Tuesday, August 28, 2012

Take the Stop Bullying Challenge

By Darcy Gruttadaro, Director, NAMI Child & Adolescent Action Center

Bullying is never okay.

It is not just kids being kids. It is not simply part of growing up. It is harmful and destructive and a major challenge to mental health.

That’s why the U.S. Department of Health and Human Services and the Department of Education are sponsoring a special website www.stopbullying.gov offering resources to support initiatives to end bullying in schools and other communities.

Between now and Oct. 14, the federal partners are inviting youth ages 13 to 18 to create 30- and 60-second public service announcements. Video submissions need to showcase ways that young people are taking action against bullying and promoting kindness and respect. Three winning videos will be featured on the stopbullying.gov website. The grand prize winner will receive $2,000 and two other honorable mention videos will each receive $500.

What exactly is bullying?

Bullying is unwanted and aggressive behavior that happens repeatedly and involves a real or perceived imbalance of power. The power imbalance usually involves someone using physical strength, greater popularity or embarrassing or humiliating information to control or harm another person.

Bullying can take many forms. It can be done with words, including repeated teasing, name-calling, threats and inappropriate sexual comments. It can be done through social interactions—repeatedly and intentionally excluding someone from a group, telling other kids not to be friends with someone or spreading rumors and embarrassing a targeted person in public. It can also be done by hurting another person physically or vandalizing possessions.

Bullying can take place in school, on the bus, in neighborhoods and, increasingly on electronic devices. Cyber bullying on the Internet gives some youth a sense of security because they are able to hide behind a computer screen. Because most kids now communicate with peers primarily through cell phones and computers, bullying messages, photos and other information can quickly “go viral” throughout the Internet.

Bullies target peers whom they often see as different, alone or in some way weak. In the long run, bullying not only hurts those who are bullied, but also those who witness it and the bullies themselves. It can destroy self-esteem and damage their ability to function in adulthood.

What can be done about it? Parents and caregivers can talk with their kids about bullying so that they understand it and recognize that it is not okay. They can give their kids advice about what to do if they are bullied or if they see someone else being bullied. Here are some things to share with kids:

  • Ask if your child is or has ever been bullied
  • If so, reassure your child that it is not her/his fault and you can work together to stop it
  • If your child confides that another child is being bullied, ask your child to be a friend to that person by spending time with him/her
  • Encourage your child to let the child being bullied know that bullying is not okay and that it is okay to tell a trusted adult
  • Let your child know it is okay to suggest to the person being bullied that they go together to talk with a trusted adult
  • Your child can also confide in a trusted adult about witnessing bullying and ask for help to stop it
  • Advise your child to only intervene directly when bullying is happening to another person if it is safe to do so—otherwise your child should find a trusted adult immediately

In safe circumstances, standing up or speaking out against bullying behavior when it occurs can rob the bully of much of his/her power.

Bullying should never be ignored. More than 20 percent of high school students report being bullied in any given year. It leads to higher rates of depression and anxiety and contributes to many suicides

Let’s all take the stop bullying challenge (make a video if you can!) and put an end to bullying.

Tuesday, August 21, 2012

Gun Laws and Mental Health

Last week, Mayors Against Illegal Guns, a coalition led by New York City Mayor Michael Bloomberg and Boston Mayor Thomas Menino unveiled an interactive map to accompany its 2011 report, Fatal Gaps: Can Dangerous People Buy Guns in Your State? The coalition has been working to keep guns out of the hands of dangerous or potentially dangerous individuals, but the map focuses specifically on state reporting of mental health records to the National Instant Criminal Background Check System (NICS).

The 2011 report and map provide informative data and some helpful perspective, but the focus and tone, particularly the report introduction, has grossly stigmatized individuals living with mental illness. It has blurred public dialogue and reinforced the erroneous perception that all people with mental illness are inherently violent.

The U.S. Surgeon General has determined that the likelihood of violence from people with mental illness is low. There are many reasons why violence occurs in our society, many of which have nothing or little to do with mental illness.

In contrast to the mayors’ report, National Public Radio last week broadcast a balanced discussion on “The Law—and the Reality—of Gun Access.” Federal law currently bars certain categories of individuals—including some with a history of mental illness—from purchasing or owning guns. Potential purchasers are screened through the NICS.

The mayors’ report is correct in identifying holes in the system but in its call on the federal government to provide clear guidance as to “which mental health and drug abuse should be submitted to NICS,” falls woefully short of addressing one of the most important factors responsible for confusion among the states.

Federal law speaks in terms of individuals “adjudicated mentally defective” a term that is not only highly offensive, but has no practical meaning. Likewise, terms in the law such as “civilly committed” require practical definition.

In 2007, NAMI testified before Congress, explaining how current definitions in the law are vague, leading to holes in compliance and enforcement. To date, there has been no effort in Congress to change the law—thoughtfully and carefully—in a way that is not only overly broad, but also avoids unfair, damaging discrimination.

One paramount concern is to avoid creating a situation where people are in fact discouraged from getting help when they need it because of speculative fear over stigma.

It’s worth having public dialogue about making gun laws more effective. But extreme, broad-brushed rhetoric that ignores medical science, modern definitions and actual risk factors will only detract from the discussion.

Wednesday, August 15, 2012

Speaking Out: A Cheesy Stigma Story

by Bob Carolla

Who would have ever thought that French cheese would stigmatize people living with mental illness?

Last week Fromageries Bel, the multinational cheese maker headquartered in Paris, bowed to protests from the French mental health community over a small toy inkpad that was being given away in packages of Mini Babybel, a small round cheese coated in red wax.

The company’s U.S. subsidiary is Bel Brands USA, which produces Laughing Cow cheese as well as Mini Babybel.

The inkpads featured the term “des vacances de malade mental” (mentally ill holidays), apparently a play on words which the company claimed was intended to mean “extraordinary.” In English or French, I think something was lost in the translation.

The company has apologized and promised to meet next month with leaders of French disability organizations to talk about ways to fight discrimination—after everyone returns from vacation, I’m sure.

The story caught my eye for several reasons.

One, it’s good to keep in mind that the stigma that surrounds mental illness is not limited to the United States. It exists in popular cultures throughout the world. The challenge to overcome it is immense, but at least we are not alone.

The story also demonstrates two basic tactical approaches used in fighting stigma.

The first is protest. The second is dialogue--with the ideal hope being that dialogue can turn into partnership.

Traditionally, movies and television have lead the pack in spreading stigma, but retail products and advertising also have an impact.

Boycotts rarely work per se, but protests in general pack a punch. (With boycotts, you need to mobilize huge numbers of people over a long period of time and make a major financial dent).

No one likes bad publicity. That’s one reason why companies monitor social media carefully and, believe it or not, actually read customer comments submitted through their websites.

In the era of social media, individuals have more power than they realize.

Every little bit helps.

If you see or hear an offensive television or radio commercial, go to the company’s website and Facebook page and let them know. Share your concerns on NAMI’s Facebook page and those of other mental health organizations.

Let the public debate begin.

(Did you watch the commercial linked in above? What did you think?)

Protest may not actually change attitudes. They may only result in a “Gee whiz, we didn’t intend to hurt anyone’s feelings” type apology. Sometimes, there will be no response at all. However, protest may change behavior, quietly, behind the scenes. No business wants to “get into trouble” a second time, if only because it’s too much a headache.

Protest causes people to take notice.

It can lead to dialogue and the best outcome of all is a partnership that emerges out of controversy. Be strong in protest when it’s warranted, but always stay committed to finding common ground.

Tuesday, August 7, 2012

Letter from a Grateful Parent to a News Reporter

Editor’s note: The Los Angeles Times recently published a story about NAMI’s new national board president, Keris Myrick. The reporter, Anna Gorman, has since received many comments from readers. Here is one of them.

Dear Anna,

Thank you so much for your article featuring Keris Myrick and her accomplishments in the face of mental illness.

I have a son, age 23, who was diagnosed bipolar with schizophrenic episodes and it has been one of the most difficult challenges of my role as parent. Since this is so new for me—he had a breakdown at college last November and has been hospitalized five times since then— my hope continues for him when I read articles like yours that feature someone who has dealt with the challenge and stigma of mental illness and has forged on to function very well, in my opinion, to lead a very productive life.

My son has yet to come to terms with his illness, only recognizing that he sometimes gets depressed and because of his holistic approach to life and natural eating, doesn't like to take the medications prescribed. I have become very familiar with NAMI and have taken their Family-to-Family course, which I highly recommend, to help me be more educated and understanding of its effects on those who live with mental illness.

I want to praise you and the L.A. Times for featuring articles like this to help with the stigma and education on the subject. I think that this article, with the works of other groups like NAMI and actresses like Glenn Close and her work with Bring Change 2 Mind, only help bring attention to one of the most devastating illnesses to strike families.

I am one most grateful parent and NAMI activist. I'm currently trying to step up to the plate as I have become a Team Captain for our local NAMI Walk to help the cause.

Blessings to you and a big THANK YOU!!! 
Cindie Bassett, L.M.T.

Wednesday, August 1, 2012

The Colorado Tragedy: Mental Health System Concerns

By Mike Fitzpatrick, NAMI Executive Director

Last week, I offered reflections on the recent Colorado tragedy in which 12 people died and 58 others were wounded.

At that time, public inquiry had started to focus on whether or not the person responsible for the tragedy had ever sought help for mental illness or whether anyone or any institution had encouraged or required him to be evaluated.

This week, the Washington Post revealed that in years past his mother sought counseling for him—because of his social isolation. Court filings then revealed he was seeing a psychiatrist at the University of Colorado prior to the July 20 attack.

Public discussion initially focused on the wide availability of guns in our society. It has now shifted to the question of whether or not the mental health care system failed leading up to the tragedy. It is an issue addressed eloquently in USA Today by Pete Earley in a guest column, “Massacres No Excuse to Stigmatize the Mentally Ill.”

There are many causes of violence in society. As reported by the U.S. Surgeon General “the overall contribution of mental disorders to the total level of violence in society is exceptionally small.”

When exceptions occur, they are often a sign that something has gone terribly wrong in the mental health care system—which as Pete warns, we ignore “at our own peril.” In specific cases, public authorities or the news media need to inquire:

  • What was the full medical history?
  • Was there ever a diagnosis; if so, what was it?
  • When was he/she seen? By whom? How often?
  • Was treatment coordinated among different professionals?
  • Did the person or family seek treatment, but have it delayed or denied?
  • Was the type of treatment appropriate?
  • Was the person hospitalized and recently discharged?
  • What events may have triggered the psychiatric crisis?
  • Was the person taking medication? If not, why not?
  • Did family members receive adequate education and support?

These questions can help inform specific cases, but they are still only part of a much bigger picture.

Frankly, the nation’s mental health care system is not geared to accurate diagnosis or treatment of early-onset mental illness—assuming that a person has access to treatment at all. It doesn’t matter whether a university counseling center or community mental health clinic is involved. The system is fragmented and grossly inadequate. The chasm between need and care is devastating for persons living with mental illness and their loved ones. 

The U.S. Centers for Disease Control and Prevention (CDC) has found that about half of adults in America will develop a mental illness during their lifetime. One in four adults experiences a mental disorder in any given year, and one in seventeen lives with a serious mental illness like schizophrenia, major depression or bipolar disorder. 

Yet a new report from the federal Substance Abuse and Mental Health Services Administration (SAMHSA) has indicated that only 40 percent of adults with serious mental illness receive any treatment.

When it comes to treatment, one size does not fit all; it often depends on the severity of the condition. Treatment options along a “continuum of care” may need to include medication, psychosocial therapy, housing supports or a combination. To find a treatment provider, a person’s family doctor often is the starting point, but individuals and families then have to contend with confusing referrals or networking among different resources.

For psychiatric crises, hospital emergency rooms may be a default point of admission, but only if individuals consent to treatment—or are judged to be a danger to themselves or others, regardless of other symptoms that may be apparent. Even then, treatment assumes availability of hospital beds.

At a time when mental health care is needed now more than ever, however, many states are cutting both inpatient beds and community services. 

In 2009, NAMI published Grading the States, a report on state mental health care systems. The national average was D, based on 65 specific criteria. Since then, conditions have worsened.

In 2011, NAMI published a report on State Mental Health Budget Cuts, showing a deepening crisis.

Increasingly, emergency rooms, homeless shelters and jails are struggling with the effects of people falling through the cracks—due to lack of mental health services and supports.

No matter what facts ultimately emerge from the Colorado tragedy, Americans need to focus on the fact that the mental healthcare system is already in crisis.