Mental Illness, The Final Frontier

You may remember A Time to Kill, a 1996 movie from a John Grisham novel about a lawyer who took on a racist town. He defended a black man accused of murdering two white men after they raped his young daughter.

But the high drama came at the end -- easily the peak of Matthew McConaughey's acting career -- when he faced the white jurors and asked them to dream a dream.

Imagine a girl, he told them, who was stripped of everything short of her life. This girl could never have children of her own. She was urinated on, then tossed into a creek and "left to die," he said.

"Can you see her?" he asked the hushed jury. "Can you see her?"

"Now imagine she's white...."

Some jurors gasped; others picked their heads up, their eyes bulging. A few looked so appalled, they wept.

One could assume they looked in the mirror, and saw something in themselves that they hated: Racism, separatism, classism. They displayed a sense of generosity that, we hope, they gained while growing up and trying to cope with life in the post-civil-rights era of South. They determined that the black man, Carl Lee Hailey, was innocent.

Sure, it was only a movie. But it was symbolic of a South that's changing. A majority of conservatives, liberals and moderates now appear to share the belief that racism is wrong, even if they continue to display behavior that has a racist subtext. Those who publicly declare themselves racists - proud of it, in fact - are now the fringe. They're the radicals, the minority and, ultimately, the ones whom mainstream society is now tossing into the creek.

Carl Lee Hailey's case isn't unique; octogenarian men who conspired in some of the heinous racist crimes of the 1950s and 1960s are now being brought to justice. Advocacy groups are using DNA testing to prove that men -- particularly black men -- were wrongly convicted of murder and other crimes.

Now African-Americans and Latino-Americans are elected to high offices in the once off-limits states of Mississippi and Georgia. Though their ideology may promote classism and separatism, even conservative pundits are quick to cry "racism" if even one of their own crosses the line.

And it's not just racism, but prejudice of any kind that's changing. Comedians who mocked homosexuality, ethnic groups and races -- particularly by mangling accents and using profane language such as the n-word -- have toned down their acts. Remember the movie "48 Hours," and how the Nick Nolte character used the n-word as often as he said "what?" Years ago, the T.V. version didn't edit the n-word. Now, on TNT, you won't hear it at all -- not even once.

America still has a long way to go, but it's grown to accept diversity. America's growth, however, has never been all-inclusive. Perhaps the final frontier of conquering prejudice -- and finding some happy medium between mainstream acceptance and political correctness -- is the legitimization of mental illness.

If the path to racial equality can be measured in, say, thousands of miles, then the distance toward achieving some mainstream mutual understanding and feeling of compassion for people with mental illness must be measured in light years.

Even in this age of political correctness, terms that the mental health community considers offensive (much like the black community considers the n-word to be offensive) are still being tossed around, and they're as much a part of the fabric of society as brushing your teeth and going to bed. Some in the media never seem to even pause before blasting the word "Psycho" or "Wacko Jacko" in a headline.

Hollywood has shown progress, with movies such as Good Will Hunting and, more recently, Matchstick Men garnering praise from mental health advocates and professionals for portraying mental illness in a sensitive and intelligent way.

But for every Good Will Hunting is a Me, Myself and Irene in which Jim Carrey portrays schizophrenia or multiple personality disorder (hard to tell what he's trying to portray, actually) in a manner that's as silly and stupid as a Gilligan's Island reunion T.V. movie.

The rise of punditry, particularly on the cable news channels, has only made things worse. Media Matters is quick to jump on Don Imus for saying "nappy-headed hos" to describe the Rutgers University basketball team. But how many times has Media Matters done a You Tube search, inserted the terms "loon" and witnessed the seemingly endless list of items from T.V. news shows, each filled with some form of questionable speech?

Well, I've already done the search, so don't bother. Eighty-one items in all. Not all of them were videos of talk-show hosts using the word, but fans were quick to point out that the featured guests in each video were of the "far-left loon" variety (would You Tube change the description if they wrote the n-word instead? Just asking) who deserved the abuse they were getting.

I was inspired initially when I watched "The O'Reilly Factor" a year ago and saw Bill berate Sunsara Taylor from the anti-war group "World Can't Wait" because of her group's loud, rude protests regarding Iraq.

TAYLOR: Because of the U.S. occupation of Iraq, hundreds of thousands of Iraqi people's lives have been destroyed, people have been killed, torture has been committed and legalized

O'REILLY: OK, but look...

TAYLOR: These things are not being discussed the way they should.

O'REILLY: Miss Taylor, that's your opinion, OK, and you're entitled under the Constitution to your opinion.

TAYLOR: Those are the facts.

O'REILLY: No, they're not facts. You are a loon. You are a lunatic. And if you weren't a lunatic, 90 percent of America would agree with you.

It's no wonder Congress or various state legislatures have failed to approve mental health parity health care coverage when society -- as well as those who act as spokespeople for it -- refuses to take schizophrenia, bipolar disorder, obsessive compulsive disorder, bulimia and other illnesses seriously. A poor woman suffering from postpartum depression has a better chance of getting hospital attention -- or, at the very least, health coverage -- if she breaks her arm.

Now, just for a second, imagine if she were white...

This story originally appeared on The Huffington Post on May 29, 2008.

Childhood sex abuse shows link to bulimia

Childhood sex abuse can have long lasting unpredictable effects. Now add bulimia to the list of surprises.

A new study headed by Lena Sanci, a senior lecturer in general practice at the University of Melbourne in Australia, suggests that bulimia is just as likely to result from abuse as any other mental illness. Results were published in the March Archives of Pediatrics and Adolescent Medicine.

Sex abuse already has destroyed young people psychologically and rendered them vulnerable to a spate of mental illnesses — such as alcohol abuse, depression, drug abuse, panic disorder, post-traumatic stress disorder and suicide attempts, according to writer Joan Arehart-Treichel.

Sanci and her coworkers randomly selected some 1,000 female students from 44 public, Catholic or private schools to participate in their study, according to Arehart-Treichel. They followed their subjects until they were young adults to see whether they developed bulimia nervosa or anorexia nervosa.

Thirty-five were found to have acquired bulimia and 32 anorexia during that age span, said Arehart-Treichel.

At age 24, the subjects were asked certain questions to determine whether they had experienced sexual abuse before age 16, she said.

"We measured childhood sexual abuse in adulthood because our state has a statutory requirement to report all abuse in children younger than 17 years to government services," Sanci and her coworkers explained in their study report.

Ninety-six of the subjects reported one episode of sexual abuse, and 70 reported two or more episodes, according to Arehart-Treichel. The researchers then looked to see whether there were any links between subjects' retrospective reports of having been abused sexually as a child and their later developing bulimia or anorexia.

During this analysis, subjects' background differences — such as their parents' educational levels and whether their parents were divorced — were considered, said Arehart-Treichel.

Sanci and her colleagues found no link between reports of having been sexually abused in childhood and developing anorexia, but they did find a link with bulimia, said Arehart-Treichel. Compared with subjects who had experienced no childhood sexual abuse, the incidence of bulimia was three times higher among those who reported one episode and five times higher among those who reported two or more episodes.

Thus, "childhood sexual abuse seems to be a risk factor for the development of bulimic syndromes, not necessarily mediated by psychiatric morbidity or severe dieting," Sanci and her group concluded in their report.

Their findings largely jive with those obtained by other investigators, they pointed out. In four different studies, investigators were able to link childhood sexual abuse with both bulimia and anorexia, but the links they found were much stronger for bulimia, said Arehart-Treichel.

"I was surprised that we found such a clear association between childhood sexual abuse and bulimia symptoms, as there has been so much controversy in the past [about whether such a connection exists]," Sanci told Psychiatric News.

"This paper takes us a step further in confirming suspicions that clinicians have long had that childhood sexual abuse is common in young women with bulimia," George Patton, a professor of psychiatry at the University of Melbourne and senior investigator of the study, added.

"The paper [also] takes us a step further by suggesting that sexual abuse may initiate a pattern of dealing with emotional distress that brings a high likelihood of bulimia. Young bulimics share both emotional secrecy and profound guilt with many victims of sexual abuse. It is possible that for some patients, this emotional style begins with the abusive experience. This psychological style may be an important focus for psychotherapy."

The study was funded by the Australian National Health and Medical Research Council, the Australian Center for Excellence in Eating Disorders and a research grant from the Australian National Depression Initiative, said Arehart-Treichel.

MAD about pride - but how crazy is that?

The new MAD pride drive is gaining momentum - and publicity. But it's also drawing criticism and concerns from the mental health professionals who view it as nothing more than false hope.

At issue is a recent New York Times article that focuses on blogger and columnist Liz Spikol, who appeared in a You Tube video smiling and animated, "the light glinting off her large hoop earrings."

"Deadpan, she holds up a diaper," the article said. "It is not, she explains, a hygienic item for a giantess, but rather a prop to illustrate how much control people lose when they undergo electroconvulsive therapy, or ECT, as she did 12 years ago."

According to the Times, Spikol is speaking candidly and publicly about her issues in a way that shows how her conditions do not preclude them from productive lives. Like many advocates, she's not afraid to call herself "mad," the Times said - to the point where people are using the term to promote their cause

The article then talks about "Mad Pride" events, organized by loosely connected groups in at least seven countries including Australia, South Africa and the United States, that draw thousands of participants. Recent activities include a Mad Pride Cabaret in Vancouver, British Columbia; a Mad Pride March in Accra, Ghana; and a Bonkersfest in London that drew 3,000 participants, the Time said.

But when author Paul Raeburn reads about the movement, he stumbles over the very first word, mostly because of it's attachment to stigma.

"Mad," he said, makes him "squirm."

"I understand the idea of co-opting pejorative words, but, geez. I just don't like it," he said. "Queer was co-opted a long time ago, as was the n-word, but those make me squirm, too."

Raeburn also asked if people should be proud of their illnesses.
"Would somebody be proud to be wasting away with breast cancer?" he said. "Proud to be wheezing with emphysema? Proud to be psychotic, or manic, or depressed?"

"To me, the idea of mad pride harks back to the old R.D. Laing notion that madness is some kind of gift of awareness, or it's the "mad" people who see the truth and the so-called "normal" people who are mad," he said.

"Or something - ick."

The changing face of homelessness

By LISA BIAGIOTTI
and TOM DAVIS
NYC24.com

[For an interactive web version of this story, click here.]

Growing up, Joe Wallinger had a distinct image of homelessness: drunks shuffling through the Staten Island Ferry Terminal begging for money and turning benches into beds.

But that image changed in 2005. Wallinger, a 56-year-old accountant and former resident of Tottenville in Staten Island, N.Y., now counts himself among the homeless.

Homelessness now hides behind shelter doors, walks in designer clothes and carries cell phones. Many homeless people are working-class, college graduates, parents or the elderly, according to Project Hospitality, a private nonprofit organization that operates Staten Island's homeless shelters and many food assistance programs.

Homelessness has blended into communities that still hold on to the image of the drunken or mentally ill nesting in the ferry terminal and don't "see" the new image.

Dennis Dell'Angelo, longtime resident of southern Staten Island, said homeless advocates and city officials manipulate the image of homelessness so they can justify expanding their services.

"If all the city agencies say we have a rise in the homeless, then the people who have facilities that deal with this will build them," said Dell'Angelo, 64, president of the Pleasant Plains/Princes' Bay/Richmond Valley Civic Association, a neighborhood watchdog group.

Staten Island, as a microcosm

But Staten Island now has the second-highest percentage of homelessness in the New York City, and the number of people seeking shelter has doubled since 2001. Fewer homeless people are living on the streets, but approximately 311 people crowd into Staten Island’s seven emergency shelters every night and wait in long lines for soup kitchens and food pantries.

"We've had people come in who've had condos and because they lost their job, they lost their condo and all their means of income," said Mamie E. Daniels, 76, who has run a soup kitchen at the Stapleton Church on the island since 1987. "Before you knew it, they're in a shelter."

Contrary to the worn image of chronic homelessness, today many people are either close to finding a home, or on the verge of losing one.

Almost 62,000 Staten Islanders eat at emergency food programs--up 300 percent since 2004, according to Hunger Safety Net 2007, a report produced by the Food Bank for New York City.

People gather outside the Stapleton Church Soup Kitchen at 3 p.m. on Mondays and Fridays for a prayer before mealtime.

Staten Island's nine soup kitchens serve 4.8 million meals a year. Lines for the island's 30 food pantries wind down church steps, and still, 70 percent of these food pantries and soup kitchens run out of food.

"The food pantry or soup kitchen is the last step of desperation," said the Rev. Will Nichols, director of Project Hospitality's communications and community outreach. "People who are coming here are homeless next."

It's not always obvious who is homeless unless they are walking into the Central Avenue “drop-in” center.

On a near-freezing April night, men and women wearing dark-blue Levi's, velour jumpsuits and sports jerseys signed-in to the center as "clients," before sitting upright in plastic-covered chairs. They covered themselves with thin, white blankets.

The city rejected Project Hospitality’s application for a permit to convert the facility into a full-scale, sleep-away shelter under pressure from local officials and residents.

Cassidy Mojica, a 9-year-old Staten Islander, knows about homelessness: Her cousin can't find a shelter.

Wallinger, an accountant with 72 credits toward his master's at Baruch College, calls the Central Avenue shelter home.

Wallinger left his apartment three years ago when he couldn’t feed himself, pay his rent and the $440 a month he owed in child support.

"This is what I have to do to make a living," said Wallinger, who lost his accounting job less than a year ago.

Wallinger was clean-shaven and wore an "Izod" brand pull-over and a clean pair of jeans when he fell into his "bed" -- a chair that resembled an airplane seat. He closed his eyes behind wire-framed glasses.

At 11 p.m., the lights went out and the cell phones popped open, glowing and bleeping amid the chatter of the dark room.

[Editors note: The writers put together this story as part of an interactive web magazine, NYC24.com, that's affiliated with Columbia University].

Counting my chickens after they hatched

The chickens came home to roost last week.

The perils of doing grad school and two jobs at the same time came crumbling down on me like a Colorado avalanche.

There wasn't any long-term damage to report, actually. But there were several embarrassing episodes that made me question: Is this all worth it?

I am doing the classic journalism juggling act: I work full-time at The Record of Bergen County, N.J. I'm a part-time adjunct professor at Rutgers University. I am a part-time graduate school student at Columbia University. I am a dad full- and part-time.

And that's only half my workload.

On Thursday, I showed up at my Rutgers teaching job 10 minutes late, wearing the same clothes I wore the day before (and they weren't very professor-like) and smelling like Andy Dufresne after he crawled through that sewer pipe in "The Shawshank Redemption." I had just spent much of the previous 48 hours working on a final project at Columbia, with no sleep.

My class chuckled intermittently as I tried to explain away the previous 48 hours. The crowning blow came when I asked one student, "What do you plan to write about for your final assignment?"

"I don't have any idea," he said.

"I don't have any idea" was what I wrote on the board. Then came another laugh. It was a lighthearted moment, and I tried to play along.

But, inside, I felt empty. I felt like I just wasted a whole semester teaching 19 people how to write. Is this how they all feel? I thought.

Luckily, the next student I called on had an answer, and we moved on. But when they left at the end of the period, I felt sick and ready to collapse. All the adrenaline left my body, and left me feeling lifeless and bloodless.

I recovered soon enough, so I could go to work. Once I got there, however, my boss had some unpleasant news: I missed a story that appeared on the web involving a PATH accident near Newark.

My ever-supportive boss was not happy. And rightly so. What's interesting is that I was harder on myself than he was on me. "Don't worry about it," he said, over and over. But the sick feeling just got worse. I knew I could do better, and I didn't.

Then came Sunday. Place: Metuchen Little League field. Event: My 6-year-old's game at the town's elite field. Their names would be announced on the P.A. system. They would be given the complete major league treatment: National Anthem, dugouts, nicknames, a snack bar.

I was the manager, and I wasn't prepared for any of it. I scrambled throughout the game, carrying a piece of paper from my pocket. I wrote down the names of my players, accompanied by their favorite foods ("pizza" was the overwelming choice) and their favorite players. I continually forgot the line-up, and repeatedly sent players to the batter's box even though they were out-of-order.

I could hear one of the other coaches snicker. "He's gotta be better prepared for these games..." At the end of the game, my legs again felt lifeless.

This weekend, You Tube saved me.

Out of the ashes was my below appearance at the Metuchen Third and Fourth Grade Talent Show. It was an event that had me worried the least. But after the embarrassing of the events of the weekend, my fear-level hit an all-time high as I thought of appearing sleep-deprived, ego-blown and pale before 1,000 people.

Somehow, however, everything came together. When stressed, crawl out of your egg shell and remember your inner kid.