Meal Emotions

Burger King wants you to know that it respects your emotions and that you should feel however you want to feel.

To celebrate Mental Health Awareness month, Burger King has rolled out a new promotion in certain cities in which it is offering “real meals” in different colored boxes that are supposed to promote the “overall mental health of all Americans.”  Pointedly, there is no “happy meal.”  Instead, you can get one of five boxes with mood-matching colors — red for “pissed,” blue for “sad,” teal for “salty,” purple for “YAAAS,” and black for “DGAF.”  (If, like me, you don’t know what the last two moods are, “YAAAS” reflects extreme excitement and the first three words of DGAF are “don’t give a” and you can figure out the rest.)

Burger King explained:  “With the pervasive nature of social media, there is so much pressure to appear happy and perfect.  With Real Meals, the Burger King brand celebrates being yourself and feeling however you want to feel.”  A commercial running in one of the markets where the promotion is being offered — Columbus isn’t one of them — ends with the statement:  “No one is happy all the time, and that’s OK.”

I’m all for promoting overall mental health, but I wish companies like Burger King would just stick to making the best food they can at the best prices, and not act like they care about their customers as unique individuals with their own emotional lives — because they don’t.  And that’s really all right, because Burger King’s job is just to sell food, and any time they veer into other territory, like focusing on customer mood, they’re just being distracted from being the best at what they’re supposed to be doing.

At bottom, getting a different colored box at a fast food joint to celebrate your “mood” seems like a pretty weird and superficial way of promoting mental health.  If you feel sad when you’re ordering your burger, do you really want to confess it to the kid wearing the paper hat behind the counter so your order can be put into a blue box rather than a purple one? And the superficial nature of the whole concept is confirmed by the fact that everyone who orders a “real meal” gets a Whopper, french fries, and a drink, whether they’re feeling “pissed” or “YAAAS.”

So if you’re at one end of the mood spectrum or another, it all boils down to a different colored flimsy cardboard box that will get pitched into the trash and whether you get a diet soda or not.  That doesn’t seem like much of a way to “celebrate being yourself and feeling however you want to feel,” does it?

The Benefits Of “Forest Bathing”

The Japanese call it shinrin-yoku, which translates into English as “forest bathing.” It has nothing to do with bathing in the normal sense of the word, however.  Instead, the concept might better be described as “forest immersion.”

For some time now, Japanese people looking to reduce the stress of everyday living have been heading to the forest.  Their approach to shinrin-yoku is simple:  go out into the woods, shut off your cell phone, and take in the forest atmosphere to the maximum extent you can, without a specific goal or destination in mind.  Use your senses as you wander.  Breathe in the cool fresh air that leaves your nostrils tingling.  Touch the rough tree bark and the soft moss.  Listen to the wind rustle the leaves, and hear the birdsong.  Sit down on the ground or a fallen tree and smell the humid mix of growing plants, decaying wood, and moist earth.  Feel the tree shade on your skin.

The proponents of shinrin-yoku say that it produces all kinds of health benefits, in addition to stress reduction:  improved functioning of the immune system, reduced blood pressure, improved mood and energy, heightened mental acuity, and better sleep.  In short, regular leisurely, relaxed strolls through the woods can provide the kind of mental and physical health benefits that stressed-out Americans typically try to obtain through prescription drugs or some other artificial means.  Should this come as a surprise?

One of the weirder things about modern America is how resistant some people are to actually experiencing nature.  Every morning, as I’m on my morning walk, I travel past a small health club where people are jogging and walking on treadmills, watching TV —   when they could be jogging around the same park I’m heading to only a few blocks away, where they could breathe some fresh air rather than stale sweat smells, experience the morning quiet, and chuckle at the quacking ducks waddling by.  Why make that choice?  Why do people hop in their cars rather than walking, even for short distances?

I don’t think you need to plan a trip to a primeval forest to experience the benefits of shinrin-yoku.  I think any effort to get out into the natural world, in quiet way, walking at your own pace and listening and looking and feeling, is going to be a good thing on more levels than we can count.

Guns, Doctors, Patients, And Medical Privacy

Yesterday the Obama Administration announced some new gun control measures.  Because President Obama issued executive orders, rather than proposing legislation to be debated and approved by Congress, most of the attention was on whether the President overstepped his authority and violated the intended constitutional balance of powers between the executive and legislative branches.

I’d like to focus on a different, substantive element of the changes announced yesterday:  namely, changes to a federal law protecting the privacy of certain health information to allow reporting of individuals who would fall within the mental health prohibitions of the federal gun background check law.  Politico reports that the new rule “enables health care providers to report the names of mentally ill patients to an FBI firearms background check system.”  Diagnostic information about the nature of the mental health condition being treated, however, would still be subject to privacy restrictions.

The announcement of the new rule by the Department of Health and Human Services uses the kind of dense, acronym-filled administrative jargon that makes ordinary people scratch their heads and throw up their hands, and it is not entirely clear the extent to which it applies to doctors — although the HHS announcement acknowledges that a number of comments it received about the rule expressed concerns about how the reporting issue would affect the “patient-provider treatment relationship and individuals’ willingness to seek needed mental health care.”

This is a difficult issue, because we’ve seen, over and over again, the carnage that can ensue when a mentally disturbed person builds an arsenal and then acts out their disturbed fantasies.  We want to keep those people from buying guns.  At the same time, however, notions of doctor-patient confidentiality are important — most states have laws or rules of evidence that protect such confidentiality — and exist precisely to encourage people to see a doctor and, in this example, seek treatment for their mental health issues.  New rules, even permissive ones, that could interfere with that confidentiality raise a legitimate concern, because if people who might otherwise seek treatment understand that by doing so they risk being disclosed to a federal database as mentally unfit, they may decline to seek treatment in the first place.  And if physician reporting of information that would disqualify a patient under the gun purchase laws is permissive, and a physician chooses not to report a patient who fits such criteria and the patient then acts on their fantasies, can the physician be sued for failing to report?  And, if the answer to that question is yes, won’t reporting become routine — and therefore the prospect of discouraging people from receiving treatment in the first place become even more likely?

No one wants to see mentally unbalanced people get their hands on guns, and we’ll have to see how these new rules play out, but this is a very sensitive area.  If the new regulations have the effect of discouraging people from seeking needed mental health treatment, they may unintentionally compound the problem.

 

Responding To The Man With The Tinfoil Hat

Yesterday I heard someone describe a person as needing to put on a tinfoil hat.  It was supposed to be a funny put-down — but it really wasn’t very funny to me.

In 1981, when I was fresh out of college and working for U.S. Rep. Chalmers P. Wylie in Washington, D.C. as a legislative aide, one of my jobs was to stay late on weeknights and prepare responses to constituent correspondence.  Mr. Wylie took his job seriously, and he believed that every constituent who took the time to write a letter deserved a thoughtful response.  We would spend hours going through every letter, talking about the response and whether there was something we could do to help.

One of our regular correspondents was a man who, literally, wore a tinfoil hat.  He was a veteran who was convinced that the U.S. government was broadcasting brain waves at him, and he wore a tinfoil hat because he thought it helped.  He wrote letters to try to get Mr. Wylie’s help in stopping the brain wave broadcasts.  I chuckled at his first letter, but they kept coming, usually several a week, and it stopped being funny.  I was worried about what the man might do, but Mr. Wylie said he had been receiving letters from the man for years and he was harmless.  From information in his letters, we learned that the man had been treated at VA hospitals and was an intermittent participant in mental health programs but was suspicious of them, too.

Every week, this poor, tormented man took the time to write a few long letters beseeching us to help him.  Every week we reassured him that there was no evil government program and urged him to please go see a doctor and get medical help.  I felt sorry for him, but there was nothing more we could do . . . and the pleading letters kept coming.

Mental illness is not funny.

A Parisian Protest

Today Richard and I were walking back from La Tour d’Eiffel when we ran smack dab into a protest march.  As with everything Parisian, it was done with great style and flair.  There was music, and drum beating, and people handing out fliers, and one of those giant dancing air-inflated guys that you see at car dealerships in the States.

It turns out that they were protesting some kind of psychiatric treatment issues.  My high school French is not great — more on that later — but it appears that there is a vote coming before the French National Assembly about psychiatric treatment and hospitalization.  And one of the signs was for electric shock therapy.  Do they still do that in France?

It was interesting to see this drum-beating, musical protest walk by, stopping traffic and provoking some of the French nearby to engage in arguments.  It is one of the things that makes Paris such an interesting city.  You never know what might lie around the next corner.

S.A.D. Dance

This is the time of year when everyone in the Midwest tries to figure out whether they have Seasonal Affective Disorder — S.A.D. for short.

S.A.D. is a condition that is associated with the winter.  The symptoms will sound familiar to anyone who has experienced a Midwest winter:  weight gain, depression, increased sleep, lack of energy, withdrawal from social activities, and feeling sluggish and irritable.  They think that S.A.D. may be caused by a lack of ambient light and changes in body temperature.  Given these symptoms and causes, how in the world do they distinguish people who have S.A.D. from people who just hate the winter and grimly plug ahead through the cold, and the wet, and endless sunless days?  How many people out there love icy blasts and revel in the overwhelming greyness of a Midwestern winter?  Are there people who are actually excited about a day when the overcast sky is battleship grey rather than slate grey or platinum?

I sometimes wonder about the “discovery” of these new emotional conditions.  After all, people were dealing with winter for millennia before somebody decided there was a condition called S.A.D. Centuries ago, when native Americans toughed it out during the harsh Midwestern winters, were braves and squaws afflicted with S.A.D.?  If so, how did the chief react when Brave Eagle overslept and wasn’t able to take down a deer or buffalo because he felt sluggish?  And did the tribes perform some kind of traditional S.A.D. dance to try to convince the Great Spirit that it was high time to bring an end to the dim, frigid days?

What Would You Do?

This past week in Columbus there was a tragic story that makes you think about how you would respond if you were confronted with a very difficult situation.

At midnight last Sunday night, a naked man knocked on the door of a West Side home and stood on the porch asking for help.  At the time, the outside temperature was around 20 degrees.  The resident did not let the man in the house, but immediately called police.  The police arrived less than 15 minutes later, talked to the resident, and then looked for the naked man around the house and in the neighborhood but could not find him.  The next morning, the resident noticed blood spots and footprints in the snow and followed them to a backyard shed where the naked man’s body was found.  He apparently died of hypothermia.  It turns out that the man was mentally ill, having been diagnosed with bipolar disorder and schizophrenia, and felt frightened when his clothes were on and “free” when he was naked.

The tragic incident has prompted significant commentary on the Columbus Dispatch website — see here and here — about whether people should have done things differently.  Should the resident have let the man inside his home?  Should the resident have left blankets or clothes on the porch for the naked man to use?  Should neighbors have gone to look for the man?  Was the police search sufficient, in a situation where the frigid temperatures would make the man’s nakedness a matter of life and death?  Should the canine unit or additional police officers have been summoned under the circumstances?

It is hard for me to fault the homeowner.  Under the circumstances, his first obligation is to his family.  It is fair to infer that any person who is naked after midnight in freezing temperatures may be mentally disturbed, and you simply don’t open the door to a potentially disturbed person who might harm your family members.  Calling the police immediately seems like the appropriate response.  I’m not sure I would have thought of putting out blankets or clothing under the unnerving circumstances, before the man disappeared.

I think it also is easy to say that the police should have done more when a death occurs under these kinds of circumstances.  But were the police supposed to conduct a search of every home, garage, and other potential place of shelter on the block?  Wasn’t it reasonable for the police to think that a naked man in distress would be visible and actively seeking help?  Having conducted a search of the immediate area and surrounding neighborhood, the police could reasonably conclude that the man had returned home or found shelter, or that the incident was a bizarre prank that had concluded.

A tragic death such as this one invites Monday morning quarterbacking.  In this case, I’m not sure the criticisms are truly warranted.

One Sick Country?

A recent report by the federal Substance Abuse and Mental Health Services Administration (SAMHSA) concluded that in 2009 approximately 20 percent of American adults had some form of mental illness.  That comes out to 45 million Americans.  The report states that 11 million of those people had a serious illness.  Women reported a higher incidence of mental illness than men, and adults 18-25 reported the highest level of mental illness of any age group.

The SAMHSA numbers are an estimate based on responses to questionnaires given to representative samples.  The overall “any mental illness” statistic purports to include only people who have a “diagnosable mental, behavioral, or emotional disorder,” excluding developmental or substance abuse disorders.  The study’s determination of mental illness in adults was based on modeling the survey participants’ responses to questions on “distress” and “impairment.”  The report suggests increases in the unemployment rate had an impact on the 2009 statistics.

I recognize that many Americans struggle with mental disorders, but I seriously doubt that 1 in 5 Americans has a true diagnosable mental illness.  I suspect that many government studies are structured to produce a result that reveals a problem that needs to be resolved through increased funding and more government-payroll jobs.  The comments of the SAMHSA administrator in response to the 2009 survey results, quoted in the link above, certainly reach that conclusion — that there are many Americans who need help and treatment that aren’t getting it, and through “health care reform” and federal legislation they can get such treatment.