The Insurance Parity Bugaboo

Now we have mental health insurance parity. This is something I have never supported. As certain people have pointed out, from a financial stand point of view, one is only mentally ill until the insurance runs out. I see mental health parity as a way to guarantee this insurance never runs out, and thus as a way to insure the patient never completely recovers. Mental health insurance then becomes a way to legitimize the ‘disease’, reinforce the diagnosis, and frustrate all recovery efforts.

You’ve got a broken mental health system. People, who could be recovering from their upsets in life, are not recovering. Instead they are being warehoused. Now they are not being warehoused in a state hospital as they had been in the past, they are rather being warehoused within a community. This is an improvement over what was, but it is still problematic. This warehousing has resulted in what we may refer to as the mental health ghetto. People ‘in treatment’, who are not productive members of society at large, inhabit this ghetto, people who are essentially artificial invalids.

The problem here is first you are dealing with people undergoing personal crises. This personal crisis is what is commonly referred to as a mental illness. In reaction to this crisis, either voluntarily or involuntarily, a person has been admitted into a hospital. The repercussions of this hospitalization are immense. The person in crisis could lose their job, their residence and property, their friends and family, etc. When we talk of recovery usually we are only referring to the recovery of mental stability, but this is only where recovery starts.

You have a person who has been critically injured socially and economically, not to mention chemically through psychiatric drug use, even after his or her thought process has been restored to something approaching what it had been before hospitalization. Communities are seldom willing to go the extra nine yards for these individuals that are required if the person is to succeed. The person may go from a state hospital into an apartment in the community, but this doesn’t restore this person as a functioning working member of society. We are still doing little more than subsidizing the wastrels we have created through this disruption of life events at institutionalization.

Poverty can become a big hole from which there is no climbing out of and advancing into prosperity. This same poverty is associated with failure. The real failure is the mental health system’s. This poverty only describes its clientele, and not its employees. The employees pull their salaries primarily from the fees the clientele pay with their federal financial assistance benefits. The employees then are paid in effect to keep their clients impoverished. We should instead be paying these mental health workers to get people out of poverty rather than keeping them in it.

Do Your Part To Combat Stigma

Oh, no! Imagine a 71% increase in the mental illness rate! Well, that’s exactly what we’d get if these misinformation brochures on the stigma of mental health conditions had anything to do with it.

According to an article on the subject, New leaflets to shoot down mental health misconceptions, in the Malta Independent:

“Stigma is a real problem for people who have a mental illness. Stigma based on stereotypes is a negative judgment based on a personal trait, in this case, having a mental health condition. It used to be a common perception that having a mental illness was due to some kind of personal weakness. We now know that mental health disorders have a biological basis and can be treated like any other health condition. Unfortunately only 29 per cent of sufferers seek help,” said Mr [Mario] Galea.

Excuse me, Mr. Galea, but we do not now know that mental health disorders have a biological basis. This is all purely theoretical speculation, there is absolutely no evidense to support these suppositions, and they are not a matter to be taken seriously. That is, they are not meant to be taken seriously by people who are not desparate to spend their time in the bug house.

Mr Galea pointed out that one per cent of the population suffers from schizophrenia. One of every six men and one of every four women suffers from depression. In Malta, 33,000 people fall victim to depression yearly and studies show that eight per cent of the population suffer from some sort of mental health condition at some point in their lives. A suicide is committed every nine minutes in Europe, adding up to 54,000 suicides in 2009. The EU estimates that mental health problems will become the second most common health problem after cardiovascular diseases in a few years’ time.

If you can envision the pharmaceutical company executives rustling maps, looking for new markets to break into, behind the scenes…Ahha! I think you’ve got it.

Yeah, and if only 29% of these people have been nabbed, do you really want to raise the figure 71%? If mental health problems do become the second most common health problem in a few years time, we will know who to blame.

Thanks to improvements in mental health services 12,000 patients are receiving treatment in the community without having to be hospitalised.

Of course, deinstitutionalization didn’t have anything to do with this switch to treatment in the community. Just think what our mental hospitals would look like given an increase of almost thrice the number of patients they presently hold? In some places today there is a reinstitutionalizing reaction to deinstitutionalization taking place. Just consider what happens when, after reinstitutionalizing, we deinstitutionalize again, and dump all of these freshly recruited newly sprung looney birds in your front yard.

Don’t listen to all that pro-stigma nonsense, people, go in and get help for the condition you must be suffering from today. There are 297 of ‘em listed in the DSM IV, and there will be even more in the DSM V, set to be published in 2013. If you don’t have this or that disorder, we’ll find something for you to have. Uncle Looney Bin wants you!

No More Nitpicking

Pardon me for my overindulgent nitpicking the other day. I get like that sometimes. I’ve been suffering bouts of mad humility ever since. I don’t think nitpicking is ever a virtue, even if I uncovered a real nitpicker in the process. When our aims are the same, why quibble over words?

C/S/X is convenient shorthand for consumer survivor expatient, obviously, and who am I to argue with ease and convenience. Consumer/survivor as a designation admits that the group is more heterogeneous than some people would allow. Some people forswear the consumer designation while others object to the psychiatric survivor appellation. We have a slogan that goes: nothing about us without us. If we are true to this slogan, then we have to allow for a broad constituency with a designation that is apt.

Some people are interested in receiving mental health treatment. These are mental health consumers. (Mental health users outside of the continental US and abroad.) Others are more interested in human rights, and often forswear the mental health system entirely. These, if they have experienced abuse at the hands of the mental health system, are psychiatric survivors. The lines are perhaps not as sharp I indicate, but you get the idea nonetheless.

I realize that some people are perhaps not at the place in their development that certain other people are. I don’t need to add appreciably to the divisiveness that already exists in our movement. A few of us must serve as bodhisattvas for the others among us who are not so highly advanced. We have faith that a higher consciousness will eventually be achieved even among the slower moving and dim witted.

I’m not an armchair activist. I’m not an ivytower radical. I don’t need to pretend that I am one. If the struggle is to be taken to the streets then I am one of the people to take it there. I’m not a person to sit idly by on the sidelines and watch as other people do our campaigning for us. I want to be among the people being dragged away by the police after they come to make their arrests.

By merely clawing at the surface one could miss entirely the substance of the matter. Words are never as important as substance. Words are only indicators of the substance that resides beyond them. We don’t need to waste valuable time arguing about the proper word to use. These things can be decided in committee, and I would be one to go along with the committee decision.

Some people have a tendency to take rather dubious diagnostic tags altogether too seriously. Some doctors, as when exaggerating the extent of their clients’ disability and deterioration, do the same. Some of these exaggerations even have a tendency to become self-fulfilling prophesies. Humor is but one more weapon in our arsenal that we can use against this ‘sick’ ‘sickness’ system. The burden of such weighty prophesies can be lifted by applying a little bit of levity to the situation. In this sense, we carry around in our little black bags the antidote to the physicians’ error, and to the ‘disease’ itself. I am not going to disavow the use of this weapon.

Mental Disorder Associated With Smoking

Somebody has to do a study on the ridiculous research techniques and wasteful spending habits of academia. Now we get this piece of soon to be trivia from the odd files of dubious science.

Comorbidity of psychiatric and substance use disorders represents a significant complication in the clinical course of both disorders. Bipolar Disorder (BD) is a psychiatric disorder characterized by severe mood swings, ranging from mania to depression, and up to a 70% rate of comorbid Tobacco Use Disorder (TUD).

Yep, you heard right, ‘Tobacco Use Disorder’.

Just think of what an evil doer Sir Walter Raleigh must have been for having delivered tobacco smoking from the native populations of the New World to what was then regarded as civilized society. Little did he know he was actually spreading disease far and wide.

America’s one cash crop way back when and now linked to, uh, mental disease.

Connect the gene for this disorder with the gene for ‘bipolar disorder’, a disorder whose rate has climbed 40 fold in recent times due to the manipulation of a certain Harvard psychiatrist, Dr. Joseph Biederman, recently under investigation by Senator Grassley and his Senate committee for taking unreported kickbacks from drug companies, and you have a case of high farcical tragic-comedy.

Results: We estimate risk for TUD among BD patients at 2.4 times that of the general population.

I know…cancer. Everybody else is quitting, but those whose nerves demand some kind of extra stimulation.

They’ve even identified 3 genes they are associating with the highs and lows of ‘bipolar disorder’ and, cough (excuse me, no smokers hack, just the mock reflex), ‘Tobacco Use Disorder’.

We found three candidate genes associated with both BD and TUD (COMT, SLC6A3, and SLC6A4) and commonality analysis suggests that these genes interact in predisposing psychiatric and substance use disorders. We identified a 69 gene network that influences neurotransmitter signaling and shows significant over-representation of genes associated with BD and TUD, as well as genes differentially expressed with exposure to tobacco smoke.

I would suggest somebody needs to take a serious look at the genes of the hare-brained researchers who conduct research based on such wild and bizarre hypotheses. Alas, but I also suspect self-control is rabidly being drained from the gene pool.

Nursing Homes Drugging the Elderly In Massachusetts

Johnson & Johnson is being sued for the tactics it uses to get psychiatric drugs, specifically Risperidal, into nursing homes in Massachusetts. This is what an op-ed piece in the Boston Globe has to say on the subject:

Talk about death panels. The US attorney in Boston recently filed suit against the world’s largest maker of health products, Johnson & Johnson, for using kickbacks to get more nursing home patients onto its drugs, including one that was later found to be so lethal to the elderly it had to carry a black-box warning. The government’s complaint leaves little doubt that the drug company acted in a predatory way to increase sales and market share for its products, especially Risperdal, an antipsychotic often used to keep Alzheimer’s and dementia patients under control.

The psychiatric drugs referred to in this article are not recommended for use on Alzheimer’s and dementia patients. In fact, prescribing them is ‘off label’, or not approved for these purposes by the FDA. Use of nueroleptic drugs on elderly patients have been known to have many detrimental effects, and tend to cut short the lives of those elderly patients maintained on them.

The kickbacks referred to were given to Omnicare, the country’s largest pharmacy for nursing home care. This is to say, the drug company is paying the drug supplier to push it’s pharmaceutical product to area nursing homes.

The middleman between Johnson & Johnson and the nursing homes is Omnicare, the country’s largest pharmacy for nursing homes. Last November, it agreed, without “any finding of wrongdoing’’ or “any admission of liability,’’ to a $98 million settlement with the government for its role in helping Johnson & Johnson boost sales to nursing homes. The government says that between 1999 and 2004 Omnicare received tens of millions of dollars in the form of escalating rebates based on greater market share for Johnson & Johnson drugs and in payments ostensibly made by Johnson & Johnson for “data’’ from Omnicare, much of which Omnicare never provided. Other kickbacks, the government says, came in the form of “grants’’ and “educational funding.’’

Omnicare is not just a supplier of drugs. It also provides nursing homes with the consulting pharmacists who check over patients’ medications and make recommendations to the doctors who visit the nursing homes periodically and check through patient charts. In more than 80 percent of cases, according to a Johnson & Johnson document, doctors follow the pharmacists’ recommendations on prescriptions. In a memo, the company viewed Omnicare’s consulting pharmacists as an “extension of (Johnson & Johnson’s) sales force.’’

New Jersey, the article goes on to say, requires the independence of its consulting pharmacists, suggesting that Massachusetts should do the same, and going so far as to say Congress should mandate this independence of consulting pharmacists throughout the entire nation.

I would have to agree. Nursing homes are getting away with murder time and time again through the use of these harmful pharmaceuticals on the elderly. It is going to take awhile before the cries of alarm breaking out here and there across the nation rise to a level that can be heard on Capitol Hill. The longer it takes for these cries to reach the Capitol, the more lives will be expended through neglect, abuse, and turning a blind eye to the greed of corporate drug peddlers.

Language and our movement

C/S/X movement – I have problems sharing an acronym with a commercial railroad company. I can see the movement there, sure, but I don’t think that train would necessarily be bound for glory.

Consumer/survivor/expatient movement – uh–long pause–next entry.

Consumer/survivor movement – I cannot link these two disparate groups of people with a slash mark. When somebody tells me they’re a consumer advocate. I respond by saying I am not a consumer advocate. I wouldn’t advocate ‘consuming’ that which destroys me.

I can’t really stomach the use of the consumer/survivor designation. It’s a shortcut I don’t wish to take. I prefer to separate the two terms in any sentence I use having to deal with them. For me, it’s always mental health consumers and psychiatric survivors. There is a difference, and I like to acknowledge that difference.

There is some overlap, surely, but…not always!

Mental health consumer movement – on this, all I can say is, to each his or her own.

Psychiatric survivor movement – works for me.

Ex-patient movement – got no problem with it.

Anti-psychiatry movement – Wow! We have a word with a history here. David Cooper a psychiatrist coined the term, dealing with theories of those psychiatrists, himself included, associated with RD Laing, author of the Divided Self. RD Laing, a psychiatrist, didn’t like the term. I have heard psychiatric survivors argue against the use of the term due to the fact that a psychiatrist came up with it.

I’m fine with anti-psychiatry.

Critical psychiatry movement – some more recent psychiatrists, wishing perhaps to separate themselves from the taint of association with David Cooper, came up with this term.

I’m only so-so with critical psychiatry.

The self-help movement – somebodies part way there. Book after book on the book shore shelf. Boring books, too. You snooze you pick up some good dreams. In the hand and in the trashcan. Somebodies got a government job though. Makes good money, too. Look this way, and motivate this!

I’m not too keen on ‘self’-help.

The Mad Pride or Mad movement – yes, read Plato on divine madness sometimes, and you can see the logic, or perhaps illogic, behind the use of this term. Show some backbone and gumption then. Come out of the treatment closet, and live! Let your madness rage and flare.

You go, Mad Pride girl or boy! All the way to the top!

On the use of the clunky ‘people labeled mentally ill’. What’s that? I see a person, but no label unless there’s one hanging from his or her clothing. Call ‘em schizowhazzoever, multi-polar, less than lovely personality disordered, and yer using fightin’ words, bub. We need to step outside.

Anyway we would need to step outside if I wasn’t so into nonviolence.

People works.

Changing The Kansas Constitution

Talk about unconstitutionality! Having received a mental illness diagnosis is apparently a potential disqualification to vote in the state of Kansas. Mental health advocates are urging legislators there to place a proposal on the ballot to remove the mention of mental illness from a provision in the Kansas state Constitution.

As an article in the Lawrence Journal-World & 6News, Mental health advocates seek constitutional change, explains.

The Kansas Constitution states: “The legislature may, by law, exclude persons from voting because of mental illness or commitment to a jail or penal institution.”

Advocates for those with disabilities asked the Senate Judiciary Committee to adopt Senate Concurrent Resolution 1622, which would remove mental illness from the constitutional provision. The committee took the matter under consideration.

It is argued by some mental health advocates that it is wrong to treat the mentally ill the same way as you would treat felons who have had their voting rights taken away from them as punishment for violating the law.

Several committee members questioned whether people with mental illness who are legally committed to an institution could exercise the proper judgment to vote.

Many other committee members were more receptive to reason.

Although this legislation has never been enforced with regards to people baring psychiatric labels, its high time the law was changed to suit conditions existing in a free and open democratic society.

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