Integrative Mental Health

A New York Times Op-Ed by Cornell psychiatry professor George Makari connects the surprise over the results of the widely-covered RAISE study to American psychiatry’s shift toward pharmacology and the oversimplification of disorders as brain diseases.

The Guardian reports growing concerns from the Buddhist Society conference: “Jon Kabat-Zinn, who created the Center for Mindfulness in Medicine at the University of Massachusetts medical school, warned last week that some people feared a ‘sort of superficial ‘McMindfulness’ is taking over, which ignores the ethical foundations of the meditative practices and traditions from which mindfulness has emerged, and divorces it from its profoundly transformative potential.’”

Neuroskeptic weighs in on the controversy over the lack of antipsychotic dose data in the RAISE study and the misleading media coverage. He points out that one of the treatment interventions was a computerized medication management system called COMPASS, which recommends doctors use lower doses than they otherwise might.

Last Tuesday, The New York Times and several other outlets (including Mad In America) reported on the highly-touted results of a study on psychosocial treatment for patients diagnosed with schizophrenia. Now, claims made about the study, which the ‘Times called “the most rigorous trial to date,” are coming under increased scrutiny.

Minn Post did a feature story last week on Vail Place, an alternative mental health treatment center run on a community “clubhouse” model where the nearly 900 members and staff work side by side to run the center’s activities. Vail Place was founded in Hopkins, Minnesota in the early eighties by mental health activists and family members as a community for psychosocial rehabilitation. “The work isn’t therapy,” a member explains. “It’s growth. It’s ‘I cans’ rather than ‘I can'ts.’ And that’s important for mental health and survival.”

Writing on his 1 Boring Old Man blog, Dr. Mickey Nardo reflects on the media frenzy around the RAISE study and asks why the prescription data has not been released. He adds skepticism about the political motives of the potentially overblown results, which he sees as a clear push for increased mental health funding.

Everyone in the world is either touched by their own mental health issues or have had a family member affected. What if they directed their buying power to an organization that would use the profits to fund exciting mental health & recovery projects both in the developing world and in their own countries; projects that would be ethical, non-coercive, personal recovery-based, and were aimed at creating recovery communities? What if they could buy products, crafts, services, art, music, books from people who had experienced mental health issues, enabling them to set up their own businesses or buy from social co-operatives that enabled distressed people to work and earn a living wage?

Yesterday, the New York Times reported that schizophrenia patients in an experimental treatment program (RAISE) who experienced better outcomes had been on lower doses of antipsychotics than normal. However, the article published in the American Journal of Psychiatry on Tuesday did not divulge any data on the varying antipsychotic drug doses in the different study groups.

The Society for International Psychology, Division 52 of the American Psychological Association, will host a webinar entitled “The Humanistic, Vigorous and Universal Approach of Rational Emotive Behavior Therapy.”

The American Psychological Association is hosting a two and half day interdisciplinary summit on November 3rd through 5th entitled Global Approaches to Integrated Care: Translating Science And Best Practices Into Patient-Centered Health Care Delivery. The summit features presentations and discussions on social determinants of health, demographics, culture and health disparities, and patients’ perspectives, among others. It can be livestreamed here.

Based on the Finnish Open Dialogue approach, the Parachute program is an alternative to current health care systems where a team of health care workers collaborate with families and those in distress to develop a path to recovery. The success of Parachute is now spurring the development of similar programs in the UK.

Results of a large government-funded study call into question current drug heavy approaches to treating people diagnosed with schizophrenia. The study, which the New York Times called “by far the most rigorous trial to date conducted in the United States,” found that patients who received smaller doses of antipsychotic drugs with individual talk therapy, family training, and support for employment and education had a greater reduction in symptoms as well as increases in quality of life, and participation in work and school than those receiving the current standard of care.

People diagnosed with severe depression show the same changes in brain scans when they respond to a placebo as they do when they take an actual antidepressant, according to a new study. Researchers also found that those whose symptoms were decreased by a placebo were more likely to report relief from antidepressant drugs.

Even thought current mental health treatments are “suboptimal,” there is a lack of attention paid to the preventative effects of diet and nutrition. Recent studies suggests that nutritional changes can influence the risk for mental health issues and that nutritional supplements, called nutraceuticals, can be prescribed for existing conditions.

On Wednesday, JAMA Psychiatry released a meta-analysis comparing the results of cognitive-behavioral therapy and antidepressant medication in severely depressed populations. Currently, many practice guidelines suggest that antidepressants be used over psychotherapy for major depressive disorder. The analysis, however, found that “patients with more severe depression were no more likely to require medications to improve than patients with less severe depression.”

Chile’s Skills for Life (SFL) program, the largest school-based psychosocial intervention program in the world, has demonstrated improved behavioral and academic outcomes for elementary students identified as “at risk.” A team of Chilean and U.S. researchers assessed the SFL program and will publish their results in the October issue of the Journal of the American Academy of Child & Adolescent Psychiatry (JAACAP).

About a year ago, my partner Ron Coleman said to me "let's have a recovery camp." I said "what’s one of those?" and he said "I'm not sure, but let's invent it." And so, from June 7^th to 12^th 2015, we created a community of recovery for a week. The next step is to create communities of recovery around the world — not just as temporary camps, but long-lasting oases within our communities.

Much of what we term “madness” is, in fact, the awakening of the "Self" to its own Wholeness/Divinity. We are born totally pure. Throughout our lives we are subject to projections, flung at us from a multitude of directions: from Mom and Dad, from schools, religious institutions, the media, and the medical model. We are all buried, to some degree, under projections, and interesting symptoms emerge: nightmares, stress and anxiety, fear, flashbacks, and so on. These are not "Madness," but symptoms of health; of a "Self" attempting to break free from lies.

Robert Whitaker extended one of his core arguments from Anatomy of an Epidemic in a blog post last week. His argument revolves around the claim that psychiatric drugs are the principal cause of increasing psychiatric disability, as measured by U.S. social security disability claims. But does this really explain the rise in recipients of these SSI & SSDI benefits?

For those who actually believe that psychological problems are on the rise, serious inquiries must ensue. Many have rightly raised concerns about iatrogenic culprits, including drug-induced effects, but this too seems to fall short of accounting for the meteoric rise. Except for those forced to take psychiatric drugs, I would suggest that most seek out drugs in the hope of relieving iniquities caused by factors such as those I discuss below; unfortunately, this may not only lead to avoiding addressing the real issues, but may even lead to further complications of the drugs. Given this, I present five areas for further discussion, which I believe are causal agents for the mental health crisis.

Many of us spend a lifetime avoiding our emotional pain, and it does become more and more toxic as long as we keep it buried. It will literally make us ill, physically and mentally, as Bessel Van talks about in the book, The Body Keeps Score. The little quip, "What you resist, persists" has proven very true in my life. The only way out of that trap is to stop avoiding and learn in whatever way makes sense to us as individuals to feel once again and to embrace and absorb and therefore transform the pain of our lives. This is how I am healing.

Based on any data from any country it is clear that we have a problem. Mental illness is on the rise. Researchers in the emerging field of nutritional psychiatry have documented the benefits of micronutrients to treat mental illness, showing that micronutrients help treat depression, stress, anxiety and autism and ADHD. Not a single study shows that the Western diet is good for our mental health. Many questions remain to be answered, but we can make some recommendations.

To help my non-recovery oriented colleagues understand the stigma/resentment associated with ‘borderline personality disorder,’ I simply mention this: “Let’s say I call you and say, ‘Hey, I’ve got a referral for you. She’s been diagnosed with borderline personality disorder . . .’” I need to go no further; without fail, my colleague will smile or laugh. We both know that such a referral is a no-no, so much so that it doesn’t even have to be mentioned; it is a given.

Eighteen years ago, in the fall of 1996, I plunged into a major depression that almost killed me. Over the next eighteen years I took what I had learned in my healing and put together a mental health recovery program which I taught through my books, support groups and long distance telephone coaching. In the process, I counseled many people who were in the same desperate straights that I had been in. I shared with them what I had learned through my ordeal---that if you set the intention to heal, reach out for support, and use a combination of mutually supportive therapies to treat your symptoms, you will make it through this. And in the cases where people used these strategies and hung there, they eventually were able, like myself, to emerge from the hell of depression.

Recently I wrote an article on MIA entitled Trauma, Psychosis, and Dissociation. Several people responded privately with some very thought-provoking questions that I would like to explore and possibly answer to some extent here. Dedicated readers of the MIA website are all too familiar with the myriad problems that exist with diagnoses in general, the stereotypical (and often untrue) assumptions associated with these various categories, and their lack of scientific validity or reliability. First, though, I want to state that my area of experience and research is with trauma, psychosis, and dissociation . . .