TAG: "Mental health"

Twitter could provide key details about transgender people’s health needs

UCLA study suggests that social media could help fill knowledge gap.

Sean Young, UCLA

By Enrique Rivero, UCLA

Transgender and gender-nonconforming people have a higher-than-average risk for AIDS and are more vulnerable than others to depression. But because stigma about gender identities makes them less likely to disclose information about themselves to researchers, it also has been difficult for doctors to understand the best ways to provide care for them.

New research by the University of California Institute for Prediction Technology suggests that social media could help fill that knowledge gap.

In a study published in the peer-reviewed journal JMIR Mental Health, the researchers reported that because transgender and gender-nonconforming people frequently use social media to discuss important health and social needs, resources like Twitter may provide a wealth of useful information for doctors and public health professionals.

“Transgender individuals are at risk for some of the most important public health problems, such as HIV, substance abuse and depression,” said Sean Young, the study’s co-author and the executive director of the institute, which is based in the UCLA Department of Family Medicine. “There has been little research studying transgender communities because they can be very closed communities who fear stigmatization. Our institute has studied how to use social big data to address public health needs and we wanted to apply this work to address the needs of transgender communities and researchers.”

Young and co-author Evan Krueger collected 1,135 tweets with 13 relevant hashtags, including terms like #trans or #girlslikeus. The tweets discussed issues such as violence, discrimination, suicide and sexual risk.

“This approach can be used to better understand people, prevent diseases and predict important trends — including views on policies that affect transgender populations or changes in health,” said Krueger, a doctoral student at the UCLA Fielding School of Public Health.

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Researchers receive grant to study schizophrenia in children with 22q11.2

UC Davis MIND Institute researchers will investigate this very high-risk population.

UC Davis MIND Institute

By Phyllis Brown, UC Davis

Researchers studying a genetic disorder that in childhood causes anxiety and learning differences, but in adolescence or early adulthood results in schizophrenia in nearly one third of those affected, will investigate how emotional and intellectual challenges impact the development of early psychosis symptoms in this very high-risk population, through a new five-year, $2.5 million grant from the National Institute of Mental Health.

The grant will allow the UC Davis MIND Institute’s 22q11.2 Deletion Syndrome Research Center and Clinic to assess how cognition, stress and emotions are associated with the the likelihood of developing psychosis among teens with chromosome 22q11.2 deletion syndrome, or 22q11.2DS — a genetic condition that previously has been known as Velocardiofacial Syndrome or DiGeorge Syndrome.

The symptoms of 22q11.2DS vary so widely that the condition often is misdiagnosed in childhood. Children may have a range of medical complications, including congenital heart disease, defects of the palate and mild facial anomalies. Infections are commonplace because of problems with their immune systems. Most children with 22q11.2DS have mild to moderate intellectual disability and difficulties with acquiring written and spoken language.

The center is led by Tony J. Simon, professor in the Department of Psychiatry and Behavioral Sciences, who noted that news of the grant’s selection for funding came almost 10 years to the date from when he joined the MIND Institute. “This is truly ‘the grant that the MIND Institute made’,” Simon said.

“When I arrived at the MIND Institute, my primary focus on 22q11.2DS was on the cold cognitive neuroscience aspects of the learning difficulties,” he said. “But we were so strongly influenced and shaped by the MIND’s clinical translational environment, the interaction between our researchers and clinicians, and the intense time we spend with the kids we study and their families, that our research mission and how we approach it has been literally transformed.”

“Now our approach is to combine measures of neurocognitive and emotional functioning and stress biology with established and novel clinical measures to attempt to establish, not only the predictors of risk for, but also protection against psychotic thinking symptoms. As a result we might be able to reduce the burden of psychosis symptoms on the individual and their families, and maybe even prevent the development of schizophrenia in some,” Simon said.

The research will enroll 100 youth diagnosed with 22q11.2 deletion syndrome between the ages of 12 and 18 years and 50 age- and gender-matched typically developing youth, who will receive two assessments 2-1/2 years apart over the five-year life of the project. The measures will include cognitive functioning tasks that involve either positive or negative emotional stimuli along with variants that do not contain any emotional content.

Some of the tests will be done while brain activity is measured using Event-Related Potentials (ERP) in the MIND Institute’s new ERP Lab. ERPs measure specific responses from brain cells in reaction to events, images or sounds. They are measured by placing an elasticated cap in which are embedded numerous electrodes that can detect electrical brain activity merely by resting next to the scalp.

Stress hormone levels will be sampled during testing via simple saliva tests and all participants will complete a structured interview for psychosis-proneness symptoms carried out by a highly trained clinician. Brain connectivity will be assessed using functional magnetic resonance imaging (fMRI). A third assessment will be included, at 3-1/2 years, for a subset of young people whose psychosis symptoms worsen.

Other members of the project team include Cameron Carter, professor of psychiatry and behavioral sciences and director of the Behavioral Health Center of Excellence and Imaging Research Center at UC Davis; Tara Niendam, assistant professor of psychiatry and behavioral sciences; Steven Luck, professor of psychology and director of the UC Davis Center for Mind and Brain; and Emilio Ferrer, professor of psychiatry and behavioral sciences. The team also will include consultants from Stanford University, Emory University and Tel Aviv University.

For more information visit the 22q11.2 Deletion Syndrome Research Center and Clinic on the Web at www.ucdmc.ucdavis.edu/mindinstitute/research/cabil.

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Shock treatment changes key areas of brain that play roles in memory, emotion

UCLA study may help physicians identify patients who will respond to treatment.

Katherine Narr, UCLA

By Kim Irwin, UCLA

Scientists know that depression affects the brain, but they still don’t know why some people respond to treatment and others do not.

Now UCLA researchers have shown for the first time in a large cohort of patients that electroconvulsive therapy, or ECT, changes certain areas of the brain that play a role in how people feel, learn and respond to positive and negative environmental factors. The team imaged the hippocampus and amygdala in patients before, during and after undergoing ECT — also known as shock treatment — and compared those images to scans of healthy brains.

The scientists also showed that in patients with major depression, as the hippocampus increases in size, mood improved and parts of the hippocampus and amygdala change more with treatment.

The findings provide vital clues that could help doctors identify patients who will respond well to treatment. They would also help spare patients who won’t respond to treatment from taking drugs that ultimately won’t work for them, said Katherine Narr, a senior author of the study and a UCLA associate professor of neurology.

Major depression affects 350 million people each year and it affects not only those who suffer but also their families, the health care system and the economy.

“Major depression affects all ages, races and ethnic groups, and it has serious consequences on people’s family lives and work,” Narr said. “People with depression also are at higher risk for suicide, which on average accounts for more deaths than car accidents, natural disasters and war each year. Unfortunately, standard types of medication used to treat major depression take a long time to work, and for at least a third of people, the medication will not work well enough to provide any real help.”

Finding better ways to select patients for treatments that will alleviate their symptoms would go a long way to reducing that suffering, Narr said.

The study was published online by the peer-reviewed journal Biological Psychiatry.

ECT, which has been used for more than 50 years, carries a certain stigma. However, within the past decade, advances in anesthesia and electrical stimulation equipment, and new evidence about electrode lead placement have improved the safety and reduced side effects of the procedure, said Shantanu Joshi, the study’s first author and a UCLA assistant professor of neurology.

In addition, advances in high-resolution MRI have allowed more accurate measurement of the changes to the brain induced by ECT.

“ECT has been shown to be very effective for treating patients with major depression who don’t respond well to other treatments,” Joshi said. “People with smaller hippocampal size prior to starting treatment are less likely to respond as well to treatment. While our research investigates structural neuroplasticity in depression in response to ECT, we believe our findings are of much broader interest to the field.”

The researchers believe that the conclusions also would extend to more standard medications used to treat depression, including selective serotonin reuptake inhibitors, and could be used to predict patients’ responses.

The team took three sets of images of 43 patients who were undergoing ECT: before their treatments, after their second session and within one week after they completed treatment. The images were compared to two sets of brain scans from 32 healthy people.

Going forward, the UCLA team will examine the relationship between the neuroplasticity of the hippocampus structure and its neurochemistry in terms of the metabolite response, which could help them understand how metabolism in the brain is either suppressed or excited in response to ECT. Additionally, the researchers will use the shapes of the hippocampus and amygdala to classify and predict depression diagnosis and treatment response, and will investigate how structural changes are related to novel disease maintenance treatments for depression, as well as relapse and recurrence rates.

“Our findings newly show that hippocampal structure prior to ECT may be an important indicator of treatment outcome,” the study states. “That is, patients with smaller hippocampal volumes at baseline are shown to more likely exhibit increases in volume with ECT and to show concomitant improvements in clinical symptoms. Results further indicate that both clinical response to ECT and ECT-induced changes in volume occur rapidly.”

The study was funded by the National Institute of Mental Health (RO1MH092301 and K2MH102743).

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UC Davis receives $10M grant to establish center to study schizophrenia

New Conte Center for Basic or Translational Mental Health Research is one of 15 nationwide.

Cameron Carter, UC Davis

By Phyllis Brown, UC Davis

UC Davis will establish a prestigious, leading-edge center to advance innovative research into the origins of schizophrenia: A Silvio O. Conte Center for Basic or Translational Mental Health Research, one of only 15 such centers in the United States.

The center will be funded through a $10 million grant from the National Institutes of Mental Health, which will allow UC Davis’ Conte Center to investigate the novel hypothesis that an origin of schizophrenia may be dysregulation of immune molecules that play a key role in the normal development and functioning of connections in the brain.

Because mental-health disorders affect between 15 and 20 percent of the United States population, it is crucial to identify new pathways to address them, said Cameron Carter, professor in the Department of Psychiatry and Behavioral Sciences and the principal investigator for the Conte Center grant.

“This center brings together an exceptional team that exemplifies the collaborative culture of UC Davis, with investigators from multiple centers, departments and colleges at UC Davis and beyond, all working together,” said Carter, who also is director of the newly established UC Davis Center for Behavioral Health.

“It places UC Davis in the upper echelon of mental health research institutions in the world, and is testimony to the strength and depth of our basic and translational science enterprise,” Carter said.

Conte Center grants support innovative, collaborative interdisciplinary research that advances brain and behavioral-health discoveries that lay the groundwork for new approaches to psychiatric disorders by integrating basic- and clinical-neuroscience investigations into severe mental illness and employing extraordinary synergy across disciplines. The grants are named for 16-term Pennsylvania Rep. Silvio O. Conte, a champion of neuroscience research and the severely mentally ill.

Schizophrenia and maternal immune activation

Central to the UC Davis Conte Center will be exploring the hypothesis that schizophrenia is a neurodevelopmental disorder, and that one important factor in its cause is the activation of a family of immune molecules that alter fetal brain development, leading to structural and functional changes in connectivity that result in the emergence of psychosis in adolescence and young adulthood.

Through four highly interactive projects, the investigators will explore when and how maternal immune activation alters immune signaling in the brain, and whether it leads to changes in synaptic connectivity, gene expression, functional connectivity, dopamine dysregulation and neural inflammation, causing schizophrenia.

The research will employ state-of-the-art techniques from molecular, cellular and cognitive neuroscience to elucidate how changes in immune molecules in the developing brain may uncover a common pathway through which genetic and environmental risk factors lead to the changes in brain function that underlie development of serious psychiatric diseases such as schizophrenia.

The center emerged out of an unprecedented approach that involved the coordination of experiments by five accomplished research groups with appointments in the UC Davis School of Medicine, the College of Biological Sciences, the College of Letters and Sciences, and the School of Engineering.

Center had its genesis in RISE grant

Led by Kimberley McAllister, associate director of the Center for Neuroscience, the team found that maternal immune activation leads to long-lasting alterations in the expression of immune molecules in the brains of offspring. Importantly, this subset of altered immune molecules is identical across disparate species, implying that this central immune-signaling pathway in the brain may cause changes in neural circuitry and function, eventually leading to the aberrant behaviors characteristic of schizophrenia. The Conte Center will test this hypothesis.

If true, then these immune molecules will serve as important new targets for developing novel diagnostic tools and a new class of therapeutics for earlier diagnosis and treatment of schizophrenia and other potential neural-immune-based psychiatric disorders.

McAllister’s concerted effort was made possible by a grant through the Research Investments in the Sciences and Engineering (RISE) Program from the Office of Research at UC Davis.

“I am delighted that the hard work and collaborative efforts of our RISE team led to this Conte Center award to UC Davis,” McAllister said. “This group of faculty, trainees and staff are an incredible group of people to work with and it was only through their creative collaborations that we were able to generate the preliminary data for the Conte Center.”

“The RISE Program allowed us to take scientific risks that we would never have been able to consider without this unique form of support from the UC Davis Office of Research,” McAllister said.

“This historic success by UC Davis demonstrates how modest campus investments in focused, interdisciplinary faculty teams can result in breakthrough discoveries that in turn can lead to major federal funding for research that addresses grand-challenge problems in medicine,” said Harris Lewin, vice chancellor for Research Evolution and Ecology. “As a result, UC Davis now will join just a handful of institutions that will conduct coordinated translational research aimed at improved diagnosis and treatment of schizophrenia.”

Collaborating across disciplines

The center also will create interdisciplinary basic and translational research opportunities for investigators in training, said Carter, who also is director of the UC Davis Imaging Research Center and Center for Neuroscience.

The Conte Center will provide $2 million each year for five years to fund four distinct but highly synergistic projects. Carter will be joined in the enterprise by a team of elite neuroscience investigators, including:

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UC Davis Behavioral Health Center announces mental health pilot awards

16 grants awarded in behavioral health public policy, treatment,  basic science research.

Cameron Carter, UC Davis

By Phyllis Brown, UC Davis

The recently established UC Davis Behavioral Health Center has announced new two-year grants as part of its 2015-17 Pilot Award Program. The awards, granted to 16 investigators across UC Davis schools, colleges, departments, centers and programs, in Sacramento and Davis, support projects in the areas of behavioral health public policy, treatment and basic science research. Together, they total approximately $3.7 million.

The goal of the Pilot Award Program is to propel UC Davis faculty and researchers to positions of strength in competing for extramural funding and to strengthen collaborations with community, regional and statewide partners in improving mental health care in Sacramento, California and nationwide. The awards are made possible by funding from Proposition 63, the California Mental Health Services Act.

“We are very excited to announce the recipients of these pilot awards, which are designed to stimulate new programs in mental-health research across UC Davis,” said Cameron Carter, director of the Behavioral Health Center. “From a total of 52 applications, we were able to fund 16, all of which were judged by a distinguished panel of external reviewers to be scientifically outstanding with high potential for impact on mental health research.”

“These projects include the development of novel diagnostic tools and biomarkers, novel therapies, innovative mental health technologies and new tools for evaluating the outcomes of mental health treatments,” Carter said. “This pilot award project was the first step in the work of the center, which seeks to bring together the broad range of mental health research across UC Davis, from basic and translational neuroscience to clinical and mental health services research, in order to stimulate innovation and advance treatment.”

The awardees and their projects are:

  • Nick Anderson, assistant professor
    Department of Pathology and Laboratory Medicine, School of Medicine
    “Developing Population-Scale Analytics to Evaluate Long-Term Health Care Utilization and Comorbidities Associated with Autism Spectrum Disorder”
  • Evangelos (Evan) Antzoulatos, assistant project scientist
    Center for Neuroscience, College of Biological Sciences
    “A Translational Approach to Development of Electrical Brain Stimulation for Cognitive Enhancement”
  • Ester Carolina Apesoa-Varano, assistant professor
    Betty Irene Moore School of Nursing at UC Davis
    “Social Capital and Latina Caregiver Well-Being Study: Intervention Development and Feasibility Testing”
  • Melissa Bauman, assistant professor
    Department of Psychiatry and Behavioral Sciences, School of Medicine
    “Evaluating Gene x Environment Risk Factors for Neuropsychiatric Disorders in a Rat (Rattus norvegicus) Model of Prenatal Immune Challenge to Develop Disease-Prevention Strategies”
  • Marie Burns, professor
    Department of Cell Biology and Human Anatomy, School of Medicine
    “New Technologies for Assessing Neuroinflammation in vivo
  • Katherine Ferrara, distinguished professor
    Department of Biomedical Engineering, College of Engineering
    “Development and Evaluation of Technology for Ultrasonic Neurostimulation”
  • Amanda Guyer, associate professor
    Department of Human Ecology, College of Letters and Science
    “Charting the Gateway Years: Linking Brain Connectivity Trajectories and Psychosocial Risk Profiles with Substance Use from Early Adolescence into Young Adulthood”
  • Anthony Jerant, professor
    Department of Family and Community Medicine, School of Medicine
    “Tailored Patient Activation to Reduce Suicide Risk in Primary Care”
  • Tara Niendam, assistant professor
    Department of Psychiatry and Behavioral Sciences, School of Medicine
    “Using Mobile Technology to Detect Early Warning Signs of Mental Health Challenges and Enhance Treatment Delivery for Youth with Early Psychosis in Community Outpatient Settings”
  • Charan Ranganath, professor
    Department of Psychology, College of Letters and Science
    “Individualized Transcranial Alternating Current Stimulation (tACS) to Enhance Oscillatory Activity and Cognition in Healthy Individuals and Patients with Schizophrenia”
  • Julie Schweitzer, professor
    Department of Psychiatry and Behavioral Sciences, School of Medicine
    “Participant-Driven Engagement for Advancing the Dissemination of Diagnosis and Treatment for Attention-Deficit/Hyperactivity Disorder”
  • Marjorie Solomon, associate professor
    Department of Psychiatry and Behavioral Sciences, School of Medicine
    “Improving the Lives of Adults with Autism Spectrum Disorder and their Families: A Pilot Trial of the Adult Social Knowledge (ASK) Workshop”
  • Ben Waldau, assistant professor
    Department of Neurological Surgery, School of Medicine
    “Transplantation of Induced Pluripotent Stem and Neural Progenitor Cells Derived from a UC Davis Patient with Mental Illness into a Mouse Model of Endogenously Deficient Dentate Neurogenesis”
  • Glen Xiong, associate professor
    Department of Psychiatry and Behavioral Sciences, School of Medicine
    “A Pilot Study Examining Use of Asynchronous and Synchronous Telepsychiatry Consultation for Skilled Nursing Facility Residents”
  • Peter Yellowlees, professor
    Department of Psychiatry and Behavioral Sciences, School of Medicine
    “Telepsychiatry Services Across Languages: Development and Testing of an Automated Translation and Transcription Tool Using Speech-Recognition Technologies”
  • Karen Zito, associate professor
    Department of Neurobiology, Physiology & Behavior, Center for Neuroscience, College of Biological Sciences
    “Analyzing Functional Plasticity with Synaptic Resolution Using a Novel Genetically Encoded Sensor”

More information about the Behavioral Health Center is available on the Web at ucdmc.ucdavis.edu/behavioralhealth.

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UCLA opens center for brain and behavioral health

Gift from Staglin family will fund research on returning unhealthy brains to health.

Michael Fanselow’s research addresses fear, memory and anxiety disorders, including how traumatic memories lead to post-traumatic stress disorder, anxiety disorders and depression. (Photo by Reed Hutchinson, UCLA)

By Stuart Wolpert, UCLA

More than 30 percent of Americans will experience an anxiety disorder at some time in their lives. A new research center at UCLA will be dedicated to increasing our understanding of the brain and learning how to help the brain recover when those, and other malfunctions, occur.

The formation of the Staglin Family Music Festival Center for Brain and Behavioral Health, which is scheduled to open July 1, was announced today (March 17) by UCLA Life Sciences Dean Victoria Sork. Michael Fanselow, distinguished professor of psychology in the UCLA College, was appointed its director.

Genetic risk factors, combined with environmental experiences, can cause the brain to malfunction. The center’s researchers will seek to discover what those changes are and develop novel methods to address them.

“The center will focus on brain health and will develop novel methods to get the unhealthy brain back to the healthy state,” said Fanselow, who also holds a UCLA faculty appointment in psychiatry.

Fanselow said anxiety disorders are generally chronic and do not go away on their own. Some of these disorders, like post-traumatic stress, are devastating.

Understanding fear

Fanselow’s research addresses fear, memory and anxiety disorders, including how traumatic memories lead to post-traumatic stress disorder, anxiety disorders and depression. He has studied how fear works in the brain using rats and mice, whose fear systems work in remarkably similar ways to that of humans.

Fear serves an important function: to protect us from danger.

“When we’re in danger, it’s really adaptive to be afraid. When we’re not in danger, it’s adaptive not to be afraid,” Fanselow said. “But we can make mistakes. One mistake is when there’s true danger and I don’t defend myself. The other mistake, which is much less costly, is when there’s no danger and I do become afraid. That’s an anxiety disorder.”

Fanselow’s laboratory is identifying and learning about the brain circuits that give rise to inappropriate fear, with the goals of reducing — or even eliminating — unnecessary fear, while preserving healthy fear.

Fanselow also was appointed to the Staglin Family Chair in Psychology.

“We are delighted to have such a prominent scientist assume our Staglin Family Chair and the leadership of the Staglin Center,” said Shari Staglin.

Garen Staglin said, “UCLA is among the leading institutions studying brain health, and we applaud its approach to campus-wide collaborations to accelerate the science of the brain and resultant treatments.”

Getting the brain back to where it should be

Psychology and psychiatry professor Michelle Craske, an expert on fear and anxiety disorders, will be associate director of the center, which is being funded by the family of Shari and Garen Staglin through the Staglin Family Music Festival for Brain Health and their philanthropic organization, the International Mental Health Research Organization.

Fanselow and Craske are currently studying whether cognitive behavior therapy, combined with a pharmaceutical called scopolamine, will help suppress fear in people with anxiety. In cognitive behavior therapy, people with anxiety disorders are repeatedly exposed to the object or situation they fear, in a non-threatening environment, and eventually they learn not to be afraid.

“We want to get the brain back to where it should be, either by combining drugs with psychotherapy or by finding different drug approaches,” said Fanselow, whose research is funded by the National Institute of Mental Health, a branch of the National Institutes of Health.

Fanselow and colleagues reported in 2013 that at the right dose, scopolamine — which has been used to treat including nausea, motion sickness, depression and other conditions — might also be useful in treating anxiety disorders.

“UCLA and the UCLA College are extremely grateful to Shari and Garen Staglin and their family, for their extremely deep and long-standing commitment to fighting mental illness, and their generosity over many years to UCLA and the College,” Sork said.

The center will also provide seed money to interdisciplinary teams of scholars to advance our understanding of many areas in brain health, ranging from depression to memory loss to schizophrenia.

Dedicated philanthropists

“The Staglins are providing UCLA with wonderful opportunity to accelerate research, enhance treatment and lead to new approaches in combatting mental illness,” Fanselow said.

Garen Staglin, a UCLA alumnus and private equity investor, is co-chair of the $4.2 billion Centennial Campaign for UCLA. His wife, Shari, a UCLA alumna, has been a director of the UCLA Foundation and a member of UCLA’s Women and Philanthropy. The Staglins own the acclaimed Staglin Family Vineyard in Napa Valley. Shari Staglin is the vineyard’s CEO and the Staglins’ daughter, Shannon, also a UCLA alumna, is president.

The Staglins became active in supporting mental health research and treatment after their son, Brandon, was diagnosed with schizophrenia. Brandon has since graduated with honors from Dartmouth and is currently marketing communications director for both the Staglin Family Vineyard and IMHRO. He also is a member of the joint board of directors of IMHRO and One Mind.

The Staglins raise funds for brain health charities and research through a variety of major events including The Music Festival for Brain Health. All of the music festival’s expenses are underwritten by its sponsors, and all proceeds go to scientific research. They also serve as founders and board members of One Mind, where Garen is co-chairman.

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Darrell Steinberg joins UC Davis Behavioral Health Center of Excellence

Former Senate pro tempore will direct policy and advocacy for the new center.

Darrell Steinberg

By Phyllis Brown, UC Davis

Darrell Steinberg, former Senate pro tempore for the state of California, has joined the faculty of the UC Davis School of Medicine as director of policy and advocacy for the recently launched UC Davis Behavioral Health Center of Excellence.

Steinberg, who will be visiting professor in the Department of Psychiatry and Behavioral Sciences, was well known during his legislative career as a champion of the mental health needs of the people of Sacramento and California. His crowning achievements include the passage and implementation of groundbreaking mental health legislation that dramatically increased access to care for millions of Californians. Steinberg’s partnership with UC Davis continues this longstanding commitment to greater access to mental health services statewide.

“With UC Davis as a partner, my goal is to strengthen and unite our voice for mental and behavioral health in California,” Steinberg said. “We will connect and inform the next generation of policy leaders, researchers, health professionals, providers and our communities.”

Among his many accomplishments, Steinberg is the author of Proposition 63, the California Mental Health Services Act, approved by voters in November 2004. To date it has raised more than $1 billion in state and federal funds for mental-health programs. Steinberg also served as chair of the ballot measure steering committee formed to pass the initiative.

His more than 20 years in public life include six as a member of the California Assembly and six as a member of the Sacramento City Council. He left the state Senate after being termed out in 2014.

Steinberg will help develop the behavioral health center’s policy arm, by providing consultation and advice related to its goals and initiatives and by meeting with community, university and state leaders to advocate for mental-health programs, said center Director Cameron Carter.

“Sen. Steinberg’s leadership role as director of policy and advocacy will serve as a much-needed bridge between research and policy and between the mental- and behavioral-health communities,” Carter said.

The Behavioral Health Center of Excellence is UC Davis Health System’s hub for bringing together its wide-ranging research, education, clinical and community engagement programs as they relate to neuroscience, mental health and public health improvement. The unique academic research center is designed to improve scientific investigations into mental and behavioral health, and engage with communities around the state to improve treatment options.

Funded by Proposition 63, the $7.5 million UC Davis center will be a catalyst for expanding the understanding of problems surrounding behavioral health, and serve as a national model for finding answers for individuals, their families and their communities. It is mirrored by a $7.5 million sister center at UCLA.

“We already are expanding research to better understand all facets of mental and behavioral health through a pilot award program,” said Frederick J. Meyers, vice dean of the School of Medicine, who launched the new center. “We are honored to add Sen. Steinberg’s leadership in policy and advocacy.”

Steinberg is a shareholder in the Sacramento office of the international law firm of GreenbergTraurig LLP, where he is chair of the California Government Law and Policy Practice. In 2010, he was honored with the John F. Kennedy Profile in Courage Award from the Kennedy Library Foundation in recognition of his leadership during the 2008 bipartisan budget negotiations. His work enabled California’s fiscal recovery from a $42 billion dollar deficit following the most recent recession.

In addition to mental health care, Steinberg is highly regarded for advancing health causes on multiple fronts, including autism care, foster care and homeless services.

“Sen. Steinberg will add a public mental health perspective to a variety of our educational courses for psychiatry residents,” said Robert Hales, chair of the Department of Psychiatry and Behavioral Sciences. “He will enable us to expand our recruitment efforts for future residents interested in community-based and public mental health services.”

As visiting professor, Steinberg will not receive a salary.

For more information, please visit UC Davis School of Medicine at medschool.ucdavis.edu.

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Study ID’s biological mechanisms for schizophrenia, depression

Genes relating to immune function and histone methylation are risk factors.

Daniel Geschwind, UCLA

By Mark Wheeler, UCLA

Common psychiatric disorders such as schizophrenia, bipolar disorder and major depression share genetic risk factors related to immune function and DNA regulation, according to new findings by a large collaborative research project from the Psychiatric Genomics Consortium involving UCLA, King’s College London, Cardiff University, Harvard and MIT.

The study was published online by the journal Nature Neuroscience.

Thousands of genetic differences in the human genome act together to increase the risk for psychiatric conditions such as schizophrenia. However, until now, it has not been clear how these genetic changes affect biological processes that then go on to alter brain function.

In the study the group analyzed genetic data from more than 60,000 participants, including individuals with schizophrenia, bipolar disorder, major depression, autism spectrum disorders and attention deficit hyperactivity disorder, as well as healthy individuals. The aim was to identify which biological and biochemical pathways caused risk for these disorders.

By grouping the genetic data together, the consortium found that genes relating to immune function and histone methylation — molecular changes that alter DNA expression — are risk factors associated with the development of all the disorders. Such biological pathways are important, they noted, because they are much broader drug targets than single genes or proteins.

“We took the hundreds of genes in the biological pathways identified by our collaborators and modeled them as a gene network,” said Daniel Geschwind, a UCLA professor of neurology, psychiatry and genetics, and a study author.

This approach allowed the researchers to explore the role of these pathways during brain development and aging. Geschwind said that this further enhanced their ability to detect shared biology across these diseases and identifies the points in time and regions of the brain that are most susceptible.

“The success of this approach supports the utility of pathway and network analyses in understanding psychiatric disease,” said Geschwind, who is also director of the Center for Autism Research and Treatment at the UCLA Semel Institute. “This is an approach that will only grow more powerful as more loci are identified with even larger studies in the next few years.”

The study is the result of many years of work by hundreds of investigators worldwide in the Psychiatric Genomics Consortium, an international, multi-institutional collaboration founded in 2007 to conduct broad-scale analyses of genetic data for psychiatric disease. The PGC is currently genotyping new samples to further study these and additional psychiatric diseases, including anorexia and post-traumatic stress disorder.

Core funding for the Psychiatric Genomics Consortium comes from the National Institute of Mental Health, along with grants from governmental and charitable organizations, as well as philanthropic donations. Work conducted at King’s College London was funded by the National Institute for Health Research Biomedical Research Centre and Dementia Unit at King’s and South London and Maudsley, the NHS Foundation Trust and Cardiff by the MRC and the Wellcome Trust. Work at the Broad Institute’s Stanley Center for Psychiatric Research was funded by Sylvan Herman Foundation and the Stanley Medical Research Institute.

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UCLA’s resilience-building programs for veterans, their families lauded

Research-based programs to enhance mental health help veterans, their families cope.

By Mark Wheeler, UCLA

A new report evaluating the impact of research-based programs designed to enhance the mental health of military families, has found compelling evidence that such programs help veterans and their families build resilience to cope with the effects of wartime service and combat-related physical and psychological injuries.

The report, issued by the nonprofit RAND Corp., a global think tank, assessed the impact of the Welcome Back Veterans Initiative, a joint project of philanthropic groups and six major academic centers, including the UCLA Nathanson Family Resilience Center, which provide an array of patient care, educational and other services to veterans and their families. The initiative, funded by Major League Baseball Charities and the Robert R. McCormick Foundation, was launched in 2008.

Between 2011 and 2013, the Welcome Back Veterans Initiative awarded grants totaling $5.4 million to support returning service members, veterans and their families. During that period, the six academic medical centers received funding. The RAND study found that initiative partners collectively provided screening, referral and treatment services to more than 3,600 individuals with military and veteran affiliations; networked with 188 organizations; and conducted 228 training sessions or workshops to build new skills and capacities among veterans, organizations that serve them, and community-based providers.

The report concluded that the Welcome Back Veterans Initiative could provide a model for similar efforts should federal officials decide to expand privately provided health care as part of its reform of the Veterans Affairs health system.

“Wartime military experience can be psychologically challenging for both service members and their families,” said Dr. Patricia Lester, the Jane and Marc Nathanson Family Professor of Psychiatry at the UCLA Semel Institute for Neuroscience and Human Behavior and director of the Nathanson Center. “As a nation, we owe these families the best possible mental health care services, supported by the latest research, to strengthen their ability to cope with the separations, reintegrations and traumatic events. That is what we have built at the Nathanson Center, thanks to the support of the Welcome Back Veterans Initiative.”

The UCLA Nathanson Family Resilience Center used the financial support from the Welcome Back Veterans Initiative to adapt, evaluate and disseminate innovative programs that decrease the negative effects of deployment among Iraq and Afghanistan war veterans and their families. Significant numbers of military personnel who served in those wars suffer from mental health issues such as post-traumatic stress, anxiety, trauma and even traumatic brain injury.

Since 2006, the Nathanson Center has partnered with the U.S. military to provide an array of evidence-informed programs in resiliency training that have touched the lives of thousands of military families facing the challenges of deployment and reintegration. The programs aim to build on strengths and reduce stress through communication, problem-solving skills and proactive strategies that include learning how to recognize and cope with emotional triggers.

Housed within the Semel Institute, the Nathanson Center’s Welcome Back Veterans program works closely with local, state and national military and veteran leadership, community agencies, health and mental health systems, educational institutions and policy-makers. Combining research, practice and innovative technologies, the center develops family and community interventions — including web-based tools, education and training materials — that can be implemented in a variety of contexts. Programs include:

  • FOCUS (Families OverComing Under Stress) Family Resilience Training. FOCUS strengthens families and couples facing stressful or traumatic events with a skill-building program that helps to clarify misunderstandings, enhances communication and supports collaborative problem-solving through the expression of a shared family story. FOCUS can be customized, with specialized services available for wounded warriors, female veterans and families with children of any age.
  • TeleFOCUS. Adapted for wounded warriors and their families, TeleFOCUS provides family resilience training at a distance, via a remote videoconferencing system, to help the entire family heal from the visible and invisible wounds of war.
  • National Military Family Association Operation Purple Family Retreats and Healing Adventures. Operation Purple supports military families during the reunification process by bringing them together in beautiful national park settings to strengthen and renew relationships using the FOCUS model. Healing Adventures offers a similar experience with adaptive activities for families of a wounded, ill, or injured service member.
  • Project FOCUS. Contracted by the Navy Bureau of Medicine and Surgery and the Office of Military Family and Community Policy, Project FOCUS provides an embedded psychological health and resilience program for military couples and families affected by transitions, combat stress and physical injuries. FOCUS is currently available on 24 military installations throughout the United States and Pacific Rim.
  • Operation Mend-FOCUS for wounded warriors and their families. Operation Mend-FOCUS extends mental health care and FOCUS services to patients with combat-related injuries and their families. The program collaborates with expert surgeons at UCLA’s Operation Mend program to heal physical wounds while recognizing that comprehensive care requires loving attention to the needs of both the service member being treated and the family.

The RAND report, “Enhancing Capacity to Address Mental Health Needs of Veterans and Their Families: The Welcome Back Veterans Initiative,” is available at www.rand.org. More information about the Welcome Back Veterans Initiative is available at www.welcomebackveterans.org.

Other centers funded by the Welcome Back Veterans Initiative include BraveHeart Southeast Veterans Initiative at Emory University; Duke University Veteran Culture and Clinical Competencies (V3C) initiative; Massachusetts General Hospital’s Home Base Program; the University of Michigan’s Military Support Programs and Networks; and Weill Cornell Medical College Department of Psychiatry’s Program for Anxiety and Traumatic Stress.

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Perceptions, referrals by providers affect mental health treatment disparities

Asian-American patients least likely to be assessed or counseled for mental health problems.

Oanh Meyer, UC Davis

By Phyllis Brown, UC Davis

Disparities in mental health treatment are known to be associated with patients’ racial and ethnic backgrounds. Now, a large study by researchers with UC Davis has found one possible reason for those disparities: Some racial and ethnic minorities are less likely to be assessed and referred for treatment by their medical providers.

The study of more than 9,000 diverse individuals, including Latinos, African Americans, Asian Americans and non-Hispanic whites, found that patients of different racial and ethnic backgrounds reported experiencing differing treatment approaches from medical providers, such as primary care physicians and specialists, including referrals to mental health care and medications, and that these differences were associated with race.

The research, “Disparities in Assessment, Treatment, and Recommendations for Specialty Mental-Health Care: Patient Reports of Medical Provider Behavior,” is published online today (Dec. 1) in Health Services Research, a journal of the Health Research and Educational Trust of the American Hospital Association.

It found that when compared with non-Hispanic white patients, Asian-American patients were the least likely to be assessed or counseled for mental health or substance abuse problems, and also were less likely to receive recommendations for treatment with medication. These differences were resolved after factors such as education, income and clinical diagnosis were taken into account, said Oanh Meyer, a postdoctoral scholar in the UC Davis Department of Neurology.

“These findings are especially important for medical providers treating racial and ethnic minorities,” Meyer said. “Minorities are far more likely to seek treatment for their mental health problems from their primary care physicians. Since these providers are the source of referrals to mental health professionals, they serve as the gatekeepers.”

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UC Davis launches Research Center for Behavioral Health

Sacramento campus receives $7.5M for new research hub; UCLA launching similar center.

The launch of the Behavioral Health Center of Excellence at UC Davis featured a ceremonial ribbon-cutting. Pictured (from left) are UC Davis Provost Ralph Hexter, patient advocate Bonnie Hotz, UC Davis Vice Dean Fred Meyers, Sen. Darrell Steinberg, UC Davis Vice Chancellor and Dean Julie Freischlag, and UCLA professor Peter Whybrow. Hidden from view is UC Davis professor Cameron Carter, who's expected to become the executive director of the new center.

UC Davis Health System officials and California Senate leader Darrell Steinberg today (Oct. 1) announced the founding of a unique academic research center designed to improve mental health in California and serve as a national model for advancing innovative research in neuroscience, as well as the prevention of and early interventions in mental illness.

Known as the Behavioral Health Center of Excellence at UC Davis, the $7.5 million project will become the university’s hub for bringing together its wide-ranging research, education, clinical care and community engagement as they relate to neuroscience, mental health and public health improvement.

The new center will be located on the university’s Sacramento campus. It will complement a similar, $7.5 million center that is being established in Southern California at UCLA.

“Mental health is an issue that knows no partisan lines. Its impacts and suffering escape no race, class, gender, age, or sexual orientation. It affects every other agenda we address in the Legislature.” Steinberg said. “Having dedicated behavioral health centers in the state will be the catalyst for improving our understanding of the human mind and finding answers for individuals and their families.”

Grant funding for the two centers was approved by the state’s Mental Health Services Oversight and Accountability Commission earlier this year. UC Davis plans call for researchers to explore everything from telehealth delivery of behavioral health care and the economics of prevention to how medical and mental-health services might be better integrated in clinical settings.

“This center is so promising because it enables UC Davis to work from its core strengths in brain research, new technologies for clinical care, reducing health disparities and effectively engaging communities,” said Frederick Meyers, vice dean of UC Davis School of Medicine and who will serve as director of the new center. “We plan to closely measure and evaluate our research results so that we can identify and translate into practice the best ways to achieve behavioral-health improvement.”

Meyers said the UC Davis center will be a catalyst for developing more research expertise in behavioral health, as well as better techniques and training to address wellness, recovery and resilience to mental illness. The university plans to partner in its research efforts with other health organizations and government-related institutions, including counties throughout Northern California.

The new center’s leadership team, which includes Cameron Carter, a UC Davis professor of psychiatry and behavioral sciences specializing in the early diagnosis and treatment of schizophrenia and other cognitive mental disorders, will also study community programs, alternatives to hospitalization, shared services with jails, hospitals and courts, and identify new approaches to reducing mental health stigmas.

“The center of excellence in behavioral health is one product of the work we started many years ago with Proposition 63 and the state’s Mental Health Services Act,” said Steinberg, a longtime leader on mental health issues. “Like the UC Davis’ MIND Institute, which has earned international recognition for its work in autism, the Behavioral Health Center of Excellence at UC Davis can bring together in one place the academic skills, talent and experience that we need to address some of the most challenging problems that many California families are facing.”

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Project launched to develop depression care for older adults

UC Davis and University of Washington receive $2.5M grant from Archstone Foundation.

Ladson Hinton, UC Davis

UC Davis and the University of Washington are implementing a project to develop innovative new models of care for depression in older adults through a $2.5 million grant from the California-based Archstone Foundation, a private grant-making organization whose mission is to contribute toward the preparation of society in meeting the needs of an aging population. The grant launches Archstone Foundation’s Depression in Late Life Initiative to improve the quality of life for older adults suffering from depression.

The work of this grant is based on a one-year systematic review of the literature and current practice. It will advance care for late-life depression by supporting innovative approaches to promote partnership and collaboration among primary care clinics, family members, friends and community-based organizations. Through the Archstone Foundation’s Depression in Late Life Initiative, a number of organizations will also be funded to carry out this effort in California.

Depression is common among older adults and comes at a high cost to patients and their families. Major depression affects 2 to 5 percent of older adults in the community, 5 to 10 percent of older adults in primary-care settings, and as many as 50 percent in nursing homes.

The UC Davis group will be led by Ladson Hinton, professor in the Department of Psychiatry and Behavioral Sciences and a nationally recognized expert in minority mental health and aging. Hinton is the director of the Latino Aging Research Resource Center and the education core of the UC Davis Alzheimer’s Disease Center. The University of Washington group is led by Jürgen Unützer, chair of the Department of Psychiatry at the University of Washington, and the developer of the Improving Mood–Promoting Access to Collaborative Treatment (IMPACT) model, the leading collaborative care program for late-life depression, which has been implemented in more than 500 clinics around the country.

“This initiative will help build on the success of collaborative care and include important partners, such as family members and community-based organizations,” Hinton said.

“While we have evidence-based treatments for depression in primary care, such as collaborative care, very little work has been done to mobilize community agencies (i.e. adult-day health programs, senior centers, meals on wheels, faith-based organizations) and families to help in the process,” he said. “Archstone Foundation’s Depression in Late Life Initiative addresses this important gap in the field, and may also help to engage groups at risk for under-treatment of their depression, such as ethnic minority elders and older men.”

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