April 29: PsychOdyssey To Join NJPAC’s Stage Reading Symposium For SANISM, A New Play About Mental Illness

On Friday, April 29, from 7:00 pm to 9:30 pm, the New Jersey Performing Arts Center (NJPAC), one of America’s leading cultural venues, is hosting a stage reading and audience discussion symposium for a new docu-play about mental illness. The play is called SANISM, written by David Lee White, who was awarded a commission by NJPAC’s Stage Exchange Program to create the play. PsychoOdyssey’s Tom Pyle has been invited to be one of symposium’s panelists to react and respond to the play and its message after the performance. Proceeds from the event will benefit the Mercer County affiliate of the National Alliance on Mental Illness.

SANSIM is a 90 minute docu-play based on interviews with people with mental illness, as well as their families, health care workers, and social service organizations. The reading will feature actors Maria Konstantinidis, Newton Buchanan, Deena Jiles, and Dara Lewis under the direction of Charlotte Northeast.

Playwright David Lee White is Associate  Artistic  Director  and  Resident  Playwright  at  Passage Theater  in Trenton, New Jersey. Mr. White is also the curator of the Rider University New Play Festival, a play writing instructor at Play Penn in Philadelphia, and teaches Dramatic Analysis at Drexel University. White describes SANISM below:

SANISM’s patron is NJPAC’s Stage Exchange, a new play development series that commissions local playwrights to create works with social issues in mind. All commissioned plays are already guaranteed full productions beyond their one-night-only staged readings. SANISM is one of three new plays commissioned by Stage Exchange for 2016 that will receive staged readings at NJPAC in Newark, accompanied by panel discussions with academics, activists and artists on the subject matter.

Also joining the symposium panel will be Suzanne McConnell, a New York based fiction writer and editor, and Nancy Gross, formerly a writing instructor at City University of New York and now Community Liaison consultant for Palliative Care at Overlook Medical Center in Summit, NJ. Co-sponsoring the April 29 stage reading and symposium is the New Jersey Theatre Alliance, based in West Orange, NJ, a service association “megaguild” of 33 theaters around New Jersey. Mr. White’s home theater, the Passage Theater of Trenton, NJ, is one of the Alliance’s members.

For further information about the event, click here.

For tickets, click here.

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NJ’s Supportive Housing Association’s Excellent Op-Ed, and Psychodyssey’s Response in Support

Supportive Housing AssociationThe New Jersey Supportive Housing Association is a leading crusader in the Garden State for more and better supportive housing especially for those with psychiatric and developmental disabilities. Its energetic, impassioned, and very effective executive director is Ms. Gail Levinson. Gail recently took up her cyber pen to editorialize in NJ Spotlight about the affordable housing crisis in New Jersey, challenging among others the New Jersey League of Municipalities to do the right thing, namely, permit more affordable and supportive housing stock to be built in New Jersey’s towns.

Gail Levinson, Executive Director, NJ Supportive Housing Association

Gail Levinson, Executive Director, NJ Supportive Housing Association

Gail wrote: “Much more can and should be done to solve our housing crisis; limiting access is not a solution. A primary goal for individuals with disabilities is the desire to be accepted and included in local communities. So why does the New Jersey League of Municipalities, which represents the interests of towns and cities, exclude rather than accept them?”

 Read the rest of Gail’s fine editorial here.

Psychodyssey’s Tom Pyle wrote a response to Ms. Levinson’s op-ed and one of the comments made about it. Psychodyssey reprints the response it its entirety here:

Bravo, Gail Levinson for a critical op-ed on a critical subject. So many things to talk about! Hear the wail of one lowly citizen seeking and not yet finding affordable housing for his disabled loved one!…

Indeed ZONING is a critical obstacle. In Princeton, where I live, the entire zoning plan completely skews to large and expensive single family housing. There is little possibility currently to intensify land use sensibly by permitting denser zoning, or to enable innovations possible from the “small house movement”, or to permit families to build on their own properties stand-alone supplemental housing for their disabled loved ones.

Another impediment in many towns is ENVIRONMENTAL FUNDAMENTALISM which seems unfortunately, if surely unintentionally, to put plants before people. Recently in Princeton, the Town Council voted to take 22 developable acres off the market as another “open space” purchase, despite the Town already having met and exceeded its master plan for open space, and also despite the Town not properly tending to the maintenance and care of the open space it already has. The acquired land was slated to be developed as a 55+ community. We need better balance in our priorities. Housing first always!

A third impediment is INORDINATE MUNICIPAL SPENDING which shrinks options for more affordable housing. Despite local candidates’ perennial pledges to promote “affordability”, many municipal leaders keep busting through their budgets. Princeton’s aforementioned purchase of “open space” was voted despite a yawning $6mm gap in the Town’s capital budget that no one knows how will be closed. Rarely do municipal leaders seem to reduce spending, streamline services, and avoid duplication. While Mercer County has a perfectly suitable Board of Social Services in Trenton tending to the county’s disadvantaged, Princeton has its own human services department doing the same thing. This is expensive duplication of salaries for such municipal staff without the benefits of larger county-wide economies of scale.

A fourth impediment is RECKLESS STATE SPENDING. New Jersey’s state budget is in a world of hurt. How bad is our state’s budget? The credit rating agencies rank New Jersey 49th out of 50th. Decades of bad spending decisions by Trenton’s politicians in the pockets of special interests now leave no reserves or flexibility for our critical problems. We are left debating constitutional amendments to pay for politically determined pensions for the powerful while HMFA’s Special Needs Trust Fund, so needed to catalyze more affordable housing creation, remains depleted. Meanwhile, New Jerseyans remain the highest taxed citizens in the country, which is leading many to migrate. (If you don’t believe this, ask any New Jersey financial advisor.)

A fifth impediment is subtle but continuing ECONOMIC DISCRIMINATION. Despite many fine achievements, still many rich towns don’t want more poor people, thinking they have “done enough”. According to the Mercer County Office of Housing and Community Development (2010) and others, current affordable housing stock skews away from those who most need it towards those who need it less. As true around the State, Princeton’s stock for the upper end of the affordability class, i.e., middle income, is in surplus. At the very low, extremely low, and deeply low ends of the cohort, there is a deficit. Consider the plight of a disabled citizen with a permanent disability on SSI/SSD, receiving $785 per month or less than $10,000 p.a. As reported by SHA and other NJ housing advocates, some 120,000 New Jerseyans are at this lowest rung, but only 40,000 housing stock slots are available to them at their income levels. The parameters of the “affordable” housing programs are still too exclusionary, and thus discriminatory.

A sixth impediment is an excessive impulse of some municipal leaders toward SOCIAL ENGINEERING. In rich towns especially, there are sentiments in some quarters that the town “do something” for the middle class. Indeed the plight of the middle class is serious. They have lost ground in the last two decades. But they still have options and mobility as the disabled do not. Yet some housing policy makers in Princeton are suggesting that the Town subsidize middle class residents seeking affordable housing in that segment of stock already in surplus, for people up to 250% of the federal poverty level. Meanwhile, the extremely low and deeply low disabled citizenry must scramble, if their disabilities don’t preclude, for the woefully insufficient stock at their level. Such well-meaning but misguided elite sentiment sometimes seems to want to subsidize the “little” people who already have while denying the littlest people who still have not.

So much need. So far to go. Affordable housing for New Jersey’s disabled—a truly vexatious challenge. It is our state’s premier social justice issue at this time. I salute Gail Levinson and her excellent SHA team for keeping the spotlight squarely on this very difficult problem. She needs and deserves all our support.

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New at “Yikes!…”: NJTV stigmatizes NAMI Mercer Board Member Robert Hedden

NAMI Mercer Board Member Robert Hedden (l) with NJ Gov. Chris Christie at yesterday's Catholic Charities supportive housing roundtable in Trenton.

NAMI Mercer Board Member Robert Hedden (l) with NJ Gov. Chris Christie at yesterday’s Catholic Charities supportive housing roundtable in Trenton.

Here in New Jersey, Governor Chris Christie yesterday visited Trenton’s Catholic Charities to recognize both the successes of its supportive housing program for loved ones with psychiatric disabilities and the challenges of addictions of some within its programs. The event was covered by many New Jersey media outlets, including the state’s very own public television station, NJTV.

To accompany its video footage, NJTV posted a news article of the event to its website. One of the quoted subjects was Mr. Robert Hedden, a personal friend of Psychdodyssey and a mental health advocate and community leader in the Trenton, NJ, area.

While performing a general public service by reporting on an important event at Catholic Charities, NJTV unfortunately did a serious disservice to Mr. Hedden, a disclosed non-addicted mental health services consumer with a serious and persistent psychiatric disability, with a disparaging description of him as “a behavioral health patient”. Such a descriptor created the kind of needless and insensitive stigma that too often confronts our loved ones with psychiatric disabilities.

To address this matter, Psychodyssey’s Tom Pyle wrote the following message to NJTV:

To: NJTV

Attn: Mr. Michael Hill, Correspondent

Thank you for reporting Gov. Christie’s visit to Catholic Charities. Good news about success stories in New Jersey’s public mental healthcare system are most appreciated.

I note, however, your description of my friend and colleague, Mr. Robert Hedden, a Catholic Charities supportive housing client and fellow board member of NAMI Mercer,  as a “behavioral health patient”.

While surely not intentionally so on your part, this is a stigmatizing characterization of Mr. Hedden and other New Jerseyans like him. While not widely acknowledged or understood, stigma against fellow citizens with psychiatric disabilities is often one of the most pernicious forms of social bigotry against a class of people (and their families) as exists in our country today.

Robert has done our local community a great service in disclosing his personal psychiatric disability, thus helping us all better understand the challenges all loved ones with psychiatric disabilities face. He also well represents a supportive housing success story of how a fellow citizen with a serious psychiatric disability, with proper supports and community integration, can not only live, but thrive in spite of such a challenge. He is a vigorous and vibrant fellow citizen and local community leader who happens to have a psychiatric disability, not a “behavioral patient”, which conjures a disparaging image of a helpless, pathetic crazy person in a hospital gown or, worse, straitjacket. All of us who work with him are so grateful for his leadership, as we are for his inspiring model of personal recovery.

We New Jerseyans are fortunate to have NJTV as  a media leader for our state. Your coverage of such events and the way you describe them are critical not only to learning of the good work being done in our public mental health system, but also in guiding and correctly framing the public’s understanding of them and those like Mr. Hedden who are its success stories. With great appreciation for the good reporting you and the whole NJTV team undertake every day, let me gently but firmly request that you and your team do all you can with your descriptors to portray our loved ones with psychiatric disabilities as the heroes they truly are, and not diminish their dignity with stigmatizing, diminutive, and incorrect appellations such as “patients”.

With best wishes,

Sincerely,

Tom Pyle

Princeton, NJ

Member, NJ Behavioral Health Planning Council

Board Member, NAMI Mercer

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New Jersey Addictions: Charts, Graphs, and Data

(Updated March 31, 2016)

Charts, Graphs and Data title pageNew Jersey is in the midst of a opiate/heroin crisis. The crisis has vast implications for families of loved ones with psychiatric disabilities. More information for the public is desperately needed to understand the gravity of the crisis.

As part of work for the New Jersey Behavioral Health Planning Council, PyschOdyssey’s Tom Pyle has assembled charts and graphs that describe this urgent problem. Information has been sourced about the crisis at both the national and state level.

See PsychOdyssey’s slide deck of New Jersey Addictions: Charts, Graphs, and Data below.

Part One: US Information

Part Two: NJ Information

 

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New Link: Special Needs Alliance (a PsychOdyssey “best ever” find!…)

Special Needs AlliancePsychOdyssey is pleased to share its discovery (possibly one of our best ever finds!…) of an excellent information source for parents contemplating the special needs of their loved ones. The Special Needs Alliance (SNA) is a national, not for profit organization of attorneys dedicated to the practice of disability and public benefits law. Individuals with disabilities, their families and their advisors rely on the SNA to connect them with nearby attorneys who focus their practices in the disability law arena.

The mission of the SNA is to maintain a professional organization of attorneys skilled in the complex areas of public entitlements, estate, trust and tax planning, and legal issues involving individuals with physical and cognitive disabilities.

The SNA was formed in 2002 by a core group of prominent disability and elder law attorneys who recognized the unique planning needs of younger individuals with disabilities and their families. While the SNA now has members in 47 states, the organization continues to limit membership to those who have proven credentials in the area of disability law and advocacy.

Based in Tucson, AZ, the SNA is an invitation-only organization for attorneys. SNA membership is based on a combination of relevant legal experience in the disability and elder law fields, direct family experience with disability, active participation with national, state and local disability advocacy organizations, and professional reputation. As a result, an SNA member will have an average of 18 years of relevant legal experience, with no member having practiced law for less than 5 years. The majority have been certified as Elder Law Attorneys (CELAs) by the National Elder Law Foundation, the certifying entity for the National Academy of Elder Law Attorneys (NAELA).

The SNA website provides an excellent source of information for the lay reader about the complex area of special needs law. All families in the maelstrom would do well to get acquainted with the site and partake of the special needs lawyers who make the site possible.

 

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New Link: Consortium for Citizens with Disabilities

Consortium for Citizens with DisabilitiesThe Consortium for Citizens with Disabilities (CCD) is a coalition of national consumer, advocacy, provider and professional organizations headquartered in Washington, D.C. Since 1973, the CCD has advocated on behalf of people of all ages with physical and mental disabilities and their families. CCD has worked to achieve federal legislation and regulations that assure that the 54 million children and adults with disabilities are fully integrated into the mainstream of society.

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New Video: A Day In The Life Of A PACT Team

act_logoIn the field of psychiatric rehabilitation, one of the best established evidence-based practices is “ACT”, or Assertive Community Treatment. ACT is a comprehensive community outreach care modality for persons with psychiatric disabilities that do not or cannot participate in group programs at a central site. PACT teams consist of a full transdisciplinary group of mental health professionals reaching out together: psychiatrists, therapists, case workers, specialists in co-occurring disorders, supported employment, supported education, and peer counselors (Schmidt, Pinninti, Garfinkle, & Solomon, 2013). ACT is like a hospital without walls.

The concept originated in Wisconsin in the 1960s (Stein & Test, 1980).  It is based on several service principles, e.g.:

  • Comprehensive, intensive, individualized care
  • Assertive, flexible, open-ended, consumer-based care
  • Community-based
  • 24/7 availability

In New Jersey, the practice is called PACT, for Program of Assertive Community Treatment. The New Jersey Division of Mental Health and Addictions Services contracts with various community agencies around the state to provide PACT services. (For a list of all New Jersey mental health service providers, including PACT, click here.)

Assertive Community Treatment is effective both in its clinical outcomes and its economic value (SAMHSA, 2008). It is also very hard work. ACT work is indeed almost a calling, and  loved ones and their families can greatly benefit from the special care it delivers.

Catholic CharitiesCatholic Charities Trenton, which fields 4 PACT Teams, has produced an insightful 18 minute video that soberly portrays the intense work performed every day by its PACT teams. The video can help families in the maelstrom understand the dimensions and difficulties of this important care modality.

References

Schmidt, L. T., Pinninti, N. R., Garfinkle, B., & Solomon, P. (2013). Assertive community treatment teams. In K. Yeager, D. Cutler, D. Svendsen, & G. M. Sills (Eds.), Modern community mental health: An interdisciplinary approach (pp. 293-301). New York: Oxford University Press. Retreived on January 7, 2016 from https://books.google.com/books?hl=en&lr=&id=mRtpAgAAQBAJ&oi=fnd&pg=PA293&dq=garfinkle+assertive+community+treatment&ots=EgyyZMQkGO&sig=2MINsbnyiwfBUjywGANEFlGieo0#v=onepage&q=garfinkle%20assertive%20community%20treatment&f=false.

Stein, L. I., & Test, M. A. (1980). Alternative to mental hospital treatment. Archives of General Psychiatry, 37, 392-397.

Substance Abuse and Mental Health Services Administration. (2008). Assertive community treatment: Evidence-based practices (EBP) kit. (DHHS Pub. No. SMA-08-4344). Rockville, MD: Center for Mental Health Services Retrieved from http://store.samhsa.gov/product/Assertive-Community-Treatment-ACT-Evidence-Based-Practices-EBP-KIT/SMA08-4345.

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Telepsychiatry: The New Wave for the Underserved

1docywayTwo weeks ago PsychOdyssey attended a talk at NAMI New York Metro about telepsychiatry, a new and fast developing field in psychiatry. The presenter was Mr. Samir Malik, Co-Founder and CEO of 1DocWay, a fascinating start-up telepsychiatry technology company.

Samir Malik, Co-Founder of 1DocWay, a telepsychiatry technology company

Samir Malik, Co-Founder of 1DocWay, a telepsychiatry technology company

Lack of access to psychiatry is an enormous problem, especially in remote areas. Existing telemedicine solutions are not adequate. They are neither scalable nor sufficiently service oriented. Malik’s company, 1DocWay, “brings the doctor’s office online”. It does so with these product features:

  • Secure video chat
  • Appointment scheduling
  • Patient notes recording and filing
  • Turnkey implementation
  • HIPAA compliance
  • Emphasis on ease of use

In the US today, over 80 million people live more than 60 miles from a psychiatric specialist. Malik believes this inaccessibility will drive enormous demand for telepsychiatric services. In just 5 years, Malik predicts the potential market for telepsychiatric services will reach $30 billion. As to connection security,1DocWay uses 256 bit encryption, which is the same as online banking facilities.

1DocWay believes that 85% of all psychiatric sessions can be done online. Major insurers, including Medicare, United HealthCare, Blue Cross, and Aetna, are now willing to reimburse doctors for telepsychiatry. Even Medicaid in all but one state now reimburses telepsychiatry services. And today 9 states—and very soon, 26 states—require commercial insurers to do so.

A telepsychiatrist consults remotely with her patient.

A telepsychiatrist consults remotely with her patient.

Working in over a dozen states with 70 registered clinicians, currently 1DocWay’s technology enables telepsychiatry for over 30,000 patients, of which 97% are Medicaid beneficiaries. Telepsychiatry is opening up new therapeutic horizons. Nearly 85% of 1DocWay’s patients were not seeing a psychiatrist previously. Pathologies that seem particularly suited to telemedical care include dual disorders and mood disorders, while phobias and thought disorders so far seem less well suited to it.

Psychiatrists are finding telepsychiatry a suitable compensation modality. Clinical outcomes of telepsychiatry appear from research to be as good as face-to-face consulations. Ancillary benefits include reduced institutional resource utilization, wider patient access, and reduced transportation and logistic constraints.

Legal issues are not insignificant, but they are addressable.  Clinicians need to be licensed in those states where they provide care. In some cases under Federal domain, clinicians licensed in one state can practice in another state. With some exceptions, they also need to be credentialed by organizations for which they are providing care. Malpractice coverage remains needed for telemental health.

Indeed, 1DocWay’s biggest challenge is not technology or even regulation, but credentialing, e.g., the credentialing requirements of third party payers for providers and facilities that seek to participate with 1DocWay. Efforts to standardize credentialing, such as the Federal non-profit Council for Affordable Quality Health Care (CAQH) are somewhat helpful, but many hospitals think CAQH’s required credentialing data is not sufficient, which complicates 1DocWay’s enrollment efforts.

According the Malik, the states right now most favorable to telepsychiatry are California, Michigan, and Minnesota. Thanks to robust efforts of the University of Texas Medical Branch’s telehealth initiative, Texas has become the most developed telepsychiatry state. Unfortunately, the worst state for telemedicine is New Jersey, due to the Garden State’s lowest-in-the-country Medicaid rates and its hostile regulatory climate.

For families navigating the maelstrom, telepsychiatry represents an interesting modality that can increase a loved one’s services, especially in rural and other hard to serve areas. In time, telemedicine will also be useful for family members for modalities like family psychoeducation and social networking for solutions to common but difficult coping problems.

For further information about the emerging telepsychiatry market, University of Colorado Denver maintains a very helpful website on all things telepsychiatric at http://www.tmhguide.org/.

 

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Best of PsychOdyssey: 10 Key Points About Violence and Mental Illness

Gun in headThe public is quite understandably distraught about last week’s evil ISIS-inspired terrorist slaughter of innocents in San Bernardino. Meanwhile, controversial mental health legislation is also moving through Congress that some partisans are wrongly claiming to be akin to evil. In both cases, there are too many false associations of violence and mental illness being publicly proclaimed by too many politicians and pundits who should know better and behave better.

Over two years ago, PsychOdyssey editorialized on this problem with copious academic references. It seems a good time to re-read it, so we offer it again to help leaven the public discourse on the highly overwrought association of violence and mental illness.

——————

10 Key Points About Violence and Mental Illness

PsychOdyssey Op-Ed, June 4, 2013

John Monahan, a great New Jersey community mental health leader and retired CEO of Greater Trenton Behavioral Health (now part of Oaks Integrated Care)

John Monahan, a great New Jersey community mental health leader and retired CEO of Greater Trenton Behavioral Health (now part of Oaks Integrated Care)

John Monahan, CEO of Greater Trenton Behavioral Healthcare in Trenton, NJ, is a leader in New Jersey’s mental health field. He has written a fine editorial in his local Trenton Times, entitled “Mental Illness Should Not Be The Scapegoat For Violence”. For his editorial and his leadership we commend Mr. Monahan. He is right: the issue of violence is not about mental illness per se. Those with mental illness who commit violence are a small minority—and who usually have one tragic fact in common: lack of sufficient (or any) treatment.

To reduce violence, especially gun violence, society would be far better served by concentrating on urban gang warfare and continuing “stop and frisk” policies. To reduce the small percentage of violence by those with serious mental illness, we should get them not unconstitutionally listed in some national registry, but earlier and better assessed and into treatment at more good community mental health agencies like Greater Trenton Behavioral Health.

Above all, let’s also keep all the facts in view—and in perspective. From our own research, here are 10 important points that PsychOdyssey has learned about violence and mental illness:

1.  Statistically speaking, yes, there is a moderate association between schizophrenia and violence (Matthias & Angermeyer, 2000; Mulvey, 1994).

2.  But severe mental illness alone does not independently predict violent behavior. Those with mental illness exhibiting violence do so mostly because of other factors (Elbogen & Johnson, 2009).

3.  One such factor is substance abuse. The association of substance abuse and violence is far greater (Matthias & Angermeyer, 2000) than of schizophrenia and violence.

4.  So, those with schizophrenia who abuse substances are much more prone to violence than those who don’t (Elbogen & Johnson, 2009; Steadman Hj & et al., 1998).

5.  In any event, when someone with schizophrenia is violent, it is mostly towards other family members and rarely towards strangers (Ferriter & Huband, 2003).

6.  The different symptoms of schizophrenia (e.g,, “positive” like hallucinations and delusions; “negative” like alogia, anhedonia, and avolition) factor differently in any particular association with violence. There is no one consistent risk factor for violence among those with schizophrenia who exhibit violence (Swanson, Swartz, Van Dorn, & et al., 2006).

7.   4 million Americans have severe psychiatric disorders. 10% of these (400,000) would be problematic if not treated. 1% (only 40,000) are estimated to be “dangerous” if not treated (Torrey, 2008). By contrast, the FBI says there are 1.4 million active gang members (Federal Bureau of Investigation, 2013).

8.   While those with schizophrenia may be relatively more prone to violence than those without it, the relative incidence of violence caused by those with schizophrenia than by those without is small  (Walsh, Buchanan, & Fahy, 2002).

9.   Why is treatment critical? Because the association of violence and schizophrenia is 15 times higher for those not being treated than for those being treated (Nielssen & Large, 2010).

10.    In any event, current research about the association of violence and schizophrenia is limited and needs to increase and improve (Mulvey, 1994).

 

References

Elbogen, Eric B., & Johnson, Sally C. (2009). The intricate link between violence and mental disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry, 66(2), 152-161. doi: 10.1001/archgenpsychiatry.2008.537

Federal Bureau of Investigation. (2013). 2011 national gang threat assessment: Emerging trends. from http://www.fbi.gov/stats-services/publications/2011-national-gang-threat-assessment

Ferriter, M., & Huband, N. (2003). Experiences of parents with a son or daughter suffering from schizophrenia. Journal of Psychiatric & Mental Health Nursing, 10(5), 552. doi: 10.1046/j.1365-2850.2003.00624.x

Matthias, & Angermeyer, C. (2000). Schizophrenia and violence. Acta Psychiatrica Scandinavica, 102, 63-67. doi: 10.1034/j.1600-0447.2000.00012.x

Mulvey, Edward P. (1994). Assessing the evidence of a link between mental illness and violence. Hospital & Community Psychiatry, 45(7), 663-668.

Nielssen, Olav, & Large, Matthew. (2010). Rates of homicide during the first episode of psychosis and after treatment: A systematic review and meta-analysis. Schizophrenia Bulletin, 36(4), 702-712. doi: 10.1093/schbul/sbn144

Steadman H.J., Mulvey, E. P., Monahan J. [no relation], & et al. (1998). Violence by people discharged from acute psychiatric inpatient facilities and by others in the same neighborhoods. Archives of General Psychiatry, 55(5), 393-401. doi: 10.1001/archpsyc.55.5.393

Swanson, J.W., Swartz, M. S. , Van Dorn, R. A., & et al. (2006). A national study of violent behavior in persons with schizophrenia. Archives of General Psychiatry, 63(5), 490-499. doi: 10.1001/archpsyc.63.5.490

Torrey, E. Fuller. (2008). The insanity offense. New York: W.W. Norton & Co., Inc.

Walsh, Elizabeth , Buchanan, Alec, & Fahy, Thomas. (2002). Violence and schizophrenia: examining the evidence. The British Journal of Psychiatry, 180(6), 490-495. doi: 10.1192/bjp.180.6.490

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PsychOdyssey Editorial: Paranoia About Pot Is Rational

Marijuana smokerAmericans today see a vast public movement favoring decriminalization of marijuana, whether for medicinal purposes (as in many states, including PsychOdyssey’s home state of New Jersey) or even for recreational purposes (as in Colorado). Many Americans seem to favor such action. But for most families navigating schizophrenia, such action is antithetical to good mental health. Indeed, such action hinders family efforts to curb their loved ones from its deleterious use.

Marijuana seems to induce psychosis in some. While marijuana is not believed to cause schizophrenia, many believe marijuana can trigger schizophrenia if latent and certainly exacerbates the illness when manifest. For many families, to facilitate greater public access and use of today’s highly potent marijuana is  foolish, misguided, dangerous to public health, and even an irresponsible and harmful act against those with schizophrenia.

Daily MailPsychOdyssey opposes policies that would loosen strictures on the public’s use of marijuana, especially for recreational use. Marijuana has undeniable–and for many, damaging–effects on the brain, shown by increasing research evidence and deduced from simple logic and experience. Like alcohol, the substance for many is dangerous, especially to youth during prime periods of cognitive and neuronal development. Why would society wish to encourage increased use of it?

yale_university_school_of_medicine_logo_colorPsychOdyssey’s anxiety about marijuana’s dangerous association with schizophrenia is rekindled by a recent news article. The UK’s Daily Mail reported that a new Yale Medical Study study on marijuana underscores the psychotic dangers of marijuana. As published in the academic journal Biological Psychiatry, the Yale study, led by Dr. Deepak D’Souza, seems to show that marijuana induces schizophrenia-like psychosis, and thus implies that marijuana can be a particularly bad substance for use by those with schizophrenia, either manifest or latent.

The research article concludes (in technical language) the following:

At doses that produced psychosis-like effects, Δ9-THC increased neural noise in humans in a dose-dependent manner. Furthermore, increases in neural noise were related with increases in Δ9-THC-induced psychosis-like symptoms but not negative-like symptoms. These findings suggest that increases in neural noise may contribute to the psychotomimetic effects of Δ9-THC [emphasis added].

For the link to UK Daily Mail’s news article about the Yale research study, click here.

For the link to the Biological Psychiatry abstract about the research study, click here.

For the link to Dr. Deepak D’Souza’s website and a list of his research articles about cannabis and schizophrenia, click here.

Below is a video on marijuana’s schizophrenic effects from Britain’s National Health Services:

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Even pro marijuana advocates urge caution. Below is a video on physical side effects of medical cannabis… with a warning about use by those with schizophrenia (from Americans for Safe Access, a pro-medical marijuana organization) (pardon the ad…):

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To view all of PsychOdyssey’s editorials, click here.

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