Some Connecticut hospitals and doctors and a clinic are starting to treat severely depressed patients with a new nasal spray called Spravato, touted as the most significant federally approved depression medication since Prozac was approved in 1987. Spravato, which received Food and Drug Administration (FDA) approval in March, has raised hopes for preventing suicides and relieving depression after other treatments have failed. But there are concerns about possible side effects, including drug abuse, elevated blood pressure and heart rate, sedation, and hypersensitivity to surroundings. The nasal spray is prescribed for treatment-resistant depression after at least two other antidepressants haven’t worked and is given with an oral antidepressant. It is only administered in restrictive clinical settings to reduce potential for abuse and side effects.
As state policymakers debate ways to improve mental health services for youths, the Connecticut Health I-Team (www.c-hit.org) is hosting a forum May 7 that will bring together parents, clinicians, educators and others to discuss ways to identify, treat and prevent teen depression. “Uncovering Our Kids: Towards a Better Understanding of Teen Mental Health,” will feature a panel of experts in adolescent behavioral health who will lead a discussion about teen mental health screening, intervention and treatment. The Conn. Health I-Team, in collaboration with ConnectiCare and Hartford Hospital’s Institute of Living, invites the public to come “talk openly about teen mental health, learn from experts, and help Connecticut reduce the stigma of depression and mental illness,” said C-HIT co-founder and editor Lynne DeLucia. The event will run from 5 to 7:30 p.m. at the Lyceum Conference Center in Hartford.
Morbidly obese individuals who had weight loss surgery are seeking treatment for eating disorders years after their procedure, prompting concerns among some experts about the assessment process used to identify surgical candidates. “They are terrified of gaining the weight back,” said Dr. Sara Niego, medical director of the Eating Disorders Program at Hartford Hospital’s Institute of Living, who has treated patients with anorexia, bulimia and binge eating disorder years after weight loss surgery. The lack of a national “gold standard” to psychologically assess prospective patients has led Connecticut mental health professionals to call for standardized criteria to identify those who are at risk before and after surgery. They worry some patients with mental health problems may slip through the cracks because each hospital and insurance company has different psychological screening requirements. “Unfortunately, there is no consensus in the field regarding what constitutes a psychological evaluation or what would prohibit an individual from obtaining surgery from a psychological standpoint,” said Kimberly Daniels, a clinical psychologist with the Center for Weight Loss Surgery at Middlesex Hospital.
As the state works to improve its mental health system, new federal data show that hospitals in Connecticut restrain psychiatric patients at more than double the average national rate, with elderly patients facing restraint at a rate seven times the national average. In addition, the state lags behind in providing adequate post-discharge continuing care plans for psychiatric patients, especially teens and the elderly. Connecticut’s 28 inpatient psychiatric units and hospitals developed continuing-care plans for fewer than 70 percent of patients they discharged from October 2012 to March 2013 – indicating that thousands of patients may have left facilities without adequate treatment and medication plans. A C-HIT analysis of the federal data, released by the Centers for Medicare & Medicaid Services for the first time, show that Connecticut ranks in the top fourth of states (11th highest) in the use of physical restraints in inpatient psychiatric facilities – and is the third highest state in restraining patients 65 and older. Two psychiatric units – at Bridgeport Hospital and Masonicare Health Center in Wallingford – have the 10th and 12th highest rates of restraint use, respectively, among the 1,753 psychiatric facilities nationwide that are included in the federal reports, which cover October 2012 through March 2013.