‘Suicide Prevention Sheds a Longstanding Taboo: Talking About Attempts’ – The New York Times

Dese’Rae L. Stage, a photographer and writer living in Brooklyn, tried to kill herself in 2006. She has since created an online photo exhibit of people who have also survived suicide attempts and is among the dozens whose stories are becoming known on Internet forums and through social media.

Benedict Carey writes for The New York Times:

The relationship had become intolerably abusive, and after a stinging phone call one night, it seemed there was only one way to end the pain. Enough wine and pills should do the job — and would have, except that paramedics barged through the door, alerted by her lover.

“I very rarely tell the story in detail publicly, it’s so triggering and sensational,” said Dese’Rae L. Stage, 30, a photographer and writer living in Brooklyn who tried to kill herself in 2006. “I talk about what led up to it, how helpless I felt — and what came after.”

The nation’s oldest suicide prevention organization, the American Association of Suicidology, decided in a vote by its board last week to recognize a vast but historically invisible portion of its membership: people, like Ms. Stage, who tried to kill themselves but survived. About a million American adults a year make a failed attempt at suicide, surveys suggest, far outnumbering the 38,000 who succeed, and in the past few years, scores of them have come together on social media and in other forums to demand a bigger voice in prevention efforts.

Plans for speakers bureaus of survivors willing to tell their stories are well underway, as is research to measure the effect of such testimony on audiences. For decades, mental health organizations have featured speakers with schizophrenia, bipolar disorder and depression. But until now, suicide has been virtually taboo, because of not only shame and stigma, but also fears that talking about the act could give others ideas about how to do it.

“This is a real shift you’re seeing,” said Heidi Bryan, 56, of Neenah, Wis., who has been speaking for years about suicide attempts she made in the 1990s. “For people working in suicide prevention, they always told us not to talk about our own experience, like they were afraid to tip us over the edge or something. Honestly, we’re the ones who know what works and what doesn’t.”…

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Are we using antidepressants to paper over the cracks of a fractured society?

Frankie Mullin writes for The Guardian:

Use of antidepressant drugs has become more common than ever before. Perhaps it’s time that we looked at the wider causes of this trend

More than 50m prescriptions for antidepressants are written in the UK every year. Photograph: Alamy

 

The chances are that you know someone who takes antidepressants. Or maybe you take them yourself. If so, you are in good company. More than 50m prescriptions for antidepressants are written in the UK every year and, although the not all of the pills will be swallowed – taking into account repeat prescriptions and failure to collect from pharmacies – the figure is still staggeringly high.

There’s a positive side to the 50m statistic, though. It suggests that as the stigma has decreased, people have become more willing to ask for help. And, for many, antidepressants work. However, while professionals are quick to acknowledge the benefits – which can be life-saving – many express concern about our growing dependence.

“Prescription levels have gone through the roof,” says Dr Matthijs Muijen, head of mental health at WHO Europe. “On the demand side, people know antidepressants work. I would even argue there’s a degree of fashion about antidepressants. On the supply side, antidepressants have become cheaper and more easily available. Doctors now know it’s easy and ‘good’ to prescribe.”

Key to arguments around antidepressant use are questions about what constitutes “normal” sadness and where the boundary lies between this and clinical depression. There is no cut-and-dried answer, and this ambivalence around the use of antidepressants seems to be characteristic of those taking them. “It’s not ideal, but I just make use of the resources available,” is a characteristic response.

Lisa Cunningham, 45, was signed off on sick leave and prescribed Prozac after suffering problems at work. Soon afterwards, she was attacked, leaving her with facial injuries and even deeper depression. For nearly 11 years, Lisa remained on medication, becoming steadily more withdrawn, until she barely left the house.

Cunningham’s story has a positive outcome: after being referred to a volunteering scheme by her GP she got involved in a gardening project which led to a full-time job. She then felt able to stop taking her medication. “Antidepressants did a vital job and I definitely think I had clinical depression,” Cunningham says. “But I was a nervous, anxious child.” She explains that while growing up, she was subjected to physical aggression from people close to her, “so it was almost inevitable I’d get depression. Looking back, it would probably have been better if I’d had some sort of psychotherapy in school.”…

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Ketamine ‘exciting’ depression therapy

The illegal party drug ketamine is an “exciting” and “dramatic” new treatment for depression, say doctors who have conducted the first trial in the UK.

Ketamine offers an avenue of research into a field that has struggled to find new treatments for depression

James Gallagher reports for BBC News:

Some patients who have faced incurable depression for decades have had symptoms disappear within hours of taking low doses of the drug.

The small trial on 28 people, reported in the Journal of Psychopharmacology, shows the benefits can last months.

Experts said the findings opened up a whole new avenue of research.

Depression is common and affects one-in-10 people at some point in their lives.

Antidepressants, such as prozac, and behavioural therapies help some patients, but a significant proportion remain resistant to any form of treatment.

A team at Oxford Health NHS Foundation Trust gave patients doses of ketamine over 40 minutes on up to six occasions.

Eight showed improvements in reported levels of depression, with four of them improving so much they were no longer classed as depressed.

Some responded within six hours of the first infusion of ketamine.

Lead researcher Dr Rupert McShane said: “It really is dramatic for some people, it’s the sort of thing really that makes it worth doing psychiatry, it’s a really wonderful thing to see.

He added: “[The patients] say ‘ah this is how I used to think’ and the relatives say ‘we’ve got x back’.”

Dr McShane said this included patients who had lived with depression for 20 years…

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Has cognitive behavioural therapy for psychosis been oversold?

CBT is a recommended treatment for schizophrenia in the UK, but how strong is the evidence that it works? Keith Laws suggests it’s not as strong as we might hope.

The evidence for cognitive behavioural therapy to treat psychosis is not as strong as guidelines might make you think, according to Keith Laws. Photograph: Alamy

In 1952, the same year that chlorpromazine was introduced as the first effective drug treatment for schizophrenia, Aaron Beck first employed a form of cognitive-based talk therapy to treat delusional thinking. While chlorpromazine inaugurated the era of drug treatments in psychiatry, Beck’s psychological alternative was a slow-burner. Cognitive Therapy or Cognitive Behavioural Therapy (CBT), as we now know it, became part of the mainstream treatment for psychosis in the UK in 2002 when the National Institute of Clinical Excellence (NICE) endorsed it; and again in 2009, they further recommended that CBT be offered “to all people with psychosis or schizophrenia.” Despite repeated endorsements by this Government agency, is it possible that CBT for psychosis has been oversold?

NICE, along with almost everyone else nowadays, ‘takes stock’ of the results of clinical trials by using the quantitative technique of meta-analysis. This allows findings of different trials to be mathematically summed, giving more weight to larger (and usually methodologically more rigorous) trials. Notably the dozen meta-analyses of trials investigating CBT for schizophrenia document the shrinking evidence for its effectiveness on symptoms. Although initial meta-analyses optimistically suggested that around 50% of patients showed significant symptom reduction following CBT, more recent meta-analyses estimate that just 5% benefit significantly when compared to controls…

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Thich Nhat Hanh: is mindfulness being corrupted by business and finance?

The Zen master discusses his advice for Google and other tech giants on being a force for good in the world

Jo Confino writes for The Guardian:

Mindfulness has become an increasingly popular topic among business leaders, with several key executives speaking publicly in recent months about how it helps them improve the bottom line.

Intermix CEO Khajak Keledjian last week shared his secrets to inner peace with The Wall Street Journal. Arianna Huffington, editor in chief of the Huffington Post, discussed mindfulness in Thrive, her new book released this week. Other business leaders who meditate include Aetna CEO Mark Bertolini, Salesforce.com CEO Marc Benioff and Zappos.com CEO Tony Hsieh, to name just a few.

In a blog post last month, Huffington wrote that “there’s nothing touchy-feely about increased profits. This is a tough economy. … Stress-reduction and mindfulness don’t just make us happier and healthier, they’re a proven competitive advantage for any business that wants one.”

But by focusing on the bottom-line benefits of mindfulness, are business leaders corrupting the core Buddhist practice?

Thich Nhat Hanh, the 87-year-old Zen master considered by many to be the father of mindfulness in the west, says as long as business leaders practice “true” mindfulness, it does not matter if the original intention is triggered by wanting to be more effective at work or to make bigger profits. That is because the practice will fundamentally change their perspective on life as it naturally opens hearts to greater compassion and develops the desire to end the suffering of others.

Sitting in a lotus position on the floor of his monastery at Plum Village near Bordeaux, France, Thay tells the Guardian: “If you know how to practice mindfulness you can generate peace and joy right here, right now. And you’ll appreciate that and it will change you. In the beginning, you believe that if you cannot become number one, you cannot be happy, but if you practice mindfulness you will readily release that kind of idea. We need not fear that mindfulness might become only a means and not an end because in mindfulness the means and the end are the same thing. There is no way to happiness; happiness is the way.”

But Thay, as the Zen master is known to his hundreds of thousands of followers around the world, points out that if executives are in the practice for selfish reasons, then they are experiencing a mere pale shadow of mindfulness.

“If you consider mindfulness as a means of having a lot of money, then you have not touched its true purpose,” he says. “It may look like the practise of mindfulness but inside there’s no peace, no joy, no happiness produced. It’s just an imitation. If you don’t feel the energy of brotherhood, of sisterhood, radiating from your work, that is not mindfulness.”….

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The play that wants to change the way we treat mental illness

Laura Barnett writes for The Guardian:

The Eradication of Schizophrenia in Western Lapland is based on a new approach called ‘open dialogue’, and replicates the experience of having an auditory hallucination

Can theatre offer a cure for psychosis? It’s unlikely – and it would be unwise for any theatre-maker even to try. What theatre can do, though, is convey the experience of psychosis: the hallucinations and delusions – often terrifying, sometimes comical – that define reality for those with schizophrenia and related conditions.

This, at least, is the belief shared by David Woods and Jon Haynes, co-founders of the theatre company Ridiculusmus. Their new show, The Eradication of Schizophrenia in Western Lapland, examines the effects of psychosis on several members of a fictional family, using an innovative conceit. The audience is split in two, with each half sitting on either side of a dividing wall. For the first act, each half of the audience watches one scene, while another scene is performed on the other side. Later, the audiences swap places; and in the final section, the wall becomes transparent, so that both halves of the audience are watching the same scene.

The effect, at least at first, is bewildering – and that is the point. “It’s as if you’re having auditory hallucinations,” Woods tells me when we meet during rehearsals at the Basement in Brighton, where the play is beginning a national tour. “Initially it’ll be overwhelming, chaotic. Then the audience will go out of the theatre, change sides. Slowly the voices will settle into place. In a way, it’s the same with schizophrenia. You don’t get cured, but you can recover.”…

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Mental health and race – the blight of dual discrimination

Mary O’Hara from The Guardian writes:

Black and minority ethnic people living with mental illness face a double dose of prejudice, says a new report from the anti-stigma organisation Time to Change

An overwhelming majority of people from black and minority ethnic (BME) backgrounds in the UK living with mental health problems face regular discrimination because of their illness according to a new report from the anti-stigma organisation, Time to Change. In the first survey the organisation has conducted, exclusively of people from BME groups, 93% said they had experienced discrimination in everyday life due to their mental health difficulties.

Respondents also reported high levels of racial discrimination (73% had faced it at some point and 28% in the previous 12 months), leading the study’s authors to warn about the serious issue of “dual discrimination” blighting people’s lives. The research surveyed 740 people in 2013 from a mixture of African, Caribbean, Indian, Pakistani and Bangladeshi backgrounds in England with mental health issues. Most alarmingly, it found that almost half (49%) had faced discriminatory behaviour from mental health staff.

“Discrimination as a result of mental ill health is reported across a wide range of every day activities,” the researchers found. “There are some slight variations across ethnic groups but the overall picture is constant: discrimination is everywhere.”

Areas of life where discrimination was common included employment, in communities, within families and during contact with mental health services. Only a fifth of people from BME communities said they felt able to speak to people about their mental health. “This suggests that most are functioning in social circles where one of the most important parts of their lives is left unspoken,” the report concluded…

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Benefits assessment led to woman’s suicide says watchdog

Eleanor Bradford for BBC News reports:

The way a woman was assessed for benefits led to her suicide less than a month later, according to a mental health watchdog.

The woman had a history of depression and was on significant medication, but scored zero points in a Work Capability Assessment (WCA), carried out by Atos.

A Mental Welfare Commission report said it could see no other factor “in her decision to end her life”.

The Department for Work and Pensions said correct procedures were followed.

The woman, who is identified only as Miss DE, was in her early 50s and had been out of work for just under two years due to stress-related depression when she was assessed for Employment and Support Allowance (ESA).

ESA replaced incapacity benefit as part of changes to the benefits system, introduced by the UK government in 2007…

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Can what you eat affect your mental health? New research links diet and the mind.

Gisela Telis of the Washington Post writes:

Jodi Corbitt had been battling depression for decades and by 2010 had resigned herself to taking antidepressant medication for the rest of her life. Then she decided to start a dietary experiment.

To lose weight, the 47-year-old Catonsville, Md., mother stopped eating gluten, a protein found in wheat and related grains. Within a month she had shed several pounds — and her lifelong depression.

“It was like a veil lifted and I could see life more clearly,” she recalled. “It changed everything.”

Corbitt had stumbled into an area that scientists have recently begun to investigate: whether food can have as powerful an impact on the mind as it does on the body.

Research exploring the link between diet and mental health “is a very new field; the first papers only came out a few years ago,” said Michael Berk, a professor of psychiatry at the Deakin University School of Medicine in Australia. “But the results are unusually consistent, and they show a link between diet quality and mental health.”…

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Inside the UK’s mental health crisis: ‘It is my view that people will die’

Two major reorganisations and ongoing budget cuts have left many NHS mental health units running at or beyond full capacity – here, staff under pressure explain why they fear patients will suffer as a result

Overnight there have been seven admissions to this mental health crisis unit in west London, which means that 68 out of the 71 beds are full. There are almost no beds elsewhere in west London, and the senior management team use their 8.30am meeting to discuss who might reasonably be discharged to make room for incoming patients.

Operating with just three free beds in the unit is either a mark of commendable efficiency, or a sign of the terrifying pressure the system is under, and even the consultants are not sure which it is. A senior manager concedes: “We are sailing very close to the wind.”

Ward managers are asked to assess if anyone on their lists could be sent home. “We’ve already sent home everyone we could,” one says, scanning his list. “There’s a remote chance we could discharge Maria,” a ward nurse, says doubtfully. “Have there been any improvements in Mikhail?” the senior manager wonders, but there haven’t. “Is there no one else?”

Occupancy levels for acute adult psychiatric beds elsewhere are often running at 100%, and this level of intense demand is not considered particularly extreme. But the pressure on beds is not the only sign of strain the team faces. One senior nurse complains that the trust’s mental health teams have been so radically and repeatedly restructured over the past two years that it is her view that “people will die”. A psychologist describes feeling “despairing” and “heartbroken” at the eight-month waiting list for his services. Some patients are angry at being discharged from hospital and given what they feel is inadequate follow-up care.

Three days with the teams working with patients experiencing a mental health crisis in west London reveal some of the profound pressures the NHS’s service is operating under. But it also reveals how overworked staff are managing to look after a challenging group of patients with immense care and dedication, despite the combined pressures of those restructurings and ongoing funding cuts (which are still officially supposed to be referred to as “efficiency savings”)…

To read the rest of this article from The Guardian’s Amelia Gentleman, follow this link