Doctor on the screen

You know the drill. You go to your primary care doctor and indirectly talk into an Electronic Health Record system. The doctor gives some bare attention as the nurse or assistant records the essentials. The doctor’s time is spent on paperwork and not on his/her judgment and diagnostic feeling; the patient just data. Worse yet, you may have a phone or video appointment (sometimes from silly vaccine mandates). The human is taken out.

As the late Charles Krauthammer wrote, EHR government mandates present you with just billing, legal documents, and degraded medicine. He pointed out that (in 2015) the supposed savings for the government with the move to EHR–$27 billion–was gone already. Unfortunately, EHR also made it easier for fraud with Medicare. Ease of use for the EHR system allowed cutting and pasting of data into data fields. Billing could be inflated.

At XiFin, I supported the company in the marketing department. Along with HIPAA compliance, we enabled form-fill features. Billing was simplified and waste rooted out. Still, there is still some waste, impersonal service, and the reflex to drug prescription.

As Krauthammer suggested, some tort reforms could improve the industry: No limits on a plaintiff’s lost earnings, a reasonable cap on pain and suffering ($250K), a similar cap on punitive damages, and serious penalties for frivolous lawsuits. These are tall orders, but he had the right idea.

He summed up with these suggested avenues for improvement: changes in public policy, malpractice reform in which loser pays all, separating routine treatments from major ones, and “allowing old age to take place.” (I don’t completely get this last one.)

Beyond the lack of personal care due to legal requirements, there is also the specter of Big Pharma. (Psychiatrists are one of the specialties in the prescription racket.) My views on healthcare have changed much from 30 years ago fresh out of college. I used to think that research and development were responsible for escalating drug costs, but the apparent collaboration in selling and prescribing is eye-opening.

In the U.K., my nan, uncle and aunt, sister and brother all of course get national healthcare. While I know my grandmother and stepgrandfather had various problems with scheduling visits and surgeries(!), I think my uncle, aunt, and siblings have had good services. My brother’s recent birth of his son was completely covered, my sister-in-law had in-home visits from maternity, and my uncle had successful hip work. I know the British are proud of their healthcare (they had dancing medical professionals in Olympic ceremonies), but I do wonder about more critical health needs. Some Europeans come to the top American clinics for advanced cancer care among other fields.

While I appreciate the advances here, I do feel a certain disconnect from a doctor looking down at a screen during an appointment that I had set up three months in advance. I think a redo is needed.

Breakfast and Confidence

Went out with four of my prayer buddies today and an Indian man came in and started to debate incessantly. I was asking him questions to see where he was, but the guys cut it short. Turns out this was the same man who sat next to my mother once in church and just kept bringing up objections.

I later realized that my questions were pretty much pointless in this case.

Spiritual discernment can be difficult. Your worldview affects (mental illness affects even more). But the spiritual things are foolishness to the world. Questioning can add nothing if the hearer does not want faith.

Still thought I could have some positive effect. Am I being too much in the flesh?

You can also speak with knowledge, but be ignored if you don’t have confidence. Outer strength shows inner strength to the listener. Fake it til you make it.

Respect comes to the confident. Recognition to respect.

How many great minds and hearts are unrecognized because they doubt themselves? Perhaps in writing one can show confidence and be read. If you meet the author, sublime text can be lost on you.

OK, so the world can be unkind. So with my other thoughts on spirit versus flesh, the spirit can give you that confidence that you lack. You will have listeners, at least some. You can know when it’s pointless to argue (pearls to swine).

Digging

Evaluating oneself continually is not promoting health. I have to refer this back to the scripture “do not depend on your own understanding.” For me, this came into my spirit as to self-reflection. “The over-examined life is not worth living.”

I’ve found that there is great wisdom in this text. Trying to determine why I feel a certain way or going back in personal memory to repeatedly ask for forgiveness does not promote tranquility of mind.

At this point, I will refer to medicine, but also “mindfulness” may be helpful here. I never looked at that as a serious practice; just some hokum.

Pandemic depression, self-harm and suicide jumps

It’s easy to blame the pandemic for everything, but there was a 45% increase in self-injury and suicide cases among 5- to 17-year-olds in the first half of 2021. We can blame social media, and we’d be right to, but it’s not all due to that either.

Now I don’t have children, but my interactions with friends’ kids and my nephews have made me realize that there is intense need for understanding and importance in our youth at those ages. Then in college, young adults are trying to grasp their meaning and place in the world through a career. Both of these times are critical in self development–but the last thing they needed was a pandemic shutdown (imho).

https://www.morningbrew.com/daily/stories/2022/04/24/the-teen-mental-health-crisis-mystery

Bermuda Citizen Number One

Larger than life.

At the Royal Bermuda Yacht club, Charles lifted his whisky again and let loose some blue language. Then with that twinkle in his eye flirted with my mother. He had just returned from the Arctic sailing trip with Warren “War Baby” Brown and was once again the center of attention in Hamilton.
Continue reading “Bermuda Citizen Number One”

Reddit emotion; Psycho-physical pain

Two mental health articles.

A Dartmouth study found that major depressive, anxiety, and bipolar disorders can be recognized by the emotions of Reddit posts; the posts can reveal an “emotional fingerprint” for a user. They didn’t examine the content, just the emotion–so the study is an incomplete look at emotional disorders in my opinion. Also, what about the bomb throwers and trolls? Online mass movements?
https://home.dartmouth.edu/news/2022/03/ai-model-detects-mental-disorders-based-web-posts

Continue reading “Reddit emotion; Psycho-physical pain”

Will Someone Please Stop the Oversaturated Vendor Problem in Balboa Park?

UPDATE: Well, according to sources at the Balboa Park visitor’s center, someone put in a new rule that vendors there have to be 100 feet apart. Doesn’t mean a lot imho; street vendors have been a problem for business owners throughout the city, who have some of the same products, just without the overhead. But now the city council said they will vote on March 1 to rule on placing restrictions on vendors and prohibit them in certain parks, beaches, and places like Old Town: “The ordinance requires vendors to obtain a business license and vendor permit. It would define specific distance parameters around statues, art displays and other vendors.”

Though the park website says “The City of San Diego must issue a permit for any commercial filming for exterior areas in Balboa Park,” vendors, with hygiene requirements, don’t need a permit? I don’t see why this took so long to address.

—-

Ah, to get back to normal life. At Balboa Park, the museums are starting to open, the Spanish Village artists are back at work, and the rose garden is in full bloom.

But now someone needs to do something about the high number of what appears to be unapproved vendors who are in Balboa Park. They seem to have little food safety and basic hygiene, and poor trash management. The U-T interviewed Alexis Villanueva, senior program manager of economic development with City Heights CDC, who maintains that “micro-enterprise” vendors contribute to the economy. Yes, but they can also contribute other, unwanted things. There has to be a balance here between rules, regulations and freedoms.

 

Continue reading “Will Someone Please Stop the Oversaturated Vendor Problem in Balboa Park?”

Dictionary.com Changes and Early Covid-era Mental Health Suggestions

ATTENTION: The discussion below includes talk of suicidal ideation. If you or someone you know is having any suicidal ideation, please contact the National Suicide Prevention Lifeline at 800-273-TALK (8255). People care about you.

Dictionary.com has removed the word “commit” in various references to suicide.
https://www.dictionary.com/e/mental-health-language/

And has the following recommendations for being aware of and helping those struggling with suicidal ideation:

  • Adopt a nonjudgmental and open-minded attitude
  • Show you care by listening actively, without interrupting or giving advice unless prompted
  • Ask open-ended questions instead of “yes”-or-“no” questions to keep the conversation going
  • Validate the feelings of the other person; it’s OK to not be OK, and sometimes just holding space for another to express themselves can be deeply comforting

Because I am so high functioning, it took me a long time to acknowledge having a mental illness. Talk it out. Below are some early Covid-era mental health suggestions (by early I mean under more stringent sheltering conditions), from Mental Health During Coronavirus (seizetheawkward.org):

  • Engage in live streams – from your favorite yoga studio to your favorite artists
  • Schedule virtual dinners or dance parties with friends
  • Start a virtual book club
  • Participate in online game nights
  • Plan to watch television shows or movies at the same time and video chat to share reactions
  • Enroll in remote learning classes or look up tutorials online
  • Go on virtual museum tours together
  • Share your favorite recipes or host a virtual cooking competition
  • Try a home workout together

“Whatever Gets You Talking” | Seize the Awkward | Ad Council – YouTube

Taking Meds as Prescribed!

I was just thinking about what happened to me that caused me to become med compliant. There was quite a bit of time from when I became ill to finally taking my medications as prescribed.

I had some tumultuous times at first. I had some violent mood swings, many very up periods and very little down moods. One doctor told me I was acting like Superman.

I said, “No I’m not.”

“OK then Batman.”

Funny now. But it was a warning that my mood swings would get worse over time if I didn’t stay compliant. I remembered in that moment that I feared getting to a place where, they told me, the medications would not help any longer. That fear thank God, set me right.

I now use 9 PM as the time to remember. I usually do.

If you have had any similar experiences or wisdom to apply here, please leave a note at bottom!

Take ’em.

I Have Hope for the Concern Over Olympics Mental Health

I have hope that all this mental health talk at the Olympics turns into some thing genuine, not just some virtue signaling or worse, a pure fad.

But I must repeat what has enabled me to get as far as I have: you must press through to a better life. Don’t let the waves tumble over you, situations to be too much for you. You can talk with others, you can live a good life. But step out and be aware that you are loved.

Please read my 7 things that I have learned over the past 23 years of mental illness and please talk to someone if you are having a rough time–or just leave comment here and I will reply.

Peace and grace.

Simone Bile’s Exit

Blessings to Simone as she exits the Olympics. CNN had a brief press conference. I don’t know the condition of her mental health, but I can imagine the stress of interviews and the spotlight. She was also magnanimous in passing the torch for this year to her teammates.

Also, noticed this piece about stigma of mental illness in churches. Mental health stigmas can be distinctly unbiblical. This is why | Voice | The Christian Post. Olympian tennis star Naomi Osaka is quoted in the article saying “it’s O.K. to not be O.K.”

Stigma is an interesting word, derived from the Greek word stizein,meaning to tattoo. In the Graeco-Roman world, an owner would brand (stigma) their cattle. It was also a practice to brand or tattoo criminals, prisoners of war and slaves. The stigma or brand said it all, told the story and circumscribed the person stigmatized. If you had the criminal tattoo in Greece, you were a criminal, enough said, no further information was needed. 

The Christian Post

PBS’ Mysteries of Mental Illness Pts. III and IV

In Pt. III

From this episode, I learned that there are ten times the number of people in jail today than in mental hospitals — and 90% of them are black. In Chicago, jails and prisons have 40% of their inmates with a mental illness. I see a disportionate number of black men living on the street today, some obviously disturbed and who need help.

Continue reading “PBS’ Mysteries of Mental Illness Pts. III and IV”

PBS’ Mysteries of Mental Illness Pts. I and II

Watched the first two episodes of PBS’s Mysteries of Mental Illness last night; the third and fourth are tonight. Had a few thoughts.

In Part I

My favorite realization is that there is no objective test for mental illness. Like the subatomic realm, the brain to a large extent is a black box. We are just treating the symptoms we see (in physics, we see the indirect evidence of some things we can’t directly investigate). With over one hundred fifty genes involved in schizophrenia for instance, we sometimes can feel helpless against something we can’t see. In an industrial and technological age, we are used to diagnosing, treating and conquering things with science. We don’t like that we can’t change some things.

The show goes over the historical development in understanding mental illness. In the past, people would blame the Devil. With our limited knowledge, we did so in a quest for the meaning of it. The churches I initially went to 28 years ago tried to cast demons out of me. They meant well of course. They may have felt helpless.

I did have a little experience with dream interpretation and analysis of thoughts, but it wasn’t these things that helped me. Neither were the psychoanalytic ideas that I, my mother or anyone else was responsible. (My relatives did think that stress at college was responsible, but stress is only a catalyst for what was bound to happen because of genetics.) Past horrific treatments included starvation and abuse, like bleeding and what can only be termed, physical torture and electro-shock therapy (much more extreme than what is still used today).

I was also reminded that schizophrenia can get worse over time. Having tried dozens of med combinations, I am stable right now and the point is to sustain the positive effects of the meds. I do think that cognitive behavioral therapy (CBT) was slightly helpful and regular therapy still helps me.

The show is also right to point out that the pandemic has exasperated mental illnesses. There is some evidence that suicidal ideation has increased in a number of age groups. I have some anger here because of that.

In Part II

The topic of how we evolved from “who’s normal” and “who’s not” to a more compassionate set of diagnoses features heavily in this episode. The show covers how the Diagnostic and Statistical Manual of Mental Disorders 1 (DSM1) used the terms “normal” and “not normal” and how now the DSM5 has evolved to not use those terms, but to have more specific diagnoses — 265 illnesses right now. My doctors have always given me loose diagnoses. They vary, having started with bipolar type I when I first got sick 28 years ago and then having evolved from schizophrenia to schizoaffective.

I didn’t like the implication that “conservative America” has been detrimental to those with mental illnesses. On the contrary, the American nuclear family — not perfect by any means — has been a positive force. Family is my primary support and I would love to have had both a mother and father, which is an ideal.

I also found that the parts about post-traumatic stress disorder (PTSD) was important and interesting. There are many soldiers, Marines, and first responders that experience it.

Though mentioned in an aside, the much-quoted Psalm 23 (“Though I walk through the valley of the shadow of death…”) has been a scripture that has assuredly helped me.

People should be able to overcome with pushing past certain thoughts and practices, taking their medications, and relying on family and friends.

I look forward to tonight’s third and fourth parts.

Continuing Alarm for Children’s Mental Health in The Age of Covid

Rady Children’s Hospital here in San Diego is seeing a 25% increase in child mental health issues to their emergency room. Granted, the rate may have been going up in years prior to Covid, but it is worse since the pandemic started. Similarly, Children’s Hospital Colorado declared its first mental health emergency. Symptoms include suicidal ideation and attempts, perhaps due to isolation and stress about returning to school.

I wrote a post on mental health coping mechanisms. Please read them. I learned these lessons over 28 years and have been there. Also, feel free to leave a post here, too, if you are in need of some suggestions or an open ear.

If your kids or you are having any suicidal ideation, please contact the National Suicide Prevention Lifeline at 800-273-TALK (8255). People care about you.

Symptoms to watch for, from the National Insitute for Mental Health:

Continue reading “Continuing Alarm for Children’s Mental Health in The Age of Covid”

7 Mental Health Tips for These Trying Times

Loneliness, anxiety, and distressing thoughts are part of life in the Age of Covid. I’m among those afflicted this season of woe. Dread sometimes intrudes on ordinary daily life. These thoughts have at times been disorganized and racing.

The Centers for Disease Control and Prevention (CDC) has said during the pandemic depression has increased by four times, anxiety by three times, and suicidal ideation by two times. With job losses and school closings, domestic and child abuse have been proliferating, and life expectancy has dropped 0.5 percent, particularly in the African-American population and among women.

While professionals offline (your healthcare provider) and online (pay services like tenpercent.com or joincoa.com) can help, I wanted to pass along some behavioral practices that I have learned over the past two decades: Continue reading “7 Mental Health Tips for These Trying Times”