Wednesday, March 21, 2007

This I Believe: The Importance of Community

This week my blog will take on a bit of a different style, formatted after the ever growing “This I Believe” website phenomena. This site has become an open arena for all types of individuals to express their feelings and beliefs about anything and everything. In their exploration of finding some purpose or deep understanding for the complex system in which we live, they discuss issues from a belief in god to childhood memories.

I believe in the idea of a strong sense of community. By making connections with other individuals and forming close-net groups based on common interests we can allow ourselves to grow, thrive, and give back to society. There is a Chinese proverb that says, “one generation plants the trees; another gets the shade." A community could include family, friends, institutions such as colleges, or even social groups based on ideas such as moral beliefs. This broad scale idea is one that everyone can relate to and provides people with a sense of support, self-worth, and opportunity. The ties to community that led me to pursue studies in psychology, Spanish, and a career in the medical field began forming at a very early age and have shaped the person I am and the subjects that interest me. In my early interaction with community I was exposed to diversity, the academic world, and working with others towards a common goal. These, along with many other valuable experiences have led me on a very rewarding life path.

One of the earliest values I learned as a child was to always be accepting of others. Being a product of an interracial marriage, my mother being Caucasian and my dad African American, from day one I held a strong belief in equality. As Helen Keller stated in the early 1900’s, “the highest result of education is tolerance”. Growing up I always had a large assortment of friends from all different backgrounds. As time passed, and I realized this was not the truth for all people, I began to take on an even greater interest in those individuals and cultures that are different from my own. My acceptance of others cultivated into a concept so significant to me that it is now tattooed on my wrist saying “etwid” or “embrace that which is different”. I strongly believe that our diversity is our greatest asset, and this is what sparked my great love for the Spanish language and culture that is so rich and unique.

My fascination with the human body and the amazing technological advances the medical world has discovered was passed onto me by my uncle, who is a doctor and medical malpractice lawyer among numerous other professions. With the great support from my family and the deep connection I felt to the academic community, an educational experience that would adequately prepare me for a career in medicine became a top priority. As I have immersed myself in the beginning stages of this higher educational experience involving great amounts of medical school preparatory work, I have become more determined and intrigued. This later exposure has allowed me to extend my studies into the field of psychology, which I think will only make me a more knowledgeable and well-rounded person.

Being on a team in high school really made me understand the importance of others. Before this time, I often did not think of all the other players involved in any task. Just because someone may not be seen or the work they do might not be the final product, does not mean they are not a necessity. It is important for people to understand this concept of the whole only being as strong as its weakest link because this is the essence of community, and it affects our daily lives. When building a house, for example, there are many people involved besides the architects including contractors, landscapers, safety inspectors, not to mention all the those that are an integral part of the beginning stages of the process such as obtaining the materials such as granite for the counter-tops or wood for the floors. Without my community of family, friends, and school, I would not have learned all these amazing life lessons and would not be able to one day give back something to this world that has given me so much.

Monday, February 26, 2007

In the Dark: The Stigma Surrounding Mental Illness

Despite the large growth in the psychological community and the world’s interest in mental illness, it seems that psychology still lies in the unknown for many. The data is limited due to the lack of funding and support needed to perform clinical research, provide information to the public, create programs to allow personal accounts to be heard, and ultimately end the stigma surrounding these disorders. This week I have found two blogs that discuss this ongoing problem and voice very similar concerns to those I have briefly stated above. Below are my additional views of their accounts of stigma the mentally ill face today beginning with Brain Blogger and then followed by an excerpt found in Medical Mondays.

The constant cycle that continues to keep mental illness in the shadows seems to be hopelessly true. Many years ago people were thought of as a disgrace to their family and community and were often sent away to insane asylums where they were mistreated, drugged, and dehumanized. Even today things have not changed much. The mentally ill are often abandoned, victimized, jailed, and/or left homeless. This is due to the lack of understanding of their situation and how to best accommodate those with mental illnesses as well as an inability to put ourselves out there as selfless beings in order to improve ourselves as a whole. As this blog states, the predominance of these disorders is evident in the statistics shown, and those alone should be enough to at least get people thinking and talking about our situation with mental illness.

I was so pleasantly surprised to come across this post when searching for the latest talk on mental illness. I find it especially noteworthy because not only does it suggest the intriguing work of Stephen Hinshaw’s book, The Mark of Shame: Stigma of Mental Illness and an Agenda for Change, but it also brings this extremely important issue of stigma into a very public arena. Although society’s view of mental illness has changed greatly over the past few decades, we are nowhere near where we need to be in the progression of addressing and treating those afflicted with these diseases. As a community we should have the knowledge and will to support our peers in this difficult way of living, but the stigma we place on psychological disorders only disables our efforts. By being straight forward with ourselves and saying we are pre-judging and negatively addressing the mentally ill, we can hopefully make the choice to change our way of thinking and create a movement that will lead to more accessible, more productive, and less invasive treatment and support.

Wednesday, February 21, 2007

Our Limiting Resources: Treating the Mentally Ill in Jails

Recently, MSNBC had a special on Los Angeles County Jails in which they gave detailed tours of correctional facilities such as Men's Central and Twin Towers. Through the video and several interviews with inmates and officers working in these facilities, we are able to see the conditions on the inside and the stressors that must be dealt with everyday. Today, approximately 283,800 inmates are identified as having a mental illness. This represents 16% of the inmate populations of state and local jails. Jails have effectively become America’s new mental institutions; they house a larger volume of mentally ill people than all other programs combined. However, these inmates rarely receive the treatment that they need and have a right to. The criminal justice system is overpopulated and under equipped to deal with those with psychotic disorders requiring mental health care services.

The shift in residency of the mentally ill from hospitals to the criminal justice system is the result of deinstitutionalization, which occurred in the early 1990’s. This grave process began in the 1970’s to eliminate the negatively infamous mental institutions. These “warehouses” of the past where known for their sparse living conditions, brutal treatment of patients, and harsh medical procedures and treatments such as electroshock therapy. Concern for the civil rights of mentally ill persons, a desire to cut costs, and a hope that new medications could replace supervised care spurred the movement to close the institutions.

The overflow of the mentally ill has overloaded the prison system. The American Correctional Association recommends that jails should operate at 90% of capacity. All jails were at 85% capacity in 1985, and were already up to 111% capacity by 1987. The overcrowded conditions disrupt the efficiency and function of the prison system. Room for booking and close observation areas upon admission is scarce. Even if a mentally ill inmate is correctly recognized as in need of further observation or treatment, on-sight mental health professionals are very limited and there may not be anyone on duty due to time of day or location of the facility. Admittance screening is rushed and many mentally ill inmates who should receive treatment instead slip through the cracks of the system. On the other end of the spectrum, this inefficient process may allow for malingering inmates to sneak their way into the psychiatric system for some secondary gain. Some individuals do this to avoid a more harsh sentencing while others may want the benefits of being prescribed medications that they can use to either continue their substance abuse or for some monetary gain while incarcerated. This takes away from the already limited means provided to treat the mentally ill in our legal systems. The original social goal providing these individuals with more humane mental health care is lost.

Our society has attached a heinous stigma to mental illness, which makes it difficult for individuals to ask for or receive help. The perception that mentally ill people are violent is a common one. In reality, studies have shown that they commit violent acts no more often than a random sample of their peers, if they do not abuse alcohol or drugs. The small percentage of mentally ill people who do represent a significant risk to themselves or others should not be ignored though. These people do belong in a correctional facility. However, many are arrested on minor charges and for non-violent crimes. In fact, 29% of jails in one survey reported holding mentally ill persons against whom no charges were ever pressed. They are jailed because more appropriate community based programs do not have the funding or space to deal with them.

A large number of prison inmates today suffer from psychotic disorders that are severe enough to warrant mental health care. Numerous court cases have established that mentally ill inmates have the constitutional right to these services. However, more often than not, inmates are denied these needed services. Most prison administrators report that they do not have the resources or ability to respond to the needs of mentally ill offenders. They describe their programs as “grossly understaffed” and “in urgent need” of help from mental health organizations to develop appropriate programs. In effect, today’s prisons and jails are shouldering the responsibility for the mentally ill which used to reside with community based hospitals and institutions.

Monday, February 12, 2007

The Great Escape: Our way of dealing with reality

In my blog this week I will be looking at and later commenting on the findings of other individuals in the blogosphere. Looking at indulgences such as the media frenzy on celebrities and the technological playground of video games, I will evaluate our need to live through others. By focusing on the lives of people we either do not know or may not even really exist, we can escape the common stressors of our everyday lives and in turn make ourselves feel better about our own situation or feel as though we have control over something in this crazy, fast-paced world in which we live.

While there is obvious truth in the fact that morally we should show more interest and empathy for the fatalities of people who show bravery, selflessness, and respect for themselves and others, the truth about our celebrity-obsessed society is that people we could never truly know take priority in our thoughts and discussion. Being in the age group of young adults, whether choosing to immerse yourself in the celebrity gossip or not, it is almost impossible to escape the news on even the questionably famous. Psychologically speaking, I feel the reason for this is an unusual sense of closeness society feels towards people like Anna Nicole Smith. The war in Iraq seems distant, misunderstood, and ill supported by a large number of people. It is more difficult to relate to the casualties of war victims because it seems surreal and never-ending. There is more of a connection formed between an individual and the death of a person in the spotlight because we feel like we know them personally and can relate to their tragic downfalls of drug addiction, poor self-image, and slip-ups of moral judgment.

The video game Kudos seems to be a very interesting one that, unlike most I’ve seen lately, shows a very blatant reflection on our society today. By having a game in which one dictates the life of made up individual, the player can forget about his/her own life and feel in complete control for at least a short period of time. This is a feeling that is very hard to come by in our real lives, and yet, it is still something that is clearly longed for by many. The psychological high we receive from the instant gratification of doing something right is much more easily obtained through the fairytale of a video game than in our own lives. Although this approach to happiness may be a quick fix that is ever fleeting due to its biologic relation to the release of endorphins that will be reabsorbed and released continuously, people will find comfort in almost anything. In an extremely competitive, high stress world like today, one cannot really blame them.

Monday, February 5, 2007

Genetic or Societal: What really causes Psycholigical Disorders?

With the growing interest in mental illness and its progression into the scholarly world, much discussion has evolved in the debate of causes of these life changing diseases. As with any other illness, the key starting point to its treatment is knowledge of its origin so that those primary factors may be changed in future populations or their negative effects may possibly be reversed by therapy, medication, or counseling.

Among the large, up-to-date libraries of information The National Mental Health Information Center provides on psychological disorders, there are detailed articles involving the great amounts health risks that a child incurs when born to mentally ill parents. It is said that the general population has a risk of suffering from mental disorders of about 20% while children of parents with diagnosed psychological disorders have an increased rate of 30-50%. They also often show greater risks of social disorders, lower academic performance, and increased pregnancy complications and post-birth health problems. The issue with statistics such as these, however, lies in the inability to perform error-proof experiments. It is nearly impossible for a researcher to attribute these passed on psychological disorders to genetics based on parent to offspring transmission. Because having a psychological illness may greatly affect one’s personality and lifestyle, these factors, which would be considered environmental, may really be the cause of the child’s similarities in behavior and affinity for a mental illness.

A 30 year long study at the Mount Sinai School of Medicine has recently revealed that low birth weight and child abuse greatly increase the chances of depression and other social and psychological disorder. This contributing factor is a combination of the two hypotheses, and, due to its nature, could be very useful information to the psychological world. By providing easily accessible, affordable, quality healthcare to expecting mothers the issue of low-birth weight can be heavily monitored throughout the pregnancy and taken care of through medicinal support such as steroids and extended womb incubation. Programs to monitor the infant after birth can also be coordinated through donations and free-clinic programs. The latter part of the problem must be dealt with by improving many bigger social issues such as poverty, drug-abuse, homelessness and finally domestic abuse. Dealing with such high stressors in the primary stages of development has lifelong diminishing effects.

Although the search continues for answers to this unnerving question, the data is small in comparison to the big picture and our quest for an answer continues without much guidance. It seems at this stage in the research there is substantial evidence for both cases and many psychologists would confirm that both genetic and environmental factors contribute to the presence of mental illnesses. Based on information I have read and cases I have seen, I believe there is a genetic predisposition is certain individuals that is then set off by some traumatizing series of events in their lives that leave them psychologically and socially defective. It does not help however that society lacks knowledge and desire to assist people in this situation and therefore debilitates them further. The answers to our questions of the source of mental illness lie in a joint effort to achieve resolution in cures for these diseases and better lives for the people they afflict.

Monday, January 29, 2007

Diverse Minds: A look at how our differences affect Psychology

A few decades ago it would have been unheard of to find a Jewish, African-American and Caucasian female from Maryland married to a Catholic, Mexican-American male from California. In society today, however, diversity is the norm and relationships and interactions as multi-faceted as this occur all over the world. Besides race, gender, and religion people may, and often do, associate themselves with varying cultural backgrounds and ethnic groups. The formation of a person’s character is complex and unique. It occurs over an entire lifetime and involves the influences of cultural factors such as lifestyle and behavior like diet and exercise, attitudes and beliefs about health and illness, as well as environmental factors like geography and the health care system in which one is immersed. Due to this great increase in diverse cultural interactions, there has been an increasing interest in the psychological research and the means by which to obtain the most accurate and beneficial information from clinical testing in this field.

Although the terms are not binding, most cultural psychologists believe that certain traits are culture-specific while cross-cultural psychologists most commonly believe in an overlap or similarity across different cultural groups. There is great evidence that some behavioral traits are common among all humans such as the tendency towards similar ways of expressing certain emotions such as anxiety, fear, happiness, and sadness. However when dealing with more specific psychological disorders such as depression we may see drastic differences across cases. For example, Patricia Greenfield, a cultural psychologist, argues that there is a cultural framework surrounding psychological tests that is not universally shared. This means that a test created by one individual of a given background is not applicable to another individual of a different background due to its lack of empathy towards those differences. Obstacles such as this one would therefore make it nearly impossible to evaluate clinical results and compare them across cultures. This debate has been ongoing for a number of years now, and does not seem to be coming any closer to a resolution.

The research we have today is much more extensive for some groups than for others. Caucasians continue to be extensively tested, and we therefore have a lot of information on their ethnic group. Minority groups such as African Americans, Hispanic Americans, and Asian Americans have begun to join in this process and provide more data for psychological research. Besides this obvious dilemma, the true problem lies in the fact that these tests and their results are not simply black and white. They can be interpreted very differently by the numerous people involved including both administers and the subjects. Some problems that may affect these results include researchers’ inability to free themselves of stereotypical thinking or biases or a subjects inability to relate to only one group and therefore difficulty in consistently portraying their true feelings. The results of many studies have been indecisive or ambiguous, resulting in information that still leaves the researchers wondering about the validity of testing and the ability to perform tests over various cultures.

Our diversity is one of our greatest assets and should be embraced. When dealing with associations of ethnicity, race, religion, culture, and the like however, it is most important to look at the individual as a separate entity that is not solely classified in the terms of those narrow guidelines. Because the combinations of one’s background are endless, it is impossible to assume the traits a person will have or how they will react to different situations based on generalizations about a group he/she may belong to. The research done to evaluate the significance of these factors is important nonetheless as it ultimately allows professionals in the psychology field to better understand its patients and therefore provide them with more specialized and productive care.