Serious Mental Illness Blog

An LIU Post Specialty Concentration

46 notes

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 

Filed under schizophrenia psychosis psychotic Hallucinations hallucination delusion delusions delusional mad madness mental health mental illness health illness mental healthy wellness mind body brain treatment stigma jewish jew crazy hope recovery recover news meds

7 notes

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 

Filed under paul gross theater theatre shakespeare creative creativity art artist writer write mad madness creative process steven page depression depressed major depression mental illness mental health mental illness health healthy mind psychology psychiatry body brain artists canada

20 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

63 notes

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

 


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

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

 





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

Filed under mental illness mental health mental illness health healthy wellness schizophrenia psychosis psychotic mind body brain theater play art artist creative news diagnosis disorder hallucination hallucinations recovery mad madness playwright playwriting psychology psychiatry

153 notes

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. 

 

 


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

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. 

 

 





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

Filed under prison jail prisoner inmate psychology psychiatry mental health mental illness mind brain mental health illness healthy wellness body mad madness rethinking madness news diagnosis disorder mental breakdown mental disability mental disease mental disorder research symptoms feelings thoughts

29 notes

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.” 

 

 


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

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.” 

 

 





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

Filed under race mixed race racial racism racist health mental health mental illness mental illness healthy wellness psychology psychiatry awareness news color stigma recovery treatment treat mad madness rethinking madness culture cultural society population america usa

73 notes

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\

 


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

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."

Click here to read the rest of the article\

 





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

Filed under mental health mental illness mental health illness healthy wellness psychiatry psychiatric psychology psych therapy recovery treatment news crime prison jail inmate criminal top news story mental breakdown isolation med meds medication doctor correctional correctional officer correctional facility

33 notes

Doctors’ notes on mental health shared with patients: Policy shift at Beth Israel DeaconessBy Liz Kowalczyk, The Boston Globe
At the end of every workday, psychiatrists, social workers, and other mental health providers write notes describing their patients’ visits. It is where they chronicle paranoid behavior, excessive drinking, or relationship problems. These candid comments often are available to other doctors, but they are rarely shared with patients themselves.
Now, as part of an ongoing effort to make care more transparent, clinicians at Beth Israel Deaconess Medical Center have begun posting the mental health notes in patients’ electronic medical records, allowing the patients immediate access to the summaries at home.
On March 1, about 40 providers started sharing their notes with more than 650 patients. Some are eagerly reading every word, clinicians said, while others have no interest.
“We all had some reservations,’’ said Dr. Michael Kahn, a psychiatrist who has worked at Beth Israel Deaconess for 20 years. “What about if a patient misinterpreted a note? Would they be upset about it? Would it confuse them?’’
But ultimately, he and his colleagues decided that sharing the notes could improve care by encouraging patients to more actively participate in their treatment, while inspiring providers to describe patients nonjudgmentally.
Patients can correct mistakes, such as a wrong medication dose. And rather than write a word such as “paranoid,’’ which to many people “means crazy or bad,’’ Kahn said he now uses less-loaded terms such as “persecutory anxiety.’’
Primary care providers at the Boston hospital, along with those at a handful of medical centers and physicians groups nationally, have been posting notes from medical visits in patients’ secure online medical records for several years — with mostly positive results.
But except for the Veterans Health Administration, which gives veterans online access to mental health notes, providers have hesitated to share psychiatric notes out of a belief that this approach is a minefield for patients. They worry patients will be rattled upon learning that their firm convictions are seen as delusions, or angered by diagnoses that feel harsh and stigmatizing.
Patients have a right under federal law to request their medical records, including doctors’ notes. But most patients do not ask for them, in part because the process is cumbersome and can take days or even weeks. But as electronic medical records become more widespread, it is far easier to share sensitive health information.
Stephen O’Neill, social work manager for psychiatry and primary care at Beth Israel Deaconess, said he has offered to share notes with patients informally for years. Most, including Lori, a 53-year-0ld woman who suffers from depression, have not taken him up on it. But now that he has made the summaries available online, she said she plans to read them.
On Wednesday, he showed her how the system works in his office and she read the notes from their appointment that day. “It’s not what I thought it would be,’’ she said.
Lori, who did not want her last name used because she feels mental health problems still carry a stigma, said she was surprised at the detail in O’Neill’s notes about issues she did not see as important. For example, she had discussed turning down a friend’s request for a significant favor.
After reading the entry, she understood how it related to her overall therapy. “We again reinforced. . . that she should share how she feels with her friend so that she does not internalize this,’’ O’Neill wrote.
Reading the notes is “a good way to see if you are on the same level,’’ Lori said. “Sometimes when I am in session with [him], I wonder does he understand what I am trying to get across. I get to see if he does.’’
In an opinion piece published in the Journal of the American Medical Association, Kahn and three colleagues argued that sharing notes could be particularly beneficial for patients who abuse drugs or alcohol, who are “often so used to being lectured that they tune out real-time discussions of harmful consequences.’’ Allowing them to read a doctor’s assessment in private “may diminish the need for defensive maneuvers,’’ the authors said.
Still, not all mental health providers are ready for this level of openness with patients.
Nina Douglass, who works in obstetrics and gynecology at Beth Israel Deaconess, is one of five social workers who declined to participate — for now. Some of her patients are addicted to drugs, while others are in abusive relationships. Douglass tells them at the outset that she is required to report abuse or neglect of a child to state officials. If she writes about a specific concern in a note, and the patient reads it, Douglass is worried the patient might flee rather than risk losing custody of the child.
“I absolutely share the hospital ethic of transparency,’’ she said. “But I want more time to see how this works.’’
At Geisinger Health System in Pennsylvania, where more than 1,300 providers share medical visit notes with 200,000 patients, mental health providers and pain specialists do not participate yet. The organization is planning to share psychiatric notes in the next six months, but Dr. Jonathan Darer, chief innovation officer, said doctors can exclude patients whom they feel will be harmed by easy access to visit notes, such as those with anxiety disorders who see even minor symptoms as catastrophic.
At Beth Israel Deaconess, mental health providers have identified at least 10 percent of their patients to participate in the project initially, and most are starting with those who are functioning at a high level.
“We thought, how can we find a safe place to start?’’ said Pamela Peck, clinical director for the psychiatry department. “Are there patients who would feel” upset by reading “about aspects of their psychiatric illness? That is a question that is still up for discussion.’’
Beth Israel Deaconess began encouraging providers to share medical notes nearly five years ago. Now, almost 2,300 doctors and nurse practitioners post notes for almost 225,000 patients. According to surveys done by the hospital, the vast majority want access to continue, though patients and caregivers have suggested changes.
Some patients want to approve what doctors write or to write responses. Some doctors want the option to hide notes, or portions of them, from patients or families, and want ways to communicate with colleagues privately, according to an opinion piece published in the New England Journal of Medicine earlier this year.
Partners HealthCare, the largest health care system in Massachusetts, is moving toward putting medical notes online, but is still debating whether to post mental health notes in patients’ records. One unanswered question is whether a psychiatrist’s notes are still useful and precise for other doctors, including those in the emergency room, if they are written with the knowledge that the patient can read them, said Dr. Gregg Meyer, chief clinical officer.
“One of the key points that physicians need to think about is whether the way we document care is going to fundamentally change,’’ he said. “First and foremost we have to make sure patient care is not compromised. We are watching their experience closely.’’
At Beth Israel Deaconess, doctors still have the option of putting certain notes in a locked area of the record, which patients cannot see and other doctors can access only if they provide written justification.
The hospital said it is too early to know how many patients are reading the mental health notes. Kahn spoke to one patient, a highly educated, successful woman whom he thought would jump at the chance. Kahn was surprised by her response.
“She said, ‘No, no no, I don’t want to read anything. I prefer not to look.’”

Liz Kowalczyk can be reached at kowalczyk@globe.com.

 


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

Doctors’ notes on mental health shared with patients: Policy shift at Beth Israel Deaconess
By Liz Kowalczyk, The Boston Globe

At the end of every workday, psychiatrists, social workers, and other mental health providers write notes describing their patients’ visits. It is where they chronicle paranoid behavior, excessive drinking, or relationship problems. These candid comments often are available to other doctors, but they are rarely shared with patients themselves.

Now, as part of an ongoing effort to make care more transparent, clinicians at Beth Israel Deaconess Medical Center have begun posting the mental health notes in patients’ electronic medical records, allowing the patients immediate access to the summaries at home.

On March 1, about 40 providers started sharing their notes with more than 650 patients. Some are eagerly reading every word, clinicians said, while others have no interest.

“We all had some reservations,’’ said Dr. Michael Kahn, a psychiatrist who has worked at Beth Israel Deaconess for 20 years. “What about if a patient misinterpreted a note? Would they be upset about it? Would it confuse them?’’

But ultimately, he and his colleagues decided that sharing the notes could improve care by encouraging patients to more actively participate in their treatment, while inspiring providers to describe patients nonjudgmentally.

Patients can correct mistakes, such as a wrong medication dose. And rather than write a word such as “paranoid,’’ which to many people “means crazy or bad,’’ Kahn said he now uses less-loaded terms such as “persecutory anxiety.’’

Primary care providers at the Boston hospital, along with those at a handful of medical centers and physicians groups nationally, have been posting notes from medical visits in patients’ secure online medical records for several years — with mostly positive results.

But except for the Veterans Health Administration, which gives veterans online access to mental health notes, providers have hesitated to share psychiatric notes out of a belief that this approach is a minefield for patients. They worry patients will be rattled upon learning that their firm convictions are seen as delusions, or angered by diagnoses that feel harsh and stigmatizing.

Patients have a right under federal law to request their medical records, including doctors’ notes. But most patients do not ask for them, in part because the process is cumbersome and can take days or even weeks. But as electronic medical records become more widespread, it is far easier to share sensitive health information.

Stephen O’Neill, social work manager for psychiatry and primary care at Beth Israel Deaconess, said he has offered to share notes with patients informally for years. Most, including Lori, a 53-year-0ld woman who suffers from depression, have not taken him up on it. But now that he has made the summaries available online, she said she plans to read them.

On Wednesday, he showed her how the system works in his office and she read the notes from their appointment that day. “It’s not what I thought it would be,’’ she said.

Lori, who did not want her last name used because she feels mental health problems still carry a stigma, said she was surprised at the detail in O’Neill’s notes about issues she did not see as important. For example, she had discussed turning down a friend’s request for a significant favor.

After reading the entry, she understood how it related to her overall therapy. “We again reinforced. . . that she should share how she feels with her friend so that she does not internalize this,’’ O’Neill wrote.

Reading the notes is “a good way to see if you are on the same level,’’ Lori said. “Sometimes when I am in session with [him], I wonder does he understand what I am trying to get across. I get to see if he does.’’

In an opinion piece published in the Journal of the American Medical Association, Kahn and three colleagues argued that sharing notes could be particularly beneficial for patients who abuse drugs or alcohol, who are “often so used to being lectured that they tune out real-time discussions of harmful consequences.’’ Allowing them to read a doctor’s assessment in private “may diminish the need for defensive maneuvers,’’ the authors said.

Still, not all mental health providers are ready for this level of openness with patients.

Nina Douglass, who works in obstetrics and gynecology at Beth Israel Deaconess, is one of five social workers who declined to participate — for now. Some of her patients are addicted to drugs, while others are in abusive relationships. Douglass tells them at the outset that she is required to report abuse or neglect of a child to state officials. If she writes about a specific concern in a note, and the patient reads it, Douglass is worried the patient might flee rather than risk losing custody of the child.

“I absolutely share the hospital ethic of transparency,’’ she said. “But I want more time to see how this works.’’

At Geisinger Health System in Pennsylvania, where more than 1,300 providers share medical visit notes with 200,000 patients, mental health providers and pain specialists do not participate yet. The organization is planning to share psychiatric notes in the next six months, but Dr. Jonathan Darer, chief innovation officer, said doctors can exclude patients whom they feel will be harmed by easy access to visit notes, such as those with anxiety disorders who see even minor symptoms as catastrophic.

At Beth Israel Deaconess, mental health providers have identified at least 10 percent of their patients to participate in the project initially, and most are starting with those who are functioning at a high level.

“We thought, how can we find a safe place to start?’’ said Pamela Peck, clinical director for the psychiatry department. “Are there patients who would feel” upset by reading “about aspects of their psychiatric illness? That is a question that is still up for discussion.’’

Beth Israel Deaconess began encouraging providers to share medical notes nearly five years ago. Now, almost 2,300 doctors and nurse practitioners post notes for almost 225,000 patients. According to surveys done by the hospital, the vast majority want access to continue, though patients and caregivers have suggested changes.

Some patients want to approve what doctors write or to write responses. Some doctors want the option to hide notes, or portions of them, from patients or families, and want ways to communicate with colleagues privately, according to an opinion piece published in the New England Journal of Medicine earlier this year.

Partners HealthCare, the largest health care system in Massachusetts, is moving toward putting medical notes online, but is still debating whether to post mental health notes in patients’ records. One unanswered question is whether a psychiatrist’s notes are still useful and precise for other doctors, including those in the emergency room, if they are written with the knowledge that the patient can read them, said Dr. Gregg Meyer, chief clinical officer.

“One of the key points that physicians need to think about is whether the way we document care is going to fundamentally change,’’ he said. “First and foremost we have to make sure patient care is not compromised. We are watching their experience closely.’’

At Beth Israel Deaconess, doctors still have the option of putting certain notes in a locked area of the record, which patients cannot see and other doctors can access only if they provide written justification.

The hospital said it is too early to know how many patients are reading the mental health notes. Kahn spoke to one patient, a highly educated, successful woman whom he thought would jump at the chance. Kahn was surprised by her response.

“She said, ‘No, no no, I don’t want to read anything. I prefer not to look.’”

Liz Kowalczyk can be reached at kowalczyk@globe.com.

 





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

Filed under doctor psychologist therapist psychiatrist psychology psychiatry hospital mental health mental illness illness health mental mind body brain treat treatment recovery wellness healthy diagnosis disorder therapy news respectful mad madness rethinking madness med meds

20 notes

Ideas of New Attention Disorder Spurs Research, and DebateBy Alan Schwarz, The New York Times
“Some powerful figures in mental health,” according to today’s New York Times, “are claiming to have identified a new disorder that could vastly expand the ranks of young children treated for attention problems.” Sluggish Cognitive Tempo (SCT) – characterized by lethargy, daydreaming, and slow mental processing – was the subject of 131 pages in the January issue of the Journal of Abnormal Child Psychology. The lead paper claims that the question of the disorder’s existence “seems to be laid to rest as of this issue,” with other papers claiming “exciting findings” of pharmaceutical treatment for the disorder. Eli Lilly promises to study the disorder as part of its mission to “help satisfy unmet medical needs around the world.”
Read more at http://www.nytimes.com/2014/04/12/health/idea-of-new-attention-disorder-spurs-research-and-debate.html?hp&_r=0

 


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

Ideas of New Attention Disorder Spurs Research, and Debate
By Alan Schwarz, The New York Times

“Some powerful figures in mental health,” according to today’s New York Times, “are claiming to have identified a new disorder that could vastly expand the ranks of young children treated for attention problems.” Sluggish Cognitive Tempo (SCT) – characterized by lethargy, daydreaming, and slow mental processing – was the subject of 131 pages in the January issue of the Journal of Abnormal Child Psychology. The lead paper claims that the question of the disorder’s existence “seems to be laid to rest as of this issue,” with other papers claiming “exciting findings” of pharmaceutical treatment for the disorder. Eli Lilly promises to study the disorder as part of its mission to “help satisfy unmet medical needs around the world.”

Read more at http://www.nytimes.com/2014/04/12/health/idea-of-new-attention-disorder-spurs-research-and-debate.html?hp&_r=0

 





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

Filed under add adhd attention deficit hyperactivity attention disorder attention deficiency attention disorder diagnosis kid kids child children med meds medication medications cognitive science psychology psychiatry mind body brain health healthy wellness mental illness mental health news world news breaking news

46 notes

Ted Talk: “Andrew Solomon: Depression, the secret we share” Duration:29 mins 22 secs Date: Dec 18, 2013
“The opposite of depression is not happiness, but vitality, and it was vitality that seemed to seep away from me in that moment.” In a talk equal parts eloquent and devastating, writer Andrew Solomon takes you to the darkest corners of his mind during the years he battled depression. That led him to an eye-opening journey across the world to interview others with depression — only to discover that, to his surprise, the more he talked, the more people wanted to tell their own stories. 

 


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

Ted Talk: “Andrew Solomon: Depression, the secret we share” 
Duration:29 mins 22 secs 
Date: Dec 18, 2013

“The opposite of depression is not happiness, but vitality, and it was vitality that seemed to seep away from me in that moment.” In a talk equal parts eloquent and devastating, writer Andrew Solomon takes you to the darkest corners of his mind during the years he battled depression. That led him to an eye-opening journey across the world to interview others with depression — only to discover that, to his surprise, the more he talked, the more people wanted to tell their own stories. 

 





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

Filed under ted ted talks depression depressed sad sadness mind body brain health healthy well wellness mental illness mental health mental illness diagnosis recovery happiness happy mood writer interview story news mental breakdown depressing major depression major depressive disorder

60 notes

A Call to Revisit the Media’s Harmful Portrayal of the Relation between Violence and Mental Health ProblemsBy Tristan Barsky, M.S., SeriousMentalIllness.net
Recent media coverage of shootings in the United States have implied that mental health problems cause violent behavior, despite overwhelming evidence of the contrary. Here are three important pieces of that evidence and some reasons why the relationship between violence and mental health problems should be revisited.
Columbine High School, the Aurora Movie Theater, Sandy Hook, and most recently Fort Hood are a few of the sites of the most widely-covered and tragic shootings in recent American history. Another thing they have in common is that the shooters were persons apparently suffering from mental health problems. A lot of the national dialogue they prompted in the media and elsewhere revolved around the causes of, and policy responses to, mass shootings perpetrated by mental health problem sufferers. For instance, researchers analyzed a random 25% of news stories on mental health problems and gun violence from 1997 to 2012 in national and regional news sources. Most of this coverage happened after mass shootings and described them as the results of “dangerous people” rather than “dangerous weapons”. As would be expected, it’s been shown that framing mental health problems as one cause of gun violence and murder can lead the public to take on fearful, hateful, and ultimately stigmatizing attitudes towards persons suffering from mental health problems.
The problem with this kind of conversation on mental health problems and violence is that key facts are often overlooked or discounted:
1. “Mental health problems are common in the United States and internationally” (National Institute of Mental Health, 2007)
In 2007, the National Institute of Mental Health, which is the largest scientific organization in the world dedicated to the research of mental health problems, released a document called The Numbers Count: Mental health problems in America. In this census study, they show that mental health problems are “common” in the United States, where over one in four people ages 18 and older suffer from a diagnosable mental disorder in any given year. This translates to 57.7 million people, and mental health problems are the leading cause of disability in the United States and Canada. Also, many people suffer from more than one mental disorder at a given time and almost half of those with any mental disorder meet criteria for two or more mental disorders. The fact that this many people suffer from mental health problems makes it clear that having had a diagnosed illness is simply not a good predictor of violent behavior.
2. “The vast majority of people who are violent do not suffer from mental illnesses” (American Psychiatric Association, 1994)
Recent studies like this one and this one have shown not only that most people with mental health problems do not commit more violent acts than the rest of the population, but that most violent acts are not committed by people with diagnosed mental health problems. The fact is that the absolute risk of violence among this population as a group is very small and only a small proportion of the violence in the United States can be attributed to persons suffering from mental health problems. Despite the fact that sound empirical research has proven time and time again that the contribution of people with mental illnesses to overall rates of violence is small, the media continues to suggest otherwise. This has the effect of pushing this false relationship into the minds of the general public and of expanding its magnitude in the public discourse.
3. “People with psychiatric disabilities are far more likely to be victims than perpetrators of violent crime” (Appleby, et al., 2001).
Contemporary research –some of which you can find HERE and HERE– shows that people with mental health problems not only commit less violent acts than the rest of the population, but that they are actually much more likely to be victims than perpetrators of violence in the community. A recent study showed that in the past year, almost half of a large sample of individuals suffering from mental health problems and receiving outpatient treatment were victims of a violent offence. Another large-scale study examined this phenomenon and found that people diagnosed with Serious Mental Illnesses such as schizophrenia, bipolar disorder or psychosis, have been found to be 2 ½ times more likely to be attacked, raped or mugged than the rest of the population.
Many policy approaches (this one for example) have been proposed as a result of the recent tragic shootings in the United States. They range from expanding psychological screening to further limiting the rights of individuals suffering from mental health problems, to increasing the length of Assisted Outpatient Treatment, hospitalizations, and institutionalization. Because such a large number of Americans suffer from mental health problems and because mental health problems predispose their sufferers to becoming victims of violence rather than perpetrators of it, these policies are unlikely to be effective.
By implying a link between mental health problems and violent offenses, they also suggest that people who suffer from these problems should be feared and blamed in the wake of these recent tragedies. If this harmful trend continues, it is likely that the violence towards individuals suffering from mental health problems will increase, which could compromise their sense of safety and ultimately, their recovery.

 


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

A Call to Revisit the Media’s Harmful Portrayal of the Relation between Violence and Mental Health Problems
By Tristan Barsky, M.S., SeriousMentalIllness.net

Recent media coverage of shootings in the United States have implied that mental health problems cause violent behavior, despite overwhelming evidence of the contrary. Here are three important pieces of that evidence and some reasons why the relationship between violence and mental health problems should be revisited.

Columbine High School, the Aurora Movie Theater, Sandy Hook, and most recently Fort Hood are a few of the sites of the most widely-covered and tragic shootings in recent American history. Another thing they have in common is that the shooters were persons apparently suffering from mental health problems. A lot of the national dialogue they prompted in the media and elsewhere revolved around the causes of, and policy responses to, mass shootings perpetrated by mental health problem sufferers. For instance, researchers analyzed a random 25% of news stories on mental health problems and gun violence from 1997 to 2012 in national and regional news sources. Most of this coverage happened after mass shootings and described them as the results of “dangerous people” rather than “dangerous weapons”. As would be expected, it’s been shown that framing mental health problems as one cause of gun violence and murder can lead the public to take on fearful, hateful, and ultimately stigmatizing attitudes towards persons suffering from mental health problems.

The problem with this kind of conversation on mental health problems and violence is that key facts are often overlooked or discounted:

1. “Mental health problems are common in the United States and internationally” (National Institute of Mental Health, 2007)

In 2007, the National Institute of Mental Health, which is the largest scientific organization in the world dedicated to the research of mental health problems, released a document called The Numbers Count: Mental health problems in America. In this census study, they show that mental health problems are “common” in the United States, where over one in four people ages 18 and older suffer from a diagnosable mental disorder in any given year. This translates to 57.7 million people, and mental health problems are the leading cause of disability in the United States and Canada. Also, many people suffer from more than one mental disorder at a given time and almost half of those with any mental disorder meet criteria for two or more mental disorders. The fact that this many people suffer from mental health problems makes it clear that having had a diagnosed illness is simply not a good predictor of violent behavior.

2. “The vast majority of people who are violent do not suffer from mental illnesses” (American Psychiatric Association, 1994)

Recent studies like this one and this one have shown not only that most people with mental health problems do not commit more violent acts than the rest of the population, but that most violent acts are not committed by people with diagnosed mental health problems. The fact is that the absolute risk of violence among this population as a group is very small and only a small proportion of the violence in the United States can be attributed to persons suffering from mental health problems. Despite the fact that sound empirical research has proven time and time again that the contribution of people with mental illnesses to overall rates of violence is small, the media continues to suggest otherwise. This has the effect of pushing this false relationship into the minds of the general public and of expanding its magnitude in the public discourse.

3. “People with psychiatric disabilities are far more likely to be victims than perpetrators of violent crime” (Appleby, et al., 2001).

Contemporary research –some of which you can find HERE and HERE– shows that people with mental health problems not only commit less violent acts than the rest of the population, but that they are actually much more likely to be victims than perpetrators of violence in the community. A recent study showed that in the past year, almost half of a large sample of individuals suffering from mental health problems and receiving outpatient treatment were victims of a violent offence. Another large-scale study examined this phenomenon and found that people diagnosed with Serious Mental Illnesses such as schizophrenia, bipolar disorder or psychosis, have been found to be 2 ½ times more likely to be attacked, raped or mugged than the rest of the population.

Many policy approaches (this one for example) have been proposed as a result of the recent tragic shootings in the United States. They range from expanding psychological screening to further limiting the rights of individuals suffering from mental health problems, to increasing the length of Assisted Outpatient Treatment, hospitalizations, and institutionalization. Because such a large number of Americans suffer from mental health problems and because mental health problems predispose their sufferers to becoming victims of violence rather than perpetrators of it, these policies are unlikely to be effective.

By implying a link between mental health problems and violent offenses, they also suggest that people who suffer from these problems should be feared and blamed in the wake of these recent tragedies. If this harmful trend continues, it is likely that the violence towards individuals suffering from mental health problems will increase, which could compromise their sense of safety and ultimately, their recovery.

 





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

Filed under quotes news headlines world news violent fort hood shoot opinion mind body brain recovery mental health mental illness mental health illness healthy media news newspaper stigma diagnosis disorder violence gun guns gun law gun laws policy united states

60 notes

Real Men Talk About Their Feelings — For Real
By Josh Rivedal, professional actor, author, playwright, speaker on suicide prevention
Posted on The Huffington Post Healthy Living
Men are willing to talk about the size of their prostate glands, or how much Viagra they’re allowed to take, but they’re still not willing to be open about their mental health.
If men want to live long, healthy and productive lives it’s absolutely crucial that the dialogue surrounding men’s mental health has to change.
I lost my father Douglas to suicide in 2009. Douglas lost his father Haakon to suicide in 1966. Each suffered from undiagnosed mental disorders and each suffered in silence because of the stigma surrounding men talking about and getting help for mental illness.
Haakon was dealing with post-traumatic stress disorder after having been shot down in Hamburg, Germany, in 1941. Douglas may have been clinically depressed for a very long time, but my mother filing for divorce was a catalyst (not the cause) for his action in taking his own life.
There’s a relatively new case study in The Journal of Men’s Health that says that men are affected tremendously by divorce. They have higher rates of alcohol and drug abuse, depression and detach themselves from personal relationships and social support.
In 2011, I had several catalysts for my own near-suicide attempt: the dissolution of a relationship with a long-term girlfriend (similar to a divorce), a lack of work, and fallout from my mother’s betrayal. I was in terrible emotional pain and unknowingly suffering from clinical depression.
Standing at the ledge of a fourth floor window, I realized I didn’t want to die. I just wanted to end my inner torment. And I needed to break the familial cycle. So I came back inside, took a risk and asked for help by calling my mother.
Over the next few months I continued to take more risks. I called old friends to tell them I needed their support. I got into therapy. And no one ever told me I was crazy, stupid or a bad person. They told me they loved me and wanted to help me.
While recovering from clinical depression, I wanted to help youth and other men like me. So I used a biographical one-man play, The Gospel According to Josh, about my foray into show business along with my father’s suicide and took it to high schools, colleges and community centers all across the U.S. and Canada. With it, I talk about the importance of mental health and suicide prevention. Most of my audiences were and still continue to be women. One of the things I’ve found is that men have a difficult time talking about and getting help for their mental health or if they’re feeling suicidal. There seems to be some societal pressure that says “You’re not a true man if you don’t have it all together, all the time.”
But I have a message for men everywhere that’s simple yet profound. There’s always hope and help out there for you. As a man who has suffered from clinical depression, I can say from personal experience that this is not a character flaw or a weakness. It doesn’t make you any less of a man. In fact, by asking for help it makes you a stronger man. It gives you a fighting chance to improve your life and become the person you want to be. Reach out to your family and friends and ask for help. Nip it in the bud before it can turn into a crisis.
And while I’m not a mental-health professional, here are several resources to where you can ask for additional help from a professional if you need it: ManTherapy.org — an interactive tool to learn about men’s mental health; MentalHealthAmerica.net — find your local chapter of Mental Health America, a place where you can find information to help you live mentally well; SuicidePreventionLifeline.org — a general crisis line where you can reach out 24/7 to speak with someone if you’re feeling suicidal.



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

Real Men Talk About Their Feelings — For Real

By Josh Rivedal, professional actor, author, playwright, speaker on suicide prevention

Posted on The Huffington Post Healthy Living

Men are willing to talk about the size of their prostate glands, or how much Viagra they’re allowed to take, but they’re still not willing to be open about their mental health.

If men want to live long, healthy and productive lives it’s absolutely crucial that the dialogue surrounding men’s mental health has to change.

I lost my father Douglas to suicide in 2009. Douglas lost his father Haakon to suicide in 1966. Each suffered from undiagnosed mental disorders and each suffered in silence because of the stigma surrounding men talking about and getting help for mental illness.

Haakon was dealing with post-traumatic stress disorder after having been shot down in Hamburg, Germany, in 1941. Douglas may have been clinically depressed for a very long time, but my mother filing for divorce was a catalyst (not the cause) for his action in taking his own life.

There’s a relatively new case study in The Journal of Men’s Health that says that men are affected tremendously by divorce. They have higher rates of alcohol and drug abuse, depression and detach themselves from personal relationships and social support.

In 2011, I had several catalysts for my own near-suicide attempt: the dissolution of a relationship with a long-term girlfriend (similar to a divorce), a lack of work, and fallout from my mother’s betrayal. I was in terrible emotional pain and unknowingly suffering from clinical depression.

Standing at the ledge of a fourth floor window, I realized I didn’t want to die. I just wanted to end my inner torment. And I needed to break the familial cycle. So I came back inside, took a risk and asked for help by calling my mother.

Over the next few months I continued to take more risks. I called old friends to tell them I needed their support. I got into therapy. And no one ever told me I was crazy, stupid or a bad person. They told me they loved me and wanted to help me.

While recovering from clinical depression, I wanted to help youth and other men like me. So I used a biographical one-man play, The Gospel According to Josh, about my foray into show business along with my father’s suicide and took it to high schools, colleges and community centers all across the U.S. and Canada. With it, I talk about the importance of mental health and suicide prevention. Most of my audiences were and still continue to be women. One of the things I’ve found is that men have a difficult time talking about and getting help for their mental health or if they’re feeling suicidal. There seems to be some societal pressure that says “You’re not a true man if you don’t have it all together, all the time.”

But I have a message for men everywhere that’s simple yet profound. There’s always hope and help out there for you. As a man who has suffered from clinical depression, I can say from personal experience that this is not a character flaw or a weakness. It doesn’t make you any less of a man. In fact, by asking for help it makes you a stronger man. It gives you a fighting chance to improve your life and become the person you want to be. Reach out to your family and friends and ask for help. Nip it in the bud before it can turn into a crisis.

And while I’m not a mental-health professional, here are several resources to where you can ask for additional help from a professional if you need it: ManTherapy.org — an interactive tool to learn about men’s mental health; MentalHealthAmerica.net — find your local chapter of Mental Health America, a place where you can find information to help you live mentally well; SuicidePreventionLifeline.org — a general crisis line where you can reach out 24/7 to speak with someone if you’re feeling suicidal.





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

Filed under mental health mental illness mental health illness healthy mind body brain men man masculine Josh Rivedal suicide suicidal disorder diagnosis psychology depression depressed recovery hope pain emotional major depression major depressive disorder news therapy recover help

149 notes

You are not alone: student stories of mental healthBy Libby Page and Guardian readers, The Guardian
Students share their experiences of mental health issues and reveal a common and worrying problem
When I asked students to share their experiences of mental health at university, I had no idea of the reaction it would receive. Over five days we received over 200 stories. Many entries we weren’t able to include, for legal reasons or because the experiences described were too harrowing to publish.
Originally planned to stay open for two weeks, we decided to close the project early because there wasn’t the capacity to moderate the influx of entries. Each morning we were met with more stories – from students who opened up about their anxieties and struggles.
If you are reading this and are dealing with a mental health issue yourself – you are not alone.
Students shared stories of depression, anxiety, self-harm and suicidal thoughts. Some spoke of diagnosed conditions such as obsessive compulsive disorder and bipolar disorder, and the distructive effect these conditions sometimes have on their education.
When it came to lesser-known issues such as borderline personality disorder, students spoke of a lack of understanding about what they were going through.
Others talked about the embarrassment they felt about asking for help. Some were as yet undiagnosed but clearly struggling: “I stay up all night crying” was a common phrase.
No one tells you that university might be difficult, said students. You were sold on stories from your older friends and the glossy prospectus – there are no footnotes about loneliness and disillusionment.
One anonymous student said: “As a fresher you are constantly reminded that this is supposed to be the ‘time of your life’. When it feels like the worst time of your life you feel both a sense of guilt and a pressure to keep these negative thoughts to yourself.”
Another said: “I spent the first few weeks of uni hiding in my dorm room crying my eyes out. I was homesick and wasn’t sure if I wanted to be there at all.”
Mental health issues can start in childhood, and many students spoke about a history of depression or self-harming that they carried to university. But a new life can add pressures.
"My depression and anxiety started some time before I came to university, but leaving home, being in an extremely taxing social environment and being under large academic pressure all took their toll on me," said one student.
Another said: “Getting tubes or being anywhere I didn’t know felt uncertain. I always had a burning, itching, tormenting anxiety bubbling in my chest. At the time, my boyfriend had no comprehension of mental illness and would regularly tell me panic attacks didn’t exist, that I was stupid and that I had no friends.”
Managing your studies alongside a mental health issue can be a daily struggle. “Panic attacks followed by depression meant things rapidly spiralled out of control,” said one student.
"I found I simply couldn’t think straight and my short term memory became terrible. The best description I could muster was that it felt as though the entire world had been rotated very slightly and nothing was the same anymore."
Another student said: “I’m absolutely terrified of being in social situations in which I don’t know the people I’m speaking to – seminars are a nightmare. I’ve often missed my contact hours because I’ve been up all night crying and stressing and can’t face going in.
"I don’t feel like I can tell my tutors why I’m missing their classes, because I feel like they won’t believe me as I haven’t been officially diagnosed."
Others said the stress of deadlines and feedback from tutors contributed. One student said: “I had a burn-out from the pressure of juggling nine modules. One of the triggers was some negative feedback I recieved in writing from a lecturer which included the word terrible. It was hard to get family support as they live far away.”
Students expressed a general feeling that university support services were helpful – when they could access them. After suffering from a severe anxiety attack, one student took the step to contact their university counselling service.
They said: “I’d put it off for so long, but finally I defined myself as ‘mentally ill’. It did take a few weeks for them to back to me, but nothing can describe the relief I felt when a therapist for the first time said to me, ‘that must be really hard’. Yeah, it was hard! Finally, someone who understood, who didn’t tell me to snap out of it.”
But others are still struggling. “When I started my undergraduate degree I did the responsible thing and informed my supervisor that I had depression,” said one anonymous student, who has since been diagnosed with bipolar disorder.
"He informed me that in his opinion depression was a girls issue and he didn’t know what to do with girls issues and sent me on my way."
Another student said: “My university supported me in my decision to suspend my studies and have helped me get back on track to resume my studies in September, yet I can’t help feel more could have been done to help me, before I reached breaking point.”
What do students think needs to be done? Education needs to start early. An anonymous student said: “People need to know what signs to look for in their friends. They need to understand that depression, anxiety, eating disorders, OCD and bipolar are illnesses, not character flaws.
"The support and education about them need to be on par with the education we get about other medical issues. If we learn about it in school, we will be more prepared when we get to university."
At this year’s National Union of Students (NUS) conference, a motion will be discussed that urges student unions to move “away from awareness, towards action”. It calls for training for staff, integrating mental health into the widening participation agenda, better advertising for support services, and an ensurance that academic policies do not cause additional mental distress to students who experience mental health issues.
Now is the time for action. But the response to our call to share stories shows that there are still many young people who want to talk.
What you said
"I thought everything was my fault and I was just defective and bad and that this was what I deserved from life. I missed out on social life and extra-curricular activities because I struggled with acute feelings of social anxiety, self-hatred and fear. Now I have access to support, I can support others, too, and that’s the best feeling I could ask for."
"I hope my words might help some of you to see that you really aren’t the only one. In my opinion, searching out for help in whatever small way you can manage, really is the best thing."
"Mental health issues are nothing to be ashamed of and affect almost everybody and it’s about time everyone realised this and stopped skirting round the subject and faced it head-on. "
"One thing I’ve found is that so many more people than you realise suffer from mental illnesses. As I’ve talked to friends, more and more of them have been telling me that they too suffer from the same things I do, or they have in the past."
"No matter how bad it gets and how much you think there is no hope and let your depression take over, you can always dig yourself out of that hole and find a way to manage your depression and you are not alone."
"Get help, be heard, let yourself be supported. You’re important."
Read the rest of the contributions to the GuardianWitness assignment here.



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

You are not alone: student stories of mental health
By Libby Page and Guardian readers, The Guardian

Students share their experiences of mental health issues and reveal a common and worrying problem

When I asked students to share their experiences of mental health at university, I had no idea of the reaction it would receive. Over five days we received over 200 stories. Many entries we weren’t able to include, for legal reasons or because the experiences described were too harrowing to publish.

Originally planned to stay open for two weeks, we decided to close the project early because there wasn’t the capacity to moderate the influx of entries. Each morning we were met with more stories – from students who opened up about their anxieties and struggles.

If you are reading this and are dealing with a mental health issue yourself – you are not alone.

Students shared stories of depression, anxiety, self-harm and suicidal thoughts. Some spoke of diagnosed conditions such as obsessive compulsive disorder and bipolar disorder, and the distructive effect these conditions sometimes have on their education.

When it came to lesser-known issues such as borderline personality disorder, students spoke of a lack of understanding about what they were going through.

Others talked about the embarrassment they felt about asking for help. Some were as yet undiagnosed but clearly struggling: “I stay up all night crying” was a common phrase.

No one tells you that university might be difficult, said students. You were sold on stories from your older friends and the glossy prospectus – there are no footnotes about loneliness and disillusionment.

One anonymous student said: “As a fresher you are constantly reminded that this is supposed to be the ‘time of your life’. When it feels like the worst time of your life you feel both a sense of guilt and a pressure to keep these negative thoughts to yourself.”

Another said: “I spent the first few weeks of uni hiding in my dorm room crying my eyes out. I was homesick and wasn’t sure if I wanted to be there at all.”

Mental health issues can start in childhood, and many students spoke about a history of depression or self-harming that they carried to university. But a new life can add pressures.

"My depression and anxiety started some time before I came to university, but leaving home, being in an extremely taxing social environment and being under large academic pressure all took their toll on me," said one student.

Another said: “Getting tubes or being anywhere I didn’t know felt uncertain. I always had a burning, itching, tormenting anxiety bubbling in my chest. At the time, my boyfriend had no comprehension of mental illness and would regularly tell me panic attacks didn’t exist, that I was stupid and that I had no friends.”

Managing your studies alongside a mental health issue can be a daily struggle. “Panic attacks followed by depression meant things rapidly spiralled out of control,” said one student.

"I found I simply couldn’t think straight and my short term memory became terrible. The best description I could muster was that it felt as though the entire world had been rotated very slightly and nothing was the same anymore."

Another student said: “I’m absolutely terrified of being in social situations in which I don’t know the people I’m speaking to – seminars are a nightmare. I’ve often missed my contact hours because I’ve been up all night crying and stressing and can’t face going in.

"I don’t feel like I can tell my tutors why I’m missing their classes, because I feel like they won’t believe me as I haven’t been officially diagnosed."

Others said the stress of deadlines and feedback from tutors contributed. One student said: “I had a burn-out from the pressure of juggling nine modules. One of the triggers was some negative feedback I recieved in writing from a lecturer which included the word terrible. It was hard to get family support as they live far away.”

Students expressed a general feeling that university support services were helpful – when they could access them. After suffering from a severe anxiety attack, one student took the step to contact their university counselling service.

They said: “I’d put it off for so long, but finally I defined myself as ‘mentally ill’. It did take a few weeks for them to back to me, but nothing can describe the relief I felt when a therapist for the first time said to me, ‘that must be really hard’. Yeah, it was hard! Finally, someone who understood, who didn’t tell me to snap out of it.”

But others are still struggling. “When I started my undergraduate degree I did the responsible thing and informed my supervisor that I had depression,” said one anonymous student, who has since been diagnosed with bipolar disorder.

"He informed me that in his opinion depression was a girls issue and he didn’t know what to do with girls issues and sent me on my way."

Another student said: “My university supported me in my decision to suspend my studies and have helped me get back on track to resume my studies in September, yet I can’t help feel more could have been done to help me, before I reached breaking point.”

What do students think needs to be done? Education needs to start early. An anonymous student said: “People need to know what signs to look for in their friends. They need to understand that depression, anxiety, eating disorders, OCD and bipolar are illnesses, not character flaws.

"The support and education about them need to be on par with the education we get about other medical issues. If we learn about it in school, we will be more prepared when we get to university."

At this year’s National Union of Students (NUS) conference, a motion will be discussed that urges student unions to move “away from awareness, towards action”. It calls for training for staff, integrating mental health into the widening participation agenda, better advertising for support services, and an ensurance that academic policies do not cause additional mental distress to students who experience mental health issues.

Now is the time for action. But the response to our call to share stories shows that there are still many young people who want to talk.

What you said

"I thought everything was my fault and I was just defective and bad and that this was what I deserved from life. I missed out on social life and extra-curricular activities because I struggled with acute feelings of social anxiety, self-hatred and fear. Now I have access to support, I can support others, too, and that’s the best feeling I could ask for."

"I hope my words might help some of you to see that you really aren’t the only one. In my opinion, searching out for help in whatever small way you can manage, really is the best thing."

"Mental health issues are nothing to be ashamed of and affect almost everybody and it’s about time everyone realised this and stopped skirting round the subject and faced it head-on. "

"One thing I’ve found is that so many more people than you realise suffer from mental illnesses. As I’ve talked to friends, more and more of them have been telling me that they too suffer from the same things I do, or they have in the past."

"No matter how bad it gets and how much you think there is no hope and let your depression take over, you can always dig yourself out of that hole and find a way to manage your depression and you are not alone."

"Get help, be heard, let yourself be supported. You’re important."

Read the rest of the contributions to the GuardianWitness assignment here.





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

Filed under mental health mental illness mental health illness healthy diagnosis disorder hope recovery story news anxiety ocd bipolar bipolar disorder bpd borderline borderline personality disorder personality emotion feeling mind body brain sad depression depressed sadness

126 notes

Shooting Unfairly Links Violence with Mental Illness — AgainBy Joseph Shapiro, Shots: Health News from NPR
Experts in mental health say (even as more facts about Lopez emerge) that it’s highly unlikely the violence could have been predicted. Just raising that question, psychologists and psychiatrists say, shows how much Americans misunderstand the link between mental illness and violence.
With the Army’s disclosure that Army Spc. Ivan Lopez was being evaluated for post-traumatic stress disorder before he went on a shooting rampage Wednesday, there were once again questions about whether the Army could have prevented the violence at Fort Hood.
Experts in mental health say (even as more facts about Lopez emerge) that it’s highly unlikely the violence could have been predicted. Just raising that question, psychologists and psychiatrists say, shows how much Americans misunderstand the link between mental illness and violence.
One national survey in 2006 found that most Americans — 60 percent — believed people with schizophrenia were likely to be violent. But the vast majority of people with psychiatric disorders are not violent. In fact, another study found they are far more likely to be the victims of violence, and that 1 in 4 experience violence every year.
Dr. Carl Bell, a psychiatrist at the University of Illinois at Chicago, says being able to predict who will be violent in advance “is impossible.”
"The reality," Bell says, "is that prediction of violence is only useful in an immediate clinical situation: Someone comes in and says, ‘I’m going to kill myself.’ Then you take their word for it, and can predict violence in the short term. But you cannot use that to predict violence in the long term."
Army officials said Thursday that Lopez had seen a psychiatrist in the past month, but there were no indications that he was suicidal.
Dr. Thomas Grieger, a clinical and forensic psychiatrist who worked in military hospitals for three decades, says that one reason violence is so hard to predict is because it is so rare. “Acts of extreme violence and acts against yourself — suicide attempts — are so infrequent that it really becomes almost impossible to predict when any individual or situation is going to escalate to that,” Grieger says. “So many factors come to play: interpersonal relationships, difficulty in the workplace, issues at home, career issues and true mental health issues like depression, bipolar disorder or psychosis.”
Medications are another complicating factor — which ones and whether a soldier was taking them. For many troops back from deployment, multiple medications are prescribed to deal with pain, mental health issues and other problems. Army officials say Lopez had been prescribed Ambien, a drug to help him sleep, and other medications to treat anxiety and depression.
Still, there are a few factors that are more likely than others to be present among people who do become violent. The best predictor of future violence is whether a person with a psychiatric illness has been arrested or acted violently in the past. And people with substance abuse problems, on top of mental illness, are also at a greater risk of committing violence.
Bell says there’s growing study of “mass murder preceding suicide.” In these cases, someone who goes on a shooting spree wants to die, but wants to do so in a way that gets a lot of attention.
"There’s a huge dynamic in suicide where people get angry because they’re hurt," Bell says. "They say, ‘I’ll fix you. I will kill myself and I’ll get even with you.’ What better way to get even (and make a big splash) than to kill a bunch of people before you kill yourself?" It’s been reported that Lopez shot himself, bringing his shooting spree to an end, after he was confronted by a police officer.
This was the second mass shooting at Fort Hood in less than five years. Last year, Maj. Nidal Hasan, an Army psychiatrist, was sentenced to death for killing 13 people and wounding 32 others in the November 2009 shooting that remains the worst mass murder at a military installation.
It’s more reasonable to question whether the Army could have prevented Hasan’s violence — but not because of mental illness. The FBI had seen email that Hasan had sent to the website of terrorist Anwar al-Awlaki, expressing his own sympathy toward suicide bombers.
And, as my NPR colleague Daniel Zwerdling reported, Hasan’s supervisor at Walter Reed Army Medical Center was so concerned about Hasan’s “pattern of poor judgment and a lack of professionalism” that he wrote a memo sharply criticizing the doctor. That kind of document could have ended a military career.
But instead, the Army — with a shortage of psychiatrists and a flood of soldiers returning from Iraq and Afghanistan with mental health problems — kept Hasan working.
After the 2009 shootings, the Pentagon commissioned a report on how to prevent a repeat of the shootings. The report made 47 recommendations for how to improve security. One was to improve training so that military personnel could better “identify contributing factors and behavioral indicators of potentially violent actors.” Another was simply to realize that its own soldiers could be a threat. Another was to find ways to restrict the carrying of personal firearms on military bases. Lopez, it’s been reported, died of a self-inflicted gunshot wound from a .45-caliber Smith & Wesson semiautomatic pistol. The gun, according to media reports, was purchased at the same Killeen, Texas, store where Hasan bought his pistol.



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

Shooting Unfairly Links Violence with Mental Illness — Again
By Joseph Shapiro, Shots: Health News from NPR

Experts in mental health say (even as more facts about Lopez emerge) that it’s highly unlikely the violence could have been predicted. Just raising that question, psychologists and psychiatrists say, shows how much Americans misunderstand the link between mental illness and violence.

With the Army’s disclosure that Army Spc. Ivan Lopez was being evaluated for post-traumatic stress disorder before he went on a shooting rampage Wednesday, there were once again questions about whether the Army could have prevented the violence at Fort Hood.

Experts in mental health say (even as more facts about Lopez emerge) that it’s highly unlikely the violence could have been predicted. Just raising that question, psychologists and psychiatrists say, shows how much Americans misunderstand the link between mental illness and violence.

One national survey in 2006 found that most Americans — 60 percent — believed people with schizophrenia were likely to be violent. But the vast majority of people with psychiatric disorders are not violent. In fact, another study found they are far more likely to be the victims of violence, and that 1 in 4 experience violence every year.

Dr. Carl Bell, a psychiatrist at the University of Illinois at Chicago, says being able to predict who will be violent in advance “is impossible.”

"The reality," Bell says, "is that prediction of violence is only useful in an immediate clinical situation: Someone comes in and says, ‘I’m going to kill myself.’ Then you take their word for it, and can predict violence in the short term. But you cannot use that to predict violence in the long term."

Army officials said Thursday that Lopez had seen a psychiatrist in the past month, but there were no indications that he was suicidal.

Dr. Thomas Grieger, a clinical and forensic psychiatrist who worked in military hospitals for three decades, says that one reason violence is so hard to predict is because it is so rare. “Acts of extreme violence and acts against yourself — suicide attempts — are so infrequent that it really becomes almost impossible to predict when any individual or situation is going to escalate to that,” Grieger says. “So many factors come to play: interpersonal relationships, difficulty in the workplace, issues at home, career issues and true mental health issues like depression, bipolar disorder or psychosis.”

Medications are another complicating factor — which ones and whether a soldier was taking them. For many troops back from deployment, multiple medications are prescribed to deal with pain, mental health issues and other problems. Army officials say Lopez had been prescribed Ambien, a drug to help him sleep, and other medications to treat anxiety and depression.

Still, there are a few factors that are more likely than others to be present among people who do become violent. The best predictor of future violence is whether a person with a psychiatric illness has been arrested or acted violently in the past. And people with substance abuse problems, on top of mental illness, are also at a greater risk of committing violence.

Bell says there’s growing study of “mass murder preceding suicide.” In these cases, someone who goes on a shooting spree wants to die, but wants to do so in a way that gets a lot of attention.

"There’s a huge dynamic in suicide where people get angry because they’re hurt," Bell says. "They say, ‘I’ll fix you. I will kill myself and I’ll get even with you.’ What better way to get even (and make a big splash) than to kill a bunch of people before you kill yourself?" It’s been reported that Lopez shot himself, bringing his shooting spree to an end, after he was confronted by a police officer.

This was the second mass shooting at Fort Hood in less than five years. Last year, Maj. Nidal Hasan, an Army psychiatrist, was sentenced to death for killing 13 people and wounding 32 others in the November 2009 shooting that remains the worst mass murder at a military installation.

It’s more reasonable to question whether the Army could have prevented Hasan’s violence — but not because of mental illness. The FBI had seen email that Hasan had sent to the website of terrorist Anwar al-Awlaki, expressing his own sympathy toward suicide bombers.

And, as my NPR colleague Daniel Zwerdling reported, Hasan’s supervisor at Walter Reed Army Medical Center was so concerned about Hasan’s “pattern of poor judgment and a lack of professionalism” that he wrote a memo sharply criticizing the doctor. That kind of document could have ended a military career.

But instead, the Army — with a shortage of psychiatrists and a flood of soldiers returning from Iraq and Afghanistan with mental health problems — kept Hasan working.

After the 2009 shootings, the Pentagon commissioned a report on how to prevent a repeat of the shootings. The report made 47 recommendations for how to improve security. One was to improve training so that military personnel could better “identify contributing factors and behavioral indicators of potentially violent actors.” Another was simply to realize that its own soldiers could be a threat. Another was to find ways to restrict the carrying of personal firearms on military bases. Lopez, it’s been reported, died of a self-inflicted gunshot wound from a .45-caliber Smith & Wesson semiautomatic pistol. The gun, according to media reports, was purchased at the same Killeen, Texas, store where Hasan bought his pistol.





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

Filed under news shooting violence mental illness mental health mental health illness healthy mind brain body psychology psychiatry ivan lopez lopez army military disorder diagnosis ptsd post traumatic stress disorder trauma traumatic anxiety depression ambien drug drugs med

26 notes

Psychiatry a Key Player in Effective Health Reform, APA SaysBy Megan Brooks, Medscape
An American Psychiatric Association (APA) work group on healthcare reform outlines key issues facing the field of psychiatry and offers recommendations for action in a report released today.
"Throughout this recent period of change, the focus on behavioral health, which includes mental illnesses and substance use disorders, has begun to shift from a compartmentalized provider approach to an integrated delivery system linking behavioral health and primary care services. This has led to a renewed awareness that mental health is critical to overall health and wellbeing," the report notes.
The work group was established by the APA board of trustees and chaired by Paul Summergrad, MD, chair of the Department of Psychiatry at Tufts University School of Medicine, Boston, Massachusetts, and president-elect of the APA. The group met numerous times during an 18-month period with input from the board of trustees, the assembly, and relevant councils and components.
Critical Role for Psychiatrists
According to the report, as healthcare reform expands insurance coverage and extends parity of benefits for behavioral health needs, it will be “critical to monitor new developments, models of care, and payment methodologies, and to enforce compliance to ensure patients and families receive the best quality of care.”
"Psychiatry must play a central role in the new patient care and delivery and payment models. These models must include an expanded emphasis on behavioral health," the report says.
The report also notes that integrated care models “hold promise” in addressing many of the challenges facing the healthcare system, but “more research is needed to build their evidence base, explore their financial impact and define the role of psychiatrists, primary care providers and other behavioral health providers.”
"Psychiatrists, alongside primary care providers, must play a major role in formulating integrated care solutions by defining their role and benefit to patients," the report recommends. It encourages the National Institutes of Health, the Centers for Medicare and Medicaid Services, and other federal agencies to continue their ongoing research and evaluation of these models.
The work group also tackled issues of financing of psychiatric care, concluding that fundamental payment issues, including implementation of parity laws, “must be addressed” to achieve the coverage, access, and new care delivery goals of the Affordable Care Act. This includes the economic impact of integration, Medicaid reimbursement policies, Medicare fee schedule distortions, fee for service payment methodologies, and the structure and management of payment.
IT Challenges Ahead
They conclude that payer and systems’ budgeting mechanisms must include management of psychiatric care within the broader medical healthcare budgets, while protecting core services for those with mental illnesses.
On the subject of quality performance and measurement, the group notes that healthcare reform has accelerated the development and use of performance indicators and recommends that the behavioral health field “become more fully engaged in the development of performance measures.”
"The field must lead on quality metrics for psychiatric care and their consistent adoption across payers and other regulatory entities. This can be accomplished by identifying a few priority areas for improvement, as well as establishing a series of goals covering various areas of practice," the group advises.
On health information technology (HIT), the group says several “challenges” lie ahead in the behavioral health field. The success of integrated care models is particularly dependent upon the deployment of electronic health records and patient registries, the report says.
The report concludes that HIT “should be a priority focus of communication and education for the psychiatric field, healthcare providers in general, patients, policy makers and the public.”
The report also addresses workforce, work environment, and medical education and training. Its key finding: “Without changes in the workforce, the field will have difficulty meeting the increased demand for specialty psychiatric physician services. Curriculum, accreditation standards, new Continuing Medical Education (CME) trainings and collaboration with primary care practitioners are needed to meet newly insured patient needs as well as provide for new care delivery models.”
The recommendations of the work group “serve as a springboard for discussion and action within the field of psychiatry,” the authors say.
APA. Integrated Care. Full article



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

Psychiatry a Key Player in Effective Health Reform, APA Says
By Megan Brooks, Medscape

An American Psychiatric Association (APA) work group on healthcare reform outlines key issues facing the field of psychiatry and offers recommendations for action in a report released today.

"Throughout this recent period of change, the focus on behavioral health, which includes mental illnesses and substance use disorders, has begun to shift from a compartmentalized provider approach to an integrated delivery system linking behavioral health and primary care services. This has led to a renewed awareness that mental health is critical to overall health and wellbeing," the report notes.

The work group was established by the APA board of trustees and chaired by Paul Summergrad, MD, chair of the Department of Psychiatry at Tufts University School of Medicine, Boston, Massachusetts, and president-elect of the APA. The group met numerous times during an 18-month period with input from the board of trustees, the assembly, and relevant councils and components.

Critical Role for Psychiatrists

According to the report, as healthcare reform expands insurance coverage and extends parity of benefits for behavioral health needs, it will be “critical to monitor new developments, models of care, and payment methodologies, and to enforce compliance to ensure patients and families receive the best quality of care.”

"Psychiatry must play a central role in the new patient care and delivery and payment models. These models must include an expanded emphasis on behavioral health," the report says.

The report also notes that integrated care models “hold promise” in addressing many of the challenges facing the healthcare system, but “more research is needed to build their evidence base, explore their financial impact and define the role of psychiatrists, primary care providers and other behavioral health providers.”

"Psychiatrists, alongside primary care providers, must play a major role in formulating integrated care solutions by defining their role and benefit to patients," the report recommends. It encourages the National Institutes of Health, the Centers for Medicare and Medicaid Services, and other federal agencies to continue their ongoing research and evaluation of these models.

The work group also tackled issues of financing of psychiatric care, concluding that fundamental payment issues, including implementation of parity laws, “must be addressed” to achieve the coverage, access, and new care delivery goals of the Affordable Care Act. This includes the economic impact of integration, Medicaid reimbursement policies, Medicare fee schedule distortions, fee for service payment methodologies, and the structure and management of payment.

IT Challenges Ahead

They conclude that payer and systems’ budgeting mechanisms must include management of psychiatric care within the broader medical healthcare budgets, while protecting core services for those with mental illnesses.

On the subject of quality performance and measurement, the group notes that healthcare reform has accelerated the development and use of performance indicators and recommends that the behavioral health field “become more fully engaged in the development of performance measures.”

"The field must lead on quality metrics for psychiatric care and their consistent adoption across payers and other regulatory entities. This can be accomplished by identifying a few priority areas for improvement, as well as establishing a series of goals covering various areas of practice," the group advises.

On health information technology (HIT), the group says several “challenges” lie ahead in the behavioral health field. The success of integrated care models is particularly dependent upon the deployment of electronic health records and patient registries, the report says.

The report concludes that HIT “should be a priority focus of communication and education for the psychiatric field, healthcare providers in general, patients, policy makers and the public.”

The report also addresses workforce, work environment, and medical education and training. Its key finding: “Without changes in the workforce, the field will have difficulty meeting the increased demand for specialty psychiatric physician services. Curriculum, accreditation standards, new Continuing Medical Education (CME) trainings and collaboration with primary care practitioners are needed to meet newly insured patient needs as well as provide for new care delivery models.”

The recommendations of the work group “serve as a springboard for discussion and action within the field of psychiatry,” the authors say.

APA. Integrated Care. Full article





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

Filed under psychiatry psychiatric psychology health healthcare mind body brain healthy news apa health reform medicine diagnosis disorder reform politics dsm mental illness mental health mental illness american us unites states america patient doctor psychiatrist therapist