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Slate

Funding the Suicide Barrier on the Golden Gate Bridge

by John M. Grohol, Psy.D. 9/10/2024

Two recent articles in the LA Times and Slate caught my eye, as they discussed the progress — or lack thereof — of the suicide barrier to be installed on the Golden Gate Bridge in San Francisco.

While I found the articles covered eerily similar ground, I also found they didn’t answer the questions I really had… For instance, why is the progress so slow? Who’s going to fund the suicide barrier, if not the Bridge District?

Why does it appear that both articles paint the Golden Gate Bridge, Highway and Transportation District as some sort of bad guy?

9/10/2024 2 comments

Jesse Jackson, Jr. is Entitled to His Privacy for Treatment of Mental Illness

by John M. Grohol, Psy.D. 4/12/2024

written by John M. Grohol, Psy.D.

Jesse Jackson, Jr. is Entitled to His Privacy for Treatment of Mental Illness Should politicians and celebrities see it as their responsibility to share the specific details of their mental illness or mental disorder diagnosis in order to help reduce the prejudice surrounding these conditions?

That’s the question Torrie Bosch asks over at Slate and arrives at this conclusion — yes, it is a politician’s duty and responsibility to offer full disclosure about their mental health concerns.

But I think Bosch is missing a key component here. When in the throes of a full-blown episode (whether it’s bipolar disorder, depression, or something else), one shouldn’t be making any life-changing decisions or decisions that could forever alter one’s future career.

While it’s easy to believe that politicians and celebrities are something special, underneath their public persona beats the heart of an ordinary person — someone who is entitled to his or her privacy. Especially for health or family concerns.

4/12/2024 3 comments

Addicted to Sex? The Internet? Friendship?

by John M. Grohol, Psy.D. 3/10/2023

written by John M. Grohol, Psy.D.

Addicted to Sex? The Internet? Friendship? Some would argue that one can become “addicted” to the Internet. I’ve argued for over a decade this is a fairly ridiculous assertion that doesn’t even withstand a simple test of logic. Because if we can become addicted to the pipes that bring us information and friendship, it stands to reason one can become “addicted” to virtually anything in the world — sex, cake, shopping, TV, reading, the Internet, even friendship itself. Where do we draw the line and how? Why single out Internet use as its own disorder, but not someone who can’t be pried from in front of the TV 30 hours a week? Or from reading a book?

I’m certainly not alone noting how the term “Internet addiction” helps sells newspapers more than it helps us understand human behavior. And certainly I write about the latest rounds of research every year that call into question “Internet addiction” for various reasons.

For instance, did you know that despite the fact that dozens of studies have been done on “Internet addiction,” few studies have been done examining the scales used to measure this phenomenon? One that was published last year found that a commonly used scale in early Internet addiction research was basically useless and invalid (invalidating any research that used it). And there has been only one independent study done on the psychometric properties of the “new and improved” 20-item Internet Addiction Test (IAT) used by virtually all other researchers. Five years ago. The researchers who did the study — Widyanto & McMurran (2004) — called for more studies to be done, as its sample size was small, self-selected (not randomized) and therefore their results could hardly be classified as “conclusive:”

[The IAT’s] reliability and validity need to be further tested using a larger sample. Once a valid and reliable measure has been devised, more can then be researchers about the nature of Internet addiction.

Despite the fact that nobody has done that followup research yet (at least for U.S. populations), it hasn’t stopped researchers from using the IAT anyways.

So I was glad to read Vaughan Bell’s entry in Slate yesterday, as he makes sensible points about why it’s bad to medicalize every behavior we engage in a bit too much:

This creeping medicalization of everyday life means that almost any problem of excess can now be portrayed as an individual falling foul of a major mental illness. While drug addiction is a serious concern and a well-researched condition, many of the new behavioral addictions lack even the most basic foundations of scientific reliability. In light of Tiger Woods’ extramarital trysts, “sex addiction” has been widely touted by the global media despite the fact it lacks official recognition and scientific support. Perhaps the most widely publicized of these new diagnoses, Internet addiction, is flawed even on its own terms: A 2009 study published in the journal CyberPsychology and Behavior revealed that it has been classified in numerous, inconsistent ways in published research. Most studies of the “disorder” rely on self-selecting samples of college computer users and are otherwise subject to significant bias.

Despite the scientific implausibility of the same disease — addiction — underlying both damaging heroin use and overenthusiasm for World of Warcraft, the concept has run wild in the popular imagination. Our enthusiasm for labeling new forms of addictions seems to have arisen from a perfect storm of pop medicine, pseudo-neuroscience, and misplaced sympathy for the miserable.

The full article is worth your time if you’re interested in this topic.

Read the full article: Can you really be “addicted” to shopping or using the Internet?.

3/10/2023 27 comments

Hospitals Full Up? State Suggests We Cut Beds

by John M. Grohol, Psy.D. 12/8/2022

written by John M. Grohol, Psy.D.

Tough economic times affect everyone. Even, apparently, the ability to look at data in a rational and logical manner.

When your data tell you that your psychiatric hospital bed capacity is hovering around 97 percent, many people would consider that a sign that perhaps more psychiatric hospital beds are needed.

But in Massachusetts, apparently the reverse is true — at least, that is, when you start looking at ways to cut the budget. The Boston Globe has the story:

A state commission has proposed speeding up the closure of Westborough State Hospital and a slate of other measures that would cut about 120 psychiatric beds at a time when the mental health system is already under significant strain.

The proposal is in response to a $13 million budget deficit at the state Department of Mental Health and would reduce its 788 adult continuing-care psychiatric beds – those that provide inpatient mental health services and are operating at 97 percent capacity. Yet a commission member said the impact would be partially offset by 200 people being discharged from hospitals into community programs.

Not only will speeding up the closure of a psychiatric hospital already slated to close save money, but it will actually improve care to patients needing psychiatric hospitalization. How so? Well, according to the state’s logic, we’ll just discharge those “extra” patients into outpatient or community care settings sooner. Like, right now.

But wouldn’t you already have done so if there were people who could be better served in a less restrictive environment? The state appears to be saying, “We admit, we’re not presently providing the best possible, least restrictive psychiatric care for patients today.”

Or, more cynically, they’re saying that only as a matter of convenience to save some money.

The state has already cut 100 social workers from a system that could ill-afford such human services cuts. Now this state commission has recommended further cuts to services in the hopes that the community services will somehow magically make up for the lack of psychiatric hospital beds.

What happens when a community has fewer psychiatric beds than the population needs? Patients partake of emergency medicine services in ERs. Are ERs well-equipped to address a patient’s mental health needs? Most are not. And guess how much an ER bed costs? Significantly more than a psychiatric hospital bed does. A perfect example of not seeing the forest for the trees.

The commission also suggested that funding for the additional community treatment services could be paid for this year by Obama’s economic stimulus package. That’s great for this year, but what happens next year, when nobody’s looking and the hospital beds have already been cut? The state will cut back the community services, since there won’t be any federal stimulus money to partake of every year for years to come. And once again, the most vulnerable people in Massachusetts will be forsaken by their government.

I’m all for cutting back unnecessary psychiatric hospital services, especially for less-restrictive and more open-ended outpatient services. I already believe this should be the norm — that a psychiatric hospitalization is usually an avenue of last resort. And it would make absolute sense if these hospitals were running at 40 or 50 percent of their capacity.

But when your hospitals are running at 97 percent capacity and you have only a short-sighted plan on how to make up for the cut of 15 percent of that capacity, I don’t feel like it’s necessarily been well-thought through with an eye for “What’s best for patients?,” not, “What’s best for meeting this budget deficit?”

What a strange world we live in where politics — not science or scientific data — dictates the best treatments and care for an individual in need.

Read the full article: State commission proposes speeding closure of Westborough State Hospital

12/8/2022 2 comments