Tuesday, May 31, 2011

Drugging the Vulnerable Atypical Psychotics in the Elderly and Children

Pharmaceutical companies have recently paid out the largest legal settlements in U.S. history — including the largest criminal fines ever imposed on corporations — for illegally marketing antipsychotic drugs. The payouts totaled more than $5 billion. But the worst costs of the drugs are being borne by the most vulnerable patients: children and teens in psychiatric hospitals, foster care and juvenile prisons, as well as elderly people in nursing homes. They are medicated for conditions for which the drugs haven't been proven safe or effective — in some cases, with death as a known possible outcome.

The benefit for drug companies is cold profit. Antipsychotics bring in some $14 billion a year. So-called "atypical" or "second-generation" antipsychotics like Geodon, Zyprexa, Seroquel, Abilify and Risperdal rake in more money than any other class of medication on the market and, dollar for dollar, they are the biggest selling drugs in America. Although these medications are primarily approved to treat schizophrenia and bipolar disorder, which combined affect 3% of the population, in 2010 there were 56 million prescriptions filled for atypical antipsychotics.

In a presentation this week at an American Psychiatric Association meeting, Dr. John Goethe, director of the Burlingame Center for Psychiatric Research in Connecticut, reported that over the last 10 years, more than half of all children aged 5 to 12 in psychiatric hospitals were prescribed antipsychotics — and 95% of these prescriptions were for second-generation antipsychotics.

Many of these children didn't have a condition for which the drugs have been shown to be helpful: 44% of youngsters with post-traumatic stress disorder (PTSD) and 45% of children with attention deficit hyperactivity disorder (ADHD) were treated with them.

(More on TIME.com: SPECIAL: Kids and Mental Health)

Pharmacologically, the ADHD prescriptions make no sense: FDA-approved drugs for the condition raise levels of the neurotransmitter dopamine, while antipsychotics do the opposite, lowering them.

Goethe also noted another study that showed that the number of office visits by children and teens that included antipsychotic drug prescriptions rose 600% from 1993 to 2002. "The obvious second-generation bias is very apparent in these data, as is the irrational use of antipsychotics for indications such as PTSD and ADHD for which there is no controlled evidence whatsoever that these are safe or effective treatments," says Dr. Bruce Perry, senior fellow at the ChildTrauma Academy in Houston. (Full disclosure: Dr. Perry is my co-author on two books.)

The situation is similar in state-run juvenile detention systems. Late last week, an exposé by the Palm Beach Post revealed that antipsychotics were among the top drugs purchased by the Florida Department of Juvenile Justice (DJJ), and were largely used in kids for reasons that were not approved by the government — for instance, sleeplessness or anxiety. The Post reported:
In 2007, for example, DJJ bought more than twice as much Seroquel as ibuprofen. Overall, in 24 months, the department bought 326,081 tablets of Seroquel, Abilify, Risperdal and other antipsychotic drugs for use in state-operated jails and homes for children.
That's enough to hand out 446 pills a day, seven days a week, for two years in a row, to kids in jails and programs that can hold no more than 2,300 boys and girls on a given day.

Among the psychiatrists hired by the state to evaluated incarcerated kids, about a third received drug company money, the Post reported. Those 17 psychiatrists wrote 54% of the prescriptions for antipsychotics; the 35 doctors who did not take such payments wrote the rest. In other words, one-third of doctors — all of whom were paid by drug companies — wrote more than half of all antipsychotic prescriptions for the state's locked-down youth.

(More on TIME.com: Perspective: Why Comparing Painkiller Addiction to Crack Worsens the Problem)

The statistics on children in foster care are equally alarming. Youth in foster care are not only three times as likely to be medicated as comparable low-income youth on Medicaid, but more than half are treated with antipsychotics. It is not likely that all or even most of these children have a condition for which antipsychotics have been approved by the government to treat.

Among the problems with unnecessary use of antipsychotic medications is that they can cause serious, sometimes irreversible, damage. Atypical antipsychotics are associated with weight gain and may double users' risk of Type 2 diabetes. Recent research also suggests that they may shrink the brain and there is little data on how they affect brain development during the teen years, when the brain grows more than at any other time but infancy. Indeed, youth are more vulnerable than any other group to the drugs' worst side effects (with the possible exclusion of death).

(More on TIME.com: Why Has Childhood Bipolar Disorder Become an Epidemic?)

"The majority of antipsychotic medication use in children and adolescents has not been limited to the few age groups or conditions for which there is credible evidence of efficacy and safety," says Perry. "There is no reason to expect irrational prescribers to change their bad habits."

He adds that many experts would argue that if doctors began prescribing antipsychotics "responsibly and cautiously" — that is, being mindful of the lack of efficacy data and the evidence of harm — the rate of prescriptions in children would drop by 90%.

Meanwhile, prescribing at the other end of the lifespan is also out of control. In nursing homes, 14% of residents have been given at least one prescription for a second-generation antipsychotic, according to a government investigation. A full 88% of these prescriptions are given to people with dementia, despite the fact that these drugs may double the risk of death in these patients (there is a black box warning on the drug to this effect). The investigation estimated that $116 million Medicare dollars have been spent filling antipsychotic prescriptions that never should have been written.

So why are these drugs so widely prescribed? Aggressive drug company marketing is only one part of the story. A key reason they are overused in institutional settings is that they are sedating, making patients easier to manage. Secondly, unlike other sedative drugs, they are not associated with misuse (except perhaps Seroquel, which has fans among some addicts). In fact, most people resist taking antipsychotics, which is why overmedication is much more common in settings where people are locked-in and compliance can be forced.

The fact that the drugs are not associated with addiction is another big part of why drug companies have been able to get away with so much misleading marketing and the resultant overprescribing. Unlike traditional sedatives like benzodiazepines (Valium or Xanax), which are controlled substances, few people enjoy misusing antipsychotics. With side effects like weight gain, pleasurelessness, movement disorders, and low energy and motivation, there's not much of a recreational market.

Consequently, they can be prescribed for unapproved uses like behavior control and sleep-inducement in children and the elderly, without government scrutiny or fear of prosecution for "overprescribing."
In other words, addiction is basically seen as a worse side effect than, say, death (or any other outcome such as Type 2 diabetes or the complete inability to feel pleasure). The fact that the most vulnerable youth and elderly often cannot advocate for themselves has made it easier to sweep the problem under the rug.

Fortunately, there is at least one bright spot in this depressing picture. The main patent on Risperdal expired in 2007, and those for Zyprexa and Seroquel expire this year. Geodon's patent expires next year, while Abilify's comes up in 2015. When most drugs go off-patent, drug companies' marketing pressure — and profits — will subside, perhaps keeping children and the elderly safer from inappropriate medication.

Read more: http://healthland.time.com/2011/05/26/why-children-and-the-elderly-are-so-drugged-up-on-antipsychotics/#ixzz1NwRuOUWY

Study finds "Unnecessary" drugs in nursing homes

Burch Family
William Killingsworth and his daughter Debra Burchard are seen in a family photo.
(Credit: CBS)
NEW YORK - Anyone who's ever been through it will tell you that putting a loved one in a nursing home is one of the toughest decisions you'll ever have to make. You hope and pray your relative will be well-cared for.

But a troubling new report from the government finds that, all too often, nursing homes are giving antipsychotic drugs to patients who should not be getting them.

CBS News chief investigative correspondent Armen Keteyian reports Debra Burchard moved her ailing father William Killingsworth into a Northern California nursing home in September 2005. Within days - she says- he had completely changed.

Dementia Patients: Enough with the Doping?

"Eyes glassed over with sweating, cracked mouth," Burchard said. "How did that happen in three days?"
Less than four weeks after entering the nursing home Killingsworth was dead. Burchard blames, in part, an antipsychotic drug the nursing home inappropriately gave her father who suffered from dementia.
"He was laying in his bed, unresponsive," Burchard said. "I just looked at him and thought what's going on?"
Watch the video
 
Antipsychotic drugs like Seroquel, Risperdal and Zyprexa were never approved for elderly patients with dementia.

In fact, in 2005 the FDA gave them its most severe warning - noting an increased risk of sudden death in patients with dementia.

Now, a new government study has found that 88 percent of the time Medicare paid for antipsychotic drugs in nursing homes - they went to patients with dementia.

The report by the Health and Human Services Inspector General, also found that antipsychotic drugs were given to nursing home residents "unnecessarily" over 300,000 times between January and June 2007, with more than half of those drugs (150,106) given "in excessive dose."

"The use of anti-psychotic drugs when they are not necessary is a form of restraint," said Dr. David Zimmerman, University of Wisconsin. "It's a form of chemical restraint."

The Department of Health and Human Services also says it's "very concerned" that there are "financial incentives for unnecessary drug use." In the past those incentives have led to charges of "kickbacks" between nursing homes, pharmacies, and a drug company.

Dr. Kenneth Brubaker represents nursing home medical directors and agrees antipsychotics are being used too often. He says the problem is staff turnover and training.

"Oftentimes lack of training, lack of adequate workforce, whatever else it might be - we tend to shortcut it by going to drugs," Brubaker said.

"I wish I would have said, 'what are you giving him? How much are you giving him?'" Burchard said.
Instead Burchard sued and settled. She's using some of the money to create a nursing scholarship in memory of her father.

Posted at cbs news reposted at darkestcloset.blogspot.com

Friday, May 27, 2011

NY’s Highest Court Upholds Privacy Rights in Victory over Kendra’s Law

The New York Court of Appeals recently ruled to enforce the privacy provisions of the Health Insurance Portability and Accountability Act (HIPAA) in a case where the state was seeking to compel an individual to receive mental health treatment under Kendra’s Law, a 1999 outpatient commitment law.

In 2007, the New York City Department of Health and Mental Hygiene tried to force-treat Miguel M., and – against his wishes and without a court order – wanted to use as evidence records of his two recent psychiatric hospitalizations. On May 10, 2011, the state’s highest court overturned the rulings of two lower courts, which had ruled in favor of the state. “To disclose private information about particular people, for the purpose of preventing those people from harming themselves or others, effects a very substantial invasion of privacy without the sort of generalized public benefit that would come from, for example, tracing the course of an infectious disease,” the Court of Appeals noted in its ruling.

Source: http://cts.vresp.com/c/?NationalMentalHealth/d0e7c89bdd/084cd67ede/fc5dee5df7

Wednesday, May 25, 2011

Free Community Wellness Fair

You are invited to the
Downtown Newark Community
Wellness Fair
Compeer is a program of Mental Health America of Licking County. Call 740.788.0303 for more information

May 31, 2011 
2 p.m.-6 p.m.
at the Newark Public Library
101 W. Main Street, Newark
Free and open to the public!

SAVE THE DATE

OEC’s Second Annual Conference
Peer Support: Transforming Ohio’s Mental Health System
August 12-13, 2011
Embassy Suites, 2700 Corporate Exchange Drive, Columbus, OH 43231

The Ohio Empowerment Coalition, Inc. (OEC) is a statewide consumer-run organization designed to reflect the valuable ethnic and geographical diversity of all persons in Ohio dedicated to mental health,
Peer Support, Recovery and Advocacy

An Agenda Packed Full of Peer Support and Recovery Information
·        Election of OEC Board Members
·        Friday and Saturday Peer Support, Recovery and Advocacy Workshops
·        Special Keynote Speakers
·        CEU’s Available
·        Vendor Booths
·        Art Display
·        Dance and Raffle
·        Scholarships Available (limited number)
·        Kids’ Program
…and much, much more!

Stay Tuned: More information and Registration Materials will be available in the near future. If questions, contact OEC at 1-877-643-6701 (toll free) , 614-310-8054 or ohioempowermentcoalition@gmail.com
posted at darkestcloset.blogspot.com

Arpaio Under Fire

Monday, May 23, 2011

Social Media for Preparedness 101: Zombie Apocalypse

The CDC provides information and resources for preparing for and responding to public health emergencies. CDC has created four badges that you can copy and paste into your website, social network profile, blog, or email to provide people with access to information on how to prepare for a zombie take over… and real emergencies like hurricanes or floods. Check out CDC Social Media for badges, widgets, content syndication, and more: http://emergency.cdc.gov/socialmedia/zombies.asp

If you've had trouble accessing the related blog pos, a copy of the page is available at http://emergency.cdc.gov/socialmedia/zombies_blog.asp.

I am not a superhero

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Wednesday, May 18, 2011

Peer Support Beats Usual Care for Depression, Analysis Finds

But it may not be helpful for people with severe depression, one expert suggests
FRIDAY, Feb. 18 (HealthDay News) -- A new analysis of existing research finds that peer support may do a better job of treating depression than standard care.

Depression is difficult to treat even with the help of psychotherapy and antidepressant drugs. According to the analysis, one-third of depressed patients have significant symptoms even after being treated with four different medications. In addition, among depressed people who recover while taking antidepressant drugs, more than half relapse within a year.

The researchers looked at 14 studies involving depression and peer support in their meta-analysis, which is a method that pools the results of different studies examining a common problem so they can be analyzed statistically. All of the studies had randomly assigned depressed people to receive peer support with at least one other person, or one of three other types of treatment including standard care, cognitive behavioral therapy, or both. The studies examined the experiences of 869 participants in total.

The researchers combined the results of the studies and reported their findings online in advance of publication in an upcoming print issue of the journal General Hospital Psychiatry.

Dr. Paul Pfeiffer, an assistant professor of psychiatry at the University of Michigan Medical School in Ann Arbor, and colleagues found that support groups were "superior" to regular care but didn't do significantly better or worse than cognitive behavioral therapy, which trains people to develop new patterns of thought and behavior.

Why might support groups be so helpful? Pfeiffer's team suggested that it may have something to do with their ability to lessen isolation, provide a buffer against stressful events, help patients share health information and offer role models. "Peer support programs may also empower patients to play a more active role in their own self-care," they wrote.

"Given the high level of functional burden imposed by depression worldwide, peer support for depression should also be studied as a potentially low-cost intervention in primary care or other settings where more established but costly depression services are unavailable," the authors concluded.

One expert who was not involved with the meta-analysis had some criticisms of the findings.
Dr. Bernard Carroll, scientific director at the Pacific Behavioral Research Foundation and past chairman of psychiatry at Duke University, said that several of the studies in the review were weak, and the stronger ones showed the treatment approaches were just about equally effective. In addition, some of the studies focused on people with mild symptoms, he noted.

But peer support might still have its uses in depression treatment, he noted.

Overall, Carroll said, the review suggested that peer support "may be somewhat helpful" -- with caveats -- in certain people without severe symptoms of depression.

For more about depression, visit the U.S. National Library of Medicine.
-- Randy Dotinga
SOURCES: Bernard Carroll, Ph.D., scientific director, Pacific Behavioral Research Foundation, Carmel, Calif.; Nov. 13, 2010, General Hospital Psychiatry, online
Last Updated: Feb. 18, 2011
Copyright © 2011 HealthDay. All rights reserved.

Posted at http://consumer.healthday.com/Article.asp?AID=650065, reposted at darkestcloset.blogspot.com

Proposals aim to improve safety in state mental hospitals

Reposted at darkestcloset.blogspot.com

A worsening safety trend at California's mental health facilities has spurred legislation to better screen and separate violent patients, increase surveillance and improve workers' disability insurance.

 

By Lee Romney, Los Angeles Times  May 16, 2011 Posted in LA Times, Reporting from San Francisco
Nearly eight months after a Napa State Hospital patient strangled a psychiatric technician, lawmakers and employee groups are pushing proposals aimed at reversing a worsening safety trend at California's mental health facilities.

Among them are bills that would enable officials to better assess patients' potential for violence, speed up the process to involuntarily medicate certain individuals and punish those who funnel contraband — such as tobacco and cash — to patients, feeding a black market that goes hand-in-hand with assault and extortion.

FOR THE RECORD:
Mental hospital safety: In the March 16 LATExtra section, an article about efforts to curb violence in state mental hospitals erred in stating that Atascadero State Hospital psychologist Henry Ahlstrom said excessive paperwork demands from a federal monitor had pulled staff away from direct care to focus on patient records. Many of the paperwork demands are not imposed directly by the monitor, who oversees federal reforms, but by state hospital administrators seeking to satisfy the monitor. —

Legislators are working closely with California Health and Human Services Secretary Diana Dooley, who lifted a hiring freeze at the state's psychiatric hospitals last month. In a long-awaited report, the Department of Mental Health, which Dooley oversees, recently called for better alarm and surveillance systems at the facilities.

"We are maybe for the first time in a long time approaching critical mass for driving reform," said state Sen. Sam Blakeslee (R-San Luis Obispo), who wrote the contraband bill and whose district includes Atascadero State Hospital.

Meanwhile, the Select Committee on State Hospital Safety chaired by Assemblyman Michael Allen (D-Santa Rosa) is expected to convene in about a month to propose longer-term solutions. And a coalition of employee groups formed at Napa in the wake of Donna Gross' death has expanded statewide to demand safer conditions for staff and the more than 5,500 patients they treat.

"We're very close here to coming to a boiling point," said Eric Soto, a psychiatric technician at Metropolitan State Hospital who heads the Norwalk facility's chapter of the California Assn. of Psychiatric Technicians.

Soto said he understands that "there is an element of risk" in working with state hospital patients, most of whom have been accused or convicted of crimes related to their mental illnesses. However, he said, "We all expect our employer to take steps to minimize that as much as possible."

Violence is among the issues the U.S. Department of Justice sought to address when it filed suit in 2006 and imposed court-ordered reforms at four of the state's five mental hospitals. Yet data show that assaults against patients and staff have increased at most of the facilities.

A study obtained by Allen's committee shows that in 2010 there were 6,700 victims of aggressive incidents and 5,100 injuries at the state's mental hospitals — 1,000 of those to staff. That's a rate of 14 injuries a day.

On Wednesday night, a 49-year-old Napa patient described by staff as "frail" and "shy" was found unconscious and bloodied beyond recognition. Charged with attempted murder in the assault was 31-year-old Victor Hugo Mandujano. Mandujano was not responding to medication, often complained of hearing voices and suffered frequent bouts of violence, a fellow patient said.

"People would lend him headphones and radios just to drown out the voices so he could get some rest," said Tim Breckenridge, 35.

A psychiatric technician who responded to the attack said the hospital houses patients of various ages and violence levels in close quarters, with insufficient supervision.

The fears run systemwide. At Metropolitan last week, three female patients adorned their shirts with the slogans "Stop the Violence" and "Be Kind," said Denise Nicks, a rehabilitation therapist who is that hospital's union steward for AFSCME Local 2620.

Nicks, whose nose was broken by a patient last year, said it is upsetting that employees cannot keep patients safe, attributing the problem to inadequate staffing and excessive and redundant paperwork.

Yet consensus is building to place greater restrictions on the most violent patients. A bill by state Sen. Noreen Evans (D-Santa Rosa) would require thorough violence assessments, place the most aggressive patients in specialized units and, if secure housing cannot be found, send them to prison or jail. Patients who commit serious assaults would also be transferred.

Allen has also moved two bills through committee — one that makes it easier to involuntarily medicate certain patients deemed incompetent to stand trial, and another that enhances the disability insurance policies for all hospital staff.

Labor groups contend the Department of Mental Health has not moved with sufficient urgency to address the violence. But department spokeswoman Jennifer Turner said 50 employees have been hired since Dooley lifted the freeze and officials are working to expedite the process of sending violent patients to prison.

The department's recent safety report endorses the creation of special units to hold the most aggressive patients. They would have extra staff and on-site police officers, the rooms would have high-security doors and patients would be restrained when moved.

The most extensive reviews were conducted at Napa and Metropolitan, which have open campuses not designed for patients with violent criminal histories. Recommendations include more fencing and outside lighting and teams of psychiatric technicians and police officers to monitor the grounds as they do at Patton State Hospital in San Bernardino. The department's call for new video monitoring and upgraded alarm systems applies to all state hospitals.

While the price tag of these reforms would be high, the cost of doing nothing could be steeper. In 2010, Napa recorded 384 staff injuries resulting in 289 workers compensation claims and 10,724 missed work days, according to an analysis accompanying one of the bills. Systemwide, overtime costs in the last fiscal year ran up to $100 million, Allen said, in part due to injuries.

Psychologist Henry Ahlstrom, Atascadero's chief steward for AFSCME Local 2620, said he and other members of the statewide safety coalition applaud the legislation. But he stressed that underlying problems that feed the violence also need to be addressed.

The federal government's lawsuit brought about some positive changes, he said, including documentation and, to some extent, accountability through stricter protocols and audits. But excessive paperwork demands from the federal monitor have pulled staff away from direct care to focus on grooming patient records. The result is eroded therapeutic relationships, which are key to de-escalating violent situations, he said.

"We don't have sufficient time to help our patients develop healthy attachments and regulate their emotions better," Ahlstrom said.

Patient advocates say fear only worsens the equation. At Napa in particular, interactions with patients have become "guarded, tense, conveying orders or instructions, leaving patients feeling disrespected and disregarded," said Barbara Duncan, spokeswoman for Disability Rights California, which advocates on the patients' behalf. That atmosphere can cause patients to "back away, apologize for every request, avoid eye contact, close down," she said.

"When you have little positive human interaction, the result is hopelessness," she said, adding that the response "can be withdrawal and depression, but can also be anger and violence."


Mental Health Issues Related to Veterans in the News

IN FOCUS: VETERANS AND MILITARY MENTAL HEALTH
Court Calls for Overhaul of VA Mental Health Services: A federal appeals court has ordered the Department of Veterans Affairs (VA) to dramatically overhaul its mental health care system. The court criticized both Congress and the administration for failing vets. The "unchecked incompetence" in handling the flood of post-traumatic stress disorder and other mental health claims is unconstitutional, the court said. It noted that it takes the VA an average of four years to fully provide mental health benefits owed to veterans and often takes weeks for a veteran with suicidal thoughts to get an initial appointment. One member of the three-judge panel dissented, stating that the decision would only prolong litigation and complicate the agency’s efforts to improve services. (Reuters, 5/10/11)

More Than Half of Recent Vets Have Mental Health Problems: More than half of all Iraq and Afghanistan veterans treated in Department of Veterans Affairs’ hospitals since 2002 have been diagnosed, at least preliminarily, with mental health problems, according to statistics. The data, which is released quarterly, also shows that the raw number of returning soldiers with psychological problems is rising. Nearly 18,000 new patients were treated for mental health issues at VA facilities in the last three months of last year—the most recent time period for which data is available— upping the total to more than 330,000. (Pro Publica, 5/11/11)

Stress of Troops Reaches Five-Year High: U.S. troops fighting in Afghanistan are experiencing some of the greatest psychological stress and lowest morale in five years of fighting, according to a military study. Mental health strain was most severe among veterans of three or more deployments, with a third of those showing signs of psychological problems defined as either stress, depression or anxiety. The report notes that the number of mental health staff has doubled in war zones in order to ensure treatment is available immediately for soldiers who suffer psychological trauma. (USA Today, 5/8/11)

Few Troops Exposed to Bomb Blasts Examined for Concussions: More than half of U.S. combat troops in Afghanistan have been exposed to bomb blasts in the last year, but only about 1 in 5 of them said they were examined for concussions, according to a draft of a recent military survey. Medical officials failed to screen about 80 percent of soldiers and Marines who reported being within 50 meters of a roadside blast during their tour of duty, according to combat troops surveyed in July and August of last year. However, the survey was conducted before the full implementation of a new policy beginning in June that mandates screening of troops exposed to bomb blasts. (Pro Publica, 5/10/11) 

Monday, May 16, 2011

Facebook rolls out anti-bullying tools with White House support

Reposted at darkestcloset.blogspot.com
Facebook announced two new safety features Thursday in conjunction with a White House summit on bullying.

A new reporting tool will let Facebook users, including teens and younger users, to privately report troubling content not just to the site itself but to parents, teachers and others in their support system.
And an improved Safety Center, due out in the next few weeks, will provide educational videos, articles and other content created by bullying experts to help adults address the problem.

"Today's summit is about collaboration and being innovative in the ways in which we address safety," the networking giant wrote on its Facebook Safety page. "We hope these new resources will help all of us -- parents, teachers, kids, safety experts, and Facebook itself -- work together to create safer environments."
In a video posted on the safety page, President Barack Obama and first lady Michelle Obama encourage Facebook members to join in the effort to decrease bullying, both online and off.

"For a long time, bullying was treated as an unavoidable part of growing up," President Obama says in the video. "But more and more we're seeing how harmful it can be for our kids, especially when it follows them from their school to their phone to their computer screen."

Facebook said the "social reporting" feature is intended to get reports of bullying to the people with the best chance of stopping it.

Under the new system, a user could identify a photo, status update or other item as bullying them, then privately send a message to someone in their friend network about it.

"Safety and child psychology experts tell us that online issues are frequently a reflection of what is happening offline," Facebook wrote. "By encouraging people to seek help from friends, we hope that many of these situations can be resolved face to face."

The new Safety Center will constantly be updated with new information and tools, according to the post.

The World May One Day Be Led by Persons with Mental Illnesses

By Steve Harrington, J.D., Executive Director, National Association of Peer Specialists

Two bits of information recently came to me that, taken together, caused me to formulate the following, inescapable conclusion: persons with a mental illness, particularly those with schizophrenia, are destined to lead the world.

This conclusion is well-supported by social scientists and organizational theorists. Very recently, researchers have concluded that the best leaders for organizations of all types are those who know themselves best. Experience has shown that those who know themselves well, and are comfortable with who they are, relate to others in a humane, compassionate way. That, in turn, inspires workers with loyalty and a desire to become more creative and productive. Everyone wins! Gone is the attitude that productivity is best driven by cold-hearted bean counters who monitor every move it takes to create a widget.

One business author, Robert Thomas, CEO of Accenture Performance, uses current leaders as examples. In his new book, Crucibles of Leadership, Thomas writes that the best way for people to know themselves, and thus become more effective leaders, is through adversity. He cites cases where deaths and illnesses forced now-effective leaders to reevaluate their lives and reprioritize their values. The result: compassionate people who lead with their hearts and workers who have never been more happy, productive, and creative. Businesses, especially the most successful in the world, know this lesson well.

So, it struck me. Where would you go to find people who have experienced adversity and grown through the experience? Psych hospitals! (Or those who have been there.)

Complementing this revelation is another. I recently heard a respected psychiatrist, sitting on a panel of his peers, go through a litany of challenges persons with schizophrenia face. The doctor painted a pretty ugly (and, fortunately, unrealistic) picture of what life is like for all persons with schizophrenia. At the end of his presentation, an audience member asked if there could be anything positive resulting from schizophrenia.

“Oh, yes,” the doctor replied immediately. “Persons with this illness are often great problem solvers. They think ‘outside the box.’ Once you've had your sense of reality shaken, it's easier to take risks and be creative.” The doctor used Nobel laureate John Nash as an example of how schizophrenia can result in creative thinking.

I thought for a moment about my own reality challenges. Walls moved, ceilings collapsed, lines on the road shifted, and voices--oh, those voices telling me what to do! And then there was that day I had a stimulating conversation with an unseen companion on a street corner. That little incident sent me back to the hospital, where meds ended the conversation—but not its memory.

Then I remembered the words of a professor recommending me for a doctoral program in public administration.

“Steve, you just don't think like other people,” he said. “You come up with ideas and approaches that are totally unique. Your head just doesn't accept reality, and that challenges us to change our perception of reality. That's what creative problem-solving is all about. You don't just think outside the box—you don't even know there is a box!”

Here's the bottom line: Those of us who have been there know all the disadvantages of having a mental illness, especially one like schizophrenia, which can affect cognitive abilities and perceptions of reality. On the other hand, society appears on the brink of recognizing the value of serious life challenges, especially when those challenges are used to foster personal growth.

The professional must therefore work to build upon the person's strengths (such as the perspective of yours truly being a creative problem-solver) and use them as the motivating factors to enhance his/her recovery. As is illustrated above, we can look at strengths instead of just the illness.

I foresee a time when executive headhunters will prowl the hallways of our psychiatric hospitals, looking for new leaders for organizations of all types. Gone will be the days when executive job descriptions require an MBA. Instead, job descriptions will read:

“Life-changing experience through adversity desired; mental illness a plus.”

Look out, world. We're taking over! 

Posted in May 12, 2011, Vol. 12, Issue 17 Recovery To Practice Newsletter.

HHS: Healthcare reform law saves Medicare $120 billion

By Julian Pecquet - 05/12/11 The Hill
Democrats' healthcare reform law and other recent steps will cut Medicare costs by $120 billion over five years while improving care for seniors, the Obama administration claims in a new report released Thursday.
The report from the Medicare agency comes as Republicans are pressing for large cuts to the nation's healthcare entitlements as part of negotiations on the debt ceiling. It points to provisions that aim to crack down on fraud and abuse, reward doctors and hospitals for quality of care and improve care for people with disabilities as key to future savings.
"At the same time we have helped improve Medicare's finances," White House Deputy Chief of Staff Nancy-Ann DeParle wrote on the White House blog, "we have also extended important new benefits to everyone on Medicare."
DeParle goes on to highlight further reforms that the president wants to tackle as part of deficit talks, including strengthening the Independent Payment Advisory Board that will recommend provider payment cuts and decreasing payments for prescription drugs. The administration says those steps could save another $200 billion over the next decade.

Schizophrenia Awareness Week

In honor of Schizophrenia Awareness Week, here are some chilling reminders of the not-so-distant past.
Warning: this images, published as ads in medical journals may disturb some individuals.

http://www.bonkersinstitute.org/medshow/thorazsenile.html



Reposted at darkestcloset.blogspot.com

Friday, May 6, 2011

Secondhand smoke isn't just bad for kids' bodies, it's bad for their brains

By Karen Kaplan, Los Angeles Times  1:05 p.m. CDT, April 5, 2011
la-heb-second-hand-smoke-mental-health-20110405Children and teens exposed to secondhand smoke are more likely to develop symptoms for a variety of mental health problems, including major depressive disorder, attention-deficit/hyperactivity disorder and others, according to a study published in Tuesday’s edition of the journal Archives of Pediatrics and Adolescent Medicine.

At this point, it should come as no surprise to anyone that exposure to tobacco smoke is unhealthy. Plenty of studies have linked secondhand smoke to respiratory problems, asthma, sudden infant death syndrome, middle ear infections and other physical health problems. But the link between secondhand smoke and mental health has not been examined as closely.

The new study is believed to be the first that looks at how secondhand smoke exposure – as measured by the presence of a nicotine metabolite in the blood – is associated with mental health in a nationally representative sample of American kids and teens.

Researchers from the National Institutes of Health, the University of Miami and Legacy, the nonprofit that fights tobacco use, used data on 2,901 youths who were between the ages of 8 and 15 when they were part of the National Health and Nutrition Examination Survey from 2001 to 2004. As part of the study, the kids were asked to provide blood samples; those who were exposed to secondhand smoke had higher levels of the cotinine, which is produced as the body metabolizes nicotine. The kids were also assessed for a variety of mental health disorders as defined by the National Institute of Mental Health’s Diagnostic Interview Schedule for Children Version IV.

Here’s what the researchers found: On average, the kids had almost five symptoms of major depressive disorder, almost four symptoms of ADHD, almost three symptoms of generalized anxiety disorder and more than one symptom of conduct disorder.

After taking into consideration the kids’ health history and other factors, the researchers determined that levels of cotinine in the blood were strongly correlated with ADHD symptoms and weakly linked with symptoms of major depressive disorder, conduct disorder and generalized anxiety disorder. Overall, the links between cotinine and psychiatric symptoms were greater for boys than for girls, and for whites compared to blacks and Mexican Americans.

But none of those symptoms added up to a single diagnosis of a mental health disorder that could be linked with exposure to secondhand smoke in the children and teens in the study. At first, it looked like higher cotinine levels might be associated with a higher risk of ADHD. But upon further analysis, it turned out that the increased ADHD risk was actually due to smoking by mothers during pregnancy.

Still, the authors make the undeniable point that there’s no upside to secondhand smoke for kids, teens – or anyone else:

“Efforts to ban smoking in public places where children and adolescents are present, including all child care settings and schools, should continue, as well as increased efforts to develop interventions targeted directly at parents and and designed to prevent [secondhand smoke] exposure in the homes of children and adolescents.”

The study is available online here. (http://archpedi.ama-assn.org/cgi/content/full/165/4/332)
Reposted at darkestcloset.blogspot.com