#mentalhealth

Thank the progressive left for this

Image may contain: one or more people

Top marks to the progressive left for generating so much horsesh*t that allows this type of behaviour. If you need an emotional support anything outside of a blanket, you probably shouldn’t be flying. What if CM wanted to bring an emotional support elephant? Why are my rights not equally respected? Supporting mental health is one thing. Caving to the preposterous is another.

One has to wonder whether this violates FAA rules as regards airline safety in an emergency. Will airlines have to retrofit all fleets with horse-sized life jackets?

Mental Illness = Gun Violence?

As ever, the mainstream media are sensationalizing “mental health” and the connection to gun massacres. Let’s not forget that mental health can be categorized in a broad variety of ways – from mild anxiety, ADHD to PTSD and full blown bi-polar or schizophrenia. The mainstream media would have us believe that Trump wants the keys to the gun cabinet handed over to certified crackpots to go on white supremacist fueled mass rampages. It is easy to say that those who commit these atrocities must be mad. How easy is it to fall for that assumption? Yet the stats say otherwise.

First, what is this bill that has been repealed by Trump? Why is the media making such clickbait hyperventilating news of something that was already enacted c.2 years ago?

The previous Obama bill allowed gun retailers to get access to “mental health” related social security benefits paid to potential buyers. There are nine categories of mental disorders covered in the Social Security Blue Book. These include:

Affective disorders

Anxiety Disorders

Autism and related disorders

Mental retardation

Organic Mental Disorders

Personality disorders

Schizophrenia, paranoia, and psychotic disorders

Somatoform disorders

Substance addiction

The idea is that if one had claustrophobia or similar mild anxiety, it would be unlikely to be a factor in causing someone to shoot up a Walmart. In order to get mental health disability checks, the applicant must prove compliance to prescribed medication and that they seek regular treatment from professionals. Why do we automatically assume that mental health status is a direct trigger to mass murder? Simply because it is easy to categorize these events to unhinged crazies and presume that there was ‘illness’ involved.

A study conducted by the National Institute of Health (NIH) in America showed,

Thirty-four subjects, acting alone or in pairs, committed 27 mass murders between 1958 and 1999. The sample consisted of males with a median age of 17. 70% were described as a loner. 61.5% had problems with substance abuse. 48% had preoccupations with weapons. 43.5% had been victims of bullying. Although 23% had a documented psychiatric history, only 6% were judged to have been psychotic at the time of the mass murder. Depressive symptoms and historical antisocial behaviors were predominant. There was a precipitating event in most cases–usually a perceived failure in love or school–and most subjects made threatening statements regarding the mass murder to third parties. The majority of the sample clustered into three types: the family annihilator, the classroom avenger, and the criminal opportunist.”

Recall Cuban Parkland, Florida student Emma Gonzalez admitted she’d bullied the shooter Nikolas Cruz. It doesn’t excuse his actions. Nor hers.

Take cyber bullying stats from the Association of Psychological Science in the US. In 2015 more than 16,000 young people were absent from school daily because of bullying. 83% of young people say cyber bullying has a negative impact on their self-esteem. 30% of young people have gone on to self-harm as a result of cyberbullying. 10% of young people have attempted to commit suicide as a result of cyberbullying.

So the stats tell us in 3 out of 4 cases, mental illness was not the culprit in mass shootings. A violent/bullying, substance abuse based environment was.

As mentioned in the previous post, how is it we can find out about the history of shooters within hours of the terror? Surely the powers at the FBI, NSA etc can monitor the traffic of hate – death lists, death threats etc and use that as the basis of background checks rather than rely on whether someone received mental health related disability cheques? Perhaps someone who is fully healed from a mental illness as a child poses no threat if wanting to hunt or fire at a supervised gun range. Perhaps that individual wants to be a security guard?

Dr Jeffrey Swanson, a professor in psychiatry and behavioral science at the Duke University School of Medicine believes that in the event of unlawful use of a firearm by those with mental illness, 95% likely to turn the weapon on themselves than commit homicide.

He also believes that those who are violent or been charged with assault make far better predictors of homicidal behavior than the outcome of a mental health diagnosis.

In Connecticut, almost 23,300 people were diagnosed with a history of serious mental illness. 7% were disqualified from owning a gun because of that mental record. 35% were banned based on a disqualifying criminal record that wasn’t necessarily linked to the mental illness.

Dr. Swanson closed with,

We need to think of violence itself as a communicable disease. We have kids growing up exposed to terrible trauma. We did a study some years ago, looking at [violence risk] among people with serious mental illness. The three risk factors we found were most important: first, a history of violent victimization early in life, second, substance abuse, and the third is exposure to violence in the environment around you. People who had none of those risk factors ― even with bipolar disorder and schizophrenia ― had very low rates of violent behavior…Abuse, violence in the environment around you ― those are the kinds of things you’re not going to solve by having someone take a mood stabilizer.”

Sadly such is the state of lazy journalism that ‘respected media outlets’ simply infer that those that commit mass murder are simply head cases and giving them access to guns will somehow create a bigger problem. That’s how the mainstream media is portraying a 2-yr old bill to whip up more misunderstanding.

NZ Wellbeing Budget? Kiwis still better off in Australia

Image result for wellbeing budget nz

NZ PM Jacinda Ardern’s Wellness Budget is receiving lots of accolades. A true leader! Champagne socialist Sir Richard Branson also praised her saying other countries should take note. The idea that a budget should be solely based on economics is not progressive and more should be directed at “well-being”. That is not to say this budget is not “well-intentioned”. However, the statistics compared to across the ditch do not fare well on relative terms.

Comparing her newest policies versus Australia reveals the kangaroos get better access to social services than the kiwis. How surprising that none of the mainstream media bothered to look at the budget numbers on a like for like basis? Just praise her because she represents their ideal version of a socialist leader.  CM has looked through both budgets and adjusted for currency to make for easier like-for-like comparisons.

When it comes to health spending per capita (currency adjusted), Australia is expected to climb from A$3,324 in 2019 to A$3,568 in 2022. NZ is expected to go up slightly from A$3,516 to A$3,561 respectively.

On social security and welfare, Australia is expected to pay out A$7,322 per capita in 2019, growing to A$7,977. NZ, on the other hand, is forecast to go from A$5,573 per head to A$6,489.

On mental health, Australia forked out around A$9.1bn exclusively on these services reaching 4.2m citizens last year. NZ is planning on spending A$45.1m in 2019 with a total of A$428m by 2023/24 to hit 325,000 people on frontline services for mental health. While the move is a positive one, NZ will allocate A$1.78bn to mental health as a whole over 5 years. On an annualised basis, Australia will still allocate 5x the NZ amount to mental health per capita. So much for wellbeing.

On education, NZ plans to increase per capita spending 7.9% between 2019 and 2022 whereas Australia will lift it 12.5% over the same period. NZ spends around 2x Australia per capita on education although PISA scores between 2006 and 2015 are virtually identical (and both heading south)

On public housing, Ardern can claim a victory. Australia is expected to cut spending per capita from A$240 in 2019 to A$194 in 2022 when NZ will go from A$137 to A$282. Although let’s hope Ardern has more success than her KiwiBuild policy. The Australian’s Judith Sloan rightly pointed out,

“Ardern also has stumbled with other policies, most notably KiwiBuild. The pledge was to build 100,000 additional affordable homes by 2028.

It has since been modified to facili­tation by the government to help build new homes. Moreover, the definition of afford­ability has been altered from between $NZ350,000 ($340,000) and $NZ450,000 to $NZ650,000.

What started off as an ill-considered public housing project has turned out to be an extremely unsuccessful private real estate scam. The government estimated that there would be 1000 homes built last year under KiwiBuild; it turned out to be 47.”

In the process, NZ’s national debt per capita will grow from A$21,550 in 2019 to A$25,206 by 2022. Australia will climb from A$22,764 to A$23,293.

Look at page 119 of the NZ Wellbeing Budget, we can see the government is forecasting the economy to slow and unemployment to rise.

As we wrote several weeks ago, the statistics that Aussies are about to pack their bags and head of to NZ are not supported. CM wrote,

“According to the Australian Bureau of Statistics, there are 568,000 New Zealanders in Australia, or more than double the total 3-decades ago. Therefore more than 11% of the Kiwi population lives in Australia. At last census count, 35,000 New Zealanders migrated to Australia in 2018.

According to the New Zealand Statistics Bureau, 38,700 Aussies live in New Zealand. In the January 2018 year, 24,900 migrants arrived from Australia and a similar number departed for Australia.

Stats NZ stated, “Over half of migrants arriving from Australia are actually returning Kiwis who have been living across the Tasman for more than a year…The number of migrants going back and forth to Australia in the past year almost balanced each other out – the net gain was just 40 people in the last 12 months.”

As socialists love to point out, “feelings matter far more than facts“. Just goes to show how easily people will fall for a catchy headline, rather than judge it on its merits. Time the “woke” wake up from this slumber. By all means, celebrate more recognition of higher mental health spending but best put it in perspective. Jacinda Ardern is ordinary.

Gladys Berijiklian wipes the floor with Michael Daley

Listening to the NSW Election debate, incumbent Premier Gladys Berijiklian wiped the floor with Opposition Leader Michael Daley. Daley’s opening remarks were well prepared but it was all down hill from there when it was impromptu.

Daley was short on figures on pretty much every issue. Berijiklian knew them off by heart. Schools, climate change spending, public assets, electricity costs, mental health, hospitals, tolls, unemployment, education, water etc etc. Daley mentioned numerous times in his answers that he needed to double check his figures. On TAFE spending he guessed $3 billion. In reality it is $64 million.

When asked for a show of hands over the contentious Allianz Stadium rebuild, the Penrith audience backed the Premier by around 2:1.

The Premier made the rebuild costings clear and pointed out they’ve been in the public domain for over 12 months. Daley didn’t even have clear costings on how much it would cost to renovate. At one point Berijiklian was telling him how much bringing up to meet building codes would be. One would think he’d be all over the numbers on an issue he has expressed much passion over. She said that the new stadium would cost the same as renovating the current one.

Whether 100 undecided voters influence the election is a moot point but Berijiklian was the clear winner. The end result. Of 100 undecided, 50 would vote for the Premier and only 25 for Michael Daley.

It costs HOW MUCH?

VAbudget

The mind boggles. War is expensive to conduct. Once wars finish, the cost of looking after veterans is massive. In 2000, the Department of Veteran Affairs (VA) in America spent $43.6bn to look after returned servicemen and women. In 2020 it is expected to exceed $212bn (c. 5x), the equivalent of what the Chinese currently spends on its military.  Digging deeper into the data reveals that the cost of the aftermath of Operation Iraqi Freedom (OIF), Operation Enduring Freedom (OEF) and Operation New Dawn (OND) on veteran treatment keeps growing in a straight line.

VAOIF.png

Total obligations for OIF/OEF/OND patients has grown 19-fold in the last 14 years to over $7bn. Total veterans from those campaigns now totals 965,000 and is expected to hit 1.1mn by 2020. Cost per veteran patient over the 2006-2020 period will virtually treble.

VAOIFPatient.png

Expenditure on prosthetic devices (e.g. limbs, hearing aids) has near as makes no difference quadrupled in that period.

VAprosthetics.png

Spending on pharmaceutical products is up 1.9x since 2006.

VApharma.png

Drugs such as Oxycontin which contain opioids have found their way to creating problems in the US armed forces. 15% of Army troops admitted to taking illicit drugs (cocaine, heroin, marijuana) and opioids back in 2008.

IMG_0378.PNG

Spending on programs to prevent substance abuse is up 1.8x since 2006.

VAsubstanceabuse.png

The VA notes key clinical metric trends from Quarter Four of 2012 to Quarter Four of 2017 show:

• 67% reduction in Veterans receiving opioid and benzodiazepine together;
• 44% reduction in Veterans on long-term opioid therapy (> to 90 days);
• 38% reduction in Veterans receiving opioids;• 56% reduction in Veterans receiving > 100 Morphine Equivalent Daily Dose;
• 51% increase in Veterans on long-term opioid therapy with a Urine Drug Screen
(UDS) completed within last year to help guide treatment decisions.

Spending on mental health programs is up almost 4x since 2006. The VA plans to promote the development of skills in VA providers to diagnose and assess PTSD
by developing a computer-based training using simulated virtual patient
technology that will allow clinicians to practice and receive customizable feedback
on giving CAPS-5 to a lifelike virtual patient.

VAMH.png

The 2019 VA Budget requests $8.6 billion for Veterans’ mental health services, an increase of 5.8% above the 2018 current estimate. It also includes $190 million for suicide
prevention outreach. VA recognizes that Veterans are at an increased risk for suicide and
implemented a national suicide prevention strategy to address this crisis. Veteran suicide in the US is at a 22/day clip.

The price of freedom. All said and told the US over the last 20 years will have spent the equivalent of $2.476 trillion with a “T” on veterans. That is the equivalent of one entire year of UK GDP.

Smart technologies are an absolute must for the VA. The cost of veteran health is the equivalent of 29% of what the US spends on defence, up from 14.8% two decades ago. Asking for yearly increases is a band aid solution.

First responder assaults – the shocking stats

3FD2A6A9-AD75-4084-945E-BCFD28FB429B.jpeg

We must question the sanity of the world we live in. First responders – police, fire and ambulance – are generally people trying to save the community from danger by putting themselves in harm’s way. Yet the incidence of assaults against them has grown to shocking levels around the world. These are not exhaustive stats (this will come in a more comprehensive piece) but this piece paints a picture of what is going on and why we shouldn’t be surprised at the growing incidences of PTSD suffered by first responders. Something must be done. The next journey for CM is to provide a solution.

By branch:

POLICE

The FBI noted in 2016 that 57,180 (c.10% of all) US police officers were assaulted while performing their duties. 28.9% were injured (enough to enforce time away from work). The largest percentage of victim officers (32.2%) were assaulted while responding to disturbance calls (domestic violence, family disputes, pub fights).

Assailants used hands, fists or feet in 78% of the incidents, firearms in 4.2% of incidents, and knives or other cutting instruments in 1.9% of the assaults. Other types of dangerous weapons were used in 16% of assaults. Assaults on police in the US are up 17% in the past two years. 

In NSW, Australia some 2,343 (13.3%) police officers out of 16,500 have been at the receiving end of assault in 2017. That’s 6 per day. With regard to official statistics, the NSW Police Force indicated that over a three year period from 2013 to 2015, an average of 2,236 police officers per year were assaulted during the course of their duties. Around 7% of officers actually end up physically injured. 

 AMBULANCE/EMS

In the US health care professionals experience the highest rate of workplace violence (WPV) compared to all other industries, with the majority of violent injuries committed by their patients according to the Bureau of Labor Statistics. Studies show EMS responders were three times higher than the national average for all other occupations to suffer WPV. In regards to occupational fatalities, the rate among paramedics is more than twice the national average for all occupations and is comparable to those of police and firefighters at 12.7 per 100,000 workers per year.

The rate of nonfatal injuries among US paramedics was 34.6 per 100 full-time workers per year — a rate more than 5x higher than the national average for all workers.  In regard to fatal injuries, a retrospective cohort study of nationally registered emergency medical technicians (EMTs) in the U.S. found that 8% of fatalities were due to assaults. 

Males have been reported as the most frequent perpetrators of violence however, a separate study found female patients of the mean age of 32.5 years +/- 8.1 years to be the most frequent perpetrators. 

In the NSW Ambulance Service, approximately 51% of assault incidents were attributed to mental illness, 22% to alcohol, 15% to drugs. Similarly, statistics provided by the NSW Bureau of Crime Statistics and Research (BOCSAR) concerning violence against Police from July 2006 to June 2016 suggest alcohol is a factor in many incidents.  Assaults on ambos in NSW are up 8-fold since 2001. Median lost hours for those EMS crew assaulted is around 8.6 weeks.

FIRE FIGHTERS

In what world do people shoot fireys? Here are 3 specific incidents in 2016 of attacks on fire fighters in the US. 

April 15, 2016: Firefighter fatally shot, second wounded in Prince George’s, Baltimore, Maryland

Jan. 22, 2016: Ark. firefighter shot, killed on EMS call, Pulaski County, Arkansas,

Jan. 20, 2016: Denver fire chief stabbed near station, Denver, Colorado,

Fire and Rescue NSW indicated its officers do not have the sort of violence prevention training of police and paramedics better able to protect their crew’s health and safety, including in respect of violent incidents. At the Parliamentary Committee’s hearing on 14 November 2016, Fire and Rescue NSW witnesses provided the following evidence:

Basically, when a crew arrives at an incident, you have a station officer and a station commander in charge of the crew and the…truck. That person undergoes promotional programs to get to that position. Part of that is understanding how the legislation is applied in reality from a practical point of view. Also, during that experience – we are talking probably eight to 10 years for that to occur …The promotional programs…cover the responsibilities of the officer and advise around the standard operational guidelines of when to withdraw and ask for police support and what is safe or not safe.

…If we look overseas for experiences and tried to align our experience to that, you would have to say that the civil unrest that is happening in the United States probably would not occur here to that degree. However, there is also an underlying issue in the United States where emergency service is seen as part of an arm of government and there is, hopefully, a small growing trend where emergency service ambushes are occurring…random shooters are calling emergency services to locations to make a point. We hope that never crosses to this country here, but we would always have an eye on what happens in other jurisdictions…because it is quite possible someone would pick that up as a possibility in this jurisdiction….”

PRISON GUARDS

The UK HMPS note that there were 7,159 assaults on staff in the year to March 2017 up 32%YoY. Serious assaults were up 25%YoY to 805 incidents. The National Tactical Response Group (NTRG) which is only called under extreme levels of prisoner violence  surged from 120 in 2010 to an annualized 630 by the end of 2016.  

THE PTSD IMPACT

This was the fascinating part of the research. It isn’t that the job isn’t hard enough already, it’s the lack of resources to support first responders when waiting for incidents. Lots of idle time to ponder.

US FEMA note stress has not only been categorized by exposure to traumatic incidents, but also the monotonous operational characteristics of EMS organizations, such as paperwork, lack of administrative support, low wages, long hours, irregular shifts, and cynical societal attitudes toward public safety officers.

Cumulative stress associated with the monotonous duties or low acuity calls has led to feelings of desensitization for patients, and their job as a whole. Concerns have also been raised regarding sleep quality and fatigue and the impact it has not only on the provider, but also job performance and patient  outcomes. Some research has posited that organizational stress often contributes more to the development of PTSD than traumatic events.

Also noteworthy is the notion that paramedics are often the source for a lot of criticisms by society for the decisions they make in determining life or death situations for patients and themselves. This can affect EMS providers in many ways and may contribute to the slow decline in provider morale.

Burnout (emotional exhaustion) is one of many organizational outcomes that may arise as a result of violence experienced by EMS responders. The question of whether or not violence would eventually lead to burnout was first raised in the early 1990s . Exposures to violence were noted as a reason many EMTs, especially volunteers, left the profession. In an early study from 1998, 7% of survey respondents within one urban fire department considered leaving EMS as a direct result of an abusive situation they encountered while on the job. Knowing how to emotionally cope following a tough incident can help to reduce anxiety and burnout.  

Mixed methods studies conducted in the U.S. and Sweden found that violent encounters altered the patient-provider relationship. Yet, some in the industry feel that exposures to violence do not cause stress or negatively impact providers. This lack of effect has been attributed to the internalization of the mentality that violence is a part of the job.  It has been posited that years of experience may be a protective factor that allows more experienced responders to experience less stress and anxiety after violent events. 

Evidence weighing the social and economic costs associated with increased violence and burnout is based mostly upon anecdotal evidence, with no assessments conducted on monetary value. Some suggest that, as violence increases, the need for police backup also increases, thereby increasing response time and delaying potentially critical care to a patient in need. 

Other concerns include altered operations for the private sector of EMS. Intent to leave the profession is also a concern. As more EMS responders leave the profession, numerous organizational and patient impacts have been hypothesized, including increased costs for training new EMTs and paramedics, greater numbers of inexperienced paramedics serving at any one point in time, and increased error rates committed by new and inexperienced paramedics. EMS responders also report seeking a job change away from their ambulance role. In some cases, responders stated they lost interest in fieldwork and tried to get off the road and into desk positions. 

What’s clear is that not enough is being done to help first responders cope with occupational hazards and handling the stress that comes from it. That is going to change very soon. Stay  posted!

While you’re at it, why not thank those first responders randomly in the street for the great work they do. It goes a long way! They need you just as much as you will need them when you’re in a bind!

A link between crime & IQ?

IQ

While updating all of the data for crime in Japan, CM was intrigued by the IQ test data compiled by the Ministry of Justice (MoJ) for all 20,000 new inmates in 2016. The average IQ recorded was 81.4. All said and told, 57.4% of new inmates scored an IQ of more than 80. The MoJ also recorded that the level of education attained by criminals showed 62.5% had attained a maximum of middle school (years 7-9) or dropped out of high school (years 10-12).

HS.png

Japan has a high school matriculation rate of around 95% which places it in the top 4 countries around the world. The US has around a 76% completion rate (rank 13) for high school according to the OECD.

To study IQ for inmates on a more global basis, a 2003 study by Ellis & Walsh revealed that of all the Texas inmates who entered the prison system in 2002 approx. 23% of the inmates scored below 80, almost 69% scored between 80 and 109, and only 9.6% scored above 110. The average was 85. The Prison Reform Trust in the UK said 1/3 of prisoners had an IQ less than 80 and one-third of that was less than 70. A Levine study in 2011 showed that those who had been to jail had a mean IQ of 89.61 while those who had not who had a mean IQ of 100.6.

Although a deeper look at serial killers showed extremely high IQs. The Dating Game serial killer Rodney Alcala had a reported IQ of 170. Uni-bomber Ted Kaczynski 167 and Jeffrey Dahmer 144. Hideo Murai, chief scientist of the Aum Shinrikyo (responsible for the Tokyo subway sarin attacks), was also reported t have an IQ of 160. On the other and, Australia’s worst mass murderer, Martin Bryant, reportedly has an IQ of only 68.

We shouldn’t forget that months after winning a national title, Harvard’s debate team lost to a group of New York prison inmates. A three-judge panel concluded that the jailbirds had raised arguments the Harvard team had failed to consider or was it a slight bias that the judges feared repercussions were they ever released?

Many prevailing theories of intelligence suggest people with lower IQs are most likely to break the law, since impulsivity, struggles at school and a lack of social bonding are all linked to criminality.  Although James Oleson, a criminologist based at the University of Auckland in NZ, suggests real-life geniuses have a penchant for breaking the law. He noted there may be an IQ threshold after which a high it becomes more of a risk factor for committing crimes. Intelligent offenders were more likely to get away with their crimes.

The flip-side to claiming mental disability is also that of avoiding execution. In the US, there are some states debating whether an inmate with an IQ below 70 cam be executed on the grounds he or she may not have sufficient mental faculty. Abandoning the 70-point IQ cutoff could double the number of death row inmates who claim they are mentally disabled.

According to the 2005 Annual Report on Government Measures for Persons with Disabilities published by the Japan Cabinet Office, of the total estimated 3,600,000 people with a mental disability, 459,000 people possessed the Certificate of Mental Retardation – 12% of all mentally disabled people in Japan possess it vs. 6.3% of mentally disabled inmates. The Yokohama National University suggested this clearly indicates a tendency that people who are bound to be in prisons are less likely to have possessed the certificate, therefore likely to have missed some form of assistance from social welfare programs.

Morie and Matsushi wrote, “5.9% of all population on average is categorized as intellectually disabled. However, the percentage of children who are classified as mentally disabled and receiving special education as well as social welfare is stagnant at 1%. Because the Certificate of Mental Retardation is only issued upon request, many of the parents/guardians are reluctant to apply due to the fear of being stigmatized. This is especially true for a mild case of mental retardation. Lack of appropriate education and opportunity to receive social welfare can lead the children with mental disability to anti-social behavior, ultimately connecting them to crimes. Therefore, guardians should be strongly recommended to apply for the certificate without hesitation…”

Although it is worth noting that despite prison capacity in Japan expanding 50% over the last decade, the number of inmates is 31% lower at around 56,000 or 62% capacity, down from 105% at the peak. Compared to the 2.2mn prisoners in the US, Japan is still at the very low end of the crime spectrum. That is to say the US has 13.1x the number of prisoners relative to the population than Japan. The US ranks 1st while Japan ranks 35th.