While not the first such minister, the loneliness epidemic in Japan will make this one the hardest working.
- The Japanese government has appointed a Minister of Loneliness to implement policies designed to fight isolation and lower suicide rates.
- They are the second country, after the U.K., to dedicate a cabinet member to the task.
- While Japan is famous for how its loneliness epidemic manifests, it isn't alone in having one.
The Ministry of Loneliness<iframe width="730" height="430" src="https://www.youtube.com/embed/I5FIohjZT8o" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen></iframe><p><a href="https://www.jimin.jp/english/profile/members/114749.html" target="_blank" rel="noopener noreferrer">Tetsushi Sakamoto</a>, already in the government as the minister in charge of raising Japan's low birthrate and revitalizing regional economies, was appointed this <a href="https://www.japantimes.co.jp/news/2021/02/21/national/japan-tackles-loneliness/" target="_blank" rel="noopener noreferrer">month</a> to the additional role. He has already announced plans for an emergency national forum to discuss the issue and share the testimony of lonely <a href="https://www.japantimes.co.jp/news/2021/02/12/national/loneliness-isolation-minister/" target="_blank" rel="noopener noreferrer">individuals</a>.</p><p>Given the complexity of the problem, the minister will primarily oversee the coordination of efforts between different <a href="https://www.insider.com/japan-minister-of-loneliness-suicides-rise-pandemic-2021-2" target="_blank" rel="noopener noreferrer">ministries</a> that hope to address the issue alongside a task <a href="https://www.japantimes.co.jp/news/2021/02/21/national/japan-tackles-loneliness/" target="_blank" rel="noopener noreferrer">force</a>. He steps into his role not a moment too soon. The loneliness epidemic in Japan is uniquely well known around the world.</p><p><a href="https://en.wikipedia.org/wiki/Hikikomori" target="_blank" rel="noopener noreferrer"><em>Hikikomori</em></a><em>,</em> often translated as "acute social withdrawal," is the phenomenon of people completely withdrawing from society for months or years at a time and living as modern-day hermits. While cases exist in many <a href="https://www.frontiersin.org/articles/10.3389/fpsyt.2019.00247/full" target="_blank" rel="noopener noreferrer">countries</a>, the problem is better known and more prevalent in Japan. Estimates vary, but some suggest that one million Japanese live like this and that 1.5 million more are at <a href="https://www.nationalgeographic.com/photography/article/japan-hikikomori-isolation-society" target="_blank" rel="noopener noreferrer">risk</a> of developing the condition. Individuals practicing this hermitage often express contentment with their isolation at first before encountering severe symptoms of loneliness and <a href="https://www.sciencedaily.com/releases/2020/01/200110155241.htm" target="_blank" rel="noopener noreferrer">distress</a>.</p><p><a href="https://en.wikipedia.org/wiki/Kodokushi" target="_blank" rel="noopener noreferrer"><em>Kodokushi</em></a>, the phenomenon of the elderly dying alone and remaining undiscovered for some time due to their isolation, is also a widespread issue in Japan that has attracted national attention for decades.</p><p>These are just the most shocking elements of the loneliness crisis. As we've discussed before, loneliness can cause health issues akin to <a href="https://www.inc.com/amy-morin/americas-loneliness-epidemic-is-more-lethal-than-smoking-heres-what-you-can-do-to-combat-isolation.html" target="_blank" rel="noopener noreferrer">smoking</a>. A lack of interaction within a community can cause social <a href="https://bigthink.com/in-their-own-words/how-religious-neighbors-are-better-neighbors" target="_self">problems</a>. It is even associated with changes in the <a href="https://bigthink.com/mind-brain/loneliness-brain" target="_self">brain</a>. While there is nothing wrong with wanting a little time to yourself, the inability to get the socialization that many people need is a real problem with real <a href="https://bigthink.com/mind-brain/brain-loneliness-hunger" target="_self">consequences</a>.</p>
The virus that broke the camel's back<iframe width="730" height="430" src="https://www.youtube.com/embed/Hp-L844-5k8" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen></iframe><p> A global loneliness pandemic existed before COVID-19, and the two working in tandem has been catastrophic. </p><p>Japanese society has always placed a value on solitude, often associating it with self-reliance, which makes dealing with the problem of excessive solitude more difficult. Before the pandemic, 16.1 percent of Japanese seniors reported having nobody to turn to in a time of need, the highest rate of any nation <a href="https://www.japantimes.co.jp/news/2021/02/21/national/japan-tackles-loneliness/" target="_blank" rel="noopener noreferrer">considered</a>. Seventeen percent of Japanese men surveyed in 2005 said that they "rarely or never spend time with friends, colleagues, or others in social groups." This was three times the average rate of other <a href="http://www.oecd.org/sdd/37964677.pdf" target="_blank" rel="noopener noreferrer">countries</a>. </p><p>American individualism also creates a fertile environment for isolation to grow. About a month before the pandemic started, nearly<a href="https://www.npr.org/sections/health-shots/2020/01/23/798676465/most-americans-are-lonely-and-our-workplace-culture-may-not-be-helping" target="_blank" rel="noopener noreferrer"> 3 in 5</a> Americans reported being lonely in a <a href="https://www.cigna.com/about-us/newsroom/studies-and-reports/combatting-loneliness/" target="_blank" rel="noopener noreferrer">report</a> issued by Cigna. This is a slight increase over previous studies, which had been pointing in the same direction for years. </p><p>In the United Kingdom, the problem prompted the creation of the Jo Cox Commission on Loneliness. The commission's <a href="https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/reports-and-briefings/active-communities/rb_dec17_jocox_commission_finalreport.pdf" target="_blank" rel="noopener noreferrer">final report </a>paints a stark picture of the U.K.'s situation in 2017, with millions of people from all parts of British society reporting feeling regular loneliness at a tremendous cost to personal health, society, and the economy.</p><p>The report called for a lead minister to address the problem at the national level, incorporating government action with the insights provided by volunteer organizations, businesses, the NHS, and other organizations on the crisis's front lines. Her Majesty's Government acted on the report and appointed the first Minister for Loneliness in <a href="https://time.com/5248016/tracey-crouch-uk-loneliness-minister/" target="_blank" rel="noopener noreferrer">2018</a>, <a href="https://en.wikipedia.org/wiki/Tracey_Crouch" target="_blank" rel="noopener noreferrer">Tracey Crouch</a>, and dedicated millions of pounds to battling the problem. </p><p>The distancing procedures necessitated by the COVID-19 epidemic saved many lives but exacerbated an existing problem of loneliness in many parts of the world. While the issue had received attention before, Japan's steps to address the situation suggest that people are now willing to treat it with the seriousness it deserves.</p><p>--</p><p><em>If you or a loved one are having suicidal thoughts, help is available. The suicide prevention hotline can be reached at 1-800-273-8255.</em></p>
As a new industry emerges, therapists need to be educated.
- Psychedelic therapy is predicted to become a $7 billion industry by 2027.
- Emerging research on psilocybin, MDMA, ibogaine, and LSD is showing a lot of promise in treating a variety of conditions.
- Therapists will not be able to write a script and send patients on their way, which will create a new training model.
The future of psychedelic-assisted psychotherapy | Rick Doblin<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="77ce91efe94f41d6506350d131ed9781"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/Q9XD8yRPxc8?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>The Multidisciplinary Association for Psychedelic Studies (MAPS) foresaw the possibility of psychedelic therapy decades ago. The organization's founder, Rick Doblin, argued against the scheduling of MDMA in the mid-80s. The group's <a href="https://maps.org/research/mdma/training-protocol" target="_blank">training protocols</a> for MDMA, ayahuasca, ibogaine, and LSD are holistic and include screening sessions, pre-treatment meetings, day-long sessions, and post-treatment integration.</p><p>You cannot ingest psychedelics and go about your day. Unlike SSRIs and SNRIs, they don't take weeks for you to feel the effects. This is an entirely different model than current psychiatry protocols. If psychedelic therapy is going to be integrated into psychiatry, mental health professionals need training. They'll have to adapt. Cutting corners will be impossible.</p><p>Besides overcoming the hurdle of federal regulations (which is quickly happening), psychedelics should be subject to Risk Evaluation and Mitigation Strategies (REMS), <a href="https://www.nature.com/articles/d41586-021-00187-9" target="_blank">writes Paul Tulls in Nature</a>. This means these novel therapies will be administered according to current FDA guidelines.</p><p style="margin-left: 20px;">"The effect would be to bundle the delivery of the drug with the therapy component, and potentially certify practitioners. A source working on one of the trials says that discussions are under way with the FDA over whether therapists who administer the drugs ought to be trained, what that training might involve and whether therapist certification should be required."</p>
Credit: Microgen / Adobe Stock<p>This will not be without its challenges. As Tullis writes, some therapists have been skirting federal law by offering psychedelic therapy for 30 years, reminiscent of LSD sessions in the 1950s and MDMA therapy in the 1970s. In fact, LSD was subjected to over 1,000 studies before being criminalized, though it's admittedly hard to offer a placebo. (Niacin <a href="https://link.springer.com/article/10.1007/s00213-020-05464-5" target="_blank">has worked in some trials</a>.) The comprehensive protocols being developed now have early pioneers to thank. </p><p>Psychedelics are also entering an industry with standard practices. Some therapists are likely to remain skeptical; others might not train properly before administering the drugs, which could create problems for the entire industry should some patients experience adverse effects. Psychotherapy will always be necessary before and after administration. In an industry where many are accustomed to writing scripts, not providing in-depth existential explorations with their patients—and many patients are accustomed to quick visits that result in refills—a giant learning curve is necessary. </p><p>While many are hopeful that psychedelic therapy will have broad appeal, the more likely result is a slow integration with specialized clinics (such as with ketamine today). There will undoubtedly be players with no history of psychedelics involved only for economic gain; we're already seeing it with tens of millions of dollars pouring into companies. The competing forces of revenue maximization and psychedelic ritual are likely to create friction. </p><p>Regardless, this emerging industry requires funding to get off the ground. We just need to temper expectations with the real-world consequences of the psychedelic model—a hard sell in a world accustomed to quick returns. And we'll need therapists willing to explore uncharted territory on its own terrain, not the ground they're accustomed to walking on.</p><p>--</p><p><em>Stay in touch with Derek on <a href="http://www.twitter.com/derekberes" target="_blank">Twitter</a> and <a href="https://www.facebook.com/DerekBeresdotcom" target="_blank" rel="noopener noreferrer">Facebook</a>. His most recent book is</em> "<em><a href="https://www.amazon.com/gp/product/B08KRVMP2M?pf_rd_r=MDJW43337675SZ0X00FH&pf_rd_p=edaba0ee-c2fe-4124-9f5d-b31d6b1bfbee" target="_blank" rel="noopener noreferrer">Hero's Dose: The Case For Psychedelics in Ritual and Therapy</a>."</em></p>
Textual analysis of social media posts finds users' anxiety and suicide-risk levels are rising, among other negative trends.
A new study pushes back on psychiatry industry talking points.
- Australian researchers note a link between rising antidepressant usage and rising suicide rates in youth.
- Their research pushes back on psychiatry talking points that SSRIs decrease suicide risk.
- The top method for self-harm and suicide in younger age groups is overdosing antidepressants.
Antidepressants Can Cause Suicide and Homicide — Peter Gotzsche, M.D.<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="15dabef55fc56a46396faf9486151ad0"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/oIxcMIBhHS4?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>Australia, which ranks second in the world in per-capita consumers of antidepressants among <a href="https://www.oecd.org/about/" target="_blank">OECD countries</a>, has never been provided the same safeguards as America—and the efficacy of America's safety measures are questionable at best. The FDA first issued that block box warning in 2004, updating it to reflect adults under age 25 three years later. In 2005, the Australian Therapeutic Goods Administration (TGA) required leaflets be included in antidepressant packages to reflect the risk of suicidal ideation.</p><p>The researchers write that the data put forward by psychiatrists and mental health organizations was misleading. Much like the industry ran with Rusk's assertion, many professionals cite a 2007 <a href="https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2007.07030454" target="_blank">ecological study</a> by Robert D. Gibbons that incorrectly associates SSRI usage with a decreased risk of suicide among U.S. youth. This misreading is the basis of the narrative of minimized harm.</p><p>The data tells another story. The researchers point out that between 2008-2018, prescriptions for antidepressant (predominantly SSRIs) increased by 66 percent in the 0-27 year age group, while suicide rates increased by 49 percent in a similar age group (0-24 years). Between the years of 2006-2016, there was a 98 percent increase in intentional poisonings in New South Wales and Victoria. An overlap emerges: the most common method of attempted self-harm and suicide is prescription antidepressants. </p><p style="margin-left: 20px;">"There is clear evidence that more young Australians are taking antidepressants, and more young Australians are killing themselves and self-harming, often by intentionally overdosing on the very substances that are supposed to help them."</p><p>The researchers note that the FDA has long been criticized for not offering more non-pharmacological treatments. The cost of psychotherapy is prohibitive for many in the U.S. health care system. The reflex action of the medical establishment is to write a script. When one pill doesn't work or loses efficacy, it's usually replaced by another pill or added to an ever-growing pharmacological cocktail. Some people take four to six (or more) drugs to manage mental distress, each one countering the side effects of the other. </p>
Photo: Ryan McGuire / Pixabay<p>As in America, Australia suffers from corporate lobbying. The team writes that many opinion leaders receive funding from pharmaceutical companies; it makes sense that these figures will tout the benefits of antidepressants while downplaying potential harm. They also note that governing bodies are likely relying on outdated evidence of risk, which translates into a lack of consumer awareness.</p><p>They also write that general practitioners account for 90.4 percent of antidepressant prescriptions in Australia. Since mental health is not their area of expertise, they often repeat what psychiatrists initially prescribed.</p><p>Correlation is not causation, a limitation the researchers acknowledge. They list another cocktail, this one labelled "drivers of mental health distress." Smartphone addiction, online bullying, lack of meaningful relationships, climate change, and debt top the list. Antidepressants are not the cause of mental distress. What we need to know is whether they help alleviate it or add to the burden. </p><p>This forces us to confront a longstanding question: Why are we treating the symptoms of mental health problems with pills while never addressing their <a href="https://bigthink.com/mind-brain/antidepressants-dangers" target="_self">actual cause</a>? Put another way, why does the psychiatry industry rely on pills with a long list of <a href="https://bigthink.com/surprising-science/antidepressants-withdrawal" target="_self">side effects</a> instead of addressing the environmental and social issues that are at the foundation of mental distress? And why are we putting increasingly higher numbers of teenagers on drugs that <a href="https://www.health.harvard.edu/blog/anti-depressants-for-teens-201601229018" target="_blank">negatively impact their brains</a> while their prefrontal cortex is still in development? This seems to set them up for a lifetime of dependence, which is a great profit model but a terrible health care solution. </p><p>The psychiatry industry faced an existential crisis in the nineteen-seventies when the public grew weary of their growing reliance on drugs. The industry's response was to double down on pharmacology. Thanks for a massive PR campaign around Prozac, that move worked. You cannot both have <a href="https://www.health.harvard.edu/blog/astounding-increase-in-antidepressant-use-by-americans-201110203624" target="_blank">increasing numbers of prescriptions</a> and <a href="https://www.sciencedaily.com/releases/2019/03/190315110908.htm" target="_blank">increasing mental health problems</a> and pretend that this intervention is working. </p><p>While more work needs to be done, the researchers are confident in their assertion between increased self-harm with antidepressant usage. </p><p style="margin-left: 20px;">"These results are consistent with the hypothesis that antidepressants increase the risk of suicidality and self-harm in young people. Furthermore, they provide compelling evidence that the antidepressants prescribed to children and adolescents are frequently the means of self-harm."</p><p>These children deserve more from us at a pivotal time in their development. The psychiatry industry needs to come through this existential crisis with better solutions. </p><p><span></span>--</p><p><em>Stay in touch with Derek on <a href="http://www.twitter.com/derekberes" target="_blank">Twitter</a>, <a href="https://www.facebook.com/DerekBeresdotcom" target="_blank">Facebook</a> and <a href="https://derekberes.substack.com/" target="_blank">Substack</a>. His next book is</em> "<em>Hero's Dose: The Case For Psychedelics in Ritual and Therapy."</em></p>
As little as an extra dollar could mean a significant decrease in suicide rates.
- A new study found that a dollar increase in minimum wage correlated to nearly a six percent reduction in suicide rates among adults aged 18 to 64 with a high school degree or less education.
- Increasing the minimum wage was found to be most effective in the reduction of suicides when unemployment levels were the highest.
- According to the researchers' predictions, raising the minimum wage by just one dollar during the 2008 economic collapse could have prevented over 13,000 suicides.
Over the last few years, suicide rates have been on an alarming rise in the United States. An analysis by the Center for Disease Control found that American suicide rates have gone up by 33 percent since 1999, the highest rate recorded in the country since 1942.
Mental health is a complex topic, and suicide cause and prevention can't be chalked up to any one thing or solution. But, according to a recent study, one answer to preventing at least some of these suicides might be a simple little public policy adjustment: Raising the minimum wage.
The link between financial stress and suicide
Topical Press Agency / Stringer
There are, of course, a multitude of variables that can foster the extreme anxiety and depression that might lead a person to consider ending his or her life. A number of studies in the past indicated that financial stressors — such as mounting debt, the loss of a job, or unemployment — are a big contributor when it comes to the factors that play the most significant roles in suicide. The likelihood of suicide increases among financially distressed people as things like debt become harder to manage.
Because suicide and depression more often affect people who have lower incomes and levels of education, it means that this demographic is also likely to be working at or close to the minimum wage. It seems obvious that researchers would be interested in looking at the correlations between suicide and minimum wage.
New research on suicide and minimum wage
Recently, a team of researchers from Emory University took an in-depth look at the relationship between minimum wage laws and suicide rates. They found that the two do correlate, but only during times of high unemployment and among those with a high school level education, or less.
When it comes to minimum wage, state and federal governments both set standards. The federal government sets a bottom "safety net" for minimum wage. State governments can't dip below that, but they can exceed it. The minimum wage rules of individual states are easy to track and, conveniently, a few states changed their minimum wage during the time period of the study providing a usefully before-and-after comparison for the researchers. Collecting the rest of the data was relatively simple. States provide their unemployment rates, share of GDP, and various other forms of public assistance. Additionally, the National Vital Statistics System provided researchers with a trove of death information, including the cause of death as well the individual's educational background.
Researchers used a "differences in differences" analysis to determine how minimum wage laws were linked to suicide rates. This is a statistical technique used to measure data from two groups, a "treatment" group and a "control" group, at at least two different time periods. One time period being before the "treatment" (in this case, higher minimum wage) and the other being after. In this study, the researchers used individuals with a college-level education as the control group as they are statistically less likely to work a minimum wage job or commit suicide. So, that group's response to changes in the minimum wage laws was compared to that of individuals with a maximum of a high school education. This data was then tracked monthly.
Findings: Higher minimum wage meant lower suicide rates
Photo Credit: Wikimedia
The effect of a one U.S. dollar increase in the minimum wage ranged from a 3.4 percent decrease to a 5.9 percent decrease in the suicide rate among adults aged 18 to 64 with a high school degree or less education. The researchers estimated a six percent reduction in suicide for every dollar increase in minimum wage among that population.
Researchers also observed that increasing the minimum wage was most effective in the reduction of suicides when unemployment levels were the highest. Specifically, a higher minimum wage had maximum impact on reducing suicide when the unemployment rate was over seven percent and minimum wages were at least $1.75 over the national minimum. According to the researcher's predictions, during the 2008 economic collapse raising the minimum wage by just one dollar could have prevented over 13,000 suicides!
Of course, poverty is not the root cause of all suicides, and mental health issues go deeper than one single economic factor. But the study underlines how reducing economic burdens during times when financial stresses are higher can reduce some of the anxiety and depression that leads to suicide risk. Ultimately, this study shows that beyond being good economic policy, raising the minimum wage can save lives by improving the quality of life for America's working class.
Now the question is, will legislators do it?