Improving the Mental Health System
According to a news release that was dated May 9, 2006, the "Standing Senate Committee On Social Affairs, Science and Technology" in Canada recommended the creation of a Canadian Mental Health Commission that will be responsible for significantly upgrading the Canadian mental health system. As stated by Senator Michael Kirby, the Chair of the Committee, "The Senate Committee is committed to improving the range, quality and organization of health and support services that are required by the tens of thousands of Canadians who are living with mental illnesses and addictions."
Funding The Proposed Change
Based on an extensive three-year study on mental health and addiction, the Committee determined that it will cost $5.36 billion over a 10-year period for this mental health system upgrade. Where will these funds come from? According to the Committee, the revenue will come from raising the excise tax on alcoholic drinks by 5 cents per drink.
Part of the rationale for the 5-cent increase per drink was obviously the goal of raising the needed funds for the proposed changes in the mental health system. Another justifying factor for the price increase, however, was the fact that since each alcoholic drink will cost more, Canadians will be more inclined to drink lower-alcohol products such as beer and wine instead of liquor.
Let's Do the Math
At first glance, this proposal seems to make sense. Why shouldn't those who drink help finance a program that will provide them with a better mental health system? Why not let those who are part of the "problem" become part of the "solution"? This logic seems sound until you do the math. If $5.36 billion is needed to help finance the upgraded mental health system, then how many drinks will have to be consumed in a ten-year period to reach $5.36 billion dollars? The answer: 107,200,000,000 drinks. That's 107 billion, 200 million drinks.
To arrive at how many drinks this is per year, all we have to do is divide this number by 10 (for the ten-year program) and the result is 10,720,000,000. This is still a huge number that fortunately can be "massaged" even more. According to The World Factbook website, the population of Canada was estimated to be 33 million people in 2006. Dividing 10,720,000,000 by 33,000,000 equals 325. Putting this in terms that the average person can understand, every man, woman, and child in Canada will have to consume 325 alcoholic drinks per year for the next ten years to finance the new mental health system! Simply put, these numbers are not realistic.
More Flaws
The "logic" of this proposed mental health program also breaks down when it is examined more deeply. For instance, why would people drink lower-alcohol products such as beer if the increased excise tax applies to all alcoholic drinks? To help understand this better, let's use an example. Let's say that the average shot in Canada currently costs $3.00 and the average beer costs $1.00. Based on the proposed price increase, if Joe drinks an average of 5 shots per week, his weekly average alcohol expenditure will be $15.25. When the numbers are calculated, this figures out to be 1.7% more than Joe would have spent before the proposed tax increase. Let's do a similar exercise with beer. Based on the projected price increase, if Pete drinks an average of 5 beers per week, his weekly average alcohol expenditure will be $5.25. When the numbers are calculated, this figures out to be 5% more than Pete would have spent before the proposed tax increase. The point: since the proposed price increase affects higher-alcohol products (such as shots) proportionately less than their lower-alcohol counterparts (such as beer), why would Canadians switch to lower-alcohol products?
Alcohol and Mental Health
Another question. What if tens of thousands of Canadians, realizing that drinking alcohol is not good for their "mental health," significantly reduce their alcohol intake or quit drinking alcoholic beverages altogether? Where will the money come from to offset this lack of revenue? In a similar manner, what if thousands upon thousands of Canadians who drink alcoholic beverages decide that they don't want to pay the extra excise tax and, as a result, stop drinking alcoholic beverages? If this happens, where will the government get the money needed to transform the mental health system? In other words, does the Canadian government have a realistic "plan B" for this major transformation?
A Logical Contradiction
From a different perspective, isn't it rather ironic that those who drink alcoholic beverages will pay for the revamped mental health system? Isn't there a contradiction in logic somewhere in this proposal? Stated differently, if tens of thousands of Canadians have mental illnesses or are addicted to alcohol or drugs, wouldn't the government want Canadians to drink LESS alcohol in order to reduce the existing alcohol abuse, alcoholism, and alcohol-related mental health problems? Yet according to the current mental health proposal, from strictly a financial standpoint, it would appear that the Canadian government is banking the entire mental health system upgrade on historical data that strongly suggests that Canadians will continue to drink at their current or even higher levels of consumption.
Budgetary Miscalculations
What happens, for instance, if there are cost overruns in the proposed mental health system? There are, of course, two "easy" solutions to this problem: increase the excise tax on each drink or motivate Canadians to drink even more alcoholic beverages. Either "solution," however, is predicated on the fact that in order to "work," the upgraded mental health system needs to be funded by Canadians who continue to drink alcoholic beverages.
Conclusion
It appears logical to conclude that the Canadian mental health system is in need of a major overhaul. As with most comprehensive government programs, however, the issue of funding becomes a major obstacle to overcome. The proposed Canadian mental health system upgrade is no exception. Based on the reasons given above, it seems obvious that the Canadian government needs to come up with alternate sources of revenue generation for this worthwhile project. Indeed, to point out one of the major "flaws" in the current proposal, consider the following question: When is more drinking a "good thing?" Answer: when it finances a nationwide mental health system upgrade. Something tells me that Andy Rooney from "60 Minutes" would have a lot of fun with this.
Copyright 2007 - Denny Soinski. All Rights Reserved Worldwide. Reprint Rights: You may reprint this article as long as you leave all of the links active, do not edit the article in any way, and give the author credit.
Thursday, September 30, 2010
Saturday, September 25, 2010
Career Prospects in Community-based Mental Health in Maryland
There is a lot of prospect in community-based mental health careers both in the state of Maryland and all over the country. This is because for years now, there has been a lot of emphasis on prevention and reduction of inpatient hospitalization for all illnesses, including mental illness. This might primarily have been intended for cost control, it has also facilitated quality and access. The second reason why career prospects in community mental health are many is that there is currently a severe shortage of mental health workers in all sectors. The 2007 Maryland Mental Health Workforce White Paper revealed that the number and complexity of mental health problems experienced by children and their families have increased over the past decade. It further said, “At least one in five children and youth, or 20%, experience a mental health disorder. The crisis of mental health in the United States is such that 75-80% of youth with mental health diagnoses receive no services, and services received are often inadequate”. Thirdly, there is inadequate diversity among the few mental health workforce. For example, 28% of Maryland population is of ethnic minority but only 12% of mental workforce is of ethnic minorities. Furthermore, there is an acute shortage of African American males in mental health workforce.
1. Outpatient Mental Health Clinics (OMHC)
Outpatient mental health clinics provide therapy, counseling, medication management, social skills teaching, and case management services to individuals with severe and chronic mental health problems. Career prospects available in OMHC include:
Therapists and Counselors: New regulations require therapists and counselors in OMHC to have a minimum of a Masters degree and a license (such as LGSW, LCSW, LCSW-C, LGPC, LCPC, RNC, APRN/PMHN) in nursing, social work, psychology, counseling, or psychiatric rehabilitation. Also, an RN without a Masters degree but with an RNC from ANCC can be employed as a therapist. Salaries are very attractive.
2. Psychiatric Rehabilitation Programs (PRP)
PRP programs are an extension of the services provided to the patient in the OMHC. A PRP may stand alone or be an additional service to an OMHC. The purpose of PRP is to promote the rehabilitation, integration and improved quality of life for the patient at home, school, work and community. It aims at helping the patient to function at his or her optimum best in life. The counseling can be done at the Program office (onsite) or at the patient’s home (offsite). PRP counseling could be about a wide range of topics, including anger management skills, social skills, assertiveness skills, medication compliance, coping with symptoms, managing peer pressure, taking a bus, determining bus route, drug and alcohol, gang prevention, sex education, STD education, accessing community resources such as food stamps, affordable housing, bus pass, ID card, driver’s license, job search, preparing for job interview, keeping a job, improving attention in school, completing homework and school projects, respect of authority, etc.
Even though a mere one-year work experience in a mental health setting or having an AA degree qualifies one to be a PRP counselor, PRP programs prefer to employ persons with a BS degree in any health or mental health related field such as nursing, social work, counseling, psychology and rehabilitation. PRP counselors are usually paid $14 or more per counseling session. Each client receives 2 to 8 counseling sessions per month.
3. Expanded School-Based Mental Health (ESBMH)
In addition to the school clinic, some schools also have an ESBMH clinic. A therapist assigned from an OMHC manages each of such clinics. Apart from providing therapy to troubled kids sent to the therapist’s office from the class or principal’s office, the therapist also serve as a resource person to the school staff regarding particular children, issues or topics related to mental health.
4. Crisis Response Programs (BCRI, BCARS)
Mental health professionals are also needed in crisis centers where services are provided for anyone in mental health crisis. The two main centers in Baltimore are Baltimore Crisis Response, Inc. (BCRI) and Baltimore Child and Adolescent Response System (BCARS). For employment inquiries, please call 410-433-5255. There are positions that do not need a Masters degree.
BCARS website provides the following information about what they do:
BCARS is a mobile crisis response service that provides emergency contact with mental health professionals throughout the city. Dedicated crisis clinicians staff the program as part of a continuum of clinical care provided by the Catholic Charities. The Johns Hopkins Division of Child and Adolescent Psychiatry provide psychiatric consultations to the program. BCARS assists children and families facing psychiatric and psychosocial crises by providing hospital diversion and immediate intervention and respite. For information or assistance, please call the BCARS hotline (410) 752-2272. It is available 24-7.
BCRI web site provided the following information: about what they do:
HOTLINE: The telephone crisis “hotline” (410-752-2272) is available 24 hours a day and is staffed by trained counselors who have the ability to provide information and referral to the network of human services in the Baltimore metropolitan area. The counselors also provide supportive counseling, dispatch emergency assistance and link callers with more intensive BCRI services. In FY 2004 – 34,852 and FY 2005 – 30,257 calls were received on the Hotline.
MOBILE CRISIS TEAMS: Mobile crisis teams are comprised of mental health professionals including psychiatrists, social workers and nurses who can be dispatched to community locations to provide immediate assessment, intervention and treatment. Teams operate from 7:00am till midnight seven days per week. Currently the teams average over 2000 responses per year.
IN HOME SUPPORT: Persons experiencing a mental health crisis can often be maintained in the community through regular visits from the BCRI mobile crisis teams. An average of 350 people a year is cared for in this manner.
RESIDENTIAL CRISIS BEDS: Baltimore Crisis Response, Inc. operates 18 psychiatric crisis beds. Crisis beds are not new to Maryland. However, since its inception, BCRI has operated with an average length of stay of 4.5 days compared with the historical statewide average of 16.5 days.
PUBLIC EDUCATION AND TRAINING: BCRI provide public and professional education and training on a wide range of mental health related topics including: suicide prevention, crisis intervention, mental illness, and stigma. Training has also been provided to members of the Baltimore City Police Negotiation Team, over 3,000 patrol officers, Housing Police and Sheriff’s officers. Through special grants and contracts, BCRI has provided training to Baltimore City Public School teachers and guidance counselors, clergy, 911 operators, shelter care staff and others. Public education is also provided via a cable television program called “Mental Health Matters”. This program provides practical information regarding mental health issues and community resources. BCRI has also offered professional training conferences, workshops and symposia.
ADDICTIONS SERVICES: In response to the growing need for addictions treatment services BCRI has expanded and now provides a 10-day residential detoxification program for chemically addicted and dually diagnosed persons. There are currently 16 beds operated for this purpose.
5. Group Homes
Direct care staff and counselors are needed in group homes to manage, care and support the residents in the areas of activities of daily living, behavior management, life progress, and community living. Employment preference is usually given to individuals who have a degree related to health or mental health. Salary rates are very attractive. New regulations now mandate each group home especially for children to be managed by a Program Administrator (PA) who must possess at least a BS degree in any field but preferably in a health or mental health related field. Program Administrators are very well paid, depending on their education and experience and the size and intensity of the group home.
6. Private Practice
There are a lot of prospects for licensed mental health professionals with at least a Masters degree to establish their own private practice. The practice could be in the area of clinical, research, educational, or consultancy.
Saturday, September 18, 2010
Trained Memory versus Natural
Trained Memory Versus Natural Memory
Most people complain about their bad memory, but few people ever do anything about it. In this article you will learn that there is a great deal you can do about your bad memory.
The truth is there is no such thing as a bad memory or a good memory, only a trained memory and an untrained memory. I want you to fix that thought firmly in your mind. The only reason people forget things is simply down to the fact that they didn't remember it properly in the first place. The most valuable lesson that you will learn here is that the more you train your memory the better your "natural memory" will develop. By natural memory I mean your ability to remember without the aid of any memory training.
Observation:
During our normal everyday lives most people only "see" where as only a few people actually "observe". there is a vast difference between seeing and actually observing and this plays a fundamental roll in training your memory. Most of us have a clock in our kitchen or living room to tell us the time during the day. Let me ask you a question about your clock and please do not look at the clock until I have ask the question. Is the number 6 on the clock the figure 6 or the roman numeral V1? Think about this for a moment before you all rush off to look at the clock. Now remember that you see this clock everyday and most people do not know the answer to this question. We did not observe all of the information presented to us by this time piece. People see but do not observe.
Association:
This is probably the most important key element in remembering facts, event and most things in general. After something is observed it must be associated in our minds with something we already know or remember. Association, in relation to memory, simply means the connecting up of two or more things to each other. A typical example of this can be seen in the old rhyme "thirty days hath September, April, June, and November, all the rest have thirty one etc". This rhyme helps us to remember the number of days in a particular month. Simple associations, just like the rhyme above, can be applied to remembering anything and everything in our normal everyday lives.
Conclusion:
Most of us in our subconscious minds have a fear of losing our memory. Let us look at it in another way. If we fail to exercise our arms and legs on a daily basis our muscles will become weak and deteriorate from the lack of exercise. The same can be said with our memory. If our memory is not exercised constantly it too will deteriorate. There are many memory training exercises on the market today. I personally studied memory training techniques during my college years. I really was amazed at the potential power of some of the training exercises. To improve your memory you must go to a good book shop and decide which course to buy. It is important to set aside at least fifteen minutes a day to study the techniques shown on the course. If you need advise on which course to choose please feel free to contact me. After completing your memory training course you will make four remarkable discoveries.
1. Memory training systems actually do work.
2. Your "natural" memory will start to improve considerably.
3. Memory techniques will become "second nature" to you and thus your "natural" memory improves even further.
4. The final thing you will notice with this memory improvement is desire. The desire to remember more and more.
Only you can make that all important decision to improve and develop a super power memory.
Thursday, September 9, 2010
Do you feel your life is not as it used to be?
Are you currently coping with anxiety? Do you feel as if your life is not as it used to be? Do you find yourself worrying or fearing what should be the simple things in life? It is not unusual for most people to experience small amounts of anxiety in their day to day lives. People may feel anxious about meeting new people or buying a new car. Small amounts of anxiety in a person's life is considered normal. It is when the anxiety takes over and the small amount of anxiety a person used to experience landslides into copious amounts of anxiety. Having too much anxiety in our lives is what causes problems.
So when you realize that the amount of anxiety in your life is unacceptable how do you decide what therapy is right for you? There are loads of websites with anxiety treatments, but how credible are they? You could also see your doctor for assistance in choosing the right treatment. Your doctor may prescribe medicine to help you cope with your anxiety, but with most medications there will be side effects. What if you were able to find a natural drug free way to cope with your anxiety?
You can find masses of information on the internet, websites with all different types of treatments. Before you decide to hand over your credit card details, make sure you do your research first. Read the testimonials on the website and see what people are saying about the product. Also Google the product – you can usually find forums and read the discussions of individuals who have tried the product and get their opinions on the product, both good and bad. Most forums will have an unbiased review of the product as the reviews are not on the products website.
You may even find a forum that discusses different techniques to cope with anxiety that others have tried. Coping with anxiety may be as easy as making simple lifestyle changes, but for others it may not be that simple. So before you part with your hard earned cash maybe you should try a few lifestyle changes, cut out refined and processed foods, eliminate negative features of your life and see how that goes first. If you are still struggling to cope with anxiety then do your research and try to find a natural product that will work for you that individuals have given a great review and best of luck to you!
Sunday, July 11, 2010
How To Counteract Depression
Many people feel sad and depressed for a variety of reasons. Maybe you are one of those people. It is easy to become disillusioned, especially during times of stress or grief. However, it is possible to feel better and enjoy life, too.
When you are depressed or upset you tend to think in ways that are unhealthy, unrealistic or even unreasonable. The thoughts going around in your brain make you feel sad, lethargic and hopeless. There is a strong relationship between what you think and how you feel.
Here is a good example.
One day, I walked out of my house to go to work. I got in the car, turned the key and nothing happened. Of course, I tried again and it still didn't work. I became upset because I didn't want to be late to work. I also was afraid that car repairs would be costly. I remember thinking, "It is going to cost a thousand dollars to fix the car." This is a great example of an irrational, unreasonable thought. Why? Because I know very little about the inner workings of cars. I didn't know what was wrong with the car and I certainly didn't know how to diagnose a car problem. So what made me think car repairs were going to cost one thousand dollars? Who knows? I only know that after having the thought or belief that repairs would cost one thousand dollars, I became very upset.
This event is a perfect example of what I would call mixed-up thinking. It is a particular type of mixed-up thinking called jumping to conclusions. I don't know much about cars. It was unreasonable to believe that the repairs would cost some amount that arbitrarily popped into my brain.
This is the way that depressed or upset people think all the time. There are many different types of thoughts that cause you to be in distress. I will outline these various thoughts so that you can start to recognize them yourself. Once you recognize them, then you can change them.
The title of this article is "Sing For Your Sanity: How to Counteract Depression." Now for the singing part. One of the interests I have in life is music. I like to sing in the church, listen to music, and see musicals. One day I noticed that many songs are great demonstrations of unhealthy, mixed-up thinking. Here is one of my favorites. Frank Loesser wrote a song called "Marry the Man Today." The best line is Marry the man today and change his ways tomorrow." Some people believe that it is actually possible to change someone! I hope you don't. If you follow the advice in this song, you are in for a lot of trouble and distress. So the fun part of this article is that when I describe unhealthy or mixed-up ways of thinking, I will use examples of songs to demonstrate the point. Let's get started. I hope you have fun. I know I will. As an aside, if you come up with your own songs that demonstrate irrational thinking, please let me know. I am always interested in new ways to apply these ideas.
Irrational Beliefs
There are many lists of irrational beliefs that have been developed by therapists
over the years. If you look up cognitive-behavioral therapy on the Internet or in a library you will find a lot of information. I have included here the ones that I think are the most powerful and potentially unhealthy.
Irrational Beliefs are ways of thinking that are unhealthy. When you subscribe to these beliefs you are causing yourself distress, such as depression, anger or anxiety. The Snoopy Song from "You're A Good Man Charlie Brown" by Clark Gesner
exemplifies this nicely.
It starts off where Snoopy is happy and thinking good thoughts.
"Pleasant day, pretty sky, life goes on, here I lie, not bad, not bad at all."
Everything is good, right?
Then he starts talking about the little birds that visit him. They come
"every day, sitting here, on my stomach, with their sharp little claws which are usually cold and occasionally painful... Sometimes there are so many...Rats!
I feel every now and then that I gotta bite someone. I know every now and then what I want to be!
A fierce jungle animal crouched on the limb of a tree!
I'll wait very, very still till I see a victim come. I wait knowing very well every second counts. And then like the fierce jungle creature I am, I will pounce!"
Poor Snoopy. There he was, sitting happily on his dog house roof with not a care in the world. What happened? He talked himself into being angry and upset!
We are all just like Snoopy. We can talk ourselves into feeling any way possible. That is the bad news. The good news is that we can talk ourselves into feeling good!
So what do we have to do? First, we have to be able to recognize when we are thinking in unhealthy ways. Then we need to replace the unhealthy thoughts with healthy ones.
Here is a list of unhealthy thoughts.
1. Jumping to Conclusions
This is when you decide you know something that you can't actually know. Maybe you think someone is thinking poorly of you. This is not possible because you can't read someone's mind. You can also jump to conclusions by thinking you know what will happen in the future. If you know what will happen in the world before it does, let me know. I want to know the winning lottery numbers, please.
I haven't yet come up with a song for this one. Does anybody have any ideas?
2. All-or-Nothing Thinking
This type of thinking is very rigid. It is when you view the world in very rigid, perhaps legalistic, terms. Sometimes this is helpful, ie a belief that robbing banks is wrong. However, most of the time people upset themselves over things that don't have to be black and white. There is a lot of gray in the world. Look for that and you will be mentally healthier.
A good example of this type of thinking can be found in the song "Oh, How I Hate To Get Up I The Morning" by Irving Berlin.
"Oh! How I Hate To Get Up In The Morning,
Oh! How I'd love to remain in bed
For the hardest blow of all is to hear the bugler call:
'You've got to get up, you've got to get up,
You've got to get up this morning!'"
Someday I'm going to murder the bugler
Someday they're going to find him dead
I'll amputate his reveille and stomp upon it heavily
And spend the rest of my life in bed!"
This soldier basically thinks it is the worst thing in the world to get up early in the morning. He is so upset about it that he is willing to kill the bugler. Now admittedly, I have never been in the army so it is entirely possible that I could feel the same way myself. I don't like to get up early either. But please notice that his hatred for the morning results in a homicide! It is far better to tell yourself that although getting up early is unpleasant, you can do it if necessary. I do this every day when I have to get up and take my daughter to school at 7:30 a.m.
3. Should Statements
Should statements are demands that people or circumstances behave the way that you think they should. This is, in essence, having rules for how other people, yourself or the world should behave. Rules are all well and good but other people don't have to follow your rules most of the time. The world doesn't either. For example, I believe that the car in front of me should drive faster. Does my belief make this happen? Of course not. All my belief does is get me angry. And truly, why does anyone have to do what I want? I am not that powerful. I will let you know when I am Queen of the world. Then everyone will have to do what I want. Actually, again in "You're A Good Man Charlie Brown," Lucy sings a song about becoming a Queen. I think this is only in the original version, not the new one. Anyway, she sings about becoming a Queen. Her little brother Linus comes along and says that you have to inherit a royal position and Lucy is not in line to inherit. Lucy replies that she will buy a Queendom. She believes she should be able to do this and no amount of logical argument from Linus will persuade her otherwise. She wants it to be so, so it should be.
4. Exaggeration
When you exaggerate, you blow things out of proportion. We do this all the time in a harmless way. "I'm starving," we might say but of course we aren't really. Or we say, "This is terrible," or horrible or awful or any other term denoting doom. Most of the time something is not as awful as we portray it to be.
An example of exaggerating comes from "No, No, Nanette" again. Nanette, who is a teenager says,
"No, no, Nanette,
that's all I hear!
I get it the whole day through.
'No, no, Nanette,' regales my ear
no matter what I may do.
Sometime, perhaps,
I'll have my way
when I am old and turning grey.
But just as yet it's always
no, no, no, no, no, no, no, Nanette!"
Any of you have teenagers? Does this sound familiar? It does to me.
5. Blame
You can blame yourself or others for bad things that happen. The problem with blame is that it makes you powerless. Blaming yourself or another for a problem does not help solve the problem. Some people blame themselves unnecessarily for a problem that they really don't have control over. "My daughter failed her English test. I should have made her study more." Ultimately she is responsible for studying, not you. Actually, if you take the blame for this, you are helping her get out of the responsibility she really has for her grade.
Blaming others, on the other hand, is when you make someone else responsible for your behavior. In either case, you can not solve the problem. You have taken someone else's problem as your own, or given up your problem to someone else. See how that makes you powerless? You can blame yourself or others for bad things that happen.
A great song that demonstrates taking too much blame is "I Want to Be Happy" from "No, No, Nanette," a musical comedy with lyrics by Irving Caesar and Otto Harbach and music by Vincent Youmans. In this song, the singer Nanette refuses to be happy unless her boyfriend is happy. She sings,
"I want to be happy
But I won't be happy
Till I make you happy too.
Life's really worth living
When you are mirth giving
Why can't I give some to you?
When skies are gray
And you say you are blue
I'll send the sun smiling through
I wanna be happy
But I won't be happy
Till I make you happy too."
She makes her happiness dependent upon the happiness of her boyfriend! And while I am in complete agreement that it is nice to do nice things for your loved ones, it is possible to be happy when your loved ones are not. Otherwise you have to always be a people pleaser. That is not a healthy way to live. It is especially bad if you are raising children. To be a good parent, you have to make your kids unhappy sometimes. Otherwise you are setting no limits for them.
So in order to be less depressed you need to identify your unhealthy beliefs. Once you do that, then you can change them to healthy ones. You will feel better and enjoy life more. Be happy!
copyright Angela K. Williams 2010
When you are depressed or upset you tend to think in ways that are unhealthy, unrealistic or even unreasonable. The thoughts going around in your brain make you feel sad, lethargic and hopeless. There is a strong relationship between what you think and how you feel.
Here is a good example.
One day, I walked out of my house to go to work. I got in the car, turned the key and nothing happened. Of course, I tried again and it still didn't work. I became upset because I didn't want to be late to work. I also was afraid that car repairs would be costly. I remember thinking, "It is going to cost a thousand dollars to fix the car." This is a great example of an irrational, unreasonable thought. Why? Because I know very little about the inner workings of cars. I didn't know what was wrong with the car and I certainly didn't know how to diagnose a car problem. So what made me think car repairs were going to cost one thousand dollars? Who knows? I only know that after having the thought or belief that repairs would cost one thousand dollars, I became very upset.
This event is a perfect example of what I would call mixed-up thinking. It is a particular type of mixed-up thinking called jumping to conclusions. I don't know much about cars. It was unreasonable to believe that the repairs would cost some amount that arbitrarily popped into my brain.
This is the way that depressed or upset people think all the time. There are many different types of thoughts that cause you to be in distress. I will outline these various thoughts so that you can start to recognize them yourself. Once you recognize them, then you can change them.
The title of this article is "Sing For Your Sanity: How to Counteract Depression." Now for the singing part. One of the interests I have in life is music. I like to sing in the church, listen to music, and see musicals. One day I noticed that many songs are great demonstrations of unhealthy, mixed-up thinking. Here is one of my favorites. Frank Loesser wrote a song called "Marry the Man Today." The best line is Marry the man today and change his ways tomorrow." Some people believe that it is actually possible to change someone! I hope you don't. If you follow the advice in this song, you are in for a lot of trouble and distress. So the fun part of this article is that when I describe unhealthy or mixed-up ways of thinking, I will use examples of songs to demonstrate the point. Let's get started. I hope you have fun. I know I will. As an aside, if you come up with your own songs that demonstrate irrational thinking, please let me know. I am always interested in new ways to apply these ideas.
Irrational Beliefs
There are many lists of irrational beliefs that have been developed by therapists
over the years. If you look up cognitive-behavioral therapy on the Internet or in a library you will find a lot of information. I have included here the ones that I think are the most powerful and potentially unhealthy.
Irrational Beliefs are ways of thinking that are unhealthy. When you subscribe to these beliefs you are causing yourself distress, such as depression, anger or anxiety. The Snoopy Song from "You're A Good Man Charlie Brown" by Clark Gesner
exemplifies this nicely.
It starts off where Snoopy is happy and thinking good thoughts.
"Pleasant day, pretty sky, life goes on, here I lie, not bad, not bad at all."
Everything is good, right?
Then he starts talking about the little birds that visit him. They come
"every day, sitting here, on my stomach, with their sharp little claws which are usually cold and occasionally painful... Sometimes there are so many...Rats!
I feel every now and then that I gotta bite someone. I know every now and then what I want to be!
A fierce jungle animal crouched on the limb of a tree!
I'll wait very, very still till I see a victim come. I wait knowing very well every second counts. And then like the fierce jungle creature I am, I will pounce!"
Poor Snoopy. There he was, sitting happily on his dog house roof with not a care in the world. What happened? He talked himself into being angry and upset!
We are all just like Snoopy. We can talk ourselves into feeling any way possible. That is the bad news. The good news is that we can talk ourselves into feeling good!
So what do we have to do? First, we have to be able to recognize when we are thinking in unhealthy ways. Then we need to replace the unhealthy thoughts with healthy ones.
Here is a list of unhealthy thoughts.
1. Jumping to Conclusions
This is when you decide you know something that you can't actually know. Maybe you think someone is thinking poorly of you. This is not possible because you can't read someone's mind. You can also jump to conclusions by thinking you know what will happen in the future. If you know what will happen in the world before it does, let me know. I want to know the winning lottery numbers, please.
I haven't yet come up with a song for this one. Does anybody have any ideas?
2. All-or-Nothing Thinking
This type of thinking is very rigid. It is when you view the world in very rigid, perhaps legalistic, terms. Sometimes this is helpful, ie a belief that robbing banks is wrong. However, most of the time people upset themselves over things that don't have to be black and white. There is a lot of gray in the world. Look for that and you will be mentally healthier.
A good example of this type of thinking can be found in the song "Oh, How I Hate To Get Up I The Morning" by Irving Berlin.
"Oh! How I Hate To Get Up In The Morning,
Oh! How I'd love to remain in bed
For the hardest blow of all is to hear the bugler call:
'You've got to get up, you've got to get up,
You've got to get up this morning!'"
Someday I'm going to murder the bugler
Someday they're going to find him dead
I'll amputate his reveille and stomp upon it heavily
And spend the rest of my life in bed!"
This soldier basically thinks it is the worst thing in the world to get up early in the morning. He is so upset about it that he is willing to kill the bugler. Now admittedly, I have never been in the army so it is entirely possible that I could feel the same way myself. I don't like to get up early either. But please notice that his hatred for the morning results in a homicide! It is far better to tell yourself that although getting up early is unpleasant, you can do it if necessary. I do this every day when I have to get up and take my daughter to school at 7:30 a.m.
3. Should Statements
Should statements are demands that people or circumstances behave the way that you think they should. This is, in essence, having rules for how other people, yourself or the world should behave. Rules are all well and good but other people don't have to follow your rules most of the time. The world doesn't either. For example, I believe that the car in front of me should drive faster. Does my belief make this happen? Of course not. All my belief does is get me angry. And truly, why does anyone have to do what I want? I am not that powerful. I will let you know when I am Queen of the world. Then everyone will have to do what I want. Actually, again in "You're A Good Man Charlie Brown," Lucy sings a song about becoming a Queen. I think this is only in the original version, not the new one. Anyway, she sings about becoming a Queen. Her little brother Linus comes along and says that you have to inherit a royal position and Lucy is not in line to inherit. Lucy replies that she will buy a Queendom. She believes she should be able to do this and no amount of logical argument from Linus will persuade her otherwise. She wants it to be so, so it should be.
4. Exaggeration
When you exaggerate, you blow things out of proportion. We do this all the time in a harmless way. "I'm starving," we might say but of course we aren't really. Or we say, "This is terrible," or horrible or awful or any other term denoting doom. Most of the time something is not as awful as we portray it to be.
An example of exaggerating comes from "No, No, Nanette" again. Nanette, who is a teenager says,
"No, no, Nanette,
that's all I hear!
I get it the whole day through.
'No, no, Nanette,' regales my ear
no matter what I may do.
Sometime, perhaps,
I'll have my way
when I am old and turning grey.
But just as yet it's always
no, no, no, no, no, no, no, Nanette!"
Any of you have teenagers? Does this sound familiar? It does to me.
5. Blame
You can blame yourself or others for bad things that happen. The problem with blame is that it makes you powerless. Blaming yourself or another for a problem does not help solve the problem. Some people blame themselves unnecessarily for a problem that they really don't have control over. "My daughter failed her English test. I should have made her study more." Ultimately she is responsible for studying, not you. Actually, if you take the blame for this, you are helping her get out of the responsibility she really has for her grade.
Blaming others, on the other hand, is when you make someone else responsible for your behavior. In either case, you can not solve the problem. You have taken someone else's problem as your own, or given up your problem to someone else. See how that makes you powerless? You can blame yourself or others for bad things that happen.
A great song that demonstrates taking too much blame is "I Want to Be Happy" from "No, No, Nanette," a musical comedy with lyrics by Irving Caesar and Otto Harbach and music by Vincent Youmans. In this song, the singer Nanette refuses to be happy unless her boyfriend is happy. She sings,
"I want to be happy
But I won't be happy
Till I make you happy too.
Life's really worth living
When you are mirth giving
Why can't I give some to you?
When skies are gray
And you say you are blue
I'll send the sun smiling through
I wanna be happy
But I won't be happy
Till I make you happy too."
She makes her happiness dependent upon the happiness of her boyfriend! And while I am in complete agreement that it is nice to do nice things for your loved ones, it is possible to be happy when your loved ones are not. Otherwise you have to always be a people pleaser. That is not a healthy way to live. It is especially bad if you are raising children. To be a good parent, you have to make your kids unhappy sometimes. Otherwise you are setting no limits for them.
So in order to be less depressed you need to identify your unhealthy beliefs. Once you do that, then you can change them to healthy ones. You will feel better and enjoy life more. Be happy!
copyright Angela K. Williams 2010
Facing Your Depression
Depression is an illness and needs to be acknowledged as such. It is not a reason to be ashamed. The reason so many people fail to seek help for their depression is that they are ashamed, confused or don't know exactly where to turn. Unfortunately, these are some of the feelings associated with depression anyway and make the illness difficult to face.
If you are constantly feeling particularly low, stressed and/or anxious, well-meaning friends might tell you to "snap out of it" or even start to get irritated by your mood. Your depression will feed off this negativity and you start to wonder why you can't just "snap out of it". You then start to feel that there's something wrong with you because it should be so easy and it's just "not right" that you feel so bad all the time. Well, it's not right and there is something wrong with you. You have a medical condition and you deserve treatment in the same way as any other patient. If you had a cold for six months would you ignore it and hope it would pass? No, you would dose yourself up with anything you could find and maybe see a doctor to find out if there's an underlying reason for it to last so long.
In my case I let my depression go far too long thinking it would go away. Well it didn't go away. It got to the point where it built into panic attacks, restlessness and then severe anxiety to the point where I could not function. I could not work; deal with people, or even deal with my family. I was finally forced by my wife to see a doctor.
I was eventually hospitalized, and I admit that it was a low point in my life, but I got treatment and it was only up from there. Sure it didn't happen overnight. It was hard, but little by little I had begun to feel better, lighter, like a weight was being lifted off of me. The better I felt, the bigger the strides I could take to overcome this illness. Before long I felt like a Superman compared to where I was.
Depression is sadness that lasts too long. Everyone is sad at some point in their lives but depression is more than that. It is a feeling that you can't bring yourself up from the bottom. In the end you give up trying. People start to avoid you. You feel worse. You need to find external help to treat the problem in the same way as you would if you had a long-lasting cold. Don't wait like me until you are at a point where you can no longer function in daily living. You could try herbal remedies, or all natural programs, or you could see your doctor. There may be an underlying physical cause for your depression.
If your doctor cannot help you they may refer you for counseling. Don't be embarrassed to go for counseling but do make sure you are comfortable with your counselor. If not, try another one. It is important you find someone to talk to. It feels better to get things off your chest. Counseling should not be discounted because you don't feel comfortable with your first choice of practitioner. In everyday life you will naturally find that you get on with some people and clash with others. You cannot afford to have a personality clash with your counselor. On the other hand you must be sure that it is a personality clash and not just that you don't agree with what they are saying. A general rule is to go with your instincts. If you like the person and seemed to get on well in the first couple of sessions then stick with it because they might just have touched on the root cause of your problem.
In some cases, acknowledging depression may be difficult because you have lived with it so long that you don't know whether it is depression or not. If you have grown up with depression it is possible not to realize that you are actually depressed because you have no concept of how normal people should feel. You may feel angry all the time or you may feel like going to the middle of an empty field and simply screaming. You may feel anxious, have trouble sleeping or even sleep too much. You may think that your family would be better off without you (and actually believe that to be true) and may have considered running away or suicide. You may worry about death all the time (yours or someone else's) and not let yourself be happy just in case…… (Or even "I must enjoy this now in case……….."). If you are feeling any or all of the above then you need to consider talking to someone. Even if it is just a friend or family member to start with, they may be able to advise you and encourage you to seek professional help.
Once you have acknowledged that you have depression please remember that it is a medical condition and can be cured. You don't have to feel this way for ever. Nobody actually thinks of you the way you think they do. Talk to someone. Seek and accept help and you will find that there is a different way of seeing life. The bottom line for me was that I dealt with it, and conquered it and you will too. Again, don't wait to be forced into dealing with it. Attack it now and live the life you deserve.
To your health and well being,
Terry Poster
If you are constantly feeling particularly low, stressed and/or anxious, well-meaning friends might tell you to "snap out of it" or even start to get irritated by your mood. Your depression will feed off this negativity and you start to wonder why you can't just "snap out of it". You then start to feel that there's something wrong with you because it should be so easy and it's just "not right" that you feel so bad all the time. Well, it's not right and there is something wrong with you. You have a medical condition and you deserve treatment in the same way as any other patient. If you had a cold for six months would you ignore it and hope it would pass? No, you would dose yourself up with anything you could find and maybe see a doctor to find out if there's an underlying reason for it to last so long.
In my case I let my depression go far too long thinking it would go away. Well it didn't go away. It got to the point where it built into panic attacks, restlessness and then severe anxiety to the point where I could not function. I could not work; deal with people, or even deal with my family. I was finally forced by my wife to see a doctor.
I was eventually hospitalized, and I admit that it was a low point in my life, but I got treatment and it was only up from there. Sure it didn't happen overnight. It was hard, but little by little I had begun to feel better, lighter, like a weight was being lifted off of me. The better I felt, the bigger the strides I could take to overcome this illness. Before long I felt like a Superman compared to where I was.
Depression is sadness that lasts too long. Everyone is sad at some point in their lives but depression is more than that. It is a feeling that you can't bring yourself up from the bottom. In the end you give up trying. People start to avoid you. You feel worse. You need to find external help to treat the problem in the same way as you would if you had a long-lasting cold. Don't wait like me until you are at a point where you can no longer function in daily living. You could try herbal remedies, or all natural programs, or you could see your doctor. There may be an underlying physical cause for your depression.
If your doctor cannot help you they may refer you for counseling. Don't be embarrassed to go for counseling but do make sure you are comfortable with your counselor. If not, try another one. It is important you find someone to talk to. It feels better to get things off your chest. Counseling should not be discounted because you don't feel comfortable with your first choice of practitioner. In everyday life you will naturally find that you get on with some people and clash with others. You cannot afford to have a personality clash with your counselor. On the other hand you must be sure that it is a personality clash and not just that you don't agree with what they are saying. A general rule is to go with your instincts. If you like the person and seemed to get on well in the first couple of sessions then stick with it because they might just have touched on the root cause of your problem.
In some cases, acknowledging depression may be difficult because you have lived with it so long that you don't know whether it is depression or not. If you have grown up with depression it is possible not to realize that you are actually depressed because you have no concept of how normal people should feel. You may feel angry all the time or you may feel like going to the middle of an empty field and simply screaming. You may feel anxious, have trouble sleeping or even sleep too much. You may think that your family would be better off without you (and actually believe that to be true) and may have considered running away or suicide. You may worry about death all the time (yours or someone else's) and not let yourself be happy just in case…… (Or even "I must enjoy this now in case……….."). If you are feeling any or all of the above then you need to consider talking to someone. Even if it is just a friend or family member to start with, they may be able to advise you and encourage you to seek professional help.
Once you have acknowledged that you have depression please remember that it is a medical condition and can be cured. You don't have to feel this way for ever. Nobody actually thinks of you the way you think they do. Talk to someone. Seek and accept help and you will find that there is a different way of seeing life. The bottom line for me was that I dealt with it, and conquered it and you will too. Again, don't wait to be forced into dealing with it. Attack it now and live the life you deserve.
To your health and well being,
Terry Poster
Tuesday, April 20, 2010
Mental Health in Maryland
1. Outpatient Mental Health Clinics (OMHC)
Outpatient mental health clinics provide therapy, counseling, medication management, social skills teaching, and case management services to individuals with severe and chronic mental health problems. Career prospects available in OMHC include:
Therapists and Counselors: New regulations require therapists and counselors in OMHC to have a minimum of a Masters degree and a license (such as LGSW, LCSW, LCSW-C, LGPC, LCPC, RNC, APRN/PMHN) in nursing, social work, psychology, counseling, or psychiatric rehabilitation. Also, an RN without a Masters degree but with an RNC from ANCC can be employed as a therapist. Salaries are very attractive.
2. Psychiatric Rehabilitation Programs (PRP)
PRP programs are an extension of the services provided to the patient in the OMHC. A PRP may stand alone or be an additional service to an OMHC. The purpose of PRP is to promote the rehabilitation, integration and improved quality of life for the patient at home, school, work and community. It aims at helping the patient to function at his or her optimum best in life. The counseling can be done at the Program office (onsite) or at the patient’s home (offsite). PRP counseling could be about a wide range of topics, including anger management skills, social skills, assertiveness skills, medication compliance, coping with symptoms, managing peer pressure, taking a bus, determining bus route, drug and alcohol, gang prevention, sex education, STD education, accessing community resources such as food stamps, affordable housing, bus pass, ID card, driver’s license, job search, preparing for job interview, keeping a job, improving attention in school, completing homework and school projects, respect of authority, etc.
Even though a mere one-year work experience in a mental health setting or having an AA degree qualifies one to be a PRP counselor, PRP programs prefer to employ persons with a BS degree in any health or mental health related field such as nursing, social work, counseling, psychology and rehabilitation. PRP counselors are usually paid $14 or more per counseling session. Each client receives 2 to 8 counseling sessions per month.
3. Expanded School-Based Mental Health (ESBMH)
In addition to the school clinic, some schools also have an ESBMH clinic. A therapist assigned from an OMHC manages each of such clinics. Apart from providing therapy to troubled kids sent to the therapist’s office from the class or principal’s office, the therapist also serve as a resource person to the school staff regarding particular children, issues or topics related to mental health.
4. Crisis Response Programs (BCRI, BCARS)
Mental health professionals are also needed in crisis centers where services are provided for anyone in mental health crisis. The two main centers in Baltimore are Baltimore Crisis Response, Inc. (BCRI) and Baltimore Child and Adolescent Response System (BCARS). For employment inquiries, please call 410-433-5255. There are positions that do not need a Masters degree.
Outpatient mental health clinics provide therapy, counseling, medication management, social skills teaching, and case management services to individuals with severe and chronic mental health problems. Career prospects available in OMHC include:
Therapists and Counselors: New regulations require therapists and counselors in OMHC to have a minimum of a Masters degree and a license (such as LGSW, LCSW, LCSW-C, LGPC, LCPC, RNC, APRN/PMHN) in nursing, social work, psychology, counseling, or psychiatric rehabilitation. Also, an RN without a Masters degree but with an RNC from ANCC can be employed as a therapist. Salaries are very attractive.
2. Psychiatric Rehabilitation Programs (PRP)
PRP programs are an extension of the services provided to the patient in the OMHC. A PRP may stand alone or be an additional service to an OMHC. The purpose of PRP is to promote the rehabilitation, integration and improved quality of life for the patient at home, school, work and community. It aims at helping the patient to function at his or her optimum best in life. The counseling can be done at the Program office (onsite) or at the patient’s home (offsite). PRP counseling could be about a wide range of topics, including anger management skills, social skills, assertiveness skills, medication compliance, coping with symptoms, managing peer pressure, taking a bus, determining bus route, drug and alcohol, gang prevention, sex education, STD education, accessing community resources such as food stamps, affordable housing, bus pass, ID card, driver’s license, job search, preparing for job interview, keeping a job, improving attention in school, completing homework and school projects, respect of authority, etc.
Even though a mere one-year work experience in a mental health setting or having an AA degree qualifies one to be a PRP counselor, PRP programs prefer to employ persons with a BS degree in any health or mental health related field such as nursing, social work, counseling, psychology and rehabilitation. PRP counselors are usually paid $14 or more per counseling session. Each client receives 2 to 8 counseling sessions per month.
3. Expanded School-Based Mental Health (ESBMH)
In addition to the school clinic, some schools also have an ESBMH clinic. A therapist assigned from an OMHC manages each of such clinics. Apart from providing therapy to troubled kids sent to the therapist’s office from the class or principal’s office, the therapist also serve as a resource person to the school staff regarding particular children, issues or topics related to mental health.
4. Crisis Response Programs (BCRI, BCARS)
Mental health professionals are also needed in crisis centers where services are provided for anyone in mental health crisis. The two main centers in Baltimore are Baltimore Crisis Response, Inc. (BCRI) and Baltimore Child and Adolescent Response System (BCARS). For employment inquiries, please call 410-433-5255. There are positions that do not need a Masters degree.
Sociology of Mental Illness
The more one reads about mental illness, sees or interacts with some of the mentally challenged, or those whom society considers as mentally ill, the more the question about the reality of the problem comes to the mind. Also the more the question crops up the harder it is to arrive at a conclusion regarding what mental illness really is. An attempt to define mental illness helps to expose the ambiguity and the futility involved. This fact guided the thought of Mechanic (1980) in his book, “Mental Health and Social Policy.” For example, Webster’s Third New International dictionary defines insanity as, “such unsoundness of mind or lack of understanding as prevents one from having a mental capacity to enter into a particular relationship, status or transaction or as excuses one from criminal and civil responsibilities.” One can infer from this definition that the law has been assigned the role of determining what behaviours and who fits into this category. Of course, the law is manmade and influenced by the types of behaviours identified, compiled and classified as “unsoundness of mind or lack of understanding.” In short, the law can only ruminate on what is already in existence. Thus, the law in response to the evidence adduced before fits them into this predetermined categories. The point here is that the law, is culturally determined by the society or the social structure. That is, the social structure, in one way or the other determines who is mentally ill, cured, and who should continue to bear the label. Another question is how does the law conclude that one person is sane while the other is not? This point needs some clarification. That the social structure determines what falls into the category of mental illness is a source of concern because it introduces subjectivity into the meaning, definition and interpretation given to the “behaviours” in question. Let us assume that people within the social structure know what the normal behaviours that are expected of their members are. We can garner this from the fact that we all operate within the boundary of the “assumptive world.” The concept “assumptive world” relates to the fact that our behaviours are continuously being evaluated by others and by ourselves - relative to others. That means that the reactions (real or perceived) of the people to our behaviour(s) will determine/influence how we feel about ourselves, the nature of the world around us, our ability to predict what to expect from others and the resultant effect of our actions (Frank, 1974:27-29). The factor that should be noted is that the assumptive world varies and depends on the culture. For example, it is assumed that shoes are to be worn on the feet, not on the palms. Again, the type of shoes worn depends on the setting — bathroom slippers (depending on the social class) are not expected to be worn to formal functions. Eye contact should be made while discussing with somebody not for one to continue to stare at the other’s ears — the Yoruba culture makes a further restriction, it does not expect a child to maintain eye contact with an adult. This shows that even though these norms are not codified or written into law, they exist and people through socialization are expected to acquire/learn them in conjunction with the appropriate cues. In fact, most of the times we do not know that some of them exist until we have violated them - but we are always prepared to make appropriate amends. Despite this, we are subjected to and we subject ourselves to the reactions of others as to whether our behaviours are positively or negatively responded to. A positive reaction could mean that the behaviour is acceptable within the context in which it occurs and we can thus afford to repeat it. For instance, in some churches, a spiritualist who goes into trance while devouring the wrong doings of others, or while claiming to have seen God if praised for the revelations made is apt to repeat the behaviour following the prescribed cue. However with the interpretation of the Bible today, particularly by the Pentecostal Churches, such persons could be ostracized or marked out for deliverance — for according to this faith or new interpretation, no human being (because of sin) can ever see God but could see His son Jesus Christ. Also, going into trance is not the order of the day but speaking in tongue is the current norm. This being the case, it becomes risky or too expensive of behaviour for any member to repeat the unmerited. The above reinforces the view that a particular behavior in different setting will elicit different reactions and responses from people as dictated by cultural interpretations, definitions and understanding (Frank, 1974; Mechanic, 1980; Henslin, 2002). These definitions and responses are also influenced by factors such as the person involved his/her personality, and the where and when of the behaviour. A good example is an incident that occurred while a hungry Nigerian musician who was in a foreign country was “bowling” down some “akpu/fufu” (a Nigerian meal made from cassava) at a station. Somebody called the police claiming that a Blackman was trying to commit suicide. In summary, all of the above reactions exert influence on the actors and the observers and the decision as to whether to continue with the specified behaviour or not. The key factor is for the person to know the cues and to respond appropriately, else, it draws unwanted attention.
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