EBD Blog

Writing under the headline “Pros and cons of screening teens for depression,” Brendan Borrell examined some of the issues that sometimes roar around surveying youths to identify those who are depressed or at risk for depression. Mr. Borrell’s article, which is one in a series of articles about depression appearing in the Los Angeles Times, addressed concerns such as parental reservations about testing of their children without permission, false positive identification of a high percentage of students, and the absence of adequate treatment for many who need help.

Mr. Borrell established the importance of the issue in his lead:

By the time a teenager graduates high school, about one out of nine of his or her peers has attempted suicide. Suicide is the third leading cause of death among young people, behind car accidents and homicide, and 10% to 12% of teens ponder suicide every day.

Continue reading ‘Screening teens’

Tom Jackman’s article about Danny Watt to which I referred a few days ago (see this post) is generating a lot of discussion on the Post’s Web site. The comments on Mr. Jackman’s story are informative. For example, at least a half dozen mention having a family member with mental illness. Link to the comments.

Over on Science-Based Medicine, John Snyder has an extended post that systematically analyzes the assertions of Robert Sears about vaccinating children. The title is “Cashing In On Fear: The Danger of Dr. Sears.” Highly recommended.

The recent posts about news coverage of mental illness (e.g., “Danny Watt’s Story” and “Jani Illustrates Troubles“) has had me thinking about how popular media portray these problems. Over on Psych Central, Margarita Tartakovsky has an article entitled “Media’s Damaging Depictions of Mental Illness” that I recommend to readers of EBD Blog. In addition to discussing myths that are too commonly perpetuated by media such as television and film, she recommends ways to help distinguish between accurate and inaccurate portrayals of mental illness.

Link to Ms. Tartakovsky’s article.

The parents of Daniel Watt, a youth who had multiple problems, told the story of their son’s life and suicide. Tom Jackman of the Washington Post reported the story of Danny and his parents, helping explain some of the problems of addressing the needs of children with multiple diagnoses—co-morbid schizoaffective disorder and substance abuse, in Danny’s case.

Danny Watt once leapt from a moving train. He hurtled through the windshield of a rolling car. Got pummeled by drug dealers. Overdosed. Swallowed rat poison. Tried to hang himself.

In his tumultuous 21 years, Danny Watt danced with death in the most amazing, horrible ways. In the end, two college students spotted him facedown in the cold, murky water of the C&O Canal one afternoon in April 2008. The medical examiner said Danny had drowned.

Continue reading ‘Danny Watt’s story’

In “‘Benefits Go Beyond Sports’: Autistic Children Find an Outlet In Swimming,” Bill Oram of the Washington Post reports about the social benefits of participating in sports.

Justin Etherton, 13, a swimmer in the Montgomery County Swim League, is autistic. Swimming provides him a social outlet, and has been “the best thing that’s ever happened to him and to us,” his mother said.

Read Mr. Oram’s article. Check Toni L. Sandys’ photos.

According to Mary Ann Roser of the Austin (TX, US) Statesman, a clinic that provided chelation therapy for Autism is apparently under investigation by federal authorities. Ms. Roser did not report the nature or cause of the investigation of the CARE Clinics.

CARE Clinics, an autism clinic on Bee Cave Road that was being investigated by insurance companies over insurance claims, was raided by the FBI and IRS agents today.

The clinic has been closed, perhaps permanently.

Agents are removing dozens of boxes of documents, but they declined to say what they are looking for. They directed inquiries to Special IRS Agent Mike Lemoine, who did not immediately return a call.

In an article in May of 2009, Ms. Roser reported that the clinic was having financial trouble.

The owner of an Austin-area clinic that treats children with autism — using techniques that are controversial in mainstream medicine — says investigations by three major insurers have left it with a pile of unpaid claims and a crisis: She’s had to lay off most of her staff and drastically reduce the clinic’s hours.

In addition, Kazuko Grace Curtin said the Texas Medical Board is investigating her medical director. She and the doctor — Jesus Caquias — say the investigation is a way of harassing them because they offer nontraditional care for autism patients.

Link to Ms. Roser’s post entitled “Autism clinic raided by federal authorities” and to the earlier article, “Insurance companies question autism clinic’s charges” Check the discussion following the blog post (the first link).

Children and youths with ADHD and their families ought to know about systems of care. Systems of care are networks of services that are coordinated across different agencies and groups within the community. A system of care focuses on the needs of individuals and should be designed so that it takes advantage of that person’s strengths (i.e., is “strengths based”) and unique characteristics (e.g., ethnic background and native language).

Systems of care have been studied extensively in the disciplines focused on Emotional and Behavioral Disorders. They are not just for kids “lost to the streets.” The coordination of services can be beneficial for individuals with ADHD, too.

Learn more about ADHD and systems of care from the SAMHSA, the US Substance Abuse and Mental Health Services Administration. Download a PDF.

On behalf of the families of two children with Autism, a consumer advocacy groups claims that regulators in California (US) are allowing insurers to deny access to needed therapy. Consumer Watchdog seeks to require the Department of Managed Health Care to mandate that insurers pay for treatment based on applied behavior analysis for children with Autism.

KABC LA coverage

On the heels of the recent agreement in Michigan (US), I have to wonder whether advocates for children with Autism are seeing the beginning of a wave of changes in insurance support for early and intensive behavioral treatment of Autism.

Consumer Watchdog, which was previously known as “Foundation for Taxpayer and Consumer Rights,” has a pretty broad agenda. In addition to insurance issues, it addresses patients’ rights, political corruption, corporate excesses, and other topics. Consumer Watchdog’s site has links to multiple items regarding Autism.

Also see coverage by Lisa Girion of the Los Angeles Times: “Autism patients’ treatment is denied illegally, group says“; Ms. Girion covered this topic previously (see 10 Mar 2009). For other earlier posts on EBD Blog about insurance coverage for children with Autism, see 25 Jun 2009 and 20 Sep 2008.

Shari Roan’s article entitled “Jani’s at the mercy of her mind” illustrates the difficulties encountered by children with schizophrenia and their families. For those who do not know about schizophrenia in children, this journalistic case study will be a good introduction.

It’s been a rough week. A few days ago, at UCLA’s Resnick Neuropsychiatric Hospital, 6-year-old Jani toppled a food cart and was confined to her room. She slammed her head against the floor, opening a bloody cut that sent her into hysterics. Later, she kicked the hospital therapy dog.

Jani normally likes animals. But most of her animal friends — cats, rats, dogs and birds — are phantoms that only she can see. January Schofield has schizophrenia. Potent psychiatric drugs — in doses that would stagger most adults — seem to skip off her. She is among the rarest of the rare: a child seemingly born mentally ill.

Here’s a video segment (7:45) from the story; it’s by Don Kelsen and Tim French.

Link to Ms. Roan’s article. For other resources about childhood schizophrenia, see these links:

• The American Academy of Child and Adolescent Psychiatry’s Facts for Families page about schizophrenia.
• The recruitment page for the US National Institute of Mental Health’s “Childhood-onset Schizophrenia Study.”
• The Merck Manuals’ entry about childhood schizophrenia.
• The NARSAD page about childhood-onset schizophrenia.
• The North American Society for Childhood Onset Schizophrenia (Web site).
• Mayo Clinic definition.
• The US National Alliance for Mental Illness’s (NAMI) fact sheet about early-onset schizophrenia.
• Pam Belluck’s excellent article, “Living With Love, Chaos and Haley” from the New York Times (22 Oct 2006).
• Living with Childhood-onset Schizophrenia (Web site)

Summer in the US finds children and youths out of school and, perhaps, less vulnerable to some of the problems that are associated with the social and academic demands that are part of schooling. As a result, perhaps fewer of the familiar problems illustrated in this poster are apparent during summer.

If summer seems like a relief from such problems, though, that could be an important indicator that those very problems need to be addressed. A few weeks away from school probably will not cure them. Those same difficulties may still be occurring, just less obviously, and they are likely to recur soon.

Individuals or the families of children who experience the kinds of problems noted in the poster should consult the resources available from the US government’s Substance Abuse and Mental Health Services Administration. One will not find easy cures there, but by carefully perusing the resources available one can learn what signs to monitor and where to go to get help.

The image is hot. Click it to get to a good starting place.

In the US state of Michigan, a major health insurance provider will now reimburse families for the cost of providing therapy for children with autism. The case, Johns v. Blue Cross Blue Shield of Michigan, arose because Blue-Cross-Blue-Shield denied payment for behavioral treatment often called “ABA” to the family of a child with Autism. The case was settled in favor of the family last week.

Represented by Gerard Mantese, Mr. Christopher Johns alleged that the insurer should pay for the therapy for his son under the provisions of the policy. The insurance company refused and Mr. Johns sued. During depositions, Mr. Mantese and others on the Mr. Johns’ legal team learned of a draft memorandum identifying the behavioral therapy as effective and that a representative of the insurer would probably elect the behavioral therapy if that representative had a child with Autism.

Because Mr. Johns’ complaint was part of a class action suit, many other families will also benefit from the settlement. In an independent analysis of the case, Tresa Baldas discussed the implications.

The $1 million class action settlement from Blue Cross Blue Shield of Michigan comes amid a legislative wave in which a growing number of a states are passing laws that require insurance companies to pay for autism treatments and screenings. To date, 13 states have such laws, the most recent being Connecticut, Colorado and Nevada. New Jersey is currently considering an autism bill, and Pennsylvania’s law goes into effect July 1.

The June 17 Michigan settlement, meanwhile, has autism advocates hopeful that insurance companies will stop claiming that behavioral therapy for autistic children is experimental, and start paying for it.

“It is a significant victory for the families, obviously, and it marks a trend, hopefully, that insurance companies will start to look at autism treatment differently,” said Areva Martin, an attorney at Los Angeles-based Martin & Martin who is currently handling about 30 autism cases. She believes the labeling of autism treatments as experimental is “absurd.”

I wonder what this will mean for the California rules that do not expressly exclude behavioral therapies, but set requirements for deciding whether they are reimbursable (see my earlier post on that story).

Link for a quasi-news article about the settlement. Read another of the law firm’s press releases. Here’s link to Ms. Baldas’ analysis of the case.