Why We Still Need Psychiatric Hospitals


(Feb. 14, 2014) Two tragic stories out of Washington, DC, in the last week highlight why access to psychiatric hospitalization remains so essential despite the best efforts of America’s policy makers to get rid of the nation’s mental hospitals.

hospital-bedsDaniel Ellis, 59, was committed to mental illness treatment at St. Elizabeths Hospital in the District but somehow managed to wander away unnoticed last weekend. Four days later, his frozen body was found in the snow two blocks from a Metro station (“St. Elizabeths patient Daniel Ellis found dead in the snow,” DCist, Feb. 14).

Two weeks earlier, Lillian Alvarado, a 21-year-old District resident, was ordered into treatment at St. Elizabeths after she allegedly suffocated and dismembered her newborn baby boy as a result of “mental health matters” (“DC woman charged with dismembering newborn ordered to St. Elizabeths,” Washington Post, Jan. 29).

Whatever details emerge about how Ellis escaped the hospital despite his commitment to care and the circumstances surrounding Alvarado, it should be obvious to any reasonable person that both needed intensive treatment, and lives were lost when they didn’t get it.

The drive to close psychiatric hospitals has for 50 years been persistent and relentless. It needs to stop – and to be reversed. As recent Torrey Advocacy Commendation winner DJ Jaffe argues in an op-ed, public officials need to “just say no” to closing more beds – and start saying yes to providing the intensive care that men and women in psychiatric crisis need (“Just say no, Governor Cuomo,” New York City Journal, Feb. 13).

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“Inside a Mental Hospital Called Jail”


(Feb. 10, 2014) New York Times columnist Nicholas Kristof describes how the dearth of mental health services has propelled people with severe mental illnesses into jails and prisons in last weekend’s column, “Inside a Mental Hospital Called Jail,” (Feb. 8).

jail_barbedwire“The largest mental health center in America is a huge compound here in Chicago, with thousands of people suffering manias, psychoses and other disorders, all surrounded by high fences and barbed wire,” he writes. “Just one thing: It’s a jail.”

Kristof says psychiatric diseases “are the only kind of sickness that we as a society regularly respond to not with sympathy but with handcuffs and incarceration.”

One of the inmates Kristof interviewed at the massive compound, Russel, 46, is diagnosed with severe depression and has spent most of his life in jail for minor offenses. “I just want to be normal,” Russel tells Kristof. “I want to have a job, I’ve never had a job. I want to be able to say hi to a co-worker.”

To care for people like Russel and others with psychiatric disorders who are incarcerated, “taxpayers spend as much as $300 to $400 a day,” Kristof reports.

Other facts on the criminalization of mental illness from the article:

  • More than half of prisoners in the United States have a mental health problem. Among female inmates, almost 75% have a mental disorder.
  • Mentally ill inmates are often preyed upon while incarcerated, or disciplined because of trouble following rules. They are much more likely than other prisoners, for example, to be injured in a fight in jail.
  • About 40 percent of people with serious mental illnesses have been arrested at some point in their lives.

Kristof also quotes from our 2010 study, “More Mentally Ill Persons in Jails and Prisons: A Survey of the States.

“In the 1800s, Dorothea Dix led a campaign against the imprisonment of the mentally ill, leading to far-reaching reforms and the establishment of mental hospitals,” the columnist says. “Now we as a society have, in effect, returned to the 1800s.”

Read the full article from the New York Times.

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Lillehammer to Sochi, Not Much Has Changed – personally speaking


(Feb. 7, 2014) Today all of the world will have its eyes on Sochi for the much ballyhooed Olympics Games. Many tales of grit and heroism will be told and we will enjoy many deeds of overwhelming strength against all odds that will inspire us. 

sochiYet, as we hold aspirations for our ice dance team, the lyrical and lovely Meryl Davis and Charlie White, everyone’s favorites for the gold, I am reminded of another American ice dance team from exactly twenty-years ago in Lillehammer, Elizabeth Punsalan and Jerod Swallow. 

A week before this team embarked for the Olympics, Punsalan’s father, Dr. Ernesto Punsalan was stabbed to death by her brother, Ricardo, who was mentally ill and on a pass from a psychiatric facility. Yet, the ice dancing team carried on and continued in the competition even though they had this devastating sorrow hanging over their heads. 

Twenty years have passed and the mental illness treatment system is still fractured and psychiatric treatment beds are continuing to shrink. We need more professionals ready to help, longer stays in hospitals and better education for the public about the consequences of untreated serious mental illness. Most of all it should be easier to get someone who needs help into treatment. 

If these lessons from the past are learned and applied, it will certainly level the playing field for the person suffering from a serious mental illness. This would be a victory of the ages and would match any of the feats that will be performed on the slopes and on the ice rink. Let us step up to the plate and make things better for the mentally ill and their families now! We will save so many lives.

Brandon W. Fitch  

Brandon Fitch is recovering from a serious mental illness and has received great help from treatment. He is the program annotator for the Cleveland Philharmonic and the Black River String Quartet. His interests are Russian and medieval history and classical music.

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"Ashamed of the Crazy"


(Feb. 6, 2014) “I was ashamed of the crazy. I thought the best way to make it go away was to pretend it wasn’t happening,” Kate Woodsome writes about her mother’s struggle with mental illness (“Mental illness, suicide, depression were in my family. But they didn’t have to be in me,” the Washington Post, Feb. 3).

mentally_ill_motherFew people knew of Woodsome’s tormented life at home with her mother and the psychiatric disease that consumed her. “I didn’t tell anyone that she would fly into violent rages, pummeling me for stretching out the collars of my T-shirts…or that she would punish me by refusing me food,” Woodsome writes.

Too scared to tell her friends or anyone else about her mother’s mood swings and erratic behavior, she believed if she said anything her friends would avoid her because “the crazy might rub off on them.”

In her adulthood, she sought out unstable relationships and tumultuous situations because they seemed more familiar to her.  “I lived in a high functioning state of chaos,” she writes.

After spending much of her life running from her mother's mental illness and its effect on her, Woodsome has finally come to peace with confronting her mother’s illness and the stigma that kept her quiet for so long.

In therapy, she explored how mental illness shaped her childhood. "I stopped believing I was unlovable just because my mom hadn’t loved me right," she writes. Eventually Woodsome was diagnosed with post-traumatic stress disorder.

“People are afraid that if you name it, your life is over,” she concludes. “The truth is, once you name it, your life can finally begin.”

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Indiana to Improve Care for Inmates with Mental Illness


(Feb. 5, 2014) It should come as no surprise that confining inmates with mental illness in prison cells without adequate treatment was found to be an inadequate way of dealing with seriously ill prisoners in Indiana (“Prison to show upgrades in care for mentally ill,” the Associated Press, Feb. 5).

prison_mental_illnessBy doing so, “the state system was violating the inmates’ constitutional right against cruel and unusual punishment,” US District Judge Tanya Walton Pratt ruled in 2012. “A prison that deprives prisoners of adequate medical care is incompatible with the concept of human dignity.”

Prior to the 2008 class action lawsuit that inspired Pratt’s ruling, mentally ill inmates in Indiana were routinely placed in solitary confinement, which usually results in a worsening of the symptoms including paranoia, depression, suicide attempts and extreme anxiety.

In 2005, an inmate in Indiana’s Wabash Correctional Facility committed suicide by setting himself on fire inside his cell.

Since being found guilty of acting “deliberately indifferent” toward the plight of inmates with mental illness, prison officials say there have been improvements to the system.

We applaud any and all efforts to improve the treatment of incarcerated people with mental illness. But if we really want to help persons with mental illness and severe mental illness who are likely to encounter the criminal justice system, then we need to collectively agree that criminalization of people with psychiatric diseases is a cruel and ineffective public policy and a gross waste of tax dollars.

What we need are public policies that provide treatment for individuals before they end of up in jail.

Read our study, "More Mentally Ill Persons Are in Jails and Prisons Than Hospitals."

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