Archives for Public Policy

Public Policy

Mental health groups ask Kenneth Cole to remove billboard

Twenty-three mental health organizations delivered a letter to fashion designer Kenneth Cole this morning, protesting the bizarre billboard Cole posted on a New York City highway in August that was supposed to support  mental healthcare reform and gun reform.

Two comments:

1. Thank God the country's most prestigious mental health organizations have taken a strong, united stand in urging Cole to take down the billboard.

2. What the hell was Cole thinking?

When the words mental illness...
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Drug treatment: How many times will you go to go to rehab before you realize it isn’t working?

This is going to make some people mad. I'm going to say it anyway.

Why do addicts and alcoholics go to rehab over and over and over if it doesn't work for them? If you had cancer and you did 10 rounds of treatments and they weren't working, would you keep going?

I know you are going to say relapse is part of the disease. But if you relapse over and over and over and over, why go back to the same treatment? At a certain point you have to stop blaming the disease for your relapse and realize the treatment you are doing for your disease simply isn't working.

Stop going to rehab. Stop paying tens of thousands of dollars for a treatment protocol that isn't working for you. I'm not saying that rehabs don't work. They do - for some addicts and alcoholics. Treatment will work for the highly motivated addict or alcoholic who won't be distracted by the cushy, resort-like facilities that offer massages, tai chi, golf "therapy" and meditation on a Florida beach.

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Why the religion of the Chattanooga shooter trumps his depression

Now we learn that Muhammad Abdulazeez, the gunman who fatally shot four Marines and a sailor at a recruiting office and naval reserve center in Chattanooga  last week, had depression and self-medicated with drugs an alcohol.

Normally, this would spark the usual debate on whether depression can make someone homicidal. The media would tell us that yes, in very, very rare cases depression could cause homicidal thoughts but much more common are suicidal thughts.

And the media would tell us that some anti-depressants can make depression worse and that Abdulazeez had taken anti-depressants.

However, in this case the media is more focused on whether Abdulazeez was a Muslim terrorist whose alleged fanaticism was sparked by a lengthy trip to the Middle East last year. The media is throwing the word Isis into their coverage and voila! They've got a gazillion hits on social media.
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Government scrubs substance-abuse data but doesn’t tell researchers

What if the government decided to withhold the data it gathers on an insidious mental illness that affects nearly one in ten Americans and did not bother to tell researchers it had done so?

It happened. The data are collected by the Centers for Medicare and Medicaid Services. The mental illness - substance abuse.

The New England Journal of Medicine exposed these shenanigans and explained the consequences in an article published in April: Protection or Harm? Suppressing Substance-Use Data, by Austin B. Frakt and Nicholas Bagley. According to the authors, the CMS began to withhold from its data sets, called the Research Identifiable Files, any Medicare or Medicaid claim with a substance abuse diagnosis.

Why? Patient privacy concerns. Why didn't the CMS tell researchers? Good question.
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Public Policy

Why the military can’t get suicide prevention right

Last Friday, the Inspector General of the Department of Defense released a report called the Suicide Event Report Data Quality Assessment. I had no idea what the assessment was about but I am devoted to suicide prevention and intrigued by data so I gave the 100-page report a read.

When an active service member commits suicide or attempts suicide, a Suicide Event Report is compiled. The report is an investigation of the suicide and circumstances leading up to it. It is a sort of psychological autopsy that is supposed to provide military leaders with reliable information on suicide risk factors that will assist in designing effective suicide prevention efforts.

The IG decided to investigate how Suicide Event Reports are compiled after finding a high number of  "don't know/data unavailable" responses to questions in the 2011 Annual Report - the most recent year available.  Here are the questions that received the most "don't know/data unavailable" reponses: You would think that these are among the most important questions in determining why someone committed suicide. So, why couldn't the folks assigned to complete these reports answer these questions?
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In My Experience

How the Media Covers Suicide: Day 2

Covering Suicide and Mental Illness is a three-day seminar for journalists sponsored by The Poynter Institute, The McCormick Specialized Reporting Institute and the Action Alliance for Suicide Prevention. Here are my thoughts on issues covered during today's session. #suicidereporting
Today we learned some really wonderful techniques on how to cover suicide. Unfortunately, they aren't very practical.

For example, it was suggested that we not use the word "suicide" in a headline. Really? Not only does it become impossibly difficult to write a headline about a suicide and not use the word "suicide," in these days of SEO-driven journalism, you must put the word "suicide" in the headline or your editor will.

Headlines are no longer about the sexiest verb we can find. Headlines are about SEO and using words that Google Trend tells us will attract readers. Suicide is one of those words.

We were also given suggestions on how to speak with family members at the scene. First of all, if you go to a suicide scene and there are any family members present, the cops aren't going to let you speak with them until they have ruled the death a suicide and not a homicide. This means you won't have a prayer of getting an interview with a family member until the cops have finished their interviews.

I've been doing this for 30+ years and the chances of  family members wanting to speak with you after what they have been through - the suicide itself and then an interview with the cops - are slim to none. With homicides, you can often get a family member to talk and even give you a photo of the victim. But suicide - no way.

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Justifying late-term abortions: Mother’s mental health is not enough

Last week Florida lawmakers passed a law banning most abortions during the third-trimester. A doctor who performs an abortion during the third trimester and anyone who assists can be charged with the third-degree felony.

However, the law makes an exception when a "physician certifies in writing that, in reasonable medical judgment, there is a medical necessity for legitimate emergency medical procedures for termination of the pregnancy to save the pregnant woman's life or avert a serious risk of imminent substantial and irreversible physical impairment of a major bodily function of the pregnant woman other than a psychological condition."

Without wading into the debate over abortion, I would like to weigh in on the exception in the exception of  "a psychological condition."

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Why pinching pennies on mental health care won’t work

My disenchantment with politics has hit a new low. I didn't think that was possible until I began looking at Florida Gov. Rick Scott's 2015 budget proposal line-by-line.

I was writing another story on child welfare programs and figured while I was looking at the budget, I might as well look at our governor's budget proposal for mental health programs. Going straight to the bottom line, I see the governor is proposing spending $ million...
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Sen. Creigh Deeds: The high cost of not treating mental illness

I couldn't hear what the man on 60 Minutes was saying because I was busy making dinner but I saw the scar across his face and figured he was a veteran or had been in a car crash. I record 60 Minutes every week so I figured I would watch it later. I did and then I realized this was Virginia state Sen. Creigh Deeds. I vaguely remembered reading a few news stories about some senator's son attacking his father and then killing himself but there was no follow up - just that the senator had pulled through.

I did not know that Deeds' son, Gus, 24, had bipolar disorder and that he and his father had been in the emergency room trying to get treatment for Gus the day before the attack. Or that there were no beds available in the psych unit and so Gus went home - unlike other kids who can linger for days in emergency rooms waiting for a psych bed to open up.

The story got more horrific as it went along. Deeds gave us the unimaginable details of the attack and how he looked at his son as he sliced at him with a knife and told him how much he loved him. And then there were interviews with other parents who had been in similar situations, with children much younger than Gus - discharged from emergency rooms because there were no beds for psych patients.

All I could think while watching was... What The F-word is wrong with us! Sandy Hook wasn't enough? Aurora wasn't enough? Virginia Tech wasn't enought? What astounds and infuriates me is that we - or at least I - know who is to blame.
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Depression as fashion…not

I have a few questions about Urban Outfitters controversial "Depression" shirt - like who the heck would wear that?

You've got a cropped t-shirt (who even wears those anymore?) covered the word "depression" in a busy pattern of different size letters. In the t-shirt's defense, "Depression" is the name of the clothing line. Really? Who names their clothing line after a mental illness? What's next?

Well, I don't know what's next but I can tell what the last shirt that got Urban Outfitters in trouble. It's the one that said "Eat Less" on an emaciated teenager. REALLY? I mean, REALLY? You tell me that there was a photo shoot at some studio and the stylists put an "Eat Less" t-shirt on an emaciated teenage model and SOMEONE in the studio didn't say, "Whoa, whoa, whoa. This is not cool. We can't do this!"

And there is some buyer at Urban Outfitters (who apparently didn't get the memo about the Eat Less shirt) who saw the Depression t-shirt and thought, "Ooooo! We just have to carry that shirt!"

Don't get me wrong. I like a lot of the stuff that Urban Outfitters sells. In fact, I just got a pair of tangerine Chuck Taylors for $10. Obviously, I don't have much fashion sense but I love a good deal. But what little fashion sense - and common sense - I have were thoroughly insulted by the "Depression" t-shirt.
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