Somerville: the city where policies are based on how happy they make residents
This sounds like an advance for public mental health that could be tried in many other places! Does anyone know of examples where they reside? I wish the Adelaide City Council (South Australia) had asked the residents of the entire metropolitan area before spending our rates and taxes on yet another sports stadium renovation.
Not only does Adelaide have plenty of mentally ill homeless people who live in the city centre, sheltering in parks and gardens, but it also has homeless and displaced people living in quite well-concealed tents in the parklands. They recently decided to evict them all, and a homicide resulted.
Saturday, December 29, 2012
Thursday, December 27, 2012
We Have Lift Off!! at PLoS Public Health Blog
Have a look here on PLoS blogs, where a separate Public Health stream took off on November 27 2012.
We Have Lift Off!!
We Have Lift Off!!
Wednesday, December 26, 2012
No health without public mental health!
This was the title of the Royal College of Psychiatrists position statement in October 2010, see:
http://www.rcpsych.ac.uk/pdf/Position%20Statement%204%20website.pdf
Quote:
...costs of mental illness will double in real terms over the
next 20 years [98]and it is also expected that demand for health and mental
health services will increase as a result of unemployment, personal debt,
home repossession, offending and other forms of ‘economic fallout’[245].
A strategy which invests in promotion, prevention and early intervention not
only can reduce the burden of mental ill health and inequality but also makes
sound economic sense [246]. page 31.
Have we seen any signs that mental health promotion is taking hold in the UK or elsewhere since the Global Financial Crisis put the contrast between needs and compulsory funds reduction in the spotlight?
I haven't gone into the background on this topic yet, but I'm certainly intrigued enough to make a study of it over the next few weeks. Has anyone else discovered any evidence that national health systems have extracted their digits??
On the positive side, I have heard of early intervention centres for psychosis and other youth mental health difficulties having success with numbers of individual cases in Australia. There has been no news about the category I'm in: mature, unemployed skilled white-collar workers, suddenly deprived of income, ineligible for pensions or state benefits and very depressed. Yet the RCP report (above) mentions my category as a real standout in the push for greater consideration of mental health as a public health, community-wide issue.
In Australia, we were dismayed by the dismantling of the Better Access to Mental Health Care Program (known as Better Access by most), cutting the number of mental health care visits available on Medicare (the national health insurance scheme paid with 1.75% of income) to people without extra private cover. Worldwide it is known that the lower socio-economic strata have worse health and more worries to contend with, yet they are the ones worst hit by cuts to publicly subsidised services. Hello, rich company executives... do you want your workers collapsing in nervous heaps, becoming unproductive and ruining your bottom line? How about campaigning for better value for everyone's health dollar so that you'll receive better returns on your investment dollar??
Since psychiatrists put out the rallying paper two years ago, psychiatrists haven't been noticeable on their soapboxes calling for better care for their less well-heeled neighbours. One or two psychs in Australia have been heard uttering encouraging phrases,, but most are still attending drug-company sponsored seminars and social activities- they're not down at the local community centre joining the depressed and unemployed on any mutually engaging tasks! My own shrink seems personally more warm and willing to try less well-tested aids to recovery, and I have certanly benefitted. However, she really has NO IDEA "how the other half lives", and I'm sure most of her colleagues are the same. They just never mix with the likes of us, who are just as worthy human beings, well educated, but down-trodden by social and financial circumstances we have little resources to cope with. Psychologists are much more likely to feel some affiliation with the average mental health client as their training and remuneration are not congruent with somewhat insulated upper-class backgrounds. However, the upper echelons of the psychology profession are also the province of may rich and remote people who don't see why their increasingly high recommended fees are way beyond the capacity to pay of folks like me. You see, psychologists, at least in Australia, have been concerned that they deliver almost the same services as psychiatrists, yet have always been paid far less. In recent years, many have increased their fees to equal those of the cheapest psychiatrists. At the same time the Medicare fee-setters have increased the amount psychiatrists can receive from Medicare per visit, plus the Scheduled Fee allowed to be charged (the maximum a psychiatrist is advised to ask for on the open market), while they haven't increased corresponding amounts for psychologists very much at all. Fair enough, psychiatrists have done a whole lot longer training and know how the physical health interacts with the mental, so they can prescribe powerful medications. However, psychologists usually have a far greater array of techniques available to them for creating change in the minds of their clients, particularly along the lines of Cognitive (Behavioural) Therapy. Either of these professions continually increasing their fees seems to put the public and their mental health more at risk, so I'd like to see everyone come to an agreement to moderate their desires for a while!
Meanwhile, if you're interested, have a look around your own community and see if psychiatrists are becoming more open and friendly and if psychologists are showing their faces in public, willing to mix with people who might become their clients. A lot of the mystery and stigma of mental illness and psychological difficulties might be relieved by professionals making themselves known as human beings and saying "Hello" to their neighbours. I don't mind that my neighbour is a Social Worker (also currently unemployed and rather depressed)- why should you worry if yours is a shrink?
How about making public mental health an open topic rather than keeping the professionals and clients in separate paddocks?
Here, at least, is a report on public mental health and schools:
Mental Health in Schools and Public Health from UCLA.
It's not only the mental health field that needs more doctor engagement; Web 2.0 working means modern folk need it from primary care as well, as Bill Sinn says here:
http://www.rcpsych.ac.uk/pdf/Position%20Statement%204%20website.pdf
Quote:
...costs of mental illness will double in real terms over the
next 20 years [98]and it is also expected that demand for health and mental
health services will increase as a result of unemployment, personal debt,
home repossession, offending and other forms of ‘economic fallout’[245].
A strategy which invests in promotion, prevention and early intervention not
only can reduce the burden of mental ill health and inequality but also makes
sound economic sense [246]. page 31.
Have we seen any signs that mental health promotion is taking hold in the UK or elsewhere since the Global Financial Crisis put the contrast between needs and compulsory funds reduction in the spotlight?
I haven't gone into the background on this topic yet, but I'm certainly intrigued enough to make a study of it over the next few weeks. Has anyone else discovered any evidence that national health systems have extracted their digits??
On the positive side, I have heard of early intervention centres for psychosis and other youth mental health difficulties having success with numbers of individual cases in Australia. There has been no news about the category I'm in: mature, unemployed skilled white-collar workers, suddenly deprived of income, ineligible for pensions or state benefits and very depressed. Yet the RCP report (above) mentions my category as a real standout in the push for greater consideration of mental health as a public health, community-wide issue.
In Australia, we were dismayed by the dismantling of the Better Access to Mental Health Care Program (known as Better Access by most), cutting the number of mental health care visits available on Medicare (the national health insurance scheme paid with 1.75% of income) to people without extra private cover. Worldwide it is known that the lower socio-economic strata have worse health and more worries to contend with, yet they are the ones worst hit by cuts to publicly subsidised services. Hello, rich company executives... do you want your workers collapsing in nervous heaps, becoming unproductive and ruining your bottom line? How about campaigning for better value for everyone's health dollar so that you'll receive better returns on your investment dollar??
Since psychiatrists put out the rallying paper two years ago, psychiatrists haven't been noticeable on their soapboxes calling for better care for their less well-heeled neighbours. One or two psychs in Australia have been heard uttering encouraging phrases,, but most are still attending drug-company sponsored seminars and social activities- they're not down at the local community centre joining the depressed and unemployed on any mutually engaging tasks! My own shrink seems personally more warm and willing to try less well-tested aids to recovery, and I have certanly benefitted. However, she really has NO IDEA "how the other half lives", and I'm sure most of her colleagues are the same. They just never mix with the likes of us, who are just as worthy human beings, well educated, but down-trodden by social and financial circumstances we have little resources to cope with. Psychologists are much more likely to feel some affiliation with the average mental health client as their training and remuneration are not congruent with somewhat insulated upper-class backgrounds. However, the upper echelons of the psychology profession are also the province of may rich and remote people who don't see why their increasingly high recommended fees are way beyond the capacity to pay of folks like me. You see, psychologists, at least in Australia, have been concerned that they deliver almost the same services as psychiatrists, yet have always been paid far less. In recent years, many have increased their fees to equal those of the cheapest psychiatrists. At the same time the Medicare fee-setters have increased the amount psychiatrists can receive from Medicare per visit, plus the Scheduled Fee allowed to be charged (the maximum a psychiatrist is advised to ask for on the open market), while they haven't increased corresponding amounts for psychologists very much at all. Fair enough, psychiatrists have done a whole lot longer training and know how the physical health interacts with the mental, so they can prescribe powerful medications. However, psychologists usually have a far greater array of techniques available to them for creating change in the minds of their clients, particularly along the lines of Cognitive (Behavioural) Therapy. Either of these professions continually increasing their fees seems to put the public and their mental health more at risk, so I'd like to see everyone come to an agreement to moderate their desires for a while!
Meanwhile, if you're interested, have a look around your own community and see if psychiatrists are becoming more open and friendly and if psychologists are showing their faces in public, willing to mix with people who might become their clients. A lot of the mystery and stigma of mental illness and psychological difficulties might be relieved by professionals making themselves known as human beings and saying "Hello" to their neighbours. I don't mind that my neighbour is a Social Worker (also currently unemployed and rather depressed)- why should you worry if yours is a shrink?
How about making public mental health an open topic rather than keeping the professionals and clients in separate paddocks?
Here, at least, is a report on public mental health and schools:
Mental Health in Schools and Public Health from UCLA.
It's not only the mental health field that needs more doctor engagement; Web 2.0 working means modern folk need it from primary care as well, as Bill Sinn says here:
New age of patients wants a new age of engagement from doctors
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