Positive Changes in Global Mental Health: Year in Review, Part I

global mental health map

United States

Advances in Mental Health Parity

This marked the beginning of parity for mental health/substance use disorders and medical/surgical benefits covered by Medicare in the United States. Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD). Before this time Medicare beneficiaries were required to pay up to 50% of the approved amount for mental health and substance use disorder services as opposed to 20% copayment for most other outpatient services. This marked the end of the five-year phaseout of the mental health treatment limitation effectively providing nondiscriminatory outpatient mental health coverage to the millions of Medicare recipients throughout the country.

United Kingdom

Mindfulness Solution for Symptom Relief

The University of Oxford in partnership with the Mental Health Foundation found that practicing mindfulness online can reduce stress, anxiety and depression. These researchers reported on BMJ Open that participants in the their study had a 58% reduction in anxiety, 57% reduction in depression and a 40% reduction in perceived stress. In addition there continued to be a reduction in symptoms of stress, anxiety and depression one month after the course was completed indicating that participants continued to practice the techniques they had learned during the study.

The mindfulness class used in this study was developed at the Centre for Mindfulness Research and Practice, Bangor University, UK. It can be found here.

Another useful and free online course, Mindfulness-Based Stress Reduction, has been developed by the University of Massachusetts Medical School in the the United States and can be found here.


Mental Health System at a Crossroads, Australia

A new report by Inspire Foundation based upon a collaboration between EY and ReachOut.com assessed the demands on and provision of services for Australians with mental health issues. It estimated that if the mental health system remains the same in Australia it will require 9 billion dollars to increase services in order to meet the current needs of the population. The good news is that the report recommends an overhaul of the entire mental health system with a refocus on prevention and early intervention as well as promotion of self-help options. In this case efficiency and sustainability could translate into more services that help people help themselves and their peers at earlier stages of distress. Sounds like a winning combination.

The entire report can be found here.


Changing the Mindset

A new media guide, Mindset: Reporting on Mental Health, was launched. It is a guide for journalists by journalists and promotes more factual and less stigmatizing coverage of mental health issues. It also encourages journalists to address systemic issues in mental health. It has been issued in both English and French versions. The Canadian Journalism Forum on Violence and Trauma led the effort with additional funding from the Mental Health Commission of Canada.

It can be found here.

The Walking Dead, apocalypse and our sense of control

Walking dead barn

A friend and I were talking the other day about the spate of movies, TV shows and video games that revolve around the theme of apocalypse. We agreed that this seems to be the zeitgeist of the early 21st century. Of course, beyond the obvious, there is always something a little more subtle going on that moves our national mind-set along in one direction or the other.

I began to examine my own feelings about the state of the world (a little grandiose I know) and I came around to the fact that, despite my desire to be a positive person, I feel at least a small amount of trepidation about where we are headed in this country and on this planet. There seems to be an underlying hum of fear and discontent which is based upon a lack of control. Yes, we can often keep things under wraps in our personal sphere but, when the circle expands to the national and global levels the flat earth theory begins to take hold. We feel that we could cross that boundary and go off the edge into the abyss at any time.

Why would we choose to give up so much control?

There are many ways that we give ourselves permission to let go of control. That’s why we have institutions such as governments and bureaucracies that hold the social, legal and ethical underpinnings of society in place. Our place in the world seems secure because we subscribe to what these institutions represent. They equip us with the tools to navigate through our daily lives. We are educated, in one way or another, to fit in.

But, gradually, these same institutions become large and unwieldy. They eat their young. They create roadblocks. They are not responsive. This can happen in medicine, law, government and the military as well as in all the other less formal institutions that we have come to depend on.

So, what does this have to do with apocalyptic thinking?

Simply put, in my view, if we give up our independence of thought to institutions then we may be at a loss as those same institutions fail us. Our security is threatened and we start to feel that things are out of control. The apocalypse comes into view. And maybe, if we just keep indulging in apocalyptic scenarios we might learn enough to be able to survive.

What is a better alternative?

We can make it our business to promote institutional responsiveness. We can go to our city council meeting and make suggestions about how the city might better provide a service. We can vote, work on campaigns or write a letter. There are many ways that we can make the effort to become a part of something that we participate in as opposed to merely being the recipient of rules, regulations, policies and laws. This is what is called participatory democracy.

It really is up to us. And we don’t even have to give up watching The Walking Dead.