Mental Health and the Brain: Working Group, March 30

Mental Health and the Brain Working Group:

Summary

Laura's presentation: Laura presented several accounts of adults suffering from brain damage, some from subjects and others from observers. She addressed practical issues such as who should take responsibility for care and suitable living arrangements. She also discussed more abstract concepts such as the overlap between definitions of brain damage and mental illness. Both internal and external experiences of individuals with brain damage are also consistent with mental illness. Suggestions were made about how to improve the quality of life of severely brain-damaged individuals. Such as developing obsessions into more broadly defined interests. Perhaps both brain damage and education can be addressed by increasing the education of the individual. The idea that everyone might be brain damaged, in the sense that everyone’s brain is different, was discussed. Such a characterization removes the notion of a deficit associated with brain damage and replaces it with the idea that any individual can be better than they currently are. It is a model for personal growth, focusing on an individual’s abilities to pursue a meaningful life and contribute to the lives of others. Concerns were raised that this model is too general to allow for defining practices. It does not provide criteria for determining individuals in need of assistance or how to develop a treatment plan. Tension between internal and external accounts of an individual is unresolved.

--- summarized by Julia

Grace discussed diagnosing and treating children in special education by presenting a case study of a young girl, "Susie" who has been diagnosed with, among other things, cerebral palsy. Grace expressed the concern that not many teachers working in special education are able to research the specific and unique needs of their students. In Susie's case, her team of teachers and psychologists recommended her placement in a regular classroom because they felt she was not being challenged enough. However, Grace feels that she falls in between and may not fit in a normal classroom either. Aside from academics, Susie also does not fully engage in social interactions. She speaks seldom and has had speech therapy in the past. Grace notes though that she has a large imagination and reports that Susie will frequently talk on a pretend cell phone and be unusually expressive and articulate. Some issues discussed in the group involved the gap between children's cases being managed by social services and the educational system. Some participants expressed the notion that although the academics in the normal classroom setting may be challenging for Susie, it is important and beneficial to her to be exposed to social interaction.

The second half of the session focused on brain injury. Laura presented several case studies to open up discussion about brain injury and mental health. The distinction between a mental disorder or "illness" and brain damage may not be good therapeutically. The goal in either case should (?) be to help people acquire new ways of doing things, but not necessarily in any particular or certain way. One participant raised the point that brain damage has a different social stigma attached to it than does, for example, schizophrenia. However, considering research in neuroscience, schizophrenia or any other "mental disorder" could be considered brain damage as well. A better description may be "brain altered". Because the brain is physically altered in everyone—with experience among other things—everyone could be described as "brain altered" at some point. The distinction between brain injuries, mental illness, and “normal/healthy” people then becomes blurred. In discussing possible treatment plans, a participant suggested that a goal for treatment is the individuals happiness, which can best be achieved by helping the individual foster a sense of personal agency and the ability to see that they have control to some degree in their own treatment and circumstances.

---summarized by Laura