Mental Health Association of Nebraska

The power of a positive thinker

University of Pennsylvania psychology professor Marty Seligman believes that "we've spent too much time trying to fix what's wrong and not nearly enough figuring out how to make more things right."  According to Seligman, "positive psychology focuses on what makes some of us stronger, happier, and more satisfied than the norm.  It involves learning to think differently about both good an bad events and appreciating that there in more than one path to an emotional satisfying life."  The US Army thinks the idea is a good one and has initiated the Comprehensive Soldier Fitness Program with the goal of making soldiers "more resilient [and] less prone to suicide and post-traumatic stress disorder.  To learn more . . .

NE Board of Health affirms Board of Psychology’s refusal to adopt compromise ethics language

On Monday, June 21, 2010, members of the Nebraska Board of Health ignored the advice of the state's Chief Medical Officer and voted to approve licensing regulations for psychologists that do not include the so-called compromise language regarding patient referral. 

Unfortunately, this doesn't end the issue.  Although the Board of Psychology is legally responsible for writing the regulations, Dr. Schaefer isn't bound by their decision and can simply refuse to forward the proposed regulations on for administrative (i.e. the Governor's) approval.  

During the meeting, Dr. Schaefer repeatedly accused the professional and advocacy groups in opposition to the so-called compromise of "not being intellectually honest" (in other words lying) in our criticism of the changes, and that "we need to come up with a way to solve the problem."  The real problem for Schaefer and her boss is to find a way to appease the Nebraska Catholic Conference.  The truth is this is a political issue, not a medical one.  When asked by the Board if there has ever been a situation where a psychologist was punished for not referring a client for a specific issue, Jim Cunningham, executive director of the Nebraska Catholic Conference, replied "No."

During the debate, a number of Board of Health members agreed that the need for compromise was a "solution looking for a problem."  The Board voted 12 to 1 to affirm the decision made by the Board of Psychology last March.

Now it's back to the Board of Mental Health Practice, and a special meeting on changes to their rules and regulations (172 NAC 94) is scheduled for Thursday, July 1, 2010, at 2:15 PM, in the State Office Building's 1st Floor Meeting Room "Y."  Come by and hear what they have to say.

To read Nancy Hicks' 6/22/2010 article in the Lincoln Journal Star, click here.  Check out the discussion comments that have been posted.  If nothing else, this issue has provided fodder for a spirited public debate.

Medical Ghostwriting

Let's say a pharmaceutical or medical device manufacturing company wants to produce a document touting the public benefit of whatever they are selling, and they want it to look as positive and legitimate as possible.  They might hire big name researchers and physicians to put it together or they might have a marketing or communication company write it for them, and then get "prominent physicians and scientists to sign on as authors."  According to  Senator Charles Grassley, ranking member of the Senate's Committee on Finance, "the objectives of that practice are to raise the credibility of the findings and conclusions and increase the likelihood that the articles, which tend to put the companies' products in a positive light, will be published in important medical journals." 

On Friday, June 24, 2010, Grassley's committee released  Ghostwriting in Medical Literature, calling on the National Institute of Health, medical journals and medical schools "to take additional measures to ensure the integrity of scientific articles many doctors rely on to make treatment decisions for their patients."  According to the report, "manipulation of medical literature could lead physicians to prescribe drugs that are more costly or may even harm patients."  To read more . . .

Strategies to Avoid Burnout in Professional Practice

According to Psychiatric Times, professional burnout (a.k.a. compassion fatigue) is characterized by emotional exhaustion, cynicism and "a sense of personal inefficiency or impeded accomplishment."  Although Strategies to Avoid Burnout in Professional Practice focuses on mental health professionals, many of the suggestions can be applied to everyone experiencing "an erosion of soul."  The key to  avoiding burnout is to identify areas where you have control, stay connected to others, and practice self-care.

"Although external stressors themselves cannot always be changed, healthy approaches to lessen the stresses . . . and avoid burnout can be learned at any age." 

To learn more . . .

Happy Father’s Day: Now dad feels as stressed as mom

The New York Times reports that "men are facing the same clash of social ideas that women faced since the 1970's - how do you be a good parent and a good worker?"  A recently released study from Boston College found that "new fathers face a subtle bias in the workplace, which fails to recognize their stepped-up family responsibilities and presumes that they will be largely unaffected by children."  However, men and women differ in their perceptions of level of sharing in domestic duties.  In one report, researchers found that "49 percent of men said that they provided most or equal amount of child care [whereas] only 31 percent of women gave their husbands that much credit."  In the men's defense, the article states that "women consistently underestimate how much their husbands do [and] don't always recognize that what he does with the kids is a form of care too."  To read more . . .

Federal Government Launches New and Improved National Resource Directory for Military and Veteran Communities

The U.S. Departments of Defense, Labor and Veterans Affairs have launched a new and improved National Resource Directory (NRD) that provides access to services and resources at the national, state and local levels that support recovery, rehabilitation and community reintegration.  Information that is accessible through the website includes:  benefits and compensation, education and training, employment, family and caregiver support, health, homeless assistance, housing, transportation and travel. and other services and resources.  Learn more by visiting the National Resource Directory.

Psychiatric drugs carry serious physical health risks

Canadian researchers report that "the risk of coronary heart disease and a cluster of conditions known a metabolic syndrome [stroke, type 2 diabetes] increases soon after otherwise healthy, but depressed people are started on psychiatric drugs, putting them at risk of early death."  In 2006, the National Association of State Mental Health Program Directors (NASMHPD) reported that persons living with a serious mental illness die 25 years earlier than the general population.  The National Institute of Health estimated that 1 in 4 adults over the age of 18 residing in the U.S. live with a diagnosable mental illness (57.7 million people) and that 20.9 million people, or about 9.5 percent of the U.S. population age 18 and older, live with a serious mood disorder within a any given year.

The Canadian study followed 52 people, newly diagnosed with bipolar or major depression, and the results were "quite disturbing, given that this was a young, healthy population when we started.  If this had been a regular clinic, the patients would never have been monitored, simply because no one thinks that a healthy 29 year-old needs to have their glucose checked regularly because they have a mental illness."  The study found that "all medication classes - antidepressants, mood stabilizers and 'atypical' or newer anti psychotics - appeared to increase the risks."  To read more . . .

From the get off the couch department: Is Exercise the best drug for depression?

Few will argue that physical activity is good for physical health, and since the 1970's it has been accepted that folks that exercise were less prone to depression than those who did not, and were also less likely to become depressed in the future.  Recent studies now show "that exercise may alter brain chemistry in much the same way that anti-depression drugs do."  According to Dallas psychologist Jasper Smits, "exercise doesn't carry the same stigma among patients that depression medication and psychotherapy do, [and] the mood-enhancing benefits of exercise can kick in . . . a lot faster."  To read more . . .

Iraq ill-equipped to cope with an epidemic of mental illness

For some residents of Baghdad, "every street is a reminder of what was, what is and what could happen again."  Even now that the "violence has subsided to a lower but still frightening level . . .many Iraqis struggle to deal with the trauma of their past and uncertainty of their future."  It is estimated that there are only 100 psychiatrists available to help 30 million people, with many resorting to self-medication, and "prescription drug abuse in now the number one substance abuse problem" in the country.  At the only long-term mental health hospital in Iraq there has been a 10 percent increase in people seeking treatment, and "about 80 percent of families abandon their relatives once they commit them . . . When patients are ready to rejoin society, they often have nowhere to go."  To learn more . . .

The ethics battle continues . . .

The latest chapter in the mental health practitioner ethics debate happened last Tuesday, June 8, 2010, when the NE Board of Mental Health Practice reviewed public input from letters received and from testimony given during the hearing held on May 6th.  After a rather lengthy discussion, the Board decided to NOT move the compromise language forward to the NE Board of Health, and instead review the ethics language within the various national professional organizations to see if they can come up with a Nebraska code of professional conduct that covers all necessary areas.  As one who is relatively new to this discussion, it seems to me that this should/could have been done years ago.

Also last week Dr. Joann Schaefer published her views on this matter by criticizing the joint "Local View" written by representatives from the Nebraska Chapter of the National Association of Social Workers, the Nebraska Association of Marriage and Family Therapy, the Nebraska Psychological Association and MHA-NE.  While no one wants to force a person to receive services provided by someone who believes they are not competent to provide necessary services, Dr. Schaefer fails to note that when the practitioner, after discovering that he/she "has moral or ethical objections to that person's lifestyle choice," and then refers the person to another professional, they don't have to tell the person or the new provider the real reasons for the referral.  While Dr. Schaefer may feel this is a trivial omission, we do not.

Dr. Schaefer also writes that the three professional organizations were party to the compromise that dreamed up the proposed language, which is not true according to representatives of those organizations (see Terry Warner's letter).  Although representatives of the state Boards were supposedly present at the non-public meeting, it isn't clear if they had the authority to enter into an agreement in the name of their respective Boards.  So, my question is: Who exactly were the parties that reached this compromise?  All I know for sure in that no one considered it important to hear the opinions, concerns and ideas from those at the heart of the matter:  the service recipient.

The next exciting installment to the debate will occur at 10:30 AM, next Monday, June 21, 2010, at the State Office Building in Lincoln, when the Nebraska Board of Health, under the leadership of Dr. Schaefer, considers the matter.  Your presence at the meeting is greatly encouraged, your voice needs to be heard.