Stuffed with Stigma

by Kimberly Rider

If you were to see these stuffed animals in a store you may think that they were your average every day adorable cuddly plush toys. However, take a closer look at them and you can see that these fluffy characters are more than just your average stuffed animals; they are stuffed to the gills with stigma toward mental illness.

A German toy company has developed these toys calling them “Psychiatry for the Abused Toys”. Each animal has a diagnosis and includes access to a virtual online clinic called “The Asylum”. This virtual set up allows you to be the doctor and treat the symptoms of the animals with various mocking methods such as therapy provided by a puppet sock and Electroconvulsive therapy (ECT). The game takes place in a bleak virtual waiting room with a noticeable sign on the wall that has a noose with a red slash through it. Players are urged to select an animal and “solve” the problem by treating the stuffed animal using some of the methods listed above.

 

At first glance, these toys might seem educational—using stuffed animals to teach children about sensitive topics is nothing new.  But upon visiting the website and the virtual game, I was disgusted. While I acknowledge that some things may get “lost in translation” and that culture plays a large role in people’s experiences with mental illness, this was simply not acceptable to me. 

Toys such as these only help to perpetuate negative stereotypes about mental illness, and by extension stigma, from an earlier age.  Instead of having toys that teach children about “institutions” and emphasize negative aspects of some people’s experiences with mental illness, why don’t we have toys that teach children about recovery?  Teaching children to ridicule, stigmatize, and worst of all, believe false things from such an early age can only be harmful.  If children are indeed our future, let’s join together to ensure that they are getting positive messages about themselves, about overcoming challenges in their life, and about the world as a whole

http://parapluesch.com/catalog/

The author may be reached at http://cnsantistigmaprogram.org/. This article was posted in the STOMP newsletter for Mar. 2011. It is not yet archived at their site.

Reposted at http://www.darkestcloset.blogspot.com/

Minds On the Edge

This is a video of a discussion on treatment of mental illness. It is created from two hypothetical situations of individuals who experience severe mental illness. It also features Dr. Fred Friese.
http://www.mindsontheedge.com/watch/

Reposted at darkestcloset.blogspot.com

Journalist at Minnesota's "City Pages" Exposes

Today, the main weekly news source in the Twin Cities -- City Pages -- became the first significant media to cover the forced electroshock of MindFreedom member Elizabeth Ellis, a 67-year-old retired teacher and counselor.
BELOW is City Page's article about taxpayer-funded involuntary electroconsulsive therapy (ECT) over the expressed wishes of the subject, right here in the USA:
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CITY PAGES Health
Elizabeth Ellis protests her forced electroshock treatment on MindFreedom
By Andy Mannix, Tue., Mar. 22 2011
It's been almost two years since we reported the tale of Ray Sanford, a Twin Cities man forced into electroconvulsive therapy by a court order. Now, another Minnesotan receiving ECT is publicly protesting her involuntary treatment.

Elizabeth Ellis, a 67-year-old retired teacher, says she's been shocked more than a dozen times against her will since last September.

In January, Ellis was part of a teleconference for Mind Freedom International, a patient-advocacy nonprofit based out of Eugene, Oregon. After introducing herself to the rest of the group during the call, Ellis announced she had been sentenced to involuntary ECT.

Mind Freedom quickly came to her defense. The site's advocates have started an online campaign for Ellis, urging readers to call Sens. Al Franken and Amy Klobuchar and protest.
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FOR MORE of City Pages article with photos and graphic of court order, click here:

or use this link:

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For info on Elizabeth campaign -- to contact her and her elected officials -- click here:

For history of the successful Ray Sandford campaign, see:

Reposted at darkestcloset.blogspot.comhttp://www.mindfreedom.org/rayhttp://www.mindfreedom.org/elizabethhttp://3.ly/CityPagesEllisECThttp://blogs.citypages.com/blotter/2011/03/elizabeth_ellis.php

I Would File this Under Inappropriate Professional Behavior

Dangerous doctors slipping through the cracks

It took the discovery of guns and grenades to suspend the license of a psychiatrist who some say should have come under scrutiny years earlier

By Megan Twohey, Tribune reporter 8:50 p.m. CST, February 24, 2011 posted on http://darkestcloset.blogspot.com/

One night a Crestwood police sergeant doing a routine building check noticed an open door to the office of psychiatrist Joel Carroll. Stepping inside the cluttered office, he discovered roaming cats, a Colt AR-15 assault rifle and other guns, ammunition, military-grade smoke grenades, sex toys, and pornography.

"Well, for the lack of better terminology, we considered it a pigsty," Sgt. Thomas Kaniewski testified about his April 2009 discovery. "It looked in complete disarray. We couldn't believe that someone could actually conduct business in an office like that because of the conditions it was in."

When state regulators determined that Carroll had engaged in sexual misconduct and committed other violations of the state Medical Practice Act, they suspended his license, proclaiming him "a danger to his patients," according to state records.

But the psychiatrist's practice could have been shut down years earlier, after the Illinois Department of Corrections in 2007 found that Carroll — as a state contractor — committed inappropriate conduct with a female inmate and barred him from working in a prison, a Tribune investigation showed.

Critics say the case raises questions about a crucial part of the medical disciplinary system.

State agencies, county prosecutors, insurance companies, and health care employers and associations are mandatory reporters — they're required to report potentially dangerous and unprofessional doctors to medical regulators, who can bar the doctors from practicing and keep patients out of harm's way.

But the mandatory reporters sound few alarms, and when they do, regulators rarely take action, the Tribune found. There were 348 mandatory reports filed with the state in 2009. That's out of nearly 46,000 physicians statewide. In only one case did the Illinois Department of Financial and Professional Regulation respond by suspending the physician's license, records show.

Sue Hofer, a department spokeswoman, said it can take longer than a year to discipline a doctor following a mandatory report. She said regulators frequently learn of a dangerous doctor from members of the public before being told about the doctor from a mandatory reporter. If they are already investigating, she said, the regulators don't make a separate record of the notification.

But in the case of Carroll, the corrections department provided no notification that the psychiatrist had breached security during a visit to the inmate and allegedly made a sexual advance toward her, even though state agencies must report any potential violation of the Medical Practice Act. Carroll's actions might have amounted to "dishonorable, unethical or unprofessional conduct" — a violation under the act that can lead to suspension — but regulators were robbed of the opportunity to seek disciplinary action, said John Goldberg, a former medical prosecutor.

"The Department of Corrections should have reported, but these agencies hardly ever do," Goldberg said. "If they had, the regulators could have opened an investigation that at the very least asked: What's the explanation for your actions against this inmate? What else is this doctor doing?"

Regulators also were not contacted at the time by Wexford Health Sources, the contracting agency that fired him after his administrative lockout from the prison system. Health care employers must report terminating or restricting a doctor's privileges based on actions that may directly threaten patient care. Elaine Gedman, a spokeswoman for the Pittsburgh-based company, said that in 2007 the "Department of Corrections did not necessarily disclose their rationale for revoking an employee's clearance."

"When we look at this, we realize there are places where dangerous doctors get caught, where they're identified, but no one reports it, or the state doesn't take action," said Gary Schoener, a Minneapolis psychologist who has consulted on thousands of medical misconduct cases across the country.

Sharyn Elman, a corrections spokeswoman, said prison officials believe they did not have to report Carroll to regulators because they could confirm only that he breached security during a visit to the female inmate, not that he engaged in sexual misconduct as alleged.

But after police stumbled on the office, regulators received documentation from the Department of Corrections indicating "the doctor had told that inmate that he would take her to Mexico, and hugged her and kissed her," a medical investigator said during a 2009 disciplinary hearing.

Carroll, who could not be reached for comment, said in the hearing that the inmate made a pass at him, not vice versa.

The psychiatrist maintained his practice while he worked in the prison system from September 2006 to February 2007 and during several months in 2009 while he worked at medical centers for veterans in Danville and Marion.

His personal appearance was concerning to patients and other observers, as was his office, according to testimony.

One former patient said the psychiatrist went shoeless with holes in his socks. A pharmacist questioned whether he was really a doctor.

"He looked messy, unkempt," the pharmacist testified in a disciplinary hearing. "I was surprised at his appearance. He did not look, to me, like any physician I had ever met before. … He was wearing a T-shirt. It did not appear to be clean. It was very wrinkled. He was unshaven."

Carroll's former secretary said the presence of pornography and guns in the office was disturbing.

"The point is, putting myself aside, why does a doctor — a psychiatrist — have guns in the office with psychiatric patients?" she said during a hearing. "That's the problem."

When asked about the weapons in his office, Carroll said he collected them for fun and protection. He told authorities he had close to 100 guns stored in the walls of a Skokie home, state records show. Carroll had a firearms license.

The police never arrested Carroll. During the disciplinary hearing, Kaniewski said he did not know whether Carroll's assault rifle was a type that is illegal for him to own, only that he thought it was cause for concern. (Crestwood police Chief Theresa Neubauer did not respond to written questions or calls seeking comment.)

While law enforcement did not pursue charges against Carroll, state regulators determined that having these weapons at his office amounted to dishonorable, unethical or unprofessional conduct.

The former secretary, who first had been a patient of Carroll's, said she was surprised when he visited her behind bars and then offered her a job immediately after she finished serving time for a drug conviction.

Carroll gave her presigned prescriptions to use when he was out of the office, she said. The woman, a recovering drug addict who had no medical training and suffered from bipolar disease, would pen prescriptions for patients — a violation of drug laws, a Drug Enforcement Administration official testified.

"The medications would range from antidepressants all the way up to controlled substances such as Methadone," the woman explained during the hearing.

Carroll took the woman to New Mexico when he attended a conference and they shared a hotel room, according to the secretary's testimony. Carroll denied it, but she testified he walked around in his underwear and made an unwelcome sexual advance toward her.

When the secretary quit after the state launched its investigation, Carroll showed up at her home more than once, prompting her to call Chicago Ridge police, records show.

"Because after the investigation started, he went and he bought more guns and he just … I don't trust him today," she said in a hearing.

Carroll admitted he spent numerous nights at the home of a patient who suffered from anxiety and panic disorder, state records show. Regulators alleged he took nude pictures of her while she was asleep, threatened to have her committed, masturbated in front of her and attempted to climb through her bedroom window while she was in bed with her boyfriend — all of which he denied.

Another former patient who had turned to Carroll for treatment of severe anxiety said she was confused when he showed up unannounced at her family's Crestwood home. He allegedly tried to kiss her as he was leaving, which prompted her to cry to her mother.

The psychiatrist allegedly returned to the house more than 20 times, records show. The woman and her mother testified he would lay his body against the doorbell and throw rocks at her window.

"It upset me. I was crying. … I did call his telephone and asked him to please don't come to my house," the former patient said in a medical disciplinary hearing.

Carroll said he only threw rocks at the woman's window once. He denied he tried to kiss her.

When she realized the Department of Corrections and Wexford Health Services had taken action against Carroll in 2007 but had not informed regulators, she was outraged.

"This guy should have been out years ago," the woman said. "This should never have happened to any of us."

Withdrawal from the drugs wasn't the only hard part, she said. Her anxiety, already debilitating, worsened.

She is afraid to leave her home, she said, for fear that Carroll will be outside.

mtwohey@tribune.com

FDA Orders New Cautions on Antipsychotic Drugs

By John Gever, Senior Editor, MedPage Today

Published: February 22, 2011

http://r20.rs6.net/tn.jsp?llr=sqa5umdab&et=1104622119011&s=9110&e=001zc3xfKsSKtg4N1-pYs_DXy5sGZyl_JqZRQ6S__GGivGRdDhhjQAGnT87c4ApeeqM-vZNl8MnT4Kirqg6R8hwMg5U5l4iRyJO-vyN-gJSz1DYsjxvzjDHy8MJ3cp6-5Ae0Vu--LIef1TRTx1HZDtN2FvUT8QEEmyzZtadl_Vib0I= 

WASHINGTON -- All antipsychotic drugs, including older agents as well as second-generation products, must contain new label information regarding their use in pregnancy, the FDA said.

In particular, the new labeling will address the risk of extrapyramidal symptoms (EPS) and withdrawal syndromes in newborns.

"FDA has updated the Pregnancy section of drug labels for the entire class of antipsychotic drugs to include consistent information about the potential risk for EPS and/or withdrawal symptoms in newborns whose mothers were treated with these drugs during the third trimester of pregnancy," the agency said in a notification to healthcare professionals.

The FDA has identified 69 episodes of neonatal EPS or withdrawal in adverse event reports submitted to the agency through October 2008.

Among the symptoms listed in the reports: agitation, hypertonia, hypotonia, tremor, somnolence, respiratory distress, and feeding disorder.

However, blood levels of the drugs involved were not provided in the reports, the agency said, so it was "not possible to determine whether the events resulted from antipsychotic drug toxicity or withdrawal."

Onset of symptoms ranged from birth to one month later, and the severity varied as well. The FDA indicated that some infants recovered within hours while others needed intensive care and prolonged hospitalization.

Most of the cases also involved other potential causes of the symptoms, such as other psychotropic drugs and medical problems associated with the pregnancy or delivery.

"However, there were some cases which suggest that neonatal EPS and withdrawal may occur with antipsychotics alone," the FDA said.

The agency's announcement did not indicate which specific antipsychotic drugs were named in the adverse event reports.

In any event, the FDA is requiring the standardized cautions be carried on all antipsychotic drugs -- 20 different types sold under 23 brand names are included in the order. These range from the first antipsychotic drug used in modern practice, chlorpromazine (Thorazine), to such newer agents as aripiprazole (Abilify) and quetiapine (Seroquel).

All the products are approved to treat schizophrenia; some also have been cleared for bipolar disorder.

The official order can be read at http://r20.rs6.net/tn.jsp?llr=sqa5umdab&et=1104622119011&s=9110&e=001zc3xfKsSKtiUHzIcX1zPrMMeu7RbjgzLOGeS1R5vSEPycP_IGuIFgPwJ3u9br8C6AnbII2XdxeN_WyjYhK84BTUjtiLIYWmDr2X3r0OK45YMuKbnSEBZPwQp673XT2FfUpvaiukBE7ud1I-1iwEiVQ==. 

Suicide more likely after brushes with the law

By Frederik Joelving

NEW YORK | Tue Feb 8, 2011 5:19pm EST

NEW YORK (Reuters Health) - People who come into contact with the criminal justice system are at increased risk of suicide, a Danish study shows, even if they're found not guilty.

The findings expand on US research showing that in the 1980s, jail inmates were nine times as likely to kill themselves as the general population.

In 2007, the US suicide rate was about 11 deaths per 100,000 people, according to the National Institute of Mental Health. That rate is only slightly higher than the rate in Denmark.
"This study is a new contribution in that it puts the criminal justice system on the agenda in terms of suicide risk factors," said Roger Webb, who studies suicide prevention at the University of Manchester in the UK and worked on the new results.

"What we have shown is a high risk of suicide across the spectrum of people who have been in contact with the criminal justice system," he told Reuters Health. "This includes people who have never been held in custody, and even people who were never found guilty."

Other risk factors include physical or sexual abuse as well as depression and other mental illnesses.

The new findings are based on data on more than 27,000 Danish men and women who committed suicide between 1981 and 2006. For comparison, the research team also studied more than half a million people of the same age and gender who were still alive.

About a third of the men who'd killed themselves had been charged with a criminal offense of some sort -- from speeding to homicide. In the comparison group, only a quarter had ever been charged.

For women, nearly one of every eight who committed suicide had been in contact with the criminal justice system, compared to one in 20 of the women who were still alive.

Of course, Webb said, people who brush up against the law tend to have a troubled history.
"It's a group of people who have quite complex needs, people who come from deprived communities or dysfunctional families, which puts them at higher risk of suicide to begin with," he said.

But even taking into account any admission to a psychiatric hospital, and factors such as poverty and education, the suicide risk was increased by more than half for men and nearly doubled among women with criminal charges.

That doesn't necessarily mean the encounter with the law caused any suicides. But Webb, whose results appear in the Archives of General Psychiatry, said the experience might in principle have pushed some people over the edge.

"You've got people who are already quite vulnerable -- they have alcohol problems or mental illness that might never have been properly treated," he said. "And then on top of this there is the stress and uncertainty of passing through the criminal justice system."

He said the authorities should be aware of the increased suicide risk, which peaks just after people land in prison and immediately after their release, according to earlier research.
However, before changing policies, more research is needed, Webb added.

SOURCE: bit.ly/e5bqSD Archives of General Psychiatry, online February 7, 2011.

Smoking pot may hasten onset of mental illness

By Nancy Lapid

NEW YORK | Mon Feb 7, 2011 5:19pm EST

NEW YORK (Reuters Health) - Smoking marijuana has been linked with an increased risk of mental illness, and now researchers say that when pot smokers do become mentally ill, the disease starts earlier than it would if they didn't smoke pot.

This means that serious psychiatric diseases that might not have shown up until kids were in their teens or twenties - or might never had developed at all - are starting in children as young as 12 who smoke marijuana.

The link between using pot and developing serious mental illness is strongest in the youngest smokers - 12- to 15-year-olds, or kids even younger, said Dr. Matthew Large in an interview with Reuters Health.

"We have to (tell) people who have marijuana in their pockets not to give it to younger people," said Large, who headed up the research at the University of New South Wales in Sydney, Australia.

Large and his colleagues looked at thousands of patients with psychotic disorders like schizophrenia. People with psychotic disorders lose touch with reality -- usually starting in adolescence or young adulthood.

The authors of the new study found that in the subjects who had been pot smokers, the psychotic symptoms began nearly 3 years earlier than in those who had not been marijuana users.

People with schizophrenia often have hallucinations (they see things that aren't there) and delusions (they're often convinced something improbable is true, when it isn't); they also tend to have unusual or bizarre behavior, social problems, and general difficulty in coping with life. According to the National Institute of Mental Health, approximately 2.4 million American adults, or about one in every 100 people over age 18, have schizophrenia.

The vast majority of young people who use marijuana don't develop psychosis. And so far, no one's been able to prove that smoking marijuana actually causes psychotic disorders like schizophrenia, but the new research adds to "growing evidence" that it does, at least in some people, said Dr. Michael T. Compton at George Washington University Medical Center in Washington, DC, who worked on the study.

A number of studies had already suggested that people develop schizophrenia at a younger age if they've been using pot - even if they weren't heavy users -- but not all researchers agreed.
To get a better sense of the evidence, Large and Compton and their colleagues systematically combined and analyzed data from 83 studies involving more than 22,000 people with psychotic disorders like schizophrenia: 8,167 who used marijuana or other substances, and 14,352 who did not.

"Those who used marijuana had an earlier age at onset of the disorder, by (about 32 months) on average, than those who had not used marijuana," Compton said in e-mail to Reuters Health.

Why was there disagreement in the past over whether this effect really exists? The reasons lie in the way the individual studies might have been done, the researchers say in their article, published in the Archives of General Psychiatry.

In their larger analysis, they made sure to account for several factors that authors of the individual studies might not have considered. For example, psychosis develops earlier in boys than in girls - but Large and Compton found that even when they adjusted for that difference, the pot smokers still developed psychotic symptoms earlier.

Also, older people are less likely to be smoking pot than younger patients, so if the individual studies had different proportions of various age groups, the results might have been skewed. Taking that factor into account, the researchers still found that marijuana users developed mental illness at a younger age.

They also tried to see whether their findings could be explained by the year the research was done (because pot may have become more potent over time), whether the research had been done according to good scientific principles, and whether the investigators had defined the start of mental illness according to the date it was diagnosed instead of the date the symptoms started (the date symptoms started is more accurate). But they kept coming back to the same result: people with psychotic disorders who smoked marijuana had symptoms of mental illness at a younger age than those who didn't use pot.

The researchers did not look at whether family history of psychosis played a role in determining who was most vulnerable to marijuana's apparent early-triggering effect.

Are there some kids who are more at risk of psychosis from smoking pot than others? "I'm sure there are," Large said. Kids with a family history of psychosis, or those with some psychotic symptoms but not full-blown schizophrenia are at particular risk, he said. But also at risk are kids who are struggling, not doing well at school or living in bad situations at home.

One study found that compared to people who didn't use marijuana, people over 18 who did use it had twice the risk of mental illness, but kids under 15 had five times the risk, Large said.
There are two main messages to take away from this work, Large said. One is that there's probably something in marijuana that triggers schizophrenia. What that is, isn't clear yet. "Schizophrenia is still a mystery," he said. "Psychotic illnesses are horrible for the people who have them, and terrible for their families too."

The second message is far more important, he believes. Public health campaigns on the dangers of marijuana are focusing on older users, Large said, and overlooking the pre-teens and young adolescents who get their pot from older peers and even older siblings at home.
"Even if the onset of psychosis were inevitable (for a particular individual)," Large's team writes, "an extra 2 or 3 years of psychosis-free functioning could allow many patients to achieve the important developmental milestones" of adolescence. That extra time could allow a young person to finish school and gain other skills that might reduce the lifelong disability that so often accompanies mental illnesses.

Whereas most studies like his are presented at medical conferences, Large said he's not going to bother traveling around to announce his results to other doctors. Instead, he said, he wants to talk about his results in public forums.

"I'm not a marketing expert," he said, "but we have to find a way to tell young kids to hold off." We might not be able to convince them to never use pot, he added, but they need to wait until they're older - a message, he acknowledged, that will be tricky to deliver.

SOURCE: bit.ly/epp4be Archives of General Psychiatry, online February 7, 2011.