Tuesday, January 16, 2024

By Courtney Wise

In other news, a new study sparks debate on the benefit of workplace wellness programs; “Succession,” a study in intergenerational trauma, dominated the Emmys last night; eczema may trigger depression; and a death row inmate ponders his life after receiving an unexpected extension of his date of execution. Plus: Gen Z workers would trade a significant pay cut for work-life balance.

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Preventable deaths all too common in the VA’s broken mental health care system

Trigger warning: This story contains descriptions of mental illness and suicide

Brieux Dash was just 33 years old when he died, devastating his wife Emma and their two children. The Army veteran had served the nation as a wheeled vehicle mechanic between 2006 and 2015, surviving two deployments to Iraq. But he wasn’t the same Brieux when he returned home the second time, Emma told ProPublica investigators. He screamed in the middle of the night. Other times, he became violent in his sleep. Then in 2019, he attempted suicide. 

Emma, who worked in the pharmacy department of the West Palm Beach Veteran Affairs Medical Center herself, reached out to the hospital to have her husband involuntarily committed. She’d done so once before and “it got him back to being him,” Emma said. She was confident the VA was best equipped to provide him optimal care. Tragically, Brieux Dash never made it home. He died of suicide during his hospital stay. An investigation by the VA’s inspector general found that a nursing assistant assigned to do patient safety checks every 15 minutes the day of Dash’s death had also conducted other tasks contrary to unit protocol. In addition, cameras meant to monitor patients for safety were revealed to be inoperable for years.

Such tales are appalling, and worse, too frequent in the Department of Veterans Affairs, which has struggled with mental health care for decades, researchers told Propublica. The problem begins with the system itself, a massive, disconnected set of 18 regional networks and dozens of smaller hospital systems, each with different leaders and policies. As requests for mental health services flood the agency, an August 2023 survey from the VA’s Office of Inspector General found that more than 75 percent of the VA’s network of hospitals and clinics had “severe shortages” of psychiatrists, psychologists, or both.

While shortages are nothing surprising, Carl Castro, director of the Center for Innovation and Research on Veterans and Military at the University of Southern California, said the VA is uniquely ill-equipped to secure new providers. “The system doesn’t pay them enough money,” he said. “It works them to the bone. That’s why it is hard to recruit people.” 

Though the VA declined an interview with ProPublica for its story, it did submit a statement acknowledging its staffing shortage and reiterating its commitment to hire 5,000 new providers within the next five years.  The West Palm Beach VA Medical Center told ProPublica that sensor alarms and new surveillance cameras were installed after Brieux Dash’s death. Emma Dash also successfully sued the VA for its failures leading to her husband’s death and was awarded a $5.75 million settlement last year. But her husband is still dead, her children without their father. Mired in that reality, Dash sent an urgent directive to the VA: “Do better!”

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Do workplace wellness programs do us any (mental) good?

Want to improve your mental health with employer support? Skip the company-sponsored wellness apps and sign up to volunteer in the community on company time. Of 90 possible interventions, charity work is the only one found to improve employee well being, according to an Oxford University study of more than 46,000 employee survey responses published earlier this month. In a New York Times story, critics of the study’s methods say that lead author William J. Fleming erroneously grouped interventions into large categories and failed to follow subjects over an extended period of time. As such, said Yale psychiatrist Adam Chekroud, a wholesale dismissal of workplace wellness programs risks “throwing the baby out with the bath water.” 

“It’s a fairly controversial finding, that these very popular programs were not effective,” Fleming conceded to the New York Times. But the study counters that if companies really want to improve worker wellness, they’ll implement sound management practices, provide schedules that promote better work-life balance, and increase wages. “If employees do want access to mindfulness apps and sleep programs and well-being apps, there is not anything wrong with that,” Fleming said. “But if you’re seriously trying to drive employees’ wellbeing, then it has to be about working practices.”

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To boost your mental health, be kinder to yourself this year

“We’re our own worst critics” is cliché for a reason. We mentally and emotionally berate ourselves for every goal we take longer than planned to reach — and we excoriate ourselves for the ones we don’t achieve at all. It’s a pattern that psychiatrist Christopher W.T. Miller is accustomed to seeing in his patients. “Given the pressure many of us face to perform to our max and the tendency to compare ourselves with others (feeling “less than” when we don’t measure up), it makes sense that our minds would quickly go down the self-criticism route,” Miller writes in a guest column for the Washington Post, “It can be easy to forget that our self-worth should not be a relative quality.”

Show yourself some compassion and edit (or replace) the harsh inner voice. It’s a tough task when criticism is all you expect, one patient told him. Recalling her childhood, she said, “Without perfection, there was no love. I ended up seeing myself as a flawed person who could never earn [my parents’] affection.” Part of her self-work included learning to appreciate and accept kindness by first being kind and compassionate to herself. 

Some time-tested strategies helped her get there, Miller says, including building a gratitude practice and exercising forgiveness to herself and others. Gratitude is shown to affect mental and physical wellbeing, one study finds, since it promotes greater life satisfaction, reduces envy, and decreases activity by lowering inflammatory blood markers in some brain areas that generate negative emotions.

In addition, forgiving others – even when the relationship must remain distant for our wellbeing – allows us to see folks’ humanity alongside their transgressions, rather than reducing them to the harm they committed. Finally, forgiveness enables us to release the mental stress of resentment, deal with the harm of the transgression, and move forward for the betterment of our own wellbeing. In the same way, forgiving ourselves helps us to remember our inherent worth. Much like those we forgive, we are not the sum of our mistakes. 

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In other news…

Keith LaMar has spent nearly 30 years on death row in Ohio. He was slated to die on November 16, 2023, but with the state short on each of the drugs needed to produce the lethal cocktail that will kill him, he received a reprieve until January 13, 2027. What’s it like to know the date and time you’ll die? How does it inspire or subdue a sense of purpose? LaMar ponders those questions in this moving column for Scalawag Magazine. 

The constant itching and physical appearance of eczema trigger depression and anxiety symptoms in 72 percent of eczema patients. For some, the symptoms persist for as long as 10 days each month, say researchers from the National Eczema Association. The findings point to a need for mental health support that isn’t being addressed by physicians, Allison Loiselle, senior manager of data science and research at the National Eczema Association, told Medical News Today. 

Succession stormed the Emmys last night. MindSite News arts and culture writer Sarah Henry had called it “a master class in dysfunctional family dynamics” and it picked up six wins, including best drama; the show’s Kieran Culkin also won outstanding lead actor in a drama series and Sarah Snook outstanding lead actress. Two other series also dominated the awards: FX’s comedy “The Bear” (six wins) and Netflix’s “Beef” (five wins). Ted Lasso, another series involving mental health that Henry has written about, also took home several awards, while the comedy series “Shrinking,” also covered by MindSite News, was nominated for two prizes. For those who missed the Emmys, here’s a full list of all the award winners.

In a survey of its workers, Ford Motor Company finds that more than half would choose a 20 percent pay cut in exchange for work-life balance. Workers in Generation Z (born 1997-2012) and millennials (born 1981-1996) were most willing to trade a good-sized pay cut for more time for themselves and their friends and family, but workers in Generation X (born 1965-1980) weren’t far behind. “People have realized that you work more because you want to save more money. But people have been burned in the last 20 years, several times,” Mauro Guillen, a business professor at University of Pennsylvania, told the Detroit Free Press. “You work very hard to save and then the stock market takes a hit … with all this volatility, who knows what’s going to happen. So why should I save for the future? Let me just enjoy life now.”

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If you or someone you know is in crisis or experiencing suicidal thoughts, call or text 988 to reach the 988 Suicide & Crisis Lifeline and connect in English or Spanish. If you’re a veteran press 1. If you’re deaf or hard of hearing dial 711, then 988. Services are free and available 24/7.

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