Feeds:
Posts
Comments

New Rules for Schools

I have a special place in my heart for anyone trying to give guided instruction in current events, especially lately. For one thing, we as a country are in the middle of an incredibly interesting journey on which we’re throwing it all on the table, getting it out in the open, and hashing out some things that have been swept under the rug for a long time. For another thing, the analysis of current events always looks different a month or a year or a presidential term later, so what we first see as truth is bound to change a little eventually. But someone has to get the conversation started.

I have a friend who says he’s teaching a class in civil discourse this coming semester. I think that’s a brave thing to do – I imagine it means he’s going to try to teach young people how to communicate without using anger or irrational behaviour. The more I think about it, the more I think it should be a required class in our schools. All of them. Catch the kids with the attitude problems before they’re old enough to buy guns.

The evidence is piling up in favor of paying extra attention to our country’s educational system. And that’s normal – schools need new rules all the time in response to a changing society. Remember typing class? That changed a bit over the years, didn’t it? In the seventies, it was typing class. In the nineties, it was keyboarding class. I have no clue what they’re calling it nowadays. For all I know, they’re now teaching 5-year-olds their ABCs using the touch typing system, word processing software, and the media controls on the computer, which takes care of all three skills at once.

So I made a little list of the new classes I think ought to be added to each and every school’s curriculum, and be made a requirement for high school middle school graduation. Correct me if I’m wrong, but I think these new classes will really make a difference in the lives of the young adults we throw out into the world with questionable social skills.

– Civil Discourse: how to state opinions and discuss issues in productive ways, especially in response to angry and hateful boneheads (must earn a B or better to pass)

– Criminal Law 101: introduction to the nature of crime and punishment, the penalties for various laws in their local area, and the difference between movies and reality (unit on survival skills to be made available in certain gang-infested school systems)

– Beginning Personal Finance: everything from making change to balancing a checkbook to the joys of compound interest (or the avalanche of compound interest, in the case of credit cards), with a special section on how to avoid getting ripped off

– Fifth-Grade Ethics: why and how to act in everyone’s best interest, how to begin figuring out what that is, and when and how to speak up in the face of injustice (violators of other school rules must repeat this class with the fifth-graders, no matter how old they are)

– Introduction to Gun Safety (mandatory in TX, NM, and AZ; optional everywhere else): how to safely handle, clean, and fire a gun; with emphasis on hunting, the difference between self-defense and self-importance, and the dangers of semiautomatic weapons (prerequisite, Ethics; must be taught concurrently with the class on Civil Discourse)

Feel free to add your own, but I think these five classes could be the start of some cool new rules in school – and save lives, and save the government a heck of a lot of money down the road, and…

Paying for health care

I’ve been reading a lot of pontifications from people who think that they’re personally having to pay for the new health care law. They see that greed exists on both ends of the economic spectrum, and they’re offended at the possibility that they’re paying more than their share. I can understand that.

But when they start talking like everyone who doesn’t work or pay their own way is lazy or not worth a hill of beans, I’m sorry – I can’t let that one roll.

I was recently remarried, and if it weren’t for my husband, I would be one of those without health insurance, so I know what it’s like to have to go without. Most of my friends are still in that situation. They don’t ask for handouts, and if they’re eligible for food stamps, they don’t abuse the system any more than sharing their extra food with hungry out-of-work friends who have even less to eat. Their pride gets in the way of trying to actively work the system.

We’re not redefining greed to borrow from Robin Hood’s “steal from the rich and give to the poor.” Not all rich people are greedy, but not all poor people are greedy. We’re all naturally motivated to get money so we can have edible food and a decent roof over our heads, and some people in every economic situation take it to extremes and find greed to be a wonderful survival tactic.

What has been redefined is how the media works. It is now easier to spread the word about decent people who honestly can’t provide for themselves and earn their keep. Many times it’s not about whether or not they want to work. Employers won’t keep sick people on the payroll if they can help it – and that goes for both physical and mental illnesses. People without insurance tend to stay sick. Others get fired because they either call off work too much or they come to work sick because they’re afraid they’ll get fired – but they’re not operating at 100% so some get fired anyway and they lose their ability to pay the doctor.

It’s a big vicious circle – and it’s a realistic explanation of why people flood the emergency room when they get sick instead of seeing a regular doctor. They know that they can just get the bill later and hope they’re working by the time they get it. A lot of my friends don’t do either one. They can’t pay a regular doctor, and they don’t want the bill collectors blowing up their phone. They’d rather stay sick than incur a bill they don’t have much hope of paying, which in turn screws their chances of staying gainfully employed and screws their kids out of being able to pay attention in school, and it just goes round and round.

Health care reform is really an economic issue as much as a social issue. Full employment means getting the right leg brace and PT for someone with a bad leg instead of letting them limp around everywhere and depend on others. It means early detection of everything from the flu to cancer. It means making sure people with certain types of mental illness get the meds they need to be functional, productive members of society. Just a little bit of the right type of health care can put a lot of people back into the workforce (job availability permitting). More payroll tax income, more sales tax income, and more property tax income could make a real difference in the country’s cash flow.

And if you don’t like Obamacare, I suggest you get execs from the insurance, provider, pharmaceutical, and technology industries together and figure something else out, because what we have in the existing free market doesn’t really work for anyone but the top brass raking in the dough. Lock everyone in a room and don’t let them out – not even to go to the doctor – until they craft a system that everyone can live with.

The Patient Protection and Affordable Care Act (PPACA) began its journey into the wild blue yonder today.

You know the laundry list of benefits that went into effect today. There’s no way some part of the media has not reached you by now. Across the board, we’re getting ready to see:

  • elimination of lifetime coverage limits
  • restrictions on or phaseouts of annual coverage limits
  • extension of dependent coverage up to age 26
  • no more policy cancellations for sick people

And these changes are also being made, but only for employer plans or new individual policies – they may not apply if your insurer chooses not to amend your existing policy:

  • no more plans that deny or cancel coverage for children with pre-existing conditions
  • free evidence-based preventive care services
  • no more out-of-network increases for medical emergencies

Now, I think that making predictions about what these changes will or won’t do is a little like predicting whether getting a new job will make you a happier, more productive person. The grass may look greener, but you don’t know until you get there. There are too many variables involved.

But I have another list for you.

According to the Bazelon Center for Mental Health Law, we have the following facts staring us in the face:

  • 26% of Americans have a diagnosable mental disorder.
  • Only 29% of those people actually receive treatment.
  • 50% of Americans with a mental disorder have problems by age 14.
  • Mental disorders are the leading cause of disability for Americans age 15-44.
  • Major mental disorders cost America at least $193 billion per year in lost wages alone. This study only focused on comparative wage levels – it didn’t include the costs of presenteeism (showing up but being unproductive) or absenteeism (calling off work) on the job.

Insurance parity is an economic issue. Mental health parity is great, but it isn’t enough. Now we need to get people into treatment and back to productivity, and cost – lack of insurance coverage – is the biggest roadblock to getting that help.

Think of the cost savings if we could get people off of public disability assistance and/or Medicaid. Think of the extra cash flow that America could experience with additional payroll tax income, sales tax income, and property tax income because so many more people would be able to work and buy things like appliances and furniture and homes. Think of what could happen if all those kids got help and became productive citizens instead of being homeless or in jail.

No matter who reacts how to the new law, we’re taking another step in the right direction for the good of our country as a whole. You can talk about bleeding hearts all you want, but the return on investment here is too great to pass up.

There’s this big puzzle I’ve been trying to figure out for years, and it’s my brain. I have to catch up with what’s going on in the mental health world, or I feel like that puzzle is never going to get solved. And the more my mood swings grumble at me, the more I go into hypomanic detective mode.

So I ran across this article in NIMH’s Science News section. I love this part of their website. I remember when I was a kid – and this was before we even had a color TV – I learned that doctors did research, and I always wondered what they were discovering. Always did like watching PBS more than the Perils of Penelope Pitstop. After I got older, I forgot all about that show…until I got cable TV and found a whole channel devoted to old TV cartoons. Rooby-Roo!!

Okay…focus…

Results of the Study

The researchers found that nearly 40 percent of those identified as having major depression also had symptoms of subthreshold hypomania (mania that lasts less than four days at a time). Compared to those with major depression alone, those with depression plus subthreshold hypomania tended to be younger at age of onset and to have had more coexisting health problems, more episodes of depression and more suicide attempts.

I could have told them that. No, really.

I think the reason I was so interested in what the doctors were discovering is because I knew I was a little off and I wished I knew why. I spent many of my pre-teen and teenage years trying to compensate in various ways for feeling so blue, and usually overdoing it. Then I would go back to withdrawing from the world because in the process of overcompensating, I had usually done something to embarrass myself. The cycle got a little more amplified over time until my late teens, by which time the ups and downs and my inability to deal with them had become painfully obvious.

The more I think about it, the more I remember being sick, too. Looking back, I think it was partly from flipping between being sedentary and being agitated. There were headaches and allergies and upset stomachs – and I remember feeling a lot better when I discovered that four Tylenol were better than two. The MDs didn’t help much. I got diagnosed with nonspecific this or that all the time in my late teens and early 20s. That was before I saw a psychiatrist and life started to make so much more sense.

Of course you’re going to get sick when your body is being unstable. We’ve always heard that it’s so important for us to take care of ourselves and be firm about giving ourselves and our kids healthy foods and a stable environment. I think we’re just now discovering the full effect of WHY we should do that. I guess the researchers can’t just take people’s word for it, though.

Can we get away from the old “because I said so” script from childhood and start being honest about the fact that mental health and physical health are intertwined in real life?

I’m talking to the people who have trouble with everyday struggles, not to the people in strait jackets. It takes practice to watch the ups and downs and to notice when the coping skills are crumbling. It takes a lot of discipline to put your foot down with yourself or your kids when you notice the subthreshold hypomania is trading jabs with the depression and something’s got to give. Find a good doctor and stay on top of your health before you end up in a corner staring at cartoons and hating life.

The great thing about the Internet is that we – the public – can weigh in on proposals that our government is trying on for size, and they’re actually asking our opinion straight up, without asking us to contact our representatives! Now that’s democracy in action – I love this country.

The latest open commentary has to do with the USDA’s recommendations on how much alcohol is too much – in this case, the cap on “low-risk drinking” and “moderation” would now be defined as 14 drinks weekly (no more than 4 drinks per day) for men and 7 drinks weekly (no more than 3 drinks per day) for women. CLICK HERE to read what other people are saying about the Rethinking Drinking report and submit your own comments. But don’t wait – the deadline for weighing in on this issue is this Thursday, July 15.

Personally, I think it’s interesting that someone thinks we’re going to consult the USDA recommendations before we go to a party or a bar and have a few. But people really take this sort of thing as an authoritative statement for how much is too much. We don’t know – we’re not doing the research. We rely on them for information. And they are citing research about how alcohol is actually good for your health sometimes. On the other hand, nobody’s changing the legal limit for how drunk is too drunk, and we’re having a hard enough time keeping the kids and the drunks from thinking that getting smashed is cool.

What do you think? Are they giving people license to drink more, or are they just telling us to lighten up?

I’ve discovered that I really like tag-surfing on WordPress. It’s a little like using the remote control to channel-surf the TV for something cool to watch – and if you have as little control over the clicker as I do, you can appreciate the excitement here. I never know what I’m going to find. I can click Tag Surfer on the left of my Dashboard, choose any word or phrase, and surf into the unknown world of anyone who decided to use that phrase on that day.

My favorite tag at the moment is Mental Health. Now that generates variety. Some people are blogging about general issues, some people are blogging about their treatment, and some people are just blogging about the struggles of everyday life. These are real stories about real people with real challenges. And this is just the thin slice of the population who have access to the Internet and decide to blog. I don’t know if this is a statistically valid sample, but it’s a start.

Some people should tag Mental Health and read these stories on a regular basis. For instance, I’d like to make it mandatory for politicians who are facing decisions about budgeting for health care and social services. Teachers at all levels could use some continuing ed on how nontraditional brains work in real life, and not just in their “special needs” course at college that they’ve already forgotten about. Educational administrators could use some of these stories when they’re contemplating budget cuts for the kids who really shouldn’t be forgotten at all. Then there are the people who truly and honestly believe that all unemployed and underemployed people are lazy. I’d like to see them tag-surf Mental Health every day, read at least a full page of entries, and see how the “different people” live.

Psychiatrists and other doctors should tag-surf Mental Health, and then suggest the tag-surfing or some specific blogs to their patients – they could all use some real-life stories to fill in the blanks about the definition of “normal” and how others experience it. Some of these bloggers seem to be contributing to a big virtual support group, and a psych patient who feels alone could really get a lot of mileage out of tag-surfing here.

WordPress is a great window into the minds of people from all over the world. Go ahead. Peek in the window. Learn something. Then take it with you when you go. You never know when it just might change your own mind about the world and the other people in it.

The diagnostic bible of the American Psychiatric Association is getting a makeover. A rough draft of version 5 (which is still being debated by the powers that be) is posted at http://www.DSM5.org. And this debate is going to be a dilly.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the manual that doctors, insurers, and scientists use in deciding what is officially considered a mental disorder and how to tell if someone has it. Every now and then they decide to re-evaluate this based on the latest research findings. In a new twist, they were seeking feedback via the Internet from both psychiatrists and the general public about whether the changes will be helpful before finalizing them. That ended in April. Now they have a committee (called the DSM-5 work group on their website) reviewing the comments; and between public input, APA member input, and private research, they will have the new version ready for publication by May of 2013.

Why so long? Take a look at their website, especially the timeline. Then check out the list of diagnostic categories on the home page. These are only the general categories. Specific disorders in each category can be seen by clicking on the name of the general category. All things considered, that final list is going to be huge – when they decide what will be on it and why.

Here’s one issue that they have to decide before 2013. Is Gender Identity Disorder a physical problem, a mental problem, or just another way for humans to behave? The LGBT community is already on the edge of their seats waiting for the APA to have an official opinion, and one way or another, that decision will make headlines for weeks.

My personal source of amusement comes from the fact that, at the moment, PMS is lumped in with bipolar disorder in the Mood Disorders category. I have both, I can tell the difference between the two, and I think that putting them in the same diagnostic category is hilarious. PMS is a physical problem with emotional side effects, and doesn’t belong in the DSM at all (although I think several men around the world would loudly disagree with me).

In other categories, the APA is officially considering hoarding, skin-picking, tics, and olfactory reference syndrome (delusional beliefs about one’s own body odor) as formally classified Anxiety Disorders. Binge eating is also being considered for placement with anorexia and bulimia in the Eating Disorders category. There’s an idea. I could get insurance to pay for a doctor to help me stop pigging out.

Seriously, if you are concerned about the diagnostic process when it comes to mental disorders, keep checking back for updates to their website. I hope that they’re carefully considering the comments of the people who have to personally deal with these issues every day, and not just letting the insurance companies tell the APA how to interpret the research.