Mentally Ill Often Targets of Violence

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Suicide Now Kills More Americans Than Car Crashes: Study

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Suicide Now Kills More Americans Than Car Crashes: Prevention efforts lowered traffic fatalities, more attention needed for suicide, experts say ***************************************************** Suicide Prevention CE Course (7 hours) Description $ - For course pricing details, see our Pricing page by clicking on the "Pricing" tab This course is designed to help you: Increase awareness of suicide prevention methods Increase familiarity with broad based support systems Become familiar with strategies to reduce stigma Learn how to promote efforts to reduce efforts to lethal means of self harm. Identify at risk behavior Implement appropriate treatment and resources Develop and Promote Effective Clinical and Professional Practices CEU LPC, ceus mft, ceu’s for social workers, BBS approved, NBCC provider, nursing ceus, online ceus, ceus for MFTs, ce courses for counselors, Social Worker ceus, continuing education units for LPCs, MHC ceus, LCSW, ASW and MFT Intern ceus, Board approved ceus in many states, national board approval ceus, alcohol and drug abuse counselor ceus. See chart below for your state and license.

Feeling Guilty Versus Feeling Angry – Who Can Tell the Difference?

When you rear-end the car in front of you at a stoplight, you may feel a mix of different emotions such as anger, anxiety, and guilt. The person whose car you rear-ended may feel angered and frustrated by your carelessness, but it’s unlikely that he’ll feel much guilt. The ability to identify and distinguish between negative emotions helps us address the problem that led to those emotions in the first place. But while some people can tell the difference between feeling angry and guilty, others may not be able to separate the two. Distinguishing between anger and frustration is even harder. In a study forthcoming in Psychological Science, a journal of the Association for Psychological Science, psychological scientist Emre Demiralp of the University of Michigan and his colleagues hypothesized that clinically depressed people would be less able to discriminate between different types of negative emotions compared to healthy individuals. Clinically depressed people often experience feelings of sadness, anger, fear, or frustration that interfere with everyday life. “It is difficult to improve your life without knowing whether you are sad or angry about some aspect of it,” says Demiralp. “For example, imagine not having a gauge independently indicating the gasoline level of your car. It would be challenging to know when to stop for gas. We wanted to investigate whether people with clinical depression had emotional gauges that were informative and whether they experienced emotions with the same level of specificity and differentiation as healthy people.” The researchers recruited 106 people between the ages of 18 and 40 to participate in their study. Half of the participants were diagnosed with clinical depression and half were not. Over the course of seven to eight days, they carried a Palm Pilot, which prompted them to record emotions at 56 random times during the day. To report their emotions, they marked the degree to which they felt seven negative emotions (sad, anxious, angry, frustrated, ashamed, disgusted, and guilty) and four positive emotions (happy, excited, alert, and active) on a scale from one to four. Demiralp and his colleagues looked at participants’ tendency to give multiple emotions (e.g., disgusted and frustrated) similar rankings at a given point in time. According to their methodology, the more two emotions were reported together the less the person differentiated between these emotions. The researchers found that clinically depressed people had less differentiated negative emotions than those who were healthy, supporting their hypothesis. Notably, they did not find the same difference between groups for positive emotions—people with and without diagnosed clinical depression were equally able to differentiate between positive emotions. It is possible that people who are clinically depressed differentiate more between positive emotions as a coping mechanism. Demiralp and his colleagues argue that the procedure used in the study to record emotions may be particularly useful in studying the emotional experience of clinically depressed people, paving the way for more treatment and therapy options in the future. “Our results suggest that being specific about your negative emotions might be good for you”, says Demiralp. “It might be best to avoid thinking that you are feeling generally bad or unpleasant. Be specific. Is it anger, shame, guilt or some other emotion? This can help you circumvent it and improve your life. It is one of our overarching goals to investigate approaches for facilitating this kind of emotional intelligence at a large scale in the population.” *** This research was supported by NIMH grants MH60655 to John Jonides, MH59259 to Ian H. Gotlib, and F32 MH091831 to Renee J. Thompson, SNF Fellowship PA001/117473 to Susanne Jaeggi, and fellowships SFRH/BPD/35953/2007 from Fundação para a Ciência e a Tecnologia and Wi3496/41 from the Deutsche Forschungsgemeinschaft awarded to Jutta Mata. Jutta Mata is now at the University of Basel, Switzerland LPCC Continuing Education ### For more information about this study, please contact: Emre Demiralp at emredemi@umich.edu. The APS journal Psychological Science is the highest ranked empirical journal in psychology. For a copy of the article "Feeling Blue or Turquoise? Emotional Differentiation in Major Depressive Disorder" and access to other Psychological Science research findings, please contact Anna Mikulak at 202-293-9300 or amikulak@psychologicalscience.org.

New national strategy paves way for reducing suicide deaths

Today on World Suicide Prevention Day, the National Action Alliance for Suicide Prevention (Action Alliance) released an ambitious national strategy to reduce the number of deaths by suicide. The strategy was called for by Health and Human Services (HHS) Secretary Kathleen Sebelius and former Department of Defense Secretary Robert Gates when they launched the Action Alliance on Sept. 10, 2010. The 2012 National Strategy for Suicide Prevention, a report from the U.S. Surgeon General and the Action Alliance, details 13 goals and 60 objectives for reducing suicides over the next 10 years. The Action Alliance, co-chaired by Gordon Smith, chief executive of the National Association of Broadcasters, and Army Secretary John McHugh, highlights four immediate priorities to reduce the number of suicides: integrating suicide prevention into health care policies; encouraging the transformation of health care systems to prevent suicide; changing the way the public talks about suicide and suicide prevention; and improving the quality of data on suicidal behaviors to develop increasingly effective prevention efforts. The Obama Administration also announced a series of activities that will help prevent suicide: •Secretary Sebelius announced $55.6 million in new grants for national, state, tribal, campus and community suicide prevention programs made possible under the Garrett Lee Smith Memorial Act and partially funded by the Prevention and Public Health Fund under the Affordable Care Act, the health care law enacted in 2010. •The Department of Veterans Affairs (VA) launched, Stand by Them: Help a Veteran, a joint VA-Department of Defense (DoD) outreach campaign that includes a new public service announcement, Side by Side, designed to help prevent suicide among veterans and servicemembers and focuses on the important role family and community play in supporting Veterans in crisis. Throughout September and beyond, VA and DoD are urging community-based organizations, Veterans Service Organizations, health care providers, private companies and other government agencies to connect Veterans and Service members in need of assistance to the Veterans Crisis Line ( 1-800-273-8255 , press 1). Additionally, as directed by President Obama’s Mental Health Executive Order issued August 31st, VA is also increasing the workforce of the Crisis Line by 50% and hiring 1,600 new mental health professionals. “Our message today is one of hope,” Secretary Sebelius said. “The national strategy will bring together the nation’s resources, both public and private, in an organized effort to provide life saving services and improve the ability of individuals, friends and family members to recognize the warning signs of despair and take action to save lives.” “By implementing this plan, we will engage diverse sectors of our communities, from health care systems and policy-makers to the media and public,” said Gordon Smith, a former U.S. senator from Oregon. “It will take all of our efforts to win this fight against suicide that touches so many American lives.” VA Deputy Secretary W. Scott Gould said, “All of us working together - friends, family, neighbors, the public and the private sector - can make a difference for Service members and Veterans transitioning back into their communities. Recognizing the warning signs of suicide and knowing where to turn for help will save lives.” Army Secretary McHugh commented on the impact of suicide on the military community in particular. “Suicide is one of the most challenging issues we face,” he said. “In the Army, suicide prevention requires soldiers to look out for fellow soldiers. We must foster an environment that encourages people in need to seek help and be supported.” Suicide is a public health issue that results in an average of 100 American deaths each day, more than double the average number of homicides. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), more that 8 million adults in the United States had serious thoughts of suicide within the past 12 months. The first National Strategy for Suicide Prevention was launched in 2001 by then-Surgeon General David Satcher. The progress achieved over the years, the significant advances in knowledge, research and practice of preventing suicide, and public comment informed the development of the new Strategy by the Action Alliance. Since the development of the first strategy, more than 100 best practices in suicide prevention are now documented and form the foundation of the new strategy. “The latest research shows that suicide is preventable, suicidal behaviors are treatable, and the support of families, friends, and colleagues are critical protective factors. Suicide prevention needs to be addressed in the comprehensive, coordinated way outlined in the national strategy,” said Surgeon General Regina M. Benjamin. Dr. Benjamin also released a new public service announcement promoting the national suicide prevention line –1-800-273-TALK(8255). The Action Alliance is composed of approximately 200 public- and private- sector organizations united by a common vision of a nation free from the tragic experience of suicide. One of the private sector partners, Facebook is supporting the strategy by harnessing the power of social networking and crisis support to help prevent suicides across the nation. "All too often, people in crisis do not know how—or who—to ask for help,” said Facebook’s Global VP for Public Policy, Marne Levine. “At Facebook, we have a unique opportunity to provide the right resources to our users in distress, when and where they need them most. By enabling connection to trained and caring professionals around the world, we can do our part to let users know help is available. Through a concerted and coordinated effort on the part of private industry, government, and concerned family and friends, we can make a real difference in preventing suicide and saving lives." A new service offered by Facebook enables users to report a suicidal comment they see posted by a friend to Facebook using either the Report Suicidal Content link or the report links found throughout the site. The person who posted the suicidal comment will then immediately receive an email from Facebook encouraging him or her to call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or to click on a link to begin a confidential chat session with a crisis worker. Additionally, •If you are concerned about yourself or someone you care about, call the National Suicide Prevention Lifeline 24/7 for free, confidential help ( 1-800-273-8255 ). •To view or order printed copies of the National Strategy for Suicide Prevention and other materials, visit www.samhsa.gov/NSSP. •To learn more about suicide prevention, visit www.sprc.org. •To view the U.S. Surgeon General’s new “Everyone Plays A Role” PSA, visit http://www.surgeongeneral.gov/ •To view the Department of Veterans Affairs new “Side by Side” PSA, visit http://www.veteranscrisisline.net/materials/spmsupport/files/side-by-side-SD-eng-60-cc.wmv -------------------------------------------------------------------------------- SAMHSA is a public health agency within the Department of Health and Human Services. Its mission is to reduce the impact of substance abuse and mental illness on America’s communities.

Genetic Switch Involved in Depression

The activity of a single gene sets in motion some of the brain changes seen in depression, according to a new study. The finding suggests a promising target for potential therapies. People with major depressive disorder, or major depression, have feelings of sadness, loss, anger or frustration that interfere with daily life for weeks or longer. The symptoms of depression also include memory loss and trouble thinking. Past studies have found that people with major depression have brains that are physically different from those of non-depressed people. The depressed brain has a smaller prefrontal cortex, a region at the front of the brain that handles emotion and complicated thought. The area also has fewer and smaller neurons (nerve cells) in the depressed brain. To gain insight into the neural mechanisms at work, a group led by Dr. Ronald Duman of Yale University began with data collected in a previous study. They had done a comparison of postmortem brains from 15 depressed people and 15 non-depressed people who were matched in age, ethnicity and gender. Using DNA microarray chips to analyze the activity of 20,000 genes, the researchers had found numerous genes that were expressed (turned on and off) differently in the brains of depressed people. For the new study, the team focused specifically on genes related to synapses, the place where signals pass from one neuron to another. The work was funded in part by NIH’s National Institute of Mental Health (NIMH) and National Center for Research Resources (NCRR). The findings were published in the September 2012 issue of Nature Medicine. Analysis revealed that about 30% of the genes with significantly lower expression in the depressed brains related to some aspect of synapse function. Further experiments found significantly reduced expression for 5 particular genes in the prefrontal cortex of depressed people. The scientists searched for transcription factors—proteins that bind to the DNA of other genes to turn them on or off—that were capable of regulating the 5 genes. They found one called GATA1 that is expressed significantly more in the brains of people with major depressive disorder. Expression of the Gata1 gene in the prefrontal cortex was also higher in a rat model of depression. Raising expression of Gata1 in cultured rat neurons decreased the expression of synapse-related genes. It also decreased the number of connections between neurons, supporting the idea that higher Gata1 expression can lead to the changes seen in depressed brains. The researchers next tested the gene in rats and found that putting extra copies of Gata1 into their brains made them behave as if they were depressed MHC Ceus “We show that circuits normally involved in emotion, as well as cognition, are disrupted when this single transcription factor is activated,” Duman explains. These findings may point toward a new target for treatment. “We hope that by enhancing synaptic connections, either with novel medications or behavioral interventions, we can develop more effective antidepressant therapies,” says Duman. — by Helen Fields Related Links: Depression: http://www.nimh.nih.gov/health/topics/depression/index.shtml More Young Neurons Equals Better Brain Function: http://www.nih.gov/researchmatters/april2011/ 04112011brainfunction.htm Brain Basics: Know Your Brain: http://www.ninds.nih.gov/disorders/brain_basics/know_your_brain.htm Reference: Nat Med. 2012 Aug 12. [Epub ahead of print] PMID: 22885997.

Study provides roadmap for delirium risks, prevention, treatment, prognosis and research

INDIANAPOLIS -- Delirium, a common acute condition with significant short- and long-term effects on cognition and function, should be identified as an indicator of poor long-term prognosis, prompting immediate and effective management strategies, according to the authors of a new systematic evidence review ceus for nurses "Delirium is extremely common among older adults in intensive care units and is not uncommon in other hospital units and in nursing homes, but too often it's ignored or accepted as inevitable. Delirium significantly increases risk of developing dementia and triples likelihood of death. It can't be ignored," said Regenstrief Institute investigator Babar A. Khan, M.D., M.S., assistant professor of medicine at the Indiana University School of Medicine and an Indiana University Center for Aging Research scientist, the first author of the review. The authors reviewed 45 years of research encompassing 585 studies to provide a roadmap for the identification of risks, prevention and treatment options as well as prognoses related to delirium. "As an intensive care unit physician, I have seen that about 80 percent of ICU patients who need mechanical assistance to breathe develop delirium," Dr. Khan said. "That's because in addition to being on a respirator, they have multiple risk factors that can predispose and precipitate delirium, including but not limited to serious illness, restraints and pre-existing cognitive impairment." According to the American Delirium Society, more than 7 million hospitalized Americans suffer from delirium each year, and more than 60 percent of delirium cases are not recognized or treated. "Having delirium prolongs the length of a hospital stay, increases the risk of post-hospitalization transfer to a nursing home, increases the risk of death and may lead to permanent brain damage," said Regenstrief Institute investigator Malaz Boustani, M.D., MPH, associate professor of medicine at IU School of Medicine and associate director of the IU Center for Aging Research. Dr. Boustani, senior author of the new study, is medical director of the Wishard Healthy Aging Brain Center and president of the American Delirium Society. How to lower the likelihood of delirium and increase recognition of cases that occur? Drs. Khan and Boustani recommend eliminating restraints, treating depression, ensuring that patients have access to eyeglasses and hearing aids, and prescribing classes of antipsychotics that do not negatively affect the aging brain. They and the other study authors note the need for a more sensitive screening tool for delirium, especially when administered by a non-expert. "Delirium in Hospitalized Patients: Implications of Current Evidence on Clinical Practice and Future Avenues for Research -- A Systematic Evidence Review" was published in the September issue of Journal of Hospital Medicine. In addition to presenting evidence for clinical practice, it identifies areas for future delirium research. ### The study was supported by the National Institute on Aging (grant AG054205-02) and the National Institute of Mental Health (grant MH080827-04). In addition to Drs. Khan and Boustani, authors of the paper are Mohammed Zawahiri, M.D., of the Regenstrief Institute and IU Center for Aging Research; Regenstrief Investigator Noll L. Campbell, Pharm.D., of Purdue University and Wishard Health Services; George C. Fox, M.D., MRCPsych, University of East Anglia, Norfolk, U.K.; Eric J. Weinstein, M.D., of Tri-State Pulmonary Associates, Cincinnati, Ohio; Arif Nazir, M.D., Mark O. Farber, M.D., and John D. Buckley, M.D., MPH, of the IU School of Medicine; and Alasdair MacLullich, Ph.D., of the University of Edinburgh.

Simple tool may help evaluate risk for violence among patients with mental illness

Mental health professionals, who often are tasked with evaluating and managing the risk of violence by their patients, may benefit from a simple tool to more accurately make a risk assessment, according to a recent study conducted at the University of California, San Francisco. The research, led by psychiatrist Alan Teo, MD, when he was a UCSF medical resident, examined how accurate psychiatrists were at evaluating risk of violence by acutely ill patients admitted to psychiatric units. The first part of the study showed that inexperienced psychiatric residents performed no better than they would have by chance, whereas veteran psychiatrists were moderately successful in evaluating their patients' risk of violence. However, the second part of the study showed that when researchers applied the information from the "Historical, Clinical, Risk Management󈞀–Clinical" (HRC-20-C) scale – a brief, structured risk assessment tool – to the patients evaluated by residents, accuracy in identifying their potential for violence increased to a level nearly as high as the faculty psychiatrists', who had an average of 15 years more experience. "Similar to a checklist a pilot might use before takeoff, the HRC-20-C has just five items that any trained mental health professional can use to assess their patients," Teo said. "To improve the safety for staff and patients in high-risk settings, it is critical to teach budding psychiatrists and other mental health professionals how to use a practical tool such as this one." The study was published Aug. 31 in the journal Psychiatric Services. The HCR-20-C was developed several years ago by researchers in Canada, where it is used in a number of settings such as prisons and hospitals. However, in the United States, structured tools such as the HCR-20-C are only beginning to be used in hospitals. "This is the first study to compare the accuracy of risk assessments by senior psychiatrists to those completed by psychiatric residents," said senior author Dale McNiel, PhD, UCSF professor of clinical psychology. "It shows that clinicians with limited training and experience tend to be inaccurate in their risk assessments, and that structured methods such as HCR-20-C hold promise for improving training in risk assessment for violence." "The UCSF study was unusual," Teo added, "in applying a shorter version of the tool that could be more easily incorporated into clinical practice." Teo and his team assessed the doctors' accuracy by comparing the risk assessments that they made at the time patients were admitted to the hospital, to whether or not patients later became physically aggressive toward hospital staff members, such as by hitting, kicking or biting. The study included 151 patients who became violent and 150 patients who did not become violent mhc continuing education The patients in the study had severe mental illnesses, often schizophrenia, and had been involuntarily admitted to the hospital. ### The study was partly supported by the National Institute of Mental Health, a Minority Fellowship sponsored by the American Psychiatric Association and the Clinical and Translational Science Award from the National Institute of Health (NIH). When this study was conducted, all of the authors were affiliated with the UCSF Department of Psychiatry. Teo now is with the Department of Psychiatry, University of Michigan, Ann Arbor, and Sarah Holley, PhD, a co-author, now is with the Department of Psychology, San Francisco State University. Mark Leary, MD, of the UCSF Department of Psychiatry, also is a co-author. UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.