Identifying And Treating Severe Mental Illness
http://thedianerehmshow.org/shows/2012-12-20/identifying-and-treating-severe-mental-illness
The vast majority of mentally ill people are not a danger to themselves or society, but for those who are, treatment is critical. Diane and her guests discuss the challenge of identifying and treating severe mental illness.
Guests
Dr. Liza Gold
clinical professor of psychiatry at Georgetown University Medical Center and vice president of the American Academy of Psychiatry & The Law.
Pete Earley
father of an adult son diagnosed with 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. E. Fuller Torrey
president of Treatment Advocacy Center.
Leslie Weisman
client services entry bureau chief at Arlington Community Services Board.
Comments
Please familiarize yourself with our Code of Conduct and Terms of Use before posting your comments.
"Furthermore, since many of aalve's claims are false on their face, I have a strong suspicion that he/she might be pulling your leg. "
What I claimed was fact. Every state has mental hospitals, every county has mental health services, every county has Vocational Rehabilitation, and every emergency room is stocked with medication that would stop psychotic symptoms. I also said that people who have mental illness that prevents them from working a full time job are eligible for federal benefits (Social Security Disability and SSI). All that's true and verifiable. Just facts, not opinions.
Choose any random county and look it up. How about looking at Fairfield County, CT? Here's the county's mental health services page:
http://www.ct.gov/dmhas/cwp/view.asp?a=2902&q=335234
Here's the State of CT Bureau of Rehabilitation which oversee the department of vocational rehabilitation services, which provides physically and/or mentally ill people with job placement (puts them directly in a job), sheltered work (working with a job coach), and training regardless of the severity of their condition: http://www.ct.gov/brs/cwp/view.asp?a=3890&q=461416
Call any emergency room and ask them if they have Seroquel, Abilify, and Haldol on hand. These medications stop paranoia and hallucinations.
Look up Social Security Disability and SSI. If someone qualifies for these programs they also get Medicare or Medicaid. Veterans benefits are also available to some.
I'm not saying federal programs are completely effective or comprehensive but they are better than the mental hospitals of old (there's my opinion). In addition to these major federally funded programs there are many minor federal and state programs that address mental health issues as well.
continued from above...
Here are more facts: Every school system in the US has psychologists and counselors. Every county has a program for the aging that can address dementia and assist caregivers. Every university and community college in the US has an Office of Disability Accommodation and almost all have counselors available.
One major problem is that some people in the midst of psychosis are paranoid and won't agree to be medicated. They lack insight and contact with reality. So they may isolate themselves or they may do something that causes them to encounter law enforcement. They can't be forced to get treatment (except under rare conditions) but they can be taken to jail (and by the way, every county jail has limited mental health treatment available).
Abilify effects:
fever, stiff muscles, confusion, sweating, fast or uneven heartbeats;
jerky muscle movements you cannot control;
sudden numbness or weakness, headache, confusion, or problems with vision, speech, or balance;
fever, chills, body aches, flu symptoms, sores in your mouth and throat;
increased thirst or urination, loss of appetite, fruity breath odor, drowsiness, dry skin, nausea, and vomiting;
seizure (convulsions);
thoughts of hurting yourself;
feeling like you might pass out;
jaundice (yellowing of your skin or eyes); or
urinating less than usual or not at all.
"Indeed, the main effect of the antipsychotic drugs has nothing whatsoever to do with ameliorating psychosis. The drugs, one and all, disrupt frontal lobe function causing a chemical lobotomy. The lobotomy-effect induces an apathy or indifference towards oneself that is so profound that individuals can be desperately ill without complaining about it. This failure to "complain" or even to ask for any help is the hallmark of these drugs that makes them useful in psychiatry. The drugged patients become docile and less troublesome. In Medication Madness (2008), I call this effect "medication spellbinding." "
-Breggin
Seroquel:
Approximately 10,000[17] lawsuits[18][19][20][21][22] against AstraZeneca for problems ranging from slurred speech and chronic insomnia to death have been filed by individuals from civilian populations.
Both typical and atypical antipsychotics can cause tardive dyskinesia.
Thank you Diane and your guests for a very good show that starts to speak to the difficulties of treatment for mental illness. Thank you also for clarifying that most people with mental illness are not violent and we should not associate violence with mental illness.
I would love if there were a follow up show that added in the voices of those of us who actually have mental illness and are in treatment. I think the perspective is very different when you are actually the one with the illness. And have people with mental illness with diverse socioeconomic backgrounds. I know my treatment over the past fifteen years has been a huge struggle and been barely adequate, and I have insurance and community ties. My friends who have a different situation have other problems with getting treatment and it would be good to hear from everyone.
Thank you for addressing this topic. As a mental health practitioner, I think there are three limits with the viewpoints expressed in this show.
First, although we know what factors correlate with the likelihood of future violent behavior, we have much less ability to accurately predict future violence in any specific individual. Many, many more people say they are thinking about hurting themselves or others than actually do, and we can't commit everybody at elevated risk (both logistically and for civil rights reasons). So unless a person has already behaved violently or is actively in possession of a weapon and talking about a clear plan to use it, we can't be accurate about predicting violence. This is why the criteria for commitment are written the way they are--they need to balance human rights with the need to protect the public. Much of what we do in mental health treatment is preventive, e.g. take weapons out of the hands of people who are not stable, form alliances with people who otherwise feel isolated, and try to change the stressors or biological factors making the violence more likely.
Second, our treatments, like most other medical treatments, don't always work. A large proportion of people with good insurance, good support systems, and competent treatment providers still struggle with impairing residual mental health symptoms.
Third, the issue of involuntarily imposing treatment (even for psychotic symptoms or impulsive behavior or dysregulated anger) is a human rights issue. The medicines that treat these disorders have troublesome side effects, so the decision to take them cannot be lightly forced upon people.
Next time, consider adding a mental health rights advocate (e.g. from NAMI) to your panel.