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August 15, 2019 by Sera Davidow and Cindy Marty Hadge

New Hearing Voices Online Family Support Group

Family and friends who truly love and want to help the voice hearer in their lives are often encouraged by the mental health system to hold beliefs and take actions that alienate and harm the very person they want to help. We are offering families a better way

It is widely believed that the only appropriate response to hearing voices and other unusual experiences is to deny and silence them by whatever means necessary.

In reality, hearing voices isn’t so unusual. Various studies agree that it is (at least) as common as left handedness (and much more so in certain cultures where it is more broadly accepted and even, in some cases, revered). ‘Hearing voices’ is considered an umbrella term, and also encompasses seeing visions, as well as smells, touch, tastes, and unusual beliefs that may not be common or shared.

The Hearing Voices approach offers a non-pathologizing, open way of understanding and supporting people through the experience of hearing voices. It is different from ‘care as usual’ in several ways.

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August 15, 2019 by Sheila Hamilton & Cindy Marty Hadge | Beyond Well: Science

A life worth living

We are all on a spectrum of mental health and everyone will struggle at some point in their life. Let’s build a toolbox for living better.

Beyond Well: Science With Sheila Hamilton is here to explore our understanding of mental health challenges and what we’re learning about ways to help ourselves and others navigate and grow through them.

In this episode, Sheila talks with Cindy Marty Hadge about how a Hearing Voices support group in her neighborhood helped her move from a place of despair to a life of purpose and connection.

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August 5, 2019 by Andrea Zwicknagl

What if…

What if...

Andrea Zwicknagl’s presentation at the kickoff meeting of HOPEnDialogue, a new Open Dialogue international research collaborative, in Rome, Italy, July 2, 2019. Read by Guiseppe Salamina in her absence.

To learn more and to support this project, please visit https://mental-health-excellence.networkforgood.com/projects/72234-open-dialogue-research-development

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August 1, 2019 by Foundation for Excellence in Mental Health Care

Beyond Well: Science podcast Ep.2- A psychiatrist’s road to Open Dialogue

We are all on a spectrum of mental health and everyone will struggle at some point in their life. Let’s build a toolbox for living better. Beyond Well: Science With Sheila Hamilton is here to explore our understanding of mental health challenges and what we’re learning about ways help ourselves and others to navigate and grow through them.

In this episode, Sheila talks with psychiatrist and the Foundation’s Vice Chair Chris Gordon about his path to Open Dialogue practice and how he has integrated the approach into his community mental health program and into his teaching at Harvard Medical School, MacLean and Mass General.

If you enjoy this podcast, become a sustaining partner today with an easy monthly donation.

 

 

Corporate sponsors are welcome and donors of $75,000 or more will receive special invitations to meet Sheila’s celebrity guests in studio as well as dinner with Sheila and Foundation for Excellence in Mental Health Care CEO, Gina Nikkel, PhD.

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July 24, 2019 by Bob Nikkel, MSW

Responding to “The Case Against AOT”

Next Steps for Change

Robert Whitaker and Michael Simonson produced an essential review and critique of forced outpatient interventions in their July 14 article, “Twenty Years After Kendra’s Law:  The Case Against AOT.”

Bob has sometimes been criticized for not advocating more on the issues he raises.  The way I see it, that is not his job as an investigative medical journalist.  That is the job of his readers.

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July 12, 2019 by Bob Nikkel, MSW

System Change Toward a Green Movement in Mental Health

One morning a few weeks ago, I woke up thinking maybe we should begin to think of reforms in mental health systems as a kind of “green movement” with some striking similarities to the other greens: the green environment, a green economy, green energy, and so on.

The upcoming Mad in America Continuing Education series intends to use that as a framework for the ten webinars we will launch soon. More on that in a bit, but first, some quick background is in order.

An early leader of the Modern Green Movement was Rachel Carson, whose book Silent Spring (1962) laid out the dangers of detrimental effects to the environment caused by the indiscriminate use of pesticides.

She made accusations against the chemical industry of spreading disinformation and public officials of accepting these claims. These accusations could just as easily be applied to the cozy relationships between the pharmaceutical industry and the major psychiatric organizations as documented in Robert Whitaker and Lisa Cosgrove’s Psychiatry Under the Influence (2015).

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June 28, 2019 by Sandra Steingard, MD

A Guide to Long-Acting Neuroleptics: Education or Promotion?

Several weeks ago, I received a number of emails notifying me of a new pamphlet released by the National Council for Behavioral Health titled “Guide to Long-Acting Medications for Providers and Organizations.”

The pamphlet begins:

“This Guide to Long-acting Medications (LAMs) is a Call to Action for psychiatrists, other clinicians and behavioral health organizations to increase the use of LAMs.” It goes on to suggest that psychiatrists and their organizations (which comprise the membership of the National Council) rally resources to make these drugs more readily available as “first-line treatment.”

The authors opine upon “What Science Tells Us,” namely, that “there is enough science to demonstrate the degradational effects on brain tissue of each psychotic episode.” Moreover, we are informed that — when started early — the neuroleptic drugs will “avert progressive neurodegeneration and subsequent disability.”

The pamphlet is designed as a public health promotion with this message: If we can stop the progression of schizophrenia, we will improve long-term outcomes. This is purported to be based on science.

I would argue that if one follows the science, one might support instances in which long-acting drugs are useful but not necessarily to the extent suggested in this pamphlet. In addition, one would not promote the newer drugs as first-line treatments.

By downplaying some aspects of the available science, the pamphlet implicitly is acting as a promotional tool for the pharmaceutical industry. Furthermore, this pamphlet serves as an example of why simple disclosures of conflict do not adequately address deeper issues of bias and influence in our field.

While the authors correctly state that this was not funded by pharmaceutical companies, it is nevertheless influenced by their interests via the incursion of commercial interests into academia over the past few decades.

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June 28, 2019 by Foundation for Excellence in Mental Health Care

Holistic Options for ADHD Treatment

‘Micronutrients for ADHD Youth’ Study Now Enrolling Participants


Attention Deficit Hyperactivity Disorder (ADHD) is the presence of the behaviors of hyperactivity, impulsivity, and poor attention. The root causes and best solutions for these troubling behaviors will vary from child to child.

Parents concerned about the safety and effectiveness of popular drug treatments can try some promising alternatives with a significantly lower risk of unwanted side effects. Many have found psychotherapy and parent training highly effective in resolving troubling behavior and improving their child’s social skills and relationships with peers.

For some, micronutrient supplements have been life-changing:

The Micronutrients for ADHD Youth study is now accepting new participants, with sites at Oregon Health & Science University, The Ohio State University in Columbus, and University of Lethbridge in Alberta, Canada. Eligible children are age 6-12 and have not been on ADHD medications for two weeks before their participation begins.

Contact lead researcher, Jeanette Johnstone, PhD, at  503-494-3700 or healthykids@ohsu.edu if you are within driving distance of Portland, Oregon.

If you are near Columbus, OH, contact E. Arnold, MD at OSUMC-maddystudy@osu.edu

If you are near Lethbridge, Alberta, contact B. Leung, PhD at healthykids@uleth.edu

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June 1, 2019 by Bob Nikkel, MSW

Public purse a cash cow for pharma

Could billions in taxpayer dollars for psych drugs be better spent?

A few years ago when I was directing a Medicaid mental health managed care organization, the irascible senator from Iowa, Chuck Grassley, got a burr under his saddle, as they say in the Midwest, about what the federal government was paying out for psychiatric medications in Medicaid expenditures.  And he was able to connect the cost information to individual prescribers.

The two highest prescribing billers were in my area in Oregon.  I was shocked for several reasons.

The first was that I had no idea what these figures were because they weren’t in my Medicaid budget.  The second was that the highest prescriber was in my area.  In one year alone, he had billed $457,000 of psychiatric medications, mostly Abilify.  The third—and this was an extremely dismaying shocker—was that he was a child psychiatrist, and so he had been prescribing Abilify and these other drugs to children and adolescents.

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May 3, 2019 by Bob Nikkel, MSW

Ten Lessons for Mental Health System Change

For the past several years, my blogs have centered on a topic that is admittedly not the most exciting – how policy can affect practice, especially in public mental health systems.  Distilling my 50 years of experience with a combination of direct work with people, management positions within local and state organizations and nearly 6 years as a state mental health and addictions commissioner, I think I learned a number of lessons about system changes.  But I haven’t taken a deeper dive into strategies, especially focused for advocates who seek significant and even radical changes – until now.
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