Diet and Nutrition. Natural Health, and Healthy Living

From the open text BMC family of journals comes a terrible but compelling article published in BMC International Health & Human Rights. The article is authored by Mario Incayawarand Sioui Maldonado-Bouchard, and is entitled The Forsaken Mental Health of the Indigenous Peoples -A Moral Case of Outrageous Exclusion in Latin America.

Here is the Abstract:

Background

Mental health is neglected in most parts of the world. For the Indigenous Peoples of Latin America, the plight is even more severe as there are no specific mental health services designed for them altogether. Given the high importance of mental health for general health, the status quo is unacceptable. Lack of research on the subject of Indigenous Peoples' mental health means that statistics are virtually unavailable. To illustrate their mental health status, one can nonetheless point to the high rates of poverty and extreme poverty in their communities, overcrowded housing, illiteracy, and lack of basic sanitary services such as water, electricity and sewage. At the dawn of the XXI century, they remain poor, powerless, and voiceless. They remain severely excluded from mainstream society despite being the first inhabitants of this continent and being an estimated of 48 million people. This paper comments, specifically, on the limited impact of the Pan American Health Organization's mental health initiative on the Indigenous Peoples of Latin America.

(more...)

At last weeks Health 2.0 Conference Maggie Mahar, author of HealthBeatBlog got more than a little feisty about Al Waxman's suggestion that we make people with bad health behaviors pay more. She said that 95% of smokers had some form of mental illness, and therefore we were punishing the mentally ill. Really? Read on for Maggie's explanation (lifted at her request from a comment elsewhere).--Matthew Holt

According to the New England Journal of Medicine,

(more...)

The disconnect between care and reimbursement for mental health services and other kinds of clinical services suggests just how deeply mind-body dualism pervades Western and American culture, despite the best efforts of many champions over many, many decades. The beast lives, as I put it in my dissertation. Thus, the news of a WHO Report on the need to integrate mental health care into primary care is welcome, though I admit it seems almost ridiculous to me that justification is needed for the notion that caring for those suffering from mental and emotional illnessesis crucial toimproving population health, let alone being important to lessening stigma,centering marginalized populations, and caring for persons with disabilities.

(more...)

Excellent new paper (full text unavailable) from Lawrence Gostin (Georgetown - Law & Public Health). For those unfamiliar with his work, Gostin is one of the leading scholars on public health law. Here is the Abstract:

In 1972, I covertly entered a brutal, inhumane institution for the criminally insane in Eastern North Carolina as a pseudo-patient under a U.S. Department of Justice study. What I experienced during those many weeks would shape how I view what Irving Goffman called "total institutions." Since that formative experience as a young law student I have closely observed institutions that warehouse persons with mental illness in many regions of the world ranging from the Americas and Europe to the Indian subcontinent and Asia. Those experiences, together with the careful study of human rights reports and judicial decisions, have led me to one simple conclusion. Despite countless promises for a better life by national commissions, governments, and the international community, there has evolved a vicious cycle of neglect, abandonment, indignity, cruel and inhumane treatment, and punishment of persons with mental illness. This is not true in every place, time, and circumstance - there are pockets of deep caring and compassion. But for the vast majority, and in most geographic regions, this sad fact remains a tragic reality.

(more...)

Those of you who followed Patrick's fascinating post (and the debate that ensued in the comments) on causal models of psychiatry and mental illness might be interested in the abstract of this dissertation:

In contemporary biological approaches to psychiatry it is rarely questioned that psychiatric disorders stem from biological "dysfunctions". This assumption appears to be confirmed by the fact that biological research has been successful at uncovering diverse biological disparities between the brains of persons with mental illnesses and normal controls. However, the fact that something is different or unusual does not mean it is dysfunctional. The thesis of the dissertation is that there is little warrant for the claim that psychiatric disorders stem from biological dysfunctions. This prompts a question of definition: what does it mean to say that something--e.g., a given part of the brain or nervous system--is "functioning properly" or that it is "dysfunctional"? The dissertation argues that the theory of function appropriate for psychiatry is one that holds that the function of an entity consists in that activity that, in the past, contributed to the differential persistence or reproduction of that entity or type of entity. A consequence of this view is that just because something is not adaptive in a given environment, it is not necessarily dysfunctional. Finally, the dissertation examines two major neurobiological perspectives on schizophrenia--a neurochemical perspective and a neurodevelopmental perspective. From a neurochemical perspective, it argues that even if the dopamine system is abnormal in schizophrenia, it is not dysfunctional. It also shows that on certain neurodevelopmental hypotheses, schizophrenia could be said to stem from a biological dysfunction, but on other neurodevelopmental hypotheses, it could not. The fact that there is currently not enough information to decide which of these multiple hypotheses is correct means that there is currently little warrant for saying that schizophrenia stems from a biological dysfunction. Since this has been shown to be unwarranted through detailed analysis of some neurobiological examples, then it is reasonable to suspect that careful attention to neurobiological details associated with other mental disorders might reveal the same thing. Consequently, it should not be assumed that psychiatric disorders in general stem from biological dysfunctions on the part of the brain unless there is evidence for this conclusion other than the existence of biological abnormalities.

(more...)

Last week, Congress got a step closer to passing a Mental Health Parity bill after years of debating the issue. The bill would require insurance companies to provide the same coverage for physical and mental ailments.

For more than a decade, both houses have passed different versions of the legislation only to see it fall apart at the end. The biggest hiccup now seems to be that the bill doesn't specify which mental disorders it will include.

(more...)