The Afterw@rd

Reforming Psychiatric Care with the Club Drug "Special K"

noreply@blogger.com (The Afterw@rd) — Tue, 31 Jan 2012 02:01:00 +0000

Imagine instantly being able to no longer feel depressed. Going through an episode? If you are prescribed Special K you may miraculously and immediately feel better, according to this National Public Radio report.

Before we thought that depression is caused by a chemical imbalance, but the reality is that we really don't know.

The fact is that people react differently to different drugs. So much is still unknown about the causes that it is frustrating. I feel that people refuse to dig into these issues unless it is profitable to good old pharma.

I'm not hating the playa, just hating the game.

The Afterw@rd

$1.8 Billion

noreply@blogger.com (The Afterw@rd) — Thu, 24 Mar 2011 20:29:00 +0000

State budget writers looking for cash to balance the books have stripped a cumulative $1.8 billion from mental health services over the last 2 1/2 years

You can see how these cuts are affecting Texas and Maryland.

The issues is so much greater than the general disdain and disregard our elected officials feel regarding those in need of mental health care. The reason they can get away with such deep cuts is because we let them.

(Think: Just go try to enact similar cuts on Medicare or Social Security.)

I was watching a Spanish television program where a man who had hit rock bottom had lost his job, ended up in a psych ward because he was suicidal. To look at the man, you would not have guessed it. He was well put together and seemed like a guy that had a lot to offer any firm in a professional capacity. The young man was pissed that his only brother turned his back on him during his crisis. On the other hand, his supportive partner felt unappreciated and thought that it was necessary for our guy to just "snap out of it." The host suggested that he focus on the positive and quickly moved on to the next story who as she stated had "real problems," totally discounting the pain that the depressed man was going though.

The anger that coursed through my veins fueled me to blog. Only those in the know, can truly understand how hard it is to "just snap out of it" and move beyond the pain. People would much better deal with the outlandish outbusts of the Chris Brown's or the Charlie Sheen's of the world (pick an interview, any exclusive interview).

Then I wake up and read "An Open Letter to Chris Brown" by Kevin Powell, and it gives me hope.

Some people go get it. More needs to be done. Therapy is an undervalued commodity usually restricted to the rich.

Prayer is simply insufficient. But that's a whole other blog entry.

Anacaona

PS This blog entry is dedicated to someone who understood this need well and could laugh in the face of tragedy. Rest in peace Mike DeStefano.

Loughner's Odd Behavior

noreply@blogger.com (The Afterw@rd) — Mon, 10 Jan 2011 19:47:00 +0000

I joined the country in a national moment of silence at the loss of six people, 14 critically injured, by Jared Loughner's mass shooting spree in Tuscon, Arizona. The most prominent being Rep. Gabby Gifford, a moderate blue dog Democrat, who remains in critical condition. My prayers are with her, the others injured and the family members who lost loved ones.

Politically speaking, I agree with many of the pundits that the current climate of hate from the extreme right and the decreasing support for gun control laws do bear some blame. Especially looking to Arizona, a place where so much anti-rhetoric clouded much of it's political discourse in 2010.

However, I am also drawn to speak on Loughner's behalf. To me he is simply a casualty of a failing health care system that has barely begun to recognize mental health as a real medical concern in need of attention. I am not even touching on the fact that Republican's are currently working to repeal all the progress made on healthcare reform so we can have more Loughner-type incidents.

It seems clear to me that the mental health care system failed Loughner just as much as lax gun control laws failed Gifford.

In 2011: Look for the Me in We

noreply@blogger.com (The Afterw@rd) — Sat, 01 Jan 2011 19:39:00 +0000

Happy New Year everyone!!! It has been an incredible past year but I sure am glad to see recession, gay-teen suicides, high unemployment rate-ridden 2010 go.

It's time to start anew. Dream bigger, differently, longer-term. It's a time to stretch and test ourselves. Challenge those around us. It's time to get reacquainted with our ambitious, driven self. Where the heck had it been? I know I had to get out and go find mine.

Now, I am stretching and testing myself personally and professionally in ways that I could ever have imagined. Glad to know I am in good company.

Oprah is starting her OWN network. Republicans are going to try to remember what fiscal conservatism is again. Obama and his health care program are in for a rough but win-able fight. Even, the Sunday New York Times just published their version of helping marriages self-expand.

2011 hopes to be a good year for mental health. This is the first full year that mental health parity has been in existence. This means that anyone with a need can go see a mental health professional for as long as they need to without restrictions.

It's like taking a breath of fresh air.

I finally feel like I can and want to live again.

The Afterw@rd

Welcome ObamaCare!!!

noreply@blogger.com (The Afterw@rd) — Sun, 21 Mar 2010 04:04:00 +0000

I am so excited that I can barely type. I am anticipating the upcoming House and Senate vote that will usher in a new age of health care.

As someone with pre-existing issues, this is a long time coming.

Get inspired yourself:

And here is the other one:

Visit msnbc.com for breaking news, world news, and news about the economy

However, inspiring speeches doesn't put food on the table. For folks that need the hardcore facts I've got that too. Click here for the Congressional Budget Office pre-liminary report.

That's a wrap for the scare tactics.

The Afterw@rd

Designing McQueen

noreply@blogger.com (The Afterw@rd) — Thu, 11 Feb 2010 22:20:00 +0000

I'm not a fashionista but I just learned of a 40 year old white male, Alexander McQueen, decided to take his life today for no apparent reason other than having a grieving soul.

I feel for his his friends and family left behind. Now all that is left is lament for a lost talent and creativity. The woulda, shoulda, coulda folks now wonder what they could have done to intervene and demand that he seek professional help.

Here goes the addition of another benchmark statistic, an easy one for the books. A sad, true loss of a visionary.

The Afterw@rd

Labels, Labels and More Labels

noreply@blogger.com (The Afterw@rd) — Wed, 10 Feb 2010 13:53:00 +0000

The Diagnostic and Statistical Manual of Mental Disorders is being revised and is intended for release in 2013. Be at attention, your mental state label could change. This would be the first revision in a decade and the manual's fifth edition.

Supporters of the proposed recommendation changes indicate that treatment strategies are label dependent and to provide appropriate treatment new categories of disorders must be created or old ones amended. Needless to say, much money is at stake. The pharmas are lobbying their buns off.

Over the last 10 years, and with much controversy, diagnosis of children with bipolar disorder has skyrocketed 4000 percent. Later finding that the label was inappropriate for the observed escalated temper flairs not accompanied by mood swings often experienced by those with bipolar mania or manic depression. The issue is that temper flairs are dealt with behavioral treatment while the other is best treated with anti-psychotic medication. Hence, we end up with the controversy highlighted recently in the Afterw@rd that poorer children were likelier to get antipsychotic medication. When you don't have a voice nor a vote due to a lack of resources for even a second opinion, your kids end up paying the price.

The funny or not so funny thing of it all is that what we do in the United States affects other countries, other cultures, other people.

Diagnostic labels matter, but getting the treatment right matters even more. Sometimes, it's as simple as embracing that person with their idiosyncrasy.

The Afterw@rd

Dance, Dance, Dance Your Limbs Away

noreply@blogger.com (The Afterw@rd) — Sat, 23 Jan 2010 00:36:00 +0000

In the post-Civil War dawn, Sri Lanka's own Jehan Aloysius choreographed what he calls a "Body Narrative" of Tchaikovsky's Swan Lake, where two-thirds of the cast of dancers are physically disabled soldiers.

As Jehan states, “At this time, when the rights of the disabled in Sri Lanka are in discussion, as well as when our country, that has lost many brave soldiers due to the war, is seeking to heal itself, we believe our show has the ability to reach larger audiences and spread the message of hope and courage.”

This is where art, heart, body and mind combine to heal, forgive, and yes, indeed find the courage to move on. This is what The Afterw@rd's about.

According to the UN's Human Development Index, Sri Lanka is so advanced in health and education statistics. This performance is just one more thing to add to the wonderful list of what Sri Lanka has to offer.

The Afterw@rd

That Poor Antipsychotic

noreply@blogger.com (The Afterw@rd) — Sun, 13 Dec 2009 00:01:00 +0000

As the health care reform debate rages on, I often wonder how mental health treatment will change. Poor children are among the most vulnerable in our society. Yesterday, the New York Times published an article citing that children on Medicaid were found to be prescribed anti-psychotic drugs, at a rate of four to one when compared to their middle-class counterpart. Now, I can get on a soapbox rant, but I think it's more constructive to ask, why is it that convenience and the employment of cost-cutting measures trump appropriate mental health treatment?

Why is this happening?
Is it that poor families do not know or do not care to advocate for their children? Is it that the doctors just want to minimize paperwork and medicate a problem to oblivion? Can you imagine if the reverse were true? The fanfare and protest would be never ending!

According to the New York Times, these children are less likely to receive family counseling or psychotherapy since Medicaid pays more for medication than for counseling session and poor families are time-challenged with attending counseling or therapy sessions, if that service is available. However, I think it's more than that. I think it comes back to the stigma of mental illness and a lack of understanding of how talk therapy can help.

The data shows that these antipsychotics are given even when these children don't need them. But you have to realize that this is a rational choice for a poor and probably poorly educated family. We live in a society that allows for commercials to run non-stop to fix your CLPD (what ever that is), your arthritis, your asthma, your left nut on lockdown, your flaccid penis and your left twitching eye. In this insane world then, it makes perfect sense to correct rebellious behavior with a small blue or red pill. In a family constantly on the perilous edge of survival it is the easy way out. It makes sense.

Even the article admits that "it is often a pediatrician or family doctor who prescribes an antipsychotic to a Medicaid patient — whether because the parent wants it or the doctor believes there are few other options." Granted, the drugs are typically cheaper than long-term therapy. Who really wants to dig deep into the abandonment, alcoholism, abuse, oppression, molestation, or other dysfunctional etc. remnants these families are recycling? It's so much easier to have Medicaid pay $7.9 billion than attend years of dynamic therapy or 20 sessions of directed cognitive behavioral therapy. Even the experts agree "that some characteristics of the Medicaid population may contribute to psychological problems or psychiatric disorders."

Oh, really??
According to the article, "studies have found that children in low-income families may have a higher rate of mental health problems — perhaps two to one — compared with children in better-off families. But that still does not explain the four-to-one disparity in prescribing antipsychotics." Now, I have a bone to pick with that finding. Based on my empirical experience, better-off families are just as screwed up. They just learn to hide it better. A child's perceived abandonment by a parent is still real whether it's because of absence that came about through overwork or through disappearance.

Isn't it criminal?
"The data also indicates that poorer children are more likely to receive antipsychotics for less serious conditions than would typically prompt a prescription for a middle-class child." While the experts do not have clear evidence to form an opinion on whether or not children on Medicaid were being overtreated, where the hell is the Food and Drug Administration on this issue? To me there is something seriously wrong with this picture. "Medicaid children were more likely than those with private insurance to be given the drugs for off-label uses like A.D.H.D. and conduct disorders. The privately insured children, in turn, were more likely than their Medicaid counterparts to receive the drugs for F.D.A.-approved uses like bipolar disorder."

Again, this is about properly educating poor families about what it means to have a mental illness, what do you have to do to manage it, and what an FDA-approval means. In an over-drugged society, where a pill is supposed to fix everything, how can we expect a poor, lowly educated parent with minimal resources make what to her (given that it's probably a single-female headed household) may seem to be a rational choice in the best interest of her child?

The Afterw@rd

Revisiting the Happiness Contagion

noreply@blogger.com (The Afterw@rd) — Mon, 28 Sep 2009 19:59:00 +0000

Towards the end of last year I wrote about the happiness contagion findings of Drs. Nicholas Christakis and James Fowler. Namely, how good and bad social habits and behaviors were socially contagious within your social network. Some of their findings were that happiness was more contagious than sadness or loneliness, and directionality of the relationship mattered, that is, if I hold a friend in high regard their behavior will have a greater effect on me even if the opposite is not true.

The linked article offers a more nuanced critique of both the confirmations and uncertainties of their findings.

Needless to say, I'm still curious how these behaviors would affect the mind of a mentally ill person. Would the number of mentally individuals matter in a group? How would gender affects follow the same correlations as with the Framingham dataset? I'm also curious about how coupling or bundling behaviors can affect say weight loss and joy to overall mental health of your friend's friend's friend. These are just some of the questions that I have to get them started.

Enjoy the read!

The Afterw@rd

Health Care Reform and Suicide Prevention

noreply@blogger.com (The Afterw@rd) — Wed, 09 Sep 2009 17:18:00 +0000

Healthcare reform is currently being debated in the U.S. Congress and we want to ensure you know how important it is to include suicide prevention priorities in this historic legislation. SPAN USA/AFSP needs you to tell your Senators and Representatives about these priorities. Health reform legislation currently includes many positive provisions that will lead to greater access to mental health and substance use treatment, increase early identification of mental health and substance use disorders, and provide funding for prevention and wellness programs. However, in conjunction with SPAN USA/AFSP's health reform priorities, we remain concerned that:

· mental health and substance use parity be provided within all insurance plans covered by the legislation;
· coordination of care provisions include behavioral health providers and integrate mental health and substance use services with primary care; and
· prevention and wellness provisions include suicide prevention, not just chronic disease prevention.

Therefore SPAN/AFSP is asking you to meet with your members of Congress while they are home during the remaining weeks of the summer recess.

Please follow the steps below, asking your Congressmen to provide parity for all; coordinate care for suicide attempt survivors and those with mental illness; and include suicide prevention along with chronic disease prevention in grant programs!

Here is what you can do to help create this change:

1. Make an appointment at a district office close to you.

How to set up a meeting:

-Check your Member's website for information on setting up a meeting (many offices require a written request)

-Call the office and ask to speak to the person in charge of scheduling. Identify yourself as a constituent and an advocate with SPAN USA/AFSP, and request a meeting with the official regarding health reform.

-Make sure to follow up as the process may take some time.Keys to success:-Stick to your talking points (provided below).

-Be specific about SPAN USA/AFSP's priorities for health reform.-Treat staff with respect.

-Deliver your entire message within ten minutes.

-Get the card of the legislator (as well as staff that you meet with) and follow up within two weeks.Meeting talking points:

-Who you are: Introduce yourself.Why you are there: Describe your role in the district/state's suicide prevention community.

-Why this is important: Explain the impact of suicide on you, the local community and provide some state statistics.

-What you can do: You can ask for them to support suicide prevention health reform priorities and leave behind the document with the requests.

2. Find out when your local official is hosting a town hall meeting.

-Make sure to be well prepared.

-Ask a specific question related to suicide prevention and health reform.

3. Invite the official to a local meeting, community walk, or another event.

-Include basics such as time, date, location, and your contact information.

-Incorporate facts that will get the official's attention--e.g., number of people attending and if the media is attending..

4. Reporting Your Efforts

-Make sure to report how the visit/town hall went to SPAN USA/AFSP by using the paper form available here or via an online survey available here.

-Follow up with a thank you letter to the official or staff you met with.

-Encourage others you know to make similar visits.

If you have any questions, please contact Brian Altman at baltman@spanusa.org or 202-449-3600, x103.

Mentally Ill US Citizen Deported

noreply@blogger.com (The Afterw@rd) — Tue, 01 Sep 2009 00:01:00 +0000

I am in such shock I don't even know where to begin. It would be easier for me to better understand this horrifying true story if it had been a Spanish-speaking only U.S. citizen or even someone who was actually of Mexican descent, but this is just not the case. Mark Lyttle's story is neither of these and it's so sad, I had to laugh to stop from crying.

Mark Lyttle's story broke when Dr. Jacqueline Stevens, associate professor from University of California, Santa Barbara, got hold of the details and blogged about it. According to Dr. Stevens, his story is not unique, 10,000 U.S. citizens get deported annually.

Unfortunately for Mr. Lyttle, 32, born in Salisbury, North Carolina, was probably having a Manic episode when he committed a misdemeanor that landed him jail. Dr. Stevens writes,

Last week I received Mark's "alien file" maintained by the Department of Homeland Security. Among dozens of documents revealing the incompetence and even treachery of ICE, Customs and Border Patrol agents, and an immigration judge in Atlanta are ones triggering a series of events resulting in Mark's four month journey through five countries in Latin America.

On August 27, 2008, according to a guard at the Neuse Correctional Institute, "five or six ladies who do the admin intakes" would have been typing into the North Carolina Offender database vital statistics for the approximately 60 inmates they were screening that day.

For Mark, serving a 100 day sentence for a misdemeanor, this meant a record stating:

Race: OTHER

Complexion: MEDIUM

Ethnicity: ORIENTAL

Place of Birth: MEXICO

Mark says he remembers the interview. The woman told him he had brown skin, so maybe he was from Mexico. She was going to alert ICE to follow up. (Perhaps she did this by typing "Mexico" as Mark's place of birth? I guess Mark was lucky: she could have typed "China" -- of course Mark has no relatives from Asia, either.)

The psychologist that examined him before his first of several deportation diagnosed Mr. Lyttle with Bipolar I.

I don't know what's funnier that Immigration and Customs Enforcement (ICE) data intake administrators did not know what a Mexican looks like or that a clearly looking black man standing in a Southern state was Mexican and Oriental without a speck of an accent or a Latino name. No, Jose Thomas does not count. If it did NPR and Fox New Sunday commentator Juan Williams should be looking over his shoulder, starting NOW. Mentally ill folks can have a little fun too, but I guess Mr. Lyttle's jokes with the system left him with a bitter taste.

The scandalous part was that it took one day for State Department employee in Guatemala to verify that Mark Lyttle was a U.S. citizen. It's amazing that employees at ICE couldn't afford him the right to do their job properly, a job our tax payer dollars are paying for.

This is one of those cases that gives credence to why organizations like Mind Freedom International exist. It takes Mad Pride to represent and fight to be heard and treated with respect.

Go on Mark Lyttle, tell your story, with you Mad self.

The Afterw@rd

A Right Winger's Take on Mental Ilness

noreply@blogger.com (The Afterw@rd) — Thu, 27 Aug 2009 01:09:00 +0000

John Hawkins really thinks he knows something about living with mental illness!

The mentally ill are constantly discriminated against. They are stigmatized, rather than embraced. Folks would rather look away than actually face the conditions under which people with mental illness are treated. The list of trials and tribulations goes on and on. But, alas, I can feel Hawkins ignorance. Mental illness does not have a political party affiliation, but his party is definitely making it worse off for those who are mentally ill to receive proper treatment.

Why can't mentally ill people have a right to a second, and yes, even third, opinion? Forcibly, taking any medication should be based on a patient's right to chose. It is up to us to create a safe space for people to freely admit that something is actually wrong.

In Pennsylvania Teen Screen is a test that is given to teens to help "reduce" suicide; however, it was funded by those deep pockets. It makes it difficult to trust this particular industry. Check out Allen Jones' whistleblower's tale.

The Afterw@rd

PS Thanks TorturedSoul for the heads up!

Death Paneling Living Wills

noreply@blogger.com (The Afterw@rd) — Tue, 25 Aug 2009 21:33:00 +0000

On August 23, 2009, Fox New Sunday ran the following spin bit.

I feel it was disingenuous for FNS to cite "Your Life, Your Choices", as an Obama Administration problem when it was a document produced, distributed, and adopted under the Bush Administration. The document serves as a bad workbook example for end-of-life options and for drafting living will documents.

Granted, all the right winged false spin regarding proposed death panels within health care reform bills, still under negotiation, have virtually killed (at least in the Senate) any hope to have "voluntary end of life counseling". By spinning this story last Sunday, FNS tried to make a link where one doesn't really exists. Tricky, Fox!

However, end-of-life counseling is important. These sensitive discussions among family and friends are most fruitful when folks are healthy and well, not when elderly are knocking on heaven's door and it's simply a second past too late. 1 out of 4 elderly above the age of 65 end their life prematurely. These same individuals visited their doctor's at least 30 days before completion. A counseling session at that time could have raised warning signs for family members and care takers. At the end of the day, those who will suffer most for the proverbial pulling of the plug on the counseling option are those least able to afford it.

With all that said, an interesting point arises regarding our own choices on end of life matters. There seems to be a thin line between suicide and dying with dignity under certain debilitating conditions. Robert Pearlman, author of "Your Life, Your Choices," seems to be straddling that line. What I find is that the pamphlet could use better question structure and word choices. Also, with additional adjustments, it could serve as great indicator for mental health flags. Maybe it was this discussion that allowed for a much needed segue to analyzing suicide rate of soldiers coming back from Iraq and Afghanistan.

Another interesting point that the pamphlet brings to light is the inquiry of your church's stand on suicide, but that's for another blog entry.

The Afterw@rd

Having A This-Ability

noreply@blogger.com (The Afterw@rd) — Sat, 15 Aug 2009 09:54:00 +0000

I was surfing through the web and found that actor Joe Pantoliano was diagnosed with Clinical Depression. He took his diagnosis and transformed it to start an organization called "No Kidding, Me too!"

The mission of the organization is to eliminate the stigma surrounding brain disorders, thereby allowing people to freely claim their this-ability and seek help. He brings his message across with humor, lightness, and depth. All the Afterw@rd can hope for.

I agree with Joey that there is power in claiming your this-ability and using the talents and creativity entrusted for the greater good. Removing the stigma is at the root of it all.

Check out this clip from his upcoming documentary trailer.

Let's all step into our greatness because of our this-abilities.

The Afterw@rd

The Passing of an Advocate

noreply@blogger.com (The Afterw@rd) — Wed, 12 Aug 2009 10:15:00 +0000

Eunice Kennedy Shriver passed away yesterday. She, indeed was, such a remarkable, trailblazing woman who lived fully and advocated strongly for those with mental health disorders.

She shared not only the Kennedy name but their fire as well in defense of those like her sister, Rosemary Kennedy, who was institutionalized from the age of 23. Eunice openly discussed how we should treat those with mental retardation, convincing the general public that those with mental disabilities can be productive members of society.

I celebrate Eunice's accomplishments and learn from her experiences.

No one need live with and bear the stigma of a mental disorder. The Special Olympics is a repudiation of fringe living and a stand for being fully present where ever you are on the mental spectrum.

Cheers, Eunice, to a life well lived.

The Afterw@rd

Surviving Versus Living

noreply@blogger.com (The Afterw@rd) — Tue, 11 Aug 2009 11:16:00 +0000

Today is Mami's anniversary of her passing. Today, I am the same age as Mami when she decided to take her life. A date I have been working towards since this blog's inception.

Before I was a survivor.

I'd survive day to day, rationalizing events occurred. I told myself medical services in the 70s were not the same as they are now. No one then knew Spanish. No one really understood what it was she had. The files have all been lost in the abyss of Bellevue. But the reality is I don't have to look too far to see the holes in the health care system.

In the end, it does not really matter. She is now gone and I know I don't have to look too far to know what plagues my family. All I can do is fight for those who still choose live.

While I have always found strength from self-created environments and supportive circles, I now see these groups as a healthy living mechanism. I separate the chaff from the wheat. I love myself enough to take care of myself. I take a bottom up approach. It's an on going project.

I review my life trajectory and see how very different it is from Mami's experience in the States. I see how our achievements differ, how proud of me she would have been, how resilient, resourceful, creative I have become. I do my best to live righteously, lovingly, honestly with all, not too different from the stories I've heard of how Mami was in life.

I feel blessed that even in my darkest hours (and there have been several), I can still see light. I stand firm on not being blind sighted ever again. I proactively move when the time is right. I rest when my body says rest. I sleep when my body says sleep. And I thrive always. I make mistakes and fail, but I make sure to review and not lose the lesson. I am so much stronger for it. I build on those experiences.

I finally feel like love can exists in my life. Her experiences are not mine for I am not her. Life is too short. In fact, love is already here. I just enjoy it when it presents itself. Love comes at just the right time. I receive it and I give it. I make sure to show others how I appreciate their effort, presence, attention and advice, recognizing, I'm not always perfect because perfect is the death of life.

Before I was a survivor.

Today, I move on to living.

The Afterw@rd

P.S. These past couple of years have been interesting to say the least. I would like to thank the following folks for their consistency, caring, and visionary inspiration:

* Rita Project
* Lois Reddick and Gamila Baptiste
* Gino Williams
* The Buckners
* My Community Group
* To all my other friends and family who took time to reach out to me and/or to listen to me when I needed a friend.

Studying Soldier Suicides

noreply@blogger.com (The Afterw@rd) — Mon, 10 Aug 2009 16:15:00 +0000

Last year, I expressed my disappointment on current soldier suicides rates.

Finally, I can start to breath a little easier. Last October, the National Institute of Mental Health and the Army have teamed up to face soldier suicides head on. They are pulling the ostrich's head out of the sand. And it sounds like more than just lip service:

The five-year, $50 million study...is an ambitious attempt to solve the mystery.

I pray that those who are in the top of their fields are working on this. I look forward to seeing the initial results.

Staying tuned...

The Afterw@rd

Depressing News Indeed

noreply@blogger.com (The Afterw@rd) — Sat, 08 Aug 2009 18:31:00 +0000

Seeing the Funny?

Early this week on Late Night with Jimmy Fallon, the introductory monologue, like always, reviewed what seemed like the Yahoo! news of the day. Fallon is still warming up to his new role, but he is much smoother now that his nerves have calmed down. For the first three days he kicked some news (without his typical dead joke wince) about how antidepressants use doubled from 1996 to 2005 and how depression had been diagnosed in kids as young as 3 years old and in second graders. The audience laughed. They must have understood. I think laughter is healthy, even if it is at yourself.

But those in the know, also know, this is no laughing matter. It's the difference of laughing at you rather than with you. Depression is a real deal with scary consequences if symptoms are left untreated. The question of the day was, what does treatment really look like? No article really touched on that.

And that's what scares me.

It's too easy to say, hey, this is just the Pharma movement looking to pump up their billion dollar sales bottomline.

More than 164 million prescriptions were written in 2008 for antidepressants, totaling $9.6 billion in U.S. sales, according to IMS Health.

I've been know to be too idealistic and naive that it hurts. I like to think that's just the wise Latina in me.

I am no doctor, but here is how I see the writing on the wall. Are we going to sit idly by as pills are popped without proper weekly supervision or talk therapy treatment with a patient. Are we all not listening to the same antidepression commercials where the fine print person comes on to say that along with bad breath, acne, constipation and dizziness, etc. that antidepressant treatment in children and young adults causes/increases depression symptoms, including suicidal idealation?

What are we to do? Well, my answer is to pass health care reform. Most people must self-select their treatments based on how much it costs them. In this day of over medication, it's just easier to pop a pill and think it will all be taken care of. (In my opinion, primary care doctors misdiagnose and thus, over prescribe antidepressants, many without really keeping up with the changes in the field of psychiatry.) We now must choose between our very health and our financial survival. In this good US of A, I just find that to be unacceptable.

And yes, I am nervous. You can even say anxious. Why? The Birther Movement, who insist that President Barack Obama was born in Kenya despite all the proof shown, have joined forces with the Swift Boat people, Dick Armey and Freedomworks.org, to kill health care reform for those 50 million people without insurance and for those who think their insurance will last forever under the status quo. All those lobbyist (yes, including Pappas from Freedomworks) are all laughing themselves to the bank. Cha-ching and bling, bling, Dick.

Either we come with it to face the Brooks Brother's protesters or we may just prematurely die or go banckrupt trying to live with the status quo, which ever comes first.

The Afterw@rd

Boy, Interruped TONITE on HBO!

noreply@blogger.com (The Afterw@rd) — Mon, 03 Aug 2009 21:16:00 +0000

I met Dana Perry, director of "Boy, Interrupted," last June 26 at the HBO premiere of the documentary in Chicago, IL. I looked into her eyes and saw a mother's pain. She is still working through the interruption. It's only logical.

The documentary film, which will be on HBO tonight with an accompanying DVD release tomorrow, tells the story of Evan Perry, Dana Perry's son, who at 15 decided prematurely to end his life. This is a story of a mother's struggle with a bipolar child. This is a story of how silence and denial doesn't out live the truth. Mental illness is real. It's genetic. Its treatable, but only if discussed. It teaches that responsibility and stigma matter. It speaks the vigilance of parents aware of a history gone unspoken.

Regina Weinreich did a very poignant interviewed of Dana and her struggles making this film. It was the Chicken Soup for her soul, yet the truth is that one never truly heals from a passing such as this.

When seeing the film, I found that stigma played a much larger part than discussed. It goes back again to the simple basics of helping people understand what it means to suffer from a disease such as this. Evan, being a manic case, on one extreme, while other milder cases hide in the shadows.

The film is a personal story. But I can't help but wonder about the millions of people who have to deal but lack the resources with which the Perry's were blessed. However, the film is definitely a start and illustration of an open wound.

I hope enough people see it and start to learn what it means to live and to die. And how an interruption affects those left behind.

The Afterw@rd

A Battle for the Soul of American Medicine

noreply@blogger.com (The Afterw@rd) — Sun, 26 Jul 2009 06:19:00 +0000

In the New Yorker, Atul Gawande told a story: It was the best of times. It was the worst of times. No truer Dickensian words were better inferred. Gawande told us the story of McAllen, Texas, a town whose doctor's got bit with the entrepreneurial bug.

"[A] medical community [who] came to treat patients the way subprime-mortgage lenders treated home buyers: as profit centers."

Gawande's article goes to the heart of the health care reform battle. He cites is as a tale of two cities: McAllen versus El Paso, Texas. Two towns with similar demographic make up and populations of about 700,000, yet significantly disparate Medicare per enrollee costs. Turns out McAllen on average charges Uncle Sam for about $15,000 per Medicare enrollee, twice their income per capita as well as twice the national average, and about half as much as what is spent in El Paso. (The data is from 2006, the best available for the analysis performed.)

Why? Because they doctor's can. The incentive pay structure is per exam performed, not for overall quality of care given. In McAllen, doctors stopped being doctor's and became business men. Are they providing better health care for all these tests? The data simply says it: no.

Providing health care is like building a house. The task requires experts, expensive equipment and materials, and a huge amount of coördination. Imagine that, instead of paying a contractor to pull a team together and keep them on track, you paid an electrician for every outlet he recommends, a plumber for every faucet, and a carpenter for every cabinet. Would you be surprised if you got a house with a thousand outlets, faucets, and cabinets, at three times the cost you expected, and the whole thing fell apart a couple of years later? Getting the country’s best electrician on the job (he trained at Harvard, somebody tells you) isn’t going to solve this problem. Nor will changing the person who writes him the check.

So what to do? Change the payer-playbook, charge for overall quality care, rather than quantity care. It goes back to a wise old saying, "patient care should always come first." So Doc, don't pay-a-hate, coordinate.

Thanks Gawande!

The Afterw@rd

Giving Meaning to Evidence-based

noreply@blogger.com (The Afterw@rd) — Fri, 24 Jul 2009 13:25:00 +0000

In this era of health "insurance" reform, everyone is looking for proof that reform is the better option than the status quo.

Social policies within the United States Armed Forces have served us well in race relations. Why not in health, particularly in suicide prevention?

The Suicide Prevention Action Network, a division of the American Foundation of Suicide Prevention, is seeking that states accurately track and evaluate health results. But what does that mean? What does that actually look like in the realm of suicide prevention?

Suicides in the armed forces are an all time high. The Defense Department is not only on notice, but finally has noticed. They are doing something about it. Proper evaluation of the prevention strategies they are executing on could potentially serve as a benchmark for other suicide prevention programs nationwide.

This is the insular, control case everyone has been waiting for.

The Afterw@rd

HEALTH REFORM NOW!!

noreply@blogger.com (The Afterw@rd) — Mon, 20 Jul 2009 13:23:00 +0000

Thank you for applying for a CareFirst BlueCross BlueShield or CareFirst BlueChoice plan. Unfortunately, your application has been denied.

Cherry-picking. That's what I call it.

I was just rejected for medical insurance. I just got out of an extremely toxic work environment. It took it's toll on me and my health. Here I am trying to love myself enough to take care of myself. But self-care comes at too high of a cost. It just sounds too much like right.

Pending recent economic factors, medical care was the number one cause of bankruptcy in America.

The route we are heading with health care in America is simply unsustainable. Here is a case for rationed health care.

I thank God and a strong grassroots movement for the passing of the Mental Health Parity Bill. But more still needs to be done to ensure that mental health checkups and proper holistic treatment is included in the health reform package.

Go to the Suicide Prevention Action Network (a subdivision of AFSP).

Scroll to the bottom of the page to Alerts and Updates.

Follow the instructions to fill in your zip code and identify your Congressional and Senate representatives to ensure the mental health care is properly included in the health reform package.

DO IT NOW!!!!

Lives hang in the balance.

What do we want? MENTAL HEALTH REFORM! When do we want it? NOW!

The Afterw@rd

If You're in New York City July 19, 2009

noreply@blogger.com (The Afterw@rd) — Fri, 10 Jul 2009 00:39:00 +0000

This seems like a awesome play to go see, "Call me Crazy: Diary of a Mad Social Worker." As a native New Yorker, the fact that the play is at the legendary Nuyorican Poet's Cafe says it all. They always drop knowledge.

236 E. 3rd St. (btnw Ave B & C), NY, NY 10009

It's only $15 bucks. Interested? Buy tickets at www.theatremania.com or call 212.352.3101. Have more questions? Email callmecrazy@HDLPoet.com

'Nuf Said.

Makes me want to go home.

The Afterw@rd

Drink Your Milk And Get Your Sun

noreply@blogger.com (The Afterw@rd) — Thu, 09 Jul 2009 14:24:00 +0000

This is something deep and worthy of consideration...

Therese Borchard writes:

I've been wondering how vitamin D and mental illness are related, so I did a search and found that vitamin D does, indeed, play a role in mental illness based on these reasons from the Vitamin D Council's website:

1. Epidemiological evidence shows an association between reduced sun exposure and mental illness.
2. Mental illness is associated with low 25-hydroxyvitamin D [25(OH)D] levels.
3. Mental illness shows a significant comorbidity with illnesses thought to be associated with vitamin D deficiency.
4. Theoretical models (in vitro or animal evidence) exist to explain how vitamin D deficiency may play a causative role in mental illness.
5. Studies indicate vitamin D improves mental illness.

Here's even more details, according to the Vitamin D Council:

* Mental illness has increased as humans have migrated out of the sun.
* There is epidemiological evidence that associates vitamin D deficiency with mental illness. Two small reports studied the association of low 25(OH)D levels with mental illness and both were positive.
* Depression has significant co-morbidity with illnesses associated with hypovitaminosis D such as osteoporosis, diabetes, heart disease, hypertension, multiple sclerosis, and rheumatoid arthritis.
* Vitamin D has a significant biochemistry in the brain. Nuclear receptors for vitamin D exist in the brain and vitamin D is involved in the biosynthesis of neurotrophic factors, synthesis of nitric oxide synthase, and increased glutathione levels -- all suggesting an important role for vitamin D in brain function. Rats born to severely vitamin D deficient dams have profound brain abnormalities.

Yikes.
***

Originally published on Beyond Blue at Beliefnet.com. Linked through Huffington Post.