Thursday, June 30, 2011

Baylor Study Finds Church Congregations Blind to Mental Illness

June 22, 2011
Follow us on Twitter: @BaylorUMediaCom

Mental illness of a family member destroys the family's connection with the religious community, a new study by Baylor University psychologists has found, leading many affected families to leave the church and their faith behind.

The study shows that while families with a member who has mental illness have less involvement in faith practices, they would like their congregation to provide assistance with those issues. However, the rest of the church community seemed to overlook their need entirely. In fact, the study found that while help from the church with depression and mental illness was the second priority of families with mental illness, it ranked 42nd on the list of requests from families that did not have a family member with mental illness.

"The difference in response is staggering, especially given the picture of distress painted by the data: families with mental illness reported twice as many problems and tended to ask for assistance with more immediate or crisis needs compared to other families," said study co-author Dr. Matthew Stanford, professor of psychology and neuroscience at Baylor, who is an expert in mental illness and the church. "The data give the impression that mental illness, while prevalent within a congregation, is also nearly invisible."

The study appears on-line in the journal Mental Health, Religion and Culture, and is the first study to look at how mental illness of a family member influences an individual's relationship with the church.

The Baylor researchers surveyed nearly 6,000 participants in 24 churches representing four Protestant denominations about their family's stresses, strengths, faith practices and desires for assistance from the congregation. The results showed mental illness in 27 percent of families, with those families reporting double the number of stressors, such as financial strain and problems balancing work and family. Families with mental illness also scored lower on measures of family strength and faith practices, and analysis of desires for assistance found that help with mental illness was a priority for those families affected by it, but virtually ignored by others in the congregation.

"Families with mental illness stand to benefit from their involvement within a congregation, but our findings suggest that faith communities fail to adequately engage these families because they lack awareness of the issues and understanding of the important ways that they can help," said study co-author Dr. Diana Garland, dean of Baylor's School of Social Work. "Mental illness is not only prevalent in church communities, but is accompanied by significant distress that often goes unnoticed. Partnerships between mental health providers and congregations may help to raise awareness in the church community and simultaneously offer assistance to struggling families."

About Baylor University
Baylor University is a private Christian university and a nationally ranked research institution, classified as such with "high research activity" by the Carnegie Foundation for the Advancement of Teaching. The university provides a vibrant campus community for approximately 15,000 students by blending interdisciplinary research with an international reputation for educational excellence and a faculty commitment to teaching and scholarship. Chartered in 1845 by the Republic of Texas through the efforts of Baptist pioneers, Baylor is the oldest, continually operating university in Texas. Located in Waco, Texas, Baylor welcomes students from all 50 states and more than 80 countries to study a broad range of degrees among its 11 nationally recognized academic divisions.

Media contact: Matt Pene, Assistant Director of Media Communications, 254-710-4656.

Sunday, June 26, 2011

“Jails are being used as de facto mental care facilities, filling the role that community-based care used to provide. We need to fix this missing link.”

Community based mental health services are becoming weaker and ineffective not only in the US, but in Australia. Here's an article I came across this weekend, stating Australia is working to "fix" this problem. The priority? Getting people with mental illness out of jails. We, in the US, need to fix this problem too.

COMMUNITY-BASED mental health care is to be the main plank in the NSW Government’s mental health policy.

This is the message NSW Mental Health Minister Kevin Humphries brought with him to the weekend’s Rural Mental Health Conference at Coffs Harbour.

“Community-based mental health is what we used to have in NSW, however, these services have been severely diluted over the years, driving mental health care backwards,” Mr Humphries said.

“We have now set up a stand-alone ministry and next year we will be establishing a Mental Health Commission to set priorities.

“The commission will include clinicians, carers and consumers and will also help drive best-care research forwards.”

He said getting people with a mental illness out of jails would also be a priority.

“Jails are being used as de facto mental care facilities, filling the role that community-based care used to provide.

“We need to fix this missing link.”

He said one in 10 homicides in NSW was committed by a person with a severe mental illness, which was “simply too high”.

Guest speaker at the conference, 2010 Australian of the Year Professor Patrick McGorry, said shifting entrenched attitudes which did not take mental health seriously was still a problem.

“Young adults, especially young men, are being denied care because they are not taken seriously,” Prof McGorry, who is professor of youth mental health at Melbourne University, said.
“Psychotic illness in young men can often present as bad behaviour.

“The risk of that person committing a murder prior to treatment is 40 times greater than when they have been diagnosed.”

The NSW Government will also be establishing a Mental Health Tribunal to assist those being kept in care involuntarily and those unable to get access to care.

“We want to take a more holistic approach,” Mr Humphries said.


Saturday, June 25, 2011

Local News | Suspect's life marked by mental illness, acquaintance says | Seattle Times Newspaper

At times he recognized his need for treatment - "if only" AOT had been ordered for the times he didn't.

Local News | Suspect's life marked by mental illness, acquaintance says | Seattle Times Newspaper

Friday, June 24, 2011

A Mother Speaks Out

Is prison really where mentally ill should be?

When he was OK, Jeffrey Wittler was kind-hearted and sensitive, loved pets, flying, reading, talking philosophy and analyzing the galaxies.

But as he grew into his 20s his mental problems intensified. Besides the bipolar disorder, depression and anxiety, there were signs of psychosis, his mother, Beverly Wittler of Spirit Lake, says. Medicine helped but brought side effects, so when he felt better, he'd stop taking it.

Last July, Jeffrey became one of the many mentally ill people who end up in prison for crimes their loved ones say they didn't willfully commit. He assaulted his mother, and though she didn't press charges, he was sentenced to 15 years.

His prison stay ended last October -- in the clinical care unit at the Fort Madison prison, where the 23-year-old pulled a plastic bag over his head and died of asphyxiation.

Eight months later, his distraught parents look for answers: why no one who might have saved him was more vigorously policing a unit for mentally unstable inmates who are supposed to be checked every half hour; why a prison doctor didn't heed Beverly's warnings that her son was depressed; why he got 15 years for actions that, if charged as domestic assault, would have gotten days, at most.

Seven inmates have killed themselves in Iowa prisons in the past five years. Because of his mental problems, Jeffrey went directly into Fort Madison's clinical care unit when he got to the prison in July. Department of Corrections spokesman Fred Scaletta says the unit is for medium-level mental patients; severe cases go to Oakdale. "There was no sign whatsoever of any type of behavior that would result in this," he said, noting that Jeffrey had a prison job he liked.

But to his mother, Jeffrey seemed despondent over the sentence.

She says he got no therapy. She was told it was available if an inmate sought it out. "Well these are mentally ill people!" she responds. Scaletta said Jeffrey got medication, but he couldn't say about therapy. Beverly said about a week before her son died, she emailed a prison doctor to convey her concerns, but there was no response -- just a message relayed through Jeffrey that the doctor had been too busy: "She'll get back to you."

Scaletta said he sympathizes with the family. "Unfortunately, if someobody wants to harm themselves, it really only takes less than 10 minutes," he said.

A prison press release said Jeffrey's body was found at 6 a.m., eight hours after he went to his room for the night. A blanket covered his head. "It makes me mad that any psychiatric ward would allow that to happen," said his mother.

She said Jeffrey was uncharacteristically aggressive when he attacked her two years ago, a day after she took him to a hospital because he was agitated. The wait was so long he left, and the next day he accused her of trying to commit him. He beat her, breaking her nose, and threatened her with a knife. Her hand was slashed, she believes, from trying to grab it. She said she broke her arm when she fell trying to run. She called police.

The prosecutor wanted to charge attempted murder, but Jeffrey took a plea bargain to a charge of willful injury and going armed with intent.

Beverly thought a mental health facility would be a better option. "They didn't want to hear it," she said, noting, "People do less time for manslaughter." She says she tried to tell officials Jeffrey had tried to kill himself when he was jailed once for drunken driving.

Nearly half of state and federal prisoners are believed to have signs of mental illness. The mother of Michael Swanson, 18, now on trial for murder, testified that a psychiatrist wanted him confined at age 11. She said she locked herself in her bedroom at night for safety and begged authorities to confine him so he could get treatment.

According to Human Rights Watch, prison mental health services are "woefully deficient, crippled by understaffing, insufficient facilities, and limited programs. Many seriously ill prisoners receive little or no meaningful treatment."

Wittler says she is speaking out now not just for her son, but for the mentally ill people who should be getting proper treatment in prison -- or shouldn't be there in the first place.


Tuesday, June 21, 2011

Sunday, June 19, 2011

"We're kind of like the center that connects the spokes to the outside tire," Zimmer said. "If we see the need, we add another spoke."

What a great philosophy! If only more spokes could be added to our current system of mental health care for those with severe mental illnesses.

Wednesday, June 15, 2011

Information Well Worth Reiterating

Reprinted from the blog of the Treatment Advocacy Center

A new, long-term study published in the May 2011 issue of Psychiatric Services reports dramatic benefits of assisted outpatient treatment (AOT) to its participants and society.
“Arrest Outcomes Associated with Outpatient Commitment in New York State” by Bruce G. Link, PhD, of Columbia University and four co-authors followed 183 patients at outpatient clinics in New York City, 86 of whom had participated in Kendra’s Law and 86 who had not.  The study found:
  • The population that never received AOT was twice as likely to be arrested as the group that did receive it.
  • Among those receiving AOT, the risk of any arrest was 2.66 greater before participation than after.
  • Among those receiving AOT, the risk of arrest for a violent offense was 8.61 times greater before participation in AOT than after.
“AOT, as implemented under Kendra’s Law in New York State, is a policy that substantially reduces the risk of arrest, including arrests for violent offenses among people with serious mental illnesses,” the authors wrote. “From the vantage point of a general public concerned with violence…, this is a very positive and straightforward outcome: Kendra’s Law directly results in reduced crime and violence.”
The authors said the reduced arrest rate “pushes us to consider a very beneficial trade-off in coercion, with a relatively small exposure under Kendra’s Law forestalling a substantially larger exposure delivered by arrest.”
An abstract of the article may be viewed at no charge online. Non-subscriber access to the full article inPsychiatric Services is available on a fee basis.

"The elephant in the hall" of treatment ethics

From the blog of the Treatment Advocacy Center
There's an “elephant in the hall of medical ethics, that no one likes to talk about," according to David Berreby: "Money.”
Psychosis creates a vicious cycle, says the author and blogger whose own mother died without ever accepting treatment for severe mental illness. “We human beings get through life by making friends and allies. This capacity for coalition-building is one of the things psychosis breaks.” This leaves the mentally ill “cut off from that natural system of exchanges” - easily ignored because they have nothing to trade for society’s protection and thus easily left with the short straw when limited public resources are doled out.
Money is just one of the obstacles Berreby takes on in his incisive “More on the Issue of Forced Treatment” (June 9), written in response to comment on a previous post entitled “It’s Terrible to Force Treatment on the Mentally Ill. But It’s Worse Not To.” In the June 9 blog, he dismantles civil rights and other objections to involuntary treatment with a eloquence and efficiency that is rare and admirable. Both posts are worth the click through.
See also "When Patients Reject Treatment - Two Views" for commentary on a New Yorker examination of involuntary treatment and Berreby's counterpoint to it.

Sunday, June 12, 2011

Treatment Advocacy Center Founder Calls for Abolition of SAMHSA

From the Treatment Advocacy Center's blog:

Research psychiatrist and Treatment Advocacy Center founder E. Fuller Torrey has called for federal budget cutters to abolish the agency that supposedly sees that mental health and addiction services are delivered to those who need them the most. The Substance Abuse and Mental Health Services Administration (SAMHSA), Dr. Torrey writes in the June 20 issue of National Review, “is a federal health agency distinguished by the fact that the health of its clients would improve if it went out of business.”
What "one might think ... " or "you might expect ... " emanates from an agency that claims its mission is reducing the impact of mental illness and addiction on America's communities is not what is happening, Dr. Torrey says. "One might think," for example, that SAMHSA would have a major interest in the two most serious mental illnesses - schizophrenia and bipolar disorder - that together affect 7.7 million Americans. Instead, he writes, neither disease is mentioned even once in the 41,804-word text of SAMSHA's just-released long-range action plan or is the subject of any of the agency's hundreds of publications. 
"One might also expect" SAMHSA to "exhibit concern about the fact that 3.5 million out of the 7.7 million most severely mentally ill individuals in the US are not being treated," including a small number like Jared Lee Loughner who become dangerous without treatment. Yet SAMHSA funds organizations in several states – including Maine, Vermont, Pennsylvania and California – that have actively opposed proposed changes in state laws designed to make treatment more available for the most seriously mentally ill individuals.
Given SAMHSA’s failure to focus its resources on individuals with serious mental illnesses, Dr. Torrey recommends that the agency be abolished. He suggests that its "few valuable functions," such as data collection, would be transferred to the National Institute of Mental Health (NIMH), the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Drug Abuse (NIDA).
“Bureaucratic Insanity” is available online to subscribers or on newsstands. To comment, visit our Facebookpage.

"When their quiet suffering becomes pubic, we are reminded again how we fail that fraction of the populace who truly are ill."

The Conversation: A journey into darkness

Published: Sunday, Jun. 12, 2011 - 12:00 am | Page 1E
Should state law be changed to make it easier to compel treatment for those who are severely mentally ill? To comment on this issue, please use our forum.
First in an occasional series
Brian Lungren had been on a downward spiral since his mid-teens – using street drugs, hearing voices, hallucinating and descending ever deeper into mental illness.
Sometimes, he thought he was Mafia don John Gotti or an undercover agent. Often, he was rapper Tupac Shakur, who was gunned down in Las Vegas in 1996. He once confided to his mother that Tupac's ghost told him to commit suicide so he could become God.
Now 27, he has been in and out of drug and psychiatric treatment facilities and jails more than 30 times, beginning in his teenage years. One night when he was a teenager and had become particularly belligerent, his mother bolted shut her bedroom door and slept with a hammer close at hand.
In 2007, Brian stabbed another patient at a drug treatment home in Auburn. A Placer County judge concluded that he was not guilty by reason of insanity and sent him to Napa State Hospital in 2008.
His path to Napa State illustrates the story of mental illness in our time. With the help of 24-hour care and antipsychotic medication, he has become more stable. But he didn't receive prolonged and intensive care until he committed a crime.
Brian's crime was comparatively minor. He didn't kill six people and wound a congresswoman, or torch the Roseville Galleria, or drown a 3-year-old baby. But for Lungren and the others, help came only after they harmed someone else – and that is the crime of the mental health care system.
Mental illness doesn't care about pedigree or partisan affiliation. But if any family could have gotten help to stop his slide, it was the Lungrens. His father, Brian Lungren Sr., is a partner at Platinum Advisors, one of the top lobbying firms in Sacramento, and managed the 1998 gubernatorial campaign of his brother, Dan, then state attorney general and now a congressman.
His mother, Nancy Lungren, has worked for Republican lawmakers, Arnold Schwarzenegger and now the Brown administration. The Lungrens understand how to navigate the system, and could pay for private schools and treatment when their son was a minor. But try as they did, they could do nothing to halt his descent.
The crisis that engulfed the Lungren family has eased now that Brian is in a locked ward behind 16-foot-tall fences at Napa State. They know he is getting care. But his parents wonder if they could have done something earlier or different, and they harbor misgivings about a system that so assiduously protects the civil rights of severely mentally ill people at the expense of effective treatment.
"There wasn't enough help," Nancy Lungren said. "They make you fall before they pick you up."

Ski star on a downhill slide

Over pizza on a recent evening, Nancy Lungren popped cassettes into their video player and watched ski movies filmed in the late 1990s in the Sierra. The plots are thin and the acting isn't great. But shots of the skiers are stunning.
Extreme skiers speed down steep slopes, take dizzying leaps, flip, twist, turn and somehow land right side up. One of the extreme skier-stars is Brian, when he was 14, 15 and 16.
In exchange for performing, Brian would be plied with the latest skis, poles and other gear, given to him by equipment manufacturers as part of their marketing. By 2001, however, mental illness was taking hold, made worse by drug abuse.
"I really think Brian has some serious potential to be one of the best free-skiers in the country," an executive for Scott USA, one the biggest equipment marketers, wrote in an email to the Lungrens in January 2001.
"It seems that he might be veering off the path and not making quite the correct decisions," the executive added. "I realize that this is not my business, and I may be incorrect, but … I just want to help out any way I can."
A month later, Brian was skiing in Squaw Valley with two friends, Bryan Richmond and Brendan Allen. He decided to stay behind when they headed down a closed run between Squaw and Alpine Meadows. They died when an avalanche buried them beneath 5 feet of snow.
Soon afterward, Nancy Lungren began keeping a journal, the first entry of which included these recollections:
"Bri basically stopped skiing after that (avalanche), stood around smoking all season, couldn't ski. Then he began flipping out on us, using coke, etc., and being violent. Anger and sorrow, hating us, maybe the world.
"Bri is definitely a master skier. Fearless, strong and impossible to keep up with. …
"Also, fearless partying. … Bri started hearing voices or imagining people could read his thoughts. … Brian started being unable to function physically and mentally."

Few placement options

The Lungrens found few facilities that could handle their son. There simply aren't many that care for young people with severe mental disorders.
He did stay at one in Sonoma County for three months in the summer of 2001, but its funding ran out and it closed. From there, he went to a home in Napa County but was kicked out after he punched another resident in the face. A therapist summed up his condition:
"At this time, we believe that Brian may be suffering from a condition that could ultimately be diagnosed as a chronic psychiatric disorder. With this in mind, (we) strongly recommend continued close psychiatric treatment, a specialized education program, and family and individual therapy, without which, we feel that prognosis for any success is extremely guarded."
The Lungrens scrambled to find another place on short notice but failed, and brought him home in October 2001. Three days later, Nancy Lungren wrote in her diary:
"In bed with door bolted … my cell phone beside me and a hammer. … After tonight's bizarre conversation – if you can call it that – I think he needs to go to a mental hospital."
The next month, their son turned 18. Some families are incapable of caring for mentally ill adult children. Many want nothing to do with them. The Lungrens, however, tried to assert themselves.
On three different occasions, they petitioned judges to appoint them or the Placer County guardian as Brian's conservator so they or someone could have a say over his care.
Conservatorship is an adversarial process, and Brian resisted. His court-appointed lawyer convinced judges each time that he did not meet the legal standard for being deemed "gravely disabled."
The Lungrens' first failed attempt to become his conservator came in March 2002. Nancy Lungren described his state of mind in her journal that month, following his release from jail for a minor crime:
"Bri will deny all what I'm writing down but it was a most amazing conversation. … He says he's supernatural and that when he was in jail, people would come up to him and give him respect like he was a gang member mafia dude. That they were scared of him. …
"Tupac came to him all friendly and told him he would be God. He saw faces in the dartboard, and the Tupac and devil spirit told him he could have his powers in one year.
"Tupac became bad like the devil and told him he'd have to commit suicide, then he could come back as god on earth. He told me that he had incredible surges of energy and power."
Even if they had become his conservator, it's not clear that the Lungrens could have found a place to accept him. If they could have found a place, they could not have afforded it. In one year when he was a minor and still covered by their insurance, his care cost $90,000.
Government pays for broken bones and diseased hearts of adult indigents who have physical disabilities. It also pays for the care of people with developmental disabilities. But state law says counties are obligated to pay for the care of adults with mental illness only "to the extent resources are available."

A dad's desperate efforts

The Lungrens tried many things: psychiatrists, special schools, drug treatment. There were many people who tried hard to help. Nothing worked.
At wit's end, Brian Lungren Sr. tried to scare him straight. He brought his son to Loaves & Fishes. As they walked among bedraggled and homeless, he told his son that he might end up there. Later, he pulled a string and got him a tour inside Folsom State Prison.
"After he came out, he said it was cool to see the inside and they all 'hit the iron' hard and were buffed," Lungren said. "I told him he could be locked up inside there if he went down the gang style road. He told me not to worry."
As he tried to piece together what had gone wrong, Brian Lungren Sr. jotted down some memories, and recalled taking his wide-eyed 12-year-old son to South Bend, Ind., for a Notre Dame football weekend.
The older Lungren had graduated from Notre Dame, as did his two brothers, and their father, a physician. He assumed young Brian would carry on the tradition.
"Bri had the smarts, it seemed," he wrote of his son at age 12. "He was speaking so well in any setting. When he was young he could converse with the old folks. He was athletically talented. He talked about music, sports, fashion. He had a great sense of humor."
In October 2007, most of the Lungren clan gathered in South Bend for the Notre Dame-USC football game.
As she strolled across the campus with her family, Nancy was missing young Brian, and decided to call the drug treatment facility in Auburn where he was being housed.
The therapist told her he wasn't there, that Brian had been arrested for stabbing another patient. She spent much of the day in tears.
Whatever the reason for the attack, if there was a reason that was grounded in reality, the event may have saved Brian's life. A Placer County Health and Human Services Department therapist made clear her view to the judge deciding his fate, writing in February 2008:
"It was apparent that Brian was not taking any psychotropic medications and was experiencing psychosis. He did state that he was experiencing telepathic voices that were urging him to be a gang banger and do drugs."
The judge concluded he was not guilty by reason of insanity, and sentenced him to Napa State Hospital. There, for the first time, he is receiving round-the-clock care and taking medication that has calmed his illness.

Adjustment to Napa hospital

Whenever they can, Brian and Nancy Lungren drive over to Napa. Rather than stop at the wineries, they turn off the highway, past a guard booth, make their way to the sally port, pass through a metal detector, get wanded by guards, take their seats in the visiting room and wait for their son.
Brian walks up with a swagger. His hair is buzzed short, and he is wearing a state-issued uniform of khaki pants and sweat shirt. He speaks in bursts, jumping from topic to topic. He talks about being a professional skier, Tupac, and how the wind would talk to him.
"I know I need meds for schizophrenia," he told me the other day when I accompanied his parents on a visit. "I would love to get out. I don't know if I can. It's sickening that I'm here. I don't want to be here."
His adjustment wasn't easy. He assaulted a staff member and got in scrapes with other patients. He told me he spends much of his time avoiding conflicts with "weird people" at Napa.
He thinks about starting work therapy, but is tired. Sometimes his shoulder hurts. He pulls aside his shirt to display a thick scar on his shoulder from an operation to repair a ski injury.
He hopes to be released in October. His parents worry that if that were to happen, he would quit his antipsychotic medication, find street drugs and become captive again to his delusions.
"Without Napa, my son would be dead," Brian Lungren said.

Involuntary treatment urged

Sometimes Brian Lungren Sr. puts aside lobbying for his high-end business clients, and shows up in legislative committee hearings to argue for bills he thinks can help his son and people like him.
Recently, he aligned himself with public employee unions advocating legislation by Assemblyman Mike Allen, D-Santa Rosa, that would permit state hospital doctors to more easily medicate psychotic patients against their will.
The bill would be a small step. There should be others. Policymakers ought to confront reality. There must be a way to provide care for people with the most severe mental illness before they stab somebody. There ought to be something between state prisons and state hospitals, and nothing.
In the 1960s, California had 14 state hospitals that housed 36,000 patients. Gov. Ronald Reagan pushed to empty the facilities, and found allies among conservatives who saw a chance to save money, and liberals who saw abuses and sought to grant patients greater rights. They emptied the hospitals, but never sent money to counties to fund community care.
The state hospital population fell to 3,410 patients by 1995. The pendulum is swinging. The population under the care of the California Department of Mental Health is expected to reach 6,324 next year.
However, the mix is very different. Twenty years ago, half the people in the few remaining state hospitals had committed no crime. Now, 92 percent of the patients are in for Penal Code violations. Many thousands more severely mentally ill people are housed in state prisons.
Counties rarely send people with severe mental disorders who haven't committed crimes to state hospitals. They can't afford it. The state charges counties $184,000 a year to house a noncriminal at a state hospital.
But if an individual commits a crime and is deemed not guilty by reason of insanity or incompetent to stand trial, the state picks up the cost. That creates an incentive to criminalize mental illness, whether intentional or not.
"We called it 'trans-institutionalization.' It was transferring severely mentally ill people from the health system to the criminal justice system," former Assemblywoman Helen Thomson said.
A psychiatric nurse by training, Thomson was at the center of legislative battles over mental health care in the late 1990s and early 2000s. She pushed to permit involuntary treatment of the most severely mentally ill.
"There are people who need rules to live by," said Thomson, now retired. "They are in denial of their illness and are psychotic."
For the most part, she lost. Civil libertarians and patient advocates persuaded legislative leaders to maintain the status quo, which permits individuals to decide whether or not to accept treatment, no matter how ill they are.
In 2004, then-Assemblyman Darrell Steinberg sponsored Proposition 63 to raise taxes on the wealthiest Californians to pay for mental health care.
Since its approval, the initiative has generated $4.7 billion for programs, but none for involuntary treatment. That was intentional, said Steinberg, now Senate president pro tem.
"We believed – and I know it was the right call – that if we were going to have a chance of success, we could not have a divided mental health community," Steinberg said.
Mental health care advocates are wont to claim that 20 percent of the population has a diagnosable mental disorder. By suggesting that mental disorders are the norm, they diminish the problem. Severe mental illness is not quirky. People who suffer from it are not jerks. They're sick.
Most do no violence to anyone other than maybe themselves. Most cause no serious harm outside their circle of family and friends. But when their quiet suffering becomes public, we are reminded again how we fail that fraction of the populace who truly are ill.

Tuesday, June 7, 2011

Dying with Your Rights On: Mental Illness, Civil Rights and Saving Lives

"Indifference is cruel and costly. We can make a difference. People can have their rights and their lives -- and their families, too. That's what health care, including mental health care, is really all about."

I urge you to read Dr. Lloyd Sederer's recent Huffington Post blog entry:

Saturday, June 4, 2011

East Knoxville woman murdered; grandson accused

East Knoxville woman murdered; grandson accused: "Mary L. Harrison, 84, was stabbed to death early Friday morning in East Knoxville, allegedly by her own grandson, William G. Morgan. He then tried to commit suicide."

If only ...

Another preventable tragedy occurred in the city of Knoxville yesterday.  A grandmother was killed by her own grandson, who allegedly had a longstanding history of severe mental illness.  According to media reports, the mother tried to get help for her son.

Some say forced treatment is a terrible thing to do to someone, but in this case it certainly seems to have been the best thing that could have been done ... but wasn't.  

"If only" does not save lives.  

Treatment saves lives.

I urge you to contact Senator Doug Overbey and tell him that you strongly support Senate Bill 608 that is now being studied by the Tennessee Department of Mental Health.  

Call Toll free at 800-449-TENN, ext. 1098 or email

Lives are depending on it.

Wednesday, June 1, 2011

When Patients Reject Treatment - Two Views

From the Treatment Advocacy Center's blog
Two journalists have offered up thoughtful examinations of treatment rejection in the last week. Both, fittingly, cited the Treatment Advocacy Center, which alone among national nonprofits focuses exclusively on treatment issues affecting those with the most severe mental illnesses.
“God Knows Where I Am” in the May 30 New Yorker is writer Rachel Aviv’s account of a woman named Linda Bishop, who died in a house where she took shelter without treatment after being released from a state hospital. Like an estimated half of people with bipolar disorder and schizophrenia, Linda did not believe she was ill. Despite her heartbreaking death – she penned the details of her own passing as she slowly starved to death – there is an undercurrent of skepticism in the piece about involuntary treatment for severe mental illness. The story is available online only to New Yorker subscribers, but it remains on newsstands and in public libraries.
It’s Terrible to Force Treatment on the Mentally Ill. But It’s Worse Not To” is author David Berreby’s blog about his personal experience with a mother who, like Linda, lived and died with untreated severe mental illness. As one who grew up shadowed by the chronic mental illness of a parent, Berreby admires Aviv’s telling of Linda’s story but takes issue with the writer's “individualistic orientation.”
“Where, I wondered, are the rest of us?” Berreby writes on on “As framed in the piece, the subject of this debate is the mentally-ill person as social atom, floating in a social vacuum, with no need to consider the suffering or the rights of anyone else.
“Missing from this conversation, as it often is in discussions of disability rights, is the effects of the mentally ill person on everyone around him—those who love him, do business with him, try to help him, fear him. In fact, mentally ill people cost the rest of us a lot. They cost us love, anxiety, fear, time and money.”
Heartbreaking and eloquent, these pieces are well worth reading both for their content and as proof that the issues in severe mental illness are reaching a level of public visibility that befits their importance to millions of individuals and families.