Cross Post: Halving Subsidised Psychology Appoints is a Grave Mistake—Young Australians Will Bear a Significant Burden
Written by Dr Daniel D’Hotman, DPhil student studying mental health and ethics at the Oxford Uehiro Centre
The original version of this article was published in the Sydney Morning Herald
Unprecedented times called for unprecedented measures. COVID-19 was the most significant health crisis many of us had ever faced. While the physical effects were much discussed, the mental health burden was arguably just as devastating. In response, the previous Government doubled subsidised mental health appointments under the Better Access Program, allowing Australians suffering from mental illnesses like anxiety, PTSD and depression to claim an extra 10 appointments per year.
Now we are trying to convince ourselves COVID-19 and its impacts are over. In addition to requiring referrals for some PCR tests, the Australian Government is cutting the number of mental health visits available under Medicare to pre-pandemic levels, arguing this is a necessary step to improve equity. According to a review of the program, extra appointments clogged up waitlists and reduced access for those not engaging with services. Continue reading
Guest Post: What puts the ‘mental’ in mental illness?
Written by Anke Snoek
Macquarie University
I have a 3 year old who doesn’t eat. He seems not to be interested in food in general. We were offered many explanations for why he doesn’t eat and most specialists suspect a psychological source for his lack of appetite. But recently a friend suggested that maybe there is something wrong with the muscles in his mouth that makes it hard to swallow. I wondered: why didn’t I get offered more of these physical explanations as opposed to psychological ones? What makes ‘not eating’ almost by definition a mental disorder for most people? What other behaviour are we inclined to label as a mental disorder rather than staying open for other explanations? Continue reading
Guest Post: Mental Health Disorders in Prison: Neuroethical and Societal Issues
Guest post by Barbara Sahakian,
FMedSci, DSc, a professor in the department of psychiatry at the University of Cambridge,
and president of the International Neuroethics Society.
This article was originally published on the Dana Foundation Blog, and can be read here: http://danablog.org/2015/07/28/mental-health-disorders-in-prison-neuroethical-and-societal-issues/
More than half of all prison and jail inmates have a mental health problem.[i] In addition, according to a 2010 report released by the Treatment Advocacy Center and the National Sheriffs’ Association,[ii] more mentally ill persons are in jails and prisons than in hospitals, and many of those remain untreated. Those in prison have a higher risk of substance abuse, and suicide rates are four to five times higher than within the general population.[iii] Deaths are also increased upon release, with the most common reasons being drug overdose, cardiovascular disease, homicide, and suicide.[iv]
Many people in prison have lower than average IQs, and it is well-established that lower IQ is a known risk factor for mental health problems.[v] Rates of problems for children in the youth justice system are at least three times higher than within the general population, and are highest amongst children in custody.[vi] Almost a quarter of children who offend have very low IQs of less than 70.[vii]
At the International Neuroethics Society Annual Meeting 2015 in Chicago (Oct. 15-16), there will be a panel entitled, “Mental health disorders in prison: Neuroethical and societal issues,” which will consider vulnerabilities to mental health problems of those in prison, and whether there are inequalities in access to psychiatrists, psychologists, and other professionals for diagnosis and treatment. This panel will also reflect on what steps, in terms of improving cognition, functionality, and wellbeing, society should be taking to ensure better life trajectories when inmates with mental health problems are released.
For example, suicide mortality is reduced by antidepressant treatment,[viii] and there is evidence that for at least some disorders, such as attention deficit hyperactivity disorder (ADHD), treatment leads to a significant reduction in criminality rates in men (Lichtenstein et al, 2012).[ix] Effective treatment of neuropsychiatric disorders and education, including skill training in prisons, could help to increase cognitive reserve and resilience, helping prisoners successfully address the many challenges encountered on release.[x]
The highly distinguished panel includes Dr. James Blair, Dr. Laurie R. Garduque, and Professor Hank Greely. The panel’s moderator, Dr. Alan Leshner, has been director of the National Institute on Drug Abuse, deputy director and acting director of the National Institute of Mental Health, and chief executive officer of the American Association for the Advancement of Science. He was one of the first to highlight the neuroscientific evidence of brain changes in addiction.
[i] James DJ, Glaze LE (2006) Mental health problems of prison and jail inmates. Bureau of Justice Statistics, NCJ 213600
[ii] Torrey E, Kennard A, Eslinger D, Lamb R, Pavle J (2010) More Mentally Ill Persons are in Jails and Prisons than Hospitals: A Survey of the States. Treatment Advocacy Center.
[iii] Fazel S, Grann M, Kling B, Hawton K (2011) Prison suicide in 12 countries: An ecological study of 861 suicides during 2003–2007. Soc Psychiatry Psychiatr Epidemiol, 46, 191-195.
[iv] Binswanger IA, Stern MF, Deyo RA, Heagerty PJ, Cheadle A, Elmore JG, Koepsell TD (2007) Release from prison: A high risk of death for former inmates. New England Journal of Medicine, 356, 157-165.
[v] Barnett JH, Salmond CH, Jones PB, Sahakian BJ (2006) Cognitive reserve in neuropsychiatry. Psychological Medicine, 36, 1053-1064.
[vi] Hagell A (2002) The mental health needs of young offenders—a report commissioned by the Mental Health Foundation MHF: London.
[vii] Harrington R, Bailey S (2005) Mental health needs and effectiveness of provision for young offenders in custody and in the community YJB: London.
[viii] Morgan OWC, Griffiths C, Majeed A (2004) Association between mortality from suicide in England and antidepressant prescribing: an ecological study. BMC Public Health, 4.
[ix] Lictenstein P, Halldner L, Zetterqvist J, Sjolander A, Serlachius E, Fazel S, Langstrom N, Larsson H (2012) Medication for attention deficit-hyperactivity disorder and criminality. The New England Journal of Medicine, 367.
[x] Beddington J, Cooper CL, Field J, Goswami U, Huppert FA, Jenkins R, Jones HS, Kirkwood TB, Sahakian BJ, Thomas SM (2008) The mental wealth of nations. Nature, 23, 1057-1060.
Turning the Camera Around: What Newtown Tells Us About Ourselves
On the morning of December 14th, 20-year old Adam Lanza opened fire within the halls of Sandy Hook Elementary School in Newtown, Connecticut, killing 20 children and six adult staff members before turning his gun on himself. In the hours that followed, journalists from every major news station in the nation inundated the tiny town, and in the days that followed, the country as a whole started down a familiar path characterized best by the plethora of ‘if only-isms’.
It began in the immediate hours following the shooting: if only we had stricter gun control laws, this wouldn’t have happened. This is perhaps an unsurprising first response in a country that represents 4.5% of the world’s population and 40% of the world’s civilian firearms.[1] Over the next few days, as a portrait of the shooter began to emerge and friends and family revealed that he was an avid gamer, a second theory surfaced in the headlines: if only our children weren’t exposed to such violent video games, this tragedy never would have occurred.[2] [3] And just in the past few days, public discourse has converged on the gunman’s mental health, the general conclusion being that if only we had better mental health services in place, this wouldn’t have happened.[4][5] (The National Rifle Association [NRA] even tried to jump on board, suggesting that “26 innocent lives might have been spared” if only we had an armed police guard in every school in America.[6] They seem to be the only ones taking themselves seriously.[7]) Continue reading
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