News Briefs

GAO report examines services for young adults with serious mental illness: At least 2.4 million young adults ages 18 through 26—or 6.5% of noninstitutionalized persons in this age range—had a serious mental illness in 2006, according to data in an 81-page report compiled by the Government Accountability Office (GAO), which sought to determine how states and the federal government assist this group. In 2006 about 186,000 young adults received federal disability benefits because of a mental illness that prevented them from engaging in substantial, gainful activity. Because mental health, employment, and housing services are not always suited for young adults with mental illness, many opt not to receive them. In addition, those who received free or low-cost services as children may not qualify for them as adults, and their psychiatric disabilities may make it difficult to navigate multiple discrete programs. The report describes findings from site visits to programs in four states—Connecticut, Maryland, Massachusetts, and Mississippi—that help young adults with serious mental illness transition into adulthood by offering developmentally appropriate services that are tailored to individual needs and integrated to improve access. All four states coordinate services across multiple state agencies, leverage federal and state funding sources, and involve young adults and their families in developing policies and aligning supports. The report also describes efforts by some federal agencies to provide technical assistance on promising practices that can help states coordinate services for these young adults as they transition to adulthood. Young Adults With Serious Mental Illnesses: Some States and Federal Agencies Are Taking Steps to Address Their Challenges is available on the GAO Web site at www.gao.gov.

State-level plans for uninsured may neglect mental and substance use disorders: A new report from the National Alliance on Mental Illness and the National Council for Community Behavioral Healthcare examines benefits for mental illness and substance use disorders for adults in initiatives and proposals that have been implemented in 18 states to cover the uninsured. Among uninsured adults, about 25% have a mental illness, substance use disorder, or co-occurring disorder, according to data in the report. Eleven of the 18 states provide parity coverage for mental illness—some for serious mental illness only—in at least one of their programs or proposals for the uninsured. Only five of the 18 states provide parity coverage for substance use disorders in at least one of their programs or proposals for the uninsured. In the states that are generally viewed as closest to achieving universal coverage—Vermont and Massachusetts—treatment for mental illness and substance use disorders is covered on par with that for other health conditions. The report notes that the trend toward increased cost sharing is reflected in state plans to cover the uninsured. With few exceptions, the programs, including those targeting low-income and small-employer populations, often have significant copayments. The report concludes by calling for greater efforts to provide state officials and policy makers with the information and skills they need to implement effective state-level programs for the uninsured. The 66-page report, Coverage for All: Inclusion of Mental Illness and Substance use Disorders in State Healthcare Reform Initiatives, is available at healthcareforuninsured.org.

WHO report compares substance use in 17 countries: The United States has the highest lifetime rates of tobacco and alcohol use and also the largest proportion of survey participants reporting marijuana or cocaine use at least once during their lifetime, according to data from the World Mental Health Surveys, an initiative conducted by the World Health Organization (WHO) research consortium. The report examines patterns in the use of alcohol, tobacco, marijuana, and cocaine in 17 countries representing all six WHO regions. Household surveys, which used the WHO Composite International Diagnostic Interview with a combined sample size of 85,052 persons, were carried out in the Americas (Colombia, Mexico, and the United States), Europe (Belgium, France, Germany, Italy, Netherlands, Spain, and Ukraine), the Middle East and Africa (Israel, Lebanon, Nigeria, and South Africa), Asia (Japan and the People's Republic of China), and Oceania (New Zealand). Survey data also indicate that use of all types of drugs is becoming more common over time. In all countries males were more likely than females and younger adults were more likely than older adults to have used all drug types. Those with higher incomes were more likely to have used legal and illegal drugs. Alcohol use by age 15 was far more common in European countries than in the Middle East or Africa. The report, Toward a Global View of Alcohol, Tobacco, Cannabis, and Cocaine Use: Findings From the WHO World Mental Health Surveys, is available in the July 1, 2008 issue of the open-access journal PLoS Medicine at medcine.plosjournals.org.

AHRQ releases new Spanish-language consumer guide to oral diabetes medications: A consumer guide for Hispanic adults who have type 2 diabetes and need information to help them compare various oral medications for their illness has been released by the Agency for Healthcare Research and Quality (AHRQ). AHRQ data show that nearly one in eight Hispanic adults in the United States takes a drug for diabetes. Provision of consumer information in Spanish is intended to encourage Hispanic patients to become more involved in their health care, which may help eliminate racial and ethnic disparities in care. Pastillas Para la Diabetes Tipo 2 compares research results for ten generic and 13 brand-name diabetes medications and explains how each works to lower blood sugar; which may increase body weight; and which may cause side effects, such as stomach problems or swelling. Each drug's potential effect on "bad" and "good" cholesterol is explained. An easy-to-understand comparison of the dosage and average cost of the medications is also provided. Information in the guide is based on the recent AHRQ-funded report, Comparative Effectiveness and Safety of Oral Diabetes Medications for Adults With Type 2 Diabetes, which analyzed data from 216 published studies. The report summarizes the effectiveness, risks, and estimated costs for ten diabetes medications. Pastillas Para la Diabetes Tipo 2, along with the English-language version, Pills for Type 2 Diabetes, and other publications from AHRQ's Effective Health Care Program for consumers and clinicians, can be found online at www.effectivehealthcare. ahrq.gov. The consumer guides can be ordered free of charge by sending an e-mail to [email protected] or by calling 800-358-9295.

SAMHSA report maps behavioral health problems by localities: A new report by the Substance Abuse and Mental Health Services Administration (SAMHSA) provides analyses of substance abuse and mental health problems in 345 substate areas. Substate areas are generally defined in terms of counties or groups of counties. The report analyzes data regarding 23 behaviors from the 2004 to 2006 National Surveys on Drug Use and Health. The analysis found that some of the highest levels of painkiller use for nonmedical reasons (as high as 7.9%) were reported in one of the smaller substate areas—Utah's Salt Lake and Weber-Morgan Counties. Yet the same Utah communities had some of the nation's lowest levels of underage binge alcohol use (as low as 8.7%). The full report, Substate Estimates From the 2004-2006 National Surveys on Drug Use and Health, is available on the Web at oas.samhsa.gov/substate2k8/toc.cfm.