Psychiatric Residents Increasing
The number of psychiatric residents is increasing modestly, according to a resident census conducted by the American Psychiatric Association. As of Aug. 30, the total number of psychiatric residents had increased 1.6% over the previous year. U.S. medical graduates increased 4%, and women residents were up 5.5%, the census showed. Psychosomatic medicine, a new psychiatric subspecialty, had 60% female fellows. The top three most popular subspecialties were child and adolescent psychiatry, addiction psychiatry, and forensic psychiatry; all subspecialties had increasing numbers of fellows except for geriatric psychiatry. Geographically, the highest concentration of residents was in New York state, followed by California.
Data on Youth Suicide Attempts
About 900,000 children aged 12–17 planned to commit suicide during their worst or most recent episode of major depression, according to data from the Substance Abuse and Mental Health Services Administration. Of those who planned suicide, 712,000 attempted it. The report, which was compiled using data from the 2004 National Survey on Drug Use and Health, defined a “major depressive episode” as a period of at least 2 weeks in which a person experienced a depressed mood or loss of interest or pleasure in daily activities, and had at least five of nine symptoms of depression listed in the DSM-IV. “Suicide is a preventable tragedy,” said Charles Curie, the SAMHSA administrator. “It is a thief that sets no boundaries and seeks victims of all ages.”
Public Health Unpreparedness
Many local public health agencies are ill-prepared to learn about and respond to naturally occurring outbreaks of deadly infectious diseases or acts of bioterrorism, a test by the RAND Corporation has found. To conduct the test, researchers posed as local physicians who were reporting fictitious cases of botulism, anthrax, smallpox, bubonic plague, and other diseases to 19 public health agencies in 18 states nationwide. (Agency directors agreed in advance to participate in the test, but did not tell their staff members.) In one case, after listening to a description of the classic symptoms of bubonic plague, a public health worker advised the caller not to worry because no similar cases had been reported. Another caller who reported a botulism case was told: “You're right; it does sound like botulism. I wouldn't worry too much if I were you.” The article appears in the Aug. 30 online edition of Health Affairs.
Drug Abuse Counseling Protocol
SAMHSA has issued a new Treatment Improvement Protocol designed to help substance abuse counselors working with clients in the criminal justice system. The guidelines, known as TIP 44, provide information on screening, assessments, treatment services, and follow-up services for people in various criminal justice settings. For example, they note that in the pretrial setting, treatment professionals need to be careful not to coerce clients into waiving due process rights. The guidelines also explain that in-prison drug abuse treatment followed by community-based continuing care has been credited with reducing short-term recidivism and relapse rates. The guidelines are available online at
www.samhsa.gov/news/newsreleases/TIP%2044-CJA.pdf
Part B Premiums on the Rise
Medicare Part B monthly premiums will be $88.50 in 2006, an increase of $10.30 from the current $78.20 premium, the Centers for Medicare and Medicaid Services reported. The agency cited continued rapid growth in the intensity and use of Part B services as the main reason for the increase. “This growth is seen in physician office visits, lab tests, minor procedures, and physician-administered drugs. It also includes rapid growth in hospital outpatient services,” CMS said in a statement. They also said that “part of the premium increase is necessary to increase assets that, for accounting purposes, are held in the Part B trust fund.” Though premiums are rising, most Medicare beneficiaries will see significantly lower out-of-pocket health care costs in 2006 because of the savings in drug costs from the new Medicare prescription drug benefit, the agency contends.
Employer Health Coverage Declines
The percentage of businesses offering health insurance to employees has declined over the past 5 years as the cost of providing insurance benefits outpaces inflation and wage growth, according to the 2005 Annual Employer Health Benefits Survey released by the Kaiser Family Foundation and Health Research and Educational Trust. The survey found that three of five firms (60%) offered coverage to workers in 2005, a decrease from 69% in 2000 and 66% in 2003. “The drop stems almost entirely from fewer small businesses offering health benefits, as nearly all businesses (98%) with 200 or more workers offer such benefits,” the news release stated. The survey found that 20% of employers that offer health insurance currently provide a high-deductible health plan option. Very large companies–those with 5,000 or more employees–are significantly more likely than smaller ones to offer a high-deductible plan option, with 33% offering such an option in 2005. High-deductible health plans are defined in the survey as plans with at least a $1,000 deductible for single coverage or at least a $2,000 deductible for family coverage. In the meantime, relatively few workers are enrolled in “consumer-driven” plans, despite their growing availability.