LEAD INVESTIGATOR--This image provided by Johns Hopkins Medicine shows Dr. Deborah Persaud of Johns Hopkins' Children's Center in Baltimore. (AP Photo/Johns Hopkins Medicine)

by Lauren Neergaard

WASHINGTON (AP) — A baby born with the AIDS virus appears to have been cured, scientists announced Sunday, describing the case of a child from Mississippi who's now 2½ and has been off medication for about a year with no signs of infection.

ESTHER BUSH

This month’s issue on mental health is a continuation of the monthly series started last year, focusing on health disparities in the Pittsburgh region. The series is a partnership among the New Pittsburgh Courier, Community PARTners (a core service of the University of Pittsburgh’s Clinical and Translational Science Institute—CTSI) and the Urban League of Greater Pittsburgh. Michael Yonas, DrPH, assistant professor of family medicine at Pitt, sat down with Esther L. Bush, president and CEO of the Urban League, to talk about this month’s topic.
MY: Thank you, Ms. Bush, for your vision and leadership for these health segments and making possible this unique partnership. We hear about the importance of mental health every day—whether in the news or from our doctors. This is a health topic that affects people of all ages. This month’s segment points out that about one in four adults suffers from some kind of mental illness. Were you surprised to hear this?
EB: No, Michael. Sadly, I am not surprised. Mental illness touches the lives of so many people and often those about whom we care deeply. I have learned about how often people experience depression. It’s so important for us to learn to recognize the symptoms of depression and encourage those suffering to seek help. The work that Dr. Reynolds and his colleagues are doing to figure out how to not only treat, but also prevent depression is so important. We cannot allow our friends and family members to suffer in silence. As his research has found, when people who face barriers seek help, they achieve success through treatment just as often as people who don’t face such barriers.
MY: You’re right. It is so important to include mental health in our discussions when talking about physical health and the health of our communities. The National Alliance on Mental Illness (www.nami.org) reports that African Americans tend to rely on family, religious and social communities for emotional support rather than turning to health care professionals, even though this may at times be necessary. Shockingly, adults living with serious mental illness die about 25 years earlier than other Americans, largely due to treatable medical conditions.

EB: This is an incredible statistic, Michael, and unacceptable. I was happy to see that mental health was included in President Obama’s new plan released in January called “Now Is the Time.” It states that fewer than half of the children and adults with diagnosable mental health problems receive the treatment they need. This might be because of barriers with health insurance or due to stigma and shame. We can all educate ourselves about mental health. By educating ourselves, we are taking an important step toward being a part of the solution to lessen the secrecy that so often surrounds mental illness. As President Obama said during his second inauguration speech, “We must make the hard choices to reduce the cost of health care…but we reject the belief that America must choose between caring for the generation that built this country and investing in the generation that will build its future.”

Though attitudes are changing slowly, many people still don’t like to talk about mental illness. Yet, the National Institute of Mental Health reports that an estimated 26.2 percent of Americans 18 and older (about one in four adults) suffer from some kind of mental illness. It’s also the leading cause of disability in the U.S. Mental illness can describe different disorders from schizophrenia to anxiety to depression. Depression can often go hand-in-hand with other disorders. It can also occur at any point in the lifespan.
According to the Centers for Disease Control and Prevention, about one in 10 Americans suffers from depression each year. Everyone has days when she or he just feels sad or “blue,” especially during our region’s long, cold winters. But, depression is more than that. It’s a serious mental illness that affects a person’s thoughts, feelings, behavior, mood and physical health for longer than a couple of weeks. It isn’t caused by one single thing. Signs of depression most often include:
• Feeling sad or empty
• Not having as much interest in things you used to enjoy
• Changes in eating or sleeping habits
• Feeling restless or slowed down
• Feeling very tired
• Feeling worthless
• Finding it hard to think clearly    
Even though many people experience depression or know someone who has, it’s still a hard thing to talk about. The Allegheny County Health Survey, done in 2009-2010, asked adults about life satisfaction and social support. Black adults reported feeling dissatisfied with their lives more often (14 percent) than White adults (8 percent). In addition, the percentage of Black adults was much higher (11 percent) than White adults (7 percent) who said they never or rarely get the support they need. People feel a stigma, or shame, in talking about mental illness. The National Alliance on Mental Illness estimates that two-thirds of people with depression don’t get the help they need. According to Charles Reynolds III, MD, UPMC Professor of Geriatric Psychiatry at the University of Pittsburgh, shame is one reason African Americans in particular have trouble getting help.

“In general, African Americans face barriers to health care and mental health services,” says Dr. Reynolds. “Many feel shame from their communities about having mental illness. Some people just don’t want to be diagnosed as ‘mentally ill.’”
Because African Americans are less likely to seek mental health services, they are also less likely to receive the correct diagnosis or treatment. Dr. Reynolds says that people may define depression in their own way. Their idea of what depression is may not be the same as a mental health provider’s. They also cope differently. In some communities, people prefer to find help solely from their families, religious or from community leaders. Dr. Reynolds has found that family and friends can help bridge the gap between people who need mental health help and those who can provide it. People should not suffer in silence and isolation, Dr. Reynolds says. Finding out there’s a problem and getting help early on is important.
Depression can be prevented and treated. The first step is for people to talk to someone they trust about how they’re feeling. Then, talk to a mental health professional who can recommend behavioral interventions. These can include talk therapy, learning about better problem-solving and coping skills, help with sleep and eating practices, exercise and doing pleasurable activities. For some people, medication may also lessen the effects of depression on their lives.
Dr. Reynolds has worked with a lot of people who have complicated grief. He works with people in communities that experience a lot of violence and violent death, which is an experience that can lead to major, long-lasting depression. In studying grief, he has found that when people who face barriers to mental health seek help, they are treated with just as much success as people who don’t face barriers. Mental health intervention does help.
It’s important to know that anyone experiencing depression doesn’t need to just “tough it out” or expect it to go away on its own. Depression isn’t about people choosing to be in a “bad mood.” It is a dysfunction of the brain that can happen to anyone. Getting help is important for physical health, too. Many people know that keeping their heart healthy is important. Keeping their brain healthy is, too.
“Over time, depression can be toxic to the brain,” says Dr. Reynolds. “It can cause the brain to not work as well. People start having problems thinking and with their memories, among other things. Getting treated for depression can only better brain health.”

Some basic ways to take care of mental health include:
• Take care of yourself—make sure you have a doctor
• Stay connected with friends and family
• Watch health habits— eat healthfully, try not to smoke or drink alcohol too much
• Exercise
• Watch out for yourself and others—don’t ignore changes in yourself or loved ones. Find someone who can help.
Everyone wants to live a happy, independent life no matter what his or her age is. It’s time to begin taking our mental health as seriously as our physical health.

Resources for Mental Health Services:
Peoples Oakland is recovery center with wellness based recovery programs for adults in Allegheny County. Guiding all Peoples Oakland services and activities is a philosophy of recovery based real life experiences nurtured by peer support, hope, self-help and collaborative relationships with professionals.  For more information call Peoples Oakland at 412-683-7140.
The AgeWell program offers a wide range of mental health services for seniors provided by caring and experienced clinicians.  If you have questions, please call 412-422-3800.  Medicare and most insurance plans are accepted.
If you or someone you know does not have adequate health care, more resources can be found in the Allegheny County Health Care Guide for the Underinsured and Uninsured.  Visit www.achd.net or call 412-687-ACHD to request a copy of the guide.  
Re:solve Crisis Network provides round-the-clock services to anyone with or without a diagnosed mental illness.  Call any time and speak with a trained counselor can be reached 24 hours a day, 7 days a week by calling 1-888-7-YOU CAN (1-888-796-8226).

When people think about staying fit, they generally think from the neck down. But brain health plays a large role in almost everything you do: thinking, feeling—even sleeping. A healthy brain is important to managing stress and keeping independence as people age.
We know that depression is not a normal part of aging. We also know that while depression is treatable, it can be hard to overcome. Research has shown that about 15 percent of adults age 65 and older are depressed. But depression prevention is something we know little about.
Older adults face unique challenges that may increase their risk of becoming depressed. Chronic pain and disease, death of family and friends, declining physical abilities and financial strain are just some of the challenges faced by older adults.
A three-part study called iMANAGE (Independence, Managing Activities, No matter what AGE) is looking for participants for research studies that aim to prevent depression in older adults. If you are interested in more information about any of the studies listed, please call 412-246-6006. The studies are funded by the National Institute of Mental Health. There is no cost to join the studies, and participants will be paid for their time.

The RAPID: Knee Pain Research study is for adults 60 and older who are living with knee pain caused by arthritis. People living with knee pain are often stressed. This stress and pain put them at risk of depression, worry and trouble with movement. Our aim is to reduce knee pain, improve walking and strength and reduce the stress of living with knee pain. The study will include physical therapy. It will also include brief health coaching to help people become more physically active, better manage their pain, improve sleep and learn how to better manage daily problems. You will be seen eight to 16 times over the course of eight to 16 weeks. There are four follow-up appointments over the course of a year. All interventions are free. There is no cost to join the study, and participants will be paid for their time. We work with primary care doctors to make sure people can safely participate in the project.
The RECALL: Brain Health study is also for adults 60 and older. If you or someone you care about has trouble remembering things, you may be eligible to participate. The research team will examine health, mood and memory. You will be seen eight to 12 times over the course of eight to 16 weeks. Then you’ll return for visits three, six, nine and 12 months later. You may learn skills to help you solve everyday problems, improve your sleep and exercise better. There is no cost to join the study, and participants will be paid for their time.
The Depression ABC (Agency-Based Collaborative) study is for adults 60 and older who receive assistance with meals, transportation or personal care. The research team will examine your health and mood. You will be seen six times, every other week, over the course of 12 weeks. There are follow-up appointments three, six, nine and 12 months later. You may also learn skills to help you solve everyday problems. There is no cost to join the study, and participants will be paid for their time.