Recovery Michigan

"Bioethicists have largely overlooked the area of correctional mental health care despite the fact that there are currently over 1 million individuals incarcerated who have a mental illness and a significant subpopulation who have a serious mental illness such as schizophrenia or bipolar disorder," writes Dominic Sisti, a professor of medical ethics and health policy.

That is why, as Newsworks reported, Sisti is leading a yearlong pilot program for Penn's Leonard Davis Institute of Health Economics to research the inner workings of the prison mental health care system

Sisti's team, which includes ethicists, therapists, and criminologists, will examine policies related both to treating mentally ill inmates and reducing the number of mentally ill people in jails and prisons to begin with. They plan to interview current and former inmates who have had experiences with the mental health care system while incarcerated, then publish "a research agenda for bioethicists to address overlooked issues."

From what I’ve seen, a patient whose attempt is more “serious,” with visible life-threatening injuries or potentially deadly pathology results, is more likely to be treated with understanding, compassion and patience. It’s as if serious injuries validate the mental illness, making the inner turmoil visible to the outside world.

But the “less serious” the attempt is (for example, taking a non-lethal amount of medication or self-inflicted injuries that aren’t fatal), the less sympathy I’ve seen patients receive. This can also be said for patients who have repeat suicide attempts. I’ve heard these patients referred to as “time-wasters,” “attention-seekers,” “taking up beds,” and they’re described as “crying out for help.” Although it’s acknowledged as wrong, there’s still anger and frustration felt towards the patient. I’ve heard many question the reason for their behavior. But I believe anyone who intentionally puts themselves in harm’s way needs help, regardless of the intended outcome, and are still entitled to be treated with dignity, understanding and kindness. 

When I was 23, I tried to jump off a cliff after being discharged from a psychiatric hospital. I have bipolar affective disorder. I rarely call this a suicide attempt, although I would’ve jumped if it weren’t for a person walking past. If that person didn’t talk me down from the edge I wouldn’t be here today. I didn’t end up in an emergency department that night; instead the person called the local psychiatric triage team for advice and made sure I got home safely. The next morning my psychiatrist arranged for me to have electroconvulsive therapy (ECT).

At 64 years old, Marie* had been battling schizophrenia for nearly half her life. After three decades of wrestling down a sense of stability, her new medication, aripiprazole, threatened to unravel it all. Six months after a modest bump in her dosage, a nasty and irresistible urge to gamble – a hunger previously unknown to Marie – began to gnaw away at her. She had dabbled with the poker machines, tossing in one or two Australian dollars at a time, but her small dalliances abruptly skyrocketed, costing her up to $700 AUD per session, sums which were anything but insignificant to her. “I just wanted to keep putting money in, it was an urgency,” she said. “I would go high…and I seemed to lose all reason.”

About 4.2% of adults in the United States suffer from serious mental illness. About 1-2% of Americans are pathological gamblers. In theory, these small numbers should never overlap. But one of the most-prescribed drugs in the world is quietly facilitating the collision of these two disorders in America, with devastating consequences.

Aripiprazole, sold under the brand name Abilify, has locked itself in place as one of the top selling drugs in the United States. An atypical antipsychotic, doctors prescribe Abilify to almost a million Americans each year. The drug treats one of the most sensitive populations in the U.S.—people suffering from schizophrenia, bipolar disorder, and major depression.

Abilify is widely regarded as an effective treatment for these serious mental disorders. But the drug comes at a dangerously high – and unknown – price. Study after study links aripiprazole to the onset of pathological gambling—even in people with no prior or familial history of the disorder. Tellingly, in many of the studies, the symptoms abate almost immediately after stopping the medication.

- See more at: http://www.forthepeople.com/blog/calling-bluff-americas-top-selling-antipsychotic-creates-pathological-gamblers/?utm_source=facebook&utm_medium=cpc&utm_term=as1-samhsa&utm_content=ad2&utm_campaign=ftp-bp-abilify-calling-the-bluff-suppor-centers&key1=ad2&key2=as1-samhsa#sthash.0a19a9Tb.dpuf

Community mental health clinics, where most specialty mental health treatment is delivered, have been relying more on independent contractors to treat patients, largely for budgetary reasons. Many of these clinics have simultaneously been moving towards the greater use of evidence-based psychosocial practices (EBPs), broadly defined as talk therapies that are informed by rigorous research as well as clinician expertise and patient preferences. A new, first-of-its-kind study from the Perelman School of Medicine at the University of Pennsylvania suggests that these two trends may be in conflict. The findings appear this month in Psychiatric Services.

"The independent contractor therapists we surveyed turned out to have less positive attitudes towards evidence-based talk therapies for youth such as cognitive-behavioral therapy and less knowledge about them, compared with salaried employee therapists," said lead author Rinad S. Beidas, PhD, an assistant professor of Psychology in the department of Psychiatry at Penn Medicine. CBT emphasizes problem-solving and teaching youth specific skills to correct distorted thinking and change behavior.

Beidas, who is also director of Implementation Research at Penn's Center for Mental Health Policy and Services Research, has shown in previous work how attitudes, knowledge, and organizational culture influence the implementation of EBPs in public mental health clinics.

In recent decades, all healthcare disciplines have been moving towards better, more standardized care by identifying EBPs and pushing for their greater use. Specifically, the City of Philadelphia Department of Behavioral Health, led by Commissioner Arthur C. Evans, PhD, Jr, created an innovative program in 2007 to foster and support EBPs in its public mental health clinics.

Three years ago, Beidas and her colleagues began studying EBP implementation in Philadelphia. "One of the things that my team initially noticed, which we did not expect, was that there were a lot of independent contractor therapists at these agencies," Beidas said.

What do Don Cornelius, actor Lee Thompson Young and hip-hop mogul Chris Lighty all have in common? They were all Black men who suffered with battles of depression...tragically ending in suicide.

And while their fatal stories made national headlines for a few short weeks, the public fleetingly moved on to the next cycle of news, business as usual. But when it comes to Black men, discussions about depression and suicide are hardly ever tackled in ways that are meaningful.

An upcoming indie documentary called “Face of Darkness” seeks to do just that. Directed by independent filmmakers Squeaky Moore and Kenneth “KT” Nelson, the doc chronicles the lives of three African-American men battling depression and uses the likes of Cornelius, Young and Lighty as a way to bring a face to a often faceless epidemic.

Thanks to advances in neurobiology over the past several decades, opioid addiction is now understood to be a brain disease that arises from chronic exposure to opioids. Repeated exposure in persons who are vulnerable (due to genetic, environmental, or developmental factors) causes the brain to adapt in ways that can induce compulsive drug use and loss of control over drug-related behaviors. Opioid addiction can occur both in individuals who use opioids medically and in those who engage in prescription opioid abuse, defined as the use of an opioid medication without a prescription, in a way other than as prescribed, or for the experience or feelings elicited. In short, addiction that once would have been considered “moral weakness” is now understood to have a biological basis.

We also know that over-prescribing (particularly for chronic pain) is a major driver fueling prescription opioid addiction. The overall sale of opioid analgesic painkillers, which increased nearly four-foldbetween 1999 through 2010, parallels observed increases in opioid-related overdose deaths, emergency department visits, and treatment admissions.

In 2012 alone, providers issued 259 million opioid prescriptions — enough for every adult to have their own bottle of pills. A heightened focus on pain management beginning in the 1990s liberalized opioid prescribing, but this shift spurred tremendous growth in prescription drug abuse and addiction. Today,over 85 percent of abused prescription drugs, including opioids, are sourced directly or indirectly from prescribers.

We are less clear about the relationship between prescription opioid and heroin abuse. There is some evidence that prescription opioid addicts may have switched to cheaper, deadlier heroin when they couldno longer easily tamper with Oxycontin after its reformulation. However, a more recent review suggests that the escalation of heroin-related overdose deaths predated policy efforts to curb prescription opioid abuse — albeit a subset of prescription opioid abusers may transition to heroin use.

Although the effectiveness of most of the above-mentioned “wise” policies has yet to be proven, they at least recognize the prescription opioid epidemic as a public health priority rather than a criminal justice matter. Still, there are some opioid addiction policy responses that are ill-conceived in that they focus on criminalizing or punishing the behavior of opioid addicts, rather than preventing or treating it.

For instance, a majority of states allow law enforcement officials to access information in their state’s prescription drug monitoring program to identify and prosecute potential drug abusers. Doctor shopping laws (that typically echo federal drug control laws) make it a crime to intentionally obtain drugs by fraud or deceit. Tennessee, among other states, has criminalized the use of drugs by pregnant women. Moreover, there is inadequate treatment provided both within prisons and upon release of prisoners with opioid or other addiction disorders.

Did you know that there’s a natural antidepressant in soil? It’s true. Mycobacterium vaccae is the substance under study and has indeed been found to mirror the effect on neurons that drugs like Prozac provide. The bacterium is found in soil and may stimulate serotonin production, which makes you relaxed and happier. Studies were conducted on cancer patients and they reported a better quality of life and less stress.

Lack of serotonin has been linked to depression, anxiety, obsessive compulsive disorder and bipolar problems. The bacterium appears to be a natural antidepressant in soil and has no adverse health effects. These antidepressant microbes in soil may be as easy to use as just playing in the dirt.

Most avid gardeners will tell you that their landscape is their “happy place” and the actual physical act of gardening is a stress reducer and mood lifter. The fact that there is some science behind it adds additional credibility to these garden addicts’ claims. The presence of a soil bacteria antidepressant is not a surprise to many of us who have experienced the phenomenon ourselves. Backing it up with science is fascinating, but not shocking, to the happy gardener.

A prime example is oxytocin, which is involved in fostering emotions such as trust and love. The hormone is produced only in the brain and is released into the bloodstream by the pituitary gland. Until now it was not known why these oxytocin-producing neurons are linked to the brainstem and spinal cord. Researchers at the Max Planck Institute for Medical Research in Heidelberg have now discovered a small population of neurons that coordinate the release of oxytocin into the blood and also stimulate cells in the spinal cord. Stimulation of these cells increases oxytocin levels in the body and also has a pain-relieving effect.

Not getting enough sleep is detrimental to both your health and productivity. Yawn. We've heard it all before. But results from one study impress just how bad a cumulative lack of sleep can be on performance. Subjects in a lab-based sleep study who were allowed to get only six hours of sleep a night for two weeks straight functioned as poorly as those who were forced to stay awake for two days straight. The kicker is the people who slept six hours per night thought they were doing just fine.

As you can imagine, the subjects who were allowed to sleep eight hours per night had the highest performance on average. Subjects who got only four hours a night did worse each day. The group who got six hours of sleep seemed to be holding their own, until around day 10 of the study.

In the last few days of the experiment, the subjects who were restricted to a maximum of six hours of sleep per night showed cognitive performance that was as bad as the people who weren't allowed to sleep at all. Getting only six hours of shut-eye was as bad as not sleeping for two days straight. The group who got only four hours of sleep each night performed just as poorly, but they hit their low sooner.

Much evidence supports that peer support is a critical and effective strategy for ongoing health care and sustained behavior change for people with chronic diseases and other conditions, and its benefits can be extended to community, organizational and societal levels.

Overall, studies have found that social support:

• decreases morbidity and mortality rates
• increases life expectancy
• increases knowledge of a disease
• improves self-efficacy
• improves self-reported health status and self-care skills, including medication adherence
• reduces use of emergency services

Additionally, providers of social support report less depression, heightened self-esteem and self-efficacy, and improved quality of life.