{"id":64981,"date":"2016-04-28T17:30:12","date_gmt":"2016-04-28T21:30:12","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=64981"},"modified":"2016-04-28T17:40:37","modified_gmt":"2016-04-28T21:40:37","slug":"all-aboard-2","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2016\/04\/28\/all-aboard-2\/","title":{"rendered":"all aboard!…"},"content":{"rendered":"\n
All Aboard!<\/font><\/strong><\/em> As the ripples from the recently released suicide figures spread across the water, the usual suspects are being lined up to take the blame: not enough antidepressants, too many antidepressants, biomedical psychiatry, the American Psychiatric Association, the FDA’s Black Box Warning, Tom Insel’s NIMH, Managed Care, the Pharmaceutical Industry, Hospital Corporations, things like 911 or the Iraq War, the great recession, Republicans, Democrats, the NRA. And the non-psychiatric community who have been reimbursed to take over ongoing mental health care [along with their guilds] earned their right to be added to the list: Psychologists, Social Workers, LPCs, etc. Nobody gets off the hook here. There’s room on this train for every one of us. All Aboard!<\/font><\/strong><\/em><\/div>\n
\n
Trends in Prescription Drug Use Among Adults in the United States From 1999-2012<\/a><\/div>\n
by Kantor ED, Rehm CD, Haas JS, Chan AT, and Giovannucci EL<\/div>\n
JAMA<\/font><\/strong>. 2015 314[17]:1818-1831.<\/div>\n

<\/p>\n

hat tip to Justin Karter<\/a>… <\/font><\/strong><\/div>\n<\/blockquote>\n
and for review, the recent suicide statistics with equivalent abscissa scaling…
<\/span><\/div>\n
\n
Increase in Suicide in the United States, 1999–2014<\/a><\/div>\n
National Center for Health Statistics<\/font><\/strong><\/div>\n
Centers for Disease Control and Prevention<\/font><\/strong><\/div>\n
by Sally C. Curtin, Margaret Warner, and Holly Hedegaard<\/div>\n
NCHS Data Brief No. 241, April 2016<\/div>\n

<\/p>\n

<\/div>\n<\/blockquote>\n
It’s obvious that there’s no reason to hypothesize that there’s an antidepressant deficiency upon the land. And as for the APA President’s predictable [and irresponsible] quip<\/a>:<\/div>\n
\n
"Now, the other thing that we were anticipating with some dread was the aftermath of the black box on antidepressants," says Oquendo, referring to a warning label that in 2004 the Food and Drug Administration required for commonly prescribed antidepressants. The label says that in people under age 26, the medications can actually increase the risk of suicidal thoughts and actions. Research has suggested that the warning scared doctors away from prescribing antidepressants to people of all ages. "And some of the increment in suicide deaths in the younger populations is potentially linked to an understandable reluctance by physicians who see these youngsters to prescribe antidepressants, even when they’re aware that the individual is suffering from depression," says Oquendo. Research has shown that the benefits of prescribing antidepressants to mentally ill children tend to outweigh the risk of suicidal tendencies…<\/div>\n<\/blockquote>\n
All the Black Box Warning did was slow the acceleration of antidepressant use in kids, unlikely to have had the kind of impact shown, for example, in teenaged girls. The graph on the left is from Lu et al<\/a> with the recent suicide figures on the right:<\/div>\n
 <\/div>\n
<\/div>\n
My takeaway from these suicide figures is that it’s a solid indictment of our entire mental health system, not of any particular element. The tragedy is that we actually know how to deliver the care at a much more effective level. We’ve known for a long time. But we’re too busy haggling with each other to do it…<\/div>\n","protected":false},"excerpt":{"rendered":"

All Aboard! As the ripples from the recently released suicide figures spread across the water, the usual suspects are being lined up to take the blame: not enough antidepressants, too many antidepressants, biomedical psychiatry, the American Psychiatric Association, the FDA’s Black Box Warning, Tom Insel’s NIMH, Managed Care, the Pharmaceutical Industry, Hospital Corporations, things like […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[5],"tags":[],"class_list":["post-64981","post","type-post","status-publish","format-standard","hentry","category-opinion"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/64981","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/comments?post=64981"}],"version-history":[{"count":22,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/64981\/revisions"}],"predecessor-version":[{"id":65003,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/64981\/revisions\/65003"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=64981"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=64981"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=64981"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}