Monday, December 31, 2012

Fatal Subway Shove Renews Debate on Forced Treatment for the Mentally Ill - WNYC


Police said Menendez's family members called authorities several times in the past five years because she had not been properly taking prescribed medications and they were having difficulty dealing with her. Police did not say what the medication was.
Menendez had been arrested several times. She pleaded guilty to assaulting a man in 2003, and drug possession.

Read more: Fatal Subway Shove Renews Debate on Forced Treatment for the Mentally Ill - WNYC


Think before you speak, post or tweet -- nutcases, lunatics, crazies and all the rest of it -- because words do hurt.

Are you ever caught off guard by offensive jokes and slurs related to mental illness?   Like me, do you come across these every day in Twitter feeds, Facebook shares and statuses, or simply off the wall comments made by well-meaning friends?  My first Google hit netted nine pages of  crazy status suggestions via the Crazy Insane Facebook Status page alone.  

Here is an unfortunate sampling of social media encouraging others to perpetuate stigma:
I'm not crazy nor do I have anger issues,it's just that this rock told me it really wanted to hit you in the head!
some people call it crazy..I prefer "HAPPILY INSANE"!!
1 in 4 people are crazy. Look at your 3 closest friends, if they seem OK, you're the one!
 schizophrenia ... means never having to be alone again.
Does social media have no shame?  Or boundaries?

I'm a family member of someone with a debilitating brain disorder and admit I'm deeply offended when these words and phrases are used to refer to serious persistent mental illness that human beings struggle with every day of their lives!

NAMI thinks it's offensive too.  So much that they have a network of dedicated advocates across the country who seek to fight inaccurate and hurtful representations of mental illness. Whether these images are found in TV, film, print or other media, Stigmabusters speak out and challenge stereotypes.  They seek to educate society about the reality of mental illness and the courageous struggles faced by consumers and families every day. 
READ MORE ABOUT STIGMABUSTERS HERE

So what exactly is stigma?

Stigma is the feeling of fear or shame associated with mental illness. Despite an abundance of medical and other scientific information about mental illness, some people still believe it is a topic that is a sign of moral or personal weakness. Stigma is ignorance – not having enough knowledge or information to really understand what mental illness is all about. Stigma includes name-calling, making jokes at the expense of those who suffer from mental illness, and perpetuating myths about the mentally ill. Stigma hurts those who work very hard to battle their illnesses. It also hurts those who have lost a loved one to suicide due to mental illness or who are trying to support their loved one as they cope with mental illness. How can you fight stigma? 


Educate yourself about mental illness. Then, use this information to inform others when you believe they do not understand the realities of mental illness. 

Think before you speak.  Or tweet.  Or post.

Because words can and do hurt. 

Sunday, December 30, 2012

PREVENTING TRAGEDY REQUIRES STOPPING THE NEGLECT

From the Treatment Advocacy Center:

This year is on track to go down as the year of mass casualties in America associated with mental illness. With the Sandy Hook tragedy, more than 100 people have now been killed or wounded by rampaging assailants with reported mental health issues.
eoyimageHorror over the inconceivable violence of these attacks has for a moment focused public awareness on the human cost of inadequate mental illness treatment. Yet - numerous and deadly as they have been - rampages such as those in Newtown and Aurora are the most rare of the consequences untreated mental illness inflicts.
Affecting millions more are the routine circumstances under which people in this country live - and die - as a result of five decades of failed mental health experiments and systematic neglect. These are the millions who live with untreated severe mental illness, behind bars or on the streets, who are arrested, hospitalized or victimized, and who die by their own hands under the influence of psychiatric symptoms.
Behind each number is a human being with a treatable disease that is not being treated. Behind every statistic is a mental health policy that elected leaders have endorsed and the public has tolerated.
It should not take the deaths of 20 small children to produce a day of reckoning for our national neglect of those who are most vulnerable. If it has, these are three public policies that offer hope for stemming both the sensational and the quieter consequences of non-treatment:
  • We must stop closing public psychiatric hospitals and restore sufficient inpatient treatment facilities to provide treatment for those with acute or chronic severe psychiatric disease. Deinstitutionalization has reduced the number of such beds more than 95% from their peak numbers 50 years ago.
  • We must stop viewing mental illness as a state of freedom to be protected at all costs from involuntary commitment to treatment. It is an uncivil liberty to leave people to die in the streets or lock them up behind bars because of acts they commit while experiencing psychiatric symptoms.
  • We must reform our civil commitment laws - and use them. Legal standards requiring people to become dangerous before being court-ordered into treatment must be broadened. Assisted outpatient treatment(AOT) laws making it possible to commit individuals to treatment while living in the community must be enacted in the six states where they don't exist and used more widely in the 44 states where they do.
It is not only for the 20 children and eight adults dead in Newtown that this day of reckoning should not be allowed to pass without action. It is for us all.
(Adapted from an op-ed in the Milwaukee Wisconsin Journal Sentinel by Doris A. Fuller, executive director of the Treatment Advocacy Center. Click here to read the op-ed in its entirey.
 

Studies show that untreated severe mental illness is among the most reliable predictors of future violence. And yet when an outpatient goes "off meds" in Tennessee, families and caregivers must stand by helplessly, knowing with certainty that dangerous behavior is around the corner, but legally powerless to prevent it.

A CALL TO ACTION!

Just this morning, I heard panelists on WBIR's Inside Tennessee echo the very same sentiments as I have been reiterating on this blog on an almost weekly basis ... IT'S TIME TO CHANGE TENNESSEE'S MENTAL HEALTH LAWS!

And I also heard them say that Governor Haslam has made improving Tennessee's mental health laws a 2013 priority as well. 

Finally!  We must increase funding, we must move forward! 

And not just talk about it, just DO IT.

Abdo Ibssa was not a monster. But the man who shot three staff members at Parkwest Hospital last month, killing one before taking his own life, lived in the grip of a monstrous disease. Severe mental illness made Mr. Ibssa believe that a doctor at Parkwest had implanted a tracking chip in his body, and propelled him to the hospital on a violent rampage.
How did we as a community allow this to happen? One might assume that Mr. Ibssa somehow slipped under the radar of an overburdened mental health care system. But the truth is even sadder.
Far from being under the radar, Mr. Ibssa was known to local authorities. According to news reports, Ibssa was accused of violently attacking a man last year, and earlier in 2010 was committed by his family to a Knoxville mental hospital. When he was deemed stable, he was released with a prescription for medication and (tragically) nothing more. After the shooting, police found the pills in his home, apparently un-utilized.
It is a pattern all too familiar to people like me, who struggle endlessly to keep a mentally ill family member out of harm's way. Our loved ones reject outpatient care, and the system does nothing to stop them until they do something to prove they are "dangerous to self and others," the standard for involuntary hospitalization.
Eventually they are released to repeat the heartbreaking cycle, unless of course their dangerous behavior included a violent crime. Then they get years of free mental health care in a prison cell.
The root of the problem is that many people with severe mental illness are incapable of recognizing that they are sick and in need of treatment. The clinical term is anosognosia, or lack of insight. In the minds of those who suffer from it, there is nothing wrong with them. When left on their own in the community, they stop taking medication.
While people with mental illness on the whole are no more violent than the general population, untreated severely mentally ill individuals are a different story. Studies show that untreated severe mental illness is among the most reliable predictors of future violence. And yet when an outpatient goes "off meds" in Tennessee, families and caregivers must stand by helplessly, knowing with certainty that dangerous behavior is around the corner, but legally powerless to prevent it.
In most states, a legal tool known as "assisted outpatient treatment" (AOT) is a potential solution. Under an AOT law, a mental health official or family member can seek a court order, requiring a severely mentally ill person to comply with treatment as a condition of remaining in the community. The purpose of the court order is not to punish the person if they should happen to stray off treatment. Quite the contrary. It is to ensure that the person's condition is constantly monitored, and to give authorities the legal right to help as soon as treatment non-compliance is detected.
 These laws have been found to dramatically improve outcomes for patients. In New York, researchers have documented steep declines in rates of homelessness, hospitalization and incarceration.
Tennessee is one of only six states without some form of AOT on the books. In recent years, attempts by legislators to pass an AOT law have been stymied by the state Department of Mental Health, which has cited concern for the civil liberties of the mentally ill and the cost of comprehensive outpatient care.
The civil liberties objection is absurd to me, as it should be to anyone who has spent time in the company of an actively psychotic person. This condition is a living hell that no one would ever rationally choose for himself. These individuals are crying out for our help, even if their words and actions say the opposite.
The cost objection is incredibly short-sighted. Want to talk high cost? Look at what the state spends to hospitalize, prosecute and incarcerate people who we currently permit to become dangerous. The opportunity to spend a little up front to avoid these bills down the line should be seized by even the most hard-hearted fiscal conservative.
The time has come for Tennessee to leave the Dark Ages of mental health care and enact an AOT law. Some of us on the front lines of this issue have been saying so for years. But if the Parkwest tragedy doesn't wake up our legislators and mental health officials to this urgent need, I can't imagine what will.
Karen Easter
KNS May 23, 2010
parkwest-shooting-points-to-need-for-a-new-law

Saturday, December 29, 2012

Cost of closing Lakeshore? High.

Letter to the editor in today's Knoxville News Sentinel:  Cost of closing Lakeshore high

Thursday, December 27, 2012

Young wants Kendra’s Law strengthened - Olean Times Herald: Editorial - Young wants Kendra’s Law strengthened: Editorial

Hoping this will soon be on the legislative forefront for every state - enacting/strengthening AOT laws!

Young wants Kendra’s Law strengthened - Olean Times Herald: Editorial - Young wants Kendra’s Law strengthened: Editorial: ALBANY — Following the wake of the tragic massacre at Sandy Hook Elementary School in Newtown, Connecticut, state Sen. Catharine Young, R-Olea…

The Time is NOW


"The time has come for Tennessee to leave the Dark Ages of mental health care and enact an AOT law. Some of us on the front lines of this issue have been saying so for years. But if the Parkwest tragedy doesn't wake up our legislators and mental health officials to this urgent need, I can't imagine what will." 
- May 2010, Knoxville News Sentinel op-ed  
Parkwest shooting points to need for new law
Illness plagued gunman
Last month, we were all finally able to imagine the scenario that would wake up our legislators and mental health officials.  Yet it was not our imaginations, it was a shocking reality - the tragedy in Connecticut that shook our nation to its core.  Times have not changed and here at the end of 2012 in Tennessee, things have only slightly changed.


It is my hope, and the hope of many other Tennesseans, that 2013 will see a renewed interest by our legislators and mental health professionals to improve our mental health laws.   It is my further hope that the pilot program in Knoxville that only received $125,000 in state funding will receive increased funds and step up its efforts to identify potential AOT candidates, and there are many to chose from.  

In a videoclip released last month by WBIR-TV, Knox County Sheriff JJ Jones states:  
Up to a quarter of the inmates at the Knox County Detention Center have some type of mental illness, totaling 180 to 200 people.  The number of repeat offenders is startling.  Jones said in a single year, 20 people accounted for 600 arrests.  
 "Probably 90% of these people probably have dual dependency, drugs and alcohol addiction, or mental illness."
Most of the arrests were attributed to minor crimes, like shoplifting, public intoxication, and indecent exposure. While inmates do get help from Helen Ross McNabb Center counselors, Jones said the mentally ill need more.  
School shooting sheds light on treating mentally ill
The "more" that is missing could be court ordered mandatory Assisted Outpatient Treatment via Knoxville's own AOT pilot program.

After all, a law is only effective if it is used.


Wednesday, December 26, 2012

Important Information & Message from DJ Jaffe, Executive Director of Mental Illness Policy Org.


While everyone has read lots of opinions on what to do about mental illness, re: Newtown. We thank all the media outlets that published our own ideas and hope you will share them with others. 

NATIONAL
 "5 Point Action Plan for Obama to Reduce Violence by Persons with Mental Illness" Op-ed in National Review that also appeared in Huffington Post. 

"Why the public no longer believes mental health advocates"

NEW YORK STATE
"What Cuomo should look for in the next Office of Mental Health Commissioner (There is currently a vacancy in the position)(Op-ed in Albany Times Union)
"3 point plan for NYS to improve services for most seriously mentally ill" (3 minute presentation to a NYS editorial board)

BY OTHERS:

President of NYS Chiefs of Police Assoc., Michael Biassotti http://www.nydailynews.com/new-york/firearms-mental-care-fix-article-1.1222444


Thank you for your support. Please share widely. Hope you will consider a donation to help us increase our efficacy. We believe we are one of only a very few organizations focused exclusively on  serious mental illnesses.
Happy Holidays

Following are ways you can follow us

Huffington Post: huffingtonpost.com/dj-jaffe
Follow us on Twitter: @MentalillPolicy 

DJ Jaffe
Executive Director
Mental Illness Policy Org.
50 East 129 St., PH 7
New York, NY 10035

A Caregiver’s Christmas Wish List

Although this article appears to have been written for caregivers of dementia patients, we parents of adult children with serious mental illness have similar needs.  So if you know a special someone who desperately needs a break, here are some top wishes that only YOU can grant.  All it requires is a little of your time and empathy.

1. an empathetic ear
2. positive reinforcement
3. practical help
4. connection
5. fun

In recognition of a true Knoxville hero, Joe Bryant

"But the biggest thing I ask people to do is just raise their awareness that we have so many folks in need. People are often fearful of what they don’t know or understand. Getting to see what’s happening, and where folks are, has been helpful to people that don’t normally cross paths with the people in need. There are some that are mentally ill and some that are kind of distant. But by and large, the folks in need are just regular people that are in a bad spot and need a hand. I get more “thank you’s” and hugs downtown than just about anywhere else I cook." ~ Joe Bryant
It happens every last Wednesday night of the month under the I-40 bridge in downtown Knoxville.  Selfless acts of kindness.  The below article from Knoxify pretty much sums up the selfless and kind acts of Mr. Joe Bryant, BBQ master extraordinaire who always gives his best to those less fortunate.  Thank you, Joe, for all you do.


Black Eyed Joe’s BBQ gives time, BBQ, to Lost Sheep Ministries

Volunteers help feed the homeless.
Joe Bryant loves BBQ. But, more importantly, he loves his community. Within that community, he sees a great need. Joe has found the marriage of those two loves by a monthly giving to Lost Sheep Ministries fight to help feed homeless men, women and children. In times like these, its folks like Joe that make Knoxville better. Something we should all strive for, getting better, here on the precipice of the holiday season.
Knoxify: You’ve described BBQ as a hobby. What made you get into making BBQ?
Joe Bryant: Aside from the fact I love to eat real BBQ, I love the community aspect of it. In the truest sense, to BBQ means to gather around a fire, and forgo the modern rush and instant gratification. Real BBQ takes time. You can’t fake that. And I love the gathering and the fun. A great BBQ just seems to make people happy. I love that.
K: How did you connect with Lost Sheep Ministries?
JB: I’d been fortunate enough to be on the board of Knoxville Leadership Foundation, and they work with Lost Sheep. Where I really got to know them was my friend Ben Esterday, who’s worked with Lost Sheep for a long time. He invited me to come see what they do one Wednesday night. I fell in love with Maxine Raines, and what they’re doing under the bridge.
They get a ton of food donated to them, and God bless the companies that donate. But it’s mostly leftovers. The stuff that didn’t sell the first time. I’d been thinking about the idea of “First Fruits,” and how God calls us to give our best. It seemed like a fun idea to see how it would go over if we started helping feed with our BBQ. It’s just BBQ, so nothing fancy. But it’s the best we know how to make it. When I cook for my family and friends, I make it the exact same way as when we cook for Lost Sheep. It’s our best. Without saying anything, I think that comes across to the people we’re feeding. It resonates. You can nourish someone with food physically. But when you show someone you care about them, they’re nourished mentally and emotionally.
BBQ on the rack
K: How often do you all feed the homeless?
JB: We feed on the last Wednesday of each month.
K: About how many are you able to feed?
JB: It’s just a guess, but the crowds have been between 400 and 700 people. Most people are surprised the first time they help to see so many folks that are in need. I was blown away to see the size of the crowds early on.
Joe Bryant on the right
K: Where do you normally set up?
JB: Under the I-40 bridge, not far from the Salvation Army in downtown Knoxville. It sounds kind of weird, “under the bridge,” but the reality is that it’s under the interstate there that’s 8 lanes wide or whatever it is. It’s all graveled and level, a great place to have it. Essentially just a huge covered outdoor pavilion with an 80 foot ceiling. Completely in the dry.
Map here:
Map data ©2012 Google - Terms of Use
 Traffic
Powered by MapPress
Map
Satellite
K: Is there anyway people can help?
JB: People are welcome to come help us prepare the meat. I smoke it all day but starting about 6:00 p.m. under the bridge. We need volunteers to help us take the smoked meat and break it down to smaller chunks, so we can pull and chop it for sandwiches.
But the biggest thing I ask people to do is just raise their awareness that we have so many folks in need. People are often fearful of what they don’t know or understand. Getting to see what’s happening, and where folks are, has been helpful to people that don’t normally cross paths with the people in need. There are some that are mentally ill and some that are kind of distant. But by and large, the folks in need are just regular people that are in a bad spot and need a hand. I get more “thank you’s” and hugs downtown than just about anywhere else I cook.
Black Eyed Joe’s BBQ’s official website . You can visit them, and see photos from previous Lost Sheep Ministries days, at their Facebook page.


"Today we have thousands of mentally ill persons wandering our streets or living in decrepit boarding homes, refusing to take needed medications and, in some cases, committing acts of aggression against themselves, their families and the community. Many people have “a state hospital in the back bedroom” — a child or sibling who withdraws from society and shows signs of serious mental illness."


Legal limits on treatment for the mentally ill


By Steven R. Pliszka, M.D.
The murder of so many children and their teachers in Newtown, Conn. is a terrible tragedy for the nation; made greater by the fact it is one of many. One of issues uniting the Columbine shooters, Seung-Hui Cho (Virginia Tech incident), Jared Lee Loughner (Giffords), James Holmes (Aurora) and Adam Lanza is their history of mental illness and the failure of society to deal with it. In 1955, there were nearly 550, 000 patients with mental illnesses in state hospitals. The U.S. population has doubled since then, yet the population of persons in state hospitals has fallen to less than 100,000. There are good reasons for some of this decline. Antipsychotic medication, developed in the 1950s, was not a cure for schizophrenia but allowed many patients to function more fully in society (when it was taken). The Supplemental Security Income (SSI) program provided a meager income to those mentally ill unable to work. Those patients who did leave the state hospitals were supposed to be cared for in community mental health centers, such that in the 1960’s, mental health professionals looked forward to a new era in the treatment of mental illness involving community services and intensive rehabilitation services. Then it all went horribly wrong.
Today we have thousands of mentally ill persons wandering our streets or living in decrepit boarding homes, refusing to take needed medications and, in some cases, committing acts of aggression against themselves, their families and the community. Many people have “a state hospital in the back bedroom” — a child or sibling who withdraws from society and shows signs of serious mental illness. Adam Lanza, by reports, showed this pattern — an early history of withdrawal, poor social skills and lack of functioning in daily life. There appears to have been no particular trigger for his behavior — but he was at the age that many with serious mental illness have their first episode of psychosis. His mother was worried about him — but where would she have gone, especially if he did not wish to seek treatment? She would have found few options.
What got us on this track? In 1975, in O’Connor vs. Donaldson, the Supreme Court sharply restricted involuntary hospitalization, and any treatment had to take place in the “least restrictive environment.” Today commitment procedures are difficult to initiate and require imminent danger. Subsequent court decisions have prevented mandatory treatment of the mentally ill except in “emergency” situations and established a “right” to refuse treatment. In essence, this means that even an involuntarily committed patient cannot be made to take medication once released from a hospital. All of these decisions are based on a false premise: that being mentally ill is a lifestyle choice that should not be interfered with unless there is “danger to self or others.” But schizophrenia and manic-depressive illness are brain disorders which rob a patient of insight; even when there is no overt danger the patient still suffers. We would not leave an epileptic to lay seizing on the street, so why do we allow a schizophrenic to wander the streets talking back to tormenting voices?
The concept of “least restrictive treatment” led to the concept of a “right” to community as opposed to hospital treatment of mental illness. Today, there are so few long-term hospital beds that even patients who want to be admitted often are not. We do not want to go back to the days of 4,000-bed state hospitals located in rural areas far from families and qualified staff. Patients who are well situated in the community should remain there. We need, however, a wholesale re-examination of American mental health care policy of the last 50 years. Federal courts decisions establishing rights to refuse treatment and restricting involuntary treatment should be reconsidered. We should replace the legal concept of “least restrictive environment” with “the most therapeutic environment which balances the interests of the patient with the public safety.” Those released from state hospitals must continue outpatient care even after the crises has passed. Our state hospital system needs to be re-expanded, with acceptance of the fact that some patients need long-term care. This is not denying liberty to any person; it is freeing a mind enslaved by mental illness. Most critically, legislators should reject those who seek to put restrictions on psychiatric hospitalization or treatment with psychiatric medication. If we will place more barriers to treatment of the mentally ill, then the tragedy of Newton may be repeated many times more.


Pliszka: Legal limits on treatment for the mentally ill

Tuesday, December 25, 2012

Diane Mufson: Mental illness help is the elephant in the room - The Herald Dispatch


"In my three decades as a licensed psychologist, I have worked with quite a few young people who showed significant violent and/or psychiatric problems. While some of these youth came from dysfunctional families, most had good and caring parents.
Very young children with violent behaviors sometimes can be managed with medications and physical control. When these disturbed children become teenagers, everything changes.
Then physical strength increases and some mental illnesses, such as schizophrenia, emerge. Whatever control or leverage the family had previously is often lost.
These disturbed young people scare family, friends and school personnel. Parents then desperately seek help; psychiatric hospitalization, if it occurs, is brief. The unstable person frequently refuses prescribed medication that might control temper outbursts or irrational thoughts.
Eventually, many people know that the young person (often male) is a crisis waiting to happen. But our mental health system requires evidence that that a person is actually homicidal or suicidal before any involuntary action can be taken."
Read more: Diane Mufson: Mental illness help is the elephant in the room - The Herald Dispatch

An Update on two of six states in the U.S. without statewide AOT Laws: Connecticut and Tennessee


According to the Treatment Advocacy Center, Tennessee and Connecticut remain as only two of six states without statewide AOT laws on the books.

Although a two year AOT pilot program was passed in the Tennessee legislature this past year, Tennessee has yet to implement statewide AOT Laws.  

As for what's currently unfolding in the Connecticut legislature, they're reopening the debate of forcibly committing the untreated mentally ill into treatment:
“It’s a cultural and mental health problem and it’s something we need to address soon and seriously,” former Homeland Security Secretary Tom Ridge told Fox News. “We need to balance individual rights with the needs of the community.”
Ironically, a Connecticut mental health bill calling for changes that could have taken someone like shooter Adam Lanza off the streets was defeated earlier this year in the state legislature. The bill would have allowed the state to commit someone if there was a reason to think that would prevent them from harming others. 
Read more: http://www.foxnews.com/politics/2012/12/22/connecticut-killings-reopen-debate-on-mental-illness/#ixzz2G7oeD5W0
It is the hope of many Tennesseans that our soon-to-convene legislature will also re-open its long-standing debate on a statewide AOT law that has been defeated every year since it was introduced in January 2007.  

And although my own hometown of Knoxville, Tennessee has seen more than its fair share of preventable tragedies - the shootings at Parkwest Hospital, Inskip Elementary, Hooters, TN Valley Unitarian Church - perhaps we have all learned a valuable lesson from Connecticut on the importance of timely intervention.