In tough times one local clinic allows patients to pay what they can afford.You can learn more about The Clinic at theclinicpa.
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It can and should be used for administrative purposes and doctor's offices. It could have a practical use.
The building was built in 1938 and designed by the architectural firm of Seiforth and Dreyfous, who also did the Capitol in Baton Rouge. It is a part of history.
This building would be too expensive to reproduce today. When will we learn to stop destroying our historic past?
As a preservationist, I want to save the Charity Hospital building. Put it to a different use.
E.H.
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According to the study, firm evidence exists that shows timely surgery of the neck arteries [Carotid Endarterectomy or CEA] for those people with the symptoms of a TIA can prevent a major stroke, but the vast majority of patients receive treatment far too late to make a difference.
The report goes on to state that CEA should be performed as rapidly as possible and appropriate vascular surgical services should be funded and re-organised to achieve this goal. This will require more qualified vascular surgeons, better organisation of rotas with weekend operating lists and an increase in funds.
Also, the jointly commissioned investigation claims that patients experience unacceptable delays in the course of their treatment from the time their symptoms are diagnosed to surgery.
In addition, the report highlights significant variations in the quality of care provided across the UK and the complete lack of cohesive referral pathways in most NHS hospitals.
Every year in the UK, approximately 120,000 people have a stroke which is the single largest cause of significant adult disability, with nearly one million people living with the after-effects of stroke, onethird of them with long-term disability. Yet the UK carries out the lowest number of CEAs per head-of-population in the developed world, 10-times fewer than in Australia and the USA.
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The Co-op has a central mission of bringing fresh, organic produce to people in the Houston community at a reasonable price. We use a network of local farmers and a national distributor to source our produce, and a group of strongly committed volunteers supporting the equivalent of 3 paid staff to make the business work. This includes our Wednesday operations on Taft Street AND the Farmers Market at Discovery Green on Sundays. Each market day, remaindered unsold produce is donated to feed the least fortunate in our community. In 2008 we donated over $10,000 in produce to support SEARCH, the Salvation Army and the Beacon at Christ Church Cathedral.
Our volunteers and staff have worked in area schools to do nutrition education and outreach, including Healthy Harvard Happenings. We work now with the Urban Farm Belt coalition to help develop more community-based gardens so that people in the inner city will have access to the fresh produce they need to have balanced diets at reasonable cost. Our Sunday operation at Discovery Green provides free booth space to community service groups to bring their messages of caring for the environment and each other to the masses of park attendees each weekend.
We pride ourselves on being a Texas not-for-profit corporation, serving our community. We do not have IRS 501 C3 status, however, and this presents challenges as we apply for grant funding to grow and expand our educational programming. It also hampers us when we need to replace capital goods. Things like refrigerators, computers, shelving and scales do break. The margins we use to keep our prices low dont allow us a lot of wiggle room. So we need a capital campaign.
We have begun our first capital campaign this summer, with a goal of raising sufficient funds to replace and expand our refrigeration system, buy new shelving and replace our scales. We have multiple projects planned throughout the summer and fall to meet this goal. Our summer projects include:
- a car wash ticket sale for Bubbles Express. Now through the 22nd of July, purchase a Choice Wash ticket from us for $8 (the same $8 they charge you if you drive up), and the Co-Op keeps $4. We all like clean cars, right? And the Bubbles on Washington Avenue is really convenient. And did you know that they RECYCLE the water in their carwash? Each 18 gallons used in a typical Choice Wash gets used for 2 or 3 cars (depending on how dirty they are). And of course it is filtered and then sent to the treatment plant. So theres no groundwater contamination AND it uses very little water. Doesnt it just make you want to buy a block of tickets from me right now? Theyre good through 22 December, so you can stock up!
- a community garage sale. On Saturday 11 July, the folks at Fixers Automotive on Harvard at 11th are letting us use their space for a large community garage sale. Wed love to have your household goods for sale, and wed love to have you stop by and clothe your kids or round out your household in some other way. Contact me for drop-off information. Well be selling from 8 am to noon on the 11th. And well have carwash tickets there, too.
I encourage all of you to support Central City Co-op. Ive found it to be a wonderful group of people who believe passionately in good food, good stewardship and strong community. We are always looking for more good folks to help, as well, so if the spirit moves you to learn more and become involved, please dont hesitate to ask me for more information.
Thanks for your time. I look forward to hearing from you.
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April 29, 2009
San Jose Mercury News
Barbara Marshman, Editor
750 Ridder Park Drive San Jose, CA 95190
Regarding: OP-ED Piece Psycho Donuts
The California Mental Health Services Oversight and Accountability Commission (MHSOAC) has serious concerns about the new eatery in Campbell, California named “Psycho Donuts” and its marketing strategy. Although the owners might have meant to be “cool and funny” they are, in fact, promoting stigma and discrimination towards individuals with severe mental health problems and mental illness. In addition to its name and menu selection drawing upon mental health terms, sales staff dress as psychotic lab characters, or persons in white lab coats. Their décor not only includes a padded cell where children can take a photo opportunity while wearing a straight jacket but also a “group therapy” seating area. Their menu features items such as “Manic Malt,” “Massive Head Trauma,” “Split Personality,” or the “Bipolar.” The owners of “Psycho Donuts” perpetuate the continued ignorance towards mental health issues and amplify erroneous beliefs about mental health recovery.
Stigma is commonly defined as the use of stereotypes and labels when describing a person. Stereotypes are often attached to people with a mental illness. Stigma is what keeps many people from seeking the help they need. The negativity and misunderstanding that often surrounds mental illnesses fosters prejudice and discrimination, diminishing human dignity, creating fear and shame, and adding unnecessary pain to people who are already struggling. Stigma goes far beyond the misuse of words and information, it is about disrespect. Unfortunately, our society tends to not give the same acceptance to mental illness as it does to other health concerns, such as heart disease. The stigma surrounding these misunderstandings can limit opportunities, stand in the way of a new job, increase feelings of loneliness, and cause many other unfortunate outcomes.
In its efforts to reduce stigma and discrimination against individuals with mental illness, the MHSOAC wrote a policy paper entitled, Eliminating Stigma and Discrimination Against Persons With Mental Health Disabilities, June 2007. The document stresses that
the media, such as radio and television stations, novels, newspapers and movies have portrayed and continue to portray individuals with mental illness as violent and pathetic victims, using the element of comedy. This portrayal has been adopted by some in our society, whose sentiments and reactions towards individuals with mental illness are guided by fear and mistrust.
In a similar vein, the National Council on Disability (NCD) poignantly stated in their March 2008 paper, Inclusive Livable Communities for People with Psychiatric Disabilities, that society’s deep-seated negative attitudes toward mental illness create real obstacles for people with psychiatric disabilities, as they attempt to be part of the many aspects of community living. In addition, this internalized stigma of having a psychiatric disability keeps individuals locked in a state of hopelessness because their immediate and extended support network, such as family members, physicians, teachers, or employers accept the notion of limited opportunities.
Using exaggerated themes of psychiatric diagnosis and treatment, Psycho Donuts reinforces stereotypical beliefs about mental illness held by society. The owners defend their beliefs by stating that society has become politically sensitive with little room for a sense of humor. They offer a simple solution that those people disagreeing with their marketing strategy should buy doughnuts elsewhere; or, they should spend their time on what the owners consider “bigger problems in the world.” However, for people living with mental illness and their families, the fight against the stigma associated with mental illness constitutes their “bigger problem” and we believe this is a societal problem for everyone to solve.
Sincerely,
Mental Health Services Oversight and Accountability Commission (MHSOAC)
Andrew Poat, Chair
Larry Poaster, Vice-Chair
Linford Gayle, Commissioner
cc: Kip Berdiansky and Jordan Zweigoron, Owners of Psycho Donuts
Santa Clara County Board of Supervisors
Nancy Pena, Ph.D.
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So to get things started, I thought I would just provide a little background about myself and my journey through, well, journalism. While still a senior at Rutgers University in 1999, I began working at the Courier News as a part-time sports writer. Within a year, I was kicked upstairs to become an editor and page designer. I worked at that for five years before becoming the Assistant Sports Editor. Sports is one of my biggest passions and it was a good job.
But things change, and by 2007 the Courier News and Home News Tribune merged operations and I was sent from Bridgewater to East Brunswick. Within a few months, a got out of sports to try something new. So I began working in the features department. And that is how my association with the health beat was born. Initially, I served as just the editor and decision-maker for those pages, writing just the column and occasionally a feature story or two. But the time came to put that behind and become a full-time writer. And here I am.
I am very much enjoying working as a full-time writer again for the first time in a decade! Its giving me the change to fully explore the exciting world of health care. And what better place to do it than with New Brunswick the health-care city right in the middle of everything. So as time goes by, you can look to this blog to include as much as possible about whats going on in New Brunswick and beyond in the health world. We cover Middlesex, Somerset, Hunterdon and Union counties, so you will get happenings from all of those places.
Also, be sure to look here for links to stories that have appeared in our Tuesday print health sections, teasers about what is to come and other fun things. I promise I wont bore you, either. Theres nothing I hate more than something that is totally and completely boring and not worth someones time. My time is precious, and so is yours. So be sure to leave me feedback on how I can provide you the best coverage. Thanks for reading, and stay tuned for much, much more.
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Hey everyone! I just want to THANK everyone for your support (both morale and financial) with the Cartoon-A-Thon. It has been so much fun drawing the cartoons.
The fundraiser site has 25 new cartoons and has had 22,080 Unique Visits in the last 30 days! With 54,661 Page Views!
We hit our goal for the the sites exposure. I had no doubt about thatI just knew it would be another story with the funds. Right now, we have been able to raise $239.00 which is a great effort in these hard economic times. As I said, all proceeds from our Cartoon-A-Thon go to support the development and implementation of the Mental Health Humor Project and funding free public presentations.
And we have already put the funds to good use. On May 16, I was able to be part of a NAMI Walk-A-Thon and was able to meet a lot of great people on the providers side of mental health. On the 20th, I did my first mental health presentation at a local Drop-in center.
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I was recently horrified by something I saw on television. It made my hands clammy, my stomach sick, and broke my heart into a billion pieces. I couldnt sleep that night because my mind wouldnt let go of the heart-breaking tragedy and senseless suffering. It wasnt a horror movie, an episode of Fringe (love), or even a Swine Flu story. It was beyond anything these could ever dream up.
It was the story of a young boy who killed himself. Unless youre familiar with the story, you may initially think the young boy was in his early twenties or a teenager. Would it stop you cold in your tracks to know he was a fifth grader? Hence the clammy hands.
Dont get me wrong, Im greatly disturbed by anyone committing suicide - after all, the next day or even the next hour could right the ship and turn their life entirely around. The next person they spoke to could have JUST the thing they need to hear. Suicide is one of the most senseless and heartbreaking things I can imagine. Murdering yourself? I cant even imagine the sort of extreme pain and helplessness that goes on inside of someones mind right before they end their own life. But a child? What a complete and total tragedy.
In this case, this little boy was the victim of bullies at school. According to his mother, he had complained to the school authorities but they had failed to do anything. If thats the case, its something theyll live with forever.
However, can I say something without seeming like a total jerk? If my child were being bullied at school, I wouldnt have left it to the school authorities. I would have gone to the parents of the bullies: Face to face. Never leave something entirely up to someone else, chances are theyll fail you - dont give them that chance.
In everyones defense, this is an entirely different generation that were dealing with here. Think back to an episode of Andy Griffith - the one where Opie is being bullied by a little chump who wants Opies lunch money. Andy decides to let Opie take care of it and, by the end of the show, Opie has a black eye - but he also has his lunch money.
Im afraid that a lot of parents and school authorities seem to think theyre in Mayberry in the 1960s. Can you say, Far freaking from it?
The little boy who hung himself was being called ugly, gay and the Virgin (because he was from the Virgin Islands) at school. On his last day on earth, he didnt want to go to school. Im certain it was far too painful. When he came home from school, he went up to his room and hung himself with a belt in his closet. A fourth grader! A baby! And Im getting sick again.
I wasnt going to write about this simply because its such a painful and tragic subject. However, I cant NOT write about it. Why? Because its such a painful and tragic subject - and one I hope to never see or read about ever again. Im urging everyone to speak out against bullying, name calling, and intolerance. In our society, in our daily conversations, in our blogging, in our jokes, and so on.
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Researchers examined levels of lithium in drinking water and suicide rates in the prefecture of Oita, which has a population of more than one million.
The suicide rate was significantly lower in those areas with the highest levels of the element, they wrote in the British Journal of Psychiatry.
High doses of lithium are already used to treat serious mood disorders.
But the team from the universities of Oita and Hiroshima found that even relatively low levels appeared to have a positive impact of suicide rates.
Levels ranged from 0.7 to 59 micrograms per litre. The researchers speculated that while these levels were low, there may be a cumulative protective effect on the brain from years of drinking this tap water.
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Jim Dearing, DO, a family physician in Phoenix, often refers patients with significant mental health issues to a psychiatrist. But he rarely hears back from the specialist. In addition, his patients sometimes come to him with a prescription in hand, but are unable to name the doctors they saw or articulate the care plan.
"Psychiatrists treat them to the left, I treat them to the right, and patients get lost in the middle," said Dr. Dearing, who is on the American Osteopathic Assn. board of trustees.
To increase the coordination of care between physical and mental health and make this situation less likely, two psychiatrists published a paper in the April Psychiatric Services. They suggest creating a "mental health home" for patients with serious mental ills.
Their goal is to increase the access to behavioral, social and medical services that these patients require and to reduce the risk of repeated hospitalizations, incarcerations and homelessness. Access to primary care, in particular, is important because many of the newer medications used to treat mental illnesses put patients at increased risks for diabetes and other metabolic problems.
"We work primarily with a population of seriously mentally ill people, and they have the most disability and the most difficulty, not only with mental illness, but with all sorts of comorbidities. We're struggling with this population to coordinate services and integrate primary and specialty care," said Thomas E. Smith, MD, lead author and associate professor of clinical psychiatry at Columbia University's College of Physicians Surgeons in New York. This proposal "is taking the same principles and overall approach of the medical home but tailoring it to individuals with serious mental illness."
Drugs used to treat mental illnesses can increase a patient's risk for diabetes.
The idea of a medical home for those with serious mental illnesses or other health problems is not new, and the details in the Psychiatric Services paper have much in common with community mental health centers, a concept first established in the 1960s. These organizations still exist, although many now operate much differently.
"It's old wine in new bottles, and it's absolutely the exact right thing to do," said Carl Bell, MD, director of the Institute for Juvenile Research in the Dept. of Psychiatry at the University of Illinois in Chicago. He also is chair of the American Psychiatric Assn.'s Council on Social Issues and Public Psychiatry.
The APA is working to understand the implications of the medical home concept on the specialty because the care model has been put forward for a broader base of patients by the AAP and AOA as well as the American College of Physicians and the American Academy of Family Physicians. These organizations issued "Joint Principles of the Patient-Centered Medical Home" in March 2007. Their principles defined the comprehensive primary care approach as one involving an ongoing relationship with a physician who leads a team and coordinates care across all areas of the health care system, all stages of life and all aspects of a person's well-being. It includes patients' active participation in decision-making. It also involves enhanced access through open scheduling or other options.
The American Medical Association signed on to the concept in November 2008, although the organization is continuing to study funding issues for the medical home model. A report on the topic is due from the AMA Council on Medical Service at the Annual Meeting in June.
Generating a buzz
So far, the response to the mental health home proposal has been enthusiastic.
"The article is absolutely right on," said Kim Griswold, MD, MPH, associate professor of family medicine and psychiatry at the University at Buffalo in New York. "If anyone needs a medical home, it's a person with serious mental illness. We have neglected this population." She researches primary care access for this population.
The model has been promoted mostly as a way to improve primary care, and proponents were happy to see specialists express interest.
"There's a longstanding problem integrating mental health and physical health. The fact that the mental health community is interested in the medical home is a very good sign," said Robert Phillips, MD, MSPH, director of the AAFP's Robert Graham Center for Policy Studies in Family Medicine and Primary Care.
But concern stems over the possibility of creating multiple medical homes. In addition, care in the proposed mental health home will tend to be coordinated by a behavioral health clinician who is unlikely to be a physician.
"The family is at the center of the medical home, and they are not well-served by the fragmentation of having two homes. We have got to collaborate in such a way to provide for the needs in one home," said Jane M. Foy, MD, professor of pediatrics at Wake Forest University School of Medicine in North Carolina. She also is chair of the AAP Task Force on Mental Health.
Creating a mental health home faces similar barriers to the medical home, including finding funding streams and educating physicians on how it should work, and reimbursement for mental health services can be more challenging. In addition, mental illness tends to be more stigmatized than physical health issues, and many experts believe this will prove to be a significant stumbling block to improving coordination of care.
This content was published online only.
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(a) reduced concentration and attention;
(b) reduced self-esteem and self-confidence;
(c) ideas of guilt and unworthiness (even in a mild type of episode);
(d) bleak and pessimistic views of the future;
(e) ideas or acts of self-harm or suicide;
(f) disturbed sleep;
(g) diminished appetite.
The lowered mood varies little from day to day, and is often unresponsive to circumstances, yet may show a characteristic diurnal variation as the day goes on. As with manic episodes, the clinical presentation shows marked individual variations, and atypical presentations are particularly common in adolescence.
In some cases, anxiety, distress, and motor agitation may be more prominent at times than the depression, and the mood change may also be masked by added features such as irritability, excessive consumption of alcohol, histrionic behaviour, and exacerbation of pre-existing phobic or obsessional symptoms, or by hypochondriacal preoccupations. For depressive episodes of all three grades of severity, a duration of at least 2 weeks is usually required for diagnosis, but shorter periods may be reasonable if symptoms are unusually severe and of rapid onset.
Some of the above symptoms may be marked and develop characteristic features that are widely regarded as having special clinical significance. The most typical examples of these "somatic" symptoms are: loss of interest or pleasure in activities that are normally enjoyable; lack of emotional reactivity to normally pleasurable surroundings and events; waking in the morning 2 hours or more before the usual time; depression worse in the morning; objective evidence of definite psychomotor retardation or agitation (remarked on or reported by other people); marked loss of appetite; weight loss (often defined as 5% or more of body weight in the past month); marked loss of libido.
Usually, this somatic syndrome is not regarded as present unless about four of these symptoms are definitely present.
The categories of mild, moderate and severe depressive episodes described in more detail below should be used only for a single (first) depressive episode. Further depressive episodes should be classified under one of the subdivisions of recurrent depressive disorder.
These grades of severity are specified to cover a wide range of clinical states that are encountered in different types of psychiatric practice. Individuals with mild depressive episodes are common in primary care and general medical settings, whereas psychiatric inpatient units deal largely with patients suffering from the severe grades.
Acts of self-harm associated with mood (affective) disorders, most commonly self-poisoning by prescribed medication, should be recorded by means of an additional code from Chapter XX of ICD-10 (X60-X84). These codes do not involve differentiation between attempted suicide and "parasuicide", since both are included in the general category of self-harm.
Differentiation between mild, moderate, and severe depressive episodes rests upon a complicated clinical judgement that involves the number, type, and severity of symptoms present.
The extent of ordinary social and work activities is often a useful general guide to the likely degree of severity of the episode, but individual, social, and cultural influences that disrupt a smooth relationship between severity of symptoms and social performance are sufficiently common and powerful to make it unwise to include social performance amongst the essential criteria of severity.
The presence of dementia or mental retardation does not rule out the diagnosis of a treatable depressive episode, but communication difficulties are likely to make it necessary to rely more than usual for the diagnosis upon objectively observed somatic symptoms, such as psychomotor retardation, loss of appetite and weight, and sleep disturbance.
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As the date for Mental Health Camp approaches, I find myself more and more excited. Im not excited at attending; unfortunately, being a poor student doesnt lend itself to travel so much. But what Ive read so far, and the very prospect of discussing the stigma of mental illness and how to combat it with emerging technology, really make me hopeful, not to mention glad that someone is taking up the cause.
Im a firm believer in developmental models; aspects of our culture dont just appear, they develop from previous and current cultures rather organically. Views of mental health, and accompanying stigma, are no different. Current cultural perceptions of mental health are connected to those of the past, and in confronting the stigma we deal with today, its important to look at all three spots on the timeline: past history, present realities, and future possibilities. This is by no means a comprehensive view; more, what I consider an interesting snippet of the subject.
Mental Illness in History
Most of us are familiar with some aspects of the history of abnormal psychology. The theory of humours is well-documented, and while important, doesnt have as much of an effect on current opinion as cultural and religious views. Humours were the topic of physicians and philosophers, the experts of their time; for present purposes, its more important to consult the non-experts. I want to ferret out a few cases and aspects that I think are important to note.
When looking at the history of medical science, few cultures were more important than the ancient Greeks. They provided, arguably, most of the underpinnings that allowed step-by-step progression from religion and superstition to empiricism. However, it needs to be acknowledged that what have come to be seen as game-changing philosophies werent representative of the culture at large, only a select few (harkening back to the experts versus non-experts theme). To get a better cultural cross-section of the Greeks, an example from their literature and mythology is warranted. Aeschylus Eumenides, part of his Oresteia, presents us with the story of Orestes being pursued by the three Erinyes (Furies), goddesses intent on driving him mad in revenge for killing his mother. Another story has one Erinye, Tisiphonie, drive mad King Athamas for a wrong committed against the goddess Hera. Further mythology about the three dreaded goddesses follow suit. The Erinyes are seen in Greek mythology as beings of balance who act out of revenge for universal wrongs. The implication is clear: madness was inflicted upon mortals for transgressing against universal norms as well as deities.
The Greeks was not the only religious viewpoint that spoke along those lines. Saint Augustine, arguably one of the most important figures in western Christianity, considered depression to be a sign of disfavor from God. To that can be added the Job reference about being tested by God; given that context, depression becomes something to endure but not complain about. The Quran of Islam carries a similar philosophy of purification through trial, as well as punishment for misdoings, that have been applied to depression and similar topics.
However, there are some cases that throw any absolutist statement about any religion or culture in history out the window, as regards treatment of mentally ill. Often, societys reaction to an individuals mental illness depended on that individuals position and finances. But there were rare cases where social status had nothing to do with the acceptance or at least tolerance found. Socrates himself spoke of the benefits of mental illness, believing it was a divine gift. But up until the 18th century, the general view was both theological and stigmatic.
Consider Christina the Astonishing (1150-1224). Christina was a Belgian who (likely) suffered from epileptic seizures. Just as much or moreso than purely mental illnesses, seizures were often viewed through a demonistic lens, and epileptics were treated accordingly, often shut away or thrust out of communities. However, Christina was venerated by many, and her condition explained in a uniquely theological fashion: during her seizures, she descended to purgatory to provide some respite for sufferers there. Such an explanation set her apart from the normal as did her periods of calm and rationality between seizures and her embarrassment and shame. While one could say that she internalized the stigma of the time, she also represents a valid exception to it.
There are a number of cases like Christina the Astonishing; sadly, there are many more that conform to the general principle of mental illness especially being demonistic. Such views contribute to the stances we take today, which may be more secular than those of twelfth century Belgians, but that doesnt mean theyre better.
Views and Stigma in Current Culture
Obviously, stigmas still a problem. Otherwise we wouldnt need things like Mental Health Camp (as awesome as it is). People with a range of different diagnoses are described as lazy, spoiled, entitled, frail, weak, or otherwise negatively. We still deal with shock jocks and conservative pundits that describe depressives as and tell us to get over it. Perhaps this is one of the reasons that, according to a NIMH/Harvard Medical School study, non-Latino white males were the most likely to perceive mental illness stigmatically. Its hard not to notice a correlation when looking at the racial makeup of conservative talk show listeners like Rush Limbagh and Michael Savage.
Stigma isnt just media-based, either. Its sometimes hard to focus on the interpersonal level when everything screams global in this day and age, but its necessary. Research done by a nationwide stigma campaign in the UK found that your partner is four times more likely to leave you if you have a mental illness rather than a physical disability. Four times!
Weve still got a lot of work to do, but all is not lost. Campaigns are increasingly springing up all over the place, Mental Health Camp being one of them. Others are nationwide like UKs Time for Change. Still others are vocation-based, targeting stigma between police officers or in the military and utilizing technologies like YouTube to spread the message that getting help is okay.
The Future of Stigmais up to you. If youre reading this, youre involved. You dont have to hold a degree or attend a conference. If youre reading this, youre involved in the current and future directions that our cultures may adopt regarding mental illness.
Technology can assist us on all sorts of levels. The first is awareness, and relates directly to Mental Health Camps goal of integrating destigmatization with social media. Using the web, and specifically facilities like Facebook and Twitter to network and inform, were seeing facts and stories being distributed and discussions springing up all over the place. This helps interpersonally as well, as long as we encourage it. The availability of information to a partner, as well as an active support system to be there in the bad times made up of people that have been there, may help save some otherwise untenable relationships.
The second level technology can help us is experiential. Stigma takes a toll, causes isolation. By progressively working from virtual social interactions to real ones, I think virtual reality type technologies can help beat back that five-hundred pound gorilla that perches on your shoulders and constantly shouts ll just embarrass yourself, things will go wrong, just stay home!
As for me, Im looking forward to the future. There are a lot of motivated, empowered people out there working for a better one. Itll be interesting not only to see what the future brings, but how our current attitudes look in hindsight.
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Making the call in Lagos last week during a mental health stakeholders meeting at the Lagos State University Teaching Hospital (LASUTH), Prof. Oye Gureje of the Department of Psychiatry, University of Ibadan, Ibadan, noted that there exists a major deficit between the need for mental health service and available resources to address the need. He opined that there may be no improved mental health services in Nigeria, until the National Mental Health Programme and Action Plan promulgated in 1991 is well implemented in addition to availability of essential drugs in primary care clinics and reduction of stigma.
Gureje, who lamented the yawning treatment gap in the management of mental disorders in the country, said result of a large Nigerian study revealed that 90 per cent of all cases of mental illness in Nigeria, obtained no treatment within the last 12 mobnths while in serious cases, 82 per cent had no treatment access. Among those who obtained treatment, only 6 per cent do so withing the first do so in the first year of uillnes while it takes an average of six years for the average mental illness patient in Nigeria to seek and obtain treatment.
Even though 1 in 12 Nigerians will have a mental illness at any given time, and one or two persons in the nation out of eight will experience a mental illness within their lifetime, the real impact of mental disorders is not because they increase chances of dying, but because they cause considerable disability and impairment of role functioning.
Gureje noted that, in Nigeria, the average loss in earning in 2002 among persons with serious mental disorders was grossed N21.6 billion amounting to N60,126 per person. He described as grossly inadequate the general response to the burden of mental health in the country. Mental disorders often go unnoticed even though effective treatment is available for most, and when treated, it is often too lateand frequently inappropriate.
He said a functional PHC, is crucial to any attempt to deliver good health care everywhere. Primary care providers are poor at detecting mental health problems. Most commonly offer inappropriate or inadequate treatment wghile the primary care clinics hardly have the essential medications for common mental health problems. In his view, a lot can still be done with the available resources if only the health service system was better organised.
THERE is currently a ratio of one resident doctor to 2000 patients at the Federal Neu-opsychiatric Hospital, Yaba, Lagos. President of the hospitals branch of the Association of Resident Doctors, Dr. Niran Okewole noted this while lamenting acute shortage of staff in the system just as he noted that the Associaltions industrial action embarked upon last week was to ensure quality patient care.
Okewole argued that even though the hospital has a total number of 80,000 registered patients, total number of resident doctors is just 40 leaving a ratio of 2,000 patients per doctor. He said: Over the years, there has been an exponential increase in the number of patients being seen in the hospital. this in itself is a good thing because it suggests that public awareness of psychiatric services is growing. However, the number of specialist available to attend to this teeming mass has dwindled.
Mental disorders are common in the United States and internationally. An estimated 26.2 percent of Americans ages 18 and older about one in four adults suffer from a diagnosable mental disorder in a given year. When applied to the 2004 U.S. Census residential population estimate for ages 18 and older, this figure translates to 57.7 million people.Even though mental disorders are widespread in the population, the main burden of illness is concentrated in a much smaller proportion about 6 percent, or 1 in 17 who suffer from a serious mental illness.1 In addition, mental disorders are the leading cause of disability in the U.S. and Canada for ages 15-44. Many people suffer from more than one mental disorder at a given time. Nearly half (45 percent) of those with any mental disorder meet criteria for 2 or more disorders, with severity strongly related to comorbidity.
What Occupational therapy has to do with Mental health:
The overall goal of occupational therapy in community mental health is to help people develop the skills and obtain the supports necessary for independent, interdependent, productive living. Particular emphasis is given to interventions that result in improved quality of life and decrease hospitalization.
Occupational therapists and occupational therapy assistants provide purposeful, goal-oriented activities that teach and facilitate skills in:
assertiveness;
cognition (e.g., problem solving);
independent living including using community resources, home management, time management, management of medication, and safety in the home and community;
avocational interest and pursuits:
self-awareness;
interpersonal and social skills;
stress management;
activities of daily living (e.g.; hygiene);
role development (e.g., parenting);
self-sufficiency and interdependency; and
wellness.
Occupational therapy services include:
adapting (changing) the environment at home, work, and school to promote an individual's optimal functioning
providing education programs, experiential learning, and treatment groups or classes;
consulting with employers responding to requirements of the Americans with Disabilities Act;
functional evaluation and ongoing monitoring of clients for placement in jobs and housing;
providing assistance or guidance with client-run support groups;
goal setting and rehabilitation plan development with client; and
providing guidance and consultation to persons in all employment settings, including supportive employment.
Occupational therapists and occupational therapy assistants working in the area of community mental health are employed by or provide consultation to:
adult day care centers,
day treatment centers,
home health agencies,
community rehabilitation programs,
mental health clinics and hospitals,
clubhouse programs,
outpatient psychiatric clinics,
foster care residents,
sheltered workshops,
group and private homes,
community support programs.
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Captain of USS Bainbridge was authorized to use force if he determined Captains life was in danger. He made this determination as the Pirates aboard Lifeboat were holding AK-47s and Small Arms at Captain Phillips. One pirate was aiming AK-47 at Captains back.
Captain Phillips was uninjured in his first escape attempt. Vice Admiral Gortney could not clarify if a 2nd escape attempt occurred at time of rescue.
Surviving Pirate was onboard the USS Bainbridge. Lifeboat was being towed by the USS Bainbridge.
US Special Operations from unknown location were involved in rescue. Snipers aboard USS Bainbridge shot and killed 3 remaining pirates. At time, one pirate was completely exposed. Two were exposed from shoulders up.
The CinC had NOT authorized specific action. He had given standing authority to the Bainbridges Captain through Vice Admiral Gortney to take action ONLY if Captain Phillips life were in danger.
Some members of the media at the press conference seemed upset that actions were taken while the pirates were not actively engaging friendly/hostage forces.
Some members of the press demonstrated hostility that the US Navy had not provided active escort to the ship based on a ships report to the Navy that it had successfully repelled a pirate attack on the day prior to the second attack.
UPDATE 2: (Clarifications)Captain Castellano, of the USS Bainbridge, made the decision based on standing authority, to take action to save the life of Captain Phillips. That decision could literally put his career in jeopardy. This is the kind of officer we need to reward and promote.
These two Captains, one a Naval Officer and the other a Merchant Ship Officer, have this week done more to prevent piracy than the entire body politic of the United Nations, the European Union, and the United States.
The Special Operations Snipers aboard the USS Bainbridge may or may not have been US Navy SeALs but they did an excellent job.
Original Facts: Three Pirates Killed. One Pirate Wounded Captured. Captain Phillips free and safe aboard the USS Bainbridge. Captain Phillips is a man of courage, who refuses to be a willing victim.
Apparently, Captain Phillips again escaped the pirates and lifeboat. It appears US Forces were able to neutralize the threat when they began firing.
Unknown: Whether orders came from CinC. Whether SeALs, Sailors, or Marines carried out the operation. Whether US Forces acted within RoE which always allows for protection of life and limb or otherwise.
Details to be published as they become available.
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OKLAHOMA CITY Oklahoma is expected to receive nearly $2.6 billion of federal stimulus money over the next two years, but none is earmarked for mental health or substance abuse services, the states mental health commissioner told a House panel Monday.
s very unfortunate, Commissioner Terri White of the state Department of Mental Health and Substance Abuse Services told a House budget subcommittee. I know there were people fighting to get some.
We will try to see if we get any of the grant funding we can compete for, but not only is it not earmarked for mental health, but then were competing for it against all of health care, so its not a source I feel like we can count on.
White told the panel that her department needs nearly $25 million to maintain programs.
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