Scottish Mental Health Arts and Film Festival 2011

CALL FOR ENTRIES

Our annual open film submission gives filmmakers the opportunity to share their work and ideas with audiences across Scotland and internationally. The festival is committed to finding and celebrating the work of filmmakers who explore mental health in film. In its broadest sense ‘mental health’ is a term which touches most aspects of our lives; from our relationships to how we respond to the world around us. We’re looking for films which show that mental health is something we all have, and something we all need to prioritise from time to time.

Previous winning submissions have looked at topics such as moving home, ageing, grief, loss, endurance, support, friendship, equality, sport, music, childhood as well as films about specific diagnoses or conditions.

Entry is free. The closing date for entries is Friday 6th May 2011. Please visit the website www.mhfestival.com for more information. Email smhaff@gmail.com for submission guidelines and entry form.

The fifth annual Scottish Mental Health Arts and Film Festival will take place across Scotland throughout October 2011. 

Measuring the Value of Culture: a report to the Department for Culture Media and Sport 
Dr. Dave O’Brien

The cultural sector faces the conundrum of proving its value in a way that can be understood by decision-makers. Arts and cultural organisations face a ‘cooler climate’ than the one that prevailed during the early 2000s. As a result it will not be enough for arts and culture to resort to claiming to be a unique or special case compared with other government sectors. Since the 1980s the value of the cultural sector has been demonstrated through the lens of ‘impact’, whether economic or social. However in recent years there has been recognition, both within central government and in parts of the publically funded cultural sector, of the need to more clearly articulate the value of culture using methods which fit in with central government’s decision-making. Thus the cultural sector will need to use the tools and concepts of economics to fully state their benefits in the prevailing language of policy appraisal and evaluation.

Full report can be found at:
http://www.culture.gov.uk/publications/7660.aspx  

S C E N A R I O S in Arts and Health
Following on from the ongoing M A N I F E S T O events and building on an emerging, shared vision, MMU will be hosting a free event on the 23rd September 2011 to explore where the arts/health agenda is in relation to the ongoing financial downturn; government changes and cuts; and societal shift, to explore our future practice over a generation. Places will be strictly limited to this event and you can register your interest at artsforhealth@mmu.ac.uk (this does not guarantee a place). 

What’s the difference between all these medications?

By Sara Coffey, D.O.





This is a question I am often asked by my patients. Several times a day we see commercials for prescription pills to treat a variety of diseases from high cholesterol to heart disease and treatment for mental illness is no different. Today I would like to talk about one of the most common mental illnesses, Depression and its treatment.

Depression affects roughly 15 million Americans adults, and it is an illness that can be readily treated with antidepressant medications, talk therapy or a combination of medication and talk therapy. Antidepressants have been around for decades and include several classes of medications that work on different chemicals in the brain, but today the first line treatment for depression are medications called, SSRI’s or Selective Serotonin Reuptake Inhibitors. For the most part medications in this class are very similar; they work by increasing the amount of serotonin between nerve cells which is thought to play a role in depression. Unlike a pain pill that works right away, antidepressants can take up to 4 to 6 weeks to have an affect.



Which SSRI a doctor chooses will depend on each individual patient. Just like every other medication, antidepressants can have side effects and interact with the body or other medications in a way that may be dangerous or uncomfortable for patients. Some SSRI’s may be more likely to make a person tired or sedated, while others may have a tendency to give a patient more energy. Depending on an individual’s depressive symptoms, your doctor might prescribe a medicine that would be more likely to help you fall asleep or feel more alert and energetic. Furthermore, certain SSRI’s have been studied more in patients with a particular medical disease, like heart disease for instance and this might leave a physician to try a medication that has research data to show that the medication is safe for their patient. Certainly, some medications work better in some patients than others, and after a period of 4-6 weeks of adequate dosages if no improvement in symptoms occurs your doctor will likely recommend increasing your dose or switching to another antidepressant to treat your depression. In some instances a physician might recommend augmenting your medication by adding another medication that works in a different way to treat your Depression.



Even if the first anti-depressant doesn’t seem to work for you, there are still other options for treatment. Newer medications that work on norepinephrine and dopamine in the brain are also used quite frequently to treat depression, and older medications to treat depression, although they often have more side effects are still effective in treating depression and can be used in refractory cases.



As a patient it is important for your prescribing doctor to know about your symptoms, side effects, and other medical history and current medications that you are taking. And, as always if you have any questions about the medications you are being prescribed don’t hesitate to ask your doctor about your concerns.

M A N I F E S T O for Arts and Health update...

Dear friends...the first manifesto event was a great success and more sessions are planned for the new year. As a taster and keep you interested, the first group that met in October worked wonders and some of their thoughts and aspirations are here for you to see...but there, is more, much more to follow between now and June.

Bipolar in kids? Probably not.

By Scott Benson, M.D.



The 5-year-old little girl had been referred to a therapist by her school because of her severe disruptive behavior. The almost daily tantrums had everyone concerned. She was uncooperative with the assessment and arrangements made for further evaluation. The therapist wrote a diagnosis of bipolar disorder.

The patient was certainly reactive to any limits and her tantrums seemed like they would never end. But she slept well at night; she rarely had behavior problems with her grandparents who provided afterschool care.

After a few parent training sessions with the little girl and her parents her behavior control improved. But continued treatment was threatened when her dad tried to get her on his new health insurance. The diagnosis of bipolar got the application bumped by the computer and it took a lot of calls and several letters to get her on the policy so that her treatment could continue.

At times it seems we are a little too quick to throw a label on a child’s behavior, and bipolar disorder seems to be the most popular current label.

But new research at the October meeting of the American Academy of Child and Adolescent Psychiatry found that children with some symptoms of mania probably do not have bipolar disorder.

Boris Birmaher, M.D., a child and adolescent psychiatrist at the University of Pittsburgh presented his group’s research. More than 2,000 children presenting to 10 different academic centers were included in the Longitudinal Assessment of Manic Symptoms (LAMS) study. 621 were found to have elevated symptoms of mania, but the full evaluation did not find sufficient symptoms for a diagnosis of bipolar disorder. Most had attention deficit hyperactivity disorder (ADHD), others had another disruptive behavior disorder. Children who did have bipolar disorder have poor function and are likely to require treatment in hospitals.

"Kids with manic symptoms don't necessarily have bipolar disorder," he told Reuters Health. On the other hand, "Many children with bipolar disorder are not being correctly diagnosed."

The LAMS study which will follow these children for five years should provide direction for the assessment and treatment of children with severe behavior problems. In the mean time parents should insist on an adequate evaluation for children with severe behaviors.

The Parents' Medication Guide for Bipolar Disorder in Children & Adolescents is a great source of information for understanding the evaluation process and treatment options. Or visit HealthyMinds.org for more information on bipolar disorder or mental health issues in children.

Networking Evening Events 2011

I’m pleased to announce that the North West Arts and Health Network evenings are continuing through 2011 and the dates below are confirmed, but are of course, subject to change and all updates will be made on the BLOG and Arts for Health main website http://www.artsforhealth.org  

• January 27th


• March 24th


• May 26th


• July 28th


• September 29th


• November 24th

All sessions will be held at Manchester Met between 6:00pm and 8:00pm in a room that will be confirmed in the week prior to the event.

On the January 27th, Bits and Bats evening, I’m going to share some short archive films from the early days of the NHS in the late 1940’s. It’s all good fun and interesting given today’s climate of change. If you have any interesting archival footage that you’d like to share that relates to our Arts/Health agenda, please get in touch.

I’m still very keen for members of the network to influence these sessions and encourage you to send in ideas for themes for the evenings.

...a stimulus

I wonder what are the works of art that inspired you towards this arts/health agenda? Or, do certain works impact on your thinking. I gave a paper recently that explores the relationship between the pharmaceutical industry; the happiness industry and the arts. I had to edit such a lot out of it, and this includes a poem by Philip Larkin called, This Be The Verse, which links very much into my thoughts around the pathologising of depression and dissatisfaction with our lot. I'll leave you to work out any subtleties.

This Be The Verse
They fuck you up, your mum and dad.
They may not mean to, but they do.
They fill you with the thoughts they had
And add some extra, just for you.

But they were fucked up in their turn
By fools in old-style hats and coats,
Who half the time were soppy-stern
And half at one another’s throats.

Man hands on misery to man.
It deepens like a coastal shelf.
Get out as early as you can,
And don’t have any kids yourself.

Parenting in the Internet Age

By Molly McVoy, M.D.

Facebook, blogging, Twitter, email, texting. How is a parent supposed to keep up with all of the technology available to children and teens in today’s world? Many parents and children struggle with safety on the Internet. Although there are no easy answers, some simple steps can help keep you and your child safe.

First, and most important: all of the things that make a good parent in everyday life also make a good parent on the Internet. Spend time with your child in their daily life and spend time with them learning about what they do online. Educate yourself on your child’s school and social life. In the same way, educate yourself about the websites they visit and who they are talking to online.

In addition, keep their access to technology limited and in public settings. Put the computer in the kitchen or the living room – in other words, in a place where secrecy is difficult and monitoring is easy. Online time should only come after homework and other activities are done for the day. Also, talk about what they are doing online, but do not invade their privacy by reading emails unless absolutely necessary. If you suspect dangerous things are happening by or to your child online, then invading their privacy may be necessary. Otherwise, encourage open communication and respect their privacy.

For more information:

http://www.webwisekids.org/

http://www.kids.gov/6_8/6_8_computers_internet.shtml

http://www.attorneygeneral.gov/uploadedFiles/Consumers/cybersafety.pdf

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Hypertexting and risky behaviors: A cautionary tale?

By Tristan Gorrindo, M.D.

Last month, researchers at the American Public Health Association’s annual meeting reported some alarming statistics about the connection between high levels of message texting and risky behaviors. In a study of high school students in the Midwest, the researchers found a relationship between those that send more than 120 texts per school day (20% of the students surveyed fell into this group) and increased experimentation with cigarettes and alcohol, binge drinking, physical fighting, and a high number of sexual partners. These results were widely reported by several major media outlets including CNN and the Associated Press .

While the authors of this research clearly state that they don’t think that “hypertexting” causes students to drink more or engage in risky behaviors, I worry that this fine-point is lost on most people who are just reading the headlines.



Since most of us don’t remember our high school statistics class, I think it’s worth thinking about how two ideas can be related (as they are here) but not necessarily in a causal relationship. An analogy I often use is the finding that yellow teeth and lung cancer are highly connected in research studies. It isn’t that tartar covered teeth cause lung cancer, or that lung cancer causes teeth to yellow. It turns out that there is a common root-cause of both– that is smoking cigarettes causes both yellow teeth and lung cancer.



In a similar manner, there might be an underlying root-cause (or several different causes), which cause kids to use cigarettes and alcohol and to be hypertexters. These root-causes might include poor parental supervision, mental illness, or even a learning disability, just to name a few. But until we conduct more careful studies, we won’t know for sure.



Certainly, parents should know how many texts per day their child is sending. And in the same way that I encourage parents to talk to their kids about alcohol use or sexual activity, they should also be talking to their kids about the ways in which they are using technology.

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Coping with Stress in America

By Adair Parr, M.D.

A survey by the American Psychological Association highlighted the negative impact that stress can have on families and children. This is an extremely important topic that affects many family caregivers, who are under a great deal of stress taking care of loved ones. More and more Americans are affected by stress. The survey indicates that many Americans feel that they are experiencing unhealthy amounts of stress. The economy is one of the main reasons. Fewer are satisfied with the ways that their employer helps employees balance work and non-work demands and many are concerned about job stability.

In addition, stress impacts the entire family. Children recognize when their parents are stressed and that could make them feel sad and worried. Nevertheless, parents frequently underestimate the impact that their own stress has on their children.



Stress affects both our mental and physical health. Some people manage stress by smoking, drinking or over-eating. That can lead to bigger problems. The study shows that Americans understand the importance of healthy behaviors like getting enough sleep, exercising and eating healthy. However, lack of time and motivation gets in the way of following through on these goals. Willpower was identified as a barrier to many healthy behaviors, even when they are recommended by a health care provider.

Managing your stress is extremely important. Stress does affect the family members you care for. There are healthy ways to manage your stress. Some suggestions are: exercising or playing sports; listening to music; spending time with friends and family; going to religious services; journaling; and practicing yoga / meditation. 





If you find that you are overwhelmed or suffering physical symptoms from stress like headache, poor appetite and insomnia, or if you are feeling depressed or suffering from chronic irritability and crying spells, you may need to see a mental health provider. The Healthy Minds website has brochures about dozens of mental health issues including early warning signs of mental illness.

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Where to go for Mental Health

By Sara Coffey, D.O.



Sara Coffey, D.O.



Trying to find the right doctor for you? With so many specialties and titles it can be confusing to navigate the complex array of mental health professionals. So, where do patients with mental illness start?

Understanding a doctors training and background may be the first place. Patients with mental illness may be seen by their primary care doctors, counselors, psychiatrists, or psychologists. But, what makes these professionals different? All physicians, either M.D.’s or D.O.’s (Osteopathic Doctors), have similar training. Most often, they have completed four years of undergraduate school, with an emphasis on science courses including biology and chemistry. Then they must pass an entrance exam to start a four-year medical school program where they will receive two more years of core science training as well as other courses to help them understand the human body, disease, and prevention. The last two years of medical school focus on clinical rotations through surgery, OB/GYN, psychiatry, internal medicine, family medicine, and include several months of extra training in a specialty area.

Upon completion of medical school, you are officially referred to as “doctor,” but a psychiatrist’s training does not end there. A residency program comes next with hands-on training under the guidance of a more seasoned physician. Take my background for example. As a psychiatry resident, my first year of residency training included two months working on an inpatient pediatric floor, two months on an inpatient general medical hospital floor, and two months on a neurology service. These rotations are important in psychiatry training because psychiatric patients often have other medical issues in addition to mental health problems. A physician should know the difference between anxiety and a heart attack.

It takes eight years or more of school and four to six years additional years of training to become a fully practicing psychiatrist. I’m on that path, and now I will be able to focus on my psychiatry specialty. That will give me the opportunity to learn the science and art of treating patients from experienced psychiatrists. My integrative medical training will also provide a solid foundation to work with a variety of patients and their mental illnesses.

Finding Meaning in Modern Life - Part 2

By Roberto Blanco, M.D.

Last month, I wrote about Viktor Frankl’s book “Man’s Search For Meaning” and how some of the principles in his book could be applied to modern life. In response to the blog, one of the readers, Mukesh Samani, asked what it was in Dr. Frankl’s book that touched me the most. I would like to take this opportunity to thank Mr. Samani for his question and to respond.

What touched me the most from Dr. Frankl’s work was his motivation to live, share his experience, and teach something positive. As a psychiatrist during a time when any type of self-revelation was taboo and frowned upon, he showed great courage in revealing some of the darkest, innermost details of his life to the entire world. He did this so others could learn from his experience.

As a Psychiatrist, I work with many people who may be down on their luck or are the victims of unfortunate situations. Like Dr. Frankl, the ones who are able to discuss their situation, find some meaning from it, and continue to move forward, generally do the best.

Mr. Samani also asked what is special or specific in Dr. Frankl’s model of psychotherapy known as Logotherapy. Mr. Samani, I would refer you back to Dr. Frankl’s book which has a nice summary on Logotherapy. I am not an expert on Logotherapy. However, in short, it is a therapy which focuses on man’s desire to find meaning as the main motivating force in life.

I see following role models, like Dr. Frankl, as a way to find meaning in life. Looking back on your own life, is it clear which people affected you the most in positive ways? What was it about these people that moved or affected you? Did they have some special characteristic that set them apart from others or allowed them to connect with you? If so, finding out what that is and trying to reproduce it with others can give your life more meaning.

I have a lot of admiration for Dr. Frankl’s work and I appreciate the comment from “Mary” about a new documentary coming out on his life titled “Viktor and I.” I’ll be interested to see how he used his experiences in his professional life and what he was like on a personal level from the perspective of his close friends, family and colleagues. Thank you for your comments and questions.

National Caregivers Month: Alzheimer's Disease

By Felicia Wong, MD



Alzheimer’s Disease is a progressive, irreversible brain disease. The cause is poorly understood, and there is no known cure. Symptoms of Alzheimer’s include memory loss, confusion, impaired judgment, personality changes, disorientation and loss of language skills. It is the most common form of irreversible dementia.

Watching someone you love slowly lose their memory, thinking and reasoning skills can be heartbreaking. Caring for a person with Alzheimer’s Disease is a difficult task and can become overwhelming at times. As Alzheimer’s patients gradually lose their memory and their skills , each day brings new challenges to the caregiver. This is why I wanted to recognize caregivers for Alzheimer's patients in November, which is National Family Caregivers Month and Alzheimer's Disease Awareness Month.



Over time, communication diminishes, rewards decrease, and without strong support from family, friends and the community, caregivers of Alzheimer's patients face challenges to their very own well-being. Maintaining emotional and physical fitness while providing care for a loved one with Alzheimer’s Disease is crucial. Preparing and protecting yourself, understanding your loved one’s experience, and accepting help from others can reduce the stress associated with care-giving, and maximize the joys of being there for a loved one.



Here is a link to tips to help caregivers of loved ones with Alzheimer’s cope.



Additional support for Alzheimer’s and Dementia Caregivers, including warning signs of caregiver burnout, and tips on how to plan your own self care can be found on Helpguide.



Find additional information on Alzheimer's and other issues affecting mental health in seniors on the American Psychiatric Association's Healthy Minds website.

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National Family Caregivers Month: Self-Care for Caregivers

By Felicia Wong, MD

I love helping others. That is why I became a doctor, and why I love my job as a psychiatrist. But when I was a pre-medical student in college, my mom shared the following words of wisdom with me:  “In order to take care of others, you need to take care of yourself first.”

It took me a moment to understand the importance of the point she was making. I had taken a break from my community service projects due to a sports injury, and was eager to return to them. However, at that time, I was not fully recovered and was often in pain, and would tire easily. My mom encouraged me to take some more time off in order to focus on my own recovery and healing. Initially, I felt guilty taking the time out for myself. But in the end, I realized mom was right. Once I became strong and well again, I had so much more to offer to others.

Caregivers tend to be selfless, and expect a lot of themselves without recognizing their own need for self-care. Studies have found that caregivers have higher levels of depression and stress than non-caregivers. Sometimes caregivers are so committed to helping others that they forget to take care of themselves. They fail to recognize that if they drive themselves to exhaustion or sickness, they may not be able to help at all.

Warning signs of caregiver burnout from the non-profit Helpguide.org include:

• You have much less energy than you used to


• It seems like you catch every cold or flu that’s going around


• You’re constantly exhausted, even after sleeping or taking a break


• You neglect your own needs, either because you’re too busy or you don’t care anymore


• Your life revolves around caregiving, but it gives you little satisfaction


• You have trouble relaxing, even when help is available


• You’re increasingly impatient and irritable with the person you’re caring for


• You feel overwhelmed, helpless, and hopeless

Key strategies to prevent burnout include getting the help you need, seeking emotional support, and taking time out to care for yourself.

• Learn and use stress-reduction techniques.


• Attend to your own healthcare needs.


• Get proper rest and nutrition.


• Exercise regularly.


• Take time off without feeling guilty.


• Participate in pleasant, nurturing activities.


• Seek and accept the support of others.


• Seek supportive counseling when you need it, or talk to a trusted counselor or friend.


• Identify and acknowledge your feelings.


• Change the negative ways you view situations.


• Set goals.

For additional strategies for self-care for caregivers, visit the Family Caregiver Alliance, and watch for my next post on caring for someone with Alzheimer's. 

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National Family Caregivers Month

By Gariane Gunter, M.D.



November is National Family Caregivers Month and what a worthy group to stop and recognize. Those who are caregivers for family members or friends with mental illnesses need support and encouragement just as those caring for loved ones with other illnesses. There are many groups and resources available across the nation that are available to help. I would like to tell you about one of them.

The National Alliance on Mental Illness is a grassroots organization that was started in 1979. I have had the wonderful opportunity to work with them in my area and have seen firsthand the difference they make in the lives of those suffering from mental illnesses as well as their families. One special program they offer for family members is called Family-to-Family. The NAMI Family-to-Family Education Program is a free 12-week course for family caregivers of individuals with severe brain disorders (mental illnesses). NAMI recognizes that family members of people with serious mental illnesses need information and support to cope with the considerable stresses they experience.



The Family to Family Education Program is a structured, peer-led, 12-week information and support self-help class for such individuals. Research shows reduced subjective burden and increased empowerment among graduates. Family-to-Family classes are offered in hundreds of communities across the country. You can find more information on this program as well as many other resources available in your area by visiting NAMI online at www.nami.org. There you can find a support group, connect online in NAMI's discussion groups, contact your state or local NAMI and more. Caregivers please take the time to take care of you this month.

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News and Events

A  M A N I F E S T O  f o r  A R T S   

a n d  H E A L T H

Thanks to everyone who took part in Fridays first event. A dedicated BLOG is being prepared...

P L A C E B O S  f o r  A R T

The Behring Institute is seeking placebos for art. With these placebos, long-term research on the influence of art on public health will be carried out. Artists, art lovers, professionals as well as amateurs, are being called on to submit proposals for potential art placebos before 1 January 2011.

Relationships between art and healthcare, as well as the influence and effects of art on health, have been studied frequently. The results of many studies indicate a positive outcome with regard to the health of people and suggest that art can lead to the improvement of mental and physical health. For the purpose of a long-term European study on the effects of art on the health of individuals, the Behring Institute now seeks placebos for art, which can be offered to a control group.

Examples and leads can be e-mailed to Mrs. Andersom, j.andersom@behringinstitute.com, or posted to: Behring Institute, attn: Mw. J. Andersom, Herenmarkt 93F, 1013 EC Amsterdam, The Netherlands. Once the selection process has been completed, the submitted documentation can unfortunately not be returned.

For more information, see: www.behringinstitute.com Mrs. Andersom of the Behring Institute can be contacted during office hours at j.andersom@behringinstitute.com

New website

Health professionals can find out how creative activities can benefit people affected by long-term conditions, and locate local voluntary arts/creative groups, on a new website: www.healthysocialcreative.org.uk The site has been created by Voluntary Arts, to raise awareness of the wealth of creative activities that exist in local communities – from choirs to quilt-makers, dance groups to painting societies, drama groups to samba bands – and the health benefits of taking part.


K E E P  L E A R N I N G  
S E M I N A R S 
19 November–11 December 


Building on the positive momentum from 2008, the arts and cultural sector have played a significant role in Liverpool’s Year of Health & Wellbeing. We know that arts and culture impact on our sense of self individually and collectively, and it is increasingly important that we find ways to articulate why this is the case.  We are promoting these events as a series to NHS staff, researchers, clinicians and GP’s to raise awareness of the scope, quality and value of this work in the City, and with the hope of engaging more health professionals and researchers in the work going forward, both to raise awareness of Liverpool’s innovation in this area of work and to develop collaborations longer-term as we embark on a Decade of Health and Wellbeing.

Concussion: Getting Back in the Game?

American Psychiatric Association Healthy Minds blogger and sports psychiatriy expert Claudia Reardon, M.D., discusses concussions in young athletes in this video blog:

Depression: Should I Tell the Boss?

By Gina Newsome Duncan, MD

Depression is the leading cause of disability among people ages 15-44, affecting nearly 7 percent of the adult population in a given year. That means that close to one in ten American adults is suffering from depression at any given point in time. A recent CNN Health article highlighted the dilemma one woman with depression faced when considering whether to tell her employer.

It may not be talked about much, but depression is most certainly present in the workplace. What are the effects? People suffering from depression can experience a decrease in concentration, difficulty making decisions, feelings of isolation, feeling slowed down in their thinking and mental processing, and poor sleep, which can lead to daytime fatigue. All of these factors can result in poor job performance. In fact,a decline in job performance is often the wake-up call that someone is experiencing depression and needs to do something.

If you feel that you may be suffering from major depressive disorder and are concerned about the effect on your work, what should you do?

1. A good first step is to talk with a psychiatrist or your primary care physician about your symptoms and explore possible treatment options. Psychiatrists and primary care physicians are familiar with employment issues and should be able to get you started on a plan to address your concerns.


2. Find out about your company’s Employee Assistance Program (EAP). It is in your company’s best interest for you to function at your optimal level, and most large companies offer some type of EAP. In most cases, confidentiality and privacy requirements apply to EAP services, and the employer does not usually know who is or is not using them, except in cases where the employer referred the worker to the EAP. Employee Assistance Programs offer a broad range of services, including psychological assessment, counseling, support and referrals.

Other things to keep in mind:



Depression is real, but it is not as visible as something like a broken leg. Depression can be difficult for others to accept as a true illness or valid reason for being excused from work. As a society, we can be stoic when it comes to issues of emotional distress; “Just suck it up and keep going,” we tell ourselves and others. It can be hard for others to understand or appreciate the effects of a major depressive episode or another mental illness unless they or a loved one have experienced it. Employers are beginning to understand that attending to their employees’ mental health is not just a nice thing to do, it makes good business sense.



Federal laws protect the rights of workers who become medically ill or disabled. This includes workers who are unable to work due to a mental illness such as major depression. However, employer sensitivity toward such employees can vary, particularly if the employee has not taken official medical leave but is frequently calling out sick or requesting time off for regular psychiatrist or therapist appointments during work hours.



Whether or not to disclose your illness to your boss and/or your coworkers is an individual decision that depends on your company’s culture and your own preference. But here are a couple of thoughts to keep in mind: If your symptoms are not affecting your job performance in a visible way and if, with the help of your doctor, you have started a treatment plan that you are finding helpful, then disclosing your illness to your employer may not be necessary. If, on the other hand, your symptoms are severe, causing frequent missed days of work or other job performance issues that threaten your employment, and if you have not yet started treatment, then being proactive and addressing the issue with someone you trust, like a doctor, Employee Assistance Program or a boss, can be an important step.



Have you experienced firsthand the effects of depression in the workplace? If so, how was it addressed? How can we reduce the culture of stigma that surrounds mental illness in the workplace?

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Family-Based Treatment May Benefit Teens with Anorexia

By Molly McVoy, MD



A recent Wall Street Journal article reported on a study regarding teens with anorexia. The results of the study, published in the Archives of General Psychiatry, indicate that having parents actively involved in the treatment of adolescents with eating disorders is more effective than the traditional one-on-one treatment with a therapist.

The study looked at 120 teenagers using the Maudsley model versus traditional one-on-one therapy. The Maudsley model encourages parents to take charge of the eating habits of their children with eating disorders, such as anorexia. At one year, the study found that about 50 percent of patients treated with this family based therapy were in remission versus 23 percent in the more traditional individual therapy.



Anorexia nervosa is a serious, often life-threatening illness in which patients fear gaining weight to such a degree they restrict their diet and maintain a body weight below the 85 percent of a healthy weight. Successful treatment is intensive, involving medical monitoring, dietary interventions, therapy and, at times, medication.



This study adds to accumulating evidence that family involvement is critical in successful treatment of adolescents with eating disorders. As more studies are published with similar data, treatment centers for eating disorders and increasingly involving families in the intensive treatment programs.



The HealthyMinds.org has more information on eating disorders. 



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ADHD: Can My Kid Just Outgrow It?

By R. Scott Benson, MD





Won't he just outgrow it? This is the wish of every parent – that a little time, a little more love, or discipline, or happy thoughts will solve what might be a serious problem. And I hear this question often from parents of pre-schoolers who are having behavior problems in pre-K programs or daycare settings.

But we can’t wait. And now there is even more research to support the importance of a careful evaluation and treatment when indicated. This month’s Archives of General Psychiatry reports the results of a long term study of children who were diagnosed with ADHD between the ages of 4 and 6 years old. There was a control group of children without ADHD. As adolescents the children with the early diagnosis of ADHD had higher rates of depression and suicidal thoughts. Fortunately, there were no suicides in this study. Benjamin Lahey, Ph.D., the study director is a professor of health studies and psychiatry at the University of Chicago. He said the study “reinforces our belief that parents of young children with ADHD should pay close attention to their child’s behavior and its consequences and seek treatment to prevent possible long-term problems.”



So the better question is “What treatment is recommended for pre-schoolers?” And we have good science to help answer that question. Carefully managed studies have shown that pre-school children and their families should have at least 12 weeks of behavior management training as a first level of care. And this is not just any behavior management. At a conference in Florida, Dr. Regina Bussing recommended that families should consider a number of behavior training programs – the Positive Parenting Program, The Incredible Years, and Parent Child Interaction Therapy. These are intense programs that are very different from a few words of advice from a well-meaning pediatrician or the do-it-yourself manuals that are so prevalent in the bookstores.



Let us know of other successful behavior training programs in your community, and we will post those links here.

Supporting Gay Youth as a Way to Prevent Suicide

By Tristan Gorrindo, MD



Coming out of the closet is one of the hardest things that a gay, lesbian, or bisexual person will do.

“Coming out,” is the process of revealing to friends, parents, family members, and acquaintances that he or she is gay. It is more that just a simple act or decision to announce that a person is gay, but rather a process that unfolds overtime, usually in small steps. For many people, it involves telling one person, then a group of friends or family members, then classmates or co-workers, and finally the world at large. But for each person, the journey is different and often filled with emotional ups and downs.

Recent events in the national media have highlighted the issues surrounding coming out and youth suicide. By some estimates, as many as nine gay youth died by suicide since September 1, 2010. Government officials and celebrities have publicly referred to this as a national crisis.



Many population scientists have tried to understand why gay teens are at such high risk for suicide -- by some estimates 7 times the national average for their age. And although there are many possible contributors to what might make a gay teen suicidal, we must first remember that all teens, gay and straight alike, are struggling with basic questions about self-identity.



A friend of mine once described being a teenager is like, “being at a costume ball where the costumes and guests are constantly changing.” As part of normal teenage development, teens are “trying on” different roles, different groups of friends, and even different kinds of dress. It is a time when teens are first experimenting with the idea of romantic relationships and at the same time trying to separate from their parents. Gay teens have the added burden of sorting out the confusing, often negative messages from the culture about what it means to be gay. When these ingredients mix -- unsure sense of self-identify, novice experience with romance, trying to separate from one’s parents, and fear of what it means to be gay -- gay teens run the risk of feeling quite isolated and alone.



Regardless of one’s personal views of homosexuality, I think we can all agree on the importance of supporting our youth during difficult times. The American Psychiatric Association is committed to reducing the stigma around homosexuality and to promoting the psychological health of gay, straight, and bisexual individuals.



We owe it to our teens to make sure that they know that coming out is not a process that they have to go through alone. A wide variety of resources exist, from grass-roots YouTube videos which offer gay teens hope, as in The Make It Better Project, to 24-hour suicide hotline for gay teens offered through The Trevor Project. Additionally, The National Suicide Prevention Lifeline also is available 24/7 at 1-800-273-TALK (8255) to anyone struggling with suicidal thoughts. The Healthy Minds website is a source of clear factual information on sexual orientation. And let us not forget the parents that may also be struggling with how to help their gay child; for them there is support and advice offered through PFLAG.

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