By Gariane Phillips Gunter, M.D.
Over the past several years, with great help from Brooke Shields and others sharing their stories, postpartum depression in new moms has become well known. However, recent evidence suggests that new dads may be suffering too. A recent study in the May 19th issue of the Journal of the American Medical Association reports that “14% of American men develop depression, either during their partner’s pregnancies or in the first year after delivery”.
Unfortunately, dad’s depression may be overlooked as the symptoms may not present as sadness but as irritability, anger or isolation from their loved ones. Without identification and treatment of dad’s depression, negative outcomes for the new baby and family can occur.
New babies need secure, healthy attachments for their physical and emotional development and these attachments are strained when either parent is suffering from their own depression. If you are a new mom or dad and feel you may be suffering from depression, please talk to your doctor and ask for help.
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Kamis, 20 Mei 2010
Selasa, 18 Mei 2010
UPDATE on Pandemic Planning and Response
Between 23rd and 25th March 2010 I took part in the first Asia Europe Foundation Network for Public Health workshop exploring ways of enhancing the pandemic preparedness capabilities across partner countries. This, the first of three workshops, brought together 26 high-level participants from multiple sectors including amongst others, scientists, governments, NGO’s and the health sector. The event was facilitated by Prospex http://www.prospex.com/ and managed by the Asia Europe Foundation (ASEF) http://www.asef.org/
Although the detail of the work, is at this stage not public, I’d like to share some of the themes and process’ to keep those of you who are interested in this agenda, up to speed. I’d also like to encourage dialogue around these themes to continue our own explorations of this agenda.
Through an active participatory workshop the partners identified some of the driving factors and uncertainties around future pandemics and as such, were exploring the themes to feed into the second session which will develop and test some of the ideas which in turn, will feed the third session aiming to refine and analyze the scenarios developed to inform long-term strategic implementation and outreach.
The main elements of this first workshop involved participants identifying their own hopes and fears around the issues which included aspects of co-ordination, current preparedness and human capacity. The facilitators enabled the group to contextualise individual factors and further explore those from very specific perspectives ranging from the legal, economic and political, to demographic, ethical and cultural.
By introducing and interrogating existing foresight studies, the facilitators enabled, (for what was many of us our introduction to this field) an analysis of the successes and failings of contemporary thought. Much of the workshop unpicked the uncertainties associated with pandemic and enabled a clustering of factors with innovation (R&D) and notions of the Human Factor high on the agenda. Through the exploration of 15 clusters, the group further identified polarities in thinking and possibilities of response.
By way of example, I was personally very engaged in conversation around information and communication, particularly with reference to how messages are communicated. The polarities explored around these factors focused on whether pandemic messages would be critically received, or would be met with indifference. Worse than this perhaps, and a theme of many of my papers relating to arts/public health; would be that the media propagate hysteria. Participants from the media sector who took part in this work provided strong critical debate and crucial input into my thinking.
With hindsight, many of the subtle discussions I’d had here in Manchester prior to the workshop, weren’t given a full airing, but notions of the human element, universal metaphor and understanding the roles of both the media and new technologies were robustly discussed as part of the bigger picture. I was also able to make opportunities to discuss the notion of diversity and how different societies/communities around the world will interpret messages differently.
Whilst a good deal of the workshop gave opportunity for blue-sky thinking, it grounded very diverse perspectives in a community of joint interest. For my own part being jet-lagged, in a strange environment and in extreme heat made for quite an anxious start. However, the sessions were meticulously thought through and conducted in English. It is mortifying as a native English speaker, to be surrounded by people for whom this is a second or third language and who speak far more eloquently and with insight than someone who can barely master his own tongue. The company was truly diverse and I felt under a good deal of pressure as one of only two participants from the arts sector.
I most certainly feel that I added to the mix and injected the notion of thinking creatively around this public health agenda, but I could have more explicitly inputted on the role of the artist in society, both as reflecting and questioning societal norms. In particular, the role of the artist within research and development and community engagement is an area I hope to develop further in this work.
I was impressed by the creative insight of a number of participants from wildly different backgrounds, who positively exuded a deep understanding around the potency and relevance of the arts to this area of work.
Clive Parkinson
Although the detail of the work, is at this stage not public, I’d like to share some of the themes and process’ to keep those of you who are interested in this agenda, up to speed. I’d also like to encourage dialogue around these themes to continue our own explorations of this agenda.
Through an active participatory workshop the partners identified some of the driving factors and uncertainties around future pandemics and as such, were exploring the themes to feed into the second session which will develop and test some of the ideas which in turn, will feed the third session aiming to refine and analyze the scenarios developed to inform long-term strategic implementation and outreach.
The main elements of this first workshop involved participants identifying their own hopes and fears around the issues which included aspects of co-ordination, current preparedness and human capacity. The facilitators enabled the group to contextualise individual factors and further explore those from very specific perspectives ranging from the legal, economic and political, to demographic, ethical and cultural.
By introducing and interrogating existing foresight studies, the facilitators enabled, (for what was many of us our introduction to this field) an analysis of the successes and failings of contemporary thought. Much of the workshop unpicked the uncertainties associated with pandemic and enabled a clustering of factors with innovation (R&D) and notions of the Human Factor high on the agenda. Through the exploration of 15 clusters, the group further identified polarities in thinking and possibilities of response.
By way of example, I was personally very engaged in conversation around information and communication, particularly with reference to how messages are communicated. The polarities explored around these factors focused on whether pandemic messages would be critically received, or would be met with indifference. Worse than this perhaps, and a theme of many of my papers relating to arts/public health; would be that the media propagate hysteria. Participants from the media sector who took part in this work provided strong critical debate and crucial input into my thinking.
With hindsight, many of the subtle discussions I’d had here in Manchester prior to the workshop, weren’t given a full airing, but notions of the human element, universal metaphor and understanding the roles of both the media and new technologies were robustly discussed as part of the bigger picture. I was also able to make opportunities to discuss the notion of diversity and how different societies/communities around the world will interpret messages differently.
Whilst a good deal of the workshop gave opportunity for blue-sky thinking, it grounded very diverse perspectives in a community of joint interest. For my own part being jet-lagged, in a strange environment and in extreme heat made for quite an anxious start. However, the sessions were meticulously thought through and conducted in English. It is mortifying as a native English speaker, to be surrounded by people for whom this is a second or third language and who speak far more eloquently and with insight than someone who can barely master his own tongue. The company was truly diverse and I felt under a good deal of pressure as one of only two participants from the arts sector.
I most certainly feel that I added to the mix and injected the notion of thinking creatively around this public health agenda, but I could have more explicitly inputted on the role of the artist in society, both as reflecting and questioning societal norms. In particular, the role of the artist within research and development and community engagement is an area I hope to develop further in this work.
I was impressed by the creative insight of a number of participants from wildly different backgrounds, who positively exuded a deep understanding around the potency and relevance of the arts to this area of work.
Clive Parkinson
Jumat, 14 Mei 2010
For Mental Health Month, Join a Former First Lady In Bringing Down Barriers to Mental Health Treatment.
By Roberto Blanco, M.D.
I was seeing a very depressed patient the other day and we were discussing how far he had fallen in his functioning since he had gotten ill. He said, “I used to be strong. I used to be able to provide for my family.” And yes, there was no doubt that he was unable to provide for his family now. Despite being relatively healthy physically, mental illness had made it so that he could not work, had difficulty leaving the house, or finding enjoyment in anything.
I try not to read too much into simple statements. But the phrase “I used to be strong” resonated with me because I think that it had something to do with why he waited until it was almost too late to seek treatment. While I think that he was trying to express the depths of his feelings of helplessness and need, his statement implied that he was now weak. Fatigue, lack of energy, and poor sleep from depression could make anybody weak. However, I don’t think that this is what he meant.
I often hear people stigmatizing mental illnesses like depression by saying that it only happens to “the weak”. One thing that I’ve learned from my experience practicing psychiatry is that it can affect anyone from CEOs to valedictorians to world-class athletes. Just like this patient indicated, it doesn’t matter how strong you are or think you are, mental illness can affect you if life and genetic predisposition put you in the wrong circumstances.
One of my main concerns with the stigmatization of mental illness is that if it is seen as a weakness, then the solution is often seen as needing to “be stronger”, deny a physiologic problem, and not seek help. As many mental illnesses are quite treatable with medications, psychosocial interventions, and therapy, this can often have tragic and unintended consequences such as loss of close relationships, occupations and careers, or even death.
The other concern is that if mental illness is seen as a fault of character and not as a group of illnesses, then appropriate and necessary resources and medical services won’t be available. In North Carolina, where I work, acknowledging that you need help is not the biggest barrier to treatment. Actually, it is trying to find a provider or an inpatient bed.
With the demand for inpatient psychiatric services skyrocketing in North Carolina, the number of psychiatric beds available has decreased and the outpatient mental health system, which was once a model nationally, has crumbled. It’s hard to imagine that with greatly increasing rates of kidney disease in this country that dialysis clinics or transplant services would be closing down. However, this is exactly what is happening to psychiatric services in North Carolina. It is a complex issue but is due to the national trend of closing state psychiatric hospitals as well as to the privatization and decentralization of outpatient mental health services.
Some people are taking notice of this disturbing trend, including the former First Lady of the United States, Rosalynn Carter. She has written a book on the mental health crisis in the United States and is encouraging people to be vigilant in taking care of their mental health, to overcome challenges, and to get involved.
May is Mental Health Month. So, please take this opportunity to join our former First Lady in advocating for mental illness treatment. Go to your local legislatures or call your congressional representatives and ask that they support funding for mental health services.
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I was seeing a very depressed patient the other day and we were discussing how far he had fallen in his functioning since he had gotten ill. He said, “I used to be strong. I used to be able to provide for my family.” And yes, there was no doubt that he was unable to provide for his family now. Despite being relatively healthy physically, mental illness had made it so that he could not work, had difficulty leaving the house, or finding enjoyment in anything.
I try not to read too much into simple statements. But the phrase “I used to be strong” resonated with me because I think that it had something to do with why he waited until it was almost too late to seek treatment. While I think that he was trying to express the depths of his feelings of helplessness and need, his statement implied that he was now weak. Fatigue, lack of energy, and poor sleep from depression could make anybody weak. However, I don’t think that this is what he meant.
I often hear people stigmatizing mental illnesses like depression by saying that it only happens to “the weak”. One thing that I’ve learned from my experience practicing psychiatry is that it can affect anyone from CEOs to valedictorians to world-class athletes. Just like this patient indicated, it doesn’t matter how strong you are or think you are, mental illness can affect you if life and genetic predisposition put you in the wrong circumstances.
One of my main concerns with the stigmatization of mental illness is that if it is seen as a weakness, then the solution is often seen as needing to “be stronger”, deny a physiologic problem, and not seek help. As many mental illnesses are quite treatable with medications, psychosocial interventions, and therapy, this can often have tragic and unintended consequences such as loss of close relationships, occupations and careers, or even death.
The other concern is that if mental illness is seen as a fault of character and not as a group of illnesses, then appropriate and necessary resources and medical services won’t be available. In North Carolina, where I work, acknowledging that you need help is not the biggest barrier to treatment. Actually, it is trying to find a provider or an inpatient bed.
With the demand for inpatient psychiatric services skyrocketing in North Carolina, the number of psychiatric beds available has decreased and the outpatient mental health system, which was once a model nationally, has crumbled. It’s hard to imagine that with greatly increasing rates of kidney disease in this country that dialysis clinics or transplant services would be closing down. However, this is exactly what is happening to psychiatric services in North Carolina. It is a complex issue but is due to the national trend of closing state psychiatric hospitals as well as to the privatization and decentralization of outpatient mental health services.
Some people are taking notice of this disturbing trend, including the former First Lady of the United States, Rosalynn Carter. She has written a book on the mental health crisis in the United States and is encouraging people to be vigilant in taking care of their mental health, to overcome challenges, and to get involved.
May is Mental Health Month. So, please take this opportunity to join our former First Lady in advocating for mental illness treatment. Go to your local legislatures or call your congressional representatives and ask that they support funding for mental health services.
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Senin, 10 Mei 2010
Talking about Mental Health
By R. Scott Benson, M.D.
In May a few years ago I was asked to give a talk to the seniors who exercised at the mall in the early morning hours. The timing was right for a mental health talk, since May is Mental Health Month.
The focus of my talk was new understanding of the brain and changing thoughts on the cause and treatment of mental illness. The audience was attentive but asked few questions. But after the talk an elderly man approached to clarify some comments I had made about schizophrenia. He called his wife over and they shared the painful story of their adult son’s deterioration as he developed unmistakable signs of this tragic disease.
This couple had been told by the treatment team that their parenting had caused their son’s condition and they needed to leave him alone so that he could recover. And they had carried a burden of guilt for years, viewing themselves as somehow toxic. I was able to answer a few of their questions and then I was encouraged them to join other families involved with our local chapters of Mental Health America and the National Alliance on Mental Illness.
The positive impact of these brave families sharing their stories was reinforced in a new survey from the American Psychiatric Association. And the results of this survey are a cause for celebration telling us how far we have come. More than a third said that stigma has declined, and openness about personal experiences by friends, family and public figures was influential.
The internet has become a valued source of information and was cited by 75% of those surveyed as at least moderately influential in reducing stigma associated with mental illness.
In addition to HealthyMinds, what are the reliable sources of information that have been useful to you? Where have you heard patient and family stories that have reduced stigma in your community?
In May a few years ago I was asked to give a talk to the seniors who exercised at the mall in the early morning hours. The timing was right for a mental health talk, since May is Mental Health Month.
The focus of my talk was new understanding of the brain and changing thoughts on the cause and treatment of mental illness. The audience was attentive but asked few questions. But after the talk an elderly man approached to clarify some comments I had made about schizophrenia. He called his wife over and they shared the painful story of their adult son’s deterioration as he developed unmistakable signs of this tragic disease.
This couple had been told by the treatment team that their parenting had caused their son’s condition and they needed to leave him alone so that he could recover. And they had carried a burden of guilt for years, viewing themselves as somehow toxic. I was able to answer a few of their questions and then I was encouraged them to join other families involved with our local chapters of Mental Health America and the National Alliance on Mental Illness.
The positive impact of these brave families sharing their stories was reinforced in a new survey from the American Psychiatric Association. And the results of this survey are a cause for celebration telling us how far we have come. More than a third said that stigma has declined, and openness about personal experiences by friends, family and public figures was influential.
The internet has become a valued source of information and was cited by 75% of those surveyed as at least moderately influential in reducing stigma associated with mental illness.
In addition to HealthyMinds, what are the reliable sources of information that have been useful to you? Where have you heard patient and family stories that have reduced stigma in your community?
Rabu, 05 Mei 2010
North West Arts and Health Network Event:
DEMENTIA and IMAGINATION
There is a growing awareness that whilst humans are living longer (depending on your global post-code!) and science strives to cure disease, we’re nowhere near having the ‘magic bullet’ for dementia.
Charismatic and articulate individuals like Sir Terry Pratchet who are going through life with dementia are beginning to reduce the stigma associated with the disease and to an extent, reduce fear and raise awareness.
I’m most certainly not an expert in this field, but have had the pleasure of meeting individuals who are including people with the disease, those working in the field in a caring capacity, and those who believe that the arts have something to offer this issue.
I’ve read a little of Gene Cohen’s work on the subject www.creativeaging.org and the wealth of experience offered by Anne Davis Basting in her very readable ‘Forget Memory’ which sets out example of practice that creates better lives for people living with dementia. http://forgetmemory.org/
Last year I had the pleasure of hearing Carrie McGee from the Museum of Modern Art (MoMA) in New York, sharing work from the MoMA Alzheimer's Project which set out a trailblazing programme of activity, introducing people affected by dementia to iconic 20th Century art from its collection. The impact this has had on individuals and carers is profound, as is the passion and conviction of those educators running the programme. www.moma.org/meetme/index
More recently I have begun a very practical working relationship with an NHS dementia assessment unit where one of Ian Roberts' inspirational MMU, MA Three Dimensional Design students is working with hand crafted objects to stimulate discussion and engagement. It’s too early to elaborate on this work yet, but its been very enthusiastically embraced by those working in the unit.
During a panel discussion held at Staffordshire University last week, I sat alongside colleagues from the wider arts/health field and heard stimulating and challenging accounts of arts activity with older people in general and more specifically, around the issue of dementia. It seems there’s a lot of activity out there that engages people meaningfully, challenges and stimulates and raises wider understanding around aging and illness. http://www.praxisartsandhealth.org.uk/
And with the very unsettling, ‘Can Gerry Robinson Fix Dementia Care Homes?’ broadcast by the BBC earlier in the year, I am mindful of a huge area of need in the delivery of care for our most vulnerable elders. Can the arts offer something to this primary agenda? www.guardian.co.uk/society/joepublic/2009/dec/15/can-gerry-robinson-fix-care-homes
I’d like to invite submissions of arts-based practice for sharing at the networking event on the 27 May between 6:00 and 8:00 here at MMU.
What do I mean by this? Well, people have talked about film they’ve been involved in; dance and gallery based work. I am happy to facilitate an event that gives opportunities to discuss this, sharing film/materials and raising our own awareness of each other’s practice and aspirations.
If I have sufficient interest to put on a stimulating event, I will provide detail the week before. So if you’re interested in this idea, but don’t have work to share, please make a note of the date.
Something that has stayed with me and that I hope will influence this event is a focus on the possibilities of flourishing whilst experiencing dementia. Gene Cohen and Anne Basting both talk about cognition most certainly being impaired by dementia, but the resulting impact on inhibition has a profound effect on an individuals creative potential through imagination…which it’s suggested, can thrive.
So, what’s your practice and would you like to share it?
…Clive
To make this event manageable and enable discussion to be had on the evening, I’d be grateful if you could email ISB@mmu.ac.uk with any suggestions for your input, by Friday May 14.
These lovely images are from Arthur and Martha http://www.arthur-and-martha.co.uk/
Selasa, 04 Mei 2010
"Green Exercise" 5 minutes a day for better mental health!
by Felicia K. Wong, M.D.
Researchers from the University of Essex found that as little as five minutes of a "green activity" can boost mood and self esteem. Jules Pretty and Jo Barton, who led this study, looked at data from 1,252 people of different ages, genders and mental health status taken from 10 existing studies in Britain.
They analyzed "green activities" such as walking, gardening, cycling, fishing, boating, horse-riding and farming. They found that the greatest health changes occurred in the young and the mentally ill, although people of all ages and social groups benefited.
All natural environments were beneficial, including parks in towns or cities, they said, but green areas with water appeared to have a more positive effect.
Dr. Wong enjoying a spring stroll through the Portland Japanese Garden
Portland Japanese Garden
May is Mental Health month and these are all great activities to do during May and throughout the year!
Researchers from the University of Essex found that as little as five minutes of a "green activity" can boost mood and self esteem. Jules Pretty and Jo Barton, who led this study, looked at data from 1,252 people of different ages, genders and mental health status taken from 10 existing studies in Britain.
They analyzed "green activities" such as walking, gardening, cycling, fishing, boating, horse-riding and farming. They found that the greatest health changes occurred in the young and the mentally ill, although people of all ages and social groups benefited.
All natural environments were beneficial, including parks in towns or cities, they said, but green areas with water appeared to have a more positive effect.
Dr. Wong enjoying a spring stroll through the Portland Japanese Garden
Portland Japanese Garden
May is Mental Health month and these are all great activities to do during May and throughout the year!
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