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The Forum > Article Comments > A new paradigm shift for mental health > Comments

A new paradigm shift for mental health : Comments

By Nicholas Procter, published 19/1/2006

Nicholas Procter argues there should be an examination of the way mental distress is understood and the way help is sought.

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Nicholas, speaking from experience of severe/extreme depresssion in myself and others, your emphasis on trust, access and the scope to take risks is spot on. Critical factors in depression are the distortion of perspective, inability to communicate and the fact that people who have not experienced depression can not comprehend what you’re going through – there is a terrible feeling of isolation, alienation and helplessness. As I argued to relevant Ministers, depressioNet is an excellent low –cost facility which allows people, without risk, to expose themselves and their illness, to discover that they are not alone, to receive excellent advice and encouragement, and to take first steps on the road to recovery. The benefit-cost ratio for government support to dN must be very high compared to most government spending.

In my case, my work-related depression (coming on top of severe viral illnesses) effectively ended my career, in part because my employers were so concerned to deny any responsibility for my illness that they refused to respond to medical advice that I could recover full health and productivity subject to them addressing the issues in such a way as to support my return to work in a safe environment. No paradigm shift there!
Posted by Faustino, Thursday, 19 January 2006 12:12:08 PM
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I agree with Nicholas comment that the following need to be examined "the way in which symptoms of mental distress are understood and presented, the way help is sought, and the way care is evaluated by those who receive it. This process links the mental health experiences of people in our community as they are held by them and other concerned individuals with governments’ interpretation of them."

Adding to Faustino point - businesses either don't know how to recognise mental health problems in employees or simply refuse to the recognise the problems or deal with them.

More loss to employers as experienced employees walk elsewhere.

Regarding Government. I don't think Mr Abbott's "Darth Vader" approach to psychological disorders is typical of the Liberal Party. He will also need to recall that his Catholic Church has a strong vein of humanity.

The Government needs to keep in perspective that funding depressioNet.com.au costs less than one medium size anti-aircraft missile in our army's armoury.
Posted by plantagenet, Thursday, 19 January 2006 4:57:00 PM
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I have had a long battle with depression owing to issues with my family and a few other things. It is a greatly underreported big health problem.
Posted by Inner-Sydney based transsexual, indigent outcast progeny of merchant family, Thursday, 19 January 2006 5:34:52 PM
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As well as environmental factors, physical disorders such as hypoglycemia and hypothyroidism can contribute to depression.
Posted by Bronwyn, Thursday, 19 January 2006 10:53:37 PM
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Well said Nicholas Procter, and your article is very timely. Mental distress is on the rise and the mental health system (if it can still be called that) is already threadbare. Faustino mentioned helplessness. As many would be aware it is helplessness that is a major signifier of loss of reason to live - what a shame that we can't all see helplessness like we can a broken leg. Perhaps sometimes we simply do not look hard enough...... I agree Nicholas with your conclusions that "a paradigm shift will also help bring about more informed and compassionate awareness". I would also add that people as a nation need to be educated to realise that mental distress is a real illness but that many people do recover given support and belief in themselves. Sadly there is still a stigma that surrounds mental illness that adds to distress. Only a long term nationwide education program will reduce such stigma. The utopia would be that such illness be seen like someone having a long term bout of shingles. In the interim perhaps educating people to look out for family and friends when they are doing it mentally 'tough' or to be more aware of warning signs that a loved one is completely helpless (not always possible) may be useful. Informed and compassionate awareness is not just for Governments and mental health workers - it is for all of us if we truly wish to call ourselves meaningful titles such as friends,lovers, family, co-workers,or neighbours.
Posted by Coraliz, Thursday, 19 January 2006 10:56:26 PM
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Faustino

Similar circumstances occurred to me - I was subjected to a high level of workplace stress within an organisation I had worked for for many years. I also contracted a serious viral illness. While my overall prognosis was good, because the employer wished to avoid any responsibility - I was subjected to further stress due to litigation. I eventually resigned, found part-time work (my new boss fancied me - I didn't fancy him) forced to resign. As a result I now work as a temp. Have had enough.

Also cannot continue seeing my psychologist with whom I had developed trust as I can't afford her. I am seeing someone through government assistance - but not the same. Have to keep on explaining myself over and over. Another reason why I have been silent on many forums here regarding mental health. Just sick of talking about it.

However, must speak out. Many people can make full recovery and become contributing members of society again with consistent support. The stance of "too hard" is false economy. What is lost in litigation, sick leave, compensation payout etc would be regained if people actually helped to recover rather than fighting just to be taken seriously as I have been. Depression is very real.

BTW - one of the reasons for my excessive workload was due to Kennett dismantling of many public sector departments resulting in one person doing the work of 4. And now Kennett trots himself out every time someone mentions 'depression'. Also BeyondBlue doesn't really DO anything its just an info site. No assistance with affordable psychotherapy for example.

I was responding well to Cognitive Behaviour Therapy - as do many. But it is not finacially supported.
Posted by Scout, Friday, 20 January 2006 8:30:01 AM
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Mr Proctor is right when he calls for the need to "emphasise the importance of meaningful engagement and connectedness between people with mental illness, governments and health professionals".

However it is a hard row to hoe when the notion of connectedness is becoming increasingly foreign to our community - we are in a constant state of "disconnect" as a community and dominated by competetive independance; every year we see some boffin who has calculated the cost of having children - this week an ad will appear in our papers featuring the new "baby" from the Porsche factory - the tag is "one good reason to delay having yours".

Gated villages are on the increase, color bonded roller shutters are fitted to more and more houses every day,sophisticated entertainment and communication devices reduce the need to interact with real people. The sea change/tree change shift is as much about living in the middle of 5 acres away from every one else as it is about getting in touch with real communities.

One of the fastest growing "family" units is the singleton - one out, alone and blissfully solo - or so we're led to believe.

Mental illness remains stigmatised - symptoms are seen as a sign of weakness - people suffering from stress are scorned, told to pull up their socks and get on with it - in defence of Beyond Blue, info site or not, it has put the focus on depression and given it a profile as a genuine illness.

It is timely to call for a new paradigm - but people remain more scared of those who suffer with mental illness than they do of the diseases themselves - turn around the prejudice and the new paradigm might see the light of day. And the more isolated we become the more fearful we get.
Posted by sneekeepete, Friday, 20 January 2006 10:08:30 AM
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It's pathetic isn't it? It takes Alan Jones to shame Abbott into supporting what is a life saving organisation. I never thought I'd agree with Alan on anything but he's found a heart. Thanks for the support Alan.

People should be asking why it is that the Government's site, Beyond Blue, does not achieve what Dnet has. And why is it funded if it is not achieving at the same levels?

The truth is the difference is that people who have experienced the illness are running the Dnet site, people who know what is needed rather than endless noises of support but no acceptance.
Posted by RobbyH, Friday, 20 January 2006 1:14:39 PM
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These changes may be welcomed by many but why o why can't a person get
to a Psychologist via Medicare. Psychologists provide the single greatest highly trained workforce to deal with Mental Health problems but the Govt provides virtually no funding? Why? It makes no sense.

Many depressed people don't require MEDICAL help they require PSYCHOLOGICAL help, at their own expense of course.
Posted by Atman, Saturday, 21 January 2006 9:47:25 PM
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There are those on other threads that have exemplified just how prevalent mental problems are. Shonga has shared his experiences and others followed and like many, many others, depression has had a dramatic impact upon my life. Mental problems alienate, isolate and debilitate to a point where the act of mere functioning takes all the resources left at one's disposal. That many suffer as they do means little for, just as women having children, every time is the first time.

People can sympathise and, to a point, empathise but no one can feel as one feels at any given moment. The turmoil within defies explanation and is driven by experiences only you have had, enveloped in emotion that only you can feel. Unlike the miracle of childbirth, the pain only serves to create darker corners, even further from the light.

As Coraliz points out, it is the elevation of compassionate awareness that will do most to combat the ambivalence and humiliation that only encourages its perpetuation.

The modern age is, arguably, the worst environment for a solution to mental problems for it is one of its primary symptoms. In today's world, time is not dictated by a season or a tide but by the second hand of a clock that is thrust more forcefully in our face as each day passes. Days, or hours, now hold the importance that was attributed to weeks or even months.

Mental health workers are far from a luxury in contemporary society. Sneekeepete alluded to the changing role of family and community in the mollifying of emotional peaks and troughs. Individualism is stripping the capacity of community to have any effective role in combating the effects of modern society on mental welfare. Without someone to step in and assume that position we will find ourselves in a state where happiness is limited to those we can only aspire to be.
Posted by Craig Blanch, Saturday, 21 January 2006 11:21:33 PM
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Craig

You convey the experience of major depression sufferers (like me) concisely but vividly.

I'd like to add (in my experience) that workplaces and families either can't spot the syptoms of mental illness or won't come to terms with the illness.

Its taken me years to successfully manage the illness through a finely balanced mix of medication, wide research on bipolar illness, and insight that when I'm either "up" or "down" what I'm feeling is really the illness - and this feeling will pass eventually.

I've also adjusted my lifestyle to reduce the kind of stress that might wreck me. So I was lucky enough to be able to retire early from my middle management type job and become a "househusband".

Even though my "job" pays less I look after my loving partner while she goes out to work. I keep me mind active (and cut geographical isolation) through writing, intensive blogging and emailing friends overseas who are in a similar situation.

All the best Craig

Pete
Posted by plantagenet, Sunday, 22 January 2006 12:49:08 AM
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I have had the following illnesses for the previous 8 years Chronic Major Depression, Generalised Anxiety Disorder, Obsesseive Compulsive Disorder, Chronic Fatigue Syndrome, and Insommnia. Note the time of this post, I have been up for hours.

My main problem is that unlike WA Premier Gallop who has the means to seek private medical help, I and many like me do not have the means to seek private help, and must rely on State Health. Which is sadly lacking in Mental Health specialists, because the last Federal/State Health funding Agreement in 2004 cut health funding to the States by nearly $1 billion over 5 years, which is why all State Health departments are in crisis, especially Mental Health.

How are we supposed to go from welfare to work with little or no treatment, I don't know I have seen a Psychiatrist once in the last 4 months. While we have a Federal surplus of $11.5 billion, partially made up of the $1 billion cut from State health depts.

To me this is insanity, however other posters may have a better explanation.
Posted by SHONGA, Monday, 23 January 2006 4:44:15 AM
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The issue of time that Craig raised is an important one. To extend on this, I think that generation gaps are becoming much smaller as well. Whereas once they were divided into decades, it is now a matter of months where we see marked changes in behaviours between successive groups.

As a result we have family breakdowns. Vanishing are the role models, gone is the consistency. We have, instead, an artificial role model in the form of an endlessly ticking societal clock that drives us from one fleeting moment to the next.

Even our words and sentences are becoming rushed and excessively abbreviated to a kind of throw back reminiscent of 19th century field slaves. Text messages now pass as communication that resembles something more like hieroglyphics than the English language.

Children know more about American television than world history. Parents no longer bother to show up for teacher interviews and fails are now passes to appease the expected literacy rate demanded by a government refusing to adequately fund our schools.

Then our money-driven, overcrowded universities pump out professionals who are probably not fit for the pressures of a full time job.

In conclusion, I say the answer is simple... slow down. Introduce siestas to the work place, take time out for walks, go to the beach, work part time and earn less money, get a pet and spend time with it, and eat a well-balanced diet, cooked at home.
Posted by tubley, Monday, 23 January 2006 5:52:43 AM
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Atman makes a valid point: Recent suggestions by the Productivity COmmission that allied health professionals and nurses be given access to medicare type funding to irease efficiency of the system and partly off set the shortage of doctors are welcome.

They have of course been roundly rejected by the AMA but do have some support form amongst the more enlightened in the meidcal profession.

Similar moves have been put forwad on and off for years but always come up against the opposition of the Doctors Union - the forthcoming cabinet re shuffle will be interesting - if may throw up a new Minister for Health who is prepared to take the medicos on; we shall see. Abbot has been an abject failure on the post.
Posted by sneekeepete, Monday, 23 January 2006 7:29:53 AM
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One may access psychiatrists through medicare but not psychologists. This is absurd. All psychiatrists do is offer medication, sit and listen and that's about all. Now I admit I am on anti-depressants and being listened is wonderful in the short term. However, psychology offers long term pro-active and effective treatment.

I have been on and off anti-depressants for years - while they assist with mood swings they are not addressing the issue of managing my abilities to cope with my perceptions and ways to deal with the real world - psychology is a great way to achieve living life as it is.

However, psychology is longer term; anti-depressants are quick-fix - which costs more? And there is your answer.
Posted by Scout, Monday, 23 January 2006 8:38:07 AM
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Scout

I think its different strokes for different folks.

The value of medication and use of psychiatrists and/or psychologists depends on the type of mental illness you have and the degree to which you can recognise your problem.

As I have severe bipolar (manic depression) which would require long term hospilisation if it were not for a long term (permanent) drug treatment, I just accept a generalisation that "anti-depressants are quick-fix". Maybe what you say is accurate for other illnesses but not the severe end were lithium and valproate are (literally) life savers for many depression sufferers.

At the severe end cognitive therapy (discussing the problem to realise you can think your way out of it) is not enough to handle chemical imbalances in the brain which need to be countered by medication.

My attempt to slowly wean myself off medication in the past (even with a positive outlook) met with disaster.

In my experience its difficult to find a psychiatrist who is approachable and not "a pillar of the establishment". It took me 20 years to find a decent one "on my wavelength". In terms of availability I've always been in severe medical need so psychiatrists have been fairly readily available and this is on Medicare.

I think that psychiatrists are very human in that they open doors to patients who are likely to respond positively to therapy. I've found that if I a read up about my illness and then discuss it with "my shrink" in an "objective" way this encourages the psychiatrist to want to help more than just a dry question and answer session followed by script writing.

So as you say "perception" (or insight), education, along with permanent medication (for me anyway) has kept me above water.

The range of mental illnesses and severities obviosly makes generalisations difficult.

Pete
Posted by plantagenet, Monday, 23 January 2006 9:46:31 AM
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Scout, Then following your reasoning, not only qualified Nurse Practioners, but Psycologists should also be covered by Medicare, I suppose next you will want Dentists covered by Medicare, if so I agree!

The situation of Pshcologists is pathetic, as you say they are the people you can sometimes teach you living and coping skills, however cannot write a prescription. They are Medical Professionals, why can't they be included under the Medicare banner?

Sneeky, The good money for Abbott's job is Dr. Nelson, the current Education Minister, doesn't that fill you with confidence, someone who will take on the doctors, I think not! He has destroyed Education, now he will be let loose to replicate his efforts in Health.

Wouldn't you have thought as Education Minister he would have increased the places for Doctors and Nurses and allied Health Professionals at Australian Universities, at James Cook University in Townsville, a small University, we had 900 applications to fill 83 Medical School places, when you have a world wide Doctor Shortage, and $11.5 billion in the bank, no new places at Uni, does that not tell people that something stinks....
Posted by SHONGA, Monday, 23 January 2006 9:59:45 AM
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Sadly Scout, medication for mental health is the cheap fix - the band-aid. There is a place for meds, however they should be used temporarily, if possible, whilst psychological help is being established. Alone they are only a partial fix; long term much more is needed. It is the same for diabetes and heart disease. In the same way as for mental health it is cheaper to dispense insulin and blood pressure tablets, yet evidence shows for both mental health and the aforementioned diseases that life-style changes, diet, exercise, various psychological therapies such as CBT, PCP, Gestalt, systematic desensitisation, are more effective and without side effects. Mostly money spent for psychology is well spent. However, because medication 'works' and is cheap it is offered. Therefore long term cures that psychology can offer, as Shonga intimates, are outside the reach of those without reasonable incomes. It may sound like I am saying that psychology has all the answers – I’m not because it dosn’t. In the same way that there are many determinants that contribute to disturbances in mental health – so too many ways can co-join to assist in a return to a state of equilibrium. However, I am suggesting that the benefits of psychology are worth trying to find funds for in any way that you can. Even 4-5 visits are better then nothing. If you shop around there are psychologists who charge realistic prices. I realise psychology may remain for the time being outside the reach of many – hang in there, do what you can yourself. Many people lobbying for changes, join in that fight. Mental health disturbances will effect most people (either directly or indirectly) at some time in their life – so it is everyone’s fight. Changes will eventually come if people don’t keep rolling over and accepting the current situation.

Good luck to you all – keep believing in yourselves and your own ability to overcome. Be proactive in the search, don’t accept that you are simply at the mercy of some drug whilst waiting for a ‘wonder drug’ to appear.
Posted by Coraliz, Monday, 23 January 2006 10:18:49 AM
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I hate the words perception and perspective.

One of the reasons why there is so much mental illness is that what should be regarded as an environment that is hostile, aggressive and unfair is regarded as ‘normal’ and those who are sensitive to the environment and react emotionally are told that it is their perspective or perception that is the problem. This happens in school, work and in society. As a result the only way to help those that are affected is to drug them to the eyeballs so that their perception is blurred and so that they no longer feel and care and/or for them to withdraw from society.

I attended a psychologist with my 7 year old son who was withdrawn, depressed and was terrified to attend school, he didn’t feel safe – it actually triggered physical problems that resembled Chronic Fatigue and rheumatoid arthritis that was so severe that he couldn’t walk or even lift his arms at times. His pediatrician said it was psychological and triggered by his fears and he commented on the fact that he was starting to see a lot of young children presenting the same way. He suggested my son see a Psychologist. When I explained to the psychologist that my son was scared of life and fearful to attend school as he felt victimized, bullied and treated unfairly the Psychologist actually looked straight at me and said “What have you come to see me for?”.

My son is sick to death of people telling him that the problem is his perspective and that he is the one that needs to learn to accept the violence, neglect, the bullying and the aggression. He can’t understand why society doesn’t just deal with those that are violent and aggressive and protect those that are good.

My son is on Distance Education at the moment on Psychological and medical grounds and he is being educated at home. It shouldn’t have to be this way, he should be able to attend school and feel safe, validated and protected.
Posted by Jolanda, Monday, 23 January 2006 10:24:20 AM
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Well Done Everyone... this is one of the BEST and SANE -ist discussions yet on Mental Health and Society.

I feel proud to be part of this forum.

Thank-You Everyone for your Strength and Honesty!

May we walk with knowledge, for action and "real change" at ground levels, in Australia.
Posted by miacat, Monday, 23 January 2006 10:55:05 AM
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Yes, I agree Miacat, lots of strength and honesty shown here. Plus a sense of compassion and support which is great to see.

No-one seems to have picked up on an earlier post of mine, but it is something I would urge you to at least to consider. From my understanding, depression is caused by a chemical imbalance that can often be corrected without having to resort to anti-depressants. (Bi-polar and severe manic are probably different as pointed out by Plantagenet, I know little about them). I have overcome depression though through going on a hypoglycemic diet and taking medication for an underactive thyroid. My anxiety and insomnia are now also under control. If you are interested, try reading this article

http://www.hypoglycemia.asn.au/articles/depression_disorder.html

If you'd like to know more, try this website

http://www.hypoglycemia.asn.au/

This may seem too simplistic for some of you at first glance but stay with it. It requires lots of research and discipline, it's no quick fix and it's not exactly cheap. But I've done it without psychologists, psychiatrists and anti-depressants so big savings there. My general health has improved and I have never felt better.

I know I sound like a walking billboard! Sorry, but I just want to share something that has worked for me.
Posted by Bronwyn, Monday, 23 January 2006 7:19:12 PM
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Yep ,no money for mental health or infrastructure,and no one asks why.We have 700,000 on DSP.The numbers have doubled in 25yrs [200% increase]while our pop has only increased by 25%.540,000 on the dole,330,000 single parents and an enormous wasteful bureaucracy to support it.

Basically it is just too damn easy to get on social security and those in real needs,miss out.

Alan Jones a Liberal supporter made Tony Abbott look very ordinary.Many don't like his abrasive style,but he cuts through the BS and gets things done.His detractors need to look a little closer at the substance,rather than the weak mentality that is consumed with envy.
Posted by Arjay, Monday, 23 January 2006 9:01:26 PM
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Excellent thinking, Scout and Shonga.

These things should definately be covered by medicare. I also think that registered psychologists and psychiatric nurses should have their powers extended so they can prescribe and administer medicines.

I have seen a range of professionals to help me with the depression I have suffered and on all occasions they knew exactly what medication I needed.

Of course then I had to go through a GP anyway, re-explain my history and then hope that she would have the same opinion as the referring expert.

I think we could streamline things a lot more, free up specialist time and reduce waiting lists if more medical power was handed over to multi-diciplinary fields.
Posted by tubley, Tuesday, 24 January 2006 2:47:19 AM
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Tubley

Your post: "Of course then I had to go through a GP anyway, re-explain my history and then hope that she would have the same opinion as the referring expert."

How true - the number of times I have had to "tell" my GP what my psychologist said is like something either Kafka or Monty Python thought up.

The same goes for reports requested by Insurance companies - back when I had a claim.

GP's should be able to concentrate on being GP's, they are already overworked. Trained and competant psychologists are treated as third class in the medical profession.

Plantagenet,

I take your point regarding bipolar and for that matter include schizophrenia - I don't suffer from those problems and cannot comment on what it the best approach. Having dealt with people suffering from both of those disorders in my days as a housing officer I can understand that drug treatment is essential. However, as a chronic depressive, chronic fatigue sufferer I can only speak from my experiences over the years with a variety of psychiatrists (who are important, but not for me), physiotherapists (assist with appropriate exercise) and psychologists (essential for behaviour therapy).

Shonga

100% with you on dental care. How to tell rich from poor - count the teeth!

In summary; our economy would benefit (apart from ourselves) if resources were provided both in prevention (safe workplaces, taking staff seriously, re-education of workplace bullies etc) and in appropriate treatment - which ever medical practioner is most appropriate for the type of illness suffered. After all we don't fund neurosurgeons to treat knee injuries, so why is all mental illness lumped into one category?

Bronwyn - am giving consideration into changing diet.

To all thank you for all your contributions thus far. Looking forward to hearing more from everyone.

Dianne
Posted by Scout, Tuesday, 24 January 2006 7:25:31 AM
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It's interesting how many regular posters on OLO have mental health problems. In a press release I received today, dNet CEO Leanne Pethick says "It is essential that people living with depression have the opportunity to safely communicate with other people they can relate to and understand. Education about the condition, information on symptoms and treatment options, access to quality professional treatments and the ability to access peer support and encouragement are all important elements in the recovery process." That's certainly my experience, and after being socially and professionally disengaged for some years, I've found posting on OLO a good way ro re-engage. Of course, it doesn't substitute for face-to-face interaction, but it's a stepping stone. And writing pseudonymously on economic and political issues reduces the risk of further attack from those whose actions precipitated my depression.

As a result of posting on OLO, I got asked to contribute to some economic work which is directly related to my former tormentors, a chance both to assess my current capacity (not too great, although the work I did was up to standard) and the possibility of re-engaging face-to-face (not quite ready with my former employers). But moving in the right direction, now coping without anti-depressants.
Posted by Faustino, Tuesday, 24 January 2006 10:48:13 AM
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Faustino, Yes I agree with you this Forum is the perfect transition for those able to progress, and those of us not yet able to do so.

The surpriseing thing for me is how many of us are this way because of our past employment of stress related conditions. I would have sued my former employer if I had recovered enough in the 7 years you are given to sue. In my case I couldn't even get out of bed [except fot toileting] for 9 months. And even now could not tolerate a court case if my life depended on it.

If you are indeed in transition, congratulations to you, I have "come out" in my local newspaper, admitting my illness, as I have nothing to lose, or gain, however my intention was to break down the barriers, and surprise, surprise I recieved support from the general community, and Vietnam Vetrans in particular. It seems Mental Illness could be even more prevelant than first thought.

Which of course adds to my curiousity re Federal funding, to the State health Depts. We don't need Beyond Blue, we need more Health professionals to help us fight this debilitating illness, and we need them now.
Posted by SHONGA, Tuesday, 24 January 2006 4:34:57 PM
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Nicholas

Thank you for your timely article.

To all posters: thank you for sharing your mental health and mental illness experiences.

I have been a mental health nurse since 1978 - the love of my life. Sadly, I was put out to pasture 2003 as a result of another work nursing injury (seven knee ops as a result of mental health nursing). I am now am on a disability benefit and totally lost. Mental health nursing was my love and my identity.

I became a senior lecturer in mental health nursing at a southern university some years ago. Loved it with a passion - but left because of academic bullying.

My last years were in community mental health nursing. Loved it with a passion. My clinical skills were honed beyond belief over a five year period. I was privileged to assist people, such as yourselves.

I also have experienced mental illness in my family. My sister-in-law suicided leaving a 5 months old bub and and 18 months infant. My brother and the children are still suffering, as is my mother.

I can also identify with depression and panic attacks after having been bashed and gang raped.

Sadly, the above traumaatic experiences made me a much better mental health nurse.

I miss working with people who have mental health problems. When the heat is over, I shall be volunteering to assist people.

I have the qualifications to become an independent mental health practitioner, but QHealth will not help me.

Go to a community mental health centre. I was a case manager for 5 years. I was the person who recommended treatment plans to psychiatrists - not vice versa. I was the one who recommended psychologists - not vice versa. I worked closely with both professional groups on behalf of my clients. There is no cost. You do not need a referral to a community mental health service. I cannot understand the reason that so many of you do not realise that you are entitled to same.

Cheers
Kay
Posted by kalweb, Tuesday, 24 January 2006 9:07:49 PM
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Shonga, re suing employers, my work-related depression came on top of (and prevented my recovery from) serious long term viral illnesses (shingles, Ross River fever, post-viral syndrome (that's CFS with a known cause)), and I was strongly advised on all sides that I was in no fit state to take on anybody, and that if I tried I would get a vindictive response. I also knew I'd be faced with lies and character assassination. In the end, I just had to walk away, it was the only way I could resolve it, and started to pick up then (two years ago). But I'll never have a regular job again.
Posted by Faustino, Tuesday, 24 January 2006 9:50:40 PM
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They Actually found a way to make money out of these people. They get volunteers and call them councilers for god sake and stick them on phones and call it life line and others. Then of course they fund raise and fund raise. These good people are not allowed to meet anybody[even the old and lonely] or a young girl of 15 on the side of the road for fear they will loose the hold on donations. People need face to face support if they are upset. Thats what mental health is all about but they have turned it into a biz with no thought for helping anybody other than themselves.
Posted by Wendy Lewthwaite, Wednesday, 25 January 2006 5:08:33 AM
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The sad fact is to fight for and receive compensation one has to be mentally and physically 'strong' - which is the last thing a claimant is during depressive/anxiety illness. Character assasination is only a part of it. Attempting to claim compensation can exacerbate the illness. The 'powers-that-be' treat everyone as if they are fraudulent, leaving the genuine cases in a mess.

For that reason, I did not seek to sue my last employer - I had had enough. It is another reason why I will not seek permanent employment - temp work will be enough and that way I can keep out of 'office politics'.

Kalweb - I don't know about your community health centres where you are, but here (Victoria) they are minimal and do not offer the long term psychological counselling and therapy required. Why should I not be able to continue seeing a psychologist with whom I had established 18 months of trust, knowledge and understanding? With community centres if you can see someone it is not always the same person, it is not indepth and it is not long term.

I am so tired of repeating myself to new counsellors - I am seeing someone now but she is not my preference. I am starting all over again. This is one of the reasons why recovery becomes so difficult.

Shonga agree with you about Beyond Blue - it is Beyond Contempt and offers nothing for those who are experiencing mental illness. Whenever I hear Kennett waffle on about it I could scream.

Finally, however, I too find websites like this to be very beneficial. Being able to offer opinions and finding like minded people is wonderful. I don't mind those who disagree - even the nasty ones as they are generally on the extreme fringe any way.

Cheers
Posted by Scout, Wednesday, 25 January 2006 6:46:41 AM
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I think it is very easy, in a forum such as this, to perpetuate and strengthen the demons that can keep us captive. They may manifest themselves as human figures for some, while others sense an ethereal and indistinct cloud that descends and suffocates reason.
What I believe is that to battle your demons you must first acknowledge your own complicity in their existence. This is a difficult step but, as strange as it may seem, it can be empowering. The recognition that your own decisions had a part to play in situations that on the surface are all too easily attributable to another person or situation, carries with it an inherent possibility that decisions that affect the course of your life are well within your own ability.
An army of psychologists and psychiatrists with a mountain of medication are not going to alter the fact that the answer lies within us. That we may need their assistance in taking steps is not, in itself, a panacea. Ultimately we all want to be responsible for the road that our lives take and, just perhaps, we need to take some responsibility for the road that led us to where we are.
As I said, this is not an easy exercise but it has given me strength from time to time. It does not always work, but, then again, a single answer may lie in a thousand little pieces in a hundred locations. Maybe this is one of them.
Posted by Craig Blanch, Wednesday, 25 January 2006 2:06:54 PM
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Excellent post Craig, both the content and the way it was written.
Posted by Coraliz, Wednesday, 25 January 2006 2:34:04 PM
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Scout

I am very surprised that you are not offered long term and consistent counselling with the same therapist in Vic community mental health. That it disgraceful.

I must have been really lucky. I worked with a wonderful dedicated team. In the main, we had the same staff for the five years that I was there. We always saw our clients face to face on a regular basis - sometimes three times a week when a person was very ill, and every other day was phone contact. Sometimes, when clients were seriously ill, we did home visits every day. That was the philosophy and practice of our team.

Also, we made sure that we all knew each others' clients - in the event of staff absence or an unexpected emergency. That way, our clients always had continuity. Continuity, mutual respect and trust were essential elements within our team.

We allowed our clients to "sack" us, in the event that they thought that they were not getting the best from their therapist, or that they were not appropriately matched to their therapist (by, the way, mental health nurses assess, diagnose, counsel, and are therapists).

We had mini reviews of our clients on a daily basis - and major team reviews every three months. Our clients always had on-going counselling and support - some for many, many years. This reduced the need for repeated hospitalisation.

Case managers could be: mental health nurses, psychologists, rehab professionals, or social workers. The hierarchy was flat. I am amazed that Vic does not offer what I have proudly experienced. No wonder you are frustrated! I could rave on forever.

Great post Craig. Yes, we all have an internal therapist.

Cheers to all
Kay
Posted by kalweb, Wednesday, 25 January 2006 6:31:23 PM
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Plantagenet

What general area do you live in? Would love to find an accessible psychiatrist, and my bipolar partner would love it even more - hardly surprisingly, he's far more sick of the psychotic episodes than I am, and sicker still of being spoken at, not to, as though he's mentally defective when he's very, very much not so.
Posted by anomie, Thursday, 26 January 2006 12:22:53 AM
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Third try! Let's see if I can make my point a bit clearer this time! I've been ignored up till now (with the exception of Scout and Shonga) and I know you're discounting my contribution as irrelevant to your situations! That's fine, I was a total sceptic on things like this too at one stage.

While environmental factors undoubtedly contribute, depression is largely caused by a chemical imbalance or to be more precise not enough glucose reaching the brain. It results from a complex blood-sugar condition where too much insulin is produced in response to any sugar or stimulant. A person suffering from this condition, or Hypoglycemia as it is called, has a big spike in their blood sugar levels when they ingest something sweet, an over supply of insulin then kicks in, blood sugar levels then drop to really low levels, causing tiredness, foggy headedness, depression, forgetfulness, ... there's a long list of symptoms. It affects the adrenal glands as well as they produce too much adrenalin as the body's way of counteracting the insulin spike. This leads to problems with anxiety, insomnia and irritability.

This condition affects 4% of the population or nearly a million Australians. The numbers I suspect are probably much higher. Most people just live with the condition without really knowing what it is. The medical profession in general does not recognize the condition though there are increasingly doctors who do. It's a lifetime condition, largely heriditary, and if left untreated leads to mental health problems and to adult-onset diabetes.
Posted by Bronwyn, Thursday, 26 January 2006 2:46:40 PM
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Continued

If you're sceptical, which I know you all are and I was too to begin with, just try omitting sugar, white flour, alcohol and caffeine completely from your diet, up your protein intake and eat smallish amounts every 2-3 hours. You could feel worse to begin with but if you stay with it and keep refining it you should improve. Nutritional supplement is vital also but I won't go into that here.

I was beginning to develop mental health problems and really could feel myself going mad. Like most of you I'm sure, I had considered myself intelligent and in control of my life until that point. It's an increasingly common illness in western society - brought on by the coming together of genes, stress, chemical overload, indifferent nutrition and our sedentary lifestyle.

If interested, check out the website I mentioned previously. If not, I really do give up this time!
Posted by Bronwyn, Thursday, 26 January 2006 2:53:22 PM
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Bronwyn, let me assure you that you have not been ignored. I have browsed the websites though have had little chance to study the material but I will on the weekend. Sometimes simplicity is overlooked because we are conditioned to expect complexity in all things related to modern life.
Thanks for the tip and will give it a go.
Posted by Craig Blanch, Thursday, 26 January 2006 3:26:19 PM
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Craig, I understood intellectually for a long time that my (then) extreme depression was due to my own reaction, that the people whose actions and attitudes were the proximate cause of my depression might not have given me a thought for 12-18 months or so. But intellectual understanding isn’t sufficient to resolve depression. Fortunately, I have another tool to use, Vipassana meditation, although most of the time I’ve been ill it’s been difficult to maintain. In Vipassana you work at deeper levels, with the so-called unconscious (in fact always conscious) mind, it’s here that the problems lie and here that they must be resolved. On a ten-day retreat in March 03, I was able to see at a deeper level what I’d known intellectually, and there was a dramatic improvement in my condition. A trip to Burma in Dec 04, where I was able to meditate in a strong atmosphere and at times with my teacher, S N Goenka, led to a further dramatic improvement. My depression was in part because the senior management at Queensland Treasury managed to press all the buttons from emotional trauma when I was two-years old, when my father walked out and my mother transferred her affections to my new-born brother. This left long-term problems with fear of rejection, inability (for many years) to make a commitment, etc. I’d been able for many years to cope and make a contribution to society both through my professional work and my voluntary work, but Treasury pushed me over the edge. Meditating in Burma, I was able after 60 years to resolve the issues with my (long-dead) father; this took much of the force out of my reaction to my treatment by Treasury. (More follows)
Posted by Faustino, Thursday, 26 January 2006 5:10:02 PM
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(part 2) So, yes, we are ultimately responsible for our mental reactions, but few who suffer depression have the tools to recognise and deal with this, certainly when it is at its worst. I was regarded as being at the level of depression normally associated with suicide for about 10 months (beginning when after a long period of severe depression, a series of discussions led to all hope of rectifying my situation being lost.) The reasons that I was not, in fact, suicidal were, first, my understanding from Vipassana and, second, the enormous support I had from my wife, and to a lesser extent from my children. Without those, I’d have been gone.
Posted by Faustino, Thursday, 26 January 2006 5:10:35 PM
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Faustino, let me start by saying that I did not, by any measure, mean to infer that the reasons for mental illnesses are figments or illusions. Trauma, in the way that it has visited you over the period of your life, is very real and extremely potent.
I believe that you have demonstrated that what I posted was only one tiny facet in the dilemma that we call life.
The retreat that you have mentioned cannot be dismissed lightly as many have gone before you into similar self-enabling and cleansing experiences with similar outcomes. It is something that I have thought of trying from time to time but, I must admit, it does daunt me.
The monetary side of such a journey makes it somewhat of a luxury at present though I have always wanted to visit the Burma railroad and the bridge over the River Kwai. Sorry, I do digress.
You are correct that intellectual understanding is limited in its scope in dealing with depression. Intellectualising does little more than attribute labels from which we see problems but rarely, if ever, solutions.
Solutions come about by people that refuse to submit to the hopelessness that a label can bestow. No case could exemplify that better than yours.
Thanks for sharing and extend my very best wishes to your family.
Posted by Craig Blanch, Thursday, 26 January 2006 6:07:20 PM
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Yesterday on the way to Australia Day celebrations I noticed a sign outside a Public High School in Miranda in the Sutherland Shire.

It really upset me so I took a photo and put it on my blog to hopefully hear other people's opinions about the sign.

This is what the sign said "Our committed teachers will be released and return Monday January 30" http://jolandachallita.typepad.com/education/

Am I just too sensitive or is this wrong?
Posted by Jolanda, Friday, 27 January 2006 10:23:04 AM
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Jolanda,
Is it possible that the notice meant the teachers were committed as in dedicated and will be released (from holidays) to return. It would be very well phrased but it is also a possibility. I guess there is always two ways of construing everything....
Posted by Coraliz, Friday, 27 January 2006 1:00:43 PM
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Have to agree that we must spend all that it takes to care for, to rehabilitate and to prevent mental illness.
My concern is how we spend the money.
The achievements of an NGO need scrutiny to evaluate its success/cost effectiveness,so only those organisations that perform continue to receive taxpayers' money.
My concern is where will the money come from.
Taxpayers are expected to subsidise so many interest groups these days that money needed for needs is being channelled into providing for less urgent wants eg. does someone in employment, earning over $50,000 per annum, really need a government grant to 'kick start' a business when its establishment costs are not more than a few thousand dollars? Look through the grant websites ( a challenge and full time job in itself) to see illustrations of petty little grants and the proliferation of grants for every occassion...( An indication of the business grants have become is the number of workshops, all funded of course, conducted to teach people how to apply for a grant ... oops...funding)
When will all levels of government learn its time to say 'no' to greed and 'yes' to need?
My concern is where we spend the money.
It is time to provide more money and resources into schools so specialists (not teachers) can recognise at risk children and provide for their needs before other problems develope due to unmet needs.

Yea' for keeping this issue alive!
Posted by Cynthia2, Friday, 27 January 2006 1:33:29 PM
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Craig, my trip to Burma was a vital circuit-breaker. But there are many Vipassana courses in Australia, and there is no charge for the courses.

You wrote that doing a retreat “is something that I have thought of trying from time to time but, I must admit, it does daunt me. The monetary side of such a journey makes it somewhat of a luxury at present.”

The teaching and running of Vipassana courses in Goenka’s tradition is done entirely on a voluntary basis, and the courses and centres are funded entirely by donations from students who feel that they have benefited from practising Vipassana and want to share that benefit with others. So if you’re interested in doing a course, funding should be no barrier, so long as you can get 10-11 days free. There are centres in all states and NZ, with almost continuous courses at the centres in NSW (Blue Mountains) and Queensland (north of Brisbane), and occasional courses in more isolated places such as Darwin and Alice Springs.

As for being “daunting”, the courses are hard work, but their design and setting are very supportive. Everyone has difficulties, but over many years the drop-out rate from courses is about six per cent, those who complete the course almost all find it very beneficial.

The global website, www.dhamma.org, has more info and links to the Australian centres. I’ll be happy to tell you more about the practice if you wish.

If you can ever get to Burma, great – the people are very harmonious, generous and helpful, in spite of the oppressive regime. But better than going to Burma is doing a Vipassana course.
Posted by Faustino, Friday, 27 January 2006 5:17:46 PM
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anomie

My general area is Toowoomba. He has an Indian sounding name. That should narrow it down sufficiently.

Good luck.
Posted by plantagenet, Friday, 27 January 2006 11:43:46 PM
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Thanks, Plantagenet. Bugger. About 1000k away. Anyone know a decent psychiatrist within 2 hours drive of Canberra? There was one, but he moved to New Zealand. To the distress of many.
Posted by anomie, Saturday, 28 January 2006 10:38:52 PM
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Hello and thank you for your comments and feedback. Some of the drivers for a new paradigm come from what I have learned from working with refugees and new arrivals. They have helped 'free my vision' and look beyond taken-for-granted assumptions and points of view in relation to human suffering and what is considered (defined, really) as a 'good outcome' and by whom. As my teachers they have also given me strength to make some bold decisions about what services may do in response to when help is sought. And... I thank people for coming forward with their views ... Some of the issues raised in the discussion have touched on stigma, discriminaton and alienation - factors that are active across the lifespan and across all cultures. Factors that are sometimes made worse in a mental health crisis. In my learning from refugees and new arrivals I have been able to create a practical understanding the deeper meaning structures of their situation, take this forward in my teaching and public speaking and encourage my students (in particular) to make sensitive revisions of how they operate in the mainstream. While there is much still needed in leadership of mental health services (click here for another essay on this http://www.contemporarynurse.com/14-3p223.htm )it is the face-to-face interactions of what we say, do, think and believe inevitably shapes the care we give. As health professionals we must more open to the imporance of respect and humility.
Nicholas Procter
Posted by Nicholas Procter, Sunday, 29 January 2006 6:10:38 PM
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Dear Nicholas

Thank you for your last post. Much appreciated.

As a mental health/psychiatric nurse since 1978, I have very strong views about a mental health model.

"Empowerment" has almost become a corny word for consumers of mental health services. The system does not want people holding their own power and control. What the hell would bureaucrats do with their time?

A major answer to the problem is educating specialist mental health nurses. We are a dying breed. The average age of a specialist mental health nurse is 45-50 years of age. University nursing programs in relation to mental health nursing and future mental health nurses is in my view, a disgrace. I have taught in university nursing programs. I know what I am talking about. I returned to clinical nursing in community mental health. That is where the power lies for consumers and professionals.

If you need a curriculum writer, I will volunteer.

Get nursing back into hospitals where it belongs.

Cheers
Kay
Posted by kalweb, Sunday, 29 January 2006 7:59:58 PM
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