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A recent CDC report shows that the percentage of adults with serious psychological distress who are uninsured has dropped from 28.1 percent in 2012 to 19.5 percent in the first nine months of 2015.
OBAMACARE’S DEMISE IS A LOOMING DISASTER FOR MENTAL HEALTH
AUTHOR: ISSIE LAPOWSKY
Look at a map of states president-elect Donald Trump won in November alongside a map of states with the highest rates of opioid prescriptions, and you’ll see they mostly overlap. Look more closely at the data, as one Penn State professor recently did, and you’ll find that Trump outperformed his Republican predecessor Mitt Romney the most in counties where opiate and suicide mortality rates are highest.
It’s little wonder, then, that mental health and substance abuse issues have become a key talking point for Trump, who has promised to crack down on drug cartels and called America’s mass shootings an issue of mental health—not guns.
He’s not the only Republican to adopt behavioral health as a priority. House Speaker Paul Ryan pushed for mental health legislation in the wake of the San Bernardino shooting. Senate Majority Leader Mitch McConnell, whose home state of Kentucky is a leader in opioid deaths, recently penned an op-ed titled “More Must Be Done on Heroin – soon.” And the Republican-authored 21st Century Cures Act, signed into law in December, will set aside $1 billion over two years to fight opioid abuse.
And yet, late last week, Senate and House Republicans set in motion the first steps of a plan that researchers warn could cut mental health and substance abuse treatment off at the knees: the repeal of Obamacare.
“I don’t think there’s anyone in the mental health community who thinks withdrawing the Affordable Care Act would be good for behavioral health,” says Sherry Glied, dean of New York University’s Robert F. Wagner Graduate School of Public Service, who advised the George H.W. Bush, Clinton, and Obama administrations on health policy. “It’s hard to even conceive of how that would be true.”
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Experts in behavioral health and lawmakers who have been fighting for mental health awareness vehemently oppose the legislation.
Trumpcare Will Be Catastrophic For People With Mental Health Issues
House Republicans on Thursday passed an updated version of the American Health Care Act, which could affect the millions of people who live with a mental health or substance-use disorder.
Analysis of the GOP bill by various organizations shows a grim outlook. Not only would people dealing with mental health conditions or drug dependency have to pay higher premiums, many may not even be covered.
This could have serious consequences, with the country in the throes of one of history’s worst opioid epidemics. Drug overdose is the leading cause of accidental death in America.
And, according to experts, if Trumpcare becomes law, it may undo years of progress on behavioral health.
How the bill can affect those with mental illness and addiction
The legislation threatens to gut protections for the majority of people with pre-existing conditions, which could include mental illnesses and addiction. This means the GOP legislation could allow insurers to make coverage more costly for people with existing health issues.
Premiums are likely to skyrocket. A person around the age of 40 with a drug dependency could see increases as high as 500 percent, according to the liberal think tank Center for American Progress. Those with bipolar disorder or major depressive disorder may see a 200-percent rise in surcharges.
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Even getting adults to commit to group therapy can be a challenge. Adults are burdened with more responsibility than adolescents and may have trouble finding the time and effort to make the commitment for their own healing, even when resources are available.
Why Aren’t There More Resources for Adult Self-Injurers?
By Renée Fabian 03/21/17
Over time, self-injury itself can become a habitual, nearly addictive behavior, and 8.7 percent of self-injurers are also addicts.
Erin Hardy, a Wisconsin-based therapist, found herself in a quandary when an uptick of people who self-injured came to her about five years ago. This was a new area to her practice, so Hardy sought consultation with her colleagues on resources, but they came up empty. An internet search left Hardy with unsatisfactory results.
“All the sudden I had this flood of individuals that were engaging in self-harm,” says Hardy. “There is really nothing [online] about self-harm other than the theme of, ‘Anybody who self-injures has borderline personality disorder,’ and … ‘there’s no cure, nobody can get better.'”
Undeterred, Hardy kept searching until she found S.A.F.E. Alternatives, an organization co-founded by Wendy Lader and Karen Conterio in the mid-1980s dedicated to self-injury recovery with the belief, “people can and do stop injuring with the right kinds of help and support.” Through their S.A.F.E. Focus program, Hardy got the training and materials she needed to lead a dedicated self-injury support group in her city.
Today, a similar internet search for self-harm resources yields information focused on adolescents. As one PsychForums member put it, “I have been online searching for several hours today regarding finding help for self-harm, and I’m 40. I have been seeing that it is mostly in young people, and feeling pretty embarrassed and ashamed that I’m an adult dealing with it. I feel like I should have grown out of this long ago.”
The pervasive idea that self-injury is a behavior relegated to emo teenagers is simply false. Self-injury affects 4 to 5.5 percent of adults, yet the stigma persists, leaving millions of self-injurers to struggle in silence and feel invisible.
Defined as intentionally harming the body without suicidal intent through behaviors such as cutting, burning or hitting oneself, self-injury serves as a maladaptive coping skill to deal with difficult emotions, experiences and feeling states.
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Those exhibiting personality traits associated with negative affect such as depression and anxiety (such as that found in BPD), non-conformity, impulsiveness, emotional instability, sensation-seeking and thrill-seeking, poor external locus of control, as well as low self-esteem, tend to be particularly susceptible to substance abuse disorders.
Personality disorders correlated with drug abuse, say researchers
Recent research suggests that drug addiction is frequently comorbid with personality disorders. According to Zimmerman and Coryell (1989), up to 43-77 percent of individuals with personality disorders qualify for a diagnosis of alcohol use disorder at some point in their lives. Likewise, Verheul and colleagues (1995, 1998) examined the co-incidence of personality disorders with substance abuse and found that 44 percent of individuals addicted to alcohol meet the criteria for a personality disorder. In addition to this, 77 percent of those who abuse opiates qualify for a diagnosis of a personality disorder. Cluster B personality disorders, such as borderline personality disorder, and antisocial personality disorder, were found to be particularly associated with substance abuse disorders.
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People with drug use disorder were much more likely to have psychiatric illnesses, the researchers reported in JAMA Psychiatry, as they were… 1.8 times as likely to have borderline personality disorder, when compared to people without drug abuse.
Ten Percent of Adults Have a Drug-Use Disorder in Their Lifetime
A survey of American adults revealed that drug-use disorder is common, co-occurs with a range of mental health disorders and often goes untreated. The study, funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health, found that about 4% of Americans met the criteria for drug use disorder in the past year and about 10 percent have had drug use disorder at some time in their lives.
A diagnosis of drug-use disorder is based on a list of symptoms including craving, withdrawal, lack of control, and negative effects on personal and professional responsibilities. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) no longer uses the terms abuse and dependence. Instead, DSM-5 uses a single disorder which is rated by severity (mild, moderate, and severe) depending on the number of symptoms met. Individuals must meet at least two of 11 symptoms to be diagnosed with a drug-use disorder.
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‘She suffers from this,’ you have every expert saying, ‘No, she’s not bipolar, she really has borderline personality disorder …’”
Should I Smile Back Be Categorized as an “Addiction Movie”?
By Aisha Harris
In I Smile Back, which opened this past weekend, Sarah Silverman plays very much against type: She stars as Laney, a wife and mother whose struggle to manage her mental illness threatens to upend her family and relationships. The film has been referred to casually as an “addiction movie” by many critics, as over the course of the film, Laney indulges in drugs, infidelity, and reckless behavior that put her and her loved ones at risk. But when I interviewed screenwriter and author of the novel of the same name, Amy Koppelman, and director Adam Salky (Dare) at the Toronto International Film Festival in September, they talked about not wanting the movie to be pigeonholed as such. “That’s not to say that addiction movies aren’t powerful and meaningful,” said Koppelman. “But we just always looked at the addiction, or the drinking, or the drugs, or the fucking around as symptoms of her trying to relieve herself of her fears, her having moments of being able to be numb, and in those moments not have the anxiety that’s so all-consuming for her.”
And it’s true that it doesn’t fully make sense to brand I Smile Back with that simplistic genre tag. Whereas many addiction movies like Requiem for a Dream or Drugstore Cowboy are memorable primarily for their uncomfortably bleak, unrelentingly graphic depictions of substance abuse, I Smile Back doesn’t lean so heavily on disturbing drug-fueled moments. In scenes with her husband, played by Josh Charles, Laney confesses her bleary outlook on life: She doesn’t want to get a dog for the family because she “doesn’t want the kids to be hurt by its eventual death,” she says at one point. She finds it difficult to find meaning in life—though she tries hard, and clearly loves her children and family, as shown in one particular scene in which they bond in the middle of the night during a power outage. The story is just as concerned with Laney’s depression and unhappiness as it is with watching her succumb to her addictions. In fact, it’s probably more accurate to call it a movie about mental illness—onscreen, Laney gives in to addiction over and over again, but her addiction feels much more character-driven than drug-driven.
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