Via Scoop.it – Healthcare Continuing Education
Just about every mainstream medical, psychological, and educational organization in the U.S. long ago concluded that ADHD is a real, brain-based medical disorder, and that children and adults with ADHD benefit from appropriate treatment. So, do you know what appropriate treatment is? Are you up-to-date on what kind of help is available? A lot has changed in the last 20 and even in just the last five years. Get strategic. Learn more.
Tag Archives: Mental Health
Via Scoop.it – Healthcare Continuing Education
When my wife died in 2004, I looked for books to help me understand grief and deal with it. Most of what I found was useless, based on highly subjective speculations and anecdotal evidence, although I did find one helpful resource: Therese Rando’s How to Go on Living When Someone You Love Dies. I found it lamentable that so little of the popular advice on grief was based on scientific evidence. So I was pleased to encounter in my local Wordsworth bookstore a new, evidence-based but highly readable review that corrects many widespread misconceptions about bereavement, Ruth Davis Konigsberg’s The Truth about Grief. Here are some of the facts about grief I learned from this book.
Continuing Education Courses on Grief:
- The Grieving Self
- The Magical Thoughts of Grieving Children
- Grief and Mourning: The Impact on Professional Caregivers
- Bereavement Groups: Successful Facilitation Strategies
- Transformed by Grief (griefrevelations.com)
- Grief vs self-pity (waxinggibbous.net)
- On Grief and Loss: The Law of Attraction (bodyquirks.wordpress.com)
Thanks to the generosity of the professional borderline personality disorder community, the National Education Alliance for Borderline Personality Disorder will be hosting lectures on the phone providing the larger community the opportunity to hear the latest information and research on the disorder.
- Borderline personality disorder: 8 dangerous myths (cbsnews.com)
- Video: Brandon Marshall has borderline personality disorder (cbsnews.com)
- 10 Myths about Borderline Personality Disorder Dispelled (showard76.wordpress.com)
By Thomas R. Insel, MD (NIMH Director)
Five years ago, Colton and Mandersheid surveyed mortality data from eight states and concluded that, on average, Americans with major mental illness die 14 to 32 years earlier than the general population. The average life expectancy for people with major mental illness ranged from 49 to 60 years of age in the states they examined — a life span on par with many sub-Saharan African countries, including Sudan (58.6 years) and Ethiopia (52.9 years). Average life expectancy in the United States is 77.9 years. It would appear that the increase in longevity enjoyed by the general U. S. population over the past half century has been lost on those with serious mental illness (SMI). In fact, this drop in life expectancy due to mental illness would surpass the health disparities reported for most racial or ethnic groups. Yet this population is rarely identified as an underserved or at-risk group in surveys of the social determinants of health.
Why is there such a profound disparity in life expectancy for those with SMI? Disorders such as schizophrenia, major depression, and bipolar disorder are risk factors for suicide, but most people with SMI do not die by suicide. Rather, the 5 percent of Americans who have SMI die of the same things that the rest of the population experiences — cancer, heart disease, stroke, pulmonary disease, and diabetes. They are more likely to suffer chronic diseases associated with addiction (especially nicotine), obesity (sometimes associated with antipsychotic medication), and poverty (with its attendant poor nutrition and health care) and they may suffer the adverse health consequences earlier.
The risks are striking. People with a mental illness are more than twice as likely to smoke cigarettes and more than 50 percent more likely to be obese compared to the rest of the population. But this only partly explains the premature mortality. Recently, when Druss and colleagues analyzed the early mortality data derived from a nationally representative survey, they found three drivers: clinical risk factors, socioeconomic factors, and health system factors.
The clinical risk factors include the frequent co-occurrence of mental illness with heart disease, diabetes or other medical conditions, generally referred to as “comorbidity.” For example, people with major depressive disorder are at higher risk for cardiovascular disease and stroke. Conversely, for those who have had a heart attack, experiencing depression increases their risk for cardiac-related death three-fold, more than any cardiovascular variable except congestive heart failure. And people with diabetes have double the risk for depression. We do not fully understand the relationship between diabetes or heart disease and depression, but current thinking attributes the increased risk to both depressive behaviors (e.g., poor diet, low activity, low adherence to treatment) as well as some common biology such as elevated inflammatory factors.
While we are still trying to understand the cause of comorbidity between mental disorders and other health problems, the health system factors may offer a better short-term target for change. Few people in the public mental health care system are receiving high quality health care.
The Patient Protection and Affordable Care Act outlines a specific model of integrated care, the patient-centered medical home (PCMH), which could improve access and quality of health care to those with multiple chronic disorders. The PCMH model includes comprehensiveness, holistic patient-centered care, and, emphasis on care in the community. The Centers for Medicare and Medicaid Services has been tasked with piloting a series of PCMHs and studying their impact over the coming years with the goal of wider dissemination in the future. Knowing that people with SMI are a high risk group for multiple chronic disorders and targeting the PCMH for their specific needs could be an effective approach to improving health outcomes for the entire population.
Short of a new health care system, there are models for improving health outcomes for people with mental illness. Collaborative care, in which primary care and mental health providers work closely together to deliver effective treatments within the primary care setting, represents a fundamental change toward addressing mental disorders in conjunction with other physical conditions. Over the past two decades more than 40 research trials have demonstrated the effectiveness of the collaborative care model. In the case of major depression, for example, studies have shown collaborative care programs to be an effective approach for treating depression alongside other conditions, and to be more cost-effective than standard treatment. A recent study indicates that implementing this approach for depression in the Medicare system would result in cost savings of approximately $15 billion annually.
Collaborative care for depression and diabetes or depression and heart disease is the proverbial low hanging fruit. What about schizophrenia and bipolar disorder, which are usually treated in specialty mental health clinics rather than primary care? Is it better to add primary care capacity to the behavioral health center or to integrate patients with SMI into primary care? Can our current system, which separates behavioral health from health care, ever be “equal” in quality or outcomes? These remain research questions of urgent importance.
The unavoidable fact is that we will not improve overall longevity or contain health care costs in this nation without addressing the needs of the nearly 5 percent of Americans with serious mental illness. This is a population that not only dies early; they have multiple chronic diseases requiring expensive care, often in emergency rooms and intensive care units. We need better strategies for dealing with this urgent public health issue and we need to ensure that whether these strategies are collaborative care for depression or an innovative medical home for those with serious mental illness, we implement these interventions where the need is greatest.
- Mental Health Medications – Free Guide (pdresources.wordpress.com)
- CDC: Mental Illness Affects Roughly Half Of Americans (zocdoc.com)
- Mental Woes on the Rise, but Fewer Get Help (abcnews.go.com)
- Is California Eliminating Mental Illness Treatment? (psychcentral.com)
- Half of Americans Have Mental Health Problems, But Why? (blisstree.com)
- CDC: Mental Illness Surveillance Among Adults in the United States (bespacific.com)
Free resource from the National Institute of Mental Health.
- Depression CEUs for Mental Health Professionals (pdresources.wordpress.com)
- Suicide Prevention and Research (pdresources.wordpress.com)
- The Simple Facts of a Very Strange Life (brokenbelievers.com)
- Mental Health Resources (everydayhealth.com)
- Safeguarding Your Mental Health (everydayhealth.com)
- Mental Health Medications (pdresources.org)
Throughout time, theologians, philosophers and ordinary people in unfortunate circumstances have pondered the question “Why do bad things happen to good people?” While people much wiser than I have written volumes on the subject, I would like to propose a one-word answer: choices. Regardless of how “good” we are or strive to be, most of us will experience bad things in life that occur largely as a result of our own choices.
I’m not talking about the unavoidable tragic death of a loved one or being hit by a drunk driver when you’re obeying the rules of the road and minding your own business. Rather, I am referring to all the bad stuff that tends to occur, recur and build day after day—unhappiness in a marriage; obesity; depression; fatigue; certain chronic health problems; dissatisfaction with your job, your life circumstances and yourself.
Of course, no one consciously chooses these things for themselves. If we had our way, we would all have great marriages; boundless happiness; trim, healthy, energetic bodies; challenging, well-paying jobs; and loads of self esteem. Yet every day, people unwittingly choose actions and attitudes that work against what they really want from life. These actions and attitudes are what I call self-defeating behaviors (or SDBs). We develop them at low points in our lives and continue to use them long after it stops being appropriate to do so.
In abstract terms, your life can be viewed as a line with various high and low points, representing a variety of experiences—some positive, some negative. Positive experiences develop healthy behaviors. Negative experiences (including being held to the unrealistic expectations of a parent, rejection of a romantic partner, taunting by peers as a child) can breed SDBs, as we strive to cope with the stresses in our life. SDBs are misguided attempts to deal with those stresses.
For example, a woman who as a young girl was teased for being chubby might come to associate being overweight with the stress of rejection and associate being thin with love and acceptance. For that reason, she may choose SDBs such as crash dieting, binging or taking dangerous diet pills to avoid rejection. Certainly her longing to be accepted is understandable and her desire to have a slender figure is generally healthy. But her ways of going about getting both are all misguided.
Life today can be stressful on all fronts. You may be working with all your might to balance a marriage, a family, a career and social life, while trying to maintain a home and pay the bills. Alternatively, you may be trying to cope with loneliness—the lack of marriage and family—or joblessness and the inability to pay your bills. You may have feelings of inadequacy when you can’t have—or give your children—the kind of life that others seem to have.
All of these things can lead to stress, which in turn lead to the development of SDBs. While SDBs may be a particular problem for people with chronic health conditions, the average healthy person practices six SDBs on an on-going basis.
Eliminating Self-Defeating Behaviors, a 4-hour continuing education course for mental health professionals, is designed to teach concepts to eliminate these negative patterns. The course is educational: first you learn the model, then you apply it to a specific self-defeating behavior. A positive behavioral change is the outcome. Following the course, participants will be able to identify, analyze and replace their self-defeating behavior(s) with positive behavior(s). The course also provides an excellent psychological “tool” for clinicians to use with their clients. The author grants limited permission to photocopy forms and exercises included in this course for clinical use.
- From Bad to Good Habits in Five Achievable Steps (psychologytoday.com)
- The danger of self-identifying as “stressed” (psychologytoday.com)
- Reaching Consensus About Behavioral Expectations in Schools (education.com)
- Stay in Balance to Boost Your Immune System (joyofspa.com)
- Healthy Thinking (healthy1dayatatime.wordpress.com)
True clinical depression is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life for weeks or longer.
Usually the most effective treatment for depression is a combination of medication and psychotherapy.
For this reason, mental health professionals need to stay current on clinical advances in the treatment of depression. Professional Development Resources offers the following continuing education courses for that very purpose:
Depressive Disorders – Overview – This 1-hour online course reviews the different types of depressive disorders including major depression, dysthymia, and mania. The etiology, assessment, and treatment of depressive disorders in both children and adults are discussed. National Institute of Mental Health | 2001 | 11 pages | 10 posttest questions | Course #10-15
Depression: What You Must Know – This 2-hour online course provides in depth information about the diagnosis and treatment of depression in a simple, straightforward way. Major Depression is a very common illness that can be life threatening, yet the majority of sufferers of this illness never get proper treatment. This is despite the fact that there are many different and varied treatments currently available. Dr’s Kuna and Nelson-Kuna will share with you published information combined with their joint 36 years of experience to give you their honest opinion on what is likely hype and what has been proven to work. KunaLand Productions, Inc | 2009 | 22 pages | 25 posttest questions | Course #20-25
- Clinical Depression and Self-Talk (depressionmywitnessyoursolution.org)
- A Step-by-Step Guide to Depression Recovery (everydayhealth.com)
- Help for Treatment-Resistant Depression (everydayhealth.com)
- Are Migraines Symptoms of Depression? (everydayhealth.com)
- Chronic Ketamine for Depression: An Unethical Case Study? (neurocritic.blogspot.com)
- The ABCs of Depression (everydayhealth.com)
- Can a Person Be Diagnosed with Simultaneous Depression and Bipolar Disorder? (everydayhealth.com)
- Bipolar and Depression: What’s the Difference? (everydayhealth.com)
- The Search for Treatment Options for Depression (everydayhealth.com)
- DSM-IV: Depression Defined (everydayhealth.com)