How to Cover A Suicide August 29, 2010Posted by Crazy Mermaid in mental illness, Suicide.
Tags: mental illness, Suicide
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This information was taken from a website addressing how to cover news event associated with suicide. http://depts.washington.edu/mhreport/WA
Quick Tips to Improve Mental Health Reporting
Tips for Reporting on Suicide
Copycat/ Suicide Contagion is real. Research shows that the incidence of suicide increases following news coverage of suicide. The following guidelines are suggested to minimize copycat attempts:
- Refrain from using photographs of grieving relatives and friends when a suicide has occurred. Photographs might encourage someone contemplating suicide to act as a way to get attention or get back at someone, creating a dangerous copycat effect. Youth are especially vulnerable to these effects.
- Do not report the method or place of suicide in detail. Exposure to suicide methods, including photographs, can encourage imitation among vulnerable individuals.
- Do not portray suicide as a heroic or romantic result of a single event or cause. This obscures the long and painful process that results in completing suicide. Over 90 percent of suicide victims have a significant psychiatric illness at the time of their death.
- Always include information about crisis intervention services in the area and a referral phone number.
- Do not use suicide in headlines, even when they take place in public. This unnecessarily dramatizes the event and shifts the focus from the tragic loss of life. There are exceptions, as in the term “suicide bomber” when reporting on terrorist activities.
Facts About Mental Illness and Suicide
The great majority of people who experience a mental illness do not die by suicide. However, of those who die from suicide, more than 90 percent have a diagnosable mental disorder.
People who die by suicide are frequently experiencing undiagnosed, undertreated, or untreated depression.
Worldwide, suicide is among the three leading causes of death among people aged 15 to 44.
- An estimated 2-15 % of persons who have been diagnosed with major depression die by suicide. Suicide risk is highest in depressed individuals who feel hopeless about the future, those who have just been discharged from the hospital, those who have a family history of suicide and those who have made a suicide attempt in the past.
- An estimated 3-20% of persons who have been diagnosed with bipolar disorder die by suicide. Hopelessness, recent hospital discharge, family history, and prior suicide attempts all raise the risk of suicide in these individuals.
- An estimated 6-15% of persons diagnosed with schizophrenia die by suicide. Suicide is the leading cause of premature death in those diagnosed with schizophrenia. Between 75 and 95% of these individuals are male.
- Also at high risk are individuals who suffer from depression at the same time as another mental illness. Specifically, the presence of substance abuse, anxiety disorders, schizophrenia and bipolar disorder put those with depression at greater risk for suicide.
- People with personality disorders are approximately three times as likely to die by suicide than those without. Between 25 and 50% of these individuals also have a substance abuse disorder or major depressive disorder.
Depression versus Bipolar Disorder August 24, 2010Posted by Crazy Mermaid in Bipolar Disorder, Depression, Medication, mental illness, Mental Illness and Medication.
Tags: Bipolar Disorder, Depression, mental illness
The stigma of having a mental illness has hit in yet another tangible way.
For the second time in a row, a friend who has suffered for years from depression went to a psychiatrist because her medication was no longer working for her Or at least it was no longer working well enough for her. She had been on an anti-depressant for about 15 years, but had wearied of the side effects. So she had gradually weaned herself off all but a tiny amount of the medication. When she recently encountered a tremendous amount of stress, she got very depressed and a severe panic disorder reared its ugly head. In desperation, she went to see her General Practitioner, who referred her to a psychiatrist. She made an appointment with that psychiatrist but the earliest she could see her was 2 weeks out. So she waited it out, trying her best to work though her bouts of panic disorder and depression.
Two weeks later, arriving at her new psychiatrist’s office, she was given a battery of questions and interviewed at length by the psychiatrist. Finally, after much interrogation, she was diagnosed with Bipolar Disorder Type 2.She wasn’t devastated at the news but she was definitely unpleasantly surprised as she relayed the turn of events to me. She had expected her new psychiatrist to simply regurgitate the previous diagnosis of depression, and it hadn’t occurred to her that her diagnosis might be something else.
In her mind, she had depression. End of subject. She never considered the possibility that she might have anything else. In most people’s minds, depression doesn’t really qualify as a mental illness. It isn’t spoken of in the same breath as schizophrenia or Bipolar Disorder, which are both generally accepted by society as full-blown mental illnesses. With depression, it’s socially acceptable to admit you have it and that you’re taking medication for it because nobody considers you to have a mental illness. But with Bipolar Disorder you can’t hide from that label “mentally ill”.
With Bipolar Disorder, society in general puts that problem into the mental illness category. There’s no getting around the fact that it’s a genuine mental illness. And with having a mental illness comes all of the stigma associated with such a thing.
Furthermore, the use of an anti-depressant for treating depression is commonplace. There’s even a book called “Prozac Nation” that intimates that many, many people are on Prozac. It isn’t viewed as a mental illness in part because too many people have it. A mental illness is thought by the general public as being something that is uncommon. Depression is not uncommon.
According to her new psychiatrist, the medication for Bipolar Disorder Type 2 is a mood stabilizer. The concept of being put on a mood stabilizer rather than an anti-depressant is bad, because of the stigma associated with a mood stabilizer. By definition, it means that your mood needs to be stabilized. That your mood is unstable. That your mind is unstable. That you are unstable. All of the negative ramifications of having an unstable mind come to the forefront.
It’s okay to suffer from depression, which doesn’t have the connotation of instability. You might feel terrible- possibly like committing suicide- but at least you’re not considered to be unstable or out of your mind. But Bipolar Disorder Type 2 is another story. With Bipolar Disorder, you’re unstable. That’s why you need a mood stabilizer. And, as the theory goes, people who are unstable have all kinds of problems. They’re not to be trusted.
No matter than with the mood stabilizers the thoughts of depression go away. No matter that they feel better than they have for years. The important thing, in their mind, is the stigma associated with having to take a medication that makes them stable. It means that they weren’t stable to begin with.
It will take my friend awhile to come to grips with this new reality. In fact, she plans to visit another psychiatrist to get another opinion. In the meantime, although she can hope that her diagnosis is wrong, I hope that she will continue to take her mood stabilizer.
Suicide and Mental Illness August 19, 2010Posted by Crazy Mermaid in Medication, mental illness, Mental Illness and Medication, Psychiatrists, Suicide.
Tags: mental illness, Mental Illness Medication, Suicide
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While at the NAMI Conference this past weekend, I was exposed to the concept of suicide in all its forms except for one. With the exception of seeing someone actually commit the act in front of me, almost all other aspects were covered in some form by someone or something at the conference.
There was the mother/daughter team that dealt with attempted suicide many times as a symptom of the daughter’s bipolar disorder. There was the wife who serenaded us about her survival from her husband’s unexpected suicide. There was the daughter whose father committed suicide during the filming of a documentary about him (“Unlisted”). There was the woman whose son committed suicide (“When Medicine Got It Wrong”). Suicide was everywhere. There was even a booth addressing the various aspects of suicide, all from the standpoint of the family.
Missing was in-depth coverage of suicide from the perspective of someone who considered it or tried it. I know these people are around. I qualify for the first part and know people who qualify for the second part.
Back in July 2008, after I was released from the mental hospital, I had a major relapse of symptoms. The choice I was given by my psychiatrist was to either return to the mental hospital or go on a drug called Haldol.
Wishing to stay out of the hospital at any cost, I chose the Haldol. I should have had a clue about the task I was to undertake (stopping the psychotic symptoms dead in their tracks) when I had trouble filling the prescription. The usual dose carried by pharmacies is .5 mg. My prescription was for 5 mg. Calling around to various pharmacies, we finally found a Fred Meyer pharmacy that carried the dose I needed.
Taking the pills the second I got in the car, I felt the symptoms subside within hours. But the prescription said to continue the Haldol beyond the point that the symptoms disappeared. As I continued the Haldol, I became more emotional, crying at nothing at all. My husband took me to a very nice restaurant for our 25th wedding anniversary, and I could do nothing but sit across from him and cry. Fortunately it was summertime, so I had an excuse for wearing dark sunglasses. It was a miserable time for both of us.
At around the second week of taking the drug, I got the twinge of a desire to commit suicide. As the days progressed, my desire got stronger. I cried and cried, wanting desperately to end my life. I spent hours thinking about the method I would use to do it. That was my sole focus. My guns were gone, confiscated by my dad as a condition of my release from the mental hospital. I didn’t think I could get away with a knife because someone would stop me. The same went for pills. I was stymied. I didn’t care one ounce about the people around me, who it would hurt, what kind of a terrible wake it would leave behind me. None of that mattered. All that I could focus on was how good it would feel to be dead.
In the meantime, my psychiatrist had given me his emergency telephone number during my first visit with him a month before, with strict instructions to use it to contact him during a crisis. Interestingly enough, I didn’t want to bother him with my crisis. Despite my family begging me to call him, I repeatedly refused to call him to tell him about what was going on. As I lay there suffering, my family swarmed around me, not knowing what to do. They were helpless. They were scared. They wanted to make the emotional pain go away, but they didn’t know how.
Finally, I was persuaded by my husband and sister that this was precisely the condition my doctor meant when he gave me his emergency number. So, after much cajoling, I made that call to my doctor. But he didn’t answer the phone immediately. So I left him a message, and then I got up from the couch that I had been sitting on and walked around the room. I felt a little better after having made the call, but I still felt like committing suicide.
Besides imparting the urge to commit suicide, one of the other side effects of Haldol was that it increased my anxiety level. Not able to just sit around and wait for his call, I decided to take a walk. I thought the activity would be good for me. My family didn’t know whether to leave me alone while I went on the walk, fearful that I might find a way to commit suicide while I was out. In the end, they decided to let me go for the walk unaccompanied. In hindsight, I realize that their decision could have been a huge mistake had I realized that all I had to do to die was to step in front of a moving car.
In the meantime, while I was on my walk, my doctor called. As I wasn’t there to take the call, he talked with my husband instead. He probably did a better job of explaining what was going on, being more objective that I could have been. When I returned from my walk, my husband told me the doctor said to stop the Haldol immediately. As I discontinued the Haldol, it left my system over a period of days. As it left my system, my suicide desire gradually left. But my family couldn’t be sure exactly when I was out of danger, so they continued to swarm around me, trying to assess when the danger was gone. Finally they satisfied themselves that I was out of danger and life returned to normal.
Having lived through this episode of wanting desperately to commit suicide due to a reaction to a medication, I am convinced that most, if not all, suicides are caused by brain function impairment of some sort. The brain chemistry of the suicide victim gets messed up, just like mine did. But the difference is that they aren’t put on “suicide watch” and aren’t under the care of an experienced psychiatrist. Those two things are what saved my life.
Eastern State Hospital (WA) and Photovoice August 18, 2010Posted by Crazy Mermaid in Involuntary Committment, Mental Hospital, mental illness.
Tags: Insanity, Mental Hospitals, mental illness
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At a recent NAMI Conference I attended this past weekend, I had the privilege of listening to Dr. Jeff Ramirez and Ms. Elaine Alberti discuss the culture of Eastern State Hospital (http://www.dshs.wa.gov/mhsystems/esh.shtml). Housing involuntarily committed civilly committed patients as well as patients who have been acquitted of committing crimes due to the fact that they were found Not Guilty By Reason of Insanity, the hospital is located in Medicine Lake, a rather isolated part of the State.
Dr. Ramirez and Ms. Alberti brought with them a wonderful Photovoice display, which showcased the work of some of the patients. Bringing the voice of hospitalized patients to the outside world, the powerpoint was a very powerful demonstration of the sometimes-forgotten humanity behind the various incarcerated individuals housed at that facility.
In an experiment designed and conducted by a clinical nurse specialist, a group of patients had the opportunity to participate in photo sessions in which they took pictures every other week. Photos were taken in and around the hospital grounds. Patients were not allowed to leave the grounds in order to take photos.
Taking four photos at each session, those photos were developed for the patients. Then, during group sessions, the photos were handed out to each patient. Patients put meaning and interpretations to their photos, sharing those meanings and interpretations with the group.
The clinical nurse specialist in charge of the program assisted the group in categorizing the narratives into four overarching themes: finding meaning, expressing anger, fighting stigma, and finding hope. Each of the photos were identified as belonging to one of those four groups. The resulting collage of photos were combined and set to music, and the end product was shown to the staff as well as others. Giving voice to the patients, it presented itself as a strategy to help reduce seclusion and restraints. Delivering a powerful message to all who saw the presentation, it resulted in a 96% reduction in restraint use.
Unfortunately, one of the unintended consequences of the escape of Philip Paul, the Eastern State mental patient, included the dissolution of this program. For about 4 months after Philip Paul’s escape, patients were in total and complete lock-down, unable to even get to their treatment mall to receive their medication much less take photographs even inside the hospital grounds.
For those unfamiliar with his story, Philip Paul was incarcerated at Eastern State Hospital in eastern Washington for the death of Ruth Motteley, a woman whom Paul thought was a witch. He said that voices in his head told him to kill her, and he obeyed them. Diagnosed as a paranoid schizophrenic, he was found not guilty by reason of insanity and taken to Eastern State Hospital, where he has been held on and off since April 1987, escaping from a field trip to a fair on September 17, 2009. The history of his incarceration can be found in a September 21, 2009 article in the Spokane Review (http://www.spokesman.com/stories/2009/sep/21/key-developments-pauls-legal-history/).
It’s unfortunate that a program with the success rate of this one has been cast aside because of the behavior of a few.
Tags: Escalating Healthcare Costs, Involuntary Committment, Mental Hospitals, mental illness
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$58,752. Take a good look at this number. It’s the cost for 18 days of room and board (no additional services like medication and Dr. visits are included) at Fairfax, a private mental hospital in Kirkland, Washington.*, where I was involuntarily committed back in May 2008 to mid June 2008. That breaks down to $3,900.20 per day for the first 10 days and $2,468.75 for the final 8 days.
At Eastern State Hospital (WA), a comparative public facility, the average cost per day for a stay there is $524 per day. My stay there (room and board ONLY) would have cost $9,432. At Western State Hospital in Lakewood, Washington, also a public facility, the average cost per day is $438. My cost for 18 days of room and board there would have been $7,884. Fairfax, a private hospital, charged over six times as much for the identical service. What’s wrong with this picture?
It gets even better. At these rates, if 25 patients pay $3,900 a day, Fairfax grosses $97,000 a day. If the beds stay full for a year, Fairfax grosses $35 MILLION dollars.
My family and, by extension, I, had no say in whether I would be involuntarily committed, much less the location or cost of my commitment. The State of Washington made the determination that I would be involuntarily committed. Because it was an emergency situation, forced on me, my family had no opportunity to explore the various facilities and then do a cost comparison. Even if we had known the cost, we had no choice. Fairfax was the only mental health hospital in the State with a bed. The State of Washington was forcing me to be involuntarily committed (against my will). I had to go somewhere, and Fairfax was the only place with a bed. That’s why I went there. Fairfax had me over a barrel, with no other options. They took advantage of the situation to make their stockholders a little richer.
Lest you think I was at Club Med, let me rid you of that misconception. The food was cafeteria-style, brought to us on trays stacked in a three foot high mobile metal tray rack. Built in the 1960′s, the building has not undergone any visible major or minor remodeling since its inception. As it is a private hospital, the public information disclosure required by the State hospitals is not required of it. My stay there was not in some kind of padded room. It was in a plain old regular dorm room, similar to one you’d find at an old college. Granted, the doors to the outside were locked 24/7, but the facility itself was run-down. Unlike Western and Eastern State Hospitals, there is no website data from Fairfax citing its daily cost. It’s a private facility.
Oh yeah: one more thing. Fairfax is owned by Psychiatric Solutions Inc. (PSI). Please join me in congratulating PSI for making Fortune Magazine’s list of Top 100 Fastest-Growing Companies:
FRANKLIN, Tenn., Aug 18, 2009 (BUSINESS WIRE) — For the fourth consecutive year, Psychiatric Solutions, Inc. (”PSI”) (NASDAQ: PSYS) has made Fortune magazine’s list of the Top 100 Fastest-Growing Companies. It is the only Tennessee company to make this year’s list, as it was in 2008 and 2006. https://www.psysolutions.com/facilities/news/fortune-magazine.html
PSI, which is the largest operator of psychiatric inpatient facilities in the country, ranked No. 98 on the list released by the magazine in August 2009, which considers factors such as revenue and earnings per share (EPS) growth rates. Last year, PSI ranked No. 64. In 2007 and 2006, it ranked No. 49 and No. 34, respectively.
How can they get away with this? Simple: There is more demand than supply for short-term mental health care facilities. Solution: build more short-term care facilities. I think that everyone would agree that $35 Million builds quite a few new facilities.
* Taken from Fairfax’s invoices to my insurance company.
Psychotic Wife Tests Marriage August 5, 2010Posted by Crazy Mermaid in Bipolar Disorder, Delusions, Hallucinations, Involuntary Committment, Mental Hospital, mental illness.
Tags: Bipolar Disorder, Delusions, Hallucinations, Mental Hospitals, mental illness
My nervous breakdown tested my marriage in a major way. I’m very lucky that my marriage has survived that horrible ordeal- at least for the present.
From the time the voices started in February to the time I was hospitalized in late May, the voices tried to convince me to divorce my husband of 25 years.
The first reason that the voices told me to divorce him was to protect my newly acquired $1.5 million jewelry collection. This collection included a supposedly “yellow diamond” ring acquired at Target for $20, which the voices assured me was actually a real yellow diamond ring worth a million dollars (not true) and an abalone bracelet that I bought from Goodwill that the voices said was an antique bracelet once owned by my Great-grandmother Mermaid and now worth $500,000 (also not true).
The second reason they said I should divorce him was that he was the real behind-the-scenes person responsible for locking me up in a mental hospital, and he was going to keep me there as long as he legally could (not true) and that my only chance of escape from my “prison” was to divorce him as soon as possible. So the first chance I got at the mental hospital I called my attorney to get the divorce proceedings started. But as the medication began to take effect, I lost the ability to follow through with my actions because I became lethargic and confused. Finally, as the medication began to cause the delusions and hallucinations to go away, I came to realize that my husband wasn’t really trying to keep me locked up, and that I really didn’t have a $1.5 million jewelry collection for him to go after.
After I returned home and began to realize the magnitude of the damage I inflicted both personally and financially, I became convinced that he was going to divorce me, and that he was just waiting for me to get well enough to divorce him. After all, why would he stay?
Besides the paranoia about what I perceived as my impending divorce, I was undergoing a major medication-induced identity crisis.
The reality was that Bob was free to divorce me at any time, and many less patient men would have simply walked away from me at numerous points. Some husbands would have left back in February or May, when I started talking about wanting a divorce, or in late May when I was spending tens of thousands of dollars. Others would have served me divorce papers in the hospital, as happened to some of my fellow patients. Still other spouses would have waited until I was on my feet again, able to take care of myself, before cutting the cord.
He put up with the trials of living with a woman going through a severe break with reality, including the delusions and paranoia that accompanied the break. He watched helplessly as an out-of-control woman who was legally still his wife but whom he didn’t recognize begin to dismantle his financial future by spending thousands of dollars on clothes and plants and even a $50,000 Lexus convertible.
Then, he suffered through the three weeks I spent at a mental hospital, unable to share that fact with anyone due to the tremendous stigma attached to that fact. As if the fact that I was at a mental hospital wasn’t shocking enough, he found the courage to visit me on a daily basis, despite my less-than-pleasant reception ( I thought he was holding me there on purpose against my will). He didn’t understand what kind of world I inhabited, but realized that I wasn’t really “there” when he visited me, but nevertheless suffered through his daily visits with me anyway. He watched as I tried to take up smoking. He listened when I continued to ask him for a divorce, even listening patienly as I gave him a piece of paper that represented a preliminary breakdown of the assets I planned to receive in our upcoming divorce settlement.
Even when he saw that I was not getting better, and when I ignored him when he visited, he still hung in there. He understood the very real possibility that my mind might be forever locked up in my fantasy world, unable to return to the real world. He realized that he might have to take care of me – what was left of me- alone, might have to raise our kids- alone.
My real road to recovery didn’t begin to materialize until several weeks after I was released. But as the medication that would bring me back to the real world began to take effect, the side effects from the medication were another nightmare. Depression, suicide thoughts, Parkinson’s disease symptoms, grogginess, fainting, constant crying, weight gain, and a myriad of other medication-induced symptoms became the norm. I couldn’t read, couldn’t drive, could barely walk, had balance problems, couldn’t comb my hair or peel a banana or make my bed. I was anxiety-riddled, having to have my days planned out to the last minute or I’d become miserable. I was almost totally helpless, and there was no guarantee that my physical health would ever return. He supported me through that horrible period without complaint. He was always there for me.
As my side effects slowly began to diminish over time, and as I again returned to the land of the living, some of the pressure is off. But without the love and support of him and my family, I would still be in the psychotic world, disconnected from reality, for the rest of my life. I’m one of the few lucky ones who has managed to find their way back.