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Info Posts Return with.... Mental Health

10:41 am - 12/04/2011
MENTAL HEALTH SERIES : General Information/Discussion Post

Info posts may contain triggering elements, so please be mindful of the topic and read at your own discretion. Specific triggers and warnings are listed below, but if any additional warnings are needed please don't be shy about making the suggestion. Thanks!

IMAGE WARNINGS: Um, lots of pictures of heads and puzzle pieces...?
WebMD WARNING: Have you ever been on WebMD before? If your answer is yes, you understand the warning. If you haven't, take the advice of those who have come before you and DO NOT CLICK OUTSIDE OF THE ARTICLES. You will be pregnant with a brain tumor while dying of testicular cancer within 15 minutes. Oh yeah, you have syphilis too.
DISCLAIMER: Please do not use the information found within to diagnose yourself with a medical condition. If you believe that something is amiss in your life, please seek the help of a professional.

These posts are a "safe space" to ask questions you might otherwise be too shy to. Please do not reply to people with "Plz Google" or "educate yourself". Everyone should enter them with a learn and teach mindset (in that order). WITH THAT SAID, HOWEVER, please remain mindful of your questions and phrasing, be open-minded, learn, and know when to be quiet. If you are flippant with your ignorance, I will not stop angered members from telling you about yourself.

Welcome to the Mental Health Series opener! This post will cover a few basics about mental health. It will be followed up in the future with post that highlight and bring awareness to specific mental health issues and topics, so if you don't see what you're looking for here it will likely be featured in a future post where we break things down with a more specificity.

What is Mental Health?

While there is no official definition of mental or emotional health, these terms generally refer to our thoughts, feelings and actions, particularly when faced with life's challenges and stressors. Throughout our lives, mental health is the foundation of our thinking and communication skills, learning, emotional growth, resilience and self-esteem.

Most of us, most of the time, will be somewhere on the left half of the continuum – experiencing reasonably good emotional health and negotiating life events that, while stressful, do not feel unmanageable. In this state of well-being, the stress and discomfort caused by the everyday ups and downs of life do not impair daily functions such as eating, sleeping, or problem-solving. Generally we resolve these stresses ourselves, without seeking professional help.

But when major negative life events occur, or more serious or prolonged problems arise, coping becomes progressively more difficult. During these times you may experience what are identified on the right side of the continuum as “mental health problems.” Within the category identified as “mental health problems,” there are two major mental health states: emotional problems and mental illness.

Emotional problems or concerns: When emotional discomfort or distress begins to noticeably impair your daily functioning (e.g., changes in appetite or sleeping habits, lack of concentration), you are experiencing emotional problems. This experience may be commonly referred to as a “rough patch”, a “low point”, or “the blues.” Some people in this area of the continuum may be diagnosed with mild or temporary medical disorders such as “situational depression” or “general anxiety.” Self-care strategies and the support of friends and loved ones can be especially helpful during these times. In addition, many people experiencing this level of distress and impairment seek professional counseling to help them return to a state of emotional well-being

Mental illness: The most serious type of mental health problem, located at the right end of the continuum, is a diagnosable “mental illness.” Mental illness is characterized by pronounced or prolonged alterations in thinking, mood, or behavior. Though they don’t take up a large amount of space on the continuum, mental illnesses are common: it is estimated that one in five Americans will personally experience a mental illness in their lifetime. Mental illnesses include relatively common disorders such as depression and anxiety as well as major disorders such as schizophrenia. Individuals with mental illness typically experience chronic or long-term impairments that range from moderate to disabling in nature. Like physical illnesses, mental illnesses are treatable. Professional help in the form of counseling and/or medication can lead to recovery or successful ongoing management of the condition.

So, what causes mental health problems?

Mental health researchers and professionals have developed several theories to explain the causes of mental health problems (including addiction), but they have reached no consensus. One factor on which they agree is that the individual sufferer is not responsible for the condition, and cannot simply turn it on or off at will. Most likely several factors combine to trigger a condition.

Environmental Factors: People are affected by broad social and cultural factors as well as by unique factors in their personal environments. Early experiences, unique to individuals, such as a lack of loving parents, violent or traumatic events, or rejection by childhood peers can negatively impact mental health. Current stressors such as relationship difficulties, the loss of a job, the birth of a child, a move, or prolonged problems at work can also be important environmental factors.

Cultural factors such as racism, discrimination, poverty and violence also may contribute to the causes of mental illness. Poverty is especially significant: according to the U.S. Department of Health and Human Services, people in the lowest socio-economic status are two to three times more likely than those in the highest strata to have a mental illness.

Biological Factors: Scientists believe that the brain can produce too many or too few of certain chemicals, resulting in changes in how we perceive and experience things around us, as well as changes in behavior, mood and thought. While causes of fluctuations in brain chemicals aren’t fully understood, physical illness, hormonal change, reaction to medication, substance abuse, diet and stress have been identified as contributing factors.

Genetics: Researchers have found that there appears to be a hereditary pattern to illnesses: individuals with particular disorders tend to have had parents or other close relatives with the same illnesses. Research has shown that the likelihood of inheriting disorders varies, but scientists aren’t clear which genes are involved.

Frequently Asked Questions

Question: Is mental illness really an illness?

Answer: Yes. The brain is an organ that is susceptible to illness. Chemicals in the brain regulate how people think, feel and act. Brain function can become affected if these chemicals are out of balance or disrupted, contributing to mental illness. Thus, mental illness is a real bodily illness, not just something “in your head.”

Question: Does the prevalence of mental health problems differ among different racial or ethnic groups?

Answer: No. The prevalence of mental health problems is similar for all racial and ethnic groups. However, members of racial or ethnic minority groups may experience greater disability from mental health problems because of difficulties in accessing culturally sensitive, good quality care.

Question: Is it true that mental illness can’t be cured?

Answer: This is a complex question. In many cases, mental illness cannot be “cured” in the sense that it will go away and never return. Most often, the symptoms of mental illness can be eliminated or reduced and managed through treatment with medication, therapy or a combination of both. For example, 80 to 90% of people with depression or anxiety can be helped when properly assessed and treated, though it is still possible that the illness will return at a future time.

Question: Are people with mental health problems likely to be dangerous?

Answer: No. Research shows that people with mental health problems do not commit significantly more violent acts than do people in the general population. Research does indicate, however, that substance abuse isfrequently involved in violent acts committed by individuals with or without other mental health problems.

Question: If someone has a mental health problem, should they abandon their hopes for a fulfilling career?

Answer: No. Although mental health problems can negatively affect individuals in a significant manner, with treatment and appropriate work accommodations, even people diagnosed with a serious mental illness have succeeded famously.


Anxiety disorders: People with anxiety disorders respond to certain objects or situations with fear and dread, as well as with physical signs of anxiety or nervousness, such as a rapid heartbeat and sweating. An anxiety disorder is diagnosed if the person's response is not appropriate for the situation, if the person cannot control the response, or if the anxiety interferes with normal functioning. Anxiety disorders include generalized anxiety disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), panic disorder, social anxiety disorder, and specific phobias.

Panic disorder - the person experiences sudden paralyzing terror or imminent disaster.

Phobias - these may include simple phobias - disproportionate fear of objects, social phobias - fear of being subject to the judgment of others, and agoraphobia - dread of situations where getting away or breaking free may be difficult. We really do not know how many phobias people may experience globally - there could be hundreds and hundreds of them.

(OCD) Obsessive-compulsive disorder - the person has obsessions and compulsions. In other words, constant stressful thoughts (obsessions), and a powerful urge to perform repetitive acts, such as hand washing (compulsion).

PSTD (Post-traumatic stress disorder) - this can occur after somebody has been through a traumatic event - something horrible and scary that the person sees or that happens to them. During this type of event the person thinks that his/her life or other people's lives are in danger. The sufferer may feel afraid or feel that he/she has no control over what is happening.

Mood disorders: These disorders, also called affective disorders, involve persistent feelings of sadness or periods of feeling overly happy, or fluctuations from extreme happiness to extreme sadness. The most common mood disorders are depression, mania, and bipolar disorder.

Major depression - the sufferer is not longer interested in and does not enjoy activities and events that he/she previously got pleasure from. There are extreme or prolonged periods of sadness.

Bipolar disorder - also known as manic-depressive illness, or manic depression. The sufferer oscillates from episodes of euphoria (mania) and depression (despair).

Dysthymia - mild chronic depression. Chronic in medicine means continuous and long-term. The patient has a chronic feeling of ill being and/or lack of interest in activities he/she once enjoyed - but to a lesser extent than in major depression.

SAD (seasonal affective disorder) - a type of major depression. However, this one is triggered by lack of daylight. People get it in countries far from the equator during late autumn, winter, and early spring.

Psychotic disorders: Psychotic disorders involve distorted awareness and thinking. Two of the most common symptoms of psychotic disorders are hallucinations -- the experience of images or sounds that are not real, such as hearing voices -- and delusions -- false beliefs that the ill person accepts as true, despite evidence to the contrary. Schizophrenia is an example of a psychotic disorder.

Schizophrenia disorders Whether or not schizophrenia is a single disorder or a group of related illnesses has yet to be fully determined. It is a highly complex illness, with some generalizations which exist in virtually all patients diagnosed with schizophrenia disorders. Most sufferers experience onset of schizophrenia between 15 and 25 years of age. The sufferer has thoughts that appear fragmented; he/she also finds it hard to process information. Schizophrenia can have negative or positive symptoms. Positive symptoms include delusions, thought disorders and hallucinations. Negative symptoms include withdrawal, lack of motivation and a flat or inappropriate mood. (See the article "What is schizophrenia")

Eating disorders: Eating disorders involve extreme emotions, attitudes, and behaviors involving weight and food. Anorexia nervosa, bulimia nervosa and binge eating disorder are the most common eating disorders.

Impulse control and addiction disorders: People with impulse control disorders are unable to resist urges, or impulses, to perform acts that could be harmful to themselves or others. Pyromania (starting fires), kleptomania (stealing), and compulsive gambling are examples of impulse control disorders. Alcohol and drugs are common objects of addictions. Often, people with these disorders become so involved with the objects of their addiction that they begin to ignore responsibilities and relationships.

Personality disorders: People with personality disorders have extreme and inflexible personality traits that are distressing to the person and/or cause problems in work, school, or social relationships. In addition, the person's patterns of thinking and behavior significantly differ from the expectations of society and are so rigid that they interfere with the person's normal functioning. Examples include antisocial personality disorder, obsessive-compulsive personality disorder, and paranoid personality disorder.

Other, less common types of mental illnesses include:

Adjustment disorder: Adjustment disorder occurs when a person develops emotional or behavioral symptoms in response to a stressful event or situation. The stressors may include natural disasters, such as an earthquake or tornado; events or crises, such as a car accident or the diagnosis of a major illness; or interpersonal problems, such as a divorce, death of a loved one, loss of a job, or a problem with substance abuse. Adjustment disorder usually begins within three months of the event or situation and ends within six months after the stressor stops or is eliminated.

Dissociative disorders: People with these disorders suffer severe disturbances or changes in memory, consciousness, identity, and general awareness of themselves and their surroundings. These disorders usually are associated with overwhelming stress, which may be the result of traumatic events, accidents, or disasters that may be experienced or witnessed by the individual. Dissociative identity disorder, formerly called multiple personality disorder, or "split personality", and depersonalization disorder are examples of dissociative disorders.

Factitious disorders: Factitious disorders are conditions in which physical and/or emotional symptoms are created in order to place the individual in the role of a patient or a person in need of help.

Sexual and gender disorders: These include disorders that affect sexual desire, performance, and behavior. Sexual dysfunction, gender identity disorder, and the paraphilias are examples of sexual and gender disorders.

Somatoform disorders: A person with a somatoform disorder, formerly known as psychosomatic disorder, experiences physical symptoms of an illness even though a doctor can find no medical cause for the symptoms.

Tic disorders: People with tic disorders make sounds or display body movements that are repeated, quick, sudden, and/or uncontrollable. (Sounds that are made involuntarily are called vocal tics.) Tourette's syndrome is an example of a tic disorder.

Other diseases or conditions, including various sleep-related problems and many forms of dementia, including Alzheimer's disease, are sometimes classified as mental illnesses because they involve the brain.


Experts say we all have the potential for suffering from mental health problems, no matter how old we are, whether we are male or female, rich or poor, or ethnic group we belong to. In the UK over one quarter of a million people are admitted into psychiatric hospitals each year, and more than 4,000 people kill themselves. They come from all walks of life.

According to the NIMH (National Institute of Mental Health, USA) mental disorders are "common in the USA and internationally". Approximately 57.7 million Americans suffer from a mental disorder in a given year, that is approximately 26.2% of adults. However, the main burden of illness is concentrated in about 1 in 17 people (6%) who suffer from a serious mental illness. Approximately half of all people who suffer from a mental disorder probably suffer from another mental disorder at the same time, experts say.

In the UK, Canada, the USA and much of the developed world, mental disorders are the leading cause of disability among people aged 15 to 44.

There are various ways people with mental health problems might receive treatment. It is important to know that what works for one person may not work for another; this is especially the case with mental health. Some strategies or treatment are more successful when combined with others. The patient himself/herself with a chronic (long-term) mental disorder may draw on different options at different stages in his/her life. The majority of experts say that the well informed patient is probably the best judge of what treatment suits him/her better. It is crucial that healthcare professionals be aware of this.

Self help

There are a lot people with mental health problems may do to improve their mental health. Alterations in lifestyle, which may include a better diet, lower alcohol and illegal drug consumption, exercise and getting enough sleep can make enormous differences to a mental health patient's mental health. Let's have a closer look and some of these strategies:

Diet and mental health

Scientists, psychiatrists, and other health care professionals know that the brain is made up in large part of essential fatty acids, water and other nutrients. It is an accepted fact that food affects how people feel, think and behave. Most experts accept that dietary interventions could have an impact on a number of the mental health challenges society faces today. So, why is it that governments and public health authorities in developed economies invest so little in developing this knowledge?

The evidence is growing and becoming more compelling that diet can play a significant role in the care and treatment of people with mental health problems, including depression, ADHD (attention deficit hyperactivity disorder) to name but a few. If experts are talking about an integrated approach which recognizes the interplay of biological, psychological, social and environmental factors - with diet in the middle of it as being key - and challenging the growing burden of mental health problems in developed nations, surely individuals can speed things up and do something about their diet themselves and improve their mental health.

It is estimated that in the UK people eat 4 kilograms of food additives each year. We are not sure what effect decades of such consumption may have on the brain. We don't know for one simple reason - governments are reluctant to fund, conduct or publish rigorously controlled large scale studies which look at the effect of additives on human mental health.

Changing farming practices have introduced higher levels of different types of fat into our diet. For example, chickens reach their ideal weight for slaughter twice as quickly today compared to three decades ago - this has changed the nutritional profile of meat, according to a report by the Mental Health Foundation (UK). Three decades ago a typical chicken carcass used to be 2% fat - today they are a whopping 22%. The omega-3 fatty acid content in chicken meat has dropped while the omega-6 fatty acids have risen. The same is happening to farmed fish.

The function of fats and amino acids in our brains:

Our brains' dry weight consists of approximately 60% fat. Our brain cell membranes are directly affected by the fats we eat. Saturated fats make our brain cell membranes less flexible. Saturated fats are those that harden at room temperature. 20% of the fat that exists in our brain is made up of essential fatty acids omega-3 and omega-6. The word essential here means we cannot make it ourselves, so we have to consume it in order to get it.

Fatty acids perform crucial functions in the structuring of neurons (brain cells), making sure that optimal communication is maintained within the brain. Nutritionists say omega-3 and omega-6 essential fatty acids should be consumed in equal amounts. If we consume unequal amounts there is a higher chance of having problems with depression, concentration and memory. It is crucial omega-3 intake is kept up. While one study shows a link between omega-3 intake and mental skills, others show there are benefits for cardiovascular problems, diabetes, ADHD, and a host of other problems:

Fish and omega-3 linked to mental skills.

Experts recommend that infant formula should include DHA omega-3 and AA omega-6 to guarantee correct eye and brain development.

The diet of Typical North Americans is deficient in omega-3 fatty acids and may pose a risk to infant development.

Trans-fat, which has appeared in growing quantities into much of the food we eat over the last few decades, assumes the same position as essential fatty acids in the brain. In other words, the proper vital nutrients are not able to assume their right position for the brain to function effectively. Trans-fats are commonly found in cakes, biscuits, shortbread, some pastries and many ready meals.

Neurotransmitters, such as serotonin, are made from amino acids which we often have to get by eating it. If you want to feed your brain with good stuff eat less intensively farmed chicken and meat, and go for organic chicken and non-farmed oily fish, such as tuna, sardines, trout, or salmon.

The Mental Health Foundation has a booklet "Healthy eating and depression", for anyone who wishes to protect their mental health through healthy eating.

A study found that eating a Mediterranean diet appears to be associated with less risk of mild cognitive impairment - a stage between normal aging and dementia or of transitioning from mild cognitive impairment into Alzheimer's disease.

An Australian study found that a high quality breakfast, with foods from at least three different healthy food groups, was linked with better mental health in 14 year old boys and girls. The researchers found that for every extra food group eaten at breakfast, the associated mental health score improved.

Excercise and Mental Health

An interesting animal study found that physical and mental exercises help improve schizophrenia symptoms.

A Harvard University study found that exercise may help people with depression by enhancing body image, providing social support from exercise groups, a distraction for every day worries, heightened self-confidence from meeting a goal, and altered circulation of the neurotransmitters serotonin, norepinephrine, and the endorphins.

Even a very small amount of additional exercise has been seen to have an important impact on mental health. A Scottish study involving 20,000 people found that performing as little as twenty minutes of any physical activity, including housework, per week is enough to boost mental health.

Exercise can boost an exercise-related gene in the brain that works as a powerful anti-depressant, scientists at the Yale School of Medicine found. They then compared the brain activity of sedentary mice to those who were given running wheels. The researchers observed that the mice with wheels within one week were running more than six miles each night. Four independent array analyses of the mice turned up 33 hippocampal exercise-regulated genes-27 of which had never been identified before.

The UK's National Institute for Clinical Excellence (NICE) issued guidelines for health professionals on how to encourage older people to engage in more physical activity as a way to boost their mental health; one suggestion is for GPs to encourage their older patients to join local walking schemes and tell them how walking benefits mental wellbeing.

Another study, carried out in the United Kingdom found that regular intense physical exercise is linked with lower rates of depression and anxiety in men up to five years later.

Sadly, the Mental Health Foundation found that very few UK patients are offered the choice of exercise therapy for mild to moderate depression. Apparently, only 5% of GPs (general practitioners, primary care physicians) use it as one of their most regular treatment responses, compared to 92% who use antidepressants as one of their most popular treatment responses. In 2006 only 42% of UK GPs reported having access to exercise referral schemes, despite the overwhelming evidence of its benefits for patients. Even among GPs who do have access to exercise referral schemes, only 15% use them very frequently or frequently for patients with mild or moderate depression. Unfortunately, apart from a couple of exceptions, much of the rest of the world's health care professionals seem to ignore exercise as a vital treatment for mental illness.

If you have a mental disorder, remember that you can do the exercise yourself. You do not need to wait for your doctor to "prescribe" it for you. Perhaps you should initially check whether you are in acceptable physical health to do exercise. If you are not, insist that your doctor help you devise an exercise plan that suits you. The benefits may surprise you.

Alcohol is a common form of "self-medication" for people with mental health problems

There is evidence that very moderate alcohol consumption may aid mental health in some cases. However, the evidence is overwhelming that excessive alcohol has a very bad impact on people's mental health. Whatever your attitude is to alcohol, remember that alcohol will not resolve your mental health problems, and will most likely make them worse if you are not very, very careful.

Drinking to deal with difficult feelings or symptoms is referred to by some mental health professionals as self medication. It is important to know that excessive drinking is a likely medium to long term consequence of this type of self medication. Most studies clearly prove that consuming high amounts expose people to significant risks of higher levels of mental health problems. People who suffer from more severe mental health problems are more likely to have alcohol problems too, compared to other people. Experts say this does not necessarily mean that alcohol causes severe mental illness. Perhaps it is more linked to 'self-medication'.

A report in 2008 said that urgent action is needed to prevent a 'silent epidemic' of alcohol-related dementia in the UK.

A statistical modeling study suggests that problems with alcohol abuse may lead to an increased risk of depression, as opposed to the reverse model in which individuals with depression self-medicate with alcohol. In other words, alcohol increases depression risk - it is not the other way round.

A study found a clear link between binge drinking and depression. It seems the link is stronger for women. However, the relationship between alcohol use and depression when depression is measured as recent feeling of depressions or unhappiness, is the same for both sexes.

Scientists at the University of North Carolina School of medicine found that stopping drinking - including at moderate levels - may lead to health problems including depression and a reduced capacity of the brain to produce new neurons, a process called neurogenesis.

OP Note: No one's requested this specific topic yet as a highlight post, but I think I will anyway.

Barriers to Mental Health Treatment by People of Color
By, Maria Jose Carrasco; Director, Multicultural Action Center

The significant progress made in discovering effective treatments for serious mental illness has unfortunately not translated into better services for people of color living with these illnesses. In fact, as the U.S. Surgeon General has reported, people from diverse communities—both adults and children—are less likely than whites to receive needed mental health care. When they do receive treatment, they often receive poorer-quality care (Surgeon General’s Report, 2000).

People from diverse communities often face additional barriers to treatment, such as discrimination and a lack of culturally competent mental health providers and services. It is crucial that a comprehensive plan to improve services and outcomes for people of color with mental illness address these surrounding circumstances as well as specific treatment and service issues. What follows are descriptions of some of the main barriers to mental health care treatment for people of color, and NAMI’s recommendations.

Racial and Ethnic Disparities in Mental Health Care

While the health status of all population groups has improved, the gaps between Caucasians and minorities persist, and in some cases, have become more pronounced. The Institute of Medicine’s 2002 report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare, highlighted the fact that health disparities are prevalent not only in the treatment of illness but also in the delivery of care to people of color, and these disparities persist even after adjustments are made for economic status, education levels, age and insurance coverage. The mental health care arena is no exception to this reality. For example, a 2001 study indicated that people of color are less likely than Caucasians to receive the best available treatments for depression and anxiety (Young, A.S., et al., 2001).


Federal agencies and organizations that receive federal funds should collect race and ethnicity data, which will help identify major health disparities and their sources in order to implement effective solutions. Organizations such as NAMI should actively advocate for systems change and for more equal quality of and access to care. New legislation such as the recently proposed Healthcare Equality and Accountability Act of 2003 should be passed in order to reduce health disparities and improve the quality of care for racial and ethnic minorities. Action should be taken to expand health coverage, remove cultural and language barriers, improve workforce diversity, fund programs to reduce health disparities, improve data collection, promote accountability and strengthen health institutions that serve minority populations.

Lack of Cultural Competence in Service Delivery

As the surgeon general stated, "culture is a concept not limited to patients…clinicians view symptoms, diagnoses, and treatments in ways that sometimes diverge from their clients’ views, especially when the cultural backgrounds of the consumer and provider are dissimilar. This divergence of viewpoints can create barriers to effective care … Clinicians and service systems, naturally immersed in their own cultures, have been ill-equipped to meet the needs of patients from different backgrounds and, in some cases, have displayed bias in the delivery of care" (Surgeon General’s Report, 1999). Furthermore, the Institute of Medicine’s report Unequal Treatment concluded that "although myriad sources contribute to these disparities, some evidence suggests that bias, prejudice, and stereotyping on the part of healthcare providers may contribute to differences in care."

A 2001 study reported that 51 percent of white health care providers believe that their patients do not adhere to medical treatments as a result of cultural or linguistic barriers. Of this same group, 56 percent reported having no form of cultural competency training (Institute of Medicine, 2002). For mental health consumers of color, access to mental health services and the quality of the services they receive are negatively affected by the lack of cultural competence in service delivery. Unfortunately, in many cases, the lack of knowledge of the consumer’s culture creates misunderstandings that result in inappropriate diagnosis, treatment, and/or adherence to treatment. Furthermore, a mental health provider who is not aware of the consumer’s culture is more likely to misdiagnose a psychiatric illness.


Mental health providers must adapt to meet the needs of people of color. Systems of care need to integrate the consumer’s culture into the treatment process. To establish a culturally competent system, all providers should receive education and training on cultural competence. This training should be part of their regular curriculum.

Governmental and private providers of mental health services should start by performing a cultural self-assessment, adopting cultural competence standards such as those proposed by the Center for Mental Health Services, embracing diversity and adapting their services at all levels to address the needs of diverse populations. Culturally competent service providers, regardless of their own cultural background, will be able to better understand and treat consumers of color.


How to Improve Mental Health Care for LGBT Youth:
Recommendations for the Department of Health and Human Services

By Carlos Maza, Jeff Krehely | December 9, 2010
The recent reported suicides of gay teens including Asher Brown (13), Seth Walsh (13), Billy Lucas (15), and Tyler Clementi (18) have sparked a national debate over the problem of bullying and harassment directed at lesbian, gay, bisexual, and transgender youth. A 2009 survey of middle and high school students found that 85 percent of LGBT teens experienced being verbally harassed at school because of their sexual orientation. Nearly two-thirds experienced being harassed because of their gender expression.

Bullying is one of several factors that put immense strain on LGBT teens’ mental health. Fear of rejection from family members, anti-LGBT messages heard in places of worship and in the media, and the chronic stress associated with having a stigmatized and often hidden identity all serve to exacerbate the mental health problems affecting LGBT youth in America.

Research has demonstrated the connection between anti-LGBT messages and actions, and a young person’s mental health. Studies have established a clear link between a family’s rejection or acceptance of an LGBT young adult and that person’s long-term mental and physical health. LGBT youth as a whole are significantly more likely than their non-LGBT counterparts to experience depression, anxiety, suicidal thoughts, and substance abuse. Research has demonstrated that gay and lesbian youth are significantly more likely than heterosexuals to attempt to commit suicide—up to 40 percent more likely, according to some reports. And a recent survey found that 41 percent of transgender and gender-nonconforming respondents in the United States report having attempted suicide at some point in their lives, compared to 2 percent of the general population.

A discussion of the difficulties experienced by America’s youth in accessing effective mental health services was largely absent from the recent national debate over health care reform. Passage of the Patient Protection and Affordable Care Act of 2010 was an important victory for progressives, but few have fully recognized the law’s potential to help the thousands of young adults with mental health concerns—LGBT or not—that are struggling to find appropriate treatment.

When LGBT youth do receive treatment, it is usually through primary care providers. Age restrictions, an inability to pay for treatment, and transportation problems prevent many teenagers from being able to reach out to secondary mental health service providers. Young adults struggling with their sexual orientation or gender identity in particular may be hesitant to contact a mental health provider, fearing that their search for help may reveal their LGBT status to unsupportive parents or other family members.

Primary care providers cannot always rely on patients to reveal the nature or severity of their mental health concerns. Young adults experiencing mood disorders wait seven and a half years before seeking treatment, on average. General practitioners trained in noticing and responding to the first signs of mental health issues in LGBT youth are therefore an invaluable asset in the effort to mitigate the damaging effects of severe depression and other mental health problems that LGBT youth often experience.

There are several large structural problems that prevent the primary care system from being able to adequately meet the mental health needs of LGBT youth. These include lack of LGBT-specific training for health care providers, the limited accessibility of services, lack of financial incentives to treat LGBT youth, a failure to deal with the intersection between mental health and substance abuse issues, and a general lack of information about LGBT health needs.

This brief describes these problems and offers potential solutions that the United States Department of Health and Human Services can implement, especially in relation to the recently passed health care reform law. Many of the recommendations, if implemented, could benefit the entire LGBT population. This brief supports the findings of a previous Center for American Progress brief, “Mental Health Services in Primary Care,” which advocated for bringing mental health and primary care services together for the general public.

Health care providers are unprepared to treat LGBT youth

Many health care professionals are not trained or equipped to effectively treat vulnerable LGBT youth. A majority of medical school curricula include no information about LGBT issues, and most public health school programs only mention population diversity in sexual orientation and gender identity when discussing HIV/ AIDS. This lack of training and awareness may cause care providers to misdiagnose or underestimate the extent of emerging disorders in the LGBT population.

Poorly trained medical practitioners may even make the mistake of viewing homosexuality and gender nonconformity as illnesses that can be overcome with appropriate “reparative” therapy, further magnifying the psychological damage and personal trauma already experienced by LGBT youth and young people who experience discrimination because of their perceived gender identity or sexual orientation.

LGBT people are unlikely to fully disclose the severity of their mental health problems to medical professionals they do not perceive to be LGBT-friendly. In fact, the possibility of being discriminated against or misunderstood is enough to deter many LGBT youth and adults from seeking treatment for their mental health concerns in the first place. Establishing rigorous, LGBT-supportive cultural competency training programs for primary care providers is essential to improving provider-patient relationships so that LGBT youth can feel comfortable seeking out the help they need.

Read more at the source.

Seasonal affective disorder (also called SAD) is a type of depression that occurs at the same time every year. If you're like most people with seasonal affective disorder, your symptoms start in the fall and may continue into the winter months, sapping your energy and making you feel moody. Less often, seasonal affective disorder causes depression in the spring or early summer.

Treatment for seasonal affective disorder includes light therapy (phototherapy), psychotherapy and medications. Don't brush off that yearly feeling as simply a case of the "winter blues" or a seasonal funk that you have to tough out on your own. Take steps to keep your mood and motivation steady throughout the year.

Risk Factors
Preparing for Your Appointment

You can find more information at the source, of course!

Child and Adolescent Mental Health
Chronic Illness and Aging - Maryland Coalition of Mental Health and Aging
Chronic/Serious Mental Illness
Medline Plus - Has TONS of links about how mental health affects different communities
Mental Health and Psychology Resources Online
Mental Health Facts from the American Psychiatric Association (.pdf)
National Institute of Mental Health (NIMH)
Substance Abuse and Mental Health Services Administration
SAMHSA Mental Health Services Locator - USA
Royal College of Pyschiatrists

OP Notes: THere is so much crossover between mental health (and everything else) that it's impossible to fit everything into a General Post, but rest assured I will do my best to make sure that everything gets a highlight (glances at calendar)... at some point... in the future. But FYI, Mental Health and how it intersections with poverty, different minority groups, chronic illness, children, the elderly, different groups across the world, etc. will all get their own day in the sun (glances at calendar)... one day.

But if you have any links or great resources, please send them my way! I'll either add them to this post or stockpile for a megapost later on. Thanks!

Official threads for sign-ups and updates found within!

MOD NOTE: A Language Post will be included in the lineup and has been given priority simply because it can't hurt to know where slurs come from.

mycenaes 4th-Dec-2011 08:22 pm (UTC)
Does anyone have problems with their psychiatric meds causing night terrors? This happened to me since I started taking medicine at the age of 15, and it's really upsetting and frustrating. I've even taken medication that's supposed to stop the terrors, but it made it worse!
perthro 4th-Dec-2011 08:28 pm (UTC)
My friend does, but she had them before the meds, too. They just got worse while on the meds... thing is, she needs them to function in her every day life. I think she's on Paxil, a relatively low dose. It gives her more anxiety on top of what she already deals with. Still looking for a solution.
mycenaes 4th-Dec-2011 08:30 pm (UTC)
Yeah, it's hard to tell for me when they began, because when I was 15, I had a small psychotic episode, where I was hallucinating and delusional. So I dunno if that's how they started or not.
teacup_werewolf 4th-Dec-2011 08:28 pm (UTC)
Depakote use to do some freaky shit when I slept D:, I got off of it and the terrors stopped for a while.
mycenaes 4th-Dec-2011 08:32 pm (UTC)
Klonopin made me hallucinate hardcore at night. It was ridiculous.
mycenaes 4th-Dec-2011 08:31 pm (UTC)
I've even been to a sleep specialist and they've told me outright that no one knows what causes night terrors, and that there is no real treatment for them. :(
mycenaes 4th-Dec-2011 09:00 pm (UTC)
Yep. Basically any psychiatric medication that I've taken, I've had night terrors while on it.
mycenaes 4th-Dec-2011 08:41 pm (UTC)
Yeah, I usually will wake up SCREAMING from a night terror. Once I even got as far as trying to run away from something and attempting to unlock the back door of my house so I could get outside. It can be dangerous.
grimmerlove 4th-Dec-2011 11:34 pm (UTC)
Yup, I've been on several antidepressants and since I started taking them, I've had really creepy, unsettling lucid dreams. Since they're not of me hurting myself/others, my nurse practitioner doesn't seem to be alarmed, but they bother me...
mycenaes 5th-Dec-2011 01:36 am (UTC)
Yeah, it's really disconcerting.
thenakedcat 5th-Dec-2011 05:40 am (UTC)
I haven't had night terrors exactly but since I went on antidepressants (tricyclics in particular) my dreams have morphed into technicolor Wagner-length epics of anxiety and creepiness...and I had some pretty weird-ass dreams to begin with. There have been a couple times where I had to switch medications because the dreams got so unending and unsettled that I would wake up more tired than when I went to bed. My doctor didn't see it as a serious issue, though, until I started showing signs of long-term sleep dep as well as reporting subjective distress.
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