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June 16, 2019 by MARIA POPOVA |

The Healing Power of Gardens: Oliver Sacks on the Psychological and Physiological Consolations of Nature

“In forty years of medical practice, I have found only two types of non-pharmaceutical ‘therapy’ to be vitally important for patients with chronic neurological diseases: music and gardens.”

( – “I work like a gardener,” the great painter Joan Miró wrote in his meditation on the proper pace for creative work.

It is hardly a coincidence that Virginia Woolf had her electrifying epiphany about what it means to be an artist while walking amid the flower beds in the garden at St. Ives.

Indeed, to garden — even merely to be in a garden — is nothing less than a triumph of resistance against the merciless race of modern life, so compulsively focused on productivity at the cost of creativity, of lucidity, of sanity; a reminder that we are creatures enmeshed with the great web of being, in which, as the great naturalist John Muir observed long ago, “when we try to pick out anything by itself, we find it hitched to everything else in the universe”; a return to what is noblest, which means most natural, in us.

There is something deeply humanizing in listening to the rustle of a newly leaved tree, in watching a bumblebee romance a blossom, in kneeling onto the carpet of soil to make a hole for a sapling, gently moving a startled earthworm or two out of the way.

Walt Whitman knew this when he weighed what makes life worth living as he convalesced from a paralytic stroke: “After you have exhausted what there is in business, politics, conviviality, love, and so on — have found that none of these finally satisfy, or permanently wear — what remains? Nature remains; to bring out from their torpid recesses, the affinities of a man or woman with the open air, the trees, fields, the changes of seasons — the sun by day and the stars of heaven by night.”

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June 13, 2019 by Knvul Sheikh | The New York Times

How Much Nature Is Enough? 120 Minutes a Week, Doctors Say

Researchers have now quantified the ideal amount of time needed to reap the health benefits of the great outdoors.

(The New York Times) – It’s a medical fact: Spending time outdoors, especially in green spaces, is good for you.

A wealth of research indicates that escaping to a neighborhood park, hiking through the woods, or spending a weekend by the lake can lower a person’s stress levels, decrease blood pressure and reduce the risk asthma, allergies, diabetes and cardiovascular disease, while boosting mental health and increasing life expectancy. Doctors around the world have begun prescribing time in nature as a way of improving their patients’ health.

One question has remained: How long, or how frequently, should you experience the great outdoors in order to reap its great benefits? Is there a recommended dose? Just how much nature is enough?

According to a paper published Thursday in the journal Scientific Reports, the answer is about 120 minutes each week.

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June 13, 2019 by Rachel H. Tribe | BJPsych Open

Open dialogue in the UK: qualitative study

Rachel H. TribeAbigail M. FreemanSteven LivingstoneJoshua C. H. Stott and Stephen Pilling

Open dialogue is an integrative approach to the organisation of specialist mental health services and therapeutic meetings.

This qualitative study sought to explore service users’ and clinicians’ experiences of network meetings during the implementation of open dialogue in a modified version, for a UK-based mental health service.

In total 19 participants were interviewed (8 service users and 11 clinicians) and an inductive thematic analysis of the data was conducted.

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June 13, 2019 by Emmarie Huetteman |

FDA Overlooked Red Flags in Drugmaker’s Testing of New Depression Medicine

( – Ketamine is a darling of combat medics and clubgoers, an anesthetic that can quiet your pain without suppressing breathing and a hallucinogenic that can get you high with little risk of a fatal overdose.

For some patients, it also has dwelled in the shadows of conventional medicine as a depression treatment — prescribed by their doctors, but not approved for that purpose by the federal agency responsible for determining which treatments are “safe and effective.”

That effectively changed in March, when the Food and Drug Administration approved a ketamine cousin called esketamine, taken as a nasal spray, for patients with intractable depression. With that, the esketamine nasal spray, under the brand name Spravato, was introduced as a miracle drug — announced in press releases, celebrated on the evening news and embraced by major health care providers like the Department of Veterans Affairs.

The problem, critics say, is that the drug’s manufacturer, Janssen, provided the FDA at best modest evidence it worked and then only in limited trials. It presented no information about the safety of Spravato for long-term use beyond 60 weeks. And three patients who received the drug died by suicide during clinical trials, compared with none in the control group, raising red flags Janssen and the FDA dismissed.

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June 12, 2019 by Dr John Read |

Making Sense of Madness

What causes psychosis, and what can help? Psychotherapy, with its interest in life history and circumstance, and its emphasis on the transformative power of the therapeutic relationship, has more to offer in this area than we are often trained to think. Ahead of an upcoming conference on the origins and meaning of psychosis, Dr John Read, Professor of Clinical Psychology, explains why the psycho-social model must be hauled back into view

( – During the 15 years or so that I worked as a nursing assistant, clinical psychologist and manager of mental health services, I was always struck by the fact that even the seemingly weirdest of behaviours and experiences (‘psychotic symptoms’) made sense once I knew a bit about the person’s history and circumstances. And much of what I heard about the early lives of these people was none too pleasant. Of course the trick, the hard bit, was gaining the trust of people so that they felt like telling me about themselves in the first place. I had entered the field, nearly 50 years ago, full of Ronnie Laing’s ideas about the meaning of madness, and my experience proved to me, over and over again, that he was right.

I was also repeatedly struck by the lack of interest in history and circumstances from many of my colleagues, including most (but not all) psychiatrists. But they had entered the field with a psychiatry textbook and the DSM in their heads. And their inability to reach the person in front of them, to form a ‘therapeutic relationship’ – partly because all they did was ask about symptoms and drug them – proved to them that what they had read about ‘schizophrenia’ being a devastating and intractable illness was right.

When I eventually left mental health services to return to academia I was determined to research what so many ‘psychotic patients’ had taught me about the origin of their distress, despair and confusion. It is more than 20 years ago now that I published the first of many reviews of the literature on childhood adversities and psychosis. The pivotal one, however, was eight years later, which we managed to get some media coverage for. The Guardian wrote, ‘The psychiatric establishment is about to experience an earthquake that will shake its intellectual foundations’.

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June 12, 2019 by

EMA Acknowledges Persistent Sexual Dysfunction After SSRIs & SNRIs

( – The European Medicines Agency has just concluded a review into sexual dysfunction after the discontinuation of SSRIs and SNRIs. Before we discuss their findings, it’s worth looking back over the events of the past year.

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June 12, 2019 by Helen McArdle | Herald Scotland

Psychiatrist Peter Gordon claims Royal College ‘gaslighted’ him in antidepressant row

A PSYCHIATRIST said he was “gaslighted” by his own professional body after openly criticising its stance on antidepressant withdrawal and conflicts of interest.

(Herald Scotland) – Dr Peter Gordon, an experienced old age psychiatrist from Bridge of Allan, resigned from the Royal College of Psychiatrists Scotland in November last year.

In his resignation letter – which he subsequently published on his online blog – Dr Gordon criticised the College’s treatment of patients who had suffered “less than positive, and sometimes harmful, effects of psychiatric interventions including prescribed medications”.

He said the College was too close to the pharmaceutical industry, adding: “as a direct consequence informed consent and realistic psychiatry are compromised”.

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June 10, 2019 by René Keet | BMCPsychiatry

Recovery for all in the community; position paper on principles and key elements of community-based mental health care

(BMC Psychiatry) – René Keet, Marjonneke de Vetten-Mc MahonLaura Shields-ZeemanTorleif RuudJaap van WeeghelMichiel BahlerCornelis L. MulderCatherine van ZelstBilly MurphyKoen WestenChris NasIonela Petrea and Guido Pieters


Service providers throughout Europe have identified the need to define how high-quality community-based mental health care looks to organize their own services and to inform governments, commissioners and funders. In 2016, representatives of mental health care service providers, networks, umbrella organizations and knowledge institutes in Europe came together to establish the European Community Mental Health Services Provider (EUCOMS) Network. This network developed a shared vision on the principles and key elements of community mental health care in different contexts. The result is a comprehensive consensus paper, of which this position paper is an outline.
With this paper the network wants to contribute to the discussion on how to improve structures in mental healthcare, and to narrow the gap between evidence, policy and practice in Europe.

Main text
The development of the consensus paper started with an expert workshop in April 2016. An assigned writing group representing the workshop participants built upon the outcomes of this meeting and developed the consensus paper with the input from 100 European counterparts through two additional work groups, and two structured feedback rounds via email.
High quality community-based mental health care: 1) protects human rights; 2) has a public health focus; 3) supports service users in their recovery journey; 4) makes use of effective interventions based on evidence and client goals; 5) promotes a wide network of support in the community and; 6) makes use of peer expertise in service design and delivery. Each principle is illustrated with good practices from European service providers that are members of the EUCOMS Network.

Discussion among EUCOMS network members resulted in a blueprint for a regional model of integrated mental health care based upon six principles.

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June 9, 2019 by Frontiers

Call for submissions: Antidepressant Prescriptions in Children and Adolescents

Abstract submission deadline is June 17; manuscript deadline October 17

Editors Michael P. Hengartner, David Healy, Irving Kirsch


(Frontiers) – The prescription of antidepressants to children and adolescents is a controversial topic. With respect to depressive disorders, to date no single pediatric antidepressant trial found efficacy on the pre-specified primary outcome (Healy et al., 2019). However, when meta-analytically pooled across all trials, antidepressants appear to have a statistically significant albeit marginally small benefit over placebo (Locher et al., 2017). It also appears that antidepressants are more effective for anxiety disorders than for depressive disorders (Locher et al., 2017). On the other hand, the risk of suicidal events in antidepressant recipients is about twice that seen in placebo recipients, indicating that antidepressants increase the suicide risk in children and adolescents (Sharma et al., 2016).

Another issue related to the risk-benefit conundrum is the influence of the pharmaceutical industry on the design, conduct and publication of pediatric antidepressant trials (Leo, 2006). Systematic biases and even research misconduct have been documented in several industry-sponsored trials, and these flaws further complicate the interpretation of published findings on the usefulness of antidepressants in children and adolescents (Jureidini et al., 2004).

The aim of this Research Topic is to provide a forum to discuss these important issues. Researchers from the field of child and adolescent psychiatry, paediatrics, clinical psychology, social work, public health, sociology, epidemiology, clinical pharmacology and toxicology, and psychopathology, may submit high-quality research.

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June 7, 2019 by Sadie Cathcart |

Are Mental Health Screenings for Youth Worth the Risk?

Researchers shed light on the limitations of mental health screening instruments for youth that are increasingly being used in schools and medical settings.

( – In an effort to increase support for children vulnerable to “psychiatric illness,” mental health screening assessments are now recommended by a wide range of regulatory agencies for adverse childhood experiences (ACEs), depression, anxiety, suicidality, etc. However, recent years have seen an increased intensity and zeal in the application of blanket screening policies, particularly related to depression and suicide risk.

In their commentary published last week in the Journal of the American Academy of Child & Adolescent Psychiatry, researchers Schuyler Henderson, Ruth Gerson, and Blake Phillips, offer a timely, critical perspective regarding the conflicting evidence for what constitutes “high risk,” and what can (and can’t) be done in response when risks are identified.

“The Joint Commission mandates a suicide assessment for patients ‘who exhibit suicidal behavior or who have screened positive for suicidal ideation’ followed by risk stratification: after ‘this assessment, patients should be classified as high, medium or low risk of suicide,’” they write. “But is suicide risk stratification in child psychiatry ready for prime time? Are we putting the risk assessment cart before the horse?”

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The contents of this Headlines page are provided for informational purposes. Any material, conclusions, or opinions presented in the linked articles are not necessarily endorsed by the Foundation for Excellence in Mental Health Care.