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Psychiatric Updates

September 02, 2015 at 16:21 MDT

Severe Poverty Affects Brain Development, Study Shows.

The Milwaukee Journal Sentinel (8/29, Boulton) reported that a study conducted at the University of Wisconsin-Madison “has added to the mounting evidence that growing up in severe poverty affects the way children’s brains develop, potentially putting them at a lifelong disadvantage.” The study, published recently in JAMA Pediatrics, “found that the parts of the brain tied to academic performance were 8% to 10% smaller for children who grow up in very poor households.” The study drew from 823 MRI scans “of 389 children, ages 4 to 22, from a National Institutes of Health study done to show normal brain development.”
Judge orders immigrant kids released

By Seth Robbins / The Associated Press
PUBLISHED: Sunday, August 23, 2015 at 12:14 am
In this July 2015 photo, immigrants from El Salvador and Guatemala board a bus after being released from a family detention center in San Antonio, Texas. (AP Photo/Eric Gay, File)
SAN ANTONIO – A federal judge in California has ordered the government to release immigrant children from family detention centers “without unnecessary delay,” and with their mothers when possible, according to court papers.
In a filing late Friday, California U.S. District Judge Dolly Gee refused the government’s request to reconsider her late-July ruling that children held in family detention centers after crossing the U.S.-Mexico border illegally must be released rapidly.
Calling the government’s latest arguments “repackaged and reheated,” she found the U.S. Department of Homeland Security in breach of a longstanding legal agreement stipulating that immigrant children cannot be held in unlicensed secured facilities, and gave agency officials until October 23 to comply.
Lawyers for Homeland Security had argued that the agency was already doing its best to move families through detention quickly and that the facilities had been converted into short-term processing centers.
Attorneys for the government are reviewing the order, said Nicole Navas, a spokeswoman for the Department of Justice, Friday night.
This is the second time Gee has ruled that detaining children violates parts of a 1997 settlement from an earlier case that requires minors to be placed with a relative or in appropriate non-secure custody within five days. If there is a large influx of minors, times may be longer, but children still must be released as expeditiously as possible under the terms of the law.
In her order, Gee countered that immigration officials “routinely failed to proceed as expeditiously as possible to place accompanied minors, and in some instances, may still be unnecessarily dragging their feet now.”
Peter Schey, executive director of the Center for Human Rights and Constitutional Law, said the order “will protect refugee children and their mothers from lengthy and entirely senseless detention.”
The government poured millions of dollars into two large detention centers in Texas after tens of thousands of immigrant families from Central America, mostly mothers with children, crossed the Rio Grande into the U.S. last summer. Many have petitioned for asylum after fleeing gang and domestic violence back home.
The centers in Karnes City and Dilley, south of San Antonio, recently held more than 1,300 women and children. A third, smaller facility in Berks County, Pa., held about 70 people. All three are overseen by U.S. Immigration and Customs Enforcement, but the two Texas centers are run by private prison operators.
Between September 2013 and October 2014, some 68,000 people – mostly mothers with children – were caught at the border, according to U.S. Customs and Border Protection. Between last October and July of this year, less than 30,000 have been apprehended, a drop authorities say is a result of better enforcement in both the U.S. and Mexico.
In her order Friday, Gee challenged Homeland Security’s claim that drastically limiting or ending its family detention policy could spark another surge in illegal border crossings, calling it “fear-mongering.”
Opting Out of Medicaid Expansion: 
Impacts on Behavioral Health Services at Community Health Centers

ARLINGTON, Va., Aug. 17, 2015 — A cost analysis of states’ decisions to opt out of Medicaid expansion under the Affordable Care Act shows these states will receive less revenue and have a reduced capacity to serve people with mental illness. If all 50 states expanded Medicaid by 2020, an additional 70,500 behavioral health services would be provided that year. The study is published online today in Psychiatric Services in Advance.

The study focused on community health centers, a key source of medical and behavioral health services in underserved communities because they serve all patients regardless of the ability to pay. Health centers are not required to provide behavioral health services, making these services vulnerable to cuts if there is not enough funding. Most health center patients have incomes below the federal poverty line; centers in states that have expanded Medicaid are likely to see increased revenue as more patients will have health insurance to cover the cost of their care, according to study authors.

The authors calculated that, if all 50 states expanded Medicaid by 2020, health centers would accrue nearly $230 million in additional revenue during that year, because fewer of their patients would be uninsured. Based on previous health center spending, the study found this would likely provide an estimated $11.3 million for mental health services and $1.6 million for substance use disorder services in 2020, resulting in more than 70,500 additional encounters with behavioral health specialists.

The authors, led by Emily Jones, Ph.D., M.P.P., with the U.S. Department of Health and Human Services and the George Washington University, conclude that onsite mental health services are necessary at community health centers and that the financial consequences of opting out of Medicaid will limit the ability to provide these services in states that opt out. The study also highlights an important indirect benefit of Medicaid expansion — that expanding Medicaid would likely result in higher utilization of behavioral health services in health centers.

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