Read Insanity Offense...for a better understanding

I finished reading E. Fuller Torrey's The Insanity Offense this weekend and would highly recommend it to anyone who wants to understand the history of deinstitutionalization and the effect it has had on people with severe mental illnesses and the families and friends who love them.

Dr. Torrey gives examples of actual cases of individuals whose untreated mental illness led to devastating consequences from three states in our country, although any state could have been chosen. Sadly, the good intentions of closing down our state hospitals and providing treatment in the community wasn't followed through with intensive services and supports as originally planned and so many have suffered the consequences.

We have a current example from our own state of can happen when a hospital that provided intensive support closes as described in the article from The Pittsburgh Tribune-Review, State probes ex-Mayview patients deaths, arrests on June 22, 2008.

Living in the community when you have been accustomed to having the type of intensive support that a hospital provides requires very similar intensive support, such as an ACT (assertive community treatment) program can provide, if the person is willing to remain in treatment and continue prescribed medications. Members of the team can visit a client several times a day when they first are discharged and can continue visits as often as needed. ACT also provides 24-hour crisis intervention.

However, it is voluntary, and without an effective AOT (assisted outpatient treatment) law for someone who lacks the insight that prescribed medications may be necessary, a discharge from a hospital can turn in to a revolving door of crisis situations and repeated hospitalizations, or worse, incarcerations or victimization.

Before any more state hospitals close, hopefully very careful considerations will be given to how many hospital beds are required to provide intensive services for individuals who need that level of support as well as what type of living accommodations and services need to be provided.

Also, read Dr. Torrey's book for his suggestions on what we need to do now that deinstituionalization has changed the way those with severe mental illness receive treatment. There's still hope, but we need to make those changes soon, for the sake of everyone.