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Posts Tagged ‘mental-health’

Continuing in the Throwback Thursday vein, I’ve come up with a “selfie” from 1975. CLR Hippie Chick 20131120 WebOf course I didn’t take the photo, and don’t remember who did. Except that it was a photographer who stopped me on Madison Avenue near my sister’s NYC apartment with that age-old ruse about making me a star.  I told him he could take my picture, but gave him the Flapper’s address because I didn’t buy into his nonsense. Not wanting to be the next Ms Goodbar, I forgot about it until the picture appeared in my Mother’s inbox mailbox.

At the time I was putting my Psychology degree to good use.                                                                                            http://www.silive.com/news/index.ssf/2010/05/willowbrook_survivors_recollec_1.html

Because of my future employer’s investigative reporting, most of the psychiatric hospitals, previously known as “State Lunatic Asylums” were closing down. The overcrowded, inhuman conditions, coupled with advances in drugs like Thorazine marked the 70s trend toward de-institutionalization. The question remained, what should we do with these patients who were returning to society, sometimes after decades of neglect? The answer was a different type of warehousing, “day treatment facilities.”

I was hired to drive a bus and pick up patients from their group homes, delivering them to a bevy of activities in the state of NJ. I also got to run a few of the group therapy sessions, and since I enjoyed gardening, my supervisor encouraged me to plant a garden of vegetables around the back patio with like-minded patients. Passivity was a continuing problem, either due to the psychotropic drugs they were taking or the years spent behind hospital bars, or both. So actually digging in the dirt was considered a milestone.

Today, many people with severe disabilities are able to live a normal life. Modern pharmaceuticals allow them to work, to drive, to love, and to make a home for themselves. But sometimes psychotic patients stop taking their meds, for various reasons and when that happens, when they become a threat, “to themselves or others,” it’s time for a reboot which includes a short hospital stay. And when those psych beds, which may be on a floor of any hospital in your neighborhood, are full, when a doctor can’t find one bed for his or her patient, well then sometimes that patient falls through a crack. Over the years, Bob has had to discharge too many severely ill psych patients because there were no beds available.

964831-creigh-deeds-and-familyMy prayers go out to VA Sen Creigh Deeds who was stabbed by his own son, Gus, on Tuesday after being released from a hospital in Bath County on Monday. Gus Deeds later turned a gun on himself in a continuation of this Shakespearian tragedy now called a “murder suicide.” And we can’t blame the lack of will to pass gun control legislation after VA Tech, or the shortage of mental health beds in the state alone, because blame can be shared by a tightening of budgets over the past few years that was reported by the  National Alliance on Mental Illness: “Virginia’s overall state mental-health budget decreased $37.7 million dollars from $424.3 million to $386.6 million between fiscal years 2009 and 2012.”  The wheels on this bus cannot continue going round and round. If a state senator’s son could not access help, what does that mean for the rest of us?

 In 2011, Virginia inspector general G. Douglas Bevelacqua released a report chastising the state for turning away in a month an estimated 200 patients determined to be a threat to themselves or others who met the criteria for a temporary detention, only because state facilities lacked the room to hold them. Twenty-three of Virginia’s 40 community-services boards acknowledged that “streeting” occurred at their facilities.

Read more: Virginia State Senator Creigh Deeds’ Son Evaluated and Released Before Stabbing | TIME.com http://nation.time.com/2013/11/19/before-senators-stabbing-a-shortage-of-psychiatric-beds/#ixzz2lI6Mmsqu

 

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Something happened this week in Atlanta that will affect 50% of American households, over 11 million adults and 2 million teens in this country. Just think about it, a woman who had recently been chastised by a congressional hearing, turned around to announce “…the largest expansion of behavioral health coverage in a generation.” HHS Kathleen Sebelius told a crowd on Friday she was happy to be out of Washington while speaking at the Carter Center in Georgia. As you can imagine, this got a polite laugh from the audience. src.adapt.960.high.1383940058477

From now on, insurers will have to cover mental health and substance abuse services in order to comply with standards of the Affordable Care Act. In the past, nearly 60% of Americans have reported not seeking mental health services either because of a lingering stigma or an inability to pay for help. The latest round of mass killings has highlighted the need for improved mental health care, although adding this “parity rule” without concomitant gun control legislation seems illogical imho. Still this is BIG news.

Coverage for mental health problems should be the same as for physical problems, but the public needs to speak up,” Rosalynn Carter, speaking with her husband, last year told several hundred members of the Association of Health Care Journalists. “What is holding up equal coverage? I think it’s the political consequences of an election year. Excuse me for being so blunt.       ww.forbes.com/sites/brucejapsen/2013/11/09/carter-bush-backed-mental-health-equality-now-bipartisan-part-of-obamacare/

Maybe you’ve seen the homeless veteran get a makeover on vimeo, and then join AA ? Or maybe you’ve seen Congresswoman Tammy Duckworth (D-IL), a double amputee, dress down a contractor for scamming the system to get government contracts related to his “disability?” http://www.upworthy.com/whats-the-worst-thing-you-could-say-to-a-congresswoman-who-lost-her-legs-in-battle-found-it?c=ufb2

Our veterans have been suffering long enough, waiting to get treatment for PTSD and head injuries. Homelessness and suicides in this population have been rising . Many seek help outside of the VA, because of the stigma, as well as the red tape. http://www.apa.org/about/gr/issues/military/critical-need.aspx

Let’s talk about mental health, like any other illness. My parent’s generation never mentioned the word “cancer.” We didn’t talk about lots of things related to lady parts, now we all wear pink ribbons. Reagan didn’t want to say, “AIDS.” But if we can’t talk about something as a nation, how can we cure it?

“Comfort Food”  is a fascinating essay about a Mother who was diagnosed with breast cancer, and later her daughter was hospitalized with bipolar disorder complicated by substance abuse. Her friends didn’t bring casseroles or even try to talk with her about her daughter. “Friends talk about cancer and other physical maladies more easily than about psychological afflictions. Breasts might draw blushes, but brains are unmentionable. These questions are rarely heard: ‘How’s your depression these days?'” http://www.slate.com/articles/life/family/2013/11/families_dealing_with_mental_illness_need_support_too.html

Now if we could only get that darn website to work…

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Holden 09 005 FB

Serenity in a mountain view

August and September are filled with birthdays in my family. The Bride and my sister Kay share back to back birthdays, I call us Virgo/Libra types (you can count me in later this month) – the Christmas party babies! Happy Birthday to them on this glorious weekend.

These two share more than a couple of dates on the calendar. Kay introduced the Bride to art in her New York City apartment. My sister studied at the Art Student’s League and she also helped to illustrate many medical books during her years working at Mt Sinai Hospital and producing graphic art for the Medical School. With sun pouring through her beautiful Upper East Side window overlooking a garden, the young Bride was given a pencil and a blank canvas along with the love and encouragement of her Aunt Kay.

Painting has been a common thread throughout both their lives. After a long high school day filled with too many AP classes, the Bride would settle into her art class and paint along with beautiful music.  My home is filled with drawings from those days. And Kay’s renditions of our farmhouse in the Berkshires, and our beautiful Welsh Corgis will always decorate our walls.

This meditative time, setting up the instruments of art, the pencils or delicate brushes and turpentine, the smells, the easel outdoors, the time alone to ponder and really see – to see their way into a subject – this bit of creation helped them deal with the everyday stress of school and work. It helped them to slow down.

The Bride sent me an article this week about being busy. http://opinionator.blogs.nytimes.com/2012/06/30/the-busy-trap/?_r=1&

Almost everyone I know is busy. They feel anxious and guilty when they aren’t either working or doing something to promote their work. They schedule in time with friends the way students with 4.0 G.P.A.’s  make sure to sign up for community service because it looks good on their college applications. I recently wrote a friend to ask if he wanted to do something this week, and he answered that he didn’t have a lot of time but if something was going on to let him know and maybe he could ditch work for a few hours. I wanted to clarify that my question had not been a preliminary heads-up to some future invitation; this was the invitation. But his busyness was like some vast churning noise through which he was shouting out at me, and I gave up trying to shout back over it.

The author, Tim Kreider, calls this addiction to busyness a kind of hedge against emptiness, an “existential reassurance.”  We impose it on ourselves and it makes us feel important. After all, if we’re always so busy, how can we ever take time off for self-awareness. He posits that you don’t hear people holding down two jobs with four kids complaining about being too busy, because they’re just plain exhausted. Interesting stuff, this monkey brain!

Surprisingly an old friend simultaneously posted an article about being a distracted parent, about always saying, “Hurry up!” to her child. And I could see how this attraction to being busy can get its start. The child who likes to dawdle, who stops to talk with strangers, who wants to engage with her environment soon learns to make a goal and stick to a time schedule. And if she or he doesn’t, they may be labeled “special” in school…instead of “artist.”

The Love Bug likes to stop for ice cream with her parents. Slowing down is something children can either help us to do, or we can teach them how to be anxious. We’re the adult in this equation, it’s our choice.  photo

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The first night in Nashville I left my book club book in the car. Not wanting to go downstairs and back outside in my nightgown, I picked up a little paperback I found on the bedside table, The Spirit Catches You and You Fall Down, by Anne Fadiman. Little did I know how much I would enjoy reading about the Hmong people of Laos…currently living in California.http://www.nytimes.com/books/97/10/19/reviews/971019.19konnert.html

It’s a story about seizure disorder, and about the many ways modern medicine can fail a refugee population. Cultural dissonance is bound to happen when doctors want to order invasive tests for a baby who’s only problem is that her older sister slammed the door coming in and so an evil spirit invaded her body. For the Hmong, animal sacrifices, amulets, and strings around the wrist should cure her, but instead her parents, who speak no English, are supposed to dose her with a varied cocktail of drugs many times a day. You can see where we’re going.

But it’s not all medicine. I’m almost done with the book and I’ve had quite a history lesson on Southeast Asia. I was talking about the book to one of the Bride and Groom’s friends, an academic internist at Vanderbilt. She said it was required reading in her medical school. “Which medical school did you go to,” I asked. “Yale,” she said.

This morning, after working all night, my ER doctor asked me to read this article.
http://www.theatlantic.com/magazine/archive/2013/05/how-not-to-die/309277/

Have no fear, yes, it is about dying. Let’s face it, the spirit eventually does leave us and we all have to think about this stuff, unless of course denial works for you. It’s about a doctor who becomes an educational/documentary film maker. He makes short films that actually show people what advanced dementia (among other maladies) looks like, and he tells us to have “The Conversation” with our doctors:

“In the health-care debate, we’ve heard a lot about useless care, wasteful care, futile care. What we”—Volandes indicates himself and Davis—“have been struggling with is unwanted care. That’s far more concerning. That’s not avoidable care. That’s wrongful care. I think that’s the most urgent issue facing America today, is people getting medical interventions that, if they were more informed, they would not want. It happens all the time.”

Which made me think. Sometimes, even when you speak the same language, you still can’t communicate.
black_hmong

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“If I am not for myself, then who will be for me?”

But I don’t want to know his name
Or that he wore combat armour
That he lived with his mother
Or they seemed like a normal family

I don’t want to know the number
The size or make of the guns
Or that there will be 20 brighter
Stars in heaven this Christmas

I don’t want to know “Why”
What motivated a man to
Wake up one morning and
Cowardly mow down children

Because it doesn’t matter
All that doesn’t begin to explain
The unexplainable or to stem
The tide of grief and anguish
Still to come in this nightmare

What matters is that we
Wake Up
And take a collective sigh
And make gun violence a priority

“And if I am only for myself, then what am I?”
https://petitions.whitehouse.gov/petition/immediately-address-issue-gun-control-through-introduction-legislation-congress/2tgcXzQC
“The signatures on this petition represent a collective demand for a bipartisan discussion resulting in a set of laws that regulates how a citizen obtains a gun.”

Our society will always have mentally ill people; they will go to a classroom at VA Tech or Columbine High School, they will walk into a shopping mall or a movie theatre. They will get into a taxi, then stroll into a parking lot and shoot a congresswoman. I must be crazy to think that the overwhelming factor in this national carnage isn’t the shooter – so let’s lock all our doors and live in fear, and btw let’s arm ourselves?

NO, the problem is GUNS…the abundance of guns in our country and their easy access. The United States loses 87 people a day to gun violence. Yesterday we lost 27 people in a small New England town, including the shooter and his mother. Let’s not play the blame game, and ask how he got into the school, or if somebody heard his threats. Without those guns in his hands, he would have injured his mother, with a knife or a heavy object or his own hands, and maybe, just maybe that would have been all? We place second in the world to gun ownership per citizen, next to Yemen.
http://www.thedailybeast.com/articles/2012/07/20/gun-violence.html

“If I am not for myself, then who will be for me? And if I am only for myself, then what am I? And if not now, when?” Rabbi Hillel
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We’ve all heard of seasonal workers, and seasonal affective disorder (SAD) when you live, say in England, and rarely see the sun. Well seasonal stress disorder (SSD) should get its very own ICD9 code. For the non-medical reader, these are the letters and numbers that correspond to a diagnosis your doctor provides you and your health insurance system with – then someone at a desk decides if the doctor (or NP or PA) gets paid. Simple as that. I imagine that depression gets its own ICD9 code, with all its reasoning and corresponding symptoms, but the stress of everyday life? Probably not so much.

Starting with the Thanksgiving day bird that needs stuffing, and quickly moving on to the next day…the Blackest of Shopping Fridays…the push is on to get going:
Deck the halls and drag out or cut down a tree;
Find our buy ornaments;
Decorate the tree and serve eggnog;
Bake cookies;
Mail holiday cards:
Attend parties;
Act happy.

And it’s the “acting happy” part if you’re feeling blue that can hurt. I don’t want to be all Scrooge about it, but even if you’re a reasonably sane person for most of the year, the stress of added or forced jubilation coupled with going into debt to serve a consumer-driven culture during the last six weeks of the year can squeeze the joy out of a season that’s truly all about giving. According to this article, 90% of doctor visits are due to stress-related problems. http://www.huffingtonpost.com/2012/11/29/reduce-stress-real-life-tips-that-really-work_n_2204938.html?ncid=edlinkusaolp00000009#slide=1814158 So how to avoid burn-out in a nutshell when we’re getting down to the wire? Easy. Put on the brakes and give yourself permission to relax:
Take a walk, preferably with your dog; EXERCISE
Take a bath, or better yet, jump into a hot tub; STAY WARM
Write down 3 things you are grateful for; THINK POSITIVELY
Help someone else who needs help; ACT KINDLY
Watch a funny movie LAUGH
Learn to love chaos ACCEPT YOURSELF
(ie give up perfection or trying to live a “clutter-free” life)

Where have you gone Betsy Ford? OK, maybe that last part is more mine than yours, but studies show that putting a smile on your face makes the brain trick the mind into feeling happy. Most moms today are working AND trying to do all of the above Christmas-related chores which would drive anyone nuts, IMHO (which I just learned means “in my humble opinion”) but if you use this too much are you really humble? Just heard Deepak Chopra say that babies learn very early on whether life is going to be “Yummy or Yucky.” So I’m starting my NEW New Year’s List
and it’s not about the good the bad and the ugly with resolutions galore to add up to more stress. It’s simply a reading list and Chopra’s new book “Super Brain” will be on it. Here’s a little brain test – can you tell which card doesn’t belong? I forgot, along with keeping Santa, I also do “Merry Everything” cards, which is much easier with Shutterfly. There’s Betsy upper left, my Rumson Clutter Counselor.
photo copy

Answer key: The new 2013 card of the Love Bug is nestled in last year’s display. Don’t worry, I’m archiving the old to make way for the new. Make it a perfectly yummy holiday and Happy Hanukka to all my Jewish friends and family…is it easier or harder when Hanukka comes so early? Answer key: Easier!

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