October 3, 2023
By Courtney Wise
Good afternoon, MindSite News readers! In this issue, we explore a collaboration on growing through grief — including a Mississippi art museum’s “grief in the soil” installation that grew into a living memorial. Also in this edition: Your therapist may need a therapist. And emergency physicians call for an end to the unscientific diagnosis of “excited delirium,” which has been used to exonerate officers in wrongful death suits.
Plus: Med students need mental health care, Shadow Work Journal makes a splash, and the Going Mental host combats stigma via sweatshirts.
What color is your grief?
If there’s anything I’ve learned these past three years, it’s that life finds a way. We Grow On, a collaboration between Scalawag Magazine and the Mississippi Museum of Art, was a stunning visual display of how life continues in and around us, even in grief, when we want everything in the world to freeze under the weight of our mourning. Artists Sarah Jené and Jasmine Williams used “the grief in the soil,” described by writer and editor Alysia Nicole Harris, and native Mississippian plants to create an art installation that shows we don’t get over grief, we grow through it. The exhibition closed in early September, but stills from the display remain available on the MMA’s audio guide, available through Bloomberg Connects, a free arts and culture app.
As part of the exhibit, photographer Justin Hardiman captured images of people in an audio-visual exploration of grief. Subjects’ voices are recorded to answer two questions: What colors remind you of grief? and What tools, objects, or practices allow you to creatively engage your grief? The answers are intimate and striking.
“I picked a neutral brown to be representative of us as [Black] people… Every single inkling of us is [in] some kind of grief, some kind of trauma we’ve carried on, whether it was our own or not,” said Dee Spillman. “I often think we take on grief that isn’t ours.” She chose a camera to connect with her grief over the death of her grandfather, of whom no photographs existed.
Your therapist needs a therapist
Depressed, anxious or grief-stricken? Go to therapy. But what if the therapist is grieving or burned out? An August 2023 survey from SimplePractice suggests therapists are overwhelmed and in need of therapy, too. The company, which primarily operates a software that assists mental healthcare workers in private practice, surveyed 550 therapists who use their product – including counselors, social workers, psychologists, substance abuse workers and others – to learn about their overall wellbeing.
For the survey, SimplePractice customers were capped at 400 respondents, while the remaining 150 surveys came from therapists who do not use the product. Of all 550 respondents, more than half reported feeling burned out – and it’s affecting clients. Seventy-three percent said they hesitate to take on clients with severe or acute needs, while 29 percent said they’re considering leaving mental health work altogether or have thought about doing so within the past year. Many who stay say they’ve reduced their caseloads, with 33 percent saying they even raised their rates due to the stress they feel.
Aside from work life balance, compassion fatigue, heavy caseloads, and the severity of client needs, overseeing various patient insurances contributed to their exhaustion. Besides seeking more rest and longer recovery time between clients, survey respondents said they’re following their own advice and tapping into their professional networks for support, reinforcing boundaries between clients and work hours, and getting their own mental health treatment.
“SimplePractice’s report highlighted therapists’ need for support and resources” to ensure therapists continue to help those who need them the most, said the company’s chief marketing officer Smita Wadhawan. As such, the company has gathered resources to help therapists with their own mental wellness, all available for free on their website. Among the counsel from SimplePractice (see graphic above): Even as you celebrate a cherished client for moving on from therapy, it’s all right to mourn that loss.
The call for an end to “excited delirium”
Over the past 40 years, so-called “excited delirium” in a victim has been argued to defend and exonerate police officers involved in wrongful death lawsuits. But now, emergency physicians argue it needs to stop. “It’s junk science,” said Martin Chenevert, an ER doc whom attorneys often recruit as an expert witness. The concept exists to cover for police misconduct, he told KFF Health News. “It had an agenda.”
The idea is pretty simple. Excited delirium is purportedly a medical condition in which a very distressed or frustrated person can suddenly die in police custody through no fault of the police. Sheldon Haleck’s family believes the theory is why the officers responsible for his death were not convicted in a wrongful death suit brought against the Honolulu Police Department. Haleck, a former Hawaii Air National Guardsman, was behaving erratically when police pepper-sprayed and shocked him with a Taser before placing him under restraint. He died during the encounter and an autopsy ruled his death a homicide. Officers, however, were exonerated by a jury after their attorneys argued “excited delirium” in court. “The entire use of that particular theory, I think, is what convinced the jury,” said Eric Seitz, an attorney for Haleck’s family.
Chenvert and the Halecks aren’t alone in this fight. The American College of Emergency Physicians (ACEP) will vote later this month to formally disavow a 2009 ACEP position paper that supported excited delirium as a medical diagnosis. Supporters of the measure want to eliminate the concept altogether. “If we don’t fully denounce this now, it will be there for the grasping, again,” said Jennifer Brody, a physician with the Boston Health Care for the Homeless Program. “Historically, we know what happens: The pendulum swings the other way.”
It’s especially important because the theory persists in courts even though the American Medical Association, the American Psychiatric Society, or National Association of Medical Examiners do not recognize it as a diagnosis or cause of death. However, some medical examiners continue to cite it, and according to KFF Health News, Florida recorded 85 deaths due to excited delirium between 2009 and 2019, with excessive force by police cited in 62 percent of those cases. As Joanna Naples-Mitchell, an attorney who worked on a Physicians for Human Rights review of excited delirium, told KFF Health News, “This is a really important opportunity for ACEP to make things right.”
In other news…
Medical school students need more support for their mental health: Not only are med school students under constant stress, conditions have only gotten worse since the onset of COVID-19. Now, new data shows they’re not getting the proper help. Besides a fear of being punished for struggling in the first place, students now have to navigate med school health insurance plans with deductibles so high they can’t afford to get mental health treatment. Med school students Amelia Mercado and J. Wesley Boyd wrote about the challenges in STAT News.
Side eyes for the Shadow Work Journal all over social media: Keila Shaheen, 24, is not a therapist. Though she holds a BA in psychology and marketing from Texas A&M and completed an online course in CBT at another school, she’s really more of a TikTok influencer these days. But no matter; her videos on the subject have reached as many as 10 million views followed by bestselling author weeks on Amazon. The Shadow Work Journal is Shaheen’s self-published work intended to help people struggling with their mental health. “It’s exciting because it can open doors for people, said psychotherapist Connie Zweig, “but it’s also dangerous if people think this is all they need.”
Your sweatshirt on Prozac: Eileen Kelly, host of the Going Mental podcast quickly sold out of apparel labeled Lexapro, Prozac, and “Depressed, but make it hot!” “I was really focused on making sure no one feels ashamed for having to take these medications,” she told the New York Times. Her goal is to help break the stigma of having mental illness. Destigmatization of mental illness is a good thing, said Shannon Bennett, clinical director at Center for Youth Mental Health at NewYork-Presbyterian. “The goal of raising awareness, decreasing stigma and contributing to a culture of shared support is a good thing,” she said. “By seeing someone on the street you may identify with, it validates your feelings and helps you feel less alone.”
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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