General

Help Support TILT Magazine

A longtime colleague of mine, DeeAnna Nagel, has asked for my help, and I'm glad to oblige. She and co-founder Kate Anthony started a beautifully produced publication called TILT Magazine to help mental health professionals and students better understand how technology impacts their profession. Where does a therapist go to learn about online interventions? How is cyberculture impacting the way people get help for a mental health issue?

Now they need your help in crowdfunding the continued production of the magazine through 2015 -- and I hope you'll take a moment to consider their plea.

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General

The Lie of Focusing on Those with Serious Mental Illness

I've long scratched my head at one of the arbitrary political lines drawn in the sand in the world of mental health and mental illness advocacy -- "serious mental illness." (Some people refer to it as "severe mental illness," but the correct term is "serious.")

Focusing on this division is a lie. It is a lie told to Congress and to the public with earnest testimonials. But also with little evidence that it represents a valid -- or meaningful -- scientific distinction.

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ADHD and ADD

Why No One is Talking About the Possible Overdiagnosis of Autism

With the latest CDC figures out, it appears autism is now appearing in about 1 in 68 children in the United States. The disorder -- now officially known as autism spectrum disorder -- is being diagnosed at a rate that represents a 30 percent increase from 1 in 88 two years ago.

What's amazing to me is that I couldn't find a single media report that floated the idea that this increase represents an overdiagnosis of the disorder. While "overdiagnosis" seems to be the first thing suggested when the topic is attention deficit hyperactivity disorder's (ADHD) huge jump in diagnoses over the past two decades, it's not mentioned in any description of autism's increase.

Why the double-standard?

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Disorders

Help Us Win This Design Challenge in Mental Health


It's not everyday I turn to our readers for their help, but I'm going to do so with the first design challenge Psych Central has entered. Along with my colleague and regular Psych Central contribute (and an "Ask the Therapist") Marie Hartwell-Walker, Ed.D., we've submitted an entry we'd like you to vote for.

Your vote matters, so please, take the 20 seconds it takes to vote for our entry now (sorry it's not obvious, but the voting form is at the very bottom of the entry... so keep scrolling!).

If you'd like to read more about our thinking and entry behind the challenge, click through...

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General

Why Getting Good Mental Health Treatment is Complicated

As long-time readers of World of Psychology know, there's no easy fix to the convoluted, second-class mental health care system in the United States. People with mental disorders -- like depression, anxiety, ADHD or bipolar disorder -- are shunted away from the mainstream healthcare system into a patchwork quilt of "care" that varies greatly depending upon where you live, what kind of insurance you have (if you have any), and whether you want to pay cash for treatment instead of using your insurance.

It shouldn't be this way. It shouldn't be so hard to find a good treatment provider. It shouldn't be so complicated to get integrated care from a single practice.

Why is it so hard to get good mental health treatment in the U.S.?

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General

Why Waitlist Control Groups in Psychotherapy Research Studies Suck


It's long been recognized that the gold standard in medical drug research is a randomized, placebo-controlled study. While not without its faults, this type of research ensures that the drug being tested is more effective (and just as safe) as a pill that contains no active ingredients. That way, the data can show that secondary effects -- such as the act of taking a pill once a day or seeing a doctor for refills or collecting study data -- aren't the main cause of any benefits the research may find.

In psychotherapy research, there is no pill. So a long time ago, some researchers developed what they believed to be a similar control group as those receiving a placebo -- the waitlist control group. The wait-list control group is simply a group of subjects randomized to be placed on a fake "waitlist" -- waiting for the active treatment intervention.

But there are more than a few problems with this type of control group in research. In a word, waitlist control groups suck.

Here's why.

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Disorders

Lawmakers: Don’t Pass New Involuntary Commitment Bills Without Funding

Nothing angers me more than when the media -- and the public -- come down on those with a mental illness when we hear of another violent mass shooting. The vast majority of shootings and deaths in America are due to the ease-of-access to a handgun, and simply knowing the person you're going to kill (as most murders are conducted by people known to the victim). Mental illness does not enter into the picture in most homicides.

Well, wait a minute... There is one thing that angers me more than attributing a higher rate of violence to someone with mental illness. And that's feel-good but idiotic lawmakers across the country passing a new round of involuntary commitment bills in their state -- but leaving out any additional money to help fund these efforts.

Apparently common sense doesn't enter into a lawmaker's head when they author or lobby for the passage of such bills.

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Creativity

Answering the Question: ‘What Should I Do With My Life?’

What’s the first question exchanged when we meet someone new? You guessed it: “So... What do you do?”

In our culture, what you do for a living is inextricably tied to society’s perception of your worth. A stable job with a good salary is highly regarded, but we often look less lovingly upon the self-trained artist or entrepreneur who gives blood, sweat, and tears to make their vision possible.

Why is this? Is the number on your paycheck the true meaning of success?

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General

What’s the Point if Psychiatrists Don’t Accept Insurance, Medicare?

For all of the hailing of mental health parity rules and the affordable care act over the past year, few advocates in these discussions actually talk about the reality on the ground.

And that reality is that most psychiatrists -- about 57 percent -- don't accept Medicaid, the government's insurance for the poor. Which probably doesn't matter to you if you're not poor.

But what might matter to you more is how few psychiatrists accept private insurance or Medicare. According to a recent study, that number is at a surprising 55 percent -- and dropping.

What's the point of these laws if so few psychiatrists even accept this form of payment?

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Depression

Perimenopause & Depression

Research suggests, especially in women with a history of depression or susceptibility to a mood disorder, that reproduction-related hormonal changes raise the risk of depressive episodes.

A few recent studies have concentrated on the perimenopausal period (when women experience skipped and irregular periods), in particular, and found that women in the menopausal transition were up to three times more likely than premenopausal women to report depressive symptoms.

Let's take a closer look at perimenopause and depression.

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Bipolar

The Cost of Mental Illness to Employers & Employees

In a previous post, I asserted the need for people with mental illness who are functioning well to speak out about their success with their disease. I also spoke of the importance for people to hold themselves as examples of how one can live successfully and productively with a mental illness.

On second thought, you may want to be cautious about doing this at work.

Individual contributions help make companies successful, and surely people with mental illness contribute greatly to their employer’s success.

However, people with mental illness may also contribute greatly to their employer’s health care and productivity costs. All companies seek to minimize costs. In doing so they may limit opportunities available to those with a known mental illness in order to avoid the significant costs often associated with psychiatric conditions.

How much does an employee with mental illness cost?

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Books

Bibliotherapy: Do You Really Need a Doctor or Government to Tell You to Read?

In an article that notes there are over 100,000 self-help books (I think the actual number is much larger, since Amazon lists over 285,000 in-print self-help books), apparently Leah Price is enamored at the thought of a doctor "prescribing" reading. And a government agency -- the UK's National Health Service -- endorsing the idea.

The idea of a "prescription" for a book is as ridiculous as the idea that you need to be told to shower regularly to remove the stink. Reading to understand something better is a basic skill nearly everyone should have learned in grade school.

That's patient paternalism x2: that only a doctor could be knowledgeable enough to recommend a good self-help book and that the government needs to legitimize this practice.

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