Thursday, January 31, 2019

New York, Virginia become first to require mental health education in schools

From CNN on 07/02/18:
On Sunday, New York and Virginia became the first two states to enact laws requiring mental health education in schools.
New York's law updates the health curriculum in elementary, middle and high schools to include material on mental health. Virginia's law mandates that mental health education be incorporated into physical education and health curricula for ninth- and 10th-graders.
For more click here.
To see the New York State laws enacted click here.
Editor's note:
It's hard to believe that it took until 2018, for New York and Virigina to become the first two states in the United States to require mental health education as part of the health education curriculum. 
Every time there's a mass shooting in the U.S, the politicans, funded by the NRA, state that these mass shootings are a mental health issue not a gun issue. However, these same politicians have not taken steps to see to it that the issue is addressed except in New York and Virginia.

More college students are turning to emotional support animals,

From the Inquirer on 01/21/19

"Emotional-support animals (ESAs) are owned by people with mental-health disorders and deemed necessary by medical professionals. The animals, which typically have not had special training, gained popularity in 2015 when they prompted a federal guideline for housing providers, but they seemed to go viral last year following news stories about someone trying to take a dog or a peacock or a goat onto an airplane — sometimes with success.

Ever since, ESAs have become the target of ridicule. Popeyes released an “emotional support chicken” carrier available only in airports. Ellen DeGeneres poked fun at them in her recent Netflix special. Some talking heads have questioned whether ESAs are just elaborate scams.

But despite the cries of “they’re just trying to bring their pet everywhere for free,” people — particularly those of the younger variety — keep turning to emotional-support animals as a means of treating depression and anxiety.

Besides perhaps airports, nowhere is the trend more apparent than on college campuses, some of which have seen residence halls turn into true animal houses as more students file paperwork to keep an emotional-support cat, dog, or hamster in their dorm room. The ESA trend took hold over the last several years, as rates of anxiety and depression among college students have soared in the last decade."

For more click here.

Editor's note:
I have written a few letters for existing clients where support animals in dorm rooms and apartments seem appropriate and helpful. I have also turned down requests from people just seeking an evaluation in order to obtain a letter of support.

Wednesday, January 30, 2019

MBH index - School lock downs 2017 - 2018

  • Number of children who experienced school lock downs in the U.S. 2017-2018 = 4 million
  • Number of school lock downs in the U.S. 2017 - 2018 = 6,200
  • Number of school lock downs, on average, per day in U.S. schools 2017 - 2018 = 16

Source - Washington Post as reported in The Week on 01/11/19

Editor's note:
There is growing evidence that school lock down drills are very traumatizing to children which raises the question of whether the benefit of such practices are worth the psychological and social costs.

These statistics also make one pause and consider what kind of a society we have become as a result of our love of freely available guns and what kind of a society we want for our future.

Is there a significant difference in fatal police killings from state to state?

There are huge differences in the number of people killed by police by state.

Click on image to enlarge.

From Peter Moskos' blog, "Cops In The Hood" on 01/01/19

"The national annual average (2015-2018) is 0.31 (rate per 100,000). And yet New Mexico is 0.98 and New York is 0.09. This is a large difference. 

Or take Utah (because of this story in the paper). Utah has a murder and violence rate below the national average, a low poverty rate, and is 90 percent white. And yet people in Utah are almost 5 times as likely an in New York to be killed by a cop. Utah has murder rate lower than NYC, 1/5 the poverty rate, far fewer cops, and Utah is 90% white. In 2018, the rate of people shot and killed by police in Utah is multiple times higher than NYC. 

I'd speculate significant variables are (in no particular order) training, fewer cops per capita, fewer cops per mile (no backup), one-person patrol, more guns, gun culture, more meth, more booze, and race (with more white states having more police-involved shootings). 

The ten leading states -- as in cops most shootingest states -- in rank order, are New Mexico, Alaska, Oklahoma, Arizona, Colorado, Nevada, Wyoming, West Virginia, Montana, and Idaho. It certainly seems like if we were to focus on the states that have the highest rates of police-involved shootings (and by far), we could find some low-hanging fruit to reduce the number of said shootings. But to do this we'd have stop thinking of police-involved shootings as primarily related to race. 

Collectively the top-10 states are 4.9 percent African American (compared to 13 percent nationally). These are the cowboy states out west. The 10 states with the highest percentage of black population (collectively 25%) have a rate of police-involved homicide (0.24) that is below the national average."

For more click here.

Editor's note:
I have added the bolding.
Another factor which Moskos does not mention is politics. The high shooting states are red states while the low rate states are blue. Political orientation while not a cause does seem to be correlated.

Indiana offers to pay student loans for Mental Health Professionals willing to work in 11 rural counties

From US News & World Report on 01/07/19:

"The Indiana Department of Health is hoping to entice mental health care professionals to work in rural and opioid-stricken counties in the state by offering to help pay their student loans.

"This program will help bring more qualified medical professionals to rural Indiana communities and expand access to quality treatment for individuals with substance use disorder,” Jim McClelland, the state's executive director for drug prevention, treatment and enforcement, said in a release on the initiative.
For more click here.

Editor's note:
I wonder if other states will offer similar programs?

Tuesday, January 29, 2019

Pediatricians should talk with parents about guns and their children.

From Science Daily on 01/28/19 -

Paradoxically, as overall firearm ownership decreased in U.S. households with young children from 1976 to 2016, the proportion of these families who owned handguns increased. This shift in firearm preferences over decades from mostly rifles to mostly handguns coincided with increasing firearm-mortality rates in young children, researchers report Jan. 28, 2019, in Pediatrics.

"Almost 5 million children live in homes where at least one firearm is stored loaded and unlocked," Kavita Parikh, M.D., a pediatric hospitalist at Children's National Health System, and co-authors write in an invited commentary. "This study is a loud and compelling call to action for all pediatricians to start open discussions around firearm ownership with all families and share data on the significant risks associated with unsafe storage. It is an even louder call to firearm manufacturers to step up and innovate, test and design smart handguns, inoperable by young children, to prevent unintentional injury," Dr. Parikh and colleagues continue.
The Children's commentators point to the "extremely dangerous" combination of "the small curious hands of a young child" and "the easily accessible and operable, loaded handgun" and suggest that pediatricians who counsel families about safely storing weapons tailor messaging to the weapon type and the family's reason for owning a firearm.
For more click here.

Editor's note:
  • There are more than 393 million guns in circulation in the United States — approximately 120.5 guns for every 100 people.
  • 1.7 million children live with unlocked, loaded guns - 1 out of 3 homes with kids have guns.
  • In 2015, 2,824 children (age 0 to 19 years) died by gunshot and an additional 13,723 were injured.
  • For more click here.

Dads Who Change Diapers in Public Get Help From New York Law

From Governing on 01/07/19

Change is coming to men's restrooms in New York -- and it's going to be a big help to fathers all over the state.
A new law requires all new or renovated buildings in New York that have bathrooms used by the public to make changing tables available to both men and women.
The rule, which passed in April 2018 but didn't go into effect until the new year, applies to restaurants, stores and movie theaters as well as state facilities such as parks and offices of the Department of Motor Vehicles.
For more click here.
Editor's note:
Another law which influences social change in enhancing the equality of the sexes. This law influences changes in norms and attitudes in a positive direction.

Monday, January 28, 2019

MBH index - People killed by police in U.S.

  • Number of people killed by police in the United States in 2015 = 995
  • Number of people killed by police in the United States in 2016 = 963
  • Number of people killed by police in the United States in 2017 = 987
  • Number of people killed by police in the United States in 2018 = 998
For more click here.

Books - The Square and The Tower by Niall Ferguson

Two organizing ideas about how society is organized can be described as hierarchies and networks. Both have existed throughout human history. 

Understanding social organization is important because the structures and dynamics of the ways of organizing social life at a marcosystemic level influence behavior at the microsystemic level.

Most of the macrosystemic organizing structures and dynamics are unconscious and as such, people don't understand why they think what they think, why they feel what they feel, and why they do what they do. The individual and the micro systems the individual is partipating in are influenced by higher level forces and dynamics. Knowing what they are is the source of social power.

Niall Ferguson does a good job tracing the operation of hierarchies and networks over the human history. Significant changes in human society were advanced with the printing press, transportation systems, and especially the internet in the last 25 years.

Ferguson points out that the democratization of society which the internet promises has been replaced by the manipulation of huge oligapolies like Facebook, Amazon, and Google. As we have seen in our last election in the U.S. in 2016, and with the Brexit vote in the United Kingdom, the manipulation of these communication mediums for the purpose of propogandizing populations is undermining the ability of citizens to rationally decide policy options for their governance.

The use of these communication systems to advance special interests which may run counter to the welfare of societies is a huge new threat in our modern age.

It is easy to manipulate people who don't know they are being manipulated. Raising the consciousnesses of the targets of these propoganda efforts is important to restore integrity to democratic processes.

Understanding the structure of the society within which one participants is a major contributor to healthy functioning.

The Square and The Tower is a book with important ideas. It earns a 5 out of 5 on the MBH book rating scale.

Federal Judge blocks Trump administration new rule letting employer health insurance deny birth control coverage

From Governing on 01/15/19
A federal judge in Philadelphia on Monday barred the Trump administration from implementing new rules that would let almost any employer deny female employees coverage for birth control by citing religious or moral objections.
U.S. District Judge Wendy Beetlestone found that the new regulations would make it more difficult for thousands of women to obtain no-cost contraception currently mandated under the Affordable Care Act and inflict an undue burden on states who would step in to pick up the tab.
For more click here.
Editor's note:
The ability to control and manage one's fertility is a significant factor in quality of life decisions which affect not only individuals but couples, families, communities, and the world.

Sunday, January 27, 2019

What is Bowen's idea of "differentiation?"

This is the first of several articles about major concepts in Murray Bowen's family systems theory.

Bowenian Family Systems theory has been a major cognitive map or model which informs my psychotherapy practice. It assists me in thinking and understanding my client's situations and I often share Bowen's ideas with my clients in the hope that understanding Bowenian concepts will be helpful to them in enhancing their self knowledge and in being purposeful and intentional in their interactions with others.

The topic of this article is on "differentiation."

Differentiation is simply "self knowledge," one of the major components of what is called "Emotional Intelligence."

How well do you understand what makes you tick? People who understand what makes them tick are described in collogquial terms as "having their shit together." Some people "have their shit together" and some people don't. Of perhaps a better way to think about this is "To what extent do I and other people have their shit together?"

This idea of self knowledge is based on Socrates statement that "an unexaminded life is not worth living." To what extent do you or others live an examined life? In psychology this capacity for examining one's own functioning is called "reflective functioning."

When the idea of differentiation is applied to our every day functioning, it makes one consider whether one's behavior is "reactive" or "responsive." Reactive means that your buttons get pushed and you just engage in a knee jerk response with no thought or impulse control. Responsive means that you are able to resist impulsively reacting, step back, get yourself and the situation into perspective, and then decide how to proceed in a purposeful and deliberate way.

The goal in life is to always be responsive and never be reactive. Jesus, Buddha, and other enlightened masters were always responsive 100% of the time. They were enlightened, self realized, self actualized human beings. Few of us become "masters."  If a person can be responsive 80% of the time and reactive only 20% of the time, they have become very mature, semi - awakened human beings.

The idea of differentiation can be useful in assessing marital, family, and organizational functioning because the level of differentiation of the individual has significant consequences for marriages, families, and organizations. These idea will be shared in the next article.

To be continued

Movies - On the Basis Of Sex

On The Basis of Sex is a movie about Ruth Bader Ginsberg's early life and career establishing her expertise in  advocating for women's rights in the U.S. in the later half of the twentieth century.

It is a five out of five on the MBH movie scale and is highly recommended.

Editor's note:
This is not only a biographical story about RBG but a good example of how social change is made in an intentional and deliberate way.

The norms, attitudes, beliefs, practices of a society are highly influenced in a democracy by the "rule of law." The impact of the changes in women's rights in a patriarchal society made by Ruth Bader Ginsberg's and others efforts are enormous. What is taken for granted today and "just the way things are" has not always been the case, and the recipients in todays society of the changes made by those who came before us deserve recognition, acknowledgement, and support.

This movie is informative on multiple levels and inspirational. It filled me with gratitude for the work that has been done to improve the lives of people in our society by what are called in Unitarian Universalism, "Words and deeds of prophetic women and men which challenge us to confront powers and structures of evil with justice, compassion, and the transforming power of love."

Saturday, January 26, 2019

Monroe County, NY jail offers treatment for opioid addiction

From WHEC NBC Channel 10 news on 01/17/19


For more click here.

American Psychiatric Association denounces Supreme Court decision to ban the service of transgendered people in U.S. military

From the Psychatric News Alert of 01/24/19:

"APA has denounced a Supreme Court decision handed down earlier this week that gave a green light to the U.S. military to restrict service by individuals who are transgender.

A sharply divided high court handed the Trump administration the victory for its policy banning transgender military service by a vote of 5-4, without discussing the merits of the case. In response, APA issued a statementcalling for the protection of transgender individuals’ civil rights and expressing great disappointment in the decision to lift the injunctions on the transgender service ban imposed by a lower courts.

After President Donald Trump signed the ban last March to disqualify individuals who are transgender from military service except under certain limited circumstances, four federal courts issued preliminary injunctions to block it. The Supreme Court decision lifts the injunctions and allows the ban to take effect while the cases challenging the policy continue to wind their way through the courts."

For more click here.

What does the devastation of the opioid epidemic look like on the ground?

Jan Rader is the fire chief, first responder, and a nurse in Huntington, West Virginia who describes her community's reponse to the opiod epidemic.

Huntington is a county of 95,000 people which, in 2017, experienced 1831 overdoses, and 183 deaths.

Rader describes some innovative programming in her community to deal with substance use disorder which as reached epidemic proportions not only in her county but across the U.S.


Editor's note:
I was the executive director of GCASA, the Genesee Council on Alcoholism and Subtance abuse in Genesee and Orleans Counties in Western New York state from 2000 - 2011. I continue to consult with counselors at GCASA who are obtaining psychotherapy superivision hours for their licensure.

The opioid crisis has hit Western New York hard as it has in Huntington. As Chief Rader describes, the deaths and crisis nature of the phenomenon are very difficult for people suffering from substance use disorder as well as their families, friends, and communities.

The opioid epidemic in 2018 created more deaths in the U.S. than car fatalities. It takes a whole community working together with people from multiple sectors to restore our communities back to an acceptable level of public health.

Friday, January 25, 2019

Tomorrow, January 26, is National Spouses Day

Celebrated annually on January 26th, National Spouses Day is an unofficial holiday which encourages couples to celebrate each other on this day. On this day, people are supposed to take time out of their busy schedule to show just how important their spouse is to them. After all, the love that isn’t tended is most likely the one that doesn’t thrive. This holiday shouldn’t be confused with Military Spouses Day – a holiday which falls on May 12th.

Interesting facts about marriage:
  • The average married couple has sex once a week
  • 20% of married couples have a sex-less marriage
  • Over 300 couples marry in Las Vegas every single day
  • Every hour, there are a 100 divorces in the United States. Couples who seriously dated at least two years or more before marriage have much lower divorce rates.
  • The divorce rates for second marriages is higher than for first marriages. 
  • The symtoms of marriage becoming toxic and breaking up are hurtful criticism, and the expression of contempt and disdain.
  • Interracial marriage was banned in the U.S up until 1967. The number of mixed racial marriages has been rising since then.
  • Gamophobia is the fear of commitment
  • Wedding rings go back to Ancient Egypt
  • Marriages and families are happier when there is at least a 5:1 ratio of compliments to criticisms.
  • There are five love languages: physical touch, words of affirmation, spending quality time, acts of service, recieving gifts
  • Most important thing people want from marriage is to know that their partner is going to be there for them.
  • The best kind of marriage is one characterized by unconditional love. This kind of relationship is holy.
For more click here.

What are cognitive distortions in CBT( Cognitive Behavioral Therapy)

Cognitive Behavioral Therapy or CBT is one of the strategies of psychotherapy which is often studied and sometimes referred to as "research based."

In general, when psychotherapy outcomes are studied, psychotherapy which applies some of the ideas of cognitive behavioral therapy, it is found that CBT gets good results usually as good, if not better, than psychotropic medications.

One of the significant ideas of CBT is what are called "cognitive distortions." Cognitive distortions are very common and often are engaged in unconsciously. The person is thinking in certain ways that interfere with the person's good functioning.

In the short video below, five cogitive distortions are identified:

  1. Emotional reasoning
  2. Disqualifying the positive
  3. Mind reading
  4. All or nothing thinking
  5. Catastrophizing

As I am fond of reminding my clients, "If you can't name it, you can't manage it." If you can't name the problem, you are doomed to be influenced by emotional and cognitive forces which you are not consciously aware of. Once you can "see it" and name it, you can think of ways to manage it.

Most people are not aware of how their psyche works and consciousness, knowledge, is power.

A skilled psychotherapist can help a person identify the cognitive distortions which are operating in the person's thought system. Once identified, the person has the power, then, of deciding how they can be managed and changed for the better.

Thursday, January 24, 2019

Movie - On The Basis Of Sex

On The Basis of Sex is a movie about Ruth Bader Ginsberg's early life and career establishing her expertise in  advocating for women's rights in the U.S. in the later half of the twentieth century.

It is a five out of five on the MBH movie scale and is highly recommended.

Editor's note:
This is not only a biographical story about RBG but a good example of how social change is made in an intentional and deliberate way.

The norms, attitudes, beliefs, practices of a society are highly influenced in a democracy by the "rule of law." The impact of the changes in women's rights in a patriarchal society made by Ruth Bader Ginsberg's and others efforts are enormous. What is taken for granted today and "just the way things are" has not always been the case, and the recipients in todays society of the changes made by those who came before us deserve recognition, acknowledgement, and support.

This movie is informative on multiple levels and inspirational. It filled me with gratitude for the work that has been done to improve the lives of people in our society by what are called in Unitarian Universalism, "Words and deeds of prophetic women and men which challenge us to confront powers and structures of evil with justice, compassion, and the transforming power of love."

How have your handled burnout in your career?

From "Burnout and Self Care: A Process In Helping" by David Papia, LCSW in The New Social Worker, Fall 2014
"Our social work profession is noble. This is a very special career path. We get to participate in important matters in people’s lives. We learn about ourselves, about others, and about humanity. We engage in giving and receiving, and we engage in relationships that further who we are and further those to whom we attend. However, our profession comes with many significant challenges and occupational hazards that threaten to weaken our profession and the resolve of the professional social worker.  
    We know that our profession has become deeply entrenched in managed care practices, bureaucracies and governing bodies determining our daily work conditions, very high caseloads, low salaries, and a profound amount of accountability expectations.  These realities and conditions can and sometimes do weigh very heavily. It is easy to recognize the feelings and sentiment of doubt and questioning: Should I continue in this profession? Am I enjoying my job? How can I sustain? We might even wonder if someone should consider entering our profession. As a father whose daughter has recently gone off to college and has an interest in social work, I notice myself being “on the fence” about her interest in our field."

Editor's note
This past October 31, 2018 I celebrated 50 years in the field of Psychiatric Social Work. It has been a very satisfying and fulfilling career because I have never seen it merely as a job. It has been a calling and something that I believe I have been called to do.
The money is terrible. The benefits are awful. The working conditions difficult and sometimes dangerous. The thanks and appreciation for efforts and skills expended meager. So why would anyone want a career and profession like this?
Because the human dilemna is fascinating. No two days or even hours in the day are alike. There is always something to learn and the problem solving activity is extremely creative as every person is special and unique. The overall faith that somehow the world is becoming a better place one person at a time is paramount and it is this faith that dispels burnout.
Dr. Susan McDaniel, the best mentor and teacher I ever had, told me one time after watching a family interview I conducted in front of a one-way mirror (with the family's permission), "Dave, If you aren't having fun you aren't doing it right," was the best feedback I have ever received about my clinical interviewing work.
So, whenever I am feeling stressed and burned out, I remind myself to lighten up. Am I trying too hard? How can I have a little fun and enjoy my interaction with this client(s)? And I smile and silently thank Dr. McDaniel for her wise encouragement.

Wednesday, January 23, 2019

New York State enacts the Reproductive Health Act on 01/22/19

Yesterday, 01/22/19, on the 46th anniversary of the Roe v. Wade ruling, New York State  enacted the Reproductive Health Act. 

With the Reproductive Health Act now enacted, a woman’s right to make personal decisions about her own reproductive health will be protected in New York State — no matter what the federal government or the Supreme Court do in the future.

Violent Crime down in U.S. 49% in last 24 years.

From Pew Research Center Fact Tank, 01/03/2019
Violent crime in the U.S. has fallen sharply over the past quarter century. The two most commonly cited sources of crime statistics in the U.S. both show a substantial decline in the violent crime rate since it peaked in the early 1990s. One is an annual report by the FBI of serious crimes reported to police in approximately 18,000 jurisdictions around the country. The other is an annual survey of more than 90,000 households conducted by the Bureau of Justice Statistics, which asks Americans ages 12 and older whether they were victims of crime, regardless of whether they reported those crimes to the police.
Using the FBI numbers, the violent crime rate fell 49% between 1993 and 2017. Using the BJS data, the rate fell 74% during that span. (For both studies, 2017 is the most recent full year of data.) The long-term decline in violent crime hasn’t been uninterrupted, though. The FBI, for instance, reported increases in the violent crime rate between 2004 and 2006 and again between 2014 and 2016.
Click on image to enlarge

For more click here.

Tuesday, January 22, 2019

Who gets the pet when couples split?

Who gets the pet when couples divorce? Only California, Alaska, and Illinois have any statutes on the books to help judges decide when couples can't with California being the last to pass such a law which took effect on  January 1, 2019.

For more click here.

New York State bans mental health professionals from providing "conversion therapy." in 2019.

From New York Times on 01/19/19

Between 2012 and 2018, 14 states and Washington, D.C., passed laws prohibiting “conversion therapy” for minors. Deep-blue New York was not among them.
That finally changed this month when the State Legislature voted overwhelmingly to bar mental health professionals from working to change a minor’s sexual orientation or gender identity.
For more click here.
Editor's note. I have practiced in the mental health field for over 50 years and have seen great changes in professional and public attitudes towards homosexuality. As a Professional Social Worker I have worked with my colleagues to diminish and eliminate the homophobia in our society. I have worked with many clients who have been harmed by homophobia and have striven to provide acceptance and unconditional positive regard for the worth and dignity of every person. It is a great joy to see this law passed in the New York State legislature at a very fittiing time in the calendar year when we also celebrate Martin Luther King, Jr. day.

In our contemporary society do we have two adulthoods?

Psychotherapy Stories

Episode 11, Two adulthoods

With our expanded life expectancy in contemporary times, people are faced with two adulthoods: the period of 20-50, and 50 - 80. The first adulthood we are biologically programmed by Mother Nature to mate and procreate and assure the continuation of our species. The second adulthood engenders all kinds of existential anxiety because Mother Nature doesn't help us at all. How have you, are you, or will you negotiate this transition from adulthood number one to adulthood #2?