NIMH · Atonement

In his blog post entitled AtonementThomas Insel, MD, Director of the National Institute of Mental Health (NIMH), calls for humility:

So this year on Mental Illness Awareness Week, my call is for humility. We need to be aware that mental disorders are immensely complex—too complex for scientists, clinicians, patients, or families to solve alone. Prevention, recovery, and cure—the NIMH vision—need a collective effort. Beyond the day—or week—of atonement, we need a massive campaign to transform diagnosis and treatment.

http://www.nimh.nih.gov/about/director/2014/atonement.shtml

Below I directly quote his very moving and thoughtful piece in its entirety.

Thank you, Dr. Insel.


Director’s Blog: NIMH · Atonement
By Thomas Insel on October 8, 2014

One of my first meetings when I arrived at NIMH 12 years ago was with board members of the National Alliance on Mental Illness (NAMI). I asked them how NIMH could be helpful. One board member’s request was especially memorable. “Declare a day of atonement,” she suggested. When I saw this same board member last month at the annual NAMI meeting, we both recalled that 2002 meeting with a touch of regret. I wished I had had a better response to her request. And, as she said to me last month, “I wished I had asked for a week.”

As it turns out, Mental Illness Awareness Week this year began with Yom Kippur, the Jewish Day of Atonement. Which begs the question: what do we (in the mental health community) need to atone for? There are so many answers. For some, it may be the culture of blame and shame perpetuated for years by clinicians who explained all mental illness as being caused by trauma and evil parents. For others, it may be the singular reliance on medication and modifying behavior rather than holistic care and the provision of skills. Others will name the paternalistic structure of mental health care, which can undermine rather than empower individuals and their families. The list goes on. Maybe it would take a week, not just a day, to capture the many complaints.

My own favorite atonement issue for Mental Illness Awareness Week this year is the lack of humility in our field. Mental disorders are among the most complex problems in medicine, with challenges at every level from neurons to neighborhoods. Yet, we know so little about mechanisms at each level. Too often, we have been guided more by religion than science. That is, so much of mental health care is based on faith and intuition, not science and evidence. On the plus side, we put a premium on listening and compassion. We help people to change through understanding. But not enough of our care has been standardized to a high level of quality, as expected in the rest of medicine.

On the research side, it’s easy to lose humility. The pace of discovery in genomics and neuroscience is ever more rapid—this week’s Nobel Prize in Physiology or Medicine is a good example of how neuroscience is revealing the fundamentals of brain activity—in this case describing the brain’s “GPS” network. Advances in systems neuroscience, from dissecting circuits to human brain imaging, are unequivocally stunning. But, and this is a humbling caveat, we simply have not been able to translate this revolution in neuroscience to diagnostics or therapeutics for people with mental disorders.

Why the disconnect? Translation takes time. Translation requires replication, regulation, and ultimately reimbursement. Fundamentally, translation is really difficult. For instance, we have thousands of neuroimaging studies but none that has delivered a clinically useful biomarker. For NIMH this is a humbling realization—we still lack biomarkers to identify who should get which treatment. We still lack effective treatments for many aspects of mental illness.

So this year on Mental Illness Awareness Week, my call is for humility. We need to be aware that mental disorders are immensely complex—too complex for scientists, clinicians, patients, or families to solve alone. Prevention, recovery, and cure—the NIMH vision—need a collective effort. Beyond the day—or week—of atonement, we need a massive campaign to transform diagnosis and treatment.

http://www.nimh.nih.gov/about/director/2014/atonement.shtml

I Loved It! ~ Patients Rights Advocacy

Loved shadowing an MHA Hearing Advocate earlier today. Look forward to learning more. Great opportunity for me to make use of my experience having been psychiatrically hospitalized for bipolar disorder (albeit voluntarily), while dusting off old knowledge and skills from my education and the careers of my early adulthood. After all, I have a BA in Legal Studies and experience as a legal assistant, an MA in Psychology and counseling skills gained as a Marriage and Family Therapist, and advocacy skills. Those careers date back to my twenties. I’m 51 now. In between, I spent a decade working in commercial real estate and a decade on disability, sometimes struggling to do something as simple as make dinner.

Californians with mental illnesses who are receiving treatment in mental health facilities, including those persons subject to involuntary commitment, are guaranteed numerous rights under State and federal laws, including the right to be free from abuse and neglect, the right to privacy, dignity, and humane care, and the right to basic procedural protections in the commitment process.

~ http://www.dsh.ca.gov/Publications/Patients_Rights/

Mental Illnesses #MIAW

Quoting NAMI‘s webpage entitled Mental Illnesses

What is mental illness?

A mental illness is a medical condition that disrupts a person’s thinking, feeling, mood, ability to relate to others and daily functioning. Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life.

Serious mental illnesses include major depression, schizophrenia, bipolar disorder, obsessive compulsive disorder (OCD), panic disorder, posttraumatic stress disorder (PTSD) and borderline personality disorder. The good news about mental illness is that recovery is possible.

Mental illnesses can affect persons of any age, race, religion or income. Mental illnesses are not the result of personal weakness, lack of character or poor upbringing. Mental illnesses are treatable. Most people diagnosed with a serious mental illness can experience relief from their symptoms by actively participating in an individual treatment plan.

Learn more about treatment and services that assist individuals in recovery.

Find out more about a specific mental illness:

Find out more about conditions sometimes related to mental illness:

What does recovery look like?

As people become familiar with their illness, they recognize their own unique patterns of behavior. If individuals recognize these signs and seek effective and timely care, they can often prevent relapses. However, because mental illnesses have no cure, treatment must be continuous.

Individuals who live with a mental illness also benefit tremendously from taking responsibility for their own recovery. Once the illness is adequately managed, one must monitor potential side effects.

The notion of recovery involves a variety of perspectives. Recovery is a holistic process that includes traditional elements of mental health and aspects that extend beyond medication. Recovery from serious mental illness also includes attaining, and maintaining, physical health as another cornerstone of wellness.

The recovery journey is unique for each individual. There are several definitions of recovery; some grounded in medical and clinical values, some grounded in context of community and some in successful living. One of the most important principles is this: recovery is a process, not an event. The uniqueness and individual nature of recovery must be honored. While serious mental illness impacts individuals in many ways, the concept that all individuals can move towards wellness is paramount.

Mental illness by the numbers

Check out NAMI’s fact sheet, Mental Illness: Facts and Numbers, to find out more about mental illness.

Related Files: Mental Illness brochure (PDF) (PDF File)

http://www.nami.org/Template.cfm?Section=By_Illness

Mental Illness Awareness Week #MIAW #B4Stage4

Facts listed on this infographic from MHAScreening.org:

Get Screened, America!

  • 125,000 screens since the launch of MHAScreening.org in May 2014
  • 66% screened positive for moderate to severe anxiety, depression, bipolar disorder, or PTSD…
  • and 64% of them had never been diagnosed.
  • 44% said they would discuss results with someone.
  • Stay healthy. Take a screen, and talk to a doctor, family member, or friend about your results.
  • After taking a screen, this is what people want most. HELP (most heavily weighted word in word cluster)
  • Take a screen MHAScreening.org
  • MHA Mental Health America#B4Stage4

Why B4Stage4?

When we think about cancer, heart disease, or diabetes, we don’t wait years to treat them.  We start way before Stage 4.  We begin with prevention…

This is what we should be doing when people have serious mental illnesses, too.  When they first begin to experience symptoms such as loss of sleep, feeling tired for no reason, feeling low, feeling anxious, or hearing voices, we should act.

http://www.mentalhealthamerica.net/b4stage4