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"Shot in the Head”

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(May 5, 2014) Paul was a shapeshifter, a skinwalker, a Navajo witch able to spot another witch no one else could see. He had powers none of us could understand.

shot in the headIn actuality, a toothless 48-year-old with schizophrenia, Paul needed nebulizer treatments twice a day for his bad lungs. He also suffered from anosognosia, like many mentally ill people he didn’t really believe he was mentally ill.

But why did someone else have to be in jeopardy for Paul to be given intensive care? The bottom line was that the state had a timetable and the social workers had followed it, without letting us know about it. The decision to give him more freedom seemed to be disconnected from any evaluation of his connection to reality. Unless he was a danger to himself or others, he was a free man.

He’d never been able to hold down any sort of job. And his hygiene was certainly terrible. Even with the rules at the halfway house, he sometimes arrived at family gatherings smelling so bad we had to send him to the shower.

As I drove to his apartment for the first time, I tried to imagine treating another kind of neurological disorder this way. Tell someone with a spinal cord injury that they’ve been in a wheelchair long enough. Time for you to walk! someone says, and the wheelchair is whisked away.

Or imagine telling someone who suffers from Alzheimer’s, enough of this hanging around doing nothing. You’ve been in this nursing home for six months now. We can’t look after you forever. From now on you’ll have to take care of yourself.


Absurd.

Excerpted from Shot in the Head: A Sister’s Memoir, A Brother’s Struggle
Katherine Flannery Dering.


In the book, Flannery details her life with her younger brother. “My younger brother Paul was more than a schizophrenic,” the author says. “He was a brother, a son and above all, a person that my eight siblings and I loved.” Meet the author.

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One Day Our Son Just Disappeared

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(May 2, 2014) One day our happy 14-year-old boy disappeared and in his place was a paranoid person who heard voices and believed the FBI was out to get him, Ed Kelley tells NPR host Robert Sullivan (“Effort to force treatment on severely mentally ill meets resistance,” May 1).

fathersonThat is why Kelley supports the Helping Families in Mental Health Crisis Act,introduced by Rep. Tim Murphy (R-PA) last December and co-sponsored by more than 70 members of both parties in Congress.

The bill, among other things, would lower or remove some of the barriers to treatment that commonly prevent people with severe mental illness from getting the treatment they need.

Kelley believes his son would never harm anyone, and a majority of people with mental illness never become violent. But a small subset of people with severe mental illness can be prone to violent acts, or other consequences of non-treatment when untreated. It is this subset of people the bill intends to help.

“I hope that the people who are shouting and keeping the families from having their loved ones treated properly, I pray they never have the experiences that our family or other families have had because it would change their perspective,” Kelley tells Sullivan.

Listen to the interview.

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Gov. McAuliffe Signs Bill Spearheaded By Sen. Deeds

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(April 30, 2014) Virginia Governor Terry McAuliffe signed legislation on Monday to reform the state’s mental health system with Sen. Creigh Deeds seated at his side (“McAuliffe signs ‘first step’ to reforming Virginia’s mental health system,” the Washington Post, April 28).

deedssigningLast November, less than a day after Sen. Deeds’ son, Gus , was released from an emergency hold at a Virginia hospital - reportedly because no psychiatric beds were available - the young man stabbed his father in the head and torso before fatally shooting himself.

Just two months after losing his son, Sen. Deeds returned to the Virginia capital determined to turn personal loss into public gain by changing the laws that hindered access to treatment for his son.

On Monday McAuliffe and Deeds traveled to the same hospital that treated Deeds’ son to ceremonially sign SB 260, spearheaded by Deeds, which increases the duration of emergency psychiatric holds from 4 hours – currently the shortest in the nation – to 12, with a safety net clause that state mental health hospitals are required to accept patients for temporary detention after 8 hours. The bill also extends the time period that a person can be held involuntarily under a temporary detention order from 48 hours to 72 hours.

“It’s an important first step,” McAuliffe said. “Let us be crystal clear: We have a long, long way to go.”

While every improvement is worth celebrating, Gov. McAuliffe is correct, there is much more work to do.

Virginia remains the nation's extreme outlier on providing enough time for a mental health examiner to be called, to get to wherever the patient is being held because of psychiatric symptoms and to conduct an evaluation (48-72 hours is much more common).

What's more, some individuals - especially suicide risks – do not stabilize sufficiently during the emergency hold to leave the hospital safely. This is far more likely when the hold exceeds just a few hours.

The new law will go into effect on July 1.

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What Happened in Apartment 433

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(April 29, 2014) “Bruce Williams couldn’t sleep. It was after midnight and quiet in his Portsmouth apartment complex,” write Janie Bryant and Joanne Kimberlin in Hampton Roads. “Quiet, except for the voices in his head. He'd told people about them – the way they shrieked for violence, his fear they'd win. Those voices had led him to kill before (“Pilot Investigation: Part 1, Can’t hold him,” April 27).”

brucewilliamsThrough the story of Williams, a middle-aged man with schizophrenia, Bryant and Kimberlin provide a glimpse into America’s mental illness treatment system and its many victims. The journalists describe a fragmented mental health care delivery model where people with severe mental illness, like Williams, are “patched up in hospitals and sent back into the community,” regardless of whether or not they are able to live successfully on their own.

In the case of Williams, he wasn’t.

On that same quiet night in Portsmouth, he walked into his neighbor’s home, number 433, searched for knives while she was sleeping and “moments later…left, covered in her blood.”

This wasn’t his first murder and it wasn’t his first contact with the mental health system. In 1989, after being released from his first stay at a psychiatric hospital, he crossed paths with a young woman in Virginia, an encounter that ultimately ended with her death.

Williams served nearly 18 years in prison but prison records leave little doubt as to his mental illness, Bryant and Kimberlin report. “He also left [prison] in the same condition he was in when he arrived: seriously mentally ill.”

Following his release from jail, Williams was in and out of psychiatric hospitals for several years, often set free before he was ready. In December 2008, Williams told doctors at a Norfolk hospital that voices were “laughing at him, calling him worthless and telling him to hit people or kill himself.” He was admitted and released 12 days later, despite his previous murder conviction.

On February 25, 2010, he walked into apartment 433 and murdered Linda Gay Carroll, a 64-year-old resident of his housing complex.

“If I am a danger to myself and to others, why would they put me on the street with [no] medication or after care,” he had written in his journal.

The writers wonder why stories like those of Bruce Williams don’t make national headlines and compel policy makers to change laws. “Unlike a Seung-Hui Cho or an Adam Lanza, Bruce Williams killed one person at a time. Unlike a Gus Deeds, he’s a nobody who attacked unknowns.”

Even though the majority of people with severe mental illness are not violent, it shouldn’t take a mass murder, or even one murder to compel policy makers to change laws that facilitate access to treatment.


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When Police Are Mental Health Providers

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(April 24, 2014) My son ended up dead because a police officer wasn’t trained to handle a person with mental illness, Mary Wilsey told Al Jazeera America about the death of her son last January (“How lack of police training can be deadly for the  mentally ill,” April 23).

cit_trainingWilsey’s son, Keith, was 18-years old and diagnosed with schizophrenia. He had a long history of trying to hurt himself, but Wilsey says every morning he would ask her if she wanted a cup of hot chocolate and at night he would tell her he loved her.

Sometimes, with the help of local police, Wilsey was able to have him involuntarily committed for treatment at a psychiatric hospital. That was why she called the police on the night of her son’s death, she said.

The first two police responders were able to speak calmly to Keith, despite his psychotic state, Wilsey told Al Jazeera.  “Then a third officer showed up and escalated the situation . . . Then I heard the gun go off and saw my son start bleeding.”

Keith died in the ambulance on the way to the hospital.

Stories with similarly tragic endings were the subject of our recent report, “Justifiable Homicides by Law Enforcement Officers: What is the Role of Mental Illness?,” in which the authors found that the responsibility of law enforcement officers for seriously mentally ill persons has increased sharply in recent years and is continuing to increase.

Many of these officers are ill equipped to handle such confrontations, and as a result, untreated mental illness is an increasing factor in officer-involved homicides.

Wilsey is now an advocate of crisis intervention team (CIT) policing, which consists of specially training officers who respond to calls involving mental illness.  

“Train them so they can handle the population that they deal with every day,” Wilsey said. “My goal is to prevent another family from going through a terrible tragedy that has ruined our lives.”

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