Academics and Legislators Come Together to Learn About Mental Health

The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.

By Office of Public Policy Outreach at VCU Wilder School
September 14, 2018              

One in five adults in the United States is impacted by a mental illness, according to the National Alliance of Mental Illness. Policymakers, researchers and the public recognize a need for policies that provide mental health services efficiently and effectively to those that need them, but the complexities of mental illness and the development of new knowledge from research mean legislators and policymakers may struggle to stay up to date. What are some of the most pressing mental health concerns in society today? What struggles do people encounter, and what policies should be created to help?

To help policymakers stay current about the complex field of mental health, Virginia Commonwealth University’s L. Douglas Wilder School of Government and Public Affairs, the Department of Psychiatry and Virginia’s Joint Subcommittee to Study Mental Health Services in the Commonwealth in the 21^st Century, joined together to host a “mental health mini university” at the Virginia State Capitol on September 6. The public event brought experts in the field of mental health together with legislators, members of the executive branch, as well as a number of other practitioners and other interested attendees.

After opening remarks from VCU’s president, Dr. Michael Rao and an introduction to the goals of the day from Dr. Robyn McDougle of the Wilder School and Dr. Joel Silverman of the Department of Psychiatry, the gathering focused on two topics.

Dr. Peter Buckley, Dean of the VCU School of Medicine presented recent insights on “mental health and workforce development.” The number of psychiatrists available to assist those who are suffering from serious mental illness is insufficient, Buckley shared, for several reasons:

• Too few go to medical school with the intent of focusing on psychiatry, and even fewer enter the field of child psychiatry, and;
• Limited slots are available for doctors’ residency within the state in these specializations.

Dr. Buckley argued that focusing on improved, more attractive options for mental health professionals (i.e. improving facilities’ appearances and peer support services), as well as investing in research to find biomarkers for certain mental illnesses and drug development, will grow the supply of psychiatrists to assist those who are suffering from serious mental illness not only in number, but in also in ability to assist those who need it most.

Following this, Dr. Mishka Terplan, professor of Obstetrics and Gynecology and Psychology, delivered a presentation on “the health effects of alcohol, marijuana, and opioids;” this included the history, neurobiology and possible solutions to treating addiction to alcohol, cannabis and opioids. Terplan noted that while use of these substances can be traced back for several hundred years, the concept of addiction emerged in the early 18^th century in relation to alcohol. This evolved with increased understanding of addictions to cannabis and opioids, including adrenaline, heroin and most recently fentanyl. After addressing the history of addiction, Terplan explained the neurobiology of what he referred to as “The Hijacked Brain,” showing how the brain’s dopamine levels change as a result of the continuous use of these substances. The high levels of dopamine that are released by ingesting the mentioned drugs result in the natural ability of the brain to produce dopamine naturally, which causes individuals who are initially using a drug for reward seeking (the high) eventually need to use it as a means of relief seeking from withdrawal symptoms. Continuous use of such substances causes physical deficiencies:

• For alcohol, it can lead to damage to the liver, muscles, heart and immune system;
• For marijuana it leads to respiratory, reproductive and immune deficiencies, as well as potentially even triggering psychosis; and,
• Consistent heroin use can lead to infection, Hepatitis C, as well as a slowed digestive system.

Terplan repeatedly stressed the need for a focus on recovery rather than more treatment, and urged attention to finding solutions for those who are at risk for becoming addicted to a certain substance.

Each session shed necessary light on the current state of the mental health in the Commonwealth of Virginia, as well as potential solutions to challenges. Following these presentations legislators had the opportunity to ask questions of the presenters in order to gain further insight and deepen their understanding on detailed topics.

In the face of a recognized need for improved mental health services in every community, the format of the event represented a coming together of policy maker interest and academic research expertise to support the creation of new research informed policies. This, in turn, will hopefully allow legislators to craft important solutions that respond to the crucial dilemma that faces the wellbeing of their constituents.

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Author: The Office of Public Policy Outreach is part of the Center for Public Policy at Virginia Commonwealth University’s L. Douglas Wilder School of Government and Public Affairs. The office prepares VCU faculty for effective interactions with state and local lawmakers and helps generate and translate academic knowledge into successful public policies for the commonwealth. Email address: [email protected] | Twitter handle: @OPPOatVCU

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