As we come to the end of the year, if you haven't already seen the Treatment Advocacy Center's (TAC's) list of The Top 10 Underreported Mental Illness Stories, 2007 I would encourage you to do so.
The second, "Requiring 'dangerousness' before someone can get mental illness treatment is dangerous for everyone," and fifth, "Psychiatric beds are shifting from civil to criminal" really hit home because I have personally had to watch my family member deteriorate to the level of "clear and present danger to self or others" before receiving treatment and because I have a friend whose daughter's untreated mental illness meant that she is currently serving time in a correctional facility, instead of receiving the help she needed in a psychiatric hospital.
As an advocate for changes to our mental health laws in Pennsylvania, the eighth, "Assisted outpatient treatment (AOT) programs make a difference – when they are used" and the tenth, "We are still protecting the right to be psychotic over the right to treatment" really summarize my reasons for trying to see our laws change to an AOT law such as our proposed SB 226. Hopefully, 2008 will see this timely treatment for mental illness piece of legislation become law in my state.
Monday, December 31, 2007
Sunday, December 23, 2007
Abandoned to the Streets - Around the World
Through the "google alerts" I've set on my computer, I found a new web site, World Fellowship for Schizophrenia and Allied Disorders, an organization that was originated in Canada with a membership of organizations around the world, including NAMI. The opening paragraph of the article I read, "Abandoned to the Streets" is: "It's been a hard year. I would not have been able to tell you most of the time where my daughter was — how she spent her days, or with whom. Carrie is a grown woman, attractive and kind-hearted; but she also suffers from the most debilitating of mental illnesses: schizophrenia."
The story really hit home because of a caring, concerned mother I've recently been in touch with, Bernadette, who was very worried because her daughter with a mental illness was constantly wandering off and not taking her medications that helped her. Bernadette worried for her daughter's safety and, after her daughter was missing for a month, Bernadette finally learned that she had spent that month in jail for a minor crime, because, without medications, her daughter wasn't thinking very clearly.
Unfortunately, the treatment laws in my state, Pennsylvania, require that individuals with a mental illness and lack of insight to make a request for medications and other treatments that could help them must first do something that shows that they are a "clear and present danger to self or others" before treatment is provided. While waiting for this dangerous level to be reached, many people in this situation do wander off, sometimes become homeless and find themselves in situations where they are victimized or sometimes are involved in minor crimes or worse.
When treatment works and helps someone with a diagnosis of mental illness, why put them and their families through the torture and worry of waiting for a dangerous situation to occur? That simply makes no sense at all. Any caring society would want to provide the help that would enable someone to avoid the type of dangerous situations that routinely occur with untreated mental illnesses. When enacted, Pennsylvania's proposed assisted outpatient treatment (AOT) bill, SB 226, will help people like Bernadette's daughter to receive treatment in a psychiatric hospital or in the community with the support of an intensive case manager or an ACT program, not in a jail.
The story really hit home because of a caring, concerned mother I've recently been in touch with, Bernadette, who was very worried because her daughter with a mental illness was constantly wandering off and not taking her medications that helped her. Bernadette worried for her daughter's safety and, after her daughter was missing for a month, Bernadette finally learned that she had spent that month in jail for a minor crime, because, without medications, her daughter wasn't thinking very clearly.
Unfortunately, the treatment laws in my state, Pennsylvania, require that individuals with a mental illness and lack of insight to make a request for medications and other treatments that could help them must first do something that shows that they are a "clear and present danger to self or others" before treatment is provided. While waiting for this dangerous level to be reached, many people in this situation do wander off, sometimes become homeless and find themselves in situations where they are victimized or sometimes are involved in minor crimes or worse.
When treatment works and helps someone with a diagnosis of mental illness, why put them and their families through the torture and worry of waiting for a dangerous situation to occur? That simply makes no sense at all. Any caring society would want to provide the help that would enable someone to avoid the type of dangerous situations that routinely occur with untreated mental illnesses. When enacted, Pennsylvania's proposed assisted outpatient treatment (AOT) bill, SB 226, will help people like Bernadette's daughter to receive treatment in a psychiatric hospital or in the community with the support of an intensive case manager or an ACT program, not in a jail.
Friday, December 14, 2007
When is it time to overhall mental health system?
In an article in the Washington Post, December 14, 2007, Kaine to Overhaul Mental Health System, Virginia's governor is preparing to overhaul their state's mental health system. While Virginia has an "imminent danger," standard, it is similar to the level of dangerousness required in Pennsylvania, which is "clear and present danger." As stated in this article by Christopher Ryan, a psychiatrist at the University of Sydney in Australia, "It would be better if people with these illnesses could receive the treatment they need before dangerousness becomes an issue."
The problem that sometimes exists with mental illness is that of anosognosia, or lack of insight. As stated in the article, "When someone doe not realize that they have an illness that can be helped by treatment, they do sometimes fall into crisis situations, as they decompenstate to the level of dangerousness required by some states laws." What a tragedy for that person as well as for the family and friends who wait by helplessly, watching this slow decent to a level of "imminent" or "clear and present" danger.
"Family members of mentally ill patients and mental health workers said Virginia's standard is too strict and results in the denial of treatment for people who need it."
I would echo the same sentiment regarding the laws in Pennsylvania that make it impossible to get someone the timely treatment they need, to help prevent something too dangerous happening to that individual or someone else.
According to the Treatment Advocacy Center, eighteen states have revised their standards since 1999. Hopefully, Pennsylvania will be one of the next states to change their outdated Mental Health Procedures Act through SB 226.
The problem that sometimes exists with mental illness is that of anosognosia, or lack of insight. As stated in the article, "When someone doe not realize that they have an illness that can be helped by treatment, they do sometimes fall into crisis situations, as they decompenstate to the level of dangerousness required by some states laws." What a tragedy for that person as well as for the family and friends who wait by helplessly, watching this slow decent to a level of "imminent" or "clear and present" danger.
"Family members of mentally ill patients and mental health workers said Virginia's standard is too strict and results in the denial of treatment for people who need it."
I would echo the same sentiment regarding the laws in Pennsylvania that make it impossible to get someone the timely treatment they need, to help prevent something too dangerous happening to that individual or someone else.
According to the Treatment Advocacy Center, eighteen states have revised their standards since 1999. Hopefully, Pennsylvania will be one of the next states to change their outdated Mental Health Procedures Act through SB 226.
Sunday, December 9, 2007
The Right to Treatment
How does one go about protecting one of the human rights that is most important to an individual with a severe mental illness and a lack of insight into the need to receive treatment?
The question is a global one, and was addressed recently in an article from the Irish Medical News, "Right to treatment should not be forgotten in psychiatry". As mentioned in this article, Dr. Brendan Kelly of the Department of Adult Psychiatry, UCD stated that "the Act [Ireland's Mental Health Act, 2001] does increase protection for the right to liberty – but indicated that other important rights relating to mental health, may not be equally protected." He stated “The Act certainly increases protection for the right to liberty, but it focuses on that right so much that there is scant attention paid to other rights – the right to treatment, for example."
I agree with Pete Earley's statement on this blog site under Commonsense Quotes: "If I had a chronic mental illness and there were medicines that could help me recover, I would want my loved ones and doctors to make certain that I got them, not to stand by and watch me suffer."
I think that we should take the same compassionate stand to help those whose lives are affected by the devastating consequences of untreated mental illness. They should have a right to receive timely treatment and we should do all that we can to advocate to help protect that vitally important right.
The question is a global one, and was addressed recently in an article from the Irish Medical News, "Right to treatment should not be forgotten in psychiatry". As mentioned in this article, Dr. Brendan Kelly of the Department of Adult Psychiatry, UCD stated that "the Act [Ireland's Mental Health Act, 2001] does increase protection for the right to liberty – but indicated that other important rights relating to mental health, may not be equally protected." He stated “The Act certainly increases protection for the right to liberty, but it focuses on that right so much that there is scant attention paid to other rights – the right to treatment, for example."
I agree with Pete Earley's statement on this blog site under Commonsense Quotes: "If I had a chronic mental illness and there were medicines that could help me recover, I would want my loved ones and doctors to make certain that I got them, not to stand by and watch me suffer."
I think that we should take the same compassionate stand to help those whose lives are affected by the devastating consequences of untreated mental illness. They should have a right to receive timely treatment and we should do all that we can to advocate to help protect that vitally important right.
Tuesday, December 4, 2007
The Church and Mental Illness: What is Their Role?
We certainly have come a long way from the days when the church considered those with mental illness as possessed by demons. http://encarta.msn.com/encyclopedia_761566888_9/Mental_Illness.html
However, how involved are churches today in dealing with mental illness? Or, more specifically, how knowledgeable are churches about mental illness?
Considering that one in four families copes with the challenges brought on by a family member dealing with mental illness, it would seem that most congregations, depending on their size, have several families who fit the profile.
During the brief period that my son, Todd, was taking his medication for schizophrenia, he sought out a church after moving into a new apartment in a new town. Soon thereafter, when Todd stopped taking his medication because he felt he wasn’t sick (see http://www.treatmentadvocacycenter.org/BriefingPapers/BP15.htm ) and started displaying symptoms, I contacted the church.
I was grasping at straws.
The ministers, a husband and wife team, said they would watch out for him. And they did. Months later, when Todd began acting inappropriately during services—pulling out his battery-powered electric shaver or shouting something out in response to the sermon—the ministers contacted me. They said they didn’t want to discourage his coming to church, but they didn’t want to cause discomfort for their congregation either. So, they formed “The Todd Project,” consisting of about 10 people, including a physician, a therapist, and several retired persons, whose job it was to more or less watch Todd and be with him when he came to services, kind of “guiding” his behavior—or misbehavior. Todd was never told of this group or of my interaction with group members. We didn’t want to alienate or cause any more paranoia than he already had.
To this church’s credit, during the next several months, the Todd Project met with me to better understand Todd’s history. And they did help him when the electric company terminated service due to nonpayment. Someone from the group regularly drove him to a nearby clinic to get his high blood pressure medication. Then, recently, Todd patted the head of a younger child, and the mother became frantically afraid. No one seems to know if he said anything inappropriate to the child. The mother told the minister she was going to leave and go to another church. The minister immediately told Todd that now he would need to come to report to the Todd Project. Todd turned on his heels and left. I’m not sure if he has returned. And I understand how the church as a whole wants to their church to be a safe place for their congregation. I can’t help but wonder, however, how frantic the mother would have been had a “normal” person patted her child’s head.
One of the Todd Project members told me that the head-patting issue had been elevated to The Session, and this group wondered why I hadn’t had him involuntarily committed.
http://www.phillyburbs.com/pb-dyn/news/111-11182007-1442905.html
That’s when I knew that our job of educating the world about mental illness has only just begun.
The need to address chronic mental illness is urgent. The 1988 General Assembly of the Presbyterian Church (U.S.A.) adopted a report and resolution which called the church to ministry and mission with those persons affected by serious mental illness including family, friends and professionals. http://www.pcusa.org/nationalhealth/programs/seriousmentalillness.htm#top
The report:
· acknowledged that the religious community is in a unique position to be the bridge between clinical settings and life in the home community and to offer support to the diversity of persons whose lives are touched by mental illness
· urged pastors and congregations to develop ways of inclusion
· urged that congregations cherish the presence of all in the community of faith as it worships, studies, gives, grows and heals together
· encouraged the church to learn more about mental illness and
· encouraged the church to seek new ways to respond to those with severe mental illness and their families.
What do you think? Did Todd’s church helped him, or did they lose him?
However, how involved are churches today in dealing with mental illness? Or, more specifically, how knowledgeable are churches about mental illness?
Considering that one in four families copes with the challenges brought on by a family member dealing with mental illness, it would seem that most congregations, depending on their size, have several families who fit the profile.
During the brief period that my son, Todd, was taking his medication for schizophrenia, he sought out a church after moving into a new apartment in a new town. Soon thereafter, when Todd stopped taking his medication because he felt he wasn’t sick (see http://www.treatmentadvocacycenter.org/BriefingPapers/BP15.htm ) and started displaying symptoms, I contacted the church.
I was grasping at straws.
The ministers, a husband and wife team, said they would watch out for him. And they did. Months later, when Todd began acting inappropriately during services—pulling out his battery-powered electric shaver or shouting something out in response to the sermon—the ministers contacted me. They said they didn’t want to discourage his coming to church, but they didn’t want to cause discomfort for their congregation either. So, they formed “The Todd Project,” consisting of about 10 people, including a physician, a therapist, and several retired persons, whose job it was to more or less watch Todd and be with him when he came to services, kind of “guiding” his behavior—or misbehavior. Todd was never told of this group or of my interaction with group members. We didn’t want to alienate or cause any more paranoia than he already had.
To this church’s credit, during the next several months, the Todd Project met with me to better understand Todd’s history. And they did help him when the electric company terminated service due to nonpayment. Someone from the group regularly drove him to a nearby clinic to get his high blood pressure medication. Then, recently, Todd patted the head of a younger child, and the mother became frantically afraid. No one seems to know if he said anything inappropriate to the child. The mother told the minister she was going to leave and go to another church. The minister immediately told Todd that now he would need to come to report to the Todd Project. Todd turned on his heels and left. I’m not sure if he has returned. And I understand how the church as a whole wants to their church to be a safe place for their congregation. I can’t help but wonder, however, how frantic the mother would have been had a “normal” person patted her child’s head.
One of the Todd Project members told me that the head-patting issue had been elevated to The Session, and this group wondered why I hadn’t had him involuntarily committed.
http://www.phillyburbs.com/pb-dyn/news/111-11182007-1442905.html
That’s when I knew that our job of educating the world about mental illness has only just begun.
The need to address chronic mental illness is urgent. The 1988 General Assembly of the Presbyterian Church (U.S.A.) adopted a report and resolution which called the church to ministry and mission with those persons affected by serious mental illness including family, friends and professionals. http://www.pcusa.org/nationalhealth/programs/seriousmentalillness.htm#top
The report:
· acknowledged that the religious community is in a unique position to be the bridge between clinical settings and life in the home community and to offer support to the diversity of persons whose lives are touched by mental illness
· urged pastors and congregations to develop ways of inclusion
· urged that congregations cherish the presence of all in the community of faith as it worships, studies, gives, grows and heals together
· encouraged the church to learn more about mental illness and
· encouraged the church to seek new ways to respond to those with severe mental illness and their families.
What do you think? Did Todd’s church helped him, or did they lose him?
Monday, December 3, 2007
Clarifying Senate Bill 226
I recently received a comment to the previous blog on the complexities of mental illness which made me realize that many people probably do not understand exactly how Pennsylvania's proposed legislation, SB 226 would be enacted, who it would affect, and the period of time that it would be in place.
In order for someone to qualify for an assisted outpatient treatment (AOT) court order under SB 226, the person has to meet ALL of the numbered criteria to be eligible for the program. There is one area of either/or in the criteria – number (4), parts (i) and (ii). To be eligible, a person must meet all of the other criteria, but they only have to either have had the history of hospitalization (i), or the history of violent behavior (ii), not both.
For example, simply meeting (7) “likely to benefit from AOT” would not be enough for entry into the program. ALL of the other criteria would have to be found by a judge by clear and convincing evidence, as well.
(1) The patient is 18 years of age or older.
(2) The patient is suffering from a mental illness.
(3) The patient is unlikely to survive safely in the community without supervision, based on a clinical determination.
(4) The patient has a history of lack of compliance with treatment for mental illness that has:
(i) at least twice within the preceding 36 months been a significant factor in necessitating hospitalization, or receipt of services in a forensic or other mental health unit of a correctional facility, not including any period during which the person was hospitalized or imprisoned immediately preceding the filing of the petition; or
(ii) resulted in one or more acts of serious violent behavior toward self or others or threats of, or attempts at, serious physical harm to self or others within the preceding 48 months, not including any period in which the person was hospitalized or imprisoned immediately preceding the filing of the petition.
(5) The patient is, as a result of the patient's mental illness, unlikely to voluntarily participate in the recommended treatment pursuant to the treatment plan.
(6) In view of the patient's treatment history and current behavior, the patient is in need of assisted outpatient treatment in order to prevent a relapse or deterioration which would be likely to pose a clear and present danger of harm to others or to himself as determined under section 301.
(7) It is likely that the patient will benefit from assisted outpatient treatment.
The initial court order would be for a period of six months, followed by a review. If it was determined necessary, this could be continued for an additional year.
The number of people in New York under Kendra's Law, which SB 226 is modeled after, is approximately 750 each year. Given the size of Pennsylvania in comparison, the number of people who might be in an assisted outpatient treatment order would be approximately 500 each year. If that is broken down into counties, that could mean about 8 people in each county.
The benefit behind a sustained period of time in treatment cannot be underestimated, as the outcomes from Kendra's Law show. The major goal of a bill such as SB 226 would be to enable the very small minority of people with a mental illness who meet the criteria and who often initially lack insight and end up homeless, hospitalized, or incarcerated to receive timely, sustained treatment and then for them to move forward in whatever direction they may choose.
Without this supportive bill, are we really providing the care and support that someone with an untreated mental illness deserves?
In order for someone to qualify for an assisted outpatient treatment (AOT) court order under SB 226, the person has to meet ALL of the numbered criteria to be eligible for the program. There is one area of either/or in the criteria – number (4), parts (i) and (ii). To be eligible, a person must meet all of the other criteria, but they only have to either have had the history of hospitalization (i), or the history of violent behavior (ii), not both.
For example, simply meeting (7) “likely to benefit from AOT” would not be enough for entry into the program. ALL of the other criteria would have to be found by a judge by clear and convincing evidence, as well.
(1) The patient is 18 years of age or older.
(2) The patient is suffering from a mental illness.
(3) The patient is unlikely to survive safely in the community without supervision, based on a clinical determination.
(4) The patient has a history of lack of compliance with treatment for mental illness that has:
(i) at least twice within the preceding 36 months been a significant factor in necessitating hospitalization, or receipt of services in a forensic or other mental health unit of a correctional facility, not including any period during which the person was hospitalized or imprisoned immediately preceding the filing of the petition; or
(ii) resulted in one or more acts of serious violent behavior toward self or others or threats of, or attempts at, serious physical harm to self or others within the preceding 48 months, not including any period in which the person was hospitalized or imprisoned immediately preceding the filing of the petition.
(5) The patient is, as a result of the patient's mental illness, unlikely to voluntarily participate in the recommended treatment pursuant to the treatment plan.
(6) In view of the patient's treatment history and current behavior, the patient is in need of assisted outpatient treatment in order to prevent a relapse or deterioration which would be likely to pose a clear and present danger of harm to others or to himself as determined under section 301.
(7) It is likely that the patient will benefit from assisted outpatient treatment.
The initial court order would be for a period of six months, followed by a review. If it was determined necessary, this could be continued for an additional year.
The number of people in New York under Kendra's Law, which SB 226 is modeled after, is approximately 750 each year. Given the size of Pennsylvania in comparison, the number of people who might be in an assisted outpatient treatment order would be approximately 500 each year. If that is broken down into counties, that could mean about 8 people in each county.
The benefit behind a sustained period of time in treatment cannot be underestimated, as the outcomes from Kendra's Law show. The major goal of a bill such as SB 226 would be to enable the very small minority of people with a mental illness who meet the criteria and who often initially lack insight and end up homeless, hospitalized, or incarcerated to receive timely, sustained treatment and then for them to move forward in whatever direction they may choose.
Without this supportive bill, are we really providing the care and support that someone with an untreated mental illness deserves?
Sunday, November 18, 2007
Complexities of untreated mental illnesses
The issues surrounding untreated mental illnesses are very complex. Jo Ciavaglia, a reporter from the Bucks County Courier Times took on this assignment and delivered an excellent overview of how this issue affects individuals who have a diagnosis of a mental illness and who have anosognosia (lack of insight) and do not receive treatment as well as the affect on their families and friends. In her article, "Bill mandates treatment for mentally ill," Ms. Ciavaglia gives a very clear description of our current law in Pennsylvania that requires "clear and present danger to self or others" before someone can be required to receive treatment as well as the proposed legislation, Senate Bill 226.
The points made by those who are opposed to SB 226 include that there "is little evidence that court orders are effective." However, there is very clear proof as seen in the outcomes of New York's Kendra's Law, which SB 226 is modeled after and which show a major reduction in homelessness, hospitalizations, and incarcerations.
There are also concerns that there is a "lack of funding for expanded treatment and support services" that would be required under this bill. However, Pennsylvania is ranked second against other states in its expenditures for mental health services according to NAMI National's Grading the States. Although some additional funding might be needed in setting up a new system for assisted outpatient treatment (AOT) as defined by SB 226, perhaps another look at how we are spending our mental health dollars might also be beneficial, especially since NAMI gave PA an overall grade of "D+" in mental health care services and systems.
The other fear that was stated by patient advocates was that the "law could be abused by applying it whenever a patient disagrees with a doctor's recommendations." As explained further in the article, there is very stringent criteria for someone to be on a court-ordered AOT and this law would only affect those individuals with a history of non-compliance of treatment and of hospitalizations or incarcerations.
While the majority of individuals with a diagnosis of a mental illness are able to move forward in their own recovery by deciding what treatments are best for them, there is a small minority of people who have a mental illness such as schizophrenia or bipolar and also have anosognosia, or lack of insight, and who do not understand the benefits or need of treatment. SB 226 would enable that very small group of people to have access to the treatments that will help them move forward in their lives and, then be able choose the treatments for themselves that would be most beneficial. It is a short-term court order that in the long run, could help someone to regain the life they once had and take control of their future.
Isn't that what we wish for everyone?
The points made by those who are opposed to SB 226 include that there "is little evidence that court orders are effective." However, there is very clear proof as seen in the outcomes of New York's Kendra's Law, which SB 226 is modeled after and which show a major reduction in homelessness, hospitalizations, and incarcerations.
There are also concerns that there is a "lack of funding for expanded treatment and support services" that would be required under this bill. However, Pennsylvania is ranked second against other states in its expenditures for mental health services according to NAMI National's Grading the States. Although some additional funding might be needed in setting up a new system for assisted outpatient treatment (AOT) as defined by SB 226, perhaps another look at how we are spending our mental health dollars might also be beneficial, especially since NAMI gave PA an overall grade of "D+" in mental health care services and systems.
The other fear that was stated by patient advocates was that the "law could be abused by applying it whenever a patient disagrees with a doctor's recommendations." As explained further in the article, there is very stringent criteria for someone to be on a court-ordered AOT and this law would only affect those individuals with a history of non-compliance of treatment and of hospitalizations or incarcerations.
While the majority of individuals with a diagnosis of a mental illness are able to move forward in their own recovery by deciding what treatments are best for them, there is a small minority of people who have a mental illness such as schizophrenia or bipolar and also have anosognosia, or lack of insight, and who do not understand the benefits or need of treatment. SB 226 would enable that very small group of people to have access to the treatments that will help them move forward in their lives and, then be able choose the treatments for themselves that would be most beneficial. It is a short-term court order that in the long run, could help someone to regain the life they once had and take control of their future.
Isn't that what we wish for everyone?
Wednesday, October 31, 2007
Untreated Mental Illness - Who's To Blame?
I had originally written and planned to post information about my personal experiences of the heartaches and frustrations that I encountered as a family member of a loved one with mental illness who lacked insight and did not take prescribed medications. The process of watching someone you love deteriorate until they reach an acceptable level of dangerousness, as determined by a law, which requires "clear and present danger to self and others" as the law in Pennsylvania does, is the most unbearable experience that anyone could ever live through.
However, I then read an article this morning from a paper in Virginia: http://www.inrich.com/cva/ric/news.apx.-content-articles-RTD-2007-10-30-0149.html. The incident is tragic enough, but what really drew me to want to write about this terribly sad incident, instead of my own personal experiences, were some of the comments posted under that article, such as:
Posted October 30, 2007 @ 09:55 AM by Anonymous
after reading this man's rap sheet i too am finding compassion a hard sell. i agree the family dropped the ball, this man needed to be under lock and key somewhere and his family should own up to their responcibility.
Posted October 30, 2007 @ 09:07 AM by Anonymous
I find it incredible that the man's sister, and whatever other family members, are blaming the community for their own failure. She knew he was sick and was required to take his medication. She states she was not his guardian, so she is indicating a third party was supposed to be his guardian thereby releasing her from any burdens. His family should be held liable for neglect and endangering the public by not providing the proper supervision and care for their own family member.
Posted October 30, 2007 @ 06:49 AM by OpEd
What's up with this man's sister? Somebody dropped the ball? Where does family responsibility come in? Perhaps I'm jumping the gun here, but it sounds like she was blaming the "system." If the community of family and aquaintances knows about this guy, then they are the first line of defense, not the overburdened mental and social services departments.
I was shocked and appalled by these comments because, as a family member who repeatedly waited and was frustrated by the mental health system when treatment was desperately required for my own daughter, only to be stopped by both lack of enough intensive services and our state's requirement for "clear and present danger to self or others" before she could receive the treatment she needed, it hit me hard to think that others would even consider blaming this family.
As a NAMI advocate, I was able to successfully work for the establishment of more intensive services in our county, and Bucks County was the first Program of Assertive Community Treatment (PACT, a.k.a. ACT) established in Pennsylvania that follows the national standards set up by the original program.
However, the extreme difficulty of obtaining timely services for family members when they desperately need them is still blocked by our current treatment law, the Mental Health Procedures Act of 1976, that still requires a level of dangerousness that no one should ever have to wait for, before they can receive treatment. I am now working with the Treatment Advocacy Center (TAC) to change our law, through the proposed Senate Bill 226.
Blame and pointing a finger at families who try desperately to get help for their loved ones and who often are involved in advocating for the changes needed will not resolve the issue of ensuring that someone with a mental illness receives the treatment they need. Enacting common-sense, timely assisted outpatient treatment (AOT) laws with adequate services and programs, as well as providing sufficient support in a hospital when needed, is what should happen.
As John Snook, Esq. from TAC stated about this tragedy in Virginia, "Unfortunately, the reports we've heard echo what families tell us far too often," Snook said. "Even when an individual has been ordered by a court to maintain their treatment, adequate supervision in the community simply isn't taking place."
I invite you to post your thoughts and comments on this issue. Do you think that the family was to blame? Should we be looking for changes to our mental health systems and laws?
However, I then read an article this morning from a paper in Virginia: http://www.inrich.com/cva/ric/news.apx.-content-articles-RTD-2007-10-30-0149.html. The incident is tragic enough, but what really drew me to want to write about this terribly sad incident, instead of my own personal experiences, were some of the comments posted under that article, such as:
Posted October 30, 2007 @ 09:55 AM by Anonymous
after reading this man's rap sheet i too am finding compassion a hard sell. i agree the family dropped the ball, this man needed to be under lock and key somewhere and his family should own up to their responcibility.
Posted October 30, 2007 @ 09:07 AM by Anonymous
I find it incredible that the man's sister, and whatever other family members, are blaming the community for their own failure. She knew he was sick and was required to take his medication. She states she was not his guardian, so she is indicating a third party was supposed to be his guardian thereby releasing her from any burdens. His family should be held liable for neglect and endangering the public by not providing the proper supervision and care for their own family member.
Posted October 30, 2007 @ 06:49 AM by OpEd
What's up with this man's sister? Somebody dropped the ball? Where does family responsibility come in? Perhaps I'm jumping the gun here, but it sounds like she was blaming the "system." If the community of family and aquaintances knows about this guy, then they are the first line of defense, not the overburdened mental and social services departments.
I was shocked and appalled by these comments because, as a family member who repeatedly waited and was frustrated by the mental health system when treatment was desperately required for my own daughter, only to be stopped by both lack of enough intensive services and our state's requirement for "clear and present danger to self or others" before she could receive the treatment she needed, it hit me hard to think that others would even consider blaming this family.
As a NAMI advocate, I was able to successfully work for the establishment of more intensive services in our county, and Bucks County was the first Program of Assertive Community Treatment (PACT, a.k.a. ACT) established in Pennsylvania that follows the national standards set up by the original program.
However, the extreme difficulty of obtaining timely services for family members when they desperately need them is still blocked by our current treatment law, the Mental Health Procedures Act of 1976, that still requires a level of dangerousness that no one should ever have to wait for, before they can receive treatment. I am now working with the Treatment Advocacy Center (TAC) to change our law, through the proposed Senate Bill 226.
Blame and pointing a finger at families who try desperately to get help for their loved ones and who often are involved in advocating for the changes needed will not resolve the issue of ensuring that someone with a mental illness receives the treatment they need. Enacting common-sense, timely assisted outpatient treatment (AOT) laws with adequate services and programs, as well as providing sufficient support in a hospital when needed, is what should happen.
As John Snook, Esq. from TAC stated about this tragedy in Virginia, "Unfortunately, the reports we've heard echo what families tell us far too often," Snook said. "Even when an individual has been ordered by a court to maintain their treatment, adequate supervision in the community simply isn't taking place."
I invite you to post your thoughts and comments on this issue. Do you think that the family was to blame? Should we be looking for changes to our mental health systems and laws?
Friday, October 26, 2007
Mentally Ill Offenders: Do They Belong in Prison?
Recently, my son Todd, who suffers with schizophrenia and remains unmedicated, was arrested for simple harassment. When he failed to appear for a hearing, a bench warrant was issued, and he was arrested. After spending 3 weeks in prison for something he didn’t quite understand, Todd finally had someone call me, and I posted bail. He was then scheduled for trial.
When my daughter told this to her therapist, the therapist’s response was that maybe Todd would be better off in prison because he might then get some type of treatment for his illness.
As of 2003, approximately one in six, and three times as many men as women, in United States prisons suffer with serious mental illnesses such as schizophrenia, bipolar disorder, and major depression. In fact, the rate of mental illness in the prison population is reported to be three times higher than in the general population. And for those who suffer serious mental illnesses, prison can be the worst of places. Often victimized, exploited, and sexually abused, mentally ill prisoners are not uncommonly punished by the prison staff for their symptoms such as being noisy, refusing orders, or even attempting suicide.
As for treatment, while prison mental health services have improved over the past two decades, the number of men and women entering prison has outrun the availability of services, and public officials have been unwilling to provide the funds necessary to ensure adequate treatment for those with mental illnesses. And so, prisons have become the new mental institutions. http://www.geocities.com/stargazers_here/mental_illness.html
Although Todd’s “offense” was shaking his finger in the face of a police officer, there are those with mental illnesses whose offenses may warrant some sort of incarnation. However, these individuals should at least be housed in facilities designed and funded to meet their mental health needs.
When all is said and done, the fact is that current psychiatric laws forbid us from committing our mentally ill loves ones into treatment unless there is “clear and present danger.” The flip side is that then the mentally ill are punished because they can’t function according to society’s rules and expectations. It’s a catch-22.
I disagree with my daughter’s therapist.
What do you think?
When my daughter told this to her therapist, the therapist’s response was that maybe Todd would be better off in prison because he might then get some type of treatment for his illness.
As of 2003, approximately one in six, and three times as many men as women, in United States prisons suffer with serious mental illnesses such as schizophrenia, bipolar disorder, and major depression. In fact, the rate of mental illness in the prison population is reported to be three times higher than in the general population. And for those who suffer serious mental illnesses, prison can be the worst of places. Often victimized, exploited, and sexually abused, mentally ill prisoners are not uncommonly punished by the prison staff for their symptoms such as being noisy, refusing orders, or even attempting suicide.
As for treatment, while prison mental health services have improved over the past two decades, the number of men and women entering prison has outrun the availability of services, and public officials have been unwilling to provide the funds necessary to ensure adequate treatment for those with mental illnesses. And so, prisons have become the new mental institutions. http://www.geocities.com/stargazers_here/mental_illness.html
Although Todd’s “offense” was shaking his finger in the face of a police officer, there are those with mental illnesses whose offenses may warrant some sort of incarnation. However, these individuals should at least be housed in facilities designed and funded to meet their mental health needs.
When all is said and done, the fact is that current psychiatric laws forbid us from committing our mentally ill loves ones into treatment unless there is “clear and present danger.” The flip side is that then the mentally ill are punished because they can’t function according to society’s rules and expectations. It’s a catch-22.
I disagree with my daughter’s therapist.
What do you think?
Monday, October 22, 2007
Why Assisted Outpatient Treatment (AOT)
I am a mother of two lovely, intelligent adult daughters, a full-time employee at a local community college, and an advocate for programs, services, and laws that would help individuals with a diagnosis of a severe mental illness and their families and friends who care about them. I have been a member of NAMI since 2000, a member of the LVF PACT Advisory Committee since 2002, and am currently the Co-Chair of the PA Treatment Law Advocacy Group. I am fortunate to have the support and advice of the Treatment Advocacy Center for our advocacy effort to change our treatment laws in Pennsylvania http://www.psychlaws.org/StateActivity/pennsylvania.htm.
I decided to start this blog in an effort to bring about an open discussion on assisted outpatient treatment (AOT) laws, such as the one I am advocating for in Pennsylvania, Senate Bill 226, which is modeled after New York’s Kendra’s Law. We hope to discuss why AOT laws are important for the small minority of people with a diagnosis of a severe mental illness who may also lack insight and stop treatments that have been prescribed. SB 226 would benefit those individuals with a mental illness who have a history of repeated hospitalizations or incarcerations and also their family and friends, who care about them and who often find themselves in the position of having to stand by helplessly, until a level of "clear and present danger to self or others" is reached, as required by our current law. It truly is a heartbreaking and frightening experience to watch a family member with an untreated mental illness as they wait to reach that precarious level of dangerousness, while hoping that nothing too serious or irreversible occurs.
You will also be seeing some posts on this site from a fellow advocate, Dorothy, such as one posted on October 21. Both Dorothy and I are two of the family members who testified at the public hearing on SB 226 on October 2, 2007 in Harrisburg http://senatorerickson.com/health/100207/agenda-100207.htm. Dorothy’s unique perspective and writing style will, I am certain, help to bring more clarity to the reasons behind why assisted outpatient treatment laws can help the small minority of people who would benefit from them.
I hope you will decide to join our conversation and post comments whenever you have an opinion on the topic that is posted. Or, please send us your ideas of topics that you would like to talk about.
A better understanding of the issues related to mental illness can only benefit all of us, whether it is the person with a mental illness, the friends and family members of that person, or society at large. I hope you will become a participant in helping to reach this better understanding.
I decided to start this blog in an effort to bring about an open discussion on assisted outpatient treatment (AOT) laws, such as the one I am advocating for in Pennsylvania, Senate Bill 226, which is modeled after New York’s Kendra’s Law. We hope to discuss why AOT laws are important for the small minority of people with a diagnosis of a severe mental illness who may also lack insight and stop treatments that have been prescribed. SB 226 would benefit those individuals with a mental illness who have a history of repeated hospitalizations or incarcerations and also their family and friends, who care about them and who often find themselves in the position of having to stand by helplessly, until a level of "clear and present danger to self or others" is reached, as required by our current law. It truly is a heartbreaking and frightening experience to watch a family member with an untreated mental illness as they wait to reach that precarious level of dangerousness, while hoping that nothing too serious or irreversible occurs.
You will also be seeing some posts on this site from a fellow advocate, Dorothy, such as one posted on October 21. Both Dorothy and I are two of the family members who testified at the public hearing on SB 226 on October 2, 2007 in Harrisburg http://senatorerickson.com/health/100207/agenda-100207.htm. Dorothy’s unique perspective and writing style will, I am certain, help to bring more clarity to the reasons behind why assisted outpatient treatment laws can help the small minority of people who would benefit from them.
I hope you will decide to join our conversation and post comments whenever you have an opinion on the topic that is posted. Or, please send us your ideas of topics that you would like to talk about.
A better understanding of the issues related to mental illness can only benefit all of us, whether it is the person with a mental illness, the friends and family members of that person, or society at large. I hope you will become a participant in helping to reach this better understanding.
Sunday, October 21, 2007
The Power of Prayer: Assisted Outpatient Treatment
“Ask and ye shall receive,” was one of many quotes from the Bible I heard from my mother as I was growing up.
That was a long time ago. Now, I am a mother, a medical writer at a pharmaceutical company, a NAMI member, and a recent advocate for not only those who suffer with mental illness but also for their families whose lives are often even darker than their mentally ill loved ones.
I have two adult daughters and an adult son. My son, Todd, suffers from schizophrenia, and every day I pray that something will happen to convince him to take his medication. But my prayers remain unanswered. What I ask for remains elusive. Although I often feel alone with my fears, anxieties, and heartbreak, I know I am not. I know there are others out there like me who go about their daily lives, or try to, under the cloud of loved ones who refuse medication because they lack the insight to know that they are ill. In many ways, we all walk together through this most turbulent of storms. And yet, we each walk alone.
I would like to change that.
On October 2, 2007, I traveled alone to Harrisburg, a sort of journey beyond my boundaries of comfort, to testify at the public hearing on SB 226. There, I met another advocate for assisted outpatient treatment (AOT), Jeanette Castello, who many of you already know. I was impressed with her dedication and fortitude to the issues surrounding mental illness even though her daughter is no longer in the danger zone of being untreated. Jeanette’s strength and passion and the feelings that we shared during our first conversations motivated me to move past my prayers to something more.
I’m not sure what “more” is yet. But I have many stories about my life as a mother of someone with severe mental illness to share with you. Some stories are probably strikingly similar to yours. Other of my stories may move past bizarre. Some stories reflect actions I’m not so proud of. Some feelings I wish I didn’t have.
Jeanette and I have the same intention—to invite you to share your views, experiences, and concerns, to listen, to be heard, to learn, all in an effort to foster a better understanding of the issues that surround mental illness, particularly the plight of family members and how AOT would help. If there is only one person in the world with mental illness who remains untreated, it’s not a minority; it’s one too many.
Having said all that, maybe, in some ways that I don’t quite understand yet and so, fail to be able to verbalize, our interchanges on Families for Timely Treatment Laws Blog will be the answer to my prayers, maybe your prayers as well.
That was a long time ago. Now, I am a mother, a medical writer at a pharmaceutical company, a NAMI member, and a recent advocate for not only those who suffer with mental illness but also for their families whose lives are often even darker than their mentally ill loved ones.
I have two adult daughters and an adult son. My son, Todd, suffers from schizophrenia, and every day I pray that something will happen to convince him to take his medication. But my prayers remain unanswered. What I ask for remains elusive. Although I often feel alone with my fears, anxieties, and heartbreak, I know I am not. I know there are others out there like me who go about their daily lives, or try to, under the cloud of loved ones who refuse medication because they lack the insight to know that they are ill. In many ways, we all walk together through this most turbulent of storms. And yet, we each walk alone.
I would like to change that.
On October 2, 2007, I traveled alone to Harrisburg, a sort of journey beyond my boundaries of comfort, to testify at the public hearing on SB 226. There, I met another advocate for assisted outpatient treatment (AOT), Jeanette Castello, who many of you already know. I was impressed with her dedication and fortitude to the issues surrounding mental illness even though her daughter is no longer in the danger zone of being untreated. Jeanette’s strength and passion and the feelings that we shared during our first conversations motivated me to move past my prayers to something more.
I’m not sure what “more” is yet. But I have many stories about my life as a mother of someone with severe mental illness to share with you. Some stories are probably strikingly similar to yours. Other of my stories may move past bizarre. Some stories reflect actions I’m not so proud of. Some feelings I wish I didn’t have.
Jeanette and I have the same intention—to invite you to share your views, experiences, and concerns, to listen, to be heard, to learn, all in an effort to foster a better understanding of the issues that surround mental illness, particularly the plight of family members and how AOT would help. If there is only one person in the world with mental illness who remains untreated, it’s not a minority; it’s one too many.
Having said all that, maybe, in some ways that I don’t quite understand yet and so, fail to be able to verbalize, our interchanges on Families for Timely Treatment Laws Blog will be the answer to my prayers, maybe your prayers as well.
Saturday, October 13, 2007
Welcome to a Family Perspective Blog on Mental Health Treatment Laws
Welcome to a blog on the issues that many families face when a member of their family has a severe mental illness, possibly lacks insight, and does not seek the treatment they may need.
I hope to use this blog as an opportunity for anyone who is interested in this topic to share information, express concerns, offer solutions, and hopefully educate others about the many issues involved when a family member suffers from a mental illness and does not receive timely treatment.
I hope to use this blog as an opportunity for anyone who is interested in this topic to share information, express concerns, offer solutions, and hopefully educate others about the many issues involved when a family member suffers from a mental illness and does not receive timely treatment.
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