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robertogreco : publichealth   8

Mental illness is a result of misery, yet still we stigmatise it | Richard Bentall | Opinion | The Guardian
"Of course genes play a role in making some people more vulnerable to psychiatric disorder than others, but the formidable advances in molecular genetics over recent years show that the same genes are involved when people are diagnosed with schizophrenia, bipolar disorder, ADHD and even autism.

More importantly hundreds, possibly thousands, of genes are involved, each conferring a tiny increase in risk. Hence, as American genetic researcher Kenneth Kendler says: “The genetic risk for schizophrenia is widely distributed in human populations, so that we all carry some degree of risk.” Everyone reading this article is likely to have some risk genes although, of course, some will have more than others.

The fact that so many genes are involved suggests it is unlikely that studying them will lead to therapeutic breakthroughs anytime soon. (Consider Huntington’s disease, a terrible degenerative neurological condition that is caused by a single dominant gene with a known biological function. Years after this gene was discovered there is still no sign of a medical therapy for this simplest of all the genetic conditions.)

Recent studies have pointed to a wide range of social and environmental factors that increase the risk of mental ill health. These include poverty in childhood, social inequality and early exposure to urban environments; migration and belonging to an ethnic minority (all trending in the wrong direction); early separation from parents; childhood sexual, physical and emotional abuse; and bullying in schools.

In an analysis of all the research on childhood trauma and psychosis, my colleagues and I found that exposure to any of these childhood adversities increased the risk of psychosis approximately three-fold, and those who had multiple traumatic experiences were at much higher risk. In fact, the evidence of a link between childhood misfortune and future psychiatric disorder is about as strong statistically as the link between smoking and lung cancer.

There is also now strong evidence that these kinds of experiences affect brain structure, explaining many of the abnormal neuro-imaging findings that have been reported for psychiatric patients. And of course there are myriad adult adversities that also contribute to mental ill health, including debt, unhappy marriages, excessively demanding work environments and the threat of unemployment. Arguably the biggest cause of human misery is miserable relationships with other people, conducted in miserable circumstances.

Why is all this important? For one thing, many psychiatric patients in Britain feel that services too often ignore their life stories. In the words of Eleanor Longden, a mental health activist, “They always ask what is wrong with you and hardly ever ask what happened to you.” Patients are routinely offered powerful drugs (which clearly have a place but only help some patients), but very rarely the kinds of psychological therapies that may help them come to terms with these kinds of experiences, or even practical advice (debt counselling probably has a place in the treatment of depression, for example).

A narrow medical approach has been extraordinarily unsuccessful, despite what many people assume. Whereas survival and recovery rates for severe physical conditions such as cancer and heart disease have improved dramatically since the second world war, recovery rates for severe mental illness have not shifted at all. Those countries that spend the least on psychiatric services have the best outcomes for severe mental illness, whereas those that spend the most have the highest suicide rates.

To make matters worse, research shows that an exclusively biological approach tends to increase the stigma associated with mental illness. The more that ordinary people think of mental illness as a genetically determined brain disease, and the less they recognise it to be a reaction to unfortunate circumstances, the more they shun psychiatric patients. An exclusively biological approach makes it all too easy to believe that human beings fall into two subspecies: the mentally well and the mentally ill.

Finally, a narrow biomedical approach entirely neglects the public health dimension. Given the evidence, we should be able to dramatically reduce the prevalence of mental health problems by, for example, addressing childhood poverty and inequality, figuring out which aspects of the urban environment are toxic (not surprisingly, living close to a park appears to provide some protection against mental illness), and by aiming to ensure that all our children experience benign childhoods. Some potential influences on mental health (eg the way we organise our schools) have hardly been studied. We cannot create a mentally healthier world if we spend all our time peering into test tubes.

This is not to say that biological approaches have no value, or that research into the genetics and neuroscience of psychiatric disorders has no place. I have been involved in biological studies myself. But portraying mental ill health simply as brain disease can only increase stigma, diverts our attention away from other ways in which we can help patients, stops us from building a healthier world, and encourages in patients alienation, pessimism and a deep despair."
richardbentall  health  mentalhealth  2016  economics  poverty  schizophrenia  bipolardisorder  depression  psychology  publichealth  inequality  socialinequality  migration  race  class 
may 2016 by robertogreco
Los Angeles Vaccination Rates 2014
"Vaccination rates are plummeting at top Hollywood schools, from Malibu to Beverly Hills, from John Thomas Dye to Turning Point, where affluent, educated parents are opting out in shocking numbers (leaving some schools’ immunization rates on par with South Sudan) as an outbreak of potentially fatal whooping cough threatens L.A. like “wildfire”"
antivax  medicine  parenting  losangeles  2014  whoopingcough  publichealth  schools  science  health  vaccinations  immunizations  immunization 
september 2014 by robertogreco
JAMA: The Journal of the American Medical Association | Silencing the Science on Gun ResearchSilencing the Science on Gun Research
"To ensure that the CDC and its grantees got the message, the following language was added to the final appropriation: “none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control.”"

"Health researchers are ethically bound to conduct, analyze, and report studies as objectively as possible and communicate the findings in a transparent manner. Policy makers, health care practitioners, and the public have the final decision regarding whether they will accept, much less act on, those data. Criticizing research is fair game; suppressing research by targeting its sources of funding is not."
publichealth  regulation  2012  gunviolence  guns  guncontrol 
december 2012 by robertogreco
‪Jane Jacobs: Neighborhoods in Action‬‏ - YouTube
"Produced by the Active Living Network, a project of The Robert Wood Johnson Foundation. An interview with legendary author, Jane Jacobs, who wrote "The Death and Life of Great American Cities." The film explores the role of the built environment in physical activity and public health."
janejacobs  urban  cities  toronto  seattle  urbanism  newurbanism  transportation  publichealth  classideas 
august 2011 by robertogreco
An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All | Magazine
"Ah, risk. It is the idea that fuels the anti-vaccine movement — that parents should be allowed to opt out, because it is their right to evaluate risk for their own children. It is also the idea that underlies the CDC’s vaccination schedule — that the risk to public health is too great to allow individuals, one by one, to make decisions that will impact their communities. (The concept of herd immunity is key here: It holds that, in diseases passed from person to person, it is more difficult to maintain a chain of infection when large numbers of a population are immune.)"

[more at: http://kottke.org/09/10/killer-vaccines-and-the-killers-who-kill-with-them ]
culture  children  healthcare  publichealth  pandemic  drugs  politics  autism  conspiracy  safety  medicine  fear  reading  health  parenting  science  vaccinations  vaccines  antivax  epidemics 
october 2009 by robertogreco
Driven to Distraction - In 2003, U.S. Withheld Data Showing Cellphone Driving Risks - Series - NYTimes.com
"That letter said that hands-free headsets did not eliminate the serious accident risk. The reason: a cellphone conversation itself, not just holding the phone, takes drivers’ focus off the road, studies showed.
multitasking  psychology  distraction  attention  driving  texting  mobile  phones  cognition  publichealth  safety 
july 2009 by robertogreco
Realtime disease detection for your city - SickCity
"SickCity watches Twitter (and soon Facebook) for any mentions of disease in a city. It then collects this information and presents it over time through graphs. SickCity is still quite new. Our algorithms are improving everyday and we are still getting in historical data for some cities."
twitter  cities  facebook  tracking  publichealth  aggregator  health  trends  disease  location  data  crowdsourcing 
july 2009 by robertogreco

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