Category Archives: Mental health

Weathering and Its Impacts on Health

By | January 4, 2024

What comes to mind when you hear the word “weathering”? Perhaps you think of erosion, depletion, and wearing down. Or maybe enduring, surviving, and withstanding. All of these associations accurately describe what happens to our bodies in response to chronic stress. This particular type of physiological stress affects the brain and other parts of the… Read More »

Healthy Intersections Podcast: October 2023

By | February 17, 2024

This month’s topic focuses on suicide and social determinants of health (SDoH) Welcome to the Healthy Intersections podcast for October, 2023. Today’s podcast focuses on the links between suicide and social determinants of health in the United States. Suicide is one of the causes of deaths of despair, along with deaths from drugs and alcohol.… Read More »

Postpartum Depression is Overlooked and Undertreated

By | October 10, 2023

The postpartum period, recognized as the fourth trimester or the 12 weeks after birth, is often overlooked. In 2021, 52% of all maternal deaths occurred during the postpartum period. And mental health was the top underlying cause, accounting for 23% of all deaths (mostly suicides and overdoses related to substance use disorder). More than 60%… Read More »

Health effects of tech overload: Can public health see it?

By | August 31, 2023

What if there was a public health problem so big that even public health leaders were too enmeshed in its grip to be able to warn against its perils? I worry that we are in that very conundrum with regard to our relationship with technology. It has accelerated from being part of our world to… Read More »

Negative Health Outcomes of American Anti-LGBTQ Laws

By | September 8, 2023

This entry was one of the winners of our Summer 2023 student blog contest! Anti-LGBTQ laws are flooding the United States. As of June, a historic 491 anti-LGBTQ bills have been introduced in 2023 – a 203% increase from the entire 2022 year. More bills were introduced in the first three months of 2023 than… Read More »

Telemedicine and Depression

By | March 23, 2023

 The rapid transition from in-person to care to telemedicine visits at the start of the COVID‑19 pandemic did not adversely affect the quality of care – and even improved some aspects of care – for patients with major depression in a major integrated health system, according to a new report. The study appears as part of… Read More »

Healthy Intersections Podcast: February 2023

By | February 10, 2023

This month’s podcast features a round-up of this month’s blog posts and a summary of three articles recently published in the journal Medical Care. Listen here or via your favorite podcast platform! Transcript Hello friends. Welcome to the Healthy Intersections Podcast for February 2023. This podcast is sponsored by the American Public Health Association’s Medical… Read More »

A Renewed Outlook on Substance Use Prevention

An Opportunity to Get Ahead of the Overdose Crisis For many Americans, drug use ‘prevention’ conjures memories of early public health campaigns using fearsome imagery and catchy slogans to deter substance use. Campaigns implored youth to “just say no” to drugs, and the public received stark warnings: “this is your brain on drugs.”

Improving treatment adherence with evidence-based approaches

Over the last 25 years, researchers have documented the broad impact of behavioral interventions on a range of psychological and physical health outcomes. Despite the promise of evidence-based treatments, a common challenge for practitioners is ensuring treatment adherence to maximize benefits. This is especially challenging for most chronic conditions. Integrating research and recommendations from medication… Read More »

SDoH in Same-Sex Couple Hotspots and Coldspots

By | June 24, 2022

Happy Pride month! In this post, I’d like to share about a research project in progress that is relevant to the LGTBQIA+ community. This post may also be interesting to those of you who care ok about health equity and the social determinants of health (SDoH). I am a member of the queer community myself.… Read More »

February 2022 Podcast

By | February 10, 2022

In this episode of our podcast series, Samyuktha Anand, secretary-elect for the Medical Care section, recaps the blog posts we published in January. Next, Jess Williams, co-editor, interviews Nien Chen Li about her recently published paper — a winner of the APHA Medical Care Section’s Student Paper Award in 2020. Dr. Li’s paper is about… Read More »

“Carve In” Mental Health and Substance Use Treatment

By | December 21, 2021

More than 150,000 avoidable deaths occur each year due to mental, emotional, and behavioral health problems. This includes nearly 50,000 suicide deaths and 100,000 overdose deaths. People with chronic persistent mental illness suffer a 20-year shorter life expectancy. This country urgently needs to address how we pay for mental health services. Medicaid is a major… Read More »

Supporting Front-line Workers with Resiliency Training

By | September 15, 2021

Front-line workers are always at risk. It’s in the name. The COVID-19 pandemic has made this reality more salient for everyone. Risks of sickness from COVID-19 include death and morbidity. Front-line workers may also have lost more friends and co-workers than the average person. Healthcare workers have also been subject to violence and see the… Read More »

Multimorbidity and Psychosocial Aspects of Homelessness

By | September 13, 2021

Homelessness persists in the US, and across the world, despite decades of recognition and longstanding efforts to end the condition. There have been major successes in our understanding of what policies and programs work to prevent and end homelessness. However, the work must and will find new ways to adapt and improve if we are… Read More »

Unconscious Bias in Health Care

By | June 30, 2021

The global Covid-19 pandemic came with financial, emotional, and physical health implications for just about everyone worldwide. Along with those burdens, a significant strain was placed on resources, people, and systems. Issues that were lingering just beneath the surface bubbled up, inequities became highlighted, and urgent outcries and demands for swift solutions became harder to… Read More »

Reorienting Care for Undocumented Immigrants

By | April 28, 2021

Barriers to immigration into the United States are a common topic of political debates. Less frequently publicized are the numerous barriers to healthcare that undocumented immigrants (UIs) face even after their arrival. These obstacles can have profoundly negative effects: not just on the individual immigrants’ health, but on their local communities as a whole. Medical… Read More »

Rewarding ACOs that Manage Complex Patients

By | March 22, 2021

Health insurers often pay health plans to manage the care of their members. Good care can help prevent emergencies, such as avoidable trips to a hospital emergency department (ED). Medically complex patients, such as those with behavioral health problems or substance use disorders, tend to have a lot of ED visits. Social determinants of health… Read More »

Treating the Opioid Crisis: Current Trends and What’s Next, Part 2

Last week, we discussed three noteworthy trends from the past decade in treating the opioid crisis. The first was recognizing medication for opioid use disorder (MOUD) as the standard of care. The second was formalizing an addiction medicine specialty. And the third was expanding the availability of MOUD. This week, we’ll consider three additional trends in… Read More »

Treating the Opioid Crisis: Current Trends and What’s Next

Throughout the past decade, the U.S. has seen a dramatic shift in addiction medicine research, clinical practice, and related stigma in seeking care. In a pair of blog posts, we will explore the top six trends related to treating the opioid crisis. And we’ll consider what may be next. The Opioid Epidemic Opioid addiction has… Read More »

Suicide Risk and Prevention Among Women

By | February 2, 2021

We have reached a 30-year high in the rate of suicide in the United States. Suicide risk and prevention efforts among women are the focus of a recent Medical Care supplemental issue. Efforts at prevention and recovery have been especially important for the Departments of Defense and Veterans Affairs. As mentioned in the introduction to… Read More »

Is Sleep Driving Up Your Medical Costs?

By | October 22, 2020

  Millions are losing sleep due to anxiety, fear, and the difficulty of maintaining a schedule during this pandemic. Research suggests that those who get insufficient sleep may be at risk for health conditions such as obesity and heart disease. Yet, too much sleep may increase the risk of other health conditions such as diabetes and… Read More »

Complementary and integrative health in the VA

By | October 8, 2020

The Veterans Health Administration (VA) has expanded research and education on complementary and integrative health (CIH) programs, focusing on pain, mental health, and chronic illness. CIH programs are a part of “Whole Health,” an approach to support veterans’ health and well-being. A recent Medical Care supplement contains several articles on the effectiveness and implementation of… Read More »

Behavioral Health: Actuarial Value, Integration, & Innovation

Behavioral health — counseling, mental health care, and care for substance use issues — is one of the basic benefits associated with health insurance and healthcare delivery. The COVID-19 pandemic has reminded us of the gross inadequacy of current behavioral health to deliver high quality care to most Americans. The past 30 years of health… Read More »

Primary care doctors are well-trained to treat common mental health conditions

The COVID-19 pandemic and the killing of George Floyd are further stressing the already strained U.S. mental health care system. Primary care doctors train to treat common mental health problems, and they can help alleviate this strain on the system. Mental health issues on the rise In a national survey [pdf] of primary care patients… Read More »

Rural Postpartum Mental Health: the Challenge to Improve

Postpartum depression is common, preventable, and treatable. The Agency for Healthcare Research and Quality (AHRQ) challenge competition, “Cross-Sectional Innovation to Improve Rural Postpartum Mental Health,” identifies what communities are doing to improve access to mental healthcare for rural women. Furthermore, the challenge seeks new solutions to ensure that more women and families receive the help… Read More »

Moving Upstream to Reduce Harm from Fake Opioids

By | July 16, 2020

When a call came in from the county coroner, it was never good news. Every once in a while, her work included a shock big enough to share with the public health team where I served as Medical Director. This was the case that Monday afternoon. Two teenage deaths, likely from opioid overdoses, likely the… Read More »

Deportation and the Traumatizing of a Generation

By | June 18, 2020

With less than five weeks to go before welcoming a second child, the patient sat in my exam room in tears. By all accounts, this was a routine appointment at the end of a routine pregnancy. Except on this particular day, clutching family photos from their recent baby shower, the patient shared with me that… Read More »

Framing Success for Supportive Housing Services

By | June 11, 2020

In this post we reflect on the definition of success in a study measuring the value of peer support services administered through the HUD VASH program and discuss client-centered definitions of value. We propose designing and understanding programmatic success goals tailored to unique need categories within veteran participant groups. With stay-at-home orders lifting all across… Read More »

#SexEdForAll: What We Need to Prevent Intimate Partner Violence

By | June 1, 2020

We just wrapped up #SexEdForAll month in May, yet most people still believe sex education is just about sex. But it’s so much more than that! That’s why I created the Sexuality Education Legislation and Policy: A State-by-State Comparison of Health Indicators story map, in conjunction with the Robert Graham Center for Policy Studies in… Read More »

Risks of inpatient psychiatry during COVID-19 and beyond

By | May 3, 2020

COVID-19 has revealed many vulnerabilities in our societal structure. One particular vulnerability is the risk inherent in our use of congregate institutions to house and treat people. This includes the risks of inpatient psychiatric facilities. Inadvertently, the pandemic has surfaced critical questions that we should seek to answer even when the virus is under control: What is the right… Read More »

COVID-19 and homelessness

Our neighbors who are experiencing homelessness during this SARS-COV-2 pandemic are facing unique risks and extreme hardships. In the corner of American society almost defined by economic and racial disparities, COVID-19 has compounded and taken advantage of these long-standing vulnerabilities. An outsized burden of risk factors for COVID-19 compound the risks of crowded shelters and… Read More »

Telehealth for Addiction, Part 2 – Confidentiality: Real Concerns in Virtual Settings

As of April 17, 2020, the novel coronavirus has infected more than 2.4 million people globally and led to 170,000 deaths. The global response to the COVID-19 pandemic largely emphasizes social distancing and shelter-in-place ordinances. These policies impact everyone, also upending the lives of those not directly affected by the virus COVID-19 pandemic. Like other… Read More »

Telehealth for Addiction: Online Support Groups

The current requirements for social distancing affect support groups for people with substance use disorders, but online support groups may provide the perfect solution. This post is the first in a series of planned posts on telehealth for addiction. COVID-19, the disease caused by the novel coronavirus called SARS-CoV2, is putting tremendous strain on all… Read More »

COVID-19: health and the coming economic recession

By | April 3, 2020

The first reports of COVID-19, the name now used to describe the disease caused by a novel coronavirus, first emerged around New Year’s day of 2020. Since then, the conversation has shifted from containment efforts in Wuhan, China to social distancing and mandatory closures across the U.S., including in New York, California, Illinois [pdf], Massachusetts,… Read More »

The myth of female hysteria and women’s health disparities

By | March 5, 2020

What role might the myth of “female hysteria” play in women’s health disparities? For thousands of years, women’s health complaints were often diagnosed as “female hysteria” – a catch-all term that basically implied “it’s all in her head.” The condition was sometimes believed to be caused by a wandering uterus and/or sexual frustration. Doctors treated… Read More »

Decriminalization of Drug Possession: Key to the Public’s Health and Health Equity

By | December 19, 2019

Research shows that decriminalization of drug possession, combined with other harm reduction efforts and treatment services, is an important component of efforts to improve public health and health equity. It was early in medical school when I encountered the first of many patients who had spent years in jail or prison for drug possession. On… Read More »

School Health Policy Series: Part 3 – Three Strikes for Student Health

By | December 2, 2019

This year, teachers striking across the country have found common ground on a priority outside of typical debates around salaries or pensions. Educators in three major cities–Los Angeles, Oakland, and Chicago–among others, have been calling for more school counselors, librarians, nurses, psychologists, and social workers to support their students’ development beyond academic benchmarks. These public… Read More »

Using Paolo Freire’s Methods to Teach Inmates About the Social Determinants of Health

Mass incarceration is a true epidemic. It is also one fueled by social determinants, including race. Over the past four decades of “war on drugs” and “tough on crime” policies, the US incarceration rate has increased by over 500% [pdf]. There are over 2 million men and women in jails and prisons across the country… Read More »

Moving from Stigmatization to Healthy Sexuality: The Vital Role of Comprehensive Sex Ed

By | August 21, 2019

As a sexual health educator at public high schools in Tennessee, teachers would consistently jump in as I approached the topic of contraception. Required by law, these teachers would “emphatically promote sexual risk avoidance through abstinence.” After this abrupt interruption, I would then proceed to talk about all forms of contraception, including abstinence. Students would… Read More »

The State of Abortion in America in 2019

By | June 19, 2019

A 14-year-old girl came to my primary care clinic with abdominal pain, similar to abdominal pain she’s had intermittently for years. As with all women of reproductive age, I checked a urine pregnancy test, and it was positive. I returned to the patient’s room to talk with her about the result, and her first question… Read More »

Finding Happiness As We Age

How happy are you? That’s a tricky question and there’s a lot that can impact your answer.  According to a 2016 article in The Economist, these include factors like your financial status, health, relationships and education.  One factor that might also have a big influence on your answer is your age.  As a society, we… Read More »

Hospitalizations of Individuals Experiencing Homelessness Driven by Behavioral Health Concerns

By | February 6, 2019

Individuals experiencing homelessness are among the most medically, socially, economically, and politically vulnerable in our society. Because of this, patterns of service use by these individuals can often serve as indicators of the safety net capacity and overall wellness of the systems of care we have in place – like “canaries in the coal mine.”… Read More »

Social Media and our Mental Health

By | September 26, 2019

Do you use social media? If so, how many social media platforms (e.g., Facebook, Twitter, Instagram, Pinterest, LinkedIn) are you a member of? With about 40% of the world’s population already on some form of online social media, even if you don’t use it, you’ve probably heard of it.  Devoting several hours each day to… Read More »

Can teamwork make the dream work?

By | January 17, 2019

In 2019, mental health and opioid use disorders remain major public health issues. The most recent estimates suggest that 40 million adults experience mental illness in the U.S. and nearly 8 million adults experience both mental and substance use disorders at the same time. Individuals with mental illness also face higher risks of co-occurring chronic health conditions and… Read More »

The Health and Social Costs of Homelessness

By | September 26, 2019

The burden of homelessness on the health of those afflicted continues to be a major global public health concern. Last year, the United States recorded an increase in the number of homeless for the first time since 2010. On any given night in 2017, there were 553,742 people in the U.S. experiencing homelessness. In terms of… Read More »

Medication-Assisted Treatment: A Vital Player in the Opioid Epidemic

By | August 15, 2018

For two years in a row, the United States has experienced a decrease in life expectancy, which researchers have largely attributed to the opioid epidemic. Life expectancy for the United States population was 78.6 years in 2016, a decrease of 0.1 year from 2015 [PDF]. Age-specific death rates between 2015 and 2016 increased for younger… Read More »

What’s Next? The Ongoing Crisis for Children Taken from Families Seeking Asylum at the US-Mexico Border

By | August 3, 2018

This year, we’ve seen more than 2,000 children separated from their parents, who were legally seeking asylum in the US. Most were from Central American countries in which crime and unrest place many at risk for violence. These children were taken from their families by US government employees between April 19 and May 31, 2018,… Read More »

Discussion of antidepressant black-box warnings and youth suicide

By | May 2, 2018

In many situations, randomized controlled trials are infeasible and one must draw conclusions from observational data.  Certain quasi-experimental designs – for example, interrupted time series analyses – strengthen the conclusions that can be drawn from observational data.  However, particularly when the intervention evaluated is important, either clinically or from a health policy perspective, implied or… Read More »

Should time management take a back seat to energy management?

Growing up we were encouraged to learn how to manage our time.  Many of us were told that time management was the key to successful careers, personal lives, and finding the balance between the two.  A cursory search online of time management brings you to a world of articles, blog posts, and books on time… Read More »

The Social Determinants of Addiction

By | February 15, 2018

Opioid use is a serious concern that the executive branch of the United States government recently declared a public health emergency. Based on data from the Department of Health and Human Services, in 2016, 2.1 million people misused prescription opioids for the first time, and 42,249 people died from overdosing on opioids. Also in 2016, 170,000… Read More »