Tagracism

Reading of the Week: Cardiovascular Diseases & Mental Disorders – The New AJP Paper; Also, Systematic Racism & Depression (JAMA Psych)

From the Editor

When people with mental health problems have physical illness, how does their care measure up?

Not surprisingly, we worry about their access and follow up. Evidence suggests poorer outcomes. But how do people with mental disorders fare on an international basis?

In the first selection, Dr. Marco Solmi (of the University of Padua) and his co-authors try to answer that question, focusing on cardiovascular diseases (CVD). In a new American Journal of Psychiatry paper, they conduct a systematic review and meta-analysis, drawing on the data of more than 24 million people. (!) They find: “People with mental disorders, and those with schizophrenia in particular, receive less screening and lower-quality treatment for CVD. It is of paramount importance to address underprescribing of CVD medications and underutilization of diagnostic and therapeutic procedures across all mental disorders.” We discuss the paper and its clinical implications.

heart-palpitations

In the second selection from The American Journal of Psychiatry, Drs. Nathalie Moise and Sidney Hankerson (both of Columbia University) consider structural racism and depression care, using a clinical vignette. Rather than just seeing the patient’s experience in terms of genetic loading and medications, they describe a person who has struggled with various forms of racism. They argue: “Mental health professionals need to recognize the effect of structural, individual, and internalized racism on individuals with depression symptoms.”

DG
Continue reading

Reading of the Week: Tweets for a Good Cause, But Suicide Prevention? Also, Racism in Mental Health (QT), and Rap & Awareness (JAMA Peds)

From the Editor

It’s an incredible campaign. With each passing year, Bell Let’s Talk Day gains more recognition, with many, including the Prime Minister, tweeting for a good cause.

But does the campaign affect suicide? In the first selection, we look at new paper from The Canadian Journal of Psychiatry. David Côté (of the University of Toronto) and his co-authors study the tweet contents of Bell Let’s Talk Day and suicide completions. “There was no associated change in suicide counts.” We mull the big campaign and the big paper.

bird

In the second selection, we look at a new podcast that explores race and racism in mental health. In this Quick Takes episode, I’m joined by Drs. Amy Gajaria and Saadia Sediqzadah (both of the University of Toronto). “Racism exists and it exists in the lives of our patients.” The podcast covers some big topics – but it is also practical, with solid clinical advice.

And in the third selection, Alex Kresovich (of the University of North Carolina) and his co-authors wonder about the cultural discussion of mental health. To that end, they review popular rap songs in a JAMA Pediatrics paper. “The findings of this qualitative study suggest that mental health discourse has been increasing during the past 2 decades within the most popular rap music in the US.”

DG

Continue reading

Reading of the Week: Suicide Prevention in the Acute Care Setting (JAMA Psychiatry); Also, Gottlieb on Racism (Wash Post)

From the Editor

In the year before they suicide, more than 90% of people have had contact with some type of acute care – an ED visit, a trip to the family doctor, or an appointment at an outpatient specialty clinic. So how can we help people better? Given the contact, what can we do to reduce suicides?

This week, we have two selections; the first focuses on this question. In a new JAMA Psychiatry paper, Dr. Stephanie K. Doupnik (of the University of Pennsylvania) and her co-authors do a systematic review and meta-analysis of 14 studies that used brief suicide prevention interventions in acute care settings (think brief contact interventions like a phone call after an ED visit). They find an encouraging result: “In this meta-analysis, brief suicide prevention interventions were associated with reduced subsequent suicide attempts.” We consider the big paper, and the editorial that accompanies it.

emergency-room-3326156_1280-720x480

In the other selection, therapist Lori Gottlieb discusses race and therapy in a Washington Post essay. She examines her own biases, and the way they play out in her therapy session. “Here’s what we didn’t talk about [in school]: the racism that might take place inside the supposedly ‘safe space’ of our therapy rooms – our patients’ racism and our own.”

Please note that there will be no Reading next week. Happy Canada Day.

DG

Continue reading