Newport Police and Aaron Alexis- Lost Opportunity?

No one has yet asked Newport police why they did not take Aaron Alexis to the hospital yet thought the incident merited informing the Navy police regarding his behavior.

NAMI Meeting in Newport

NAMI-Rhode Island has an affiliate called NAMI-Newport County, which is primarily for friends and family members whose loved ones are living with serious mental illness; such as, schizophrenia, manic depressive/bipolar disorder, depression, obsessive-compulsive disorder, and panic disorder. This group does not focus on one particular mental illness. We serve families in the Newport County area.

We meet once a month, on the second Tuesday of each month from 7:00-8:30 at the Newport Public Library.

It is an opportunity to talk about our loved ones, difficulties that you or the loved one may be facing, challenges of day-to-day life, and meet family members who have similar concerns. We offer support rather than therapy and talk about any subjects members care to discuss.

Call or e-mail Eileen Spillane for more info at 846-8523 or spookys6@aol.com.

The Stigma of Schizophrenia

Schizophrenia. Just the name sends shivers. This is the story of an artist & her brother in his last year of college undergoing this diagnosis. "For the next two years, Josh's family struggled to secure the best treatment and help him accept his illness. Levine says the inability to recognize one's illness, or 'a lack of insight,' has recently been recognized as a symptom of schizophrenia instead of a patient's denial."

"Last month, Osterhout teamed up with National Alliance on Mental Illness — New York State (NAMI-NYS) to unveil the educational art exhibit 'Gaining Insight: An Examination of the Relationship Between Schizophrenia and Stigma.'"

Click here for her family's story and here for her artwork & a presentation.

For those interested, there is a NAMI Family Group that meets in Newport every second Tuesday of the month from 7-8:30 PM in Newport Library. Contact me if you want more info. I'll do a posting on it later.

Mental Illness, Meds, and Rep. Kennedy

**UPDATE** Kennedy's House bill passed. Now comes the hard part, getting another bill passed in the Senate (see Projo).

“If you have diabetes, no one holds it against you,” Kennedy said during the three-hour debate yesterday afternoon. But Kennedy said the mentally ill are still too often stigmatized, in part by insurance rules that often impose higher fees or tighter treatment limits on mental-health patients than on those suffering from physical maladies.
“It’s your fault if you wander around in the streets and you’re homeless” because of addiction or mental disease, declared Kennedy, who has framed the mental-health parity debate as a question of civil rights.

Original post:

Rep. Kennedy (our District Federal Rep) has been working in Congress for health parity for those suffering from mental illness and mental health issues. There are currently two bill versions in the House & Senate. His Dad, Sen. Kennedy, is working on the Senate side. The Senate bill is somewhat more restrictive.

"...they [both bills] require that insurers who offer any treatment for mental illness must use the same basic rules that they apply to the treatment of cancer or broken bones or other physical ailments. For example, a managed health-care company cannot impose a higher copayment for a session with a clinical psychologist than it charges the same patient for a visit to the internist." ( Projo)

The House debate and vote on the Kennedy-Ramstad bill is scheduled for Wednesday. I hope the staff keep me updated. Rep. Kennedy suffers from bi-polar, a truly debilitating condition that is incurable but can be treated. The meds can be hard, though, & often have debilitating side effects. Mental illness is often accompanied by drug/alcohol addictions (self-medicating).

When speaking to him last week he also pointed me to an N.Y. Times article in regards to the mother of all mental illnesses- schizophrenia. Schizophrenia, a most cruel illness striking young people just entering adulthood, cannot be cured. Over two million Americans have it with twenty-four million worldwide. Symptoms, though, are often be controlled with drugs making for a very profitable industry (billions). Although it would be nice if the National Institute of Health would fund more projects to actually comes up with a cure or even an explanation for this illness and others. Presently, we're not even sure how the current meds (all based on lowering dopamine- a brain receptor) work.

One new drug on the horizon promises safer & more effective treatment. It's LY2140023 & currently in the testing stage. Rather than decreasing dopamine, it's focus is on reducing glutamate, a different neurotransmitter in the brain. Glutamate ties together the brain’s most complex circuits. Even if this med eventually fails, it opens up a whole new treatment area not focusing solely on dopamine.

"...it was slightly less effective overall than Lilly’s schizophrenia blockbuster Zyprexa, but also appeared to have fewer side effects — an important finding, since Zyprexa can cause severe weight gain and diabetes. More testing is needed and FDA approval is at least three or four years away."

The actual study is published in the scientific journal Nature Medicine.

"People say that there are drugs to treat schizophrenia,” says Dr. Carol A. Tamminga, professor of psychiatry at the University of Texas Southwestern, in Dallas. “In fact, the treatment for schizophrenia is at best partial and inadequate. You have a cadre of cognitively impaired people who can’t fit in." (Times citation)

While newer antipsychotic drugs have been developed, the older generics are still frequently prescribed because they are cheaper & often effective: e.g. haloperidol or Haldol. However, long-term use often results in facial tics & involuntary hand movements (hand rolling). The newer ones (atypicals) help treat other symptoms of schizophrenia; e.g. withdrawal, lack of energy and motivation, and the inability to experience pleasure, more effectively. But these drugs may also can have serious side effects (weight gain, tics, heart problems, diabetes, etc.). There have been no new drugs on the market since Zyprexa in 1996 with 2005 sales of over 4 billion dollars. The overall cost of schizophrenia to the USA in 2002 was estimated to be $62.7 billion, with $22.7 billion excess direct healthcare expenses- read this as to why you should care.

"Another glutamate drug, meanwhile, has been shown in preclinical studies to reverse mental retardation in adult rats, a finding that previously appeared
impossible, Dr. Insel said. "(Times citation)

Wow! Remarkable possibilities. These new drugs also hold promise for those suffering from Parkinson's Disease.

I heart Rep. Kennedy.

Mental Illness- Seeking Help! Pt. 2

Everyone once in awhile we receive a slap alongside the head to remind us that not treating mental illness can result in serious tragedies to many. While most are still focused on the availability of guns to those having mental illness, I have yet to hear anyone speculate on how one guarantees anyone's sanity even AFTER a legal gun purchase.

Only Clinton, Obama, & Edwards bothered to respond to a mental health candidate surveysby NAMI. McCain gave a policy statement & along with Romney stated that he doesn't respond to surveys. Well, excu-u-u-u-se me!

McCain stresses individual responsibility in his statement (think ownership society meaning it's YOUR problem) along with physical fitness & healthy lifestyles. Duh! New cure. At least he bothered to respond.

Author Danielle Steel's son suffered from bi-polar & comitted suicide. While she had long suspected a problem, he wasn't diagnosed until he had seen many doctors at age 16. He then killed himself at age 19. "... what you have to be [parents] is extremely loving, extremely resourceful and extremely persistent and every time you're defeated, just go at the problem again," Steel told Reuters in a rare interview.

Hospitalizing a mentally ill person who does not want to be, or even does, may often take some creativity. Firstly, know that police will NOT take them to a hospital for treatment unless the person is in" imminent danger." They must have injured themself or threatened suicide/homicide. That's it. They do NOT have to do this in front of the police. However, remember it must all be done in a relatively short timespan. Don't call & report what happened yesterday.

If you take them to a hospital the above applies OR they must sign an admission slip. You may ask for some private time for this document signature which will not be verified. Another suggestion is to offer the individual affected $ to comply. Butler Hospital is best if you have a choice.

If another person has been injured (no weapon), then it's off to the stationhouse & jail. No mental health assistance there, although they may be encouraged to take their meds (if they have them & are willing). You then will have the double problem of not only illness, but legal woes. But this may also result in incentive to get treatment & take meds. Generally this will be a misdemeanor charge. Sometimes there is no alternative.

If there is a weapon involved it will result in a felony. Either way- try to stay calm, don't threaten, be prepared beforehand & have a plan. Don't block their access & make sure you have one or a safe room with a phone & a lock. Dial 911. If they are off their meds, let that be known.

There will be jail time locally until the charged person is take before a judge. Find out when this is & be there. What you're opting for is a minimum of jail with the ultimate goal of treatment with compliance. Bail or personal recognizance release will likely be offered at this hearing in front of a judge. The charged must plead- "Not guilty" should be initially offered.

Work with the Prosecutor (from your town), & the Public Defender (free). Try to come up with a plan for release. Seek help for this. The person charged cannot return to the home of anyone they injured. The charged person will have to return for another hearing. If they don't comply, they will be back before the judge & any bail offered may be revoked/changed. Back to jail with another hearing set (usually 2 wks).

If they are admitted to a hospital & you are not a "guardian," it is difficult to get any information from anyone. Be aggressive & persisitent & creative, like the lady said. Don't let them release too early or threaten lawsuit for any resulting problems. Make sure there is an aggressive post-treatment plan in place. Try contacting NAMI or your local mental health care center (Newport County Mental Health) for advice at anytime. Otherwise, zilch will be offered/done. Write everything down & let everyone see that you are doing this.

Guardianship requires a lawyer & money & time. You also need a Dr. to fill out a 5 page form. A psychlogist will NOT due. You will need to pay for this ($550). The rest of the guardianship fees may be up to $5000. As part of this you the Court will appoint another lawyer to represent the individual's best interests. This is a charge. The reason you may want to do this is to legally gain some control over a non-complaint person. It is the same process with the same rights as filing for an aging parent. Simple it is NOT. But ultimately often necessary

"When people aren't medicated it can be lethal," she said, adding that she hadn't realized that when dealing with her own son. "I thought it could ruin his life. I really didn't understand how high the possibility was that it could cost him his life." Steel ... believes the laws need to be changed to allow mentally ill people to be hospitalized against their will.
"Usually bipolars present extremely well and they can bounce into court ... look very together and be a complete mess three hours later on the streets somewhere," she said. "There's nothing you can do."

"[tragedies such as those of Britney Spears] illustrate the drama and dilemma of the family of mentally ill people in this country -- it's a very, very tough thing."She said all this while speaking at the foundation she founded in her son's memory- the Nick Traina Foundation. Suicide is the second leading cause of death of young people under the age of 25.

Amen, sister.

People with untreated mental illness can be dangerous. They need to be treated whether they recognize their illness or not. Many are incapable of recognizing that they are indeed ill due to the nature of their sickness which effects this part of the brain. It's a Catch-22. If you knew you were sick you would get help. But you don't know that you are sick. Indeed, you may never acknowledge this fact. Why? Because the brain isn't working as it should.

Medical compliance is the most significant determiner of sucess in combating mental illness. It's also the biggest problem. No compliance= return of debilitating symtoms= hospital (if lucky) or jail. It's that simple.

Sufferers of mental illness need a psychiatrist first. Ask your physician or others for a recommendation. You can also go through your mental health center, but there will be a long list & appointments won't be soon. You first will have to go through an intake counsellor- another appointment, before you can get a team assessment. This is not a quick process. Medical insurance is a real plus.

The Presidental candidates have all commented on the newest college incident regarding gun laws. Not one has mentioned the possibility of an underlying cause- mental illness care (or non-care). The shooter, a young man, was no stranger to meds, treatment, etc. College-age students are at prime risk for a number of serious mental illnesses as stress is often a precipitating factor. Since many are not at home with family when this occurs, colleges need to be offering more services. So what are they doing about it? Not enough and their concentration is often depression. But then neither are we as a broader society bringing much to the dialog.

Next part- solutions.

Mental Illness in R.I., Pt. 1

It's not mental health that I'm writing of, or of the "worried well." It's mental illness. Brains that are disordered and do not work as they should. You may be familar with the names of some of them: "major depression, schizophrenia, bipolar disorder, obsessive compulsive disorder (OCD), panic disorder, post traumatic stress disorder (PTSD), and borderline personality disorder."

"Mental illnesses are medical conditions that disrupt a person’s thinking, feeling, mood, ability to relate to others, and daily functioning." These illnesses are rarely as easily spotted or even diagnosed as a broken leg or diabetes. They are understood even less with often little sympathy, much less empathy, for those who look relatively normal & should just be able to take care of it. The trouble is that they often can't or have good reasons not to.

Mental illness has been on my family's mind a lot lately- up close & personal. We've had to deal with a close family member who was struck all too cruely with schizophrenia, the cruelest of all mental illnesses. It robs those just entering the blossoming of adulthood with a lifelong, usually debilitating, disease.

Mental illnesses are not yet curable, but are treatable with varying degrees of sucess. The treatments are rarely simple though, and come with their own consequences to be dealt with. We've all heard about it in the news lately- the young man in Cranston who was shot by police when his mother called them believing that she was ultimately "helping" her son. The college students who have comitted mass murders while off their meds or going without needed treatments. We' even seen them- in Washington Square, wandering/living on the streets of Prov. We may even known some of them or heard about them through friends or relatives.

Beyond sad. But why does this happen? Whose fault is it? What can we do about it? Why should we even care?

"Federal costs for the care of seriously mentally ill individuals now total $41 billion yearly and are rocketing upward at a rate of $2.6 billion a year.""Schizophrenia, long considered the most chronic, debilitating and costly mental illness, now consumes a total of about $63 billion a year for direct treatment, societal and family costs." Care now?

So we're doing a lot of research into improving treatment & possible cures, right? Think again. In 2002 the Institute of Mental Health (federal) spent less than 12% of its budget on the most serious illness- schizophrenia. Yet its budget between 1988 & 2002 quadrupled to over $1.3 billion- thank you Sen. Domenici (R) & former Sen. Wellstone (D).

Putting aside funding, states make it easy for mentally ill individuals to get help, right? Au contraire, mon ami. And I can testify on this from firsthand knowledge. This statement says it all:

The "freedom" to be penniless, helpless, ill, and finally arrested, jail and criminally committed is not freedom at all- it's abandonment. The "right" to be demented, agonized and terrorized in the face of treatment which cannot, because of legal Prohibition, be applied is no right at all- it's a new form of imprisonment." (Dr. Darold Treffert).

This is a system which places roadblocks at every road. "You can't get there from here" should be the motto. Privacy and protection for the individual, at any cost, finally sacrifices the mentally ill individual to the to a functionaly non-functional system. Lawyers, providers, courts and police all have sympathy. But the reality is that we have turned out backs to the mentally and thrown them to judicial corrections system which is ill-prepared for them. Hospitals, doctors, community health centers have all failed. A system which promises housing, jobs, training, support, money, medical care, etc. to many of our most vulnerable, is a national shame and disgrace.

I don't think that I could phrase it any more succinctly than this mourning mother, "Betty Swift said when her 30-year-old son had emotional problems a few months ago in Massachusetts, she called the police for help. They took him to Massachusetts General Hospital without incident.
“I thought he could get the same help here [as he had in Mass. when police took her son to a hospital],” she said yesterday in a telephone interview. “But I was wrong.” Indeed, the Cranston police shot him.

My next article will focus on trying to get the mentally ill services when they deny it's needed- good luck!