Mental health

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Prescriptions for Antidepressants Have Increased by 30% Since 2016

Published by Anonymous (not verified) on Tue, 10/05/2022 - 12:41am in

While NHS spending on antidepressants increased above inflation over four years, mental health care in England remains in crisis. Sian Norris reports with the Byline Intelligence Team

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The prescription spend on antidepressants has risen from £266 million in 2016 to £374 million in 2020 – an inflation-busting 30.06% in a four year period. 

The data analysed by the Byline Intelligence Team, revealed during Mental Health Awareness Week, is based on the NHS Prescription Cost Analysis report for England. It shows that, alongside the rising prices of heart disease treatments and diabetes drugs, some medicines are seeing above inflation cost increases that are putting pressure on NHS budgets and GP budgets in particular. 

Between January and March 2021, a total of 20.2 million antidepressant drugs were prescribed in England: a 3% increase from 19.6 million items for the same quarter in 2019/20. The majority of those prescriptions were for selective serotonin reuptake inhibitors (SSRI) medicines.

The mental health impacts of lockdowns meant that more people were seeking antidepressant prescriptions than had initially been forecast. Between March 2020 and March 2021, there were 803,000 more antidepressant prescription items issued than expected based on historical trends. The NHS Business Services Authority noted that while this was higher than expected, it was not a “significant increase for the period”. 

In 2021, 5,203 suicides were registered in England: equivalent to a provisional rate of 10.5 suicide deaths per 100,000 people. The Office for National Statistics noted that this was a small increase from 2020, but one that most likely reflected the resumption of coroner’s inquests following the initial COVID-19 lockdown periods in 2020, as opposed to a genuine increase in suicide. In 2016, the suicide rate in England was 9.5 per 100,000 people. 

Although the data analysed by the Byline Intelligence Team represents a significant rise in prescription cost of antidepressants since 2016, it’s important to note that this may not indicate a rise in the number of people diagnosed with depression. SSRIs can be offered to people living with post-traumatic stress disorder, anxiety, and even menopausal symptoms such as hot flushes.

Other reasons why prescription costs may have increased is due to doctors prescribing more frequent prescriptions for the same number of patients (e.g. providing a packet of pills that cover two weeks, rather than one month – this can be a safety measure for vulnerable patients); and could be linked to a small increase in the same number of patients needing treatment for a longer period of time. 

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Mental Health Crisis

While there may be numerous explanations for why the spending on antidepressants has increased, it remains the case that mental health care is in crisis in the UK.

People with severe mental illness are far more likely to die prematurely (before the age of 75) than their peers – and the number of people dying early has increased. 

Data for 2016 to 2018 for England showed that over the three year period, 95 people with severe mental illness died per 100,000 adults. Based on the same data set, in England people with severe mental illness are 4.5 times more likely to die prematurely than those who do not have a similar diagnosis. The inequality in life expectancy is the same for men but greater for women, who are 4.7 times more likely to die prematurely than their female peers.

Worryingly, the inequality for excess premature mortality has increased over time. For all people with severe mental illness, the increase in the excess premature mortality was 355% to 365% – or 10% – when comparing data for the periods 2015 to 2017 and 2016 to 2018. For men it was a 9% increase; for women 10%. 

Beyond prescriptions for antidepressants, people struggling with severe mental illness are facing barriers to accessing appropriate treatment.

As previously reported in this paper, the number of mental health patients receiving treatment out of area is concerningly high. The latest data for January 2022 shows that in England, 700 of 770 placements are considered to be “inappropriate”, or where “patients are sent out of area because no bed is available for them locally, which can delay their recovery”. 

The highest rate of inappropriate placements is in the North West, where 100% (215 out of 215) of placements were found to be “inappropriate”. 

There are limitations to the data, for example, only 79% of organisations providing acute mental health care participated in the collection for January 2022. The data only includes out of area placements that have started since the beginning of the collection: 17 October 2016.  

Of the patients placed out of area, 60 in England were being treated more than 300km from their homes. The majority (235 patients) were being treated 50-100km away. 

While there are some examples where treatment out of area could conceivably be helpful – for example moving people away from toxic situations – overwhelmingly it’s agreed that going through treatment away out of area creates barriers to recovery. It can be harder for loved ones to visit a patient, patients are treated away from their support networks such as family and friends, and away from local specialist services which they may have previously engaged with.

There has been a 14% fall in the number of mental health beds from 2014/15 to 2018/19. Reducing the number of mental health beds has formed part of strategic commitment to support people in the community, however as the growth in out of area care shows, not all treatment can be provided in a community setting. 

Increasingly, what mental health beds are left in the NHS are being run by private providers: it is estimated 30% of mental health hospital capacity is now in the private sector – with 98% of private facilities’ earnings coming from the health service. In Bristol, North Somerset and Gloucestershire, 95% of mental healthcare beds are owned by private providers, and three-fifths are owned by US companies. 100% of patients in the South West (65) were being treated in out of area placements in January 2022. 

Additional reporting by Iain Overton

This article was produced by the Byline Intelligence Team – a collaborative investigative project formed by Byline Times with The Citizens. If you would like to find out more about the Intelligence Team and how to fund its work, click on the button below.

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Helping Forest Firefighters Battle a Different Kind of Burnout

Published by Anonymous (not verified) on Wed, 04/05/2022 - 4:39am in

Wildfire season is back. Over the weekend, hundreds of firefighters fought to contain a wildfire in New Mexico that forced thousands of people to be evacuated and destroyed at least 166 homes. In late April, more than 700 homes were evacuated as a “wall of fire” swept across parts of Arizona. Experts say such events are an early warning sign of what’s to come in the warmer months, with the situation heavily exacerbated by human-induced climate change and set to get even worse in coming decades.

The toll uncontrolled wildfires take on communities is enormous and well documented. Less discussed is the lasting, invisible mark these fires can leave on wildland firefighters after the wildfire season is over. 

In Canada, definitions of safety for wildland firefighter crews have previously centered almost exclusively on physical safety. And mental health resources, where available, haven’t been widely known, with any support offered predominantly limited to that provided after traumatic events. But a new preventative form of peer support is helping Canadian crews address the cumulative stress of their jobs before they get to the point of mental burnout or breakdown.

“When you defuse these things properly, then you have the potential not only to mitigate negative things but to enhance positive things and growth and new directions,” according to Erik Hanson of the BC Wildfire Service, who says he has experienced first hand the difference a preventative approach can make.

BC Wildfire launched Resilient Minds with help from ​​the Canadian Mental Health Association in 2019 following two unprecedented wildfire seasons. It was adapted from a successful pilot program serving City of Vancouver firefighters in 2016. In a few days of training, peer leaders learn to recognize and talk about early signs of stress among their ranks, as well as civilians, to help prevent further harm. While similar preventative, peer-led models for mental health exist in the U.S., Resilient Minds is the first program of its kind to be offered in Canada and is slowly gaining traction across the country.

The need for mental health support is apparent. Structural firefighters – those who work in cities or towns – have been shown to experience post-traumatic stress disorder at two times the rate of the general population. In turn, wildfire fighters are at higher risk of developing mental health conditions like depression, PTSD, and anxiety than the general public, according to Patricia O’Brien, a researcher and member of the PTSD clinical team for Veterans Affairs in Portland, Oregon, who adds that these conditions are often under-treated, if detected at all.

Firefighter helmet hanging in a locker room.Firefighter helmet hanging in a locker room. Credit: Michael Gabelmann, Flickr.

Since the 1990s, wildland firefighters have used what’s called Critical Incident Stress Management (CISM), an internationally recognized standard for debriefing and mental health support in response to traumatic situations, like an injury or death of a crew member. But CISM is reactive, a form of emergency first aid. In contrast, Resilient Minds and programs like it aim to build resilience through early intervention, something Hanson and his colleagues argue is more vital than ever as climate change increases the rate and intensity of wildfires, and as communities sprawl into forested areas.

“In the not so distant past, Erik [Hanson] and I would have almost exclusively fought fire in the forest. And now we almost exclusively fight fires in and around communities,” says Steve Lemon, who works with Hanson. “This has raised the stress response significantly.” 

Adding to the stress is the transient nature of wildland firefighters’ jobs which can make it hard to connect with family, community, and healthy routines, all of which buffer mental health impacts, says O’Brien. “They’re in high risk environments for a big chunk of the year. They’re with a team of people that they may belong to… and then fire season ends and often people kind of go their separate ways.”

For wildland firefighters, there’s no avoiding potentially traumatic events. And mental and physiological responses like sleep disturbances, depression, anxiety, and substance use are normal reactions to abnormal events. What Resilient Minds seeks to do is support individuals to process stressful situations in healthier ways.

Take the 2021 wildfire season in British Columbia, which will forever be known as the year the village of Lytton burned to the ground just after the highest temperature in Canada was recorded at 49.6C. As the long season came to a close, for the first time ever, crews across the province called in help to debrief. Not to review operations, or because of one traumatic incident in particular, but because “so much crazy shit happened,” recounts Hanson. “We know that part of keeping healthy is talking about this stuff.”

As well as communication, Resilient Minds helps wildland firefighters learn ways to manage stress through measures such as better sleep habits and healthy nutrition. They also cover what services are available, like CISM, counseling, and a dedicated crisis line. When team leaders go back into the field, they’re able to help break a barrier of stigma that has contributed to so many wildland firefighters suffering in silence.

“I’ve known five people within wildfire who have chosen suicide. That has left a really profound impact on me,” says Lemon, whose career spans 26 years. Forty-six first responders died by suicide in Canada in 2017 and this does not include those who are retired or no longer on the job. 

 Fallen Firefighters' MemorialThe Last Alarm statue honors all professional and volunteer firefighters who have lost their liv​es in the line of duty within British Columbia. Credit: Province of British Columbia, Flickr.

Today, the addition of two words to Lemon’s job title reflects a culture shift across the BC Wildfire Service — head of safety and wellbeing.  

“We don’t profess to be counselors or therapists ourselves,” he says. “But if coworkers can say, ‘Hey, it looks like you’re struggling here. Can I get you some help to talk to a therapist or counselor?’ That’s what we find the biggest benefit of it is.”

While these supports are in their infancy, according to O’Brien, similar peer-based programs are on the rise. Comprehensive Wellbeing and Resilience is offered in the U.S. In Ontario, they’ve adopted a Road to Mental Readiness training, which is used by the military. The long term impacts of these types of resiliency programs are still being studied. But they hold promise, especially when widely implemented before traumatic events.

At the outset of the Resilient Minds pilot study involving roughly 400 Vancouver firefighters, 30% reported having little to no knowledge about mental health. Coming out, nearly everyone surveyed reported feeling more prepared to respond to a colleague who may be struggling.

“Most workers will seek out support from people they know and from their community, before they will go to an outside therapist or counselor,” says Lemon. Since the Resilient Minds training, he’s noticed more leaders and supervisors in the field checking in with their staff to ask if there’s anything they’re struggling with. “It really just kind of opens the door and allows people to say, ‘I am feeling stressed,’ or ‘I am feeling burnt out.’”

In the past, says Hanson, the attitude was generally “let’s just suck it up and go forward”. Today, he says, the volume of calls to their 24 hour safe reporting line has gone up dramatically. Awareness is leading to new services, like phone apps and access to a mental health retreat for first responders called Honour House, and mental health conditions are now tracked as workplace injuries like physical wounds. They aim to have one in five wildland firefighters trained with Resilient Minds across B.C., to mirror their supervisor structure. Though they have yet to reach the target in some regions, Hanson and Lemon are hopeful as they work to adapt the training for all new recruits.

“In many cases, just like if you irrigate a wound, it doesn’t get infected and you don’t have to worry about it. It just heals,” says Hanson. “Ideally, if we put enough time and energy into Resilient Minds ahead of time, then people understand and they sort of see stuff coming.”

The post Helping Forest Firefighters Battle a Different Kind of Burnout appeared first on Reasons to be Cheerful.

Talking About My Generation: How the Conservative Party has Punished Young People

Published by Anonymous (not verified) on Fri, 22/04/2022 - 8:00pm in

From mental health services to tuition fees, the Government has damaged the welfare and prosperity of the next generation, says Daisy Steinhardt

The Government is decades into its war on young people. Disinterest in providing for the needs of children and young adults is endemic among an establishment that seemingly has zero interest in providing younger generations with financial or institutional support.

The interest rates on student loan debt for those earning under £41,930 is set to rise from 1.5% to 9% from September if the Government chooses not to intervene, new data from the Institute of Fiscal Studies shows. For those earning over that amount, the rates will increase from 4.5% to 12%.

If this alone isn't enough to deter young people from pursuing higher education, there are also new changes to loan repayment schemes for people beginning undergraduate degrees in 2023-24. Under this change, the repayment term after graduation will rise from 30 years to 40. The Treasury is now set to gain an estimated additional £600 million from student loans that would otherwise have expired after 30 years. 

Data from the National Office for Statistics (ONS) shows that the number of suicides among full-time students in England in 2019 was 174, up from 127 in 2017 and 154 in 2018. The dataset states that the ONS is “currently undertaking work to develop a robust method for understanding the risk of suicide among certain kinds of students”. Despite this assurance, a 2021 Freedom of Information request to the ONS asking for 2020 figures on the same dataset was denied on the grounds that “public authorities are not obligated to create information in order to respond to requests”.

Blatant disregard for young people is by no means exclusive to those pursuing higher education.

In 2017, after years of austerity cuts imposed by successive Conservative-led governments, a-third of NHS Child and Adolescent Mental Health Services (CAHMs) teams faced cuts or closures. As a direct result, the current average waiting time for young people to access CAHMs services is 15 weeks for an initial appointment and 54 to begin treatment. The only alternative to this lengthy waiting time is private mental health treatment, which many cannot afford. 

A report from Parliament's Health and Social Care Committee last December provided recommendations to the Government on the funding of young people’s mental health – including setting up a Cabinet sub-committee to bring together Government departments, local governing bodies and the healthcare system, in order to respond to the diverse nature of mental health care needs in young people.

Of the 25 recommendations, only three have been accepted in full by the Government, one of which is “subject to future funding decisions”. The Government’s official response is littered with examples of actions that have previously been taken to improve access to mental health services for young people – rather than assessing the state of the sector now, and what may be done to improve it.

Law-Breakers

As Maheen Behrana has written in these pages, the Government’s indifference to young people is part of its 'culture war' – the pitting of different groups against one another for cynical political purposes.

Four Nottingham Trent University students made national headlines in October 2020 after being fined £10,000 each for hosting a house party during the Coronavirus lockdown. All four were suspended from the university.

Boris Johnson, meanwhile, attended at least six of 12 events during lockdown, now being investigated by police – most notably his own birthday party at which he was “ambushed by a cake”, according to one of his MPs.

Johnson and Chancellor Rishi Sunak are among those to have been issued with fixed penalty notices for breaking lockdown rules, amounting to just £50 each. Both have remained in post in the two highest offices of the land, without the imminent threat of suspension.

A few students being stupid and reckless, meanwhile, face years of debt and public shame – under laws put in place by the same Government ministers who broke them. Few Conservative politicians called for these students, and others in a similar position, to be given a second chance.

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The most recent large-scale protests against the Government’s treatment of young people came in 2010 and 2011 when student anger peaked at the Coalition Government’s proposed increase in university tuition fees and cuts to means-based educational support.

The Metropolitan Police’s response of kettling the protestors – encircling them in a huddle for nearly 10 hours at temperatures reaching almost freezing – was reported in the Telegraph as a firm and effective response to a “serious threat to public order”.

Then Prime Minister David Cameron described the protests as “extremely serious” and the actions of the student protestors as “unacceptable”. He too praised the police response. Boris Johnson in his position as Mayor of London stated that the protests were “intolerable” and that all those involved would be “pursued and face the full force of the law”.

The framing of these protests as riots by both the right-wing press and the Government helped to cultivate the national image of young people as violent, immoral and therefore implicitly deserving of the extortionate financial burden placed upon them.

The Government has failed and continues to fail the young people of the UK. It has decided that we are not electorally important and are therefore worthy of demonisation and contempt. The Conservative Party’s record will live long in our memories.

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Loving Machines: Mental Health by Algorithm Is Reshaping Care and Sociality

Published by Anonymous (not verified) on Sat, 16/04/2022 - 11:13am in

Online stores currently offer hundreds of mental health applications. These apps promise to enhance your coping mechanisms, relieve your stress, make you happy, fix your depression, and much more. As popular and diverse as these digital gizmos are, however, they occupy only one corner of the ‘mental health digital space’. In the rapidly changing field of mental health care, these emerging technologies are of special interest to cash-strapped state-funded mental health services, non-government agencies and private health companies alike.

In what follows, I examine a variety of mediated forms of mental health care, ending with the latest development, which is a particularly profitable commercial combination: the marriage of artificial intelligence (AI) with the industry’s most popular form of psychotherapy—cognitive-behavioural therapy (CBT). This pairing is noteworthy for at least two reasons. First, it has implications for the user-client’s sense of self and for the mode of sociality it calls the person to enact. Second, it points to an immensely lucrative market. Mental health is a huge and growing industry: the Kaiser Foundation estimates that around $200 billion is spent on mental health disorders in the United States every year. This has made mental health the ‘top’ cost category among medical conditions.

These latest developments have emerged in a field that is already roiled in controversy and contradiction. Even the notion ‘mental health’ is contested. Is it about wellness, an absence of mental illness, resilience, vitality, normality, quality of life, the demonstration of correct attitudes, genetics, biology? Yet the digital applications discussed below all work with a restricted notion of what mental health might be, as easily read in their limited view of the processes that constitute a self and how they understand a person’s ‘mental’ difficulties.

That CBT has a highly individualistic and mechanistic understanding of the person is in turn highly relatable to neoliberal ideology, which has been working its way through the institutions for decades, allocating the carriage of care to the lowest-level entity—the private self. In this allocation we find a kind of mental hygiene approach that is the grooming of ‘resilience’, an increasingly high-priority personal concern. The assumption is that, yes, life can be stressful, but it is the responsibility of each citizen to identify, manage and eventually overcome the ‘challenges’ that inevitably come their way.

Now the existing mix of mediated care-giving sees the introduction of newly minted forms of online care: delivered by bots, according to algorithms. These mediated forms, but especially the new digital techniques, are significantly de-territorialising the location-based, in-person setting of traditional therapeutic services. Among a range of impacts, a ‘keep-your-distance’ imperative seems to be slipping into place, disrupting received expectations of the respective roles and responsibilities of those who seek and those who offer help. Any form of mental health care presupposes certain ‘technologies of the self’, as Nikolas Rose reminds us, but the question is: what will the new technological forms of mental health care bring?

Under COVID

Technologically mediated therapy is not new, but during COVID it has been reframed in terms of necessity, and as something that should perhaps be embraced even after lockdowns end. This turn to digital is revolutionary. A hundred years’ worth of assumptions mandating the primacy of face-to-face, here-and-now interaction are in the process of being upended It is remarkable how quickly even the most august segments of the business adapted: within months of the pandemic’s arrival the International Journal of Psychoanalysis had published an editorial, ‘The Current Sociosanitary Coronavirus Crisis: Remote Psychoanalysis by Skype or Telephone’, advising members how to practise in non-face-to-face settings. Practical perhaps, but setting the context for more incursions to come.

More than simply pragmatic, it has been argued elsewhere that the digital turn in care is also moral. Australian policy grandees Ian Hickie and Stephen Duckett advised mid-2020 in The Conversation that ‘Australia’s governments must seize the opportunity that COVID-19 has created. Digital systems must now be viewed as essential health infrastructure, so that the most disadvantaged Australians move to the front of the queue’. It’s a proposition that packs ethical and rhetorical punch, and the equalitarian impulse is not to be rejected outright. But there are other problems with this kind of approach, as seen in the language of the queue, a recycling of the framework in which health services are treated as commodities. As Dylan Riley observed recently in New Left Review, health services are not goods, and they are not all of a type. In the field of mental health especially, care is not a ‘deliverable’—a product that can be shipped along a supply chain. Frameworks that position us as ‘consumers’ and ‘providers’ deny the reciprocities present in any health setting, but especially mental health settings. This interactionless vocabulary de-natures the actors, rendering one executant, the other passive recipient. As will be discussed, a lexicon of providers and recipients makes the shift into care-via-AI not only possible but even, it would seem, ‘logical’.

Of course, in the short term, and in some specific cases, there may be advantages in de-territorialising the therapeutic situation. Some clients have reported that online offers comfort: there’s benefit in the distance technology imposes. If the ‘other’ is mediated by a machine/screen, it is easier to quell anxieties regarding one’s interlocutor’s thoughts, feelings and judgements. On the ‘supplier’ side, some therapists see online as useful, with cuts in travel time and rental costs, and potential danger minimised as well.

So, for some patient-clients—the young person exploring their sexual diversity; the neuro-atypical person seeking non-corporeal contact—the advantages of distance might outweigh what others think of as the costs of being removed or hidden behind a screen. Similarly, questions of accessibility and convenience cannot be flatly dismissed. But if the normative condition of accountability and the complexity of ‘recognition’ that is built into face-to-face communication is put under threat by the extension and naturalisation of technological models, then we are entering new terrain. What does it mean that the helping ‘other’ is not present—or, in the most extreme example, that the other is an algorithm?

Mediated and online

A variety of online and other mediated formats are presently in use, each with their risks and rewards. Telehealth consultations are frequently described as ‘digital medicine’, and there has been huge growth in their use during COVID. To an extent this is a misleading description, as telehealth retains a person-to-person, if not face-to-face, relationship. It involves real-time contacts and, while mediated, they are synchronous. Asynchronous, non-face-to-face interactions and asynchronous written exchanges are less common, but they are on the rise. Examples are the ‘mood tracking’ apps such as the Monash University and beyondblue collaboration ‘MoodPrism’, in which clients map their states of mind.

A key difference between traditional care practices and the disembodied distance of telephone or video-based contact concerns touch. More precisely, what discriminates between mediated and face-to-face modes of relating is the actuality in the former, and the absence in the latter, of the possibility of touch. In one mode there is the possibility that kinaesthetic contact might occur; in technologically distanced contexts, even the possibility is precluded. Put more subtly, in situations of physical co-presence, as in face-to-face therapeutic situations, there is a sensitivity to the non-specific qualities of communication. Where there is person-to-person immediacy, the ambit of intimacy, what couples therapist Tom Paterson termed the ‘co-ordination of meanings’ is more likely. One can feel closer, or, alternatively, that the other, or oneself, has emotionally moved away. The potential for actual touch may be slight—it is unlikely your therapist will hug you, or attack you, unexpectedly halve or double the physical distance between you—but a degree of the tactile is provisionally built into the face-to-face therapeutic relationship, and meaning takes shape in the reference points it provides.

By contrast, in technologically mediated contexts there is an absolute guarantee that participants will not touch—will not ever physically interact. Because this is materially precluded, a particular ‘realm’ is created, one where a property that was once outside the control of participants is no longer so, and may now even be elevated as a right: the ‘right’ to be insulated from the possibility of contact.

Of course, differences between face-to-face and digital interaction go way beyond the matter of touch. For example, in-person encounters present a dense and dynamic milieu within which participants have to filter, and respond to, a multi-dimensional mix of external communications and inner experience. The psycho-social dance may be patterned by custom, but in the immediacy of here-and-now, in-person exchanges, there is always the potential for surprise. Depending on one’s disposition, that there is an edgy quality in co-presence can be seen as a formidable challenge, which needs to be acknowledged, and abated; or, the possibility of non-linearity in intersubjective situations might be welcomed as an element in, if not the sine qua non of, in-depth human relating.

In a promotional video for the MoodPrism app, we are told that daily monitoring and ‘mapping’ of an individual’s mood can allow the person to gain control over the patterns that produce feelings of anxiety or depression and thereby gain a greater sense of freedom. ‘Autonomy’ is on offer. The video ends with the friendly injunction: ‘MoodPrism, map your mood and learn more about yourself’. But here, the Enlightenment motto sapere aude, ‘Dare to know’, applied to the self, becomes an injunction to dare to know one’s data! Critical commentators such as Catherine Loveday, professor of cognitive neuroscience at the University of Westminster, point out the potential, much larger costs of this framing when she argues that the apparent freedom these applications offer is associated with self-preoccupation and a state of ‘degraded social interaction’.

As noted, then, some people experience the technologically mediated realm as ‘safer’, as less intense than the demands of unpredictable, in-the-moment, face-to-face encounters. Technological mediation appears to confer the advantage of a buffer, a diminution of circumstances that could lead to awkwardness. Offering a sense of control, distance means less communicational load, lightening the processing demands of embodied situations. Metaphorically, and sometimes literally, mediated exchanges even give anonymity; less judged and less pressed at a distance, and especially if the exchange is asynchronous, participants may have a very strong sense of freedom and release. But if this becomes the norm, it follows that clients will not only tend towards interpersonal wariness but will also miss out on the positive effects of relational co-presence on which care and therapeutic situations have typically depended.

Of a different order to these mediated forms is a more transformational technology again, one that introduces an even greater discontinuity with past practice. What happens when the client’s interlocutor is not human—when your interlocutor is an AI-driven application that simulates a form of sentience?

Cognitive-behavioural therapy

CBT, and its sibling rational-emotive therapy (RET), share the basic premise that the person is an autarkic unit whose presenting problem—depression, anxiety; for some, even psychosis—is produced by an individual’s problematic pattern of thought. This rests on the assumption that rational thought pursues what is best for the self. What is described as ‘rational’, ‘logical’, ‘correct’ or ‘positive’ thought is not to be evaluated against some ultimate standard; rather, it is to be judged on a ‘hedonic calculus’. Jettisoning the murkiness of intersubjectivity, the rational thinker calculates, and the user/consumer of this therapy will be taught to be more effectively self-centred. Albert Ellis, founder of rational emotive therapy (RET), and Windy Dryden put it this way in The Practice of Rational Emotive-Therapy: ‘rigid absolutism is the very core of human disturbances’. Alongside ‘flexibility’, ‘acceptance of uncertainty’ and a commitment to ‘long-term hedonism’, mental health is seen as conditional on the person’s ability to sustain ‘scientific thinking’, as ‘nondisturbed individuals tend to be more objective, rational, and scientific than more disturbed ones’.

According to CBT advocates, non-calculating thought is the result of defective ‘automatic’ thought patterns. These seem to be a variety of programming error, which can be corrected by standardising the subject’s inner cognitive life. The image is of a machine, either functional or dysfunctional; in the latter case, thinking is beset with operational errors, termed ‘distortions’ or ‘inaccuracies’, and the subject needs to be reprogrammed with a different form of automatic thinking, a regime that is properly ‘rational’, ‘correct’, ‘functional’.  Signing up to the project—admitting that your problems are due to the patterns of thought you take for granted—is the first step. In the critical literature this is referred to as ‘client socialisation’ and seen as deeply problematic; for CBT/RET practitioners it is called ‘insight’ or more simply ‘buying in’.

Unlike either the biological perspective on mental illness or analytic approaches exploring deep intra-psychic processes, CBT posits a clockwork-like inner process that is readily accessible verbally. This purportedly regular and predictable set of processes means the source of the problem—and appropriate intervention steps—can be rendered as reproducible segments of dialogue between client and therapist. Abstracted as protocols that absorb individual variations to pursue a known end, CBT assumes a kind of robotic organisation of the human mind. This assumed quality now seems to be attractive to the various corporations advancing AI machines dedicated to mental health interventions.

Alison Darcy, a psychologist and the CEO of Woebot, a high-profile private provider of online mental health services, has developed Woebot as an ‘automated conversational agent’. Leaving the Stanford Artificial Intelligence Lab to start up her company, she sees Woebot as ‘the future of mental health’. In the official publicity, the company intends

to bring the art and science of effective therapy together in a portfolio of digital therapeutics, applications and tools that automate both the content and the process of therapy. To develop technology capable of building trusted relationships with people, so that we can solve for gaps along the entire health care journey, from symptom monitoring to episode management.

CBT is not only practical but is the essence of a modern, evidence-based psychological method, according to Darcy. Opposing what she sees as a mystification muddling the psychotherapeutic field, Darcy describes CBT as accessible and structured. For her, and for others, this means CBT ‘lends itself well to being delivered over the internet’. Programmers are now busy proceduralising CBT: processing it into algorithmic form. Users type in responses to questions, are sent prompts, and receive guidance in the form of messages, emojis and videos. On official Woebot sites it is claimed that the online application is as effective as in-person CBT. Even more:

it may be easier to share your stress with a non-judgmental nonentity than friends, family, or mental health professionals, especially if you’re a person who spends all your time online and has come to find personal interaction offensively intimate.

The above is key:

the program’s non-human disposition [is] a surprising asset in comforting millennials. [In the trials] Testers were more willing to disclose personal information to an artificially intelligent virtual therapist than they were to a living breathing clinician.

Many individuals (and especially men), reports Darcy, are ‘not able or ready to speak to another human’. Part of it is shame, the other part is fear of stigma, which has often been considered a barrier to entry into therapy. ‘There is no risk of managing impressions. [Robots] are not going to judge you’, explains Darcy. ‘We’ve removed the stigma by completely removing the human.’

But it goes further. Awkwardness is minimised by the interlocutor’s machine status; but does this other have a persona? As a piece on fastcompany.com describes:

Darcy and her colleagues assigned a non-gender specific identity to their creation, which they infused with a dorky personality described as a mix between Kermit the Frog and Dr. Spock. But users quickly and repeatedly imprinted one on the digital pen pal. They referred to Woebot as ‘he’, ‘little dude’ and ‘friend’.

A taste of what is offered is signalled in the introduction, delivered by a therapist pictogram to first-use customers: ‘I’ll teach you how to crush self-defeating thinking styles’. Darcy is committed to ‘mak[ing] great psychological tools radically accessible’. And as with earlier programs where humans interacted with minimally sentient machines—the 1960s ELIZA experiments at MIT Artificial Intelligence Lab, for example—the Woebot official site claims users bond with their robot therapist.

Is there research on this claim? In a paper titled ‘The Digitalization of MH Support’ delivered to a 2020 lockdown conference, UK-based academic Ian Tucker presented his research into the use of AI-driven chatbots providing a mental health service to members of a community-based peer-support hub. He reported that service users overwhelmingly valued the use of AI-driven chatbots. The reasons given included ‘support [was] available 24/7’; service users ‘did not feel judged’; chatbots delivered ‘automated empathy’; and, rather than feeling stressed about ‘being on call to others’, it was good with a machine because there was ‘no expectation of reciprocity’.

Although this was a small study, might these responses suggest a particular orientation to self and other? Respondents appear to be needy and vulnerable (‘round the clock help is what we want’); sensitive to embarrassment (‘it’s good the machine did not look down on me’); wanting to be listened to (‘the machine is good at understanding me’); and reluctant to be there for others (‘I’m stressed and fragile, so give me a break: real people want too much of me’). This last take-out is especially interesting, as the hub these young people were attending describes itself as a ‘peer support’ service.

Might the format and content of this automated service be playing a part in shaping the subject position, and the understanding of respective roles and responsibilities, of its consumers? Does the use of a CBT-fuelled chatbot encourage mutuality, camaraderie and a sense of accountability, or might it summon self-concern, vulnerability, entitlement and the valorisation of convenience? Far from the assumed benefits of peer support, this instance of technological mediation—CBT-with-chatbot—may well be fostering I-centred, non-accountable forms of selfhood and promoting interpersonal illiteracy.

Ironically, while CBT maintains the importance of avoiding absolute and static understandings of selfhood, it has facilitated forms of digital mental health care centred on dogmatic attachments to diagnostic identity, together with repetitive cognitive actions. ‘Hey, if I’m not feeling good, it must be because I’m failing to put myself first with sufficient focus and assertion’; ‘I’m failing to complete the homework set by my app e-therapist’; ‘I’m failing to maintain the lifestyle associated with effectively managing my diagnosis’. Mental health care in this form is encouraging recipients to see themselves as automata that can regulate their states by modifying their inputs—their thinking sequences.

Is this just a different form of relating?

How does this square with the realities of the offline world?

Pierre Bourdieu emphasised that attitudes inform practice. It is also true that what is practised requires less dedicated attention than what is only occasionally performed. Like driving a car or piloting oneself about, the more this is practised the easier, the more naturalised, this activity becomes. For example, in map reading one has to dynamically engage in a series of reflexive operations, a-conscious processes of scaling up/scaling down, in order to make sense of the correspondence between map and territory. The more this is done, the easier it is. Conversely, the more a person relies on Google Maps, on a voice or a simple visual signal, to navigate, the less competent—and, arguably, the less engaged with nature, or place—one becomes. The same can be said for being able to navigate social situations: what is practised tends to become easier, and what is not practised tends to become more difficult and feels less natural.

In face-to-face relationships—in any real relationship—no single party is in control; the rules are often opaque, even invisible; and you can’t really ‘drop out’  (just exit) if you feel uncomfortable. Mostly this is the opposite of what happens online, and now, as online manners and relations become normalised, the offline world is an increasingly foreign territory. In this now-almost-foreign place, interactions tend to feel awkward, even unsafe. They present a lack of predictability. ‘I feel it’s bumpy. I’m vulnerable, I feel trapped, confused.’ The real world becomes ‘inferior’, ‘strange’, ‘unwelcome’ and ‘unsafe’: face-to-face is intense, just too demanding.

Perhaps this critique lacks compassion. Service users don’t choose to have mental health issues. Indeed they are beset by some problem, condition, syndrome, affliction, disorder, disease—identifying the appropriate form of address is itself a difficulty. However labelled, given one has been involuntarily visited by a ‘trouble’ of some kind, one is a victim of misfortune rather than guilty of an offence. But as Sarah Schulman writes in Conflict Is not Abuse: Overstating Harm, Community Responsibility, and the Duty of Repair, we appear to be in a cultural moment where we view our entitlement to compassion as requiring a certain self-pathologisation. We are given culturally to seeing ourselves as victims, in need of protection from psychically threatening forces and contexts. One of the issues here is that, as digital mental-health therapies become more popular, and given their apparent cost-effectiveness, all manner of personal experiences, even those that range out to political conflicts, could be recast as mental-health issues.

Woebot may sit at the outer rim of digital mental health technologies, but we can see the shape and trajectory it implies for understanding mental health, the care relation and, beyond that, the person generally. Where the CBT-AI combination sets up a relentlessly positive artificial other—an interlocutor that is never awkward or demanding, and becomes naturalised as ‘what I like’—real-world relationships are bound to be found unsatisfactory. At the least, it is likely that our capacity to ‘read’ and respond to the other diminishes where the structures and protocols of digital communication take over.

This is consistent with the aggregate effect of the use of online mental health products, which draw the user’s horizon of awareness away from any other and more and more tightly around ‘the me’—my sensitivities, my needs, my entitlements. Given that in these applications the vitality of personal accountability and the expectation of reciprocity typical of the in-person therapeutic setting is depleted, if not expressly dismissed, it would not be surprising to find that the other more-or-less disappears beyond the event horizon. One might observe the same dynamic in a range of fields where the offline world lifts the individual and persons generally out of the conditions and challenges of embodied life and relationships. In this we might observe that the conditions that have led to this reconstitution of the self–other relationship, and the profound implications if this situation is normalised, go well beyond the realm of technologised ‘mental health’.


Sham Diagnosis

David Ferraro, Mar 2021

…denial of care to a particular group of patients is not the application of some apolitical, medical procedure. It is thoroughly reactionary, and continues the worst traditions of psychiatric care, updated for the neoliberal age.

Action by mental health workers wins concessions from Victorian Labor

Published by Anonymous (not verified) on Fri, 08/04/2022 - 3:35pm in

Stop work action by Victorian public mental health workers has forced the Victorian Labor government to sign off on a statewide enterprise agreement.

The campaign by Health and Community Services Union (HACSU) members won some concessions and a pay rise but fell short of what could have been achieved. 

The agreement expired nearly two years ago in June 2020. This coincided with the first serious COVID-19 community transmission in Victoria and enormous strain on health and community services.

Mental health workers have worked all through pandemic with worsening conditions and pay rises below the increasing cost of living but have also been taking industrial action to fight back for workers and service users.

Three months after the EBA expired, HACSU filed to hold a protected action vote, which was endorsed by the majority of union members across Victoria.

Many of the bans implemented at the beginning of protected action were designed to frustrate management, make things easier for workers and not adversely impact service users, for example bans on logging contact hours, non-clinical meetings and paperwork.

These bans were popular among workers and effective but after several months of negotiations key claims hadn’t progressed and people began calling for a step up of industrial action through statewide stop work action.

Excuse

Government officials and the bosses’ union used COVID as an excuse to stall negotiations. They also asked the union to drop key demands and industrial action until the Mental Health Royal Commission recommendations were handed down, arguing that they would improve the sector. This process also took for ever and the union pushed back against this technocratic approach.

Many workers have worked overtime to fill big holes in service delivery and staffing shortfalls, which is a way the system increases overall exploitation of the workforce.

This is a particular challenge in more feminised industries when the product of our labour is human health and wellbeing—we feel the pressure to fill the gaps because we want to support our colleagues and service users who may be placed at increased risk without adequate staffing cover.

Healthcare employers struggle to retain and recruit new staff because of over-work and underpay, relying on goodwill and the “hero narrative” to celebrate healthcare workers without providing them with wages and conditions that support workers on the job and outside of it.

The health system has become so reliant on overtime that some workers who have difficulty making ends meet take on extra shifts, which only exacerbates burnout.

Mental health clinicians who had been around in the 1986 nurses’ strike and periods of broader union militancy called for statewide stop work actions.

HACSU issued a 12-hour stop work and people were planning to come from all across Victoria on the 26 May 2021 until another COVID wave led the Andrews government to ban large outdoor gatherings.

This happened again on 4 April and many unionists joked that COVID-19 was a conspiracy to stall the EBA.

While stop work actions still took place at localised clinics and hospitals this made it difficult for unionists across the state to connect with each other, share strategies and a broader vision for a better mental health system. Zoom organising was also difficult.

While COVID was a very real threat, governments also leveraged the crisis to restrict organising. Black Lives Matter demonstrated it was possible to hold powerful and safe rallies with tens of thousands of people during the pandemic.

Gains

While a range of strategies were used to get the EBA over the line it’s telling that it was only in-person industrial action which finalised the agreement.

The union put on hold industrial action when a draft agreement was reached and endorsed by the majority of members in November 2021. Then nothing happened for another four months as the government continued to stall and delay. It was only when another stop work action on 17 March 2021 was held in person at Victorian Trades Hall that the agreement was finalised.

There were some gains in this EBA including extended leave for child rearing, emergency management and disaster relief (timely in the current and future climate), and improvements in career structure for the growing lived experience workforce.

In terms of wages, nurses were able to secure a 3 per cent increase in wages each year but unfortunately the government has split the workforce by only offering 2 per cent a year to allied health (social work and occupational therapy), the lived experience workforce and administration.

This is in line with Labor’s commitment to the public sector wage cap, which is repressing wages below inflation, contributing to a cost-of-living squeeze on public sector workers.

Workers did fight back against this and were able to secure backpay for the two years of backsliding in wages and living costs and a modest $1500-$2000 lump sum “retention bonus” each year to stay in the sector.

These gains barely keep up with the cost of living in the harsh industrial and inflationary environment of the last two years but could also only be achieved through withholding labour and industrial struggle.

It will take more of this for workers to begin to claw back some control, particularly in industries like healthcare, disability and social services where work is consistently undervalued and under enormous systemic strain.

By a HACSU member

The post Action by mental health workers wins concessions from Victorian Labor appeared first on Solidarity Online.

Welcome to Your Friendly Neighborhood Mental Health Center

Published by Anonymous (not verified) on Fri, 04/03/2022 - 7:00pm in

In the fall of 2019, Lauren Lucht was walking to the ribbon-cutting ceremony of the new Strawberry Hill mental and behavioral health center in Kansas City, Kansas, when a passing driver rolled down his window. “He started honking and then screamed, ‘Thank you for bringing the grocery store!’” she remembers with a laugh.

It’s not every day that Lucht, a mental health care professional, gets thanked for providing a new local food shop. But the project she shepherded into existence just over two years ago isn’t typical, either. As the executive director of mental and behavioral health for the University of Kansas Health System, Lucht oversaw the opening of the Strawberry Hill center, and has since witnessed the gradual reawakening of the long-neglected surrounding neighborhood. 

The decision to locate the center in this particular spot was intentional. “It would have been less expensive to purchase land in a more rural area and build a psychiatric hospital there,” Lucht says, “but the partnership with the community was really the driving force here.” 

kansasThe atrium at Strawberry Hill Behavioral Health Hospital. Credit: CannonDesign

This approach represents an emerging school of thought in mental health facility design. Until recently, many such facilities purposefully removed their patients from public life, sending them out into serene rural environments, or walling them off in fortress-like psychiatric hospitals. This arrangement, though isolating, was long thought to be best for both patients and society. 

But new facilities like Strawberry Hill exhibit a new way of thinking, one in which mental health facilities are seen not as a risk or a burden to the surrounding community, but a potential boon, bringing with them the same social and economic benefits that any medical hospital would — while helping to destigmatize mental health care in the process. 

For a long time, the neighborhood of Strawberry Hill has struggled with vacant lots, derelict buildings and street crime. The very building the new mental health facility is housed in, in fact, had been abandoned for years. Now, it’s bustling with hundreds of workers, and the neighborhood around it is slowly coming back to life. The new grocery store, opened in what was once a food desert, is a prime example.

“We know that a healthy diet is part of keeping ourselves healthy,” Lucht says. “My motto is: Mental health is health. And until we start thinking of mental health as being one component of our overall health care, we continue to silo things out in a very unhealthy way.”

A history of hiding away

The previous incarnation of the Strawberry Hill mental health center was a nondescript cinderblock building cloistered within the University of Kansas’s sprawling, difficult-to-navigate main campus. Lucht says the old space didn’t have the capacity for its growing demand for services, so she and her team began searching for a bigger location with a more expansive mission.

From about the 1850s into the early 1900s, not much middle ground existed in the care of people struggling with mental and behavioral issues. According to Stephanie Vito, a Buffalo-based architect at CannonDesign who was on the design team for the Strawberry Hill project, families either cared for the ailing or, if they were unable, the person would go to an asylum in the countryside. “The idea was that the patient will go there for, most likely, the rest of their life,” says Vito. “The landscape in the rural setting was really bucolic; they could do farming, they could ride horses — it was a different kind of model of treatment, with a different end goal.” 

While the countryside was thought to be therapeutic, the remote location had the effect of “othering” those seeking psychiatric care, perpetuating their stigma and isolation. To this day, neighborhoods often oppose new mental health facilities, viewing them as a liability rather than an asset — a perception the Strawberry Hill center works to disprove. It is housed in a building that was formerly the offices of the Environmental Protection Agency, nestled in a community near homes, businesses and restaurants.

The former offices of the Environmental Protective Agency now house the Strawberry Hill facility. Credit: CannonDesign

Clinical Manager Stacie Stoltz wants local residents to think of the campus as another business that’s part of their daily lives. She says discussions are underway to identify and provide more services those residents might need, like an easy-to-access urgent care.

“We want to be a one-stop shop for health, not just mental health,” Stoltz says. “We’re walking distance from the library and the grocery store, so we’re definitely like, you know, ‘Come to the library, come to our building for mental health,’ and, hopefully, someday, perhaps some physical health as well.”

Clinical Manager Stacie Stoltz. Credit: Anne Kniggendorf

The center is already providing knock-on benefits that go beyond the services it directly provides to the community. The most tangible is the creation of — and ability to fill — over 300 new jobs. 

Lucht points out that, in a job market where hiring is already a challenge for many businesses, behavioral health centers are especially difficult to staff. Staffing shortages at two other state psychiatric hospitals, one in Larned and another in Osawatomie, are partially due to their undesirable locations, she says. Not so in Kansas City, where the talent pool is broader. 

“We’ve been able to hire people from the community, which also pours money back into the community,” says Lucht. “And so there’s really a win-win there for keeping your patients, your employees and the revenue within your county and the community that you’re really partnering with to serve.”

Designed to be open and visible

As members of the community both staff the new facility and are served by it, the repurposed former office building also fosters a more open connection with the outside. Streams of light flow in through towering windows, illuminating a central atrium space that features living green walls and a view of the Kansas River and Kansas City, Missouri’s skyline.

“We took advantage of that central atrium, and we actually brought greenscape and nature and plants from the ground level all the way up vertically within the building,” says Vito. “So, it wasn’t just this kind of center strip, but it actually went three dimensionally.”

kansas“We’re walking distance from the library and the grocery store, so we’re definitely like, you know, ‘Come to the library, come to our building for mental health,’” says Stoltz. Credit: CannonDesign

Many of the rooms have about a foot of glass around the ceiling so that light floods from one room to the next. Murals in the hallways depict the Kansas plains and the wetlands of the southeastern part of the state. These aren’t just ornamental touches — according to Lucht, more comfortable surroundings make patients more likely to stay the full length of their treatment.

Stoltz, who’s worked in mental and behavioral health for over 30 years, says those treatments are as forward-thinking as the facility’s central location. Each patient is assigned to a psychiatrist, mental health therapist and licensed case manager. Everyone also receives a variety of “expressive therapies” such as art, music and recreational therapy, as well as individual, group and family talk therapy. This is a dramatic change from just six years ago, Stoltz says. “The programming at the old facility was really heavily emphasizing medications and psychiatric treatment … with some support from the psychology groups that they were getting once a day.”

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Strawberry Hill is part of a vanguard of mental health centers that attempt to soften the barriers between the facility and its surroundings. The Margaret and Charles Juravinski Centre for Integrated Healthcare in Hamilton, Ontario, was designed for its non-clinical spaces, like its swimming pool, auditorium and conference center, to be accessible to the public. Pilgrim Psychiatric Center on Long Island, New York, opened an on-site museum in 2002 where the public can learn about the facility’s history and current treatments. 

So far, Strawberry Hill doesn’t have amenities that are open to the public, and Lucht and her colleagues know that if the campus was to truly integrate into the community, neighbors would need to be on board. Even plans to add more health services, the new grocery store and the economic benefits — what Lucht calls the center’s amazing trickle-down effect — were initially not enough for some anxious residents. But developing neighbors into stakeholders was important.

So, during the design work’s developmental stage, health system representatives like Lucht met with the Unified Government of Wyandotte County, neighborhood associations, the mayor, churches and local residents to talk about the project.

“They were a little bit nervous about a psychiatric hospital coming to town,” Lucht says. “That conjures up for people a lot of things that they’ve seen on TV that don’t depict the reality of what psychiatric healthcare in 2022 looks like.”

Lucht and her team talked to community members about the difference between a dangerous person and a person with a mental health condition. “They’re not interchangeable,” she says. She believes people are starting to understand that, and that more facilities like Strawberry Hill, which attempt to integrate into local communities rather than wall themselves off from them, will begin to emerge.

“We have now multiple generations that have grown up, that are growing up, thinking and knowing that it’s normal and okay to treat your mental health as importantly as your physical health,” Lucht says. “We’re raising generations of kids who understand that a broken heart is not any less real than a broken arm.”

The post Welcome to Your Friendly Neighborhood Mental Health Center appeared first on Reasons to be Cheerful.

Uganda’s LGBTQ Church Is an Act of Faith

Published by Anonymous (not verified) on Wed, 16/02/2022 - 7:00pm in

A revelation

In Uganda, homosexuality is outlawed and anti-gay violence is a serious problem, in part because of hateful rhetoric spread by religious leaders. Now, an LGBTQ-led church is defying the threats, providing a safe, joyful place to worship for Uganda’s Christian sexual minorities.

Formed near Kampala in 2019 by Pastor Ram Gava, a gay man, Adonai Ministries has over 40 members who attend services physically, and dozens more who attend virtually. Its existence speaks to the dilemma of Uganda’s gay Christian community, which is deeply devout depsite the fact that the church is their chief antagonist. “In this gathering, you get confidence, your self-esteem is boosted, and you start being yourself,” said one congregant.

In Uganda, the need for such a space is particularly acute. But Black LGBTQ churches exist all over the world, not just in Uganda as Minority Africa reports. In London, House of Rainbow CIC, a fellowship for Black LGBTQ Christians, carves out a space for those who feel rejected by other Black churches. “A lot of pastors, priests, or theologians do not understand human sexuality,” said its reverend. “They should practice that principle that all are truly welcome.”

Read more at Minority Africa

Mending young minds

Covid hasn’t been easy on kids. According to the American Psychological Association, 71 percent of parents believe the pandemic has taken a mental health toll on their children. Demand for counseling services reflects this – mental health-related hospital visits rose by 31 percent for U.S. teenagers in 2020 over the previous year.

What if some of those hospital trips could be prevented? An initiative in Philadelphia is attempting just that with “integrated behavioral health,” which brings mental health care into mainstream settings. 15 primary care practices operated by Children’s Hospital of Philadelphia (CHOP) have begun screening all young patients for mental health issues during their annual checkups. If needed, the children can immediately be referred to mental health practitioners on site, with whom they can begin regular sessions. The idea is to lower the barriers to mental health services by integrating primary care doctors as overall health care “quarterbacks.” 

Research has shown the model to be highly effective at making mental health care more accessible. Now, CHOP is bringing the model out of the clinical setting entirely. A multi-year initiative has started providing on-site mental health services to all 258 students at Girard College, a Philly boarding school for disadvantaged students, 80 percent of whom are Black. According to one psychiatrist, putting mental health treatment in schools “side-steps the stigma issues and relieves parents of the additional challenges of child care, scheduling, transportation and other social determinants/barriers.”

Read more at the Philadelphia Citizen

Carry the water

California has roughly 4,000 miles of canals, and much of the water they carry evaporates before reaching its destination. This fall, a pilot project will begin covering those canals with solar panels, saving huge amounts of water while turning the Golden State’s plentiful sunshine into clean energy.

A rendering of one of the canal coverings. Credit: TID

The public-private partnership, with $20 million in initial state funding, will build the solar coverings over a portion of the state’s canals, allowing researchers to analyze reductions in evaporation, water quality improvements and electricity generation. A 2021 study estimated that if all of California’s canals were covered in solar panels, it would save 63 billion gallons of water and generate 13 gigawatts of green energy annually – enough to power nearly 10 million homes.

Read more at Renewable Energy World

The post Uganda’s LGBTQ Church Is an Act of Faith appeared first on Reasons to be Cheerful.

What can universities do to support the well-being and mental health of postgraduate researchers?

Published by Anonymous (not verified) on Tue, 01/02/2022 - 10:00pm in

As highlighted in a recent LSE Impact blogpost, there is evidence to show that postgraduate researchers face particular risks in relation to poor mental health and well-being. Reporting on a recent review of interventions carried out by universities and higher education institutions, David Watson, outlines four areas in which universities can develop initiatives to support … Continued

Revenge Capitalism

Published by Anonymous (not verified) on Fri, 21/01/2022 - 5:03pm in

Is Revenge Capitalism messing up our world?

Ross Ashcroft met up with Author and Teacher, Dr Max Haiven.

The post Revenge Capitalism appeared first on Renegade Inc.

Revenge Capitalism

Published by Anonymous (not verified) on Fri, 21/01/2022 - 5:03pm in

Is Revenge Capitalism messing up our world?

Ross Ashcroft met up with Author and Teacher, Dr Max Haiven.

The post Revenge Capitalism appeared first on Renegade Inc.

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