Mental health isn't the issue - stigma is

Mark Dayton at his campaign headquarters in downtown Minneapolis.

Many politicians have overcome admissions of addiction or depression, thanks to better understanding of the manageable diseases. Can Dayton, too?

There was a time when the public admission of mental illness could derail a candidate's political career.

That could still happen to Mark Dayton, the Democratic candidate for governor who went public this week with his history of depression. But if so, experts say, it's the stigma -- not the disease itself -- that would sabotage his run for office.

Today, more than a decade into Prozac Nation, there is no reason why someone being treated for mild to moderate depression shouldn't hold a job with enormous responsibility, doctors say. Abraham Lincoln and Winston Churchill both suffered from depression, they say, and that was long before Prozac and even more effective medications that are available now.

READ MOE @ Minneapolis Star Tribune

The stigma of mental illness The suicides of a German footballer and two of my colleagues show how destructive is the stigma of psychiatric ill-health

Last week's suicide of the German goalkeeper Robert Enke revealed more than the terrible news of one man's death, the cruelty of depression and the pressures on sportsmen to protect the public's idealised view of them; it also exposed the ongoing shame and stigma of mental illness. For years he had been struggling with depression, kept secret from the public and his colleagues for fear of a vicious backlash that could, he apparently feared, raise questions about his capacity to care for his adopted baby girl and play for his nation.

Rather than risk this, and perhaps further despairing under the force of these private terrors, he chose the solution of death. That this seemed preferable to risking public awareness of his depression and the imagined consequences of personal shame, family destruction and exclusion from his nation's crucial sporting event, demonstrates something of the huge level of hatred that mental illness still evokes in the public imagination. The stigma only worsens the burden on those with mental health problems, typically reported as one in four of the adult population in the UK.

When people die by their own hand, a response of shocked disbelief, of the sense of an awful secret that has been starkly exposed, occurs all too often. How is it in this advanced age of emotional literacy, psychological self-help and media shrinks that the shame of depression and other mental illness causes people to desperately try to hide their problems rather than challenge society to accept that they, like so many others, are vulnerable?

READ MORE @ THE GUARDIAN

Web-based counseling service Vets Prevail offered to veterans

Veterans in need of counseling, support or information to deal with mental and emotional issues can now turn to an online, interactive program called Vets Prevail. The services are provided confidentially and free of charge.

The website allows veterans to connect with other vets through forums, blogs and multimedia content. Vets can also sign up for a six-week online mental health program tool designed to help them build resilience and readjust to life after deployment. The aim of the training is to help vets tackle negative emotions and keep the trauma of the battlefield from affecting daily life and relationships.

About 500 veterans will be able to access the training program based on funds provided by Major League Baseball and the McCormick Foundation. However, organizers aim to continue the service with additional funding.

READ MORE @ LS ANGELES TIMES

Purging the stigma of mental illness

Joseph Rochford, associate professor of psychiatry at McGill and a director at the Douglas Hospital, hopes the hospital's Mini-Psych School will help debunk myths surrounding people suffering from mental disorders.

"Molecular biologists and geneticists are like the engineers who develop a new Formula One racing car. We're the ones who test drive it and then go back and say 'this is how it behaves.' "

That's Joseph Rochford, associate professor of psychiatry at McGill University and director of the Douglas Hospital Research Centre, on what a behaviour pharmacologist does.

The head of the neurophenotyping centre at the Douglas Institute studies how drugs used for treating mental disorders affect behaviour.

Starting this week, Rochford - also the director of academic affairs - will launch the Douglas's Mini-Psych School by giving the first session on the myths of mental illness. The purpose of the six-week course is to educate and sensitize the public to mental health issues.

READ MOEW @ MONTREAL GAZETTE

From War to Home: Psychiatric Emergencies of Returning Veterans

Since the time of Homer, warriors have returned from battle with wounds both physical and psychological, and healers from priests to physicians have tried to relieve the pain of injured bodies and tormented minds.1 The "soldier’s heart" of the American Civil War and the shell shock of World War I both describe the human toll of combat that since Vietnam has been clinically recognized as posttraumatic stress disorder (PTSD).2 The veterans of Operation Iraqi Freedom (OIF) and of Operation Enduring Freedom (OEF) share with their brothers and sisters in arms the high cost of war. As of August 2009, there have been 4333 confirmed deaths of US service men and women and 31,156 wounded in Iraq. As of this writing, 796 US soldiers have died in the fighting in Afghanistan.3

Yet, there are also unique aspects of the combat experience of these veterans that influence their psychiatric presentations in acute settings.

First, far more of the troops (up to 45%) are reserve or National Guard rather than active duty compared with earlier wars.4 Their combat exposure, severity of PTSD, and impairments in interpersonal functioning are more similar to those experienced by career military.5 These individuals are most likely to appear in crises in community emergency departments (EDs); they may present with problems that may be different from veterans of previous wars or from soldiers in active military duty.

Typical presenting symptoms are marital stress from unexpectedly long deployments of 15 months (rather than the standard 12), employment concerns, financial stresses, and overall difficulty in reintegrating into civilian life. The absence of a strong military identity and cohesion, geographical separation from comrades, greater stigma, and misunderstanding from communities without exposure to the military or combat trauma serve as formidable barriers to care for these citizen-soldiers.

READ MORE @ PSYCHIATRIC TIMES

EEOC Sees Mental Health Stereotypes at Work

The federal government is suing a North Carolina employer for what it calls a pervasive problem in the workplace: discrimination against employees with mental illness.

In the federal suit filed Sept. 21 in the Eastern District of North Carolina, the Equal Employment Opportunity Commission contends that the Smith International Truck Center relied upon "myths, fears and stereotypes about mental impairments" when it unlawfully terminated an employee who took leave for a mental health issue.

According to the suit, the employee, Stephen Kerns, took one week off from work to obtain medical treatment and get his dosage adjusted for medicine he took for what the complaint calls a mental impairment. The man then returned to work with no restrictions, but was fired shortly thereafter, according to the EEOC.

The agency asserts that his employer fired Kerns because of his perceived disability -- in violation of the Americans With Disabilities Act. "The employer just assumed, acting on stereotypes, that if he's getting treatment for any kind of mental impairment, that he must not be able to work, and that's the problem. They didn't look at his abilities," said Carol Miaskoff, assistant legal counsel to the EEOC.

READ MOLRE @ THE AMERICAN LAWYER

Preventing Another Camp Liberty

Midway through her 2004 deployment to Iraq's Anbar province, Navy psychologist Heidi Kraft was e-mailing her husband about her experiences, and the message somehow turned into verse. The poem became the basis for her memoir "Rule Number Two: Lessons I Learned in a Combat Hospital" -- lessons that she revisited last week following the shooting at a combat stress facility in Baghdad. Kraft, who left active duty after nine years in the Navy and now treats combat stress patients, spoke with Outlook's Rachel Dry about how the military handles mental health and why PTSD can be like a sprained ankle. Excerpts:

Last Monday, Sgt. John M. Russell allegedly walked into a combat stress facility at Camp Liberty in Baghdad and opened fire, killing five service members. What did you think when you heard about the shooting?

My heart sank. I was so terribly saddened to hear it. As a provider, I can understand how something like this might have happened. Certainly if someone expresses either suicidal or homicidal thoughts, that person is categorized as a psychiatric emergency and steps are taken to stabilize that person. Sometimes those thoughts are not expressed in a way that makes it very clear what you're dealing with, and sometimes there's nothing to be done.

READ MORE @ WASHINGTON POST

Listen without prejudice

People with mental health problems deal with bigotry daily. What training is being offered to public sector workers to address this?

At any one time, one in six of us will have a mental health problem. The majority of us will surely have had some contact with someone who has personal experience of mental ill health. Yet stigma and discrimination are widespread and stop many people from admitting to mental health problems and doing things that the rest of us take for granted: applying for jobs; going out and meeting new friends; going to clubs and the shops; and even using public services like buses and libraries.

Every year the Department of Health carries out a public attitudes survey to gauge beliefs and attitudes towards people with mental illness. The 2008 survey found that one in eight people would not want to live next door to someone with a mental health problem, while a third thought those with mental health problems should not have the same rights to a job as everyone else.

The new statutory disability equalities duty (part of the Disability Discrimination Act) and the government-led social inclusion agenda are spurring public services to ensure people with mental health problems have equal access to mainstream services, from housing and transport through to education, arts, health and sport.

READ MORE @ THE GUARDIAN

People With Schizophrenia Say Bias Is Part of Their Lives

People with schizophrenia often expect to be discriminated against, and are, in various aspects of their life, new research finds.

The study, which included 732 people with schizophrenia in the United States and 26 other countries, found that 47 percent reported discrimination in making or keeping friends, 43 percent from family members, and 27 percent in intimate or sexual relationships. Also, 29 percent of the participants said they experienced discrimination while trying to find or keep a job.

What the study referred to as positive discrimination was reported by less than 5 percent of the participants.

The researchers also found that 64 percent of the participants didn't bother applying for work, training or education because they expected to fail or to face discrimination, and 55 percent anticipated discrimination when seeking a close relationship. However, more than a third of participants who expected these types of discrimination did not actually experience it.

READ MORE @ WASHINGTON POST

US general bucks military silence on mental health

It takes a brave soldier to do what Army Maj. Gen. David Blackledge did in Iraq.

It takes as much bravery to do what he did when he got home.

Blackledge got psychiatric counseling to deal with wartime trauma, and now is defying the military's culture of silence on the subject of mental health problems and treatment.

"It's part of our profession. ... Nobody wants to admit that they've got a weakness in this area," Blackledge said about mental health problems among troops who return from America's two wars.

"I have dealt with it. I'm dealing with it now," said Blackledge, who came home with post-traumatic stress. "We need to be able to talk about it."

As the United States marks another Veterans Day on Tuesday, thousands of troops continue coming home with anxiety, depression and other emotional problems.

Up to 20 percent of the more than 1.7 million who have served in Iraq and Afghanistan are estimated to have symptoms. In a sign of how tough it may be to change attitudes, roughly half those who need help are not seeking it, studies have found.

READ MORE @ INTERNATIONAL HERALD TRIBUNE

Stigmatising attitude of medical students towards a psychiatry label

The aim of this study is to evaluate the effect of a psychiatric label attached to an apparently normal person on the attitude of final year medical students at a Nigerian university.

Methods: A questionnaire with sections on demographic information, a single-paragraph case description illustrating a normal person, a social distance scale and questions on expected burden was used to elicit responses from 144 final year medical students who have had previous exposure to psychiatric posting.

The students consisted of two randomly assigned groups; group A received a case description with a psychiatric label attached while group B received the same case description but without a psychiatric label.

READ MORE @ 7TH SPACE INTERACTIVE

Stigma of mental illness pervasive: CMA head: 10% of Canadians think those who are ill could 'just snap out of it' if they wanted to, new survey finds

Almost half of Canadians believe that a diagnosis of mental illness is merely an "excuse for poor behaviour and personal failings" and one in 10 thinks that people with mental illness could "just snap out of it if they wanted," according to the startling findings of a new opinion poll.

The survey, commissioned by the Canadian Medical Association, shows that the stigma of mental illness remains pervasive, making it the "final frontier of socially acceptable discrimination," Canada's top doctor says.

Brian Day, a Vancouver orthopedic surgeon and president of the CMA, said the survey "shines a harsh, and frankly unflattering, light on the attitudes we Canadians have concerning mental health."

But he added that it is best to expose such views and tackle them head-on rather than allow stigma to fester. "It's important that these data be out there and we discuss them," Dr. Day said.

READ MORE @ THE GLOBE AND MAIL

Nine out of 10 people with mental illness suffer discrimination, says report

Nine out of 10 people with mental health problems do not go out or apply for jobs due to the stigma associated with their condition, a report said today.

They feel most discriminated against by their family (36%), followed by their employers (35%), neighbours (31%) and friends (25%), according to the survey by the mental health charity Rethink.

The groups most likely to be accepting are children, teachers, shopkeepers and public transport workers.

The results of the survey, which consulted more than 3,000 people in England, have been released ahead of an £18m mental health anti-stigma campaign that will be launched across the UK in January.

Paul Corry, Rethink's director of public affairs, said: "Our research clearly shows that stigma and discrimination are ruining people's lives. People with mental health problems have enough on their plates without facing additional pressure caused by other people's archaic and bigoted opinions.

READ MORE @ THE GUARDIAN

Mental illness must be taken from the shadows

In the 19th century England, mental health issues were governed by what was known as 'lunacy law'. Although Victorian parliamentary acts changed the status of those suffering from mental illness from prisoners to patients, they were still kept in brutal asylums.

Today, modern medicine has a sophisticated understanding of the broad spectrum of disorders that constitute mental illness, but politics seem scarcely to have moved on. Mental health treatment is in crisis. Acute psychiatric wards are 'not safe' and are 'uninhabitable', according to Dinesh Bhugra, the new president of the Royal College of Psychiatrists, whose damning verdict is reported in today's Observer. Patients are neglected and often put at risk of violence and sexual assault. The problem, as it has been for decades, is a woeful lack of funding compounded by ministerial failure to address the needs of mental health patients.

Nine years ago, the government cited transforming treatment of mental illness along with heart disease and cancer as one of its top three priorities for the NHS. Since then, the only substantial change has been the Mental Health Act 2007, which strengthened the regime under which people can be forced to accept medication and be 'sectioned' - detained on wards against their will. Those wards were described earlier this year by the Mental Health Commission as having become 'tougher and scarier' places in the last decade. In other words, the most vulnerable and disorientated people are sent to a place likely to exacerbate depression and psychosis.

READ MORE @ THE GUARDIAN