“Take your pills dear.” Do we really know if they’re doing us any good? There is no control version of us not taking the meds for comparison, and if there are any benefits maybe they’re just down to the all-powerful placebo effect. According to Peter Gøtzsche in a debate in the British Medical Journal, “we could stop almost all psychotropic drugs without causing harm.” Meanwhile, new research shows that mindfulness-based cognitive therapy can be as effective or more effective for some kinds of psychological distress. Are we overprescribed? Are we at the mercy of a powerful pill-pushing pharmaceutical industry?
Anti-depressants and other psychiatric drugs do more harm than good says expert
From The Independent:
The negative effects of psychiatric drugs, including those used to treat depression and dementia, outweigh the positives, an expert on clinical trials has suggested.
Professor Peter Gøtzsche, the director of the Nordic Cochrane Centre at Rigshospitalet in Copenhagen, has argued that the “minimal” benefits of psychiatric drugs are not enough to justify the deaths of more than a million people aged over 65 in the Western world each year.
In a controversial article in the British Medical Journal (BMJ), he went on to say that drug trials do not accurately evaluate the side effects of taking many types of medication at once, and said that deaths in such trials are under-reported.
Citing a study by the US’ Food and Drug Administration (FDA), he said he estimated that there are 15 times more suicides among people than is claimed.
... “Given their lack of benefit, I estimate we could stop almost all psychotropic drugs without causing harm - by dropping all antidepressants, ADHD drugs, and dementia drugs (as the small effects are probably the result of unblinding bias) and using only a fraction of the antipsychotics and benzodiazepines we currently use,” he wrote.
He added: “This would lead to healthier and more long lived populations. Because psychotropic drugs are immensely harmful when used long-term, they should almost exclusively be used in acute situations and always with a firm plan for tapering off, which can be difficult for many patients.
With one billion prescriptions written every year, it's time to wean ourselves off the drugs
Janet-Street Porter in The Independent:
Medication has reached a shocking level in the UK: the NHS in England dishes out one billion prescriptions a year to half of the population, 2.7 million items every single day. Add to that the cost of blood tests and millions of routine exploratory procedures and you can see how the NHS could be chucking away money it can’t afford.
One reason for this surge in costs is the way the NHS is structured: hospitals receive funds based on the number of procedures they perform, and GPs get rewarded according to the number of people they diagnose and treatments they prescribe. This seems utterly misguided. Surely it encourages patients to expect miracle cures when (a lot of the time) we could be adopting healthier lifestyles and better pain management. Every time we go to the doctors we want a magic bit of paper or another appointment, instead of being more realistic.
From The Guardian:
It may be an ancient Buddhist practice, co-opted and misrepresented by celebrity practitioners, but scientists and health practitioners have found that mindfulness has specific benefits for mental health patients. The medical profession, too, is beginning to take it seriously.
Consultant psychiatrist Dr Florian Ruths explains why: “MBCT [mindfulness based cognitive therapy] is a powerful intervention –it isn’t fluffy or alternative. The MBCT course is based on solid scientific research, and Nice [the National Institute for Health and Care Excellence] has recommended it since 2005 for keeping patients with recurrent depressive vulnerability depression-free.”
Last month, research found that MBCT may be as effective as medication for treating recurrent depression, and may work even better than medication for patients with a history of childhood abuse.
The Oxford Mindfulness Centre, part of the University of Oxford’s department of psychiatry, has found that the MBCT course reduces the risk of relapse into depression by 44%. There is emerging evidence to suggest MBCT is also effective for treating generalised anxiety disorder, stress and other mental health conditions. Cancer patients have also benefitted from it.
But despite these findings, mindfulness isn’t appropriate for some patient groups as Dr Christina Surawy, a clinical psychologist, warns: “MBCT isn’t suitable for patients who are in the grip of a drug or alcohol dependency, as they won’t be able to fully engage with the therapy. Also, patients who are recently bereaved may find MBCT too overwhelming.” Ruths echoes these concerns, adding that it is not useful for patients during an episode of severe depression. These patients should wait until they recover to a mild or moderate state before engaging with MBCT.
• Mindfulness isn't going to cure our mental health crisis, and we need to stop pretending like it could (The Independent)
Surge in young people seeking help for exam stress
From The Guardian:
The number of young people in Britain seeking counselling over exam stress has increased by 200% in recent years, according to the child protection campaigners NSPCC, with worry over education one of the leading causes of concern for children.
The NSPCC said last year that its ChildLine service received record numbers of approaches from students worried about exams, with a tripling in the number of those receiving counselling over exam stress specifically.
In 2013-14 ChildLine said it received more than 34,000 approaches from young people over school worries such as revision, workloads, problems with teachers and other issues, putting education into the top 10 of most frequent concerns among users for the first time.
Where school and education was given as a young person’s main concern, more than half of subsequent counselling sessions dealt with exam stress specifically, a 200% increase compared with 2012-13.
The NSPCC also said that there were also more than 87,500 visits to ChildLine’s website over the same issue.
Cuts are 'driving people to the edge'
From The Guardian:
The day before last week’s election, leaked minutes from the meeting of a key mental health steering group, the Crisis Care Concordat, warned of an NHS “system failure” that was leading to large numbers of people in mental distress turning to A&E for help, due to inadequate community-based mental health services. Concerns were also raised about how many patients, especially young people, were being admitted to hospitals miles away from home because of mental health bed shortages.
It was a stark indication of the increased pressure on emergency healthcare over the previous five years but also, according to Mark Winstanley, the chief executive of the charity Rethink Mental Illness, a reminder that insufficient funding of mental health services for people in crisis was “costing lives”.
Winstanley, who has been in the job since October 2014, points out that despite the previous government’s promises of increased investment in mental health until 2020, budgets were cut and services “badly funded and overstretched”. With the Conservatives securing an overall majority, the situation will deteriorate yet further if firm commitments are not quickly forthcoming, he concludes. “For too many people with mental illness, going to A&E is the only way they can get care if they’re going through a crisis. In many parts of the country there are no suitable crisis services available, full stop.”
With mental health beds reduced by 8% since 2010, Winstanley warns there is no time to lose and that without action more people will have to travel miles for a appropriate care. “Even worse, thousands of people, including children, end up in police cells each year because they can’t get the treatment they need,” he says.
Mental health awareness week 2015 - a few things to keep in mind
From Yvette Caster writing in Metro:
It’s Mental Health Awareness week and the Mental Health Foundation wants us all to think about mindfulness.
This is all well and good – I’ve got nothing against people meditating on their lunch breaks or turning off their phones to appreciate their quinoa salad.
But, as someone who is bipolar, I can’t help but think there are some things that deserve the limelight more – things that everyone should be aware of when it comes to mental health.
Like the fact that, according to Mind, 75 per cent of people with mental health problems get no help at all. None.
They’re just struggling on, regardless, trying to get through every day.
Or the fact that, in its pre-election manifesto, the Conservative Party said it would increase funding for mental health care.
That’s something to look forward to, then, given that, during the last government, mental health trusts in England had their budgets cut by 8 per cent aka nearly £600million while referrals to community mental health teams increased by nearly 20 per cent.
MORE: 14 things you only know if you’ve gone mad
I work in mental health but colleagues don't understand my depression
It’s a curious paradox that the so-called caring professions can be so uncaring in the treatment of their own. Psychotherapists conduct petty, unempathic public feuds with each other. A mental health charity is ruthless with its staff. There are endless tales of cruelty by HR managers. Here a mental health nurse details a personal experience of depression—and colleagues’ reactions. From The Guardian:
It’s extremely difficult to describe the experience of depression to those who are lucky enough to have not experienced it. I’ve been a qualified mental health nurse for 20 years and have worked in various jobs in middle clinical and operational management. Yet, despite my clinical experience, I was ill-prepared for depression when it hit me in 2001. I ignored my increasingly difficult symptoms through shame until eventually I was overwhelmed. I broke down completely – and then of course everyone knew.
There are only a handful of senior managers that I feel that I can trust now. My experience of receiving services from the trust I work for is mixed. Most of the clinical care has been very good. Over the past couple of years, however, I’ve seen these core services slowly erode through budgetary restrictions. I used to be able to book directly to see my psychiatrist and therapist in a discrete social services clinic away from work and my consultant kept my case notes to protect my confidentiality. These days I have to ensure that I’m booked to be seen at my GP practice and worry that my online records will be viewed by others. During my last, and worst, breakdown I had several appointments at a hospital where I’d been a service manager. I’d made it clear that I didn’t want to be seen there but felt so wretched and desperate for help that I went. It was a demoralising and dehumanising experience. A constant flow of staff who I’d worked with walked past me. Those who saw me looked uncomfortable and didn’t acknowledge me. Having to shout through a glass screen because the receptionist couldn’t hear me left me feeling at worst like a criminal and at best like I’d hit rock bottom.
Call for international LGBT psychology and counselling standards
From the British Psychological Society:
Collaborating counselling psychologists at Regent’s University London, Dr Markus Bidell and Professor Martin Milton have called for the development of international lesbian, gay, bisexual and transgender (LGBT) psychology and psychotherapy standards.
Both academics say that LGBT people encounter serious mental health disparities that can be critically worsened by discriminatory and prejudicial LGBT policies and human rights violations.
In an international symposium at the British Psychology Society’s Annual Conference in Liverpool earlier this week, Dr Bidell and Professor Milton highlighted the psychosocial problems negatively impacting many LGBT individuals, along with the historic and current role of psychologists in addressing LGBT civil rights in the UK and US.
Most significantly, they added, prejudice and discriminatory policies in many countries are directly connected to mental health problems and civil rights violations experienced by many LGBT people.
Mental health mission for Leicestershire officer
From Leicestershire Police:
A Leicestershire Police officer is to spend the next three weeks in the USA and Canada learning about emergency response to mental health crisis, after being awarded the prestigious Winston Churchill Travelling Fellowship.
This week, during Mental Health Awareness Week, PC Alex Crisp, who is currently working in the Office of the Police and Crime Commissioner as the mental health partnership development manager, will travel to Memphis, Tennessee to meet the Memphis Crisis Intervention Team(CIT).
CIT is a specialised unit made up of police from each precinct in the area. They are called upon to respond to incidents that present officers with complex issues relating to mental health.
Alex will then head to LA to meet officers from the Los Angeles Police Department and take part in their Mental Health Intervention Training, a 36-hour intensive course that covers all aspects of mental illness and crisis intervention.
Next he will travel to Vancouver to visit an initiative very similar to Leicestershire Police’s own mental health triage car, which sees an officer and a nurse working together in a police response car to provide on-site assessment and intervention for people with psychiatric problems. Known as Car 87, the program is a partnership between the Vancouver Police Department and the Vancouver Coastal Health Authority, and has been running since 1984.
Whilst there he will also spend time with the assertive community treatment team, that takes treatments to people in the community, and the assertive outreach team - a group of nurses, social workers, psychiatrists and officers that work together to support people who suffer from addictions and mental health and help them transition from emergency department care to appropriate community services.
Finally he will spend three days in Portland, Maine with the Portland Police Department, which has a mental health coordinator who manages a behavioural health response program and facilitates crisis intervention training.
“Providing better services for those in need is a big passion of mine so I’m extremely honoured to have been given the opportunity to find out about mental health response provision in other countries,” said Alex.
Man who shot Ronald Reagan seeks release from mental health hospital
From The Guardian:
The man who shot President Ronald Reagan in 1981 should be released from a mental health hospital, his lawyer argued in federal court on Tuesday, while prosecutors said he should only be freed under tight restrictions.
John Hinckley Jr, who shot Reagan and three others, no longer suffers from the personality disorder that led him to try to kill the president, his attorney Barry Levine said during final arguments of a hearing in US district court.
“Every witness agrees that the risk of danger is decidedly low,” Levine told US district judge Paul Friedman.
Hinckley, who turns 60 this month, spends 17 days a month at his mother’s home in Williamsburg, Virginia. He spends the rest of the time at Saint Elizabeths hospital in Washington DC, where he was institutionalized in 1982 after a jury found him not guilty by reason of insanity.
A prescription for mental health in America
From Huffington Post:
The future for the next 10 years of mental health in America will not derive from sudden breakthroughs in decoding our DNA or fashioning designer drugs that are categorically different from what we have now -- though either or both would of course be welcome. A sanguine future is possible if we do what we know now a lot better (quality) and deliver what we know now to a lot more people (access).
The greatest gains we can achieve in the next 10 years in public mental health will derive from closing the gap between what we know and what we do in both mental health and the addictions. The "science to practice" gap, as it has been called, is the (hard to imagine but real) fact that advances in medical practice (in general medicine as well as psychiatry) are typically years in going from "bench (lab) to bedside."
• May is Mental Health Month: One sister's story - San Jose Mercury News
• 10 ways to protect your mental health - Marie Claire.co.uk (blog)
• 4 myths about mental health in the US - A 3-minute video from AJ+/Facebook
McCray ties mental health to income inequality
Chirlane McCray, wife of New York City mayor Bill de Blasio, on the impact of divided societies on mental health. From Capital New York:
In her latest public appearance, first lady Chirlane McCray on Monday detailed the importance of the city's mental health services in an interview with HuffPost Live.
McCray tied mental health services to broader issues of race, income inequality, and homelessness, and she reiterated her own family's struggles with mental health. Her father suffered from depression, and her daughter has admitted to using drugs to quiet her anxiety, said McCray, who called for an end to the stigma that surrounds mental illness.
McCray has raised her own profile of late to help combat that stigma.
After carefully selecting her media appearances during a quiet first year, McCray has done three interviews in the past week, including a rare question-and-answer session with New York City reporters, and an interview on NPR.
On Monday, she connected her mental health efforts to income equality, the signature cause of her husband, Mayor Bill de Blasio, who is positioning himself as a national spokesman on the issue.
“What we're doing right now with our multiple agency approach is showing how housing, education, incarceration is connected everything else,” McCray said during the HuffPost Live interview.
McCray said the nation's most pressing problem is income inequality, which compounds the difficulty many face when trying to deal with mental illness.
“It's very hard, when you have poverty on top of everything else, it's not healthy for anyone,” McCray said.
McCray also commented on racial disparities, citing a study that said African-Americans are 20 percent more likely to report a mental illness, but, she said, they also find it more difficult to access appropriate services.
"Here’s what that means in real life," she wrote in an op-ed for The Root. "Millions of African Americans suffer from a mental-health condition and do not get the treatment they need to live a full and productive life."
McCray's public relations blitz comes after the de Blasio administration announced plans to spend $54.4 million in new funding this year for mental health and social service programs. There is a promise of $78.3 million in fiscal year 2017.
The money, which is set to be funded annually through the budget, will be used to hire social workers and counselors at agencies across the city, including providing mental health services in all contracted family shelters and the city's five justice centers, which serve domestic violence victims.
Canada: ‘Sad but rad': Fashion brand aims to get people talking about mental health
A new fashion brand is trying to spark a conversation about mental health — and it starts with our clothes.
Wear Your Label's T-shirts and tank tops feature slogans like "Self-care isn't selfish" and "Sad but rad," and the founders told TODAY.com their goal is to reduce the stigma around issues like depression, anxiety and eating disorders.
"Mental illness is invisible — you can't see it," co-founder Kyle MacNevin said. "When you break your arm, you get a cast. It's a symbol to the world that something happened and you're getting better. We try to do that with our clothing. So it says, I'm going through something, but I'm working on it."
MacNevin, 22, and co-founder Kayley Reed, 21, started selling the clothes about eight months ago. They came up with the idea for Wear Your Label last year, while students at the University of New Brunswick in Canada, where they met and connected over their shared struggle with mental illness — Reed is recovering from anorexia nervosa and MacNevin struggled with anxiety disorder and ADHD.
"It was something that I was really shy about, and really reluctant to tell anyone about for a really long time," Reed said. "It wasn't until I met Kyle, who has been really open about his mental health experiences, that I became open about my experiences."
Australia: $200 voucher for troubled couples to use for relationship counselling dumped
From the Daily Mail:
In a bid to slow down Australia’s spiralling divorce rate, which sees one in three marriages end in divorce, former Social Services Minister Kevin Andrews came up with the romantic notion of giving $200 counselling vouchers to 100,000 couples who wanted advice in 2014.
However, Mr Andrews’ interest in saving married couples relationships wasn’t purely a heartfelt move – it came at the same time it was revealed divorce and family breakdowns cost the economy more than $14 billion a year.
Only around 10,000 couples actually registered for the scheme and 90 per cent of the vouchers remain unused.