Providentia

September 10 is World Suicide Prevention Day

World Suicide Prevention Day is held on September 10th each year as an initiative of the International Association for Suicide Prevention (IASP), and is co-sponsored by the World Health Organization (WHO). The theme in 2009 is "Suicide Prevention in Different Cultures." Begun in 2003, the purpose of World Suicide Prevention Day is to improve education about suicide, disseminate information, decrease stigmatization and, most importantly, raise awareness that suicide is preventable.

World Suicide Prevention Day 2009, "Suicide Prevention in Different Cultures" provides an opportunity to remind people that suicide is influenced by cultural, religious, legal, historical, philosophical and traditional factors and that these contexts need to be taken into account in considering suicide prevention. Suicide needs to be understood in terms of its cultural background, and, to save lives, suicide prevention programs need to be tailored to different cultural contexts

For more information.

Cannibal Looking For Love

After 37-year old Sumanto was convicted for stealing an elderly woman's corpse and eating it, he served five years in prison before being returned to the Javanese village where he spent most of his life. Describing his motives for eating the old woman's body, he told reporters that, "She was delicious. I love meat...All types of meat so long as it's cooked."He added that "I don't eat people anymore, now I eat spinach". Due to the lack of suitable inpatient forensic facilities in Indonesia, Sumanto was returned to his native village without followup care despite considerable resistance from his neighbours. He has since been been taken in by a local Muslim mental rehabilitation centre for religious guidance. The privately-run community religous centres represent the only real option for high-profile mental patients such as Sumanto given the absence of secure psychiatric facilities in Indonesia.

Branded "The Cannibal" by his fellow villagers, Sumanto was reportedly depressed and violent following his release from prison in 2006. After being taken in the religious centre, Sumanto has been spending his time reading the Qur'an, as well as farming and fishing. His stay at the centre is being paid for by private donations. Although Sumanto's father has said that he misses his son, he recognizes that he would never be able to take him back. Ostracized by their neighbours, the entire family was forced to move to the edge of the village and fear what would happen if Sumanto ever returned. The villagers still talk about his "pointed teeth and bad temper" and share stories about his bizarre eating habits. One neighbour stated that, "There'll be chaos if he comes back.  I don't want him to kill me and have me for dinner".

Despite these fears, Sumanto insists that he has changed and now craves love and freedom more than meat.  In discussing the villagers' fear, he stated: "I'm sad. People said so many bad things about me. I will strive to get the villagers to open their hearts and accept me again," Adding about his desire for finding love, "What is love? How can I describe it when I've never experienced it, never tasted it?"

While mental health professionals have stressed Sumanto's need for proper therapy and medication, it seems doubtful whether the necessary treatment will ever be available.

For more information.

Child Soldiers

When Charles Taylor goes into the docket at the International Criminal Court in the Hague, he will face charges of crimes against humanity for his brutalities both as a rebel leader and as President of Liberia. Among those looking on in their quest for justice will be Taylor's most innocent victims, the estimated 15,000 children who were forced to fight in Liberia's bloody regional war.

Starting in the 1990s, Taylor first developed a military model that was since exported over the border into neighbouring Sierra Leone: raiding villages, killing adults, and kidnapping children to be recruited into the military. Boys were taken to fight while girls were taken as sexual slaves. Prior to overthrowing previous president Samuel Doe in 1990, Taylor's National Patriotic Front controlled much of Liberia. His most feared battalions were made up of children as young as 11 which committed numerous atrocities.

After becoming president in 1997, Taylor's government was locked into perpetual warfare with rebel groups that copied his methods. He was eventually forced to step down in 2003. Although his son, Chucky Taylor has been sentenced to a 97-year sentence for his role in his father's brutal government. Charles Taylor himself faces 11 charges including the deployment of child soldiers.  He is currently being held in the United Nations Detention Unit in the Hague.

Many of Taylor's child soldiers continue to be stigmatized by their involvement in the civil war and are ostracized by many elements of Liberian society. Even those with surviving family members are typically rejected and many turn to prostitution or crime to survive. Relief agencies are attempting to aid former child soldiers although they admit that the legacy of psychological trauma and suicide will haunt the region for decades to come.

For more information.

For more information

Chinese Parents Boiled Man's Head in Soup As a Folk Remedy for Daughter's Psychiatric Problems

By all accounts, Lin Zomgxiu and her husband Luo Tianhu were desperate.

Living in the southwestern Chinese province of Sichuan with their twenty-five year old daughter, they had been coping with the daughter's chronic psychiatric problems for the past seven years. The stigma surrounding mental illness remains especially strong in China, especially in the rural areas with few treatment resources available. In 2008, Lin Zomgxiu reportedly heard of a folk remedy for mental illness that involved feeding the victim a soup made from a man's head. Hoping to cure their daughter, the couple solicited the help of an acquaintance to find the necessary ingredients for the remedy.

Last December, the acquaintance attacked a passing 76-year old man who had been intoxicated. The body was beheaded and the upper part of the head was then boiled in a stew (apparently duck meat was added to mask the taste). Chinese authorities arrested the parents and their accomplice and has court has since sentenced the accomplice to death for committing the murder. The death sentence carries a two-year reprieve and may be commuted to life imprisonment. Lin Zomgxiu has been sentenced for destroying evidence, including the victim's bloody clothes and shoes.

The daughter's reaction on discovering the ingredients of the folk remedy her parents provided has not been recorded.

For more information.

When Men Are Raped

While male sexual assault is being increasingly recognized as a public health issue, it continues to be underreported and unrecognized. A study published in a recent issue of Violence and Victims presents the results of a population-based study conducted on 705 adult men in the state of Virginia. Researchers found a lifetime prevalence of 12.9% in sexual assault among men, with 94% assaulted for the first time before the age of 18. Statistical analysis showed that male victims of sexual violence were 3.4 times more likely to be depressed and 2.4 times more likely have suicidal thoughts (only 15.4% sought counseling however). This study confirms that male sexual assault is a prevalent problem. The researchers also concluded that victimized men were more likely to be depressed and have suicidal thoughts and yet did not seek health services. Clinicians and social agencies need to make a greater effort to identify and treat male victims of sexual assault.

Click here for the abstract.

Fallen Women

Long before Dan Brown and his DaVinci Code, the legend of Mary Magdalene was a strong part of early Church doctrine. Despite the lack of any scriptural basis, the tradition of Mary Magdalene as a reformed prostitute who found salvation through repentance made her the natural patron saint for convents in which "problem" women could be redeemed. The notion of the inherent sinfulness of women and their need to atone for their inappropriate behaviour through acts of penitence had the full backing of the Church with cloistered "penitentiaries" throughout most of Europe dating back to the Middle Ages. To be fair, these convents could also be places of refuge for women who needed protection from unwanted marriages or sexual harassment. Unfortunately,the women who went there for shelter were often unable to leave afterward.

Beginning as early as the eighteenth century, there was public alarm in the United Kingdom over the joint problems of illegitimate children and prostitution which rose dramatically with the Industrial Revolution. Not only were brothels and street prostitution rampant, but women in "service" (usually as maids or cooks) often faced chronic sexual abuse and the unwanted pregnancies that went with it. Prominent social reformers including Henry Fielding propose the establishment of special "homes" for the reform of prostitutes and other "fallen women". Evangelist movements such as the Society for the Suppression of Vice (founded in 1802) pushed for the closing of brothels and stronger anti-prostitution legislation. As a result of this crusade, women were taken off the street and placed in asylums which, from the very beginning, were dubbed "Magdalene" homes after Mary Magdalene. By the end of the 19th century, Magdalene asylums could be found virtually everywhere (including in North America). In the United Kingdom alone, there were more than 300 asylums caring with an estimated 6,000 inmates annually by 1900.

While Magdalene asylums were meant to be an alternative to the prisons or poorhouses that sex trade workers often endured, there was little doubt that they were prisons in their own right. Placement in the asylums was supposedly voluntary but the fact that women were locked in and police would often bring back anyone who tried to escape showed otherwise. The inmates were typically retrained for "useful work", i.e., domestic service, despite the fact that domestic workers were often targets for the sort of abuse that led to their becoming "fallen" in the first place.

While in the asylums, women were subjected to various attempts at "redemption" including shaved heads, institutional smocks, supervised visits, flogging and poor diet. They were also put to work (typically in laundries) which provided money for the religious and social agencies that ran the asylums. In addition to the workload, the women were subjected to heavy religious indoctrination stressing the various sins to which they were susceptible. In countries where the Catholic Church was strongest, Magdalene asylums quickly came under church control.

Run by the orders such as the Sisters of Mercy in Ireland, the asylums became even more prison-like in nature with women being actively discouraged from leaving (and often staying for decades). Asylum life was harsh with women being expected to stay silent throughout the day and to address all of the sisters as "Mother", regardless of age. They also worked long hours in the laundry without compensation. Not only were the laundries the primary financial support of the asylums but "penitents" were often told that they needed to "scrub away their sins" through laundry work.

Although the original idea of the asylum was the reform of prostitutes, the admission criteria became even looser over time. Unwed mothers, girls suffering from mental illness or developmental disabilities, and even victims of abuse were often sent to the asylums by parish priests or other community leaders. Pregnant women usually had their babies put up for adoption in other countries without their consent. Without family support, women taken into the asylum system could be forced to stay for the rest of their lives.

The Magdalene asylum system in Ireland has probably been the most well-publicized in recent years although allegations of abuse were hardly unique to that country. The devastating Potato Famine in Ireland led to a tremendous upswing in the number of children placed in orphanages and a breakdown in social order. Magdalene asylums seemed ideal for placing girls who were considered sinful and, by the time the last Magdalene asylum was closed in 1996, an estimated 30,000 women and girls had been through the system.

The controversy over Magdalene asylums erupted in 1993 when an order of nuns in Dublin sold of part of their convent to real estate developers. The discovery of 133 bodies of former inmates who had been buried in unmarked graves sparked a major scandal. Although the true number of asylum inmates who had been quietly buried on asylum grounds may never be known, the revelations provided by former inmates who told their stories seemed shocking enough.

The former inmates described how they were sent to the nuns for being (or at least suspected of being) sexually active. Due to the power of the Church in Ireland, there was no possible appeal for their placement in the Good Shepherd Convent in Cork. Their names were changed (to provide a break with their past lives) and they were assigned to work in the laundry for long hours. Not only were they required to do laundry all day long, they were also expected to pray out loud for their sins. Inmates who were unclaimed by family members could never leave.

In 1998, a gripping documentary titled Sex in a Cold Climate first aired in the U.K. The expose on the Magdalene system generated a tremendous uproar (it was never shown in Ireland due to opposition from the Church). Another well-known film titled The Magdalene Sisters was released in 2002.Although many former inmates have refused to come forward due to the shame that is still associated with having been a Magdalene, hundreds of others have spoken out about their abuse.  Sadly, none them have received any form of compensation or even a formal apology.

As for Magdalene asylums in other countries (including the United Kingdom, Canada,and the United States), information about the number of women who went through the system and when they were finally closed is even scarcer. The legacy of abuse that surrounds the Magdalene asylum system will likely remain hidden until more women speak out.

Spiritual Leader Kills Boy For Being a Witch

Police in Ghana have arrested 52-year old Yaw Payni for his role in the death of a seven-year old boy for witchcraft. Johnny Kweifio was one of four children who had been brought to the self-proclaimed prophet of the Twelve Apostles Church at New Botianor near Accra for spiritual cleansing. Since the children had suffered from frequent ailments, the parents of the children had believed that evil magic was responsible. Payni accused the children of witchcraft and subjected them to weeks of forced starvation and whippings while tied to pawpaw trees. While the other three eventually confessed, Johnny Kweifio refused and eventually died.

Following Johnny's death, Payni told the boy's father that he had been killed by an "angel of the Lord" for refusing to confess. The other children were freed by police who responded to a report by a passerby on December 1.  After arresting Payni, they found Johnny's corpse where it had been thrown behind a wall. The parents have also been charged but were later granted bail.  The corpse is awaiting an autopsy.

Persecutions of accused witches (particularly children) remain common in many Central and West African countries. Exorcisms to "drive out" evil spirits have led to the deaths of countless children with others being forced from their homes to fend for themselves. Cases have also been reported of children living in Western countries who were brought to Africa by their parents to be "cleansed". Given the popularity of the exorcism churches, government agencies seem powerless to intervene. Despite increasing attention in the media, these deaths are likely to continue.

Click here for more information.

Click here for more information.

Women and Suicide Around the World

Around the world, girls and women have higher rates of suicidal ideation and behavior but lower rates of suicide than boys and men. A review in the April 2008 issue of the American Journal of Orthopsychiatry examines the significant variation in gender patterns and meanings suicidal behavior within and across cultures. For example, in the United States, suicide is most common among older "White" men, and is typically considered "masculine" behavior. Women who kill themselves are viewed as acting like men, and therefore deviant. By contrast, in other societies, including China, suicide is viewed as an act of the powerless, and is most frequent in young women. In these societies, men who kill themselves are considered weak and effeminate. The cultural diversity in gender patterns and interpretations of suicidal behavior challenges essentialist perspectives on gender and suicidal behavior. It also challenges the assumption, common in industrialized countries, that women are protected from suicide as long as they stay "feminine" and subsumed within the family. This cultural diversity also points to the pitfalls of theorizing about clinical phenomena as if they were culture-free, and calls for culturally grounded theory, research, and practice.

Click here for the abstract.

What Is A Pedophile?

It was in 2000 when a pediatrician living in the Welsh village of St. Brides was targeted by a group of vigilantes who vandalized the house that she shared with her brother. Dr. Yvette Cloete was alarmed to find that the word "paedo" had been crudely scrawled across her front porch and door. After reporting the incident to the police and cleaning off the graffiti, she moved out of the area. As she later stated, "when something like this happens, you just cannot feel safe in your own home". Police linked the vandalism to a wave of anti-pedophilia protests that had swept the United Kingdom following a tabloid campaign directed against "paedophiles". The protestors had apparently confused the words paediatrician and paedophile and attacked Dr. Cloete's home as a result. The same anti-pedophilia campaign also resulted in numerous families being driven from their homes after being accused of harbouring sex offenders. The "naming and shaming" campaign that sparked the violence, published in the U.K. tabloid News of the World, also called on the British government to allow people full disclosure concerning the identities and addresses of known pedophiles in their area. Although the furour died down eventually, anti-pedophile hysteria goes on.

The word, pedophile (also spelled paedophile), frequently generates panic and outrage but the actual meaning of the term is often misunderstood. While commonly considered to be a synonym for "child molester", clinicians tend to be more specific concerning how the term is used. The diagnostic criteria for pedophila have remained fairly stable over time since it was first included in the 1980 edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). According to the latest revision (DSM-IV-TR), a diagnosis of pedophilia must meet the following conditions: a) recurrent intense sexually arousing fantasies, urges or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger) over a period of at least six months, b) the person has acted on these sexual urges, or the sexual urges or fantasies cause marked distress or interpersonal difficulty, and c) the person is at least age 16 years and at least 5 years older than the child or children in Criterion A. The diagnosis can be further sub-classified depending on whether the pedophile is primarily attracted to children (few, if any, age-appropriate sexual relationships) as well as whether the attraction is homosexual, heterosexual or bisexual (this distinction remains controversial).

Based on the DSM-IV criteria, not all offenders convicted of molesting children can be considered pedophiles (although some researchers have suggested otherwise). The majority of sexual offenses against children (including incest cases) involve adults with age-appropriate sexual preferences using children as sexual surrogates. Although there is little actual difference to the victims, the question of whether or not the offender is a pedophile becomes crucially important in determining risk of reoffending and treatment needs.

Richard von Krafft-Ebbing first coined the term paedophilia erotica in his 1886 work, Psychopathia Sexualis, although he regarded it as being extremely rare. Of the hundreds of case histories that he discussed in his work, only one actually dealt with a case of pedophilia. Other early sexual pioneers including Havelock Ellis and Magnus Hirschfeld touched on pedophilia briefly but the term did not appear much in the clinical literature prior to 1950. A related term, hebephilia (also spelled ephebophilia) was first coined by Hirschfeld to refer to a sexual attraction toward children at or above the age of puberty. Hebephilia is not included in the DSM as a formal diagnosis (its diagnosis is usually covered under the catch-all DSM category of paraphilias not otherwise specified). Despite attempts by researchers to include hebephilia as a distinct diagnosis in future versions of the DSM, current treatment models tend to follow those used for pedophilia.

While the ideal of child sexuality is typically viewed with repugnance, the definition of "child" and appropriate age of sexual consent has varied widely across cultures and time. Female children (often as young as 10 or 11) are frequently given in marriage to older men in spite of attempts to stamp out the practice. Until the 20th century, legislation in Western cultures established legal age of consent for females to be as young as 10 in some jurisdictions (current age of consent varies from 14 to 18 depending on local legislation). Age of sexual consent for male children remains controversial and until relatively recently, any sexual offense involving male children was prosecuted under anti-homosexual statutes (and still is in some countries both for offenders and victims).

Research into the actual incidence of pedophilia and hebephilia in the general population has yielded widely varying estimates depending on definition and methodology. In their 1993 nationwide survey on sexual practices, Janus and Janus found that 2 per cent of sampled males reported having had sex with a child (0 per cent for female respondents). A 1989 study of undergraduate males reported that 21 per cent of the sample acknowledged sexual attraction to some small children although concerns about methodology limits how these results can be interpreted.

Despite the highly-publicized existence of organization such as the North American Man/Boy Love Association (which seems to be defunct at present), rumours of pedophile rings that routinely abduct and abuse children have rarely been proven true. Moral panic over child sexual abuse (typically associated with satanic ritual abuse) has inspired horrendous examples of false accusation and persecution. The McMartin Preschool case and the Wenatchee Sex Ring, among other cases, have led to the forming of support organizations for victims of false abuse accusations. Known or suspected pedophiles have been frequently targeted by vigilantes who consider their actions justified.

Anti-pedophile hysteria remains the greatest barrier towards successfully reintegrating convicted sex offenders into society. The existence of publicly accessible sex offender registries in many jurisdictions has spurred neighbourhood activist campaigns designed to drive real or suspected pedophiles away from their homes (and the treatment programs that might have helped prevent reoffending). The counterproductive nature of these campaigns is doubly tragic: not only is the risk to children in other neighbourhoods increased, but parents who obsess over pedophiles are often caught off guard when their children report being abused by "safe" adults who were considered trustworthy.

Staying vigilant is the only real protection for children.

WHO Calling for Treatment of Mental Disorders in Developing World

A representative for the World Health Organization has announced a new program to raise awareness of the critical need for treatment programming in developing countries for people suffering from psychiatric and neurological disorders. Although an estimated 300 million people in the world suffer from mental health problems, developing countries lack essential resources to address these issues. More than 75 per cent of all mentally ill individuals in less economically prosperous countries remain untreated.

The proposed WHO program, titled the mental health Gap Action program (mhGAP) is focusing on eight conditions including schizophrenia, substance abuse, psychiatric illnesses in children, dementia, epilepsy and suicide. The goal is to provide treatment by 2015 for 20 per of individuals needing help. The program is also focusing on the stigma that surrounds mental illness which prevents sufferers from seeking treatment and which also results in discrimination and neglect. The WHO is planning to train local health professionals to integrate mental health programs into primary health care.

Critical problem areas include the nine out of ten epilepsy sufferers in Africa who are currently not receiving proper medication to control seizures as well as the growing number of HIV dementia cases that are straining available resources.

As evidence of the feasibility of the new program, the WHO has cited several initiatives that have been extremely effective. Chile has successfully incorporated treatment for depression into primary health care providing treatment for thousands of Chileans with emotional difficulties. An epilepsy treatment in China has also been successful.

Click here for more information.