Friday, August 29, 2008

What You Don't Know Can Hurt You

The single most significant reason why individuals with schizophrenia and bipolar disorder fail to take their medication is because of their lack of awareness of their illness (anosognosia).

The interesting fact is that the vast majority—9 out of 10—realize their illness after treatment and stay on their medications.

Critics of assisted outpatient treatment will frequently give other reasons.  The medications don't work.  There are too many side effects.  These can be dangerous red herrings.

Think about heart disease and all that was unknown decades ago.  What was unknown was a danger.  Doctor’s couldn’t prevent high cholesterol because it was largely unknown.  Today, having your cholesterol checked is standard operating procedure. 

Medical science has proven that anosognosia is often part of severe mental illness.  Yet there are some who would rather put decisions about care in the hands of lawyers rather than doctors.   This, for the lack of a better term, is a backward policy that needs to be changed.


Thursday, August 28, 2008

Helping Police on the Line

“It could be your uncle, your cousin, your sister, your baby, your son or your daughter. You never know who's going to come up with mental illness.”  That was the advice given recently to Wichita, Kan. police by Carr Floyd at a training session aimed at better protection for people with mental illness by law enforcement.

Floyd, who suffers from a mental illness, could see fear from both sides of the issue as her mother was a police officer.

“I know you’re just as scared as we are, at least that’s what Mom always said,” Floyd commented.  “She said that you never know what you’re stepping into.  But realize we’re just as scared of you as you are of us.” 

Studies show that in such situations it is more often than not the person with mental illness who becomes the victim.  This is something that people with a mental illness, like Floyd intuitively know. 

I can tell you if you come in aggressive with someone with mental illness, someone is going to get hurt. And it's probably going to be the person with mental illness,” Floyd told the Wichita Eagle

While it is unfortunate that the lack of treatment for people with mental illnesses too often put police officers in avoidable situations, the more such trainings occur the better, at least until assisted outpatient treatment is made more widely available. 

Tuesday, August 26, 2008

Political Campaigns and Mental Illness

As the political season is entering full swing, it’s important to keep your ears open to what the candidates are saying. Better yet, if you don’t hear much discussion about mental illness from the candidates, ask.

For many candidates at the national level, the discussion of mental illness is often tied into broad statements about health reform and the need for parity in treatment for mental illnesses. Having statements of support from Barack Obama, John McCain and other prominent national officials is important. This is a much needed step but there are other steps to be taken.

There is more that would-be elected officials can do should they emerge victorious, especially at the state and local level. Most of the laws and policies affecting treatment for people with severe mental illnesses occur at the state and local level.

There is also much advocates can do this election year to ensure issues affecting treatment for mental illness receive attention. Attending candidate forums and asking questions can make a big difference. Candidates for state assembly seats, mayors, county and city councils, and sheriff will all be in positions of affecting policy for people with mental illness. Ask the tough questions about why is it so difficult for someone with a severe mental illness to get into treatment. Speak out on behalf of your families and the families like yours who are having difficulty getting treatment for a loved one.

There is a good chance that many candidates for local and state office will be unfamiliar with the complexities of these issues. They may not have a good answer for you right away. Tell them that it is understandable and offer your help in finding better solutions. Offer the Treatment Advocacy Center as a resource to find those answers.

Asking the right questions before someone gets elected could make a big difference in what that person does once they are in office.

Editor’s Note: As a nonprofit organization, the Treatment Advocacy Center does not oppose or endorse any political candidates.

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Friday, August 22, 2008

Leaving a Lasting Legacy

Retiring New Mexico Senator Pete V. Domenici, a true champion for people with mental illness, will leave a lasting legacy to his work. 

The newly formed Domenici Public Policy Institute at New Mexico State University will continue to shine the light on needed mental health legislation that Sen. Domenici made a focal point of his career.  Among the Senate leader’s many efforts is his commitment to the Treatment Advocacy Center and ensuring people with severe mental illnesses receive the help they need. 

Sen. Domenici and his wife Nancy know first hand the importance of working on mental illness.  Like many others, they have a daughter who has had to deal with a mental illness.

“That put us in touch with families in the same situation,” Sen. Domenici recently told a New Mexico newspaper.  “And it puts us on a path of extraordinary involvement.”

He would know.  He has walked the walk.

Thursday, August 21, 2008

Healthy Minds Across America

Imagine a day devoted to the nation learning more about the tremendous advances science has made in the understanding and treatment of mental illness.  That is exactly what will happen on Sunday, Sept. 14, 2008 thanks to the good work NARSAD.

Healthy Minds Across America is an unprecedented opportunity for people in large and small cities from coast-to-coast to hear about the state of mental health research today.  Some 48 public forums on the progress, challenges, and promise of mental health research will bring some of the leading minds in the field together with family members and others looking for information.

NARSAD, the world’s leading charity dedicated to mental health research, is kicking off this initiative along with a fundraising drive to expand research on mental illnesses.  “Funding has remained flat for our federal research agency, the National Institutes of Health,” said Dr. Herbert Pardes, president of NARSAD’s Scientific Council.  “But we can’t wait for the federal government.  Too many lives are at stake, and we must not lose the momentum in the place of discovery we’ve achieved over the past two decades.”

A list of sites and other information is available on the NARSAD website.  Be sure to reserve your seat for Healthy Minds Across America my emailing or by calling 1-800-829-8289.


Wednesday, August 20, 2008

An Aloha State Wake Up Call

A string of recent tragedies in Hawaii has put mental illness high on the list of state concerns. The most prominent was high-tech millionaire Steven Thomas who disappeared from his home and later hung himself.

Thomas had bipolar disorder and all the financial resources necessary to get help. Unfortunately, like many people with the illness, he didn’t realize how sick he was. His wife did, but she couldn’t get him the help fast enough.

State officials are looking at the recent tragedies as a wake up call, holding hearings at the State Capitol to help figure out how to keep people from falling through the cracks. They are to be commended.

The state would be wise to listen to family members, like Thomas’ wife, who saw the warning signs and could almost foresee tragedy in the making. Providing assisted outpatient treatment will help give options to family members and other loved ones. Resources are important, and certainly Hawaii, like many states should examine ways to allocate more to improving mental health. Resources, however, as the case of Thomas illustrates, aren’t the only barriers to care.

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Tuesday, August 19, 2008

A Grandmother's Quest

Marjorie Bull has a mission. To save other families from what happened to her own.

On February 3, 2007, her granddaughter Arabella Rose was killed by her mother, Sherri Love who struggled with bipolar disorder. Her grandson survived` the stabbing.

That was just days after Love checked herself out of a hospital. She left without any follow up. Bull believes her daughter needed assisted outpatient treatment, care she could not receive in Nevada, where they live.

Today Love is in prison, sentenced to 56 years to life. Bull is trying to change Nevada’s Law to mirror New York’s Kendra’s Law. She points to the numerous successes of that law. In short, Kendra’s Law works. Bull wants to make sure Nevada stops playing roulette when it comes to treating people with mental illnesses and do the same.

“If Nevada would have had Kendra’s Law, or as I would like to call it, Arabella’s Law, my granddaughter would be here today,” Bull recently wrote in a letter to Governor Jim Gibbons.

Nevada’s law is in great need of improvement. The smart money is on Grandmother Bull.

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Monday, August 18, 2008

A Death in the Family

“William Bruce approached his mother as she worked at her desk at home and struck killing blows to her head with a hatchet,” accounts an August 16, 2008 story in The Wall Street Journal.  Just two month before, the 24-year old man with schizophrenia was released against doctor’s orders from the Riverview Psychiatric Center in Augusta, Maine.  “Very dangerous indeed for release to the community,” wrote one doctor.

This didn’t stop government-funded patient advocates, none of them doctors, to fight for his right to be psychotic.

“No matter how psychotic, that voice is still worthy of being heard,” said Helen Bailey, one of the William’s former attorneys with the Maine Disability Rights Center.

The convoluted sense of rights is continuing to be pushed in a pending lawsuit in the state, as well as in other actions around the country.  Ms. Bailey continues to find new clients and continues to use taxpayer dollars to push a misguided agenda. 

Did Ms. Bailey act in William’s best interest?  William is likely the best judge.  Here is what he told The Wall Street Journal in his first interview about the case: 


“I blame the illness, and I blame myself,” William said of his mother's death. “The guilt is...,” he paused, struggling to find a word “...tough.”

William said the first time he came to Riverview, he refused to believe he was mentally ill and approached the advocates because he wanted out.

“They helped me immensely with getting out of the hospital, so I was very happy,” he said. He later added, “The advocates didn't protect me from myself, unfortunately.”

“There are times when people should be committed,” William said. “Institutions can really help. Medicine can help.

“None of this would have happened if I had been medicated.”


Perhaps Ms. Bailey and other advocates should adhere to the first rule of medicine, and that to first do no harm.

The Bruce family story is not an isolated occurrence. The Treatment Advocacy Center is collecting stories from people about their experiences with federally funded Protection & Advocacy attorneys.  If you have had an experience where Protection and Advocacy organization tried to keep a loved one from getting needed treatment, or were involved in lobbying against treatment law reforms, please email us your story.


Friday, August 15, 2008

Devolution into America's Largest Mental Hospital

It’s known as the Twin Towers.  It’s not at Johns Hopkins, the Mayo Clinic, Massachusetts General, or some other famous medical institution.  It is part of the Los Angeles County Jail.

The Los Angeles County jail houses some 1,400 people with mental illness.  Reporters from National Public Radio recently visited the Twin Towers in downtown Los Angeles

For many in the prison, they were searching for treatment, NPR reports.  Treatment that is unavailable in the community.

Dr. Arakel Davtian, one of the psychiatrists at the prison, tells the reporters how easy it is for a person to end up at the Twin Towers.

“Indecent exposure, having open containers, something very, very minor.  Peeing on the street, disturbing the peace,” Dr. Davtian says. 

The transformation of the Twin Towers into the nation’s largest mental hospital didn’t happen overnight.  It devolved from the deinstitutionalization of people with mental illness in the 1970s. 

“Rather than leading to quality treatment in small, community settings,” NPR reports, “it often resulted in no treatment at all.  As a consequence, thousands of mentally ill ended on the streets, where they become involved in criminal activity.” 

It is now time to move from this devolution of social policy, to a more evolved program of assisted outpatient treatmentLos Angeles and the rest of California can help lead the way by implementing Laura’s Law

Wednesday, August 13, 2008

More Florida Facts

With news that a Miami-Dade County Grand Jury has issued a strong call for expanding assisted outpatient treatment in the state, it would be useful to examine some facts about the state.

A recent search found an interesting study from August 11, 2008, the same day as the Grand Jury’s report, from Florida Today. Among the findings:

  • About 125,000 people annually with mental illnesses requiring immediate treatment are arrested and booked into Florida jails, mostly for misdemeanor and low-level felony offenses.
  • About 25 percent of the homeless population has a severe mental illness, and more than half have spent time in jail or prison.
  • Individuals ordered into forensic commitment -- charged with a crime -- "are now the fastest-growing segment of the publicly funded mental health marketplace in Florida."
  • Florida ranks 12th in the nation in spending for forensic mental health services, but 48th nationally in overall per-capita public mental health spending.

Tuesday, August 12, 2008

Watching a Fire Burn

A Miami-Dade County, Fla. Grand Jury issued a report calling for broad, needed reforms in the way the state treats people with severe mental illnesses.  The Grand Jury was called to examine Florida’s laws with the aim of preventing a repeat there of what happened at the campus of Virginia Tech on April, 16. 2007.  Something the Grand Jury called, “the shots heard ‘round the world.”

State Attorney Katherine Fernandez Rundle and others involved in this effort should be commended for this unique and insightful approach.  Their warning should be taken seriously by state elected officials. 

The Florida Grand Jury found that their laws, much like Virginia’s and other states, have too strict a standard to get someone with a mental illness needed care.  The current system doesn’t allow for help to be given until there is a crisis.  This jury wants to avoid the crisis.

The results “are akin to having a forest ranger posted in a forest to watch for fires.  However, the law says the ranger cannot call the firefighters at the first sign of smoke,” the Grand Jury report states.  “Of course, by the time he is able to confirm that a fire is in fact blazing, significant damage has already been done.”

The Grand Jury wants the system changed so that treatment is provided, “at the first wisp of smoke.”  They point to the Treatment Advocacy Center’s Model Law as a way to clear the smoke. 

“We believe,” the Grand Jury concluded, “the TAC Model Law should form the framework for changes to Florida’s involuntary inpatient and outpatient treatment laws.  Making these changes will surely cause a shift in the way we have dealt with the mentally ill for years.”

Making these changes will not be easy.  Less than 24 hours after the Grand Jury issued the report, critics were already lining up.  Nice ideas, but too expensive.  Really?  This is what the jury of their peers had to say.

“The fire is out of control.  The total costs, as it relates to the amount of time, effort and resources it will take to extinguish the raging inferno have grown exponentially from the point in time when a ranger spotted the first wisps of smoke.”


Monday, August 11, 2008

Misguided Justice

Here is an example of a “Catch 22” created by a system limiting the rights of a family to get treatment for a loved with a mental illness, yet allows another legal battle to ensue because the family failed to control the same loved one.

In 2007, Eddie Mies gunned down his father, resulting in a shootout with El Dorado County deputies that left Mies dead and two of the deputies injured.  A year later, the deputies have filed an $8 million civil law suite against the widow and the estate of her deceased husband, Arthur, and her son. 

The story, detailed in the Sacramento Bee, is tragic.  Nothing can undo that June 5, 2007 day.  Given the limited income and financial resources of 66-year old Karen Mies, the lawsuit is as unrealistic as it is misguided.

“June 5 was a tragic day for me and my family, and it was a tragic day for the deputies who were injured,” Karen Mies told the Bee. “We were all victims that day. But this lawsuit is victimizing our family again. What do they want? My husband's dead, my son’s dead. Do they want my house and my 10-year-old car?”

Here is a better solution that won’t eat up additional resources in court and provide a public policy aimed at prevent future tragedies.  El Dorado County should implement Laura’s Law.  This law would give families like the Mies’ the ability to get help for a loved one who needs it, but denies they are sick. 


Friday, August 08, 2008

Another Family Tragedy Strikes

He was described as a “ticking time bomb” by some family members.  Those who were related to Ronald Weed felt his schizophrenia would someday lead him to harm those closest to him.

Now the whole New Jersey family’s worst fear turned to grim reality. 

Weed is facing charges of killing his mother in her home and the stabbing of his 12-year-old twin nieces who were visiting their grandmother.

His family kept trying to get him help, but their options were limited and their hands tied by outdated New Jersey laws.  Weed had spent as much as six weeks in a psychiatric hospital.  When released he wouldn’t take his medication. 

The tragic story is all too common.  Without changes in New Jersey and other states laws to provide for assisted outpatient treatment, the risk of another tragedy occurring again is all too great.

Wednesday, August 06, 2008

Jail or Treatment?

Readers to this blog will be familiar with this choice and how it impacts people with a mental illness.  Now you can vote

Let your voice be heard.

Should mentally ill people be treated in hospitals and outpatient facilities rather than imprisoned for their disabilities?


Tuesday, August 05, 2008

Even the Strongest of the Strong Can Need Help

Professional football fans recently learned why the Philadelphia Eagles two-time Pro Bowl player Shawn Andrews wasn’t showing up for practice.  He was sick.  Not just any disease.  Andrews told his team and the larger public that he is battling depression.

Not an easy thing for anyone to admit, and certainly not easy for someone who builds a career based on strength. 

“I’m willing to admit that I’ve been going through a very bad time with depression,” Andrews told the Philadelphia Daily News.  “I’m on medication, trying to get better.”

Last year Andrews got scared of going in for treatment, fearing a fan might recognize and spot him. 

There was a lot of speculation—most of it wrong—about why Andrews was missing practice, a decision costing him $15,000 a day. 

“The consequences are what they are. I'm willing to accept them,” Andrews said. “Football is important, it's a means to an end, but my mental health, I feel like, is a lot more important . . . It is a ton of money, but, at this time, I don't feel like I can put a price tag on my mental state.”

Andrews was most worried about what his teammates would think.  Turns out he wasn’t alone. 

Another Eagle, Brian Dawkins had this to say.  “As a guy who went through that early in my career, taking the medication, I certainly understand.” Dawkins said he was treated for depression as a rookie in 1996. Dawkins said he eventually eased off the medication and thinks he resolved his problem through “prayer and having people around me that I knew cared about me.”

Andrews sought treatment before something really bad happened.  He is all the much stronger for doing so.  A speedy recovery to him.


Monday, August 04, 2008

Preventable Tragedies

“Yet another death that was preventable,” reads the headline from The Oregonian.  Unfortunately, it is all too common.

This preventable tragedy involved 20-year old Andrew Hanlon who had schizophrenia and was off treatment when he was shot by a police officer.  A few months earlier, his family out of frustration called 9-1-1.  That was enough to a police officer to get Hanlon to a hospital.  That got him evaluated but not much more.  There was no outpatient care to help Hanlon stay on treatment.

“Hanlon should be alive today,” read the editorial. “His death was preventable. Had he received appropriate treatment, he wouldn't have been pounding on a stranger's door at night and the police wouldn't have been called. If the officer on the scene had been better trained to deal with a mentally ill person, Hanlon wouldn't have been killed.”

Friday, August 01, 2008

The Police and People with Mental Illness

From coast to coast, mentally ill people, without reliable access to the costly on-demand care they need, are left to fend for themselves. In the aftermath of the movement in the 1970s to close large mental asylums, many of today's mentally ill are left to their own devices; they are often homeless and without full-time advocates. With government unable or unwilling to properly serve this population, the criminal-justice system is left to pick up the slack.


Is the above passage from a Treatment Advocacy Center report?  You might think it was, but it is from a recent web article from Newsweek

“Experts on treatment say the police for the most part do a good job handling the millions of interactions they have each year with the mentally ill,” the article continues. “But is it irresponsible to ask them to undertake duties that perplex even trained, savvy professionals?”

A very good question indeed.