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Mental Health Bill Would Help Families Before Crisis Strikes – guest column

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(Sept. 15, 2014) At age 27, my son's life and the lives of his family changed forever. He was transformed into a different person. His behavior became weird, psychotic and delusional. He was obsessed with neurotic religious beliefs: He thought that God had anointed him a prophet and commissioned him to write another book for the Bible.

dottie pacharis2He believed he was in the witness-protection program, and federal agents were trying to assassinate him because he was in possession of top-secret information that would take down important people in the government if he went public. He developed an unhealthy fixation for the president and made many attempts to get into the White House. He thought he had a top-secret White House security clearance, and that the FBI had issued him a special gun permit.

There were days he actually believed he was the president, living in the White House. He was in complete denial that anything was wrong with him. It took the assault of a police officer to get him committed to a hospital where he was diagnosed with bipolar disorder.

My son was so ill my family feared he would never recover. But recover he did after 32 days of treatment with forced medications. He suffered four additional, prolonged bipolar-manic episodes, each episode preceded by his decision to stop taking his medication. Each episode more severe than the previous and of a longer duration. The longer duration was because of judges at commitment hearings who ruled time and time again that my son was not a danger to himself or others — oftentimes against the recommendation of the treating psychiatrist.

These judges were complying with state laws that set strict controls regarding hospitalization with forced treatment, restricting it to circumstances when a person is suicidal or homicidal. These laws force families to watch their loved ones deteriorate mentally until they reach the crisis stage and meet the commitment criteria of being a danger to themselves or others. By that time, it is sometimes too late.

Each time my son was allowed to go untreated for long periods of time, he sustained further brain damage. His downward course was aided by an ineffective legal system that continually protected his civil right to refuse treatment until he became suicidal or homicidal. This illness left him trapped in a body ravaged by irreversible damage from untreated bipolar disorder. Sadly, he was allowed to reach the crisis stage one time too many. His third attempt at suicide was successful.

Following the Newtown shootings, Rep. Tim Murphy (R-Pa.), a clinical psychologist by training, raised awareness of the need to fix our broken mental-health system and led the charge on Capitol Hill for reform. He spent a year reviewing federal mental-health policies and last December introduced the Helping Families in Mental Health Crisis Act, HR3717.

This bill emerged from a series of hearings on mental-illness-treatment issues before the House Energy and Commerce Subcommittee on Oversight and Investigations, which Murphy chairs. These hearings, according to Murphy, "revealed that the approach by the federal government to mental health is a chaotic patchwork of antiquated programs and ineffective policies across numerous agencies."

Families for decades have had to work within the constraints of our broken, dysfunctional mental-health system that fails the sickest — those people who need treatment the most, but are too sick to recognize their illness, and refuse treatment. This bill addresses the obstacles families face when trying to save loved ones from untreated serious mental illness. It would expand access to treatment for individuals who miss out on mental-health services because they are too ill to seek them.

Serious psychiatric disorders, such as bipolar, schizophrenia and severe depression, require medical intervention. They are treatable. They do not have to result in suicide or mass shootings. Helping Families in Mental Health Crisis is the most comprehensive mental-health-reform legislation to be introduced in 51 years. It will lead to treatment before tragedy.

Dottie Pacharis
Author of "Mind on the Run - A Bipolar Chronicle"


This piece originally appeared in the Orlando Sentinal.

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Reports of Abuse by Mentally Ill Inmates in Michigan

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(Sept. 11, 2014) Mentally ill inmates at Michigan’s only women’s prison are “deprived of food and water for days and hog tied naked as punishment,” detail eyewitness reports complied by the American Civil Liberties Union of Michigan (“Mentally ill inmates at Michigan’s women’s prison report they were hog tied naked, deprived of water,” ThinkProgress, Sept. 8).

inmateInmates with mental illness “are being treated so inhumanely that we believe many corrections experts would characterize their experience as a form of torture,” the ACLU said. One inmate was “crying naked on the floor and unable to move because her feet were cuffed to her hands behind her back.”

The abuses occurred against inmates in solitary confinement in particular, which “punishes people for having a brain disorder and then exacerbates their conditions by creating an environment that is totally inconsistent with effective therapy,” the Mental Health Association of Michigan told ThinkProgress.

Reports of abuse of mentally ill inmates at the hands of corrections officers are becoming far too normal. While shocking, these eyewitness reports are no longer surprising.

In April, the Treatment Advocacy Center noted that the consequences of failing to treat mentally ill inmates are “usually harmful and sometimes tragic.” Without proper intervention and treatment, symptoms worsen of mental illness often worsen, leaving inmates vulnerable to victimization and other abuses.

The same report also found there are now ten times more individuals with serious mental illness in prisons and jails than there are in mental institutions.

Until we resolve to use proven diversion tactics, or provide court-ordered treatment before people with serious mental illness end up in jail in the first place, we will continue to see reports that mentally ill inmates are enduring practices that the Justice Department have deemed “cruel and unusual.”

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A Young Man’s Death Spurs Interest in Crisis Intervention Training

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(Sept. 9, 2014) Following the shooting of 18-year-old Joseph Jennings last month, who reportedly suffered from suicidal thoughts, depression and delusions, law enforcement in Kansas has renewed its interest in crisis intervention training (CIT) for police officers (“Ottawa shooting renews focus on crisis intervention,” Kaiser Health News, Sept. 4).

josephjennings“They had to have known that he was not alright,” Jennings’ aunt, Brandy Smith, said. “But . . . I want this to be about police officers getting the knowledge and training they need so that this doesn’t happen again and no other family has to go through what we’ve been through.”

The day before the shooting, Jennings attempted suicide and spent that night in the psychiatric unit at Ransom Memorial Hospital. When he returned home the following day he was still agitated, according to his aunt.

That evening he walked to the local grocery store only one block away from his aunt’s house.

When Smith heard the police appeared ready to shoot her nephew in the parking lot, she ran barefoot to the scene. “I was screaming at them (police) at the top of my lungs: ‘Don’t shoot him! He’s suicidal! That’s Joseph Jennings! Don’t shoot him!’”

But it was too late.

Sadly, tragedies like these are no longer surprising. The responsibility of law enforcement officers for seriously mentally ill persons has increased sharply in recent years and is continuing to increase.

This makes tactics like training police on how best to respond to people in a psychiatric crisis even more important.

But in Kansas, only 1 in 4 law enforcement officers have received CIT training. Our report, ““Prevalence of Mental Health Diversion Practices: A Survey of the States,” awarded the state a C- for its use of CIT programs and other diversion tactics that have been consistently found to reduce deadly encounters, arrests and incarcerations that sometimes occur when people with severe mental illness meet law enforcement.

Homicides, like Jennings’, are a symptom of our broken mental illness treatment system. Ultimately, tragedies like these would be less likely to occur if people were getting treatment when they needed it.

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“Better off Without Antipsychotics?”

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(Sept. 8, 2014) It is not news that some psychiatrists think some patients are better off without antipsychotic drugs, writes Dr. Torrey in Psychiatric Times (“Better off without antipsychotic drugs,” June).

eft -- color head and shoulders thumbnail 3.20.11“It has been known for a century that some individuals with schizophrenia recover and do not need ongoing treatment,” he writes.

Citing two studies, Dr. Torrey illustrates why the key word is “some.”

  • In 1939 Dr. Harry Stalker published outcome data from 3551 patients with schizophrenia that showed 21 percent were in “complete remission and another five percent had improved or were living at home.”
  • A 1978 study by Dr. Joseph Stephens shows similar results. Stephens found that after 10 years, “29 percent of patients with schizophrenia were in complete remission.”

These scenarios “view the glass as half full,” writes Dr. Torrey. “But it is equally important to look at it as half empty … It is important to note that antipsychotic medications improve the quality of life for most, but not all, patients with chronic schizophrenia and most of them will require medication for many years.”

Torrey again points to Stalker’s 1939 research that also found 67 percent of the patients with schizophrenia showed little to no improvement and five percent had died. He directs the audience to later research from Stephens showing similar results.

“So yes, it has been clearly established for many years that some patients are better off without antipsychotic drugs,” Torrey writes. But in recent years, “advocates have interpreted this to suggest that most individuals with schizophrenia are better off without antipsychotic drugs.”

But, Torrey argues, during a time when approximately 1.3 million people with schizophrenia remain untreated, we need look no further than our homeless shelters, bus stations and jails and prisons to determine whether these individuals are better off without treatment.

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Singer Demi Lovato Joins NAMI Convention

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(Sept. 4, 2014) Demi Lovato, the 22-year-old singer who has been candid about her struggle with bipolar disorder, was on the schedule for the opening day of sessions at the National Alliance on Mental Illness (NAMI) 2014 National Convention in Washington, DC.

demilovato“I’ve seen some dark times, especially with the depressive phase of the illness,” Lovato has said. "Our society tends to shame or ignore people with mental illness, and I want to change that too. I want people to expect more from our society and for their futures."

Following the death of actor and comedian Robin Williams, Lovato spoke out about treatment, calling herself “living proof that someone can live, love and be well with bipolar disorder when they get the education, support and treatment they need.”

"I want to shine a light on the people out there who, like me, are learning to live well with mental illness by getting the right diagnosis and the right treatment plan," the singer said (“Demi Lovato speaks out against the ‘shame and silence’ around mental illness,” E! News, Aug. 15).

If you are one of the thousands at NAMI 2014, please come visit us at Booth 410 in the exhibit hall. Members of our advocacy and communications teams will be on hand whenever the hall is open to introduce themselves, provide up-to-date information on critical developments in mental illness treatment laws and policies and answer your questions.

If you aren’t in Washington for the convention, follow our live posts on Twitter and other reports on Facebook.

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