Friday 11 March 2011

Charlie Sheen, the Media Circus and Mental Disorder

I for one am getting sick of the media circus that revolves around Charlie Sheen. It reminds me of a group of sharks circling around a bloodied and dying mammal, waiting for an opportunity to move in for the kill.

It may well be that Charlie Sheen has a mental health problem. He may also have a mental disorder: bipolar illness has been suggested by some. He may be suffering from the emotional, cognitive and behavioral effects of substances. Or it may be all of the above. Or it may be something else.

Armchair diagnostician’s aside, it is simply not possible to come to a substantive conclusion about the presence or absence of a mental illness such as bipolar disorder without careful, comprehensive and detailed analysis of presenting problems and a life history. The same goes for any other psychiatric diagnosis, including substance abuse and personality disorders. Nobody can speak with any authority about Mr. Sheen based on media reports!

Personally, I find it sad that so many do. I also find it sad that we as a society seem to revel in the difficulties and life problems of those who we have made celebrities. This is not fair to them and certainly does not say much about us.

Recently, Dr. Paul Keedwell wrote a thoughtful piece on this issue. Actually, it has been the first thoughtful piece I have read in the media about this: http://www.bbc.co.uk/news/health-12701154. As for me, I think the media circus should stop. Let us leave Mr. Sheen alone so that he can start to address his concerns in private. Send the sharks away.

--Stan


Tuesday 8 March 2011

Can Facebook Prevent Suicides?

Today I read about yet another suicide intervention strategy, launched with media fanfare in the UK. According to the BBC News, an NGO in the UK called the Samaritans has now launched a Facebook scan for people who discuss ideas about suicide http://www.bbc.co.uk/news/technology-12667343. If they identify someone at risk they will contact police and ask them to go and intervene.

Apparently this idea was in response to a suicide tragedy in which a young person died by suicide after posting their intent on Facebook. Is this a good idea? I do not know. Will it work? I have no idea. Will it have the opposite effect of maybe encouraging suicide in vulnerable youth? I do not know. Will this become the focus of hoaxes and “crying wolf”? I have no idea.

On the one hand, it could be argued that addressing youth suicide through social media makes sense because that is where youth “live”.  On the other hand, it could be argued that such Facebook vigilance will lead to more harm than good – either through “copy-cat” activities or to hoaxes that lead to police “interventions”. 

Suicide is an emotional issue. Not every good idea turns out to be a good idea. Sometimes good ideas have negative unintended consequences. However, it seems that the cat is out of the bag on this activity. I hope that someone is doing a careful and appropriate evaluation of what is happening. That alone will give us an idea if this idea is worth pursuing or not.

In the meantime, I would really like to see us all put into place those things that we know actually do work. This includes: limiting access to lethal means (such as controlling access to guns); training all health care providers to better identify and treat those people at risk; providing “gatekeeper” training for teachers and others who spend a good amount of time with young people – so that they can identify those at risk for mental disorder (still the single largest risk factor for suicide) and seamlessly refer them for the care that they need.

It seems pretty simple to me. Let us do what we know works. Not do what we know does not work. And, if we do not know, let us study it properly so that we can find out.

--Stan