Tag: public policy

Reading of the Week: Public Policy & Mental Health – Daylight Saving Time (CMAJ) & Opioids (JAMA); and Lopez on Wyoming & Suicides

From the Editor

This week, the three selections look at the intersection of mental health and public policy.

With daylight saving time ending, many North Americans set their clocks back an hour this past Sunday morning, seemingly gaining an extra hour. But several jurisdictions have ended “spring forward, fall back,” instead choosing permanent daylight saving time. What are the effects on mental and physical health? In the first selection, Dr. Raymond W. Lam (of the University of British Columbia) and his co-authors attempt to answer that question with an impressive CMAJ paper with 42 references and two tables. “Ending biannual clock adjustments may eliminate transition harms that last a few weeks, but the health effects of permanent time are likely to be chronic.”

In the second selection, a research letter published in JAMA, Dr. Lyna Z. Schieber (of the Centers for Disease Control and Prevention) and her co-authors analyzed US pharmacy data to better understand opioid dispensing in recent years. They report some good news, in part because of federal and state legislative changes: “Opioid dispensing continued to decline through 2025, extending more than a decade-long downward trend in the United States since its peak in 2012.”

Finally, in the third selection, German Lopez writes about suicides in Wyoming in the New York Times. His excellent essay describes a state facing a major problem: its suicide rate is double the US national average. He writes about the different people he has met, noting a general reluctance to talk about mental health. He also describes legislative reforms that would help. “If the state wants to lose its status as one of the worst for suicides, something has to change.”

DG

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Reading of the Week: Lived Experience & Psychosis – the New World Psych Paper; Also, the Evidence for Cannabis (QT) and Bob Bell on Psychotherapy (Globe)

From the Editor

“Something as basic as grocery shopping was both frightening and overwhelming for me. I remember my mom taking me along to do grocery shopping as a form of rehabilitation… Everything seemed so difficult.”

So comments a patient on the experience of a relapse of psychosis.

Typically, we describe psychosis with lists of symptoms. But how do patients understand these experiences? In a new World Psychiatry paper, Dr. Paolo Fusar-Poli (of King’s College) and his co-authors attempt to answer this question with a “bottom-up” approach. As they explain: “To our best knowledge, there are no recent studies that have successfully adopted a bottom-up approach (i.e., from lived experience to theory), whereby individuals with the lived experience of psychosis (i.e., experts by experience) primarily select the subjective themes and then discuss them with academics to advance broader knowledge.” We discuss their paper.

In the second selection, we consider a new Quick Takes podcast. Dr. Kevin Hill (of Harvard University) reviews the cannabis literature and weighs the evidence. He notes the hazards of CBD, the lack of evidence for cannabis and sleep, and his fondness for the Chicago Bears. “There are very strong proponents for cannabis and there are people who are entirely sceptical about it. And the answers to a lot of these questions are somewhere in the middle.”

Finally, in the third selection, Dr. Robert Bell (of the University of Toronto) and his co-authors advocate for the expansion of public health care to cover psychotherapy. Dr. Bell, who is a former Deputy Minister of Health of Ontario, makes a clear case drawing on international examples. “Canadians understand that good health requires mental-health support, and co-ordinated investment in mental-health treatment would pay dividends in reducing the impact of mental-health disability on the economy.”

DG

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Reading of the Week: The Best of 2015 — Books, Papers, and Hope

From the Editor

This will be the last Reading of the Week for 2015. (The Readings will resume in a fortnight.)

A bit of housekeeping: the Reading of the Week is a labour of love. There is no industry support for this project – or, in fact, any funding. Still, it’s hardly my project. Many readers (particularly residents) suggested papers and made comments over this past year. I’m also deeply grateful for the support of several colleagues; Drs. David Goldbloom and Mark Fefergrad deserve particular mention. And my father and wife have been great editorial supports.

It’s a Reading of the Week tradition to close the year by highlighting the best of the past 12 months.

Looking over the Readings of this year, I’m struck by the diversity of the publications that I could draw selections from. Sure, the Readings of 2015 included papers from The New England Journal of Medicine and JAMA Psychiatry. But they also included moving personal essays that were published in newspapers; The Economist (yes, The Economist) covered mental illness and the burden of disease well and thoughtfully; the best articles on global psychiatry appeared in The New York Times.

It wasn’t that long ago that we hoped that discussion of mental illness would move out of the shadows. Today, slowly but surely, it is. And so, 2015 closes after 48 Readings and on this hopeful note.

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