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Halloween Entertainment and the Use of Mental Illness

10/31/2016

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Wishing everyone a safe and fun Halloween! With another All Hallow's Eve upon us, we reflect on the abundance of news articles over the last few weeks that explore the use of psychiatric wards and mentally unwell patients in Halloween entertainment, from horror shows and haunted houses to individual costumes.

While those who dress up in straightjackets or visit houses designed like asylums often do so in the quest for frightful fun, it is important to remember the deeper impact this sort of entertainment can have on those with lived experience and even society in general. Mental health advocates believe using mental illness to generate screams serve only to perpetuate stigma surrounding mental health and further entrench long-held myths such as how mental health patients are violent. Moreover, for those who suffer from mental illness these attractions can be hurtful or offensive, as for them their diagnosis is not a costume that they "can take off whenever we feel like it".

In both the articles below, two mental health advocates and those with mental health issues themselves, including Professor of Psychology at Columbia university and TED speaker Andrew Solomon, share their take on mental illness in Halloween. 

"For those of us with firsthand experience with mental illness — especially those who have experienced trauma in a mental hospital — such entertainment ventures cut much too close to the bone. When my mother was dying of cancer, she was admitted to some miserable wards, but I find it hard to envision a Halloween event at which you would pretend to be getting chemotherapy and vomiting constantly while surrounded by patients driven into the quasi-dementia that comes of unremitting pain...
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Sanity and mental illness lie on a spectrum, and most people occasionally cross over from one side to the other. It’s the proximity of mental illness rather than its obscurity that makes it so scary. But it should be scary in a “fix the broken care system” way or in a “figure out the brain’s biology” way, and not in a “scream for laughs” kind of way."

For more information, click here:
http://www.nytimes.com/2016/10/26/opinion/mental-illness-is-not-a-horror-show.html?smid=fb-share&_r=0
https://themighty.com/2016/10/why-mental-illness-shouldnt-be-a-halloween-costume/


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Substance Use Assessments - Don't Forget About Spices!

10/24/2016

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When conducting a comprehensive substance use assessment, clinicians will ask patients about their use of many drugs including caffeine, nicotine, alcohol, cannabis, stimulants such as cocaine and crystal meth, opiates, hallucinogens, and party drugs like ecstasy or ketamine. Often times one will even ask about misuse of prescription or over the counter medications like Gravol or benzodiazepines or ADHD medications. However, chances are you haven't been asking about misuse of common household spices ... but new case studies and research suggests we should!
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While spices may not be commonly abused substances, they are legal, readily available, and are ideal recreational substances for those including youth, those in the prison system or even those who are under drug monitoring and are looking for a "legal high" as these spices cannot be identified with toxicology testing. 

"Clinicians often are unaware of a patient’s misuse or abuse of easily accessible substances such as spices, herbs, and natural supplements. This can lead to misdiagnosed severe psychiatric disorders and, more alarmingly, unnecessary use of long-term psychotropics and psychiatric services...

Acute nutmeg intoxication [for example] produces anxiety, fear, and hallucinations, and generally is self-limited, with most symptoms resolving within 24 hours. Chronic effects of nutmeg abuse resemble those of marijuana abuse."

To learn more about abuse of spices and their psychoactive effects, check out these two articles:
  • "Out of the cupboard and into the clinic: Nutmeg-induced mood disorder" by Parthasarathi U, Hategan A and Bourgeois JA (Current Psychiatry).
  • "Taking the spice route: Psychoactive properties of culinary spices" by Bourgeois JA, Parthasarathi U, and Hategan A (Current Psychiatry).  
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Adverse childhood experiences: the single greatest unaddressed public health threat

10/17/2016

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We now understand better than ever how exposure to early adversity affects the developing brains and bodies of children. It affects areas like the nucleus accumbens, the pleasure and reward center of the brain that is implicated in substance dependence. It inhibits the prefrontal cortex, which is necessary for impulse control and executive function, a critical area for learning. And on MRI scans, we see measurable differences in the amygdala, the brain's fear response center. So there is concrete neurologic evidence why those exposed to high doses of adversity are more likely to engage in high risk behaviour and suffer worse health outcomes. 

To learn more about this enlightening research see Dr. Nadine Burke Harris' TED Talk: 

https://www.ted.com/talks/nadine_burke_harris_how_childhood_trauma_affects_health_across_a_lifetime?language=en

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Benzodiazepines and PTSDĀ 

10/11/2016

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Benzodiazepines are a type of medication which fall under the sedative-hypnotic class, and work by enhancing the activity of the neurotransmitter GABA. While benzos are most well-known for their sedating and anxiolytic effects, they have been used in the treatment of those with seizures, alcohol withdrawal, for anesthesia purposes, as well as for insomnia and mental health issues like anxiety (particularly in the short term).

Interestingly from a historical perspective, benzos were also the original treatment for PTSD, and were thought to be beneficial in treating PTSD symptoms rapidly, particularly anxiety and trouble sleeping. While statistics range from 30% to upwards of 74% of those with PTSD being treated with benzodiazepines of some kind, there is growing evidence that suggests that these medications are not effective in treating the core symptoms of PTSD (i.e. hyperarousal, dissociation, and avoidance). 

In addition, studies have also suggested that use of benzodiazepines for those with PTSD may be in fact be harmful with risks that far outweigh the benefits. The studies below suggest that we should be very cautious in prescribing benzos for PTSD due to the high rates of comorbid substance use disorders (a serious risk given the tolerance/withdrawal associated with these meds), in addition to suggestions that benzos may in fact worsen overall severity of PTSD, depression and treatment outcomes for those who are affected.
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To learn more, check out these articles:
https://www.ncbi.nlm.nih.gov/pubmed/26164054
http://www.ptsd.va.gov/…/newsl…/research-quarterly/v23n4.pdf

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Mental Illness Awareness Week 2016

10/3/2016

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Don't forget that this week (October 2 - October 8 2016) is Mental Illness Awareness Week, a public education campaign run annually by the Canadian Alliance on Mental Illness and Mental Health.

"This year’s MIAW theme is Spreading Awareness, Reducing Stigma. As one in five Canadians live with mental health issues, the campaign encourages Canadians to share their personal stories about stigma and how it negatively affects them in their personal life, in the workplace, or in their community."

To find out more about this campaign, watch videos from Canadians impacted by mental illness share their stories, and get in on the online conversation you can use #MIAW2016 on Twitter or visit http://www.camimh.ca.
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Code Lavender: Rapid Support For Medical Staff

10/2/2016

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Many of us who work in a hospital environment are familiar with emergency codes including Code Red, Code Blue and even Code White. But does your hospital happen to have a "Code Lavender"? A few hospitals in the US have begun employing this new code as a way to provide urgent care to patients, families, and more especially nurses and physicians who are in need of emotional and/or spiritual support. Physician burn-out, grief, or stress ... now there is a code for that!

At the Cleveland Clinic in Ohio, the Code Lavender Program has been operating for over 8 years, and provides holistic care services for both their patients and employees. In addition, they also have a rapid response team which can provide more intensive and immediate support for those who are struggling with stress, burnout, grief and loss while on the job. 

"Within 30 minutes of a call, the Clinic’s team of holistic nurses arrives at the unit in need to provide Reiki and massage, healthy snacks and water, and lavender arm bands to remind the nurse or physician to take it easy for the rest of the day...

The Healing Services Team employs holistic methods that include spiritual support, counseling and therapeutic massage. Bringing together conventional medicine and alternative remedies, the Clinic also offers employees yoga classes, weight loss programs and mindfulness training."


To find out more about this program, click the link below:
http://www.huffingtonpost.com/2013/12/02/the-amazing-way-this-hosp_n_4337849.html

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    Supporting and enhancing students' and health professionals' knowledge and understanding of mental health and psychiatry

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