Welcome...

Welcome to the Leadership21 blog, an ongoing conversation on mental health, civil rights and social justice. Posting on the blog are twelve young mental health advocates who comprise the L21 commitee, and anything goes--the personal, the political, the cultural, whatever! We hope that you'll check out what's here, and make some comments, and please know that if you're concerned about anonymity, you can comment anonymously. We hope that what you read, and what you contribute, will make you want to return regularly, because to our knowledge, there really isn't anything out there that has the potential to engage people on so many levels about mental health. But we need "outsiders" like you to make it grow into a robust, contagious online blog. So thanks for coming, welcome to the conversation, and please, pass it on--L21

Tuesday, November 13, 2007

Iraq, Afghan Vets at Risk for Suicides

I can't imagine this article will be a surprise to anyone, but it still affects me deeply every time I hear something of the sort. There is a new Veterans Suicide Prevention Hotline being developed, but what else is being done to support the mental health of our returning vets? So many of these people are of the prime age of onset of mental health issues, 18-25, and they have been through just so much. We have a long way to go. Anyone have thoughts as to where efforts should be focused?

http://www.truthout.org/docs_2006/103107A.shtml

Wednesday, October 31, 2007

Happy Halloween from Anna Rexia

I love Halloween. I love the joy of thinking of a great costume six months in advance, I love seeing people who are bona fide adults out in public wearing totally bizarre getups, and I love candy. I especially love creative costumes, but this year I broke down and bought a costume off the internet. And that's when I stumbled across this jewel!

This is not creative. This is not hilarious. This won't win a costume contest.

This is the "Sexy Anna Rexia" costume, complete with TAPE MEASURE belt and choker, from http://www.foxyladyboutique.com/d4503annarexia-costume.html?productid=d4503annarexia-costume&channelid=FROOG.

I don't know anyone who would wear this, but apparently enough people to make the small and medium sell out. If you see anyone wearing this tonight, try to find out know why they chose it--I'm interested.

I hope everyone has a safe and happy Halloween...

Behold, the Power of YouTube

I just saw CNN link to this story--apparently a man in Orlando posted his last will and testament on YouTube before taking a large quantity of pills, and someone in NY saw the video in time and was able to call the police in Florida. The police were able to locate the man, who was unresponsive, and he's now in the hospital.

Dear New Yorker, whoever and wherever you are, thank you.

http://www.local6.com/news/14471080/detail.html

Saturday, October 13, 2007

Eat, Pray, Love

I am reading this amazing book right now by Elizabeth Gilbert called "Eat, Pray, Love" about woman who travels for a year after a difficult and messy divorce. She spends four months in Italy, four months in Indonesia, and four months in India. Early in the book, she has a moment when she is sitting in the park and her familiar and hated companions, Depression and Lonliness, in the form of two pushy police detectives overtake her. They question her, they follow her back to her apartment, they won't leave her be.

I loved the idea of these two old companions in the form of two hated, overbearing policemen that a person cannot shake--they will follow you even to the most exotic destinations. They will overtake you in your most private and even happy moments. "Why do you deserve to be happy?" they sometimes ask. "Look at the people you've hurt, the things you've messed up."

I imagine most of us have had this dialogue with ourselves and far be it for me to advise anyone on how to make those voices stop. But reading Gilbert's words today really spoke to me. And then I realized why: just knowing that other people face those voices too makes the ones in my own head a little diminished.

Wednesday, October 10, 2007

Baz Alert

Help Congress Override the President's Veto!
October 10, 2007 Congress is poised for an October 18 vote to override the President's October 3 veto of the compromise bill to renew and expand SCHIP the program of health care for low-income children. H.R. 976, the Children's Health Insurance Program Reauthorization Act, would authorize $35 billion over five years to provide healthcare coverage to roughly 10 million children, about 4 million more than covered over the past 10 years. (See the Bazelon Center's August 6 Mental Health Policy Reporter)
Renewal would improve mental health coverage.
The legislation would for the first time establish parity for mental health benefits in SCHIP plans by prohibiting discriminatory financial requirements or treatment limitations.
It eliminates the provision in SCHIP that allows states electing to develop benchmark-equivalent plans to lower the amount of mental health coverage to 75 percent of the coverage provided in the benchmark plans.
It includes a six month moratorium that temporarily halts the Administration's efforts to limit reimbursement for services under Medicaid's rehabilitative services option and for school -based administration or transportation costs. These are outlined in the President's fiscal year 2008 budget proposal (see our February 22 Policy Reporter) and proposed regulations released by the Centers for Medicaid and Medicare Services (see our August 20 Action Alert). The Medicaid rehabilitative services option is critical to community-based mental health services for children and adults.
More House votes needed to override the veto.
The Senate passed the bill by a veto-proof majority (67-29). But while the House passed the bill by 265-159, that is not enough to override the President's veto. To realize the victories won in this compromise legislation, 289 House votes are needed.
Please Act Now!
If your Representative is on the following list, call today and urge him or her to vote YES for health insurance for children in low-income working families. And if you know people in those states, forward this email and ask your friends and colleagues who are constituents to make the call.

Use the toll-free number 1 800-828-0498 set up by Families USA to access the Capitol switchboard, which will connected you to your Representative's office.

Target List of Representatives
AL Robert Aderholt
AR John Boozman
CA Brian Bilbray
CA John Doolittle
CO Marilyn Musgrave
FL Gus Bilirakis
FL Ginny Brown-Waite
FL Tom Feeney
FL Rick Keller
IL Judy Biggert
IL Tim Johnson
IL Peter Roskam
IL Jerry Weller
LA Rodney Alexander
MI Joseph Knollenberg
MI Thaddeus McCotter
MI Tim Walberg
MN Michelle Bachman
MO Sam Graves
NJ Rodney Frelinghuysen
NJ Scott Garrett
NJ Jim Saxton
NY Randy Kuhl
OH Steve Chabot
OR Greg Walden
PA John Peterson
TX Kay Granger
VA Thelma Drake
VA Randy Forbes

Republicans Who Didn't Vote
CA Wally Herger
WY Barbara Cubin

Tuesday, October 9, 2007

Luxury Rehab, Part Two



Here's a fascinating link to an LA Times story about a cluster of pricey rehabs in Malibu--so f'ed up--they get away with some pretty shady stuff--and seem to prey on families when they are at their most vulnerable.

http://www.latimes.com/news/local/la-me-rehab9oct09,0,5556868,full.story?coll=la-home-local

And here's a description I got from one of the rehab Passages' web site; the pic above is from there as well:

"Framed between the rugged Santa Monica mountains to the rear and a beautiful view overlooking the Pacific Ocean, Passages' three acre grounds are the perfect place to heal. From the babbling koi pond to the exquisitely manicured lawns, Passages offers an ideal setting for working with the lives of people who come to us from situations and life conditions that are anything but ideal."

Makes me want to go to rehab. Not!

Monday, October 8, 2007

The struggle goes on

I've been struggling this weekend. The sort of sadness that you recognize as having the potential to lead to something deeper. Mornings where I'd rather stay in bed then get up. Afternoons where I want to watch movies instead of going out. The desire to lose myself in sad music. I think a lot of us have been there.

It's a three day weekend for me, so I can afford to lose myself a little--but only a little. I can't let that sense of exhaustion overurle me because tomorrow morning, I know I will have to get up when my alarm goes off and use whatever core of strength I've got to propel myself to my front door, out into the world, to work. And I know how much energy it will seem to take to do it, but I know I will do it anyway.

I find myself in awe of you who I know struggle sometimes like I do and work for yourselves. If you didn't leave your apt, there'd be no one to answer to. And yet, Lizzie, Ross, Anastasia, Alison, you keep working everyday, for yourselves, rolling the ball forward up the hill. I admire all of your strength.

Go Massachusetts


I'm hoping this is a victory for accountability:

From the Boston Globe:

"Following the death of a 4-year-old Hull girl from an overdose of psychiatric drugs last December, state officials have set up a unique early-warning system to spot preschoolers who may be getting excessive medication for mental illness. In just the first three months, the system has flagged the cases of at least 35 children for further investigation, and the number is sure to rise.

The state Medicaid program is analyzing records of 82,900 children under age 5, looking for those taking at least three psychiatric drugs or a single prescription of a powerful antipsychotic drug. Mental health professionals will review the care of these children and, if necessary, contact the prescribing doctor for an explanation, say officials of the state insurance program for lower-income families, known as MassHealth."

Read the rest of the Article here:
http://www.boston.com/yourlife/health/articles/2007/10/07/mass_tracks_children_on_psychiatric_drugs/?page=full

Sunday, October 7, 2007

Hurts So Good


I’ve just been asked if I’m available for abuse over the weekend. I have a roommate in New York City. Let’s call her Maria. I call her the Queen of the Gypsies because she’s traveled all over the world and never keeps an address longer than a year. She’s a filmmaker, art dealer, human rights activist and clothing designer. She knows a lot of people. Apparently she knows a Nice Guy who’s a masochist with a foot fetish and would like to come over and clean. The entire loft. For free. How does she know him?

“I used to be in the S&M scene, you know…”

"What exactly does that mean, he wants to clean the place for free?"

“Organize the closets, dishes, anything you want.’ Her arms are flapping, Martha Graham-style as she moves through the apartment. “All you gotta do is yell at him.”

"About what?"

"About anything."

"Like what?"

"Think of something. And he's AMAZING at TOILETS."

This guy's called Pony Boy she’s Mistress Jade. They've known each other for five years, never using real names, and they’ve never had sex. This is, unbelievably, not uncommon. Foot fetishists are rarely looking for sex. Some might say they’re looking for something more intimate: an assault to their sense of self-worth.

I’m skiddish, of course. if I have a problem with it, she says, she’ll invite him when I’m not here. I do have a problem with it, I'm repulsed. I'm also repulsed by Frank Lentini, the man with three legs and two penises. This fact doesn’t stop me from staring at his picture every time I get the chance, of course. After a few minutes I agree.

“Good. You have to come up with a name. Mistress Something.

“He’s not going to touch me or anything, right?”

“Oh, no. Never. Just tell him he’s a worthless piece of sh** and he might ask to suck your toes. But you don’t have to let him.”

You wonder who on earth wants to be told that they’re worthless, much less travel all the way across town for the pleasure. A relationship of this kind has to be organized and planned. Not exactly like stumbling home with someone after a party. I wonder if I’m going to participate – however peripherally – in a psychotic event. I wonder if, instead of barking insults, I should ask Pony Boy how much sleep he’s been getting lately. Appetite shift. If he’s had or is having suicidal ideation.

Being depressed for me is like having a thousand Mistress Jades in my head. They hog-tie my thoughts. They collapse my body into a motionless mass. They tread their spike-heeled boots over my life force. But what would happen if these voices were attatched to real bodies? Is this really worth thinking about? I just want a clean apartment and a toilet scrubbed with bleach. Still, I can't help but wonder: is this man trying to fetishize his demons and thereby conquer them? Or is it simply a sexual lifestyle choice? Like being gay? Actual clinicians submit this argument. Others contend that it’s a psychological disorder. Is depression a masochistic disorder? What do you think?

Also: any ideas for a mistress name?

Wednesday, October 3, 2007

Revenge Plastic Surgery?


I was standing in my local supermarket waiting to check out and as usual I was perusing the tabloids. Tucked behind the typical Brangelina, Britney, and whoever is on Cosmo’s cover this month was a headline on US Weekly that really caught my eye and turned my stomach. The title is “Revenge Plastic Surgery.” It shows a smiling Heidi Montag star of reality show? The Hills. I say reality show? because I don’t know who’s reality that is. Anyway Miss Montag gave an exclusive interview to US in which she tells the magazine she was tired of being made fun of for being flat chested so she got revenge by not only investing in some fake breasts, but also some rhinoplasty. She didn’t mention anyone making fun of her nose, so that may have been an add on and not revenge. US was kind enough to show the before and after here. Interesting pictures for a 20 year old, who is now 21.

You will notice the poll on the page asks people which they liked better and I was so happy to see a definitive 82% liked her body before the surgery. As a male I am not going to go into the confidence issues and difficulty of having smaller breasts in today’s world. I know women with fake breasts which they got for a variety of reasons, but none of them were revenge. Revenge seems like a really bad motive for what is in essence mutilating your body. It scares me how normalized mutilating your body has become. The other scary thing is the rhinoplasty because her face isn’t finished maturing and changing. Ashlee Simpson did the same thing at the ripe age of 20 and again you don’t know how your body will change. Granted in Heidi’s case her breasts may have been finished developing for now, but there’s a lot of changes left in a woman’s life like I don’t know pregnancy. And a quick google search turned up that Heidi wasn’t too ashamed of her body to pose for Stuff Magazine before the plastic surgery. Even saying in the article she loves looking sexy. Apparently she also said she feels really insecure in the US article and was willing to risk her life for these changes.

SO I don’t know all that goes into the plastic surgery decision, but I do know it’s not the best thing for role models of the tweener girls and teenage girls to be doing. And let’s be honest women from their 20’s-40’s who are obsessed with the Hills as well. SO I guess it’s good on one hand to see how many people don’t like this, but sad that people in the public eye feel compelled to do this.

Tuesday, October 2, 2007

Mental Illness and Love: Part Two



Some Thoughts on How Untreated Mental Illness (Depression, Anxiety, Trauma, Mania) Messes with Love:
1. Mental Illness is pain and pain makes you seek pain relief above all, when in healthy relationships, you need to be able to seek love above all.
2. Mental Illness is internally pre-occupying, when in healthy relationships you need to not be self-absorbed.
3. Mental Illness distorts self-perception. Mental Illness distorts perception of others. In healthy relationships you need a fair perception of self and others.
4. Mental Illness interferes in one’s capacity for relaxation, which is necessary for healthy intimacy.
5. Mental Illness, in early childhood development, may interrupt a child’s ability to feel safe and loved.

Thoughts?

My Mets and Mental Health?


Some of you may be reading the title of this blog and thinking what do the New York Mets have to do with mental health. That is exactly what I was asking myself this morning when I saw a little title on CNN that says, "Mental Help for Mets Fans." Not only is this a story, but it's also in Time Magazine. I don't know if my book will ever be in Time, but alas my message and my favorite baseball team is.

I guess I should start at the beginning. As a youngster growing up in northeast Pennsylvania I had choices for my favorites teams. We lived an hour from Philadelphia and an hour and a half from New York City. So in a lot of cases favorite teams are divided. My dad really doesn't have any favorite teams so I wasn't bred to like any team over another. At the ripe old age of 8 I started to watch baseball on TV and low and behold that year the New York Mets won the World Series. As an 8 year old this was amazing to me! I was so elated that surely the Mets had to be my favorite team for the rest of my life. I bought all of the paraphernalia. I begged my parents to take me to spring training games when we were on vacation in Florida. I went to see them play in different cities. I have even stuck with them through some terrible years since I was 8. Granted I am no different from other sports fans, especially my Philadelphia Phillie fan friends who are definitely tougher than me, because they used to choke worse than anyone, until this year at least. For those of you who don't follow sports the Mets just had the worst collapse in major league baseball history, which brings me back to the point of this blog!
A fellow Mets fan wrote this article for Time. In it he interviewed about 5 or 6 psychologists to find out what fans can do to deal with the Met's downfall. There is actually some really good advice in there. And I know a lot of times people don't get why sports affects other people so much and this has been studied endlessly. For me I think it's a mixture of things. You follow a team for 162 days and it becomes a routine in your life, once that routine ends you can be lost as to what to do. For others they may project everything that is going wrong in their lives into the hope of having their favorite team succeed. As someone who worked at a Circuit City Distribution Center near Philadelphia I watched this in a lot of Eagles fans. SO when the team loses you're forced to go back to your life and if that sucks, well then you need another distraction. Also let us not forget that nationalistic pride in one's country also translates into individual sports teams. And if you don't think nationalism is dangerous may I remind you of World Wars 1 and 2 and just about every other war. SO what can people do. Well the article says to definitely feel the loss and make sure you talk about how much it affects you. If you don't it can come out in other ways, like drinking etc. It also says to start following other sports to take up a new routine and get your mind off how terrible the Mets finished the season. Another coping strategy that is suggested is to look at how competitive the field was and how maybe the Mets were beat out by better teams. (which is a total lie, but we'll let it slide) The article recommends remembering it is just the end of the season and not the end of the world. And lastly the article promotes a sense of community saying I am not alone in my misery. There are other Mets fans to cry with!
Overall this is a great example of how we can tie mental health into an area that isn't often directly associated with it. I mean talk about promoting cognitive behavioral therapy! The advice given for dealing with the Mets loss can be used in everyday life. Talk about your pain. Find healthy ways to deal with it and know that you're not alone. Remember any loss is not the end of the world. If more people opened up about all of their emotions on a regular basis, not just sports, then maybe it wouldn't be so hard to deal with your favorite sports team's failures! As for my Mets there's always next year!

Monday, October 1, 2007

when protective laws hurt people??

I know I'm double-blogging but there is another story I'd like to share. Last week I did a hearing with a boy (teenager) accused of breaking a school rule who was facing two months expulsion. He prepared a bunch of material about how the expulsion would harm himself, his mom, his family, his grades, his chances at colllege. . . .etc. I prepared material on how the expulsion was unlawful because the conduct was "disability-related." Only problem was, this smart guy pulled me out of the hearing and explained to me during a break that he didn't really feel good about the words I was saying -- that he didn't like how it felt to argue that his disability had caused his actions, and that he'd prefer that we just stick to the strategy of trying to convince school personnel and their lawyer that the expulsion was too severe. I explained to him that I needed to make the argument because, in my experience, the "too severe" argument would get us nowhere -- there was no liability there, and the lawyer would be moved only by my "disability-related" legal argument. I got permission from him to make the argument, we won at hearing, and I went home feeling like crap. This kid -- really, a man -- had articulated something really important about accountability. The law had no room for it.

are we really talking cancer or diabetes?

Last night (watching Tony Soprano on DVD) I again was reminded of that "treat us like we have cancer or diabetes" thing that has always bugged me. A mother on the show has a son with ADHD and she tells hubby and friend that medications are OK because, certainly, she'd give him medicine if he had been diabetic. This analogy about medication for mental health conditions really bothers me because having a mental health issue is probably nothing like having a physical ailment. I guess it most bothers me because most people with mental health "histories" do not really discuss their experiences "with" mental illness -- as if they were a person with a mind separate from and completely apart from a disease -- isn't it far more personal than that? Isn't there personality and aren't there all the issues with explaning behavior and being accountable and being proud about progress, etc., etc., and doesn't this claim that "it's just like cancer" really get in the way of that? What do you guys think?

Soldiers get boot for 'pre-existing' mental illness

Many soldiers get boot for 'pre-existing' mental illness
By Philip Dine
POST-DISPATCH WASHINGTON BUREAU
09/30/2007

WASHINGTON — Thousands of U.S. soldiers in Iraq — as many as 10 a day — are being discharged by the military for mental health reasons. But the Pentagon isn't blaming the war. It says the soldiers had "pre-existing" conditions that disqualify them for treatment by the government.

Many soldiers and Marines being discharged on this basis actually suffer from combat-related problems, experts say. But by classifying them as having a condition unrelated to the war, the Defense Department is able to quickly get rid of troops having trouble doing their work while also saving the expense of caring for them.

The result appears to be that many actually suffering from combat-related problems such as post-traumatic stress disorder or traumatic brain injuries don't get the help they need.

Link to the story:
http://www.stltoday.com/stltoday/news/stories.nsf/washington/story/B8F5491DEDE1CF2C8625736500190F67?OpenDocument

Anti-Anorexia Billboard Creates Controversy

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An anti-anorexia billboard in Milan featuring a naked woman with anorexia, French actress Isabelle Caro, has created quite a stir. The ad campaign coincided with fashion week and was supposed to display, as stated by the photographer, how scary being too skinny can look. He also states that this is how most of the models today would look without any clothes. While some may say that the intentions are noble, others comment on the fact that this campaign is still, in fact, an advertisement.

In my opinion, the ad would have been more effective if it was a photograph of a woman of healthy weight being presented as desirable, sexy, and the ideal, so that we as a society become more accustomed to this as the standard of beauty rather than an emaciated young woman. Of course, my idea would most likely not create nearly as much controversy. But is controversy necessary in order to get a message across? Would an ad featuring a model of "normal" weight be a less effective tool in getting the message of how the media and fashion world create an unreasonable ideal of beauty?

Thoughts? Comments?

Got an Old Backpack?


Donate it to Active Minds, Inc. and Help Us Send Silence Packing!

Here is a plug for a new campaign Active Minds is running, to represent the incidence and impact of college student suicide. Every backpack we collect will represent a college student who has died by suicide in the past year. Unfortunately, many of us know at least one such tragedy - please donate in honor of anyone you know, or all who you hope never get to that stage.

_____

Suicide claims the life of over 1,100 college students each year*, and the impact of each one of those deaths touches us all. Active Minds, Inc., the only national organization dedicated to utilizing the student voice to raise mental health awareness on the college campus, is embarking on an aggressive campaign to promote a dialogue about mental health issues on campus and combat the incidence of student suicide. By empowering students and the student voice in mental health awareness, we envision one day when mental health issues are widely discussed, and the number of these tragic deaths is reduced to 0.

To demonstrate the crisis of college student suicide, we are looking to collect 1,100 backpacks/messenger bags/book bags this fall to be publicly displayed to represent all of those promising lives lost each year. If you have a plain backpack that you would like to contribute to this campaign, please send it to**:

Send Silence Packing
Active Minds, Inc.
1875 Connecticut Ave, NW Suite 418
Washington, DC 20009

If you would like to donate a backpack in memory or in honor of a loved one and would like to attach a name/story/picture/etc. to the bag, please laminate your message and attach it securely to the outside of the bag. Please do not put your message inside the bag, as it will not be seen. If you don’t have a backpack but would like to contribute to the Campaign and the work of Active Minds, please send donations to Active Minds, Inc. at the address above, or donate online.

The first presentation of the Send Silence Packing Campaign will be on Friday, October 26, 2007 on the National Mall in Washington, DC. A special gathering with guest speaker Rep. Patrick Kennedy (D-RI) will occur between 12:30-2pm at 13th and Jefferson Streets, NW, as part of the Fourth National Mental Health on Campus Conference.

**Please note – due to the nature of this exhibit, your backpack will not be returned to you. However, if you include your email address in your correspondence, we will be sure to keep you informed of where and when the backpacks will be displayed.


*National Mental Health Association & The Jed Foundation. (2002). Safeguarding your students against suicide: Expanding the safety network. Alexandria, VA.

Click here for PDF of this document

Sunday, September 30, 2007

Text Messaging

Like many students this fall, I received an email from my school asking me to sign up for a campus text-messaging service so I can be notified if there is an emergency on campus. I signed up, knowing full well that this was most likely a reaction to the tragedy at Virginia Tech. The email went on to describe the various other measures the school would use to get in touch with the campus, including phone calls, emails, and sirens. But nowhere was there any info about what to do in an emergency--any emergency. Wouldn't it be good to know what to do if I see a fire on campus? Or who should I call if I witness a car accident? Or even where is the counseling center, in case I want to show one of my friends where to get help? Don't the thousands of people who received the same email about the text messaging need that info, too?


Ruined Lives

Yesterday I returned from Argentina, where we released the report we've been working on for three years, Ruined Lives: Segregation from Society in Argentina's Psychiatric Asylums. The report documents the conditions and treatment of the nearly 25,000 people detained in Argentina's psychiatric institutions. Abuses documented include people burning to death in isolation cells, physical and sexual violence, forced sterilization, arbitrary detention, long-term sensory deprivation in isolation cells, lack of appropriate medical care, among others.

The abuses are nothing new. In every institution I've monitored there are abuses. The striking thing about Argentina is the number of people detained in institutions for socio-economic reasons. According to authorities and mental health professionals interviewed, anywhere between 60 and 90% of those institutionalized are there because they have nowhere else to go. Indeed, authorities have coined the phrase, "the psychiatrization of poverty" to explain the phenomenon. Argentina has almost no community-based mental health services and supports, so people who are institutionalized tend to stay there: 80% of those committed to public institutions are detained for a year or longer; the average length of institutionalization is 9 years.

Despite this bleak outlook, there are mental health reform efforts under way. Two large institutions (more than 1,000 beds) are working to discharge people and provide them with community supports to aid in their social reintegration. The psychiatric forensic unit where we documented people detained naked in tiny, dark cells for months at a time have been dismantled. There are a number of movements lobbying the government to deinstitutionalize.

The transformation of mental health services in Argentina will doubtless take many years, but the reform movement is gaining momentum. Likely, the tide will not turn back. Ruined Lives is available in PDF at: www.mdri.org.

Sleezebags


This from a Department of Justice Press Release:

Bristol-myers Squibb to Pay More Than $515 Million to Resolve Allegations of Illegal Drug Marketing and Pricing

WASHINGTON – Bristol-Myers Squibb Company (BMS) and its wholly owned subsidiary, Apothecon, Inc., have agreed to pay over $515 million to resolve a broad array of civil allegations involving their drug marketing and pricing practices, United States Attorney Michael J. Sullivan announced today.

“The integrity of our health care system rests on physicians being able to make decisions based on the best interests of their patients,” said Keisler. “This settlement reflects the Justice Department’s strong commitment to holding drug companies accountable for devising and implementing fraudulent marketing and pricing schemes that undermine that decision-making process at the expense of federal health care programs for the poor and the elderly.”

Sullivan added: “Patients are entitled to unbiased decision-making from their physicians and should not have to worry that financial inducements or lavish entertainment have influenced their physicians’ prescribing choices. Kickbacks are especially nefarious when they are used as part of a marketing effort to convince physicians to prescribe drugs for uses that the Food and Drug Administration has not determined to be safe and effective.”

“The government alleges that Bristol-Myers Squibb, among other wrongdoing, fraudulently inflated the cost of a drug used primarily to reduce the side effects of cancer treatments and other generic drugs without regard to the increased costs borne by government health care programs or elderly and indigent patients,” said U.S. Attorney R. Alexander Acosta of the Southern District of Florida. “Corporations cannot continue to mislead the government into paying vastly exaggerated prices by exploiting a health care system based on trust and fair play.”

Today’s settlement covers a wide assortment of illegal marketing and pricing practices.

First, the Government alleged that, from approximately 2000 through mid-2003, BMS knowingly and willfully paid illegal remuneration to physicians and other health care providers to induce them to purchase BMS drugs. BMS paid the illegal remuneration in the form of consulting fees and expenses to physicians and other health care providers to participate in various consulting programs, advisory boards, and preceptorships. Some of these programs involved travel to luxurious resorts. The Government also alleged that, from 1994 through 2001, Apothecon knowingly and willfully paid illegal remuneration such as stocking allowances, price protection payments, prebates, market share payments, and free goods in order to induce its retail pharmacy and wholesaler customers to purchase its products. In both cases, the Government alleged that, by paying this illegal remuneration to physicians and others, BMS and Apothecon knowingly caused the submission of false and fraudulent claims to the federal health care programs.

Second, the Government alleged that, from 2002 through the end of 2005, BMS knowingly promoted the sale and use of Abilify, an atypical antipsychotic drug, for pediatric use and to treat dementia-related psychosis, both “off-label” uses. The Food and Drug Administration has approved Abilify to treat adult schizophrenia and bi-polar disorder, but has not approved the use of Abilify for children and adolescents or for geriatric patients suffering from dementia-related psychosis. Indeed, the FDA has mandated that the package for Abilify carry a “black box” warning concerning its use in the treatment of dementia-related psychosis. Nonetheless, BMS directed its sales force to call on child psychiatrists and other pediatric specialists, and the sales force then urged physicians and others providers to prescribe Abilify for pediatric patients. BMS also created a specialized long term care sales force that called almost exclusively on nursing homes, where dementia-related psychosis is far more prevalent than schizophrenia or bipolar disorder.

Third, the Government alleged that both BMS and Apothecon set and maintained fraudulent and inflated prices for a wide assortment of oncology and generic drug products with the knowledge that federal health care programs established reimbursement rates based on those prices. By reporting false and fraudulent prices that were substantially higher than commonly and widely available prices in the marketplace, BMS and Apothecon created a “spread” between the reimbursement rates for federal health care providers and the actual prices for the drugs charged to its customers. The larger the spread on a drug, the larger the profit or return on investment for the provider. Because reimbursement from federal programs was based on the fraudulent, inflated prices, the United States alleged that BMS and Apothecon caused false and fraudulent claims to be submitted to federal health care programs.

Finally, the Government alleged that BMS knowingly misreported its best price for the anti-depression drug, Serzone. Under the provisions of the Medicaid Drug Rebate Statute, BMS was required to report to Medicaid the lowest, or "best" price, for Serzone that it charged its commercial customers. In making its mandatory best price reports, BMS knowingly failed to include the low prices at which it sold "private-label" Serzone to Kaiser, a large commercial purchaser. As a result, BMS denied the Medicaid program and certain Public Health Service entities the benefit of the lowest price in the marketplace.

Out of the settlement amount, the federal recovery is over $328 million, of which over $25 million constitutes disgorgement of profits under the Food, Drug and Cosmetic Act resulting from BMS’s illegal promotion of Abilify. BMS also will pay over $187 million to the Medicaid participating states, and $124,000 to certain Public Health Service entities.

As part of today’s settlement, Bristol-Myers Squibb entered into a Corporate Integrity Agreement with the Office of Inspector General of the Department of Health and Human Services that, among other things, requires the company to report accurate average sales prices and average manufacturer prices for its drugs covered by Medicare and other federal health care programs.

“Illegal drug marketing schemes and deceitful pricing by manufacturers will be vigorously pursued by OIG," said Daniel R. Levinson, HHS Inspector General. "We are committed to ensuring that beneficiaries participating in federal health care programs are not taken advantage of by those engaging in unscrupulous practices.”

http://www.usdoj.gov/opa/pr/2007/September/07_civ_782.html

Saturday, September 29, 2007

Rock Therapy



It was the summer before second grade and we were living at the Jersey Shore. My mother painted seascapes in a men’s dress shirts and rolled up jeans. My father worked at the Silica Sand Company; where giant mounds of sand turned into wall-sized sheets of clear glass. My sister played jacks with Trudy Golday and Susan Pettibone. I spent most of my time alone, controlling the weather.

I kept small rocks in my mother's old prescription bottles and lined them up in the narrow wedge between my bottom bunk and the wall. There were seven bottles of varying sizes, and forty-nine stones. These could summon the sun, stop the rain, and generally keep the beach from blowing away. I would, as magic law required, touch the top of each bottle before I went to sleep, and do the same thing right when I woke up every morning. I never forgot.

Every few days I would take the stones out to our gravel driveway for cleaning, rearranging and evaluation. Often the odd few had lost their power, and would be thrown into the bay and replaced.

Early one afternoon, a real estate agent came to speak with my mother about renting out our house for the winter. I was in the driveway looking for new stones. I held them in the folded bottom half of my t-shirt, belly exposed, deeply concentrating. The agent was pale and pear-shaped -- covered in a thin layer of sweat. He looked as though he had recently been boiled. Within moments of getting out of his car he was less than half an inch from my face, shouting, "Oh! I see we have a little rock collector here!"

I was thunderstruck. Breathless. I couldn't think of what to say and finally whispered, "I do not collect rocks." Those were the last words I spoke for the next 24 hours. I gathered my prescription bottles and buried them behind our house. I locked the door to my room and refused move from my bed. That night my uncle and cousins came for dinner. Each in their turn: Aunt Emma, Uncle Jimmy, Cynthia, Georgia, Little Jimmy, my parents, my sister, came upstairs one at a time. Each like a horse whisperer with a feral mare; convinced they could pry me from my misery and my bed. All failed. No one, not even my famously intuitive mother, could figure out what had made me so upset. Even I didn't know.

I suspect it had something to do with the fact that I thought I was very special - an alchemist, a seer, marked by God to help out with the weather - but in fact the rest of the world just saw a kid collecting rocks. The shame was new, overwhelming, and unconquerable. I wanted to go downstairs for spaghetti and meatballs, but the longer I stayed in my room the more disconnected I felt from this world that had rejected me.

That is a solar plexus memory. The feeling, however, has grown familiar. I feel a spasm of that shame every time I hear the words Mood Disorder. I don't believe the fiction that we're all a bunch of geniuses with too much brainpower to hold in one skull, but I believe we're engaged in a struggle with more heft and rigor than the word "mood" can possibly describe. Disorder? Okay, I've learned to live with that one. When I'm walking through the West Village in my pajamas and talking to strangers about how atoms travel, we can safely say something's "out of order." But is it that I'm not in the mood to wear street clothes and shoes? This from dictonary.com:

mood
–noun
1. a state or quality of feeling at a particular time: What's the boss' mood today?
2. a distinctive emotional quality or character: The mood of the music was almost funereal.
3. a prevailing emotional tone or general attitude: the country's mood.
4. a frame of mind disposed or receptive, as to some activity or thing: I'm not in the mood to see a movie.
5. a state of sullenness, gloom, or bad temper.


It puts me in a bad mood, reading those definitions. I'll tell you a few things about mood: The boss is in the mood to talk to God. The mood of the music was almost funereal but she couldn't hear it because she couldn't get out of bed. The country's mood is uncertain, but the country is nodding and smiling and serving up meds. I'm not in the mood to see a movie, or to watch Oprah squint with pity at the bipolar travails of Sinead O'Connor. I am sullen, gloomy, and in a bad temper. But I do not collect rocks.

And tomorrow's going to be partly sunny.

Friday, September 28, 2007

The people who want to help

Last Sunday night I sat at a table with a bunch of middle aged college educators. My mother was running a conference to educate people about mental illness on campus and Alison Malmon and I came down for it. Alison spoke at the conference, I was just along for the ride. The dinner the night before the conerence was one of those striking moments, with Alison and I sitting in the middle of all these well meaning older people tring to comumincate what it was to feel isolated at college and what educators might do to ease the burden of it. They were looking for us to guide them and I felt useless.

I listened and I tried to answer their questions about what I had needed and hadnt gotten at Amherst, but I felt like a phoney. My experience of being unhappy in college had been so personal and shameful, I couldn't relate to the stories of finding sources of support among other students. I don't I would have known how to look or how to utilize what I found. I was too busy pretending things were fine.

So how do we reach the kids like I was who struggled along because they feared the shame? If I don't know that answer all these later, I am not convinced there is a good answer.

Shopping Anxiety


Some people fear death, some public speaking. I'm comfortable with both but I hate shopping. Recently I've become addicted to Tim Gunn's makeover show, which brilliantly mixes psychology into shopping, and it's motivating me to go and buy new clothes. Ones that fit and express who I am. I know I need help--I'm way out of touch with how my body works in clothing, in fact I routinely buy clothes too big for me, or buy things I already have, or wear things that are worn out, stained, missing buttons, etc. I need help. That's the first step, right? Admitting the problem. And the second step is asking for help. And so I've asked my warm and wise friend Dominique, who is stylish and getting her PHD in Buddhism from Columbia, to assist me in the endeavor. I truly feel that only a Buddhist scholar can get me in and out of the dressing rooms without triggering a depressive episode or panic attack. I'm not being dramatic. I really hate shopping. I will blog after our date, next wed.

Thursday, September 27, 2007

Dawdy on Oprah and Kay


From Philip Dawdy's blog, FuriousSeasons.com:

"After mulling it over for a day, I've come around to the idea that Oprah, who featured bipolar disorder and several examples of the same on her program on Monday, is out to paint bipolars as inherently violent and dangerous. I've not seen a lot of data on this point. Most of the research on violence and mental illness has been done on schizophrenia and shows a risk that is not particularly elevated above the general population.

But this is Oprah and she gets to do what she wants, data or no data. Why Kay Redfield Jamison, who appeared on the program and should be acutely aware of this issue, didn't peep in protest is beyond me. She appeared to be on the program to lend some medical authenticity to the affair and get a major plug for one of her books, which have been strong sellers for years and have had major media plugs aplenty. Jamison is an odd case--she's a professor of psychiatry, works in private practice as a psychologist, has oodles of money and privilege, and yet I have never heard her speak up on behalf of her brothers and sisters when they are getting kicked around by the media. There literally hundreds of thousands, if not millions, of positive stories around people with bipolar disorder, and she stands aside and let's the talk show queen get away with painting the rest of us who work very hard on these matters with the problems and bad outcomes of three other people, two of them Hollywood actors and one a convicted murderer.

If Jamison cannot start standing up when she makes her many media appearances, then perhaps it is time for her to stand down.

And, yes, like many readers, I am sick and tired of Hollywood actors being the go-to bipolar examples on shows such as these. They are poor proxies for the reality the rest of us live with. But have no fear: I hear that Sinnead O'Connor is coming out as bipolar on Oprah next week. I'm so happy. The Irish singer and the rest of us have so much in common."

Agree? Disagree? Please comment!

Tuesday, September 25, 2007

Baz Alert


Calls on Children's Health Insurance Urgently Needed

House Vote on SCHIP Is Imminent

September 15, 2007--Today, the House of Representatives will vote on the House-Senate compromise that would extend and expand health care coverage to low-income children through the State's Health Insurance Program (SCHIP). The bill (H.R. 976, Children's Health Insurance Program Reauthorization Act) would provide $35 billion over five years. The Senate will vote on the compromise bill later this week.

Bill Adds Parity for Children's Coverage
This critical bill would for the first time establish parity for mental health benefits in SCHIP plans. It would also provide a six-month moratorium on the Administration's effort to restrict Medicaid rehabilitative services and school-based services, as outlined in the President's fiscal year 2008 budget proposal and proposed regulations released by the Centers for Medicaid and Medicare Services. These two provisions are important victories.

With President Bush threatening to veto SCHIP legislation, it is imperative to garner a veto-proof vote in both the House and Senate. Your call is needed now!

Please Call Today!
Urge your Representative to vote for the State Children's Health Insurance Program bill. A simple message to help extend health insurance to 4 million more uninsured children! Use the toll-free number 1-800-828-0498 to connect to the Capitol switchboard and ask for your Representative's office. To find out who your Representative is, access www.congress.org or www.house.gov and enter your zip code.

Saturday, September 22, 2007

What School Doesn't Need $960,685?

Yesterday the U.S. Dept. of Education announced it will award Virginia Tech $960,685 in federal grant money to improve counseling services.

Can you imagine what university health care could be like if every school received that much money? If mental health was prioritized to the extent that its budget could rival a college sports team's?

I'm thrilled that Virginia Tech will get this money, but it would be even better if a tragedy like that which occurred there didn't have to happen before college mental health was on the national radar.

[The Dept. of Education press release on the grant can be found here: http://www.ed.gov/news/pressreleases/2007/09/09212007a.html]

Wednesday, September 19, 2007

Pop Culture


I was watching the Redskins/Eagles game on Monday night, and was pleasantly surprised to hear the commentators respectfully discuss the issues that Andy Reid's family has been dealing with, including alcoholism and trouble with the law with some of the family members. The commentators spent over five minutes discussing the issue, and how 'real' celebrities really are; that they have problems just like all of us. It was one of the most honest discussions on the matter I've heard in a while.
Then I got to thinking about a couple of years ago when Tony Dungy's son took his life. What a terrible tragedy for him and his family. But I don't remember hearing anything then like what I heard this week - is this a sign that our society is slowly but surely opening up, or is it that suicide is still behind other serious issues like alcoholism in the popular culture dialogue?

Monday, September 17, 2007

"The Real Behavior Crisis is Among Baby Boomers, Not Teenagers"


Mike Males has a great Op-Ed today in the NY Times that says brain researchers are overstating neuro research about young people and its implications while ignoring the research that shows that American adults ages 35-54 are in more trouble than the youngins, and in more trouble then ever. He cites these stats about the 35-54 set: 18, 249 deaths from illegal overdose, up 550% since 1975; 46, 925 fatal accidents and suicides, "leaving today's middle-agers 30 percent more at risk for such dealth than people aged 15-19"; more than 4 million arrests in 2005 for violent crimes, up 200% since 1975; 21 million binge drinkers, which is "double the number among teenagers and college students combined"; and more than half of all new HIV/AIDS diagnoses in 2005 went to middle aged Americans. I appreciated his last sentence: "Commentators slandering teenagers, scientists misrepresenting shaky claims about the brain as hard facts, 47 year olds displaying far riskier behavoirs than 17 year olds, politicans refusing to face middle-aged crises...if grown ups really have superior brains, why don't we act as if we do?"

I think this may shed light on the overdiagnosis of bipolar disorder----if the above people are in charge, what kid wouldn't show symptoms of mental unbalance? When we focus on the problems of teenagers, are we just avoiding shining a light on the problems of adults?

Mental Illness and Love


I feel like when I was a teenager, as many of my peers were developping a sense of their romantic and sexual identities, I was preoccupied with anxiey, depression, and mania; mental illness seriously disrupted the development of healthy intimate interpersonal skills. If you grew up with mental illness, do you agree? Disagree?

Wednesday, September 12, 2007

AFTER Tragedies Every Sports Team Has the Best Community

I am going to start this post by saying the issue I am covering can be really sensitive for people and I hope that no one will take offense to this, but will rather think about it before the emotional reaction. Yesterday it was reported that a man wearing a Texas football t-shirt was nearly castrated at a bar in Oklahoma by an Oklahoma Sooners football fan. Yes you heard that right it took 60 stitches to repair a man’s “area” after he was attacked in an Oklahoma bar. And this reminded me of something I have been thinking about a lot lately.

I am an avid college football fan and love watching games. On the first weekend of the games the largest ESPN college football show went to Virginia Tech and there were endless stories about how VA Tech was the nicest community in the world, and the head coach was saying they’re America’s team now. They weren’t going to let one person destroy their community. At the Clemson vs. Florida State game there was a story about a Clemson player who had to adopt his younger brother to get him out of a negative home environment and then the town of Clemson raised money to help him get the things he needs. That night it was Clemson that had the best community in the country. Obviously in these situations I think it’s great that football can bring people together etc. and I’m happy that people turn to this to heal, but I really wish people would stop saying communities are the best AFTER a tragedy. Shouldn’t we focus on being good before a tragedy?

Here’s another example. Virginia Tech won their first game and played at LSU last weekend. LSU honored Virginia Tech by playing their alma mater before the game instead of LSU’s and two of LSU’s top players asked their fans to show respect to the Hokie fans at the game. So when Virginia Tech was introduced the LSU fans didn’t chant their usual “Gator Bait,” instead they either cheered or said nothing. All nice things, but why would people be compelled to do this only after tragedy? Why would large football communities continue to treat people like this all year round, unless of course something terrible happens? Trust me I know that for a large majority of people at these games it’s just all in good fun to chant or cheer for your team and a little yelling or harassment rarely turns into castration, but I just find it fascinating that announcers are just endlessly commenting on how amazing of a community LSU has to treat the Hokie fans this way, when next week a team that didn’t happen to have the largest school shooting in the history of the country will come in and they’ll be “gator bait” and booed.

Is it too much to ask for people to treat people in a humane way all of the time and not just after something terrible happens? In the same train of thought would it be too much for Extreme Makeover to not just take a ton of money and build one house for one family, but take the same amount of money and build a neighborhood? Or do we just feel better when we have one instance to look at and smile and say what a great world we live in?

Now I know there are a lot of amazing people at all of the schools I mentioned in this piece and many more. There are a lot of fans who don’t fight, don’t treat people with disrespect and some of my views here may be coming from the few people that get focused on and seem to ruin a lot. So if you are one of the good fans, then maybe we need to start making our voices heard louder and larger than those who give schools and communities a bad name.

Monday, September 10, 2007

Here I go again


I was disturbed that the VMA's were at the Palms casino in Las Vegas. How does MTV get away with such a cheery endorsement of partying at the Palms when the majority of its viewers are under 21? Bob Herbert wrote a great Op-Ed about prostitution in Las Vegas last week in the Times, and it really disturbed me that so many teenage girls are getting swept into prostitution there at such a young age. It already disturbed me that Las Vegas markets itself as a great place to get loaded, gamble, and fuck without anyone at home knowing. But for MTV to sell that place to children is inexcusable.

Friday, September 7, 2007

A provocative analysis of the suicide data

Provided by Philip Dawdy, over at the Furious Seasons blog---

http://furiousseasons.com/

His writing is so smart, and so persuasive. Please read, think, digest, comment---

Thursday, September 6, 2007

Increased suicide rates linked to removal of warnings on anti depressants?

Ross brought this up with me earlier in the day and I just saw a piece on NBC news making the same link. It's so hard to tell if this is based on real information or on pharmaceutical propaganda. The stat was that suicide has gone up in teenage girls 76% since the warnings came on. This increase does not seem possible. And the idea that this rise in suicide is caused by all of the young people who didn't go on meds because there were warning labels sounds totally unbelievable too. What is really happening out there?

Drunk and Unbalanced Astronauts?


I've just glanced at a fascinating piece that reveals that NASA is trying to ignore the mental health issues of its astronauts; this an even bigger, broader problem than the "drunks in space" issue currenly in the spotlight, which already has officials scampering around denying that many of the astros blast off before takeofff. What I appreciate is that the article peels back the misuse of alcohol and discovers mental health issues, which I hope, as an informed culture, we can start doing more and more automatically, since most of the time these things are linked. Any way, here's the piece:
http://news.yahoo.com/s/ap/20070906/ap_on_sc/astronauts_drinking


NASA is pretty much an arm of the military, so that they are military like in their denial of problems seems totally consistent.
But I love the power logic at work, which underlies so many dysfunctional institutions, never mind colleges, and families, which is this: if you make a culture that discourages people from seeking help, then you won't have a problem. We're really going to have to make an economic argument that says encouraging people to disclose is much more cost effective, because the moral underpinnings don't tend to inspire as effectively.

Thoughts?

Wednesday, September 5, 2007

Owen Wilson and his Fans



I had the awesome opportunity of blogging about how Owen Wilson's suicide attempt and emotional difficulty may make him very similar to his young fans on the Huffington Post! You can read it here!

Healthy Skepticism

This from the LA times report in the surge of bipolar diagnoses in children:

Dr. Gabrielle A. Carlson, a psychiatrist at Stony Brook University, said only 1 of every 5 children referred to her with a diagnosis of bipolar disorder actually has it. The rest have autism, depression, anxiety or another psychological disorder. All these conditions involve different treatments, either with drugs or behavioral therapy, or both.

Carlson, who has studied the increase in bipolar diagnoses, said some parents seemed to prefer a diagnosis of the disorder because the illness, thought to be largely genetic, absolves them of blame. "They don't have to deal with their chaos, their psychiatric disorder, their marital troubles or abuse.'"

This Guy


Homophobia is toxic--to those who feel it and upon whom they spew it---and the mental health toll is real, and deep. I don't think you can be a mental health advocate without being a gay rights advocate. Speaking of which: Here's a brilliant and funny essay in the Nation about Larry Craig, written by my friend Tim McCarthy----
http://www.thenation.com/doc/20070910/tpmccarthy2
Enjoy!

Tuesday, September 4, 2007

Front Page of NY Times

Today the times reported that there was a forty percent increase in children being treated for bipolar disorder. That is astounding--and disturbing--I worry that many of those kids have emotional problems, not pyschiatric ones, problems for which the the solution lies in better parenting, schooling, communities, and family therapy, not medication. I was a kid with bipolar disorder, so of course I believe they exist. But not in these numbers. What also bothered me about the report is that 100 percent of these kids were treated with medication, and only forty percent of them with therapy. What I would really like to see is how many of those kids are still on those meds---because the only checks and balances in this situation is that those meds are so expensive and have so many side effects that I doubt a kid without bp with stay on them for very long. I hate blaming parents---especially since I'm not a parent---but many of them are colluding with myopic child psychiatrists and greedy pharmaceutical companies.

Friday, August 31, 2007

Whoa.




Since Halloween is one of my favorite holidays, I decided to try to beat the crowd and figure out my costume early. Just a few minutes into my search, I came across this costume from http://www.buycostumes.com/, entitled "Ella Mental Adult." Tag line: "Even when over medicated, this patient is tons of fun."

disability -- casting too broad a net?

Posted by Lucy

Yesterday I met with a deaf woman who told me that she didn’t go to a therapist for her PTSD symptoms because she’s not “one of those crazy people” – signed by waving the hands around the head with a disgusted face – and I refrained from scolding her for having such scorn for people who experience mental illness.

A little over a week ago a person in the mental hospital informed me in a very loud voice that they were not “a retard” and wanted a new roommate that [didn’t have a developmental disability.]


An hour ago a would-be law clerk contacted me about writing a paper about state law requirements to report abuse of persons with disability that trump the privileges of lawyers, clergy, and social workers, requiring them to call in to the state any abuse of a “person with a disability.” This law would require me to report it to the government were a deaf client to tell me in confidence that her boyfriend had hit her!

Why is it that many people with disabilities are constantly trying to distance themselves from being lumped together with other disability groups? I always assumed it was the pressures people with disability confront in society that cause them to push harder on others perceived to be “beneath” them. But could it be the law itself – our own legal category of “disability” – that causes my clients to distance themselves from one another time and again?

Is the law the REASON these groups are at pains to distinguish themselves from each other?

Can you ever be too rich or too thin?

"The New iMac. You can’t be too thin. Or too powerful." This was Apple's latest ad campaign for their new flat screen monitors. While it is easy to see why they decided to reference the Duchess of Windsor's famous saying for selling thin paneled monitors, it is also easy to see why this is an irresponsible use of the adage.
As a recovering anorectic and bulimic, I found this to be completely offensive and I wasn't the only one. As discussed in the following article, http://news.yahoo.com/s/prweb/20070820/bs_prweb/prweb547551_1, The Alliance for Eating Disorders Awareness called upon Apple to remove the ad. It should be noted that Apple has since withdrawn the ad and changed the slogan to "The all new, all-in-one iMac", which I applaud, but I can't help but be amazed that the ad was even created, designed, and distributed. The impact that the slogan could have on millions of young men and women is astounding.
In fact, when I read "You can't be too thin. Or too powerful." it brought back memories of how I used to question whether or not the statement that "you can never be too rich or too thin" was really true. Its commonality in everyday dialogue once led me to conclude that one really can never be too thin, but the millions of individuals (including myself) that have suffered or are suffering from an eating disorder know that one can, in fact, be too thin.
But am I (and the Alliance for Eating Disorders Awareness) simply being oversensitive? In another blog, an individual reacted to the Alliance for Eating Disorder Awareness's press release by stating, "Where to start with this one...Never mind that Apple is one of the few companies to never have used wafer-thin models in its commercials to lure the young male geek audience. (By the way, has anyone ever met an anorexic computer geek?) Heck, never mind that it's an ad for a freaking computer. The really ridiculous part about all this is that they making this claim that images in advertising could have an effect one eating disorders against a company that, for the last thirty years, has used a piece of food for its logo. Oh, the irony..." (http://www.macinspector.com/2007/08/group-takes-iss.html)
Is this blogger correct? What do you think? How responsible should advertisers be for the messages they send?

Thursday, August 30, 2007

The System is Messed Up!

There is an article the New York Times today detailing the findings of the VA government report on the VA Tech shootings and what went wrong. The report claims that though Cho was ordered to seek therapy and scheduled an appointment at the campus counselling center, he was given only a pre-screening interview, never actual therapy, and that the files regarding this interview have been lost.

To me, the saddest part of this story is not Cho (although that is plenty sad) but all the students who have the courage to seek out the counseling centers and don't get what they need. It breaks my heart that you can be brave enough to try to get that help and to end up another number shuffled through paperwork, forgotten, untreated, still alone.

I think that is part of what L21 should be about. By letting people know there is a community of support, maybe we can get them to try again, to push for the treatment they deserve, to seek out peers who can help them meet their own needs. But it certainly feels like a huge job...

Thursday, August 23, 2007

Young, Stressed Out and Going Through the Motions



This is an interesting article that cites an AP/MTV study showing a bunch of things:
http://news.yahoo.com/s/ap/20070822/ap_en_ot/youth_poll_stress It shows that young people are stressed out today and that more young women report being stressed more than young men. It says middle income people are more stressed than lower or upper classes. Inner city people are more stressed than rural peeps. And that overall only 25% of young people feel safe from a terrorist attack, but when asked if it is a major concern few report that it is.



I have so many thoughts here. Is it that young women don't deal with stress as well as young men or is it that young women are more likely to report that? Are people in upper and lower classes not as stressed because they feel their futures are kind of determined? The stress in cities over rural areas makes sense. The terrorist thing is well the terrorist thing.



When you read the article you will see a phenomenon I have seen growing over the past 7 years. It seems no matter where I go just about every young person I meet is going through the motions of life in some way or another and never taking time for themselves to appreciate the day or focus on their mental health. All of this pressure and STRESS certainly adds to it! May you have a less stressful day and if you are stressed, well apparently you're not alone!

Tuesday, August 21, 2007

When Pop Goes Mental


So you know that song "beautiful girls"? It's one of the top songs in the country right now, and it also has a really weird lyric--something like "you got me feeling suicidal, suicidal, suicidal!" I feel about this lyric as I do about Amy Winehouse's "Try to make me go to rehab and I said No!No!No!"--uneasy. Am I just having a another granny moment? Of course, Amy Winehouse is reportedly in rehab for bulimia and drug addiction as I write this. One other thing---ethan and I were driving to the airport this morning and on the radio we heard an alternative lyric to the beautiful girls song, and it was "you got me in denial, in denial, in denial!". Anybody know if there was a controversy over the suicidal lyric? Mental illness isn't catchy, but pop songs are. So what happens when pop goes mental?

Here's the beautiful girls video:
http://www.youtube.com/watch?v=Lt6o8NlrbHg

Thursday, August 16, 2007

I just spent the morning at the computer store, frantically trying to figure out why my 6-month old, kinda expensive, laptop stopped working this morning. Who knows. But while there I got to talking with the employees, who asked me what I do. I explained Active Minds, and they asked me if my work has anything to do with the shootings at Virginia Tech. Yes, I said, in that we are addressing mental health issues among college students - but no, in that we don't actually know what the young man at VTech was suffering from, and most importantly, that the vast majority of college students who are on campus living with a mental illness are actually no more likely to be violent than those without, and if they are, the likelihood is greater that they'll be a risk to themselves than anyone else.


After saying that, the first thing out of one of the technician's mouths was "Yeah, this guy was nuts. But it's the roommates' fault. They wouldn't even talk to him, of course he did something stupid." I came back saying that the roommates did what they knew/thought to do, that this incident was no one's fault and is not a typical threat on campus, and that we just need to use it as a learning opportunity to figure out where the pieces didn't fit together. And I absolutely believe that. But it got me thinking about the bigger issue, which is one I feel so passionately about...the role of friends and other peers, especially in young adult mental health.


In hindsight, Mr. Cho's roommates could be looked upon, along with many other people, as potential factors; but in reality, are we ever really taught what to look for in friends and peers, how to interact with them in a way that is supportive, and when far is too far and that we should keep pushing them into professional help? How can we place blame on anyone, when no one is taught the proper way to talk about these issues or how to encourage others into help? Sadly, that blame is often self-inflicted and felt by friends and family members of people who take their own lives. But in our society, we do not grow up being taught the words to use or the actions to take when worried about a peer or loved one. So how is anyone supposed to know?

Wednesday, August 8, 2007

Hot and Bothered


So I read today that people between the ages of 10-29 comprise the highest percentage of people without health insurance in this country. This group is also (basically) the same age range of people at the highest risk of developping mental disorders AND statistically the group who seeks help for mental disorders the least. We've always blamed stigma for this, but maybe they don't seek help BECAUSE THEY CAN'T AFFORD TO. Isn't that enough to make you sick? We have an election coming up people!!! And we in the mental health movement must insert ourselves into the discussion about health care--because of course it's a tragedy that so many people are uninsured--but it's even worse that many forms of mental health treatment are not adequately covered by health insurance. This is worth fighting for! Barriers to treatment costs people their lives, drain families, and weaken communities. Our leaders need to be reminded that the brain is a body part and when it's broken it needs the same level of coverage we give to the all important arm, or knee, or lung. Among candidates, who is saying what on this issue??!? Please report in....

Sunday, August 5, 2007

Let Em Party?


I live in the basement apartment of a brownstone. Last night the twin teens who live upstairs had a rager in our backyard while their parents were out of town. They are great girls, they have a close relationship to their wonderful parents, and I'm sure their friends are lovely, but teenage girls partying totally freaks me out. I woke in the night to use the bathroom and saw dozens of teens in the backyard in full out debauchery. Are they having innocent fun? I really really really hope so. I'm sure they were, right? I was when I was their age. Right? I'm really not sure anymore. I have this reoccuring nightmare--I've had it at least a hundred times since I was a teenager---the details change but the template is the same: I'm throwing a party and it's getting out of control. Lately the party hasn't been at my house. The last time I had the dream, the party was at my neighbors, and the nightmare was that I didn't protect my neighbor's house enough. But every time, in the dream, disrespectful partiers are making a mess. And it was only recently that I considered that maybe all of those parties I threw in high school gave me my night mares. I have great parents, but where drinking parties were considered, I think they were too permissive. They always said they'd rather we party in their house instead of elsewhere, but that's kind of nuts. Teenagers are so freaking young. They shouldn't be getting plastered anywhere--but they definitely shouldn't be getting plastered while on site adults look away. So question one: HOW DID I TURN INTO SUCH A GRANNY?!??! It's just that I worry that while they're chugging away, the heaviest partiers are probably masking unacknowledged mental disorders, and the girls who already have low esteem are decimating the self respect they have by giving blow jobs to assholes or something. So question two: What's the right balance of permission to have with teens about partying?

I found this article about a case in New Mexico where a 19 year old had a party; his parents bought all the booze and allowed the party at their house; but it got way out of hand and the 19 year old got extremely violent and injured a bunch of his friends, female and male. The interesting part: they indicted him AND arrested his parents. Check out the links, and please, weigh in on this topic! http://www.news-bulletin.com/news/73250-08-04-07.html

Thursday, August 2, 2007

Oy Gavult



Yes. In an article entitled "Is Britney Spears Bipolar?" US Magazine "reports" the following:
From stripping down to her skivvies for a July 18 dip in the Pacific to melting down at a July 19 photo shoot for OK! Magazine, Britney Spears could hardly be classified as stable. What could be plaguing the pop tart?
“Her erratic behavior has moved into bipolar disorder,” surmises psychologist Dr. Robert Butterworth, who has not treated Spears, 25. “Your energy level and emotions alternate between highs and lows, and that seems to have happened here.”
Psychologist Robi Ludwig, who also hasn’t treated her, agrees – to a point. “It seems that Britney has a mood disorder,” she says, acknowledging that the singer’s behavior is “self-destructive, erratic and dramatic,” which could also be symptomatic of drug and alcohol abuse. She added: "She strikes me as someone going through a delayed adolescence."
http://www.usmagazine.com/britney_spears_31

Monday, July 30, 2007

New Pot Research


A new study shows that pot ups the chances of developping a psychotic illness by 40%. Thoughts? Here's a link:
http://www.washingtonpost.com/wp-dyn/content/article/2007/07/26/AR2007072602014.html

Greensane


Thought this was interesting---article about building a mental health center that is as "green" as possible. Would love for people to comment about the connections they see between mental health and environmentalism.
http://www.greenbaypressgazette.com/apps/pbcs.dll/article?AID=/20070729/GPG0101/707290688/1207/GPGnews

Wednesday, July 25, 2007

Lindsay's Arrest


So....she was arrested for dui and cocaine possession again, only a few weeks after getting out of rehab--I just read that she'd denying that the drugs were hers--and I also read a quote from the NY Times-- "'I hope they put her in jail for as long as they can,' said Bernie Brillstein, whose company has represented John Belushi and Chris Farley. 'Maybe she'll realize how serious it is. I believe she's uninsurable. And when you're uninsurable in this town, you're done.'" Amazing!

Tuesday, July 24, 2007

YouTube Debate: Guns and People with Mental Illnesses

Last night on the CNN/YouTube Democratic Presidential debate, the discussion briefly touched on mental illness--in the context of if people with mental illnesses should be allowed to own guns. New Mexico Governor Bill Richardson said, "Nobody who has a criminal background or is mentally ill should be able to get a weapon. That is the key, and that includes gun sales. That includes gun sales at gun shows." (See http://www.cnn.com/2007/POLITICS/07/23/debate.transcript.part2/ for a transcript of the discussion about guns).

This got me thinking. There are alarming statistics that show firearms in the home are a risk factor for suicide--but should having a diagnosis of a mental illness automatically disqualify you from the right to bear arms? Should people with certain diagnoses be held to a different standard than people with other diagnoses when attempting to purchase a gun?

I have been trying to come up with answers, but I can only think of more and more questions.

Thoughts, comments, suggestions?

A Life Worth Living

Wille and Ray on the streets of skid row.

Every Saturday morning for the past 18 years a man named Ray Castellani has pulled a truck or van onto the streets of skid row in downtown Los Angeles and fed some of the most forgotten people in our country. It all started one day after Ray, a retired actor, and recovering alcoholic heard a voice telling him to feed people. That day he made 111 peanut butter and jelly sandwiches and got in his truck. Today Ray has a fully functioning non-profit organization called the Frontline Foundation and a kitchen staffed only by volunteers that makes 12 trays of hot food, hundreds of sandwiches and hot dogs that he brings down to the same street corner he started on. Ray estimates that he has fed close to 1 million people, but the feeding isn’t the important part. The humanity, the hugs, the conversations and the care seem to matter most.

I am very familiar with Ray and his foundation because my fabulous girlfriend, Heidi, has gone with Ray every Saturday she has been in LA for the past 6 years and I have gone whenever I can for the past 4. Heidi found Ray a long time ago and as Ray always says if he wasn’t 74 they would be quite the couple! Heidi and I have a lot of friends on skid row. Our friends are convicted felons, people with severe mental disorders and no treatment, ex and sometimes current drug addicts, victims of abuse, and some have extremely violent criminal records, which include killing people. A good majority of the people down there have known Ray for all 18 years of his service as he has visited them in jail or helped them in other difficult times.

What amazes me most when we get down there is how many people with absolutely nothing, sometimes not even a shirt on their back, continue to find the will to live. My closest friend on skid row is named Willie. Willie grew up in Texas. He came to Los Angeles to play football for USC. Much like a lot of other homeless people he had tryouts in the NFL. Two of my other homeless friends played for the Raiders. Somewhere along the way things went wrong for Willie. He got into the system and hasn’t got out. Willie has a tracheotomy that he had to get due to an accident when he was high on crack. When Willie now in his late 50’s goes to jail, which is only once in the past 3 years for a minor offense, he can only be transported in full shackles, because of his violent criminal record. Willie has been able to get off the street sometimes for the past 8 years. He has spent a lot of time in hotel rooms that he pays for with his disability and social security checks. Recently he had to move to Long Beach, because they raised the rents for hotel rooms in downtown LA from $600 a month to $1,800 a month, which is a topic for another blog. Heidi and I have dropped Willie off at his hotels and also in front of spots on the corner where a blue tarp is hung over cardboard boxes marking his home and now we drop him off at the train station to get back to the LBC.

Willie really doesn’t have much outside of his hotel room. He has people he sees occasionally. His family is in Texas and he hasn’t seen them in years. He has a tv with local stations for sports and a dvd player which he cherishes. He loves any violent movie and Shrek! (who knows?) Whenever I see Willie we chat about sports, my speaking, what I am doing and what he does. He has an awesome sense of humor and is usually in a chatty mood, so he jokes about my life constantly calling me a motivational speaker and asking me to motivate him. He does talk about his life and he’s come a long way. He got off of crack about 7 years ago without the luxury of rehab and hasn’t gone back to it. He does drink beer. He tells me that he spends most of his time sitting in his apartment. No one will hire him, because he has the tracheotomy and it’s too much of a risk. He wants to work and I do believe he would, but he is stuck with a life filled with poor decisions, some things out of his control and even poorer outcomes. In the 4 years I have known Willie he has never mentioned giving up. He has said it’s hard. Stressed how much he thinks his situation sucks. And at times I have worried if I’d ever see him again, but no matter what happens every Saturday morning when we pull around the corner there he is in the middle of the street smiling, holding one hand to his throat to say hello. As we get out of the car he hugs both of us, when he says goodbye he tells us he loves us sometimes he cries and when we moved to Berkeley two years ago he wrote Heidi the most tear jerking letter telling her how much she meant to him and how he spends most of his week just wanting to get to Saturday to see us. He wrote just seeing us one day a week keeps him going.

Whenever I see Willie, my other friends and the hundreds of homeless people on Skid Row I wonder to myself could I do this? If I had nothing, no chance at growing, no chance at getting out, no way of seeing my family, could I wake up everyday to a tarp or a hotel room and keep going? I honestly don’t think I could. Anytime I am in any city I look around and see people like Willie and I’m amazed by their resiliency and will to live and love.