Friday, June 24, 2011

Hammering Our Kids


I've written before (Ruminations: Little Pharma: Read It and Weep) about the troubling use of antipsychotics in children as young as 5 or 6. The study linked below reports the impact of these drugs on insulin resistance and increased adiposity, two significant risk factors for cardiovascular disease. Why are these drugs being used? It's not because there has been a sudden epidemic of psychosis in children. It's for purely behavioral reasons. These drugs reduce outbursts and disruptive behavior. Of course they do! If you're agitated, and I hit you over the head with a sledgehammer, I guarantee you will quiet down! That's what's happening here. Kids are being hit with a chemical sledgehammer that puts them at risk for major health problems. It quiets them down. It's quick and requires little thought or effort on anyone's part.What it doesn't do is address the behavior itself or the underlying reasons for the behavior. It also doesn't help children develop internal behavioral controls, coping skills, and ways to meet their needs effectively and appropriately. That would require the expenditure of effort and resources by clinicians, parents, and insurance companies. It's much easier and more profitable to just drug them.

Wednesday, June 22, 2011

Preventing Relapse of Major Depression



All dis-ease has biological, psychological and social components. Here's an article about an educational intervention with family members of people who suffer from major depression. The family intervention proved highly effective in preventing or delaying relapse. 


Brief and Effective Insomnia Treatment


Insomnia plagues many people. Nobody ever dies of it but it sure makes you miserable! Due to heavy advertising, most people believe the only treatment for insomnia is addictive and expensive medication. It's not. CBT (cognitive behavioral therapy), mindfulness meditation, biofeedback, and hypnosis are all well established and efficacious. Here's a link to a very brief behavioral treatment that was demonstrated to be quite helpful.

Sunday, June 19, 2011

The Real Cost of Budget Cuts


This article by Dr. John Grohol in PsychCentral (America's Mental Health) discusses the Stephanie Moulton murder and the reasons behind it. If you don't come away from it angry, there's something wrong.

This is, of course, not a new problem. De-institutionalization took hold in the 80's as a response to civil rights concerns. Advocates for disability rights pushed for integration and full participation in society, something they believed could not be achieved in institutions. All in all, a worthy and noble goal. Sadly, over the course of the last 25 years or so, de-institutionalization became mainly about money. Resources that were to be shifted to community treatment never got there. Political trends resulted in a dismantling of government provided services and an emphasis on private, so called non-profit agencies. These agencies have a lower staff to patient ratio and thus more patients for fewer workers, pay employees significantly less with minimal benefits, and often have high turnover of younger, generally less well educated staff who get some experience and move on to the few remaining government jobs or get out of the field altogether. The irony is that de-institutionalization has really served no one particularly well. Many former psychiatric inpatients found themselves inmates, as the Corrections systems took over from the mental health system when these individuals were unable to successfully navigate in the community and wound up in trouble with the law. Communities saw increases in homeless populations and, often, crime. Families experienced increased stress in desperately trying to find services for their mentally ill relatives. Taxpayers failed to see a reduction in taxes as resources were shifted to much more expensive correctional services. (In New York, this was a highly visible process as former psychiatric and developmental centers were converted directly into prisons.) In this context, violence is not only unsurprising, it is predictable. Stephanie Moulton is not the first nor will she be the last victim. In February, 2008, Dr. Kathryn Faughey (Casualties of a Failed System and No Justice) was murdered in her New York City office by David Tarloff, a psychotic patient who couldn’t find his intended target and killed her instead. Two days later and a thousand miles away, Steven Kazmierczak walked into a college classroom and opened fire, killing Daniel Parmeter, Catalina Garcia, Ryanne Mace, Julianna Gehant, and Gale Dubowski before killing himself. What did the killers have in common? Both had long histories of mental illness, revolving door hospitalizations, and repeated refusal of medication.

The system worked as designed – and somebody died.

Friday, June 17, 2011

The System Worked - And Somebody Died



Stephanie Moulton was killed this January by Deshawn Chappell. Stephanie was a worker in a group home for the mentally ill in Massachusetts. Deshawn is a schizophrenic who was decompensating for some time prior to the killing. They were alone in the group home. The mental health system worked as designed - and somebody died. This isn't the first time and it certainly won't be the last. Mental health budgets are being slashed all over the country and, in time, more people will pay for the budget cuts with their lives. It's not just money, though. The system as designed is fatally flawed. I wrote about this issue after the murder in 2008 of Dr. Kathryn Faughey, a friend from graduate school (Casualties of a Failed System and No Justice.) Not only have things not changed. They've gotten worse. 

Wednesday, June 15, 2011

Hypnosis Helpful in Breast Cancer Treatment and Recovery


"A new European study using hypnosis in combination with local anesthesia for certain types of surgery found the the paired approach aided healing, reduced drug usage and allowed an earlier hospital discharge."

I've used hypnosis in my practice for many years and found it quite helpful in treating chronic pain, irritable bowel syndrome, and a number of other conditions. Most interesting to me is its utility in helping people get through surgery, chemotherapy, and radiation treatment. I've used it myself with my own surgeries and rehabilitation.


"Good" Things That Might Make You Feel Worse!



There are things "everybody knows" that are actually wrong, sometimes even harmful. Here's a post on six common solutions to feeling bad that actually might make things worse. By the way, the blog, Psych Central, is quite informative and solid though sometimes, from my point of view, too prone to pathologizing normal human experience and too biased towards medication as the answer to life's problems.