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Breaking news: Live from a mental institution

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Breaking news: Live from a mental institution

sickAn anchor woman holds her microphone steady as she reports live from ‘We have the power’ , an old mental institution where the walls should have been painted decades ago. Her voice intermingle with twenty other reporters looking seriously into the camera, pointing occasionally to the building behind them. The anchor woman turns her voice dramatically down when she arrives at the conclusion.

“Sources tell us that in this mental institution, often just keep patients long enough to give them medication before they send them back. They sometimes don’t arrive at the right diagnose, and it is rumored that they don’t take enough time with traumatized victims or that they even consciously decide not to talk about what they have experienced. Only 30% report that they felt better or had hope for the future after being released, and surveys show that staggering 20 % of the patients will be readmitted after not receiving the help they wanted”

Her face is now full of rage. Her mother killed herself after being hospitalized in a mental health clinic. When she had read through her mother’s journal she saw how many pills she was on, barbiturates strong enough to knock out a mammoth. When she tried to find therapy notes where her mother could process her traumatic past, she only found short conversations where the doctors wanted to know if she slept well, eat what she should or if she felt a bit better after taking another pill. She shouldn’t even be reporting, but she manages to do her job, t is important for her to get it all out there.

Another reporter talks with the direction, who promises that they will do everything to make this right. They will look into their routines and see what they can do to make sure this will never happen again.

The news report goes viral. Oprah dedicate her next show to the cause, and Internet users on Twitter have started protest demonstrations, venturing into the street with their fists pumping in the air as they chant: ‘Stop this, stop this, stop this’. They bring posters where with personal accounts: ‘My mother only got three days in the institution, when her depression intensified they said they have done everything they could so she was not prioritized. Take mental health seriously!” Some write messages to the government. ‘We want that our tax payers money go to mental health care for the 450 billions who needs better treatment” or “Why only research on drugs?”.  The protesters don’t make to much of a fuss. They don’t shout out obscenities, but they gather in every city, staying put and showing their support. They have started a peaceul war.

Why don’t we see this in the real world? Where is the public outcry over the state of unsatisfactory mental health care? When someone breaks a leg, we demand full treatment until the injury is fully treated. We never take off the bandage after three weeks instead of six, telling our patient that they can come back if the leg breaks again as it will because it simply was not healed. We protest when the plumber does a bad job, demanding to sue them if they don’t come back and fix it. When politicians have done something wrong, news papers write about it for days, as they do when an actress have broken down and been sent to rehab. But where are the headlines after it thousands of citizens have been ignored by the health care system? Where are the depth interviews with families who’ve seen their loved ones break down after unsuccessful treatment?

In my future news scenario, the media would focus on mental health daily. They would write nuanced articles on every subject relating to how we suffer and what our options are when we do. There would be demonstrations to so that we get what we need.

We would all be small Ghandies, damanding justice. We wouldn’t close our eyes, we would engage and try to change things. The media would not ignore us.

In my future utopia, the mental institution ‘We have the power’ would change their ways. They would give the power back to their patients, not giving up before they had tailor made the treatment that was right for them. They would listen to them and find their resources.

They would use money on educating their employees, giving their patient the very best care. We do it with cancer patients, we even do it at Starbucks to make sure that the customers are a hundred percent satisfied with their coffees. I dream about a world where surveys about how satisfied their patient are with their treatment. Why shouldn’t we give mental health all of our attention? When almost a fourth of us have psychological issues, stigma should be lifted by never ignoring our troubled minds.

We should not be afraid to speak up.

More:

Demonstations

Mental health research in India

 Stigma | Mental Health Commission of Canada

Readmission Rates for Mental Health Patients – NBRHC

Strategies for reducing stigma toward persons with mental illness 

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Prison without trial

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I always start the day with looking through interesting blogs, and was a bit surprised and saddened when I found this news article on BBC. Are we not further along the road of becoming a better world, than still imprisoning people without giving them a proper trial? Obama has promised to close Guantanamo, but it is not easy to do so, when you don`t have powerful people supporting you.

US reveals Guantanamo ‘indefinite detainees’

File photo of US prison camp at Guantanamo Bay, CubaBarack Obama has recently renewed a pledge to close the detention centre

The US has listed 46 inmates held at its military prison in Guantanamo Bay who it says it does not have the evidence to try but are too dangerous to release.

It revealed the men’s names in response to a freedom of information request by the Miami Herald.

Most are from Yemen and Afghanistan.

President Barack Obama vowed last month to renew efforts to shut the prison. Lawyer Clifford Sloan has been appointed to oversee the closure.

Mr Sloan, whose appointment was officially announced on Monday, will be tasked with releasing detainees cleared for transfer.

Of the 166 detainees at Guantanamo in Cuba, 86 have been cleared for transfer if conditions can be met, including 56 from Yemen.

Hunger strikeThe list of prisoners designated for indefinite detention was drawn up in 2010 but not made public.

It includes 26 Yemenis, 12 Afghans, three Saudis, two Kuwaitis, two Libyans, a Kenyan, a Moroccan and a Somali.

Two Afghans who were on the list have died, one of a heart attack and one who committed suicide.

The US says it either does not have sufficient evidence to try the men, or that the evidence it has is tainted by coercion or abuse.

After taking office in 2009, Mr Obama promised to close the prison within a year, but his plans to transfer detainees to maximum security prisons in the US and to try some detainees in the civilian justice system met fierce resistance from both parties in Congress.

More than 100 detainees have joined a hunger strike which began in early February to protest against the failure to end their detention without charge. Many have been held for more than a decade.

Officials say 44 of those are being force-fed through nasal tubes.

On Monday, five prisoners accused of helping orchestrate the 11 September 2001 attacks against the US returned to a military court in the Guantanamo camp for the first time since February, for a week of pre-trial hearings.

They include Khalid Sheik Mohammed, the alleged mastermind of the attacks.

The government has requested that a trial to be scheduled in late 2014.

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Psychopaths, who are they?

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I Am Fishead: Are Corporate Leaders Psychopaths?

I Am Fishead: Are Corporate Leaders Psychopaths?

It is a well-known fact that our society is structured like a pyramid. The very few people at the top create conditions for the majority below. Who are these people? Can we blame them for the problems our society faces today? Guided by the saying “A fish rots from the head” we set out to follow that fishy odor. What we found out is that people at the top are more likely to be psychopaths than the rest of us.

Who, or what, is a psychopath? Unlike Hollywood’s stereotypical image, they are not always blood-thirsty monsters from slasher movies. Actually, that nice lady who chatted you up on the subway this morning could be one. So could your elementary school teacher, your grinning boss, or even your loving boyfriend.

The medical definition is simple: A psychopath is a person who lacks empathy and conscience, the quality which guides us when we choose between good and evil, moral or not. Most of us are conditioned to do good things. Psychopaths are not. Their impact on society is staggering, yet altogether psychopaths barely make up one percent of the population.

Through interviews with renowned psychologist Professor Philip Zimbardo, leading expert on psychopathy Professor Robert Hare, former President of Czech Republic and playwright Vaclav Havel, authors Gary Greenberg and Christopher Lane, professor Nicholas Christakis, among numerous other thinkers, we have delved into the world of psychopaths and heroes and revealed shocking implications for us and our society

Watch the full documentary now

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Hostels and Women’s Refuges Still Under Threat

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Sometimes it appears to be choices, when there really is none. This is an interesting post about how hard it can be for women fleeing from abusive relationship. This is very actual considering the new report from WHO that show that 1 in every 3 women has experienced abuse in some way.

Here is the whole text, with the link to the original post under.

lord-fraud-freudWomen fleeing abusive relationships could be faced with the stark choice of sleeping on the streets or returning to a violent partner due to the benefit cap a leading charity has warned.

Meanwhile Lord Fraud’s dithering means that many women’s refuges and homelessness hostels may be forced to close when the benefit cap is introduced in July.  The cap on benefits, set at £500 a week for families, or £350 for single people, includes housing benefits which in some cases meet the cost of supported accommodation.

Last year Women’s Aid issued a stark warning that this change could potentially close every single one of their refuge’s for those fleeing domestic violence.  Homelessness hostels are also under threat.  Hostels and refuges charge high rents to pay for the cost of support staff, with most supported housing having 24 hour staffing cover and specialist support workers.

Astonishingly neither bungling Lord Fraud or Iain Duncan Smith appeared to know this.  In a panicky response the Government hastily u-turned, saying that the benefit cap would not apply to “supported exempt accommodation”.  Ministers also claimed that when Universal Credit is introduced, the system of Housing Benefits, administered by local authorities, would remain in place for this type of housing.

The problem is that the legal definition for “supported exempt accommodation” is several years old and does not apply to much of the supported housing available today.  This also seemed to come as a shock to Lord Fraud, who was forced to write charities promising not to worry,  he would have it all sorted out soon.

And that appears to be the last anyone has heard from the bungling old toff.  An important piece published on The Guardian website by Sandra Horley, chief executive of Refuge, warns that with just one month to go until the benefit cap is launched nationally, many women’s refuges are still facing closure.

The charity also warns that many women who have already been housed after moving on from a refuge are likely to be affected by the cap and may “face eviction and be left with an impossible dilemma either to sleep rough or return to their violent partner”.

The truth is that the majority of those paying high rents and affected by the benefit cap are not people living it up in Chelsea mansions as the right wing press has attempted to portray.  In many cases they are people whose life has taken a desperate turn and who have been forced to take any housing they could find in an emergency.  Often this housing, despite being expensive, is sub-standard with grasping landlords charging a fortune for properties they couldn’t get away with renting to anyone who had a choice about where they lived.

The benefit cap is a truly nasty policy which punishes tenants for the greed of slum landlords.  A DWP impact assessment suggested almost 200,000 children could be made homeless due to the cap.  It is unlikely to even save any money.  All it will achieve if the expulsion of poor, often genuinely vulnerable families from rich local authorities into areas where councils are already struggling to pay the bills.

The end result will be lower council tax for the rich and cuts to public services for the rest of us.  And this, some would claim, is the Tory’s most popular policy.  If that is true then a lot of people need to have a serious fucking word with themselves.

via Hostels and Women’s Refuges Still Under Threat As Lord Fraud Dithers.

Antipsychotics and Brain Shrinkage

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Antipsychotics and Brain Shrinkage:

An Update

Joanna Moncrieff June 19, 2013

Evidence that antipsychotics cause brain shrinkage has been accumulating over the last few years, but the psychiatric research establishment is finding its own results difficult to swallow. A new paper by a group of American researchers once again tries to ‘blame the disease,’ a time-honoured tactic for diverting attention from the nasty and dangerous effects of some psychiatric treatments. In 2011, these researchers, led by the former editor of the American Journal of Psychiatry, Nancy Andreasen, reported follow-up data for their study of 211 patients diagnosed for the first time with an episode of ‘schizophrenia’. They found a strong correlation between the level of antipsychotic treatment someone had taken over the course of the follow-up period, and the amount of shrinkage of brain matter as measured by repeated MRI scans.

The group concluded that “antipsychotics have a subtle but measurable influence on brain tissue loss” (1). This study confirmed other evidence that antipsychotics shrink the brain. When MRI scans became available in the 1990s, they were able to detect subtle levels of brain volume reduction in people diagnosed with schizophrenia or psychosis. This lead to the idea that psychosis is a toxic brain state, and was used to justify the claim that early treatment with antipsychotics was necessary to prevent brain damage. People even started to refer to these drugs as having “neuroprotective” properties, and schizophrenia was increasingly described in neo-Kraeplinian terms as a neurodegenerative condition(2). The trouble with this interpretation was that all the people in these studies were taking antipsychotic drugs. Peter Breggin suggested that the smaller brains and larger brain cavities observed in people diagnosed with schizophrenia in these and older studies using the less sensitive CT scans, were a consequence of antipsychotic drugs(3), but no one took him seriously.

It was assumed that these findings revealed the brain abnormalities that were thought to constitute schizophrenia, and for a long time no one paid much attention to the effects of treatment. Where the effects of antipsychotics were explored, however, there were some indications that the drugs might have a negative impact on brain volume(4). In 2005, another American group, led by Jeffrey Lieberman who headed up the CATIE study, published the largest scanning study up to that point of people with a first episode of psychosis or schizophrenia(5). The study was funded by Eli Lilly, and consisted of a randomised comparison of Lilly’s drug olanzapine (Zyprexa) and the older drug haloperidol. Patients were scanned at the start of the study, 12 weeks and one year later and patients’ scans were compared with those of a control group of ‘healthy’ volunteers. At 12 weeks haloperidol-treated subjects showed a statistically significant reduction imageof the brain’s grey matter (the nerve cell bodies) compared with controls, and at one year both olanzapine- and haloperidol-treated subjects had lost more grey matter than controls. The comparative degree of shrinkage in the olanzapine group was smaller than that in the haloperidol group, and the authors declared the olanzapine-related change not to be statistically significant because, although the result reached the conventional level of statistical significance (p=0.03) they said they had done so many tests that the result might have occurred by chance. In both haloperidol and olanzapine treated patients,however, there was a consistent effect that was diffuse and visible in most parts of the brain hemispheres.

The idea that schizophrenia or psychosis represent degenerative brain diseases was so influential at this point, that the authors first explanation for these results was that olanzapine, but not haloperidol, can halt the underlying process of brain shrinkage caused by the mental condition. They did concede, however, that an alternative explanation might be that haloperidol causes brain shrinkage. They never admitted that olanzapine might do this. It seems as if Eli Lilly and its collaborators were so confident about their preferred explanation, that they set up a study to investigate the effects of olanzapine and haloperidol in macaque monkeys. This study proved beyond reasonable doubt that both antipsychotics cause brain shrinkage. After 18 months of treatment monkeys treated with olanzapine or haloperidol, at doses equivalent to those used in humans, had approximately 10% lighter brains than those treated with a placebo preparation.(6) Still psychiatrists went on behaving as if antipsychotics were essentially benign and arguing that they were necessary to prevent an underlying toxic brain disease (Jarskoget al 07 Annual review).

Andreasen’s 2011 paper was widely publicised however, and it started to be increasingly acknowledged that antipsychotics can cause brain shrinkage. Almost as soon as the cat was out of the bag, however, attention was diverted back to the idea that the real problem is the mental condition. Later in 2011 Andreasen’s group published a paper that reasserted the idea that schizophrenia is responsible for brain shrinkage, in which there is barely a mention of the effects of antipsychotics that were revealed in the group’s earlier paper(7). In this second paper, what the authors did was to assume that any brain shrinkage that could not be accounted for by the method of analysis used to explore the effects of antipsychotic treatment must be attributable to the underlying disease. The way they had analysed drug treatment in the first paper only looked for a linear association between antipsychotic exposure and changes in brain volume, however. A linear analysis only detects an association that is smooth and consistent- in other words an association in which brain volume shrinks by a consistent amount with each increment in antipsychotic exposure.

The total effect of drug treatment may not follow this pattern however. It seems from other evidence that there is a threshold effect whereby being on any amount of an antipsychotic has the greatest relative effect, with a levelling out of the impact as duration of exposure reaches a certain level.(8) In any case, without a comparison group which has not been medicated, a virtual impossibility in this day and age, it is simply not possible to conclude that the whole effect is not drug-induced. The latest paper by this research group replicates the findings on antipsychotic-induced brain shrinkage, but also claims that brain volume reduction is related to relapse of the psychotic disorder(9). Relapse was defined retrospectively by the research team for the purposes of this particular analysis, however, and not at the time the study data were collected. Moreover, the definition used does not refer to any significant change in functioning, but only to a deterioration in the severity of symptoms. But the group’s previous analysis of severity of symptoms, using data collected at the time, found that severity had only a weak association with brain volume changes, and moreover that symptom severity was correlated with antipsychotic exposure.(1)

The most recent analysis ignores the probable association between antipsychotic treatment intensity and relapse, but it seems likely that people undergoing periods of ‘relapse,’ or more accurately deterioration of symptoms, would be treated with higher doses of antipsychotics. If this is so, and the two variables ‘relapse’ and ‘treatment intensity’ are correlated with each other, then the analysis is questionable since the statistical methods used assume that the variables are independent of each other. So Andreasen’s group have found strong evidence of an antipsychotic-induced effect, which they have replicated in two analyses now. The predictive value of the severity of symptoms, on the other hand (which is essentially what relapse appears to define) is weak in the initial analysis, and in neither analysis was it clearly differentiated from drug-induced effects. These researchers seem determined to prove that ‘schizophrenia’ causes brain shrinkage, although their data simply cannot establish this, as none of their subjects seem to have gone without drug treatment for any significant length of time. So even though their recent analysis once again confirms the damaging effects of antipsychotics, they conclude that the results demonstrate the need to make sure patients take, and do not stop, their antipsychotic medication.

The only concession made to the antipsychotic-induced changes revealed is the suggestion that low doses of antipsychotics should be used where possible. Yet other prominent psychiatric researchers have now abandoned the idea that schizophrenia is a progressive, neurodegenerative condition, and do not consider that Andreasen’s study provides evidence of this.(10) Bizarrely, Nancy Andreasen is a co-author of a recently published meta-analysis which combines results of 30 studies of brain volume over time, which clearly confirms the association between antipsychotic treatment and brain shrinkage (specifically the grey matter) and finds no relationship with severity of symptoms or duration of the underlying condition.(11) What should antipsychotic users and their families and carers make of this research?

Obviously it sounds frightening and worrying, but the first thing to stress is that the reductions in brain volume that are detected in these MRI studies are small, and it is not certain that changes of this sort have any functional implications. We do not yet know whether these changes are reversible or not. Of course the value of antipsychotics has been much debated on this site and elsewhere, and their utility almost certainly depends on the particular circumstances of each individual user, so it is impossible to issue any blanket advice. If people are worried, they need to discuss the pros and cons of continuing to take antipsychotic treatment with their prescriber, bearing in mind the difficulties that are associated with coming off these drugs.(12)

People should not stop drug treatment suddenly, especially if they have been taking it for a long time. People need to know about this research because it indicates that antipsychotics are not the innocuous substances that they have frequently been portrayed as. We still have no conclusive evidence that the disorders labeled as schizophrenia or psychosis are associated with any underlying abnormalities of the brain, but we do have strong evidence that the drugs we use to treat these conditions cause brain changes. This does not mean that taking antipsychotics is not sometimes useful and worthwhile, despite these effects, but it does mean we have to be very cautious indeed about using them.

Reference List (1) Ho BC, Andreasen NC, Ziebell S, Pierson R, Magnotta V. Long-term Antipsychotic Treatment and Brain Volumes: A Longitudinal Study of First-Episode Schizophrenia. Arch Gen Psychiatry 2011 Feb;68

(2):128-37. (2) Lieberman JA. Is schizophrenia a neurodegenerative disorder? A clinical and neurobiological perspective. Biol Psychiatry 1999 Sep 15;46(6):729-39. (3) Breggin PR. Toxic Psychiatry. London: Fontana; 1993(4) Moncrieff J, Leo J. A systematic review of the effects of antipsychotic drugs on brain volume. Psychol Med 2010 Jan 20;1-14. (5) Lieberman JA, Tollefson GD, Charles C, Zipursky R, Sharma T, Kahn RS, et al. Antipsychotic drug effects on brain morphology in first-episode psychosis. Arch Gen Psychiatry 2005 Apr;62(4):361-70. (6) Dorph-Petersen KA, Pierri JN, Perel JM, Sun Z, Sampson AR, Lewis DA. The influence of chronic exposure to antipsychotic medications on brain size before and after tissue fixation: a comparison of haloperidol and olanzapine in macaque monkeys. Neuropsychopharmacology 2005 Sep;30(9):1649-61. (7) Andreasen NC, Nopoulos P, Magnotta V, Pierson R, Ziebell S, Ho BC. Progressive brain change in schizophrenia: a prospective longitudinal study of first-episode schizophrenia. Biol Psychiatry 2011 Oct 1;70(7):672-9. (8) Molina V, Sanz J, Benito C, Palomo T. Direct association between orbitofrontal atrophy and the response of psychotic symptoms to olanzapine in schizophrenia. Int Clin Psychopharmacol 2004 Jul;19(4):221-8. (9) Andreasen NC, Liu D, Ziebell S, Vora A, Ho BC. Relapse duration, treatment intensity, and brain tissue loss in schizophrenia: a prospective longitudinal MRI study. Am J Psychiatry 2013 Jun 1;170(6):609-15. (10) Zipursky RB, Reilly TJ, Murray RM. The Myth of Schizophrenia as a Progressive Brain Disease. Schizophr Bull 2012 Dec 7. (11) Fusar-Poli P, Smieskova R, Kempton MJ, Ho BC, Andreasen NC, Borgwardt S. Progressive brain changes in schizophrenia related to antipsychotic treatment? A meta-analysis of longitudinal mri studies. Neurosci Biobehav Rev 2013 Jun 13. (12) Moncrieff J. Why is it so difficult to stop psychiatric drug treatment? It may be nothing to do with the original problem. Med Hypotheses 2006;67(3):517-23. This entry was posted in Antipsychotics, Blogs, Featured Blogs, Foreign Correspondents, Psychiatric Drugs by Joanna Moncrieff. Bookmark the permalink.

We share, and need no reason to help

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Have you ever wondered how people can become more active contributors in their communities? Or do you ever think about how community issues can impact the health and wellness of individuals?

 

These are both major topics of interest within the field of community psychology. We are therapists (maybe others groups after a while) that want to share our knowledge with you. We might expand what this site will be used for, after a while. Ideas are much appreciated!

We also try to:

    • Finding ways to help disadvantaged or disenfranchised individuals feel more connected with each others
    • Understanding social issues among minority groups
  • Building relationships between individuals and community 
  • Spreading information and skills about psychological well being in personal and professional spheres of life

About psychology and psychologists:

While psychological knowledge is often applied to the assessment and treatment of mental health problems, it is also directed towards understanding and solving problems in many different spheres of human activity. The majority of psychologists are involved in some kind of therapeutic role, practicing in clinical, counseling, or school settings. Many do scientific research on a wide range of topics related to mental processes and behavior, and typically work in university psychology departments or teach in other academic settings (e.g., medical schools, hospitals). Some are employed in industrial and organizational settings, or in other areas[9] such as human development and agingsports,health, and the media, as well as in forensic investigation and other aspects of law

More:

http://www.amazon.com/Modernizing-Mind-Psychological-Knowledge-Remaking/dp/0275974502

http://www.rozrada.kiev.ua/about-e.htm

http://web4health.info