Mental Health Tuesday

Show Notes for February 7, 2012: The Annual Stress in America Report

2012-02-06T23:15:00.000-06:00

Since 2007, the American Psychological Association has commissioned an annual nationwide survey as part of its Mind/Body Health campaign to examine the state of stress across the country and understand its impact. The Stress in America™ survey measures attitudes and perceptions of stress among the general public and identifies leading sources of stress, common behaviors used to manage stress and the impact of stress on our lives. The results of the survey draw attention to the serious physical and emotional implications of stress and the inextricable link between the mind and body.

Download the Full Report (PDF, 3.2MB)

In a related story, see also:

The beginnings of mental illness

Autism, schizophrenia and other disorders may have roots in life's earliest stages.

Show Notes for January 3, 2012: What is Mental Illness?

2012-01-01T11:38:00.000-06:00

By special request, Mental Health Tuesday explores the question: "What is Mental Illness?"

A recent news story stating that half of all Americans will experience mental illness at some point in their lives prompted the question addressed on today's show. The news story drew its information from a book entitled What is Mental Illness? by Richard J. McNally and published last January. McNally is an advisor to the American Psychiatric Association's Diagnostic and Statistical Manual, Fifth Edition, the day-to-day practical guide on the definition of mental illness, scheduled for publication in 2013. McNally is a critic of the overuse of psychiatric diagnoses, and also defends a careful approach of describing disorders by patterns of observable symptoms.

The following is a quote from the current edition of the Diagnostic and Statistical Manual (DSM-IV-TR) under the heading Definition of Mental Disorder:

"Although this volume is titled Diagnostic and Statistical Manual of Mental Disorders, the term mental disorder unfortunately implies a distinction between "mental" disorders and "physical" disorders that is a reductionistic anachronism of mind/body dualism. A compelling literature documents that there is much "physical" in the "mental" disorders much "mental" in the "physical" disorders. The problem raised by the term "mental" disorders has been much clearer than its solution, and, unfortunately, the term persists in the title of DSM-IV because we have not found an appropriate substitute."

"Moreover, although this manual provides a classification of mental disorders, it must be admitted that no definition adequately specifies precise boundaries for the concept of "mental disorder." The concept of mental disorder, like many other concepts in medicine and science, lacks a consistent operational definition that covers all situations. All medical conditions are defined on various levels of abstraction - for example, structural pathology (e.g., ulcerative colitis), symptom presentation (e.g., migraine), deviance from a physiological norm (e.g., hypertension), and etiology (e.g., pneumococcal pneumonia). Mental disorders have also been defined by a variety of concepts (e.g., distress, dyscontrol, disadvantage, disability, inflexibility, irrationality, syndrome pattern, etiology, and statistical deviation). Each is a useful indicator for a mental disorder, but none is equivalent to the concept, and different situations call for different definitions."

Some points from today's show include:

1. There is no clear difference between the mind and the body (which includes the brain), or, said, another way, there is considerable overlap in all disorders, though some emphasize one presentation or the other. For example, a recent survey in the State of Washington found the following diagnoses within their sample:

31% physical illness only
21% mental illness and substance use disorder
14% mental and physical illness
13% mental and physical illness and substance use disorder
11% physical illness and substance use disorder
5% mental illness only
5% substance use disorder only

2. The risk of developing a given mental disorder is small. However, when you add them all together, as in the study that prompted this episode, the numbers do support the notion that lifetime risk of mental illness is about 50%. However, most of these mental illnesses are mild, transient, and end with full recovery.

3. Diagnosis cannot be made by reading a book. To recognize schizophrenia, for example, a clinician needs to see a lot of people with schizophrenia. The DSM offers an imperfect description of the disorder that is necessarily less than the experience of interviewing people with schizophrenia. The description grew out of that experience, but is not equal to it. That is why clinicians must not only study the book, but must have clinical residencies and internships before they practice on their own.

A link to the proposed revisions of the DSM (DSM-5), can be found here:

http://www.dsm5.org/Pages/Default.aspx

The Amazon link to What is Mental Illness? by Richard J. McNally can be found here:

http://www.amazon.com/What-Mental-Illness-Richard-McNally/dp/0674046498

Show Notes for December 6, 2011: Personality Disorders

2011-12-05T21:19:00.000-06:00

From the U.S. National Library of Medicine - The World's Largest Medical Library

Personality disorders

Last reviewed: November 14, 2010.

Personality disorders are a group of psychiatric conditions in which a person's long-term (chronic) behaviors, emotions, and thoughts are very different from their culture's expectations and cause serious problems with relationships and work.

Causes, incidence, and risk factors

The causes of personality disorders are unknown. However, many genetic and environmental factors are thought to play a role.

Mental health professionals categorize these disorders into the following types:

Symptoms

Symptoms vary widely depending on the type of personality disorder.

In general, personality disorders involve feelings, thoughts, and behaviors that do not adapt to a wide range of settings.

These patterns usually begin in adolescence and may lead to problems in social and work situations.

The severity of these conditions ranges from mild to severe.

Signs and tests

Personality disorders are diagnosed based on a psychological evaluation and the history and severity of the symptoms.

Treatment

At first, people with these disorders usually do not seek treatment on their own. They tend to seek help once their behavior has caused severe problems in their relationships or work, or when they are diagnosed with another psychiatric problem, such as a mood or substance abuse disorder.

Although personality disorders take time to treat, there is increasing evidence that certain forms of talk therapy can help many people. In some cases, medications can be a useful addition to therapy.

Expectations (prognosis)

The outlook varies. Some personality disorders go away during middle age without any treatment, while others only improve slowly throughout life, even with treatment.

Complications

Problems with relationships
Problems with career
Other psychiatric disorders

Calling your health care provider

Call for an appointment with your health care provider or mental health professional if you or someone close to you has symptoms of a personality disorder.

References

Blais MA, Smallwood P, Groves JE, Rivas-Vazquez RA. Personality and personality disorders. In: Stern TA, Rosenbaum JF, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier;2008:chap 39.

: Review Date: 11/14/2010.
Reviewed by: Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and David B. Merrill, MD, Assistant Clinical Professor of Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Disclaimer

Show Notes for November 1, 2011: Some of the Latest Findings from Positive Psychology

2011-11-01T00:10:00.000-05:00

Positive Psychology is the scientific study of the strengths and virtues that enable individuals and communities to thrive. In his keynote address to the Second World Congress on Positive Psychology this past summer, Dr. Martin Seligman stated that the notion that we are driven by the past is "a profound error about human nature" made by most schools of psychology. Rather, he sees human beings as being "drawn into the future" by meaningful goals.

More about Positive Psychology can be found at the following links:

Positive Psychology Center of the University of Pennsylvania

Authentic Happiness

A Recording of Dr. Martin Seligman's Keynote Address on Shrink Rap Radio

A Recording of Dr. Ed Diener's Keynote Address on Shrink Rap Radio

Dr. Martin Seligman on Positive Psychology from a 2004 presentation:

Show Notes for October 4, 2011: How to Successfully Reach Your Goals

2011-10-03T18:58:00.000-05:00

One common theme that emerges in psychotherapy is goal setting. Clients often talk with therapists about how to set goals and their frustrations when goals are not reached. Therapists often come up with steps about how to set realistic goals. They might even work sometimes.

A fast Google search turns up a variety of psychologists writing things like "5 steps to reach your goals" or "7 steps to reach your goals." Clearly, people want to reach their goals!

In this blog, I want to take a different approach. I'm going to assume that failure to reach a goal may not be a problem with the person, but with the goal. I'm going to assume that people generally know how to set and reach goals. People do this all the time. Maybe when people fail to reach their goals, its because of a problem with the goal.

Here's what I mean: To be motivated to reach a goal, it either has to mean something to you, or be the means to an end that means something to you. If you want to reach your goals, you first have to figure out what is really important to you. You have to determine your top values.

After that, look at your goals. Do your goals really reflect your values. If you are like most people, you will find that the goals you reach are the ones that really reflect your values. One of three possibilities will emerge for each of your goals:

1) You will see the connection between the goal and the value and discover new motivation to reach the goal.

2) You will discover the goal does not reflect your values, at which time you may discard the goal.

3) You will discover values that you are doing nothing about, at which time you may set new goals.

A colleague of mine, Dr. Robert Hutzell, created a workbook to guide people through this process. It is not a quick-fix, follow 5, or 7, steps-approach, but it is one way to help people figure out what they really want to do in life. The workbook is now out of print, so he has made an electronic version of it available for free:

A Workbook to Increase Your Meaningful and Purposeful Goals by R. R. Hutzell, Ph.D. and Mary D. Eggert, Ph.D. (2009 PDF version).

I hope you enjoy it!

Show Notes for September 6, 2011: Procrastination

2011-09-08T21:52:00.000-05:00

Links on Procrastination from Psychology Today:

Don't Wait Until Tomorrow

Show Notes for August 2, 2011: Psychology and Heat

2011-08-01T10:58:00.019-05:00

HOT UNDER THE COLLAR: Psychology and Heat

As multiple heat records have been set throughout the country this summer, and almost everyone you talk to mentions the heat, it seems like a good time to review what is known about the effects of heat on human behavior.

One thing to keep in mind is that heat is at least partly subjective. A string of 90-degree days in Chicago prompts the city to open cooling centers for the underprivileged while the evening news reports on heat related deaths. The same string of 90-degree days in southern Texas, on the other hand, would be normal and expected. A string of 110-degree days in Austin, however, is something to talk about!

While studies on the effects of heat are somewhat mixed, there are a few things that do stand out:

Hotter-than-expected temperatures are associated with more aggression. Some of the earliest studies in social psychology looked at crime rates, especially violent crime rates, and found a stable correlation with temperature. These studies have been replicated several times and the findings hold up. Smaller studies find that people even blow their car horns more and gesture more from vehicles when the temperatures are hot.

Depression has been found to increase with hotter temperatures along with the number of suicide attempts. According to national averages, the months of April through June are the times of greatest suicide risk, though at our center we received a low number of emergency calls in June, while the number has been steadily increasing as the heat wave has persisted.

Heat waves appear to be associated with greater alcohol and drug abuse. Popping open a cold beer on a hot day may seem like a good idea, but alcohol is one of the worst things you can drink in the heat. Alcohol absorbs moisture, and it is a diuretic. So, alcohol places people at higher risk for dehydration.

One interesting set of studies is exploring the effect that temperature may have on perceptions of human closeness. The warmer the temperature -- within normal and expected limits -- the more a person's choice of words reflects feelings of closeness to others, while the cooler the temperature, the more abstract and remote a person's vocabulary becomes. This has been studied with small changes in room temperature, as well as on a smaller scale by giving a person either a warm or cold drink to hold. Its highly speculative, of course, but when one considers the more communal cultures that have developed close to the equator versus the more individual cultures that have developed far from the equator, one wonders if the temperature influenced the way the culture developed.

When high heat is accompanied by high humidity, especially when people don't have air conditioning, sleep becomes more of a problem. A number of factors are associated with high heat and humidity, all of which could also be related to sleep. These include poorer concentration, irritability, and sleepiness during the day.

So what can you do to minimize the effects of the heat?

For one thing, take a look at the cultures that have already adapted to warmer temperatures. People closer to the equator often take a siesta or a nap during the hottest part of the day. This is offset by fewer hours of sleep at night and by workdays that stretch longer into the evening when temperatures are cooler.

Drink more water and less alcohol. Be aware of the signs of dehydration.

Spend as much time as you can out of the heat, preferably in cool buildings with air conditioning.

Keep an extra eye on your kids and check in on the elderly. Heat tends to affect the very young and the very old the most. Also, talk to your doctor about any heat related effects of your medications.

Practice patience. If you are feeling tired and irritable in the heat, chances are everyone else is, too!

Show Notes for July 5, 2011: Delusional Disorder and other Psychoses

2011-07-04T11:19:00.000-05:00

Today's topic is Delusional Disorder, and, if time, other rare psychotic conditions. For more information on Delusional Disorder, please see this Psychology Today article.

Definition:

Delusional disorder refers to a condition associated with one or more nonbizarre delusions of thinking—such as expressing beliefs that occur in real life such as being poisoned, being stalked, being loved or deceived, or having an illness, provided no other symptoms of schizophrenia are exhibited.
Delusions may seem believable at face value, and patients may appear normal as long as an outsider does not touch upon their delusional themes. Mood episodes are relatively brief compared with the total duration of the delusional periods. Also, these delusions are not due to a medical condition or substance abuse.

Themes of delusions may fall into the following types: erotomanic type (patient believes that a person, usually of higher social standing, is in love with the individual); grandiose type (patient believes that he has some great but unrecognized talent or insight, a special identity, knowledge, power, self-worth, or special relationship with someone famous or with God); jealous type (patient believes his partner has been unfaithful); persecutory type (patient believes he is being cheated, spied on, drugged, followed, slandered, or somehow mistreated); somatic type (patient believes he is experiencing physical sensations or bodily dysfunctions—such as foul odors or insects crawling on or under the skin—or is suffering from a general medical condition or defect); mixed type (characteristics of more than one of the above types, but no one theme dominates); or unspecified type (patient's delusions do not fall in described categories).

Show Notes for June 7, 2011: A Day in the Life of Your Mental Health Center

2011-06-06T10:45:00.000-05:00

This is a "snapshot" of a typical day at the Area Mental Health Center. The random date chosen was April 5, 2011. On that day, the Ulysses office had three therapists, one adult case manager, three child case managers, one targeted case manager and one mental health assistant on duty. The Ulysses office services Grant, Stanton and Morton Counties.

Services by Gender:
Male: 26
Female: 24

Service by Age:
0-5: 1
6-12: 21
13-18: 19
18-65: 7
Over 65: 1

Services by Presenting Problem (some may overlap):
Abuse Issues: 3
ADHD: 19
Aggression: 24
Anxiety: 19
Depression: 25
Eating Disorder: 0
Emergency: 1
Marital/Family: 29
Psychosis: 0
Substance Use Disorder: 5
Suicidal Thoughts: 2

The following numbers refer to the entire Area Mental Health Center, serving 13 counties in Southwest Kansas. The include the numbers from the Ulysses Office.

Services by Gender:
Male: 377
Female: 252

Service by Age:
0-5: 42
6-12: 193
13-18: 166
18-65: 219
Over 65: 12

Services by Presenting Problem (some may overlap):
Abuse Issues: 37
ADHD: 174
Aggression: 139
Anxiety: 137
Depression: 182
Eating Disorder: 3
Emergency: 8
Marital/Family: 79
Psychosis: 120
Substance Use Disorder: 20
Suicidal Thoughts: 9

Show Notes for May 3, 2011: Children's Mental Health Awareness Day

2011-05-01T19:30:00.000-05:00

JOIN US FOR

CHILDREN’S MENTAL HEALTH AWARENESS DAY!

HOSTED BY THE AREA MENTAL HEALTH CENTER

MAY 3^RD, 2011

AT THE GRANT COUNTY LIBRARY

4:00 – 6:00 p.m.

MEET THE AMHC CHILDREN’S SERVICES PROVIDERS AND LEARN ABOUT THE DIFFICULTIES AND TRIUMPHS OF SERIOUSLY EMOTIONALLY DISTURBED CHILDREN.

COME WITH YOUR CURIOSITY, QUESTIONS, AND APPETITE, AS WE WILL HAVE INFORMATION, DOOR PRIZES, SNACKS, AND REFRESHMENTS AVAILABLE!

COME AND SHOW YOUR SUPPORT AND LEARN ABOUT HOW TO HELP THE YOUTH OF OUR COMMUNITY!

ALSO BE SURE TO CHECK US OUT ON MENTAL HEALTH TUESDAY ON AM 1420 KULY FROM 8:30 – 9:00 am.

BROUGHT TO YOU BY THE COMMUNITY BASED SERVICES TEAM AT THE AREA MENTAL HEALTH CENTER, ULYSSES OUTPATIENT OFFICE

404 N. BAUGHMAN ULYSSES KS 67880

(620) 356-3198

FOR CONTRIBUTIONS / DONATIONS MADE TO THE ULYSSES AMHC CHILDREN’S SERVICES DEPARTMENT, A SPECIAL THANKS GOES OUT TO:

JR’S GLASS COUNTRY BASKETS AND GIFTS OBSESSIONS

PIZZA HUT TARBET CONCRETE SUBWAY

GRANT CO. BANK WESTERN STATE BANK GRANT CO. LIBRARY

WALDRON’S PHARMACY RUSS’ FOOD CENTER THE MAIN ARTERY

1420 KULY PIONEER COMMUNICATIONS

Show Notes for April 5, 2011: Panic Disorder

2011-04-09T10:10:00.000-05:00

Information from the National Institute of Mental Health

What is Panic Disorder?

Panic disorder is an anxiety disorder and is characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress. More about Panic Disorder »

Signs & Symptoms

People with panic disorder have feelings of terror that strike suddenly and repeatedly with no warning. During a panic attack, most likely your heart will pound and you may feel sweaty, weak, faint, or dizzy. Your hands may tingle or feel numb, and you might feel flushed or chilled. You may have nausea, chest pain or smothering sensations, a sense of unreality, or fear of impending doom or loss of control. More about Signs & Symptoms »

Treatment

Effective treatments for panic disorder are available, and research is yielding new, improved therapies that can help most people with panic disorder and other anxiety disorders lead productive, fulfilling lives. More about Treatment »

Getting Help: Locate Services

Locate mental health services in your area, affordable healthcare, NIMH clinical trials, and listings of professionals and organizations. More about Locating Services »

Related Information

Information about medications
Panic Disorder Information and Organizations from NLM's MedlinePlus (en Español)
Some mental illnesses also carry an increased risk for suicide.

Show Notes for March 1, 2011: Obsessive-Compulsive Disorder

2011-03-02T23:15:00.000-06:00

Information from the National Institute of Mental Health:

What is Obsessive-Compulsive Disorder?

Obsessive-Compulsive Disorder, OCD, is an anxiety disorder and is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive behaviors such as handwashing, counting, checking, or cleaning are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these so-called "rituals," however, provides only temporary relief, and not performing them markedly increases anxiety. More about Obsessive-Compulsive Disorder »

Signs and Symptoms

People with OCD may be plagued by persistent, unwelcome thoughts or images, or by the urgent need to engage in certain rituals. They may be obsessed with germs or dirt, and wash their hands over and over. They may be filled with doubt and feel the need to check things repeatedly. More about Signs & Symptoms »

Treatment

Effective treatments for obsessive-compulsive disorder are available, and research is yielding new, improved therapies that can help most people with OCD and other anxiety disorders lead productive, fulfilling lives. More about Treatment »

Getting Help: Locate Services

Locate mental health services in your area, affordable healthcare, NIMH clinical trials, and listings of professionals and organizations. More about Locating Services »

Related Information

Information about medications
Obsessive-Compulsive Disorder Information and Organizations from NLM's MedlinePlus (en Español)
Some mental illnesses also carry an increased risk for suicide .
NIH OCD Fact Sheet

Obsessive-Compulsive Disorder Treatment

According to the 2005 National Comorbidity Survey-Replication study, about 2.2 million American adults have obsessive-compulsive disorder (OCD), a brain disorder that often begins in childhood. The persistent, unwanted thoughts and rituals of OCD sometimes take over people’s lives to the point that they can’t work or maintain relationships or engage in everyday tasks and social interactions.

YESTERDAY

The standard treatment for OCD was a type of long-term psychotherapy aimed at overcoming psychological defenses. There was no evidence that this treatment was effective.
Clinicians lacked objective measurements that could help them accurately diagnose OCD – a crucial prerequisite for appropriate treatment.
There were no proven medications for OCD.
OCD was thought of primarily as a psychoanalytic issue, not a brain disorder.

TODAY

Effective treatments are now available. Among them are antidepressant medications that act on serotonin, one of several neurotransmitters (brain chemicals) through which brain cells communicate with each other. These medications also act on brain systems and circuits involved in OCD. Recently developed antipsychotic medications may become another option when prescribed alongside standard medications for hard-to-treat patients with OCD.
A type of psychotherapy called “exposure and response prevention,” which breaks the cycle of repetitive behavior, is an effective treatment for many patients.
Clinicians now have objective tools for identifying OCD subtypes and measuring their severity, allowing treatment to be personalized.
Imaging studies show that people with OCD have differences in specific brain areas, compared with other people. Successfully treated patients have brain-activity patterns like those of healthy people.
Traditionally, OCD was thought to “run in families.” Genetic studies now suggest that variations in certain genes are involved and that risk is higher when certain variations occur together.
Researchers are following up on early evidence that infection from the Streptococcus bacterium might lead to some cases of OCD.
Using genetic engineering, NIH-funded researchers created an OCD-like set of behaviors in mice. They then reversed these behaviors with antidepressants and genetic targeting of a key brain circuit. The study suggests new strategies for treating the disorder.

TOMORROW

Researchers are studying the potential of deep-brain stimulation, a surgical technique that stimulates cells in specific brain areas, for patients who don’t respond to other treatments.
Genetics research may help clinicians decide what treatments are likely to work for each patient. Whether a treatment works may be partly due to variations in certain genes.
Imaging, molecular biology, and genetics research are pointing the way to brain mechanisms involved in OCD. Features of these mechanisms are potential biomarkers that could identify people at risk – a key to early intervention.
Research to identify brain mechanisms involved in OCD also holds the potential to reveal targets for better medications with fewer side effects.

For more information, please contact the NIMH Information Center at nimhinfo@nih.gov or 301-443-4513.

National Institute of Mental Health (NIMH) http://www.nimh.nih.gov

Show Notes for February 1, 2011: Schizophrenia

2011-02-01T20:40:00.000-06:00

Today's topic is Schizophrenia, a devastating mental illness that effects about 1% of the population. To learn more about Schizophrenia, visit the links below:

For a detailed booklet from the National Institute of Mental Health that describes symptoms, causes, and treatments of Schizophrenia, with information on getting help and coping, click the link below:

Download the PDF version for the Web (22 page(s), 365 KBs)

Show Notes for January 4, 2011: 50th Anniversary of the Area Mental Health Center

2011-01-02T21:49:00.001-06:00

Historical Overview

In January 1959, the Garden City Junior Chamber of Commerce in Garden City, Kansas began a community project to raise awareness of mental health issues. This included an open house at the Larned State Hospital, Larned, Kansas. In February of that year, the Finney County Association of Mental Health was created. The Association formed a speaker’s bureau and presented films and lectures to over 40 groups within the first four months. The Kansas State Legislature passed a supplement to the Social Welfare Act whereby counties could levy a ¼ mill tax in addition to the public health tax levy to help finance a mental health center. The law required the county commissioners and the city commissioners to sign a joint resolution and form a joint Board of Health. This agreement was signed in May 1960. A United Fund was established with $1,200 earmarked for the creation of a mental health center. An additional $2,600 was raised in contributions and $3,500 was anticipated in client fees the first year.

The Area Mental Health Center opened on January 13, 1961 in Garden City, Kansas, located in a former World War II Federal housing unit. The Area Mental Health Center spent $2,175 on remodeling the facility. In addition, the Garden City Commission leased two ground floor apartments and waived the rent. Three staff members were employed on opening day: one full time secretary/receptionist, one part time psychologist and one part time psychiatrist. The Area Mental Health Center initially served five counties in southwest Kansas: Finney, Ford, Grant, Gray, Greeley and Hamilton.

Today, the Area Mental Health Center serves thirteen counties in four regions: Region I, the Garden City outpatient office, serves Finney, Kearney and Hamilton Counties. The Region II Dodge City outpatient office opened in 1968 and serves Ford, Gray and Hodgeman Counties. The Region III Ulysses office opened in 1970 and serves Grant, Stanton and Morton Counties. The Region IV Scott City office opened in 1976 and serves Greeley, Lane, Scott and Wichita Counties. Community Support Services day treatment programs are available in Garden City and Dodge City. Special programs serving the needs of adults with severe and persistent mentally illness and children with serious emotional disturbance are available in all counties. Partnering with St. Catherine Hospital in Garden City, the Area Mental Health Center jointly operates a 10 bed behavioral health inpatient unit.

The Area Mental Health Center is governed by a 28-member Board of Directors. Two board members are appointed by the County Commissioners of each of the 13 counties with two at-large members. The Board hires an Executive Director to oversee operations. The Executive Director is assisted by a nine-member Administrative Council that includes Regional Directors from each region as well as Directors of Medicine, Finance, Human Resources, Children’s Services and Adult Community Support Services. The Center currently employs over 150 staff. These include master’s level psychotherapists (psychologists and social workers), child and adult case managers, advanced registered nurse practitioners, one psychiatrist and clerical staff.

The Area Mental Health Center provides comprehensive behavioral healthcare services to the residents of southwest Kansas. Types of problems typically treated include depression and other mood disorders, anxiety disorders, chemical dependency, life change issues, and many other emotional and personal concerns. Primary core services include crisis services, psychotherapy, case management and medication management. A variety of assessment services are also available including psychological testing, psychiatric evaluation and chemical dependency assessment. In 2009, the Area Mental Health Center opened 3,254 new cases, a 15% increase over 2008. Over 500,000 specific mental health services were provided to 4,968 clients in 2009. $1.3 million in services were offered on a charity basis.

Show Notes for December 7, 2010: The Psychology of Sleep

2010-12-11T13:39:00.002-06:00

Today we discussed the science of sleep. To learn more, please visit:

http://healthysleep.med.harvard.edu/healthy/science

Show Notes for November 2, 2010: Addictions

2010-11-02T22:16:00.001-05:00

For current information about many drugs of abuse, see the NIDA Research Reports series below:

This series of reports simplifies the science of research findings for the educated lay public, legislators, educational groups, and practitioners. The series reports on research findings of national interest.

Comorbidity: Addiction and Other Mental Illnesses [Revised 2010]
MDMA Abuse (Ecstasy) [Revised 2006]
Marijuana Abuse [Revised 2010]
Therapeutic Community [Printed 2002]
Anabolic Steroid Abuse [Revised 2006]
Cocaine: Abuse and Addiction [Revised 2010]
Hallucinogens and Dissociative Drugs [Printed 2001]
Heroin: Abuse and Addiction [Revised 2005]
HIV/AIDS [Revised 2006]
Inhalant Abuse [Revised 2009]
Methamphetamine: Abuse and Addiction [Revised 2006]
Tobacco Addiction [Revised 2009]
Prescription Drugs Abuse and Addiction [Revised 2005]

Spanish Research Reports

Abuso de la MDMA (Éxtasis) [Revised 2006]
Alucinógenos y Drogas Disociativas [Printed 2003]
La Comunidad Terapéutica [Printed 2003]
Abuso de la Marihuana [Revised 2005]
La Heroína: Abuso y Adicción [Revised 2005]
Adicción al Tabaco [Printed 2007]
Esteroides Anabólicos Abuso [Revised 2007]
Cocaina Adicción y Abuso [Revised 2010]
Abuso de Inhalantes [Revised 2005]
Abuso y Adicción a la Metanfetamina [Revised 2007]
Medicamentos de Prescripción - Abuso y Adicción [Printed 2001]
VIH/SIDA [Printed 2006]

Show Notes for October 5, 2010: Jungian Typology

2010-10-05T15:29:00.000-05:00

Today we discussed Jung's two attitudes of interversion and extroversion, his two perceiving functions of sensation and intuition, and his two judging functions of thinking and feeling.

To take Jung's personality test for free, follow this link and click on "Jung Typology Test":

http://www.humanmetrics.com/

To learn more about Jung, follow the podcast link at the following site:

http://www.jungian.ca/

These ideas are presented because versions of the Jung typology test are often used in corporate team building exercises. If these ideas help you understand yourself better, then well and good. If not, then it is probably not for you. Under no circumstances should you make major life decisions based on these types of tests.

Show Notes for September 7, 2010: Who We Are, What We Do

2010-09-06T15:00:00.000-05:00

We are therapists, case managers, clerical staff and psychiatric providers.

We help ordinary people with depression, anxiety, behavior problems and stress.

We help couples solve problems in their marriages and learn to communicate better.

We treat serious situations like suicidal thinking, schizophrenia and delusions. We deal with child abuse, drug addiction and people prone to violence.

We work in the office, in the school and in the home. You will see us working in the hospitals and jails of our communities.

We respond to emergencies in 13 counties, 24 hours a day.

We are your

Area Mental Health Center

serving Southwest Kansas since 1961.

Show Notes for August 3, 2010: Substance Abuse and Dependence

2010-08-02T15:06:00.000-05:00

Definitions

Substance Dependence is when a person has become physiologically dependent on a substance. Evidence of this is a change in tolerance to the drug, or withdrawal symptoms when the drug is not present, or both.

Substance Abuse is continued use of a drug despite negative consequences. An example would be to continue to drink and drive after receiving a DUI.

Causes

Biological causes are thought to be mediated by the the neurotransmitter dopamine. Drugs of abuse raise dopamine levels; the body responds by reducing levels. Thus, a person starts to drink or use drugs just to maintain a feeling of normalcy.

Psychological causes are thought to be mediated by learning theory, especially classical conditioning. A person who always picks up a cigarette when the phone rings is classically conditioned.

Self Help Groups

Many self-help organizations work to help a person trying to stay away from alcohol or drugs. These include:

Alcoholics Anonymous

Narcotics Anonymous

Celebrate Recovery

Rational Recovery

Professional Solutions

A relapse prevent plan will address the factors that are associated with return to drug use: stress, boredom, lack of pleasure (until dopamine levels return to normal), withdrawal symptoms, and various people, places and things associated with drug use.

Cognitive Behavioral Therapy will address the changes that need to be made in thinking and behavior.

Meaning-Centered Therapy will help a person find fulfillment in other areas of life so that a return to drug use becomes an interference with more important goals.

Show Notes for July 6, 2010: Three Theories of Dreams and the Unconscious

2010-07-05T08:46:00.001-05:00

Today we compare and contrast three views of dreams and the unconscious. Freud is the thinker most often presented when discussing the unconscious, but his view is not the only one.

Note that none of these theories can ever be proven in a scientific sense. They do not reflect the psychological theory or practice most often used today. They are presented here, in simplified form, for historical interest.

Sigmund Freud (1856-1939)

The Unconscious: For Freud, the unconscious is the seat of repressed memories. Memories or desires that are too unacceptable to the conscious mind are found here and may produce psychiatric symptoms if defense mechanisms fail or if the conflicts are not resolved. Three processes, the id, the ego and the superego, make up the unconscious. Part of the ego rises into consciousness.

Dreams: The part of the dream recalled is the "manifest content" that symbolically represents the "latent content," or what the dream really means. The latent content expresses the unacceptable unconscious material.

Carl Gustav Jung (1875-1961)

The Unconscious: For Jung, a deeper level of the unconscious exists, called the collective unconscious. The collective unconscious contains universal symbols - symbols that we all share - known as archetypes. The most common archetypes are the persona (the self we present to the world), the shadow (the moral opposite of ourselves), the anima or animus (the sexual opposite of ourselves), and the self (who we really are). Other common archetypes are the hero, the trickster, the sage, the great mother, among many others.

Jung also proposed the idea of continuity of the unconscious. Just as consciousness picks up where it left off each morning, so the unconscious picks up its train of thought each night upon sleep.

Dreams: Archetypes appear in dreams, often in disguised form. They are symbolic ways that the unconscious has of communicating with the conscious mind and help it to solve problems or become aware of things that need to be changed. Jung rejected the Freudian notion of latent content and believed that dreams should be studied as they presented themselves, and as a natural phenomenon.

Viktor Frankl (1905-1997)

The Unconscious: Frankl believed that in addition to a physical unconscious (autonomic processes) and a psychological unconscious (such as either of the above two theories) that there was also a spiritual unconscious. The spiritual conscious is the site of those things that are uniquely human, such as love, humor, and conscience. Different from the Freudian superego, the Franklian conscience may also rise to a conscious level to give us hints from the spiritual unconscious about the difference between right and wrong actions.

Dreams: For Frankl, dreams may have a biological base, a psychological base, or a spiritual base. Physically based dreams reflect things such as memory encoding that may go on during sleep. Psychological dreams may reflect Freudian-like conflict. Spiritual dreams may give us guidance from the spiritual unconscious.

Show Notes for June 1, 2010: Emotions

2010-06-02T18:32:00.000-05:00

Six Basic Emotions

These are the six facial expressions of emotion that are universally recognized anywhere in the world:

happiness
sadness
anger
fear
surprise
disgust

Defining Emotions

An emotion is composed of a cognitive label applied to physiological arousal. Emotions can be changed by increasing or decreasing physiological arousal, or by changing the cognitive label.

Dr. Emina Karamanovski views emotions as messengers. By understanding their messages, we can increase our emotional intelligence. You can read more about my interview with Dr. Karamanovski here:

http://logotalkshownotes.blogspot.com/2009/05/episode-5-interview-with-dr-emina.html

Cognitions

Emotions can become extreme when the things we tell ourselves are absolute, extreme, or judgmental. Emotions become more manageable when we dispute those thoughts and change them to messages that are flexible, moderate, or forgiving.

Show Notes for May 4, 2010: Public Policy and Mental Health

2010-05-02T17:36:00.002-05:00

Federal Issue: Federal Healthcare Reform

The Affordable Health Care Act of 2010 passed the United States Congress on March 21, 2010. The act provides for full parity between mental health services and general medical services. This means that the provisions of the new law directly impact your local Area Mental Health Center. Most provisions of the new law do not come into effect until January 1, 2014.

Background: The new law is designed to reform two main problems with American healthcare: The overuse of high cost interventions and the underuse of prevention strategies. To that end, national health reform has four goals, or "pillars" of which the new law primarily addresses the first two.

Four Pillars of Healthcare Reform

Insurance Reform
Coverage Expansion
Delivery System Redesign
Payment Reform

Coverage Expansion and Insurance Reform

According to the National Mental Health Association, 83.1% of Americans currently have some type of insurance coverage. After the provisions of the new law go into effect, this number will rise to 93%. Sixty-six percent of the increase will come through an expansion of Medicaid, while the remainder will come from insurance reform and the creation of state insurance exchanges. Medicaid expansion will be accomplished by making the only requirement for coverage set at a household income of 133% of the federal poverty level.

Delivery System Redesign

Previous studies have shown that 29% of those receiving Medicaid had a mental health problem. A new study, based on data gathered about medications prescribed and not based on providers seen, suggests that 49% of those receiving Medicaid have a mental health issue. This means that those extra 20% are receiving psychiatric medications, but are not being seen by a psychiatric specialist.

The new law calls for a closer integration of mental health and general medical services. It remains unclear what this new integration will look like for our local center. It may mean entering into contractual relationships with existing community practitioners, or it could mean local medical clinics hiring mental health staff and local mental health centers hiring general medical staff.

Such a redesigned community mental health center may come to be known as a "federally-qualified behavioral healthcare center." This represents the greatest redesign of public mental health services since the passage of the Community Mental Health Act of 1963 that originally established community mental health centers.

Payment Reform

The fee-for-service model is moving toward extinction with the new law. It is being replaced by a "case rate" model. That is, a federally-qualified behavioral healthcare center would receive funds from a payor, say Medicaid, based on the number of Medicaid consumers seen. Moreover, centers with better outcomes would be paid more than centers with worse outcomes, adjusted for number of patients.

For example: Assume the Ulysses Regional Office has 200 Medicaid clients in 2014, and the Scott City Regional Office has 200 Medicaid clients in 2014. If the clients of the Ulysses Regional Office show more improvement that those of the Scott City Regional Office, then the Ulysses Regional Office would receive more Medicaid dollars than Scott City, though serving the same number of clients.

State of Kansas Issue: Mental Health Reform and State Funding

In 1990, the State of Kansas appropriated $18 million for the Kansas Mental Health Reform Act that asked the three State Mental Health Hospitals (Larned State Hospital, in our area) to close 90 beds each. In 2000, the State closed Topeka State Hospital and appropriated $8 million. The money was used by community mental health centers across Kansas, including the Area Mental Health Center, to provide community based services to those who might otherwise become patients of the State Hospital system.

The State began reducing those funds to community mental health centers in 2007, one year prior to the onset of the national recession, but the mandates of the legislation remain.

As of this posting, State Mental Health Reform funding has been cut a total of 60% to mental health centers across Kansas. State budget cuts continue, and Medicaid payments have been reduced by 10%.

Local Issues: Area Mental Health Center serving Grant, Stanton and Morton Counties

The number of admissions to your local Area Mental Health Center increased from all three counties in 2009. We had 352 new clients in 2009, compared to 313 new clients in 2008. We delivered a total of 35,053 specific services in 2009, ranging from individual psychotherapy, to medication management, to case management, to alcohol and drug classes, to emergency screenings.

To meet the challenge of reduced funding, and to maintain quality traditional services, many support services have been reduced. These include attendant care, respite care, case management, transportation, nutritional supports, and other services.

The Ulysses Regional Office will also discontinue a number of groups in 2010 that have been shown to lack cost effectiveness. These include:

Spanish-language Alcohol and Drug Information School
Adolescent-specific Alcohol and Drug Information School
Anger Management and Impulse Control Group
Divorce Education Class
Summer GET SET Program in Region III

In past years, the Area Mental Health Center was able to donate over a million dollars a year in reduced-rate services based on client income and number of dependents (the Charity Care Schedule or "sliding scale"). Beginning in 2009, a Managed Care Service Package was put into effect. Those clients who qualify for our Charity Care schedule are seen for a maximum of six psychotherapy sessions. Medical and emergency services are not included in this tally. Following the six sessions, the Charity Care rate no longer applies. Clients may appeal the decision to a standing committee based on a number of factors. Please contact your local Area Mental Health Center for more complete information on the Managed Care Service Package.

These changes allow us to maintain quality traditional services while remaining responsible stewards of the funds available.

Show Notes for April 6, 2010: Interview with John Stinebaugh

2010-04-06T13:16:00.002-05:00

John Stinebaugh, Child Case Manager, talks today about Children's Community Based Services. For more information, please see Community Based Services.

Show Notes for March 2, 2010: Disaster Psychology

2010-03-06T20:13:00.003-06:00

On Friday, March 5, the Area Mental Health Center will present a talk on Disaster Psychology as part of the Community Emergency Response Team (CERT) training sponsored by Grant County Emergency Management.

Topics include:

The Fight or Flight Response

The Alarm Stage: An immediate response to disaster with increased adrenaline, increase heart rate, increased rate of breathing, changes in blood flow, slowed digestion, and other signs of autonomic arousal.

The Resistance Stage: A pattern of "idling" if the disaster is prolonged with increased cortical steroids circulating in the blood stream, allowing one to return to the alarm stage quickly. A person may feel they are waiting for "the other shoe to fall."

The Exhaustion Stage: If the fight or flight response is not resolved, diseases of adaptation, including cardiovascular and anxiety disorders, may develop.

Good Stress Management in General

Take care of the body with proper nutrition, exercise and sleep. Avoid excessive use of alcohol, nicotine, and so forth.

Take care of the mind by balancing interests of family, work and hobbies. Avoid extremes of thinking such as the "woulda, coulda, shoulda's."

Take care of the spirit by developing attitudes of gratitude and forgiveness.

Phases of a Crisis

Impact - Immediately after a disaster, people may not panic and may show no emotion at all.

Inventory - People begin to realize what has happened, begin to assess the damage, and try to locate others.

Rescue - Emergency personnel arrive on the scene. Most people will follow their directions.

Recovery - Survivors pull together and may react against outside emergency personnel.

Tips on Working with People in Trauma

1. Get medical care to those who need it.

2. Involve uninjured people in helping.

3. Provide emotional support by listening and empathizing.

4. Help victims connect with family and friends.

Show Notes for February 2, 2010: Nomenclature Past, Present and Future

2010-02-01T12:17:00.004-06:00

Last month, Bob and I had a discussion off air about a variety of psychiatric and abnormal psychology terms, many of which are no longer used, but which are in conversational use. So, this month, we are going to explore a number of these terms from the past, the present, and even terms suggested for the future.

The definitions here are not intended to be exhaustive, but provide a little thumb-nail picture only.

Psychopath (psychopathy): A condition characterized by a lack of conscience, lack of empathy, lack of shame or guilt, and a high degree of interpersonal charm. Famous persons suspected of being psychopaths include Charles Manson, Jeffrey Dohmer, John Wayne Gacy, Jr., and Ted Bundy. Today, this condition is called Antisocial Personality Disorder.

Sociopath (sociopathy): Same as the above. The difference between psychopathy and sociopathy is based on the speaker's theory of cause. Psychopaths are born; sociopaths are made (by parental neglect, poverty, etc.). This condition is also called Antisocial Personality Disorder today.

Psychotic (psychosis): This term is still in limited use. This is an umbrella term that encompasses both hallucinations and delusions. Hallucinations are sensory experiences that are not real; delusions are false, fixed beliefs. Famous persons believed to be psychotic include John Hinckley, Jr. and Mary Todd Lincoln.

Psychoneurotic (psychoneurosis/neurosis): This term was popularized by Sigmund Freud and Carl Jung. In includes many, many conditions that are not psychotic, including anxiety, depression, and psychosomatic disorders. Famous persons believed to be neurotic include Woody Allen and Howard Hughes.

The American Psychiatric Association made an attempt at standardizing diagnoses in 1952 with the publication of the Diagnostic and Statistical Manual. The third edition (DSM-III), published in 1980, was the edition that brought reliability to the terms. The next edition (DSM-V), after many delays, is scheduled to be published in 2012.

The following website:

www.DSM5.org

is scheduled to launch on Feb 10, 2010 to provide current news on DSM-V development.

Under DSM-V rules, it now appears that ratings of depression, anxiety, cognitive impairment, and reality distortion will be part of all diagnoses. This will replace current diagnoses such as Schizoaffective Disorder, a condition in which mood symptoms co-occur with symptoms of Schizophrenia.

Possible future diagnoses will include:

Complex Post Traumatic Stress Disorder (C-PTSD), a condition that involves a loss of sense of self after prolonged captivity.

Post Traumatic Embitterment Disorder (PTED), a chronic feeling of embitterment and injustice following a single, negative event.

Relational Disorders, including Marital Relational Disorder with/without Violence and Parent-Child Abuse Disorder, will make domestic violence and child abuse issues that may be addressed by psychiatrist. This would be one of many controversial decisions, in this case possibly turning a crime into a disorder.

Show Notes for January 5, 2010: Defining Abnormality

2010-01-04T20:03:00.003-06:00

What does it mean to be normal? What does it mean to be abnormal? Today on Mental Health Tuesday, we discuss the various definitions of normalcy and abnormality.

Clinical Definition
According to the clinical definition, abnormality is defined by an expert, the clinician. This definition is further subdivided according to the Medical Model or the Behavioral Model. According to the Medical Model, a condition either exists or it does not. For example, you cannot be "a little bit pregnant." The medical model assumes that symptoms are signs of an underlying condition defined by the clinician. According to the Behavioral Model, behavior is its own phenomenon and not connected to an underlying condition. Behavior is thought of as being on a continuum, extremes of which are considered abnormal. For example, thinking you hear someone call your name when no one is there, or thinking you hear the phone ring when it did not, are examples of common auditory hallucinations that most of us have had. This is the low end of the continuum and considered normal. Hearing voices give you detailed orders, however, is the high end of the same continuum and considered abnormal.

The Diagnostic and Statistical Manual, Fourth Edition
The main reference in the United States for the Clinical Definition is the DSM-IV published by the American Psychiatric Association. Primarily based on the Medical Model, the DSM-IV outlines the symptoms of each disorder. A nod is made to the Behavioral Model, however, in that symptoms must cause impairment in "social or occupational functioning" to qualify for diagnosis. In a nod to the Distress Definition, below, the DSM-IV does allow for diagnosis in the absence of impaired functioning in the presence of "clinically significant distress."

Distress Definition
This is the inverse of the Clinical Definition. According to the Distress Definition, abnormality is defined by the person experiencing the abnormality. If you are concerned enough about certain thoughts, behaviors, or experiences to talk to a therapist, then you, yourself, have judged them to be abnormal.

Statistical Definition
This definition takes whatever behavior is under discussion and measures it within a population. Abnormality is then defined as a certain degree of variation from that mean. For example, general intelligence, the IQ, is defined based on a standard score that has a mean of 100 and a standard deviation of 15 (the Wechsler Scale). Two standard deviations before this mean (IQ=70) is one criterion, but not the only one, for a diagnosis of Mental Retardation. Two standard deviations above the mean (IQ=130) is defined as the "Superior" range. While this may be socially desirable, it is as statistically abnormal as Mental Retardation. Notice that according to this definition, there could never be an "obesity epidemic." The same percentage of people always vary to the same degree from the mean, though the mean may change among a population. (The obesity problem is based on a clinical definition).

Cultural Definition
According to the Cultural Definition, normalcy is conformity to one's culture, or to the culture in which one lives. Failure to meet the expectations of one's culture is considered abnormal. This means that those who advocate cultural change are seen as abnormal. Totalitarian governments may use the cultural definition as a tool of oppression. For contrast and example, in the United States, if a person is delusional or suicidal, we may deprive them liberty if there are judged to be a danger to others or to themselves. In the former Soviet Union, a political dissident could be deprived of liberty if judged to be a danger to the State. Cartoons that we might see as political satire are judged as blasphemy in some Middle Eastern cultures and producing them carry the death penalty.

Legal Definition
The legal definition of insanity varies by state, but, in general, means that a person could not tell the difference between right and wrong at a given time because of the effect of a mental illness. A person is never diagnosed as insane by a professional; they are found to be insane by a court. Most persons with mental illness, under the Clinical Definition, are quite sane under the Legal Definition. A person who kills someone to steal money from them is a criminal. A person who kills someone because they believe some mystical force has replaced that person with an android duplicate and, that be killing them, the original person will be returned, is quite likely insane.

Show Notes for December 1, 2009: The Attitude of Gratitude

2009-12-01T01:00:00.000-06:00

Emerging research shows that attitudes are a key factor in determining levels of happiness. Chief among these attitudes is gratitude.

Gratitude is defined as a "knowing awareness that we are recipients of goodness." Knowing awareness means that it is conscious and thoughtful, not automatic. In other words, "thankfulness requires thoughtfulness."

In one study, an experimental group that kept a gratitude journal was compared to a control group that kept a journal of daily events and a third group that kept a journal of negative events. At the end of the study, those in the gratitude group reported 25% more happiness, slept 12% longer, exercised 30% more per week, and showed a 10% lowering of blood pressure compared to controls in the other two groups.

A summary is located here:

The New Science of Thank You.PDF

A portion of a podcast with one of the authors mentioned is here:

Podcast Portion

Finally, below, we have the "Gratitude Stream," using technology to be grateful:

Show Notes for November 2, 2009: Communication Tips

2009-11-16T11:06:00.002-06:00

"The difference between the almost right word and the right word is really a large matter - its the difference between the lightning bug and the lightening." -- Mark Twain

Today, we had a rather open discussion on ways to improve communication. These include:

1) Using I-statements. This is the practice of only talking about what you know about - which is your own thoughts and feelings. Statements, therefore, begin with "I," as in "I think...." or "I feel..."

2) Active Listening. This is the practice of paying close attention to what is being said to you, rather than taking a defensive posture and only half-listening while planning your reply. Active listening can be accomplished by listening well enough to paraphrase, reflect, or summarize what was said to you.

3) Ask Questions. If you don't understand something, or if there seems to be a discrepancy between speech and body language, then ask questions to clarify the message.

4) Empathy. Try to put yourself in the other person's shoes.

5) Focus on Shared Goals. This is one means of resolving conflict, or, at least, being able to discuss conflicts without anger interfering in the message.

Some Examples:

Dr. Shelly Gable has been researching what goes right in close relationships for many years and has found that partners' reactions to good news is a better predictor of the quality of the relationship and whether it will endure than partners' reactions to bad news. For example:

Your spouse comes home and announces that he or she got a great promotion at work. You could react with:

Active Constructive Response (correct): "That's great, you've earned it, I'm so proud of you!" followed by asking questions. This conveys enthusiasm, support and interest.

Passive Constructive Response (incorrect): "That's great. What's for dinner?"

Active Destructive Response (incorrect): or "finding a cloud in the silver lining" like, "Does that mean you'll be working later hours? Are they going to pay you more? I can't believe they picked you out of all the candidates!"

Passive Destructive Response (incorrect): which can be either, "Wow! Wait until I tell you what happened to me today." or ignoring the event all together, "What's for dinner?"

Show Notes for October 6, 2009: Domestic Violence Awareness Month

2009-10-05T19:37:00.003-05:00

October is Domestic Violence Awareness Month. Some current publications from the American Psychological Association are linked here:

The Mind of the Batterer.pdf

Partner Violence: What you can do

A good website for the State of Kansas is:

helpchangekansas.com

Statistics:

A United States Department of Justice study found that 22% of women and 7% of men had been physically abused by an intimate partner at some point in their lives. The study also found that 1.3% of the women and 0.9% of the men had been abused within the past 30 days. Of those abused, 39% of the women and 23% of the men were injured.

Effects on the victim:

Physical abuse is often accompanied by humiliation, manipulation, and economic control. The effects on the victim include fear, the belief that escape is impossible, post-traumatic stress symptoms and sometimes substance abuse.

The risk of death or serious injury increases once the decision to leave is made.

How to respond if someone tells you of domestic violence:

DON'T minimize the abuse
DON'T blame the victim
DON'T shift the focus (to alcohol or some other problem)

DO be empathetic
DO tell the victim it is not her fault
DO offer to get her help (if you can)

Important Phone Numbers:

As always, if you are in danger, dial 9-1-1

Area Mental Health Center, Ulysses outpatient office for Grant, Stanton and Morton Counties:
1-620-356-3198

Domestic Violence Emergency Shelter (DoVES) of Grant County:
1-620-356-1049

Kansas Crisis Hotline:
1-888-END-ABUSE (1-888-363-2287)

National Domestic Violence Hotline:
1-800-799-SAFE (1-800-799-7233)

Show Notes for September 1, 2009: The Schools of Psychotherapy

2009-09-16T10:26:00.003-05:00

Today we talked about the three main "schools" or types of psychotherapy. Most therapy done today is an eclectic mix drawing on ideas from each of the schools to the extent that the ideas fit the problem that the client wishes to address.

The psychodynamic-systems schools:

Largely the product of early 20th Century European psychiatry, this view conceptualizes that each person or system (which can be a family, a workplace, or so forth) contains a given amount of energy (libido) that never leaves the system but that can be channeled to productive pursuits or psychiatric symptoms. The direction of this energy can be changed by gaining insights in fixation within a person or boundaries within a group. If this is not done properly, a person may substitute one symptom for another, or a different person in a family or group may develop symptoms.

Key figures: Sigmund Freud, Alfred Adler, Carl Jung, Dennis Dailey

Scientific note: The concept of symptom substitution has failed to be verified experimentally. Other concepts cannot be empirically tested.

The cognitive-behavioral schools:

Largely the product of mid-20th Century American psychology, the behaviorists hold that only observable (overt) behavior that can be measured is the proper subject matter for scientific psychology. This lead to the development of Learning Theory. The cognitive therapists believe that unobservable (covert) behavior (thinking, feeling) may be measured indirectly through verbal report and that covert behavior follows the same principles of learning theory as does overt behavior.

Key figures: J.B. Watson, B.F. Skinner, Albert Ellis, Aaron Beck

Scientific note: Cognitive-behavioral therapy is scientifically validated for the treatment of depression and many forms of anxiety.

The humanist-existentialist schools:

Largely the product of late-20th Century American psychology, the humanists and existentialists believe that something is unique about human beings that cannot be explained by learning theory. They hold that human beings have potentials that need to be made real (actualized). The humanists and existentialists base their understanding of the human being on a priori philosophical ideas such as free will and the existence of the human spirit.

Key figures: Carl Rogers, Abraham Maslow, Rollo May, Viktor Frankl

Scientific note: Members of these schools tend to research the results of psychotherapy. Their philosophical assumptions are not able to be empirically tested.

Show Notes for August 4, 2009: Viktor Frankl and Logotherapy

2009-08-01T22:59:00.004-05:00

About Viktor Frankl

Viktor E. Frankl, MD, PhD (1905-1997) is the founder of Logotherapy. He practiced psychiatry and neurology in Vienna, Austria throughout the middle of the 20th Century, interrupted by internment in four Nazi concentration camps. Frankl’s experiences in the camps provided the proving ground for his assertion that human life has meaning under any and all circumstances, no matter how grim, and that the human spirit has a defiant power to take a stand in the face of any adversity.

Frankl is the author of 31 works on psychotherapy, philosophy and neurology. His books have been translated into 31 languages. His classic Man’s Search for Meaning has sold over 12 million copies worldwide. A 1991 Library of Congress/Book-of-the-Month survey rated Man’s Search for Meaning as one of the ten most influential books in the United States.

The work of Viktor Frankl is carried on by Viktor Frankl Institutes around the world. The Viktor Frankl Institute of Logotherapy in the United States is located in Abilene, Texas. One therapist from the Ulysses Office of the Area Mental Health Center receives training there and recently returned from the 17th World Congress on Logotherapy. The coursework of the Viktor Frankl Institute is approved by the American Psychological Association and the National Board of Certified Counselors. Logotherapy is a recognized treatment by the American Psychiatric Association.

About Logotherapy

Logotherapy is a meaning-centered or existential form of psychotherapy. The “logo” in logotherapy comes from the Greek word logos which means word, meaning, or philosophical argument. Unlike many other forms of existential therapy, Frankl’s logotherapy is down-to-earth and practical. It works in a complementary way with a variety of other therapies, including the cognitive therapies most often used in the United States today.

Logotherapy teaches that the human spirit is incorruptible and can be a source of strength and health despite the weaknesses of the body and the mind.

The three basic tenets of Logotherapy are:

The Meaning of Life: Logotherapy holds that human life is meaningful under any and all circumstances.

The Will to Meaning: Logotherapy believes that part of what makes us human is an innate pull to discover the meaning of our lives.

The Freedom of the Will: Logotherapy holds that human beings have the ability to choose to live meaningful lives by actualizing values.

Three classes of values lead to the discovery of meaning in life:

The creative value is the work that we do as only we can, that which we create in life.

The experiential value is the love we discover in relationships, or the beauty we find in the world around us through nature, art, music, and so forth.

The attitudinal value is the stand we choose to take toward pain and suffering in our lives that we cannot change.

More can be learned about Viktor Frankl and Logotherapy at:

The Viktor Frankl Institut (Austria)

The Viktor Frankl Institute of Logotherapy (United States)

LogoTalk.net

About the Logo

The logo of the Viktor Frankl Institute is pictured above.

The BOAT, seen in the image, is the Greek symbol for wisdom.

The OIL LAMP, also seen, is the Hebrew symbol for eternity.

L-O-G-O-S is what you are really seeing superimposed on the globe above, the letters L-O-G-O-S.

“En archa ain ho Logos, kai ho Logos ain tou Theou, kai ho Logos ain Theo.” John 1:1

In the beginning was the Logos (word, meaning, that which is meant), and the Logos was with God, and the Logos was God.”

Show Notes for July 7, 2009: Welcoming Katie Noriega to AMHC

2009-07-07T10:09:00.000-05:00

My name is Katie Noriega and I am originally from Ulysses, Ks. I just started working at AMHC at the end of May as the new Mental Health Assistant. I'm no stranger to AMHC, as I worked here last summer as a Group Aid for the Get Set Summer Program.

After graduating Ulysses High in 2002, I attended Fort Hays State University on a volleyball scholarship where I dabbled in a couple different majors, mainly Graphic Design and Marketing. Five years later and still unsure of my 'life calling' I took a year off from school and moved to beautiful Colorado Springs to spread my wings and 'find myself'. A year of coaching high school volleyball, waitressing, hiking, and camping.

I moved back to my home town and as a summer job choice I applied at AMHC. Since then, it seems as if my life had just taken off! My experience working in the mental health field not only fascinates me but it fulfills my desire to help children in need. I have found that my greatest passion is teaching and helping others to cope with the struggles of life, as I know from my own experiences how hard living life and feeling alone can be.

In order to be considered for the MHA position I was required to have another years worth of experience working with children, so I was hired on at Hickok Elementary School as a para working with 1st and 2nd graders. As soon as the school year was up, I reapplied to AMHC and voiced my strong desire to learn and grow within a company that has such great values and working environment. Since last summer, I was inspired to return to school to finish my degree in Psychology and now I'm considering going all the way for my doctorate! Although I'm keeping my future plans open for consideration, my next professional goal is to graduate this coming May and continue on with AMHC as a Children's Case Manager.

Show Notes for June 2, 2009: Stress Management

2009-06-01T15:53:00.000-05:00

The stress response is known as the Generalized Adaptation Syndrome. It consists of three stages:

Stage 1: The Alarm Stage (also, the fight-or-flight reaction)

This stage helps us respond in the event of a physical attack. Heart rate and blood pressure increase, breathing becomes rapid, there is a sudden rush of strength, digestion is slowed as resources are directed away from the immune and digestive systems to the muscular system. In this stage, we can fight better or run-away faster.

Stage 2: The Resistance Stage

If stress is prolonged, the body returns to what appears to be a resting state. However, chemicals in our blood keep us on "hair-trigger alert," and we feel as if we are waiting for the "other shoe to drop." We may be jumpy and are ready to go back into the fight-or-flight stage much faster. Resistance to disease initially rises during this stage.

Stage 3: The Exhaustion Stage

If stress is still not resolved, the body gets profoundly fatigued. Resistance begins to fail and we are at risk of "diseases of adaptation." These include a greater change of physical problems like heart disease, and also emotional concerns like anxiety disorders.

To deal with stress, we can cope directly or indirectly. Direct coping skills involve removing or modifying the source of the stress, such as leaving a stressful job or reducing the pace of change in our lives. When this is not possible, we can manage our response to stress by any of the following:

1. We can learn to voluntarily control the sympathetic and parasympathetic nervous systems, the systems that control the fight-or-flight response. We can learn to do this through relaxation, deep breathing, or exercise programs.

2. We can learn to control our thoughts and emotions by developing meaningful beliefs and by countering thoughts that are meaningless or unrealistic.

Should an anxiety disorder develop, there are treatment programs that can help. Professional counseling can make you an expert at managing stress your personal stress. More information on anxiety disorders is available below:

Facts About Anxiety Disorders.pdf

Anxiety Disorders.pdf

Generalized Anxiety Disorder.pdf

Obsessive Compulsive Disorder.pdf

Panic Disorder.pdf

Phobia.pdf

Post Traumatic Stress Disorder.pdf

Social Phobia.pdf

Mental Health Tuesday for May 5, 2009

2009-05-04T16:39:00.000-05:00

May is Mental Health Month! To celebrate, Mental Health Tuesday has started its own blog here at:

http://www.mentalhealthtuesday.com

Show notes from each month of Mental Health Tuesday will now be available.

Live Your Life Well is the theme for this year's Mental Health Month. The official website at

www.liveyourlifewell.org

offers 10 proven tools that can help you feel stronger and more hopeful. The site offers specific, easy-to-follow tips for each tool. The 10 tools are:

1. Connect with others

2. Stay positive

3. Get physically active

4. Help others

5. Get enough sleep

6. Create joy and satisfaction

7. Eat well

8. Take care of your spirit

9. Deal better with hard times

10. Get professional help if you need it

On a previous episode of Mental Health Tuesday, we told you about a day in the life of our local Ulysses Office of the Area Mental Health Center:

http://mentalhealthtuesday.blogspot.com/2009/02/mental-health-tuesday-for-february-3_02.html

That same information is now available for our entire 13 county region.

On a random day, January 20, 2009, the entire Area Mental Health Center provided services to 209 children and 219 adults. The numbers of people who came for services on that ONE DAY with the following mental health symptoms included:

Aggression - 12

Suicidal potential - 32

Marital and family problem - 28

Substance Abuse - 28

Sexually Abuse - 12

Psychotic - 63

Bipolar Symptoms - 38

Depression - 108

Anxiety - 34

ADHD - 69

Behavior Problems - 76

Mental Health Tuesday for April 7, 2009

2009-04-06T18:25:00.001-05:00

Mental Health Tuesday is broadcast the first Tuesday of every month by KULY, 1420 AM, in Ulysses, Kansas from 8:30 to 9:00 AM. It is part of Bob Dale's Get Up and Go Show.

Today's topic is Bipolar Disorder, a condition that effects 5.7 million American adults. Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in a person’s mood, energy, and ability to function. Different from the normal ups and downs that everyone goes through, the symptoms of bipolar disorder are severe. They can result in damaged relationships, poor job or school performance, and even suicide. But there is good news: bipolar disorder can be treated, and people with this illness can lead full and productive lives.

Click here to view the National Institute of Mental Health's PDF on Bipolar Disorder.

Bipolar disorder causes dramatic mood swings—from overly “high” and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. Severe changes in energy and behavior go along with these changes in mood. The periods of highs and lows are called episodes of mania and depression.

Signs and symptoms of mania (or a manic episode) include:

* Increased energy, activity, and restlessness
* Excessively “high,” overly good, euphoric mood
* Extreme irritability
* Racing thoughts and talking very fast, jumping from one idea to another
* Distractibility, can’t concentrate well
* Little sleep needed
* Unrealistic beliefs in one’s abilities and powers
* Poor judgment
* Spending sprees
* A lasting period of behavior that is different from usual
* Increased sexual drive
* Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
* Provocative, intrusive, or aggressive behavior
* Denial that anything is wrong

A manic episode is diagnosed if elevated mood occurs with three or more of the other symptoms most of the day, nearly every day, for 1 week or longer. If the mood is irritable, four additional symptoms must be present.
Signs and symptoms of depression (or a depressive episode) include:

* Lasting sad, anxious, or empty mood
* Feelings of hopelessness or pessimism
* Feelings of guilt, worthlessness, or helplessness
* Loss of interest or pleasure in activities once enjoyed, including sex
* Decreased energy, a feeling of fatigue or of being “slowed down”
* Difficulty concentrating, remembering, making decisions
* Restlessness or irritability
* Sleeping too much, or can’t sleep
* Change in appetite and/or unintended weight loss or gain
* Chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury
* Thoughts of death or suicide, or suicide attempts

A depressive episode is diagnosed if five or more of these symptoms last most of the day, nearly every day, for a period of 2 weeks or longer.

Some other interesting statistics:

Persons with Bipolar Disorder have no symptoms 52.7% of the time. They experience depressive symptoms 31.9% of the time, manic symptoms 9.3% of the time, and mixed symptoms 5.9% of the time.

Suicide attempts and completed suicides are more common with Bipolar Disorder than with Major Depression alone. Without treatment, 20% of persons with Bipolar Disorder commit suicide. Six months after a manic episode, only 43% of Bipolar patients remain employed. Alcoholism effects 20% of Bipolar patients, compared to 8% of the general population.

Mental Health Tuesday for March 3, 2009

2009-03-03T13:10:00.001-06:00

Mental Health Tuesday is broadcast the first Tuesday of every month by KULY, 1420 AM, in Ulysses, Kansas from 8:30 to 9:00 AM. It is part of Bob Dale's Get Up and Go Show.

This morning we discussed the science of happines. Happiness was presented as a side-effect of other things that give life meaning. Specifically, the three areas to consider are:

1. Work - The work that you do, whether or not it is your main source of income, must be personally meaningful to you.

2. Love - You choose who you want to be in each of your loving relationships, as a spouse, a parent, or a friend. Happiness in these relationships comes not from the other person, but from your decision about who you want to be.

3. Attitude - You choose your attitude in any circumstance. If you are not happy now, you will not be happy when the economy improves, or when you get the new job, or when you get married, or whenever your "ship comes in." Happiness is about the attitude you choose today.

A great deal more about the Science of Happiness can be found here:

http://www.spring.org.uk/2008/01/avoid-sham-advice-on-living-good-life.php

at PsyBlog.

Mental Health Tuesday for February 3, 2009

2009-02-02T18:29:00.001-06:00

Mental Health Tuesday is broadcast the first Tuesday of every month by KULY, 1420 AM, in Ulysses, Kansas from 8:30 to 9:00 AM. It is part of Bob Dale's Get Up and Go Show.

"A Day in the Life" of your local mental health center:

On January 27, 2009 we had three therapists, two child case managers, and one adult case manager on duty. We were open from 8:00 AM until 5:00 PM and again from 6:00 PM until 9:00 PM. Some of the categories overlap, but here is what that typical day saw:

Clients by Age:

Children and Adolescents - 18
Adults - 13
Couples - 2
Senior Adults - 1

Clients by Diagnosis:

Childhood Behavior Disorders - 10
Depression and Mood Disorders - 8
Impulse Control Disorders - 8
PTSD and other Anxiety Disorders - 3
Substance Abuse - 2
Dual Diagnosis (Substance Abuse and Depression) - 1
Marital Problem - 1
Severe Mental Illness - 2

Clients by Service:

Individual Therapy - 18
Case Management - 8
Group Therapy - 6
Couples Therapy - 2
Crisis Service - 2

Special Concerns:

Suicidal Concern - 2
Acute Psychosis - 1
Psychiatric Hospitalizations - 1

Effects of State Economic Problems on Mental Health:

In 1990, the State of Kansas appropriated $18 million for Mental Health Reform legislation that asked the three State Mental Health Hospitals to close 90 beds each. In 2000 the State closed Topeka State Hospital and appropriated $8 million to the community mental health centers to provide community based services. Total funding: $26 million.

July 1, 2007, the State reduced Mental Health Reform dollars by $8.8 million. January 1, 2009, the State reduced another $1.8 million. The current state plan includes another $7 million cut for July 1, 2009 and another possible $1 to $2 million reduction now, February 2009. This represents a total of $19.5 million, or nearly a 75% reduction in Mental Health Reform funding.

Mental Health Tuesday for January 6, 2009

2009-01-05T17:05:00.001-06:00

Mental Health Tuesday is broadcast the first Tuesday of every month by KULY, 1420 AM, in Ulysses, Kansas from 8:30 to 9:00 AM. It is part of Bob Dale's Get Up and Go Show.

Two topics are scheduled for today's program: Mental health financing and what makes therapy work.

First, a word about mental health financing:

Community mental health centers are funded through a combination of public (county, state and Federal) and private (private pay and private insurance) sources. State funds to community mental health centers in Kansas have been reduced 32% over the past two years. Despite this, the state mandates that community mental health centers continue to provide services regardless of ability to pay for those services. Obviously, this creates a challenging financial environment.

The link below is to a letter to Governor Sebelius from the Executive Director of the Association of Community Mental Health Centers of Kansas.

Letter to Governor Sebelius (PDF format)

Second, and our major topic, is what makes psychotherapy work.

The Area Mental Health Center recently hosted Scott Miller, Ph.D., with the Brief Therapy Training Consortium in Chicago. Dr. Miller presented an excellent workshop on improving our ability to achieve results in psychotherapy.

Dr. Miller's website is TalkingCure.com.

As part of a committee to incorporate Dr. Miller's research into our routine clinical practices, I am working my way through some of his books. In his book, Escape from Babel: Toward a Unifying Language for Psychotherapy Practice, Dr. Miller reviews research on psychotherapy outcomes.

Four factors, the research indicates, contribute to positive psychotherapy outcome:

1. Extratherapeutic factors account for 40% of the positive change. These are factors not directly related to therapy at all. They include the strengths and resources of the client as well as random, chance happenings.

2. The therapeutic relationship accounts for 30% of the positive change. This refers to the quality of the relationship between the therapist and the client. Therapist factors include qualities such as empathy, respect and genuineness. Client factors include readiness for change, goals for therapy and the client's view of the quality of the relationship (not the therapist's view).

3. Specific therapeutic techniques account for 15% of the positive change.

4. Some combination of hope and the placebo effect account for the remaining 15% of change.

So how can we make the most of these findings?

To make the most of extratherapeutic factors, it is recommended that therapists start to ask about change that the client has experienced after calling for a first appointment and before the actual first appointment. Research shows that 15% of clients report improvement prior to the first session spontaneously, but that 60% report improvement when asked. Asking will also give therapists information about the strengths of the client that can then be used to further the positive change.

We are also working toward building what Dr. Miller calls a "culture of feedback" wherein the therapist actively asks the client about the quality of the relationship and adjusts therapy based on those responses. We are testing some of Dr. Miller's assessment tools to do this, as well as looking at some of our own.

The importance of the relationship can be illustrated by this very old clinical example cited by Viktor Frankl at the First World Congress of Logotherapy:

"An American girl, a student of music, came to see me in Vienna for analysis. Since she spoke a terrible slang of which I could not understand a word, I tried to turn her over to an American physician in order to have him find out for me what had motivated her to seek my advice. She did not consult him, however, and when we happened to meet each other on the street, she explained: "See, Doctor, as soon as I had spoken to you of my problem, I felt such a relief that I didn't need help any longer." So I do not know even now for what reason she had come to me. This was an extreme example when human encounter, without any technique, was therapeutic."

It has been shown that therapists are very poor judges of therapeutic relationships, but that actively soliciting feedback improves their therapeutic approach. Over the course of the next few weeks, clients at the Area Mental Health Center will see this and other client-centered approaches more actively pursued.

Mental Health Tuesday for December 2, 2008

2008-12-01T15:20:00.001-06:00

Mental Health Tuesday is broadcast the first Tuesday of every month by KULY, 1420 AM, in Ulysses.

Today's topic is Holiday Stress.

The most important element in managing increased stress over the holidays is to focus on your reasons for celebrating the holidays in the first place. Before getting caught up in all the activity, take some time to reflect on what the holidays mean to you. Perhaps, religious or spiritual meanings are most important to you. Perhaps, time spent with family and friends comes to mind. Maintaining tradition may be what motivates you the most. Whatever it might be, take some time to consciously put it into words and come back to that meaning again and again so that it remains the focus and context of all you do.

That being said, three areas stand out as the most common areas of holiday stress:

1. Relationships. Any problems that you might have with your family are likely to get worse when you are all under stress. On the other hand, those without family or separated from family may feel lonely and even envious of the family stress of others. To cope with this kind of stress, consider the following:

Be forgiving. Now is a good time to set aside grievances, at least for the holidays. In fact, it might even be a good time to let go of old hurts and grudges! Remember that people can and do change sometimes.

Be honest. Don't try to put on a smile and force yourself to feel something you don't. Say "no" to holiday plans if you really don't want to participate in something. You may have a good reason to not feel in the holiday spirit this year. Acknowledge this and realize it is normal.

Be realistic. Traditions change over time, as do people. Realize that grown children and grandchildren may not celebrate the way you might wish they would. If your family is scattered across the country, find new ways to celebrate together from afar.

Be charitable. If you are alone for the holidays, and bothered by it, then find some charitable or volunteer project that is consistent with your holiday values.

2. Finances. Know your budget and stick to it. We are all tempted to overspend on gifts, travel, food and entertainment. There is a reason that merchants call last Friday "Black Friday." If they have been "in the red," then they are probably now "in the black." Make sure that putting the merchants in the black does not put you in the red!

Stick to a budget. Figure out how much you can afford to spend on the holidays before you go shopping. When you go shopping, stick to that amount! Using cash rather than credit can help.

Plan ahead. Group your shopping trips together with a clear idea of what you are going to go get. Avoid buying on impulse.

3. Physical demands. The holidays can be exhausting with shopping, parties, preparing meals. Exhaustion decreases your ability to deal with stress.

Exercise. Especially with shorter, colder days it is easy to reduce the amount of physical activity you were used to in the summer. Stay healthy! Take a walk.

Eat right. Do not let go of healthy eating habits because of the holidays. Are you eating "comfort food" or too many extra cookies? Be aware of what you are doing and stay focused on your long term health.

Watch the alcohol. You may end up going to a number of parties. Be careful not to overindulge. Too much alcohol only adds to your stress in the long run. Moderation is always the key.

And, finally, don't take yourself too seriously. When problems come up, and they will, face them with humor and with confidence that comes from knowing why you are doing all this in the first place. You did figure that out already, right?

Mental Health Tuesday for November 4, 2008

2008-11-24T09:14:00.001-06:00

Mental Health Tuesday is broadcast the first Tuesday of every month by KULY, 1420 AM, in Ulysses.

This month's topic is Positive Psychology, the scientific study of the strengths and virtues that enable individuals and communities to thrive. Although this pursuit obviously has a long philosophical and theological history, it was first organized as a scientific discipline in 1998 by Martin Seligman who is, perhaps, best known for his discovery of "learned helplessness."

The key strengths and virtues examined by Positive Psychology are:

1. Wisdom and Knowledge: creativity, curiosity, open-mindedness, love of learning, perspective
2. Courage: bravery, persistence, integrity, vitality
3. Humanity: love, kindness, social intelligence
4. Justice: citizenship, fairness, leadership
5. Temperance: forgiveness and mercy, humility, prudence, self control
6. Transcendence: appreciation of beauty and excellence, gratitude, hope, humor, spirituality

Much more can be learned about Positive Psychology at the Positive Psychology Center, located on the campus of Penn State.

Mental Health Tuesday for October 7, 2008

2008-10-06T18:39:00.001-05:00

Mental Health Tuesday is broadcast the first Tuesday of every month by KULY, 1420 AM, in Ulysses.

The Area Mental Health Center has noticed an increase in the number of returning servicemen and women with symptoms of Post Traumatic Stress Disorder. To meet this need, the Area Mental Health Center offers the first six sessions of mental health treatment at no cost to military personnel returning from Iraq and Afghanistan.

One recent survey showed that 12% of personnel returning from Iraq had symptoms of PTSD and another 4% had symptoms of depression. Of those returning from Afghanistan, 6% reported symptoms of PTSD and another 5% reported symptoms of depression. This compares to 10% of personnel returning from the first Gulf War with symptoms of PTSD and 15% of personnel returning from Vietnam with PTSD.

Since the Vietnam era, military psychologists have failed to develop a test to determine who will and who will not develop PTSD. It appears that no such differentiation is possible. Instead, it appears that the duration and intensity of the combat, not the personality of the soldier, determines the onset of symptoms.

Much more about PTSD, and other anxiety conditions, can be found in this booklet published by the National Institute of Mental Health, linked below:

http://www.nimh.nih.gov/health/publications/anxiety-disorders/nimhanxiety.pdf

Marshall

Hometown Radio - KULY - 1420 AM

2008-04-02T11:42:00.001-05:00

Yesterday I went on the air with Mental Health Tuesday, a monthly radio presentation of KULY 1420 AM in Ulysses, Kansas, broadcasting at 1000 Watts to southwest Kansas, southeast Colorado, and the Texas and Oklahoma panhandles. This month's topic was finding meaning in adversity. The topic was chosen as our community struggles with the loss of four of our young people.

Please join me on the first Tuesday of every month at 8:30 AM for Mental Health Tuesday.