This is a blog for the Mental Health Policy Class at the George Warren Brown School of Social Work.

September 29, 2009

Should Roman Polanski Stand Trial for Rape?

Please come to class prepared to discuss this case.
Danny
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Great Men - and other men - sometimes do find pliant, young flesh irresistible. Geniuses are usually forgiven for it. It's a good bet Woody Allen won't be signing Henri-Levy's petition, but he could offer Roman some comfort in a jailhouse visit in Zurich about now. The Woodman's story has a happy ending. So do the sagas of the millions of wrinkled, calloused, old smelly geezers in places like Afghanistan, Saudi Arabia and Africa, where marriage of men 40 and older to girls at puberty is only just beginning to be considered locally - and only by a very, very few - to be, perhaps, not so healthy.
In the end, that is precisely why the arrest of Roman Polanski is a good idea, and should stand. It doesn't matter whether he is a genius. The world will have to live without his lifetime tribute ceremony, at least for a few months more. It doesn't matter whether his victim - 30-odd years on and handsomely paid off - forgives and wants to forget.
What matters is that the rape of a 13-year old girl, in a nation of laws, in a nation where women are striving for equality with men, in world where we are hundreds of years away from that right and good goal, be discouraged, by example if necessary.
Read more at: http://www.huffingtonpost.com/nina-burleigh/genius-and-young-flesh_b_302515.html

September 25, 2009

Should pregnancies be terminated when Down Syndrome is diagnosed?

My granddaughter Lucy is 6 years old and is part of a class of people that is quietly being eliminated in my country. She has Down syndrome, a genetic condition that frightens so many women that 92 percent of those who learn they are carrying babies with it choose to abort.
Dr. Brian Skotko, a genetics fellow at Children’s Hospital, fears this number will rise. Prenatal tests are invasive, carry a risk to the fetus, and are given in the second trimester, so many women choose not to have them. But a simple new and non-invasive blood test, to be given early in a woman’s pregnancy, is coming, perhaps as early as next year.
As new tests become available, will babies with Down syndrome slowly disappear?’’ Skotko ponders in a soon-to-be-published article in the Archives of Disease in Childhood, (a British medical journal) available online now.

September 24, 2009

Should cities, states or the federal government tax sodas?

A series of academic studies have drawn a clear line between the consumption of sugar-sweetened beverages and a host of unhealthy outcomes: obesity, diabetes and heart disease. Medical costs for obesity and excessive weight alone are estimated to be about $147 billion - and half of those costs are paid for through Medicare and Medicaid. It's no stretch to say that soda drinking affects us all.

So kudos, then, to San Francisco Mayor Gavin Newsom for taking action. Granted, the action that he's proposing is clunky: a tax on the retailers that sell sugary beverages. The legislation doesn't include restaurants that sell soda, and it sidesteps the most elegant and effective way to reduce soda consumption: Tax the stuff directly, at a penny an ounce. . . .

As for the charge that soda is only one of the major factors contributing to our obesity epidemic, that's true. But the fact that tobacco use is only one of the factors contributing to cancer doesn't mean that we don't tax it for the same reason we should tax soda - when individual people smoke too much, it has an outsize impact on the collective public health.

Why is suicide so common in Japan?

Without a doubt the grimmest statistic coming out of Japan today concerns the number of suicides, which have exceeded 30,000 annually for 11 years in a row — engendering indescribable tragedies for so many families.
But with this having spun into an issue in last month's Lower House elections — even Yukio Hatoyama, who is now prime minister, mentioned it in his speeches — it's clear the Japanese people have begun to take that awful statistic to heart and to treat suicide as a national problem. . . . In Japan, as in much of the developed world, suicide is by far the leading cause of death among young people, amounting here to one-third of deaths in the 20-to-49 age group. In all, the number of suicides in Japan is five times that of total deaths from road traffic accidents.  

September 21, 2009

Michael Moore's New Movie

Michael Moore has proven again and again that he has a remarkable feel for where the zeitgeist is heading. He's like a zeitgeist divining rod.
Roger and Me was way ahead of the curve on the collapse of the auto-industry. Fahrenheit 9/11 was way ahead of the curve on the collapse of the house of cards the Bush administration used to lead us to war in Iraq. Sicko was way ahead of the curve on the collapse of the US health care system. And now, with his new movie, Capitalism: A Love Story, he is riding the wave of the collapse of trust in our country's financial system.

September 17, 2009

Proposed Tax on Sugary Beverages Debated

The debate over a tax on sugary soft drinks — billed as a way to fight obesity and provide billions for health care reform — is starting to fizz over.
President Obama has said it is worth considering. The chief executive of Coca-Cola calls the idea outrageous, while skeptics point to political obstacles and question how much of an impact it would really have on consumers.
But a team of prominent doctors, scientists and policy makers says it could be a powerful weapon in efforts to reduce obesity, in the same way that cigarette taxes have helped curb smoking.

How we can end the cycle of bullying

While discussions of bullying usually focus on children, anyone who has worked in an organization knows that these behaviors, if not addressed, may continue into adulthood. At worst, bullying leads to violent, criminal behavior. A recent study in the Archives of General Psychiatry of 5,000 children in Finland found that both bullies and their victims were at increased risk of needing psychiatric treatment in their teens or 20s. We need to think carefully about the origins of this problem, and to devote significant resources to prevention.

Insurers Fight Speech-Impairment Remedy

Kara Lynn has amyotrophic lateral sclerosis, or A.L.S., which has attacked the muscles around her mouth and throat, removing her ability to speak. A couple of years ago, she spent more than $8,000 to buy a computer, approved by Medicare, that turns typed words into speech that her family, friends and doctors can hear.

Under government insurance requirements, the maker of the PC, which ran ordinary Microsoft Windows software, had to block any nonspeech functions, like sending e-mail or browsing the Web.
Dismayed by the PC’s limitations and clunky design, Ms. Lynn turned to a $300 iPhone 3G from Apple running $150 text-to-speech software. Ms. Lynn, who is 48 and lives in Poughkeepsie, N.Y., said it worked better and let her “wear her voice” around her neck while snuggling with her 5-year-old son, Aiden, who has Down syndrome.
. . . .
For Ms. Lynn, the iPhone, with the special software, is cheaper, more effective and essential. “Technology has become as important to me as air, food, water,” she wrote.

The Case for Killing Granny

The idea that we might ration health care to seniors (or anyone else) is political anathema. Politicians do not dare breathe the R word, lest they be accused—however wrongly—of trying to pull the plug on Grandma. But the need to spend less money on the elderly at the end of life is the elephant in the room in the health-reform debate. Everyone sees it but no one wants to talk about it. At a more basic level, Americans are afraid not just of dying, but of talking and thinking about death. Until Americans learn to contemplate death as more than a scientific challenge to be overcome, our health-care system will remain unfixable.
Compared with other Western countries, the United States has more health care—but, generally speaking, not better health care. There is no way we can get control of costs, which have grown by nearly 50 percent in the past decade, without finding a way to stop overtreating patients. In his address to Congress, President Obama spoke airily about reducing inefficiency, but he slid past the hard choices that will have to be made to stop health care from devouring ever-larger slices of the economy and tax dollar.

Healthcare Reform Wins Over Doctors Lobby

The American Medical Assn., after 60 years of opposing any government overhaul of healthcare, is now lobbying and advertising to win public support for President Obama's sweeping plan -- a proposal that promises hundreds of billions of dollars for America's doctors.

Of all the interest groups that have won favorable terms in closed-door negotiations this year, the association representing the nation's physicians may have taken home the biggest prizes, including an agreement to stop planned cuts in Medicare payments that are worth $228 billion to doctors over 10 years.

In addition, the proposal that would require all individuals to obtain medical insurance includes premium subsidies to ensure that their doctor bills would be paid.

The AMA, which many still regard as the country's premier lobbying force, is providing money and grass-roots backing for these and other reforms.

Medical school reinvented: Adding lessons in compassion

She has wanted a career in medicine since girlhood, when she saw how compassionately a doctor treated her grandmother at their home in Cuba. But she interrupted her medical studies to move to Miami with her family. Now, having mastered English, she's back on track as one of 43 students in the inaugural class of the new medical school at Florida International University (FIU).
But the curriculum here is no conventional training, representing one of the most thorough reinventions of medical education in a century.
Known as NeighborhoodHELP, it will pair each student with a low-income family facing barriers to healthcare. With teams of fellow students from nursing and social work, the aspiring doctors will observe and support the families throughout their years in medical school. Alongside more traditional medical lessons, they'll get steady doses related to ethics, cultural understanding, and public-health policy.

September 16, 2009

State Discriminated Against Mentally Ill, Judge Rules

New York State discriminated against thousands of mentally ill people in New York City by leaving them in privately run adult homes, which effectively replaced state-run psychiatric hospitals more than a generation ago but turned out to be little more than institutions themselves, a federal judge ruled on Tuesday.