Serious Psychiatric Disorders Among Young Adults
http://thedianerehmshow.org/shows/2011-01-11/serious-psychiatric-disorders-among-young-adults
President Obama is traveling to Tucson tomorrow to attend a memorial service for the victims of Saturday’s shooting. As more details about the deadly rampage come out, investigators are looking at the mental state of the twenty-two year old alleged gunman. Jared Lougher was suspended from his community college after erratic behavior in class and strange web postings. The National Institute of Mental Health reports six percent of Americans over the age of eighteen have a serious psychiatric illness. A look at the challenges of identifying young adults with mental disorders and why so many don’t get treatment.
Guests
Pete Earley
father of an adult son diagnosed BiPolar Disorder, author of "Crazy: A Father's Search Through America's Mental Health Madness", former Washington Post reporter and author of several others books including "The Hot House"
Dr. Kenneth Duckworth
the medical director for NAMI, the National Alliance on Mental Illness, an Assistant Professor at Harvard University Medical School, a board member of the American Association of Community Psychiatrists, and Medical Director of the Vinfen Corporation in Boston.
Dr. Lisa Dixon
Professor of Psychiatry at the University of Maryland School of Medicine and director Of the Division of Services Research within the department of psychiatry.
Dr. E. Fuller Torrey
president of the Treatment Advocacy Center
Comments
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I hope that someone will use the tragedy in Arizona to champion the cause of the mentally ill and their family members who struggle to get them help in our country's inadequate mental health care system. My wife has a brother with severe (albeit undiagnosed) schizophrenia. He refuses to allow doctors anywhere near him and we are powerless to try to help him; the laws in Texas do not allow the family any power to force him into a treatment program. We are worried that when my wife's father (his caretaker) passes, he will become homeless like so many mentally ill. He is too unstable and threatening to our family to live with any of us. He needs professional help.
For anyone with relatives suffering from mental illness we highly recommend attending NAMI meetings (www.nami.org). They bring knowledge and resources to those with sick family members. Though our story does not have a happy ending yet, we saw several families reach turning points in their own situations.
As libertarians, we demand the protection of our personal freedoms, but how do we balance that with the situations where we need to violate those very same rights in order to do what is best for a mentally ill adult family member? We are hoping for the wisdom of someone in power to make a thoughtful decision that increases our ability to help those ill members of our family while respecting personal freedom. Can it even be done?
As far as Jared Loughner is concerned, he was a ticking time bomb that could have been defused. The fault lies with the lack of mental health care resources in this country. I'm also concerned that his parents didn't act on his mental instability during his teens when they had the power to help. The man's political leanings are a moot point -- he is too intensely disturbed to make sense of anything that he believes. I hope we don't completely miss the wake up call we just received on the state of mental health care in this country.
Society's ability to prevent violence by psychologically disturbed young adults is crippled by: fear of lawsuits as well as the standard police policy of taking action only after a crime has been committed.
"Why was it so hard to kick Loughner out of Pima Community College?", 10_01-2011:
http://www.slate.com/id/2280704/
From article: What about students who persistently disrupt classes but are simply jerks—or nonviolent nutcases?
Why didn't Arizona's Pima Community College (PCC) have policies directing its staffers/police on specific- CONSTRUCTIVE- steps to be taken when dealing with someone who is exhibiting signs of serious mental illness and who is, apparently as a result of mental illness, disrupting class(es) or other college processes??
PCC staffers and police ought to have, at the least:
1) been trained/instructed- or had PCC policies in place directing them- in how to discern whether persons that they are in contact with are suffering from a major mental illness or similar-symptom problem such as drug-induced mania or psychosis, and what types of strategies they ought to use to deal with persons who apparently are suffering from a major mental illness or drug-induced mania/ psychosis ;
2) had state or federal laws in place supporting them that would have enabled PCC staffers/police to proactively contact a local (State) Health Authority's 'mental health department' or similar public service structure about the problemmed person who is exhibiting mental illness-caused disruptive conduct...
The local (State) Health Authority's 'mental health department', if it existed, should have had, as part of its mandate, obligations to:
a) proactively work with other state, federal and locally funded services- such as college staffers, police and the like- to engage persons that are reported to them as exhibiting serious mental illnesses; and
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PART 2:
b) legal obligations to provide services to persons that are reported to them as exhibiting symptoms of serious mental illness or a something similar such as drug induced psychosis or mania;
c) the right, if necessary, to bill the state/local/federal govt for what would be in effect- providing services to persons who had not requested such services and who may be adverse to accepting such...
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Mr. Roderick V. Louis
Vancouver, BC, Canada
The horrible events in AZ can bring the importance of mental health as part of overall health to the forefront. Prevention and early interventions are the key. The National Federation of Families for Children's Mental Health (www.ffcmh.org) is the national family voice for families, children and young adults. The work they do makes a difference everyday.
I think, National Healing will start as soon as we have the journalistic courage for looking into the Mysterious Collapse of WTC #7
Diane,
Did you ever know the existence of WTC#7?
Have you ever heard about it?
Have you ever researched and understood what the fuss is about the Collapse of WTC #7?
Do you know how the owner of WTC #7 explained the mysterious collapse?
Did you ever find out why and how there was no credible investigation?
Do you know why Architectural Schools, teachers and students of civil engineering have no clue about the largest structural (so-called) failure ever?
Did you know that Lee Hamilton has no clue about the reason of the collase - even though he wrote a book about the events of 9/11?
Diane,
Do you have the courage to invite Architect Richard Gage on your program?
As a mental health provider at a college in Western NY I see one of the biggest obstacles, if not the biggest, for this age group is the stigma attached to receiving mental health services. Fortunately, we in Western NY live in a resource rich community and are able to partner with community resources should the need arise. However, one can understand the reluctance of a young adult and/ or their parent to seek help when they are saturated with a society that consistently criticizes, ostracizes or calls them "crazy" when they do. Until we reduce the stigma we will continue to have incidents like the one in Arizona.
Mental illness is difficult to diagnose and comes in a variety of forms. For the sufferer who is able to maintain some semblance of normalcy, in a free society, there is little that can be forced upon them.
My brother was diagnosed with Paranoid Schizophrenia 35 years ago. Our family has witnessed the utter isolation mental illness can bring to the people faced with it.
What has bothered me for decades is how often people with mental illness are portrayed as being violent-- which is MOST OF THE TIME, not true.
It seems like such an unfair, ignorant and unfortunately, prolific point of view.
Loughner has repeatedly been described simply as a "loner." I'm concerned that this overly broad stereotype could lead people to treat anyone who isn't an extravert as a potential terrorist.
The "loners" who go on shooting rampages are actually frustrated extraverts. Like other extraverts, they're focused on social acceptance, but their mental illness drives people away. A true introvert is just a thinker, like Albert Einstein, who wants enough quiet time to keep his or her thoughts organized. It has nothing to do with whether one likes or dislikes people, let alone whether one has a tendency toward violence. And Loughner was described as confrontational, whereas true introverts avoid confrontation.
Dr. Laurie Helgoe, author of the excellent book _Introvert Power: Why Your Inner Life Is Your Hidden Strength_, is the only writer I've seen so far who really gets it right.
I am curious as to why it is when a white individual commits a horrific crime, it is immediately assumed that they have a mental defect or illness. Yet, on the other hand when a non-white individual commits the same or a similar crime, they are deemed immediately to be a criminal or a terrorist?
Are we saying that the only people who commit crimes or acts of terrorism are non-whites, and when an individual who is white does a similar action they could not do such unless they have a mental defect. The logic in that is blaringly biased.
This young man had the ability to plan out every detail of his actions, that does not seem to me, an untrained individual, to be mentally deficient. It seems very rational and methodical.
Diane:
What about Laughner's parents? We have heard very little about his parents and their involvement/lack of involvement in his life.
East Lansing
As someone who has taught for over 15 years in a variety of college settings, I have noticed that in the on-line or community college environment, there seems to be a higher rate of students who show characteristics of mental illness. This presents a particular challenge in the on-line environment, where professors do not have the face to face interaction that makes intervention easier.
I have had students write incoherent, frightening ramblings not unlike those of this weekend's shooter. When I have reported these to administration, the general response has been to try and grade the work as usual. Without a student divulging mental illness, instructors are often not empowered to acknowledge it.
Education is the key..
Mental Health Issues impact upwards of 20% of our society, however, it is one of the least understood conditions...
Families not only do not recognize, they do not understand what is happening... And, unfortunately help is not readily available, or easy to find.
Additionally, Stigma keeps individuals and families from disclosing and discussing not only the illness but the symptoms and side effects this may be because the media implicates such a negative side of the illness!
Treatment Works! NAMI Osceola
Why does it always only take a tragedy of this proportion to call attention (in the media) to mental illness?
Yet who has actually determined that Jared Loughner is mentally ill: has any doctor diagnosed him? And what is the difference between “mental-illness,” that is actually a compendium of medical diagnoses (re: the length of the DSMs) and the legal definition of “insanity” within the Nation’s Court-system?
And in an age when on the one hand, powerful drugs exist to make it possible for mentally ill people to live within the community versus having to languish for years in hospitals— still are their lives profoundly affected by their illness or by the failure of various, separately-operating systems: the media; the medical community itself; the schools who may fail to recognize when a young child may need help; pharmaceutical companies, medical-insurance policies, privacy laws, and so on? The list seems endless.
I am recalling your guest Diane, of a few weeks ago, Mark Vonnegut. That for every individual like Loughner (and is he really, mentally ill?) then how many other people are there who go on to work to bring success to their lives and benefit to others’ (for example as did Vonnegut, becoming a pediatrician)? Those with mental illness include the vast number of whom want nothing better than to maximize their own potential as contributors in society following medical treatment.
Far too many tragedies like this, now. Now the ultimate question becomes: to what extent does our indifference to each other's well-being, directly lead to the murders of innocent people?
As was just said, MOST individuals with mental health issues are non-violent. It is the responsibility of mass media to publish this not to over dramatize isolated incidents for the purpose of lining their pockets!
The onset of schizophrenia can not be predicted and often an individual has committed acts before getting diagnosed. Once diagnosed, no one wants to be responsible. Private health care ends at 21, public assistance doesn't allow for the spectrum of care needed and our jails certainly don't offer proper treatment for these individuals.
I would just like to point out that the REAL issue facing the mental health crisis in this country is that companies are spending more money on erectile dysfunction, acne and weight loss than they are on developing the science behind the creation of medications that will adequately address the needs of these individuals and prevent these incidents from happening.
The greatest change we could make in our society and, by extension, our systems of care is to stop penalizing people with stigma for seeking treatment. We don't heap stigma on people who take other choices to improve their well-being and daily function, but we slap labels like "loonie" and "crazy" on people who reveal that they have sought psychiatric care.
Funny.... this afternoon I see my psychiatrist for regular follow-up while taking ADD meds.
My brother is a diagnosed schizophrenic with multiple personalities - and the best thing that ever happened was for him to be arrested - because only then were we able to get him the help he needed - the difference between now and then is amazing - and that arrest was truly a blessing.
It took him walking down the middle of a road in the middle of the night proclaiming that he was the son of God and being arrested to get him treated.
My parents had tried for years before that to get help - but they could not get him admitted to anywhere - and even as a self admit no place would accept him for more than 48 hours.
It was so frustrating to know that he needed help and to not be able to get it.
The system needs to be fixed.
The incidence of schizophrenia are lower among non-white populations. But, it mainly has to do with the individuals history and symptoms not their skin color. Often it doesn't make sense but until you know a person with schizophrenia who is unmedicated you will never understand how they can seemingly function and not function all at the same time.
I wish your show had also discussed the support the family and the young man could have had, if only they had been connected with a peer support or family support network. Arizona has parent-to-parent support providers and peer support specialist that are available to teach and support youth to build on their own wellness skills with or without using the traditional medication/treatment services. Not everyone needs to be placed in in-patient facilities or court-ordered into treatment to take control of their life!
Please ask your guests to tell us more about the certification and training for local police helping them better respond to the mentally ill.
In particular, how to get more information about such a program.
from Kathy in South Carolina
I hear that many of the example given on young people suffering from mental illness show substance abuse. My question is what correlation is shown with which drug and what exact definition is being used on substance abuse. Is abuse occasional use, or is it a dependency/addiction?
I have listened to the show for years and have never called or written, but for some reason, this is the show that upset me. Loughner has not been diagnosed as schizophrenic and yet, on this show, a guest defined him as 'clearly schizophrenic.'
This is what makes the media suspect. I don't mind a show about mental illness in young people, but it shouldn't lead with assumptions about the incident in Tucson. Talking heads who have not even met with Loughner should not be 'diagnosing him'. The medical professional in Tucson have been very good about not making assumptions, just giving facts. The media and talking heads could learn from them.
Civil discussion doesn't only mean not yelling or calling names. It is about basing the discussion on fact.
It would appear that raising mentally healthy children is more important than curbing gun laws. Just as there is almost no restriction to purchase a hand gun in Arizona, there is also no test, license, or restriction to procreate and raise children.
One of the biggest justifications for arms purchases is for protection from dangerous people - the mentally disturbed, the economically challenged, the disillusioned and angry. If we did a better job of qualifying people to be parents and raise children who will NOT fall into any of these categories, then we would have much less justification for massive personal gun purchases.
Maybe programs which require much more responsibility for parenthood would reduce the number of criminals on our streets and in our jails and reduce the need for "protection". My only justification for a gun purchase is to protect myself from all of the gun wielding angry Arizonans who were potty trained at gun point.
Scottsdale, AZ
Thank you for addressing the psychiatric aspects of this terrible tragedy. The issue here is not gun control or political speech. The issue here is that this young man was terribly ill and did not receive the medical care that would have preserved his well being and the lives and well being of so many innocent people.
Arizona is a nightmare for securing mental health care. So is Texas, and so is most of this country. The cost is terrible - we've seen this happen too many times - Saturday in Arizona, Virginia Tech, and so many others.
We call this young man an animal, we attack his parents. Appalling. He is sick, terribly sick, and until we embrace and support the mentally ill, these tragedies will continue.
It seems to me that advising anyone to "raise hell" in this context could be counter-productive. Please tread carefully...
My concern is the prevalence of mental illness in America and lax gun laws. The coupling of the two can only lead to destruction and death. We can respect the right to gun ownership while restricting the type of weapons and ammunition available to the general public and that would lessen the degree of destruction one with mental illness might cause.
Having worked for years with youth who have serious emotional disabilities I have seen many, many youth and young adults who have not been able to get the treatment needed to lead healthy and safe lives. Time and time again we find that the most seriously disturbed youth have the most difficult time getting and keeping services. The system fails these children repeatedly, particularly those who do not qualify for medicaid. Long term care or supported living is almost non existent for the mentally ill -- when it can be found families can typically not afford it and all of our state systems claim it is another system's responsibility. There is really no shared responsibility or cooperative planning between the mental health system, the department of children's services, education, and the courts. We truly need our legislators at the state level to step up and create a system that will coordinate services and support each other on behalf of those in need, whatever their disability.
And then we have the topic of the cost of medication--another whole issue that doesn't work in our system.
In our experience, it is nearly impossible to secure treatment for a family member with severe schizophrenia against that person's wishes. My brother is extremely handicapped, and has been in an endless cycle of illness, substance abuse, incarceration and homelessness, and spite of it all we are unable to "prove" that he is a danger to himself or others.
Law enforcement and even many mental health provisions are hampered by their inability to compel treatment, and their unwillingness "violate" privacy laws by talking to the family of the ill person.
Diane
As a teacher formerly from Westfield HS in Chantilly. One of my former students was Michael Kennedy. He was the young man who shot the 2 police officers at westfield Station. Michael was a wonderful boy prior to his illness. Michael ask the courts for help when he was in a stable stage. He asked to be committed. The Judge would not commit him due to tax payer money issues. My friend who worked for Fairfax Health Care said the system killed those 2 people. Michael ask for help but the system failed him. As far as the Cho goes he was so ill when he was in HS. We could not help because of the system. Our young people between 18 an 30 are falling through the cracks in regard to mental illness.