“Frames of Mind” is a weekly series on Maryland Morning with Sheilah Kast that examines the mental health issues in Maryland – from the challenges patients face everyday, to the people who care for them, to the people who try to figure out how psychiatry and society can support and help pay for the care they need.  Each Monday for the next several months we’ll look at some particular aspect of mental health, and speak with people who know about it – often from the inside – and people with some answers.   We call this series “Frames of Mind,” because we hope it helps us look inside, understand better how the human mind works – and open up new attitudes toward mental illness. Week 1: Mental Health First Aid Week 2: Insurance Parity for the Mentally Ill Week 3: The Ghost in the House Week 4: Whatever It Takes Week 5: Coming Home with the War Week 6: The Hispanic Clinic Week 7: Déjà Vu, and the Meaningful Mistake Week 8: Prozac and Placebo Week 9: The Misdiagnosis of Alzheimer’s Disease Week 10: A Short History of Sex Therapy Week 11: Age and Happiness Week 12: Using Acupuncture to Treat Substance Abuse Week 13: Psychiatric Care, in the Crowded ER Week 1: Mental Health First Aid January 28th, 2008 The likelihood of encountering a stranger, friend, or family member with a mental health problem is higher than encountering someone undergoing cardiac arrest – yet there remains a large knowledge gap in the public consciousness on what mental health disorders are, and how to seek help and treatment. To address that, Maryland is implementing a mental-health first-aid program first developed in Australia, by Betty Kitchener, Director of the Mental Health First Aid Program in Australia, and Dr. Tony Jorm, Professor at the University of Melbourne. Together, they explain why the program was developed and the possibilities in an introductory course on mental health, akin to traditional, somatic first aid care. Sheilah interviews Maryland Secretary of Health and Mental Hygiene, John M. Colmers, on the program that he’s introduced to the United States from Australia. External Links: Maryland Department of Health and Mental Hygiene Mental Health First Aid Week 2, Insurance Parity for the Mentally Ill February 4th, 2008   Cindy Thomas and her family in Phoenix, MD, has faced continual challenges over the years in providing care for each of her three sons with severe mental illness. Her stepson Patrick, is on Medicaid, while her other two sons, Jordan and Zachary, are enrolled in her private insurance plan. The difference between the public and private insurance system is significant enough that if it were not for the college savings plans she holds for her son, all three would be enrolled in Medicaid.   Maryland currently has a mental health parity law that affects less than a third of its residents. The law does not apply to multi-state employers. The U.S. Congress is currently considering a bill that would expand current mental health parity laws to cover treatments for mental illness comparable to how other medical and surgical procedures are covered. Sheilah speaks with Dr. Howard Goldman, Professor of Psychiatry at the University of Maryland School of Medicine. He has studied the issue of parity as it has affected more than 8 million employees under the Federal Employees Health Benefits Plan, and shares his findings on just how much it would cost the U.S. government to legislate a mental health parity law for the private insurance industry.   External Links: The Senator Paul Wellstone Mental Health Equitable Treatment Act (S 558, HR 1424) Week 3, The Ghost in the House February 11th, 2008 Sheilah speaks with Dr. Jennifer Payne, Assistant Professor and Co-Director of the Women’s Mood Disorder Consultation Clinic at the Johns Hopkins School of Medicine; and Tracy Thompson, author of “The Ghost in the House,” and has lived with clinical depression throughout her life. External Links: Johns Hopkins Mood Disorders Program The Ghost in the House (Harper Collins, July 2007) Week 4: Whatever It Takes February 18th, 2008 This week on Frames of Mind, we explore a state-run community program called "The Baltimore Capitation Project," that wraps around all facets of a patient’s life – for those who suffer from chronic, mental illness. The program is an intensive, community-based treatment model that adopts a philosophy of doing "whatever it takes," to keep chronically, mentally ill, out of the hospital. Sheilah narrates the stories of some of the patients in the program, and interviews Lisa Abrams, Director of the Office of Adult Services from the Maryland Mental Hygiene Administration, about the future of the program. External Link: The Baltimore Capitation Project Week 5: Coming Home with the War February 25th, 2008 This week, we explore at set of therapies used to treat post-traumatic stress disorder; among them, the use of Virtual Reality Therapy. The technique, which involves a virtual simulation of combat situations in Iraq, may be used for proportion of patients at the Baltimore VA Medical Center, later this year. Sheilah speaks with Dr. Sonja Batten, Coordinator of the Trauma Recovery Programs for the VA Maryland Health Care System, and Dr. J. Raymond DePaulo, Chairman of the Department of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine. External Links: Baltimore VA Medical Center Department of Psychiatry and Behavioral Sciences (Johns Hopkins University School of Medicine) Institute for Creative Technologies at USC Week 6: The Hispanic Clinic March 3rd, 2008 Latino immigrants constitute the fastest growing ethnic group in Maryland – and the challenge of readjusting to life in the U.S., requires new connections to professional, educational, and healthcare resources. Sheilah speaks with Dr. Larry Wissow, a psychiatrist at the Hispanic Clinic at its location in the Hispanic Apostolate of Fell’s Point. The center provides legal, medical, and other professional services for immigrants settling in Baltimore. External Links: The Hispanic Clinic Hispanic Apostolate Week 7: Déjà Vu, and the Meaningful Mistake March 10th, 2008 Every once in a while, a sudden sense of familiarity with a place will strike, in an experience that many people refer to as "déjà vu." Sheilah and her guests explore the mystery of human learning and memory – and expound on two possibilities – of the déjà vu experience as being a fluke of memory; but also how the phenomenon relates to other moments in the human experience. She is joined by Arnold Bakker, a graduate student at the Johns Hopkins University Department of Psychological and Brain Sciences, who has a forthcoming publication on memory in Science; and Simone Campbell-Scott, a licensed clinical social worker and certified Jungian analyst who practices in Baltimore. External Links: Craig Stark Memory Lab – Johns Hopkins, UC Irvine National Institutes of Health - Memory Week 8: Prozac and Placebo March 17th, 2008 A recent study published by Irving Kirsch from the University of Hull (UK) and colleagues found that the overall clinical efficacy of four antidepressants, including Prozac and Paxil, are not significantly better than the performance of placebo across all clinical trial data available through the U.S. Food and Drug Administration. Sheilah is joined by Dr. J. Raymond DePaulo, Chairman of Psychiatry at the Johns Hopkins School of Medicine, and Dr. Hinda Dubin, Clinical Assistant Professor of Psychiatry at the University of Maryland School of Medicine. Together, they explore questions around the efficacy of antidepressants, as well as the role of placebo in medical practice. The researchers combined all data available at the FDA through a Freedom of Information Act Request, for the following medications: Prozac (generic: fluoxetine), by Eli Lilly Efexor (generic: venlafaxine), by Wyeth Pharmaceuticals Serzone (generic: nefazodone), by Bristol Meyers-Squibb Seroxat (generic: paroxetine), by GlaxoSmithKline External Links: Irving Kirsch’s study: “Initial Severity and Antidepressant Benefits” (February 2008, PLoS Medicine) Prozac and Placebos: Review of the Media Maelstrom (PLos Medicine, March 6, 2008) Week 9: The Misdiagnosis of Alzheimer’s Disease March 21st, 2008 The Alzheimer’s Association published a report recently that up to 10 million baby boomers may be diagnosed with Alzheimer’s disease in their lifetime – double what the current estimates are, at 4.5 million. But how many of those actually have Alzheimer’s disease? Up to a third of patients diagnosed with Alzheimer’s disease may be suffering from medically-induced dementia, according to a wealth of studies reviewed by Dr. Thomas Krajewski, Associate Professor of Psychiatry at the University of Maryland, and former Chief Physician for the Maryland Department of Health and Mental Hygiene. He explains why so many cases of dementia are misdiagnosed as Alzheimer’s Disease – and shares some of his advice to patients and families.   External Link: Elder Interventions: A Guide to Caring for the Elderly with Emotional and Behavioral Problems (Authorhouse Books) Geriatric Advisory Program Alzheimer’s Association Week 10: A Short History of Sex Therapy March 28th, 2008 Tom Hall speaks with two octogenarian sex therapists: Lois Blum Feinblatt, and Ellen Halle, about their work at the Johns Hopkins Sexual Behaviors Consultation Unit, and how they began their careers as homemakers in the 1970’s. Together, they discuss a short history of sexual therapy in the past forty years – and what the culture of psychotherapy training was like for these two women, alongside medical residents, many years ago. External Links: Johns Hopkins Sexual Behaviors Consultation Unit Week 11: Age and Happiness April 7th, 2008 Do older people think of themselves as any more or less happy when they were younger? Sheilah explores the subject of happiness, and finding meaning, in the process of aging --- and the way sociocultural norms often are at odds with the way the elderly come to terms with self-identity, and fulfillment. External Links: Mental Wellness in Aging Judah Ronch at the Erickson School Week 12: Using Acupuncture to Treat Substance Abuse April 14th, 2008 About one in eight Baltimore City residents is dependent on alcohol, heroin, or cocaine – and of the 80,000 people arrested by Baltimore City police each year, 70% test positive for drugs. Acupuncture is one of the many tools that Baltimore City Drug Treatment Courts use, as a referral for rehabilitation. Maryland Morning Producer Jennifer Chang visited the Penn North Neighborhood Center, which provides acupuncture in conjunction with counseling, for its outpatient substance abuse treatment.   External Links: Tai Sophia Institute Week 13: Psychiatric Care, in the Crowded ER April 21, 2008 For psychiatric patients facing acute mental distress, or at risk for suicide, the environment of an emergency department adds another dimension to the experience of being a patient. Howard County General Hospital recently constructed a separate emergency, psychiatric unit to its emergency department --- and on a state level, policy makers are wrestling with a way to confront and address better, less costlier, ways of treating psychiatric emergencies. Sheilah speaks with Dr. Joseph Schwartz, Clinical Director of Psychiatry at Howard County General Hospital; and Laura Cain, Managing Attorney at the Maryland Disability Law Center. External Links Howard County General Hospital Maryland Disability Law Center Week 14: Schizophrenia, and the Shortened Life April 28th, 2008 Why is it that schizophrenics live an average of 15 years shorter than the general population? Sheilah interviews Dr. Robert Buchanan, professor of psychiatry and Chief of the Outpatient Research Program at the Maryland Psychiatric Research Center in Catonsville, MD, about his work in schizophrenia research and the complications with weight, cardiac disease, and diabetes, that current medications for schizophrenia pose patients. External Link Maryland Psychiatric Research Center Week 15: Crownsville State Hospital May 5th, 2008 What was it like to be an African-American patient in the decades before hospitals desegregated? Sheilah interviews historian Janice Hayes-Williams, who has investigated some of the story of Crownsville State Hospital, and Paul Lurz, a former employee at Crownsville State Hospital, and unofficial historian of the facility. External Links Maryland State Archives – Crownsville State Hospital records - Maryland State Lunacy Commission Crownsville Hospital Center (Wikipedia Entry authored by Paul Lurz) Week 16: A Shared Grief May 12th, 2008 What happens in the long weeks and years after the death of a loved one, is often thought of as an intensely personal experience – marked by personal memories, and private pain. What happens when that pain is shared – with the community, or with the public, years after death? Kathleen Kennedy Townsend talks about her shared grief, after the loss of her father and her uncle. Sheilah is also joined by bereavement counselor Carla Jackson, who works at the Gilchrist Hospice Center at GBMC – and how she helps to normalize the emotions of guilt, anger, and grief following the loss of a loved one. Kathleen Kennedy Townsend will speak at the 10th annual Irvin B. Levinson Memorial Lecture on Wednesday, May 14th, at 6 p.m. at the Sol Levinson and Bros Funeral Home in Pikesville, MD. The lecture is free and open to the public. 8900 Reisterstown Road, Pikesville, Maryland, 21208. 410-653-8900 External Links: Levinson Lecture Series  Gilchrist Hospice Care at GBMC "Frames of Mind" is generously supported by a grant from The Jacob and Hilda Blaustein Foundation.