Mental Illness and the Military
Having previously chaired a 2009 Institute of Medicine committee report on the prevention of mental, emotional, and behavioral disorders among young people, former SPH Dean Kenneth Warner has now chaired a second IOM committee study on mental health. Funded by the U.S. Department of Defense, the new study was aimed at finding ways to prevent mental illness in members of the military and their families. The committee was also tasked with recommending interventions to reduce the adverse mental health consequences of trauma.
Committee members examined such issues as post-traumatic stress disorder, traumatic brain injuries, depression, substance abuse, interpersonal violence, and suicide. Warner notes that while they were interested in all members of the active-duty military, the committee focused on military members deployed to Iraq and Afghanistan.
The report, Preventing Psychological Disorders in Service Members and Their Families: An Assessment of Programs, was issued in February. While commending the Department of Defense on its commitment to addressing the prevention of psychological problems in the military, the report focused much of its attention on the lack of a sufficient evidence base to support the military's interventions and a lack of systematic evaluation and performance measures.
Cracking the Code of Mental Disorders
Bipolar disorder is highly heritable, with a ten-fold increased risk for first-degree relatives. There are no effective tools for prevention and limited options for treatment. But Michael Boehnke, the Richard G. Cornell Distinguished University Professor of Biostatistics, believes our genome may hold answers. He and a team of researchers are using DNA sequences of people with and without bipolar disorder to identify genes and pathways that contribute to the risk of developing bipolar disorder.
By exploring the genetic basis of this debilitating condition, Boehnke and his colleagues hope to build a valuable data resource for future studies and treatment developments. "You're dealing with diseases that are severe enough and strike so profoundly that their families are affected too," says Boehnke. "Through this research we might do a better job of predicting who will develop bipolar, and tailoring therapies to individuals." Piece by piece, whole genome sequencing will provide more data with which to explore and understand this complex disorder.
SPH biostatisticians Laura Scott, Hyun Min Kang, Gonçalo Abecasis, and Sebastian Zoellner are collaborating with Boehnke, along with colleagues at the HudsonAlpha Institute, the University of Southern California, the University of Toronto, and the Institute of Psychiatry in London. —Rachel Ruderman
Battling Stigma and Disparities in China
Health management and policy doctoral student Sasha Zhou doesn't remember much about growing up in China—her parents emigrated to the United States after 1989's Tiananmen Square protests, and four-year-old Sasha joined them two years later. Yet while completing a dual master's degree at SPH, she encountered Chinese headlines detailing suicides among factory workers, psychological fallout from China's one-child policy, and scarce job opportunities for Chinese with higher degrees.
A summer internship in Beijing reconnected her to her roots, and after experiencing a family member's bout with depression, she realized the bleak state of mental health infrastructure in the country. "For a population of 1.3 billion, there are only 20,000 trained mental health professionals," says Zhou. "It's also incredibly stigmatized. Psychiatry is the profession doctors go into when they can't get into other disciplines." Zhou's research highlights the need for structural solutions, especially within the workplace, to address these disparities. In the meantime, the Chinese government has pledged the equivalent of $1.11 million to train mental health professionals. "It's an initial step," Zhou says, "but more still needs to be done."—Nora White