New blog Mirage Media on attitudes to mental illness

New media watch blog Mirage Media includes a great post about the census worker who was forced to resign from his job after it was discovered that he had previously escaped a murder charge on the grounds of insanity (he killed three members of his family). Mirage Media points out insanity is not an easy defence - less than 1% of those who claim insanity in murder cases escape conviction on these grounds.

Strictly speaking, the census worker had no criminal convictions to disclose, and therefore no grounds for losing his job. The Mental Health Commission regards the case as a breach of the human rights act and is taking up the issue with the Human Rights Commissioner.

"Praising_idleness" of Mirage Media takes Radio Live breakfast host Martin Devlin to task for dismissing the possibility that a "murderer" should be allowed to get a job after 13 years of rehabilitation.

"Devlin often makes the assumption that mental patients are intrinsically morally corrupt. In his eyes, mental health patients are 'bad eggs', and should be stripped of basic human rights. He willingly ignores evidence which illustrates mental patients too, are victims of their illness. That they can be rehabilitated. And they are no more likely than anyone else to commit an act of violence in the first place. Instead, he maintains a bigotry which perpetuates a sceptical untrustworthy view of individuals with mental illness."

Actually there is considerable evidence to show that those who experience serious mental illness are, on average, more likely to be victims of violence than its initiators. A 2005 study found that one forth of individuals with severe mental illness were victims of violent crime in the previous year, eleven times the rate of the general population.

In response to an email from Praising_Idleness Martin Devlin said "Hmmm Somewhere in the middle lies the answer? I actually think we almost agree.. Thanks for your mail son...". In other words Devlin completely failed to engage with the issue. "Somewhere in the middle lies the answer" reminds me of the sort of meaningless nonsense that might come from the keyboard of Peter Dunne. Why is it those who attempt to position themselves in the so called "centre" of politics so often end up sounding intellectually and morally vacuous?

Welcome to the blogsphere Praising_Idleness :)

Categories: Media, Mental Health, Human Rights, Discrimination

Reflections on the natural disasters of 2005 - rebuilding lives is more than just bricks

Looking back on 2005 in the future, the prominence of natural disasters over the past 12 months will be hard to ignore. Due to the sheer scale of these disasters, people will continue to struggle with the ongoing effects the Boxing Day Tsunami, Hurricane Katrina and the Pakistani earthquake, well into the new year and beyond.

Denise Dorsey, president-elect of the New Orleans Psychoanalytic Center, said that for many, the devastation was beyond an ability to cope. "Looking down a street where it's house after house, and the garbage and the innards of the houses, there's something about it that people in general can't grasp," Dorsey said. "It's not within the realm of any experience anyone's ever had. Your ordinary American doesn't have that in their repertoire of experience."

I gained a new appreciation for the sheer scale of the disaster after reading David Helvarg's article in the latest issue of Multinational Monitor. "The Storm this Time: A Personal Account of Natural and Unnatural Disaster in the Wake of Hurricane Katrina" is a fine example of the 'make me see' school of journalism, and is well worth reading. I also really liked the irony of David's introduction.

"I'm flying to New Orleans and the Gulf Region by way of Ronald Reagan (Washington D.C) and George Bush (Houston) airports to see how "less government" functions in the wake of a coastal catastrophe. Actually, given that it's three weeks since Hurricane Katrina made landfall, we already know the answer."

When it comes to rebuilding the areas devastated by disaster, I can understand why there is an immediate focus on rebuilding houses and other infrastructure (especially in the remote areas of Pakistan where being left in cold conditions without shelter is a killer). But at the same time it concerns me so much focus is placed on the physical rebuilding because, in many cases, rebuilding the houses is the easy bit. The media also like the reassurance of the 'rebuilding' stories, and their implied message that the government and private donations are being put to a 'quantifiable' bricks and mortar use, when it is going to a great deal more to rebuild people's lives.

Earlier in the year I highlighted an article looking at the mental health impact of the Asian Tsunami. As hurricane evacuees now return to their homes in New Orleans it is good to see the US media also covering the mental health legacy of Katrina, even if the Herald Tribune story has a 'tabloid like' focus on the expected increase in the number of suicides.

While every suicide is tragic, a great many more people will continue to struggle with grief for the loss of loved ones, survivor guilt, depression and anxiety disorders such as post-traumatic stress.

I would like to see more coverage of this in the media, as this would help reinforce two things. Firstly, the need for ongoing assistance and aid to the affected areas, long after the houses have been rebuilt. Secondly, it would reinforce the scale of the "mental health disaster" and the need for public (and private) aid money to be spent on helping people cope psychologically with both the short term and long term effects of disaster.

Yay for Child Poverty Action Group Boo Labour

Great to see the Child Poverty Action Group win the right to mount a legal challenge to Labour's policy to exclude beneficiaries from the Working for Families package.

Such an exclusion is designed to widen the gap between beneficiaries and the working poor - the very same principle, among others, guided Ruth Richardson's infamous 'Mother of all Budgets' in 1991. It makes the Child Tax Credit (CTC) and the In Work Payment (IWP) nothing more than an indirect subsidy for employers, and lets them off the hook for consistently failing to pay their employees family friendly wages. The benefit cuts of 1991 are still with us, as benefit levels have never been increased in order to restore a similar comparative level with wages that existed prior to 1991.

To make matters worse, 'beneficiaries' is defined to include those receiving a student allowance, NZ superannuation or those on ACC for more than 3 months. So a single mum attending university will not benefit from the CTC or the IWP, and neither will grandparents acting as caregivers after the death of a parent.

Sue Bradford is calling on the Government not to appeal the Human Rights Review Tribunal decision. Sadly this is not an unreasonable fear given the petty litigious attitude of the Government on similar issues in the past (such as on defining a relationship like marriage).

If Working for Families was meant to be about reducing child poverty, it really needs to be asked why children of beneficiaries ought to be worse off, purely based on the source of their caregivers income. Its not something the kids can control after all.

The case is the first under 2001 amendments to the Human Rights Act that allowed Government policies to be challenged in the Human Rights Review Tribunal. It also sets another important precedent by establishing the right of non-governmental organisations (NGOs) to challenge discrimination in public policy, regardless of whether they themselves are directly affected. As an example, this decision could be of great assistance to NGOs working in mental health advocacy, as many people with past psychiatric/psychological issues regularly face systematic and unwarranted discrimination.

Don't blog at work, start a blog for your work!

Earlier this week Span posted on the ethics of blogging/reading blogs at work.

Myself, I have found a cunning solution to this quandary. Make a blog for your work!

As 'Resource Designer' at the Mental Health Education and Resource Centre in Christchurch, part of my job is keeping the website updated.

A month or so ago my boss and I were discussing ideas for the redevelopment of the website. He said he would like to develop an electronic newsletter for MHERC that would cover latest news in mental health, the latest books in our library, local information and 'informed comment' on recent research. I convinced him he could be talking about a 'blog', especially as the content from a blog could be easily reused in a newsletter sent out by email.

As far as I know we are one of the first NGOs/community groups in New Zealand to have a blog.
There is also some scope for further development. A number of people from my work are involved in a weekly radio programme on Plains FM about mental health, with a special focus on 'consumer' issues. People were enthusiastic when I mentioned it might be possible to have mp3s of the radio show downloadable from our website/blog. We now have the ok from Plains FM to do it, so its all go. Files are approximately 11 meg, so I am hoping people will not have to download the whole file before they can listen to it. Does anyone know if MP3 playing progs (such as WMP) will automatically stream (ie download while it plays) - is there a nice way to control this?

I guess it is it is good to be enthused by the stuff I am doing at work :)

Mental health legacy of Asian tsunami

I suspect the long term impacts of the January 26 Asian tsunami are only just starting to be recognised.

BBC News has a good report on the mental health legacy of the Asian tsunami. Mental health workers in the region say parts of the area are in a "state of mental emergency", and will need ongoing help for up to a year, if not longer.

Kaz de Jong, head of mental health services for Medicins Sans Frontieres (MSF), who spent eight days on the ground looking at services in Aceh, says the recovery process is just beginning. According to de Jong, at least 20% of the population will have longer term mental health problems and 5% of these will be severe, with people needing counseling for post traumatic stress disorder and anxiety.

Laetitia de Schoutheete, co-ordinator of the mental health care projects for MSF in Aceh, said guilt was a big problem for many of the survivors.

I am really pleased to see some focus on the mental health impact of the disaster, as the mental health legacy of January 26 will continue to be an issue long after the 'reconstruction' has completed.

Lets hope the aid continues long after the photo-ops and hammers - the people of the region will need help over many years to recover from the events of January 26th 2004.

United Future trivialises mental health and drug addiction

"United Future deputy leader Judy Turner today welcomed the Government's belated move to a new 'second opinion' approach to assessing sickness beneficiaries, but said that those doctors should have some psychological expertise given the rapidly rising number of stress-related claims."
...
"A number of doctors have told me that they are increasingly being asked to sign-off on claims by potential beneficiaries that they suffer from fairly intangible or subjective disorders, such as stress, depression, back pain and even drug addiction,"

Judy Turner appears to be propagating the old stereotype that mental illnesses are not as serious as physical illnesses. None of these disorders should be trivialised as 'fairly intangible' or 'subjective' in such a sweeping statement, as doctors have well developed diagnostic criteria to identify these disorders, such as the DSM IV. Left untreated these disorders can lead to some very tangible effects indeed.

"Stress is linked to the six leading causes of death: heart disease, cancer, lung ailments, accidents, cirrhosis of the liver, and suicide. Depression often predicts the occurrence of disease, and epidemiological studies have found that people with serious mental illness have higher rates of grave medical illness and premature death than the general population.

Stress and depression often have a significant cognitive angle, in that the same event or environment can have a more significant impact on one person than another. But this does not make this any less real, or any less debilitating, to the person concerned.

In regards to the issue of people moving from unemployment to sickness benefits, it is entirely possible this followed the tightening up of work test requirements. To give them their due, perhaps some WINZ case managers recognised harsh work testing arrangements are not appropriate for some 'unemployed people', especially those dealing with divorce, family breakdown or grief.

As someone who has worked with people with drug addictions I find it very hard to believe that anyone could plausibly 'fake' an addiction to get a benefit, as the general 'sense' of chaos and desperation would not be there. Its likely to be just another unsubstantiated myth invented by the right in an attempt to justify benefit cuts.

While Maharey's proposal for 'second opinions' appears reasonable, its timing looks exceptionally political, given its release a few hours before a speech propagating more myths about welfare.

Its worth noting that G.P.s can only prescribe a limited set of drugs to treat mental health. Many medications, especially newer (and more expensive) medications can only be prescribed following a referral to a psychiatrist, and a referral can mean a long wait, as NZ has a significant shortage of psychiatrists (blame student loans, its a lower paid specialty). NZ also has a shortage of clinical psychologists. So, as well as being based on some extremely dated myths about mental health, United Future's ideas are likely to be unworkable as well.

Judy Turner should stop telling doctors how to do their job. Instead she should make an effort to learn more about mental illnesses and drug addiction before she makes ill informed public comments that only reinforce ignorant stereotypes.