are historically challenged, Robert Kennedy Jr. is the son of former Attorney General and Presidential Candidate Robert Kennedy, who was assasinated in 1968.

25 Tips for Staying Married

The Evansville Courier-Press carried this article today.  As I read through them I was struck by how correct this writer is:

1. Always put her first — before work, friends, even basketball. Act as if she’s the best thing that ever happened to you, because we all know she is.

2. Keep no secrets. Pool your money. Allow nothing and no one to come between you.

3. Pick your fights with care. Play fair. Show some class. Hurtful words can be forgiven, but they’re hard to forget.

4. Fall in love again every day. Kiss her in taxis. Flirt with her at parties. Tell her she’s beautiful. Then tell her again.

5. Never miss an anniversary or a birthday or a chance to make a memory. Memories may not seem important now, but one day they’ll be gold.

6. Never give her a practical gift. If she really wants a Shop-Vac, let her pick it out herself.

7. Go to church together, and pray every day for each other and your marriage.

8. Pay your bills on time and make sure you each have a living will, a durable power of attorney and life insurance, lest, God forbid, you need them.

9. Love her parents as your own, but don’t ask them for money. Never criticize her family or friends. On her birthday, send flowers to her mother with a note saying, “Thank you for giving birth to the love of my life.”

10. Always listen to her heart. If you’re wrong, say you’re sorry; if you’re right, shut up.

11. Don’t half-tie the knot; plan to stay married forever.

12. Never go to bed mad; talk until you’re over it, or you forget why you were mad.

13. Laugh together a lot. If you can laugh at yourselves, you’ll have plenty to laugh about.

14. Never criticize, correct or interrupt her in public; try not to do it in private, either.

15. Remember that people are the least lovable when they are most in need of love.

16. Never fall for the myth of perfectionism; it’s a lie.

17. When you don’t like each other, remember that you love each other; pray for the “good days” to return and they will.

18. Tell the truth, only the truth, with great kindness.

19. Kiss at least 10 seconds a day, all at once or spread out.

20. Memorize all her favorite things and amaze her with how very well you know her.

21. Examine your relationship as often as you change the oil in your car; keep steering it on a path you both want it to go.

22. Be content with what you have materially, honest about where you are emotionally, and never stop growing spiritually.

23. Never raise your voice unless you’re on fire. Whisper when you argue.

24. Be both friends and lovers; in a blackout, light a candle, then make your own sparks.

25. Finally, be an interesting person, lead your own life. But always save your best for each other. In the end, you will know you were better together than you ever could’ve been apart.

Here’s to happily ever after.

DOC Makes Improvements At Girls School

Remember back in December when I posted this about St. Joseph County Judge Peter Nemeth? The story then was he refused to send female juveniles to the Indiana Girls School for a variety of complaints.

Well, today’s South Bend Tribune is reporting the Department of Corrections is making some staffing changes that are encouraging to Nemeth. Specifically;

The DOC has announced it will end a two-year-old arrangement to house boys and girls at the same Indianapolis Juvenile Correctional Facility by moving the boys to a recently renovated section of the Logansport Juvenile Correctional Facility.
…

Nemeth said he was encouraged by the DOC’s announcement that a “staffing plan for the facility is being developed to ensure the appropriate deployment of staff.”

“If they are actually doing a staffing plan … if it means more than just words, I think that is real progress,” the judge said. “I applaud them for that.

…

Girls will be moved into the unit being vacated by the boys. The unit will house girls in single rooms that lock from a central control location, along with a special management unit specifically programmed for girls struggling with mental health issues.
…

“It looks like they are going to do what we want them to do,” said Bill Bruinsma, executive director of the St. Joseph County Juvenile Justice Center. “We’ll have to see what staffing they’re going to add in and what kind of programming they’re going to put into it … It’s a step in the right direction.”

However, Nemeth doesn’t appear completely sold on the changes…

Nemeth said he still will avoid sending girls to the Indianapolis facility until he knows more details about the changes, especially whether staff-to-child ratios improve. Instead, he said he is sending girls who are the most difficult to rehabilitate to a private juvenile detention facility in Vincennes, at a daily cost to the county of $138, compared to $60 a day at the Indianapolis DOC girls school.