Mental Health Association of Nebraska

Environmental Affects on Mental Illness

 Environmental Connections: A Deeper Look into Mental Illness states that although mental illness remains a biological "brain disease," it is influenced by environmental factors including infection, pollution, trauma, medications, illegal drugs, and nutritional deficiencies - namely "everything that isn't an inherited gene."  Coupled with the growing "evidence" that mental illness has a biological cause, environmental risk factors will "be validated and confirmed, [and] there is every reason to expect they will point to preventative measures that lower their risks and morbidity."

Any consideration of mental illness beyond identifiable symptoms is most welcome, but the authors' argument falls short in that it fails to go beyond how the individual perceives and survives in their world (or "their problems") and address how the prevailing culture sees, interprets and labels a person's behavior.

In The Americanization of Mental Illness, the author states "that mental illnesses have never been the same the world over (either in prevalence or in form) but are inevitably sparked and shaped by the ethos of particular times and places."  The diagnosis and treatment of mental illness is influenced by cultural beliefs and expectations today as they have hundreds if not thousands of years ago.  Even here in Nebraska, a major religious faction continues their attempt to change ethical standards for psychologists and licensed mental health professionals based solely on the religious and moral beliefs of the practitioner (see Nebraska Board of Psychology votes to not change ethics language).

Mental illness is more than a collection of symptoms, and there is more to identifying mental health issues than using the DSM-IV.  We are all, the chronically normal included, a collection of all our experiences, the good and the bad.  And failing to acknowledge the overt and covert effects of dominate cultural norms on defining acceptable and unacceptable behavior, thoughts and lifestyles, only causes more harm than good.

The debate over the effectiveness of antidepressants continues

In the February 8, 2010 issue of Newsweek,  Sharon Begley writes in The Depressing News about Antidepressants of a moral dilemma that arose when a friend shared his desire to "beat his chronic depression once and for all," and asked her if she knew of any research that might help him decide whether a new medication his doctor recommended might actually work.  The problem was that she knew of numerous studies, but their results tended to show little difference in the effectiveness of medications and placebos.

 Irving Kirsch (University of Connecticut) and other researchers have looked at published drug manufacturer conducted clinical trial reports (1998), and both published and unpublished clinical trial reports (2002), and found that patients on a placebo improved about 75 - 82 percent as much as those on drugs. A report published in the January 6, 2010, issue of The Journal of the American Medical Association found that "the magnitude of benefit of antidepressant medication compared with placebo increases with the severity of depression symptoms and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms."

The question then becomes "How do the drugs work?"  Kirsch concluded that "the lion's share of the drugs' effect comes from the fact that patients expect to be helped by them, and not from any direct chemical action on the brain, especially for anything short of very severe depression."

Thus the moral dilemma: "In any given year, an estimated 13.1 million to 14.2 million American adults suffer from chronic depression. At least 32 million will have the disease at some point in their life.  Many of the 57 percent who receive treatment (the rest do not) are helped by medication.  For the benefit to continue, they need to believe in their pills."  To read more . . .

Find out the latest on herbal and dietary supplements

Two recently published articles discuss the beneficial, and not so beneficial, side effects of taking alternative medications.  In Hidden Dangers of Herbal Meds Reviewed, MedPage Today reviews a report by Mayo Clinic researcher Dr. Arshad Jahangir, M.D. that found that due to possible negative interactions with prescription medications, "herbal medicines are not always the harmless nostrums that many patients and even some physicians think."  Yet herbal meds are big business in the U.S., and Jahangir believes this may be true because "physicians aren't spending enough time with patients to understand their true needs."  To read more . . .

In a recently released study from Australia, researchers found evidence that suggests that fish oil pills may help young people experiencing early "signs of mental illness from descending into schizophrenia."  Earlier studies have shown that omega-3 fatty acids found in fish oil can lower blood pressure and lessen the risk of heart disease.  scientists in the field greeted the new findings with cautious excitement.  "The results are very impressive and very striking and really represent a step forward potentially for patients and their families."  To read more . . .

Still confused?  Check out the National Institute of Health's National Center for Complementary and Alternative Medicine website.  You'll find research-based information on numerous treatments and conditions.  Go to NCCAM to learn more.

The web's most current & comprehensive directory of Patient Assistance Programs

Patient Assistance Programs are run by pharmaceutical companies to provide free medication to people who cannot afford to buy their medicine.  RxAssist offers a comprehensive database of these programs, as well as practical tools, news, and articles so the health care professionals and consumers can find the information they need.  Visit RxAssist to learn more.

Pill Popping Pets

In going through the archives of the New York Times recently, I found an interesting, and in a sickly way humorous, article on the versatility of pharmaceutical companies entitled Pill-Popping Pets, published on July 13, 2008.  In his article, James Vlahos describes German shepherd Max's manic compulsive disorder (identified by his continual desire to chase tennis balls and chase his tail), and his prescription for Clomicalm, the doggie version of the human medication clomipramine, a commonly prescribed antidepressant.  Vlahos writes "the practice of prescribing medication for humans to animals has grown substantially over the past decade and a half, and pharmaceutical companies have recently begun experimenting with a more direct strategy: marketing behavioral-modification and 'lifestyle' drugs specifically for pets."   To read more . . . 

Nebraska’s Consumer Voice now available on line

MHA-NE's white paper, Nebraska's Consumer Voice:  Leading a Change in Mental Health Services, is now available on line.  The paper was prepared with the assistance of over 600 mental health service consumers, and outlines 11 "Rules for Quality Mental Health Services in Nebraska."  Technical assistance with the paper was provided by Steve Miccio, Executive Director of PEOPLe, Inc, and funding provided by the SAMHSA/CMHS.

These rules include

1. Transportation barriers must be eliminated
2. It must be recovery focused
3. There must be access to services
4. There must be peer provided services
5. There must be access to complete medical records
6. Care must be based on a partnership between consumer and provider
7. There must be access to affordable housing
8. There must be more recovery education
9. There must be opportunity for competitive employment
10. There must be access to information regarding benefits
11. Must do no harm

To read the paper in its entirety: Nebraska's Consumer Voice.

Resources for being a better informed consumer

Here are a few useful resources to help you be a more informed partner in all your health care decisions:

The Law Project for Psychiatric Rights (PsychRights) is a non-profit public interest law firm whose mission is "to mount a strategic legal campaign against forced psychiatric drugging and electroshock in the United States."  To learn more . . .

Askapatient.com "is a place for people to share their personal experiences with medications."  The site is careful to note that "you may or may not have the same experience with the same medication [and] to make a fully informed decision about which medications are right for you, always read the product information that comes with your medication and discuss any concerns you may have with your doctor."  To learn more . . .

MedWatch is billed as "your FDA gateway for finding clinically important information and reporting serious problems with human medical products."  To learn more . . .

The debate on forced treatment for those living with mental illness continues

With the approaching sunset of New York's controversial Kendra's Law, the subject of forced treatment v. individual responsibility and choice has begun to heat up.  In a poorly written article based on fragments of statements and then applied out of context, tabloid New York Post reporter Andrea Peyser states that in New York, "the in mates control the asylum. Be Afraid."  She goes on to state that Kendra's Law "protects New Yorkers from crazy devils who walk among us."  See for yourself that fear mongering, ignorance, arrogance and outright discrimination are alive and well by going to "Fear for this state's sanity."  I did, and then lined the cat box with it.

Judi Chamberlin, mental health consumer advocate and consultant to the National Empowerment Center disagrees with Dr. E. Fuller Torrey, President of the Treatment Advocacy Center, on the subject of involuntary treatment.  Dr. Torrey bases his argument on his belief that "individuals with no awareness of their illness will never seek out services, because they do not believe they are sick." He cites studies that show that 1 in 3 "patients" believe that, all things being considered, they are better off after being forced into treatment.  In addition, Dr. Torrey believes that there is a strong need to protect the normal people from those people, stating that "untreated individuals with [severe mental illness] are significantly more dangerous that the general public that the general population."  Ms. Chamberlin counters that the issue is about legal rights and ethics, not medicine.  "Should psychiatrists be able to define people as 'patients' against their will?" Regarding the issue of violence, she states that "not only is violence rare, but according to the American Psychiatric Association, psychiatrist share no special knowledge or ability with which to predict dangerous behavior [and] that even with patients in which there is a history of violent acts, predictions of future violence will be wrong for two out of every three patients."  To read more . . .

From the "Better be Nice to Your Roommate" department:

According to About.com, Kendra's Law allows the following people to petition the court to have someone evaluated for possible "assisted outpatient treatment:"

• an adult (18 years or older) roommate of the person
• a parent, spouse, adult child or adult sibling of the person
• the director of a hospital where the person is hospitalization
• the director of a public or charitable organization, agency or home that provides mental health services and in whose institution the person resides
• a qualified psychiatrist who is either treating the person or supervising the treatment of the person for mental illness
• the director of community services, or social services official of the city or county where the person is present or is reasonably believed to be present
• a parole officer or probation officer assigned to supervise the person

Many Antipsychotic Users Not Getting Needed Tests

Megan Brooks of Reuters Health, citing a report recently released by Dr. Elaine H. Morrato of the University of Colorado-Denver, reports that "people who take newer drugs for schizophrenia and other psychotic conditions are supposed to have their blood sugar and cholesterol levels checked regularly but many don't."   So-called "second-generation" antipsychotic drugs, which include olanzapine (Zyprexa), risperidone (Risperdal) and aripiprazole (Abilify), were developed because older antipsychotics have significant side effects. However, the newer drugs are known to significantly increase blood sugar and cholesterol levels, raising the risk for diabetes and heart disease. Click on the link to read the entire article  Antipsychotic Users Not Getting Needed Tests

How Much Profit is Enough?

In a recently received e-mail, Sharon L. Davis, a Budget Analyst with the
U.S. Department of Commerce, shares examples of the cost of the key ingredient to many popular prescription drugs compared to the retail cost of a typical prescription. Is a 560,000% profit sufficient to cover the cost of production and provide a reasonable profit? You decide.

• The Real Cost of Your Prescription Drugs