News & Views

Mental Illness and the Death Penalty

2009-08-31T14:13:00.004-05:00

Written by Gary E. Weinstein, L.C.S.W., CEO, Transitions Mental Health Services

Should an individual with a mental illness ever be put to death? It is a controversial topic right now, especially as more and more people are claiming some kind of mental dysfunction in defense of their criminal behavior.

It is a tough question. It is tough because, while no one should be put to death as a result of a symptom of any illness, when criminal behavior that translates into a particularly heinous act is a result of symptoms, it can be difficult to look at that act as being the direct result of symptoms of an illness.

Also, an insanity defense has been too easily played as a trump card (sometimes without basis) by attorneys attempting to get their clients off.

A person with a very real mental disorder that is severely impacting the functioning of his/her brain (the source of all behavior) may be punished more severely than others due to several mitigating factors.

First, the stigma associated with mental illness. There are many misconceptions and incorrect assumptions regarding mental illnesses, such as, the mentally ill are apt to be much more violent than others in society, the mentally ill are out of control, and, the mentally ill are without conscience. The mere potential of the existence of a mental illness may be enough to taint a jury member’s judgment, perceptions, and decisions about a person on trial. The result may be that the death penalty is invoked, where otherwise it might have been averted. If a jury member assumes a person on trial must be guilty because there is a mental illness (and therefore also assumes the person must be particularly heartless and cruel), the only response the jury member can give is a guilty verdict, and, very likely, a recommendation for the death penalty.

Second, the symptoms of mental illnesses can take many forms. Hearing voices, deep depression, mania, and anxiety are some of them. But there are also symptoms that may send a very negative message to the jury— symptoms that manifest themselves as stoicism, disinterest, impatience, or impassiveness. In the courtroom, the impression these symptoms give may be that the individual is unremorseful, thereby eliciting a more punitive response from the jury.

Third, there are too many incidents where individuals do not/cannot access care, with the result being that they may eventually succumb to the symptoms and, ultimately, may indeed commit some crime. Why individuals with mental illnesses do not access treatment can be due to a variety of factors, including services not being available where they live, symptoms not being severe enough to compel the individual to early treatment, the services available are minimal (i.e. one appointment every six, eight, or twelve weeks), the severe side effects of prescribed medications (which can be foul and discomforting), and the fact that some individuals with mental illnesses do not know they are sick (a condition known as anosognosia). All these factors are reasons why, although it may be necessary to keep an individual out of general society, a person with a mental illness should not be punished by death for things outside of his/her control.

So, back to the question at hand: Should people with mental illnesses be put to death? The answer can only be “no.” This does not necessarily mean that an individual with a mental illness should not pay for what he/she did, or that he/she be let back into general society. The questions are: To what extent was the person aware of his/her actions? Did he/she know his/her actions were wrong? And, to what extent were services available to him/her? Those questions should enter into what kind of punishment, if any, should be placed upon the individual, what kinds of treatments should be required and provided for the individual, and when, if ever, an individual should be reintegrated into our general society.

The bottom line is: we should not invoke the death penalty on someone who commits a crime due to the symptoms of any illness, including mental illness.

Transitions Mental Health Services is where action and compassion meet.

For information about Transitions Mental Health Services, call 309-793-4993, M-F, 8:00 a.m. to 4:00 p.m., or click on the title of this blog article to go to the Transitions Mental Health Services official website.

Stigma -- How can I talk about it?

2009-07-10T13:24:00.006-05:00

Written by Joan Holgate, Director of Training and Education at Transitions Mental Health Services.

What is stigma?
Stigma is an attempt to label a particular group of people as less worthy of respect than others. It is a mark or sign of shame, disgrace, or disapproval, and results in rejection or discrimination. This is seen in attempts to marginalize, exclude, or exercise power over individuals who are different in some way from others. Characteristics which may be associated with discrimination or stigma include physical or mental illness, intellectual or physical disability, race, weight, gender, sexuality, physical deformity/abnormality, or religion.

Why does stigma still exist?
Unfortunately, the media is responsible for many of the misconceptions which persist about people with mental illnesses. Newspapers and television news programs frequently sensationalize crimes where persons with mental illnesses are involved. Comedians make fun of people with mental illness, using their disabilities as a source of humor. National advertisers use stigmatizing images as promotional gimmicks to sell products. Movie makers often portray the villain as a mentally ill individual skulking around in the dark with an axe waiting to harm anyone who comes by.Ironically, the media also offers our best opportunity for eradicating stigma because of its power to educate and influence public opinion.

Stigma and mental illness
Over the years, many forms of discrimination have gradually declined in our society, although there is still room for improvement in many areas. It has become socially and legally unacceptable in most settings to discriminate against or ridicule someone on the basis of their race, religion, sexuality, or physical disability. Mental illness still generates misunderstanding, prejudice, confusion, and fear. Some disorders may attract greater stigma and prejudice than others. One study showed that schizophrenia attracted the most negative ratings among the public, with many respondents stating that people with with schizophrenia were unpredictable and dangerous. The same study showed a significant number of respondents had a negative and inaccurate view of depression, stating that those with severe depression could simply “pull themselves together.”Stigma, then, seems due in part to poor understanding of mental illness, and an inability to relate to the experiences of those who are affected.

The dangers of stigma
Stigma may stop people from seeking help when they experience mental health difficulties. Those who become concerned about their own mental health, or the mental health of someone they’re close to, ,may be reluctant to talk to others about the situation. Often, people do not want to acknowledge their need for support, or simply don’t know how to raise the issue with family, friends, or health professionals. This is a serious problem, since early identification and treatment is generally associated with better outcomes.

Challenging stigma
Reducing stigma requires community education, and a willingness among individuals to challenge others when discrimination occurs, or when negative stereotypes are used to describe those who have mental illness.

What you can do to combat stigma:

As individuals we can combat stigma by discouraging the use of negative language or stereotypes regarding those who have a mental illness. Words such as, “psycho” or “schizo” have a negative connotation and are usually used as terms of derision. They trivialize the impact of a serious illness and foster negative stereotypes of those who do live with mental illness.
We can also challenge people’s misconceptions of mental illness by gently pointing out the facts: that mental illness is quite common — affecting people of all ages, all intelligence levels, all socio-economic levels, regardless of race, gender, etc. — that recovery and management of symptoms are possible, and that people are not to blame for their mental illness any more than if they had become ill with diabetes, heart disease, or high blood pressure.
Respond to people who have a mental illness as individuals. Learn about the person and deal with him/her on the basis of your knowledge, not your assumptions.
Help people with mental illness re-enter society. Support their efforts to obtain housing and jobs.

Here are a few suggestions that schools and teachers may like to consider in combatting the stigma associated with mental illness (if you’re not a teacher, you may want to pass this information on to a local school, or individual teacher):

Provide professional development opportunities for staff regarding diversity, mental health issues, and fostering an inclusive school environment.
Challenge any disrespectful terms used in referring to people with a mental illness, or related words used as terms of derision, such as “psycho,” “lunatic,” “loony,” “schizo,” etc.
Refer first to a person, not his/her illness. Use phrases such as “...a person with schizophrenia,” rather than labels such as, “...a schizophrenic.”
Challenge any myths or misconceptions about mental illness, such as links to violence, or misunderstanding about the behavior of those who are unwell.

For more information go to the Transitions Mental Health website at http://www.transrehab.org/. Use the "Contact Us" page to have specific questions answered.

Depression

2009-07-09T14:36:00.005-05:00

Written by Anne McNelis, L.C.S.W., Director of Clinical Services at Transitions Mental Health Services.

Winston Churchill referred to it as “the black dog.” Like an unwanted companion, or a shadow that moves with you, depression can feel like a darkness lurking in every corner of one’s life. Although those who suffer from depression may feel very isolated and alone, they are not. Depression affects one in four Americans. Families are impacted as well when a loved one is battling this illness.1

Depression is the second most common mental health condition on the spectrum of mental illness, with anxiety disorders only recently surpassing. As our society and culture grow evermore fast-paced, stressful, interpersonally disconnected and threatened, we may see this illness become more pervasive. Just in the past decade, we have seen a rise in the number of Americans seeking treatment for depression and anxiety, especially since September 11th occurred. This illness does not discriminate due to race, gender, socioeconomic status or age groups. Among all medical illnesses, major depression is the leading cause of disability in the U.S. and in many other developed countries.2

Depression can have several causes. Biological, psychological, or environmental factors can contribute to its development. A family may have a genetic predisposition to the illness, making one biologically prone to the illness. This can be traced by doing a medical history of one’s family tree. Psychological issues or life events can be contributing factors. A life change or stressor, such as a divorce, loss of a job or a loved one, triggers this type of depression. Depression can be seasonal in some cases, caused by a change in the weather pattern. For some, this may occur during the winter months, triggered by the change in daylight, the oppressive feeling of cold temperatures, and the tendency to isolate indoors in winter months. Others may be more prone to seasonal depression in the summer, triggered by the feeling of being oppressed by the hotter temperatures. Depression can also have a cognitive trigger. Self-defeating thoughts and belief systems can cause or feed a depression. Individuals who were raised in unstable and unsafe situations such as abusive or neglectful environments, poverty or crime-ridden areas, or surrounded by addictive behavior, can be more vulnerable to depression. This illness can have several root causes but to warrant a formal diagnosis of depression, one must experience a range of symptoms for a period of time. It is important to understand that emotional experiences of sadness or loss, and passing mood states are normal. In the case of depression, persistent symptoms will significantly interfere with one’s thoughts, behavior, physical health, and activity level. In order for a diagnosis to be made, multiple symptoms must be present and affect one’s ability to function. Frequent crying spells, irritability or agitation, change in sleeping or eating patterns, and loss of interest in pleasurable activities, are just a few of the criteria. It is important to seek an evaluation from a mental health professional if you or a loved one has been experiencing these symptoms frequently and persistently for two or more weeks. An evaluation can help determine if the depression should be treated with therapy, medication, or a combination of both.

Seeking help is sometimes the greatest barrier to overcome. This is understandable. Stigma surrounds this illness. Undesirable labels, such as “weak,” “lazy,” or “crazy” have been applied to those actively suffering depressive symptoms. Even a suffering individual can stigmatize him/herself with such thoughts as “I should be stronger,” “I just need to pull myself out of this,” or, “taking medication (or getting help) means I’m weak.” Often, taking that first step of acknowledging you have an illness and you need help provides great relief, hope, and a sense of power by taking charge of your mood and your life. Recovery is a very real possibility. Learning how and what triggers your depressive symptoms, taking medications if prescribed and incorporating healthy coping skills into your daily life, are essential steps to treating this illness. Therapy and counseling are avenues of help to explore patterns of behavior or thoughts that are contributing to depression. It is important to find providers that are knowledgeable about this illness; but they should also treat you as an active and capable participant in your treatment and recovery. In addition, having a system of support including friends and family is a vital component in recovery. Research shows that treatment for depression has the highest success rate when all of the necessary components are present.

Depression is a real illness and it is very treatable. Unlike ill-informed celebrity statements challenging the validity of mental illnesses, at least 9.9 million Americans3 know this condition is real and that is has a profound effect on their ability to get things done, interact socially, and experience joy and pleasure in everyday life. Questioning the validity of diabetes would be unheard of in this day and age. We know how this disease impacts the kidneys and are aware of the efficacy of insulin in helping them function effectively. Scientists who have studied depression believe, through their research of the brain, that the neurotransmitters, specifically norepinephrine, serotonin and dopamine are chemically imbalanced in the brains of individuals suffering with major depression. Neurotransmitters are the chemical messengers that transmit electrical signals between brain cells in our brains. Antidepressants are understood to work by increasing the availability of neurotransmitters, or by the changing the sensitivity of the receptors for these chemical messengers.4

As debilitating and devastating as this illness can be, depression has an 80-90% success rate in treatment, and individuals who seek help can return to their normal daily activities and mood functioning.5 If you or someone you know is suffering from this illness, or displaying persistent signs of depression, contact a mental health professional in your area. Organizations that specialize in mental health conditions, such as Transitions, will conduct a thorough assessment, provide treatment recommendations, and offer supportive services to guide you on your path to recovery.

1 NAMI website, “What is Major Depression,” by Ellen Frank, PhD, May 2003
2 NAMI website, “What is Major Depression,” by Ellen Frank, PhD, May 2003
3 NAMI website, “What is Major Depression,” by Ellen Frank, PhD, May 2003
4 NAMI website, “What are the causes of Major Depression,” by Ellen Frank, PhD, May 2003
5 NAMI website, “How is Major Depression Treated,” by Ellen Frank, PhD, May 2003

For more information, visit the Transitions Mental Health Services website at http://www.transrehab.org/ and go to the "Contact Us" page.

Stand Up Against Funding Cuts for Mental Health Services and Other Critical Social Services

2009-06-17T18:47:00.006-05:00

Hello, everyone!

On behalf of Transitions Mental Health Services, our clients, and all citizens concerned about cuts to mental health services in the State of Illinois, I am appealing to you for help. Agencies across the State of Illinois received notice on Friday, June 12, 2009, that the legislature had not yet passed the proposed income tax increase that would allow continued funding to them through the Illinois Department of Human Services (DHS), and that by July 1st, 2009, massive funding cuts will occur.

These funding cuts will be devastating across the board, slashing mental health services by 50-90%, which will ultimately result in agencies closing their doors and citizens left with no services. The naturally occurring consequences will be a significant increase in mental health hospitalizations, homelessness, unemployment, crime rates, and suicide attempts. We must not let this happen.

Although it can be difficult to support a tax increase, please keep in mind that Illinois has one of the lowest tax rates in the nation. Even with the proposed tax increase, Illinois would continue to enjoy one of the lowest tax rates in the nation. Furthermore, the cost will be much greater if we don’t pay for prevention and have to pay later for the negative results of removing needed social services.

Our legislators need to hear from us. Please appeal to your state representatives and senators. Tell them you support continued funding for mental health services, as well as all social services; and, if you feel you can do it, tell the legislators that you support a tax increase to avoid mental health service funding cuts.

For those who live in the Illinois Quad Cities, here are the legislators names/numbers:

State Senator 36th District: Mike Jacobs, 309-797-0001

State Representative: Pat Verschoore, 309-793-4716

State Representative: Michael Boland, 309-736-3360

For those living elsewhere in the state, follow these directions if you need contact information for your state legislators:

Click on the following link, choose the “By Address” tab, and input your address. A list of your state senators and representatives will come up. Click on each name to see his/her office address and phone number.

http://www.elections.illinois.gov/DistrictLocator/SelectSearchType.aspx?NavLink=1

Thank you in advance for your support.

Sincerely,

Joan Holgate
Director of Training and Education
Transitions Mental Health Services
805 19th Street
Rock Island, IL 61201
Office: 309-283-1211
Fax: 309-793-9053
Website: www.transrehab.org

The Facts about Mental Illness

2009-05-13T22:19:00.006-05:00

Written by Gary E. Weinstein, L.C.S.W., CEO, Transitions Mental Health Services

What is Mental Illness?
Mental illnesses are medical conditions that disrupt 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), anxiety disorder and post traumatic stress disorder (PTSD).

When persons with mental illnesses are untreated or under-treated, the results can be devastating. Homelessness, unemployment, hospitalizations, difficulty in school, dropping out of school, family conflict, family dissolution, isolation, legal problems, economic problems, fear, self-loathing, drug and alcohol abuse and, in severe cases, violence or suicide are real possibilities.

The good news about mental illness is that recovery is possible. Mental illnesses are disorders of the brain that often profoundly disrupt a person’s thinking, feeling, mood, ability to relate to others, and the ability to live, work, and participate fully in the community. Mental illness includes such disorders as depression, bipolar disorder, schizophrenia, obsessive-compulsive disorder, autism, and Alzheimer’s disease.

Mental illness involves body, mood, and thoughts. It affects the way a person eats and sleeps, the way a person feels about him or herself, and the way a person acts. Mental illness is not a sign of personal weakness, lack of character, lack of willpower, or poor upbringing. People with a mental illness cannot simply overcome it and get better on their own.

Mental illnesses can affect persons of any age, race, gender, economic level. 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. You can find incidents of mental illnesses is most every community, workplace, school, church congregation, and indeed, in most every family.

Here are some important facts about mental illness and recovery:
Mental illnesses are biologically based brain disorders. They cannot be overcome through “will power” alone and are not related to a person’s “character” or intelligence.
Mental disorders fall along a continuum of severity. Even though mental disorders are widespread in the population, the main burden of illness is concentrated in a much smaller proportion — about 6 percent, or 1 in 17 Americans — who suffer from a serious mental illness. It is estimated that mental illness affects 1 in 5 families in America.
The World Health Organization has reported that four of the 10 leading causes of disability in the US and other developed countries are mental disorders. By 2020, Major Depressive illness will be the leading cause of disability in the world for women and children.
Mental illnesses usually strike individuals in the prime of their lives, often during adolescence and young adulthood. All ages are susceptible, but the young and the old are especially vulnerable.
Without treatment, the consequences of mental illness for the individual and society are staggering: unnecessary disability, unemployment, substance abuse, homelessness, inappropriate incarceration, suicide and wasted lives; The economic cost of untreated mental illness is more than 100 billion dollars each year in the United States.
The best treatments for serious mental illnesses today are highly effective; between 70 and 90 percent of individuals have significant reduction of symptoms and improved quality of life with a combination of pharmacological and psychosocial treatments and supports.
With appropriate effective medication and a wide range of services tailored to their needs, most people who live with serious mental illnesses can significantly reduce the impact of their illness and find a satisfying measure of achievement and independence. A key concept is to develop expertise in developing strategies to manage the illness process.
Early identification and treatment is of vital importance; By ensuring access to the treatment and recovery supports that are proven effective, recovery is accelerated and ?he further harm related to the course of illness is minimized.
Stigma erodes confidence that mental disorders are real, treatable health conditions. We have allowed stigma and a now unwarranted sense of hopelessness to erect attitudinal, structural and financial barriers to effective treatment and recovery. It is time to take these barriers down.

What Can Be Done?
Mental illnesses are treatable and recovery is a real possibility. Early intervention and appropriate treatment and support improve outcomes for persons with mental illnesses. It is critical for a person to receive care and support when he or she needs it. Gaining knowledge about mental illness, symptoms, and treatment options is very important. Transitions professional staff can assist in this process.

In addition to medication treatment, psychosocial treatment such as cognitive behavioral therapy, interpersonal therapy, peer support groups, and other community services can also be components of a treatment plan and that assist with recovery. The availability of transportation, diet, exercise, sleep, friends, and meaningful paid or volunteer activities contribute to overall health and wellness, including mental illness recovery.

The best treatments for serious mental illnesses today are highly effective. Between 70 and 90 percent of individuals have significant reduction of symptoms and improved quality of life with a combination of pharmacological and psychosocial treatments and supports. Transitions Mental Health Services is ready to help.

Transitions Mental Health Services is where action and compassion meet.

For information about Transitions Mental Health Services, call 309-793-4993, M-F, 8:00 a.m. to 4:00 p.m., or click on the title of this blog article to go to the Transitions Mental Health Services official website.

Schizophrenia: Complex... Chronic... Treatable

2009-05-06T17:58:00.004-05:00

Written by Anne McNelis, L.C.S.W., Director of Clinical Services at Transitions Mental Health Services

Two million Americans today are affected by an illness known as schizophrenia. Much like cancer or diabetes, schizophrenia is a complex, chronic medical illness that is highly treatable. Unlike these other illnesses, schizophrenia is stigmatized and highly misunderstood. Our society is often left to the devices of “sensational” news journalism or Hollywood movies to understand this disorder of the brain, which can lead to widespread myths that categorize individuals with schizophrenia as “split personalities” or “violent psychopaths.” The two million individuals affected by schizophrenia do not have “split personalities” and most are not violent, especially if treated for the illness.

What is schizophrenia then? This brain disorder interferes with one’s ability to think clearly, make decisions, relate to others and manage their emotions. Most significant characteristics of this illness are the prominent symptoms of hallucinations (seeing or hearing things that are not really there), or delusions (believing something that is not true or real) which one cognitively experiences. When one’s cognitive state is functioning in such a disorganized and erratic manner, it makes sense that behaviorally they are more likely to be slow in their movement, prone to rhythmic, ritualistic gestures, have difficulty finishing tasks, and may lack motivation and energy. Because the cognitive state is distorted by these symptoms of schizophrenia, individuals with this illness can be frightened of the world around them, possibly having trouble distinguishing the everyday sights, sounds and feelings surrounding them. The illness can significantly affect their insight, which can impact their ability to recognize they have this illness and, therefore, to follow through well on treatment. They may be extra-sensitive to their environment’s stimulus and may even have trouble distinguishing themselves from other people or from objects. When we understand the symptoms and this distorted perception of the world around them, it makes sense that they generally can have intense periods of extreme withdrawal and isolation.

So who gets schizophrenia? Research has found strong genetic links for this illness, much like other health conditions that run in family genes. If you do not have schizophrenia in your family, your chances are 99 out of 100 that you will not get it. If a parent or sibling has it, you have a 90% chance of not developing it and if both of your parents have schizophrenia, you have a 60% chance you will not develop the illness. Although the illness can occur at any age, 75% of those diagnosed developed the illness between the ages of 16-25 years old. The illness can be seen in children, and new cases of schizophrenia are rare after the age of 40 years old. The illness tends to occur slightly more with men than women. The exact cause is still unknown, but brain scans of individuals with schizophrenia are comparatively different in structure and chemical balance from those of “normal” brains.

Treatment advances in the last ten to twenty years have led to great success in stabilizing this illness. There is still no known cure, but a combination of medications and psychosocial programming have been very successful in managing the symptoms and supporting greater quality of living. Older antipsychotic medications, also known as neuroleptics, help relieve the “positive” (added) symptoms, such as hallucinations and delusions/thinking problems. Today’s newer “atypical” antipsychotics combat both the “positive” and “negative” symptoms, which include those functioning abilities that have been “taken away” by the illness: loss of energy, lack of interest, and cognitive abilities. Providers like Transitions offer psychosocial rehabilitation services, including supportive individual and group counseling, psycho-educational instruction, skill building training, peer support groups, and vocational programming. When these services are combined with medication, research shows that those individuals receiving these two components manage best with this illness.

We, at Transitions Mental Health Services, believe that all individuals, regardless of their specific mental illness, can be educated about their illness and how it affects them, and can be empowered to recover from their condition. We believe individuals affected by schizophrenia, as well as other mental illnesses, can lead productive, successful, fulfilling lives. With our support, counseling, education and vocational skill-building, we have successfully trained and placed many individuals affected by mental illness in service positions, industries, and organizations through both supported employment and sheltered work opportunities.

If you would like more information on schizophrenia, mental illness, or Transitions Mental Health Services, please contact our office and ask to speak with a therapist. (Contact information is in the "About Us" section of this blog.)

The Quiet Life of Stigma

2009-05-06T17:51:00.003-05:00

Written by Gary E. Weinstein, L.C.S.W., CEO of Transitions Mental Health Services

Stigma and mental illness has been a key topic long before mental illnesses were finally identified as legitimate illnesses. It isn’t hard to believe that even though research has long told us that mental illnesses are bona fide brain disorders, that there is no involvement of evil spirits, that it has nothing to do with how we live our lives, what we eat, where we live, or whether or not we masturbate, the stigma still persists. Racial, religious and age-related stigma still persists, so why not mental illness?

Stigma is the result of specific judgments being placed upon an entire group of people that result in that group being unfairly excluded from activities, acceptance and opportunities. Persons with mental illnesses have endured such stigma and the resulting discrimination that so often accompanies it. The problem is that there are still uninformed people out there who are perpetuating the stigma and keeping good people down. Whether we are talking about insurance, access to medical and mental health treatment, job attainment, depiction in the movies and in the news or even amongst friends who see someone pass them by who is acting a little unusual and one friend says to the other, “He must be schizo,” then they all have a laugh. It’s all stigma.

Stigma, regardless of the particular target, is damaging beyond what one might assume. “After all, it’s no big thing. It’s not like I’m serious. It’s just some light humor. But anyway, there are people out there with mental illnesses who do act weird and are schizo. There are even mentally ill who are dangerous so why shouldn’t I be able to say what I feel? I don’t want them living near me.”

The reason is that stigma sticks, expands and festers. Stigma also creates an environment where it is okay to berate and harm others. Who’s to say that the next target might not be people from the west side, or people in big business, or people who eat fast food, or even people who really don’t do anything notable? It’s just that they are here and an easy target.

I imagine that the majority of people would swear that they have not perpetuated or participated in stigmatizing behavior-and they probably believe it. We have to remember, however, that stigma digs away at the fabric of our communities sometimes not immediately obviously disruptive or noticed. Stigma, we have to remember, is not necessarily physically violent or even direct. It can be sneaky. It can be quiet. It’s impact can be delayed. I can easily discriminate against people with mental illnesses by simply quietly not hiring them, not buying that house next door to someone with a mental illness that I would otherwise purchase. I can quietly contact my congressperson and ask that she vote against insurance parity. Even more sneaky, I can just not call her to tell her to vote for it. I can choose not give to providers who provide services to them (because I give to other things-though I can’t think of one now). I can just not bother to get to know a person with mental illness once I am made aware of him. I can quietly not become indignant when I see a person with a mental illness who is homeless because he can’t get services so he can then get a job to support himself.

No, Stigma is not a major issue. Not around here, at any rate. I haven’t heard of any homes of individuals being burned, no public protests against them, and I certainly haven’t read about any beatings of individuals with mental illnesses.

Right, there have been no beatings reported as of late and no marches but, let’s not fool ourselves, stigma still exists. Maybe it’s just a little quieter now. But no less despicable.

For information about Transitions Mental Health Services, please call us. (Contact information can be found in the "About Us" section of this blog.)

The Pedophile

2009-05-06T17:13:00.003-05:00

Written by Gary E. Weinstein, L.C.S.W., CEO of Transitions Mental Health Services

In light of the myriad of news stories we are seeing nearly every week about child predators, this seems to be a good time to discuss exactly who these individuals are.

First, it is important to understand that sexual predators, while definitely operating with a very sick mind, should not be lumped in with the hundreds of thousands of individuals around the world with mental disorders who would never be prone to, or even think of, committing such cruel and despicable acts.

The pedophile is not easily profiled.

The acts of pedophiles are simple to articulate. They find children who are weaker than they are. They manipulate and trick, then they attack, leaving the children damaged, devastated, scared, and too often, dead.

But defining the pedophile him/herself is far more complex. It is usually a man, although it can be a woman. The pedophile crosses intellectual, socioeconomic and geographic lines. His background, while often one of being abused himself sometime during his youth, is not necessarily that of a victim. He may be young or old. He may be a homeless, transient shadow, skulking in the back alleyways, or he might be an upstanding citizen living a successful life, sometimes holding highly respected positions in our own community. He may live next door to you. He may know the victim, or he may not—although most often he does. Worse yet, he uses the trust that comes along with familiarity as a way to get in, and a way to get what he wants.

The pedophile typically has many victims over the course of his abusing career. Sometimes a hundred or more. Motives and reasons are varied. In some cases, it is simply that he is sexually attracted to children. In other cases, he may be someone who is not able to have a relationship with an adult due to low self-concept and fear, so he goes for an age that is less threatening. In some cases, he is just basically psychopathic and feels entitled. He may be seeing himself as being put here to “protect” and “teach” others—to right the wrongs of society—and he does so by victimizing these wrong-doers (even though they are children), or saving them, as he sees it (according to some perverse definition).

He sometimes will do additional despicable things to his victims, including mutilation, demonstrating his extraordinary power; and he may kill them, demonstrating his absolute power.

Ultimately, the sexual predator of children is someone who has little control over his desires and obsessions.

The sexual predator is one who can be, but is not easily treated. Although some containment and controls can be instituted, in some cases, there is no cure at this time. What can we do? Be as vigilant as possible. Form no single perception of how a predator would look, sound, act, or where he is apt to live or what he is likely to do for a living. Follow our instincts. Listen to our children. Listen to what they are saying, and to what they are not saying. Look for changes in our children’s behaviors and sensitivities. Remember, a predator, especially a sociopath, is exceptionally good at hiding any telltale signs that he is indeed a predator. Detecting such a predator may be very difficult, even for an expert—let alone typical parents, who are vigilant about the health and well being of their children. Perhaps our best bet, then, is not to detect, but to deflect. Reducing the potential for a predator to have free access to our children is critical. The pedophile often takes a significant period of time meticulously “grooming” his next victim. He may ply his victims with attention, gifts, recognition and promises, all in order to gain trust and comfort before he makes his final move. Pedophilia is not often a single event. It is a process and we must look for it.

There are things we can do or be wary of:

Be wary about any overnight trips or sleepovers. Know who is there and what kind of supervision will be in place.
Stop any unnecessary touching between your child and an adult.
Be wary of any favors, gifts and compliments provided by an adult focusing on one child to the exclusion of others.
Be present with your child. The greater your presence the less your child will be considered a target by a pedophile.
Be wary of any adult with no friends, no kids, no adult relationships and a proclivity for spending time with kids of a particular age and gender.
Be wary of any attempts of an adult to see a child outside of the established activities and boundaries of his position and role.
Be wary of how an adult looks at kids with single mothers, who he may assume to be needing, and particularly receptive to, a “father figure.”
Be wary of any internet-based relationships.

Be sure to:

Listen to your children.
Talk with your children often. Not just about these things but about all kinds of things.
Teach your children that they can trust you to always be receptive to whatever they have to say. Remember, a child being victimized by a predator, even subtly—and even if the child is uncertain about what is going on and what is right and what is wrong—is apt to feel uncomfortable talking about it. The predator may also have let the child know that if he/she tells anyone, harm might come to the family or others. It is up to us to ensure our children that it is always all right to tell us anything and everything.
Teach your children about boundaries without scaring them.
Perhaps more than anything else, we must tell our children often that they are good.

Ultimately there is one rule of thumb that should always be considered with absolute seriousness and unwavering vigilance: If a setting, or situation, or activity looks even remotely possible for a predator to squeeze in, count on him being there and be particularly careful.

For information about Transitions Mental Health Services, please call us. (Contact information can be found in the "About Us" section of this blog.)

Anxiety

2009-05-06T16:32:00.007-05:00

Written by Anne McNelis, L.C.S.W., Director of Clinical Services at Transitions Mental Health Services

Nervousness, apprehension, worry…it’s normal to feel these sensations, particularly when associated with an event in life that creates some stress. Indeed, everyday worries can be common to all of us. Anxiety as a condition or disorder, on the other hand, is persistent and debilitating to those suffering with the symptoms. It can affect people from all walks of life and impact greatly on their ability to function successfully and happily.

Nearly twenty-five million Americans suffer with some form of Anxiety Disorder. *It is one of the leading mental health conditions diagnosed, next to depression. It’s not uncommon, either, to see individuals who suffer concurrently with these two disorders. Anxiety sufferers describe feeling terror, fear, panic, physical sensations that compare to experiencing a “heart attack,” mental distress from ruminating thoughts, and the desire to avoid whatever triggered this bodily response. Feeling “keyed up,” excessive fatigue, restlessness, and irritability are also associated symptoms. When left untreated, anxiety can worsen, and for some, lead to severe isolation and suicidal thoughts.

Anxiety disorders are a wide umbrella for many types of anxiety conditions. Post Traumatic Stress Disorder, Obsessive Compulsive Disorder, Generalized Anxiety Disorder, and phobias are a few of the commonly known or diagnosed anxiety disorders. They all have physical arousal/discomfort and mental anguish in common but differ in their specific triggers. There may be underlying psychological causes for anxiety, such as a traumatic experience. Someone may be genetically predisposed to suffering with anxiety, or it may be a combination of both triggers. One woman describes her experience of nightly discomfort with anxiety: “I lay in bed at night, fixating on things I did or didn’t do right, or didn’t get done during my day. It’s like a critical tape recording I play over and over in my head. I also think about all the ‘what if’s’ and ‘what will the future bring?’ I can feel how shallow my breathing is, and the tightness in my chest, and tension in my muscles, but I can’t seem to stop the flow of negative, critical, ‘beat-myself-up’ thoughts and the constant worrying that steals sleep from me.” This young woman describes the experience of persistent ruminations, which can take on a life of their own. Often these types of ruminations are associated with depression and anxiety. Ruminations can be symptom of a type of anxiety condition, called Generalized Anxiety Disorder, or GAD. These people, who are often referred to as “worry warts”, are in perpetual state of worry and experience high levels of tension and chronic physical discomfort as a result. To be diagnosed with GAD, this worry has to be persistent and pervasive in the individual’s daily life and impact on their ability to function. GAD is prevalent in 3-5% of the general population. For anxiety disorders in general, clinics are seeing that the number of Americans suffering and seeking help for anxiety appears to be on the rise.

OCD, or Obsessive Compulsive Disorder, is more widely known of the Anxiety Disorders. Jack Nicholson’s character in “As good as it Gets” educated audience members across America about the quirky, odd, eccentric rituals he engaged in to assuage his tension and obsessions. Nicholson astutely portrayed the inner tension of OCD sufferers and the often painful repetitive behaviors they get caught up in, day in and day out. The OCD sufferer experiences obsessional thoughts or ruminations that are worry-ridden and the compulsion refers to the behavior intended to “rid” oneself of the obsessional thought. The classic example is the germ-phobic who excessively cleanses their hands till they’re dry, cracked and raw. The tragic element of this disorder is that as the compulsions tend to grow more complicated or extensive in steps, they never have the ability to alleviate the sufferer.

Those who have experienced panic attacks, know all too well how terrifyingly similar this anxiety is to experiencing a heart attack. In fact, many sufferers end up getting diagnosed in an emergency room, believing the heart palpitations, muscle tension and shallow breathing are the onset of a heart attack. Many are equally disbelieving that this condition is not a sign that they are dying. One woman who began to recognize the onset of her panic attacks describes her experience and how she copes: “…it starts way down in the pit of my stomach and it escalates throughout my body, rendering my feet jumpy, my hands shaking and my mind racing. To cope I call a friend, pet my cat, journal, or hope I’m seeing my therapist very soon! I also imagine a waterfall with all its sights and sounds lulling me to a calm and peaceful being.” This woman uses behavioral techniques intended to distract her and relax her physiologically. Her imagery exercise is a progressive muscle relaxation technique proven to provide relief to bodily tension and discomfort associated with anxiety.

Phobias are probably the most common of the anxiety disorder in the general population, with lifetime prevalence rates from community samples tending to range from 7-12%. The diagnosis of Specific Phobia refers to a marked, persistent fear of a clearly identifiable object or situation. Phobias tend to fall into these categories: animal type, natural environment type, blood-injection-injury type, or situational type. Many people with phobias do not seek treatment until it results in great impairment occupationally or socially. Psychological treatment of phobias focuses on desensitizing the individual to the phobic object or situation in a graduated manner. Medications, such as anti-anxiety meds or sedatives, have a short-term, immediate effect on the physiological response one experiences with a phobia. However, they tend to be addictive and will not alleviate the sufferer of the symptoms in the long run.

Successful treatment for any anxiety disorder should involve therapy. For some individuals, the anxiety may be so great, an anti-anxiety medication may be helpful in reducing heightened symptoms that would otherwise impair the individual to carry out the behavioral skills therapy teaches. Psychotherapy often offers the greatest long-term benefits to treat anxiety. This treatment focuses on teaching an individual the cognitive-behavioral skills and relaxation techniques to cope with exposure to a feared event/object, worry-thoughts/ruminations, and the physical arousal associated with anxiety.

If you or a loved one is suffering with symptoms of an anxiety disorder, seek an evaluation with a mental health professional or doctor for diagnosis and treatment. If you would like more information about Anxiety Disorders or treatment for these illnesses, contact Transitions Mental Health Services to speak with a therapist. (Contact information can be found in the "About Us" section of this blog.)

*National Institute for Mental Health statistics