May 7, 2013 - News of
the Week
CURRENT
PSYCHIATRIC LABELS SAID TO LACK VALIDITY
Countless millions of Americans suffer from their
diagnostic label more than from symptoms that can often be dealt
with.
Helped by self-awareness and supporting communities, many
become experts at coping with their symptoms.
Unfortunately, the popular misuse of psychiatric labels over many
years has a penalizing effect on those who seek help.
The fifth edition of the Diagnostic
and Statistical Manual of Mental
Disorders (DSM), often called the psychiatists' bible, will be
in book stores within weeks. Key leaders of the
psychiatric establishment say the DSM lacks scientific validity;
still, most will continue to accept its clinical usefulness for
diagnosing patients.
Plans for the next decade will shift NIMH research
funds to a search for biological underpinnings of
'mental illnesses'. If successful, the project is likely to
require new diagnostic terms.
Today's psychiatric labels lead to exclusion and
rejection. Will the discovery of biological markers end the
prejudice that too often deters people from seeking help?
MORE INFORMATION
Click Psychiatry
in Crisis..." (by JOHN
HORGAN, SCIENTIFIC AMERICAN, May 4, 2013)
ARTICLE: New York Times, May 7, 2013
(reprint protected by Fair Use Standard)
http://www.nytimes.com/2013/05/07/health/psychiatrys-new-guide-falls-short-experts-say.html?pagewanted=all&_r=1&
Psychiatry’s
Guide Is Out of Touch With Science, Experts Say
By PAM BELLUCK and
BENEDICT
CAREY
Published: May 7, 2013
Just weeks before the long-awaited publication of a new
edition of the
so-called bible of mental disorders, the federal government’s
most prominent psychiatric expert has said the book suffers from a
scientific “lack of validity.”
The expert, Dr. Thomas R. Insel, director of the National
Institute of
Mental Health, said in an interview Monday that his goal was to reshape
the direction of psychiatric research to focus on biology, genetics and
neuroscience so that scientists can define disorders by their causes,
rather than their symptoms.
While the Diagnostic and Statistical Manual of Mental
Disorders, or
D.S.M., is the best tool now available for clinicians treating patients
and should not be tossed out, he said, it does not reflect the
complexity of many disorders, and its way of categorizing mental
illnesses should not guide research.
“As long as the research community takes the D.S.M.
to be a
bible, we’ll never make progress,” Dr. Insel said, adding,
“People think that everything has to match D.S.M. criteria, but
you know what? Biology never read that book.”
The revision, known as the D.S.M.-5 and the first since
1994, has
stirred unprecedented questioning from the public, patient groups and,
most fundamentally, senior figures in psychiatry who have challenged
not only decisions about specific diagnoses but the scientific basis of
the entire enterprise. Basic research into the biology of mental
disorders and treatment has stalled, they say, confounded by the
labyrinth of the brain.
Decades of spending on neuroscience have taught scientists
mostly what
they do not know, undermining some of their most elemental assumptions.
Genetic glitches that appear to increase the risk of schizophrenia in
one person may predispose others to autism-like symptoms, or bipolar
disorder. The mechanisms of the field’s most commonly used drugs
— antidepressants like Prozac, and antipsychosis medications like
Zyprexa — have revealed nothing about the causes of those
disorders. And major drugmakers have scaled back psychiatric drug
development, having virtually no new biological “targets”
to shoot for.
Dr. Insel is one of a growing number of scientists who
think that the
field needs an entirely new paradigm for understanding mental
disorders, though neither he nor anyone else knows exactly what it will
look like.
Even the chairman of the task force making revisions to
the D.S.M., Dr.
David J. Kupfer, a professor of psychiatry at the University of
Pittsburgh, said the new manual was faced with doing the best it could
with the scientific evidence available.
“The problem that we’ve had in dealing with
the data that
we’ve had over the five to 10 years since we began the revision
process of D.S.M.-5 is a failure of our neuroscience and biology to
give us the level of diagnostic criteria, a level of sensitivity and
specificity that we would be able to introduce into the diagnostic
manual,” Dr. Kupfer said.
The creators of the D.S.M. in the 1960s and ’70s
“were real
heroes at the time,” said Dr. Steven E. Hyman, a psychiatrist and
neuroscientist at the Broad Institute and a former director at the
National Institute of Mental Health. “They chose a model in which
all psychiatric illnesses were represented as categories discontinuous
with ‘normal.’ But this is totally wrong in a way they
couldn’t have imagined. So in fact what they produced was an
absolute scientific nightmare. Many people who get one diagnosis get
five diagnoses, but they don’t have five diseases — they
have one underlying condition.”
Dr. Hyman, Dr. Insel and other experts said they hoped
that the science
of psychiatry would follow the direction of cancer research, which is
moving from classifying tumors by where they occur in the body to
characterizing them by their genetic and molecular signatures.
About two years ago, to spur a move in that direction, Dr.
Insel
started a federal project called Research Domain Criteria, or RDoC,
which he highlighted in a blog post last week. Dr. Insel said in the
blog that the National Institute of Mental Health would be
“reorienting its research away from D.S.M. categories”
because “patients with mental disorders deserve better.”
His commentary has created ripples throughout the mental health
community.
Dr. Insel said in the interview that his motivation was
not to
disparage the D.S.M. as a clinical tool, but to encourage researchers
and especially outside reviewers who screen proposals for financing
from his agency to disregard its categories and investigate the
biological underpinnings of disorders instead. He said he had heard
from scientists whose proposals to study processes common to
depression, schizophrenia and psychosis were rejected by grant
reviewers because they cut across D.S.M. disease categories.
“They didn’t get it,” Dr. Insel said of
the
reviewers. “What we’re trying to do with RDoC is say
actually this is a fresh way to think about it.” He added that he
hoped researchers would also participate in projects funded through the
Obama administration’s new brain initiative.
Dr. Michael First, a psychiatry professor at Columbia who
edited the
last edition of the manual, said, “RDoC is clearly the way of the
future,” although it would take years to get results that could
apply to patients. In the meantime, he said, “RDoC can’t do
what the D.S.M. does. The D.S.M. is what clinicians use. Patients will
always come into offices with symptoms.”
For at least a decade, Dr. First and others said, patients
will
continue to be diagnosed with D.S.M. categories as a guide, and
insurance companies will reimburse with such diagnoses in mind.
Dr. Jeffrey Lieberman, the chairman of the psychiatry
department at
Columbia and president-elect of the American Psychiatric Association,
which publishes the D.S.M., said that the new edition’s
refinements were “based on research in the last 20 years that
will improve the utility of this guide for practitioners, and improve,
however incrementally, the care patients receive.”
He added: “The last thing we want to do is be
defensive or
apologetic about the state of our field. But at the same time,
we’re not satisfied with it either. There’s nothing
we’d like better than to have more scientific progress.”
April 12, 2013 - News
of the Week
A CALL FOR INFORMATION
CONCERNING KENDRA'S LAW (AOT)
The New
York Safe Act Mental Health Section
Should Be Suspended and Reconsidered
Kendra's Law
(Assisted Outpatient Treatment)
Why extend a law that is not due to expire until
2015? Why are Kendra's Law's creators still quoting outcome
statistics gathered in 2003, a decade ago? Where are the Assisted
Outpatient Treatment (AOT) program's original recipients now, ten years
later? Is a longitudinal study underway so that concrete lessons
can be learned? What evidence supported moving the law's
expiration date to 2017 instead of 2015?
In 2003, a Kendra's Law interim report showed the progress
of 2,745 AOT participants after six months in the program. Issued by
the NY Office of Mental Health, the in-house report analyzed outcomes
from Kendra's Law's first six months of operation, based on interviews
with multiple stakeholders including staff and AOT recipients. Two
years later, that outcome data was reused in a "Final Report
2005." More recently, three independent evaluations found a
widely variable pattern of statewide use and program design. Although
the independent research teams noted the benefits of priority access to
scarce
programs and
housing, questions about involuntary participation were unanswered.
(See Kendra's
Law Updates for more...)
New York SAFE
Act Mental Health Section
Clarification is urgently needed concerning the New York SAFE Act's sweeping new
statute that assigns an informant role to the entire New York mental
health system and related agencies. The loosely-defined new
rules have already spawned a wrongful accusation
and
a buck-passing response. In Erie County this week a man was
mistakenly targeted under the SAFE Act provision by police but
responsibility for the error is
unclear. See news reports below.
"Attorney
Claims State Officials Intentionallhy Violated HIPPA to Enforce SAFE
Act" more...
"State
Police Mistakenly Enforce SAFE Act Provision" more...
"NY
SAFE Act notification under fire" more...
March 29, 2013 - News
of the Week
FLAWS IN KENDRA'S LAW
REKINDLE DISCUSSION
Have independent evaluations of Kendra's Law been ignored?
Fourteen years
have passed since the terrible day in January 1999 when Kendra Webdale
was pushed onto the track of an oncoming Manhattan subway train by a
man who had been recently discharged from a psychiatric facility with a
one-week supply of medication. A recent opinion piece by Patricia and
Ralph Webdale in the NY Daily News, "Our
Daughter Did Not Die in Vain," is a moving statement explaining the
family's resolve to end such tragedies. Left unsaid, though, is that
the man in the subway, Andrew Goldstein, had searched in vain for
services now on the Webdales' poignant "if only" list of life
savers. He had even requested a supervised treatment setting.
A quote
from the Webdales' opinion piece: "If only he had received
followup by a caseworker. If only he had been able to stick with his
medication without supervision. If only... Kendra would be alive and he
would not be in prison."
A quote from a New York Times investigation by Michael
Winerip: "What I
found most haunting about Goldstein's 3,500 page file was his repeated
pleas for services that had no vacancies."
Reading the Webdales' article took me back to 1999 when a
deluge of inflammatory publicity spurred the speedy passage of Kendra's
Law, a statute allowing the mandatory medication of psychiatric
outpatients. Its creators now call the law flawed and recommend
strengthening it. But the flaws may be insurmountable. A trial now in
progress in Manhattan involves a homicide committed in 2008 by a
Kendra's Law participant. According to his father (New
York Times, 2/20/2008), the assailant simply eluded the caseworkers
assigned to him. This case raises questions about compulsory
medication's inherent monitoring problems.
A major culprit in the fatal subway encounter, mostly ignored in 1999,
was New York State's downsizing policy that derailed Andrew Goldstein's
repeated tries to get the help he knew he needed. The true story of
Goldstein's futile search for help was detailed by Michael Winerip in
the New
York Times Sunday Magazine cover story, May 23, 1999.
The Webdales' commentary confirms their compassionate
intentions and moral credibilty, but it fails to show that Kendra's Law
can put a dent in the crisis of funding and services we face today. New
options include non-coercive ways to engage people who have 'given up'.
Just a few promising examples are Emotional CPR promoted by the
National Coalition for Mental Health Recovery; the WRAP program developed by
Mary Ellen Copeland; and a deceptively simple program that helps
patients make best use of today's typical 15-minute medication consult,
created by Patricia Deegan, the founder of Common Ground.
Let us hope that with
constructive input from open minds, progress is possible.
MORE INFORMATION:
Kendra's
Law Updates: 2006-2013
NOTE:
In a
whirlwind response to the killing of 26 people (20 children) in
Newtown CT, Governor Andrew Cuomo signed a new package of firearm and
mental health regulations, the NY SAFE Act on January 15, 2013,
intended to control
gun violence. The act extends Kendra's Law from 2015 to
2017, expands some aspects of the law, and adds rules requiring
professionals to inform authorities when one of their patients exhibits
signs of potentially harmful behavior. The Safe Act has raised
questions so far unanswered and treatment barriers such
as patient/professional trust. Further, the extension of
Kendra's Law is premature,
considering the cautionary findings of independent evaluations in
2009 and 2010. A new independent evaluation is needed to
update the in-house report of 2003 which the Legislature
found insufficient. Ten-year-old outome data from 2003 and
repeated in
"Final Report 2005, quoted
often as though current, is misleading.
March
11, 2013 - News of the Week
A HARVARD STUDENT PROPOSES
IMPROVEMENTS IN MENTAL HEALTH SERVICES
The Harvard Crimson recently ran a
student's account
of his failed search for mental health services. For months after
seeking help for disabling symptoms, the student was met by a series of
stone walls while his or her 'voices' worsened. If there is a
bright
side to this disturbing story, it's the student's courage in recounting
the experience with the hope of saving others from succumbing to the
spirit-breaking obstacles he or she faced. Kudos to The Harvard
Crimson
for airing this important issue and for provoking a discussion of
solutions.
"You do not become schizophrenic
overnight. When I began to hear voices, I told myself that it was
some peculiar coping mechanism that was benign and would soon go away....(more)
(Article forwarded by
Bill Lichtenstein, LCMedia.com)
March
7, 2013 - News of the Week
RECOVERY IS FOR
EVERYONE! (Conference Announcement)
Thursday,
April 4, 2013
The
Marriott, Albany, NY
Recovery is about doing things differently.
It’s about having hope and making changes.
This free
conference, “Recovery is for Everyone!,” will include
information that persons in recovery, providers, and others can use to
make recovery “real.” Speakers will discuss recovery
principles and concepts and how they can be put into practice, what a
recovery facilitating system looks like, measures for
recovery-promoting environments, and tools that support recovery.
The conference is
intended for people in recovery from mental health conditions and/or
addiction as well as their families,
educators, social workers, psychologists, psychiatrists, peer
specialists, community staff, and other behavioral health stakeholders.
This conference is offered
free of charge. Continuing education credits will be available.
You can register
for “Recovery is for Everyone!” by Friday, March 22, 2013
using the form included in the attached brochure (link is below).
Sponsored by: Community Care Behavioral
Health Organization and Western Psychiatric Institute and Clinic of
UPMC.
For more information, please visit www.ccbh.com --
and/or view the descriptive brochure linked below.
February 18, 2013 - News of the Week
Tragic mass shootings have
led to a welcome national focus on violence prevention. It is
troubling, though, to see the diagnostic term 'schizophrenia' used as a
catchall word for violent behavior. Schizophrenia affects just
over 1% (1.1
percent)
of the adult population (National Institute of Mental Health, NIMH
website) and of these people, 99.97% of them will not be convicted of serious violence
in a
given year (Walsh et al, 2002 and Wallace et al, 1998). Also
noteworthy is a research finding that violence
rates for those who did not abuse
substances were indistinguishable
from their non-substance-abusing neighbors.
With misuse of mind-altering substances (found to double violence
rates), those with schizophrenia had
"the lowest occurrence
of violence over the course of a year" compared with bipolar disorder
or major depression.
(Stuart, 2003)
How did schizophrenia acquire its inflated link to
violence? Experts point to decades of media misrepresentation.
Its catchy name and air of mystery were a gift to the advertising and
entertainment media, and confusion with "split personality" added to
its allure. An example is a tabloid column about flip-flopping
politicians, headlined, "The Schizophrenics Are Loose -- Public
Nuisances," (The New York Post, 1991).
The media's persistent misrepresentation of 'schizophrenia'
has clearly influenced public opinion. Twenty years have passed since a
public awareness booklet noted that "violence has been exaggerated in
movies and television, increasing irrational fears of persons with
schizophrenia." ("Facts About Schizophrenia") The media's active
role in shaping opinion was best summed up by a Robert Wood Johnson
Foundation survey: "Mass media is, far
and away, the public's primary source of information about mental
illnesses." (Yankelovich, 1990)
It is possible that 'schizophrenia' filled a void in
psychiatry's diagnostic jargon when the term 'psychopath' was dropped
by psychiatrists. Psychopathy (as it was called) is a psychiatric
condition that has a known association with violent behavior. This
condition has most recently been labeled 'antisocial personality
disorder', a diagnosis mired in confusion and controversy. Lacking a
usable word, the mass media may be using 'schizophrenia' as a fallback
choice when reporting unexplained violence. If so, it's a
terrible mismatch. 'Antisocial
personality disorder' and 'schizophrenia' are not the same, and the
terms are not interchangeable.
With few exceptions, a 'schizophrenia' label penalizes
forever the life of the person who receives it. One would expect such a
punishing label to be based on scientific evidence, but there is no
such evidence. Calls for a name change come and go. An
excellent discussion of this idea is Phyllis Vine's "Should
the term schizophrenia be changed?"
Our vocabulary shapes attitudes, policies, and even
laws. Surely we can head off further distortion of
'schizophrenia' by protesting its use as a blanket term in violent
contexts.
Refrerences
"Facts About Schizophrenia". A booklet issued by NYS Office
of
Mental Health, Gov. Mario Cuomo's administration (1983-1994)
National Institute of Mental Health, "Schizophrenia,
12-month prevalence," website (2013)
Stuart, Heather, "Violence and mental Illness, an overview,"
policy paper, pages 122-123, Queens University, Ontario Canada, (2003)
The New York Post. "The schizophrenics are loose - public
nuisances," R. Emmett Tyrrell Jr. October 8, (1991)
Vine, Phyllis. MIWatch.org "Should
the term schizophrenia be changed?, website (2009)
Wallace et al. "Serious criminal offending and mental
disorder," British Journal of Psychiatry, 172, 477-484. (1998)
Walsh et al. "Violence and schizophrenia: examining the
evidence," British Journal of Psychiatry, 180: page 494 (2002)
Yankelovich (DYG, Inc.). "Public Attitudes Toward People
with Chronic Mental Illness," prepared for Robert Wood Johnson
Foundation, April (1990)
February
8, 2013 - News of the Week
A
COURAGEOUS YOUNG MAN SPEAKS OUT
By
Alan Taylor
IN 2012
a string of mass shootings shook America. Ian Stawicki took five lives
at Cafe Racer in Seattle, James Holmes opened fire in a crowded
Colorado theater and, most disturbing, Adam Lanza killed 26 people,
including 20 children, in Newtown, Conn.
The
mental health of each of these perpetrators was immediately questioned,
which has led to a renewed call for better mental-health treatment.
I’m
afraid that no substantive change will occur because we are discussing
mental health in the abstract sphere of politics rather that in the
intimate communities where we live day to day — places like our
homes, jobs, schools, faith communities and social gatherings.
As a
society, we don’t talk about these issues, at least not in the
personal ways that raise awareness, foster advocacy and lead to
meaningful change. We talk about the dangers of mental health in a way
that causes those who are actually living with mental-health challenges
to gather in hushed circles and share their struggles, wisdom and
perspective with only a select few.
Their
stories, front-line experiences and insights are the key to a more
holistic societal understanding. But they don’t speak because
they are scared of losing respect, trust and relationships, and being
viewed as another mentally ill person who might go on a violent
rampage.
In 2003 I
was diagnosed with bipolar disorder, type 1. I’ve felt the cold
exclusion of stigma. In the months after my first manic episode many of
my friends withdrew; one friend told me that her boyfriend didn’t
feel it was safe for her to be around me. There are times when I
hesitate to reveal my diagnosis for fear that new people I meet will
subtly distance themselves from me — the shifty look of distrust,
unsure what erratic thing the guy with bipolar might do.
Most
times, though, I share my story, because I don’t want their
picture of mental illness to be a mad man with a gun.
Change
begins with education and conversation. Most people know very little
about mental health. Society at large seems to be mostly ignorant,
informed predominantly by popular media and gruesome news stories.
Rather than a disease of the brain — the same way diabetes is a
disease of the pancreas — we see a disease of character.
We speak
in language that perpetuates stigmas, referring to moody people as
“being bipolar.” We foster fear by putting the word
“schizophrenia” in print most often with the words
“violence,” “untreated” and “risk to
themselves and others.” We discourage transparency by
removing trust and responsibilities from those who choose to speak
openly about their depression or anxiety.
I believe
that for real change to occur, our communities must push against the
flood of bigotry and misunderstanding. fear and labeling. We must
initiate space for safe conversation that invites those living with
mental health challenges to share their stories of struggle and
survival.
What
might this look like? Religious leaders might consider devoting
time in their services to educate their members. Medical and
nursing schools might consider providing more robust mental-halth
training that includes firsthand testimony from those who live with
mental-health challenges. Business owners might make
mental-health education a part of new-hire orientation.
School
administrators might build mental-health education into the curriculum.
Media outlets might produce positive stories about mental health
that expose society to a more balanced and accurate view of this issue.
Those who live with a brain disease might share their story,
accepting the invitation to discuss and educate.
Undoubtedly,
we need better funding for mental-health treatment, but we also need a
shift in the basic way we talk and think about matters of mental
health. This shift won't take place in Olympia or Washington,
D.C. It will take place in our office, our favorite retaurant,
our church, mosque, or temple and our family gatherings.
Alan Taylor works as a
peer counselor at a community mental-health clinic in Puyallup.
January 15, 2013 -
News of the Week
Let's
Stop Blaming The Mentally Ill
By
Lollie Butler Arizona Daily Star
January 15, 2013
(courtesy of NYAPRS.org)
There
is a bloody
war being waged in America; gun advocates versus those who would ban
guns. This "civil" war may go on for a long time.
Meanwhile,
those
suffering from mental illnesses unfairly shoulder the blame for
atrocities committed against the innocent.
This is
an
unreasonable situation. Armed persons firing into crowds, whether at
schools or shopping malls, defies reason and causes all of us to feel
vulnerable. It also takes its toll on those with mental illnesses.
Words like "crazy" and "deranged" fly across the
front pages, and the mentally ill in treatment, saddled with severe
funding cuts and ongoing social stigma, take it on the chin.
A 2009
study in the
Archives of General Psychiatry states, "If a person has severe
mental illness without substance abuse and a history of violence, he
or she has the same chance of being violent during the next three
years as any other person in the general population."
"It's
unproductive to besmirch a whole group of people recovering from
(mental) illnesses as if they are all dangerous - when in fact,
they're not," says Duke University medical sociologist Jeffery
Swanson.
Who
kills? Do guns
kill or do people kill? The NRA would have us believe that the
Newtown murderer could have carried out his massacre of 26 people
including 20 children with any weapon, and that a semiautomatic rifle
is no more effective in a crowd than a cleaver. They would have us
believe that video games have created a cadre of psychotic
individuals and that the proliferation of combat rifles has no
bearing on these murders.
Our
focus of late
has been on mass murders, but every day in this country people are
killed by gunfire either by others, by their own hand or by accident.
When a child finds an unlocked gun and through natural curiosity
fires it - accidentally killing himself - the argument that it is
people, not guns who kill, falls flat.
In
every human
drama, someone profits and someone loses. In this regrettable
situation, the NRA and its members and manufacturers profit while the
public at large and those in and out of mental-health recovery lose.
In the
aftermath of
the recent tragedy that sent 20 children to their early graves and
killed teachers and others at the school who attempted to defend
them, the sales pitch of gun advocates that "freedom equals a
gun placed in the hands of every American" will probably
continue.
Though
we cry "never
again!" from the rooftops, unless we stop criminalizing everyone
with a mental illness and lift the burden of too many guns from our
shoulders, America's war with itself will continue and the body count
will increase.
Lollie
Butler is
the director of the program Heart to Heart, through the National
Alliance for Mental Illness of Southern Arizona.
October 9, 2012 - News of the Week
'I GOT BETTER' CAMPAIGN
GAINING MOMENTUM
Have you heard about MindFreedom International's new website, 'I GOT BETTER' ?
This campaign has the potential to 'go
viral – imagine first dozens, then hundreds, even thousands
of people sharing their videos...Celebrities and other public figures
coming out of the 'mad closet'...This could not only bring hope to
people in pain, but also change attitudes toward us...”
With your help, people
will get the message that there is hope, even in situations of extreme
mental and emotional distress... or even when someone feels trapped
forever in a mental health system with no exit, say Sophie
Faught and John Abbe, MindFreedom's Communications
Co-Coordinators. Read on for how-to!
SHARING YOUR STORY IN A VIDEO
COULD MAKE ALL THE DIFFERENCE
Now it's up to you -- do you have a story about
discovering and nurturing hope while in and out of the mental health
system, and mental and emotional problems?
Sharing your story could make a huge difference to someone
in the depths of their own struggle, especially young people.
Getting a psychiatric label can feel isolating. When they
see you and others sharing your stories about how you found hope and
defined recovery and wellness for yourself, you will encourage them and
give them ideas about how to make their own lives better.
Whether or not you share your story, think about people in
your life who may have such a story, and see if they would like to
share it.
IT'S EASY TO SHARE YOUR VIDEO
STORY
One of the best ways to really reach people today is with
video, so they can see your face and hear your voice. Try to keep it
short. Go ahead and share the worst of your struggles, but make sure to
follow that up with your recovery from hopelessness and positive
information about how you're achieving wellness in your life.
You don't have to be "fully recovered" (however that's
defined!) to participate. Whatever steps you've taken towards wellness,
and to get out of any oppression in the mental health system, you've
got a story to tell and we want to hear it!
Here's how to make and
submit a video:
http://igotbetter.org/videos/guidelines
We are also accepting
written stories:
http://igotbetter.org/stories/guidelines
See those new video
stories with a link to more videos here:
http://igotbetter.org
Thanks for your support in
making I GOT BETTER a success!
Please email us
with questions, feedback, or anything else about I GOT BETTER at igb@mindfreedom.org
In support,
Sophie and John
MindFreedom International
August
26, 2012 - News of
the Week
MINDFREEDOM
EXPLORES LANGUAGE OPTIONS
Years ago, David Oaks, the founder and director of
MindFreedom International, urged the mental health community to stop
using the term mental illness He
believes (and I agree) that the term spawns the public's misperception
of little-understood human conditions, and supports the medical model's
undeserved domination of the mental health field As David
explains it, My call is about
opposing domination by any
model in this complex field. My call is about opposing bullying
in mental health care.
To explore language options, David created an open-forum
online website, "Lets Stop
Saying "Mental Illness"! He emphasizes this is not
about political correctness or finding the perfect words, but sending a
message of respect about the diversity of perspectives in mental health.
In an email this week, David wondered why I (Jean Arnold)
continue to use mental illness
on my website. At first I thought he must be overstating. To
check it out, I did a word-search of www.stigmanet.org
by pressing ctrl+f (at the same time), then entering mental illness in
the FIND box that popped up. There were 143 finds for mental illness/illnesses on my home
page alone. (A number of these were in articles by other people.) I
intend to replace my use of mental illness/illnesses with language that
doesn't presume that the etiology of human behaviors has been
discovered.
"Let's Stop Saying "Mental Illness"!
is an informative and thought-provoking online essay-in-progress about
the pitfalls of language inaccuracy and bias. David
welcomes feedback suggestions regarding this "living essay." Email:
news@mindfreedom.org
SEE THE ESSAY:
http://bit.ly/not-mentally-ill
or
http://tinyurl.com/not-mentally-ill
August
20, 2012 - News of the Week
CANADIAN
FINDS FAULT WITH MEDIA DEPICTION OF PSYCHIATRIC VULNERABILITIES
"If
we continue as a society to let the media define mental illness, the
cycle of stigma and fear will only compound the problem." These
words are from Devan Munn, a Canadian who is a member of the
Community Editorial Board of GuelphMercury.com
Mr.
Munn's insightful editorial ,"Media's approach to
mental illness doesn't help us understand it" (8/18/2012), drew
the
following
response from a concerned reader.
Comment by:
NormalLikeYou
Aug
18, 2012 12:38 PM
Great Editorial
It saddens me that the only time Mental Health gains much traction in
the media is in the event of a horrible tragedy. After such times, we
usually do get calls to address the systemic problems that are
symptoms of our failure as a society to prioritize getting help to
something that affects one in five Canadians. However, often what is
overlooked is that many people who have serious mental illnesses do
not get help because they fear being identified as mentally ill. Not
only that but our society has a particular picture of those with
mental illnesses.
When
someone says the words "paranoid
schizophrenia" they tend to think of someone like Vincent Li
rather than someone like me: A multiple scholarship winner who was
told that his illness would prevent him from returning to university
but defied such odds to pursue his education. One of the reasons I
struggled so much in the beginning with my diagnosis was that I
thought that my life would be spent on a couch because that was one
of the better expected outcomes.
Instead,
after more than a few false
starts and much hardship, I discovered that I may not be able to
control all my symptoms, but I chould choose whether I accepted my
fate or not. A few years after such an epiphany, I am near complete
my M.Sc. in Mathematics. There is great pain and sorrow with mental
illness, but there is also hope in such darkness. It is my hope that
the media and we as a society do a better job at encouraging such
hope for those that may so desperately need it.
July
28,
2012 - News of the Week
SURVIVOR MAKES PLEA
FOR
OPEN DIALOG
Article Reprinted using Fair Use Protection
Link: http://www.thenewstribune.com/2012/07/27/2229396/open-dialogue-can-tear-down-walls.html
The News Tribune
Open
dialogue can tear down walls of misunderstanding about mental illness
by ALAN TAYLOR
Last updated: July 27th,
2012 12:27 AM (PDT)
Our communities are filled with people who are living
silently with mental illness, and most of us are terrified to share our
stories. We are afraid of being judged and labeled, relegated to the
edges of society.
We fear that we will be locked out of the inner circle
of community, the place where life is shared over good food, camping
trips, church events and baseball games. The place where meals are
brought to those experiencing tragedy, where money is raised for those
experiencing catastrophe, and where community support surrounds those
in need of healing. We fear that we will be on the outside looking in.
We are afraid that if we talk about our illness we will
be the subject of rumors questioning our stability, integrity, worth
and competency. We fear that when we share our diagnoses –
bipolar, depression, schizophrenia, obsessive compulsive disorder,
anxiety disorder or something else – we will be held at
arm’s length and will no longer be trusted to participate in the
responsibilities of the community; to teach young people; to manage the
finances of our local church; to organize the community benevolence
program; or to hold our position as accountant, city councilman,
barista or CEO.
Our community must do better than this, and I believe
we will. We will do better when we have eyes to see, eyes to see that
they are us. Who among us doesn’t have a mental illness or know
someone who has a mental illness?
We will do better when our communities hold forums and
town halls where we can talk openly about mental illness and stop
speaking in language that evokes fear. There is great power in sitting
in a room with someone and taking the time to hear that person’s
story.
Until we make this a priority, people living with
mental illness will continue to be cast as unstable villains, teetering
on the edge of some violent explosion, fit only to be locked away,
pushed out of the life of our community.
As a community, we have an opportunity to grow, to
bring to light a group of illnesses that are misunderstood, whose
treatment and research is underfunded, and whose effect reaches into
nearly every home. It’s time to inform the misunderstanding,
better fund the treatment and research, and open the lines of
communication that will lead to reconciliation and healing.
Allow me to start the conversation.
I have bipolar disorder, type 1. In 2003, I ran through
Lakewood in my boxers carrying an American flag. I received inpatient
treatment at the psychiatric unit of St. Francis Hospital and
outpatient treatment Greater Lakes Mental Health. I attempted suicide.
I spent weeks, on two different occasions, wrapped in a world of
delusions that caused erratic behavior. That’s a piece of my
story.
I have also been the valedictorian of my high school,
leader in my church youth group, a server at Red Lobster, an employee
of Merrill Lynch, a minister and a graduate student at the University
of Washington.
I’m a father, a husband, a resident of Pierce
County. These are also pieces of my story.
What’s your story?
Alan Taylor of Milton is a
state-certified peer counselor who works in the behavioral health field
in Pierce County as a peer specialist. He will start a master’s
of social work program at the University of Washington Tacoma in the
fall.
June
14, 2012 - News
of the Week
MINDFREEDOM PRESS RELEASE
6/14/2012:
New Campaign Defies Hopelessness In Mental
Health Care
Immediate Release:
contact news@mindfreedom.org
Today, MindFreedom
International launches the "I Got Better"
campaign with an invitation for you to participate in this "Survey on
Hope in Mental Health": https://www.surveymonkey.com/s/mfi-igb-intro
This brief, confidential introductory questionnaire takes
less than five (5) minutes to complete.
"I Got Better" is an ongoing project defying the
all-too-common message that recovery from mental and emotional distress
is impossible. The "I Got Better" campaign will make stories of
recovery and hope in mental health widely available through a variety
of media.
Your Participation Could Save a Life
Any and everybody with a stake in mental health in our
society is welcome to participate, including people who have used
mental health services, psychiatric survivors, as well as their
friends, family members, colleagues, and mental health workers. Please
share the survey link - https://www.surveymonkey.com/s/mfi-igb-intro
- freely via email, facebook, twitter, blogs, etc.
Respondents to the survey wishing to share additional
knowledge will be invited to take an optional follow-up survey about
impressions of hope and hopelessness in mental health care, and
successful strategies for recovery. Some survey respondents will be
asked to share their story on video.
David Oaks, Director of MindFreedom International, said,
"When I was in psychiatric care in college, I was told it was forever.
Your experience of hope and hopelessness in mental health care could
help youth and young adults receiving a psychiatric diagnosis for the
first time. Hope could save a life."
The Story Behind "I Got Better"
The title of the campaign is inspired by the successful "It
Gets Better" viral media effort led by columnist Dan Savage that "shows
LGBT youth the levels of happiness their lives will reach." While these
two campaigns are independent, Dan Savage has enthusiastically endorsed
"I Got Better."
___________________
The "I Got Better" campaign is funded by a grant from the
Foundation for Excellence in Mental Health Care to MindFreedom
International. MFI is an independent nonprofit coalition founded in
1986 to win human rights and alternatives in mental health. For more
information contact news@mindfreedom.org,
or call the MFI office at 541-345-9106.
To take the brief, confidential introductory "I Got Better"
survey, which will be active through 15 October 2012, click here now:
https://www.surveymonkey.com/s/mfi-igb-intro
- end -
May 20, 2012 - News
of the Week
ARTICLE:
Recovery in
Acute Care
"Before Healing Can Occur, People Must Feel Safe"
by Maggie Bennington–Davis, M.D., MMM
Source:
Recovery to Practice Highlights April 26, 2012
BEFORE
HEALING CAN OCCUR, PEOPLE MUST FEEL SAFE
There is an old medical school adage that says "first, do
no harm." In acute hospital settings, people describe all-too-frequent
experiences of fear and panic, loss of control, loss of
self-determination, seclusion, restraint, and unwanted medications.
Inpatient units can seem downright dangerous, not only to those
hospitalized, but to staff as well. Before healing can occur, people
must feel safe.
During my tenure as the medical director of psychiatry at
Oregon's Salem Hospital, I was part of the miraculous transition to a
trauma-informed environment. Seclusion and restraint were eliminated,
and there was a substantial decline in the administration of
involuntary medications (as well as a 30 percent decline in the use of
routine medication). People became more involved in psychoeducational
groups and therapeutic exchanges with staff. Injuries sustained by
staff and those hospitalized dropped dramatically, lengths of stay
decreased, and financial performance improved. It was a wonderful
example of parallel process—recovery for those coming into the
hospital and for the hospital itself.
(Highlight added)
Recently, I
had a phone call from a psychiatrist who specialized in organizational
consultation. He asked me, "After you quit doing restraint, what did
you do when someone was really upset and out of control?"
I had to
pause before I answered, because there wasn't a simple way to respond.
Staff in the program were never told not to use seclusion, restraint,
medication, or other means of control. Restraint went away because it
was no longer necessary, not because it was "banned." If a situation
required restraint or seclusion to prevent serious harm, appropriate
measures would be taken. But the environment had drastically changed,
and those situations didn't occur very often.
We included
the people we served as we began our transformation and philosophical
shift. We immersed ourselves in understanding the neurobiology of
trauma, fear, fight-or-flight response, and the realization that
traumatized people perceived our clumsy attempts at "safety" as
predatory and controlling. We were astonished to learn virtually
everyone who came (or was brought) to us had suffered through difficult
childhood experiences. It humbled us to think about our past reactions
to these folks and the pejorative language we had used to explain what
suddenly seemed like perfectly rational behavior (manipulative,
aggressive, help-seeking, belligerent, difficult, etc.). Suddenly,
power struggles made a lot of sense, disengagement seemed
self-preserving, and the minor events that precipitated catastrophic
reactions didn't seem so minor after all. When we changed the lens to
one that was trauma informed and started asking "What happened to you?"
instead of "What is wrong with you?", everything else changed too.
(highlighting added by ja)
In essence, when we changed ourselves and the hospital to
be really, truly "safe," the people we were serving also felt safe.
Independent of diagnosis, symptoms, age, sex, or history, we were by
far the most significant variable.
Then the fun really began. We started using our
environment to regulate certain physiological responses of people at
the hospital. We used drumming techniques to normalize heart rates,
music to soothe, colors to evoke calm, and artwork to inspire (instead
of posted rules forbidding balloons and knives). We asked ourselves and
those we were serving, "What helps us feel safe?" The answers were
friendly greetings, calm voices, beauty in our surroundings, constant
information, sharing meals, and talking openly about upsetting events.
We changed our language, our assumptions about recovery, and our
expectations, and made a point of including families and friends. We
educated ourselves about customer service. Putting people's fears to
rest as soon as possible became our business.
We also realized that staff interactions completely set
the tone for everyone else, so we became mindful about communicating
and working with one another.
Dr. Sandra Bloom, creator of the Sanctuary Model,
taught us how to hold daily community meetings to discuss safety with
those we were serving as well as staff (doctors, administrators,
janitors, cooks, security, etc.). The twice-daily meetings became the
anchors of our serenity. If something happened that shook our
sanctuary, we spent the next community meeting determining how to
return to safety. We knew when something frightening happened to one
person in the community, everyone was affected.
Every now and then, we still experienced an upsetting
event. I will never forget the woman who repeatedly banged her head
against the hospital wall. She had been restrained many times before,
always to keep her from harming herself. We mulled over how we could
help her in our new environment. In a community meeting, another
hospitalized woman told the newcomer, "Honey, when you bang your head
like that, it hurts my head." The group suggested we move the bed to
the center of the room, away from the walls that facilitated her head
banging. Finally, the banging stopped and the woman began to heal.
There was the man who paced the unit's perimeter, talking
frenetically to himself and occasionally banging his fist on the wall.
During a community meeting, folks who had been in the hospital for a
few days kindly told him they were frightened of him. He looked shocked
and apologized, saying he would never hurt anyone. His pacing stopped,
his fear and anger seemed to subside, and he began to pursue the
opportunities we offered to support his healing process.
We learned to have a different threshold for upsetting
behavior. Staff were constantly encouraged by managers to do what was
necessary to keep things safe, but the word "safe" became much more
inclusively defined. Our staff created an environment where everyone
really did feel safe, and the outbursts, anger, and violence mostly
melted away.
All of these changes created completely different roles
for staff—jobs that focused less on maintaining order and
policing the unit, and much more on healing and partnering with people
to initiate and support their recovery journeys. The transformation
exemplified recovery more than any treatment plan I have ever
witnessed. It was truly a highlight of my career.
Dr. Bennington–Davis is the Chief
Medical and Operating Officer at Cascadia BHC in Portland, Oregon.
May
7, 2012 - News of the Week
THE
DARK SIDE OF KENDRA'S
LAW HISTORY
The trouble-prone,
eight-year-long court case concerning Kendra Webdale's terrible death
at the hands of Andrew Goldstein ended abruptly when both sides agreed
to avert a third agonizing trial. It wasn't a perfect closure, but an
understandable one. However, the two earlier failed trials
spurred lawyer/advocate Patricia Warburg Cliff, then a board member of
national NAMI, to express her dismay in a thought-provoking article,
"The
Railroading of Andrew Goldstein." This informative commentary
(below) was published in the Journal of California AMI, vol.11,
September 2000.
Questions
remain. Key among them: Why does the press often call Andrew
Goldstein a 'treatment refuser'? Doesn't this libel a man who
knew his diagnosis was severe schizophrenia with uncontrolled violent
outbursts, and for two years had requested a supervised treatment
setting? Looking back, it is also clear that Kendra's Law
proponents missed an opportunity to point out that rare disasters are
more likely to occur when insufficient mental health services are the
norm.
Instead,
they focused their call-to-action on a man trapped by and ultimately
destroyed by draconian policy decisions.
And
still the myth goes on. Just last week, Albany's Legislative Gazette
reported a new push to make Kendra's Law permanent, wrongly describing Andrew Goldstein
as "a man diagnosed with, but not seeking treatment for,
schizophrenia."
When
fading facts become harder to verify, the insights, observations, legal
experience, and personal views of a witness can be a valuable
resource. Thank you, Patricia Warburg Cliff, for "The
Railroading of Andrew Goldstein"
For
an investigative report of Goldstein's downward spiral, click:
"Bedlam
on the Streets" New York Times,
by Michael Winerip, May 23, 1999 (This Times Magazine cover
story appeared 5 months
after Kendra Webdale's death. New York's Kendra's Law passed 3
months later, despite then-known circumstances)
ARTICLE:
THE
RAILROADING OF ANDREW GOLDSTEIN
by
Patricia Warburg Cliff
Source: (with publisher's permission)
The Journal
V.11,1.3 (September 2000)
The failure of the
legal profession, the court system and the public to grasp the vital
concepts involved in the two trials of Andrew Goldstein further
reinforce the fact that we at NAMI have much work to do.
In
January 1999, Andrew Goldstein, an unmedicated, delusional person
with paranoid schizophrenia who had been unsuccessfully seeking help
at various hospital emergency rooms, pushed Kendra Webdale to her
death on the tracks of the New York City subway. Unfortunately the
terrible tragedy of this young woman's death clouded public
perception of the situation which allowed this to occur: the failure
of the public system to offer the required state-financed housing
with day services, clinic visits and an intensive case manager, to
this seriously ill young man.
It was, however, not the system
which was on trial, but the other "victim" of this tragedy,
Andrew Goldstein himself. The first trial ended in a hung jury,
because two jury members had had some limited experience with the
mental health system and consequently understood the nature of
Goldstein's illness and his inability to form the necessary intent to
commit murder in his psychotic state. The public's outcry for
revengeful punishment did not, however, cease.
In late
February, 2000, a second trial was commenced. After hearing the
evidence, the judge instructed the jury that they had the option of
convicting the defendant of manslaughter in lieu of the second degree
murder charges, if they found that he had acted with "depraved
indifference," but without the requisite intent necessary for a
conviction of second degree murder. It took the jury only two hours
to reach the verdict of second degree murder.
The irony of
the situation should not be overlooked: Andrew Goldstein was being
held at Bellevue Hospital following his arrest where he was willingly
receiving treatment for his illness and consequently would not be
able to appear sufficiently psychotic at his trial to demonstrate to
the jury the disabling effect of this illness on his judgment. The
defense pinned its hopes on taking Mr. Goldstein off his
antipsychotic medication and putting him on the stand, to better show
the jurors his mental state at the time of the attack. This novel
concept was thwarted when Mr. Goldstein struck a social worker,
further indicating his violent state of mind when unmedicated. Judge
Berkman insisted that Mr. Goldstein be offered the choice of taking
his antipsychotic medication, which he chose to do. The result was
that the jury was able to see a passive, sedated individual and not
the person whose delusions caused his violent behavior.
NAMI's
suggestions to the defense counsel to utilize the virtual reality
videos produced by pharmaceutical companies which demonstrate the
psychotic state of mind, as well as comparisons to the diminished
capacity suffered by individuals who are experiencing the onset of a
diabetic coma or an epileptic seizure, fell on deaf ears. The
subsequent result demonstrates the ignorance of the judge, jury and
defense counsel with respect to paranoid schizophrenia. Andrew
Goldstein never got a fair chance.
At the conclusion of the
trial, the jurors were convinced that punishment, not treatment, was
warranted. Mrs. Webdale, the victim's mother spoke at the sentencing
hearing: "It is my contention that if Andrew Goldstein had been
held responsible many incidents ago, there would not have been 13
assaults and one homicide committed by him. His ongoing aggression
was tolerated and acceptable." The presiding judge concurred
saying that the attack stemmed from the state mental health system's
failure to punish Mr. Goldstein for past assaults.
On May 5,
2000, Judge Berkman gave Andrew Goldstein the maximum sentence of 25
years to life in prison for the murder of Kendra Webdale. What is
wrong with this picture? Has the "justice system" reverted
to a witch hunt to punish the violent mentally ill whom the public
system has dismally failed? Are we, as a society, going to be content
with the gross misunderstandings of mental illness which were
demonstrated in this trial? How are we going to educate the judiciary
about these issues?
The ultimate irony is that the New York
State legislature, ever reluctant to provide sufficient funding for
treatment for the mentally ill, hastily passed a bill, commonly
referred to as "Kendra's Law," allowing for court ordered
treatment or commitment of the mentally ill under certain
circumstances. Andrew Goldstein who is now rotting in the state
prison system, had tried repeatedly to get help before the attack. He
even sought his own commitment when he realized that he was out of
control. The misnomered "Kendra's Law" would not have
prevented this tragedy.
PATRICIA WARBURG
CLIFF, an
attorney and mental health advocate in New York City, serves on the
national board of NAMI as well as on the board of NAMI-NYC Metro. Her
only child, Kenneth Johnson, succumbed to depression in 1995, as a
result of the private health care system's failure to adequately
diagnose and appropriately care for his illness.
End
of article
February 15,
2012 - News of the
Week
YALE PSYCHOLOGIST EXAMINES
SCHIZOPHRENIA'S "INSIGHT
ISSUE"
How
can we help people who won't
accept any
treatment, people who deny they need
any help?
How
can the concept of recovery be
relevant for
people who say there is nothing wrong with them?
Why would someone
refuse psychiatric help? Obvious answers might be a harrowing
treatment experience, a lack of appropriate programs, or the
stigmatizing label. A more problematic reason is "lack of
insight," a loss of awareness that can occur in schizophrenia
and related disorders.
A timely article
by Larry
Davidson, PhD of the
Department of Psychiatry at Yale, asserts
that people who
appear to lack insight may be best suited to treatment
programs
that
use a recovery-oriented approach. Harvey Rosenthal of NYAPRS agrees:
"Currently,
people who are perceived to lack insight either reject any help or
end up in varying degrees of treatment against their will. Dr.
Davidson offers very practical and sophisticated guidance,
with concrete examples, towards understanding and successfully
engaging
people in a person-centered approach to care."
Over
the past several years,
recovery-oriented practice has gained momentum throughout the mental
health field. This promising trend is supported by people who
use
psychiatric services and the federal agency that oversees mental
health and substance abuse services, SAMHSA
.
Lack
of
insight has been used as a key
argument for coerced medication, and one might assume that forced
treatment is necessary for all 'treatment refusers'. Actually,
Dr.
Davidson points out that recovery-oriented, person-centered
treatments have been successful regardless of the individual's
level
of insight.
Dr.
Davidson's article
,"The Insight Issue," is posted on the temporary
website
for the Recovery to Practice group, SAMHSA
Website links:
Recovery to Practice
-- http://www.dsgonline.com/rtp/resources.html
“The
Insight Issue”
-- http://www.dsgonline.com/RTP/special.feature/2012/2012.02.12/SF.2012.02.12.html
Dr.
Larry Davidson -- http://www.yale.edu/PRCH/people/davidson.html
NYAPRS, Harvey Rosenthal, Executive Director
-- http://www.nyaprs.org
October 1, 2011 -
News of the Week
WITH
FACTS LACKING,
FACTOIDS FILL GAP AND SHAPE ATTITUDES
"A
factoid is a questionable or spurious -
unverified, incorrect, or fabricated - statement
formed
and
asserted as a fact but with no veracity. The word
appears in the Oxford English
Dictionary
as 'something which becomes accepted as fact, although it
may not be true'."
Quote is from
Wikipedia, the free
encyclopedia
In the field of
psychiatry, the lack of facts is a major
obstacle to understanding. This leaves the field open to
inventive adaptations of the existing information. For
example,
studies designed for a specific purpose are often mined inappropriately
for data to support a different purpose. Authoritative research
findings are cherry-picked for statements to support a cause.
Facts become grossly distorted when statistics reported by researchers
as relative
are presented as absolute
to bolster a cause.
Unfortunately, these methods have produced a new body of psychiatric
factoids about violence that now are becoming entrenched, with the
media acting as catalyst.
Media's
Primary Role
Years
ago, an in-depth study of public attitudes
toward psychiatric disabilities by the Robert Wood Johnson Foundation
concluded that "Mass media is, far and away, the public's primary
source of information about mental illnesses." Concerned
about
the media's vast influence, mental health advocates nationwide began in
the late 1980s to monitor media coverage of mental illnesses. In
the mid-1990s, the advocates saw and
recorded a surge of violence-loaded television features, op-eds, and
articles. Most if
not all promoted compulsory medication
for psychiatric outpatients, and most of them involved or referred to
Dr. E. Fuller Torrey, forced-medication's most visible
proponent.
It was soon clear that the violent media features were part of a
well-funded campaign to legalize forced meds that continues to this
day. By 1993, when Torrey's chief supporter (D.J. Jaffe) instructed
advocates that "it
may
be
necessary to capitalize on fear of violence to get the law passed," the
campaign had
swung into action.
Misused
Research
A
recent addition to this scene is a website headed
by D. J. Jaffe, a newly-retired adman. Judging from
a sampling of Jaffe's 'fact' sheets, he has appropriated briefing
papers developed over the years by the Treatment Advocacy Center (which
Jaffe co-founded with Dr. Torrey in the late 1990s). The papers consist
of summarized findings of original studies from many sources.
Unfortunately, the Torrey/Jaffe summaries present self-serving
interpretations of the original studies. This led authors of at
least four
authoritative studies to state that the Torrey/Jaffe team did not
accurately represent their study's findings.
But the
inaccuracies live on. In 1999, an abbreviated version of the
popular but bogus statistic, "1,000 homicides are committed annually by
untreated individuals with bipolar disorder or schizophrenia,"
reportedly made the Congressional Record. Shortened and
twisted
by 20 years of use, the 1,000-homicides factoid has morphed
to
meaningless and is now applied to people with any history of mental
illness, or half the American public.
Misperceptions
Become Entrenched
Has
the twenty-year focus on violence affected the
public's view of mental illnesses? Former Surgeon General
David
Satcher found that the public's exaggerated fear of individuals labeled
'mentally ill' raised discriminatory barriers to their health and
well-being. In his groundbreaking report on mental health in
1999
(Introduction and Themes, page 8), Dr. Satcher underscored his concern:
“Because
most people should have
little reason to fear violence from those with mental illness, even in
its most severe forms, why is fear of violence so entrenched?
Most speculations focus on media coverage and deinstitutionalization.”
There can be little doubt that the two-decade emphasis on violence by a
determined group of controversial 'advocates' has contributed to the
public's misperception of conditions called 'mental illnesses'.
MORE
INFORMATION
Article:
New York Times
Print Edition: October 4, 2011
URL:
http://www.nytimes.com/2011/10/04/health/research/04schiz.html
Reprinted
using Fair Use
Standard
Talk
Therapy
Lifts Severe Schizophrenics
People with severe schizophrenia
who have been isolated, withdrawn and considered beyond help can learn
to become more active, social and employable by engaging in a type of
talk therapy that was invented to treat depression, scientists reported
on Monday.
These new findings
suggest that such patients have far more
capability to improve their lives than was previously assumed and, if
replicated, could change the way that doctors treat the one million
patients for whom the disorder is profoundly limiting.
The therapy —
a variant of cognitive behavior therapy,
which focuses on defusing self-defeating assumptions —
increased
motivation and reduced symptoms. In previous studies, researchers have
used cognitive techniques to help people with schizophrenia manage
their hallucinations
and sharpen their attention and memory. The new study is the first to
rigorously test using the therapy to combat so-called negative symptoms
— the listlessness, exhaustion and emotional flatness that
trap
many people in solitary lives, playing out their days smoking in front
of the TV or holed up in their homes.
Dr. Bob Buchanan, a
psychiatrist at the University of
Maryland
School of Medicine who was not involved in the study, said the results
looked impressive. “This is a group of patients who have
tried
just about everything — drug treatments as well as
psychosocial
ones — and many clinicians and systems of care have
essentially
given up on them. If there’s an intervention out there that
can
make a difference, I think that’s an incredibly important
development.”
In the
study, appearing in the current
issue of The Archives of General
Psychiatry, researchers at the University of Pennsylvania enrolled 31
people from community health clinics in Philadelphia in a therapy
program that included weekly sessions, each about an hour in length, in
addition to their normal medication regimen. Each person set a goal,
whether to find a job, start a relationship or go back to school. Aided
by the therapist, the person then took incremental steps toward that
goal, going out for coffee, visiting a local bookshop or volunteering
at a community center.
“It took a
long time to get patients engaged,”
said
Dr. Aaron T. Beck, a psychiatrist and one of the authors. “We
used video games a lot at the beginning, just to give them a sense of
some mastery.” Dr. Beck invented cognitive therapy decades
ago,
about the same time another therapist, Albert Ellis, was developing
similar techniques.
The therapists in the
study, all either psychiatrists
or Ph.D.’s, all working from manuals guiding the technique,
helped their patients correct self-defeating beliefs, like
“taking even a small risk is foolish because the loss is
likely
to be a disaster,” and “making new friends
isn’t
worth the energy it takes.” After about six months, the
patients
began to show measurable improvement. After 18 months the benefit was
clear, on the Global Assessment Scale, a standard scale tracking
overall functioning.
“They made a
jump of about 10 points on that scale, on
average, which we consider to be moving a whole level up in terms of
functioning,” said Paul M. Grant, the study’s lead
author.
A comparison group of 29 patients who received standard treatment
— medication, and case management services as needed
—
showed no such improvement.
Dr. Grant’s
co-authors were Gloria A. Huh, and Dr.
Neal M.
Stolar, along with Dr. Beck, of the University of Pennsylvania, and
Dimitri Perivoliotis for the Veterans Affairs San Diego Healthcare
System.
Measures of emotional
vitality and sociability were not
changed
much. But motivation improved significantly, and some who got the
cognitive therapy altered their lives for the better, in significant
ways. One woman, who had been frequently hospitalized before the study,
began making coffee at the clinic as a part of therapy, then took her
cart to a community clinic, parlaying that into a job as a cook. She
has not returned to the hospital since.
Still, the course of
therapy was extraordinarily long
compared
with what is usually offered. A standard course for depression lasts
three or four months. That may make the approach difficult for strapped
institutions to provide, some experts said. And it is not clear whether
community therapists will be as effective as the University of
Pennsylvania’s highly trained team.
“You have to
understand that this is not like therapy
for
depressives,” who usually get better sooner or later anyhow,
Dr.
Beck said. “These people do not get better; no one had any
good
therapy for them.”
-End
of Article-
September
26, 2011 - News of the Week
'HEARING
VOICES USA' JOINS WORLDWIDE MOVEMENT
September 14, 2011,
was International Hearing Voices Day!
To celebrate, the
USA network of voice-hearers launched
their new website,
( http://www.hearingvoicesusa.org
) Already the site offers a wealth of
information including resources and links to a network of websites
across the globe -- in Australia, Greece, England, Wales, Denmark, the
Netherlands and more.
In growing numbers, people who hear voices are breaking a silence
imposed by negative social attitudes (stigma). This
breakthrough
movement, aided by the Internet, eases the pain of misunderstanding
and isolation. Learn more with a visit to About
Us: Hearing
Voices USA
http://www.hearingvoicesusa.org/about-us.html
Below is an excerpt from the National
Empowerment Center press
release:
What is World Hearing
Voices Day?
From
the Intervoice
Website (http://www.intervoiceonline.org):
World Hearing Voices Day
celebrates hearing voices as part of the diversity of human experience,
increasing awareness of the fact that you can hear voices and be
healthy. It challenges the negative attitudes towards people who hear
voices and the incorrect assumption that hearing voices, in itself, is
a sign of illness.
And
Don’t Forget to Join
the Hearing Voices Network USA on Facebook, too…
In addition to the
new Hearing Voices USA website,
we’ve also found a home on Facebook so come join us there as
well
and take part in making the Hearing Voices USA Facebook page an
informative and interesting place to be! Click here to join the Hearing
Voices Network USA on Facebook.
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