I’ve been in houses where one can just barely walk through a room. Remember being invited over to lunch at a friend’s. She said it took a whole week to clear the kitchen table so we could sit down and eat. Also remember my bother-in-law’s apartment. I kept on insisting she at least have a path form the door to her living room chair clear at all times, for the sake of safety.
Well, after reading this article, I have summoned up some compassion for folks who hoard.
Hoarding isn’t just about accumulating piles of stuff most of us would throw away. It’s more than the ceiling-high mounds of newspapers, books and dolls as shown on reality television shows like A&E’s “Hoarders” and TLC’s “Buried Alive.”
It’s about people paralyzed by the thought of getting rid of personal belongings, no matter how much – or little – they are worth. It’s about the social, physical and emotional isolation their hoarding behaviors cause. It’s about safety, not just for the hoarder but for those who live near them as well.
Initially, hoarding was considered a type of obsessive-compulsive disorder. More recently, researchers have found that only about 20 percent of people who hoard also have OCD. Depression is much more common, occurring in about 50 percent of those with hoarding disorder.
Earlier this year, the American Psychiatric Association included hoarding as a distinct disorder in its updated Diagnostic and Statistic Manual of Mental Disorders, known as the DSM.
Several factors influence the likelihood that a person may be affected by hoarding, Schwartz said. At least 50 percent of people diagnosed with hoarding disorder also have a first-degree relative – such as a parent or sibling – who also has the problem.
Trauma also can trigger hoarding behaviors, such as a death in the family or an adult child leaving for college. In some cases, people who had a tendency to accumulate items may have had someone who helped keep them from going overboard in their hoarding. When that person is no longer there – such as because of a death – the hoarding may increase. People over age 55 are three times more likely to have a hoarding disorder, Schwartz said.
A study last year of people who struggle with hoarding tendencies found that hoarders tend to have unique brain activity when faced with making decisions about their possessions, compared with people who don’t have the disorder. In general, hoarders tend to struggle with organizational, attention and information processing, which makes it hard for them to toss out what most people would consider to be unnecessary.
“This isn’t just someone who is dirty and lazy. It’s a mental disorder,” said Chalmers, who has been featured as an expert on A&E’s “Hoarders.” “To a person who doesn’t suffer, you may think why is that such a struggle to get rid of what you don’t need. But to them, just to make a decision, their brain is complete chaos. They’re not thinking clearly like us.”
Hoarders don’t just fill their homes with books, papers and knickknack collections. In some cases, well-meaning people wind up collecting animals as well.
Treatment may involve helping hoarders to understand their own behavior and connect with the emotions they’re feeling. Although it may seem counterintuitive, the cleanup is actually one of the last steps people should take when dealing with a severe hoarding problem, said Chalmers, who runs a hoarding task force in San Bernadino that was developed in 2010.
“Without appropriate intervention, it will be a never-ending cycle of response,” Brown said. “If that person is allowed to go back to their typical life and receives no ongoing support, the likelihood they will start hoarding again is very, very high. That’s another reason we need this task force.”
- ‘Hoarder fire’ guts Glendale home; woman’s hair caught fire in escape (azfamily.com)
- Don’t Let A Hoarding Disorder Ruin Your Life: 5 Anti-Clutter Strategies (health-host.co.uk)
- The psychology of the Hoarder (blogs.abc.net.au)
- Conference focuses on addressing hoarding in the First State (wdde.org)
- This Isn’t a TV Show: Life as a Hoarder (persephonemagazine.com)
- New Book Focuses On Hoarding (foxct.com)
- NBC2 Investigators: Hoarding in Southwest Florida (nbc-2.com)
- Austin Trash Removal: The One Book You Should Read About Hoarding (dirtyworkservices.wordpress.com)
- Hoarders and hoarding (lebanoncountylink.org)
- ‘Hoarding: Buried Alive’: Man Wants To Rent Duplex Unit Next To His Garbage Hoard (wonderfultips.wordpress.com)
While I believe the so called War on Drugs has largely been a failure, I am concerned about young folks indulging in substances that can have permanent health effects.
Regular marijuana use in adolescence, but not adulthood, may permanently impair brain function and cognition, and may increase the risk of developing serious psychiatric disorders such as schizophrenia, according to a recent study from the University of Maryland School of Medicine. Researchers hope that the study, published in Neuropsychopharmacology – a publication of the journal Nature – will help to shed light on the potential long-term effects of marijuana use, particularly as lawmakers in Maryland and elsewhere contemplate legalizing the drug.
“Over the past 20 years, there has been a major controversy about the long-term effects of marijuana, with some evidence that use in adolescence could be damaging,” says the study’s senior author Asaf Keller, Ph.D., Professor of Anatomy and Neurobiology at the University of Maryland School of Medicine. “Previous research has shown that children who started using marijuana before the age of 16 are at greater risk of permanent cognitive deficits, and have a significantly higher incidence of psychiatric disorders such as schizophrenia. There likely is a genetic susceptibility, and then you add marijuana during adolescence and it becomes the trigger.”
“Adolescence is the critical period during which marijuana use can be damaging,” says the study’s lead author, Sylvina Mullins Raver, a Ph.D. candidate in the Program in Neuroscience in the Department of Anatomy and Neurobiology at the University of Maryland School of Medicine. “We wanted to identify the biological underpinnings and determine whether there is a real, permanent health risk to marijuana use.”
- Marijuana use in adolescence may cause permanent brain abnormalities, study finds (medicalxpress.com)
- Marijuana Use in Adolescence, But Not Adulthood, Linked to Permanent Brain Damage (counselheal.com)
- Univ. of MD finds that marijuana use in adolescence may cause permanent brain abnormalities (eurekalert.org)
- Marijuana Use During Adolescence, Not Adulthood, May Cause Permanent Mental Illness (medicaldaily.com)
- Is Marijuana Really ‘Harmless’? (stopmyaddiction.wordpress.com)
- Cannabis May Have Less Negative Effects On Brain Tissue Than Alcohol, But Is The Trend To Legalize Marijuana Healthy For Teens? (medicaldaily.com)
Am wondering if murder, planning to murder, and domestic violence are brain disorders…
If so, or even probably so, this is a real wake up call for prison reform…
From the 23 April 2013 item at the National Institute of Mental Health
A rethink is needed in terms of how we view mental illness, stated National Institute of Mental Health Director Thomas Insel, M.D., in a recent TEDx talkat the California Institute of Technology (Caltech) in Pasadena.
Deaths from medical causes such as leukemia and heart disease have decreased over the past 30 years. The same cannot be said of the suicide rate, which has remained the same. A vast majority of suicides—90 percent—are related to mental illnesses such as depression and schizophrenia.
Insel believes part of the problem is that mental illness is referred to either as a mental or behavioral disorder. “We need to think of these as brain disorders,” he said, adding that for these brain disorders, behavior is the last thing to change.
Insel walked the audience through recent advances in neuroscience, including the Human Connectome, which indicates that mental illness may be more of a neuronal connection or circuit disorder. The earlier these circuits are identified, he said, the earlier preventive treatments could be used to save the lives of people with mental illnesses.
“If we waited for the ‘heart attack,’ we would be sacrificing 1.1 million lives every year in this country,” he said. “That is precisely what we do today when we decide that everyone with one of these brain disorders, brain circuit disorders, has a behavior disorder. We wait until the behavior emerges. That’s not early detection, that’s not early prevention.”
- Toward A New Understanding of Mental Illness (thesecretkeeper.net)
- A Break From Politics: Toward a new understanding of mental illness (freakoutnation.com)
- Once, people suffering from a mental illness were hidden … (jillsmentalhealthresources.wordpress.com)
- What Does It Really Mean for Me to Have a Mental Illness? (thedancingwriterblog.wordpress.com)
- Vaughan Bell: news from the borders of mental illness (guardian.co.uk)
- Mental Health Awareness Month (irishdragon7.wordpress.com)
- Medical Brain Disorders~The Benefits of Exercise (keepchoosingconsistency.com)
Yoga on our minds: The 5,000-year-old Indian practice may have positive effects on major psychiatric disorders, including depression, schizophrenia, ADHD and sleep complaints
Yoga has positive effects on mild depression and sleep complaints, even in the absence of drug treatments, and improves symptoms associated with schizophrenia and ADHD in patients on medication, according to a systematic review of the exercise on major clinical psychiatric disorders.
Published in the open-access journal, Frontiers in Psychiatry, on January 25th, 2013, the review of more than one hundred studies focusing on 16 high-quality controlled studies looked at the effects of yoga on depression, schizophrenia, ADHD, sleep complaints, eating disorders and cognition problems.
Yoga in popular culture
Yoga is a popular exercise and is practiced by 15.8 million adults in the United States alone, according to a survey by the Harris Interactive Service Bureau, and its holistic goal of promoting psychical and mental health is widely held in popular belief.
“However, yoga has become such a cultural phenomenon that it has become difficult for physicians and patients to differentiate legitimate claims from hype,” wrote the authors in their study. “Our goal was to examine whether the evidence matched the promise.”
Psychotherapy is effective, helps reduce the overall need for health services and produces long-term health improvements, according to a review of research studies conducted by the American Psychological Association.
Yet, the use of psychotherapy to treat people with mental and behavioral health issues decreased over the last decade while the use of medications to address such problems has increased, according to government and insurance industry data.
“Every day, consumers are bombarded with ads that tout drugs as the answer to their problems. Our goal is to help consumers weigh those messages with research-based information about how psychotherapy can provide them with safe, effective and long-lasting improvements in their mental and physical health,” said Melba J. T. Vazquez, PhD, past president of the American Psychological Association who led the psychotherapy effectiveness review project…
The resolution also states Key findings of the resolution:
• Research demonstrates that psychotherapy is effective for a variety of mental and behavioral health issues and across a spectrum of population groups. The average effects of psychotherapy are larger than the effects produced by many medical treatments.
• Large multi-site and meta-analytic studies have demonstrated that psychotherapy reduces disability, morbidity and mortality; improve work functioning; and decrease psychiatric hospitalization.
• Psychotherapy teaches patients life skills that last beyond the course of treatment. The results of psychotherapy tend to last longer than psychopharmacological treatments and rarely produce harmful side effects
• While medication is appropriate in some instances, research shows that a combination of medication and psychotherapy is often most effective in treating depression and anxiety. It should also be noted that the effects produced by psychotherapy, including those for different age groups and across a spectrum of mental and physical health disorders, are often comparable to or better than the effects produced by drug treatments for the same disorders without the potential for harmful side effects that drugs often carry.
“As Americans grapple with the ever-increasing cost of health care, it is important that consumers and those who make decisions about health care access understand the potential value in both improved outcomes and cost-saving of psychotherapies,” Vasquez said. “APA applauds and continues to support collaboration of psychologists with other health care providers as part of integrated health care teams. Psychotherapies are highly effective, but only when consumers have access to them.”
- Psychotherapy is effective, but not used enough in many health situations (examiner.com)
- 8 Reasons to Cheer for Psychotherapy and to Broaden Its Availability (psychologytoday.com)
- Should Psychotherapy Notes Be a Part of Your Electronic… (psychcentral.com)
- Managed Behavioral Health Care Just May Shorten Your Life (forbes.com)
- DSM-IV: Depression Defined (everydayhealth.com)
- Psychiatrists Who Do Psychotherapy: Vanishing Breed? (jajsamos.wordpress.com)
- The Impact of Loss on the Therapeutic Relationship in Therapist-Initiated Termination (udini.proquest.com)
- Phone-Based Psychotherapy Helps Depression, at Least in the Short Term (healthland.time.com)
- Hothouse Psychotherapy (psychologytoday.com)
Much of the debate over the future edition of the Diagnostic and Statistical Manual of Mental Disorders(DSM-5) has centered on what disorders will be added, modified or dropped. But lost in the discussion is a change that will align disorders along a developmental continuum—one that looks at them across the lifespan. This shift will provide clinicians with a critical perspective that until now has been missing.
Historically, disorders were classified in DSM by symptom manifestation and patient presentation. As a result, they generally were grouped by discreet stages of life, as if there were no connections or implications from one stage to another. In particular, the opening chapter of DSM-IV, “Disorders Usually First Diagnosed in Infancy, Childhood, Adolescence,” segregated such conditions as attention-deficit/hyperactivity disorder, pica, rumination and autism disorder from the rest of the manual. The implication was that disorders in the “child” chapter affect only children and disorders in the rest of the manual affect only adults….
he need for these changes is obvious: The real world doesn’t work within distinct boundaries, and clinicians are not best able to understand potential connections, interrelations and ramifications when they only consider a single, narrow point in time. A young girl who lashes out with persistent and significant anger could presage a young adult with similarly explosive behavior, for example. Conversely, a middle-aged man’s extreme anxiety might reflect a difficult recent event, such as a divorce or layoff. But it also might be a problem that first manifested itself decades earlier, in panic attacks or a fear of leaving the house. In both cases, diagnosis as well as treatment will be more clinically useful if the factors involved are evaluated through a longitudinal lens.
This different perspective will especially benefit women, for whom mental disorders are often linked to specific ages or periods of life. We know that young women between 15 and 22 are much more likely to have negative body image than young men and to develop eating disorders, low self-esteem, depression, self-harm and, in the most extreme cases, suicide. But what happens after 22? Even with treatment, the risk of recurrent depression remains, and it often needs to be assessed in terms of the extra emotional and physical issues many women face throughout their lives—because of lower income, discrimination, sexual harassment and violence….
- Press Release from the American Psychiatric Association: Diagnostic & Statistical Manual of Mental Disorders (DSM-5) Draws Nearly 2,300 Public Responses (jeanettebartha.wordpress.com)
- In the age of anxiety, are we all mentally ill? (msnbc.msn.com)
- Exploring the Proposed DSM-5 Criteria in a Clinical Sample (leftbrainrightbrain.co.uk)
- Checklist vs. Diagnostic & Statistical Manual of Mental Disorders (DSM): Mental Health Service Debate (jeanettebartha.wordpress.com)
- Sandusky’s “Mental Illness” Defense (thedailybeast.com)
- Two Who Resigned From DSM-5 Explain Why (psychologytoday.com)
- In the Age of Anxiety, are we all mentally ill? (vancouversun.com)
- Two resign from DSM-5 Personality Disorders Work Group over “seriously flawed” proposals (dxrevisionwatch.wordpress.com)
- ADHD in DSM-5: Lower Specificity, Increased Rates (madinamerica.com)
- DSM 5 Continues To Ignore Critics (psychologytoday.com)
- Autism Criteria Critics Blasted by DSM-5 Leader (medpagetoday.com)
Although not addressed in this study, I couldn’t help but wonder if anger is “fed” by factors not easily determined as how we think about and treat people on an everyday basis.
This morning on Facebook, a friend posted an item about snarkiness and how this affects one’s productivity. However, I think snakiness not only affects oneself but the thoughts and actions of others.I couldn’t help but think that maybe snarky attitudes can somehow draw out anger in others. Yes, we are all ultimately responsible for our actions and thoughts. But we are also “our brother’s keeper”.
This article made me more aware of how I think and act towards teens, and how I need to rethink my thoughts and actions.
Nearly two-thirds of U.S. adolescents have experienced an anger attack that involved threatening violence, destroying property or engaging in violence toward others at some point in their lives. These severe attacks of uncontrollable anger are much more common among adolescents than previously recognized, a new study led by researchers from Harvard Medical School finds.
The study, based on the National Comorbidity Survey Replication Adolescent Supplement, a national face-to-face household survey of 10,148 U.S. adolescents, found that nearly two-thirds of adolescents in the U.S. have a history of anger attacks. It also found that one in 12 young people — close to six million adolescents — meet criteria for a diagnosis of Intermittent Explosive Disorder (IED), a syndrome characterized by persistent uncontrollable anger attacks not accounted for by other mental disorders.
The results were published July 2 inArchives of General Psychiatry.
[Full Text of the Report here]
IED has an average onset in late childhood and tends to be quite persistent through the middle years of life. ..
- Uncontrollable anger prevalent among U.S. youth: Almost two-thirds have history of anger attacks (sciencedaily.com)
- Uncontrollable anger prevalent among US youth (medicalxpress.com)
- Warning over youth anger ‘disorder’ (bigpondnews.com)
- Uncontrollable anger prevalent among US youth (eurekalert.org)
- Teen rage: Anger-related disorders on the rise (vancouversun.com)
- The age of rage: psychiatrists battle over teen anger diagnosis (theprovince.com)
- The age of rage: psychiatrists battle over teen anger diagnosis (canada.com)
- One in 12 teens have ‘intermittent explosive disorder,’ study finds (news.nationalpost.com)
- Harvard Researchers Study “Intermittent Explosive Disorder” (IED); Aggression in Adolescents (madinamerica.com)
- Does your teen have a severe anger disorder? (thechart.blogs.cnn.com)
Sleeping In Vermont Dumpster Shows Psychiatric Cuts’ Cost
Katherine Gluck blurts out to the judge, “I’m guilty.”
Gluck, 47, is charged on this March morning with threatening her former husband with a hammer. Police who arrested her in Burlington, Vermont, know those tired eyes and stringy blond hair. In December, Gluck was charged but not jailed or hospitalized after she slammed a dead raccoon against the front door of City Hall. Her family urged her to get help for her bipolar disorder, which usually involves getting back on medication. She refused.
June 4 (Bloomberg) — Hurricane Irene wiped out the last state-operated psychiatric beds in Vermont nine months ago. As the only U.S. state with no government-operated psychiatric beds, Vermont’s experience reflects a growing realization among mental-health experts and advocates that the decades-long trend toward outpatient care has reached its limit and public outcry against the latest round of cuts is beginning to change the game. Bloomberg’s Tom Moroney reports. (Source: Bloomberg)
Now, court-appointed lawyer Sarah Reed hopes Judge Thomas Devine will send Gluck to a hospital. The odds aren’t good. Hurricane Irene wiped out the last state-operated psychiatric beds in Vermont nine months ago.
Since then, private-hospital emergency rooms have been backed up with mentally ill patients — some handcuffed to ER beds for as long as two days. Dozens of people are turned away each month without being admitted, and calls to Burlington police about mental-health issues increased 32 percent over the prior year.
As the only U.S. state with no government-operated psychiatric beds, Vermont’s experience reflects a growing realization among mental-health experts and advocates that the decades-long trend toward outpatient care has reached its limit — and public outcry against the latest round of cuts is beginning to change the game….
- In Vermont, what happens when the mentally ill have no place to go (bangordailynews.com)
- Rights group: Man died after neglect by son, state (mysanantonio.com)
- Vt. governor signs mental health bill (sfgate.com)
- Need for psychiatric hospital beds surges in Alabama, nation (al.com)
The Diagnostic and Statistical Manual of Mental Disorders (DSM), long the master reference work in psychiatry, is seriously flawed and needs radical change from its current “field guide” form, according to an essay by two Johns Hopkins psychiatrists published in the New England Journal of Medicine.
“A generation ago it served useful purposes, but now it needs clear alterations,” says Paul R. McHugh, M.D., a professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine and co-author of the paper with Phillip R. Slavney, M.D., a professor emeritus in the same department. “They say they can’t do any better. We disagree and can show how.”
The original DSM, published in the 1950s, was intended as a public health service documenting the incidence and prevalence of mental illnesses. By its third edition in 1980 (DSM-III), however, it had evolved into a reference book prescribing how clinicians should identify and classify psychiatric disorders.
Today, the Johns Hopkins psychiatrists say, DSM provides checklists of symptoms, offering few clues to the underlying causes of mental disease and making it difficult to direct treatment or investigate the disorders it details. A new edition, DSM-5, is due out in 2013.
The manual, put together by the American Psychiatric Association, currently identifies hundreds of conditions via lists of diagnostic criteria and symptoms, functioning exactly as does a naturalist’s field guide but for mental illness. It offers no way to make sense of mental disorders and no way to distinguish illnesses that appear to be similar but actually are quite different and require different treatments, the psychiatrists argue.
“If you just name things and don’t explain what the causes are, you do not know how to rationally treat or study the diseases,” says McHugh, former director of Hopkins’ psychiatry department. “The DSM gives everything a name but not a nature.”….
- Johns Hopkins Experts Say Psychiatry’s Diagnostic Manual Needs Overhaul (tricitypsychology.com)
- Does Everyone Have a Mental Illness? (madinamerica.com)
- Psychiatrists say diagnosis manual needs overhaul (vancouversun.com)
- ‘Label jars, not people’: Lobbying against the shrinks (newscientist.com)
- ‘Label jars, not people’: Lobbying against the shrinks (newscientist.com)
- Profit Motive? Big Psychiatry Invents and Redefines Mental Illnesses (sott.net)
- ‘Label jars, not people’: Lobbying against the shrinks (newscientist.com)
- Two proposed changes dropped from DSM-5: Media round-up (dxrevisionwatch.wordpress.com)
From the 29 January 2012 article at ScienceNews Today
New research sheds light on cycle of low socioeconomic status and depression Could depression in adulthood be tied to a parent’s level of education? A new study led by AmÃ©lie Quesnel-VallÃ©e, a medical sociologist from McGill University, suggests this is the case……
The team found that higher levels of parental education meant fewer mental health issues for their adult children. “However, we also found much of that association may be due to the fact that parents with more education tend to have children with more education and better paying jobs themselves,” explained Quesnel-Vallée. “What this means is that the whole process of climbing up the social ladder that is rooted in a parent’s education is a crucial pathway for the mental health of adult children.”
These findings suggest that policies aimed at increasing educational opportunities for all, regardless of social background, may help break the intergenerational cycle of low socioeconomic status and poor mental health. “Children don’t get to choose where they come from. I think we have a responsibility to address health inequalities borne out of the conditions of early childhood,” said Quesnel-Vallée.
- How A Parent’s Education Can Affect The Mental Health Of Their Offspring (medicalnewstoday.com)
- Exploring how a parent’s education can affect the mental health of their offspring (eurekalert.org)
- DSM-IV: Depression Defined (everydayhealth.com)
School absenteeism is a significant problem, and students who are frequently absent from school more often have symptoms of psychiatric disorders. A new longitudinal study of more than 17,000 youths has found that frequently missing school is associated with a higher prevalence of mental health problems later on in adolescence, and that mental health problems during one year also predict missing additional school days in the following year for students in middle and high school….
- School Absenteeism, Mental Health Problems Linked (psychcentral.com)
- Chronic School Absenteeism Linked to Mental Health Problems (nlm.nih.gov)
SAMHSA Announces A Working Definition Of “Recovery” From Mental Disorders And Substance Use Disorders
From the December 2011 news release
Date: 12/22/2011 10:00 AM
Media Contact: SAMHSA Press Office
SAMHSA announces a working definition of “recovery” from mental disorders and substance use disorders
A new working definition of recovery from mental disorders and substance use disorders is being announced by the Substance Abuse and Mental Health Services Administration (SAMHSA). The definition is the product of a year-long effort by SAMHSA and a wide range of partners in the behavioral health care community and other fields to develop a working definition of recovery that captures the essential, common experiences of those recovering from mental disorders and substance use disorders, along with major guiding principles that support the recovery definition. SAMHSA led this effort as part of its Recovery Support Strategic Initiative.
The new working definition of Recovery from Mental Disorders and Substance Use Disorders is as follows:
A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.
“Over the years it has become increasingly apparent that a practical, comprehensive working definition of recovery would enable policy makers, providers, and others to better design, deliver, and measure integrated and holistic services to those in need,” said SAMHSA Administrator Pamela S. Hyde. ”By working with all elements of the behavioral health community and others to develop this definition, I believe SAMHSA has achieved a significant milestone in promoting greater public awareness and appreciation for the importance of recovery, and widespread support for the services that can make it a reality for millions of Americans.”…
Through the Recovery Support Strategic Initiative, SAMHSA has also delineated four major dimensions that support a life in recovery:
- Health : overcoming or managing one’s disease(s) as well as living in a physically and emotionally healthy way;
- Home: a stable and safe place to live;
- Purpose: meaningful daily activities, such as a job, school, volunteerism, family caretaking, or creative endeavors, and the independence, income and resources to participate in society; and
- Community : relationships and social networks that provide support, friendship, love, and hope.
Guiding Principles of Recovery
Recovery emerges from hope: The belief that recovery is real provides the essential and motivating message of a better future – that people can and do overcome the internal and external challenges, barriers, and obstacles that confront them.
Recovery is person-driven: Self-determination and self-direction are the foundations for recovery as individuals define their own life goals and design their unique path(s).
Recovery occurs via many pathways: Individuals are unique with distinct needs, strengths, preferences, goals, culture, and backgrounds ? including trauma experiences ? that affect and determine their pathway(s) to recovery. Abstinence is the safest approach for those with substance use disorders.
Recovery is holistic: Recovery encompasses an individual’s whole life, including mind, body, spirit, and community. The array of services and supports available should be integrated and coordinated.
Recovery is supported by peers and allies: Mutual support and mutual aid groups, including the sharing of experiential knowledge and skills, as well as social learning, play an invaluable role in recovery
Recovery is supported through relationship and social networks: An important factor in the recovery process is the presence and involvement of people who believe in the person’s ability to recover; who offer hope, support, and encouragement; and who also suggest strategies and resources for change.
Recovery is culturally-based and influenced : Culture and cultural background in all of its diverse representations ? including values, traditions, and beliefs ? are keys in determining a person’s journey and unique pathway to recovery.
Recovery is supported by addressing trauma : Services and supports should be trauma-informed to foster safety (physical and emotional) and trust, as well as promote choice, empowerment, and collaboration.
Recovery involves individual, family, and community strengths and responsibility: Individuals, families, and communities have strengths and resources that serve as a foundation for recovery.
Recovery is based on respect : Community, systems, and societal acceptance and appreciation for people affected by mental health and substance use problems – including protecting their rights and eliminating discrimination – are crucial in achieving recovery.
For further detailed information about the new working recovery definition or the guiding principles of recovery please visit: http://www.samhsa.gov/recovery/
SAMHSA is a public health agency within the Department of Health and Human Services. Its mission is to reduce the impact of substance abuse and mental illness on America’s communities.
- SAMHSA Provides New Working Definition of Recovery (asapnys.wordpress.com)
- SAMHSA Announces A Working Definition Of “Recovery” From Mental Disorders And Substance Use Disorders (medicalnewstoday.com)
- SAMHSA issues new definition of Recovery. What does it mean for your drug-using loved one? (homedrugtestkit.wordpress.com)
- Patients Can Be Helpful Peer Counselors (psychcentral.com)
- SAMHSA Highlights Healing and Recovery from Trauma at 2011 Voice Awards Hosted by Emmy-Nominated Peter Krause (prnewswire.com)
- Mental Illness Rates By State Highlighted in New Report (prnewswire.com)
- SAMHSA Awards $22.5 Million To Advance State Substance Abuse Prevention Planning (medicalnewstoday.com)
(Comment from Blog owner Janice..
Back in the late 70′s I was in a graduate Community Information program (similar to a library science program..but not accredited by the American Library Association)
My internship was at the local state hospital for the mentally ill. The program I was in had a partnership with the state hospital.
The program set up an information and referral (I&R) center
The I & R center included pamphlets, brochures, and other handouts in areas the newly released would find handy. I remember social services, food pantries, legal aid societies, health clinics, and churches.
Abstract: Fifty years ago, America began a grand experiment by transferring to the federal government the fiscal responsibility for individuals with mental illnesses. During that half-century, it has become increasingly clear that the experiment has been a costly failure, both in terms of human lives and in terms of dollars. The outcome was, in fact, clear as early as 1984, when the chief architect of the federal community mental health centers program proclaimed it to be a failure: “The result is not what we intended, and perhaps we didn’t ask the questions that should have been asked when developing a new concept….” Bringing sanity to our present mental health system is dependent on one essential change: Return the primary responsibility for such services to the states.
In 1963, the United States embarked upon a grand social experiment. Since the nation’s founding, responsibility for providing services for mentally disabled individuals had been assumed by state and local governments. The new plan proposed by President John F. Kennedy envisioned the closing of state psychiatric hospitals and the opening of federally funded community mental health centers (CMHCs) to provide psychiatric services. This effectively shifted the burden of responsibility from the states to the federal government. The states viewed it as a way to save state funds and effectively ceased their efforts to develop or improve existing services on their own.
Half a century later, the results of this noble experiment are clear. Rarely in the history of American government has a program conceived with such good intentions produced such bad results. The patients were deinstitutionalized from the state hospitals, but most of the 763 federally funded CMHCs failed to provide services for them. The majority of the discharged patients, and those who became mentally ill after the hospitals closed, ended up homeless, incarcerated in jails and prisons, or living in board-and-care homes and nursing homes that were often worse than the hospitals that had been closed….
…The consequences of this failed experiment for mentally ill individuals, for their families, and for the public at large are legion. Mentally ill homeless persons live on our streets like urban gargoyles and expropriate parks, playgrounds, libraries, and other public spaces. Jails and prisons have become progressively filled with mentally ill inmates, thereby transforming these institutions into the nation’s new psychiatric inpatient system….
…here are ways to bring sanity to our present mental health system, but they are dependent on one essential change: Return the primary responsibility for such services to the states. …
- What to do when your mentally ill friend, sibling, child, or ward gets into criminal trouble? (attorneytomost.wordpress.com)
- Guest Consultant Donna Izor: Behavioral Health & Primary Care Integration: Make Your Practice a Leader (managemypractice.com)
- Rahm’s mental health clinic closer chased out the south side. (preaprez.wordpress.com)
From the Medical News Today article, Tue Nov 22, 2011 13:00
A new brain imaging study led by researchers at Yale University shows how people who regularly practise meditation are able to switch off areas of the brain linked to daydreaming, anxiety, schizophrenia and other psychiatric disorders. The brains of experienced meditators appear to show less activity in an area known as the “default mode network”, which is linked to largely self-centred thinking. The researchers suggest through monitoring and suppressing or “tuning out” the “me” thoughts, meditators develop a new default mode, which is more present-centred…
- Tuning out: How brains benefit from meditation (medicalxpress.com)
- When our neurones remain silent so that our performances may improve (eurekalert.org)
- Skeleton Of Human Awareness (dragonintuitive.com)
In this week’s PLoS Medicine, Shekhar Saxena of the WHO in Geneva, Switzerland and colleagues summarize the recent WHO Mental Health Gap Action Programme (mhGAP) intervention guide that provides evidence-based management recommendations for mental, neurological, and substance use (MNS) disorders.
This guide is aimed at reducing the treatment gap for MNS disorders, which is more than 75% in many low- and middle-income countries (LMICs). Further details and background material to the guide can be accessed on the WHO website:http://bit.ly/vKPSRF
The authors recommend that: “In the near future, further efforts should be made to introduce formal evaluations of the capability of [treatment] programs to induce relevant and persistent changes, and to generate useful insights on how implementation in [low- and middle-income countries] should be conducted to maximize benefit at sustainable costs.”
- Mental First Aid: How To Help In An Emotional Crisis (jflahiff.wordpress.com)
- Lagos begins free mental treatment (vanguardngr.com)
- Tulsa Specialty Hospital Fills Patient Service Gap (prweb.com)
- Linda Rosenberg: A Silent Public Health Crisis (huffingtonpost.com)
Former football players experience more late-life cognitive difficulties and worse health than other former athletes and non-athletes. An MU study found that these athletes can alter their diet and exercise habits to improve their mental and physical health. (Credit: Image courtesy of University of Missouri-Columbia)
— Football players experience repeated head trauma throughout their careers, which results in short and long-term effects to their cognitive function, physical and mental health. University of Missouri researchers are investigating how other lifestyle factors, including diet and exercise, impact the late-life health of former collision-sport athletes.
The researchers found that former football players experience more late-life cognitive difficulties and worse physical and mental health than other former athletes and non-athletes. In addition, former football players who consumed high-fat diets had greater cognitive difficulties with recalling information, orientation and engaging and applying ideas. Frequent, vigorous exercise was associated with higher physical and mental health ratings.
- Healthy Dietary Habits Can Improve Long-Term Health Of Collision-Sport Athletes, Avoid Late-Life Health Problems (medicalnewstoday.com)
- Throw a Yellow Flag on Football-related Head Injuries, Warns the Harvard Mental Health Letter (prweb.com)
- NFL Players May Be More Vulnerable to Alzheimer’s (healthland.time.com)
From the Mental Health Minute blog item –
Here is an article that denotes a personal struggle with OCD, an anxiety disorder. She is one of the lucky ones who got help and then went out to find a way to help others. OCD is a terrifying illness and I am so happy she was able to overcome it enough to participate in learning to help others with this and other mental illnesses.
Mental illness is an equal opportunity player. No one is excused or exempt from playing in this game.
Learning the skills to help a mentally ill person is fairly easy to do. What is hard is challenging your own beliefs about the mentally ill and making changes in your own behavior toward them.
I am reposting this article for NPR in its entirety because I believe the more people that are exposed to this message the better. Please do click over and leave them a comment at the original site.
by Kelley Weiss
October 10, 2011
When Nikki Perez was in her 20s, she had a job as a lab tech at a hospital in Sacramento, Calif. She said everything was going well until one day, when something changed.
“I worked in a very sterile environment, and so part of the procedure was to wash your hands,” she said. “I found myself washing my hands more and more, to the point where they were raw, and sometimes they would bleed.”
Perez went to the doctor and was diagnosed with something she had never even heard of — obsessive-compulsive disorder. At the time she was living with her parents. She quit her job and went on short-term disability.
Researchers say 1 in 4 adults has a mental disorder. But while many Americans are trained in first aid and CPR to respond to medical emergencies, few are prepared to help others experiencing a mental health crisis.
Perez said her illness turned her life upside down. She would sit in her parents’ room watching TV on the floor, afraid to move. She didn’t want to get caught up in the obsessive routines around the house.
“You check locks, check the washer, check the doors, check the window — I did a lot of checking,” she said.
Overall, it was profoundly isolating. Her family, like many people, didn’t know how to handle mental illness.
Finally, she got treatment, but her experience made her want to learn more about mental health issues so she could help others in crisis.
Emotional Crises More Common Than Heart Attacks
She found just the right class, called Mental Health First Aid. Bryan Gibb is the director of public education for the National Council for Community Behavioral Healthcare, which runs the course.
“We often train to know CPR or the Heimlich maneuver or first aid. But the reality is, it’s much more likely that we’re going to come in contact with someone suffering from an emotional crisis than someone suffering a heart attack or choking in a restaurant,” he said.
In a 12-hour course, Gibb teaches people how to identify different types of mental illness: depression, anxiety disorders, psychosis, eating disorders and substance abuse.
Part of the learning process involves group exercises. Nikki Perez participated in one that simulated what it’s like for people who hear voices. She tried to have a conversation while someone whispered in her ear “don’t trust him,” “you’re a failure,” and “is he looking at you?”
After the class, members who get this firsthand perspective of the different symptoms of mental illness then learn how to approach someone who’s having a psychotic episode. They’re told to speak calmly and clearly, and not to dismiss or challenge the person about their hallucinations.
Direct Questions For The Suicidal
As with any first-aid course, there’s an Action Plan for what to do if someone’s in crisis: assess the person for risk of harm or suicide, listen non-judgmentally, give reassurance, and encourage the person to seek professional help.
Gibb says that for this to work, people need to force themselves to ask direct questions: Are you thinking of killing yourself? Do you have a plan? Do you have the things you need to complete that plan?
Gibb told the class to never leave an actively suicidal person alone and to call the police if the person has a weapon or is acting aggressively.
Longtime mental health advocates with the National Alliance on Mental Illness, or NAMI, say courses like this raise awareness about mental illness. Jessica Cruz, executive director of NAMI California, said this reduces the stigma around getting help.
“If people know that others are trained in how to deal with a crisis situation, they may even reach out for help before they even get to that crisis point,” she said.
Cruz is so impressed with the course, her own staff is going to be trained next month.
“It seems like it could be just universally applied, just like CPR,” Cruz said.
That’s already under way at schools, the workplace and churches. Since it started three years ago, more than 30,000 people have been trained around the country; another 20,000 are expected to get training by the end of the year.
Perez says she would recommend this course to anyone.
“I think it’s one of the best things that I’ve ever done for myself so far,” she said.
The National Council for Community Behavioral Healthcare said thousands of people like Perez now have the skills to help those experiencing a mental health crisis. But the group emphasized that this is first-aid training and should be used to keep someone safe and stabilized until the professional help arrives, just like if you’re responding to someone having a heart attack.
- 50 Signs of Mental Illness: A Guide to Understanding Mental Health (Yale University Press Health & Wellness) (untreatableonline.com)
- Singer Mental Health Center Hearing: Don’t Cut Patient Care (skwillms.wordpress.com)
- Building mental health wellness in our children (canada.com)
- Americans’ Mental Health Disabilities on the Rise (skwillms.wordpress.com)
Short-stay inpatient hospitalizations for children and adolescents with a psychiatric diagnosis increased significantly over a 12-year period (1996 to 2007) and decreased for the elderly, according to a report in the early online edition in Archives of General Psychiatry by Joseph C. Blader, Ph.D., Assistant Professor, Department of Psychiatry & Behavioral Science at Stony Brook University School of Medicine…
- Prescriptions for Antidepressants Increasing Among Individuals With No Psychiatric Diagnosis (cherished79.wordpress.com)
- Antidepressants Prescribed Without Psychiatric Diagnosis (webmd.com)
- Psychiatric Hospitalizations Increased Among Children And Teens, But Dropped Among Seniors (medicalnewstoday.com)
- In Defense of Psychiatric Medications, Part Two (psychologytoday.com)
59.5% of antidepressant prescriptions were made with no diagnosis in 1996, in 2007 the figure rose to 72.7%, researchers reported in Health Affairs. Antidepressant drugs are today the third most commonly prescribed class of drugs in the USA.
Nearly 8.9% of the American population had at least one antidepressant prescription during any given month during the period 2005-2008.
A good proportion of this growth in antidepressant prescription has been by non-specialist providers whose patients were not diagnosed by a psychiatrist.
- Prescriptions for antidepressants increasing among individuals with no psychiatric diagnosis (medicalxpress.com)
- More Antidepressants Prescribed by Non-Psychiatrists (psychcentral.com)
- Antidepressants Overprescribed in Primary Care (psychcentral.com)
This is a brand new published interview-series (7 parts), with psychiatrists Dr. Joe Parks, Dr. Richard H. Weisler, and Dr. Henry A. Nasrallah on the magnitude, impact, and means of addressing this critical situation. I highly recommend not only reading this synopsis but to read through the entire series as well.
- Evidence shows that this country is short 45,000 psychiatrists.
- According to the National Association of State Mental Health Program Directors (NASMHPD), mental health spending dropped 5% from 2009 to 2010 and it is predicted to go down another 8% in 2011.
- The National Alliance on Mental Illness study in North Carolina found that there were 3000 people on a waiting list for admission in only the first 6 months of the year; 212 people out of 3000 waited more than a week and 900 just quit looking — they just left.
“The United States is facing a severe lack of psychiatric care resources. Given the current economic crisis, the problem is only getting worse as state budgets for mental health care continue to be cut.”
Evidence shows that this country is short 45,000 psychiatrists.
At times of stress, like we have had in the last few years with the economy, there is an increase in psychiatric demand, particularly in terms of depression, anxiety, suicidality, and drug abuse.
The seriously mentally ill patients are not well served for numerous reasons. Beyond just a lack of resources, the system is a problem unto itself.
Psychiatry is the number-one area in which more professionals are needed.
According to the National Association of State Mental Health Program Directors (NASMHPD), mental health spending dropped 5% from 2009 to 2010 and it is predicted to go down another 8% in 2011.
Is the Economy to Blame?
“The economy is an easy scapegoat for the recent decline in mental health resources, but it sounds like the consensus is that the system has been at least partially broken for quite a while. “
The single biggest cause of suffering for many of our patients is that they cannot be admitted to a hospital when they relapse during medical treatment. According to a 2010 report by the Treatment Advocacy Center, there was 1 bed per 300 people in the United States in 1955; currently, we have 1 bed for every 3000 people.
There are wide variances in overall funding for mental health resources, whether it’s hospital beds or community resources. There are huge maldistributions in terms of psychiatrists per 100,000 people.
There are about 3 or 4 times the number or psychiatrists in New York or Massachusetts per capita, compared with states like Texas. There are fewer psychiatrists for severely ill patients than it appears because only a small percentage of them are really seeing the very sick patients. Relatively few psychiatrists choose to work in community mental health centers or state or VA hospitals, where the sickest and most disabled patients are.
The key thing is not to treat patients in isolation, you have to reach out and develop relationships.
The recent removal of consultation codes for Medicare and some other insurance providers may undermine efforts to increase interdisciplinary consultations and collaboration because of reduced reimbursements.
Model of collaborative care.
The primary care of the seriously mentally ill is in this country, especially after the CATIE study found that a large proportion of persons with schizophrenia in the outpatient setting in the United States had their serious medical problems ignored. There is hardly any relationship between community mental health centers and primary care clinics.
The CATIE study showed:
● 60% of patients with schizophrenia who had frank hypertension had never received an antihypertensive drug.
● 90% of those who had high cholesterol or triglycerides had never received a statin.
● 30% of those with clinical diabetes have never received treatment for diabetes.
“This reflects an unconscionable neglect of the physical health of the mentally ill, and it is a result of this lack of bridging between primary care and psychiatry, especially in community mental health centers.”
Prisons: The New Psych Ward.
What are the ramifications of inadequate mental health resources?
There needs to be about 40 beds per 100,000 people, there is only 17 per 100,000. Hundreds of thousands of psychiatric patients are now being sent to correctional facilities.
According to some studies and statistics:
● 35%-54% of prisoners have symptoms of mania.
● 16%-30% have major depression.
● 10%-24% have some psychotic symptoms, such as delusions or hallucinations (Table 2).[4,12]
● Even more conservative estimates reflect that 16% of prisoners have mental illness.
Many of the people with mental illness have co-occurring substance abuse and disorders, and many of their convictions are substance abuse related. Prisons are releasing to the community people with chronic mental illness; this only predisposes them to repetitive rehospitalization for psychotic and manic episodes due to poor adherence or, more likely, incarceration.
The ER is where everybody goes when they have a medical illness but no primary care provider, and the same thing happens with the mentally ill. A substantial number of those who present to the ER have a mental illness.
The National Alliance on Mental Illness study in North Carolina found that there were 3000 people on a waiting list for admission in only the first 6 months of the year; 212 people out of 3000 waited more than a week and 900 just quit looking — they just left.
Is Healthcare Reform the Answer?
By improving the reimbursement for mental illness — the hospitalized mentally ill — would definitely incentivize hospitals to stop closing those units and maybe even to open new ones.
A report entitled “Recommendations to Foster System Reform for Adults With Serious Mental Illness,” identifying 5 key priorities for legislative, policy, and program implementation as part of National Health Reform.
The 5 key priorities are:
● Developing a set of performance measures specific to treatment of mental illness.
● Designating persons with mental illness a health disparities population.
● Including mental health treatment providers in federal funding and policy related to health information technology initiatives.
● Making sure that the new healthcare home initiatives adequately address mental illness.
● Developing a national definition of “medical necessity” that adequately meets the needs of persons with mental illness.
- Konrad TR, Ellis AR, Thomas KC, Holzer CE, Morrissey JP. County-level estimates of mental health professional shortage in the United States. Psychiatr Serv. 2009;60:1323-1328. Abstract
- President’s mental health commission recommends transforming America’s mental health care system. Mental Health Commission Web site. Available at: http://www.mentalhealthcommission.gov/press/july03press.htm. Accessed September 13, 2010.
- As economy takes toll, mental health budgets shrink. Stateline Website. Available at: http://www.stateline.org/live/details/story?contentId=499181. Accessed September 3, 2010.
- Torrey EF. More mentally ill persons are in jails and prisons than hospitals: a survey of the states. Available at: http://www.treatmentadvocacycenter.org/storage/tac/documents/final_jails_v_hospitals_study.pdf Accessed September 3, 2010.
- Wing JK. How many psychiatric beds? Psychol Med. 1971;1:188-190.
- Goplerud EN. Assessing methods of predicting the need for psychiatric beds. Hosp Community Psychiatry. 1986;37:391-395. Abstract
- Häfner H. Do we still need beds for psychiatric patients? An analysis of changing patterns of mental health care. Acta Psychiatr Scand. 1987;75:113-126. Abstract
- Hirsch SR, Gerrard B, Malin H, et al. Psychiatric Beds and Resources: Factors Influencing Bed Use and Service Planning. Report of a Working Party of the Section for Social and Community Psychiatry of the Royal College of Psychiatrists. London: Gaskell; 1988.
- Davis GE, Lowell WE, Davis GL. Determining the number of state psychiatric hospital beds by measuring quality of care with artificial neural networks. Am J Medical Quality. 1998;13:13-24.
- Hagedorn H. A Manual on State Mental Health Planning. NIMH, DHEW Publication No. ADM77-473. Washington, DC: U.S. Government Printing Office; 1977.
- Nasrallah HA, Meyer JM, Goff DC, et al. Low rates of treatment for hypertension, dyslipidemia and diabetes in schizophrenia: data from the CATIE schizophrenia trial sample at baseline. Schizophr Res. 2006;86:15-22.Abstract
- Kuehn BM. Mental health courts show promise. JAMA. 2007;297:1641-1643.Abstract
- Lamb RH, Weinberger LE. The shift of psychiatric inpatient care from hospitals to jails and prisons. J Am Acad Psychiatry Law. 2005;33:529-534.Abstract
- Swartz MS, Swanson JW, Wagner HR, Burns BJ, Hiday VA, Borum R. Can involuntary outpatient commitment reduce hospital recidivism?: Findings from a randomized trial with severely mentally ill individuals. Am J Psychiatry. 1999;156:1968-1975.Abstract
- Biesecker M. Mentally ill often turned away, end up in ER. Raleigh News and Observer. August 7, 2010. Available at:http://www.newsobserver.com/2010/08/07/618475/mentally-ill-often-turned-away.html Accessed September 13, 2010.
- National Association of County Behavioral Health and Developmental Disability Directors. Recommendations to Foster System Reform for Adults With Serious Mental Illness. Available at:http://nacbhdd.org/content/Fostering%20System%20Reform%209-8-10.pdf Accessed September 14, 2010.
- Pies R. “Prescribing psychologists:” practicing medicine without a license? March 29, 2010. Psychiatric Times. Available at:http://www.psychiatrictimes.com/geriatric-psychiatry/content/article/10168/1545667 Accessed September 15, 2010.
Stetka B. “US Psychiatric Resources: A Country in Crisis” September 22, 2010. Medscape Psychiatry & Mental Health. Available at: http://www.medscape.com/viewarticle/728676 [Accessed 22 Sept 2010].
Please See More: Severe Lack of Psychiatric Resources in the US – Today on Milhealth’s Directory – MHD http://www.milhealthsdirectory.org/today-on-milhealths-directory/severe-lack-of-psychiatric-resources-in-the-us.html#ixzz10ivE2ipf
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- Why Creigh Deeds’ Son Wasn’t In A Psych Ward Last Night (Think Progress – November 2013)
- No Room at the Inn : Trends and Consequences of Closing Public Psychiatric Hospitals -2005 to 2010 (Treatment Advocacy Center)
- Despite rising need, mental health takes back seat (skwillms.wordpress.com)
- States slash $1.8 billion in mental health funds since 2009 (skwillms.wordpress.com)
- Giving family doctors the tools to treat mental illness (theglobeandmail.com)
- More mentally ill ending up in jail (thegazette.com)
- The Mentally Ill Should Be Diverted From Offending Rather Than Prison, UK (medicalnewstoday.com)
- How to make money off the mentally ill (kevinmd.com)
- Better Benefits Information Needed for Mental Health Parity (blogs.wsj.com)
- New Study Of The Mental Health Needs Of Post-Combat Military Servicemembers Shows Only Half Are Getting The Treatment They Need
- Mental health services lacking in poorer areas, study says (modbee.com)
- Living in America will drive you insane – literally (salon.com)