The “Portrait of a Serial Killer” takes you inside the twisted minds of those who kill repeatedly. It uncovers how childhood trauma, emotional neglect, antisocial personality disorder and other deep psychological disorders shape their need for power and control. From their cold detachment to the dark fantasies that fuel their actions, the post explores the chilling traits and motivations behind these killers. With a focus on the haunting impact on victims and society, it offers a gripping, humanized look into the forces that drive someone to commit the unthinkable.

By Mureithi Melvin

Worth Noting:

Counseling, especially in today’s context, requires constant professional development and emotional investment. The mental and emotional toll it takes on practitioners is immense, yet they are often expected to provide their services without guaranteed financial support. This leaves them vulnerable to exploitation, which can further undermine the quality of services offered to those in need.
There is a pressing need for counselors to be enrolled in permanent and pensionable roles. A system that provides long-term employment opportunities would not only safeguard the well-being of counselors but also enhance the quality of care they provide. A permanent position allows for job security, benefits such as healthcare, and the peace of mind to focus on helping others without the constant fear of financial instability.
Pro bono services, while a noble undertaking, have long been the norm in the counseling profession. Many counselors, particularly those at the grassroots level, offer their expertise for free, driven by a passion to help individuals navigate life’s challenges. However, the practice of offering such services without financial compensation has serious implications, not only for the well-being of the counselors but also for the broader system of governance.

The Strain of Unpaid Work

While pro bono counseling offers critical support to marginalized and underserved communities, it places a significant strain on counselors who, more often than not, are working without the financial stability that paid employment offers. These professionals are highly trained and possess extensive qualifications, including a Bachelor of Arts in Counseling Psychology, but many still struggle to make a living through their work. The reality is that without financial compensation, counselors are often left to work in challenging conditions with little to no support, leading to burnout and high turnover rates within the field.

Counseling, especially in today’s context, requires constant professional development and emotional investment. The mental and emotional toll it takes on practitioners is immense, yet they are often expected to provide their services without guaranteed financial support. This leaves them vulnerable to exploitation, which can further undermine the quality of services offered to those in need.

The Call for Permanent and Pensionable Positions

There is a pressing need for counselors to be enrolled in permanent and pensionable roles. A system that provides long-term employment opportunities would not only safeguard the well-being of counselors but also enhance the quality of care they provide. A permanent position allows for job security, benefits such as healthcare, and the peace of mind to focus on helping others without the constant fear of financial instability.

Furthermore, pensionable employment would allow counselors to plan for their futures, as it ensures that they will be supported in their later years. The lack of such provisions often means that, after years of service, counselors are left without a safety net, making it difficult for them to retire with dignity. This is especially concerning when considering the emotional labor involved in the counseling profession.

Impact on Governance

The systemic integration of counselors into permanent and pensionable positions would have a profound impact on governance. By recognizing counselors as essential members of the workforce and providing them with stable employment, we are investing in the long-term mental and emotional health of our society. The counseling profession plays a critical role in addressing mental health issues, preventing crime, and fostering social cohesion. By ensuring that counselors are properly compensated, we acknowledge their value and prioritize mental health at the governance level.

In turn, when counselors are financially secure, they can better contribute to policy development and advocacy. Their experience and expertise become invaluable in shaping mental health frameworks, supporting vulnerable populations, and developing educational programs to prevent mental health crises. This strengthens the overall governance structure, as the well-being of citizens directly affects the stability and progress of any nation.

Conclusion

The time has come to move beyond the pro bono model for counselors and recognize their vital contribution to society. By providing permanent, pensionable employment, we are not only investing in the future of counselors but also in the future of our communities and governance structures. As a society, we must advocate for the fair treatment of mental health professionals, ensuring they are adequately compensated for their work. By doing so, we enhance not only their professional satisfaction but also the overall quality of life for the individuals and communities they serve. It’s time to give counselors the support they deserve, creating a sustainable and impactful mental health infrastructure for generations to come.

Prepared by, Mureithi Melvin, BA (Couns. Psych.) Ongoing- KCA, Dip. (Couns. Psych.), Hons. Doc. (Trg.) – Ulumudin Markaz, Assoc. Psych. (KCPA), Mental Health Advocate, ISSUP Member.

 HEALTHCARE ECONOMICS  THE IMPACT OF COVID-19 ON HEALTHCARE INEQUITIES:- Assessing the long-term Economic consequences on Vulnerable Population   By:- Sheetal  Ayush Burnwal Zaheen Qureshi Sanjula D Pankhudi Jha             INTRODUCTION The first whispers about an obscure virus were heard in Wuhan, China. A few months later, it began to spread, accompanying the number of cases contaminated rising swiftly and comprehensively in domains of the world for fear that on March 11, 2020, the WHO regularly announced the new affliction as a worldwide universal. The disease has a development ending from two to fourteen days but generally remains asymptomatic. If indicative, the universal signs and symptoms noticed include turmoil, dry cough, shortness of whiff, proneness, neck sensitivity, restlessness, and in harsh cases leads to severe respiratory distress syndrome and pneumonia that in decay can finish in multiple means of loss and certainly death. The harsh performance of affliction was majorly seen in toddlers and aging old people. Many measures were taken to stop the affliction i.e. seclusion, quarantine of distrust, tight infection administration conduct, contact security measures, and social passing.  In reference to this healthcare inequities may be delimited as differences in healthcare rank or the disposal of well-being resources between various populace groups, arising from public environments at which point people are innate, evolve, live, work, and age. Health inequities are prejudiced and could be weakened for one right join of government tactics. A big culture, variations in possessions across domains, and a feeble community health system in India formal a challenge in conditions of momentary and preparedness to handle a quickening caseload.16 In conditions of available capital, from the 3.6% GDP expense in healthcare, only 1.5% is apiece Government, and households carry more than 2%, that is to say, 65% of payment is out of pocket.12 The system working, when COVID hit, was accordingly underprepared to deal with this crisis. The risk of harsh complexities from COVID-19 is higher for certain unsafe people, particularly the ones who are retired, frail, or have diversified never-ending environments. The other susceptible group is made apiece stranded, weak, regular traders as the ever-growing strength cost keeps aggressive those just above the poverty line back into want. Vulnerable societies were individual big groups in India, labeled all along COVID. OBJECTIVE  To examine healthcare inequities from a multidimensional lens of economics, in the aftermath of COVID-19.      HEALTHCARE INEQUITIES India however confronts many difficulties in providing equitable healthcare to all due to its large population. Healthcare inequities are influenced by a number of factors such as socioeconomic status, regional differences, inadequate healthcare facilities, gender stereotypes, etc. These inequities produce systematic disadvantages and cause disparities among different sections of the population.   The rural population often prefers public health because it provides them with the most accessible and affordable healthcare option, as they typically lack the financial means to access private healthcare services, which are often more expensive and may not be readily available in their communities. It is, therefore, the public health system that serves the majority of India’s vulnerable rural population. Nearly 75 percent of health-related infrastructure, medical workforce, and other health resources are concentrated in urban areas, where only 27 percent of the population resides. This leaves the poorest segments of the population in rural areas facing numerous access barriers.    Providing well-equipped public healthcare becomes quintessential in reducing inequities between the rural and the urban. It is therefore important to have a strong and effective public healthcare system as the rural population’s access to basic health services is mainly through primary healthcare centers which is widely regarded as the most inclusive, equitable, and cost-effective way to achieve universal health coverage. PHCs in India are understaffed as more than 37% of the health assistant positions, 34% of laboratory staff and 21% of nurse positions are vacant. There is widespread absenteeism among healthcare workers in PHCs. Due to poor management and ill-equipped services provided by PHCs, the rural population is forced to seek services from the private sector, causing more financial complications and widening the rural-urban gap.   One of the main challenges is that health spending in India is mostly out-of-pocket. OOP health expenditure imposes an extreme financial burden on households because the fees and cost of treatment are very high in private facilities and unaffordable for people earning low incomes. OOP expenditure on health is one of the biggest reasons for people falling into poverty in India.   Nearly 70% of hospitals and 40% of hospital beds are private. Health insurance is largely private, and the urban poor cannot afford private care. The Indian healthcare budget is inadequate; the total healthcare expenditure was at only 1.3% of gross domestic product in 2021, which is the lowest in the BRICS group. There is a disparity in the availability of infrastructure and resources between rural and urban areas in India. Evidence points out that among all health workers, 67% were serving in urban areas where 33% of the population is based; and 33% were serving in rural areas where 67% of the population resides. India has approximately 860 beds/million population as compared to WHO’s estimate of the world average, which is 3,960 beds/million population, proving that our healthcare infrastructure is seriously lacking.    Gender stereotypes and inequalities can also impact access to healthcare, particularly for women. Cultural norms may limit women’s autonomy in making health decisions, leading to delays in seeking care or requiring approval from male family members. Additionally, gender-based discrimination and violence can further hinder women’s access to medical services. Women and elderly patients often rely on family support to reach healthcare facilities and may need permission before spending money on treatment, taking tests, or attending follow-up appointments.   India is a major hub for private health tourism. Private hospitals in India are seeing an influx of patients. India ranks among the top 20 countries in terms of private expenditure on health in percent GDP terms – around 4.5-5 percent of GDP. The extra revenue

by Palak Parashar, Humaira Hasan, Upasana Koul Introduction Schizophrenia is a serious brain disorder affecting around 1% of the global population and is one of the top 10 causes of disability worldwide (Marder & Cannon, 2019). This condition is characterized by symptoms such as hallucinations (e.g., seeing or hearing things that aren’t there), delusions (false beliefs), disorganized speech, and abnormal behavior. Additionally, individuals with schizophrenia often experience a lack of motivation, reduced emotional expression, and cognitive difficulties, including problems with thinking, memory, and decision-making (Jauhar, Johnstone, & McKenna, 2022). The impact on daily life can be significant, leading to severe disability and incomplete recovery. Even individuals who show improvement may still struggle with social isolation, stigma, and limited opportunities for building close relationships. Unemployment rates are high among those with schizophrenia, and lifestyle factors such as poor diet, weight gain, smoking, and substance use contribute to a reduced life expectancy of 13 to 15 years (Hjorthøj, Stürup, McGrath, & Nordentoft, 2017; Kahn, 2020). The lifetime risk of death by suicide for individuals with schizophrenia ranges from 5% to 10% (McCutcheon, Reis Marques, & Howes, 2020).   Current diagnosis and treatment primarily target psychotic symptoms, but negative and cognitive symptoms are equally important due to their significant impact on social and professional functioning. These symptoms often do not respond well to conventional antipsychotic medications (Kahn, 2020; Jauhar, Johnstone, & McKenna, 2022). Historically, schizophrenia was conceptualized by Emil Kraepelin as “dementia praecox,” a term later renamed “schizophrenia” by Eugen Bleuler. Notably, both Kraepelin and Bleuler did not consider positive symptoms like delusions and hallucinations as the primary characteristics of the disorder. This historical perspective supports the view that a more comprehensive approach is needed for understanding and treating schizophrenia (Kahn, 2020).   Schizophrenia diagnosis involves a detailed psychiatric history and mental status examination, ruling out other potential medical and psychiatric causes of psychosis. Risk factors for developing schizophrenia include birth complications, being born in a specific season, maternal malnutrition, maternal influenza during pregnancy, a family history of the disorder, childhood trauma, social isolation, cannabis use, minority ethnicity, and living in urban environments (Messias, Chen, & Eaton, 2007; Davis et al., 2016). The exact cause and biological mechanisms of schizophrenia remain unclear due to its complexity and variability. Despite being relatively uncommon, schizophrenia has a significant impact on the global burden of disease, with more than half of those diagnosed experiencing multiple coexisting psychiatric and medical conditions (Chong et al., 2016).    The pharmacological treatment for  schizophrenia:- Pharmacological treatment for schizophrenia primarily involves antipsychotic medications, which are categorized into two groups:- 1.First-generation antipsychotics (FGAs) 2.Second-generation antipsychotics (SGAs)  1)First-generation antipsychotics, also known as typical antipsychotics, are dopamine receptor antagonists (DRA). These include: Phenothiazines, trifluoperazine, perphenazine, prochlorperazine, acetophenazine, triflupromazine, mesoridazine Butyrophenones: haloperidol Thioxanthenes: thiothixene, chlorprothixene Dibenzoazepines: loxapine Dihydroindoles: molindone Diphenylbutylpiperidines: pimozide. (Drummond N, McCleary L, Freiheit E, Molnar F, Dalziel W, Cohen C, Turner D, Miyagishima R, Silvius J.  2018 Jennings AA, Guerin N, Foley T.  Faden J, Citrome L.  Pharmacother. 2019) .    2. Second-generation antipsychotics, also known as atypical antipsychotics, are serotonindopamine antagonists. As of 2016, the Food and Drug Administration (FDA) has approved 12 atypical antipsychotics. These are: Risperidone Quetiapine Aripiprazole Asenapine Lurasidone Iloperidone Brexpiprazole Clozapine ( Haddad PM, Correll CU.  Nov 2018) .   What is Schizophrenia? Schizophrenia may be defined as an acute mental illness that is characterized by disturbance in cognition( illogical thinking), behavior, speech, and hallucinations(hearing voices, seeing things that aren’t present) or delusions. (American Psychological Association, n.d.) The DSM-5, or the Diagnostic and Statistical Manual of Mental Disorders, describes the symptoms of schizophrenia as including disorganized speech (e.g., frequent derailment or incoherence), delusions, hallucinations, or catatonic behavior. (NCBI, n.d., Table 22)   Prevalence and Onset: Schizophrenia is a genetic neurocognitive disorder that affects approximately 1% of the population, typically appearing between the ages of 21 and 25 in males and 25 and 30 in females. (Zhan et al., 2023) Extensive research suggests that from 1990 to 2019, global schizophrenia cases rose by over 65%, new diagnoses by 37%, and health impacts (DALYs) by 65%, while age-adjusted rates stayed stable. (Solmi et al., 2023) Treatment: Schizophrenia treatment is lifelong and combines medications with psychosocial support, guided by a psychiatrist and a care team. Antipsychotic medications, including both first- and second-generation options, are the primary treatment, with long-acting injectables available for better adherence. Additional medications, such as antidepressants or mood stabilizers, may be used based on individual needs. Psychosocial approaches like therapy, social skills training, family support, and vocational rehabilitation enhance coping, communication, and daily life skills. Severe cases may require hospitalization for stabilization, while electroconvulsive therapy (ECT) is considered for those unresponsive to other treatments. With proper care, many people with schizophrenia can manage their symptoms effectively. (Mayo Clinic, n.d.)   Prescribed Drugs First-Generation Antipsychotics First-generation antipsychotics (FGAs), also known as typical antipsychotics, primarily work by blocking dopamine receptors to alleviate symptoms of various mental health conditions. These medications are commonly prescribed for issues such as acute mania, agitation, and bipolar disorder. Some examples of FGAs include Chlorpromazine (Thorazine), Fluphenazine (Prolixin), Haloperidol (Haldol), and Loxapine (Loxitane), among others. (Mayo Clinic, n.d.) Mechanism: Both first- and second-generation antipsychotics block dopamine in the ventral tegmentum to reduce positive symptoms. However, first-generation drugs also affect the nigrostriatal dopamine system, leading to extrapyramidal side effects, which second-generation drugs cause less frequently. (Grace & Uliana, 2023) Efficacy: Studies revealed minimal differences in efficacy between First Generation Antipsychotics and Second Generation Antipsychotics, but haloperidol was less effective than amisulpride and clozapine. Additionally, olanzapine showed greater improvement in functional capacity compared to quetiapine and ziprasidone. (Pike et al., 2009)   Second Generation Antipsychotics Second-generation antipsychotics (SGAs), also known as atypical antipsychotics, are newer medications that work differently from first-generation antipsychotics. Instead of fully blocking dopamine receptors, SGAs partially block them and may also influence other neurotransmitters like serotonin. Examples of SGAs include Aripiprazole (Abilify), Clozapine (Clozaril), Olanzapine (Zyprexa), Risperidone (Risperdal), and Quetiapine (Seroquel). (Mayo Clinic, n.d.)   Mechanism: These medications inhibit some serotonin and dopamine