Markham's Behavioral Health

Watchdog group raises alarm over inmate's death

"On his 70th day in solitary confinement, Billy Owens erupted into a psychotic fit and died at the hands of prison officers. An Oregon State Police investigation determined his death by asphyxiation was an accident."

Most prisons are not equiped to deal with the severely and persistantly mentally ill like Owens. I have written before about the criminalization of mental health which has gone on in this country over the last 30 years. Large numbers of people afflicted with mental illness are now being treated in prisons in the United States.

A careful read of this article which appeared in the Oregonian may make you cry.

Watchdog group raises alarm over inmate's death

Quote of the day

"They say you shouldn't say nothing about the dead unless it's good. He's dead. Good."

Moms Mabley

A Tale of Two Cities by Charles Dickens

I don't know how I missed this book as a student in high school and college, but I did. I think we read Great Expectations and of course, everyone knows A Christmas Carol by Charles Dickens. Whether we have read A Tale Of Two Cities or not we have all probably heard the opeing sentence and the closing sentence without knowing where they came from.

The book opens with the sentence "It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epock of belief, it was the epock of incredulity, it was the season of Light, it was the season of Darkness, it was the spring of hope, it was the winter of despair, we had everything before us, we had nothing before us, we were all going direct to Heaven, we were all going direct the other way - in short, the period was so far like the present period, that some of its noisiest authorities insisted on its being received, for good or for evil, in the superlative degree of comparison only."

Wow! Dickens is referring to the French revolution when La Guillotine was lopping off 60 heads a day, day after day after day.

"A Tale of Two Cities" begins in 1775, with Mr. Lorry, a respectable London banker, meeting Lucie Manette in Paris, where they recover Lucie's father, a doctor, and mentally enfeebled by an unjust and prolonged imprisonment in the Bastille. This assemblage, on their journey back to England, meets Charles Darnay, an immigrant to England from France who makes frequent trips between London and Paris. Upon their return to England, Darnay finds himself on trial for spying for France and in league with American revolutionaries. His attorney, Stryver, and Stryver's obviously intelligent, if morally corrupt and debauched, assistant, Sydney Carton, manage to get Darnay exonerated of the charges against him. Darnay, a self-exiled former French aristocrat, finds himself compelled to return to France in the wake of the French Revolution, drawing all those around him into a dangerous scene.

Dickens portrays the French Revolution simplistically, but powerfully, as a case of downtrodden peasants exacting a harsh revenge against an uncaring aristocratic, even feudal, system. The Defarge's, a wine merchant and his wife, represent the interests of the lower classes, clouded by hatred after generations of misuse. Darnay, affiliated by birth with the French aristocracy, is torn between sympathy for his native country in its suffering, and his desire to be free of his past."

The book ends with the sentence "It's a far, far better thing that I do, than I have ever done; it is a far, far better rest that I go to than I have ever known."

The creative tension is this novel is developed from several factors but primarily it's from the good intentions gone bad. How does a revolution against oppression and subjugation turn into another form of oppression and subjugation? How does debauchery and irresponsibility turn into heroism and great courage? How does atruistic and high minded intentions get misconstrued as treachery and betrayal?

I loved this book, and I see why it has survived almost 200 years as literature. I highly recommend it.

Amazon.com: Books: A Tale of Two Cities

Caregivers of Family Members With Dementia Experience More Health Problems than Noncaregivers

"More than five million caregivers of persons with dementia exist in the United States (AARP, 1988) and no quantitative review has been conducted on the physical health correlates of caring for a family member with dementia until now. In a meta-analysis of 23 studies examining self-reported health and physiological functioning in caregivers of persons with dementia, researchers found that caregivers had higher stress hormones, lower resistance to some viruses and reported poorer health than noncaregivers who were similar in age and sex. This finding is reported on in the November issue of Psychological Bulletin, published by the American Psychological Association (APA)."

And I'll bet that a study comes out in the near future which says that family caregivers have better health because of the warm fuzzies and satisfaction they derrive from caring for the people they love.

I hypothesize that caring for relatives is probably a health promoting activity up to a certain point. When the caregiving crosses the line, then the caregiver starts to get stressed and health problems ensue. So, I doubt that it is the caregiving itself which causes health problems rather it is the degree to which the caregiving taxes the resources of the caregivers.

As a therapist, I often find myself in a role of trying to convince a caregiver that their efforts to give care are heroic and that they need help. It literally would take four people to replace them because most health care providers only work 8 hour shifts 5 days per week. To be providing care 24 hours per day, 7 days a week, indefinitely is outrageous. If we, as a society, are cutting hospital stays shorter, and finding alternatives to nursing home care which are probably good things, we need to be sure that the community supports for "natural" caregiving are in place. For some reason, it seems that funders are more willing, and find it more acceptable, to pay for institutional care than it is to provide community based care.

The false conclusion that could be drawn from the headline and the article is that natural caregiving is a bad thing because natural caregivers are stressed and getting sick. My smart alec response is "No shit, Sherlock", how about giving them some help?!

Caregivers of Family Members With Dementia Experience More Health Problems than Noncaregivers

Quote of the day

"Jump at the sun."

Zora Neale Hurston, a mother, laughing and encouraging her children.

"Ah, but a man's reach should exceed his grasp, or what's a heaven for?"

Robert Browning

Stressful And Insecure Jobs Take a Toll on Health

The idea that stressful and insecure job situations cause physical and mental health problems for people in those situations is what I like to call a "well, duh............"

Us behavioral health counselors have known this for years, and could tell hundreds of stories about clients we have worked with who have been in these situations and the havoc it has wreaked on them, their relationships, and their personal lives.

It is nice, though, to have some social science to validate those anecdotal observations, and this study reported in November, 2003 issue of the Journal of Epdemiology and Community Heath by Dr. Rennie D'Souza describes a survey he did of 1188 people in their early 40s in Australia. People threatened with lay offs had higher rates of physical and behavioral health problems and people in their 40s seemed more effected probably because they had greater financial committments and families to support.

Another phenomenon which I have noticed that is very similar is the high number of people these days who are working in jobs as "temporary" workers, who usually have fewer benefits and who can be terminated at any time. Sometimes if they work very hard and are super reliable and dependable they will be offered a permanent position, but these folks often are working in tenuous positions without much of a future.

How to help these folks, I don't know. I listen, commiserate, and help them explore their options. Coping with ambiguity and insecurity is very stressful, and it appears that in our current economy much of this stress is structural. Can human beings adapt? What are the longer term impacts on individuals, families, and communities with an economy that operates this way? Could some economic and social policy changes help create communities that are more supportive of individuals and families? I don't know the answer to these questions, but I do know that our worship of the almighty dollar, our materialistic culture which demands the cheapest price, is not always good for the health of our individual community members and their families. Are you willing to pay a higher price for goods and services produced by your neighbor, or do you want the cheapest price for imported goods from third world countries?

The old saying is think globablly, act locally. Buy at home this holiday season and keep your neighbor employed if that would help.

MEDLINEplus: Stressful And Insecure Jobs Take a Toll on Health

Quote of the day

"I did not attend his funeral, but I wrote a nice letter saying that I approved of it."

Mark Twain

Problem gamblers have higher rate of suicidal behavior than nongamblers

A study in the September, 2003, issue of the Journal of Clinical Psychiatry by Otto Kausch, MD, the director of a residential problem gamblers' treatment program at the Veteran's Administration Medical Center in Brecksville, Ohio, found that 40% of the 114 patients admitted to that program from September, 2000 to September, 2001 had reported making a suicide attempt at some point in their lives prior to their admission. This group also had a very high rate of concurrent substance abuse problems. A trigger for a suicide attempt is often gambling loses.

Gambling, which is becoming much more available, is contributing to increasingly significant problems in the behavioral health arena. Just as environmental impact studies are required of new buidling projects in various jurisdictions, perhaps the public health impact of opening new casinos and gambling outlets should be required before governmental licenses to operate gambling activities are granted.

Psychiatric News -- Arehart-Treichel 38 (22): 24

Underage drinking report says all sectors of society must help

Raising taxes on beer, rating movies and TV shows based on their depiction of drinking alcohol, and enacting new measures to deter adults from buying alcohol for minors are ways the nation can reduce the problems associated with underage drinking, according to a report issued in September by the National Research Council and the Institute of Medicine of the National Academy of Sciences.

The report, titled "Reducing Underage Drinking: A Collective Responsibility," places the societal costs of underage drinking—driving-related injuries and death, violent crime, sexual assault, unwanted pregnancies, and suicide, for example—at $53 billion a year in the United States.

By age 20, according to the report, 70 percent of those who consume alcohol engage in heavy drinking, which is defined as five or more drinks in a row during a two-week period.

Psychiatric News -- Bender 38 (22): 20

Quote of the day

"A friend is a person who likes you for what you are, in spite of all your faults, all your shortcomings."

Alfred Armand Montapert

"One of my definitions of love, true love, is when a person knows the worst about you and loves you anyway."

David Gerould Markham