New Year's Resolution: Be Heard

It couldn’t have taken Frank McKnight long to write the 97 words in this letter to the editor, but those few minutes spent made the message of treatment law reform ring in papers throughout his community. Make it a new year's resolution to write a few letters of your own in 2006. Don't know how? We have some advice.

Heroic Sacrifice

Whether or not sex offenders should be retained after the expiration of their prison sentences is a morass of moral conundrums. It is also an issue outside our area of focus, and expertise. We can easily, however, insist that those adjudged to be sexual predators should not be placed in the general population of a general psychiatric hospital, and admire the self-sacrificing gesture of Dr. Brandon Krupp.

Santa in New Jersey

We’ve seen the reactions of many governors to the issues affecting severe mental illness - disinterest, encouragement, action, stonewalling, and ignorance among them. We’ve never seen this. Our hat is off to Acting Gov. Codey, the New Jersey Governor who hasn't been afraid to address the hard issues in his term, including that of AOT. Gov. Codey knows that AOT is a critical piece of the puzzle to make all his other reforms more accessible to those who are the most ill. He is a good and brave man.

The Grinch in Florida

A youth with bipolar disorder who gets in trouble when not taking his medication steals a six-pack of beer from a neighbors garage. Whether through court intervention or not, clearly what is needed is a way to keep that young man on his medication. That solution was not so clear, however, to Circuit Judge Ric Howard of Citrus County, FL. Judge Howard’s answer for Adam Bollenback? A ten-year prison sentence designed to "break his spirit."

Bollenback has served 40 months already - almost seven months per beer. When he went into jail, Florida had no mechanism to order him to treatment in the community. If the clemency board releases him, he will reenter a world where assisted outpatient treatment is an option.

Death in prison

"So long as [there is] for constant punishment instead of treatment for its mentally ill prisoners in dungeon units ... these preventable deaths will continue …"

Yates better off in hospital than prison?

Andrea Yates will be moving from prison to a psychiatric facility until her new trial. It is a small win in a story of terrible loss.

Yates’ family had a history of bipolar disorder and depression and she had a history of suicide attempts and hospitalizations. By all accounts, Yates was in a state of continued deterioration in the months before the murders – she would sit and stare into space, she had lost a tremendous amount of weight, she was not showering.

Notes from her April 2001 release from one voluntary assessment say to “contact [the doctor] if danger to self or others.”

On June 18, 2001, her husband said she was still deteriorating and asked that her medication be adjusted. The doctor “told Andrea to think positive rather than negative thoughts.”

On June 20, she drowned her five children.

In interviews after the murders she talked about how her children would “perish in the fires of hell if they were not killed.” She asked for a razor to see if the “mark of the beast (666) was still on her head.” She also mentioned that she had been unable to destroy Satan, so then-Governor Bush would have to do it.

Yes, a psychiatric hospital is a better place for her than prison. How sad that we let the debate reach this point.

MORE: A mother speaks from prison about killing her kids ... Yates’ mother hopes Andrea can get treatment ... Children deserve protection ... Wait until he escalates ... Andrea Yates ... Parents who kill their kids

LA jail = psychiatric hospital?

If Los Angeles County Sheriff Lee Baca is overstating when he calls his jail“the biggest mental hospital in the country,” it would only be because it’s not a hospital.

But there is no doubt that Los Angeles County Jail houses more people with a severe mental illness than any other inpatient facility in the nation.

Tools to help?

The Mentally Ill and the Criminal Justice System: A Review of Programs (Paul W. Spaite and Mark S. Davis, June 2005) offers an overview of tools that have emerged to deal with mentally ill people in the community – like Crisis Intervention Training (CIT) and mental health courts.

The authors note that one of their goals is to “persuade communities that have not yet adopted programs to deal with their difficult-to-treat population, to do so.” [In fact, author Paul W. Spaite would like to hear from anyone who knows of similar activities.]

Many are trying ...

• Creating a mental health court (La Crosse County, Wisconsin)
• Training cops for the mentally ill (New Utah, Utah)

Because something must be done ...

• Too soon to judge, not too soon to learn (Albuquerque, New Mexico)
• Air marshal shooting sad, but not surprising (Miami, Florida, incident)

Sister: My brother also killed by SWAT team

Alan Singletary’s family knows firsthand the pain that Mr. Alpizar’s family is going through. Alan was killed by SWAT team members after killing a sheriff’s deputy.

Alice Petree, Alan’s sister, joined with the deputy’s widow and the Florida Sheriffs Association to lead the charge to reform Florida’s treatment law. Their work resulted in a new assisted outpatient treatment law for Floridians. If you are in Florida and your family member needs help, this law may provide an answer.

Alice wrote an impassioned letter to the Orlando Sentinel, which read, in part:

Mr. Alpizar’s death is a tragic loss not only to his family and community, but to the members of law enforcement who must make life or death decisions every day in order to protect both people who may have a serious and persistent mental illness not taking the medication that helps them, and people who do not have a mental illness going about their daily lives and activities.

On July 8, 1998 my brother Alan Singletary was also killed by members of law enforcement after a 13 hour stand off. My brother killed one deputy and wounded two others before his life was ended by the SWAT team. My brother was not taking his prescribed medication or following the treatment plan that assisted him in keeping the symptoms of paranoia, schizophrenia, and bipolar disorder in balance …

How many more devastating incidents of this magnitude will it take for us to understand that untreated severe mental illnesses are the … leading cause of disability and financial burden not only in the United States but worldwide? This is more than the disease burden caused by all cancers.

Air marshals kill man with bipolar disorder

Rigoberto Alpizar’s death is making headlines because he was killed by federal air marshals after making a bomb threat on an airplane.

But is it possible that his death is more the result of an old mental health treatment system than new security measures?

People with severe mental illnesses are nearly 4 times more likely to be killed by law enforcement officers than the general public. Much of that is because people are too often required to deteriorate to dangerousness before they can receive help – and then the people who are on teh front lines are not mental health professionals, but law enforcement officers.

We will be watching this story for more details.

UPDATES:

• Blogtac 12/09/05: Sister: "My brother also killed by SWAT team
• New York Times: "Air marshals tell of burden in reacting to mental status" (free registration required)

“I can’t believe I killed my whole family”

"I have problems. I can't believe I did what I did … I want everyone to know I loved my family. I miss them and I love them."

Richard E. Henderson, 20, confessed to killing his parents, his grandmother, and his 11-year-old brother – beating them all to death with a metal pipe on Thanksgiving Day.

The Bradenton Herald says: “ … it's obvious from his record that he is a very troubled young man who did not get the help he needed. Not that his family didn't try. Friends and relatives say they continually sought treatment for his drug and mental problems. But for whatever reason - his own refusal to take medication for his bipolar condition being the chief one - he fell through the cracks.”

According to the American Psychiatric Association, family members are often the most at risk of a violent act committed by someone with a mental illness.

Loss of the father of “a right to treatment”

The staff and board members of the Treatment Advocacy Center mourn the death of Dr. Morton Birnbaum, 79, the father of the concept of a "right to treatment." In doing so, we also celebrate the life of this amazing man.

• Tribute to Dr. Birnbaum by Rael Jean Isaac, author of “Madness in the Streets”
• Obituary, The New York Sun, December 1, 2005 (reprinted with permission)