Category: Health

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Failed Mental Health App Highlights Pitfalls of Social Media

00Depression, Featured news, Health, Media, Social Networking, Stress, Suicide July, 16

Source: Jayson Lorenzen on Flickr

On October 29, 2014, The Samaritans—a suicide-prevention organization in the United Kingdom—launched an app for Twitter called Samaritans Radar. Its purpose: to detect alarming, depressive, and suicidal tweets to help prevent suicide. Less than a week later, the app was suspended due to public outcry over privacy concerns.

Social media are being used increasingly for marketing and advertising, with privacy a growing issue. Many marketing apps, like Hootsuite, track users’ social media posts in fairly covert ways. Yet, when social media pits privacy against mental health, ethical conflicts are concerning.

Traditionally in mental healthcare, there are few reasons to break confidentiality between client and therapist, such as harm to self or others.

The Samaritans Radar app worked by tracking tweets from every account the individual follows on Twitter. If alarming content was found—ranging from “I’m tired of being alone.” to “Feeling sad.”—the app would notify the user by email. Along with the email, came a link to the flagged tweet, as well as suicide intervention and prevention resources that the individual could provide to the writer of the alarming content.

At the launch of the app, the organization said that:

“Samaritans Radar turns your social net into a safety net by flagging potentially worrying tweets from friends, that you may have missed, giving you the option to reach out and support them.”

The app was quickly criticized for allowing users to track people’s tweets without their awareness or consent. The Samaritans replied by highlighting that everything posted on Twitter and all the information the app uses was public, and that it was up to the app’s user to decide whether they wanted to respond to any particular tweet.

Adrian Short, who started a petition to shut down Samaritans Radar, stated that it “breaches people’s privacy by collecting, processing, and sharing sensitive information about their emotional and mental health status.”

He also noted that the app may be used by less-than-scrupulous individuals for all sorts of purposes, not just helping individuals overcome mental health issues.

The Samaritans addressed these concerns by launching a “white list,” where people could sign up if they wanted to deny the app access to tracking their account. Many did not see this as a solution since opting out would require people to be aware of the app’s existence, leaving privacy in jeopardy.

But the problem that the app was trying to address is not trivial. In the UK, where the Samaritans are based, suicide is the leading cause of death among males under the age of 35. A free mobile app could be an easily accessible way to reach out to people who are alone and lacking other forms of support.

As one of the few supporters of the app, Hannah Jane Parkinson wrote for the Guardian:

“It is estimated that 9.6% of young people aged 5-16 have a clinically recognised mental health condition. Anything that helps to better this situation is great, and particularly as it is crucial to catch mental ill health early on.”

Yet as Adrian Short and others pointed out, this same easy access also poses potential threats. Internet bullying is common, especially among vulnerable users that Samaritans Radar targeted. The app could therefore be used for nefarious purposes.

“The app makes people more vulnerable online. While this could be used legitimately by a friend to offer help, it also gives stalkers and bullies and opportunity to increase their levels of abuse at a time when their targets are especially down,” says Adrian Short.

The app was an attempt to reach out to people in need of emotional support and to raise awareness about mental health using new media. But it highlighted the potential pitfalls of such platforms for dealing with mental health concerns. While the incidence of mental health problems is concerning, putting peoples’ mental health into the hands of anyone with access to a smartphone is naïve.

Perhaps this unsuccessful launch did successfully show that a greater understanding of social media users and platforms is needed before apps like Samaritan Radar can become commonplace.

– Essi Numminen, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Russian Adoption Laws Leave Children Warehoused and Unwanted

00Attachment, Child Development, Ethics and Morality, Featured news, Health, Law and Crime, Parenting June, 16

Source: John Manuel Sommerfeld on Flickr

It is a life of deafening silence, colourless walls, and empty corridors, a life of intense longing and disappointment. For over 600,000 children living in Russian orphanages waiting to be adopted, it is the only life they know.

In 2013, Russia passed a law to ban the adoption of orphaned children by American citizens, in part because of tense political relations between the two countries. In 2014, Russia also banned the adoption of orphans into any country that acknowledges same-sex marriage in order to “protect children’s psyche from the undesirable effects of exposure to unconventional sexual relationships.”

With these measures in place, finding homes for orphans outside the country has become very difficult.

Meanwhile, adoption within the borders of Russia faces its own set of barriers. Cultural prejudice against adoption perpetuates feelings of rejection among orphaned children and contributes to fears amongst potential adoptive parents that orphans have inherited undesirable traits and tendencies from their biological parents.

As one adoptive parent, Vera Dobrinskaya, stated in a BBC interview, many orphanage staff members discourage adoption when meeting with prospective parents. She quoted a nurse as saying to her, “Their parents abandoned them, and you want to take care of them?”

Unlike orphans in other countries, 95% of Russian orphans have at least one living parent. Often, they are taken forcibly into state custody because of family illness, disability, or poverty.

While institutions manage to provide for children’s basic physical needs, most Russian orphanages fail to take mental health into consideration. Research has shown that mass institutionalization and the absence of regular adoption practices harm children’s health and development.

To make matters worse, the interaction of staff members and children in these facilities is minimal and conducted in a formal manner, with little warmth or emotion. Daily activities like waking up, showering, dressing, and feeding are carried out in a militaristic way.

As the BBC explains, the problem of Russian orphanages is mainly in their self-identification as warehouses for unwanted children.

Georgette Mulheir, an advocate in the movement to end child abuse, explains why mental health neglect is a problem for these children in a recent TED Talk. While visiting a Russian orphanage, Mulheir reported seeing rooms lined with rows of barred beds, with children quietly gazing up at the ceiling. Newborns also lay in silence, often wearing soiled diapers but not crying, unfamiliar with the help that comes from attentive caregiving. And the head nurse proudly told Mulheir, “You see, our children are very well-behaved.”

Lacking proper stimulation and without secure attachment, many children develop odd and often self-injurious behaviours, such as rocking back and forth or banging their heads into walls. Just as healthy attachment between children and caregivers provides a sense of security for psychological, emotional, and physical development, lacking appropriate caregiving can seriously damage mental health.

As Stephen Bavolek, in the field of child abuse suggests, some of the problems these children can expect as they grow up include poor impulse control, impaired foresight, and a lack of trust in and affection for others.

Several months after the Russian adoption bans were implemented, the United Nations held a meeting to develop alternate childcare programs. Local governments within Russia were instructed to begin transferring children from orphanages to foster families.

This process, however, has encountered resistance from the institutional staff. As child rights protection activist, Maria Ostrovskaya, explains, “Institutions reject sending children into families, as state funding brings jobs and paychecks.”

The situation remains unresolved while many thousands of children wait for politicians to decide their fate. The stakes are high, as many of the children grow up with a risk of being sold into slavery, committing crimes, entering prostitution, or taking their own lives.

– Sara Benceković, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Plastic Surgery to Cope With Bullying?

00Addiction, Bullying, Child Development, Depression, Featured news, Health, Self-Esteem June, 16

Source: Aimee Heart on Flickr

Looks matter. Focusing on appearance is nothing new. And the growing popularity of plastic surgery has, to some extent, normalized changing our bodies to fit our ideals.

But how do we understand the limits, especially where children are concerned?

In 2014, fifteen-year-old Renata underwent nose and chin surgery to put an end to the constant bullying she was facing at school.

The teasing had become so bad that Renata was homeschooled for three years. And while she says that she is happy with the end results, there was great concern raised at the time by parents, health professionals, and the public over the surgeries.

Experts are split on whether children can benefit from undergoing plastic surgery to avoid bullying. But it should be acknowledged that Renata’s story is not that uncommon.

Fourteen-year-old Nadia Ilse, as well as 7-year-old Samantha Shaw, both had surgery to pin back their ears in response to bullying. They had the operations done for free by the Little Baby Face Foundation, a non-profit organization dedicated to correcting facial deformities of children from low-income families. Founder Thomas Romo tells NBC News that such procedures can have a positive impact on a child’s functioning:

“You take a child, and you change the way they look. To anybody who sees them, they’re good looking. That gives the child strength. We can’t go after the bully. But we can try and empower the children.”

A study by the Department of Psychology at the University of the West of England supports the idea of this kind of surgery, which can have a positive impact on mental health. In a pre- and post-operation comparison of 51 plastic surgery patients and 105 general surgery patients, the plastic surgery group experienced a greater decrease in their depression and anxiety.

But the extent of these positive results is questionable.

Over the course of 13 years, the Norwegian Social Research Institute studied body satisfaction in over 1,000 adolescent females, 78 of whom underwent cosmetic surgery. They found that although satisfaction with the specific body parts that were operated on increased, overall body satisfaction did not improve. Furthermore, participants who underwent cosmetic surgery had an increase in depression, anxiety, and substance abuse compared to those who had no surgery, suggesting that the positive mental effects of plastic surgery are localized and short-lived.

Child psychologist Nava Silton also tells Fox 9 News that plastic surgery could be covering up underlying emotional or mental health issues that a child might have, such as low self-esteem. Unaddressed emotional issues could lead to a plastic surgery addiction in adulthood.

Currently, there is no pre-surgery screening process for mental health issues. The American Board of Plastic Surgery (ASPS) recommends children only have plastic surgery if they understand the benefits and drawbacks, do not have unrealistic expectations, and initially requested the plastic surgery themselves. Yet media personality Laura Schlessinger questions a child’s ability to demonstrate such qualities, noting the importance of parents in guiding their children towards better decisions:

“Children, by virtue of their lack of maturity, may have exaggerated notions of how these procedures will improve their lives.”

Still, Renata insists that surgery was the right choice for her—one that she says boosted her confidence enough to return to school.

Children of different ages and different cognitive abilities vary in their ability to appreciate what they are getting themselves into, but wherever possible, it’s important to help them be realistic about the anticipated consequences of a surgical procedure that will change them permanently.

– Anjali Wisnarama, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Mental Health Initiatives for Athletes Still Lacking

00Depression, Featured news, Health, Media, Sport and Competition, Teamwork, Therapy May, 16

Source: Charis Tsevis on Flickr

Canadian NHL teams’—including the Toronto Maple Leafs—third annual Hockey Talks was a month-long initiative to discuss mental health issues and treatment. Athletes and mental health professionals gathered to discuss the stigma and stereotypes associated with mental illness and disability.

One stereotype pertains to professional athletes themselves. The suicide of Toronto-born OHL player Terry Trafford and the suicides of other players in the NHL, as well as retired NHL goaltender Clint Malaschuk’s recovery after his battle with depression, posttraumatic stress disorder, and alcoholism, show that even professional athletes are not immune to mental illness.

Research by Lynette Hughes and Gerard Leavey at the Northern Ireland Association of Mental Health in Belfast, Northern Ireland, shows that athletes may be more vulnerable to developing mental illness than the general population. Results from their studies show that increased risk stems from pressure to perform, and from the variability in healthcare and diagnostic standards between sports psychologists, who are routinely employed by professional sports federations to work with players. But sports psychologists often target only those issues that will improve athletic performance, not overall mental health.

Alan Goldberg, a sport psychology consultant for the University of Connecticut (UConn), says that athletes often work with professionals to overcome problems on the field. Based on his work with the Huskies Hockey program at UConn, Goldberg thinks that players often have trouble communicating with teammates, controlling their temper, or motivating themselves to exercise. They can become anxious or lose focus during competitions, which may lead them to choke at key times.

Big teams can fall prey to these issues as well. The Toronto Maple Leafs’ former coach, Ron Wilson, accused hockey-forward Phil Kessel of being emotionally and physically inconsistent, crippling his performance and hurting his relationships with teammates.

According to Goldberg, sport psychologists focus on helping players enhance performance, cope with pressures of competition, recover from injuries, and keep up exercise routines. But players are more than the sport that they play.

Media scrutiny of players’ behavior, strain on personal relationships from frequent travel, public criticism of their performance, and intensive training regimes can all take a toll on physical and mental health. The problem is, these issues are rarely addressed by sports psychologists.

Treating depression, anxiety, and substance abuse, which are the most common mental illnesses among hockey players, is not in the job description of sport psychologists or exercise professionals hired to work with athletes. Instead, the focus of both athletes and support staff, is on winning. According to Goldberg:

“The overall goal of the sport psychology professional is to enhance the player’s game on the ice. To make them a better teammate and a better performer who can win games and championships.”

And the work schedules of professional athletes—including travel and time away from home—make it hard for them to seek out psychotherapy with psychologists outside the team. As a result, they are left with no access to care.

The mental health programs that do exist, such as the NHL’s Substance Abuse and Behavioural Health Program which help players cope with the use of performance-enhancing drugs, still focus more on the sport than on athletes’ lives. Yet newer initiatives like Hockey Talks have shown more promise.

Giving fans, players, and coaches a chance to voice their thoughts on all forms of mental illness and remove the stigma of professional athletes experiencing mental health problems can be exactly the push professional sports associations need to start providing athletes with the care they require.

Only by realizing that athletes have lives and cares outside of their professional sports can we begin to address mental health needs holistically.

– Veerpal Bambrah, Contributing Writer, The Trauma and Mental Health Report 

– Chief Editor, Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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RUSH Prevention Program Helping Children of Bipolar Parents

00Bipolar Disorder, Emotion Regulation, Environment, Featured news, Health, Parenting, Stress, Therapy May, 16

Source: Rolands Lakis on Flickr

“It was just kind of not knowing what you were going to get every time. Emotionally when I was younger, I always cared about her. She was my mom. As I grew up, I kind of became disconnected because I didn’t know the real her. I only knew her from her diagnosis. I only knew her emotions. I didn’t know the real her.”

– Steven, child of a bipolar mother.

In 2004, the World Health Organization named Bipolar Disorder (BD) the seventh-leading cause of ‘disease burden’ for women between 15 and 44, a measure that combines years of life lost to early death and years lost to living in subpar health. Public Health Agency of Canada reports that BD occurs in one percent of Canadians, and their reported mortality rates are two to three times greater than the general population.

The disorder is marked by alternating periods of manic euphoria and intense depression. In a manic state, people experience elevated moods, racing thoughts, and sleeplessness, in addition to overspending and engaging in risky sex. The depressive phases make for overwhelming feelings of sadness, withdrawal, and thoughts of death and suicide.

Research has related BD to aggressive behaviour, substance abuse, hypersexuality, and suicide. But more recently, studies have been showing the kinds of challenges faced by children of those diagnosed with the disorder.

The Pittsburgh Bipolar Offspring Study reports that children of bipolar parents are 14 times more likely to develop bipolar spectrum disorder. Children of two bipolar parents are at an even higher risk.

And these children are also more vulnerable to psychosocial problems. A study by Mark Ellenbogen at Concordia University finds them at greater risk for problems with emotional regulation and behavioral control.

Ellenbogen and colleagues have explained how stressful home environments can alter biology to influence mood disorders in adolescents and adults.

In an interview with the Trauma and Mental Health Report, Ellenbogen stated that OBD individuals (that is, offspring of parents with bipolar disorder) show higher levels of daytime cortisol, a hormone that is released during times of stress. OBD are psychologically more sensitive to stresses in their natural environments.

“We have found that high cortisol levels in offspring may represent a biomarker of risk for affective disorders, particularly in vulnerable populations like the OBD. We believe that these changes in cortisol levels can be linked to stress, inconsistent parenting practices and disorganization in the family environment.”

Reducing the stressors in early childhood may help decrease elevated levels of cortisol, and ward off the development of BD and other problems.

Recognizing the need for early intervention, Ellenbogen initiated a pilot prevention program, Reducing Unwanted Stress in the Home (RUSH), which targets bipolar parents and their vulnerable children between six and eleven.

An assessment measures salivary cortisol, looks at the family environment, and evaluates the child’s behaviour. Then parents and children participate in weekly sessions.

With parents, the focus is on improving communication and problem-solving skills, and increasing structure and consistency in the home. With children, they teach skills for understanding and coping with stress through age–appropriate exercises and educational games.

“The goal of the RUSH program is to prevent the development of affective disorders and other mental disorders by intervening in families well before these serious mental disorders begin. That is, this is a prevention program for children at high risk of developing debilitating mental disorders.”

To date, children and parents have been responding well, but the research is ongoing.

Programs like RUSH aim to prevent the development of mental illness in vulnerable youth. And an ounce of prevention can mean a whole lot to quality of life down the road.

– Eleenor Abraham, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Killing the American Hero, Killing the Fair Trial

00Attention, Featured news, Health, Law and Crime, Media, Post-Traumatic Stress Disorder, Psychiatry, Psychopathy April, 16

Source: Quadraro on DeviantArt

Was he “insane” or not? That is the question jury members in Erath County, Texas addressed, on February 25th, 2015, during three hours of deliberation in the Eddie Ray Routh case.

Routh, a veteran of the Iraq war, was convicted of murder after he shot two fellow veterans, Chad Littlefield and Chris Kyle, who was famously known as the most prolific sniper in American history and whose memoir inspired the blockbuster film, American Sniper. Kyle, who worked to help veterans cope with post-traumatic stress disorder (PTSD), was asked by Routh’s mother to see if there was anything he could do for her son. When Routh, Littlefield, and Kyle went to a shooting range—a routine practice used by Kyle to help veterans ‘blow off steam’—Routh opened fire, killing both men.

Routh’s defence lawyers pursued an insanity plea, citing a diagnosis of paranoid schizophrenia as the reason for his actions.

According to section 8.01a of the Penal Code of Texas, an individual may successfully plea not guilty by reason of insanity if evidence proves that at the time of the incident, the accused, as a result of “severe mental disease, did not know that his conduct was wrong.” Citing a police interrogation that took place after the incident—not before, as outlined by law—where Routh answered that he knew what he did was wrong, prosecutors argued that the defense was invalid. The jury agreed, and Eddie Ray Routh was sentenced to life in prison with no chance of parole.

Decisions in so-called insanity cases are often controversial. Routh’s case calls into question the legal system’s impartiality and treatment of mental health issues, in particular.

The case was widely publicized for its duration, which coincided with the release of American Sniper. The film was highly acclaimed and portrayed Chris Kyle as a hero, especially for the townspeople in Erath County. Typically, when a jury from a particular area is likely to be biased, it is common practice for defense lawyers to move the trial outside the district in which the crime was committed. In Routh’s case, this motion was denied, despite some jurors even admitting to having seen American Sniper before making their decision.

In addition to lacking impartiality, the Texas court also failed to properly account for Routh’s mental health.

Routh was diagnosed with paranoid schizophrenia by a psychiatrist prior to the incident at the shooting range. His medication was found when police raided his home. According to Routh’s family and friends, he had also experienced episodes of aggression, irritability, suicidal thoughts and attempts, and psychotic episodes. These episodes consisted of extremely erratic delusions ranging from vampires and werewolves, to him believing he was God and Satan.

But the insanity exclusion in Texas does not take a holistic view of an individual, instead using narrow and limiting language to define insanity. While Routh may have agreed that his actions were wrong after the event, there is no way to know what he was experiencing throughout. And if his previous psychotic episodes are representative, he may have been psychologically removed from reality at the time of his actions, possibly believing he was acting to save his own life.

Some argue that Routh and others like him should still be held responsible for their actions, despite their mental health problems. But, what many do not understand, is that being found not guilty by reason of insanity does not mean the individual walks free. In many cases, such a verdict could lead to extremely long detention in a psychiatric institution, where individuals are kept under close watch as they undergo treatment for their disorder.

In refusing to accept Eddie Ray Routh’s insanity plea, the Texas legal system is doing more than just punishing an individual who may not have been aware of his own actions, they are also denying treatment to a seriously ill person. At this rate, many mentally ill individuals will continue to be punished for actions they did not intend or understand, never receiving treatment and never having a chance to recover.

For more details about the Not Criminally Responsible Defense (as it is known in Canada), see our article entitled Myth Busting the Not Criminally Responsible Defence.

– Alessandro Perri, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

Autism, Bullying, and Psychological Impacts

An Ice Bucket, an Autistic Child, and a Cruel Joke

10Autism, Bullying, Child Development, Ethics and Morality, Featured news, Health, Law and Crime February, 16

Source: Lee Morley on Flickr

A social media campaign aimed at raising awareness for one health problem becomes the cruel vehicle by which awareness is raised for another.

On August 18, 2014, a 15-year-old autistic boy in Bay Village, Ohio was encouraged by five teenage friends to participate in what he thought would be the ALS ice bucket challenge. Instead, the teenagers dropped a bucket of urine, feces, and tobacco spit on his head. When the boy’s parents found a video of the prank on his phone, they immediately took it to Fox 8 News to show how children with mental illness can be victimized.

The video went viral and was met with outrage by the general public and heralded as a disgrace to the purpose of the ALS Association’s campaign.

In an interview with Fox 8 news, the boy’s mother identifies herself as Diane to protect her son’s identity:

“The bucket challenge is supposed to be raising awareness for this disease and now they’ve turned it into a sick joke. I just can’t understand why kids would do something this cruel.”

But there is nothing that can’t be used to bring about suffering, especially when the victim is an easy target.

In a study by Benjamin Zablotsky of Johns Hopkins Bloomberg School of Public Health and his colleagues, 1221 parents of children with Autism Spectrum Disorder were asked to enroll in the Interactive Autism Network (IAN) and asked about their child’s history with bullies at school. The results showed that 63% of autistic children experienced victimization by their peers at some point in their lives and that 38% were bullied in the past month. An extreme finding when compared to the average bullying rate of 20-30% reported by students in general.

The study also revealed that autistic children in regular classroom settings with peers who do not have ASD are more likely to be bullied than children who are placed in specialized educational settings.

Catherine Cappadocia, a doctoral student, along with psychologists Jonathan Weiss and Debra Pepler in the faculty of health at York University, has studied the effects of bullying on the development of autistic children. She found that autistic children who have parents with mental health issues are three times as likely to become victims, especially at a young age.

Speech difficulties also serve to increase the risk of being bullied. For autistic children who are unable to express themselves to the offenders or to authorities, victimization can become unavoidable.

A combination of many of these factors may be what led to the victimization of Diane’s son. Yet what makes this issue more disturbing is that the five juveniles responsible claimed to be his friends.

Bay Village’s County Prosecutor, head of the office’s Juvenile Division said: “The victim and the five charged juveniles were and are friends and classmates. They regularly associate with one another and, at times, engage in distasteful and sophomoric pranks. However, this incident is clearly different. It crossed a moral and legal line, and even the five alleged perpetrators understand that and have expressed regret.”

Three of the boys involved in the prank were charged with two counts of delinquency, assault and disorderly conduct. The remaining two perpetrators were charged with a single count of disorderly conduct.

Researchers Vicki Bitsika and Christopher Sharpley have shown that a large number of children with ASD often have few or no friends and spend most of their free time at school alone. Around 40% of these children have also said that the few people they believe to be their friends tend to bully them too.

Bitsika and Sharpley also explain that this harassment can create a positive feedback loop, slowing healthy development and increasing autistic children’s difficulty displaying emotions and communicating with others.

For autistic children to grow up in a healthy environment, schools, parents, and children need to be educated not only about bullying, but about autism itself.

– Afifa Mahboob, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

Female Inmates and Psychological Impacts

Prisons Perpetuate Trauma in Female Inmates

40Bullying, Featured news, Health, Law and Crime, Post-Traumatic Stress Disorder, Therapy, Trauma January, 16

Source: r. nial bradshaw on Flickr

In May 2012, the Equal Justice Initiative (EJI) filed a complaint with the U.S. Justice Department for maltreatment of inmates in Alabama’s Julia Tutwiler Prison for Women. EJI urged an investigation of the Alabama Department of Corrections, claiming they fail to protect inmates from sexual violence.

After an on-site inspection, federal investigators confirmed allegations that officers were frequently engaging in sexual violence against inmates.

Instances of repeated rape, sodomy, fondling, and exposure were reported.

According to its website, “The mission of the Alabama Department of Corrections is to confine, manage and provide rehabilitative programs for convicted felons in a safe, secure and humane environment.”

But the reality of the modern prison system paints a very different picture.

Allen Beck, Senior Statistical Advisor for the Bureau of Justice Statistics (BJS) reported that “of the 1.4 million adults held in prison, an estimated 57,900 said they had been sexually victimized.” Statistics of abuse in local jails are similar.

Even more startling is a report by the BJS stating that 49% of nonconsensual sexual abuse in prisons involves staff sexual misconduct or sexual harassment toward prisoners.

Among those who experience the most damaging effects of sexual abuse are female inmates with preexisting mental health disorders or past trauma. These women make up a large number of prison inmates.

Charlotte Morrison, a senior attorney with the EJI, explains that to participate in the prisons’ rehabilitative programs, women are required to go through an invasive strip-search in front of male officers each day, a distressing experience for any woman, but especially difficult for those with a history of trauma or abuse.

And mental health services in prisons are either nonexistent or inadequate in supporting prisoner needs. BJS found that only 22% of prison abuse victims receive crisis counseling or mental health treatment.

The consequences are devastating. Higher rates of posttraumatic stress disorder, anxiety, depression, and suicide are frequently reported in female inmates, as well as exacerbation of preexisting psychiatric disorders.

“The key takeaway here is the levels of impunity in detention facilities” says Jesse Lerner-Kinglake, spokesperson for Just Detention International. Prison guards are often exempt from any punishment after assaulting or sexually abusing prisoners.

According to the BJS report, only 46% of sexual assault cases between staff and prisoners were referred for prosecution. In about 15% of cases, staff members were allowed to keep their jobs.

Lerner-Kinglake goes on to say that women underreport abuse because of limited legal options, and because they fear segregation and retaliation by staff.

In 2003, the Prison Rape Elimination Act (PREA) was passed into law to analyze the incidence and effects of prison rape and to provide resources, recommendations, and funding for protection. Yet a decade later, abuse persists and statistics have barely improved.

This may soon change, however, as May 15, 2014 marked thedeadline for U.S. states and territories to submit certificates or assurances agreeing to comply with PREA standards. Those not following PREA regulations face potential reductions in grant funding.

While the U.S. government is finally enforcing prisoner safety laws, inmates still suffer from limited access to mental health services.

Many organizations recognize the limitations of the prison system and work to make these services available to prisoners. For example, Just Detention International (JDI), a health and human rights initiative, provides prisons with links to community hotlines and crisis counseling for rape victims. Public ads from such organizations are also being aimed at addressing the stigma surrounding prison rape.

While these may be positive steps to improve prisoner safety, further advocacy and legislation is necessary to protect inmates’ legal rights and to facilitate rehabilitation.

– Eleenor Abraham, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

South Koreans Use Suicide to Preserve Honour.

South Koreans Use Suicide to Preserve Honour.

10Depression, Embarrassment, Featured news, Health, Stress, Suicide, Therapy December, 15

Source: Tanla Sevillano on Flickr

The suicide of a celebrity comes as a shock to fans. In the wake of Robin Williams’ death, there was an outpouring of grief. But suicide, like many aspects of mental health, varies across cultures. In October 2008, one of South Korea’s leading actresses and national icons, Choi Jin-Sil, hanged herself.

The importance of honour in Korean culture is evident throughout Choi’s story. She often spoke of the stigma of being a divorced, single mother in the public eye, which a national entertainment columnist likened to having a personality disorder. The divorce itself was a result of domestic abuse, yet a court cited Choi’s “failure of her contractual obligations” and inability to “maintain dignity and proper social and moral honour” in its ruling.

Choi’s death was only the beginning. It led to a wave of sympathy suicides in 2008, causing a 70% increase in suicides that October. In March 2010, Choi’s younger brother killed himself by hanging, and her ex-husband also hanged himself in January 2013.

This rash of suicides is exemplary of a common Korean belief: Psychological treatment is viewed with skepticism. An interview withKyooseob Ha, a psychiatrist with Seoul National University of Medicine, describes how Koreans are averse to seeking therapy, even for severe depression. Admitting to depression is seen as a character failure, shameful to the family. It is often concealed.

The same cultural norms dictate that preserving family reputation is paramount. Families asked about their loved ones who suffered from depression and committed suicide do not wish to speak about it. A common saying, “do not kill the person twice,” means that even if the person is gone, his or her “public face” can still be ruined.

Psychologist Hyong-soo Kim at Chosun University says this public face holds such sway that even in cases where people choose to see a therapist, Koreans will pay in cash to avoid their insurance companies finding out.

Research by psychiatrist Dae-hyun Yoon, at Seoul National University and the Korean Association for Suicide, shows that Koreans are more likely to seek the aid of a priest, psychic, or room salon (where a female bartender or hostess will listen to problems) than a professional therapist. Westernization hasn’t extended to mental health.

At the same time, Korea’s depression rates continue to rise and 80-90 percent of suicides are related to depression.

Refusal of professional treatment, along with wide public acceptance of suicide may be why South Korea was ranked by the Washington Post in 2010 as having the world’s highest suicide rate(in 2014, it ranked third-highest, following Greenland and Lithuania).

This has motivated South Korea’s government to develop intervention programs such as jump-barriers on bridges, glass doors along subway platforms, and 24-hour government-funded suicide hotlines. Though progress has been slow, some Koreans believe the traditional mindset to be flawed.

Currently, the Korean government is increasing funding for mental healthcare and suicide awareness. Online monitoring has led to the closure websites that encourage people to kill themselves. Gramoxone (a pesticide that was a common means of committing suicide) is now banned in Korea. And an expanded state pension system, as well as aid from major corporations, are giving less fortunate individuals the ability to access mental health services they could not previously afford.

Turning traditional ideals on themselves, public service messages now emphasize that the shame of a loved one committing suicide outweighs whatever circumstances led them to consider suicide in the first place. They focus on the idea that honour can be regained by living.

Local therapists know first-hand the values and lifestyles of their clients, and culturally based therapeutic approaches are key to curbing South Korea’s suicide rate. In a country where honour is tantamount to life, solutions must build on tradition, not break it.

– Olivia Jon, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

Laughing at Mental Illness?

Laughing at Mental Illness?

10Addiction, Bias, Creativity, Depression, Embarrassment, Featured news, Health, Humor, Laughter, Self-Esteem December, 15

Source: Fractured-Ray on DeviantArt

Whether chuckling at a New Yorker cartoon or an episode of South Park, there is nothing wrong with a bit of laughter. But certain topics are off limits.

Depression, anxiety, psychosis. Is it ever okay to laugh at mental illness?

Many mental health advocates say that mental illness is never a laughing matter. This view was reflected in public outcry after a2013 McDonald’s ad showed an apparently depressed woman with the caption, “You’re Not Alone. Millions of people love the Big Mac.” The helpline under the ad connected callers to the McDonald’s head office. The fast-food giant faced tremendous backlash and quickly pulled the ad, apologizing to those they offended.

Psychologist Howard Samuels, founder of The Hills Treatment Centre in Los Angeles, says that when we laugh at mental health issues, we lessen the seriousness of the condition and dehumanize sufferers. He cites the example of former Toronto Mayor Rob Ford, whose substance abuse made for numerous jokes, ridicule that may have delayed his decision to seek treatment.

But Janine Hobson (name changed), a stand-up comedian for Vancouver’s Stand Up For Mental Health (SMH) and Toronto’s Laughing Like Crazy (LLC) disagrees. To her, the acceptability of finding humour in mental illness depends on who is making the joke and why. Does the person have a mental illness, and is the humour playing down the condition or helping that person connect to others?

According to Janine, a sufferer of bipolar disorder, SMH and LLC help people with mental illness overcome their conditions. As part of the two programs, participants come up with a comedy routine based on their experience with mental illness and the mental health system, performing their sketches in front of live audiences.

David Granirer, the founder of SMH and Janine’s trainer, thinks that comedy gives people with mental illness a powerful voice and helps reduce stigma and discrimination around these issues.

“People with mental illness suffer from the effects of misplaced public perceptions,” states Janine. “What do people think of the mentally ill? They’re dangerous, they’ll fly off the handle and kill you.People are afraid. The other myth is that mental illness is a symptom of a weak personality. When you have mental illness there’s a lot of shame.”

Proponents say that comedy diffuses shame and fights stereotypes. Addressing mental health issues through humour improves communication and creates a meaningful and memorable dialogue about the impact of mental illness on individuals and communities. At the same time, people with severe mental illness performing stand-up comedy—a daunting prospect for most—empowers sufferers and shows that mental illness does not have to be a handicap.

Although not a substitute for treatment, laughter can be a way for people to feel better about themselves and embrace their conditions while educating others.

“It’s a way of giving power and hope back to people like myself who are going through the system and have felt so disempowered over the years, which is so important to keeping someone spirited against the obstacles they face related to their illness,” claims Janine.

Research studies on laughter appear to support these views, showing that humour is related to the development of a positive and realistic self-concept, higher self-esteem and self-worth, and more positive emotional responses to stress. Humour that is good-natured, integrating, and non-hostile is associated with higher self-esteem and competence in interpersonal settings, and more positive feelings.

Janine emphasizes that participants of the SMH and LLC programs focus on their own experiences and make light of their ownproblems (as opposed to belittling or sensationalizing mental illness).

So, can we laugh about the frightening symptoms of schizophrenia? Hard to know, the answer depends on context. At its best, humour creates partnership, hope, and open-mindedness. At its worst, it triggers ridicule and bullying.

The difference is as thin as the line separating comedy and tragedy.

– Veerpal Bambrah, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today