Prevention Matters

"Best and Worst News for Prevention” is based on a purposive sample consisting of expert staff members who each week choose to share their opinions on the best and worst news for prevention.

BEST

N.J. National Guard could serve as a national model for mental health care

During a visit to Trenton in August, the nation's top military officer turned to his hosts in the New Jersey Army National Guard, noting the group's success in monitoring and treating the mental well-being of the state's citizen-soldiers. Adm. Mike Mullen, chairman of the Joint Chiefs of Staff, then asked for more information. It wasn't an idle inquiry. At a time when suicides in the military have soared to record levels, New Jersey is one of just six states in which no Guard members have taken their own lives since 2002. While the Department of Defense mandates some mental health programs, New Jersey has gone further, marshaling state resources and assembling a network of private practitioners to treat distressed Guard members or their family members. The state's primary tool is a 24-hour helpline that's both confidential and independent of the military. Operated by the University of Medicine and Dentistry of New Jersey and funded by the state, the helpline is staffed by veterans and therapists. They counsel soldiers and their relatives, make referrals for treatment and, in the most critical cases, summon help. They also make callers aware of resources available to them, including Department of Veterans Affairs programs, family assistance centers and individuals who can help process claims with the VA.

The New Jersey Guard has deployed more than 11,000 soldiers since 2002, with the biggest mobilization -- just over 2,800 soldiers -- spanning 2008 and 2009. Shortly after that contingent returned, calls to the helpline jumped 20 percent, said Cherie Castellano, the line's director. More recently, she said, therapists fielded two consecutive calls from suicidal veterans.


WORST

Prescriptions for Stimulants, Painkillers Soaring Among Youth


The number of prescriptions for controlled medications such as opioids and stimulants has nearly doubled in adolescents and young adults since 1994. The trend, reported in the December issue of Pediatrics, mirrors a similar increase in misuse of these drugs, with adolescents and young adults' illicit use of prescription drugs now outstripping all other illicit drug use except marijuana. The researchers couldn't attribute the increased misuse directly to more prescriptions, but did urge both physicians and patients to be vigilant when considering the use of drugs such as Oxycontin or Ritalin.


The “Best and Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. "Best and Worst News for Prevention” is based on a purposive sample of expert staff members who each week choose to share their opinions on the best and worst news for prevention. More information is available at http://www.prevent.org/.

The Centers for Medicare and Medicaid Services (CMS) has forecast that the share of the economy devoted to health spending will jump a full percentage point this year. The jump from 16.6% to 17.6% would mark the biggest one-year increase recorded since the government began tracking the data in 1960.

Hopefully, this will put to rest the notion that we can't afford to do health reform right away. There are signs that people are getting this message:

New York Times: "While some people have predicted that Mr. Obama would have to shelve his priorities given rising deficits, his determination to proceed, especially on health care, reflects his economic advisers' conviction that the government cannot control its finances without reforming health care."

Long Island Newsday: "Whenever this tsunami of acute economic problems finally ebbs, the chronic problem of out-of-control medical costs will take center stage as an impediment to a healthy future," and while "it may take broad reform to fashion an affordable, sustainable health care system ... the effort has to start now," a Newsday editorial states.

Joe Conason, Salon: Neither the fiscal responsibility summit "nor any other serious discussion of fiscal problems can be confined to entitlement programs -- because the underlying issue is health care costs."

The National Health Statistics Group reports that health care spending in 2007 grew 6.1%. The overall response to that news has been an interesting mix - one that gives you the impression that while the oncoming train is still headed for your car stuck on the crossing, at least it's slowed down a bit.

Several media reports focused on the fact that it was the lowest level of growth in health care spending in nine years. But, as Forbes noted, since the total economy grew by only 2.3% in 2007, the 6.1% hike in health care costs still means everyone’s losing ground.

Drug costs grew by only 5%, as a number of low-priced generics came on the market. But hospital and doctor spending grew 7.3% and 6.5%, respectively, and health insurance premiums grew by 6 percent.

Meanwhile, Health Affairs published a study that shows out-of-pocket medical expenses in the U.S. have grown by 40% over the last decade. Study author Kathy Paetz says it's due largely to the fact that middle-aged Americans today are 10 percent more likely to suffer from more than one chronic disease. Prevention, anyone?