Medicaid reimbursement for mental health services varies widely across the United States, making it hard for many folks who need help to get it, a new study finds. Researchers found as much as a fivefold difference among states in Medicaid reimbursement rates. Even though Medicaid, the governmental health care program for low-income Americans, serves a population that is disproportionately affected by mental illness, many providers choose not to care for Medicaid patients due to low reimbursement rates. At the same time, a growing demand for help with depression, anxiety and substance use means many psychologists are unable to take on new patients, according to a 2022 American Psychological Association survey. Medicare, the federal health insurance program for American seniors, pays much more for mental health services, the study found. “We find that Medicaid reimbursement to psychiatrists for a common set of 20 frequently billed services varies across states and that on average, Medicaid pays about 80% of what Medicare pays for the same services,” said lead researcher Dr. Jane Zhu, an assistant professor of medicine at Oregon Health & Science University. Mental health services generally have low insurance acceptance rates, but this is worse in Medicaid, partly due to low reimbursement rates, she said. “Our study confirms that some states are setting these reimbursement rates quite low, which has implications not just for provider acceptance…  read on >  read on >

Life isn’t all fun and games for kids. They do a fair amount of worrying, too. In fact, according to a survey of kids ages 9 to 13, a striking number, 86%, say they worry. More than one-third worry at least once a week. School and friendships are key concerns. And as they get older, worries increase. “One of the things that we really saw rising to the surface during the pandemic was this overall increase in kids’ difficulties with mental health — and that’s both depression and also anxiety and worry,” said Meghan Walls, a pediatric psychologist at Nemours Children’s Health in Delaware. “Really what we were curious about is what does it look like now? What does it look like today in this landscape?” To better understand kids’ concerns, Nemours surveyed 504 youngsters. The oldest respondents — age 13 — were more likely than their younger counterparts to say they thought they would never stop worrying. Nearly half felt that way. About 1 in 3 kids felt they worry more than most children their age. About 50% of girls said they worry about friendships, compared to 32% of boys. About 35% of kids were worried about loved ones’ health. Girls were more likely than boys to worry about their looks (39% versus 24%). More than 6 in 10 said they worried about school.…  read on >  read on >

A therapy that bolsters the immune system may not only help certain cancer patients live longer, but better, a new study finds. The treatment, called chimeric antigen receptor (CAR) T-cell therapy, is used to fight certain types of blood cancer — including leukemia and lymphoma — that have not responded to standard treatments. It involves removing a patient’s own immune system T-cells, genetically tweaking them to target the cancer, then infusing them back into the patient. For some people with advanced blood cancers, CAR T-cell therapy is able to wipe out the malignant cells and keep the disease at bay for years. But there has been relatively little known about patients’ quality of life post-treatment, said study author Dr. Patrick Connor Johnson, an oncologist at Massachusetts General Hospital, in Boston. “That’s obviously very important to patients,” he said. While CAR T-cell therapy can send cancer into remission, Johnson said, it’s also an intensive treatment that requires about two weeks in the hospital. That’s, in part, to monitor patients for potentially severe side effects. One of the most concerning is cytokine release syndrome, where the infused T-cells flood the bloodstream with chemicals called cytokines — which can cause problems like high fever, a rapid drop in blood pressure and breathing difficulty. Severe cases can be fatal. In addition, some patients develop problems with the nervous system,…  read on >  read on >

The stress of caring for someone with Alzheimer’s disease can take a toll on loved ones. It’s important for caregivers’ own health and well-being to reduce that stress, the Alzheimer’s Foundation of America says. “Finding ways to manage and reduce stress is of paramount importance for every Alzheimer’s caregiver — untreated stress over a prolonged period of time can lead to caregiver burnout and a host of other health issues,” said Jennifer Reeder, the foundation’s director of educational and social services. “Caregivers need to take care of themselves so they can provide the best possible care for their loved ones,” Reeder added in a foundation news release. April is National Stress Awareness Month, and it “is a great time for caregivers to be proactive about managing and reducing their stress and make an investment in self-care that will benefit them and their loved one for whom they are caring,” she advised. Here, the foundation suggests six steps that may help: Be adaptable and positive. This can influence stress levels for you and the person in your care. Going with the flow can help you both stay relaxed, while feeling agitated can have the opposite effect. Deal with what you can control. Some things will be out of your control, but you can control your reactions. Concentrate on finding solutions that can help make the problem…  read on >  read on >

Cafeteria workers. Receptionists. Pharmacists. Janitors. Administrators. Physical therapists. Much has been made of burnout among doctors and nurses, but a new survey has found high rates of work fatigue in nearly every type of job associated with health care. Physicians, nurses, clinical staff and non-clinical support workers in health care all are experiencing substantial levels of burnout, according to a report published recently in the Journal of General Internal Medicine. For example, the percentage reporting burnout was very similar between nurses (56%), clinical staff (54%), doctors (47%) and non-clinical staff (46%). “Every member of the health care team is really critical to patient outcomes and patient experiences of care,” said lead researcher Dr. Lisa Rotenstein, an assistant professor of medicine at Harvard Medical School. “It’s just really important for us to remember that as we are trying to optimize both patient outcomes and experiences for our workforce.” For this study, Rotenstein and her colleagues surveyed workers at 206 large health care organizations between April and December 2020, at the height of the pandemic. The participants included more than 15,000 physicians and 11,000 nurses. But researchers also surveyed more than 5,000 clinical staff such as pharmacists, nurse assistants, therapists and social workers, as well as more than 11,000 non-clinical staff including housekeeping, administrators, lab technicians and food service workers. In addition to high levels of burnout,…  read on >  read on >

Over the last decade, more and more Americans with early-stage prostate cancer have put off radiation and surgery, the standard treatment options, new research indicates. Instead, many U.S. men with low- or intermediate-risk prostate cancer have embraced “active surveillance,” in which their disease is carefully monitored for any sign of progression that might eventually require intervention. In the new study, the investigators found that since 2010 the number of low-risk prostate cancer patients who have chosen active surveillance over immediate treatment has shot up from 16% to roughly 60%. In the same timeframe, surveillance has also risen among intermediate-risk patients, jumping from about 8% to 22%. The trend appears to reflect the fact that “professional societies have advocated for active surveillance of low-risk cancers for over a decade now,” said study lead author Dr. Bashir Al Hussein Al Awamlh, a urologic oncology fellow at Vanderbilt University Medical Center in Nashville, Tenn. “The theory behind active surveillance is that some cancers have a low potential to spread outside of the prostate and are non-lethal,” Al Hussein Al Awamlh noted. In such cases, immediate treatment is not necessary. Studies indicate that over 10 years, about half of all low- and intermediate-risk patients who choose surveillance over treatment will eventually need to undergo treatment, he said. But “active surveillance allows us to watch these cancers closely, using blood…  read on >  read on >

Post-traumatic stress disorder (PTSD) often develops following a traumatic event in someone’s life, leaving the sufferer to struggle with vivid flashbacks, nightmares and panic attacks. The U.S. National Center for PTSD estimates that about 6% of Americans will experience PTSD at some point in their lives. Women are twice as likely to experience the condition as men, and veterans and children may also be more susceptible. To help you better understand PTSD, let’s examine what the condition is, plus learn its main symptoms, causes, risk factors and treatments, including medications and therapies that are backed by science. What is PTSD? “Clinically when we think about PTSD, it is a reaction to a traumatic event,” Cleveland Clinic staff psychologist Dr. Chivonna Childs said in a podcast. “That reaction can be flashbacks, nightmares about the event, feeling as if we’re reliving the events, being triggered by people, places, things, situations that remind us of the event. That can send us into what we would normally feel like is a panic attack,” she explained. According to the U.S. National Institute of Mental Health (NIMH), people can develop PTSD from: Experiencing a traumatic event firsthand Witnessing a trauma happening to others Learning about traumatic events after the fact. The condition may also manifest as complex PTSD (C-PTSD). The CPTSD Foundation states that C-PTSD is the result of trauma that’s…  read on >  read on >

Imagine a perfect week at work. Everything runs smoothly, and you love your job. Sounds like a dream, doesn’t it? While those days are possible, work can also be a source of frequent and intense stress. Let’s face it, work stress is unavoidable. In 2022, 83% of U.S. workers suffered from work-related stress and about 1 million Americans missed work each day because of stress, according to the American Institute of Stress (AIS). But what exactly is work-related stress and what can you do about it? Causes of work stress There are a variety of reasons why work is stressful. “A leader who isn’t empathetic to what’s going on or not connected to the problems in the workplace can result in a stressful work environment,” says Dr. Jessica Gold, a psychiatrist and member of the Council on Communications for the American Psychiatric Association. Gold also identifies a lack of control over responsibilities and time as a common reason workers battle job-related stress. Other causes of work stress include tight deadlines, job insecurity and a toxic work environment (bullying, manipulation). Symptoms of work-related stress The American Psychological Association identifies physical and emotional symptoms of work stress including: Headaches Stomachaches High blood pressure A weakened immune system Insomnia Depression Anxiety Panic attacks Poor concentration Mood swings How to manage work stress There are specific ways to manage…  read on >  read on >