Category Archives: Health Care

Coaching Employees Out of a Depression Spiral

Version 2It was at least a year too late when I realized that my firing of a talented, once-energetic employee didn’t need to happen. Her bubbly, sarcastic wit had turned at times malicious. Her engaging personality became more frequently sullen and withdrawn. Work performance deteriorated after years of strength.

I didn’t know it then, but extremely difficult home circumstances triggered this woman into an episodic depression spiral, one she was not then equipped to pull herself from alone. Not knowing the circumstances, I mistook her poor results for apathy. I didn’t explore alternative explanations and enough options to restore her results. I failed her as a leader/manager. Remarkably, she has since forgiven my inability to discern the true situation and remains a personal friend today.

If any manager should have seen the symptoms of depression and known how to help, it should have been me. I had gone through several depressive cycles, the worst coming as a teen when my pain turned for long stretches to suicide ideation. But I had pulled out of these cycles through trial-and-error rather than a clinical understanding of my disease. I figured out which behavioral changes helped turn my spirals upward without knowing there was evidence that these were the right approaches for many.

I hid my disease for decades, fearful that acknowledging I sometimes struggled with depression would damage my career or cause others to avoid or, perhaps even worse, pity me. Once publicly acknowledged, I dove into researching mental health challenges as an author and volunteer for NoStigmas, the American Foundation for Suicide Prevention and other organizations.

What I’ve learned would have made me far more effective in several prior roles leading a global corporate team, a Washington, D.C. congressional office, and even back to long-ago days as editor-in-chief of a large college newspaper.

For managers, the struggle in managing a depressed employee starts with even recognizing the behavior.
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Creating Golden Rule Social Services

“Each individual has different needs, different capabilities, different dreams. What I see in government programs is an effort to fit people into boxes, to make people easy to administer, rather than to provide resources we need to become our greatest selves.”

Tamika Jackson
Doing Unto Others; The Golden Rule Revolution

With more than 100 government welfare and life-improvement programs potentially available as sources of support, Americans most in need of assistance are often overwhelmed by the sheer magnitude and complexity of government support structures.

Every year, elected officials debate adding to or deleting from this over-mixed structure, providing never-ending fodder for the divisive hate game dominating politics today. During these debates, accusations quickly turn overwrought.

Hate the poor. Burn taxpayer money. Racist. Enabler. One percenter. Cultural rot. No accountability.

When it comes to social service programs, this debate misses a more critical issue.

Existing programs are bureaucracy centric, designed to remain within the purview of particular legislative committees or to ensure the legacy of a particular elected official. Each has its own application, funding requirements, auditing processes, staffing and timelines aimed more at fulfilling process requirements than at providing support. Many programs are established with set financial cliffs that force participants to lose nearly as much, and sometimes more, in support than they gain in income when they work additional hours or earn a raise, providing dramatic disincentives to career development.

People and their needs don’t fit neatly within congressional or state legislative jurisdictions. Continue reading

Murder/Suicide Impacts on Mental Illness Stigmas

How can I reconcile my volunteer work to remove mental illness stigmas with learning that a man I once worked with and admired was the shooter in a recent Chicago murder and death by suicide in which depression likely played a role?

It’s a tough question; one I’ve been particularly contemplating since the Germanwings aircraft crash into the French Alps—a murder/suicide with 150 victims and a link to the co-pilot’s mental illness so clear that a psychiatrist’s note saying he was mentally unfit to work was found torn up in the co-pilot’s apartment.

The rare instances where mental illness contributes to mass tragedies—such as Germanwings, the Sandy Hook school slaughter and the Colorado theater massacre—dominates media coverage of mental health issues, creating a perception of a burgeoning issue particularly around murder/suicides. “The perception from media reports would be that the incidence is greatly increasing,” Dr. Scott Eliason reported several years ago in the Journal of the American Academy of Psychiatry and the Law, “but the data that we have collected show murder-suicide to be a very rare event that seems relatively constant.”

Regardless, because so few who struggle with mental health challenges acknowledge this aspect of our lives, exposure to mental illness as violent tragedy becomes the image of the disease to far too many.

Once this violent image is embedded, fear can spur a desire to stay away from those struggling to achieve mental health in much the same way as segregation metastasizes when those without regular interaction across racial, ethnic or other boundaries hear about another group only through media reports about a small percentage of its violent members.

Fear is best alleviated through exposure, an exposure almost every American unknowingly receives to mental illness on a daily basis. Continue reading

News coverage of suicide linked to ‘copy-cat suicides’

New academic research shows that placement, tone and level of suicide coverage detail can impact development of suicide clusters, particularly in newspapers and among teens. For reporters and social media writers covering suicides, please consider the implications of the study.

High-profile newspaper coverage of suicide linked to ‘copy-cat suicides’ – Medical News Today.

Specifically, Mr. President, This Is How to Fix Obamacare

Waking up this morning to read that Obamacare fell below Miley Cyrus, Kim Kardashian and Minecraft in Yahoo’s most searched terms of 2013 reminded me that substance trails celebrity in America even on the most consequential of issues. Buried further in the news, it appears President Obama also doubled down on his insistence that Obamacare is working. Combined, these stories convinced me to break my self-imposed health care pontification ban.

Specifically, I’m taking the President up on his challenge yesterday to “tell us specifically what you’d do … to make insurance more secure.” Sure, it’s a question better seriously considered before the law was passed on a strictly partisan basis, but I’ll take it as an open invitation.

The vast majority of those debating what’s wrong with Obamacare offer either fixes that tinker around the edges of the conceptually unsound Affordable Care Act or that seek unfettered return to a pre-2010 health care and insurance system battered by its own conceptual flaws.

I believe access to quality, affordable health care is the proper target, not necessarily insurance coverage as the President states. My approach focuses on reducing costs, increasing access and equity, and improving quality.

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Are We Really All Just Too Stupid?

Those who try to restrict basic freedoms do so on the basis that people sub-optimize outcomes through dysfunctional decision-making, even when the costs of a poor decision are entirely ours to absorb. To some, this dysfunction is so bad that we can’t be trusted to determine the size of our own soft drink without government control. If we can’t be trusted to consider the long-term impacts of beverage consumption, shouldn’t we question whether Americans are intelligent enough to be allowed to vote? After all, voting should require far more detailed analysis than does selecting between Coca Cola or water. The linked article raises other concerns worth considering about nanny state advocates. As government usurps more and more of our lives, it’s important to consider at what point does the arrogance of the bureaucratic “experts” end?

Zero Calories to Zero Population.


Why Another Blog?

As the author of an upcoming book, Melting Point 2040, I write stories about how our world could look in 2040 if we don’t solve our toughest issues. Having worked in Congress two decades ago, and then with Congress from the outside in many of the intervening years, I have become increasingly concerned that our political system is stacked against everyday Americans. Campaigns are too long. Money is too prevalent. Perhaps most importantly, the primary structure in most states forces candidates to adhere to political extremes to even get on the November ballot. There was a time when statesmen and stateswomen played key roles in policy decision-making. That time has passed. So, if I dwell on political system reform in this blog, it’s because I think systematic changes are a precursor to fixing many of these other issues.

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