by Mental Health Humor
Maria recently confided to her doctor that she was having a hard time at work because of her depression. He immediately referred Maria to a psychologist and she was able to start getting some benefit from therapy, combined with medicine from her physician.
Because Maria knows her problem didn’t arise overnight, she recognizes it will not go away in a week or two. Even with medicine and therapy, her treatment will probably take at least a month before any significant results occur, her therapist says.
While Maria wants to talk to her boss about this matter, particularly since she is having some trouble adjusting to her medications, she is afraid of her boss’s reaction.
“Lots of people really don’t understand mental illness very well, so you had better keep this to yourself,” Maria’s mother advises.
“It can be a real stigma for you if anyone finds out you are getting counseling,” her mother adds.
Why should stigma have anything to do with getting treatment for a mental health problem? Or talking about it?
In general, stigma is an attempt to label a particular group of people as less worthy of respect than others. It can manifest as a mark of shame, disgrace or disapproval that results in discrimination.
Too often, stigma results in fear, mistrust, and violence against people living with mental illness and their families, according to officials from the U.S. Public Health Service.
Family and friends may turn their backs on people with mental illness, exhibiting prejudice and discrimination, keeping the person with problems from seeking help.
Maria joins 1 in 5 Americans living with a mental disorder, and estimates indicate that nearly two-thirds of all people with a diagnosable mental illness do not seek treatment, especially people from diverse communities.
By visiting her doctor and seeking treatment, Maria doesn’t fall into the stigma trap, despite her mother’s misinformed warnings
Her mother’s lack of knowledge, fear of disclosure, and her predictions of Maria’s rejection and discrimination by friends are typical reasons why people with mental illnesses all too often don’t seek professional help.
Discrimination against people with mental illness violates their rights and denies them opportunities, say U.S. Public Health officials. Despite Civil Rights Laws such as the Americans with Disabilities Act, people with mental illnesses still experience discrimination in the workplace, education, housing, and healthcare. And it happens far too often.
Ethnic and racial communities in the U.S. face a social and economic environment of inequality that includes greater exposure to racism, discrimination, violence and poverty, health officials say.
“Mistrust of mental health services is an important reason why people of color are deterred from seeking treatment. Their concerns are reinforced by evidence (both direct and indirect) of clinician bias and stereotyping.”
When people like Maria do seek help, the cultures of racial and ethnic groups may alter the types of mental health services used. Clinical environments that do not respect or are incompatible with the cultures of the people they serve may deter people from seeking help to begin with, adherence to treatment and follow-up care.
Culture Counts — one’s racial or ethnic background often bears upon whether people even seek help in the first place, what types of help they seek, what coping styles and social supports they have, and how much stigma they attach to mental illness, health officials say.
In this case, Maria is the exception when she decides to speak with her company’s human relations head about her illness and her treatment, after speaking first with her psychologist and doctor to make sure she has accurate information about her treatment plan.
As it turns out, Maria’s company has a diversity awareness and support philosophy. She is reassured her company will work with her to make sure she is treated fairly as she goes through treatment.
“I’m happy that my company is so progressive,” Maria states. “Now, I’m going to do what it takes to get well.”
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For the past 20 years, especially since the introduction of system-of-care philosophy and practices, there have been tensions between community-based and residential treatment providers that serve children, youths, and families in need of mental health care. Community-based mental health providers have voiced concern that their residential treatment colleagues keep children too long and fail to demonstrate the effectiveness of their services. Residential treatment providers have asserted that their community-based colleagues do not collaboratively support their efforts, assist with discharge planning, or provide intensive service options as necessary follow-up. Families and youth have often expressed mixed reactions and opinions about both sets of mental health providers, asking that all providers become more family driven and youth guided and encouraging them to create a more integrated array of services.
In this climate, made all the more complex as systems vie for limited resources, a group of residential and community-based mental health treatment providers, policymakers, families, and youths, under the auspices of the Center for Mental Health Services, began a dialogue in the fall of 2005 to discuss ways to improve relationships and practice. The result was the initiative now known as “Building Bridges.”
From this dialogue, a group of national leaders in the field of children’s mental health participated in the first Building Bridges summit in June 2006. Inspired by compelling youth and family voices, summit participants drafted and signed a joint resolution of common principles and a shared commitment to a comprehensive, flexible, individualized, strength-based, family-driven, and youth-guided array of culturally and linguistically competent services and supports. More than 20 national mental health organizations and 19 agencies have since endorsed the joint resolution.
Building Bridges calls for restructuring the relationships among residential mental health treatment and community-based providers, families, and youths. The paradigm promotes shared responsibility and shared commitment, regardless of service needs or treatment setting. Accordingly, post-summit activities included identifying residential treatment programs and communities across the country that are implementing innovative practices consistent with the principles of the joint resolution, and seeking input from families and youth about what they consider effective practices.
Among the many promising practices embraced by Building Bridges, the use of child and families teams is fundamental. Teams use a wraparound process that gives treatment planning and service delivery a sense of purpose and accountability. CFTs bring together the expertise of residential treatment and community-based providers and capitalize on the strengths of youth and families as part of a long-term recovery-oriented plan.
Residential treatment programs and their community partners across the nation are improving their efforts to ensure that treatment is family driven and youth guided by implementing practices advocated by Building Bridges such as CFTs; hiring family and youth advocates; developing youth and family advisory councils; providing education and support to increase self-advocacy skills; integrating cultural and linguistic competence; and implementing trauma-informed care, thereby reducing the need for restraint and seclusion.
Advocates and policymakers are recognizing that residential treatment is part of the service array and that coordination and collaboration are essential to improving outcomes.
Below are some ways in which community and residential treatment providers can support the work of Building Bridges:
> Establish relationships and dialogue across all constituent groups, including families, youths, community-based mental health providers, residential treatment providers, advocates, and policymakers.
> Develop protocols and practices to make entry into residential treatment and the transition back to the community a seamless, supportive, and coordinated process.
> Support youths and families during their time in residential treatment programs with participation in community-based mental health programs and support services, thereby facilitating timely and smooth transitions home.
> Continue to implement trauma-informed, family driven, youth guided, culturally and linguistically competent and evidence-based practices.
> Support the development of and become active members of child and family teams.
> Convene meetings and dialogues among constituencies to promote conversations about Building Bridges.
In September 2007, a second summit reinforced the initiative and set an agenda to promote reform across the country. Several workgroups were created, and several products have been developed or are in development: a document on innovative best practices in linking community-based and residential treatment services, a matrix of performance guidelines and indicators, a self-assessment tool for residential treatment and community providers, family and youth “tip sheets,” and research to identify needed fiscal and policy reforms. Plans are underway to continue the important work of this initiative and bring the principles of Building Bridges to a national scale. By collaborating as partners, we can ensure that children, youths, and families thrive.
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Commonly known as insanity or madness, schizophrenia is a chronic psychotic disorder with onset typically occurring in adolescence or young adulthood. Schizophrenia results in fluctuating, gradually deteriorating, or relatively stable disturbances in thinking, behavior, and perception. Severity can range from mild and subtle with very good adaptation to everyday life, to severely disabling requiring constant supervision in a restricted environment.
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Schizophrenia is a brain disease that interferes with normal brain functioning. It causes affected people to exhibit odd and often highly irrational or disorganized behavior. Because the brain is the organ in the body where thinking, feeling and understanding of the world takes place (where consciousness exists), a brain disease like schizophrenia alters thinking, feeling, understanding and consciousness itself in affected persons, changing their lives for the worse.
Causes of Schizophrenia
Experts now agree that schizophrenia develops as a result of interplay between biological predisposition (for example, inheriting certain genes) and the kind of environment a person is exposed to. These lines of research are converging: brain development disruption is now known to be the result of genetic predisposition and environmental stressors early in development (during pregnancy or early childhood), leading to subtle alterations in the brain that make a person susceptible to developing schizophrenia.
It’s not known what causes schizophrenia. However, researchers believe that an interaction of genetics and environment may cause schizophrenia. Problems with certain naturally occurring brain chemicals, including the neurotransmitters dopamine and glutamate, also may contribute to schizophrenia.
Symtoms Of Schizophrenia
Bizarre or inappropriate behaviour
Preoccupation with spiritual matters
Incoherent illogical speech
Distorted Perceptions of Reality
People with schizophrenia may have perceptions of reality that are strikingly different from the reality seen and shared by others around them. Living in a world distorted by hallucinations and delusions, individuals with schizophrenia may feel frightened, anxious, and confused.
Cognitive symptoms (or cognitive deficits) are problems with attention, certain types of memory, and the executive functions that allow us to plan and organize. Cognitive deficits can also be difficult to recognize as part of the disorder but are the most disabling in terms of leading a normal life.
Over time, it becomes difficult to function in daily life. You may not be able to go to work or school. You may have troubled relationships, partly because of difficulty reading social cues or others’ emotions. You may lose interest in activities you once enjoyed.
Diagnosing Schizophrenia
Using mental state features alone (such as third person auditory hallucinations) is not a reliable way to diagnose schizophrenia. After all, psychotic features such as hallucinations and delusions can occur in affective disorders, dementia and acute organic psychoses. It is therefore important to look at the form of the illness as well as the content.
Treatment of Schizophrenia
Patients with schizophrenia often do not respond to treatment or only partially improve and remain functionally impaired. While medication has been found to be effective for the treatment of “positive” symptoms of the disease, treatment of the “negative symptoms” of depression (including lack of energy, motivation, and emotional range) has historically not been very successful. In nearly 25 percent of those patients, the condition is so refractory to neuroleptic pharmacotherapy that they require custodial care.
First, ensure that your loved one is taking prescribed medications. One of the most common reasons that people with schizophrenia relapse into a new episode is that they quit taking medication. Family members might see much improvement and mistakenly assume medications may no longer be needed. That is a disastrous assumption. A later psychotic outbreak will likely happen
The large majority of people with schizophrenia show substantial improvement when treated with antipsychotic drugs. Some patients, however, are not helped very much by the medications and a few do not seem to need them.
Therapy of Schizophrenia
Cognitive Behavioral Therapy has been shown to be good for a person with schizophrenia.
Psychodynamic therapy is quite controversial. The actual therapy does not seem to work so well.
When a person suffers from schizophrenia, it is helpful for the whole family to get support. This usually reduces stress and worry, and helps people cope.