Patton State Beating Victim Dies A 49-year-old patient at Patton State Hospital has died at St. Bernardine Medical Center in San Bernardino, CA, according to a San Jose Mercury News report published this morning. The man was beaten 15 days ago by a 25-year-old peer who has since been charged with battery resulting in serious bodily injury. The victim's cause of death has not been immediately identified.Sphere: Related Content
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Wednesday, December 10, 2008
Tuesday, December 9, 2008
Mental Illness Can Kill
A brief article published on the Time web site December 3 shed long-overdue attention on the tragically shortened lifespan of patients enduring chronic mental health conditions. All the anecdotal observations of behavioral health professionals, though, had never framed our patients' untimely deaths as starkly as the National Association of State Mental Health Program Directors (NASMHPD).
Scrutinizing data from 16 states, the organization concluded severe mental illness mercilessly shaves an average 25 years off a patient's life. This study, titled "Morbidity and Mortality in People with Serious Mental Illness," was published two years ago, however. Time's citation of this rather dusty report is telling about the dearth of literature questioning this sobering state of affairs.
While this health crisis results from the conspiracy of mutltiple factors, incuding an impetuous healthcare system and an uneven system of decision-making among non-psychiatric care providers, our patients' lives provide the most direct and disquieting call for more attention.
The Psychiatric 'Lifestyle'
Undoubetdly chemical abuse portends an abbreviated life for anyone and psychiatric patients abuse alcohol and drugs at an alarmingly high rate. Estimates vary, but investigators more or less agree around 50% of the chronic mentally ill are substance abusers or addicts. Pair that with the emerging rule of thumb that drug addicts die within 15 to 20 years of the onset of their addiction and an unsettling outlook materializes.
Beyond the socially proscribed drugs, the chronic mentally ill smoke tobacco at nearly twice the rate of the rest of us. In a 2000 study published in the Journal of the American Medical Association, examiners found that 41% of psychiatric patients smoked versus 22.5% of the general population. Patients rhapsodize romantically of their tobacco because a good smoke really is the brightest moment in their otherwise hellish existence. Hospitals encourage the habit, too, because we know that nicotine provides a soothing balm to our customers’ otherwise pulsing nerves. Nurses distributing cheap generic cigarettes to a patient's trembling, nicotine-stained hands is a common visual in our post-modern mental health system.
Beyond the high walls of the hospital grounds, clients often lead cruel, unforgiving lives, especially those most seriously ill. They may sleep in parks or homeless shelters, with little or no money either because they are locked outside the entitlement system or because they spend what few dollars they do get on alcohol and drugs.
The luckier ones--those whose behavior can be maintained with minimal supervision and who receive government benefits--may win a bed at a board and care facility. Some of these housing businesses are well-maintained in tidy neighborhoods. All too many of them, though, are in dilapidated buildings where the stench of feces on bed sheets, urine in hallway corners and aging cigarette smoke permeate the air. Their locations are often in the tenderloin, where scoring a gram of crack is easier than buying a gallon of milk. Typically these patients receive the Federal government’s $637 per month in Supplemental Security Income, plus any additional monies their state provides. Typical board and care rents are around 90% of that amount. Filling our belly on $50 or $100 a month is virtually impossible for even the most frugal of us.
Feeding a drug addiction costs even more dearly. One favorite drug among psychiatric patients is crack, a 1/10th gram of which costs $10-$25 on the street. Another cherished drug, methamphetamine, will set a patient back about $25 for 1/4 gram, barely enough to get a party started. The swift decline of a drug-addicted client's cash supply, then, is easily predicted.
When one is fiending for another fix, there is no limit to what they might do or with whom they may do it. Trading sex for drugs is hardly unusual, but as condoms became a must-have for recreational intercourse, the opportunities for exposure to HIV and assorted other bugs increased. If you have to be anally penetrated by a stranger for your next bump of crystal, chances are you didn't stop off at the market for a pack of Trojans.
Injectable drugs are as much to blame as any informal sodomy for our patients' deteriorating health. Dirty needles carry the double trouble of HIV and Hepatitis C. People with chronic mental illness are infected with Hepatitis C at a staggering 11times the rate of the general population, and carry HIV at eight times than the rest of the population, according to a 2001 study published in the American Journal of Public Health. Survival rates for Hep C hover around a depressing 50% after just five years of infection.
In the face of these unforgiving statistics, the disheartening NASMHPD study referenced at the beginning of this post looks almost sanguine. The numbers reveal more than just life expectancies and callous realities, though. They mirror a blind spot in our present system of care that taunts us with the question, Do we care enough to do anything about it?
PHOTO: Courtesy of Martin Walls, Kent, UK.
Sphere: Related ContentWhile this health crisis results from the conspiracy of mutltiple factors, incuding an impetuous healthcare system and an uneven system of decision-making among non-psychiatric care providers, our patients' lives provide the most direct and disquieting call for more attention.
The Psychiatric 'Lifestyle'
Undoubetdly chemical abuse portends an abbreviated life for anyone and psychiatric patients abuse alcohol and drugs at an alarmingly high rate. Estimates vary, but investigators more or less agree around 50% of the chronic mentally ill are substance abusers or addicts. Pair that with the emerging rule of thumb that drug addicts die within 15 to 20 years of the onset of their addiction and an unsettling outlook materializes.
Beyond the socially proscribed drugs, the chronic mentally ill smoke tobacco at nearly twice the rate of the rest of us. In a 2000 study published in the Journal of the American Medical Association, examiners found that 41% of psychiatric patients smoked versus 22.5% of the general population. Patients rhapsodize romantically of their tobacco because a good smoke really is the brightest moment in their otherwise hellish existence. Hospitals encourage the habit, too, because we know that nicotine provides a soothing balm to our customers’ otherwise pulsing nerves. Nurses distributing cheap generic cigarettes to a patient's trembling, nicotine-stained hands is a common visual in our post-modern mental health system.
Beyond the high walls of the hospital grounds, clients often lead cruel, unforgiving lives, especially those most seriously ill. They may sleep in parks or homeless shelters, with little or no money either because they are locked outside the entitlement system or because they spend what few dollars they do get on alcohol and drugs.
The luckier ones--those whose behavior can be maintained with minimal supervision and who receive government benefits--may win a bed at a board and care facility. Some of these housing businesses are well-maintained in tidy neighborhoods. All too many of them, though, are in dilapidated buildings where the stench of feces on bed sheets, urine in hallway corners and aging cigarette smoke permeate the air. Their locations are often in the tenderloin, where scoring a gram of crack is easier than buying a gallon of milk. Typically these patients receive the Federal government’s $637 per month in Supplemental Security Income, plus any additional monies their state provides. Typical board and care rents are around 90% of that amount. Filling our belly on $50 or $100 a month is virtually impossible for even the most frugal of us.
Feeding a drug addiction costs even more dearly. One favorite drug among psychiatric patients is crack, a 1/10th gram of which costs $10-$25 on the street. Another cherished drug, methamphetamine, will set a patient back about $25 for 1/4 gram, barely enough to get a party started. The swift decline of a drug-addicted client's cash supply, then, is easily predicted.
When one is fiending for another fix, there is no limit to what they might do or with whom they may do it. Trading sex for drugs is hardly unusual, but as condoms became a must-have for recreational intercourse, the opportunities for exposure to HIV and assorted other bugs increased. If you have to be anally penetrated by a stranger for your next bump of crystal, chances are you didn't stop off at the market for a pack of Trojans.
Injectable drugs are as much to blame as any informal sodomy for our patients' deteriorating health. Dirty needles carry the double trouble of HIV and Hepatitis C. People with chronic mental illness are infected with Hepatitis C at a staggering 11times the rate of the general population, and carry HIV at eight times than the rest of the population, according to a 2001 study published in the American Journal of Public Health. Survival rates for Hep C hover around a depressing 50% after just five years of infection.
In the face of these unforgiving statistics, the disheartening NASMHPD study referenced at the beginning of this post looks almost sanguine. The numbers reveal more than just life expectancies and callous realities, though. They mirror a blind spot in our present system of care that taunts us with the question, Do we care enough to do anything about it?
PHOTO: Courtesy of Martin Walls, Kent, UK.
Read more...
Friday, December 5, 2008
Spread the Happiness
When Rachel Dratch so brilliantly personified the wet-blanket character Debbie Downer on Saturday Night Live, we laughed in hilarious recognition of the party-poops in our own lives and their bummer effect on us. Now researchers have unearthed data illuminating just how sprawling a shadow our little Debbies cast.
A team of researchers from Harvard University and the University of California at San Diego recently undertook an expedition through the massive Framingham Study, a project started by the National Heart, Lung and Blood Institute in 1948 to find common causes of cardiovascular disease. The Framingham participants provided enough data that their friends and relatives could be traced to multiple degrees of separation.
Harvard’s Dr. Nicholas A. Christakis and UCSD’s James H. Fowler, co-authors of the current study, previously mined this data and demonstrated obesity and smoking ran in groups of friends and relatives. On this pass through Framingham, they closed-in on 12,067 study volunteers connected through 53,228 ties. A sample of their conclusions about happiness:
You can read more about this study at the LA Times web site. Of course, sharing it with our own Debbies may not be wise. They bring us a lot of laughter, too.
Sphere: Related ContentA team of researchers from Harvard University and the University of California at San Diego recently undertook an expedition through the massive Framingham Study, a project started by the National Heart, Lung and Blood Institute in 1948 to find common causes of cardiovascular disease. The Framingham participants provided enough data that their friends and relatives could be traced to multiple degrees of separation.
Harvard’s Dr. Nicholas A. Christakis and UCSD’s James H. Fowler, co-authors of the current study, previously mined this data and demonstrated obesity and smoking ran in groups of friends and relatives. On this pass through Framingham, they closed-in on 12,067 study volunteers connected through 53,228 ties. A sample of their conclusions about happiness:
| If you have a happy… | Your chances of being happier are… |
| Friend within a half-mile | 42% |
| Next-door neighbor | 34% |
| Friend two miles away | 22% |
| Acquaintance | 15.3% |
| Sibling within one mile | 14% |
| Spouse | 8% |
You can read more about this study at the LA Times web site. Of course, sharing it with our own Debbies may not be wise. They bring us a lot of laughter, too.
Read more...
Tuesday, December 2, 2008
Half of College-Aged Adults are Mentally Ill... Right?
In an astonishing study published in this month's Archives of General Psychiatry, researchers found that nearly 50% of college-aged adults in the US struggle with some sort of mental health or chemical dependency issue. A team led by Dr. Mark Olfson, a professor of clinical psychiatry at Columbia University Medical Center, mined the data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions. The college-aged group was then split between students and non-students.
Among those in school, the team detected 20% of the college-age adults wrestled with alcohol issues followed by a startling 18% displaying personality disorders. Among the non-students, nicotine dependence and personality disorders topped the list. Meanwhile, mood disorders surfaced in a relatively paltry 11% for students and 12% for those out of school.
The findings are staggering for the simple fact that they turn conventional wisdom on its head. According to the Diagnostic and Statistical Manual IV (DSM-IV), the bible of the metal health industry, Borderline Personality Disorder has been estimated to affect nearly 2% of the general population, Obsessive-Compulsive Personality Disorder shows up in about 1% and Narcissistic Personality Disorder trails them both, presenting in less than 1% of us.
Meanwhile,the same DSM-IV finds 1%-3% of us experiencing the symptoms of panic or generalized anxiety disorders. Even depression is believed to affect less than 10% of the general population.
This study's breathtaking findings can only lead us to conclude either we have an extraordinarily sick generation coming of age, or the study is flawed. Perhaps the devil is in the design. The data for the 2001-2002 study were gathered from face-to-face interviews and the current study's authors deconstructed their information. The real questions revolve around diagnosis versus presenting symptoms. Had those interviewed been formally diagnosed with the conditions reported? Or had they scored in certain ways on psychological testing scales during the survey? Given that only 25% of those surveyed actually sought out mental health treatment, one would be tempted to assume that their conclusions are based on series of questionnaires and behavioral scales. Today's study would be tenuous at best.
Until knowing the full design of the 2001 study and thereby making an informed conclusion, I for one will remain in blissful ignorance of the more alarming alternative.Sphere: Related Content
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Wednesday, November 5, 2008
A Brand New Day in America
With yesterday's emotional and historic election of Barack Obama, my hope is that he can not only bring together a fragmented country, but a disintegrating world as well. After eight years of passive-aggressive American foreign policy, I'm hopeful that President-elect Obama can reach out to the world in ways his predecessor would not. And that after eight years of neglect at home, our new president can start our country back on the path of peace, prosperity and liberty for all.Sphere: Related Content
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