New Report Finds Current Strategies Insufficient for Preventing the Most Preventable Cause of Mental Illness

Guest blog by Brenda Patoine

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Image: Shutterstock

Childhood maltreatment is recognized as the No. 1 preventable cause of mental illness – and some experts argue, of all stress-related diseases – yet science still has no clear answers for how to best prevent the spiral of neglect and abuse that threatens millions of infants and children in the U.S. alone.

In a report published this week, the U.S. Preventive Services Task Force (USPTF), a U.S. Public Health Service committee charged with recommending action to thwart preventable health conditions, conceded that there was “insufficient data” to recommend any particular strategy that has been tested as a means of preventing childhood maltreatment, which encompasses neglect as well as physical, psychological, or sexual abuse. Preventive interventions initiated in primary care focus on preventing maltreatment before it occurs, as opposed to identifying children who are victims of abuse or neglect. Continue reading

The Neuroscientist Who Lost Her Mind

barbara lipska

Photo courtesy of the Rubin Museum

On a recent night at New York’s Rubin Museum of Art, neuroscientist Barbara Lipska, Ph.D., sat down with journalist Jake Halpern as part of the museum’s annual Brainwave series. The discussion gave audience members the unique opportunity to hear a lucid perspective of what it’s like to experience psychosis. The interview was also particularly intimate because, in addition to his successful career as a writer, Halpern also happens to be Lipska’s son-in-law. His questions stemmed from firsthand experiences he shared with her as she battled malignant brain tumors that caused the psychotic episodes and nearly took her life.

As director of the Human Brain Collection Core at the National Institute of Mental Health, Lipska studies schizophrenia by analyzing postmortem brain dissections and observing the behavior of rats that have a disconnection between the hippocampus and prefrontal cortex. “They’re actually not as different as we would like to think,” she said of the rats. “They’re smaller, that’s for sure, and they don’t have this convoluted frontal cortex. But they are very intelligent animals, and they know what they have to do to get a reward.”

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Memoir by John Saunders Sheds Light on Depression

There are many sad elements of John Saunders’ autobiography, Playing Hurt, from the author’s troubled childhood to his traumatic brain injury to his persistent depression. Most heartbreaking, though, is that Saunders died before the book was published, denying him the chance to witness its impact. Readers who know nothing about the sports broadcaster’s career nor have any close ties to mental illness will find the book well-written and engaging. Those directly affected by depression could find it life-changing.

 

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Saunders died unexpectedly before his book was released to the public. He’d hoped it would help people affected by mental illness.
Photo credit: De Capo Press

In the introduction to Playing Hurt: My Journey from Despair to Hope, Saunders writes that he wanted “to reach out to the millions of people, especially men, who think they’re alone and can’t ask for help.” As a black man and a former athlete, Saunders, who appeared on ESPN and ABC in various roles from 1986 until his death in August of 2016, was a member of several cohorts often hesitant to admit mental health problems.

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Changing the World with Smartphones

“We are wildly ambitious,” Tom Insel, M.D., says when asked about his plans for Verily Life Sciences, a research organization parented by Google. After 13 years, Insel rocked the world of brain science when he announced plans to step down as director of the National Institute of Mental Health (NIMH) in late 2015. His departure from NIMH, however, wasn’t a leave from neuroscience research or public health; it was a progressive step towards advancing the technologies that are predicted to transform mental health care.

Recently, Insel was profiled in the July/August 2017 issue of The Atlantic, which offers a thorough look at the trajectory that took him from lead role at the world’s largest mental health research institution to complete submersion in the energetic tech bubble of Silicon Valley.

The article recounts Insel’s early work in behavioral research, as well as his influence on the field of antidepressants and NIMH’s involvement in clinical drug trials. Presented with an opportunity to direct a new mental health team under Google, he could now focus on taking applied research and use it to help millions of people globally, who are in need of mental health care. “At any given moment, roughly one in seven of the world’s 7.5 billion people is struggling with mental illness. ‘We’re not going to reach all those people by hiring more psychiatrists,’ says Insel. But we might reach them with smartphones.”

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Dana Grantee Aims to Offer a More Personalized Treatment for Depression

DrEtkin_Jan2013_8880_5x7eIn an effort to create a more personalized approach to treating depression and to better understand its underlying circuitry, Amit Etkin of Stanford University is studying the use
of repetitive transcranial magnetic stimulation (rTMS) in combination with whole-brain EEG and functional MRI. According to Etkin:

By stimulating brain activity and assessing circuit-level changes as they happen, we can garner important insight into what is wrong in depression and how to fix it in an optimized, personalized matter.

I’ll give you one concrete example: It matters whether stimulation is done to an area in the patient’s brain that is abnormal or normal. For any treatment in any psychiatric disorder, we don’t actually know whether the goal of treatment is to normalize abnormal brain activity or to engage compensatory circuitry. It’s a fundamental question that we cannot answer without a direct tool for manipulating brain systems and assessing the effects.

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