Loose Screws Mental Health News

In the wake of the Newtown, CT shooting, NRA chief executive Wayne LaPierre called for a national registry of those who are mentally ill. According to the Washington Post, the federal government does not possess the constitutional authority “to require state agencies to report data.” All the federal government can do is either offer or withhold funding, as it did in the wake of the 2007 Virginia Tech Shooting when it provided additional funding for state governments that shared 90 percent of their mental health records. But it seems that 38 states already maintain an active database that “require or authorize the use of” mental health records during gun background checks. And the Gun Control Act of 1968 does not allow sales of firearms to people who have been institutionalized or considered to be mentally “defective.”

For the purpose of firearms sales, I support the idea of maintaining a database of people who have been institutionalized. This could prevent a person from being a harm to himself or to others. I speak as a person who has been institutionalized for being a harm to herself more than once. If I’d had access to a firearm, I wouldn’t be here right now. There may be many others who are in the same boat.


The New York Times reported on mental health coverage through insurance. In any given year, 26 percent of adults have a mental disorder, and 6 percent of adults have a mental illness that prevents them from functioning, according to the NIMH. In addition, 21 percent of teenagers between the ages of 13 and 18 undergo a “severe emotional disturbance.” But it seems as though 85 percent of employers offer some kind of mental health coverage through insurance, and 84 percent of employers with more than 500 employees allowed access to in-network and out-of-network mental health treatment. Beginning in 2014, insurance plans will be required to cover mental health disorders as part of President Obama’s Affordable Care Act.

The New York Times notes that many psychiatrists, however, don’t accept insurance:

Plenty of psychiatrists in private practice accept no insurance at all, though it is not clear how many; their professional organizations claim to have no recent or decent data on the percentage of people in private practice who take cash on the barrelhead, write people a receipt and send them off to their insurance company to request out-of-network reimbursement if they have any at all.

My psychiatrist does not accept insurance. He writes me a receipt, and I am to seek out-of-network reimbursement, a claim that has been repeatedly rejected by my insurance. The NYT is right on the money in this instance. But I am happy with my psychiatrist and would rather pay out of pocket for him without reimbursement than to find another psychiatrist who is in network.


According to the San Francisco Chronicle, California is ahead of every other state in covering mental health services with public money. But as always, there are critics who say California does not go far enough, even though in 2004, California voters approved Proposition 63 that funnels $1 billion annually for mental health services by taxing the state’s highest earners. But funding is being cut, not just in California but also nationally, according to NAMI.

Overall, California cut $768 million from its state mental health services outlay during the past three fiscal years, according to a November 2011 report from the National Alliance on Mental Illness. California’s 21 percent reduction in mental health funding over that period is the seventh-highest among all states.

Nationally, states cut more than $1.6 billion in general funds from their state mental health agency budgets for mental health services since 2009, according to the 2011 report by the National Alliance on Mental Illness.

I’m not sure what can be done to stop funding cuts of mental health services when state budgets are slashing services across the board.


And finally, according to NY1 News, New York City Mayor Bloomberg has announced an initiative to get mentally ill people out of jail and into treatment facilities. The mayor’s office estimates that 36 percent of inmates suffer from some kind of mental disorder. The city initiative will attempt to “reduce incarceration rates, improve jail safety, and lower crime.”

Loose Screws Mental Health News

I could’ve been a statistic right here in this area.

suicides in PhiladelphiaPhiladelphia now boasts the sharpest increase in suicides in the country. Despite all the homicides in Philadelphia making the news, the 196 people who killed themselves in 2008 were quietly buried in the obit pages (if they made it there at all).

In light of this news, I’ve decided to place a suicide hotline web banner in the upper right-hand corner of my right sidebar. Susan of If You’re Going Through Hell Keep Going has one in her sidebar and I think it’s a wonderful idea. I’ve had a couple of people comment or send me emails about how they feel they’re on the brink of losing it so hopefully the banner — one of the first things to be seen on this page — will draw some attention and prompt someone to call for help. When I was a teen, I called 1.800.SUICIDE. I can’t remember what happened exactly but I called the hotline and someone talked me into why life was still worth living. People who are suicidal don’t really want to die; they want an escape from the pain they’re feeling and they feel the only way to alleviate that pain is through inflicting death upon themselves. I hope someone who is suicidal would be willing to pick up the phone and come to the same realization that I did at the time.


Speaking of suicide, researchers from the World Health Organization and the University of Verona, Italy have discovered that SSRIs (a class of antidepressants) may significantly reduce the risk for suicide in adults. SSRIs — which include such medications as Prozac, Paxil, and Zoloft — are not be confused with SNRIs such as Effexor, Pristiq, and Cymbalta. PsychCentral notes:

SSRIPrevious studies, including a 2007 study by the U.S. Food and Drug Administration (FDA), found the risk of suicide in adults was neutral, elevated in those under 25 and reduced in people older than 65. A subsequent black box warning was added to all antidepressants regarding increased risk of suicidal symptoms in people under 25 years of age.

Basically, this study just means antidepressants help those who are 25 years and older and hurt those 24 years and younger. I’m sure a new study will come out within the next year or so that contradicts this one. Especially since numerous previous studies on SSRIs found the risk of suicide to be neutral in ages 25-65.


Young adultAccording to the Boston Globe, a (really pathetic) new study shows that nearly half of young adults between the ages of 19 to 25 “meet the criteria for at least one psychiatric disorder.”

Whether in college or not, almost half of this country’s 19-to-25-year-olds meet standard criteria for at least one psychiatric disorder, although some of the disorders, such as phobias, are relatively mild, according to a government-funded survey of more than 5,000 young adults, published in December in the Archives of General Psychiatry.

The study, done at Columbia University and called the National Epidemiologic Study on Alcohol and Related Conditions, found more alcohol use disorders among college students, while their noncollege peers were more likely to have a drug use disorder.

But, beyond that, misery is largely an equal-opportunity affliction: Across the social spectrum, young people in America are depressed. They’re anxious. They regularly break one another’s hearts. And, all too often, they don’t get the help they need as they face life’s questions…

According to the 2005-2007 American Community Survey, the population for adults ages 18-24 is gauged to be around 30 million. Therefore if we’re going to take the study at its word, let’s chop the number by half (even though the number is just under half). That will put us at about 15 million young adults. The NIMH, however, estimates 57.7 million adults in the U.S. “suffer from a diagnosable mental disorder.” If this is the case, those 15 million young adults make up nearly 26 percent of the NIMH’s “diagnosable mental disorder” statistic. The inclusion of alcohol and drug addictions might explain why this figure might be a little high.

Loose Screws Mental Health News: Suicide slide

A National Institute for Mental Health in England report reveals particular progress in cutting suicides among young men.

The three-year average was 8.3 suicides per 100,000 population in 2004-06, down from 8.5 in the previous three years.

The article was brief and unclear which leaves me wondering what England is doing right.

“Sure, Grandpa gets a little cranky and blue sometimes, but he’d never
do anything stupid”, you might think. Wrong.  Elderly people account
for 13% of the US population, but make up nearly 24% of completed
suicides. Older men are the most at risk with a rate of 29 per 100,000
people.

Does this sound like anyone you know?

More than you know, Dr. Chiaramonte. More than you know.

According to the 2007 Small Arms Survey, the United States had about 90 firearms per 100 people – the highest ratio in the world – followed by Yemen, Finland, Switzerland and Iraq.

Over half of all suicides in the United States – 52% – were committed with firearms in 2005, according to the most recent CDC data available.

Gun control: good or bad? Discuss amongst yourselves.

Analysis of "Depression: Out of the Shadows"


The show is essentially Depression 101 – for those new to learning
about the illness.
As someone who struggles with depression (within
bipolar disorder), I found a lot of the two hours pretty boring (90
minutes on personal stories and about 22 minutes for "candid
conversation"). The "a lot" comes from the stuff that I've either heard before or flies over my head, eg, how depression affects the brain, prefrontal cortex, neurotransmitters, synapses, etc. The personal stories were powerful: depressingly heartwarming. (Yes, I mean that.)

My heart sank as I heard the stories of Emma and Hart, teenagers who were diagnosed with depression and bipolar disorder, respectively. Both were such extreme cases that they needed to be sent away for special psychiatric care. They are on medications for their disorders; the specific drugs are never mentioned.

While watching Deana's story of treatment-resistant depression, I instantly thought of Herb of VNSDepression.com whose wife suffers from the same malady.

I tried to listen attentively for the antidepressant that Ellie, who suffered from PPD after the birth of her first child, would be taking during her next pregnancy. It was never mentioned.

My jaw nearly dropped to the carpet as Andrew Solomon, carefully plucked brightly colored pills from his pillbox that he takes every morning for his unipolar depression: Remeron, Zoloft, Zyprexa, Wellbutrin, Namenda, Ranitidine, and two kinds of fish oil. He might have even mentioned Prozac. He takes Namenda, an Alzheimer's drug to combat the effects of an adverse interaction between Wellbutrin and one of the other drugs that I can't remember. Solomon says he's happy. I'm happy for him and I'm happy that his drug cocktail works for him but I couldn't help but sit there and wonder, "Isn't there a better way?"

While I thought the stories covered the gamut, in retrospect, I'm surprised they didn't interview a veteran or U.S. soldier to discuss PTSD. If the producers were able to fit in dysthymia, I'm sure they might have been able to throw in a story about a soldier who struggles with depression and suicidal thoughts stemming out of PTSD. Considering all the stories coming out of the VA, it's rather relevant. It would have been more interesting than the Jane Pauley segment. But I'll get to that in a minute.

As I listened to the narrator, I couldn't help but wonder what alternate perspectives could have popped up. For what it was, I fear none. This was a Depression 101 show — a program designed to either get people to fight against fear and stigma and get help or to open the eyes of loved ones to this debilitating disorder. I'm not sure how to slip in an opposing view on medication from a doctor without confusing or scaring people away. What would Healy or Breggin say that would encourage people to seek appropriate care?

Holistic or natural treatment was not mentioned. It's not mainstream and it's not recommended by most doctors as first-line therapy. I would have been surprised had something been said about it.

The depression portion of bipolar disorder was briefly discussed in Hart's story then Pauley added commentary about her personal experience in the remaining 22 minutes of the program.

Pauley appears at the end of the show promising a "candid conversation" on the topic. The three experts: Drs. Charney, Duckworth, and Primm sit and smile politely as Pauley rattles on occasionally about herself. Some people might find her exchange endearing and personal. After the first 3 minutes, I found it annoying. As a journalist, I wish she would have taken the impartial observer approach rather than the "intimate discussion" approach. In my opinion, she seemed to have dominated the "discussion."

It ended up being a Q&A with each doctor. Her questions were focused and direct. I expected a little bit of an exchange between doctors, talking not only about the pros of medication and treatment like ECT and VNS but also the cons. (Should I apologize for being optimistic?) Charney interjected into the conversation maybe once or twice but was only to offer an assenting opinion. Primm spoke least of everyone on the panel. I think she was placed on the show solely to represent diversity.

There were no "a recent study said…" or "critics say such-and-such, how do you address that?" It was a straightforward emphasis on encouraging people to get help or for those suffering to get treatment. Pauley's segment didn't discuss any negatives (not with the medical director of NAMI there!). The closest the entire 2 hours gets to any cons is with ECT shock treatment and giving medication to growing children. The childhood medication thing isn't dwelt on. The basic gist is: Doctors don't understand how medication works in children but are working on trying to understand it and improve its efficacy.

Forgive me for being negative. The point of the program was designed to give hope to those suffering. Instead, it just made me feel even worse. Thoughts raced through my head: "Well, if this doesn't work, then it's on to that. And if that medication doesn't work then I'll probably be prescribed this therapy, and if that doesn't work, then I'm treatment-resistant at which point, I'll have to do…"

I hope the program does what it's designed to do and that's to get those suffering with depression to seek appropriate care. The one upside is that talk therapy was stressed. I'm a huge proponent of talk therapy myself. Let me know what you thought of the show if you were able to catch it.

In the meantime, this depressed girl is going to cure herself for the night by going to bed.

P.S. Is it really fact that depression is a disease?

Pregnancy is NOT a mental illness

I stumbled upon Yankee Cowgirl’s blog that mentioned Congress is working on the MOTHERS (Mom’s Opportunity to Access Health, Education, Research, and Support for Postpartum Depression) Act which would “strongly encourage pregnant women into mental health programs – that means drugs – to combat even mild depression during or after giving birth.”

She links to a column written by Byron J. Richards on newswithviews.com. He writes:

The Mothers Act is pending legislation that will indoctrinate hundreds of thousands of mothers into taking dangerous psych drugs.

He goes on to slam Big Pharma about how they control Congress and how mothers don’t need psych drugs for a natural birth process.

The Mothers Act (S. 1375: Mom’s Opportunity to Access Health, Education, Research, and Support for Postpartum Depression Act) has the net affect of reclassifying the natural process of pregnancy and birth as a mental disorder that requires the use of unproven and extremely dangerous psychotropic medications (which can also easily harm the child).

These are some serious accusations. I got pretty riled up myself and decided to see what Congress said in the bill.

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Article Analysis – “Breaking it down: Mental health and the African community”

Liz Spikol linked to this article back in December and as a Black American with West Indian heritage (and by default, African and French), I couldn’t resist commenting.

Author Morenike Fasuyi blasts the United Kingdom’s mental health system as being less than inadequate for Africans. I don’t doubt it.

I do wonder about Fasuyi’s seemingly sheer hatred for anyone of European descent (in America, we’d refer to them as “white” or “Caucasian”). The article seethes with anger.

“The general consensus suggests that African people have to work twice as hard as their european counterparts in every aspect of our social, cultural and economical existence in order to make ends meet.”

This also is the case for Black Americans.

Fasuyi explains how she’s been diagnosed with bipolar disorder but says her disorder is mainly triggered by things related to Africa: “slavery, politics, oppression.” Her turning point was on May 1, 2004 when “it was as if [her] ancestors called” upon her and “removed the scales from her eyes.” She refers to Karl Marx when speaking about “groups” – Africans – who are oppressed and eventually rise up and lead a revolution. In addition, she believes the numbers 7 and 9 relate to the African people and that 2007 could be the year when “division within the African community” would be “homogenized[d]… to effect change.”

As a Black American, I know that African people truly value their ancestors and even practice ancestry worship. This is where I believe she is coming from. To any other nationality, Fasuyi is crazy (no pun intended). It wouldn’t surprise me if her mental health status file read, “bipolar disorder with psychosis.” Not knowing about African ancestry worship can make any doctor of non-African nationality misdiagnose Fasuyi. To be able to accurately help her, she must be accurately understood.

She asked for an African psychiatrist who might have a cultural understanding of where she was coming from. She mentions this was a slow process since “there [were] hardly any.” She also asked for an African social worker but was given “an insensitive male european (sic) social worker who adversely affected my health with his actions, racist remarks and incompetence.”

She takes a nice jab at Big Pharma and pharma reps, too:

“Maintaining you within the system keeps consultants in their jobs and increases the profit of the pharmaceutical industry, which has a turnover of billions.”

Zyprexa; Cymbalta, anyone?

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Saturday Stats

"Comprising only 13 percent of the U.S. population, individuals age 65 and older accounted for 18 percent of all suicide deaths in 2000. Among the highest rates (when categorized by gender and race) were white men age 85 and older: 59 deaths per 100,000 persons in 2000, more than five times the national U.S. rate of 10.6 per 100,000." – National Institute of Mental Health