The Burden of Untreated Severe Mental Illness


(May 16, 2014) “The mentally ill who have nowhere to go and find little sympathy from those around them often land hard in emergency rooms, county jails and city streets. The lucky ones find homes with family. The unlucky ones show up in the morgue,” reported USA Today earlier this week (“The cost of not caring: Nowhere to go,” May 12).

untreated mental illnessAs we know, the costs and consequences of non-treatment for severe mental illness are huge. But how many Americans are currently suffering from a serious mental illness without treatment?”

Among the individuals in the U.S. with schizophrenia or bipolar disorder, studies consistently estimate that between 40 and 50 percent are receiving no treatment, according to a Treatment Advocacy Center backgrounder called “What percentage of individuals with severe psychiatric disorders are receiving no treatment?

The newly updated backgrounder cites studies performed using data from a number of sources, including, among others:

·         The National Institute of Mental Health;

·         Medicaid claims data;

·         The National Comorbidity Survey; and

·         The five-site Epidemiologic Catchment Area survey.

According to some of these sources, approximately 3.0-3.5 million individuals with schizophrenia or bipolar disorder are not being treated on any given day in the US, the backgrounder says.

Untreated severe mental illness is a problem with wide-ranging and devastating consequences for individuals, families, and communities. Disturbingly, as our backgrounder indicates, evidence supports an estimate that millions of adults in our country with these diagnoses are not receiving treatment and thus are vulnerable to these consequences.

Our backgrounder can be a tool for educating fellow community members, press, politicians, and others with influence about the great need for meaningful intervention in our laws and services.

For access to more of our backgrounders, which summarize information about severe mental illness, policies and programs related to its treatment, and the consequences of lack of treatment, visit the “Reports, Studies, Backgrounders” page on our website.

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The Day the First Private Mental Health Hospital Opened its Doors

(May 15, 2014) It was on this day in 1817 that the Asylum for the Relief of Persons Deprived of the Use of Their Reason was founded in Philadelphia. It was the first private mental health hospital in the United States. The Asylum was founded by a group of Quakers, the Philadelphia Yearly Meeting of Friends, who built the institution on a 52-acre farm. It is still around today, but goes by the name Friends Hospital.

hospital-bed-genericAt the time that Friends Hospital was founded, mental illness was widely misunderstood and treated as criminal behavior. Mentally ill people were tied up, put in chains, isolated, or beaten. The Quakers wanted to model a new type of care. They wrote out their philosophy in a mission statement for the hospital: "To provide for the suitable accommodation of persons who are or may be deprived of the use of their reason, and the maintenance of an asylum for their reception, which is intended to furnish, besides requisite medical aid, such tender, sympathetic attention as may soothe their agitated minds, and under the Divine Blessing, facilitate their recovery."

The group purchased the 52-acre farm for less than $7,000, and tried to create a beautiful place with gardens and lots of outdoor space.

These days, the hospital occupies 100 acres, which include flower gardens and about 200 varieties of trees. Much of this was the work of one man who started out at the hospital as a bookkeeper in 1875 and ended up working there and managing the grounds until his death in 1947. One day, he found an azalea that a family member had brought for a patient and tossed out. He tended it in the greenhouse until it was healthy again, took cuttings, and planted those, and from that one plant more than 20 acres of the Friends Hospital are now planted in azaleas.

Excerpted from the Writer’s Almanac.

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USA Today Investigates Mental Illness Neglect

(May 13, 2014) USA Today has launched a series of articles of the “man-made disaster” created by “a mental health system drowning from neglect,” and it’s a don’t-miss.
The cost of not caring: Nowhere to go” tells the story of “the financial and human toll for neglecting the mentally ill” with personal narrative, video and graphics.
infographiccostdata"This is a disease, just like cancer," Colorado family member Candie Dalton tells reporter Liz Szabo. "It's just as devastating. But you don't get the support. You don't get people saying, 'Oh, your child is in the hospital. Can I come over with a casserole?'"

"We have replaced the hospital bed with the jail cell, the homeless shelter and the coffin," Rep. Tim Murphy, author of the Helping Families in Mental Health Crisis Act, tells Szabo. "How is that compassionate?"

Coverage like this in the third most widely circulated newspaper in America will significantly raise awareness of the need to reform mental health policies and remove obstacles to treatment – and provide an easy way for you to familiarize your community and elected leaders with the consequences of non-treatment.

Once you’ve seen the story, be sure to This e-mail address is being protected from spambots. You need JavaScript enabled to view it of the devastation caused by neglecting serious mental illness. If you have a personal story to tell in a few words, include it in your letter. Letters must be 200 words or less. You can also:

SHARE the story with your friends or comment by clicking on a link from the bottom of the article, tweeting it or posting it on your Facebook page.

COMMENT on the story using the link at the end of the article.

FORWARD the article to your public officials and tell them you support mental illness treatment policies that will address these problems.

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Expand Laura's Law for People with Severe Mental Illness


(May 12, 2014) A person’s lack of insight into his or her own illness is the biggest barrier to treatment, not stigma, Amy Yannello writes in the San Francisco Chronicle (“Support Laura’s Law for better mental illness care,” May 8).

jamesboydBut events scheduled around this month’s Mental Health Awareness Month are still promising to reduce barriers to treatment by “raising awareness.”

This week in California, a one-day event with the goal of decreasing stigma promises speeches, stories of empowerment, food, a minor league baseball game – and will cost taxpayers $137,000. This is in a state where several rural or small counties have no permanent psychiatrist or psychiatric inpatient treatment beds available, according to the California Psychiatric Association.

“Apart from the thousands of lime-green ‘awareness ribbons’ that ultimately will litter the [state Capitol’s] lawn . . . it's difficult to see how this group's state-sponsored extravaganza will do anything to expand treatment options for Californians with severe and persistent mental illness,” Yannello writes.

Even worse, Yannello says, is that some from that same group have used taxpayer dollars to lobby against Laura’s Law, which would bring court-ordered treatment to a small subset of people with serious mental illness, many of whom lack insight into their illness and refuse voluntary services.

They also have spread false information about the law, Yannello continues, including the incorrect claim that Mental Health Services Act funding cannot be directed toward assisted outpatient treatment.

“By actively lobbying to ensure counties do not implement assisted outpatient treatment (AOT) programs, Laura’s Law opponents ensure that only the most high-functioning Californians with mental health issues - the ones who are able to voluntarily voice their need for services, not the most seriously ill - receive help.”

As a result of efforts to block Laura’s Law and prevent treatment options from getting to those who lack awareness of their illness, “the homeless population continues to grow, as do the number of mentally ill who cycle in and out of our emergency rooms, state hospitals, jails and prisons,” Yannello says.

In the meantime, valuable funding nominally geared towards fighting mental illness is instead spent on parties for those who oppose expanding options for the most severely ill Californians.

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RESEARCH: Medications Reduce Violence Among the Mentally Ill


(May 9, 2014) Taking psychiatric medication can greatly reduce the chances that people with serious mental illness will commit violent crimes, according to a new study published in the journal The Lancet. (“Medications Cut Violence Among Mentally Ill in Study” the Wall Street Journal, May 7).

timessquareshooting“It’s another piece in the jigsaw puzzle that helps you think about the risks and benefits of putting and keeping [patients] on medication,” said Dr. Seena Fazel, lead author of the study.

The researchers from Oxford University and Sweden’s Karolinska Institute examined the registry records for more than 80,000 people who had been prescribed antipsychotic or mood stabilizing medication between 2006 and 2009. They found a 44 percent drop in convictions for violent crime while study participants were taking their medications as compared to times when they were not. There was also a 24 percent decrease in convictions for patients diagnosed with bipolar disorder when they used mood stabilizers.

Although the researchers did not determine medication adherence caused a reduction in violent crime, the treatment of psychotic symptoms likely reduced paranoia and decreased impulsivity, said Fazel.

The relationship between violence and mental illness includes nuances, such as that the vast majority of violence is perpetrated by individuals without mental illnesses and only a small fraction of those with mental illnesses commit violence. In fact, individuals with serious mental illnesses are more often victimized by violent acts than they commit them.

However, there is good evidence that rates of violent behavior are much higher among individuals with mental illness who are not being treated.

In cases where a person would be helped by involuntary treatment, improved commitment standards and outpatient commitment laws broaden the opportunities to intervene before tragedy.

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