Tag Archives: mental illness

Family writes about son’s schizophrenia

NPR’s All Things Considered featured the story of Henry Cockburn and his father, British journalist Patrick Cockburn. While the father was reporting in Afghanistan in February 2002, he learned in a shocking phone call that his son nearly drowned when he took a swim in the icy waters of England’s Newhaven Estuary. Henry was admitted to a mental hospital and diagnosed with schizophrenia.

Nearly 10 years later, after hospitalization and many medications, Henry is living on his own and the two  have written “Henry’s Demons: Living With Schizophrenia, a Father and Son’s Story.” The book features alternating chapters written by Patrick, Henry and Jan Cockburn about coping with the diagnosis and Henry’s experiences in mental hospitals.

Some fear DSM update opens door for exploitation

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

On All Things Considered, NPR’s Alix Spiegel looks to the past and future to ferret out the potential drawbacks and benefits of the expanded psychiatric diagnoses proposed in the upcoming revision of the American Psychiatric Association’s Diagnostic and Statistical Manual.

dsm-iv

Photo by Richard Masoner via Flickr

Spiegel begins with the forceful perspective of Allen Frances, the man who edited the last update of the DSM. From Frances, Spiegel pulls a few cautionary tales of the unintended consequences of changing DSM entries.

The first? Aspergers.

It’s a disease that needed to be diagnosed, Frances says, but it’s now massively overused because of the unforeseen “unintentional incentive” created by schools that offer greatly expanded educational resources to children diagnosed with Aspergers.

“And so kids who previously might have been considered on the boundary, eccentric, socially shy, but bright and doing well in school would mainstream [into] regular classes,” Frances says. “Now if they get the diagnosis of Asperger’s disorder, [they] get into a special program where they may get $50,000 a year worth of educational services.”

Another cautionary tale? Bipolar disorder. The last DSM revision made it a far easier diagnosis to get. In essence, this easier diagnosis opened a gaping door in medicine, one which pharmaceutical companies quickly muscled through.

“Drug companies got indications for treating bipolar disorder,” Frances says. “Not just with mood stabilizers, but also with the newer antipsychotic drugs. And they began very intensive ubiquitous advertising campaigns. So the rates of bipolar disorder doubled. And lots of people got way too much antipsychotic and mood stabilizing medicines. And these aren’t safe drugs.”

For the other side of the story, Spiegel spoke to a psychiatrist who argued that broadening diagnoses means that fewer of the mentally illl go undiagnosed, and that diagnoses are delivered earlier than they would be otherwise. Furthermore, he believes that adding illnesses to the DSM will spark research and investment toward treating those ilnesses.

Stories focus on suicides of doctors, soldiers

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

New York Times columnist Pauline Chen, M.D., serves up a reminder that suicide prevention isn’t just a matter of access to counseling and resources, in the form of a story about high physician suicide rates. If there’s any sector of the population that should be able to recognize that they are suffering from mental illness, and that the condition is treatable, it should be doctors, Chen writes. Yet still they kill themselves at a rate above the American average.

For several decades now, studies have consistently shown that physicians have higher rates of suicide than the general population — 40 percent higher for male doctors and a staggering 130 percent higher for female doctors. While research has traced the beginning of this tragic difference to the years spent in medical school, the contributing factors remain murky. Students enter medical school with mental health profiles similar to those of their peers but end up experiencing depression, burnout and other mental illnesses at higher rates. Despite better access to health care, they are more likely to cope by resorting to dysfunctional behaviors like excessive drinking and are less likely to receive the right care or even recognize that they need some kind of intervention.

Chen mentions two recent studies published in the Journal of the American Medical Association that shed more light on the issue, one showing that in medical school depression and burnout are separate entities, and the other showing that depressed students believe others view them as incompetent. In the end, she calls for further long-term research, but does not take the next logical step and investigate comparative research and statistics. Is it just American medical students who are depressed? Do countries with low-cost, low-pressure med schools produce doctors with better mental health? There’s a lot of room for investigation.

Suicides in another high-access group

Chen’s New York Times colleague, James McKinley, writes that as many as 20 soldiers connected with the Army base at Ft. Hood have killed themselves this year, despite the Army’s suicide prevention efforts.

The spate of suicides in Texas reflects a chilling reality: nearly 20 months after the Army began strengthening its suicide prevention program and working to remove the stigma attached to seeking psychological counseling, the suicide rate among active service members remains high and shows little sign of improvement. Through August, at least 125 active members of the Army had ended their own lives, exceeding the morbid pace of last year, when there were a record 162 suicides.

As of July, the Army requires all returning soldiers to be evaluated by a mental health specialist, though veteran advocates still point to a shortage of psychiatrists and an emphasis on treatment through medication rather than through therapy. The system is taxed by record numbers of soldiers seeking help for psychological problems, and mental health was the leading reason for hospitalization in the Army last year, McKinley writes.

Each suicide is unique, McKinley writes, and it’s hard to find patterns.

Why Texas is failing to privatize mental health care

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

In 2003, Texas passed a law that sought to turn mental health care in the state into a competitive marketplace. It’s 2010, and that marketplace still hasn’t materialized. The Texas Tribune’s Brian Thevenot tried to find out why. Thevenot describes it as “a textbook case of legislative intent crashing on the rocks of bureaucratic maneuvering and logistical realities.”

The state’s local Mental Health and Mental Retardation authorities are supposed to become “providers of last resort,” who turned most direct medical services over to networks of private providers. Instead, the state has remained among the nation’s worst in terms of mental health funding and, as Thevenot reports, the prison system and not the mental health infrastructure, has served as the real provider of last resort for Texas’ mentally ill.

In major leagues, mental illness losing its stigma

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Calling Major League Baseball a “longtime fortress against psychiatry” Sports Illustrated‘s Pablo S. Torre profiles the organization’s recent efforts to go from an organization notorious for its lack of crying to one which takes the mental health of its players very seriously.

baseball

Photo by Sister72 via Flickr

… baseball has led the way in supporting a growing number of players who have been brave enough to seek assistance for such problems and speak out about them. “Baseball’s older generations like to say, ‘Guys these days just aren’t as tough,'” says Ray Karesky, a licensed psychologist who has directed the Oakland A’s Employee Assistance Program (EAP) since 1984. “But what’s different is just that guys have come out and actually admitted their problems.”

Baseball, with its high failure rates (a great hitter still fails two out of every three at-bats), spotlight on individual performance, substantial downtime and long nights on the road, is loaded with mental health stressors. But it’s only now, thanks to the “cover” provided by those few major leaguers bold enough to come forward with their problems, that players at all levels are comfortable enough to address mental health. The revolution began last year, when an unprecedented five big leaguers went on the disabled list for mental health problems — so-called “mental DLs.”

This number isn’t anywhere close to those reported for the general population—the National Institute of Mental Health estimates that 26.2% of Americans ages 18 and older suffer from a diagnosable mental disorder in any given year—but for baseball it represents a sea change: Between 1972 and ’91 the grand total of mental DLs in the major leagues was zero.

State NAMI chapters got pharma money too

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Wall Street Journal health blogger Katherine Hobson writes that, according to an investigation by Sen. Chuck Grassley, state chapters of the National Alliance of Mental Illness received millions of dollars in contributions from pharmaceutical manufacturers in a five-year period. This follows an Oct. 2009 New York Times report which found that “drug makers from 2006 to 2008 contributed nearly $23 million to the alliance, about three-quarters of its donations.”

The group’s state chapters – except for Alabama, Arizona, Connecticut and Hawaii – reported their own donations to Grassley, he wrote in a letter to NAMI’s executive director and president of the board of directors. According to the letter, the California chapter received $632,000 in contributions between January 2005 and October 2009, the most of any state. Ohio NAMI received $623,000 and New York NAMI $448,000. The top ten states received a total of $3.84 million.