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Reading of the Week: Mental Health & the Opinion Pages – Mental Health Reform (Star), ECT (Guardian), and Suicide and “13 Reasons Why” (LA Times)

From the Editor

“Mental health is out of the closet. Now that we’ve opened the door, time for a closer look at what’s been out of sight for so long.”

This week, we consider three selections. They appeared in newspapers in recent days, and discuss mental health topics. The opening quotation – which is from the first essay – applies to all of them; a closer look: calls for more debate about how mental health services are organized, the care that patients are offered, and the way mental illness is portrayed in our culture.

In our first selection, we consider an op ed from Toronto Star columnist Martin Regg Cohn. He wonders about improving access to mental health care. In a provocative essay, he mulls the mismatch between the supply and demand of services (particularly psychiatric services). He argues: “We might as well accept that our mental health spending will increase significantly over the years. All the more reason to start reallocating funds wisely now.”

newspapersThree Selections, Three Newspapers

In the second selection, we look at an essay by Dr. Mariam Alexander, an NHS psychiatrist, who discusses ECT. She opens simply: “It might come as quite a surprise to learn that, as a psychiatrist, if I ever had the misfortune to develop severe depression, my treatment of choice would be electroconvulsive therapy (ECT).”

And in our third selection, the University of Toronto’s Dr. Mark Sinyor considers the popular show “13 Reasons Why” and offers a cautionary note about the portrayal of suicide. The LA Times op ed notes that Netflix and others have “the potential to do good in the world when handling sensitive mental health issues.”

Enjoy.

DG

 

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Reading of the Week: “13 Reasons Why” – Is This TV Show Glamorizing Suicide?

From the Editor

Is a popular TV show glamorizing suicide?

13 Reasons Why is a Netflix series in which the main character suicides – depicted graphically in the show. We will leave it to critics to judge the value of the show as a cultural contribution. Here’s a relevant question for those of us in mental health: is this show promoting suicide?

San Diego State University John W. Ayers and his co-authors consider google searches after the show’s premiere aired, bringing data to this discussion.

13 Reason Why: Popular Show, Problematic Effect?

In this Reading, we consider their research letter and an editorial responding to it – and the larger debate about the series.

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Reading of the Week: The Silence of Prozac

In the 1980s, historian of pharmacology Mickey Smith wrote that new blockbuster medicines enter society by a three-step process. First, a wild popular embrace, driven by overestimation of the drug’s potential, leads to overuse; next, the sudden discovery of “problems” with the drug leads to a backlash; and finally, a state of equilibrium is reached, in which the drug is used judiciously, its real benefits and limits seen clearly at last. Smith called these three stages the “law of the wonder drug.”

I remembered Smith’s formula not long ago, while talking to an old friend on a summer ramble around New York City. The substance of our conversation was that antidepressants – a topic we’d bandied back and forth together for almost 20 years, in various states of using them ourselves and not – had begun to seem quaint. Maybe even a little retro, like lava lamps or tube socks.

So begins a short, cutting essay on antidepressants.

The piece is timely: once considered miracle drugs for depression, this medication class has come under sharp criticism, and yet has gained wide acceptance. In my clinical work, I’m surprised by the large number of patients – particularly younger patients – who hesitate about these medications; I’m also surprised by the large number of patients – particularly younger patients – who are on these medications.

This week’s Reading: “The silence of prozac” by author and essayist Katherine Sharpe, which was just published in The Lancet Psychiatry.

Katherine Sharpe

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