Category: Loneliness

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Staffing Shortage Underserves Long Term Care Residents

10Aging, Cognition, Dementia, Featured news, Health, Loneliness, Social Life February, 17

Source: Chris Marchant on flickr, Creative Commons

In the summer of 2014, I volunteered at a long-term care facility (LTC) in the Peel Region of Southern Ontario. Most of the residents who lived there were diagnosed with some form of cognitive impairment, primarily dementia. I saw first-hand the unfortunate reality of understaffing, and how it leads to deficits in patient care.

As the elderly population has grown, Ontario has seen a 22% increase in admission rates of LTC residents as of 2014. And the number of residents with cognitive impairments is especially high. According to the Ontario Long Term Care Association’s 2014 annual report, 62% of residents have Alzheimer’s disease or another form of dementia resulting from stroke, developmental disability, or traumatic brain injury.

Patients with cognitive impairments may have other mental health disorders as well. The Canadian Institute for Health Information (CIHI) indicates that 25.9% of residents in Ontario long-term care homes have shown symptoms of depression through 2013 and 2014.

In my time volunteering at the LTC, I noticed that residents often refrained from socializing because they were unable to take part in events due to memory deterioration, speech issues, and physical ailments such as paralysis or arthritis. Most residents required staff to transport them from one place to another and though they worked hard to support residents, there were simply not enough staff to supervise these daily activities.

Jane (name changed for anonymity), the Supervisor of Activation at an LTC in the Peel Region, spoke to the Trauma and Mental Health Report about this issue. Jane is responsible for organizing activities that motivate elderly residents to engage in social interaction and improve cognitive well-being.

Jane agreed that one of the biggest challenges for LTCs is staffing:

“Year by year, the case load of different residents is increasing, but with such little funding we do not have enough staff to support their needs. If residents aren’t participating in daily events and activities, their cognitive functioning is negatively impacted.”

A University of Ottawa study found that between the years 2000 and 2010, over 60% of residents with multiple cognitive deficits lacked stimulating therapeutic activities and social support. It showed that while residents received sufficient assistance with physical needs, such as feeding and changing, cognitive functioning continued to worsen in areas like memory and attention.

Jane also explained that despite research emphasizing the importance of activities that are engaging, staffing shortages make it difficult for these activities to be held in LTC homes:

“We need more activation staff for art therapy, music therapy and physiotherapy as these activities are beneficial to residents’ cognitive functioning. However, many activities are cancelled or postponed because of a lack of staff to facilitate the activities and monitor the residents. A few years ago, residents only needed one staff member or nurse for assistance, now they need two or more people. Sometimes, they’re left waiting for support.”

But perhaps the real issue here is funding. Adequate funds are necessary to increase the amount of staff within LTCs, so that residents can develop social relationships, participate in interactive activities, and improve their cognitive functioning and capabilities. Jane agrees:

“Funding hasn’t increased yet the resident conditions are changing and they require more care. The caseload is increasing, with little funding.”

Funding should also be allotted for appropriate staff training. LTC residents with cognitive impairments have a unique set of needs. According to the University of Ottawa study, residents require assistance in areas such as memory retention and engaging in regular social activities to help them interact and feel like recognized members of their community.

Making use of mental health first aid programs, such as the workshops offered atConestoga College and the Baycrest Health Sciences’ Geriatric Mental Health Serviceconference, can go a long way in improving the services staff provide.

As a past volunteer for an LTC home, I have seen the impact of limited support on residents’ lives. Greater funding and more staff to facilitate therapeutic activities are crucial to optimizing the care residents receive and to ensuring better cognitive functioning.

–Afifa Mahboob, 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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Sexual Freedom: Only Part of the Equation for LGBTQ Refugees

00Anxiety, Embarrassment, Featured news, Loneliness, Resilience, Sexual Orientation, Stress July, 16

Source: Eric Constantineau on Flickr

Montgomry Danton is a gay man from the Caribbean island of Saint Lucia. In June 2014, he fled persecution in his home country to claim asylum in Canada because of his sexual orientation. By September 2014, he had been granted refugee status under the Immigration and Refugee Protection Act of 2002.

Leading up to his official hearing at the Immigration and Refugee Board, Danton experienced the fear and anxiety common to many LGBTQ asylum seekers. He reported feeling isolated and depressed, being unable to sleep or eat, and experiencing thoughts of suicide. At one point, Danton wanted to give up and return home to Saint Lucia, despite the danger this would have posed to his life.

One might imagine that after a successful refugee hearing, the difficult part would be over. It would be time to start building a new life in Canada. But for Danton, and others like him, the struggle to become established in a new country can be as stressful as the claims process itself. In an interview with the Trauma and Mental Health Report, Danton said:

“It was a relief to know I can actually stay in Canada to be who I really am and be comfortable with myself and also my sexuality. People think coming to Canada is a good thing, you know? But you have to prepare for challenges.”

Some challenges are broad, ranging from finding affordable housing, to gaining employment, to securing basic necessities like food and clothing. But others are more specific to individual circumstances, including language barriers and cultural unfamiliarity.

LGBTQ refugees, in particular, may continue to experience social isolation, perpetuating a sense of danger and persecution. Individuals who have undergone physical and emotional trauma may not be able to move past their experience and attain a sense of personal safety until they establish a support system in Canada.

For Danton, building a new life has been stressful, edging him back towards the depression he experienced during the refugee claims process, and before that, in Saint Lucia:

“There are certain times I just wish I was back home because if I was back home I would be comfortable living my life.”

He, like many others, has been struggling with the concept of ‘home.’

In Saint Lucia, Danton did personally meaningful work as an outreach officer for the LGBTQ organization, United and Strong, and lived with his partner. In Canada, he is unemployed, has moved four times since his arrival, and has been dependent on the assistance of acquaintances and friends.

“In Saint Lucia, if it was safe for me to be who I am, to show that I’m gay, I wouldn’t think about coming to Canada. I would have stayed.”

For Danton, and for other LGBTQ asylum seekers, safety, security, and freedom of expression are only a few aspects of a meaningful existence. As a refugee, he has had to sacrifice many other significant parts of his former life, which is a common tradeoff for many in his position.

And the choice between freedom of sexual expression and stable housing and employment is an unimaginably difficult one to make, as is the choice between safety from persecution and the comforting presence of friends and family back home.

Still, Danton emphasizes his gratitude and appreciation at being granted asylum. He is happy to feel safe, to be far from the persecution he experienced on a daily basis in Saint Lucia, to be accepted into a country like Canada where he hopes to reclaim his life.

“At the end of the day, I’m still grateful and I’m trying my best to not let the challenges get the best of me. I’m thinking about moving forward.”

– Sarah Hall, 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

Newsletter At CAMH Pet Therapy Helps...-068b08cc0811ed97f736ccd97551bc74c2a7bf44

At CAMH, Pet Therapy Helps Decrease Stigma

00Emotion Regulation, Featured news, Happiness, Law and Crime, Loneliness, Psychiatry, Therapy May, 16

Source: Ryan Faist, Used With Permission

When I tell others that I volunteer with my dog in a pet therapy program, they assume my work involves children or the elderly. I am not surprised: the benefits of animal-assisted therapy for these groups are widely known.

But my dog Rambo’s “patients” are quite different. He and I volunteer at an inpatient unit at the Centre for Addiction and Mental Health (CAMH) in Toronto. The people Rambo sees every Tuesday reside in the Secure Forensic Unit.

Accused of committing crimes ranging from shoplifting to homicide, these individuals all suffer from severe mental illness. Their treatment at CAMH is court-ordered, and they are routinely assessed by mental health professionals to determine if they can be held responsible for their crimes.

Theresa Conforti, the co-ordinator for Clinical Programs and Volunteer Resources at CAMH, explains how pets factor into the equation:

“For the past 10 years, CAMH has had their own Pet Therapy Program that is very unique and caters only to the clients at CAMH. The clients value the unconditional love and affection the dog gives them on a weekly basis. The importance is that this program bridges the gap for those who have had to leave their furry friends to come to treatment, and for those who will not be able to own a dog due to financial restrictions or housing situations. The weekly visits ease loneliness, improve communication, foster trust, decrease stress and anxiety, and are a lot of fun!”

The program assesses the volunteers for eligibility, while the dog goes through an evaluation with a professional service dog trainer. Conforti notes:

“This works because those interested in volunteering at CAMH are not here to stigmatize our patients, rather they are here to make a difference and di-stigmatize mental illness.”

To say the experience has been rewarding for volunteers like me would be an understatement. Patients are happy to see Rambo, talk to him, pet him, or just be in the same room with him. Not only does he give them a break from their daily routines and the confinement of their unit at CAMH, but he also offers unconditional affection to those in the program.

And while the benefits of pet therapy are numerous, unconditional affection is the critical point here.

When people find out where Rambo and I volunteer, I am often asked whether I fear for our safety, highlighting the common misconception that individuals with severe mental illness are dangerous and violent. Stereotypes like this further perpetuate mental illness stigmatization.

But animals do not judge. They do not care about physical appearance, diagnoses, or criminal history. Conforti recalls:

“One of our dogs went on a unit and a selective mute client—a client who chooses not to speak—had knelt down and whispered in the dog’s ear. No one heard what the client said to the dog, but it was the first time the client had ever spoken. And he had chosen to do so to a dog that will not judge nor will expect much from him. I love that story because it shows that dogs are there to help, love unconditionally, and, most importantly, they do not stigmatize.”

This may be one reason animal-assisted therapy programs are gaining popularity globally. A program in Bollate, Italy, has introduced the use of dog therapy for prison inmates. Valeria Gallinotti, the founder of the program, explains:

“My dream was to organize pet therapy sessions in prison because it’s the one place where there is a total lack of affection, where dogs can create calm, good moods, emotional bonds and physical contact.”

The program has been a hit with inmates, who look forward to the dogs’ visits and have formed a sense of close companionship with them. When asked who his favourite dog was, one of the inmates said:

“Carmela arrived and didn’t know what to do. She was so scared, sort of like us when we arrive in prison. Now, like us, she too is getting used to the experience.” 

Whether part of psychotherapy, physiotherapy, or a prison inmate program, animal assisted therapy can give people the extra motivation needed to get through the challenge of treatment or confinement. Patients and clinicians alike have a lot to gain from therapists like Rambo.

– Essi Numminen, 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

Patients with Misophonia require help and understanding

Patients with Misophonia require help and understanding

10Empathy, Featured news, Happiness, Loneliness, Neuroscience, Relationships, Social Life November, 15

Source: Rick&Brenda Beerhorst on Flickr

Some people find the sound of nails on a chalkboard or the rumbling of a snoring spouse irritating, but what if the sound of someone breathing sent you into a fit of rage?  This is a reality for many sufferers of misophonia.

Only recently garnering attention from researchers, misophonia is a condition where individuals have a decreased tolerance for certain sounds.  Chewing, coughing, scratching, or pen clicking can provoke an immediate aggressive response.  Verbal tantrums are common and in severe cases, sufferers may even physically attack the object or person causing the noise.

“I turn my eyes to face the source of the noise and feel myself glaring at that person in rage,” misophonia sufferer Shannon Morell explains to The Daily Record.  “The only thing I can think about is removing myself from the situation as quickly as possible.”

Many sufferers begin to structure their lives around their struggle with the disorder and avoid triggers by socially isolating themselves.  Public spaces like restaurants or parks are readily avoided and in extreme cases, eating or sleeping in the same room as a loved one can feel impossible.  Even establishing or maintaining relationships is very challenging.

Misophonia can interfere with academic and work performance.  In a study by PhD candidate Miren Edelstein at the University of California in San Diego, patients reported trouble concentrating in class or at work due to distraction from trigger noises.  In some cases, students may resort to isolating themselves, taking their courses online.

David Holmes tells The Daily Record that he finds refuge in using headphones (whenever possible) to block out external noises while at work.

The cause of misophonia is currently believed to be neurological, where the patient’s limbic (emotional) and autonomic nervous systems are more closely connected with the auditory system.  This may be why hearing a disliked sound elicits an emotional response.  Aage Moller, a neuroscientist at the University of Texas, describes it as a complication in how the brain processes auditory stimuli.

Research shows that misophonia usually develops at puberty and tends to worsen into adulthood.

But misophonia is still greatly misunderstood.  There is a lack of research examining its causes or possible treatments.  There is no cure, and some critics even wonder if misophonia should be considered a disorder at all, arguing instead that it’s just a personality quirk.

While it seems there is little help available for people with the disorder, Misophonia UK, an organization dedicated to providing information and support to misophonia sufferers, outlines a number of interventions.

Tinnitus Retraining Therapy (TRT) involves teaching patients how to slowly build sound tolerance, while Cognitive Behavioural Therapy (CBT) focuses on changing negative attitudes that can contribute to the severity of the disorder.  In some cases, hypnosis can be used to relax individuals.  Breathing techniques are also taught so patients can learn to sooth themselves when hearing their trigger noises.

Keeping a diary to record feelings and providing education to loved ones are also strategies recommended by Misophonia UK.  Support groups and online forums like UK Misophonia, Selective Sound Sensitivity, and Misophonia Support also provide a way for sufferers to share their experiences and interact with others.

Researchers in the Department of Psychiatry at the University of Amsterdam say that DSM classification may be necessary to pave the way for more recognition and research on the disorder, and that if misophonia is not regarded as a distinct psychiatric condition, it should at least be viewed as part of Obsessive Compulsive Spectrum Disorder (OCSD).

The prevalence of misophonia is currently not documented, and it seems few seek help.  Suffers of misophonia can only do so much on their own before the disorder starts intruding on their lives.

– 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

The Sex Offender Next Door: Why Reintegration Helps

The Sex Offender Next Door: Why Reintegration Helps

00Emotion Regulation, Featured news, Free Will, Law and Crime, Loneliness, Psychopathy, Sex September, 15

Source: Sara/Flickr

The release of a sex offender back into a community can be a deeply unnerving experience. Many of us are fearful for our comfort and safety, but attitudes like these may play a role in leading many sex offenders to re-offend.

Sex offenders are faced with multiple challenges upon release. Apart from self-regulation and learning how to control their thoughts and actions, they need to find housing, employment, and most important, a community that will accept and support their continuous rehabilitation.

Sex offenders are not typically strangers lurking in dark alleyways. The perpetrator is often someone the victim knows and trusts.  Robin Wilson, professor and program coordinator at the Humber Institute of Technology and Applied Learning, states that relatively few sex crimes, around 23%, involve a stranger previously unknown to the victim. The public has a misguided notion of who the typical sex offender is, and while sexual offender registries are valuable law enforcement tools, there is a growing need for community support.

Wilson considers a best practice approach as involving collaboration between respective operational, professional, and jurisdictional domains.  For real rehabilitation to take place, the community must be involved in the process.

In 1994, the Circles of Support and Accountability (COSA) model of reintegration began after a Canadian Mennonite pastor started a voluntary support group for a repeat sex offender. After almost 20 years in Canada and now functioning internationally, the COSA outlines a restorative approach to the risk management of high-risk ex-offenders, using professionally facilitated volunteerism.

Each ‘Circle’ is made up of a core member (the ex-offender) and four to six community members, individuals who volunteer their time to assist the core member in the community.  The program aims to create supportive relationships based on friendship and accountability for behavior –the development of openness among members being a crucial part of the process.

Simply put, ex-offenders are least likely to reoffend when they have ‘friends’ who believe in them.

Wilson found that offenders in COSA had an 83% reduction in sexual recidivism (repeating undesirable and/or criminal behaviours), a 73% reduction in violent recidivism and an overall reduction of 71% in all types of recidivism when compared to the matched non-COSA offenders. His 2012 study shows that community volunteers have an immense impact on improving offenders’ chances for leading normal and productive lives.

Sex offenders are a heterogeneous group, motivated by different factors says Michael Seto, the director of Forensic Rehabilitation Research at the Royal Ottawa Health Care Group. Seto considers that successful reintegration is not simply the absence of further offending.  “Successful integration would also mean that the person could live a pro-social, productive life within their circumstances.  This might include intimate relationships, stable employment, and positive community ties.”

The success of programs like COSA that work in conjunction with professional treatment programs can be attributed to the continuous re-humanization and the re-moralization of the offender.

Offenders are treated as members of the community and their network of support approaches them without apprehension about the past. Most important, they are given the confidence that they are in control of themselves and that they can choose to behave differently than before.

Seto says that a major obstacle for sex offender treatment is the stigma associated with being labeled a sex offender and being seen forever as high-risk, and that positive social support has a tremendous impact on treatment outcome.

Perhaps most encouraging is the story of a small community in Florida called ‘Miracle Village’, home to over 100 registered sex offenders – none of whom have reoffended. Its residents actively support each other in their attempts to build new lives and work to establish themselves as functioning members of their community.

Of note, the village does not accept those who have been diagnosed with pedophilia or convicted of violent sex crimes against strangers. Some say it is made up of lower risk ex-offenders who are easier to rehabilitate.

Wilson says that offenders targeted for COSA are usually those who have long histories of re-offending, have typically failed in treatment and have displayed intractable antisocial values and attitudes. Stable housing, as well as social support, has shown a relationship to reduced sexual recidivism and criminality among both child molesters and rapists.

The results are compelling: A supportive social network makes a difference.  Addressing an offender’s humanity, loneliness, and need for positive relationships has a strong impact.

Still, some sex offenders really are too high-risk to allow back into their communities. Seto says that while “successful reintegration is the aspiration for most sex offenders, some individuals pose such a high risk of re-offending that incapacitation is the only viable option. This can come in the form of long sentences, long term hospitalization, or indefinite sentencing according to (in Canada) Canada’s Dangerous Offender designation.”

Does it all seem too easy? One can’t help but wonder.  Then again, shouldn’t it be evident that an approach that shuns and ostracizes is doomed from the start?  Cananyone “re-integrate” when viewed as a pariah?

Perhaps the take-home message is about compassion and humanity. And our ability to overcome our insecurities when in the company of those who frighten us.

When Seto was asked whether he truly believes sex offenders can change, he responded “Yes…some of them.”

– Jana Vigor, 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

LGBTQ Refugees Lack Mental Healthcare

LGBTQ Refugees Lack Mental Healthcare

00Featured news, Health, Law and Crime, Loneliness, Sexual Orientation, Stress, Trauma September, 15

Source: William Murphy/Flickr

In 2012, the Canadian government introduced cuts to the Interim Federal Health Program (IFHP), which provides health coverage for immigrants seeking refuge in Canada. Coverage was scaled back for vision and dental care, as well as prescription medication. At the same time, the introduction of Bill C-31, the Protecting Canada’s Immigration System Act, left refugees with zero coverage for counselling and mental health services.

The bill affects all refugees and immigrants, but individuals seeking asylum based on persecution for sexual orientation or gender identity have been hit especially hard by these cuts.

LGBTQ refugees are affected by psychological trauma stemming from sexual torture and violence aimed at ‘curing’ their sexual identity. Often alienated from family, they are more likely to be fleeing their country of origin alone, at risk for depression, substance abuse, and suicide.

On arrival in Canada, refugees struggle with the claim process itself, which has been cited by asylum seekers and mental health workers as a major source of stress for newcomers. For LGBTQ individuals, the process is even harder, having to come out and defend their orientation after a lifetime spent hiding and denying their identity.

In 2013, six Canadian provinces introduced individual programs to supplement coverage. The Ontario Temporary Health Program (OTHP) came into effect on January 1, 2014, and provides refugees and immigrants short-term and urgent health coverage. But it still lacks provisions for mental health services.

Envisioning Global LGBT Human Rights, an organization and research project out of York University in Toronto, has been collecting data from focus groups with LGBTQ refugee claimants both pre- and post-hearing. A recent report by lawyer and project member Rohan Sanjnani explains how the refugee healthcare system has failed. LGBTQ asylum seekers are human beings deserving respect, dignity, and right to life under the Canadian Charter of Rights and Freedoms. Sanjnani argues that IFHP cuts are unconstitutional and that refugees have been relegated to a healthcare standard well below that of the average Canadian.

Arguments like these have brought legal challenges, encouraging courts and policy makers to consider LGBTQ rights within the framework of global human rights.

In July of this year, Bill C-31 was struck down in a federal court as unconstitutional, but the government filed an appeal on September 22. Only if the appeal fails could immigrant healthcare be reinstated to include many of the benefits removed in 2012.

Reversing the cuts to IFHP funding would not solve the problem entirely. LGBTQ asylum seekers face the challenge of finding service providers who can deal with their specific needs. The personal accounts collected by Envisioning tell a story of missed opportunity, limited access to essential services, and ultimate disappointment.

In the last two years, programs have sprung up to address these special needs. In Toronto -one of the preferred havens for LGBTQ refugees- some health providers now offer free mental health services to refugees who lack coverage. Centers like Rainbow Health Ontario and Supporting Our Youth have programs to help refugees come out, and to assist with isolation from friends and family back home, and with adjusting to a new life in Canada.

Still, the need for services greatly outnumbers providers; and accessibility issues persist.

Organizations like Envisioning try to create change through legal channels, but public opinion on LGBTQ healthcare access needs to be onside for real change to occur. Recent World Pride events held in Toronto were a step in the right direction. But specialized training of healthcare professionals and public education would go a long way in providing the LGBTQ community with the care they need.

– Sarah Hall, 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

“Pro-Ana” Websites Encourage Anorexia

“Pro-Ana” Websites Encourage Anorexia

10Body Image, Eating Disorders, Featured news, Loneliness, Self-Esteem, Social Life August, 15

Source: Wolfgang Lonien/Flickr

In 2013, 17-year old Grainne Binns came forward to the Daily Mail with her story of having anorexia nervosa, an eating disorder defined by a distorted body image, and intense fear of being or becoming fat.  Months of restricting food intake meant Binns’ weight plummeted to 84 pounds.

Her inspiration, she explained, was admiration of girls on pro-ana and thinspiration blogs and websites.

The sites claim not to promote eating disorders, yet pro-ana (pro-anorexia) websites provide diet plans with dangerously low caloric intake, and ways to eat less and burn more calories, as well as “inspiration” through images of very thin models and celebrities.  They advance the idea of anorexia nervosa as a lifestyle rather than a mental illness.

Researchers at the Department of Communication at Wayne State University assert that the biggest appeal of pro-ana websites is their ability to provide social support and a sense of self-expression.  Offline, people with eating disorders often face stigma when voicing anti-treatment views and eating habits to friends and family.  Online, the websites become a sanctuary where users are free to express their views and have them met with agreement and support.

Shared writing about issues of self-esteem or feeling misunderstood, in fact, may be therapeutic, often providing a sense of community.  Emotional support and validation from other users seem to be part of the appeal of pro-ana websites.

In a study by Professor Nicole Martins, and Ph.D. Candidate Daphna Yeshua-Katz at the Department of Telecommunications at Indiana University, interviews with regular pro-ana bloggers revealed that many felt the websites granted permission for them to continue with their eating disorder.  Bloggers also worried they would be seen as wanna-rexics (wannabe anorexics) by other online community members for not meeting their weight loss goals.

Binns knew this feeling well, describing her need to please other users when they would comment that she appeared fat in her photos.

Sonya Lipczynska, information specialist of the Institute of Psychiatry at King’s College, also describes how the cult-like nature of pro-eating disorder websites are enabling harmful behaviour.  Personifying anorexia nervosa, writers on some sites refer to the disorder as if it were a real person, “Ana,” who members must appease by following rules and dedicating attention to making “her” happy.  These rules, known as “Ana’s Laws,” reinforce the fixation users have with being thin.

Some patients get so addicted to the appeal of pro-ana websites that they use them in secret, despite being advised against doing so by their therapists or other mental health professionals.

Although these websites are active, certain efforts are being made to discourage use.  Social media sites such as Tumblr and Instagram have changed their terms of service to ban the posting of thinspo images.

And a growing number of pro-recovery websites promote optimistic thinking and positive self-image through the use of inspirational quotes, pictures, and community support.  Users get the message that they can successfully beat their eating disorder, along with recovery tips and referral information to get professional help.

Still, pro-ana websites should not be dismissed.  What we need to appreciate is that the support and understanding the sites give to users make them not only popular, but addictive.

And there may be a lesson or two here for family, friends, and those in the mental health community invested in recovery from eating disorders:  The best way to address concerns about pro-ana websites is to provide the same level of support and understanding offline as users now get online.  And, eating disorder websites devoted to recovery need to provide a similarly supportive community as well.

In the case of Grainne Binns, the road was difficult.  But, it was the support of family and friends that allowed her to delete her pro-ana blog and start a new one about healthy living, ultimately facilitating her recovery.

– 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

Poor Care Pushes LGBTQ Seniors Back in the Closet

Poor Care Pushes LGBTQ Seniors Back in the Closet

10Aging, Featured news, Gender, Loneliness, Resilience, Sexual Orientation July, 15

Source: Susan Sermoneta on Flickr

Today’s seniors grew up when their LGBTQ status was considered a mental illness, a view that has largely changed.  But, as Nancy Knauer of Temple University School of Law points out, modern attitudes towards LGBTQ individuals have not shifted nearly as much as people think.

As the western baby boomers begin relying more on extensive medical care, Knauer says this aging LGBTQ population is staying silent for fear of receiving poor treatment and losing social support, resulting in many being pushed back in the closet.  This problem is seen in hospices and in homecare.

In the 2010 documentary, Gen Silent, many nursing homes reported not having any LGBTQ individuals among their seniors (which is highly unlikely).  Having grown up in hostile environments, many of these seniors are afraid to come out, without explicit support from the staff.  Yet, 50 percent of staff reported that their colleagues would be intolerant of LGBTQ individuals.

Because of the extensive media attention from Gen Silent, more LGBTQ-specific nursing care facilities have been opening up in recent years.  But many seniors are still being forced into homes that are unwilling to accommodate their needs.

According to Associate Professor, Nancy McKenzie at the CUNY School of Public Health, a similar problem exists in homecare.  Many seniors rely on home-based visits from healthcare providers, which allow them to stay in the familiar atmosphere of their homes as long as possible, remaining in the company of family and friends and maintaining their independence.

Still, homecare presents barriers for LGBTQ seniors.  While the home is supposed to be a safe place – no discrimination, no homophobia – LGBTQ seniors have become isolated.  Some are estranged from their families for coming out.  Others are isolated from their neighbours and communities by not coming out.  This lack of informal support forces LGBTQ seniors to rely more heavily on professional services, which creates additional problems.

Many organizations providing homecare have constantly rotating staff with high turnover, greatly limiting continuity of care.  This is hard for all seniors, but those of LGBTQ status are repeatedly deciding whether to come out to the new healthcare worker.  Many seniors report receiving worse care after coming out, and therefore choose to stay silent about their identity, feeling imprisoned in their own homes.

This problem is even more challenging for those who have undergone gender-reassignment surgery, as they are unable to hide their LGBTQ status from healthcare providers who assist with dressing and bathing.  This may exacerbate stress and symptoms of depression, driving seniors away from care and into isolation.

New resources and inclusive healthcare facilities are being created at a rapid rate, but not fast enough to accommodate the aging population.  Robert Kertzner and his team at the Columbia University College of Physicians and Surgeons say the answer lies in training all doctors and nurses to provide holistic care adapted to the circumstances of each patient.  Jaime Hovey of the University of Illinois also recommends creating legislation oriented to protecting LGBTQ seniors from discrimination and allocating additional resources to meet their needs.

But ambitious as these recommendations are, there needs to be an attitude shift among family members and the public.  Family and community support are critical to maintaining high quality of life during aging.  Without support, LGBTQ seniors will continue to suffer in silence.

– Nick Zabara, Contributing Writer, The Trauma and Mental Health Report

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

Copyright Robert T. Muller

This article was originally published on Psychology Today