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Mental Health in a Failed American System

Recent tragic events like Sandy Hook, Seattle Pacific University, and the DC Navy Yard shooting have propelled issues in the mental health system to the forefront of our minds. Many of us continue to struggle with the reality that crimes, violent acts, and even murders are occurring almost weekly, perhaps even daily. We struggle with understanding why and how such evil can continue to elude us. Aren't our schools protected and prepared for tragedies like that of Sandy Hook Elementary School? Aren't our police trained and ready for catastrophes involving mental illness? Can't our mental health professionals cure the sick? All of these questions swarm through the minds and hearts of people everywhere, including those, such as myself, who work in the field of psychology.

The answers are hidden beneath a facade of control in our hospitals, clinics, and schools. The truth is that we live in a failed system that lacks the necessary tools to protect society from evil, from illness that controls the mind and consciousness of some of our fellow citizens. Because of this, it is important that families understand severe and untreated mental illness, while maintaining a balanced perspective. While the majority of individuals with mental illness do not intend to harm anyone, there is a great number of cases in which homicide or violence and aggression is likely.

For those who have questions about our failed system, this presentation is for you.

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Mental Health in a Failed American System

  1. 1. A typical family scenario 0 Family recognizes there is a problem • School, work, community, home 0 Denial/anger/guilt 0 Seeks M.H. tx 0 Difficulty finding resources 0 No single diagnosis or “umbrella diagnosis,” 0 No lasting relief from meds & rejection of tx 0 No insurance coverage 0 Expensive RTF’s 0 Prescribed a combination of drugs • Sleep aids • ADHD meds • Depression drugs 0 Hospitalization & early discharge w/referral to Psychiatrist 0 Person self-medicates • Marijuana • Alcohol • K2 or narcotics 0 Indifference to tx or alternative education (IEP, charter, home)
  2. 2. Mental Health Needs More Attention 0 Points: • Parents, families, & caregivers are often ignored/slighted • Crime & mental illness has some common ground, although it does not characterize every mental health case • We must open our eyes to frequent occurrences of crime among the mentally ill • Crime & mental illness are “connected” due to the systems’ failures
  3. 3. Recent cases involving crime & mental illness 0 According to the TAC – 50% of mass killings are committed by people w/untreated or severe mental illness. 1 in 100 male teens fit category of aggression/violence. Seattle Pacific University -Aaron Ybarra (26): “I just want people to die and I’m gonna die with them,” Ybarra wrote in his journal on the day of the shooting. Killed 1; wounded 2 others
  4. 4. Two confused systems Mental Health System Criminal/Juvenile Justice System 0 Gray area 0 M.H history or child development may be responsible for behavior 0 Seeks to tx & protect public 0 Doesn’t want to be associated with criminal behavior 0 Black/White view 0 “you did it or you di not 0 Seeks to punish 0 Developed its own standards to determine if M.H issues are to blame 0 Realizes CJS/JJS lacks M.H knowledge
  5. 5. De-institutionalization: the disorganized disaster 0 Occurred in early 1950s – 1970s 0 No aftercare/SW support/or no community tx set up for discharge 0 Released to community w/little to no skills to live independently 0 Homelessness, victimization, crimes, or hospitalized for short periods of time 0 Stigma & social ignorance including community tx teams led to mediocre system of today
  6. 6. Statistics 0 National Center for Children In Poverty (2013): 20% of adolescents have a diagnosable M.H. disorder. 0 7.7 million adults & 20% of children and teens between 13 and 18 suffer from severe mental illness. 0 Suicide is the 3rd leading cause of death among 15-24 year olds, even on college campuses as well. 0 National Institute of Mental Health (2013): 5.7 million adults age 18+ suffer from bipolar disorder each year 0 Major depression has become the leading cause of disability in the U.S. for individuals ages 15-24. 0 24-million suffer from schizophrenia 0 40 million suffer from anxiety disorders, 0 7.7 million suffer from post- traumatic stress disorder in any given year. 0 34.2 million live in low- income households
  7. 7. Today’s mental health system 0 Community Mental Health: • Mobile therapy • Family-based therapy • Outpatient care • School-based therapy • Community Treatment Teams (CTT) 0 Hospitals closed in PA: 0 Harrisburg State Hospital (closed 2006) 0 Mayview State Hospital (announced closure = 2007) 0 Overcrowded hospitals/clinics in PA: 0 WPIC (lack of beds) 0 Mercy Behavioral (waiting list)
  8. 8. The “Dangerousness Criteria” is tricky 0 a “clear and present danger” (with a plan) to self or others. "Danger" specifically includes: • the inability, without assistance, to satisfy need for nourishment, personal or medical care, shelter, and self- protection or safety. 0 a reasonable probability that death, serious bodily injury or serious physical debilitation will ensue within 30 days without treatment.
  9. 9. What the “dangerousness criteria” did to us 0 Involuntary commitment is nearly IMPOSSIBLE to obtain 0 Must have a “clear” plan & access to weapons, etc. 0 Patient must admit to having suicidal or homicidal thoughts. 0 No secondary opinions can sway a hospital’s decision 0 court cases: • O’Connor vs. Donaldson in 1975 and Lessard vs. Schmidt in 1976. • Both cases ruled it unconstitutional to confine someone capable of caring for their basic needs. • States followed these trend setters.
  10. 10. Today’s mental health system continued…. 0 Arguments against hospital stays: 0 Decrease in civil liberties and autonomy 0 Increased familial involvement without permission 0 Over involvement of state decision making 0 Lack of patient input 0 Stigma 0 Fear of hospital policies returning to those of the 1700s
  11. 11. Today’s mental health system continued….. 0 Confidentiality: your moral or legal right to privacy. • Confidentiality creates barriers for families 0 HIPAA: Health Insurance Portability & Accountability Act of 1996 – protects 2 kinds of patient information: • Privacy Rule: protects M.H. info from “outsiders” • Security Rule: protects email, faxed, telephone info about a patient. Holds healthcare providers responsible for sharing information. 0 HIPAA creates even more barriers 0 Video: (2:13) http://www.youtube.com/watch?list=PLACD9536723837201&feature=player_em bedded&v=FKTHncn-5Vs
  12. 12. Avoidable mistakes & failures 0 HIPAA: • Allow parents/families/caregiver access to records when vital • Release records with verbal consent & do not require signatures to release information 0 Confidentiality: • If an individual threatens to harm someone else • If an individual threatens to harm him/herself • If an individual reports that he/she has been abused 0 Depends entirely on company policy & therapist discretion
  13. 13. Avoidable mistakes & failures 0 Age of consent laws: 0 14yr olds in PA can reject tx or medication w/o parental input 0 Hospital policy: 0 Involuntary commitment should include input from family/close friends 0 Should never be turned away due to low # of beds 0Sen. Creigh Deeds 0John Shick – WPIC shooting 0 Should not be admitted based soley on plan/access to weapons/intent
  14. 14. Kelley Thomas (top right) Dylan Andrew Quick: (bottom far right) James Holmes (left) Adam Lanza (right) Brandon Michael Hill ( bottom right) Seung-Hui Cho (bottom left) Aaron Alexis (bottom middle) Eugene Maraventano (next to Dylan)
  15. 15. Alex Hribal – Murrysville stabbing (20 victims) Elliot Roger (right corner) Jimmy Dikes (middle to right) Jared Loughner (bottom) Sen. Creigh Deeds (bottom middle) Levi Staver (Richland Township)
  16. 16. Thoughts? 0 What do you think needs to change? 0 Can we change it? 0 How does stigma play a role in our thinking about mental illness?
  17. 17. What I think needs to change 0 State laws • Involuntary commitment -72hr hold, need plan & access • Age of consent laws – 14+ can make decisions 0 Police Training • Police training occurs in a few states, but many lack knowledge 0 Anti-stigma movements: • Ignore severe mental illness & emphasizes success stories 0 Promotion of community treatment only 0 Families need more power w/loved ones • HIPAA laws should allow close family access in emergencies • Assisted Outpatient Treatment (AOT)
  18. 18. What other’s think needs to change 0 Dr. E Fuller Torrey: the nation’s most reputable psychiatrist. Treatment Advocacy Center. 0 Pete Earley: wrote the book Crazy: A father’s search through America’s mental health madness (2007).
  19. 19. What other’s think needs to change continued…. 0 Xavier Amador: wrote the book I Am Not Sick I Don't Need Help! How to Help Someone with Mental Illness Accept Treatment (2012). 0 Congressman Tim Murphy: believes the kills involving Elliot Roger were preventable & has bi-partisan support on a new bill.
  20. 20. Where to get the book BooksAMillion.com Amazon.com BarnesandNobel.com Carnegie Library 0 On sale today (6 signed copies) for $10.00
  21. 21. How to follow me 0 Twitter: @therapisttee 0 Anchoredinknowledge.com 0 Blogs.psychcentral.com/caregivers

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