Stigma and Mental Illness

By David Trend

“The more I became immersed in the study of stigmatized mental illness, the more it astonishing to me that any such phenomenon should exist at all,” writes Robert Lundin, a member of the Chicago Consortium for Stigma Research. “I believe that serious and persistent mental illnesses, like the one I live with, are clearly an inexorably no-fault phenomena that fully warrant being treated with the same gentleness and respect as multiple-sclerosis, testicular cancer or sickle-cell anemia.”[i] Here Lundin names a central of problem in the social construction of mental illness: the misunderstanding of conditions affecting the mind as somehow different from other biological illness. The misrecognition renders mental illness prone to the judgmental attributions discussed by Susan Sontag in her 1973 book Illness as Metaphor.  To Sontag, contemporary society reverses ancient views of sickness as a reflection of the inner self.  In this new view, the inner self is seen as actively causing sickness––through smoking, overeating, addictive behavior, and bad habits: “The romantic idea that disease expresses the character is invariably extended to exert that the character causes the disease–because it is not expressed itself. Passion moves inward, striking within the deepest cellular recesses.”[ii] But as before, the sick person is to blame for the illness.

Such sentiments are especially vindictive when a mentally ill person commits a crime. Understandably perhaps, clinical terms like “mental illness” quickly acquire malevolent meanings in the public mind––even though the mentally ill statistically are no more prone to criminality than anyone else. Sometimes this semiotic slippage causes public panic over commonplace disorders. Consider the case of Adam Lanza, the young man who in 2013 shot 26 children and adults at the Sandy Hook Elementary School in Newton, Massachusetts. While mental health analysts speculate that an acute psychotic episode prompted his violence, Lanza never had been diagnosed with a serious mental illness. As reporters scrambled for a story, much was made of Lanza’s childhood symptoms of Asperger’s syndrome, a form of high-functioning autism. The repeated mention of this disorder in news coverage triggered wrong-headed fears nationally of the murderous potential in other autistic kids. According the Centers for Disease Control (CDC), approximately 1 in 50 people (1.5-million) fall somewhere on the autistic spectrum, 80 percent of whom are boys.[iii] This has prompted improved diagnostic measures, which in turn have resulted in an apparent rise in autism cases in recent years––up 78 percent from a decade ago––and made autism a source of acute anxiety for many new parents. Continue reading “Stigma and Mental Illness”

Guns and dementia

From WebMD: “A new survey looks at access to guns by people with dementia.It finds that caregivers and family members of people being checked for problems with thinking didn’t consistently remove guns from their homes or keep them locked up.The study underlines the need for doctors to ask caregivers if they have guns in the home and, if so, advise them on safety measures to take, the researchers say.In the United States, there is “a significant presence of firearms in the homes of patients with dementia, and many of these patients suffer from delusions and hallucinations, some of which can be paranoid, persecutory, or hostile,” says Jason Hsieh, a medical student at Cleveland Clinic Lerner School of Medicine.The results were presented at the Alzheimer’s Association International Conference (AAIC) 2014.

images-1“In the U.S., 27% percent of people over the age of 65 own a firearm, Hsieh says. “In general, almost 40% of households in the U.S. contain a firearm, and surprisingly, in households with a firearm, the average number of firearms is 6.6,” he says.The elderly have the highest suicide rate of any part of the population, and firearms are the most common, as well as the most fatal, method of suicide. Data from the National Trauma Databank show that as people get older, the proportion of gun injuries that are self-inflicted rises. Other data show that as they age, people are less likely to survive a gunshot and less likely to return home after recovery.

“In addition to suicide, elderly individuals can be the victim of homicide, and this often happens from their caregiver,” Hsieh says. “Most of these events happen at home, and again, just like suicide, using a firearm is the most common method.”Also, it’s been shown that caregivers, families, and loved ones with dementia often don’t remove guns from the home as the dementia gets worse, he sayThe concern comes from the fact that people with dementia more frequently behave aggressively than those without it. Increasing dementia is linked with worsening agitation and aggression, along with delusions – particularly, mistaking a person for someone else, he says.Included in this analysis were 495 people, with an average age of nearly 80. Most of the patients were women (63%).Of the group, 378 (77%) qualified for a diagnosis of dementia, and 64% were already diagnosed with depression or qualified as depressed, the researchers say. Continue reading “Guns and dementia”

Mentally ill brutalized in prison

From today’s New York Times, “After being arrested on a misdemeanor charge following a family dispute last year, Jose Bautista was unable to post images$250 bail and ended up in a jail cell on Rikers Island.

A few days later, he tore his underwear, looped it around his neck and tried to hang himself from the cell’s highest bar. Four correction officers rushed in and cut him down. But instead of notifying medical personnel, they handcuffed Mr. Bautista, forced him to lie face down on the cell floor and began punching him with such force, according to New York City investigators, that he suffered a perforated bowel and needed emergency surgery.

Just a few weeks earlier, Andre Lane was locked in solitary confinement in a Rikers cellblock reserved for inmates with mental illnesses when he became angry at the guards for not giving him his dinner and splashed them with either water or urine. Correction officers handcuffed him to a gurney and transported him to a clinic examination room beyond the range of video cameras where, witnesses say, several guards beat him as members of the medical staff begged for them to stop. The next morning, the walls and cabinets of the examination room were still stained with Mr. Lane’s blood.

The assaults on Mr. Bautista and Mr. Lane were not isolated episodes. Brutal attacks by correction officers on inmates — particularly those with mental health issues — are common occurrences inside Rikers, the country’s second-largest jail, a four-month investigation by The New York Times found.

Reports of such abuses have seldom reached the outside world, even as alarm has grown this year over conditions at the sprawling jail complex. A dearth of whistle-blowers, coupled with the reluctance of the city’s Department of Correction to acknowledge the problem and the fact that guards are rarely punished, has kept the full extent of the violence hidden from public view.

But The Times uncovered details on scores of assaults through interviews with current and former inmates, correction officers and mental health clinicians at the jail, and by reviewing hundreds of pages of legal, investigative and jail records. Among the documents obtained by The Times was a secret internal study completed this year by the city’s Department of Health and Mental Hygiene, which handles medical care at Rikers, on violence by officers. The report helps lay bare the culture of brutality on the island and makes clear that it is inmates with mental illnesses who absorb the overwhelming brunt of the violence. Continue reading “Mentally ill brutalized in prison”

The truth about violence and mental health

After mass shootings, like the ones these past weeks in Las Vegas, Seattle and Santa Barbara, the national conversation often focuses on imgres-2mental illness. But as TruthOut asks, ” what do we actually know about the connections between mental illness, mass shootings and gun violence overall?

“To separate the facts from the media hype, we talked to Dr. Jeffrey Swanson, a professor in psychiatry and behavioral sciences at the Duke University School of Medicine, and one of the leading researchers on mental health and violence. Swanson talked about the dangers of passing laws in the wake of tragedy ― and which new violence-prevention strategies might actually work.

“Here is a condensed version of our conversation, edited for length and clarity.Mass shootings are relatively rare events that account for only a tiny fraction of American gun deaths each year. But when you look specifically at mass shootings ― how big a factor is mental illness?On the face of it, a mass shooting is the product of a disordered mental process. You don’t have to be a psychiatrist: what normal person would go out and shoot a bunch of strangers?But the risk factors for a mass shooting are shared by a lot of people who aren’t going to do it. If you paint the picture of a young, isolated, delusional young man ― that probably describes thousands of other young men.A 2001 study looked specifically at 34 adolescent mass murderers, all male. 70 percent were described as a loner. 61.5 percent had problems with substance abuse. 48 percent had preoccupations with weapons. 43.5 percent had been victims of bullying. Only 23 percent had a documented psychiatric history of any kind ― which means 3 out of 4 did not. Continue reading “The truth about violence and mental health”

Dealing with the narcissist in your life

Love is great, but it’s actually empathy that makes the world go ‘round. According to The Atlantic, “Understanding other peoples’ viewpoints is so essential to human functioning that psychologists sometimes refer to empathy as “social glue, binding people together and creating harmonious relationships.”

“Narcissists tend to lack this ability. Think of the charismatic co-worker who refuses to cover for a colleague who’s been in a car accident. Or the affable friend who nonetheless seems to delight in back-stabbing.

“These types of individuals are what’s known as “sub-clinical” narcissists—the everyday egoists who, though they may not merit psychiatric attention, don’t make very good friends or lovers.images

“If people are in a romantic relationship with a narcissist, they tend to cheat on their partners and their relationships break up sooner and end quite messily,” Erica Hepper, a psychologist at the University of Surrey in the U.K., told me. “They tend to be more deviant academically. They take credit for other peoples’ work.”

“Psychologists have long thought that narcissists were largely incorrigible—that there was nothing we could do to help them be more empathetic. But for a new study in the Personality and Social Psychology Bulletin, Hepper discovered a way to measurably help narcissists feel the pain of others.

“First, she gathered up 282 online volunteers who hailed from various countries but were mostly young and female. They took a 41-question personality quiz designed to assess their levels of subclinical narcissism, checking boxes next to statements like “I like to have authority over other people” or “I will be a success.” They then read a story about a person named Chris who had just gone through a breakup, and then took another quiz to determine how bad they felt for Chris. The more narcissistic among them were indeed less likely to feel empathy for the fictional jilted man. Continue reading “Dealing with the narcissist in your life”

Three-strikes and mental illness

Passed in 1994, California’s “three strikes” law is the nation’s harshest sentencing law.As Mother Jones reports, “Designed to imprison for life anyone who commits three violent crimes, the law has inadvertently resulted in the incarceration of a lot relatively harmless people, for a long time and at great public expense. Crimes that have earned people life sentences:imgres-1 Stealing a dollar in loose change from a car, breaking into a soup kitchen to steal food, stealing a jack from the open window of a tow truck, and even stealing two pairs of children’s shoes from Ross Dress for Less. The law is one reason that California’s prison system is dangerously, and unconstitutionally, overcrowded. More than 4,000 people in the prison system are serving life sentences for non-violent crimes.

“In 2012, with corrections costs consuming ever more of the state budget, the voters in the state had had enough, and they approved a reform measure that would spring many of these low-level offenders from a lifetime of costly confinement. By August of last year, more than 1,000 inmates had their life sentences changed and were released; recidivisim rates for this group has also been extremely low. But further progress in the reform effort is being stymied by one thorny problem: Nearly half of the inmates serving time in California prisons suffer from a serious mental illness such as bipolar disorder or schizophrenia. So far, judges have been reluctant to let these folks out of their life sentences.

“A new report from Stanford Law School’s Three Strikes project notes that the number of mentally ill prisoners denied relief from a life sentence is three times larger than those without a brain disease. The disparity largely stems from the fact that judges and juries tend to give people with brain diseases much harsher sentences to begin with. Continue reading “Three-strikes and mental illness”

Mental illness and life expectancy

According to Oxford University researchers, about one in four people in the UK will experience a mental health problem sometime during the year, while fewer than that smoke cigarettes — around 21 percent of men and 19 precent of women.images

PsychCentral reports that “Many mental disorders have a higher mortality risk than smoking. Yet despite these statistics, say the researchers, mental health still lags behind as a public health priority, especially compared to smoking.

“The study, published in the journal World Psychiatry, was based on the best systematic reviews of clinical studies reporting mortality risk for a whole range of diagnoses: mental health problems, substance and alcohol abuse, dementia, autistic spectrum disorders, learning disability, and childhood behavioral disorders.Twenty review papers were identified, including over 1.7 million individuals and over 250,000 deaths.

“The findings showed that the average reduction in life expectancy inbipolar patients is between nine and 20 years, 10 to 20 years forschizophrenia, between nine and 24 years for drug and alcohol abuse, and around seven to 11 years for recurrent depression. The loss of years among heavy smokers is eight to 10 years.

“People with mental health problems are among the most vulnerable in society. This work emphasizes how crucial it is that they have access to appropriate healthcare and advice, which is not always the case,” said Dr. John Williams, head of Neuroscience and Mental Health at the Wellcome Trust.

“We now have strong evidence that mental illness is just as threatening to life expectancy as other public health threats such as smoking.”

All diagnoses had an increase in early death, though the size of the risk varied greatly. Many had risks equivalent to or higher than heavy smoking. Continue reading “Mental illness and life expectancy”

Guns and mental illness

imgresLawmakers who refuse to support effective gun safety measures often prefer to talk about better screening of the mentally ill to identify deranged would-be perpetrators before they can carry out mass shootings. As a New York Times Op Ed entry today reads:

“This is, of course, a political dodge. Even in the handful of states where law enforcement agencies are trying to confiscate the guns of unstable individuals, state and federal laws too often enable the mentally ill to reclaim their guns as a right under the Second Amendment.

“In Connecticut, which has gun confiscation laws that were tightened after the Newtown school massacre, an angry man who was off his medications for paranoid schizophrenia threatened to shoot his mother and the police if they confiscated his weapons. The police managed to seize his 18 rifles and shotguns and seven high-capacity magazines. But the man expects to reclaim his arsenal in April, asserting he is back on his medications and has had no further police incidents (although he told Michael Luo and Mike McIntire of The Times that he has experienced paranormal activities).

“Similar cases from other states and cities show that seriously troubled individuals are able to reclaim their weapons, despite serious concerns about the threat to public safety. “There is no common-sense middle ground to protect the public,” a law enforcement adviser in Ohio warned.

“Most mentally ill persons are not violent, though The Times’s analysis of 180 confiscation cases in Connecticut (dealing with people posing an imminent risk of injury to themselves or others) found that close to 40 percent of those cases involved people with serious mental illness. The common denominator in gun violence, however, is not deranged individuals; it is the easy access to assault rifles and other high-powered weapons afforded all Americans. A few determined states are attempting to deal with this issue, but real solutions must involve federal legislation and national standards, which are nowhere in sight.”

More at: http://www.nytimes.com/2013/12/29/opinion/sunday/when-the-mentally-ill-own-guns.html

Treatment lags for teens with mental health conditions

Less than half of American teens with mental health disorders receive treatment, and those who do get help rarely see a mental health specialist, a new study indicates, reports Reuters today.

“The findings underscore the need for better mental health services for teens, said study author E. Jane Costello, associate director of the Duke Center for Child and Family Policy in Durham, N.C.

“It’s still the case in this country that people don’t take psychiatric conditions as seriously as they should,” Costello said in a Duke news release. This remains so, despite a wave of mass shootings in which mental illness may have played a role, she and her colleagues noted.

“The analysis of data from more than 10,000 teens aged 13 to 17 across the United States also showed that treatment rates varied greatly for different types of mental health problems. For example, teens with attention-deficit/hyperactivity disorder, conduct disorder oppositional defiant disorder received mental health care more than 70 percent of the time, while those with phobias or anxiety disorders were least likely to be treated. The researchers also found that blacks were much less likely than whites to be treated for mental disorders, according to the study, published online Nov. 15 in the journal Psychiatric Services. In many cases, teens received treatment from pediatricians, school counselors or probation officers, rather than mental health specialists. This is because there are not enough qualified child mental health professionals to handle the demand, said Costello, who is also a professor of psychology and epidemiology at Duke University. Continue reading “Treatment lags for teens with mental health conditions”

Sleep helps with depression

imagesCuring insomnia in people with depression could double their chance of a full recovery, scientists are reporting. The findings, based on an insomnia treatment that uses talk therapy rather than drugs, are the first to emerge from a series of closely watched studies of sleep and depression to be released in the coming year, reports the New York Times

“The new report affirms the results of a smaller pilot study, giving scientists confidence that the effects of the insomnia treatment are real. If the figures continue to hold up, the advance will be the most significant in the treatment of depression since the introduction of Prozac in 1987.

“Depression is the most common mental disorder, affecting some 18 million Americans in any given year, according to government figures, and more than half of them also have insomnia.

“Experts familiar with the new report said that the results were plausible and that if supported by other studies, they should lead to major changes in treatment.

“It would be an absolute boon to the field,” said Dr. Nada L. Stotland, professor of psychiatry at Rush Medical College in Chicago, who was not connected with the latest research.

“It makes good common sense clinically,” she continued. “If you have a depression, you’re often awake all night, it’s extremely lonely, it’s dark, you’re aware every moment that the world around you is sleeping, every concern you have is magnified.”The study is the first of four on sleep and depression nearing completion, all financed by the National Institute of Mental Health. Continue reading “Sleep helps with depression”

Mandating coverage for mental health and addiction

The Obama administration today completed a generation-long effort to require insurers to cover care for mental health and addiction just like physical illnesses when it issues long-awaited regulations defining parity in benefits and treatment, as reported in the New York Times

“The rules, which will apply to almost all forms of insurance, will have far-reaching consequences for many Americans. In the White House, the regulations are also seen as critical to President Obama’s program for curbing

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gun violence by addressing an issue on which there is bipartisan agreement: Making treatment more available to those with mental illness could reduce killings, including mass murders.

“In issuing the regulations, senior officials said, the administration will have acted on all 23 executive actions that the president and Vice President Joseph R. Biden Jr. announced early this year to reduce gun crimes a

fter the Newtown, Conn., school massacre. In planning those actions, the administration anticipated that gun control legislation would fail in Congress as pressure from the gun lobby proved longer-lasting than the national trauma over the killings of first graders and their caretakers last Dec. 14.

“We feel actually like we’ve made a lot of progress on mental health as a result in this year, and this is kind of the big one,” said a senior administration official, one of several who described the outlines of the regulations that Kathleen Sebelius, the secretary of health and human services, will announce at a mental health conference on Friday in Atlanta with the former first lady Rosalynn Carter.

“While laws and regulations dating to 1996 took initial steps in requiring insurance parity for medical and mental health, “here we’re doing full parity, and we’ve also taken steps to extend it to the people covered in the Affordable Care Act,” the senior official said. “This is kind of the final word on parity.” Continue reading “Mandating coverage for mental health and addiction”

The new global depression

Depression can have a profound impact on a person’s life, work, and relationships. But a new study shows the true toll of mental health conditions on a global scale.imgres

“New research led by Alize Ferrari from the University of Queensland and the Queensland Centre for Mental Health Research in Australia found that depression is the second leading cause of the global disability burden.

“Depression, defined as a persistent state of sadness or disinterest in things once found pleasurable, is one of the most common mental disorders.

“The World Health Organization states that approximately 350 million people worldwide have depression, or about four percent of the world’s population.

“While many people have chronic depression that ultimately leads to a disability, it’s common for it to become debilitating immediately. It’s not necessarily something that builds and becomes worse over time,” Dobrenski, who was not involved in the study, said. “Unfortunately, the system moves very slowly so it can take a long time for someone to become qualified [for mental health care], even though they are ‘eligible’ within days.”   However, he added, some types of depression can fade away just as quickly, so it’s sometimes a disservice to designate someone as disabled so quickly. The new study, appearing in the journal PLOS Medicine, shows that rates of major depressive disorder (MDD) vary by country and region, but are highest in Central America and Central and Southeast Asia. Afghanistan, which has seen political turmoil and war since long before the U.S. occupation began 2001, leads the world in rates of depression, the researchers discovered. Japan, on the other hand, has the lowest rate of depression disability worldwide. To reach their conclusions, researchers scoured published studies on MDD, or clinical depression, and dysthymia, which is a milder form of depression. Continue reading “The new global depression”

Court to address death penalty and mental disability

The Supreme Court said Monday it would consider taking another step toward limiting the use of the death penalty, this time by trying to clarify the legal standard for who is ineligible for the ultimate punishment because of mental disability, reports the LA Times.images

At issue is whether states such as Florida may disqualify anyone who scores above 70 on an IQ test. A score below 70 generally indicates mental disability.

“The justices agreed to hear the case of Freddie Hall, a Florida death row inmate who killed two people in 1978, but who was described as mentally disabled when he was a child and was deemed to be mentally retarded by the judge who sentenced him to die. Three years ago, Florida prosecutors said Hall had scored a 71 on a Wechsler Adult Intelligence Scale test and therefore could be executed for his crimes. At other times he scored 73 and 80.

“His case figures to be the most important death penalty dispute decided during this court term. During the last decade, the court has limited the use of the death penalty by excluding those who were younger than 18 at the time of the crime or who suffered from a significant mental disability. But until now, the court has not intervened to clarify who qualifies for an exemption based on a mental disability. “It’s been 11 years, and this issue is still not settled,” said Richard Dieter, executive director of the Death Penalty Information Center.

Continue reading “Court to address death penalty and mental disability”

Cognitive therapy and depression

Cognitive behavioural therapy is more effective than standard care for people with hypochondria or health anxiety, say researchers writing in The Lancet.

As the BBC reported today, “In their study, 14% of patients given CBT regained normal anxiety levels against 7% given the usual care.

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“The researchers say nurses could easily be trained to offer the psychological therapy.  Between 10% and 20% of hospital patients are thought to worry obsessively about their health. Previous studies have shown that CBT, which aims to change thought patterns and behaviour, is an effective treatment for other anxiety disorders. But there is a shortage of specialists trained to deliver CBT, and as a result waiting lists can be long.

“In this study, 219 people with health anxiety received an average of six sessions of cognitive behavioural therapy while 225 received reassurance and support, which is standard. After periods of six months and 12 months, patients in the CBT group showed “significantly greater improvement in self-rated anxiety and depression symptoms” compared with standard care, the study showed. There was also a particularly noticeable reduction in health anxiety in the CBT group straight after treatment began.

“The therapy was delivered by non-CBT experts who had been trained in only two workshops.Study author Prof Peter Tyrer, head of the Centre for Mental Health at Imperial College London, said the results showed that hypochondria could be successfully treated, in a “relatively cheap” way, by general nurses with minimal training in a hospital setting. Reducing the anxiety levels of 14% of the CBT group might not seem a high figure, he said, but these were often people with serious problems who had sometimes spent thousands of pounds on private health assessments because of fears about their health. “Health anxiety is costly for healthcare providers and an effective treatment could potentially save money by reducing the need for unnecessary tests and emergency hospital admissions,” Prof Tyrer said. Writing about the study in The Lancet, Chris Williams from the University of Glasgow and Allan House from the University of Leeds, said the findings were “intriguing” but translating them into services was “problematic”. Continue reading “Cognitive therapy and depression”

Shutting down mental health care

In recent days the news has been filled with reports of shutdown related injustices to families of fallen U.S. soldiers, patients in government cancer treatment programs, students reliant on federal aid. As Forbes Magazine reports, mental health care is also taking a hit.

“In the months leading up to World Mental Health Day, DC has been shaken by a series of violent events that ended with innocent lives lost and our country’s mental health services called into question. imgresDuring this same time period, Washington, DC has been consumed by a government shutdown, with lawmakers and policymakers trying to determine how to rein in our country’s financial burdens and overspending. Unfortunately, as federal and state governments look to cut budgets at every turn, mental and behavioral health services are often on the chopping block first. Financial cuts, compounded with US stigma often applied to mental health troubles and disparate access to services across the county, mean that those who need services most are often those left without proper care.

“August though October brought DC into the spotlight for many reasons, the saddest of which is the violence that was covered by mass media as two shootings occurred. In one case, Aaron Alexis, a 34-year-old, perpetrated a mass shooting that left 12 people dead, in Washington’s Navy Yard. Previous to the shooting, it was reported that Mr. Alexis was treated at the VA for mental health issues including sleep disorders and paranoia, but had not lost clearance.

“Miriam Carey, also 34, reportedly had an unhealthy obsession with the White House when she drove her car into the White House gates and led police on a chase around DC before being killed. Although she had no reported psychosis or supposed violent intent, it was noted in the months leading up to the incident she believed that the President had been stalking her and might have suffered from postpartum depression. When killed by authorities on Pennsylvania Avenue, she had her 18-month-old child in the car.”

“Although societal stigma and knowledge of where to access behavioral and mental services are often barriers to care, budget cuts continue to make seeking care more difficult. Whether this be through decreases in available services, lack of providers due to poor reimbursements or less preventative actions in communities, the impact of mental health funding shortages is great. According to the National Alliance on Mental Illness, “increasingly, emergency rooms, homeless shelters and jails are struggling with the effects of people falling through the cracks due to lack of needed mental health services and supports.” Continue reading “Shutting down mental health care”

Insurers won’t pay mental health bills

The first time Melissa Morelli was taken to the hospital, she was suicidal and cutting herself, her mother says. imgresShe was just 13, and she had been transferred to a psychiatric hospital, where she stayed for more than a week, reports today’s New York Times.

“Her doctors told her mother, Cathy Morelli, that it was not safe for Melissa to go home. But the family’s health insurancecarrier would not continue to pay for her to remain in the hospital.

“Former Representative Patrick J. Kennedy, with Representative Rosa DeLauro of Connecticut, right, and Victoria Veltri, Connecticut’s health care advocate, backed the mental health parity law that his father, Senator Edward M. Kennedy, also championed. The second time, the same thing happened. And the third and the fourth. Over the course of five months, Ms. Morelli took Melissa to the hospital roughly a dozen times, and each time the insurance company, Anthem Blue Cross, refused to pay for hospital care. “It was just a revolving door,” Ms. Morelli said.

“You had not been getting better in a significant way,” Anthem explained in one letter sent directly to Melissa, then 14, in July 2012. “It does not seem likely that doing the same thing will help you get better.”Desperate to get help for her daughter, Ms. Morelli sought the assistance of Connecticut state officials and an outside reviewer. She eventually won all her appeals, and Anthem was forced to pay for the care it initially denied. All told, Melissa spent nearly 10 months in a hospital; she is now at home. Anthem, which would not comment on Melissa’s case, says its coverage decisions are based on medical evidence. Melissa’s treatment did not come cheap: it ultimately cost hundreds of thousands of dollars, Ms. Morelli said. Patients often find themselves at odds with health insurers, but the battles are perhaps nowhere so heated as with the treatment of serious mental illness.

“It was not supposed to be this way. A federal law, the Mental Health Parity and Addiction Equity Act of 2008, was aimed at avoiding fights like this over coverage by making sure insurers would cover mental illnesses just as they cover treatment for diseases like canceror multiple sclerosis. Long a priority of Senator Edward M. Kennedy of Massachusetts, it was squeezed into a bank bailout bill with the help of Christopher J. Dodd, then a Democratic senator from Connecticut, after Mr. Kennedy learned that he had brain cancer, which turned out to be fatal. The law requires larger employer-based insurance plans to cover psychiatric illnesses and substance-abuse disorders in the same way they do other illnesses. But five years after President George W. Bush signed the law, there is widespread agreement that it has fallen short of its goal of creating parity for mental health coverage. Continue reading “Insurers won’t pay mental health bills”

OK2TALK vs. mental health stigma

OK2TALK is a media campaign to reduce mental health stigma among teens and young adults.

A new survey from the National Association of Broadcasters (NAB) reveals that two-thirds of young adults have personal experience with mental health problems, states OK2TALK.org

“Although the overwhelming majority of parents and young adults are supportive of discussing mental illness more openly, more than one-fourth

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of young adults (28 percent) and one in six parents (16 percent) admit they avoid talking about it.

“To encourage these critical conversations and let people know that help is available and effective, NAB today unveiled a new public service announcement (PSA) campaign featuring teens and young adults opening up about their experiences with mental illness. The “OK2TALK” campaign includes television and radio ads in English and Spanish, and uses social media to invite teens and young adults to create the conversation about mental health.

“With unrivaled reach into homes across America, broadcasters have a powerful platform to encourage young people to start talking about mental health and get the help they need,” said NAB President and CEO Gordon H. Smith. Smith’s own family has been profoundly affected by mental illness. His 22-year-old son, Garrett, took his own life in 2003, after a long struggle with depression. He and his wife, Sharon, hope that encouraging conversation about mental illness helps keep other families from meeting the same fate: “I believe that had we known better the signs of suicidal tendency, and sought help and treatment earlier for Garrett, our son would still be alive today.” Continue reading “OK2TALK vs. mental health stigma”

Smoking and the mentally ill

“The lives of people with serious mental illnesses are about 25 years shorter than the rest of the population, on average, and the main causes of early death are tobacco-related diseases.imgres-5

Patients in psychiatric hospitals who take part in smoking cessation programs during their stay are more likely to be smoke-free after 18 months, compared to patients who don’t participate in the programs, says a new study as reported by Reuters today.

“What’s more, researchers found that quitting smoking appeared to be safe for the patients and was tied to a decreased risk of being admitted back into the hospital.

“That’s a new finding and it needs to be replicated, but we’re excited that it didn’t cause any harm and may have supported their recovery,” said Judith Prochaska, the study’s lead author from the Stanford Prevention Research Center in California.

“Prochaska and her colleagues write in the American Journal of Public Health that it’s estimated people with mental illnesses use two to four times more tobacco than the general population. Most U.S. hospitals have been smoke-free since 1993, but at least half of hospital psychiatric units allow smoking and sell cigarettes, according to the researchers. “It used to be that people with mental illnesses had a waiver,” Dr. Steven Schroeder, the Distinguished Professor of Health and Health Care at the University of California, San Francisco (UCSF), told Reuters Health. Schroeder, who was not involved with the new research, said some people believed psychiatric inpatients were not ready or didn’t want to quit smoking and that giving up smoking might make their conditions worse. Continue reading “Smoking and the mentally ill”

Coffee may reduce suicide risk

We know this sounds far-fetched but a new study has shown that drinking a lot of coffee may reduce suicidal thinking in some, imgresdue to the mood altering effects of caffeine.

Apparently, people who drank more than four cups of coffee a day were 53 percent less likely to commit suicide than those who drank less than one cup a day, a new study found. WebMD reported today that

“Those who drank two to three cups of coffee a day had a 45 percent lower risk of suicide, according to the analysis of data from more than 208,000 people who were followed from 1988 to 2008. During that time, there were 277 suicides, CBS Newsreported.

“The study was published in the July issue of the World Journal of Biological Psychiatry.

“The researchers said that caffeine in coffee can increased neurotransmitters, which can lift a person’s mood and act as a mild antidepressant, CBS News reported.

“Unlike previous investigations, we were able to assess association of consumption of caffeinated and non-caffeinated beverages, and we identify caffeine as the most likely candidate of any putative protective effect of coffee,” study author Michel Lucas, a research fellow in the department of nutrition at Harvard School of Public Health, said in a news release.

 

Full story at: http://www.webmd.com/mental-health/news/20130730/coffee-suicide-risk?src=RSS_PUBLIC

Continuing value of ECT

The idea of treating a psychiatric illness by passing a jolt of electricity through the brain was one of the most controversial in 20th Century medicine. So why are we still using a procedure described by its critics as barbaric and ineffective?The BBC ran a story today discussion the continuing benefits of this controversial procedure:

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“Sixty-four-year-old John Wattie says his breakdown in the late 1990s was triggered by the collapse of his marriage and stress at work.

“We had a nice house and a nice lifestyle, but it was all just crumbling away. My depression was starting to overwhelm me. I lost control, I became violent,” he explains. John likens the feeling to being in a hole, a hole he could not get out of despite courses of pills and talking therapies. But now, he says, all of that has changed thanks to what is one of the least understood treatments in psychiatry – electroconvulsive therapy (ECT).

“Before ECT I was the walking dead. I had no interest in life, I just wanted to disappear. After ECT I felt like there was a way out of it. I felt dramatically better.” The use of electricity to treat mental illness started out as an experiment. In the 1930s psychiatrists noticed some heavily distressed patients would suddenly improve after an epileptic fit. John Wattie on why he feels he needs ECT to keep severe depression at bay

“Passing a strong electric current through the brain could trigger a similar seizure and – they hoped – a similar response. By the 1960s it was being widely used to treat a variety of conditions, notably severe depression. But as the old mental asylums closed down and aggressive physical interventions like lobotomies fell out of favour, so too did electroshock treatment, as ECT was previously known. The infamous ECT scene in One Flew Over the Cuckoo’s Nest cemented the idea in the public’s mind of a brutal treatment, although by the time the film was released in 1975 it was very rarely given without a general anaesthetic. Continue reading “Continuing value of ECT”