Brian Stettin testified in pending legislation, Why the Stakes Are So High

From Treatment Advocacy Center:

Why the Stakes Are So High

(March 21, 2013) Among the critical contributions we make to mental illness policy reform is testifying in support of pending legislation that would make treatment possible for more individuals in psychiatric crisis.

The following excerpt from testimony delivered this week by Policy Director Brian Stettin relates to a bill pending in Maryland that would improve the inpatient commitment standard. The case he makes, however, is relevant to public policies that affect individuals and families living with untreated severe mental illness from coast to coast.

First and foremost, I would like to point out why the stakes are so high for the families here today and the thousands of Marylanders they represent.

These families are keenly aware of the enormous strides that medical science has made in recent decades to offer real hope of recovery to people with severe mental illness. The key, of course, is to get those individuals under medical treatment.

We know, for example, that people who are receiving treatment for a severe mental illness are no more likely to engage in violence than anyone else and that treatment is the key to maintaining strong bonds with friends and family, as well as to avoiding hospitals and jail. 

But securing that treatment for a family member in psychiatric crisis can be harrowingly difficult. A primary reason for that is anosognosia, a symptom of brain dysfunction which afflicts many – though by no means all – people with schizophrenia and severe bipolar disorder. A person with anosognosia is simply unable to recognize his own illness – no matter how painfully obvious it may be to everyone around him. The person is convinced to the core that he is perfectly fine. And so, quite naturally, he rejects all efforts to get him into treatment. 
 
That is what the families here today are grappling with – watching the people they love fall apart, truly unable to seek voluntary help or accept it when offered, because their diseases prevent them from seeing that anything is amiss. Which, I hasten to add, is not to say that they are perfectly happy in their current condition. On the contrary, many lead lives of daily torment, with no way to escape terrifying delusions.

And so at some point, we as a society must decide what we’re going to do: either leave the person to face the consequences of that “choice” to refuse treatment or to override that “choice,” as we might hope others would do for us if we were to come untethered from reality.

And this is where Maryland’s civil commitment law comes into the picture.
This is where every state’s civil commitment laws come into the picture. Advocates anywhere are encouraged to adapt the message for their own use in promoting treatment law reform and implementation.
To comment, visit our Facebook page.

http://www.treatmentadvocacycenter.org/about-us/our-blog/100-md/2272-parents-beg-maryland-laws-need-to-change

Kentucky Mom speaks out to make a difference!

When mentally ill kids become legal adults, getting them proper treatment shows gaps in system  

Written by: Chris Kenning

LEXINGTON, KY. — Joann Strunk’s “roller-coaster ride through hell” began nearly 10 years ago when her then 16-year-old daughter, Sarah, began hearing voices.

Sarah was diagnosed with schizophrenia, and her young life became marked by hallucinations, angry outbursts and depression. There were hospitalizations and several suicide attempts.
For Joann, a single mother, handling a severely mentally ill daughter while navigating a fragmented system of care with limited insurance was a constant struggle. But when Sarah became a legal adult and Joann was no longer in charge of her treatment, things got much tougher. 

Please take the time to read the entire article here. The closing statements by Joann's daughter, Sarah are profound. Her words resinate the pain of surviving a life with mental illness. http://www.courier-journal.com/article/20130317/NEWS01/107120005/-1/EXTRAS34/

"Please share a few words of wisdom and support, (in the comment section either here or on the Courier-Journal's website) for this brave Mother and her daughter, who have exposed their painful journey in hopes a better system of care will develop in Kentucky!"

GG Burns, Mental Health Advocate and Blogger

_________________________________________________________

Please email the Courier Journal and thank them for writing and sharing Sarah's and Joann's story at: Managing Editor, Jean Porter, (502)
582-4244,  jporter@courier-journal.com and"Chris Kenning" "Chris Kenning" ckenning@louisvil.gannett.com
 

Kentucky families struggle to care for violent, mentally ill children

Gun Violence and Mental Illness: Read more in our special report

 

Coping with mental illness

In the wake of the Connecticut school shootings, The Courier-Journal details the treatment problems facing families with children suffering from serious and sometimes violent mental problems.
• Today: A Western Kentucky couple wrestles with getting proper care for their violently mentally ill daughter.
• Monday: A Lexington mother struggles to get help for her adult daughter with schizophrenia.

Davies family deals with mentally ill child: Dan Davies and his wife Cynthia, of Marion, Ky., have sought access to mental health care for their violent child and have been frustrated by the difficult process.

Written by Laura Ungar The Courier-Journal

Reporter Laura Ungar can be reached at (502) 582-7190 or on Twitter @lauraungarcj.

Read the entire article here: http://www.courier-journal.com/article/20130317/NEWS01/303170035/Kentucky-families-struggle-to-care-for-violent-mentally-ill-children?odyssey=underbox|text|Home

Kentucky gets low marks for mental health spending

Written by Chris Kenning The Courier-Journal 

Kentucky’s budget for mental health services has remained stagnant in recent years, and the state ranks well below the national average in per capita mental health funding.

Only a fraction of mental health facilities offer residential treatment, the most comprehensive care for the severely ill. State Medicaid rates for mental health services haven’t been raised substantially in years. And some argue the overall system is disjointed and fragmented.

“Demand has grown and funding hasn’t met demand,” said Dr. Allen Brenzel, medical director of the state’s Department for Behavioral Health, Developmental and Intellectual Disabilities.

 "Officials at the Treatment Advocacy Center say the shootings show a need to expand court-ordered outpatient treatment programs, allow hospital commitments before a situation reaches the point of provable risk of violence, and increase beds."

Read more here: http://www.courier-journal.com/article/20130317/NEWS01/303170033/Kentucky-gets-low-marks-mental-health-spending

Neighboring state's challenges with mental health laws and mental health courts

This article was recently published in Tennessee, but it could easily be about one of hundreds of mentally ill inmates currently sitting in Kentucky's jails and prisons. Each day Kentucky state funds are used to wearhouse people that need medical attention, not time behind bars.

Joan Garrett, award winning journalist for the Chattanooga Times, reports one Tennessee family's frustrating experience of a sick son caught in the Revolving Door of Criminalization:

"In the cellblocks of the county jail, suspected murderers, drug traffickers, burglars, wife beaters and rapists wait for hearings and trials. Somewhere among them sits Dennis James' schizophrenic son.

 His crime? He's sick."

"Kyle's case is a textbook example of how thousands of mentally ill cycle through -- court and jail, court and jail, court and jail -- with no psychiatric improvement, raising questions about whether judges should be handing down sentences or treatments."

Read this powerful story here: Chattanooga Times: Hamilton County Jails Are Often Home for the Mentally Ill - Advocates Say They Have Better Idea

 __________________

Ind. scrambles to address ruling on mentally ill inmates

 

Ken Falk, left, legal director of the ACLU of Indiana, says at least 11 mentally ill inmates isolated in Indiana prisons have committed suicide, one of the reasons a federal judge ruled Monday that the state has violated prisoners' Eighth Amendment protections from cruel and unusual punishment.(Photo: Charlie Nye, The Indianapolis Star)

Tim Evans, USA TODAY10:34p.m. EST January 2, 2013

Indiana Department of Correction called "deliberately indifferent" to treatment problems.

Story Highlights

• Prisoners considered mentally ill are being confined to their cells 23 hours a day or more
• They're not getting enough access to mental health care
• The isolation and lack of treatment are causing worsening symptoms, even suicide

Read more here: http://www.usatoday.com/story/news/nation/2013/01/02/mental-illness-prisons/1804987/

Lawmakers Examine Violence and Mental-Illness

WASHINGTON, DC
Tuesday, March 5, 2013

Parents to Congress: Police no solution to mental illness!

As part of the ongoing review by lawmakers into mental health issues raised by the Newtown shooting, the House Energy and Commerce Committee talked with leading health experts to explore issues related to severe mental illness and violence.

The panelists discussed the treatment of mental illness and obstacles to seeking treatment for individual with the condition. They spoke about the most effective federal, state and local programs for prevention and early detection of severe mental illness in children and young adults.

The committee's hearing, titled "After Newtown: A National Conversation on Violence and Severe Mental Illness," included professional and personal perspectives from mental health advocates, physicians and members of victim's families.

View here: http://www.c-span.org/Events/Lawmakers-Examine-Violence-and-Mental-Illness/10737438534-1/

Opening Statement of the Honorable Tim Murphy: “The common factor in many mass tragedies is an underlying mental illness. The lessons for Americans from the horrifying tragedy in Connecticut is that we had better take off our blinders and deal with such illness or we are sure to face the same problem again. It is not only what’s in a person’s hands that it's what is in his mind."

What Families Want Congress to Know

Pete Earley, awarding winning author and and internationally known mental health advocate has asked families to to share input on "What Should I Tell Congress?"

by Pete Earley 

Read more here:

http://www.peteearley.com/2013/03/01/what-should-i-tell-congress/

I generally publish a blog from my files each Friday. However, I have been invited to participate in a forum entitled “After Newtown: A National Conversation on Violence and Severe Mental Illness” on March 5th, before an investigative subcommittee of the  U.S. House Committee on Energy and Commerce.

I mentioned in last Monday’s blog that Reps. Tim Murphy (R-Pa.) and Diana DeGette (D-Co.) are holding the forum and I’m thrilled to report that Pat and Debbie Milam also have been invited to give testimony. I wrote about the death of their son, Matthew,  in a blog entitled: A Father Grieves: No One Listened to Parents.

Along with my formal invitation came a list of potential questions that might be asked at the forum, which will begin at 10 a.m. in Room 2123 of the Rayburn House Office Building in Washington D.C. and is open to the public.  I don’t know if it will be covered by C-Span but hope it will.

Okay, now is your chance to sound off.  Here are the questions:

Below are my responses to Pete:

1. In what ways is mental illness more — or less — treatable than other serious medical conditions?
 

Mental illnesses are very treatable, but both education and resources for the individual and their family, should be an important requirement of a treatment plan — not just pills. Also, ruling out other deficits, diet deficiencies, hormonal imbalances, etc., should be required testing before a psychiatric diagnoses is determined. Historically, few tests are required before a person is diagnosed.

Additionally, not all mental illnesses are the same. An individual who has become depressed or anxious, after experiencing a traumatic event may not require the same multidisciplinary outpatient supports, as an individual who is acutely psychotic, has lost touch with reality and believes aliens are about to kill them or their family members.

Hospitals must recognize that a discharge plan should be more than an appointment to see an outpatient provider every 3 months and a prescription for pills! Just as in heart disease — diet, exercise, lifestyle changes are needed to recover, so should be solutions for an individuals with severe and persistent mental illness, SPMI. In other words, individuals with a history of SPMI, who are too sick to recognize they are sick, shouldn't be categorized the same.

2. What are the greatest obstacles to seeking treatment for individuals suffering from mental illness and their families?

HIPPA, lack of assisted outpatient treatment, (AOT) laws and a mental health system that was never designed to work! The current system is beyond broken. Families should not be forced to turn to the DOJ and criminalize their young sons/daughters in order to obtain a band aide — which might be no more than 2 weeks of inpatient care or worse, a judge's order to seek treatment for an illness they may not realize they have — through probation. "Would we force a patient with cancer or Alzheimer's into jail first, attempting to teach them to not have their illness? This approach is essentially what families face across the US"!  It should be illegal for a families and providers to turn our backs, due to civil liberties — forcing the sickest to become homeless.

3. Among individuals with untreated and severe mental illness, when, if at all, is violence — directed at the self or others — most likely?

When resources and supports aren't available. Violence occurs when individuals with 'untreated' SPMI become desperate due to hunger, lack of basic needs or inability to be successful in the community. When their ability to think logically becomes impaired, violence can be triggered quickly and can be unpredictable. Additionally, individuals with untreated SPMI may seek revenge to hurt a family member, who isn't able to help their loved one carry out their delusions or other psychotic beliefs. Some family members become 'trapped in their fears' — if they attempt to have their loved one involuntary hospitalized, they will become victimized or hurt themselves, if their loved one isn't held long enough to stabilize. Which is often the case. Legal statues for inpatient commitment laws can force family members into horrific situations and can lead to deadly consequences. Treatment Advocacy Center has a preventable tragedy data base for these families — this alone should speak volumes. Why hasn't congress listened before now?

4. What is the record of federal state, and local programs geared towards improving health outcomes among individuals with severe mental illness?

Preventive programs for 'children at risk', have produced positive outcomes in our state, (Kentucky). However, the track record for adult programs for individuals with SPMI are underfunded, ineffective or misused — in comparisons to programs designed for individuals with developmental/intellectual disabilities. Those who recognize they are ill and are able to request assistance, become an active participant in their own recovery and can utilized programs easier. However, advocates for freedom and choice, too often leave out the other 40% who lack insight to their illness.

Sometimes funds from federal grants become tied up administrative or marketing cost for awareness campaigns, etc., than actually assisting individuals and their families who have the most severe cases. It seems grants actually create conflict among advocacy groups, instead of encouraging groups to work collectively. Additionally, navigating state or federal programs — can be a draining and full time job for a caregiver, which result in health problems, lost income or jobs. This creates hardships on the entire family, resulting in additional drains on the welfare or social security system.

5. What are the most effective federal, state, and local programs for prevention and early detection of severe mental illness in children and young adults?  

Programs that provide wrap-around services for the entire family. Programing shouldn't stop for the family, after their children with SPMI aged out of the system at 18! Adequate transitioning is needed between the youth and adult systems. HIPPA Laws have become a huge barrier for families attempting to help their young adults who have SPMI.

6. How can federal programs be improved to reduce barriers to access and improve outcomes for individuals with severe mental illness?

A federal mandated Assisted Outpatient Treatment, (AOT) law should require individuals who are too sick to know they need help, (anosognosia) and often end up in the revolving door of homelessness and frequent incarcerations. Families should be considered part of the solution of the over all treatment plan for both inpatient and outpatient programing. Frequently, family members are left to pick up the pieces and support our very ill family member, yet are rarely considered in developing the treatment plan. HIPPA is to blame in most cases.