Tag Archives: Mental health

“Cause marketing” not clear as a bell

DEBORAH JONES: FREE RANGE
February 6, 2016

I just donated a few dollars to my local schizophrenia support charity. I should do so more often, knowing that we’re all, directly or indirectly, affected by mental illnesses. I don’t, though. It’s one of too many issues clamouring for scarce attention and funds.

Kudos for the reminder, then, to #bellletstalk, an annual “cause marketing” campaign by Canada’s largest communications company, BCE Inc.  Bell, as it’s known, reminded me of the cause  — but instead of joining its campaign, I gave independently. Why? Because behind its cool hash tag, #bellletstalk is a leading example of a trend we really do need to talk about.

Today is Bell Let’s Talk Day! Every time this post is shared, we’ll donate an additional 5¢ to mental health initiatives in Canada.

#bellletstalk is a leading example of a trend we really do need to talk about. Photo from Bell’s Facebook campaign page, which said, “Every time this post is shared, we’ll donate an additional 5¢ to mental health initiatives in Canada. Photo: Facebook

To give due credit, Bell, and the millions of people who participated, did good, raising money and awareness for a cause.

But here’s the caveat, why I refused to join the massively popular campaign despite the risk of being called curmudgeonly: a public issue should not be driven primarily by private interests. Mental illness is too complex, with causes and cures too embedded in our families, workplaces, communities and overall structures, to be fixed with a cause marketing program.

When I grumbled to this effect amid the torrent of posts about the campaign on social media, a friend pointed out that without #bellletstalk few would talk about, or donate, to mental health. He was right. Again, kudos to Bell.

But my friend also noted,  “that’s how the world works.” Ah — and that’s the rub.

I don’t think our world should work that way. I know we can do better.

Bell pledged five cents apiece for messages with the hash tag #bellletstalk. Canadians responded with 125,915,295 tweets, texts and shares on social media. The 24-hour fundraiser, Jan. 27, raised nearly $63 million* for mental health programs throughout Canada.

Mental illness costs Canada alone $51 billion* each year in health care costs, lost productivity, and reductions in health-related quality of life, estimates the Centre for Addiction and Mental Health in Ontario. Despite Canada’s universal health care, advocates say mental illness is neglected and underfunded compared to other diseases. Globally, the World Health Organization reports that one in 10 people have a mental health disorder, but just one in every 100 health care workers serve them.

Mental illness is a difficult subject, and a marketing campaign based on it could have backfired, even turned away customers. Instead, each January #bellletstalk gets an entire nation talking, enthusiastically — for weeks! — about mental health. Prime minister Justin Trudeau participated, noting his mother Margaret Trudeau’s famous struggles with bi-polar illness. Celebrities tweeted. Ordinary people poured their hearts onto Bell’s campaign Facebook page, like the man who wrote, “I suffer with depression, anxiety, social anxiety, panic attacks and ocd ….Thank you #Bellletstalk for helping raise awareness.”  The campaign received widespread news coverage, including in other countries.

Arguably, in just one day each year, Bell’s cause marketing campaign does more than any government or non-profit agency to raise awareness of an illness that lurks below our radar, or is swept under our rugs.

My criticism is not aimed at Bell, or the millions of people who shared the hash tag. But #bellletstalk is an example of how we confuse a public good with private interests, and of how — without thought —  we accept “that’s how the world works.”

I am an enthusiastic capitalist in the way I am an ardent democrat: both are the least bad of all the systems we’ve invented (with apologies to Winston Churchill). And, both require oversight. Healthy capitalism requires an awareness by citizens that the legal priority of corporations is to make profits for shareholders. Healthy democracy requires us to acknowledge that no marketing campaign can be equated with altruism, or substituted for public policy.

As generous as it is, the $63-million #bellletstalk campaign is no panacea for Canada’s $50 billion/year mental health burden. Mental illness is complicated, its social and medical roots deep – and they extend into Bell’s own workplace, and into most of our institutions. That point was sharply made by a former Bell Media employee, who wrote on Canadaland her job at Bell “gave me mental health issues and no benefits … I just wish they would send some of that funding and change towards their own people too.”

My criticism of #bellletstalk is in the context of private interests increasingly dominating in our societies. This is hardly news. It’s been thoroughly documented, from Thomas Piketty’s 2013 book Capital in the Twenty-First Century, to Oxfam’s report in January, An Economy for the 1%,” released at the World Economic Forum in Davos. Fewer and fewer people control more and more of our economy, and spend their vast wealth to influence our decisions, not merely on choices we make as consumers about, say, Bell mobile phones, but in our elections  — including for the legislators who regulate the communications and health care industries, in which #bellletstalk has become influential.

American philosopher Michael Sandel  warns that we’ve stumbled, without consciously thinking about it, from having a useful “market economy” to, dangerously, being a “market society,” in which anything and everything is for sale. And #bellletstalk, even as it does some good, exemplifies this market society, by  linking an essential public good with selling things to us as consumers.

Canada, and its #Bellletstalk campaign, are considered leaders in the “cause marketing” genre, noted the business publication Forbes. Cause marketing is useful to business, and it has a place in public discourse. But all marketing is aimed primarily at  “consumers.” Consuming is only part of what citizens do.

I think we citizens are capable of a great deal more than tweeting once a year about a vital area of health care. Citizens in healthy democracies have managed to develop public health and urban planning; invented vaccines and implemented public education; sent spaceships to Mars — and replaced, for a time anyway, the rule of man with the rule of law.

Citizens in a developed country like Canada, with its universal health care system, should support research, treatment and awareness of debilitating, socially-devastating mental illness the same way Canadians provide pre-natal health or vaccinations.

Bell raised nearly $63 million* in 24 hours for a neglected cause. It is a lot of money, even compared to the billions that mental illness costs Canadians. And, Bell’s campaign boosted awareness about mental health.

Bell deserves a pat on the back. At the same time, we should pause to question: Will the programs that rely on Bell continue if the company cancels its campaign in future, or the company is bought by a competitor? Will Bell’s popular marketing campaign affect government decisions on regulating the communications industry?

Even the most  enthusiastic capitalists need to ask if a market society is the model we want to serve public needs. It is now, as my friend said, the way the world works.  It doesn’t have to be so.

Copyright Deborah Jones 2016

Contact: djones AT factsandopinions.com (including for republishing.)

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People who commit ‘murder-suicide’ are extremely rare

Peter Kinderman, University of Liverpool  
March 30, 2015

It seems beyond doubt that the co-pilot of Germanwings flight 4U9525 made a conscious decision to destroy the plane and kill the passengers. As with all other “murder-suicides”, this is a psychological phenomenon that demands an explanation, and action to prevent future tragedies as far as that is possible.

But it’s not simple – and while it is entirely right to understand the psychological make-up of the young man who appears to have been responsible it’s not as simple as blaming “mental illness”, much less “depression”.

It is very rare indeed to be a victim of a murder-suicide event and in those rare circumstances where risk is associated with mental health, it’s almost always associated with the risk to the person with the mental health issue, whether from their own actions or from violence directed at them by other people. Murder-suicide events should be seen as related to a specific individual and their particular circumstances, rather than simplistically explained in terms of a person “having a mental illness”.

Of course these types of actions can each be very different. It can involve family members or those close to or known to the perpetrator – for example colleagues or classmates. Others might involve strangers and, in the case of Andreas Lubitz on the Germanwings flight, probably a mix of both. Some actions may be more detached than others, for example the use of a gun or in this case an action from a closed cockpit. Each tragedy is unique.

However we do know some things about why people violently attack others and then end their own lives. We know from the other (admittedly very rare) murder-suicide events, that these attacks are usually carried out by young men (young men are, in our society, much more likely to be aggressive), a sense of alienation and resentment against other people and society (often fuelled by very real prejudice and unjust social circumstances), a sense of disillusionment and hopelessness, and attraction towards notorious glamour – often, ironically, fuelled by the kinds of headlines that I and my colleagues in mental health resent. And of course ready access to lethal weapons.

Andreas Lubitz, co-pilot of the Germanwings aircraft downed in the French Alps. Photo: Andreas Lubitz Facebook profile.

Andreas Lubitz, co-pilot of the Germanwings aircraft downed in the French Alps. Photo: Andreas Lubitz Facebook profile.

Some of these emotions and belief systems are recognisably similar to the misery suffered by many millions of people who, of course, have no intention to harm themselves or others (even if they occasionally take a few days off work, seek professional help or even seek a medical solution). It’s disrespectful and discriminatory to suggest that, because people in these violent, alienated or resentful frames of mind have some similarities with people in more understandable distress, depressed people should not be allowed to fly passenger jets (as the Daily Mail and Piers Morgan have implied) or that “depression” or “mental illness” can somehow explain these events.

James Ogloff, a psychologist and the director of Swinburne University of Technology’s Centre for Forensic Behavioural Science, has said that those who commit murder-suicide “have more in common with a suicidal person than a murderer” – but we know of course that the vast majority of the more than 800,000 people who take their lives each year have no intention of taking other lives. Murder-suicide events suggest, then, people “particularly resentful and angry against society broadly, or against a particular organisation”.

In circumstances when these kinds of events do happen we need to be clear about how rare they are and create a culture whereby people struggling with mental health problems will feel comfortable with sharing those ideas with their friends, their relatives, their colleagues and their bosses.

In the US and in other countries, there have been instances of murder-suicide events in places such as schools. Last year Elliot Rodger killed six people and injured another 14 in Isla Vista, California before turning his gun on himself. Such actions affect the more than those directly involved, particularly the families of those who decide to kill others before themselves. 

Part of the enormously complex picture here is the ready accessibility of lethal weapons. That’s why America, with its culture of domestic gun-ownership, suffers disproportionately from these kinds of tragedies. In the Germanwings tragedy, it does appear at first sight that the co-pilot used his aircraft as a weapon (something we know is not impossible).

But it doesn’t really make sense to suggest that we would be protected if people with mental health problems were prevented from obtaining pilots’ licences. To proceed down that route seems impractical – we wouldn’t want to identify common and, in this context, irrelevant mental health issues (such as “depression”), since they are only tangentially related to this kind of behaviour. In any case, these are routinely screened for.

What we would have to do is identify young men with a sense of alienation and resentment against other people and society, a sense of disillusionment and hopelessness and the intention to kill others in a bid for notoriety. We should all be on our guard for such traits, though demonising people with mental health problems will not prevent this kind of event from happening.

So what should – what could – we do? I think we should encourage people to be open to their mental health and psychological well-being, and to seek help when necessary. We all share idiosyncrasies in our psychological make-up, and all of us experience problems from time-to-time which, when serious, get labelled as “mental health problems”. But these have nothing to do with the rare actions of mostly lone individuals.

Perhaps most importantly, we should also look to common-sense security precautions. Many airlines have introduced new security regulations to ensure that there are at least two members of the flight crew on the flight-desk at any one time. This is a perfectly reasonable response. It remains to be seen what else could have been done by the airline to prevent this terrible tragedy but there will no doubt be a close investigation and intelligent recommendations. These recommendations may well include calls for greater openness and acceptance of psychological issues and those mental health problems that are common to all of us.

Creative CommonsThe Conversation

This article was originally published on The Conversation. Read the original article.

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Gut bacteria linked to depression and brain health

Photo by Ryan Melaugh via Flickr, Creative Commons

The lives of the bacteria in our gut are intimately entwined with our immune, endocrine and nervous systems — and we are starting to understand how they affect the brain, writes Clio Korn. Photo by Ryan Melaugh via Flickr, Creative Commons Photo by Ryan Melaugh via Flickr, Creative Commons

By Clio Korn, University of Oxford
October 22, 2014

One of medicine’s greatest innovations in the 20th century was the development of antibiotics. It transformed our ability to combat disease. But medicine in the 21st century is rethinking its relationship with bacteria and concluding that, far from being uniformly bad for us, many of these organisms are actually essential for our health.

Nowhere is this more apparent than in the human gut, where the microbiome – the collection of bacteria living in the gastrointestinal tract – plays a complex and critical role in the health of its host. The microbiome interacts with and influences organ systems throughout the body, including, as research is revealing, the brain. This discovery has led to a surge of interest in potential gut-based treatments for neuropsychiatric disorders and a new class of studies investigating how the gut and its microbiome affect both healthy and diseased brains.

Research linking gut bacteria and brain health has sparked interest in new  treatments for neuropsychiatric disorders. Colour lithograph of a woman suffering melancholia, 1892, J. Williamson,via Wikimedia. Public domain.

Research linking gut bacteria and brain health has sparked interest in new treatments for neuropsychiatric disorders. Colour lithograph of a woman suffering melancholia, 1892, J. Williamson,via Wikimedia. Public domain.

The microbiome consists of a startlingly massive number of organisms. Nobody knows exactly how many or what type of microbes there might be in and on our bodies, but estimates suggest there may be anywhere from three to 100 times more bacteria in the gut than cells in the human body. The Human Microbiome Project, co-ordinated by the US National Institutes of Health (NIH), seeks to create a comprehensive database of the bacteria residing throughout the gastrointestinal tract and to catalogue their properties.

The lives of the bacteria in our gut are intimately entwined with our immune, endocrine and nervous systems. The relationship goes both ways: the microbiome influences the function of these systems, which in turn alter the activity and composition of the bacterial community. We are starting to unravel this complexity and gain insight into how gut bacteria interface with the rest of the body and, in particular, how they affect the brain.

The microbiome-immune system link is established early on. Over the first year of life, bacteria populate the gut, which is largely sterile at birth, and the developing immune system learns which bacteria to consider normal residents of the body and which to attack as invaders. This early learning sets the stage for later immune responses to fluctuations in the microbiome’s composition.

When a normally scarce strain becomes too abundant or a pathogenic species joins the community of gut bacteria, the resulting response by the immune system can have wide-reaching effects. Depression has been linked with elevated levels of such molecules in some individuals, suggesting that treatments that alter the composition of the microbiome could alleviate symptoms of this disorder.

Such an intervention could potentially be achieved using either prebiotics – substances that promote the growth of beneficial bacteria – or probiotics – live cultures of these bacteria. It is even possible that the microbiome could be manipulated by dietary changes.

In one experiment, researchers transplanted the human microbiome into germ-free mice (animals that have no gut bacteria) in order to study it in a controlled setting. They found that, simply by changing the carbohydrate and fat content of the mice’s food, they could alter basic cellular functions and gene expression in the microbiome.

Depression is not the only psychiatric disorder in which the microbiome may play a role. Research in rodents, as well as a few preliminary studies in humans, indicate that the state of our resident microbes is tied to our anxiety levels.

Germ-free mice, for example, appear to be less anxious than normal mice on behavioural tests of anxiety, whereas mice infected with pathogenic bacteria behave more anxiously. Interestingly, there seems to be a window during development when the presence of a microbiome leads to normal levels of anxiety in adulthood: germ-free mice that were exposed to microbiome bacteria at three weeks of age subsequently behaved like normal mice, whereas those exposed at ten weeks of age continued to be less anxious than normal animals. Like the data on microbiome-immune interactions, these findings highlight the critical role gut bacteria play early in life.

This research also reveals the complexity of the relationship between the microbiome and psychological state. Although the general trend is that fewer bacteria mean lower anxiety levels, it is not just the number but the identity of the bacterial species that determine how gut dynamics interact with mental state.

For example, adding beneficial bacteria through probiotic treatment may reduce elevated anxiety levels caused by inflammation and infection. A key factor in this relationship is stress and the way the body responds to it.

Researchers have shown that the presence or absence of microbes in young mice affects the sensitivity of the hypothalamic-pituitary-adrenal (HPA) axis – a key pathway in the body’s stress response system. The activity of the microbiome during development thus sways how we respond to future stressors and how much anxiety they cause us.

How do the bacteria in our gut wield such influence over our brains and bodies? The mechanisms of microbiome-host interactions appear to be as numerous and varied as the interactions themselves.

Gut microbes help break down food into its component parts, so the molecular building blocks available in the body depend in part on which bacteria are present to extract them. This can influence brain function by, for example, affecting the availability of molecules needed to make neurotransmitters.

Some gut bacteria can even alter neurotransmitter levels directly by converting glutamate – an excitatory transmitter – into GABA – an inhibitory brain chemical. And gut microbes, along with neighbouring intestinal cells, communicate with a branch of the nervous system called the enteric nervous system (ENS) whose neurons surround the entire gastrointestinal tract. This part of the nervous system is so sophisticated that many refer to it as the body’s second brain.

The study of microbiome-gut-brain interactions is still young, yet it is already spurring the development of new branches of medical research. At this rate, it is poised to become one of the most fascinating stories in neuroscience.

Creative Commons

Clio Korn blogs at http://neurobabble.co.uk.

This article was originally published on The Conversation. Read the original article.

 

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