text:
To become a mental health nurse would you have to become a hospital nurse first?
I really want to become a mental health nurse. But if i can get into a mental health nursing course at university straight after college, i dont want to become a hospital nurse. Help?
If someone told you they had access to specialty cardiology treatment but not to primary care, you may find it ironic. If someone told you they are being treated for their cancer but not for their co-occurring diabetes, it would seem ridiculous. Yet this kind of health care is typical to that given to individuals suffering from serious mental illness.
The National Association of State Mental Health Program Directors 2007 study on morbidity and mortality in people with serious mental illness revealed that, on average, people with severe mental illness die 25 years earlier than the general population. This was a bombshell. But the tragic report findings corroborated what those in the trenches — community mental and behavioral healthcare providers — suspected; community mental health organizations are helping people recover from mental illness when their lives are endangered due to neglect of other serious health issues.
The barriers to complete care seem daunting. A recent survey of community behavioral organizations revealed that although over 90% consider general healthcare for consumers a priority, only one in two organizations has any general healthcare capacity, and less than one in three has the capacity to provide the services onsite. The most common barriers to obtaining general medical services are problems in reimbursement, workforce limitations, physical plant constraints, and lack of community referral options.
The large unmet need for mental health and substance abuse specialty services within general healthcare also cannot be ignored. A 2007 Health Affairs article notes that community health centers reported that over 40% of uninsured patients and 20% of Medicaid patients had difficulty accessing mental health services; and over 50% of uninsured patients and 30% of Medicaid patients were challenged in accessing substance abuse treatment. Primary care needs the staff and skills to assess behavioral health conditions; and behavioral health care providers need the capacity to accept and treat the complex cases referred to them from primary care.
There are community behavioral health organizations that have implemented innovative clinical and financing models that make possible the provision of comprehensive care in collaboration with primary care centers. Collaboration is evident in co-located mental health and primary care services, enhanced referral processes between mental health and primary care, sharing of patient information, and cross-training of staff.
Community mental health organizations' job is saving and improving lives. In addition to legislative activity, many mental health organizations have been active on the practice improvement front. Using web-based technologies have formed virtual learning communities where behavioral health and primary care professionals share information and offer feedback and advice.
Community mental health organizations around the U.S. will continue to advocate for increased attention and resources for the whole health of our communities — but to be effective they need your help. Here are four things that every person can do to help:
1.) Make your voice heard –
Advocate within your community and your state for resources to ensure that people with serious mental illnesses and addictions have access to primary care.
2.) Be creative –
Work with existing funding mechanisms to begin to address the whole health of people with serious mental illnesses and addictions; explore all the options.
3.) Foster collaboration –
Look for ways to begin to work with your local community health center or primary care practices. What might start with sending your staff to a primary care center can evolve into a robust partnership with primary care services being delivered within your organization.
4.) Focus on health -
Consider offering Mental Health First Aid certification programs in your community, helping people identify mental illnesses and respond to mental health crises. And as the most important healthcare providers in the lives of people with serious mental illnesses and addictions, promote healthy lifestyles and effective management of chronic conditions
Let us imagine the future — a future where we prevent illness whenever possible and when we can't prevent, we educate, we intervene early, and we deliver the best possible care to every person, every place, every time. And if we imagine it — together we will make it happen.
Mental health care system under stress in Arizona
By Lynanne Gelinas Special to the Herald/Review SIERRA VISTA — A local mental health nonprofit is rallying to raise money to offset a more than 50 percent cut to its budget, while supporting an increased number of people seeking services after being cut from state programs. The Southeastern Arizona chapter of the National Alliance on Mental Illness has been hit hard by budget cuts made by the …
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Amanda Wang is the lead organizer of RethinkBPD, a peer-led advocacy and support group for Borderline Personality Disorder (BPD). Ms. Wang participated in a lecture series on BPD at the National Institute of Mental Health in Bethesda, Maryland. She shared her personal experience in coping with BPD as well as the objectives of RethinkBPD.
Mental Health Care Coverage in Minnesota: Supplementing Federal Healthcare Reform
In 2007, the governor of Minnesota proposed a mental health initiative and the legislature passed it. One of the more important components of the initiative was legislation amending Minnesota's two programs for the uninsured – General Assistance Medical Care and Minnesota Care – to add to the comprehensive mental health and addictions benefit.
Who Is Covered?
General Assistance Medical Care covers those with income at or below 75% of the federal poverty level who meet one or more of additional criteria known as General Assistance Medical Care qualifiers. Qualifiers include waiting or appealing disability determination by Social Security Administration or state medical review team; or being in a homeless or live in shelter, hotel, or other place of public accommodation.
Minnesota Care covers children and pregnant women, parents, and caretakers up to 275% of the federal poverty level, except that parents and caretakers gross income cannot exceed ,000. Single adults without children increased to 200% of federal poverty level by January 1, 2008 and will rise to 215% of federal poverty level by January 1, 2009.
What Services Are Covered?
For Minnesota Care, there are limits of ,000 on inpatient care for any condition (physical, mental health, or addictions) for parents over 175% of federal poverty level and childless adults. For General Assistance Medical Care, inpatient benefits are fully covered. Both programs cover chemical dependency outpatient services. An intensive array of outpatient and residential mental health services are available.
What Is The Cost?
In Minnesota, the Medicaid Temporary Assistance for Needy Families population, General Assistance Medical Care and Minnesota Care are enrolled in comprehensive nonprofit health plans that are responsible to deliver and are at risk for the entire health benefit, including behavioral health. Adding mental health rehabilitative services (including adult rehabilitative mental health services individual and group rehabilitation services, assertive community treatment, intensive residential treatment and mobile and residential crisis services) to Minnesota Care was projected to cost .40 per person per month. For General Assistance Medical Care, which includes a homeless population, the cost was .01 per person per month. The additional targeted case management service was projected to cost .22 per person per month for Minnesota Care and .66 for General Assistance Medical Care.
The legislature appropriated a total of million in additional state dollars in fiscal year 2008 and $ 3.5 million in fiscal year 2009 to add the adult rehabilitative services and case management in Minnesota Care. State funds previously targeted for case management were moved from the counties to the state in an amount of .4 million in fiscal year 2009.
What Led To Comprehensive Coverage?
The state collected data on the residents served by Minnesota Care, General Assistance Medical Care, and Medicaid managed care plans serving non-disabled populations, and discovered that an increasing number of individuals with serious mental illnesses were in these plans. Several insurance reforms – similar to those included in the national healthcare reform bill – modified the private market, including guaranteed issue in small and large group plans, broader rate bands, parity for mental health and chemical dependency services, medical loss ratios, high risk insurance pool, and others. A lawsuit by the attorney general called attention to health plan denials of payment for court-ordered treatment, for example for civil commitment or out of home placement for adolescents.
Health plans settled with an agreement that behavioral and mental health benefits would be covered by a health plan if the court based its decision on a diagnostic evaluation and plan of care developed by a qualified professional. In addition to the court-ordered services provision, the state contracts and capitation with prepaid health programs (Minnesota Care and General Assistance Medical Care) were amended to align risk and responsibility for services in institutions for mental illnesses, 180 days of nursing home or home health, and court-ordered treatment. There were also highly successful experiments reducing costs and improving outcomes for commercial and non-disabled Medicaid clients who were offered a more intensive community based mental health service that improved coordination with and linkages to behavioral healthcare, primary care, and other needed services.
These demonstrations produced a positive return on investment – .38/person/month – and gave the health plans tools to manage the increased risk that resulted from several insurance reforms, including parity, a statutory definition of medical necessity, and the court-ordered treatment provision.
The state supported comprehensive coverage because it sought to provide mental health and addiction services in Minnesota as part of mainstream healthcare. Minnesota's mental health agency and other stakeholders desired to move mental illness from its historical treatment as a social disease requiring social services to an illness like any other. They wanted to foster earlier interventions and avoid shifting enrollees among different programs in order to access specific services. Operationalizing this change required rethinking medical necessity determinations, provider credentialing, contracting, procedure codes and other processes common to private insurance plans.
How Did It Get Through The Political Process?
Three factors significantly contributed to the political viability of a benefit expansion in the Minnesota Care and General Assistance Medical Care programs:
>> The governor of Minnesota and the administration provided strong leadership. The provisions to expand the mental health benefits in these plans were part of the governor's mental health initiative, set forth in advance of the 2007 legislative session.
>> An extremely strong coalition of stakeholders formed a mental health action group. This group is co-chaired by a representative from the department of human services and included representation from the private insurance industry and organized and knowledgeable advocacy and provider communities.
>> There was strong support in the legislature for the expansion of benefits in Minnesota Care and General Assistance Medical Care, including from a member of the finance committee in the house, who has a son with schizophrenia. The creation of a mental health division in the health and human services policy committee also helped move the policy discussion forward.
Why Does This Approach to Healthcare Reform Work?
A recent survey of community behavioral health organizations found that on average, 42% of reimbursement for services came from private insurers. While this represents the average, the survey found that there was quite a range in reimbursement sources. For community behavioral health organizations that specialize in services such as Assertive Community Treatment or case management, Medicaid is the predominant reimbursement source, either through fee-for-service or managed care.
Reimbursement from private insurance and Medicaid managed care is uniformly better than Medicaid fee-for-service. In addition to higher rates, the private insurers and Medicaid managed care organizations have been willing to offer special contracts for packages of services for crisis care and hospital discharge plus aftercare.
Mental health employment program set to close
A program that helps people with mental health disabilities land jobs has lost its federal funding and will have to close down by the end of March. The national BUILT Network program — administered by a St.[...]
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by xeeliz
There are many facets to the world of mental health, especially when it comes to health insurance and finding adequate coverage for a variety of afflictions and disorders. We've put together some answers to some of the more common questions revolving around these topics for you below.
Do most health plans include mental health coverage? The answer, simply put, is yes. The vast majority of insurers and health plans cover at least a limited amount of mental health care.
According to a recent employer survey published in the journal Health Affairs:
•91 percent of small firms (10-499 employees) and 99 percent of large firms offer mental health and substance abuse coverage in their most used medical plans.
•Mental health and substance abuse coverage was included in 87 percent of indemnity plans, 88 percent of HMOs, 97 percent of Point of Service (POS) plans and 93 percent of Preferred Provider Organizations (PPOs).
It is commonly acknowledged today, in 2006, that most employees who have employer-based health insurance have access to mental health coverage, and many of the employees who don't have coverage have simply chosen not to join an employer's plan that includes mental health services.
Does mental health coverage cost more? Yes, this is generally the case. There are limits to mental health coverage and the reason why most employers impose limits is due to cost. Estimates vary widely of how much more mental health coverage costs. Here are some results from some studies:
•A 1998 study sponsored by National Advisory Mental Health Council (NAMHC) Parity Workgroup, a division of the federal National Institute of Mental Health, estimated that mental health services would add less than 1 percent to the cost of a health insurance policy for an HMO.
•A 1998 study by Mathematica estimated a 3.6 percent increase across all plans, with a range of 0.6 percent increase for HMOs up to a 5 percent increase for fee-for-service plans.
•A 1997 analysis by the actuarial firm Milliman & Robertson for the National Center for Policy Analysis, examining the cost of a typical mental health mandate (not specific legislation), concluded that mental health services parity legislation tends to drive up costs by 5 percent to 10 percent.
With regard to mental insurance in general, how do insurance companies treat mental illness? Insurance companies tend to be somewhat wary of mental health claims due to the increase of fraudulent claims. When Medicare looked for fraud in the community mental health centers last year, it barred 80 of them in nine states from participating in the program.
The Health Care Financing Administration (HCFA), which administers Medicare, knew something was amiss when the average yearly cost for each senior getting mental health services jumped from ,642 in 1993 to more than ,000 by 1997.
Medicare administrator Nancy-Ann DeParle contended at the time that 90 percent of the patients had no mental illness serious enough to qualify for special treatment.
That being said, it's straightforward to understand why there is trepidation on the part of health insurance providers.
What mental conditions are typically covered, and not covered by health plans? Generally speaking, a health plan pays for only those services included in the plan's list of covered services. In the case of mental health services, inpatient and outpatient treatment are most often covered by health plans.
However, there is a continuum of services between inpatient (mental health clinic) and outpatient care that effectively treat many mental disorders and are often more cost-effective than inpatient care at a mental health clinic.
These intermediate services include nonhospital residential services, partial hospitalization services, and intensive outpatient services such as case management and psychosocial rehabilitation. Psychosocial rehabilitation includes pharmacologic treatment, social skills training, and vocational rehabilitation.
Such services are covered by approximately half of employer-sponsored health plans.
Prescriptions. Are they covered? Coverage of prescription medications is also important in providing access to treatment for mental health disorders. And, on a positive note, Prescription medications are nearly always covered by health plans (U.S. Department of Labor, 1996; 1998), but this coverage is sometimes limited by formulary restrictions.
Check with your healthcare provider for the exact details on what applies to you and your family with regard to your specific circumstances.
VICTORIA – A growing number of seniors are battling mental illness. A number of factors may lead the elderly on a path to anxiety and depression. Chronic pain, isolation, limited mobility and grief are some of the possible variables – so is the fact that seniors have been told to "keep a stiff upper lip." Pam Edwards of Capital Mental Health says the stigma for seniors may be greater than more recent generations who have been encouraged to talk about their feelings. 7 per cent of British Columbians over 65 years are living with mental illness. More worrisome to health officials is a "coping" mechanism. According to the BC Government 13 per cent of seniors drink alcohol every day and 9 per cent are consuming harmful amounts of alcohol. Edwards suggests a personality shift is often the first sign of a mental illness. Exercise and staying socially engaged can help seniors combat some forms of depression.
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Norwich chief exec to lead mental health merger
The boss of Norfolk's mental health trust has been appointed to oversee the proposed merger between the Norfolk and Suffolk mental health trusts.
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Health Education as a core course for Teachers' Education: to enhance the Mental Health of students
Health Education as a core course for Teachers' Education: to enhance the Mental Health of students
Akintunde, P. G. (Ph.D)
Department of Vocational & Special Education
University of Calabar
Calabar, Cross River State, Nigeria
Olanipekun, O. Fola
Olabisi Onabanjo University
Ago-Iwoye, Ogun State, Nigeria
This paper is primarily concerned with the role of teachers in enhancement of mental health of students. It discuses the factual picture of the functions of the teachers in a changing social and education environment, identifying the social community in the actualization of the human need (mental health) that are otherwise ignored. It highlights the complex expectation of the public from the role of teachers. The expectation makes the duties of teachers diffused; they in some measures serve as social workers and perform in addition to duties other than classroom teaching. Their responsibilities for social training in a changing environment, particularly in the misconception of mental health are discussed and recommendation made.
Key Words: Health education for teachers' education, educating teachers in mental health, health education a necessity for teachers.
The World Health Organization (WHO) (1946) adopts a definition of health as "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity", at the International Health Conference, New York; 19-22 June, 1946 signed on 22 July 1946 by the representative of 61 States (WHO official records No.2 100). It enters into force on 7th April 1948, thereby declaring health as a fundamental human right.
The complex nature of public expectation of teachers' duties necessitates the need for them to have a social training that will make them meet the challenge resulting from changing environment. School health education aims at constituting healthy learning experiences, healthy environment (physical and mental health) and positive interpersonal relationships between Teachers and students, students and students inside and outside the school environment.
Healthful school living which consists of emotional health, healthful interpersonal relationships, among others provide a safe and healthful environment. The three fold goal of environmental school health education is healthy people in healthy communities in a healthy environment.
Health lies in the functional interaction of the individual and his environment and not determined in terms of the individual isolation. A clinical picture shows the interplay of psychological, physiological and structural factors. The moment a man falls ill, he regresses in an infantile type of psychological condition, a type of adoption neurosis which is normal part of the patient's reaction to his illness (Canestrari, 1963).
However, understanding of mental health by individual teacher and the society at large would be helpful in the conversion of weird and wild experience at early stage to greatness and responsibility in later life. Teachers are expected to have motivational impact on their students. Teachers have more vital role to play in student stress management. Students need to be educated on the effects of stress on achievement, and understand human behavior and how it affects other people in the environment (Olanipekun, 2006).
Key Words: Health education for teachers' education, educating teachers in mental health, health education a necessity for teachers.
Mental Health
Mental health is a term to describe either a level of cognitive or emotional well-being or an absence of mental disorders. It may include an individual's ability to enjoy life and procure a balance between life activities and efforts to achieve psychological resilience (About.com, 2006). It is regarded as expression of ones emotions which signifies a successful adaptation to a range of demands.
World Health Organization (2005) defines mental health as "a state of well-being in which the individual realizes his/her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his/her community". However, the organization recognizes the fact that a complete definition may not be available because of cultural, religion and general environmental influences on determination, recognition of mental health and disorders. World Health Research (2001) explains that definition of mental health depend on cultural differences, subjective assessments, and competing professional theories because they all affect how mental health is defined.
Mental Disorders
The definition of mental disorders is a key issue for mental health and for users and providers of mental health services. Most international clinical documents use the term "Mental Disorders" and some define it as a psychological or behavioral pattern associated with distress or disability.
Mental disorders are conceptualized as disorders of the brain circuits likely caused by development processes shaped by a complex interplay of genetics and experience. It is psychological or behavior pattern associated with distress or disability that occurs in an individual and is not a part of normal development or culture (Yolken and Torrey, 1995).
The recognition and understanding of mental health condition has changed over time and across culture, there are still variations in the definition, assessment and classification of mental disorders, although standard guideline criteria are widely accepted. Diagnoses are made by psychiatrists or clinical psychologists using various methods, often relying on observation and questioning in interviews. Treatments are provided by various mental health professionals.
Yolken and Torrey (1995) records that there are some diagnoses, such as childhood conduct disorder or adult antisocial personality disorder or psychopath, which are defined by or inherently associated with conduct problems and violence. There are conflicting findings about the extent to which certain specific symptoms, notably some kinds of psychosis (hallucination or delusions) that can occur in disorder such as schizophrenia, delusional disorder or mood disorder, are linked to an increased risk of serious violence on average.
Recently, the field of Global Mental Health has emerged, defined as 'the area of study, research and practice that places a priority on improving mental health for all people' (Patel and Prince, 2010). The mediating factors of violence acts, however, are most consistently found to be mainly socio-demographic and socio-economic factors such as age, gender, lower socioeconomic status and in particular substance abuse (including alcoholism) to which some people may be particularly vulnerable (Stuart, 2003).
Types of Mental Disorders
Mental disorders are in categories. There are many facets of human behaviors and personality that can become disorder. This paper sum them from the classifications given by Yolken and Torrey (1995), Kitchener and Jorm (2002) and Keyes (2002).
Anxiety disorder: when anxiety or fear interferes with normal functioning. This may include phobia, generalized anxiety disorder, social anxiety disorder, panic disorder, agoraphobia, obsession, compulsive disorder, and post traumatic stress disorder.
Affective disorders: Affective (emotion/mood) process can become disorders. These are mood disorder (unusual intense and sustained sadness, melancholia or despair) known as major depression or clinical depression (milder but still prolonged depression can be diagnosed as dysthymia).
Bipolar disorders (manic depression): It involves abnormally "high or pressured mood states, known as mania/hypomania, alternating with normal/depressed mood. Yolken and Torrey (1995) states that whether unipolar and bipolar mood phenomena represent distinct categories of disorder or whether they usually mix and merge together along a dimension or spectrum of mood is under debate in the scientific literature.
Pattern of belief, language use and perception can become disorder. Examples are delusion, thought disorder, and hallucinations. These are referred to as psychotic disorders (schizophrenia and delusional disorder).
Schizoaffective disorder: It is a term use for those individuals showing aspects of both schizophrenia and affective disorders.
Personality disorders: paranoid, schizoid and schizotypal, antisocial, borderline, histrionic/narcissistic, avoidant, dependent/obsessive-compulsive.
Adjustment disorder: This is an inability to sufficiently adjust to life circumstances begins within three months of a particular event or situation, and ends within six months after the stressor stops or is eliminated.
Eating disorder: anorexia nervosa, bulimia nervosa, exercise bulimia or binge eating order.
Sexual disorder: gender identification disorder, dyspareunia, and ego-dystonic homosexuality.
Sleep disorder: insomnia
Tic disorder: Tourette's syndrome, kleptomania, pyromania, gambling, substance dependence or abuse or addiction is in this category.
Conduct disorder: Inability to behave normally with expected discipline in the society. If this continues into adulthood, it may be diagnosed as anti-social personality disorder (psychopath).
Mental disorders are common world wide. WHO (2000) records that one out of three people in most communities report sufficient criteria for at least one at some point in their life.
Sanfford (1978), states that many children have behaviors that conflict with a reasonable school environment which could not be described as a healthful one and invariably affects their performance and the adaptation of others to them. Carter, Briggs-Gowan, and Davis (2004) exclaims that many children exhibit a deviation from age appropriate behaviors which interferes with child's own growth and development and/or the issue of others.
Causes of mental disorders
Mental disorders can arise from a combination of sources. In many cases there is no single accepted cause currently established. It is commonly belief that mental disorder results from genetic vulnerabilities exposed by environmental stressors.
WHO (2000) reveals that there is a strong relationship between the various forms of severe and complex mental disorder in adulthood and abuse (physical, sexual or emotional) or neglect of children during the developmental years. According to the report 'children sexual abuse' alone plays a significant percentage of all mental disorder in adult females, most notable example being eating disorder and borderline personality disorder.
Jefferoate (1969) explains that environment can cause or trigger physical or mental ill-health while psyche influences the development of organic disease in remote parts of the body, and illness begets anxiety and this in turn begets illness. The mental health of an individual depends on the continuous satisfaction of specials requisites in the pattern of his psychological stimulation, the opportunity to give and receive love and affection, to be dependent and be depended upon. When one or more of these is/are missing the level of mental soundness is altered resulting in mental illness.
The following are considered as contributing factors or causes of mental disorder (WHO, 2000; Steadman, Mulvey, Monahan, Robbins, Appelbaum, Grisso, Roth, and Silver, 1998; and Kitchener and Jorm, 2002):
Studies have shown that genes often play an important role in the development of mental disorder, although the reliable identification of connections between specific genes and specific categories of disorder has proven more difficult.
Environmental events surrounding pregnancy and birth have been implicated.
Traumatic brain injury may increase the risk of developing certain mental disorder.
There has been some tentative inconsistent links found to certain viral infections, to substance misuse, and to general physical health.
Social influences have been found to be important, including abuse, bullying and other negative/stressful life experiences.
Wider community vices/problems such as unemployment/employment problems, socio economic inequality, and lack of socio cohesion have been attributed also to mental disorder.
Society response to mentally ill people
Response of people to mentally ill persons or people with nervous breakdown is pathetic and unhealthy. A study reported by Times Online (2009) note that assistance given by extended families that often help and supportive religious leaders who listen with kindness and respect often contrast with usual practice in psychiatric diagnosis and medication. Due to lack of proper education and ignorance on causes of mental illness and emotional problems, prevention approach and treatment, the public fail to understand the true nature of many of these mental illnesses and fail to seek the available services. Thus rather than helping to reduce/cushing the effect of the problem or the cause of the problem, the condition of the affected individuals are worsen. Some conditions are not as bad as people look at them and if they are well handled the situation may change for better.
Murray, Lopez, and World Health Organization (1996) reports:
"The burden of mental illness on health and productivity throughout
the world has been profoundly underestimated. Data developed by
the massive Global Burden of disease study, conducted by the WHO,
the World Bank, and Harvard University revealed that mental illness,
including suicide, rank second in the burden of disease in established
market economics, … It further revealed that nearly two third of all
the people with diagnosable mental disorders do not seek treatment. It
is believed that when people understand that mental disorders are not
the result of moral failings or limited will power, but are legitimate
illnesses that are responsive to specific treatments, much of the
negative stereotyping may dissipate"
They report further that the 10 leading causes of disability (counting lost years of healthy life) at age 15-44 were: major depression, alcohol use, road traffic accident, schizophrenia, self inflicted injuries, drug use, bipolar disorder, obsessive-compulsive disorders, osteoarthritis, and violence.
Thompson (2010) in his study 'Addressing Suicide: is treatment more important than therapist?' reports a study by Dr. Marsha Linehan at the University of Washington who suggested that "type of treatment may make a big difference for people who have borderline personality disorder (BPD), a chronic condition associated with difficulty in effectively managing one's emotions., multiple suicide attempts, physical self harm (e.g. cutting on oneself) and impulsive, often destructive actions."
Stigma remains a serious problem, with many cases of human rights violations like chaining or beating experienced by people with mental illness. Perpetrators are rarely brought to justice.Royal College of Psychiatrist reported that research has shown that there is stigma attached to mental illness.
There are on-line psychiatric or mental illness self-diagnose available now stating the weekly changes in individual mental health and quality of life. Report has it that annual expenditure on health in Nigeria is less than 3% of Gross Domestic Product, amounting to per capita, mental health services received only a very small part of this total health budget.
Factors underlying people' behavior towards mental ill people
Many factors have been attributed to uncaring attitude of people to the mentally ill people. These include:
Predisposition factors: The antecedents to behavior. What provide the rationale or motivation for the behavior (e.g. knowledge, beliefs, values, attitudes, confidence, and existing skills).
Enabling factors: The conditions in the environment that enable the motivation to be realized. These factors may be availability, accessibility to facilities for caring for the affected (finance, psychiatric care, etc).
Reinforcing factors: What follow the behavior (acceptance of the patient that he/she needs help).
Knowledge: It is necessary for a conscious action to take place; knowledge can be gained from information provided by health professionals, parents, teachers, books and mass medial or other sources through experience.
Belief: A conviction that a phenomenon or object is true or real. Most of them are derived from parents or other respected people in the life of the beholder.
Values: The value given to things tends to cluster within ethnic group and across generations of people sharing a common history and geographical identity.
Attitude: This reflects likes/dislikes towards certain categories of objects, persons/situation. It is sometimes based on limited experience. It may be formed without understanding the whole situation.
Relationships and morality: Clinical conceptions of mental illness also overlap with personal and cultural values in the domain of morality, so much so that it is sometimes argued that separating the two is impossible without fundamentally redefining the essence of being a particular person in a society.
Tilbury and Rapley (2004) and Karasz (2005), agree that in clinical psychiatry, persistent distress and disability indicate an internal disorder requiring treatment; but in order context, the distress and disability can be seen as an indicator of emotional struggle and the need to address social and structural problems. The poor economic situation has affected the standard of living of many people especially those we can class as poor.
The unchecked wide gap between the rich and the poor has resulted in some cases to family disintegration, with adverse effect on children who are being abused. These and other factors have led to increase in mental illness of many young ones within school age.
If their society cannot accommodate them, schools have no choice, and they cannot be discriminated against. Every child has right to education in Nigeria. Therefore schools should learn how to accommodate and integrate them into the system.
Psychotherapy involves a variety of treatment techniques, often used along with medication. There are many ways of treating mental disorders, some of which are stated below (general and specific):
Individual: involving only the patent and the therapist.
Group – involving two or more patient in the therapy at the same time. It gives them the opportunity to share experiences and learns and appreciates how others feel too.
Marital or couples: helping spouses and partners understand why their loved one has a mental disorder, what changes in communication, how behaviors can help and what they can do to cope.
Family/relation: Involvement of family or a close relation that has influence or has much information on the patient in improving the condition of patient is vital and recognized. They need to understand what their loved one is going through, how they themselves can cope, and what they can do to help.
Psychoanalytic – the first approach, the patient's thoughts are verbalized including free associations, fantasies, and dreams, from which the analysis formulates the nature of the unconscious conflicts which are causing the patient's symptoms and character problems. It addresses the underlining psychic conflicts and defenses.
Behavior therapy/applied behavior analysis – focuses on changing maladaptive patterns of behavior to improve emotional responses, cognitions, and interactions with others.
Cognitive behavioral therapy – It is based on modifying the patterns of thought and behavior associated with a particular disorder. It seeks to identify maladaptive cognition, appraisal, beliefs and reactions with the aim of influencing destructive negative emotions and problematic dysfunctional behaviors.
Psychodynamic – a dept psychology with primary aim to reveal the unconscious content of a client's psyche in an effort to alleviate psychic tension. It gets its root from psychoanalysis.
Existential therapy – It is based on the existential belief that human beings are alone in the world. This association leads to meaninglessness, which can be overcome only by creating one's own values and by meanings. It is philosophically associated with phenomena.
Systemic therapy or family therapy – a process where a net-work of significant others as well as an individual are addressed.
Humanistic Approach – a psychological approach that is a value oriented, holds a hopeful, constructive view of human beings and of their substantial capacity to be self determining, guided by a conviction that intentionality and ethical values are strong psychological forces, among the basic determinants of human behavior.
Eclectic/integrative approach – a combination of two or more therapy techniques for treatment of mental disorder.
Counseling and co-counseling – a psychological approach too but in this case advice and suggestion are given base on the observation and information available to the counselor(s).
Psycho education – This program provides people with the information to understand and manage their problems.
Creative therapies – This involves art works such as music and drama therapies.
Lifestyle adjustments and supportive measures – personal adjustment to situations.
School connection and nature of teachers' duties
WHO (2000) reveals that there is a strong relationship between the various forms of severe and complex mental disorder in adulthood and the abuse (physical, sexual/emotional/neglect of children during the developmental years); and records that sexual abuse of children alone plays a significant percentage of the mental disorder in adult females, most notable examples being eating disorders and borderline personality disorder should be a thing of serious concern to our education institutions. There were records of various abuses of children in our environment, many of which could have been averted if they were well enlightened on how to relate in the society, the self protection or prevention of some of the vices in our society and even counseling for victims.
The socio economic and family problems has made many school children and even the grown ups exhibit some emotional and behavioral problems. Children are the life wire of schools. Therefore, identification and management of emotional and behaviorally disturbed children is very important since teachers are dealing with them directly in schools (Akintunde and Akintunde, 2010)). It is not economically possible for each school to have a psychiatrist as a permanent staff. This inability to have such specialist necessitates equipping teachers with essential knowledge capable of assisting in identifying and administering mental health problems to some extent (Akintunde, 2007).
The more teachers know about how to identify the children mental problems the better and easier for them to deal with such situations when they arise. Their relationship with the students and the community will improve and help tremendously in improving the performance of the students. They will even be in position to enlighten parents of these children and the public in general (Akintunde, 2007).
Educating student teachers on mental health through school health education will go a long way not to assist both students and teachers. Teachers are also part of our community; they also operate under the same condition as their students and people in the community. Therefore they are faced with many challenges as those in the community.
Teachers have their personal problems that stress them up upon which they are still expected to accommodate students' problems most of which are related to mental health problems. In order to make their job easy, they should be armed adequately with enough skills to handle those problems (Sanfford, (1978)).
Although a lay man look at teaching as a job that any man can handle, forgetting that it is a 24hours job, not ending in school hours but continues as carry over after closing hour, the teacher has to prepare for the next day job and also finish assessment/marking of any assignment given to students as home work. The same person has domestic responsibilities to attend to.
In fact he has little or no time for himself talk less of recreation to recuperate him. If he does not know how to manage the situation, he may end up a psychiatric patient. The knowledge of symptoms, identification, management and therapy of mental disorders or illnesses will help him cope and adjust.
The knowledge of mental health will enable the teachers to know how far they can push the students in terms of discipline, academic activities, co-curricular activities and what to do to assist or step down the effect of mental illness on students. There are times that the attitude of some teachers (especially the untrained or half baked ones) can be very tormenting to the life of students. This is getting worse now that teachers indulge in all sorts of corruptions in schools.
Problems associated with integration of children with mental disorders into school system
According to WHO (2000) virtually everybody seems to experience mental disorder at one time or the other. All agents of enhancement of mental health are equally affected mentally too either directly or indirectly. Stress which is a booster of mental illness strikes on everyone; thus, there is need for all and sundry to understand and know how to manage stress.
Guardians' services render by teachers stops in school but students still interact with the environment outside the school where the school is not in the knowing of the nature of the interaction. What happen to the child after school is not under the control of the school. This condition is worse now that almost all schools are operating as day school except few private schools. There is every possibility of the effort of school being rendered useless by counter interaction of the larger society.
The problem in our society is too heavy for individual to carry; talk less of adding another person's problem. As a result of this, there is insufficient value base for a committed ethic of care in our society. Thus committed teacher are rare to find.
The differences in background, ethnicity, culture and other attribute that makes individual unique couple with the general society concept and stigma associated with mental illness/disorders makes individual nature complex.
If teachers are to be carried along in alleviating the problem of mental illness in our society, it means a change in teachers' training curriculum. This is always a problem because generally people do not give in to changes easily. Before you know it Government will also give excuse of lack of money to finance the little alteration the change in curriculum will bring.
Some teachers are bad examples to students and they rather add to the existing problem than solve or reduce it. Whoever cannot manage himself cannot manage others or be a brothers' keeper. Those in this category needs attention themselves and schools should take appropriate step to help them out before they influence the students.
There is no problem without solution. Sanfford (1978) adopts and adapts some psychotherapy techniques to suggest the following ten aids for teachers to actualize a healthy school environment:
Objectivity – To be objective about self and what to do towards what the student does.
Sharing – To share problems and experiences regularly with colleagues, parents and administrators, through conference, formal and informal meeting.
Feedback – Obtain feedback from observation of the child and suggestions from parents, teachers and administration.
Consultation – Where necessary consult expert like psychologist.
Collaboration – Loan out the child for sometime with other teachers, class and environment, then collate feedback on particular trait being addressed.
Observation – Use some observational techniques such as feedback interaction, analysis and other objective recording system.
Be artistic – Literature, theatres, good films, music and art, may somehow become more meaningful to the teacher when it comes to the issue of their children. People in different community are gradually getting used to using these media as tools for integration and communicative models.
Sense of humor – Maintain sense of humor.
Be Professional – maintain a strict sense of professionalizing while remain the personality the teacher is.
Reinforce – Seek reinforcement and assurance from the children in order to provide them with assurance and solid ground to fall on.
Benefit of making health education a core course for teacher education
The awareness and ability to understand the causes and problems associated with mental disorders goes a long way to prevention, management and treatment of these problems, making teaching and learning conducive, effective and enjoyable. Therefore there are lots to benefit from introducing school health education with emphasis on mental health into teachers curriculum. The summary of the benefits are these:
Teachers will be able to discover themselves and relate well with their colleagues and students.
It will enable teachers to understand their students' inadequacies and problems.
Teachers will find it easy to assist their students in reducing the effects of their problems on their academic and relationship with other people inside and outside the school.
Students will have confidence in discussing their problems with their teachers, sharing their dreams with them with the aim of getting valuable advice and support from them.
Relationship between teachers and students will be more cordial, helpful and effective.
Both teachers and students will develop the ability to come to terms with the environment, adjust to situations and blend with people, their inadequacies not withstanding.
All these are attributes that can improve on teaching learning and lay solid foundation for development of a whole man in a child to meet society expectation.
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Mental Health Warnings Preceded Arizona Rampage
Mental health treatment years ago could have helped Arizona gunman to work out his problems before he allegedly unleashed terror on the crowd, a top state health official told FoxNews.com.
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Hearing this tragedy from the mouth of a mother is difficult, but necessary to understand the reality of suicide and how it could be prevented. mental.healthguru.com
this is the fourth song from the Phoenix album of 2008 ____________________________________________________________________________________________________ Let's Go! The lights are on but there is no one home Yeah I'm the type of guy that shouldn't be left alone They say just one more night of observation There's nothing like a permanent vacation Hey! ohh! Break down like ya want me to But I will not give control to you Hey! Ohh! Sniffed like a pound of glue To forget all the things you put me through Hey! Ohh! That left a residue Now I'm nuts just like a blue cashew I go Psycho (psycho) Psycho (psycho) And all I want is to go home just for a bit (hey hey hey) But these padded rooms are the shit! Whoa-oh–oh-oh I'm happy in my mental health Whoa-oh–oh-oh These conversations with myself Whoa-oh–oh-oh They say that only time will tell… whatever I'm happy in my mental health I'm happy in my mental health 1, 2, 123, Go! Hey meet a friend of mine, now where'd he go? He's probably sitting there but you would never know They say "just one more shock, try not to resist" They say "lie down and bite on this" Hey! Ohh! Electric shocks away But the voices in my head are here to stay Hey! Ohh! The warshack tests are lame But I get more drugs than the DEA Hey! Ohh! One day voodoo and pray They take your shoe laces away You go psycho (psycho) Psycho (psycho) And all I want is to go home just for a bit (hey hey hey) But these padded rooms are the shit! Whoa-oh–oh-oh I'm happy in my …
The Four Quadrant Model for Integrating Health Care for Mental Health and Substance Abuse Patients
by xeeliz
The Four Quadrant Model is a proposed model for the clinical integration of mental health and behavioral health services. A focus on the prevalence of co-occurring disorders (i.e. depression and alcoholism) is paramount in this model. The Four Quadrant Model builds on the 1998 consensus document for mental health and substance abuse/addiction service integration. This model for a comprehensive, continuous and integrated system of care describes differing levels of mental health and substance abuse integration and clinician competencies based on the four-quadrant model, divided into severity for each disorder:
> Quadrant I: Low mental health – low substance abuse, served in primary care
> Quadrant II: High mental health – low substance abuse, served in the mental health system by staff who have substance abuse competency
> Quadrant III: Low mental health – high substance abuse, served in the substance abuse system by staff who have mental health competency
> Quadrant IV: High mental health – high substance abuse, served by a fully integrated mental health and substance abuse program
The Four Quadrant model is not intended to be prescriptive about what happens in each quadrant, but to serve as a conceptual framework for collaborative planning in each local system. Ideally it would be used as a part of collaborative planning for each new behavioral health and community mental healthcare site, with the local provider(s) of public behavioral health services using the framework to decide who will do what and how coordination for each person served will be assured.
The use of the Four Quadrant Model to consider subsets of the population, the major system elements and clinical roles would result in the following broad approaches:
Low behavioral health – low physical health complexity/risk, served in primary care with behavioral health care staff on site; very low/low individuals served by the principle care provider, with the behavioral health care staff serving those with slightly elevated health or behavioral health risk.
The principle care providers give primary care services and uses standard behavioral health screening tools and practice guidelines to serve most individuals in the primary care practice. Use of standardized behavioral health tools by the principle care providers and a tracking/registry system focuses referrals of a subset of the population to the behavioral health clinician. The role of the primary care based behavioral health clinician is to provide formal and informal consultation to the principle care providers as well as to provide behavioral health triage and assessment, brief treatment services to the patient, referral to community and educational resources, and health risk education. Behavioral health clinical and support services may include individual or group services, use of cognitive behavioral therapy, psycho-education, brief substance abuse intervention, and limited case management. The behavioral health clinician must be competent in both mental health and substance abuse assessment and service planning. The principle care provider prescribes psychotropic medications using treatment algorithms and has access to psychiatric consultation regarding medication management.
The consumer of care, by seeking care in primary care, has selected a "clinical home." Consistent with appropriate clinical practice, that should be honored. The primary care and specialty behavioral health system should develop protocols, however, that spell out how acute behavioral health episodes or high-risk consumers will be handled. This will also lead to clarity regarding the "clinical home" of consumers with serious persistent mental illness who are currently stable, which should be based upon consumer choice and the specifics of the community collaboration.
High behavioral health – low physical health complexity/risk, served in a specialty behavioral health system that coordinates with the principle care providers.
The principle care provider provides primary care services and collaborates with the specialty behavioral health providers to assure coordinated care for individuals. Psychiatric consultation for the principle care providers may be an element in these complex behavioral health situations, but it more likely that psychotropic medication management will be handled by the specialty behavioral health system. The role of the specialty behavioral health clinician is to provide behavioral health assessment, arrange for or deliver specialty behavioral health services, assure case management related to housing and other community supports, assure that the consumer has access to health care, and create a primary care communication approach (e.g., e-mail, v-mail, face to face) that assures coordinated service planning, especially in regard to medication management.
Specialty behavioral health clinical and support services will vary based upon state and county level planning and financing; some localities may encompass the full range of services offered by specialty behavioral health systems including:
Specialty Mental Health Services
> Crisis respite facilities
> 24/7 crisis telephone
> Crisis residential facilities
> Mobile crisis team
> Crisis observation 23 hour beds
> Urgent care walk in clinic
> Locked sub-acute residential
> Inpatient (voluntary and involuntary)
> Dual diagnosis inpatient
> Hospital discharge planning
> Partial hospitalization
> In-home stabilization
> Outreach to homeless shelters
> Outreach to jail/corrections
> Outreach to other special populations
> Individual/family treatment /counseling
> Group treatment/counseling
> Dual diagnosis treatment groups
> Multifamily groups
> Psychiatric evaluation/consultation
> Psychiatric prescribing/management
> Advice nurse (medication issues)
> Psychological testing
> Services for homebound frail or disabled
> Specialized services for older adults
> Brokerage case management
> 24/7 intensive home /community case management
> School-based assessment and treatment
> Supported classroom
> Stabilization classroom
> Day treatment (adult, adolescent, child)
> Supported employment /supported education
> Transitional services for young adults
> Individual skill building /coaching
> Intensive peer support
> After school structured services
> Summer daily structure and support
Specialty Substance Abuse Services
> Sobering sites
> Social detoxification/residential
> Outpatient medical detoxification
> Inpatient medical detoxification
> Pre-treatment groups
> Intensive outpatient treatment
> Outpatient treatment
> Day treatment
> Aftercare/12 step groups
> Narcotic replacement treatment
Residential Services
> Boarding homes
> Adult residential treatment
> Child/adolescent residential treatment
> Transitional housing
> Adult family homes
> Treatment foster care
> Low income housing (dedicated to behavioral health consumers)
Supports for Serious Persistent Mental Health Populations
> Representative payee/financial services
> Time limited transitional groups
> Parent support groups
> Youth support groups
> Dual diagnosis education/support groups
> Caregiver/family support groups
> Youth after school normalizing activities
> Youth tutors/mentors
The behavioral health clinician must be competent in both mental health and substance abuse assessment and service planning. A specific standard of practice should be adopted that defines the methods and frequency of communication with principle care providers. Note that this quadrant is where most public sector behavioral health consumers currently can be found.
Low behavioral health – high physical health complexity/risk, served in the primary care/medical specialty system with behavioral health staff on site in primary or medical specialty care, coordinating with all medical care providers including disease managers.
The principle care providers provides primary care services, works with medical specialty providers and disease managers (e.g. diabetes, asthma) to manage the physical health issues of the individual and uses standard behavioral health screening tools and practice guidelines to serve most individuals in the primary care practice. Use of standardized behavioral health tools by the principle care providers and a tracking/registry system focuses referrals of a subset of the population to the behavioral health clinician. The role of the primary care or medical specialty based behavioral health clinician is to provide behavioral health triage and assessment, consultation to the principle care providers or treatment services to the patient, referral to community and educational resources, and health risk education. Behavioral health clinical and support services may include individual or group services, use of cognitive behavioral therapy, psycho-education, brief substance abuse intervention, and limited case management. The behavioral health clinician must be competent in both mental health and substance abuse assessment and service planning. The principle care provider prescribes psychotropic medications using treatment algorithms and has access to psychiatric consultation regarding medication management.
Depending on the setting, the behavioral health clinician may also serve as a health educator regarding lifestyle and chronic health conditions found in the general public (diabetes, asthma) or conditions found in at-risk populations (Hepatitis C, HIV). These population-based services, as articulated by Bob Dyer, would include: patient education, activity planning; prompting; skill assessment; skill building; and, mutual support. In addition to these disease management services, the behavioral health clinician might serve as a physician extender, supporting efficient use of physician time by problem solving with acute or chronic patients, as well as working with patients on medication compliance issues.
Specialty healthcare and disease management programs could also integrate depression screening into a wide array of self management and rehabilitation programs, building on current research findings regarding the frequency and impact of depression in cardiovascular or diabetes populations.
High behavioral health – high physical health complexity/risk, served in both the specialty behavioral health and primary care/medical specialty systems; in addition to the behavioral health case manager, there may be a disease manager, in which case the two managers work at a high level of coordination with one another and other members of the team.
The principle care providers works with medical specialty providers and disease managers (e.g. diabetes, asthma) to manage the physical health issues of the individual, while collaborating with the behavioral health system in the planning and delivery of behavioral health clinical and support services, which include those listed in Quadrant II. Psychiatric consultation is a key element in these most complex situations. The role of the specialty behavioral health clinician is to provide behavioral health assessment, arrange for or deliver specialty behavioral health services, assure case management related to housing and other community supports, and collaborate at a high level with the healthcare system team. The behavioral health clinician must be competent in both mental health and substance abuse assessment and service planning.
In some settings, behavioral health services may be integrated with specialty provider teams (for example, Kaiser has behavioral health clinicians in OB/GYN working with substance abusing pregnant women). With the extension of disease management programs into Medicaid health plans, there is the likelihood of coordinating with disease managers in addition to healthcare providers. The behavioral health clinician and disease manager should assure they are not duplicating tasks, but working together to support the needs of the consumer. A specific standard of practice should be adopted that defines the methods and frequency of communication.
Mental Health At New Low For College Freshmen
A survey shows the mental health of college freshmen sank to an all-time low this academic year.
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A mental health billing service covers many activities, but there is one main goal that any medical biller has, and that is to process treatment descriptions and file claims. A mental health billing service uses special software to handle all billing problems, generate cash flow reports or see what are the insurance contacts that generate the most money. Mental health billing services also include follow- ups in cases of overdue payments, answering insurance company or patients' concerns or questions or even offer training to their clients.
There are several reasons why a professional should use mental health billing services instead of doing his/ her own mental health billing. First of all, a mental health billing service saves their practice a lot of time and money. A mental health professional' s time is put to better use when he or she is seeing patients, instead of doing mental health billing. There are many time- consuming aspects to doing mental health billing and some of these aspects include looking into insurance benefits or appealing denied claims. This job is better done by a medical biller who has the required experience to easily obtain the necessary information. An experienced medical biller plays an important role in the mental health billing service provided to health professionals. Moreover, by using a mental health billing service, the health professional will spend less money than hiring his/ her own staff or doing the mental health billing by him/ herself. Investing in new employees' training, wages and accommodation requires a substantial amount of money. If he or she decides to do mental health billing on their own, then precious time will be wasted, and time is money. The best solution would be to use a mental health billing service.
Second of all, a mental health billing service means less paperwork. The whole mental health billing process is done by using the computer, the internet and special software, which means that paperwork will be reduced considerably. Of course not all paperwork can be left in the hands of the medical biller, but much of the paperwork related to insurance can be handled by the biller. Moreover, whenever a new client comes, the medical professional has to do little else but send the form to his medical biller. He/ she will enter the information in a computer and the only task left for the medical professional is to send day sheets with the patients who kept their appointments or what services they have received. Moreover, if the mental health professional desires, he/ she can enter all this information in the computer, thus saving more time and paperwork.
Thirdly, by using a mental health billing service, a professional can gain more clients. The time spent on doing administrative work can be put to better use by developing great marketing strategies to attract clients. A medical biller can handle many of the administrative work, so the medical professional can learn how to improve his/ her practice and have more clients.
A mental health billing service gives any mental health professional the opportunity to grow and make a name for himself or herself in that business. Doing mental health billing for them is just one of the many services that a mental health billing service offers.
For more resources about mental health billing or even about Mental health billing service please review this website http://www.mymedicalbillingservice.com
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Mental health budget goes to Sups
Uncertainty ruled Thursday over the requested budget proposed by Irene Blair, the central point coordinator for mental health and developmental disabilities services in Webster Count.
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SriLankan Airlines' entry, among an elite list of world airlines that vied for Passenger Choice Awards of the Airline Passenger Experience Association (APEX) in USA, won the award for Best in Region: Asia & Australasia, at a gala ceremony in Long Beach, California, 17th September, 2012.
The ceremony was held during the APEX 2012 EXPO at the Long Beach Convention Centre from 17-20 September, the premier venue for exhibitors to showcase new products and innovations that will improve the airline cabin environment and enhance the air travel experience.
APEX, which was formally known as the World Airline Entertainment Association (WAEA) based in New York, is a premier global association management firm with representation in USA, Europe, China, Middle East and Asia. APEX annually celebrates outstanding inflight services, products, innovations of airlines and vendors committed to improve the airline passenger experience worldwide.
Having won a prestigious award for Best in Region – Asia & Australasia competing with finalists Cathay Pacific Airways, Singapore Airlines, Kingfisher Airlines and Air New Zealand, SriLankan was also placed in the finals of three other categories: 'Best Overall Passenger Experience (Up to 50 IFE equipped in Fleet)', 'Best Inflight Video', & 'Best Food & Beverage'.
"Winning an APEX Passenger Experience award underlines our commitment to our passengers and the airline's continued pursuit of excellence to achieve our goal in providing the best experience inflight. The award is of great value to us, as the endorsements come from the passengers themselves" said SriLankan Airlines' Chief Executive Officer, Kapila Chandrasena.
The elite list of airlines that won APEX awards in other categories included, Emirates, Singapore Airlines, Virgin America, South African Airways, Virgin Atlantic, Southwest Airlines, Norwegian & Kingfisher Airlines.
"The awards this year are the result of an impressive turnout on the passenger side, as well as the continued efforts of airlines to stand out as the leaders in passenger experience," said Dominic Green, APEX Events & EXPO Chair and Senior Director for Client Services at Spafax. "We congratulate our winners and look forward to the continued success of this program."While the 2012 Passenger Choice Awards campaign closed on 30th June 2012, the 2013 awards cycle is now open to passengers, who are encouraged to express their views on what is on offer to make their inflight experience worthwhile.
SriLankan wins 'Best in Region' APEX Award
Source = SriLankan

subset: commoncrawl


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Business Ideas in the News / February 17, 2014
Products to amuse and inspire.
Disposable Sunglasses. Trims your eyebrows as a bonus.
Circus Peanut Soap. Now you can get clean with a childhood memory.
Math Quiz Wall Clock. You have to figure out what time it is? You'll never be on time again.
The Draft: Bacon Beer! One word….bacon!
Photos by redferret/trendhunter/gq.
Originally posted by Rich Whittle on February 17, 2014 in Humor.
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Silvio Berlusconi's defense says the former premier was "convinced" that a Moroccan teen at the centre of a sex scandal was related to the former Egyptian president.
Nicolo Ghedini said on Tuesday during closing arguments that the former Italian Prime Minister neither paid for sex with an under-age teen nor tried to cover it up, as charged, and should be found not guilty.
Mr. Ghedini said Mr. Berlusoni would never have discussed the young woman, Karima el Mahroug, at a bilateral lunch with Hosni Mubarak in May 2010 if he had known "she was Moroccan, a minor and lived in Sicily".
Prosecutors allege Mr. Berlusconi later said she was related to Mr. Mubarak only to get her released from custody for allegedly stealing from a roommate.
They are seeking a six-year sentence and lifetime ban from public office.


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6 quarts unsalted popped popcorn2 cups salted peanuts1 cup (2 sticks) butter2 cups packed dark brown sugar1/2 cup white corn syrup1 teaspoon baking soda1 teaspoon salt1 teaspoon vanilla
Measure popcorn and nuts into two 13x9x2 inch baking pans. Bake 5 minutes at 250° F to crisp popcorn.
In heavy saucepan, melt butter; add brown sugar and corn syrup. Bring to a full boil over medium-high heat, stirring constantly. Boil 5 minutes. Immediately remove from heat; add baking soda and salt, then vanilla. Pour syrup over popcorn and nuts, stirring to coat evenly. Bake at 250° F for 50 minutes, stirring every 10 minutes. Cool on waxed paper.
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Thanks, I will keep that in mind.
Thanks, I noted that and changed to an hourly basis concerning implied/art/nudes
Thanks much
this is it
Thanks for that. Reason being is that my last art/nude project was over a year ago and my porfolio has ovbiously changed since. I also have some implied images yet to be posted as they are pending for publication.
If someone wanted to fully go through my portfolio, they would find artistic images on my website, facebook, also under MM credits from a specific artist that I have done art/implied for in past.
Thanks for the input, Maine
She's not going to get booked by Vogue or Ford llamas at 5'2" and her age though. So what they would pay is a bit irrelevant. Someone like Vogue doesn't have to pay a lot, because what llama doesn't want to be in Vogue?
The going rate that I see for freelance nude llamas is about $100/hour, for non-adult work (glamour, art nudes). That doesn't mean that the OP will get that much. But that's the typical full rate the llamas I know quote. Most will negotiate if they like the photographers work and think they might get some good images out of it.
There is definitely a market for models who do art nudes, depending on where you are. To make it work likely means traveling a lot, and you have to be someone people are willing to pay.
Thanks, Robert. I have sought agencies but none will take me on, being that I am a petite and also an older model (though I do have a "young" face)...
As freelance it is most difficult... and my rates are what I feel is best, given the cost I put into past shoots and further experience I have had most recently ($75 max travel, $100 towards props, wardrobe, makeup/hair products *if I have to do it all myself*) .... in the end, you see, I may make it well on shoot A; as they have a hired stylist or two, but shoot B; everyone flaked/got sick/dog ate their makeup brush and I had to muster up doing/providing my own hair/face, clothing for an already set shoot
Quite a delima....gotta think on this further for sure
I'm not an expert, but do you really need all that stuff if you were to focus on artsy stuff and artsy nudes?
with your age and height, focussing on fashion and editorial is probably not the best marketingmove
See, Rich, this is another query...I thought "well, I struggle financially, so maybe if I gave a fellow artist some leeway and streach, the cost would not be so bad?"
And yes, many have stated an hourly rate is the way to go. In my experience however, I end up taking an entire day off work to shoot because the MUA takes up to 4hrs on makeup and hair, wardrobe gets there late, ect...
Am I being prude in trying to recover a days wages lost, plus half the transportation cost (most shoots are an hour-2 hrs away from my residence)...
Thanks Jolly
She isn't an agency model so what do their rates matter to us who will never have to deal with an agency? Note her measurements and you'll find that even mentioning an agency would be entirely useless here.
As a side note- All of my paid work has come from this site, so you're being a bit broad in your assumption. She can get paid work through MM, it's all a matter of compromise and finding out what he average rates are for FREELANCE models in her area.
You have been given some great insights here.
Ultimately it comes down to basic economics. If how much you think your modeling (and all the "extra") is worth does not equal or fall below what someone is willing to pay, you are not going to get paid, and if that happens and you want to get paid, you need to adjust.
I totally understand.
But...people are always reminding new photographers that no-one cares how much they've invested in camera gear (the model just wants great picture after all)...and I wonder if the same is true for models?
At the end of the day, I wouldn't look over your portfolio and say, "She has had a few not work out, I'll pay her more." For me, paid work is simple: What look does the client need, and what's their budget? And, I'll get the freshest face I can get for that dollar amount with the most experience they can afford. Those two are usually mutually exclusive, though.
Two different worlds.... what someone pays for freelance/art/etc is not at all what a commercial or fashion client might pay; but to make any money, you do have to be marketable in your genre....
Perhaps, RBM. And I do it for the love and passion I have for the craft but...to be blut, I eat too and I'd like to make even a little bit more than just the admiration and pride of being in a magazine or shooting with so-and-so...
I will consider this as well.
Thanks for that, Rich. I will make sure I never work for Vogue or Ford since Im too short and too old.
And honestly, I don't want to sell myself short and do implied/art/nudes only...I want to always keep my eyes open and my horizons broadened with the idea that a petite CAN do beauty, fashion, creative pieces...I like to be well rounded and knowledgeable in all aspects. Never placed in a box.
No offence to any other artists, but I think we far too often suceed to implied/nudes cause that does "pay the bills" and we give into this "too short, too old" concept...I know I am worthy of doing fashion and beauty just as much! But...thats my own opinion
If I focused on art or costume/character, yes. But artistic nudes? no.
I am open to either genre but I won't shut the door on fashion, couture or casual either...nor will I quit doing beauty, as parts/beauty modeling is also lucrative for petites (your face doesnt have to say that your 5'2" or 5'9" and if I did, say, a nail salon ad...my hands don't reflect my height either)...
Thanks, Emily. I will keep that in mind and see what may arrise, or fall in the coming weeks and then see if I need to adjust a bit.
Thanks, Jolly!
I was just focusing on the kind of commercial/fashion/editorial work you have displayed in your portfolio. Art nudes is a different market entirely, and you might find more success if you choose to pursue that direction.
Maybe the same does go for models as well and though we spend, say $200 on preperation, the photographer or artist frankly doesn't care...all they see on their end is that they paid a rate ($150, $300, $75 per hr)...its like a paycheck I guess...my boss doesn't hand me my check on Friday and say "Okay, Melodye, this check is for your cell phone bill, fuel, 50 to savings, groceries"...
He/she doesn't care but the fact that I do my job, do it well and I come back in on Monday.
are you getting a lot of paid freelance work for couture, fashion and beauty here?
Please hear this kindly, because that is how I intend it...but that may not come across in written form.
You asked a question about your situation. We answered it based on the parameters of who you are.
We also answered it based on the parameters set by the industry.
Those two things are facts.
No-one is trying to kill your dream, but at the same time, your dreams are not going to change the industry. No matter how much you want petite to be broadly accepted in the industry it is not. It wont be in our lifetimes.
You already have your answer by the amount of work you are booking.
Adapt to the industry or get out of the modeling industry. The industry does not owe you work.
Quite true, Emily. And to be in multipule markets as I am, perhaps there isn't a true happy medium for them, concerning fees/rates/paid assignments.
+1. Being that vast majority of editorial work is no to low budget, I would say that your rate on editorial is to high. Also remember that should it be true editorial work with publication, it is generally not that hard for a photographer to get an agency to send them models in return for tears.
A lot to consider, RBM...thanks
I have had one paid freelance fashion/beauty session and like I said, they come and go Im sure, but I don't want to box myself into artistic/nudes/implied or costume/creative only either...
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Auto News
AutoGuide News Blog
The AutoGuide News Blog is your source for breaking stories from the auto industry. Delivering news immediately, the AutoGuide Blog is constantly updated with the latest information, photos and video from manufacturers, auto shows, the aftermarket and professional racing.
We're well aware that the last Nissan you ever thought would see the track as a full-blown race car would be the all-electric Leaf, but you have to admit, the Nismo RC Leaf is one bad-ass looking piece of electric machinery. Even though Nissan has built their racing heritage on their 350Z/370Z and GT-R platform, there's no doubting automotive manufacturers wish to push the limits in proving that hybrid and all-electric technology are viable forms of real world performance.
Nissan is no exception, teaming up with Nismo to see what the Leaf can potentially do as a race chassis while still powered by the same electric drivetrain we're seeing on the streets now. The Nismo RC Leaf features a full carbon fiber body and three-door layout, streamlining the aerodynamics while making it a sleek-looking race car. And with any other race car out there, this Leaf receives a full widebody treatment while the drivetrain was relocated in order to improve weight balance.
The Leaf took to Sodegaura Forest Raceway for some shakedown testing and we're loving how it looks out on the track. It'll be interesting to see how EVs can shape the world of motorsports with zero-emissions and all.
Check out the video after the break.
[Source: Autoblog]


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A photo which Shannon has deemed - the best photo ever. Inappropriate sexual advances on an elephant, although it's ok, because it did consent.
So today has been rather lovely!
I woke up at 8, got up at 8.30, and got dressed and went to work! Work was SO, SOOOOO DEAD. I mean, seriously, WORSE THAN YESTERDAY! The duty manager sent people home at 11.30, two hours after we opened. Although I stayed because I needed the money, so I did a lot of cleaning, THOROUGHLY cleaned a freezer, went and bought some milk for the coffee machine, beat a level on candy crush…
OH! And while I was at work, I was on break. Obviously, because that's how workplaces go. But on this break, there was me and about five-six other workmates. And one workmate, Megan, says to me "so what's the deal with that photo? Was that really you?" Annnnnd then my mind kind of went into slight panic. However, by this point I knew a lot of people knew, and so I managed to not entirely shut down. I was probably a little snappier than I should've been though, because talking about it in a room full of workmates that I don't even know if all of them knew or not, evidently they did though, and well, if they didn't they do now. But Megan kept asking questions, and I tried to explain things to her but she got frustrated and confused because I was using a lot of big words apparently. She's dyslexic, so she actually did have trouble, and I totally forgot about that. But anyway, during all her questions, the other staff members were sticking up for me! They were saying "so what, if he likes to dress as a female he can! There's nothing wrong with it" and that kinda stuff, and that made me feel really good about myself, and accepted by others! Anyway, Megan went back downstairs and so did some other workmates, but two were still up with me, Mou and Glen. And they were supportive of me, saying that she had no right to bring up those questions, and she doesn't really grasp the concept of it being quite a personal thing for me, and they felt bad and thought I must've felt so uncomfortable, which was kinda true.
But anyway, after my break finished, I went downstairs and Megan apologised for making me feel uncomfortable, and explained how she gets frustrated when she doesn't understand things. So, I spent about 20 minutes if not more explaining to her all about gender and sexuality. She did ask if I was gay upstairs, but a workmate Andy said "he's got a girlfriend!" - sticking up for me. But anyway, I told Megan all about myself, the three aspects of gender, and how sexuality is different from gender. And I also delved a little into slut shaming, rape culture and feminism in general. And I think she may have taken on board some of that information, or at least will consider it a little bit more now, so I feel good about myself for that and good that she understands now. Helping people understand is so rewarding!
The shift continued along after that, and after work I messaged Chelley, drove home and then called her - getting changed as I did, and we had a lovely little chat, but then I had to head out, and told her I'd wake up with her in her morning… which she's getting up in half an hour WHICH IS WONDERFUL! She told me to say hi to all her friends and that she misses them. And I did tell them that, and Shannon said that she doesn't miss Chelle, but actually she does! They all miss her too, was their response!
But yeah, so I met up with all of them - I picked up Ash, and we drove to Riccarton Mall - went through the mall to Maki-Mono, and EVERYTHING was half off, so I got TWO 8-packs of sushi because I was starving.
We then went through to the food court, and met up with Shannon, Renae, Matthew and Mikayla, and all ate dinner! I managed to juuuuust get through all of the sushi. 16 pieces of sushi, MY GOD. THAT IS NEARLY TOO MUCH SUSHI. WEESH. I did it though and I was proud.
Afterwards we went to TImeZone. For those who don't know what that is, it's basically the gaming arcade. For those who do know what it is, I heartily pat you on the back three times. BUT NOT FOUR.
Because it was the first Sunday of the month, ALL THE MONEY WE PUT IN WAS DOUBLED, so there was six of us putting in $10 each, so we ended up with $120 to play with. AND, with that $120, we played a lot of games, and it was SO much fun! And we took some photos in a photobooth, played air hockey, Matthew won a smurf toy, Renae, Ash and I won a handful of lollies, and overall we made 469 tickets! WITH which we bought 10 bouncy balls and 3 barrels of monkeys. TOTALLY WORTH $60. Although it was awesome because we played lots of super fun games and there was no sarcasm in that statement, bouncy balls and monkeys in a barrel are totally worth it!!
Afterwards, we all went to coffee culture to relax for a wee bit, and then went off to the park! Matthew and Ash came in my car, and Renae and Mikayla went with Shannon, and I raced them there, but they won… DAMMIT. NEXT TIME, VICTORY SHALL BE MINE.
We went to the elephant park on Harewood Road, I think it's actually called "Harewood Park" but there's an elephant slide, as seen in the photo here. SO, it is named the elephant park because elephant!
The park was fun! We went on swings, and sat in the grass, and I took lots of photos of sexy elephant photos, including this one. OH, and Shannon told me that she thought me going as Clara to a halloween party was awesome, and she knows about my crossdressing! YAY! THAT MEANS SHE READS WHAT I TYPE HERE. HIIIIIIIII SHANNON!!!! I also want to tell Renae, Matthew and Mikayla too, because they're all very good friends! I should've toniiiiiiight, but I get nervous about it all >< although I know Renae follows this blog too, so Renae, if you're reading this, I'm a crossdresser! WOOO! But if you already knew that, WELL, NOW YOU DOUBLY KNOW! But yeah, I suppose I really should tell people face to face, or at least in a way so that I definitely know that they know. Mass tumblr posts, while a nice, safe way for me to come out, feels a bit less connected, and I like to be connected, especially to important people in my life! SO NEXT TIME I'M HANGING OUT WITH THEM I SHALL TELL THEM. I'VE TOLD YOU ALL NOW SO NOW I HAVE TO DO IT! INCENTIVE! - heh. Now I just remembered about the incentives list I gave Chelley last year when we were first dating, she meant it in a dirty way, but I gave her a list of cute things we could do together, and that made her so happy. Ah. I love her so much <3
Anyway, yeah after the park, I drove Ash home, and came home myself, checked some emails, uploaded some photos, chatted to Ciaran sporadically, and then put this up! I was thinking of throwing on a skirt and top, but now it's getting a bit too late to be getting changed into something girly, or getting changed into something at all that isn't pyjamas or like, lack of majority of clothing. I'll dress tomorrow night I think, I've not dressed really since I went out to the fox and gay bar a couple of weeks back, and although I'm coming out to people more, I reaaaaaaally just want to be feminine for a night again soon. Tomorrow night hopefully!
Anyway, so now I'm just waiting for Chelley, and I spent some of tonight finishing off my letter to her, which I intend to send off by the end of this week! AH, sending letters is so much fun, I may have to send more to her I think… Anywho, YES THAT HAS BEEN MY DAY I HOPE Y'ALL ENJOYED IT.


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Friday, 02 August 2013 16:49
Thumbs Way Up
Best Match - Ishii vs Tanahashi
Worst Match - Archer vs Devitt
Well worth the $150 so far. I had Ibushi vs Naito at a solid 4 stars and thought it would steal the show until the main event. I do agree New Japan should have had an option to purchase these separately, but there are no complaints from me so far, other than I need more sleep these past two nights! You weren't kidding when you said Block A was packed, and so far, it has delivered
Roy Lucier
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"Trigger" is the story of two women, Kat and Vic, who a decade ago were bandmates in a rock band — best friends and enemies at the same time.
The movie finds them a decade later, with Kat (Molly Parker, from "Deadwood") a successful TV executive and Vic (Tracy Wright, memorable in "Me and You and Everyone We Know") still trying to squeeze out a living as a guitarist.
"Trigger" screens on Monday, Dec. 12, at the Tower Theatre, 876 E. 900 South, Salt Lake City.
The movie is directed by Canadian filmmaker Bruce McDonald, and was Wright's last film before dying of pancreatic cancer in 2010.
The screening, part of the Utah Film Center's Damn These Heels! year-round program for LGBT films, starts at 7 p.m. Admission is free.