"Did Nancy Lanza live in fear? Why many mothers of the mentally ill do."

Republished with permission from the author: Asra Q. Nomani from December 21, 2012 -- Washington Post  http://articles.washingtonpost.com/2012-12-21/opinions/36017164_1_mental-illness-mothers-public-psychiatric-beds

When the doorbell rang one night in 2006, I opened my front door to find a diminutive figure standing before me, her face crestfallen.

“Mom, what happened?” I asked.

“I thought I was going to die,” she whispered, my father gently guiding her inside.

(Edel Rodriguez for The Washington Post/)

My brother, then 43, had suddenly spun into a rage, she said. She rushed to her bedroom and locked the door; my brother broke it from its hinges, chasing her. She curled into a fetal position on her bed as he pummeled her back and head before walking away as quickly as he had sprung on her.

“Why did you let this happen?” I asked. But I knew the answer. My mother, like countless other mothers on the front lines of America’s mental health battle, is in a risky position. She cares for a mentally ill child.

We don’t know whether Nancy Lanza ever thought her son Adam might hurt her — news reports say he had Asperger’s syndrome and a personality disorder and wasn’t known to be violent. But she’s part of an alarming number of parents who’ve been killed by their children.

Parricides, or the killing of parents, were 13 percent of U.S. family homicides in 2008, up from 9.7 percent in 1980, according to the FBI. About half of parricides involve children killing their mothers. The typical offenders, according to researchers, are adult sons who are ill and unemployed. Nearly half of them are 24 or younger, an age when, scientists say, the cognitive mind is still maturing; Adam Lanza was 20.

But what goes largely undocumented is the many mothers who live in fear of their children.

Kathleen Heide, a professor of criminology at the University of South Florida and the author of “Understanding Parricide: When Sons and Daughters Kill Parents,” says that most often, when people kill their mothers, they are sick and untreated.

As mental health services are cut, mothers become the agents-in-charge, serving as constant reminders to these children that they’re not well. “The moms are trying to keep their children safe. In illness, the sons many times resent their mothers,” Heide says, and that becomes particularly acute without treatment.

Even in popular culture, matricide is a theme for troubled youth. Rap star Eminem wrote a song, “Kill You,” lashing out at his mother for the dysfunction in his life that he attributed to her.

Too often, mothers search desperately for beds for their sick children, fighting with insurance companies and treatment teams. According to the nonprofit Treatment Advocacy Center, by 2010 the number of public psychiatric beds in the United States had dropped to levels last seen in the 1850s — about 14 per 100,000 people. Since 1955, the peak of psychiatric hospitalization, 95 percent of the nation’s public hospital beds for people with acute and chronic severe mental illness have been eliminated.

From Tucson to Aurora, Colo., young men suffering from mental illness have taken the lives of others.

“Those who kill are untreated most of the time. It’s not about access to weapons. . . . It’s about treatment,” says Dominique Bourget, a forensic psychiatrist at the University of Ottawa who has studied parricide. With the killing of mothers, she says, those who are sick often strike out at “the people most loving to them.”

Our failure to provide sufficient mental health support was highlighted further when Liza Long’s blog post — “I Am Adam Lanza’s Mother,” about the difficulty in caring for a mentally ill son — went viral this past week. She struck a nerve with other mothers desperately struggling in their homes with ill, untreated children. Last year, a mother who chronicles her battle to find treatment for her son wrote on her Web site, “Saving Zach”: “Living in fear became the norm in my house.”

Sometimes mothers send SOS messages to each other by e-mail, too afraid that their sons might overhear a phone conversation seeking help. In my parents’ home, my mother hid her cooking knives when my brother was very ill.

In April 2006, just before my battered mother stood at my doorstep, Amy Bruce, of the small town of Caratunk, Maine, was struggling to get her son, Will, then 24, treatment for paranoid schizophrenia. He had been discharged from a facility despite his parents’ protests.

One day two months later, after getting the mail, he walked up behind his mother and killed her with a hatchet. He is now in a forensics unit at a local hospital.

“I heard the pope telling me to kill her because she was an al-Qaeda operative,” Will told me by phone this week. He seems lucid and clear-thinking now and is receiving treatment.

He says he misses his mother. “I try to do everything to honor her memory. We had our differences, but it was petty. I miss hugging her. She used to hug me all the time.” But, he admits, “she was a little afraid of me.”

Ironically, it was only after killing his mother that Will got the right treatment.

Read more about mental health treatment laws and Asra's journey here: http://www.washingtonpost.com/wp-dyn/content/article/2007/04/27/AR2007042702 053.html

Action Plan -- What can YOU do!

President Obama said the federal government has to do something meaningful to prevent future shootings, like the recent massacre of 26 children and adults at a school in Newtown, Connecticut.  Here is what the federal government can do to prevent violence related to mental illness:
 

Five-Point Action Plan for President Obama to Reduce Violence by the Mentally Ill

Here is what states should do.

States should make greater use of Assisted Outpatient Treatment, especially for

those with a history of violence or incarceration. AOT allows courts to order certain mentally ill people to stay in treatment as a condition of living in the community. AOT works. New Yorkers remember Larry Hogue, the “Wild Man of 96th Street,” who kept getting hospitalized, going off meds, terrorizing neighbors, and going back into the hospital.  Connecticut does NOT have an AOT law on the books (see these facts about the Connecticut mental-health system), and we can’t say for sure if it would have helped in this case, but all states should have one to prevent similar incidents.

• 
States should make sure their civil-commitment laws include all the following, not just “danger to self or others:  (A) Is “gravely disabled”, which means that the person is substantially unable, except for reasons of indigence, to provide for any of his or her basic needs, such as food, clothing, shelter, health or safety, or (B) is likely to “substantially deteriorate” if not provided with timely treatment, or 
(C) lacks capacity, which means that as a result of the brain disorder, the person is unable to fully understand or lacks judgment to make an informed decision regarding his or her need for treatment, care, or supervision.


• When the “dangerousness standard” is used, it must be interpreted more broadly than “imminently” and/or “provably” dangerous.


State laws should also allow for consideration of a patient’s record in making determinations about court-ordered treatment, since history is often a reliable way to anticipate the future course of illness. (Currently, it is like criminal procedures: what you did in the past presumably has no bearing, so the court may not know past history when deciding whether to commit someone.  In fact, there are ways to know which mentally ill individuals become or are likely to become violent.) 

– D. J. Jaffe is executive director of Mental Illness Policy Org.

DJ Jaffe is the founder of Mental Illness Policy Org http://mentalillnesspolicy.org which provides the media and public officials with unbiased information about "serious" mental illness from a pro-treatment perspective. It covers issues of violence, deinstitutionalization, not guilty by reason of insanity, assisted outpatient treatment, involuntary commitment, involuntary treatment and other issues.

DJ has been advocating for better treatment for individuals with serious mental illness for over 30 years.

DJ has served multiple terms on the board of directors of the Metro-New York City Alliance on Mental Illness, New York State Alliance for the Mentally Ill, and National Alliance on Mental Illness. He is a member of the Leadership Council of the National Alliance for Research on Schizophrenia and Depression. He was a cofounder and former board member of the Treatment Advocacy Center in Arlington, VA.
 

Why can't America care for the mentally ill?

Dr. Keith Ablow is a psychiatrist and member of the Fox News Medical A-Team. Dr. Ablow can be reached at info@keithablow.com
 

Read more: http://www.foxnews.com/opinion/2012/12/17/why-cant-america-care-for-mentally-ill/#ixzz2FN5gt9au

Suggestion #8

In most states there is no way to arrange court-ordered, involuntary outpatient use of medications (including antipsychotic medications) even if someone is very violent or has reported extremely violent thoughts in the hospital, even if that person is psychotic and also addicted to cocaine or heroin, and even if that person is court-ordered to take such antipsychotic medications in the hospital.

Once that person hits the streets he or she is too often free to never visit a psychiatrist, again, to never take another medication and to never be drug-tested.

My response to: 'I Am Adam Lanza's Mother'

painting: the mental health nightmare

Once again, the news of a nightmarish killing spree had descended over our nation! Yet again by a disturbed young person, (barely a man) who is no doubt been surviving some form of mental illness.

Since early Friday, I have received dozens of text messages and emails from relatives, friends and acquaintances around the US, who are aware of our personal challenges to help my son or from those who support our efforts to amend Kentucky's Outpatient Treatment laws. 

One such response to the tragic deaths in Sandy Hook, is an article written by a Mother and Blogger named Liza Long. Liza published an entry on her daily blog titled: 'I Am Adam Lanza's Mother'.  Within a few hours, her story was republished on the Huffington Post as:

'I Am Adam Lanza's Mother': A Mom's Perspective On The Mental Illness Conversation In America

Within hours, it had been re-tweeted or republished over 810,000 times. On Liza's blog, the The Anarchist Soccer Mom, over 2000 people have left comments.

This is my response about this tragedy, to the victim's families and to Kentuckians:


I TOO COULD BE ADAM LANZA's MOTHER. 
(Except I would have never had guns in my home.)

Our son, who has suffered his entire life with an mental illness, has been bullied and tormented by people in his schools, our neighborhood and yes at Church. I am certain these horrific scars have impacted him. I am fearful of my son's threats and abuse toward me, but can only learn how to protect myself from him since the adult system gives me few options otherwise. 

Just recently when I attempted to communicate with my son regarding how concerned I was of his increasing mania, he replied, "I'll blow your f___ing brains out if you send me to the hospital again. The second I get out I'll murder you!" Yet a few hours later, my son never remembers he said such horrible things.

The process families must endure to obtain an emergency 72-hour hold is unthinkable. People with acute psychosis are literally arrested by law enforcement officers, transported to a state hospital, (or most times jail) in handcuffs and more times than not are released within a few hours. Why? Because by the time they are finally evaluated by a mental health professional -- they no longer present as a threat to self or others. The entire process is inhumane and goes without reason why those individuals living with a mental illness, who are in recovery -- strongly oppose involuntary treatment laws.

At one time or another, our son has received all of the labels the media has discussed regarding the CT tragedy. By the time our son was 10 years of age, he had been evaluated, diagnosed and treated by psychiatrist, psychologist, neurologists, nutritionist, allergist and behaviorist ... for sleep disorder, ADHD, sensory integration, Tourette syndrome, obsessive compulsive disorder, bipolar disorder, psychotic disorder, frontal lobe and executive function deficit.

With much effort, special accommodations, supports and services where available for our son in the school system. In addition, my husband and I traveled as far away as Cincinnati, Ohio seeking help from experts. Before mental health parity, we paid 100% of our son's medical bills. Insurance companies discriminated against us also, blaming our son's symptoms on bad parenting and his free will to be different and to have challenges I suppose.



Time and time again, we were ridiculed by family members and our peers for giving medications to our explosive and often out of control child! Once, after our son's doctor admitted him to a local psychiatric hospital, we were later investigated by Kentucky Cabinet for Health and Family Services, CHFS for the possibility that perhaps we were abusing our son. Even our own parents suggested our son's behaviors were our fault. Amazing, parent's aren't blamed if their children develop cancer, yet with mental illness everyone blames others.

As difficult and challenging as it was for all, our son did succeed. Labeled as a gifted genius, he was doing well and even attended college and worked at a skilled job in the community, while still in high school. He was able to achieve this success due to medicine, therapy, case management and a counselor from the Office of Vocational Rehabilitation.



At age 17, in an attempt to escape the stigma of his mental illness, our son refused treatment! It was not long before he quickly became aggressively psychotic.
 
My husband and I filed an out-of-control petition in the court system, just 6 months prior to our son’s 18th birthday -- hoping to save his life and us from his reckless and often dangerous behavior. But instead of going to a hospital or treatment facility, he was ordered to jail, punished for behaviors that were symptoms of his untreated brain disorder!
 


Months turned into years. He was homeless, desperate for food and still refused to accept treatment. When he was petitioned to a hospital, he was not held long enough to stabilize. Now, our son frequently threatens homicide or suicide which makes our life -- and his -- a living hell. He is trapped in a carousel of insanity and without long term treatment will never escape.

As our son aged into the adult system, a well meaning 

therapist who I dearly respected told me, "I must learn to let go". She suggested I buy the the book titled: 'The Sociopath Next Door', attend Al Anon classes and learn how to disconnect my love. She said, "you will not be able to help your son". She did not want to see me self destruct. At the time, I was riddled with serious autoimmune diseases due to the chronic caregiver stress. It has taken years of effort and training to become healthy enough to advocate for my son's life and others.

The very resources and laws in place to support my son as a child  --  are not available for him as an adult! Why? Because of his civil rights, our federal and state mental health laws and the fact that state funds had been redirected from the department of behavioral health to the criminal justice system. It is absurd! 

If a young person lacks insight to their illness (anosognosia), regardless as to how complex their symptoms are -- parents and 'ultimately the community' can do nothing until they fail or 'explode' and become part of the criminal justice system, commit suicide or homicide as Adam Lanza did!

Regarding the comments from readers on Liza's story, who believe GOD is the answer and 'if' we just prayed more our troubled children would be rid of their demons -- for years, church members turned their backs and avoided us! On more than one occasion, church leaders condemned us for our son's impulsive and disruptive behaviors and made it clear they didn't want our son in the same Sunday school classes or private Christian Schools, with their own children!

Children or young adults are not born with evil in their hearts. But they are born with brains that malfunction!  It is society's reactions to these troubled children's symptoms that create monsters.

 Mothers told their children that our son was bad and they could not play with him! Imagine the pain children with special needs like my son must endure? They may look normal, but their brain dysfunction -- regardless of the label, does not allow them to act normal.

Yet in spite of it all, our son did graduate due to the compassion, special accommodations and supports of a few key people. In the adult system, there are few special accommodations for those who act differently -- they quickly become outcast. And then we wonder, what could make a young man snap and kill children or worse  -- his own Mother?


Bless all the Mothers like Liza Long.



Bless all of those victims families suffering across the US.



And, yes God, Bless Adam and Nancy Lanza's soul -- because they were also victims of a cold, broken mental health system.

GGB -- Mother, Artist and Kentucky Brain Advocate

Comments on: Across nation, unsettling acceptance when mentally ill in crisis are killed

Posted: December 10
Updated: Today at 1:55 PM

By Kelley Bouchard kbouchard@mainetoday.com
Staff Writer

Even as they face a growing number of disturbed people, police often lack crisis training. And the leadership and data-gathering needed to stem the bloodshed are largely absent.

To read the entire 4-part series, click here: http://www.pressherald.com/specia/Maine_police_deadly_force_series_Day_4.html

or read:

Families mostly powerless when mentally ill adult resists help

With headlines such as this, what family member in their right mind would call the police for help -- when their ill loved one becomes to much to handle? With civil commitment laws making it almost impossible to get needed medical attention for those who lack insight and refuse treatment -- what should a family do? My husband and I call this difficult decision the 'carousal of insanity' that is worse than Russian Roulette!  GG Burns, KY Mental Health Advocate

A few quotes from this very long, but informative article:

In many cases, mentally ill people shot by police have threatened, injured or even killed others. Sometimes, they have threatened suicide or expressed a desire to be shot by the police. Frequently, the use of deadly force seems excessive, if not utterly unnecessary.

It also could save taxpayers money, they said, if government leaders were able to demonstrate that it's more cost-effective to fully fund mental health services and police training up front, rather than risk more expensive responses and sometimes tragic results when crisis situations go wrong.

The Justice Department typically only steps in when police shootings of the mentally ill or other minorities ignite public outrage. Then, its Civil Rights Division requires police departments to make after-the-fact, local policy and operational changes -- including crisis intervention training promoted by NAMI and other organizations -- that can produce questionable, unverified results.

NAMI's Honberg acknowledges that even his group has failed to push for a unified, national approach to the problem, though the organization targets over-incarceration of the mentally ill as a major concern. At least 17 percent of the 2.2 million people in U.S. jails and prisons are mentally ill, according to recent studies.

Honberg agrees that similar attention should be paid to police shootings of the mentally ill.

"(It's) not a national priority, and it should be, not only for humanitarian reasons, but for economic reasons as well," Honberg said.

Alabama Deputies' shooter struggled with mental illness -- another preventable tragedy!

By MELISSA NELSON-GABRIEL — Associated Press

FAIRHOPE, Ala. — The mother of an Alabama man accused of shooting two sheriff's deputies wrote of his increasingly erratic and threatening behavior in three requests to have him placed in mental institutions against his will in recent years, according to court documents that have surfaced since the shooting that left one of the men dead. Read the entire article here:http://www.kentucky.com/2012/11/27/2422992/deputies-shooter-struggled-with.htmlhttp://www.kentucky.com/2012/11/27/2422992/deputies-shooter-struggled-with.html

Read more here: http://www.kentucky.com/2012/11/27/2422992/deputies-shooter-struggled-with.html#storylink=cpy

Editorial review: By GG Burns, KY mental health advocate and founder of the Change Mental Health Laws in KY project.

I recently read about this preventable tragedy and took the time to GOOGLE Michael Jansen, who obliviously needed help. After a few minutes search, I realize this preventable tragedy had hit the associated press and was repeated in over 70 newspapers across the US. Violence sells newspapers, not educational solutions to an ever growing problem of individuals suffering with serious and persistent mental illness who need to access medical treatment.

I immediately identified with his 84-year-old Mother, Mrs. Helen Jansen and wondered if my life or my son's life could one day end in a brief newspaper article like this. Stories like this appear in the news frequently, sometimes daily and make my heart weep. I understand all too well the hopelessness a Mother feels when they are unable to help their adult child receive the necessary medical care needed to be a productive citizen in the community. I can't imagine how this Mother feels now that she was unable to help prevent her son's death and the death of another. 

My thoughts turned to what kind of headline would have been 'if' Michael Jansen, had received an 'assisted' outpatient agreed order 2 years ago and had remained in treatment? I wonder if this slain deputy's family will blame Micheal Jansen for the death of their son, husband or Father -- or will they blame the broken mental health system? I wonder if any good will come from this pointless and preventable tragedy?

Alabama, like every state, has its own civil commitment laws that establish criteria for determining when court-ordered intervention is appropriate for individuals with severe mental illness who are too ill to seek care voluntarily. The state authorizes both inpatient (hospital) and outpatient (community) treatment, which is known in Alabama as "court-ordered outpatient treatment." It is one of the 27 states whose involuntary treatment standard is based on a person’s “need for treatment” rather than only the person’s likelihood of being dangerous to self or others.  

For inpatient treatment, a person must meet the following criteria:

• be a real and present danger to self/others or,
• without treatment will continue to suffer mental distress and deterioration of ability to function independently, and
• be unable to make a rational and informed decision concerning treatment.

For assisted outpatient treatment, a person must meet the following criteria:

• without treatment will continue to suffer mental distress and deterioration of the ability to function independently, and
• be unable to make a rational and informed decision concerning treatment.

For more info about AOT laws in all 50 states click here.

Pay-Now-or-Pay-Later

Mental illness is a pay-now-or-pay-later disease. People who don’t get routine treatment when they are more stable often end up needing emergency treatment after they become less stable – and when it costs more. Along the way from more to less stable, they also often generate significant public costs from arrest, incarceration, victimization, etc.

Click here to read a recent article written by Treatment Advocacy Center on:

Chicago’s Psych Patients Didn’t Disappear, They Just Got Sicker