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Jonathan Trott and the Problems of Describing Mental IllnessBy Julian Baggini, The Independent
As England cricketer Jonathan Trott takes another break from the sport because of anxiety, a leading philosopher asks whether the time has come to reconsider our labelling of mental distress
We are often told that there is still a stigma surrounding mental illness. It is therefore strange that the England cricketer Jonathan Trott was stigmatized for allegedly not having one. Trott left the England tour of Australia in November citing a “long-standing, stress-related condition”. But when he gave an interview last month explaining that he was burnt out rather than depressed, the former England captain Michael Vaughan said that he felt “a little bit conned”, saying, “When I hear players talking about burnout, I suspect it is an excuse.”
Now Trott has taken another break from county cricket as his anxiety issues have recurred. Even Vaughan has tweeted his sympathy (“Very sad and I wish him a full recovery”), though others may be muttering about whether Trott is simply not made of tough enough stuff for top-level sport.
But why do people believe it matters whether the psychological distress that Trott is suffering is an illness or not? We have increasingly come to describe mental difficulties in medical terms, using the language of illness and disease. But is that becoming more of a hindrance than a help to true compassion and understanding? It is important to start by recognizing the upside of the medicalization of psychological problems. Most importantly, to talk of them as health issues normalizes both the problems and those who suffer with them.
The depressed, the anxious and the phobic are not “mad” or “crazy” but ordinary people who happen to have developed debilitating problems. This also encourages people to seek help, without feeling that they have failed or will be judged in some way.
These are real gains, but they come at a price. Although the health paradigm in one sense normalizes psychological distress, in others it sets it apart from ordinary experience, creating an artificial distinction between problems of living and bona fide “conditions”. If depression, for example, is an illness, then it follows that there must be a clear difference between people who have it and those who don’t. But although the difference between severe depression and ordinary unhappiness is as clear as that between night and day, there is much twilight between the two.
Once this is accepted, it becomes clear that there is no neat distinction between mental illness and problems of living. Whether someone has a “condition” depends on where the lines are drawn, and different people draw them differently at different times. Whether that person has a diagnosable condition depends a lot on whether they choose to see someone prepared to offer a diagnosis, and there is almost always a doctor who will happily oblige. Indeed, Trott could even have been given one. In Brisbane, England’s team doctor told him, “If I was a GP I’d sign you off for three weeks from work.” Trott declined because he thought that such an act was not the done thing on an Ashes tour.
Furthermore, what diagnosis is offered would also depend partly on when Trott sought it. The Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association remains the international reference point for this and its different editions and revisions have changed the definitions of various conditions at the stroke of a few keys.
It is possible to accept that mental distress is on a continuum and retain the language of illness and disease. In psychiatry, several conditions are classified as “spectrum disorders”, with no sharp separation point between those that are suitable for professional interventions and those that are not. The highest profile example of this to date was when the fifth edition of the DSM replaced the separate diagnostic labels of Autistic Disorder, Asperger’s Disorder, and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) with the single term “Autism Spectrum Disorder”. But we might question why we need quasi-medical diagnostic criteria in the first place. One reason is that people seem to believe that if something is a condition, with a proper name, then it is somehow more real. That is perhaps one reason why people often report relief when they are given a label for their problems. Someone whose self-esteem has been battered by crippling shyness, for example, can feel much better knowing that it is a social-anxiety disorder. Awkwardness ceases to be a personal failing and becomes an impersonal affliction, relieving the sufferer of the burden of guilt and responsibility. Instead of “I’ve failed” or “I’m inadequate”, the thought can be “I have a condition”.
I wouldn’t want to dismiss the real benefits that this kind of shift can have. But I do think that a similar positive effect is possible without resorting to medical models, and that to do so would avoid many problems that come with them.
First and foremost among these is the thorny issue of responsibility. One obstacle people often face when thinking about psychological problems is that it seems hard to imagine anything in between the individual being seen as a helpless victim of an illness or as someone who just needs to “pull themselves together”. So, as it sounds as though Trott is discovering, those who are not deemed ill are not seen as deserving of sympathy. Michael Vaughan said of him: “We were allowed to believe he was struggling with a serious mental-health issue and treated him with sensitivity and sympathy.
He was obviously not in a great place but he was struggling for cricketing reasons and not mental [reasons], and there is a massive difference.” Vaughan’s comments reflect the widespread assumption that a person’s problems are either non-medical and so entirely their responsibility, or the result of an illness which is entirely out of their control.
Once spelt out, it is obvious how absurdly simplistic this is. And it really matters from a practical point of view. Blaming people for their problems is pointless and unfair, but that should not stop us from encouraging them to take responsibility for getting out of their plights, while fully recognizing that they can’t do so by themselves. People often need to be helped to see how they have more power over their situation than it seems, and that they can take more responsibility.
This is perhaps clearest in addiction. People talk about alcoholism as a “disease” but if so, it is a very strange one. Talk of illness invites thoughts of cures and treatments. Psychotherapy and psychiatry have long embraced this lexicon and society has implored the professions to deliver on its promise. People concerned about alcoholism or depression, for example, are always calling for the government to make “treatment” more widely available. But no treatment can cure anyone of alcoholism who does not first decide they want to be better. Alcoholics are neither powerless victims of a disease nor the willing authors of their own self-destruction: the reality is much more complicated than either option suggests.
Psychiatric drugs might well be a solution for some problems, for some people. I’m agnostic about this. It is a fiercely contested issue, with some favoring pharmaceutical treatments for a wide range of problems and others claiming that even bipolar disorder is best dealt with without the use of drugs.
Whoever is right on this issue, it seems very clear that most psychological problems do not fit the model of illnesses requiring treatment. Therapists can help someone to get over their problems or at least cope with them better, but they cannot simply prescribe cures or apply treatments. Someone who goes to a therapist expecting to be “treated” as a “patient” will soon learn that therapy is a much more collaborative enterprise with uncertain outcomes.
Many people get very upset when the appropriateness of medical terms for psychological problems is questioned, wrongly believing that this belittles their suffering. But people do not need a diagnostic label to accept that a problem is a real one. Nor are they being blamed for being in the hole they are in if they are encouraged to think about how they themselves can take charge of the way out of it.
On the other hand, it doesn’t seem at all clear that medicalizing mental problems really has removed the stigma of psychological distress. In some ways, it might add to it, as people are set apart as the sick “others”, rather than the well “us”. Trott’s experience suggests that there may be something in this. “It was difficult when I got home,” he said. “I was a little bit worried about going out in public because people look at you, and I’d been all over the press and you don’t know what people are thinking. They think ‘there goes that nutcase’ or whatever.” People would come up to him and say “it’s good to see you’re out and about” as though having a genuine psychological problem means you can’t participate in society.
Thinking in terms of illness and disease perpetuates unhelpful myths. There is no neat distinction between people who are mentally ill and those who are not. The seriousness of a problem does not depend on it being clearly defined in DSM. And there are no treatments or cures that can simply be dispensed by “mental-health professionals”.
The case of Jonathan Trott should stand as a clear example of how a truly compassionate attitude towards psychological distress neither needs nor is helped by the desire to apply medical categories. Trott had ceased to be able to deal with the world he found himself in. “Just coming down to breakfast, I’d sit on my own away from the guys with my cap over my head because I didn’t know how I was going to react to having to go to the cricket ground again,” he said. “I was waking up looking at the clock hoping the clock had stopped, or that a pylon had fallen on the field and the game had been cancelled, or the stadium had collapsed – as long as there was no one in it, of course. You end up thinking of all sorts of ways you wouldn’t have to go to the ground.”
Whatever label we apply, this kind of suffering is very real. It may seem enlightened to think of Trott and others like him as ill, but if that leads us to make invidious distinctions between the genuinely sick and the merely unhappy, and to dispense support and help accordingly, then that is not enlightened at all.

 

 
For more mental health news, Click Here to access the Serious Mental Illness Blog

Jonathan Trott and the Problems of Describing Mental Illness
By Julian Baggini, The Independent

As England cricketer Jonathan Trott takes another break from the sport because of anxiety, a leading philosopher asks whether the time has come to reconsider our labelling of mental distress

We are often told that there is still a stigma surrounding mental illness. It is therefore strange that the England cricketer Jonathan Trott was stigmatized for allegedly not having one. Trott left the England tour of Australia in November citing a “long-standing, stress-related condition”. But when he gave an interview last month explaining that he was burnt out rather than depressed, the former England captain Michael Vaughan said that he felt “a little bit conned”, saying, “When I hear players talking about burnout, I suspect it is an excuse.”

Now Trott has taken another break from county cricket as his anxiety issues have recurred. Even Vaughan has tweeted his sympathy (“Very sad and I wish him a full recovery”), though others may be muttering about whether Trott is simply not made of tough enough stuff for top-level sport.

But why do people believe it matters whether the psychological distress that Trott is suffering is an illness or not? We have increasingly come to describe mental difficulties in medical terms, using the language of illness and disease. But is that becoming more of a hindrance than a help to true compassion and understanding? It is important to start by recognizing the upside of the medicalization of psychological problems. Most importantly, to talk of them as health issues normalizes both the problems and those who suffer with them.

The depressed, the anxious and the phobic are not “mad” or “crazy” but ordinary people who happen to have developed debilitating problems. This also encourages people to seek help, without feeling that they have failed or will be judged in some way.

These are real gains, but they come at a price. Although the health paradigm in one sense normalizes psychological distress, in others it sets it apart from ordinary experience, creating an artificial distinction between problems of living and bona fide “conditions”. If depression, for example, is an illness, then it follows that there must be a clear difference between people who have it and those who don’t. But although the difference between severe depression and ordinary unhappiness is as clear as that between night and day, there is much twilight between the two.

Once this is accepted, it becomes clear that there is no neat distinction between mental illness and problems of living. Whether someone has a “condition” depends on where the lines are drawn, and different people draw them differently at different times. Whether that person has a diagnosable condition depends a lot on whether they choose to see someone prepared to offer a diagnosis, and there is almost always a doctor who will happily oblige. Indeed, Trott could even have been given one. In Brisbane, England’s team doctor told him, “If I was a GP I’d sign you off for three weeks from work.” Trott declined because he thought that such an act was not the done thing on an Ashes tour.

Furthermore, what diagnosis is offered would also depend partly on when Trott sought it. The Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association remains the international reference point for this and its different editions and revisions have changed the definitions of various conditions at the stroke of a few keys.

It is possible to accept that mental distress is on a continuum and retain the language of illness and disease. In psychiatry, several conditions are classified as “spectrum disorders”, with no sharp separation point between those that are suitable for professional interventions and those that are not. The highest profile example of this to date was when the fifth edition of the DSM replaced the separate diagnostic labels of Autistic Disorder, Asperger’s Disorder, and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) with the single term “Autism Spectrum Disorder”. But we might question why we need quasi-medical diagnostic criteria in the first place. One reason is that people seem to believe that if something is a condition, with a proper name, then it is somehow more real. That is perhaps one reason why people often report relief when they are given a label for their problems. Someone whose self-esteem has been battered by crippling shyness, for example, can feel much better knowing that it is a social-anxiety disorder. Awkwardness ceases to be a personal failing and becomes an impersonal affliction, relieving the sufferer of the burden of guilt and responsibility. Instead of “I’ve failed” or “I’m inadequate”, the thought can be “I have a condition”.

I wouldn’t want to dismiss the real benefits that this kind of shift can have. But I do think that a similar positive effect is possible without resorting to medical models, and that to do so would avoid many problems that come with them.

First and foremost among these is the thorny issue of responsibility. One obstacle people often face when thinking about psychological problems is that it seems hard to imagine anything in between the individual being seen as a helpless victim of an illness or as someone who just needs to “pull themselves together”. So, as it sounds as though Trott is discovering, those who are not deemed ill are not seen as deserving of sympathy. Michael Vaughan said of him: “We were allowed to believe he was struggling with a serious mental-health issue and treated him with sensitivity and sympathy.

He was obviously not in a great place but he was struggling for cricketing reasons and not mental [reasons], and there is a massive difference.” Vaughan’s comments reflect the widespread assumption that a person’s problems are either non-medical and so entirely their responsibility, or the result of an illness which is entirely out of their control.

Once spelt out, it is obvious how absurdly simplistic this is. And it really matters from a practical point of view. Blaming people for their problems is pointless and unfair, but that should not stop us from encouraging them to take responsibility for getting out of their plights, while fully recognizing that they can’t do so by themselves. People often need to be helped to see how they have more power over their situation than it seems, and that they can take more responsibility.

This is perhaps clearest in addiction. People talk about alcoholism as a “disease” but if so, it is a very strange one. Talk of illness invites thoughts of cures and treatments. Psychotherapy and psychiatry have long embraced this lexicon and society has implored the professions to deliver on its promise. People concerned about alcoholism or depression, for example, are always calling for the government to make “treatment” more widely available. But no treatment can cure anyone of alcoholism who does not first decide they want to be better. Alcoholics are neither powerless victims of a disease nor the willing authors of their own self-destruction: the reality is much more complicated than either option suggests.

Psychiatric drugs might well be a solution for some problems, for some people. I’m agnostic about this. It is a fiercely contested issue, with some favoring pharmaceutical treatments for a wide range of problems and others claiming that even bipolar disorder is best dealt with without the use of drugs.

Whoever is right on this issue, it seems very clear that most psychological problems do not fit the model of illnesses requiring treatment. Therapists can help someone to get over their problems or at least cope with them better, but they cannot simply prescribe cures or apply treatments. Someone who goes to a therapist expecting to be “treated” as a “patient” will soon learn that therapy is a much more collaborative enterprise with uncertain outcomes.

Many people get very upset when the appropriateness of medical terms for psychological problems is questioned, wrongly believing that this belittles their suffering. But people do not need a diagnostic label to accept that a problem is a real one. Nor are they being blamed for being in the hole they are in if they are encouraged to think about how they themselves can take charge of the way out of it.

On the other hand, it doesn’t seem at all clear that medicalizing mental problems really has removed the stigma of psychological distress. In some ways, it might add to it, as people are set apart as the sick “others”, rather than the well “us”. Trott’s experience suggests that there may be something in this. “It was difficult when I got home,” he said. “I was a little bit worried about going out in public because people look at you, and I’d been all over the press and you don’t know what people are thinking. They think ‘there goes that nutcase’ or whatever.” People would come up to him and say “it’s good to see you’re out and about” as though having a genuine psychological problem means you can’t participate in society.

Thinking in terms of illness and disease perpetuates unhelpful myths. There is no neat distinction between people who are mentally ill and those who are not. The seriousness of a problem does not depend on it being clearly defined in DSM. And there are no treatments or cures that can simply be dispensed by “mental-health professionals”.

The case of Jonathan Trott should stand as a clear example of how a truly compassionate attitude towards psychological distress neither needs nor is helped by the desire to apply medical categories. Trott had ceased to be able to deal with the world he found himself in. “Just coming down to breakfast, I’d sit on my own away from the guys with my cap over my head because I didn’t know how I was going to react to having to go to the cricket ground again,” he said. “I was waking up looking at the clock hoping the clock had stopped, or that a pylon had fallen on the field and the game had been cancelled, or the stadium had collapsed – as long as there was no one in it, of course. You end up thinking of all sorts of ways you wouldn’t have to go to the ground.”

Whatever label we apply, this kind of suffering is very real. It may seem enlightened to think of Trott and others like him as ill, but if that leads us to make invidious distinctions between the genuinely sick and the merely unhappy, and to dispense support and help accordingly, then that is not enlightened at all.

 

 




For more mental health news, 
Click Here to access the Serious Mental Illness Blog

Filed under sport sports cricket uk united kingdom england mental illness mental health mental health illness healthy wellness mind body brain stigma stigmatized label labels news jonathan trott trott psychology psychiatry counseling anxiety anxious depression depressed

83 notes

Here’s What It’s Like to Have the Mental Illness Associated With Psychopaths
By Anonymous, Business Insider
An anonymous user responded with a first-person account of having Antisocial Personality Disorder, the official name for a mental illness most people know as sociopathy. The disorder, which is notoriously difficult to treat, is characterized by a lack of empathy and inability to form close relationships. We have printed the entire response below.
I’d like to answer this anonymously, so bear with me.
First of all, although it is a common misconception, having an antisocial personality disorder is different from the term “psychopath.” A sociopath can have a wide range of symptoms, meaning that not every sociopath is like Dexter, or feels the need to kill and destroy in an attempt to feel emotions or cope. Sociopaths or psychopaths can be anywhere on a large spectrum ranging from the type of behavior seen by remorseless serial killers, or the behavior seen as a general disorder in emotional capabilities or accuracy.
In my case, although as of yet there is no sure-fire method of diagnosing ASPD, I was given the label because I exhibited many of the symptoms associated with the disorder. As a child I was stubborn and had trouble maintaining friendships. I didn’t have any trouble making friends, but social norms were foreign to me and I usually lost interest in friendship. My parents described my behavior as cold and distant. I had absolutely no sense of loyalty and would use people to get what I wanted.
I can’t say that there is NO effective treatment for the problem, but in my case, I was institutionalized for many months and I was essentially re-trained how to survive in a society that I can’t understand. Since many of the problems I had evolved throughout my childhood and early teens, my parents decided to face the problem in a very extreme way, hence the institutionalization.
Today, most people wouldn’t know that I have issues. I moved to a new area to ease the transition.
Not all people who show symptoms of ASPD will involve themselves in criminal activity. Although I’ve had a few minor brushes with the law, I am not a criminal and I have no desire to break laws. Also, contrary to popular belief, I DO experience emotions. I experience emotions which are much less intense, I imagine, than others, but they are emotions nevertheless. Most of the time I have difficulty identifying what I am feeling, and my emotions are often inappropriate in context with the situation.
I have almost no ability to empathize with others, and even at the death of those close to me, I did not feel sorrow. Instead, I knew that I should be feeling sorrow, and so I exhibited the emotions that I knew I should be feeling. This was the training and treatment that I received. I was taught about my disorder, I was told that I was different from most of the world, but I was also taught that I should attempt to integrate.
One of the biggest problems with ASPD is the sense of alienation. This alienation is often the only thing which someone with ASPD can truly understand. The alienation is clear and it is not confusing. However, if i allow the alienation to define me, I become less willing to fight antisocial urges. These antisocial actions are what cause many people with ASPD to break the law or hurt others.
Although I cannot compare the treatment I received with other methods, I would say that the training I was given helped me to blend into my society and become a part of it. Pretending to feel things which I do not feel makes me appear normal, and appearing normal makes the alienation less intense, which in turn helps the ASPD. There is no firmly recognized method to treat people who have ASPD or who can be classified as psychopaths.
One of the main problems is that, compared to other mental illnesses, there is a very small knowledge base on the subject. Few functioning people with an antisocial personality disorder seek out therapy. Most of the people that society recognizes as sociopaths or psychopaths are in prison or deeply disturbed. There is a huge social stigma in relation to people who can be classified as sociopaths or psychopaths (not unfounded, I’ll admit, there is good cause). But this general mistrust makes it difficult to get a job, make friends, or date people (yes I do date) should the fact that I have a diagnosis of ASPD come to light.
Once, a well meaning, but poorly-informed neighbor put my name and address on a map online, marking me as a dangerous member of society. I had been attending therapy nearby, and I naively thought that he wouldn’t judge since his young son has schizophrenia. I was forced to quit my job and move away after the whole situation started interfering with my work and general desire to be left alone.
Despite my ASPD, I am a functioning member of society.
With continuing therapy, and the understanding that it is okay for me to be different, I have the freedom to live where I want, have friendships, work, and go to school.

 

 
For more mental health news, Click Here to access the Serious Mental Illness Blog

Here’s What It’s Like to Have the Mental Illness Associated With Psychopaths

By Anonymous, Business Insider

An anonymous user responded with a first-person account of having Antisocial Personality Disorder, the official name for a mental illness most people know as sociopathy. The disorder, which is notoriously difficult to treat, is characterized by a lack of empathy and inability to form close relationships. We have printed the entire response below.

I’d like to answer this anonymously, so bear with me.

First of all, although it is a common misconception, having an antisocial personality disorder is different from the term “psychopath.” A sociopath can have a wide range of symptoms, meaning that not every sociopath is like Dexter, or feels the need to kill and destroy in an attempt to feel emotions or cope. Sociopaths or psychopaths can be anywhere on a large spectrum ranging from the type of behavior seen by remorseless serial killers, or the behavior seen as a general disorder in emotional capabilities or accuracy.

In my case, although as of yet there is no sure-fire method of diagnosing ASPD, I was given the label because I exhibited many of the symptoms associated with the disorder. As a child I was stubborn and had trouble maintaining friendships. I didn’t have any trouble making friends, but social norms were foreign to me and I usually lost interest in friendship. My parents described my behavior as cold and distant. I had absolutely no sense of loyalty and would use people to get what I wanted.

I can’t say that there is NO effective treatment for the problem, but in my case, I was institutionalized for many months and I was essentially re-trained how to survive in a society that I can’t understand. Since many of the problems I had evolved throughout my childhood and early teens, my parents decided to face the problem in a very extreme way, hence the institutionalization.

Today, most people wouldn’t know that I have issues. I moved to a new area to ease the transition.

Not all people who show symptoms of ASPD will involve themselves in criminal activity. Although I’ve had a few minor brushes with the law, I am not a criminal and I have no desire to break laws. Also, contrary to popular belief, I DO experience emotions. I experience emotions which are much less intense, I imagine, than others, but they are emotions nevertheless. Most of the time I have difficulty identifying what I am feeling, and my emotions are often inappropriate in context with the situation.

I have almost no ability to empathize with others, and even at the death of those close to me, I did not feel sorrow. Instead, I knew that I should be feeling sorrow, and so I exhibited the emotions that I knew I should be feeling. This was the training and treatment that I received. I was taught about my disorder, I was told that I was different from most of the world, but I was also taught that I should attempt to integrate.

One of the biggest problems with ASPD is the sense of alienation. This alienation is often the only thing which someone with ASPD can truly understand. The alienation is clear and it is not confusing. However, if i allow the alienation to define me, I become less willing to fight antisocial urges. These antisocial actions are what cause many people with ASPD to break the law or hurt others.

Although I cannot compare the treatment I received with other methods, I would say that the training I was given helped me to blend into my society and become a part of it. Pretending to feel things which I do not feel makes me appear normal, and appearing normal makes the alienation less intense, which in turn helps the ASPD. There is no firmly recognized method to treat people who have ASPD or who can be classified as psychopaths.

One of the main problems is that, compared to other mental illnesses, there is a very small knowledge base on the subject. Few functioning people with an antisocial personality disorder seek out therapy. Most of the people that society recognizes as sociopaths or psychopaths are in prison or deeply disturbed. There is a huge social stigma in relation to people who can be classified as sociopaths or psychopaths (not unfounded, I’ll admit, there is good cause). But this general mistrust makes it difficult to get a job, make friends, or date people (yes I do date) should the fact that I have a diagnosis of ASPD come to light.

Once, a well meaning, but poorly-informed neighbor put my name and address on a map online, marking me as a dangerous member of society. I had been attending therapy nearby, and I naively thought that he wouldn’t judge since his young son has schizophrenia. I was forced to quit my job and move away after the whole situation started interfering with my work and general desire to be left alone.

Despite my ASPD, I am a functioning member of society.

With continuing therapy, and the understanding that it is okay for me to be different, I have the freedom to live where I want, have friendships, work, and go to school.

 

 




For more mental health news, 
Click Here to access the Serious Mental Illness Blog

Filed under psychopath psycho psychopathy psychology psychiatry counseling mental illness mental health mental illness health healthy wellness mind body brain personality personality disorder disorder diagnosis story testimony feeling feelings emotion emotions behavior thought thoughts antisocial

14 notes

Suicidality predicts violence in adults with schizophreniaBy Susan London, Clinical Psychiatry News Digital Network
Adults with schizophrenia who threaten or attempt suicide have sharply increased risks of becoming violent, according to a recently published analysis.
Katrina Witt, a doctoral candidate affiliated with the University of Oxford (England), and her associates analyzed longitudinal data from the National Institute of Mental Health’s CATIE (Clinical Antipsychotic Trials of Intervention Effectiveness), a randomized controlled trial of antipsychotic medication in 1,460 adults with schizophrenia of generally moderate severity who were receiving usual care.
During a median follow-up of 15.7 months, 33.7% of the patients experienced suicidal ideation, 11.1% threatened suicide, and 5.8% attempted suicide, Ms. Witt and her associates reported (Schizophr. Res. 2014;154:61-7). About 8.3% of the patients showed violent behavior at some time as ascertained from interviews with family members.
In univariate analyses, suicidal threats and suicide attempts were significantly associated with violent behavior in both sexes, whereas suicidal ideation was not significantly associated for either sex.
In multivariate analyses that adjusted for a variety of comorbidities (alcohol misuse, drug misuse, diagnosed major depressive disorder, or diagnosed antisocial personality disorder), men and women had significantly elevated risks of violence if they made suicidal threats (hazard ratios, 3.8 and 9.4) or attempted suicide (hazard ratios, 2.8 and 4.4).
Additionally, for both sexes, the risks were elevated by roughly the same extent after adjustment for age or baseline scores for depression, hostility, positive symptoms, or poor impulse control. In women, adjustment for 6-month scores on these measures also made little difference; however, in men, adjustment abolished the significant association between suicide attempts and subsequent violence.
Of the three suicidality measures, suicidal threats yielded the greatest improvement in the prediction of violence for both sexes when added to a baseline risk model consisting of age, comorbid substance use disorder, and previous violence.
Ms. Witt and her associates cited several limitations. First, randomized controlled trials of antipsychotic effectiveness are “less likely to recruit individuals reporting thoughts of suicidality and self-harm.” In light of that fact, it might not be possible to generalize the results of this study to all patients with schizophrenia.
Also, the CATIE data were not collected to meet the aims of this study, and as a result, it was not possible to include relevant confounding factors such as intelligence scores and “neighborhood socioeconomic deprivation.”
Nevertheless, they said, their findings have implications for clinical care and for possible explanatory mechanisms.
"First, as part of the clinical risk assessment of violence in schizophrenia, as recommended by clinical guidelines in both the [United States] and [United Kingdom], a careful examination of history of suicidality should be included," they wrote.
"Second, the association between suicidal attempts and violence may be modified by 6-month depression, hostility, positive symptomatology, and poor impulse control scores in males. Given that medication adherence was monitored during the CATIE trial, this finding may suggest that acute symptomatology, perhaps exacerbated by medication nonadherence, may account for some of the association between suicidality and violence in males," they maintained. Thus efforts to ensure adherence might improve outcomes.
Read more HERE

 

For more mental health news, Click Here to access the Serious Mental Illness Blog

Suicidality predicts violence in adults with schizophrenia
By Susan London, Clinical Psychiatry News Digital Network

Adults with schizophrenia who threaten or attempt suicide have sharply increased risks of becoming violent, according to a recently published analysis.

Katrina Witt, a doctoral candidate affiliated with the University of Oxford (England), and her associates analyzed longitudinal data from the National Institute of Mental Health’s CATIE (Clinical Antipsychotic Trials of Intervention Effectiveness), a randomized controlled trial of antipsychotic medication in 1,460 adults with schizophrenia of generally moderate severity who were receiving usual care.

During a median follow-up of 15.7 months, 33.7% of the patients experienced suicidal ideation, 11.1% threatened suicide, and 5.8% attempted suicide, Ms. Witt and her associates reported (Schizophr. Res. 2014;154:61-7). About 8.3% of the patients showed violent behavior at some time as ascertained from interviews with family members.

In univariate analyses, suicidal threats and suicide attempts were significantly associated with violent behavior in both sexes, whereas suicidal ideation was not significantly associated for either sex.

In multivariate analyses that adjusted for a variety of comorbidities (alcohol misuse, drug misuse, diagnosed major depressive disorder, or diagnosed antisocial personality disorder), men and women had significantly elevated risks of violence if they made suicidal threats (hazard ratios, 3.8 and 9.4) or attempted suicide (hazard ratios, 2.8 and 4.4).

Additionally, for both sexes, the risks were elevated by roughly the same extent after adjustment for age or baseline scores for depression, hostility, positive symptoms, or poor impulse control. In women, adjustment for 6-month scores on these measures also made little difference; however, in men, adjustment abolished the significant association between suicide attempts and subsequent violence.

Of the three suicidality measures, suicidal threats yielded the greatest improvement in the prediction of violence for both sexes when added to a baseline risk model consisting of age, comorbid substance use disorder, and previous violence.

Ms. Witt and her associates cited several limitations. First, randomized controlled trials of antipsychotic effectiveness are “less likely to recruit individuals reporting thoughts of suicidality and self-harm.” In light of that fact, it might not be possible to generalize the results of this study to all patients with schizophrenia.

Also, the CATIE data were not collected to meet the aims of this study, and as a result, it was not possible to include relevant confounding factors such as intelligence scores and “neighborhood socioeconomic deprivation.”

Nevertheless, they said, their findings have implications for clinical care and for possible explanatory mechanisms.

"First, as part of the clinical risk assessment of violence in schizophrenia, as recommended by clinical guidelines in both the [United States] and [United Kingdom], a careful examination of history of suicidality should be included," they wrote.

"Second, the association between suicidal attempts and violence may be modified by 6-month depression, hostility, positive symptomatology, and poor impulse control scores in males. Given that medication adherence was monitored during the CATIE trial, this finding may suggest that acute symptomatology, perhaps exacerbated by medication nonadherence, may account for some of the association between suicidality and violence in males," they maintained. Thus efforts to ensure adherence might improve outcomes.

Read more HERE

 




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Filed under schizophrenia schizophrenic psychosis psychotic diagnosis disorder syndrome mental illness mental health mental health illness healthy wellness suicide suicidal news mind body brain psychiatry psychology counseling delusion hallucination delusions hallucinations

215 notes

Dissociation and Facing the PastBy Noel Hunter, M.A., M.S. SeriousMentalIllness.net
Dissociation is a common, yet frequently overlooked, factor in “serious mental illness.” Although usually associated with dissociative disorder diagnoses, high levels of dissociation are also found in individuals diagnosed with posttraumatic stress disorder, schizophrenia, and, to a lesser degree, borderline personality disorder. Mental health scholars Jon G. Allen, PhD, Dick Corstens, MD, and Andrew Moskowitz, PhD  have separately been at the helm of several studies exploring and giving evidence for the strong link between dissociation and hearing voices, confused thinking, disorganized speech, strange beliefs, identity disturbances, and other anomalous experiences.  The greater the level of dissociation, the more difficulty one has in benefiting from psychological or drug treatments.
But, what is dissociation? The academics who are often looked to for definitive answers do not agree on its precise definition. In its most simplistic aspects, dissociation might be considered to be akin to disconnection. But, dissociation is so much more complicated and difficult to define, as evidenced by the great lengths scholars and mental health professionals will go to in their attempts to provide some understanding while never quite managing to completely do so. This may be because words defy what dissociation truly is: an experience. Dissociation is numbness and nothingness; it is a feeling of being lost; it is floating on a cloud that threatens to suffocate; it is automatic speech and action without awareness or control; it is looking at the world and blinking to try to remove the blurry fog; it is hearing and seeing the immediate world and simultaneously feeling very far away; it is raw fear; it is unfamiliarity in familiar places; it is possession; it is being haunted everyday by unknown monsters that can be felt but not seen (at least not by others); it is looking in the mirror and not knowing who is looking back; it is fantasy and imagination; and, above all else, it is survival. Dissociation is all of these things and none of them at once.
While clearly the concept of dissociation cannot be strictly defined, the phenomenon itself can easily be recognized by one who is familiar with it. And yet, few mental health professionals are trained to identify it, let alone understand it. Why? This is a question I have been trying to answer for many years. In large part, dissociation does not provide any favors to the biomedical concept of disease, especially as it appears in psychosis, and so it is not a focus within such a paradigm. This is because dissociation is a normal human reaction to overwhelming chronic stress and/or trauma, not a disease process. It serves to defend the self against stress and trauma by disconnecting the mind from its capacity to perceive what is too much for the person to bear. Trauma, especially that which is inflicted on a child by caregivers, is something that is often denied by both society and the individual experiencing it. To deny the effects of early chronic stress (trauma really only being one type of stress that is narrowly defined by society) as it is exhibited in present-day difficulties due to diagnosis is itself dissociation.
When one enters into a dissociative state, the entire brain shuts down except the areas vital to survival, and those related to emotions and speech. Fear of a terrifying past that enters into the present may impede the actions of awareness, inhibition, or differentiation of internal and external reality. The past is the only reality that exists. Additionally, when memories are formed in a state of dissociation, the brain maps these events in such complicated and foreign ways that manifestations of these memories in the present is usually exhibited in extraordinarily bizarre and confusing behaviors and experiences. Whether it is hearing voices, having altered personality states, or believing that the CIA is spying on you, dissociated memories serve to create a living horror story that would surely terrify any audience. Drugs might serve to damp down the fear, alcohol might ease the pain, but nothing can truly rid a person of the wicked and vile fragments of memory other than facing the past.
Whatever diagnosis might be given, when one is suffering from the effects of dissociation, one must be provided trauma-informed care. Trauma and dissociation lie at the root of most “serious mental illness.” It is a very individual process as far as who can fully heal from terror and how to do so.  It is certainly an ongoing, possibly life-long journey with many hills and curves along the way, but a journey that one must go on to escape. What is universal, however, is that nobody can or should do it alone. A caring other who can withstand not only the narrative of a horrid past, but also the creative ways in which the person has managed to deal with this past in the present is an absolute necessity. An other who is grounded when one is in another world; an other who is solid when one is fragmented shards floating in the wind; an other who STAYS, physically and emotionally, without judgment; an other who can tolerate not knowing even when one is begging and pleading for an answer; an other who is an equal; an other who does not violate, harm, or oppress; an other who is curious but not voyeuristic; an other who can guide and model without needing to be authoritarian or expert; an other who is not perfect, and is not afraid to show it; an other with all, any, or most of these qualities is what is needed to reign in the dissociative processes to manageable levels and to provide one with some semblance of “self.” This is a tall order, and not one that is inherent in many therapists. But they do exist, as do extraordinary others who are not trained at all, and can be found with some effort and perseverance.
For more on where to find a therapist who might just be this “other” see:
www.isps.org
www.isst-d.org
www.istss.org
www.estss.org
Digital sculpture by Adam Martinakis

 

 
For more mental health news, Click Here to access the Serious Mental Illness Blog

Dissociation and Facing the Past
By Noel Hunter, M.A., M.S. SeriousMentalIllness.net

Dissociation is a common, yet frequently overlooked, factor in “serious mental illness.” Although usually associated with dissociative disorder diagnoses, high levels of dissociation are also found in individuals diagnosed with posttraumatic stress disorder, schizophrenia, and, to a lesser degree, borderline personality disorder. Mental health scholars Jon G. Allen, PhD, Dick Corstens, MD, and Andrew Moskowitz, PhD  have separately been at the helm of several studies exploring and giving evidence for the strong link between dissociation and hearing voices, confused thinking, disorganized speech, strange beliefs, identity disturbances, and other anomalous experiences.  The greater the level of dissociation, the more difficulty one has in benefiting from psychological or drug treatments.

But, what is dissociation? The academics who are often looked to for definitive answers do not agree on its precise definition. In its most simplistic aspects, dissociation might be considered to be akin to disconnection. But, dissociation is so much more complicated and difficult to define, as evidenced by the great lengths scholars and mental health professionals will go to in their attempts to provide some understanding while never quite managing to completely do so. This may be because words defy what dissociation truly is: an experience. Dissociation is numbness and nothingness; it is a feeling of being lost; it is floating on a cloud that threatens to suffocate; it is automatic speech and action without awareness or control; it is looking at the world and blinking to try to remove the blurry fog; it is hearing and seeing the immediate world and simultaneously feeling very far away; it is raw fear; it is unfamiliarity in familiar places; it is possession; it is being haunted everyday by unknown monsters that can be felt but not seen (at least not by others); it is looking in the mirror and not knowing who is looking back; it is fantasy and imagination; and, above all else, it is survival. Dissociation is all of these things and none of them at once.

While clearly the concept of dissociation cannot be strictly defined, the phenomenon itself can easily be recognized by one who is familiar with it. And yet, few mental health professionals are trained to identify it, let alone understand it. Why? This is a question I have been trying to answer for many years. In large part, dissociation does not provide any favors to the biomedical concept of disease, especially as it appears in psychosis, and so it is not a focus within such a paradigm. This is because dissociation is a normal human reaction to overwhelming chronic stress and/or trauma, not a disease process. It serves to defend the self against stress and trauma by disconnecting the mind from its capacity to perceive what is too much for the person to bear. Trauma, especially that which is inflicted on a child by caregivers, is something that is often denied by both society and the individual experiencing it. To deny the effects of early chronic stress (trauma really only being one type of stress that is narrowly defined by society) as it is exhibited in present-day difficulties due to diagnosis is itself dissociation.

When one enters into a dissociative state, the entire brain shuts down except the areas vital to survival, and those related to emotions and speech. Fear of a terrifying past that enters into the present may impede the actions of awareness, inhibition, or differentiation of internal and external reality. The past is the only reality that exists. Additionally, when memories are formed in a state of dissociation, the brain maps these events in such complicated and foreign ways that manifestations of these memories in the present is usually exhibited in extraordinarily bizarre and confusing behaviors and experiences. Whether it is hearing voices, having altered personality states, or believing that the CIA is spying on you, dissociated memories serve to create a living horror story that would surely terrify any audience. Drugs might serve to damp down the fear, alcohol might ease the pain, but nothing can truly rid a person of the wicked and vile fragments of memory other than facing the past.

Whatever diagnosis might be given, when one is suffering from the effects of dissociation, one must be provided trauma-informed care. Trauma and dissociation lie at the root of most “serious mental illness.” It is a very individual process as far as who can fully heal from terror and how to do so.  It is certainly an ongoing, possibly life-long journey with many hills and curves along the way, but a journey that one must go on to escape. What is universal, however, is that nobody can or should do it alone. A caring other who can withstand not only the narrative of a horrid past, but also the creative ways in which the person has managed to deal with this past in the present is an absolute necessity. An other who is grounded when one is in another world; an other who is solid when one is fragmented shards floating in the wind; an other who STAYS, physically and emotionally, without judgment; an other who can tolerate not knowing even when one is begging and pleading for an answer; an other who is an equal; an other who does not violate, harm, or oppress; an other who is curious but not voyeuristic; an other who can guide and model without needing to be authoritarian or expert; an other who is not perfect, and is not afraid to show it; an other with all, any, or most of these qualities is what is needed to reign in the dissociative processes to manageable levels and to provide one with some semblance of “self.” This is a tall order, and not one that is inherent in many therapists. But they do exist, as do extraordinary others who are not trained at all, and can be found with some effort and perseverance.

For more on where to find a therapist who might just be this “other” see:

www.isps.org

www.isst-d.org

www.istss.org

www.estss.org

Digital sculpture by Adam Martinakis

 

 




For more mental health news, 
Click Here to access the Serious Mental Illness Blog

Filed under dissociation dissociate dissociated mental illness mental health mental illness health healthy disorder diagnosis ptsd trauma traumatized schizophrenia schizophrenic bpd borderline borderline personality disorder mind body brain recovery hope wellness stress disease drugs fear therapy

39 notes

“Talking Back to Madness”By M. Balter (2014) Science, 343.
Science notices that “For decades, antipsychotic drugs have been the main line of defense, but they have serious side effects and lots of patients end up not taking them. Recently, a number of clinical trials have suggested that psychological approaches, including old-fashioned “talk” psychotherapy and a method called cognitive behavioral therapy, can be moderately effective in many cases. These techniques engage with the human being behind the symptoms and are attracting increasing attention from the medical profession.”
From the article:
“Most schizophrenia experts subscribe to the stress-vulnerability model of the disorder, in which some individuals have a greater predisposition—either because of genes, childhood trauma, or environmental factors—to psychosis than others. In vulnerable people, psychotic episodes are often set off by some sort of stressful event, usually in the late teens or early adulthood.
“But past psychological approaches, such as psychoanalysis, have shown limited success in treating the disease. Sigmund Freud, the founder of psychoanalysis, eventually gave up on using it to treat psychotic patients, although a number of later post-Freudian psychiatrists continued to use it with sporadic success. When antipsychotic drugs arrived in the 1950s, with their clear ability to dampen the worst psychotic symptoms, psychotherapy became increasingly marginalized.”
“Drugs have serious side effects, however, and at least 50% of patients either refuse or fail to take them, according to recent studies. Moreover, the search for genes behind schizophrenia and other mental illnesses, which might lead to new drug therapies, has failed to produce any smoking guns and has led only to the discovery of a large number of genetic variants, each conferring a very small additional risk. “We’re trying to fix something, but we don’t know what’s broken,” says Brian Koehler, a psychologist at New York University in New York City who also sees schizophrenia patients in private practice.
“Now, psychological treatments are gaining ground again. Most advocates of psychotherapies insist they are not claiming that schizophrenia is purely a psychological malady caused by a dysfunctional family background. “We’re looking for a much more nuanced form of psychiatry that doesn’t reject biology, but that is able to situate the biology within the realm of lived human experience, which is socially and culturally determined,” says psychiatrist Pat Bracken, director of mental health at Bantry General Hospital in Ireland.
“In 2012, another team confirmed that CBT could be effective for so-called negative symptoms of schizophrenia, such as emotional distance, apathy, and social withdrawal, which are usually much harder to treat.
“And the most recent CBT trial, published last month in The Lancet, concludes that CBT might serve as a substitute for antipsychotic drugs in some cases, rather than just an adjunct to them as in most clinical studies (see ScienceNOW, http://scim.ag/schizCBT). In this study, 74 schizophrenia spectrum patients who were being treated in Manchester and Newcastle, and who had declined to take drugs, were randomized by computer into two groups, one receiving TAU and the other TAU plus CBT.
“After 18 months, the CBT group showed moderately better scores on various tests for psychotic symptoms; indeed, CBT performed about as well as antipsychotic drugs do when compared with placebos, meaning that CBT could substitute for drugs in some situations—especially those in which patients are refusing to take them anyway.
“Clinical psychologist Anthony Morrison of the University of Manchester, who led the study, stresses that a drug-free approach might be appropriate only for patients who are relatively high-functioning and have not shown any risk to themselves or others. Nevertheless, the results are “utterly convincing,” says Max Birchwood, a psychologist at the University of Warwick in Coventry, U.K.
“Arenella, who treats Terry and some of her other patients with a combination of psychodynamic and CBT approaches, says that in the end it doesn’t matter whether talk therapies work because of the theory behind them or just because someone is taking the patient and their symptoms seriously. “It may be a placebo effect, but I will go for all the placebo effect I can get,” she says. “I’ll take it.”
“In the end, the spread of talk therapies for psychosis could be limited by a scarcity of resources, and of therapists willing to try them. Treating such clients is very stressful and seldom financially rewarding. “A lot of people don’t want to take these patients,” Arenella says. “Working with them is scary. People get violent, people get hurt, computers get thrown to the ground, ceiling tiles get pulled out.” And Martindale says that “contact with madness is very disturbing; it conjures up all sorts of feelings.”
“Government agencies and insurance companies can help by covering such treatments, even though they are more expensive in the long run than drugs, say Arenella and others. They are worth trying, Bracken says. “I have a lot of patients whom I would say recovered from psychosis. I see people who move on with their lives, get their quality of life back, are able to live independently.” Indeed, the popular notion that a schizophrenia diagnosis is a life sentence of mental illness is not borne out by the statistics: In one typical study, published in the American Journal of Psychiatry in 2004, researchers found that nearly 50% of first-episode schizophrenia or schizoaffective disorder patients were symptom-free after 5 years.
“But many people don’t get there no matter what we do,” Bracken says, “until that spark in them finally says, ‘I want my life back.’ “

 

 

 
For more mental health news, Click Here to access the Serious Mental Illness Blog

“Talking Back to Madness”
By M. Balter (2014) Science, 343.

Science notices that “For decades, antipsychotic drugs have been the main line of defense, but they have serious side effects and lots of patients end up not taking them. Recently, a number of clinical trials have suggested that psychological approaches, including old-fashioned “talk” psychotherapy and a method called cognitive behavioral therapy, can be moderately effective in many cases. These techniques engage with the human being behind the symptoms and are attracting increasing attention from the medical profession.”

From the article:

“Most schizophrenia experts subscribe to the stress-vulnerability model of the disorder, in which some individuals have a greater predisposition—either because of genes, childhood trauma, or environmental factors—to psychosis than others. In vulnerable people, psychotic episodes are often set off by some sort of stressful event, usually in the late teens or early adulthood.

“But past psychological approaches, such as psychoanalysis, have shown limited success in treating the disease. Sigmund Freud, the founder of psychoanalysis, eventually gave up on using it to treat psychotic patients, although a number of later post-Freudian psychiatrists continued to use it with sporadic success. When antipsychotic drugs arrived in the 1950s, with their clear ability to dampen the worst psychotic symptoms, psychotherapy became increasingly marginalized.”

“Drugs have serious side effects, however, and at least 50% of patients either refuse or fail to take them, according to recent studies. Moreover, the search for genes behind schizophrenia and other mental illnesses, which might lead to new drug therapies, has failed to produce any smoking guns and has led only to the discovery of a large number of genetic variants, each conferring a very small additional risk. “We’re trying to fix something, but we don’t know what’s broken,” says Brian Koehler, a psychologist at New York University in New York City who also sees schizophrenia patients in private practice.

“Now, psychological treatments are gaining ground again. Most advocates of psychotherapies insist they are not claiming that schizophrenia is purely a psychological malady caused by a dysfunctional family background. “We’re looking for a much more nuanced form of psychiatry that doesn’t reject biology, but that is able to situate the biology within the realm of lived human experience, which is socially and culturally determined,” says psychiatrist Pat Bracken, director of mental health at Bantry General Hospital in Ireland.

“In 2012, another team confirmed that CBT could be effective for so-called negative symptoms of schizophrenia, such as emotional distance, apathy, and social withdrawal, which are usually much harder to treat.

“And the most recent CBT trial, published last month in The Lancet, concludes that CBT might serve as a substitute for antipsychotic drugs in some cases, rather than just an adjunct to them as in most clinical studies (see ScienceNOW, http://scim.ag/schizCBT). In this study, 74 schizophrenia spectrum patients who were being treated in Manchester and Newcastle, and who had declined to take drugs, were randomized by computer into two groups, one receiving TAU and the other TAU plus CBT.

“After 18 months, the CBT group showed moderately better scores on various tests for psychotic symptoms; indeed, CBT performed about as well as antipsychotic drugs do when compared with placebos, meaning that CBT could substitute for drugs in some situations—especially those in which patients are refusing to take them anyway.

“Clinical psychologist Anthony Morrison of the University of Manchester, who led the study, stresses that a drug-free approach might be appropriate only for patients who are relatively high-functioning and have not shown any risk to themselves or others. Nevertheless, the results are “utterly convincing,” says Max Birchwood, a psychologist at the University of Warwick in Coventry, U.K.

“Arenella, who treats Terry and some of her other patients with a combination of psychodynamic and CBT approaches, says that in the end it doesn’t matter whether talk therapies work because of the theory behind them or just because someone is taking the patient and their symptoms seriously. “It may be a placebo effect, but I will go for all the placebo effect I can get,” she says. “I’ll take it.”

“In the end, the spread of talk therapies for psychosis could be limited by a scarcity of resources, and of therapists willing to try them. Treating such clients is very stressful and seldom financially rewarding. “A lot of people don’t want to take these patients,” Arenella says. “Working with them is scary. People get violent, people get hurt, computers get thrown to the ground, ceiling tiles get pulled out.” And Martindale says that “contact with madness is very disturbing; it conjures up all sorts of feelings.”

“Government agencies and insurance companies can help by covering such treatments, even though they are more expensive in the long run than drugs, say Arenella and others. They are worth trying, Bracken says. “I have a lot of patients whom I would say recovered from psychosis. I see people who move on with their lives, get their quality of life back, are able to live independently.” Indeed, the popular notion that a schizophrenia diagnosis is a life sentence of mental illness is not borne out by the statistics: In one typical study, published in the American Journal of Psychiatry in 2004, researchers found that nearly 50% of first-episode schizophrenia or schizoaffective disorder patients were symptom-free after 5 years.

“But many people don’t get there no matter what we do,” Bracken says, “until that spark in them finally says, ‘I want my life back.’ “

 

 

 




For more mental health news, 
Click Here to access the Serious Mental Illness Blog

Filed under madness mad psychotic psychosis schizophrenia hallucination hallucinations delusion delusions voices drugs drug med meds medications treatment hope recovery mental health mental illness mental health illness healthy wellness mind brain body psychology counseling

68 notes

Emotional Child Abuse Has to Be Banned – The Science Backs Up Our InstinctsBy Oliver James, The Guardian
A definitive analysis of the 41 best studies into the impact of childhood adversity on the risk of psychosis (mostly schizophrenia and bipolar disorder) was published in 2012. In order of impact, emotional abuse increased the risk of psychosis the most
We cannot be blamed for feeling nervous when this government talks of criminalising lack of parental love. There are uber-Thatcherites in its ranks who talk up the ‘big society’ but blame the individual. A wheeze for dumping their failure to support parents back on them would be no surprise.
However, in proposing to criminalize emotional abuse and neglect crimes, I am inclined to give them the benefit of the doubt. Many estimable campaigning groups, such as Action for Children, have advocated such legislation.
The case for it comes from the nature as well as nurture side of the child development debate. In an astonishing admission in the Guardian last month, Robert Plomin, the country’s leading genetic psychologist, admitted of the Human Genome Project’s quest for genes for psychological traits of all kinds: “I’ve been looking for these genes for 15 years and I don’t have any.”
On the other side of the equation, the evidence for the role of maltreatment in causing emotional distress in general, and emotional abuse and neglect in particular, has become overwhelming. This applies as much to the extreme disturbance of psychosis (mostly schizophrenia and bipolar disorder) as to more common problems such as depression and anxiety.
A definitive analysis of the 41 best studies into the impact of childhood adversity on the risk of psychosis (mostly schizophrenia and bipolar disorder) was published in 2012. It broke down the role of different kinds of maltreatment. Emotional abuse meant exposure to behavior such as harshness and name-calling from parents. Emotional neglect meant lack of love and responsiveness. Overall, in order of impact, emotional abuse increased the risk of psychosis the most (by 3.4 times, physical abuse and emotional neglect did so by 2.9, sexual abuse and bullying by peers by 2.4).
That emotional abuse is more damaging than sexual and physical abuse may seem surprising, although they tend to go together. One study found that the emotionally abused were 12 times more likely to be schizophrenic than the general population (compared with six times for the physically abused and twice as likely for the sexually abused). Another study followed adolescents for 15 years and found that over a third became schizophrenic if both parents were hostile, critical and intrusive, compared with none where only one parent was or neither were. In his definitive book, Models of Madness, John Read, a clinical psychologist at Liverpool University, shows that in the 10 studies testing the matter, the more extreme the childhood adversity, the greater the risk of adult psychosis. The results are similar for the number of adversities. In one large study, those subjected to five or more adversities were 193 times more likely to suffer psychosis than those with none.
Similar findings come from studies of less extreme emotional distress. In the definitive one, which followed 180 children from infancy to the age of 18, 90% of those who suffered early maltreatment qualified for a mental illness. Emotional neglect under the age of two was a critical predictor.
It is in light of this evidence that the government’s plans must be understood: the crucial role of early nurture seems to be accepted in a cross-party consensus.
The null hypothesis of the Human Genome Project will almost certainly have to be accepted: that genes play almost no role in explaining why one sibling is different from another. In the meantime, we need not fear Orwellian intrusion on parents by social workers measuring how much we love our children.
If there were laws against hitting children, as there should be, it would not result in many, or even any, convictions. It will be the same with this law. What is important is for the authorities to signal clearly that, as John Bowlby pointed out 60 years ago, love is as vital as vitamins for a child to flourish.

 

 

 
For more mental health news, Click Here to access the Serious Mental Illness Blog

Emotional Child Abuse Has to Be Banned – The Science Backs Up Our Instincts
By Oliver James, The Guardian

A definitive analysis of the 41 best studies into the impact of childhood adversity on the risk of psychosis (mostly schizophrenia and bipolar disorder) was published in 2012. In order of impact, emotional abuse increased the risk of psychosis the most

We cannot be blamed for feeling nervous when this government talks of criminalising lack of parental love. There are uber-Thatcherites in its ranks who talk up the ‘big society’ but blame the individual. A wheeze for dumping their failure to support parents back on them would be no surprise.

However, in proposing to criminalize emotional abuse and neglect crimes, I am inclined to give them the benefit of the doubt. Many estimable campaigning groups, such as Action for Children, have advocated such legislation.

The case for it comes from the nature as well as nurture side of the child development debate. In an astonishing admission in the Guardian last month, Robert Plomin, the country’s leading genetic psychologist, admitted of the Human Genome Project’s quest for genes for psychological traits of all kinds: “I’ve been looking for these genes for 15 years and I don’t have any.”

On the other side of the equation, the evidence for the role of maltreatment in causing emotional distress in general, and emotional abuse and neglect in particular, has become overwhelming. This applies as much to the extreme disturbance of psychosis (mostly schizophrenia and bipolar disorder) as to more common problems such as depression and anxiety.

definitive analysis of the 41 best studies into the impact of childhood adversity on the risk of psychosis (mostly schizophrenia and bipolar disorder) was published in 2012. It broke down the role of different kinds of maltreatment. Emotional abuse meant exposure to behavior such as harshness and name-calling from parents. Emotional neglect meant lack of love and responsiveness. Overall, in order of impact, emotional abuse increased the risk of psychosis the most (by 3.4 times, physical abuse and emotional neglect did so by 2.9, sexual abuse and bullying by peers by 2.4).

That emotional abuse is more damaging than sexual and physical abuse may seem surprising, although they tend to go together. One study found that the emotionally abused were 12 times more likely to be schizophrenic than the general population (compared with six times for the physically abused and twice as likely for the sexually abused). Another study followed adolescents for 15 years and found that over a third became schizophrenic if both parents were hostile, critical and intrusive, compared with none where only one parent was or neither were. In his definitive book, Models of Madness, John Read, a clinical psychologist at Liverpool University, shows that in the 10 studies testing the matter, the more extreme the childhood adversity, the greater the risk of adult psychosis. The results are similar for the number of adversities. In one large study, those subjected to five or more adversities were 193 times more likely to suffer psychosis than those with none.

Similar findings come from studies of less extreme emotional distress. In the definitive one, which followed 180 children from infancy to the age of 18, 90% of those who suffered early maltreatment qualified for a mental illness. Emotional neglect under the age of two was a critical predictor.

It is in light of this evidence that the government’s plans must be understood: the crucial role of early nurture seems to be accepted in a cross-party consensus.

The null hypothesis of the Human Genome Project will almost certainly have to be accepted: that genes play almost no role in explaining why one sibling is different from another. In the meantime, we need not fear Orwellian intrusion on parents by social workers measuring how much we love our children.

If there were laws against hitting children, as there should be, it would not result in many, or even any, convictions. It will be the same with this law. What is important is for the authorities to signal clearly that, as John Bowlby pointed out 60 years ago, love is as vital as vitamins for a child to flourish.

 

 

 




For more mental health news, 
Click Here to access the Serious Mental Illness Blog

Filed under childhood child children kid kids abuse psychosis psychotic bipolar schizophrenia schizophrenic manic depression disorder diagnosis child abuse news research psychology psychiatry mind brain body wellness health healthy mental health mental illness mental illness

49 notes

Mind Matters: The Mental Health Taboo at Universities
By Jinan Younis, The Guardian
One in five students consider themselves to have a mental illness, so why aren’t we talking about it?
"I was depressed and paranoid", "I was anxious and out of control", "I had severe depression, I couldn’t get out of bed and had difficulty speaking to large groups of people".
These are the experiences of a group of students struggling with theirmental health while at university, and they’re not alone. A National Union of Students (NUS) study conducted in May 2013 shows that one in five students consider themselves to have a mental health problem.
So why aren’t we talking about this more?
"Students face a particular set of challenges that can leave some struggling to cope," says Colum McGuire, NUS welfare vice president. Students are under tremendous pressure to succeed academically, to maintain a healthy social life, and many that don’t fit into the traditional 18 year old just-left-home model also face difficulty juggling their university life with other commitments.
The lack of dialogue leaves many sufferers feeling isolated. Rebecca Latz, a first year student at the University of Huddersfield suffered with anxiety when she first started university. She describes feeling “abnormal” in comparison to her peers: “My friends were all really chilled out. I was the only really obviously anxious one.”
Habiba Khanom, a third-year student at City University London, suffered from an eating disorder, depression and social anxiety. She says: “I felt like I had no one to talk to. I found it hard to make friends because I felt like if I told someone, they wouldn’t want to be friends with me.”
When mental health is discussed, it is often met with a patronizing response, albeit with good intentions.
Students are sometimes told “there’s nothing to panic about”, people often don’t know what to say, and one anonymous student felt as though the people she spoke to were “missing the point entirely”.
This misunderstanding of mental health problems can lead to its sufferers feeling increasingly burdensome and some may retreat into further isolation.
One anonymous student says: “When people begin to feel a burden and shut off it becomes a real problem.”
There needs to be a shift in the way that we view and speak about mental health. The stigma attached to mental health problems is damaging to those that need to voice their experiences. The fear of being misunderstood, of being embarrassed or of being patronised, smothers those that are in search of care or a listening ear.
At universities there are counselling services in place to help those who are struggling with mental health problems, but are they doing enough? One anonymous student says it took him six weeks to get an appointment with his university’s counselling service, and another says the lack of emotional support she received from her university left her feeling “afraid of asking anyone for help entirely”.
Chris Leaman, policy manager at Young Minds, says: “Students feel that universities only care about the results and they’re not investing in their welfare. Some universities have not had a clear policy and route to help students out with mental health”
Alan Percy, a representative of the British Association for Counselling and Psychotherapy and head of the counselling service at the University of Oxford, fears that newer universities may “slash all support services” to offer “bargain price” degrees at lower fees.
Campaigns to change the stigma around mental health are spreading across UK universities. Time for Change aims to encourage people to speak openly about mental health.
Yet students can still fall through the net, and Nightline, a helpline which provides emotional support to students, is only present in 90 UK universities and colleges.
In the NUS study into mental health, only one in ten of students surveyed went to the university authorities for help. We may be moving forward in talking about mental health, but we still have a way to go.
Mental health fluctuations affect us all, some more than others. We need to ensure that the correct systems are in place for everyone. The way to do that is to speak openly about mental health and remove the stigma which silences sufferers of mental health problems.
Students need to be reassured that they will get complete support from the university if they are having trouble with their mental health; and should be aware that these systems of support exist and that they should never be ashamed to use them.
We need to create safe environments where those struggling with mental health can talk about their experiences, both with other students and in counseling spaces. We all have a responsibility to be open and continue this conversation about mental health. Because no one should go through this alone.
If you have been affected by any of the issues mentioned in this piece, contact Samaritans or Nightline.
Have you experienced a mental health issue at university? Share your story anonymously in our GuardianWitness assignment to help us create a true picture of mental health at university.

 

For more mental health news, Click Here to access the Serious Mental Illness Blog 

Mind Matters: The Mental Health Taboo at Universities

By Jinan Younis, The Guardian

One in five students consider themselves to have a mental illness, so why aren’t we talking about it?

"I was depressed and paranoid", "I was anxious and out of control", "I had severe depression, I couldn’t get out of bed and had difficulty speaking to large groups of people".

These are the experiences of a group of students struggling with theirmental health while at university, and they’re not alone. A National Union of Students (NUS) study conducted in May 2013 shows that one in five students consider themselves to have a mental health problem.

So why aren’t we talking about this more?

"Students face a particular set of challenges that can leave some struggling to cope," says Colum McGuire, NUS welfare vice president. Students are under tremendous pressure to succeed academically, to maintain a healthy social life, and many that don’t fit into the traditional 18 year old just-left-home model also face difficulty juggling their university life with other commitments.

The lack of dialogue leaves many sufferers feeling isolated. Rebecca Latz, a first year student at the University of Huddersfield suffered with anxiety when she first started university. She describes feeling “abnormal” in comparison to her peers: “My friends were all really chilled out. I was the only really obviously anxious one.”

Habiba Khanom, a third-year student at City University London, suffered from an eating disorder, depression and social anxiety. She says: “I felt like I had no one to talk to. I found it hard to make friends because I felt like if I told someone, they wouldn’t want to be friends with me.”

When mental health is discussed, it is often met with a patronizing response, albeit with good intentions.

Students are sometimes told “there’s nothing to panic about”, people often don’t know what to say, and one anonymous student felt as though the people she spoke to were “missing the point entirely”.

This misunderstanding of mental health problems can lead to its sufferers feeling increasingly burdensome and some may retreat into further isolation.

One anonymous student says: “When people begin to feel a burden and shut off it becomes a real problem.”

There needs to be a shift in the way that we view and speak about mental health. The stigma attached to mental health problems is damaging to those that need to voice their experiences. The fear of being misunderstood, of being embarrassed or of being patronised, smothers those that are in search of care or a listening ear.

At universities there are counselling services in place to help those who are struggling with mental health problems, but are they doing enough? One anonymous student says it took him six weeks to get an appointment with his university’s counselling service, and another says the lack of emotional support she received from her university left her feeling “afraid of asking anyone for help entirely”.

Chris Leaman, policy manager at Young Minds, says: “Students feel that universities only care about the results and they’re not investing in their welfare. Some universities have not had a clear policy and route to help students out with mental health”

Alan Percy, a representative of the British Association for Counselling and Psychotherapy and head of the counselling service at the University of Oxford, fears that newer universities may “slash all support services” to offer “bargain price” degrees at lower fees.

Campaigns to change the stigma around mental health are spreading across UK universities. Time for Change aims to encourage people to speak openly about mental health.

Yet students can still fall through the net, and Nightline, a helpline which provides emotional support to students, is only present in 90 UK universities and colleges.

In the NUS study into mental health, only one in ten of students surveyed went to the university authorities for help. We may be moving forward in talking about mental health, but we still have a way to go.

Mental health fluctuations affect us all, some more than others. We need to ensure that the correct systems are in place for everyone. The way to do that is to speak openly about mental health and remove the stigma which silences sufferers of mental health problems.

Students need to be reassured that they will get complete support from the university if they are having trouble with their mental health; and should be aware that these systems of support exist and that they should never be ashamed to use them.

We need to create safe environments where those struggling with mental health can talk about their experiences, both with other students and in counseling spaces. We all have a responsibility to be open and continue this conversation about mental health. Because no one should go through this alone.

If you have been affected by any of the issues mentioned in this piece, contact Samaritans or Nightline.

Have you experienced a mental health issue at university? Share your story anonymously in our GuardianWitness assignment to help us create a true picture of mental health at university.

 




For more mental health news, 
Click Here to access the Serious Mental Illness Blog 

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A Disease of Silence? Social Stigma and SchizophreniaBy Henry Lane, Jewish Journal
Schizophrenia is one of the most common health conditions yet it is also one of the most misunderstood, a knowledge gap that leads to a very stereotyped view of the disease. For example, many people believe that people with schizophrenia are violent and dangerous when in fact they are more at risk of attack or of hurting themselves than harming other people. Summing it up in his book, Surviving Schizophrenia, senior psychiatrist Dr E Fuller Torrey calls the condition “the modern-day equivalent of leprosy”.
Many people with schizophrenia recover fully or are able to manage the condition well enough to lead normal lives, especially if help is sought early on. However, in common with other mental health conditions, the disease brings a strong social stigma and discrimination.
In 2008, the National Alliance on Mental Illness (NAMI) conducted a survey to better understand the depths of the stigma surrounding schizophrenia. The survey found that:
85% of respondents understood that schizophrenia is a medical illness
Only 43% said they would tell their friends if they had schizophrenia.
27% admitted that they might be embarrassed if a family member had the illness.
Almost half of those living with schizophrenia said they felt that doctors did not take their physical health complaints seriously.
For many people, the stigma and discrimination they experience – from society in general but also from families, friends and employers – can make their problems far worse. Nearly nine out of ten people with mental health problems say that stigma and discrimination have a negative effect on their lives. Among those with a long-term health condition or disability, people with mental health problems are amongst the least likely to:
find work
be in a steady, long-term relationship
live in decent housing 
be socially included in mainstream society.
The NAMI survey highlighted the social and professional challenges that people with schizophrenia face, which can have huge impacts on their quality of life. The survey showed that:
Nearly one-quarter of respondents would not want to work with someone with schizophrenia, even if he or she was receiving treatment
34% would not want their boss to have schizophrenia
Nearly half would not want to date a person with schizophrenia, even if the person was in treatment. 
The stigma associated with schizophrenia also poses a dilemma for many doctors, says Ken Duckworth, MD, medical director at NAMI and assistant professor at Harvard Medical School. “Doctors are reluctant to make a diagnosis. They don’t want to give you what amounts to a social death sentence.” He called schizophrenia a “low-status illness”, meaning it doesn’t have the same acceptance as diseases such as breast cancer or inherited genetic problems.
Social stigma in Jewish communities?
Jewish communities have a long history with schizophrenia and many of those links are surprising. For example, there is a commonly held belief that those in the Ashkenazi community are at higher risk of developing the disease. This myth is explained by the fact that members of the Ashkenazi community have participated in a series of studies aimed at understanding the biological basis for both schizophrenia and bipolar disorder as part of the Epidemiology/Genetics Research Programme in Psychiatry at Johns Hopkins University.
Blogger and multi-faith chaplain, Diane Weber Bederman, quoted these studies in her blog article Mental Illness and the Jews. “Due to a long history of marriage within the faith, which extends back thousands of years, the Jewish community has emerged from a limited number of ancestors and has a similar genetic makeup. This allows researchers to more easily perform genetic studies and locate disease-causing genes.” She added: “Results of the studies: Scientists estimate the incidence of schizophrenia in the Ashkenazi Jewish population to be no higher than that of the general population (about one percent).”
Mental health problems may not be more common in Jewish populations, but what about social stigma? Betty Jampel, writing in the New Jersey Jewish News, has a clear message: “It is a sad fact of life that… we are still dealing with mental illness as a shameful malady. While there have been public awareness campaigns to stigmatize mental illness and a shift in the scientific community to understand the biochemical nature of psychiatric illnesses, the shame persists. Those with mental illnesses still tend to be viewed as flawed, as somehow not doing enough for themselves to get better.”
The focus should be on tackling social stigma, she added. “As a Jewish community of mental health professionals, clergy, and laypeople, it is incumbent on all of us to change our perceptions of mental illness and to stop perpetuating the myths that come with these disorders. We as a Jewish community need to embrace differences and practice inclusion in all the various settings that bring us together. We need to stop judging others and to lovingly accept that we are all here to fulfill different life goals. We may look different and our life’s goals may be different, but put all together, we are all here to lift each other as a collective community.” 
Artwork by Louis Wain



For more mental health news, Click Here to access the Serious Mental Illness Blog 

A Disease of Silence? Social Stigma and Schizophrenia
By Henry Lane, Jewish Journal

Schizophrenia is one of the most common health conditions yet it is also one of the most misunderstood, a knowledge gap that leads to a very stereotyped view of the disease. For example, many people believe that people with schizophrenia are violent and dangerous when in fact they are more at risk of attack or of hurting themselves than harming other people. Summing it up in his book, Surviving Schizophrenia, senior psychiatrist Dr E Fuller Torrey calls the condition “the modern-day equivalent of leprosy”.

Many people with schizophrenia recover fully or are able to manage the condition well enough to lead normal lives, especially if help is sought early on. However, in common with other mental health conditions, the disease brings a strong social stigma and discrimination.

In 2008, the National Alliance on Mental Illness (NAMI) conducted a survey to better understand the depths of the stigma surrounding schizophrenia. The survey found that:

  • 85% of respondents understood that schizophrenia is a medical illness
  • Only 43% said they would tell their friends if they had schizophrenia.
  • 27% admitted that they might be embarrassed if a family member had the illness.
  • Almost half of those living with schizophrenia said they felt that doctors did not take their physical health complaints seriously.

For many people, the stigma and discrimination they experience – from society in general but also from families, friends and employers – can make their problems far worse. Nearly nine out of ten people with mental health problems say that stigma and discrimination have a negative effect on their lives. Among those with a long-term health condition or disability, people with mental health problems are amongst the least likely to:

  • find work
  • be in a steady, long-term relationship
  • live in decent housing 
  • be socially included in mainstream society.

The NAMI survey highlighted the social and professional challenges that people with schizophrenia face, which can have huge impacts on their quality of life. The survey showed that:

  • Nearly one-quarter of respondents would not want to work with someone with schizophrenia, even if he or she was receiving treatment
  • 34% would not want their boss to have schizophrenia
  • Nearly half would not want to date a person with schizophrenia, even if the person was in treatment. 

The stigma associated with schizophrenia also poses a dilemma for many doctors, says Ken Duckworth, MD, medical director at NAMI and assistant professor at Harvard Medical School. “Doctors are reluctant to make a diagnosis. They don’t want to give you what amounts to a social death sentence.” He called schizophrenia a “low-status illness”, meaning it doesn’t have the same acceptance as diseases such as breast cancer or inherited genetic problems.

Social stigma in Jewish communities?

Jewish communities have a long history with schizophrenia and many of those links are surprising. For example, there is a commonly held belief that those in the Ashkenazi community are at higher risk of developing the disease. This myth is explained by the fact that members of the Ashkenazi community have participated in a series of studies aimed at understanding the biological basis for both schizophrenia and bipolar disorder as part of the Epidemiology/Genetics Research Programme in Psychiatry at Johns Hopkins University.

Blogger and multi-faith chaplain, Diane Weber Bederman, quoted these studies in her blog article Mental Illness and the Jews. “Due to a long history of marriage within the faith, which extends back thousands of years, the Jewish community has emerged from a limited number of ancestors and has a similar genetic makeup. This allows researchers to more easily perform genetic studies and locate disease-causing genes.” She added: “Results of the studies: Scientists estimate the incidence of schizophrenia in the Ashkenazi Jewish population to be no higher than that of the general population (about one percent).”

Mental health problems may not be more common in Jewish populations, but what about social stigma? Betty Jampel, writing in the New Jersey Jewish News, has a clear message: “It is a sad fact of life that… we are still dealing with mental illness as a shameful malady. While there have been public awareness campaigns to stigmatize mental illness and a shift in the scientific community to understand the biochemical nature of psychiatric illnesses, the shame persists. Those with mental illnesses still tend to be viewed as flawed, as somehow not doing enough for themselves to get better.”

The focus should be on tackling social stigma, she added. “As a Jewish community of mental health professionals, clergy, and laypeople, it is incumbent on all of us to change our perceptions of mental illness and to stop perpetuating the myths that come with these disorders. We as a Jewish community need to embrace differences and practice inclusion in all the various settings that bring us together. We need to stop judging others and to lovingly accept that we are all here to fulfill different life goals. We may look different and our life’s goals may be different, but put all together, we are all here to lift each other as a collective community.” 

Artwork by Louis Wain




For more mental health news, 
Click Here to access the Serious Mental Illness Blog 

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Paul Gross on Madness and the Creative ProcessBy Brad Wheeler, The Globe and Mail
Stratford Festival’s second annual Shakespeare Slam includes a one-man cabaret-rock performance by Hawsley Workman, but the main event is a debate inspired by the theme of this year’s festival, Madness: Minds Pushed to the Edge. Participants include academics, professionals and singer-songwriter Steven Page (who has suffered from depression) and actor Paul Gross (famed for his portrayal of a mentally overwrought artistic director in the miniseries Slings and Arrows). We spoke to the latter.
The subject of this year’s debate is whether or not madness is inherent in the artistic process. Who’s on which side?
Steven is arguing that madness is not required as part of the creative process. And I’m arguing that it is. Neither of us are in any position to comment with any certainty, and I don’t feel I’m an authority on mental illness per se. But I can talk about the creative process, which does have altered states involved in it. I’m actually not sure exactly what Steven’s argument is going to be. Just that I’m wrong, I’m sure.
Can you give us an idea of what your argument will be?
First, I would define madness as being slightly different from mental illness. I think madness is more closely aligned with shamanism or berserkers or oracles. I think most artists who are any good at their trade – and even those who aren’t – go into a kind of altered state where your proper self recedes to the background and you can receive creative inspiration. It goes back to as far as we can look, and it’s part of the process. But it’s manageable. Or, at its best, it should be managed so that you can enter the state, return from the state, and your consciousness comes back to the foreground and tries to make sense of what you’ve discovered.
Gord Downie has said that his goal as a songwriter is to get out of his own way. Is that the same as the altered state you’re talking about?
I think so. With the governor, the thing that controls you, you have to somehow put it in a closet for a little while, and then open it up and bring it back. I know that Kurt Vonnegut said the trick to writing, for him, was to get rid of his big brain. And yet, he does have to bring back that big brain to edit what he’s written. It’s being able to go in and out fluidly, and being able to call upon whatever you call the muse.
Getting into actual mental illnesses, what about the appeal of the so-called tortured artist?
Authenticity in an artist is what people respond to. But I think it’s a bit mixed up, and for few centuries there’s a been a romantic notion of the tortured artist. It can be difficult for audiences and artists to be able to separate a mental-health problem from inspiration. I don’t think they are aligned necessarily.
So, you’re not contending that artists with a mental illness have this weird reservoir of special inspiration or anything?
Right, that’s not what at all what I’ll be arguing for. But that an artist finds, and uses as a tool, states that are akin to mental illness.
Shakespeare Slam happens April 23, 8 p.m. $29 to $54. Koerner Hall, 273 Bloor St. W., 416-408-0208, 1-800-567-1600 or tickets.rcmusic.ca.

For more mental health news, Click Here to access the Serious Mental Illness Blog 

Paul Gross on Madness and the Creative Process
By Brad Wheeler, The Globe and Mail

Stratford Festival’s second annual Shakespeare Slam includes a one-man cabaret-rock performance by Hawsley Workman, but the main event is a debate inspired by the theme of this year’s festival, Madness: Minds Pushed to the Edge. Participants include academics, professionals and singer-songwriter Steven Page (who has suffered from depression) and actor Paul Gross (famed for his portrayal of a mentally overwrought artistic director in the miniseries Slings and Arrows). We spoke to the latter.

The subject of this year’s debate is whether or not madness is inherent in the artistic process. Who’s on which side?

Steven is arguing that madness is not required as part of the creative process. And I’m arguing that it is. Neither of us are in any position to comment with any certainty, and I don’t feel I’m an authority on mental illness per se. But I can talk about the creative process, which does have altered states involved in it. I’m actually not sure exactly what Steven’s argument is going to be. Just that I’m wrong, I’m sure.

Can you give us an idea of what your argument will be?

First, I would define madness as being slightly different from mental illness. I think madness is more closely aligned with shamanism or berserkers or oracles. I think most artists who are any good at their trade – and even those who aren’t – go into a kind of altered state where your proper self recedes to the background and you can receive creative inspiration. It goes back to as far as we can look, and it’s part of the process. But it’s manageable. Or, at its best, it should be managed so that you can enter the state, return from the state, and your consciousness comes back to the foreground and tries to make sense of what you’ve discovered.

Gord Downie has said that his goal as a songwriter is to get out of his own way. Is that the same as the altered state you’re talking about?

I think so. With the governor, the thing that controls you, you have to somehow put it in a closet for a little while, and then open it up and bring it back. I know that Kurt Vonnegut said the trick to writing, for him, was to get rid of his big brain. And yet, he does have to bring back that big brain to edit what he’s written. It’s being able to go in and out fluidly, and being able to call upon whatever you call the muse.

Getting into actual mental illnesses, what about the appeal of the so-called tortured artist?

Authenticity in an artist is what people respond to. But I think it’s a bit mixed up, and for few centuries there’s a been a romantic notion of the tortured artist. It can be difficult for audiences and artists to be able to separate a mental-health problem from inspiration. I don’t think they are aligned necessarily.

So, you’re not contending that artists with a mental illness have this weird reservoir of special inspiration or anything?

Right, that’s not what at all what I’ll be arguing for. But that an artist finds, and uses as a tool, states that are akin to mental illness.

Shakespeare Slam happens April 23, 8 p.m. $29 to $54. Koerner Hall, 273 Bloor St. W., 416-408-0208, 1-800-567-1600 or tickets.rcmusic.ca.




For more mental health news, 
Click Here to access the Serious Mental Illness Blog 

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28 notes

Making American Mental Health Care a PriorityHer Bipolar Life with Kat Dawkins, PsychCentral, April 18, 2014
In the wake of several recent violent attacks across America, including three people killed at Jewish faith and community centers, the stabbing of high school students in Pennsylvania, and the shooting of soldiers at Fort Hood, it’s that time again for the media to question and explore gun control, the root of violence, and even adequate mental health care across the country.
Last post, I discussed the unwillingness of government authorities in the state of Florida to take an educated look at the needs of patients and consumers in the mental health system.
This is an unfortunate trend, locally and federally.
While most people with mental health disorders do not engage in violence, and are actually more often the victims of violent acts, it is clear, through the nearly periodic news of deadly shootings and stabbings, family tragedies, and lost lives, that we, as a society, are failing those that are mentally troubled.
As the Washington Post says in their April 16th article about U.S. mental health care, not all of those that commit violent atrocities in America have a mental illness. But some of those people do have mental health issues.
In this country in general, can we honestly say we are doing all we can to prevent troubled people from harming themselves or others? That we are doing all that we can to make sure that those with mental disorders get the care they need?
To me, it only makes sense to fight stigma, not only by clearing up misinformation about people with a mental health condition, but by getting them medical treatment, so stigma does not in turn perpetuate, and so, most importantly, that American citizens are healthy and their quality of life increases.
Positively, the Affordable Care Act has added coverage for many U.S. citizens with mental disorders. This is not enough, though, because resources for mental health care are still, across the country, at a bare minimum.
The Washington Post article discusses some stir in Congress. Rep. Tim Murphy of Pennsylvania, for example, has a bill called  “The Helping Families in Mental Health Crisis Act”, which is considered by supporters be a reasonable way to reform the system.
This bill is hailed as a way to reorganize the way the U.S. government spends their mental health services money, prioritizing initiatives that actually matter.
Proponents say that Medicaid mental health services would be improved that mental health clinics would be better funded.
It is not a unanimously supported bill, however. One repeated criticism is the bill expands the system’s capability to hospitalize or impose treatment on patients. These critics say that money should instead be invested in community care initiatives.
One thing is constantly clear—there is much disagreement about what mental health policies and programs work, and what are a waste of time and even oppressive to patients.
It is frustrating to see much debate, but no action, and even in the wake of years of unfortunate stories and under-served consumers, we are still, as a country, at a loss of what to collectively do next.
The answer is simpler than the steps that it takes to get there.
We want people with mental illness to be a medical priority in this country, and to have better access to care, no matter who they are or what they are going through.
My psychiatrist recently retired. To get an appointment with another doctor in the same office, I have to wait nearly two months.
This kind of real-life example is paramount to understanding just how difficult it is to receive timely and quality care, in all facets of the system.
What about those that are in crisis? That can’t afford to see a doctor or receive medication? How about those that don’t know where to turn, or where to get access to services?
Just like the push of the Affordable Care Act, the U.S. government needs to step up and make mental health care a plain Jane priority.
We need to see visible evidence that we are collectively doing something to change the horrors that could be prevented, easily prevented in the richest country in the world through better mental health care services.



For more mental health news, Click Here to access the Serious Mental Illness Blog

Making American Mental Health Care a Priority
Her Bipolar Life with Kat Dawkins
, PsychCentral, April 18, 2014

In the wake of several recent violent attacks across America, including three people killed at Jewish faith and community centers, the stabbing of high school students in Pennsylvania, and the shooting of soldiers at Fort Hood, it’s that time again for the media to question and explore gun control, the root of violence, and even adequate mental health care across the country.

Last post, I discussed the unwillingness of government authorities in the state of Florida to take an educated look at the needs of patients and consumers in the mental health system.

This is an unfortunate trend, locally and federally.

While most people with mental health disorders do not engage in violence, and are actually more often the victims of violent acts, it is clear, through the nearly periodic news of deadly shootings and stabbings, family tragedies, and lost lives, that we, as a society, are failing those that are mentally troubled.

As the Washington Post says in their April 16th article about U.S. mental health care, not all of those that commit violent atrocities in America have a mental illness. But some of those people do have mental health issues.

In this country in general, can we honestly say we are doing all we can to prevent troubled people from harming themselves or others? That we are doing all that we can to make sure that those with mental disorders get the care they need?

To me, it only makes sense to fight stigma, not only by clearing up misinformation about people with a mental health condition, but by getting them medical treatment, so stigma does not in turn perpetuate, and so, most importantly, that American citizens are healthy and their quality of life increases.

Positively, the Affordable Care Act has added coverage for many U.S. citizens with mental disorders. This is not enough, though, because resources for mental health care are still, across the country, at a bare minimum.

The Washington Post article discusses some stir in Congress. Rep. Tim Murphy of Pennsylvania, for example, has a bill called  “The Helping Families in Mental Health Crisis Act”, which is considered by supporters be a reasonable way to reform the system.

This bill is hailed as a way to reorganize the way the U.S. government spends their mental health services money, prioritizing initiatives that actually matter.

Proponents say that Medicaid mental health services would be improved that mental health clinics would be better funded.

It is not a unanimously supported bill, however. One repeated criticism is the bill expands the system’s capability to hospitalize or impose treatment on patients. These critics say that money should instead be invested in community care initiatives.

One thing is constantly clear—there is much disagreement about what mental health policies and programs work, and what are a waste of time and even oppressive to patients.

It is frustrating to see much debate, but no action, and even in the wake of years of unfortunate stories and under-served consumers, we are still, as a country, at a loss of what to collectively do next.

The answer is simpler than the steps that it takes to get there.

We want people with mental illness to be a medical priority in this country, and to have better access to care, no matter who they are or what they are going through.

My psychiatrist recently retired. To get an appointment with another doctor in the same office, I have to wait nearly two months.

This kind of real-life example is paramount to understanding just how difficult it is to receive timely and quality care, in all facets of the system.

What about those that are in crisis? That can’t afford to see a doctor or receive medication? How about those that don’t know where to turn, or where to get access to services?

Just like the push of the Affordable Care Act, the U.S. government needs to step up and make mental health care a plain Jane priority.

We need to see visible evidence that we are collectively doing something to change the horrors that could be prevented, easily prevented in the richest country in the world through better mental health care services.





For more mental health news, Click Here to access the Serious Mental Illness Blog

Filed under mental health mental illness health illness healthy bipolar diagnosis disorder politics news violence gun stigma america united states usa health care shooting shootings mental mind body brain washington political news story testimonials testimonies federal state

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The Play that Wants to Change the Way we Treat Mental IllnessBy Laura Barnett, The Guardian
The Eradication of Schizophrenia in Western Lapland is based on a new approach called ‘open dialogue’, and replicates the experience of having an auditory hallucination.
Can theatre offer a cure for psychosis? It’s unlikely – and it would be unwise for any theatre-maker even to try. What theatre can do, though, is convey the experience of psychosis: the hallucinations and delusions – often terrifying, sometimes comical – that define reality for those withschizophrenia and related conditions.
This, at least, is the belief shared by David Woods and Jon Haynes, co-founders of the theatre company Ridiculusmus. Their new show, The Eradication of Schizophrenia in Western Lapland, examines the effects of psychosis on several members of a fictional family, using an innovative conceit. The audience is split in two, with each half sitting on either side of a dividing wall. For the first act, each half of the audience watches one scene, while another scene is performed on the other side. Later, the audiences swap places; and in the final section, the wall becomes transparent, so that both halves of the audience are watching the same scene.
The effect, at least at first, is bewildering – and that is the point. “It’s as if you’re having auditory hallucinations,” Woods tells me when we meet during rehearsals at the Basement in Brighton, where the play is beginning a national tour. “Initially it’ll be overwhelming, chaotic. Then the audience will go out of the theatre, change sides. Slowly the voices will settle into place. In a way, it’s the same with schizophrenia. You don’t get cured, but you can recover.”
Woods and Haynes know more about schizophrenia and psychosis than most. Haynes was sectioned in the mid-80s, and spent six months as a patient in London’s Maudsley Hospital; Woods was a carer for several family members with mental health problems. It was this that first drew them towards making a show about mental illness: a series of early improvisations on the subject of family (the company devise all their work through improvisation and extensive research) threw up memories from their own pasts.
They contacted the Tavistock clinic in London, where they took part in a workshop on child carers for adults with mental health issues. It was there that they first learned about "open dialogue": a revolutionary approach to the treatment of psychosis that has, over the past few decades, virtually eradicated the condition in Western Lapland, the area of Finland where it originated.
Intrigued, Woods and Haynes travelled to the Keropudas hospital in Tornio, Finland, where Dr Jaakko Seikkula first evolved the method - and were so struck by what they found that they decided to make open dialogue the key subject of their show. “I thought: ‘Wow, this is wonderful,’” Haynes explains. “I can imagine that if we’d had this kind of approach [in the UK] years ago, things might have been very different for me. When I was ill, I remember feeling very much that I was the problem. With open dialogue, that’s not at all how the patient feels.”
Open dialogue is, as the name suggests, a treatment based on talking rather than medicating, and on intervening as early as possible in a psychotic episode. Families are directly involved in the patient’s therapy, with the aim of identifying the skewed dynamics, or other sources of emotional tension, that may have caused the patient’s crisis. “The idea,” Seikkula tells me over Skype, “is to organise the psychiatric system in a way that makes it possible to meet immediately in a crisis, and work very intensively together with the family.”
The statistics on open dialogue are startling: according to a 2003 study conducted at Keropudas hospital, 82% of patients who were given open-dialogue treatment had no, or mild, psychotic symptoms after five years, compared to 50% in a comparison group. The method has attracted international attention – in 2011, Seikkula helped found the Institute for Dialogic Practice in Massachusetts, to take open dialogue to the US. But it still remains far from the mainstream in many countries, including the UK.
The Eradication of Schizophrenia in Western Lapland has open dialogue as an underlying theme, inherent in the idea of an audience listening to a family’s experience of psychosis, much as a psychiatrist might do during an open-dialogue session. Each scene begins with a group of disembodied voices describing the principles of the method, and the psychiatrist character in the play mentions the fact that a colleague in the NHS has been struck off for using open dialogue in the place of anti-psychotic medication.
Haynes and Woods’ key aims are to raise awareness of open dialogue, and to dispel the wider stigma surrounding schizophrenia. “I would hope,” Woods says, “that people who see the show would start listening: talking to each other rather than just barging their way through life. And that they would realise that there is a lot more to schizophrenia than just the tiny minority who go out and stab somebody with a knife.”
Seikkula, too, believes that a piece of theatre such as this has a powerful role to play in expressing what he, and other practitioners of open dialogue, consider the fundamental definition of psychosis. “Psychosis belongs to life,” he says. “In my mind, we can all have hallucinations. If we are in a stressful enough situation, each of us can react in that way. This play gives people a very concrete experience of how that really is.”
The Eradication of Schizophrenia in Western Lapland is touring the UK. See ridiculusmus.com for full details.

For more information on Open Dialogue, see opendialogueapproach.co.uk

 


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The Play that Wants to Change the Way we Treat Mental Illness
By Laura Barnett, The Guardian

The Eradication of Schizophrenia in Western Lapland is based on a new approach called ‘open dialogue’, and replicates the experience of having an auditory hallucination.

Can theatre offer a cure for psychosis? It’s unlikely – and it would be unwise for any theatre-maker even to try. What theatre can do, though, is convey the experience of psychosis: the hallucinations and delusions – often terrifying, sometimes comical – that define reality for those withschizophrenia and related conditions.

This, at least, is the belief shared by David Woods and Jon Haynes, co-founders of the theatre company Ridiculusmus. Their new show, The Eradication of Schizophrenia in Western Lapland, examines the effects of psychosis on several members of a fictional family, using an innovative conceit. The audience is split in two, with each half sitting on either side of a dividing wall. For the first act, each half of the audience watches one scene, while another scene is performed on the other side. Later, the audiences swap places; and in the final section, the wall becomes transparent, so that both halves of the audience are watching the same scene.

The effect, at least at first, is bewildering – and that is the point. “It’s as if you’re having auditory hallucinations,” Woods tells me when we meet during rehearsals at the Basement in Brighton, where the play is beginning a national tour. “Initially it’ll be overwhelming, chaotic. Then the audience will go out of the theatre, change sides. Slowly the voices will settle into place. In a way, it’s the same with schizophrenia. You don’t get cured, but you can recover.”

Woods and Haynes know more about schizophrenia and psychosis than most. Haynes was sectioned in the mid-80s, and spent six months as a patient in London’s Maudsley Hospital; Woods was a carer for several family members with mental health problems. It was this that first drew them towards making a show about mental illness: a series of early improvisations on the subject of family (the company devise all their work through improvisation and extensive research) threw up memories from their own pasts.

They contacted the Tavistock clinic in London, where they took part in a workshop on child carers for adults with mental health issues. It was there that they first learned about "open dialogue": a revolutionary approach to the treatment of psychosis that has, over the past few decades, virtually eradicated the condition in Western Lapland, the area of Finland where it originated.

Intrigued, Woods and Haynes travelled to the Keropudas hospital in Tornio, Finland, where Dr Jaakko Seikkula first evolved the method - and were so struck by what they found that they decided to make open dialogue the key subject of their show. “I thought: ‘Wow, this is wonderful,’” Haynes explains. “I can imagine that if we’d had this kind of approach [in the UK] years ago, things might have been very different for me. When I was ill, I remember feeling very much that I was the problem. With open dialogue, that’s not at all how the patient feels.”

Open dialogue is, as the name suggests, a treatment based on talking rather than medicating, and on intervening as early as possible in a psychotic episode. Families are directly involved in the patient’s therapy, with the aim of identifying the skewed dynamics, or other sources of emotional tension, that may have caused the patient’s crisis. “The idea,” Seikkula tells me over Skype, “is to organise the psychiatric system in a way that makes it possible to meet immediately in a crisis, and work very intensively together with the family.”

The statistics on open dialogue are startling: according to a 2003 study conducted at Keropudas hospital, 82% of patients who were given open-dialogue treatment had no, or mild, psychotic symptoms after five years, compared to 50% in a comparison group. The method has attracted international attention – in 2011, Seikkula helped found the Institute for Dialogic Practice in Massachusetts, to take open dialogue to the US. But it still remains far from the mainstream in many countries, including the UK.

The Eradication of Schizophrenia in Western Lapland has open dialogue as an underlying theme, inherent in the idea of an audience listening to a family’s experience of psychosis, much as a psychiatrist might do during an open-dialogue session. Each scene begins with a group of disembodied voices describing the principles of the method, and the psychiatrist character in the play mentions the fact that a colleague in the NHS has been struck off for using open dialogue in the place of anti-psychotic medication.

Haynes and Woods’ key aims are to raise awareness of open dialogue, and to dispel the wider stigma surrounding schizophrenia. “I would hope,” Woods says, “that people who see the show would start listening: talking to each other rather than just barging their way through life. And that they would realise that there is a lot more to schizophrenia than just the tiny minority who go out and stab somebody with a knife.”

Seikkula, too, believes that a piece of theatre such as this has a powerful role to play in expressing what he, and other practitioners of open dialogue, consider the fundamental definition of psychosis. “Psychosis belongs to life,” he says. “In my mind, we can all have hallucinations. If we are in a stressful enough situation, each of us can react in that way. This play gives people a very concrete experience of how that really is.”

The Eradication of Schizophrenia in Western Lapland is touring the UK. See ridiculusmus.com for full details.

For more information on Open Dialogue, see opendialogueapproach.co.uk

 





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Mentally Ill Patients Are More Likely to End Up in Jail Rather than a Hospital
By Justin Caba, Medical Daily
Left untreated, an individual with a serious mental illness is likely to suffer further as their symptoms worsen, and their perception of the world around them gets more and more out of touch. 
A recent survey conducted by the Treatment Advocacy Center (TAC) and the National Sheriffs’ Association has found that patients with a severe mental illness are ten times more likely to end up in a state prison rather than a state mental hospital.
“The lack of treatment for seriously ill inmates is inhumane and should not be allowed in a civilized society,” lead researcher and founder of the Treatment Advocacy Center, Dr. E. Fuller Torrey, said in a statement. “This is especially true for individuals who – because of their mental illness – are not aware they are sick and therefore refuse medication.” 
Torrey and his colleagues from both the TAC and the National Sheriff’s Association probed the records of state run prisons and mental hospitals in discovering where the majority of patients with a psychiatric illness end up. Unfortunately, jails and prisons are considered the largest institutions housing individuals with a serious mental illness. Findings revealed that only 35,000 patients with a mental illness are being kept in a hospital setting compared to 356,000 who currently reside in a prison or jail cell.
Researchers called the outcome of mistreatment experienced by some mentally ill inmates “usually harmful and sometimes tragic.” Due to their erratic or disruptive behavior, many inmates with a psychiatric disorder are at danger to being beaten, raped, self-mutilated, or suicidal. Mentally ill inmates also run the risk of being thrown into solitary confinement or having physical restraints placed on them for most of their day. Although moving inmates with a serious mental illness to a more suitable institution would be in their best interest, the research team said states and counties would also benefit from the funds that would be saved on corrections.
According to the National Alliance on Mental Illness, upward of 13.6 million adults in the United States are currently living with a serious mental illness. Many Americans may be surprised to find out what exactly is included as a serious mental illness. Major depression, schizophrenia, bipolar disorder, obsessive compulsive disorder (OCD), panic disorder, posttraumatic stress disorder (PTSD), and borderline personality disorder all fall under the category of serious mental illness. One in four Americans experiences a mental illness in a given year. 

 

 


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Mentally Ill Patients Are More Likely to End Up in Jail Rather than a Hospital

By Justin Caba, Medical Daily

Left untreated, an individual with a serious mental illness is likely to suffer further as their symptoms worsen, and their perception of the world around them gets more and more out of touch.

A recent survey conducted by the Treatment Advocacy Center (TAC) and the National Sheriffs’ Association has found that patients with a severe mental illness are ten times more likely to end up in a state prison rather than a state mental hospital.

“The lack of treatment for seriously ill inmates is inhumane and should not be allowed in a civilized society,” lead researcher and founder of the Treatment Advocacy Center, Dr. E. Fuller Torrey, said in a statement. “This is especially true for individuals who – because of their mental illness – are not aware they are sick and therefore refuse medication.” 

Torrey and his colleagues from both the TAC and the National Sheriff’s Association probed the records of state run prisons and mental hospitals in discovering where the majority of patients with a psychiatric illness end up. Unfortunately, jails and prisons are considered the largest institutions housing individuals with a serious mental illness. Findings revealed that only 35,000 patients with a mental illness are being kept in a hospital setting compared to 356,000 who currently reside in a prison or jail cell.

Researchers called the outcome of mistreatment experienced by some mentally ill inmates “usually harmful and sometimes tragic.” Due to their erratic or disruptive behavior, many inmates with a psychiatric disorder are at danger to being beaten, raped, self-mutilated, or suicidal. Mentally ill inmates also run the risk of being thrown into solitary confinement or having physical restraints placed on them for most of their day. Although moving inmates with a serious mental illness to a more suitable institution would be in their best interest, the research team said states and counties would also benefit from the funds that would be saved on corrections.

According to the National Alliance on Mental Illness, upward of 13.6 million adults in the United States are currently living with a serious mental illness. Many Americans may be surprised to find out what exactly is included as a serious mental illness. Major depression, schizophrenia, bipolar disorder, obsessive compulsive disorder (OCD), panic disorder, posttraumatic stress disorder (PTSD), and borderline personality disorder all fall under the category of serious mental illness. One in four Americans experiences a mental illness in a given year. 

 

 





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Panel discusses mental health care race gap
Karina Shedrofsky, The Diamondback
Even as mental health awareness and services increase, university officials said, mental health experiences vary for people of different races, a disparity they highlighted in a panel discussion last night. 
As part of Stress Less Week, an awareness campaign aimed at reducing stress and the stigma associated with mental illness, the university’s chapter of Active Minds, the Counseling Center and the Division of Student Affairs’ Diversity Advisory Council hosted a panel to address mental health resources and mental health in communities of color. A small crowd attended the event in the Benjamin Banneker room in Stamp Student Union.
Charmaine Wilson-Jones, the Diversity Advisory Council’s chairwoman, said the council wanted to host a mental health event focusing on unaddressed or underserved communities. 
“We feel like there’s a huge push for mental health right now, on campus and off,” said Wilson-Jones, a junior government and politics major. “But a lot of minority students — and people of color in general — are being left out of that discussion, and we wanted to find a way to sort of bring those two sides together.” 
Wilson-Jones connected with members of Active Minds and brought together Howard Lloyd, a doctoral intern at the Counseling Center; Na-Yeun Choi, a fifth-year psychology doctoral student; and James Houle, a Counseling Center staff psychologist. 
Wilson-Jones began the discussion by asking the speakers about their personal experiences with diversity and mental health. Each panelist identified as a different race and had different experiences but agreed that students of color face specific sources of stress and anxiety that must be combated.
“For students of color, there’s a real feeling or idea that, ‘If I go to talk to someone, they aren’t going to look like me or understand where I’m coming from. And how can someone who doesn’t look like me understand where I’m coming from?’” Lloyd said. 
Choi, a first-generation immigrant from Korea, discussed the stereotypes that can impact an individual’s mental health, such as the model minority myth surrounding Asian-American and Pacific Islander communities that creates pressure to live up to an ideal of perfectionism.
She said students of color can face numerous barriers when seeking help.   
“Maybe loss of faith and kind of bringing some shame to the families in their own community, especially in more communal and non-individual communities — they tend to look more into this concept of you really are supporting your whole community and family,” Choi said. 
Each speaker mentioned the extra emotional toll racism takes on students of color, and more specifically the idea of microaggressions — subtle and small acts of discrimination or prejudice that students who identify as white might not notice. 
“Somebody once described a million little paper cuts as a form of microaggression,” Houle said. “Over time one paper cut might not hurt, but a thousand or a million paper cuts will hurt.” 
Lloyd, who identifies as African-American, recognized that students might fear seeking help from people they don’t think they can relate to or who won’t understand their stresses and problems because of difference in race or ethnicity. 
To combat the stigma surrounding mental health issues in multiracial communities, the panelists said, talking about the issues and making students more aware of the realities of counseling — such as what psychologists and psychiatrists look like and how sessions are typically run — can go a long way.
Houle said the Counseling Center reaches out to explain the services they offer and meet people to show what psychologists look like outside of pop culture depictions, he said. The center offers Students of Color Walk-In Hour sessions during which students can see a counselor without making an appointment.
Mudit Verma, a senior psychology major and Active Minds’ fundraising director, appreciated the panelists’ advice on how to productively react when a friend or family member says something offensive that might discourage someone from seeking professional help. 
“Their responses really intrigued me,” he said. “Using objective information is really a powerful tool to sort of convince an audience.”
Josh Ratner, the Student Government Association’s student affairs vice president, said that identifying the different ways communities perceive mental health is important when trying to improve services.
“It’s really interesting to see how different communities value, stigmatize, prioritize mental health,” the junior government and politics major said. “And it’s great to see that the university has programs to try and reach out to different communities that might have more stigma associated with mental health.” 

 

 


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Panel discusses mental health care race gap

Karina Shedrofsky, The Diamondback

Even as mental health awareness and services increase, university officials said, mental health experiences vary for people of different races, a disparity they highlighted in a panel discussion last night. 

As part of Stress Less Week, an awareness campaign aimed at reducing stress and the stigma associated with mental illness, the university’s chapter of Active Minds, the Counseling Center and the Division of Student Affairs’ Diversity Advisory Council hosted a panel to address mental health resources and mental health in communities of color. A small crowd attended the event in the Benjamin Banneker room in Stamp Student Union.

Charmaine Wilson-Jones, the Diversity Advisory Council’s chairwoman, said the council wanted to host a mental health event focusing on unaddressed or underserved communities. 

“We feel like there’s a huge push for mental health right now, on campus and off,” said Wilson-Jones, a junior government and politics major. “But a lot of minority students — and people of color in general — are being left out of that discussion, and we wanted to find a way to sort of bring those two sides together.” 

Wilson-Jones connected with members of Active Minds and brought together Howard Lloyd, a doctoral intern at the Counseling Center; Na-Yeun Choi, a fifth-year psychology doctoral student; and James Houle, a Counseling Center staff psychologist. 

Wilson-Jones began the discussion by asking the speakers about their personal experiences with diversity and mental health. Each panelist identified as a different race and had different experiences but agreed that students of color face specific sources of stress and anxiety that must be combated.

“For students of color, there’s a real feeling or idea that, ‘If I go to talk to someone, they aren’t going to look like me or understand where I’m coming from. And how can someone who doesn’t look like me understand where I’m coming from?’” Lloyd said. 

Choi, a first-generation immigrant from Korea, discussed the stereotypes that can impact an individual’s mental health, such as the model minority myth surrounding Asian-American and Pacific Islander communities that creates pressure to live up to an ideal of perfectionism.

She said students of color can face numerous barriers when seeking help.   

“Maybe loss of faith and kind of bringing some shame to the families in their own community, especially in more communal and non-individual communities — they tend to look more into this concept of you really are supporting your whole community and family,” Choi said. 

Each speaker mentioned the extra emotional toll racism takes on students of color, and more specifically the idea of microaggressions — subtle and small acts of discrimination or prejudice that students who identify as white might not notice. 

“Somebody once described a million little paper cuts as a form of microaggression,” Houle said. “Over time one paper cut might not hurt, but a thousand or a million paper cuts will hurt.” 

Lloyd, who identifies as African-American, recognized that students might fear seeking help from people they don’t think they can relate to or who won’t understand their stresses and problems because of difference in race or ethnicity. 

To combat the stigma surrounding mental health issues in multiracial communities, the panelists said, talking about the issues and making students more aware of the realities of counseling — such as what psychologists and psychiatrists look like and how sessions are typically run — can go a long way.

Houle said the Counseling Center reaches out to explain the services they offer and meet people to show what psychologists look like outside of pop culture depictions, he said. The center offers Students of Color Walk-In Hour sessions during which students can see a counselor without making an appointment.

Mudit Verma, a senior psychology major and Active Minds’ fundraising director, appreciated the panelists’ advice on how to productively react when a friend or family member says something offensive that might discourage someone from seeking professional help. 

“Their responses really intrigued me,” he said. “Using objective information is really a powerful tool to sort of convince an audience.”

Josh Ratner, the Student Government Association’s student affairs vice president, said that identifying the different ways communities perceive mental health is important when trying to improve services.

“It’s really interesting to see how different communities value, stigmatize, prioritize mental health,” the junior government and politics major said. “And it’s great to see that the university has programs to try and reach out to different communities that might have more stigma associated with mental health.” 

 

 





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Mom sues psychiatric prison, alleges son isolated for 6,300 hours, shackled to bedBy ABC News
"They have criminalized his illness. That’s what they are doing," she said. "And it’s unconscionable and he’s not in a therapeutic environment. I know he is ill. I can live with that. But no one should be treated like an animal, locked in an isolation cage."
When Joanne Minich recently visited son Peter, 31, at Bridgewater State Hospital in Massachusetts, prison guards brought her to a locked cell that inmates call the “bird cage,” where he was shackled at the hands, waist and bare feet, she says.
For the past 14 months, Peter Minich has been legally committed to a legendary facility once called the state hospital “for the criminally insane” but, according to his Brookline, Mass., mother, he has never been convicted of a crime – only diagnosed with a mental illness.
Minich says her son has suffered from paranoid schizophrenia since his late teens and a court sent him to Bridgewater in January 2013, after staff members at another psychiatric hospital filed assault misdemeanor criminal charges against him. Her son had no previous criminal record or history of violent behavior, she says.
"People say it’s a hospital, but it’s not a hospital. It’s a prison," Minich, 66, said of the facility, which is administered by the state Department of Correction. "I don’t think they are helping him at all. It’s torture. It looks like a cage you put an animal in."
Minich has now filed a lawsuit in Norfolk County Superior Court against the state Department of Correction, the superintendent of Bridgewater State Hospital, the state of Massachusetts and MHM Services Inc., a national health care provider, for alleged abuses against her son.
The March 31 lawsuit, which was obtained by ABCNews.com, alleges that staff have isolated her son in a locked seclusion room at the intensive-treatment unit for at least 6,300 hours from January 14, 2013 to March 12, 2014, and restrained him to objects like his bed for 815 hours from January 14, 2013 to January 22, 2014.
She says her son’s caregivers have violated American Psychiatric Association guidelines, as well as the state’s Seclusion and Restraint law, which allows such techniques “in cases of emergency, such as the occurrence of, or serious threat of, extreme violence, personal injury or attempted suicide.”
Seclusion and restraints were ordered for incidents such as hearing voices, licking another inmate’s feet, having a seizure and being assaulted by another inmate, according to 5,000 pages of prison records cited in the lawsuit.
The lawsuit alleges that her son was offered no exercise program or outdoor activity, and his food was delivered through a “slot in the door.” His only contact with other human beings was when placed in restraints, medicated or given electro-shock treatment, according to the lawsuit.
Peter Minich’s parents have only been allowed to visit their son once a week, with a 10-minute phone call every two days. They say his condition has worsened, with more hallucinations and anxiety, and he has become more aggressive as a result of incarceration. They say their son has also lost 40 pounds.
"It’s horrible," Minich, who works in a special care nursery with premature babies, told ABCNews.com. "He’s living with this mental illness and you can’t let the system destroy him. It’s not humanitarian what they are doing to him. He is a difficult case. I am not denying that, but it doesn’t mean he should be in a prison."
Minich is demanding that her son be moved from Bridgewater. “All I want is him out of there and in a therapeutic environment,” she said. “I am afraid one day I will get the phone call saying he is dead. It’s a horrible way to live.”
The lawsuit is not seeking damages, but compliance with the seclusion and restraint statute; a treatment plan that includes individual and group therapy, and socialization and “activities of daily living” training; and a transfer to a place that is not a prison.
This is not the first time Bridgewater has come under fire for alleged abuse. In 2009, inmate Joshua K. Messier, 23, died while guards were placing him in restraints. A Boston Globe expose resulted in the discipline of six correction officials, and the state has agreed to pay the family $3 million as part of a settlement.
In 1967, Bridgewater State Hospital was the subject of a documentary, “Titicut Follies,” which showed graphic examples of physical abuse by staff and doctors. A Superior Court judge banned its public showing and ordered all copies of the film seized because of “crudities, nudities, and obscenities … eighty minutes of brutal sordidness and human degradation.”
"This is worse than anything I saw in ‘Titicut Follies,’" Minich’s lawyer, Roderick MacLeish Jr., told ABCNews.com. "At least they let them out in the yard and they had Christmas parties."
The lawsuit states that for 60 days at the end of 2013, Minich was held in seclusion for 24 hours a day, all but for eight and a half hours, including Thanksgiving and Christmas. In October of that year, he was allegedly held in mechanical restraint for more than 50 consecutive hours.
MacLeish alleges that Peter Minich, an intelligent man, has been given no reading materials when asked, nor stimulating activities while in solitary confinement, and, as a result, has deteriorated mentally.
"This is a slow death for Peter," he said. "It has evolved as part of our punitive culture." MacLeish said that Bridgewater was "cleaned up" in the 1980s. "But now we find out they are back to their old practices. … It’s a disgrace, particularly since our governor [Deval Patrick] used to be head of the Civil Rights Division at the Justice Department and has widely said that isolation should not be used."
Patrick has been outspoken on the issue, saying these measures should be used as a “last resort.”
The governor’s press secretary, Heather Nichols, responded to a request by ABCNews.com for comment by referring by citing part of a speech Patrick made last month:
"The evidence tells us that methods traditionally used to handle difficult prisoners may actually exacerbate the difficulties of those with mental illness. Solitary confinement can cause extreme disorientation that only worsens asocial behavior within a correctional institute — let alone after release. If it remains a feature of our correctional system, it should be reserved for the most exceptional situations, and only as a last resort.
"Fully restraining a mentally ill inmate carries similar risks. Unless it can be said with certainty that the inmate poses a serious and immediate physical danger to himself or his fellow inmates, he should not be tied down, limb-by-limb, in a 21st Century correctional institution. Most of our inmates — even the most difficult ones — will return to the streets of our Commonwealth. Our treatment of them must always keep that fact in mind, and preserve to the extent possible their own grip on their humanity."
Click here to read the rest of the article\

 


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Mom sues psychiatric prison, alleges son isolated for 6,300 hours, shackled to bed
By ABC News

"They have criminalized his illness. That’s what they are doing," she said. "And it’s unconscionable and he’s not in a therapeutic environment. I know he is ill. I can live with that. But no one should be treated like an animal, locked in an isolation cage."

When Joanne Minich recently visited son Peter, 31, at Bridgewater State Hospital in Massachusetts, prison guards brought her to a locked cell that inmates call the “bird cage,” where he was shackled at the hands, waist and bare feet, she says.

For the past 14 months, Peter Minich has been legally committed to a legendary facility once called the state hospital “for the criminally insane” but, according to his Brookline, Mass., mother, he has never been convicted of a crime – only diagnosed with a mental illness.

Minich says her son has suffered from paranoid schizophrenia since his late teens and a court sent him to Bridgewater in January 2013, after staff members at another psychiatric hospital filed assault misdemeanor criminal charges against him. Her son had no previous criminal record or history of violent behavior, she says.

"People say it’s a hospital, but it’s not a hospital. It’s a prison," Minich, 66, said of the facility, which is administered by the state Department of Correction. "I don’t think they are helping him at all. It’s torture. It looks like a cage you put an animal in."

Minich has now filed a lawsuit in Norfolk County Superior Court against the state Department of Correction, the superintendent of Bridgewater State Hospital, the state of Massachusetts and MHM Services Inc., a national health care provider, for alleged abuses against her son.

The March 31 lawsuit, which was obtained by ABCNews.com, alleges that staff have isolated her son in a locked seclusion room at the intensive-treatment unit for at least 6,300 hours from January 14, 2013 to March 12, 2014, and restrained him to objects like his bed for 815 hours from January 14, 2013 to January 22, 2014.

She says her son’s caregivers have violated American Psychiatric Association guidelines, as well as the state’s Seclusion and Restraint law, which allows such techniques “in cases of emergency, such as the occurrence of, or serious threat of, extreme violence, personal injury or attempted suicide.”

Seclusion and restraints were ordered for incidents such as hearing voices, licking another inmate’s feet, having a seizure and being assaulted by another inmate, according to 5,000 pages of prison records cited in the lawsuit.

The lawsuit alleges that her son was offered no exercise program or outdoor activity, and his food was delivered through a “slot in the door.” His only contact with other human beings was when placed in restraints, medicated or given electro-shock treatment, according to the lawsuit.

Peter Minich’s parents have only been allowed to visit their son once a week, with a 10-minute phone call every two days. They say his condition has worsened, with more hallucinations and anxiety, and he has become more aggressive as a result of incarceration. They say their son has also lost 40 pounds.

"It’s horrible," Minich, who works in a special care nursery with premature babies, told ABCNews.com. "He’s living with this mental illness and you can’t let the system destroy him. It’s not humanitarian what they are doing to him. He is a difficult case. I am not denying that, but it doesn’t mean he should be in a prison."

Minich is demanding that her son be moved from Bridgewater. “All I want is him out of there and in a therapeutic environment,” she said. “I am afraid one day I will get the phone call saying he is dead. It’s a horrible way to live.”

The lawsuit is not seeking damages, but compliance with the seclusion and restraint statute; a treatment plan that includes individual and group therapy, and socialization and “activities of daily living” training; and a transfer to a place that is not a prison.

This is not the first time Bridgewater has come under fire for alleged abuse. In 2009, inmate Joshua K. Messier, 23, died while guards were placing him in restraints. A Boston Globe expose resulted in the discipline of six correction officials, and the state has agreed to pay the family $3 million as part of a settlement.

In 1967, Bridgewater State Hospital was the subject of a documentary, “Titicut Follies,” which showed graphic examples of physical abuse by staff and doctors. A Superior Court judge banned its public showing and ordered all copies of the film seized because of “crudities, nudities, and obscenities … eighty minutes of brutal sordidness and human degradation.”

"This is worse than anything I saw in ‘Titicut Follies,’" Minich’s lawyer, Roderick MacLeish Jr., told ABCNews.com. "At least they let them out in the yard and they had Christmas parties."

The lawsuit states that for 60 days at the end of 2013, Minich was held in seclusion for 24 hours a day, all but for eight and a half hours, including Thanksgiving and Christmas. In October of that year, he was allegedly held in mechanical restraint for more than 50 consecutive hours.

MacLeish alleges that Peter Minich, an intelligent man, has been given no reading materials when asked, nor stimulating activities while in solitary confinement, and, as a result, has deteriorated mentally.

"This is a slow death for Peter," he said. "It has evolved as part of our punitive culture." MacLeish said that Bridgewater was "cleaned up" in the 1980s. "But now we find out they are back to their old practices. … It’s a disgrace, particularly since our governor [Deval Patrick] used to be head of the Civil Rights Division at the Justice Department and has widely said that isolation should not be used."

Patrick has been outspoken on the issue, saying these measures should be used as a “last resort.”

The governor’s press secretary, Heather Nichols, responded to a request by ABCNews.com for comment by referring by citing part of a speech Patrick made last month:

"The evidence tells us that methods traditionally used to handle difficult prisoners may actually exacerbate the difficulties of those with mental illness. Solitary confinement can cause extreme disorientation that only worsens asocial behavior within a correctional institute — let alone after release. If it remains a feature of our correctional system, it should be reserved for the most exceptional situations, and only as a last resort.

"Fully restraining a mentally ill inmate carries similar risks. Unless it can be said with certainty that the inmate poses a serious and immediate physical danger to himself or his fellow inmates, he should not be tied down, limb-by-limb, in a 21st Century correctional institution. Most of our inmates — even the most difficult ones — will return to the streets of our Commonwealth. Our treatment of them must always keep that fact in mind, and preserve to the extent possible their own grip on their humanity."

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