"Our operating budget was not reduced" – Director of teen center

I just received this from Deirdre Cronin, Executive Director of Covenant House Alaska. This debunks the Washington Post’s story I addressed yesterday. I had asked her for a statement regarding the Post story and she provided this information.

Covenant House
FOR IMMEDIATE RELEASE
September 4, 2008
Contact: Deirdre A. Cronin
Executive Director
907-339-4203
“Covenant House Alaska is a multi-service agency serving homeless and runaway youth, including teen mothers. The majority of the agency’s annual operating budget is privately raised, with no more than 10 to 15 percent of funds coming from state grants in any given year. We are grateful for the support we have received from Governor Sarah Palin, the Alaska legislature and our Congressional delegation over the years.
Despite some press reports to the contrary, our operating budget was not reduced. Our $3.9 million appropriation is directed toward a multi-year capital project and it is our understanding that the state simply opted to phase in its support for this project over several years, rather than all at once in the current budget year.”
Covenant House Alaska is Alaska’s largest private non-profit adolescent care agency serving homeless, runaway and at–risk youth between the ages of 13 and 21. With particular expertise in helping some of the most hopeless teens grow into independent, successful and productive adults.
-END

More on this story here…

Lancet: Women should be offered post-abortion psychological care

The British medical journal, The Lancet, published an editorial in their August 23 issue regarding appropriate care for women after an abortion. Although the editorial could have taken a stronger stance on the APA report, I believe they have issued an important caution to those reviewing literature on mental health and abortion.

More than a third of American women will have an abortion by the age of 45 years, if current rates continue. A study published in The Lancet last year showed that 1·5 million abortions were done in the USA and Canada in 2003, compared with 42 million abortions worldwide.
Much attention has been given to the ethical considerations of terminating a pregnancy, but little effort has been directed at the long-term mental health effects of abortion on women. In 1989, the American Psychological Association (APA) undertook a systematic review of the literature and concluded that a single elective abortion did not result in long-term mental health problems. However, in 2006, a study published in the Journal of Youth & Adolescence concluded that abortion had a greater risk of adverse mental health outcomes compared with childbirth. This review was used in a South Dakota court to support a proposal to have abortion made illegal. The proposal failed, but doctors in the state must now inform women having a termination that they will be at risk of future mental health problems.
Recognising the need for a definitive decision on the issue, the APA commissioned the Mental Health and Abortion report, released on Aug 13. The authors systematically reviewed 50 studies, published in peer-reviewed journals since their last report in 1989, and concluded that, among adult women who have an unplanned pregnancy, the relative risk of mental health problems is no greater if they have an elective first-trimester abortion than if they deliver that pregnancy.
Although this report shows that there is no causal link between abortion and mental ill-health, the fact that some women do experience psychological problems after a termination should not be trivialised. The APA report concludes that such cases are often the result of confounding issues, such as a history of mental ill-health. Abortion is an important part of comprehensive reproductive health services. Women choosing to terminate must be offered an appropriate package of follow-up care, which includes psychological counselling when needed.

Tennesee church shooter needed help but didn't get it

The Tennesee church shooter, James Adkisson, sounds like many other mass killers in this article from the Knoxville News-Sentinel. In the USA Today, the note he left was described as “irrational.”
In reading the Sentinel article, you get the sad picture of a person who was in need of mental health treatment but did not get it. His ex-wife attended this church which may have been a motive in the shooting.

Counselorlicense.com – Caveat emptor.

The public has a right to be confused about credentials in mental health. With several different mental health professions (psychiatry, psychology, professional counseling, social work, marriage and family therapy, and addictions counseling), it is hard to keep up with the various titles and credentials used by the professions as well as the differences from state to state. In some states (e.g., my former residence, Ohio), one must be credentialed in order to practice, but in others (my current residence, Pennsylvania) one does not need to be licensed to practice professional counseling, marriage and family therapy or social work.
The public can be easily fooled in this environment and even those with some mental health training might think certain credentials will help them gain competitive advantage. Hence, legitimate credentialing bodies have taken steps to alert the public about what appear to be business ventures. For instance, the National Board of Certified Counselors (NBCC) provides this information regarding the American Psychotherapy Association. Sounds official, right? However, these credentials have no legal standing or recognition with any regulatory body.
What prompts this post is the emergence of another such credential with the catchy slogan – Become a licensed counselor! at Counselorlicense.com. At first glance, I thought it might be a parody. Check out this testimonial:

From a job standpoint, I was like a fish out of water. I tried every profession known to man, from office work, to real estate, to nearly every infomercial in existence. I wanted to work for myself, but as a single parent, needed significant income, but could not do extensive travel, as required in sales positions. As a “people person” I loved helping struggling couples and Church members with everything from finances to relationships, and our Pastor suggested I check out PSU. I started in a spare bedroom, and made over $1,400 the first week, and felt happier helping people than I ever have in my life. I now have my own office, secretary and mini daycare room, and can’t wait to get up in the morning to start my day! Thank you hardly says it…

The phrase “started in a spare bedroom” pointed toward parody to me but I have learned that the American Counseling Association is not amused. David Kaplan, Chief Professional Officer, at the ACA said this in an email about the Phoenix State University “credential.”

You can be assured that ACA, through its Council of Presidents and Region Chairs (COPARC), is working on this issue and taking this credential seriously.

A Whois domain search of the counselorlicense.com reveals the following:

Registrant:
Halstead, Tom
ETI
7760 e SR 69
suite c5-390
Prescott Valley, AZ 86314
US
Domain Name: COUNSELORLICENSE.COM
Administrative Contact, Technical Contact:
Halstead, Tom
ETI
7760 e SR 69
suite c5-390
Prescott Valley, AZ 86314, US
928-830-8467 fax: 866-857-2594
Record expires on 04-Apr-2009.
Record created on 04-Apr-2008.

Not surprisingly, Mr. Halstead is the owner of the various proofs of legitimacy he advances to support the pastoral counseling certificate. For instance, the websites of the Pastoral Church of America, the Phoenix State University, and even the accrediting body he says accredits the PSU, the Association of American Trade and Vocational Schools are all owned by Mr. Halstead. Of course, they all point to each other as evidence for their prestige. The AATVS website says it is “the oldest and largest accrediting organization for trade and vocational universities, colleges and schools, and has been accrediting university schools and labs since 1897.” Google it in quotes, however, and only two listings pop up, the website and Phoenix State University.
A call to the number given yields a recording asking the caller to contact PSU via email. So I did and received an automated reply. No answers as yet to my questions about how many students PSU enrolls or how I can contact one of those counselors who started in the spare bedroom. If you go to tomhalstead.com, you will find a web design business. From the looks of all the domains and websites he has, no wonder no one is answering the phone; he probably is very busy.
UPDATE: 6/3/08 – I spoke with James Rough, Executive Director of the Ohio Counselor, Social Worker & Marriage and Family Therapist Board who informed me that he has asked the Ohio Attorney General’s office to investigate potential consumer fraud by counselorlicense.com. If this office doesn’t have jurisdiction or ability to intervene, then he will write the Arizona and Colorado consumer fraud offices to ask for an investigation. I suspect other state boards will follow suit.

House passes mental health parity legislation

I posted about HR 1424 recently, noting that the mental health parity bill was going to be voted on soon. On Wednesday, the House of Representatives passed HR 1424. See this New York Times report for details.

Today an email from the American Mental Health Counselors Association HQ provided more background.

E-News from Washington

Vol. 08-12

March 6, 2008

 

House Passes Historic Parity Legislation!

 

On March 5th the House of Representatives passed comprehensive legislation requiring private health insurance plans to use the same treatment limitations and financial requirements for mental health and addictive disorder coverage as is used for substantially all other covered services. H.R. 1424, the “Paul Wellstone Mental Health and Addiction Equity Act of 2007,” introduced by Representatives Patrick Kennedy (D-RI) and Jim Ramstad (R-MN), was passed with strong bipartisan support by a vote of 268-148. (House members’ votes are listed online at http://clerk.house.gov/evs/2008/roll101.xml.) The legislation is named for the late Senator Paul Wellstone of Minnesota, a tireless advocate for Americans with mental illness.

 

House passage of H.R. 1424 is an historic step forward for mental health and addiction treatment advocates, and comes after years of hard work by the mental health and addictive disorder advocacy community. Although similar in many respects to legislation passed last year by the Senate, H.R. 1424 provides more consumer protections by requiring plans covering mental and addictive disorder treatments to cover the full range of disorders recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM)—the same range of disorders as is covered for members of Congress and all other federal employees under long-standing requirements for Federal Employee Health Benefits Program (FEHBP) policies. Unlike the Senate’s bill, H.R. 1424 also stipulates that health plan covering out-of-network services for medical and surgical benefits must also offer out-of-network coverage for mental health and addictive disorder benefits. This requirement applies for both outpatient and inpatient care.

 

AMHCA and ACA applaud Representatives Patrick Kennedy (D-RI) and Jim Ramstad (R-MN) for their long, hard, heroic work in gaining House passage of H.R. 1424. During floor debate, both Kennedy and Ramstad spoke about their own personal battles with mental and addictive disorders, their treatment, and how their treatment has enabled them to lead productive lives. AMHCA and ACA also thank those counselors who took the time to contact their representative on this issue.

 

Attention now shifts to House-Senate negotiations to reconcile their chambers’ versions of the parity legislation. Like the business community, the Bush administration argued in favor of the weaker Senate version, issuing a statement of policy expressing opposition to H.R. 1424. Despite this, AMHCA, ACA and other mental health and addictive disorder advocates are now working to build upon the strong bipartisan support for H.R. 1424 and the unanimous passage last year of the Senate’s bill, to encourage the development and enactment of parity legislation that provides consumer protections that are as strong as possible.

Beth Powell

Director, Public Policy and Professional Issues

American Mental Health Counselors Association

I recognize some social conservatives and business advocates do not favor parity. However, I see this as a very family friendly legislation. Severe mental disorders sap the resources of working families and are leading causes of disability. If this bill is law, managed care companies/insurers will still be able to deny inappropriate care for the questionable diagnoses in the DSM (e.g., caffiene intoxication) but will not be able to deny appropriate care for those who need it.