Heath Ledger and Bipolar Disorder

In yet another shameless effort to boost my blog stats, here’s a comment on Trouble With Spikol’s recent post on the possibility that Heath Ledger had bipolar disorder.  According to a new biography, Heath’s uncle Hadyn has bipoloar disorder and suggests that the young star may have been as well.  Spikol says she hates these speculations, but I think that Hadyn makes a good point when he says that the diagnosis is nothing to be ashamed of. He told the author of the biography,  “I don’t mind people knowing I have bipolar disorder, and it’s a shame that it took this long to be diagnosed.”   You got it.  As the blogger at Mental Health Humor writes, there’s much we can learn from this example.

Rethinking the Drinking Age: a historical perspective

Once again, Historiann has beat me in posting on a hot political topic — the Amethyst Initiative, initiated last month by a group of college presidents who argue that the National Minimum Drinking Act (1984), which imposed a penalty of 10% of a state’s federal highway appropriation on any state setting its drinking age lower than 21, has been a disaster.  Not only has it not solved the problem of alcohol abuse among college students, it has actually exacerbated it by creating a “clandestine culture of binge drinking.”

[See this article from the Hartford Courant for local news on this issue]

I commented briefly on Historiann’s blog, but since this falls squarely in my area of expertise, I think a blog post of my own is in order.

As I argue in my recently published book, Student Bodies, concerns about undergraduate alcohol use and abuse date back to at least the early twentieth century. Many college presidents supported prohibition as a great solution to the problem of drinking on campus.  Even after prohibition ended in 1933, college administrators supported total abstinence even as alcohol became a normative part of adult sociability. Most states at this time established a minimum drinking age of 21.

At the same time, mental health experts classified excessive drinking as a disease.  Researchers at the Yale University Center for Alcohol Studies (later relocated to Rutgers), working closely with the Yale Mental Hygiene department in the health services, in 1949 conducted a survey of twenty-seven colleges around the country, encompassing both public and private, coeducational and single-sex, white and black, non-sectarian and religious (including Catholic, Jewish, and one Mormon college), and different regions of the country. Reports in the popular press made fun of the study, joking “Yale will get its facts about student drinking ‘At a table down at Mory’s,’” a New Haven bar popular among undergraduates.  The results of the study were that drinking was not a major problem at colleges and universities, and that patterns of drinking were no different in colleges and universities than in other parts of society.  They concluded that the key to prevention was not “scare tactics” that emphasized the pathological consequences of excessive drinking, but education that helped students make responsible choices about whether or not to consume alcohol.

During the early 1970s, partly in response to student movements of the period — many states lowered the drinking age to 18 — the thought being that if a young man could be sent to war, he should be able to legally purchase and consume alcohol. It was also at this time that the voting age was lowered to 18. In short, what happened at this time is that college students demanded, and received, the same constitutional rights as adults — e.g. to vote, freedom of speech, freedom of assembly, rights to privacy (including access to contraception, and abortion), etc.

This consensus was challenged by the College Alcohol Study started by a group of researchers at the Harvard School of Public Health, led by social psychologist Henry Wechsler, who began exploring the problem of college drinking in the late 1970s and early 1980s.  Their work in part led to the passage of the National Minimum Drinking Age act of 1984. It also led to the construction of “binge drinking” as a disease and social problem particular to young adults in higher education settings.  I was an undergraduate at the University of Vermont while all this was going on — the state was a holdout on keeping the drinking age at 18 but was eventually forced to raise the drinking age to get those federal highway funds.

More recently still, the abstinence approach bolstered by the College Alcohol Study has been challenged by research conducted by the Social Norms Institute, who argue that the “health terrorism” perpetuated by the “binge drinking” model has not solved the problem of campus drinking, it simply has created an underground culture of drinking. They argue that by focusing on the most egregious cases, prevention efforts have exaggerated the extent to which most college students drink.  Their approach is remarkably similar to that proposed by the Yale Center in the 1940s — i.e. emphasize wellness, resilience, and informed decision making.  To illustrate how their approach differs:

NOT social norms marketing:

Social norms marketing:

So, to summarize — it seems to me that Historiann is asking the wrong questions, and perpetuating notions of 18-21 as “others” who need to be controlled by older adults, especially if they enroll in colleges and universities.  Earlier this week, I sent a colleague in Scotland an article by local columnist and radio host Colin McEnroe regarding a recently imposed curfew in the city of Hartford.  He replied:

“I find our politicians approaches to ‘young people’, as they are called, as
if they are a   separate breed from humanity, rather contradictory.  Young
people like to congregate on street corners.  It doesn’t mean they are doing
any harm.  Some get up to mischief, but most of the more serious crimes are
perpetuated by not-so-young people.  The curfew experiment was carried out
in Hamilton, a town in the county of Lanarkshire.  The latest plan to
control ‘young people’ is to prevent them from buying alcohol if they are
under 21.  The problem that I have with this is that people under 21, carte
blanche, are being considered irresponsible in their consumption of alcohol,
while those over 21, carte blanche, are considered responsible.  This idea
is occurring at the same time as it is considered OK to send teenagers in
the military to Iraq or Afghanistan (they are responsible enough to be
entrusted with that!), while there is also a wish by the present governing
party in Scotland to reduce the voting age from 18 to 16 so as to include
and engage young adults in the political process.  ‘Young people’ are our
nation’s future, the responsible citizens and decision-makers for tomorrow,
but I think that today you would be hard pushed to convince them of that.”

I couldn’t have said it better.  Thanks Iain!

P.S.  After I wrote this, I saw an excellent post by Kittywampus — amen, sister!

Nostalgia Time: Bob Newhart and Mental Illness

This past Sunday, I took a break from Olympics coverage to watch the excellent PBS American Masters episode on Bob Newhart.  The documentary reminded me how much I loved the original “Bob Newhart Show” (the later one, not so much, even though it was set near my home town in Vermont).  I was also struck by Newhart’s recollections on why the producers decided to make Bob Hartley a psychologist:

“Then they wondered what kind of occupation would that be and suggested psychiatrist . . I said, I think psychiatrists really deal with more disturbed patients, and I don’t think we should get our humor from schizophrenics and multiple personalities and bipolar people.  So I suggested a psychologist.”

Playing a psychologist also appealed to Newhart because “when dealing with patients, no matter how ridiculous they are, you can’t let on that they are ridiculous.”

As I recall, the series did humanize persons who sought help from psychologists, but I’m wondering just how much the weekly “parade of crazies” really improved public understanding of mental illness.  Thoughts anyone?

MentalHealthEdu

I just completed the training module for MentalHealthEdu, an online program to raise awareness about college mental health issues .  I found the website was very accurate, drawing on material from the American College Health Association.  It also gave  good practical information for faculty, staff, administrators on how to help students in distress. However, it doesn’t really offer any concrete suggestions on how to accomplish one of its major goals, i.e. reducing the stigma associated with mental illness.  Still it’s pretty good at presenting basic information.

Help Support Housing for Mentally Ill Persons

Courtesy of NAMI National:

HR 5772 Proposes Innovative Section 811 Demonstration Program and Includes Long Overdue Reforms to Existing Section 811 Program

NAMI and our colleague disability advocacy organizations in the Consortium for Citizens with Disabilities Housing Task Force (CCD Housing Task Force) and the Technical Assistance Collaborative (TAC) are pleased to announce that important legislation to spur investment in permanent supportive housing has been introduced in Congress.  The bill, known as the Frank Melville Supportive Housing Investment Act of 2008 (HR 5772), was introduced by Congressman Chris Murphy (D- CT) and Congresswoman Judy Biggert (R – IL).  The bill is named in honor of the late Frank Melville, a longtime member of NAMI Connecticut, and the first board President of the Melville Charitable Trust – a leading force in promoting supportive housing for people with severe disabilities.

This ground-breaking legislation proposes important and significant changes and improvements to the U.S. Department of Housing and Urban Development (HUD) Section 811 Supportive Housing for Persons with Disabilities program.  The bill would authorize a new Section 811 Demonstration Program that fulfills the promise of true community integration as envisioned in the Americans with Disabilities Act, and would enact long over-due reforms and improvements to the existing Section 811 production program essential for the program’s long-term viability. These changes will provide states and localities with a new infusion of critically needed Section 811 capital and project-based rent subsidy funding to produce more permanent supported housing.

Act Now!

Contact Congress today and urge your House member to cosponsor HR 5772.  Help us address the enormous housing crisis faced by millions of extremely low income people with disabilities.

Learn More

View NAMI National’s letter of support for HR 5772. Read background information on HR 5772

Sad Anniversary

Today is the one year anniversary of the murder-suicide at Virginia Tech, so I thought I’d write something even though it’s been a long day. According to an article in last week’s Chronicle of Higher Education, the main actions by Virginia governor Timothy Kaine have been to weaken privacy rights of individuals with mental illness, e.g. notify parents if a student has received treatment, and allow both public and private colleges to obtain records of mental health treatment from any other school the student has attended. Hopefully these records will only be used to help students, but somehow I doubt that this will lead to better care for the students in question, especially since this is an unfunded mandate like so many others. The round up of articles in today’s Chronicle doesn’t seem to address this issue — maybe I’ll write something when I have more time.

Meanwhile, my article giving a historical perspective on all this got accepted by the Harvard Review of Psychiatry and will be appearing soon. Also my former adviser and buddy Joan Jacobs Brumberg decided to hand over editing the collected volume on campus violence for Rutgers to me. She says that the main change at Cornell is there are now sirens on all the buildings. Now if they could just reduce the waiting time to get an appointment at the Counseling Service. . .

P.S.  Here is a really awesome way to commemorate April 16.  Reminds of me the “die-in” organized Women Strike for Peace after Nixon authorized bombing Cambodia.

Disability History in the News

It’s been a busy week here at the University, so I haven’t had much time to do more than note the following articles related to disability history, loosely defined in one case.

First up is the New York Times review of The Lives They Left Behind, a book version of an exhibit on the Willard State Hospital at the New York State Museum. I really love the exhibit and am looking forward to reading the book. The book reviewer, being an M.D., seems to be missing the point of historical scholarship. She writes, “basing a complex argument on fragmented and archaic case histories is problematic both for science and for style. A coherent scientific argument demands complete, current data, not reinterpreted glimpses of the past.” This may be fine for “evidence-based medicine,” but really unfair to apply to historical scholarship, which by its very nature is based on the shards and pieces that manage to survive. Also, sometimes you just have to get angry about social injustice, even bitchy, like this righteous woman. [as Tina Fey said when Senatorella was on SNL, “bitches get things done.”]

Another story on exhibiting disability history to the public comes from this CBS news story on the Trans-Allegheny Lunatic Asylum, which has been turned into a tourist attraction and historic site. Some mental health advocates have objected to the use of the word “lunatic” in the museum’s promotional materials. Others have suggested that this term, while politically incorrect today, is an important part of the history that should not be covered up to suit modern day sensibilities. I’m inclined to lean toward the latter position, just as long as it doesn’t lead to a revival of the term in the popular lexicon (only we loonies can use the word!)

The final story comes from my interest in bicycling, and is not really about history except that it regards a well known cyclist from the 1980s and early 1990s, Davis Phinney. I had no idea he had Parkinson’s disease. His son is now an elite cyclists aiming for the Olympics. Maybe they’ll let Davis carry the torch, like they did with Muhammed Ali? Probably not, Davis was great in his day, but he’s not Lance.

Another Campus Shooting

I had hoped to blog about something else today, but felt it necessary to comment on this news report of a shooting at Louisiana Technical College in Baton Rouge.

The story is still developing but what is notable is that this case, unlike others in recent memory, involves a female student killing other female students. This adds some food for thought, I think, to Historiann’s comments on gender and violence. Penny Richards over at Disability Studies, Temple U, has found some nineteenth-century cases of girls perpetuating violence at school. Also, colleagues in criminology and human development tell me that girls are becoming more violent in schools, and percentage of women convicted of violent crime increasing.

Update: more on this case from Chronicle of Higher Education.

More on AHA Panel, School Violence, and Youth Suicide

Now that I have all my fellow panelists’ papers, I can get a better sense of what I want/need to say. Roger Lane points out that school shootings are very rare events although could take a longer view on this. There are several cases of students murdering teachers from the nineteenth century, including that of Etta K. Barstow, who was stoned to death by several of her male students. Kathleen Jones is looking at Seung-Hui Cho’s erasure from public memorials of Virginia Tech, and his transformation from lone gunman to face of evil to failure of campus and community mental health.

This seems to be an interesting counterpoint to stories about Robert A. Hawkins, aka the Westroads Mall Shooter in Omaha, Nebraska. An article in the Omaha World-Herald from last Friday says that “HHS did its best to treat Hawkins.” Well, what they did was spend hundreds of thousands of dollars for inpatient treatment while he was a ward of the state. Why was he made a ward of the state? Because his father’s military health insurance ran out and making him a ward of the state was the only way he could get mental health care for his son! Similar things happen in CT all the time, according to my friends at DCF and DMHAAS — the state would rather put children in foster care or state-run facilities than pay for them to be cared for at home by their own families. Then, once these children reach 18, they are let out on the streets, or if they’re lucky, get a bed in an adult facility. This is yet another reason why we need universal health care, especially for children and young people!

American Historical Association Panel

Last week I received a draft from my co-panelist Steve Mintz for a session at the annual meeting of the American Historical Association. Wow that guy is organized, so now I’ve got to get cracking on my presentation! The theme of the panel is

“Secure … for Whom? Campus Violence in Historical Perspective, from the Bell Tower to Blacksburg”

Some thoughts on Steve’s draft:

1. He discusses the bell tower shootings by Charles Whitman at University of Texas, Austin in 1966. Steve prefaces this with a discussion of Charles Starkweather and Caril Fugate and says these murders “were not disseminated through a sensationalized media, nor were they viewed as cultural symptoms.” This claim seems at odds with the historical record — Starkweather was compared with, and even cultivated, the image of James Dean in “Rebel without a Cause,” and described as a symbol of postwar youth out of control. They later went on to inspire a number of popular culture representations of youth murder and anomie, including the films “Badlands” and “Natural Born Killers.” I would agree that Whitman’s shooting was portrayed “as a shocking symbol of the social disintegration of the 1960s” but this was not new. One sees the same themes in discussions of Starkweather and Fugate, as well as the Leopold and Loeb trial in the 1920s.

2. Steve argues that “rampage killings challenge popular conceptions of mental illness.” On the contrary, I think they reinforce misconceptions about mentally ill individuals as prone to violence. [see excellent article on media coverage of Virginia Tech shootings by Otto Wahl].

3. warning signs — only became available after the shootings. Should these have been released? Patient rights to privacy being debated in mid-1960s, largely in response to criticisms of college psychiatry by Thomas Szasz as well as revolt against “institutionalized paternalism” by students.

4. describes Whitman as “superfically normal” — seems to reinforce notion of mentally ill as a different species from the rest of humanity. What is normal exactly? Who decides? Description of Whitman parallels that of Leopold and Loeb — i.e. precocious but unstable, brain abnormalities, etc.

5. mentions misogyny/harassment of women — this was true of Cho as well.

6. Overall, theme of security is aimed at victims and survivors — what about security for those who share diagnosis with the killer? Should they be labeled as “threats”?

For my paper, I may start with Szasz’ critique of college psychiatry since it was published shortly after the Texas shootings.