Social Work Today E-Zine

In a statement issued from the National Youth Leadership Council’s (NYLC) office in St. Paul, Minn., NYLC founder and CEO Jim Kielsmeier celebrated President Obama’s signing of the Edward M. Kennedy Serve America Act:

“I applaud the President and Congress for their vision and leadership in passing the Edward M. Kennedy Serve America Act. … We look forward to innovative education programs that expand high-quality service-learning practices and strengthen communities nationwide.

With schools around the country facing severe budget cuts, it is imperative that the Corporation for National and Community Service takes bold steps to help fill these growing gaps. We call on the Corporation, as the federal agency that supports service-learning across the country, to provide the financial support for K-12 Learn and Serve America programs so that high-quality programs continue to grow.

When service-learning is a K-12 teaching strategy, students gain leadership skills and apply their academic skills to make meaningful differences in their communities. With early exposure to service as an integrated part of their schooling, students often become interested in national service following their high school or college experiences, and go on to be life-long service leaders.

Now is the time to build a generation of engaged citizens who will strengthen communities around the country and world—both in their first 12 years of schooling, and beyond.

We applaud both the President and Congress for their leadership in passing this landmark legislation and look forward to working with our colleagues to make real the vision behind this Act.”

— Source: National Youth Leadership Council

The West Virginia Legislature has passed one of its first major healthcare bills of the session: Senate Bill 672, the Mental Health Stabilization Act of 2009. The bill is intended to rebuild West Virginia’s community-based mental health system.

“As the bill says, the Legislature has determined that the community mental health system is in a state of crisis,” lead bill sponsor and Senate Judiciary Chairman Jeff Kessler, D-Marshall, said. “The bill clearly states: ‘There are not sufficient community resources to meet the needs of the state’s population.’”

The bill notes that the state has been “the subject of various court orders as a result of the manner in which it dealt with people with mental health needs and the Legislature desires to be proactive and resolve issues surrounding mental illness without the intervention of the courts.”

Last summer, the court-appointed Ombudsman for Behavioral Health David Sudbeck found Bateman Hospital in Huntington, one of two state psychiatric hospitals, to be overcrowded and understaffed. In January, the West Virginia Supreme Court agreed with Kanawha County Circuit Judge Duke Bloom that he should be allowed to conduct evidentiary hearings into conditions at Bateman Hospital and also into whether the state is providing sufficient services for individuals with traumatic brain injuries.

“It’s important to get Senate Bill 672 signed into law, because without legislative action to fix the mental health system, the courts could very well impose a more costly solution,” John Russell, executive director of the West Virginia Behavioral Healthcare Providers Association, said.

The bill recognizes that the current rates of involuntary mental health commitments and the incarceration of people with mental health needs are using significant state resources. Its premise is that those resources could be used more effectively and efficiently in community-based mental health services, which should reduce the number of people needing involuntary commitments or incarceration.

“More than 37,000 people each year in our regional jails have needed treatment for mental illness,” Delegate Scott Varner, D-Marshall, said. “That places a burden on our counties that would be unnecessary if more people could receive help from mental health providers in their communities.”

— Source: West Virginia Behavioral Healthcare Providers Association

Americans expressed serious concerns regarding healthcare in a new report by the Department of Health and Human Services. The report, “Americans Speak on Health Reform: Report on Health Care Community Discussions,” summarizes comments from the thousands of Americans who hosted and participated in Health Care Community Discussions across the country and highlights the need for immediate action to reform healthcare. It can be found at the Web site www.healthreform.gov.

Over 9,000 people signed up in all 50 states and the District of Columbia to host a Health Care Community Discussion, and thousands more participated in these gatherings. After each discussion, guests and hosts were asked to fill out a survey and submit a group report summarizing the group's concerns and suggestions. Group reports from 3,276 Health Care Community Discussions as well as Participant Surveys from 30,603 participants were collected, analyzed, and are summarized in the report.

The cost of healthcare services and health insurance was the top concern about the healthcare system for 55% of discussion participants. Participants also cited lack of emphasis on prevention, preexisting conditions limiting insurance access, and the quality of care as key concerns. A qualitative analysis found that the Health Care Community Discussions focused on concerns about a "broken" health system, access to health insurance and services, rising premiums and drug costs, medical mistakes, and the system not being "for them."

Health Care Community Discussion group participants agreed on the values and direction that should guide reform. They called for a system that is fair, patient centered and choice oriented, simple and efficient, and comprehensive. Participants also offered a wide range of specific solutions, including making health insurance more accessible through an insurance "exchange" or a public plan option, creating scorecards on quality and cost, improving the nutritional content of school lunches, implementing electronic medical records, and creating an AmeriCorps for health workers.

— Source: Health and Human Services

Nearly one third of veterans who are treated at VA healthcare centers have significant depressive symptoms, and about 13% have clinically diagnosed depression, says Marcia Valenstein, MD, a clinical psychiatrist with the VA Ann Arbor Healthcare System and an associate professor of psychiatry with the University of Michigan Health System.

Depression is a “very potent” risk factor for suicide among people receiving treatment for depression at the VA, she notes, with a suicide rate that is three times higher than that of the overall VA patient population. Such high rates led Valenstein and her colleagues to study the best time to provide intensive interventions to veterans with depression to prevent suicide. In a study published by the Journal of Affective Disorders, the researchers found that veterans with depression were at highest risk for suicide in the 12 weeks after they were hospitalized for psychiatric conditions.

“This finding highlights the need for very close follow-up for patients who are discharged from our inpatient services because this is a particularly vulnerable time for them,” says Valenstein.

Current government recommendations have focused on providing intensive follow up for patients following all new antidepressant starts. More attention needs to be paid to the highest-risk periods that follow psychiatric hospitalization, Valenstein says. “Health systems with limited resources should focus their efforts on this time period to have the greatest impact on suicide prevention.”

The Department of Veterans Affairs has made mental health issues a priority, Valenstein notes. VA health centers have received more than $300 million for expansion of suicide prevention and other mental health services from the Veterans Health Administration.

— Source: University of Michigan Health System

As the Iowa Supreme Court hears a case that could clear the way for gay marriage in Iowa, a poll shows nearly 60% of voters in the state favor some type of legal recognition of same-sex relationships in Iowa.

In the random, statewide poll of 586 voters, University of Iowa political scientists found that 28% of Iowans support same-sex marriage. Another 30% support civil unions, not gay marriage. About one in three oppose both.

"Iowans are not yet ready to support gay marriage completely, but they are clearly ready to legally acknowledge same-sex relationships," says David Redlawsk, PhD, associate professor of political science in the University of Iowa College of Liberal Arts and Sciences.

Results, drawn from the Big Ten Battleground Poll, indicate that support for gay marriage will get a notable boost if the state's high court rules in favor of it. And, a majority of Iowa voters under the age of 30 are already in favor of gay marriage, suggesting that support for it could grow as time goes on.

Because of the pending Iowa Supreme Court case, the poll asked Iowans to consider what the state should do if the Supreme Court upholds a constitutional right to marriage for same-sex couples.

Thirty-five percent of respondents favored accepting a Supreme Court ruling to allow gay marriage. That means if the court rules in favor of gay marriage, support for it increases by 7 percentage points. Another 27% support the creation of civil unions as an acceptable alternative.
Even larger shifts in support are observed among independents, ideological moderates, and moderate church attendees. If the court sanctions gay marriage, support from those groups grows by 13 to 15 percentage points.

"Clearly opinion on the issue of gay marriage will change if the Iowa Supreme Court rules that the state's constitution requires it," Redlawsk says. "Overall support remains below 50% even then, but those in the political middle become much more likely to support gay marriage if the court rules in favor."

— Source: University of Iowa Health Sciences

The first of a fleet of 50 new mobile counseling centers for the VA Vet Center program was recently put into service with the remainder activated over the next three months.

"Our widespread distribution of this fleet from coast to coast marks a new chapter in VA's innovation to reach rural and underserved veterans with high-quality readjustment counseling," says VA secretary James B. Peake, MD.

Each vehicle will be assigned to one of VA's existing Vet Centers, enabling the center to improve access to counseling by bringing services closer to veterans. The 38-foot motor coaches, which have spaces for confidential counseling, will carry Vet Center counselors and outreach workers to events and activities to reach veterans in broad geographic areas, supplementing VA's 232 current Vet Centers, which are scheduled to increase to 271 facilities by the end of 2009.

Vet Centers, operated by VA's Readjustment Counseling Service, provide nonmedical readjustment counseling in easily accessible, consumer-oriented facilities, addressing the social and economic dimensions of post-war needs. This includes psychological counseling for traumatic military-related experiences and family counseling when needed for the veteran's readjustment.

The team leader at each Vet Center will develop an outreach plan for use of the vehicle within that region, not being limited to the traditional area of a particular Vet Center. These vehicles will be used to provide outreach and direct readjustment counseling at active-duty, reserve and National Guard activities, including post-deployment health reassessments for returning combat service members.

— Source: Department of Veterans Affairs

The Department of Health and Human Services (HHS) recently announced $36 million in new grant programs to 28 states to help older Americans and veterans remain independent and to support people with Alzheimer's disease to remain in their homes and communities. Just over $19 million of this funding involves a new collaboration with the VA.

HHS secretary Mike Leavitt and VA secretary James Peake, MD, announced the joint effort to provide essential consumer-directed, home- and community-based services to older Americans and veterans of all ages, as part of a Nursing Home Diversion (NHD) grants program. The new initiative builds on the similar missions of HHS and the VA with regard to caring for the populations they serve. In addition, Secretary Leavitt announced a $17 million investment to improve the delivery of home and community-based services to people with Alzheimer's disease and their family caregivers.

"Our mission is to honor and support America's veterans, and this collaboration provides an additional opportunity to do that by offering more services, choices and control over decisions to veterans in the least restrictive environment consistent with their needs and preferences," Peake said.

"The HHS funding is specifically designed to reach people who are not eligible for Medicaid, but who are at high risk of nursing home placement and spend-down to Medicaid -which often occurs when private pay individuals enter a nursing home," said assistant secretary for aging Josefina G. Carbonell. "The program will also offer consumers more control over their long-term care, including the ability to determine the types of services they receive and the manner in which they receive them, including the option of hiring their own care workers."

— Source: Health and Human Services