Category: Psychology

Posts about psychological topics, experiments, and principles.

Facebook Suicide Prevention Initiative

12 March 2015 / Sinead

On February 25th, Facebook’s safety division announced an extension of their suicide prevention initiative. They describe the initiative as being based on work with suicide prevention organisations, clinical research, and lived experiences from mental health survivors.

From what I’ve seen so far, parts of this initiative seem beneficial, and useful for helping people through a bad night or self-destructive impulse. However, there are still some concerning areas, and there has already been at least one example of just how this initiative can be dealt with wrongly.

The Benefits

Firstly I’ll go through its helpful aspects. The idea of pointing out that the post suggests someone is upset or distressed could be effective. Receiving this message might be the shock that lets someone realise they are having difficulties beyond typical ups and downs, and so might encourage them to see what the offered help is.

From the other side, allowing people to send an anonymous “someone thinks you might be in trouble” message reduces one of the barriers people often have in talking about mental health issues. It starts the conversation in a low-risk way, without requiring the face-to-face questions that many people just don’t know how to carry out.

Facebook’s post showed some pictures of the support options. The support page offers the following message:

Treating Mental Health Issues: Definitions

20 February 2015 / Sinead

When talking about treating mental health issues, it’s important to look at what medical staff, researchers, and people with mental health issues consider to be successful treatment. As its a lot harder to measure and accurately define mental health symptoms than physical ones, it is harder to accurately judge treating them. To show what kind of terms are used when treating mental health conditions, I’m using some hypothetical case studies. Imagine that each of these patients has just been diagnosed as being in their first Major Depressive Episode, and this is their first mental health issue. Each patient starts with a score of 18 on the PHQ-9, representing moderately severe depression using that system, is treated with an antidepressant, and is followed up six months later.

Response

After a six-week course of medication, Patient A retakes the PHQ-9 and scores 14. Six months later, their score is 15. Because their score has stayed lower, Patient A has had a treatment response. Their diagnosis would not change. In a purely medical sense, this is progress. An academic study testing the effectiveness of patient A’s antidepressant would be happy with a 3-point response, and would consider this a successful response. However, the patient themselves won’t see it that way.

A score of 15 is still in the category of moderately severe depression. Their day-to-day feelings and experiences may not have changed in any meaningful way and, depending on what side-effects the medication had, they may not feel the treatment was worth having.

Diagnosing Mental Health Issues: What is Mental Health?

25 January 2015 / Sinead

There is currently more published information about mental health than ever before, and it has never been so easy to connect with experts, health workers and charities supporting mental health issues. Yet misinformation, stereotypes and stigma still exist, and often people still don’t know where to turn. The problem isn’t a lack of information, but in communicating what information we currently have, and what we need to have. One of the most basic pieces of information would be a clear description of exactly what people mean when they talk about mental health and mental health issues. Definitions are often expressed differently depending on who the target audience is; articles written for a general audience will often focus on a single problem or dysfunction, while medical articles get more of the complexity across. Here are some examples of different online resources, and their definitions.

Layman’s definitions

Mind: “problems that affect they way you think, feel, or behave”.
Wikipedia: a mental or behavioural pattern or anomaly that causes either suffering or an impaired ability to function in ordinary life (disability), and which is not a developmental or social norm.
BBC Science: symptoms that go beyond typical responses, and are severe enough to interfere with a person’s ability to function.

Diagnostic Manuals

Now for the big one, the DSM- IV. As you might expect, this is a comprehensive and rigid explanation:

A clinically significant behavioural or psychological syndrome or pattern that occurs in an individual and that is associated with present distress or disability or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom. [This] must not be merely an expectable and culturally sanctioned response to a particular event.
A manifestation of a behavioural, psychological, or biological dysfunction in the individual. Neither deviant behaviour (e.g., political, religious, or sexual) nor conflicts that are primarily between the individual and society are mental disorders unless the deviance or conflict is a symptom of a dysfunction in the individual, as described above.”

Breaking this down, the DSM requires a mental health condition to be a pattern of symptoms that cause suffering to the person, go beyond culturally normal experiences, and are caused by a biological or psychological difference in that person.

The ICD- 10 definition is a common research basis, striking a good balance between comprehension and simplicity. They define a mental illness as “a clinically recognizable set of symptoms or behaviours associated in most cases with distress and with interference with personal functions.”

From Illness to Wellness

Diagnosing Mental Health Issues: What is the DSM?

25 January 2015 / Sinead

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the official instruction book for diagnosing and treating mental health conditions in the US. It is used by psychiatrists, medical staff and academic researchers.

The DSM works based on the principle that psychological symptoms can be objectively classified and observed in the same way as physical symptoms, so psychiatric illness can be diagnosed and studied as medical illnesses. Emil Kraepelin, one of the first psychiatrists, pioneered this idea, which is why systems like the DSM are sometimes described as neo-Kraepelinian methods.

In Kraepelin’s time (1883), people were diagnosed haphazardly, based on their most obvious symptoms. Most doctors also believed in Unitary Psychosis, the idea that all symptoms of mental illness were variants of one overall illness. Kraepelin instead looked for syndromes – patterns and trajectories of symptoms. He wrote an encyclopaedia of psychiatry which contained case histories and trajectories of specific syndromes and also promoted his diagnostic system.