(Jan. 9, 2015) The state of Pennsylvania and disability rights advocates have agreed to a plan that will liberate mentally ill inmates written up for misconduct from “an endless cycle of isolation and punishment” in isolation cells.

Under the settlement between the states Corrections Department and Disability Rights Network of Pennsylvania, mentally ill inmates in new treatment units will spend more hours outside of their cells than the typical 1 hour per day allowed in isolation. They will be screened and classified for serious mental illness upon intake, and prison guards will receive crisis intervention training.

The plaintiffs said the agreement will end "a Dickensian nightmare" for inmates with serious mental illness (“Pennsylvania to expand treatment for mentally ill inmates,” Associated Press, Jan. 6).

An estimated 4,000 of Pennsylvania’s 51,000 state prison inmates are potentially affected. Already, the number of mentally ill inmates in “restricted housing” for the disciplinary issues that often arise from psychiatric symptoms is down from more than 800 a year ago to about 135.

The Treatment Advocacy Center’s 2014 study, “The Treatment of Persons with Mental Illness in Prisons and Jails,” reported “The effect of solitary confinement on mentally ill prisoners is almost always adverse. The lack of stimulation and human contact tends to make psychotic symptoms worse. Thus, it is not surprising that many of the incidents of self-mutilation and suicide by mentally ill prisoners take place when they are in solitary confinement.”

The report called for careful intake screening so that individuals at risk for problems because of their psychiatric symptoms could be identified and handled more appropriately – a step contained in the agreement.

Pennsylvania is one of 44 states where a jail or prison holds more individuals with serious mental illness than the largest remaining state psychiatric hospital. Compared with the 4,000 mentally ill inmates potentially affected by the agreement, for example, the state’s largest remaining state hospital has less than 400 beds.

Anything that diverts psychotic and suffering inmates from the further torture of solitary confinement is progress, and Pennsylvania inmates will be better off for this agreement. Even greater progress would be diverting the mentally ill from prison in the first place by providing the inpatient beds and outpatient treatment they need to avoid arrest and incarceration in the first place.

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(Jan. 8, 2015) Family members are searching for answers after Matthew Ajibade, a 22-year-old artist and college student with bipolar disorder died in a restraining chair at the Chatham County jail last week (“Family wants answers after Savannah artist dies in jail,” SavannahNow, Jan. 6).

“We want to know why,” said his brother, Chris Oladapo. “Why is a young, creative soul leaving us so early?”

Ajibade was arrested after Savannah-Chatham police responded to a domestic incident with his girlfriend. According to a preliminary incident report on the arrest, Ajibade’s girlfriend called the police and told them to take him to the hospital. Ajibade resisted law enforcement “in a violent manner, and was taken to the ground so that he could be handcuffed,” according to the report.

When Ajibade arrived at the jail he was placed in an isolation cell after becoming combative with authorities. Staff later found him nonresponsive in his cell and rushed him to the hospital, but efforts to resuscitate him were unsuccessful.

Ajibade’s family wants to know why he was taken to jail instead of to a hospital in the first place.

Stories like these have become far too common. With too few beds, there are now 10 times as many people with severe mental illness in our jails and prisons than receiving treatment in a psychiatric hospital.

Tragedies like this will likely continue unless more is done to reform our broken mental health system and provide more comprehensive care for those suffering with serious mental illness.

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(Jan. 7, 2015) Sue Sanders’s husband “was the type of mentally ill person who plunged through the badly frayed social safety net and hit rock bottom, again and again,” she writes in the Washington Post.

“We met when I was 19 and he was 20. We were together 18 years, the last five of those spent with him ping-ponging on and off his medications. While on them, he was the kind, funny man I’d fallen for; off, he was a stranger plagued by paranoia who rarely slept and occasionally disappeared for days at a time,” she says (“Mental illness turned my ex-husband into someone I didn’t recognize. Still, his death left me reeling,” Jan. 7).

The one thing that made a difference?

Kendra’s Law – New York’s statewide assisted outpatient treatment (AOT) program.

“The one thing that seemed to work for Mike was New York’s Kendra’s Law, a court-ordered program where he was forced to regularly see a psychiatrist,” she writes. “He took his meds, and if he went off them the doctor noticed before he fell too far. The program stabilized him.”

He stopped taking his meds when he left the program.

“(H)is mother told me they were taking him off the program because he was doing so well. He was doing so well because he was in the program, monitored and on his meds. This seemed cruel.”

Sanders’ ex-husband died of pancreatic cancer before his mother “could figure out what to do next.”

Sanders says she and her husbands’ friends are mourning not only “the man he was ‘before,’ but also years of enormous potential cut short — not just from cancer but from severe, untreated mental illness.”

Too many people could write the same story. Treatment works. The Treatment Advocacy Center works to eliminate barriers to treatment so there are fewer stories like this to tell.

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(Jan. 6, 2015) In the aftermath of a police-involved shooting that left a mentally ill veteran dead in Lodi, California, the Sacramento Bee has published an especially trenchant and poignant editorial decrying that “we think it’s OK for police to fail in the face of brain disease.”

“(O)ne indisputable fact is that, despite the many lives lost and the millions of taxpayer dollars that get paid out each year for these kinds of shootings, we have chosen, so far, to turn a blind eye to this constant problem” (“Mental Illness Shouldn’t Be a Death Sentence,” Jan. 2).

Parminder Singh Shergill’s story is only too familiar. An India-born American who fought in the Gulf War, Shergill reportedly suffered from post-traumatic stress, delusions and psychosis. His family repeatedly called law enforcement when he was in psychiatric crisis, but he clearly did not get the treatment he needed to stabilize and recover. Responding to the family’s call for help in still another crisis, two officers shot the 43-year-old man as he raved on his mother’s doorstep.

The Bee rightly labels the shooting of Shergill a tragedy for everyone involved – the victim, Shergill’s family and the police officers – and calls for improved police training.

“Yes, the skills required to calm down a mentally ill person may be counterintuitive to standard cop training,” the editorial reads. “So change the training. Police can learn to deal with the mentally ill if we require them to."

The Treatment Advocacy Center in its 2013 study, “Prevalence of Mental Health Diversion Practices,” reported that half the US population lives where the proven crisis intervention practice of Crisis Intervention Team (CIT) policing is in effect. No doubt, universal use of CIT and other strategies to better equip officers on the front lines of psychiatric crisis intervention would reduce justifiable homicides.

But better police training is not enough. People with untreated brain disease shouldn’t be “perpetrators,” they should be patients. Police officers shouldn’t be conscripted as mental health workers, they should be enforcing laws. When untreated symptoms lead to criminal acts, treatment – not incarceration – should be the result.

And as long as we “turn a blind eye” to all these problems, Shergill’s story will remain only too familiar.

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(Jan. 5, 2015) New York Gov. Mario Cuomo closed out the old year by signing into law a bill that mandates releasing mentally ill state prison inmates into community treatment with enough medications to reach their first mental health appointment.

 This is a step in the right direction, and more states should take it.

The Treatment Advocacy Center’s 2014 study, “The Treatment of Persons with Mental Illness in Prisons and Jails,” reported that inmates with serious mental illness who were released from prison without follow-up treatment were almost four times more likely to commit another violent crime compared to mentally ill inmates who were given treatment after their release.

Mental illness is a treatable disease. Untreated, it results in behaviors that land hundreds of thousands of individuals behind bars every year. Treated, it reduces the chances they will return there.

New York’s new law mandates that every inmate who has received mental health treatment within three years of his or her anticipated prison release “shall be provided with mental health discharge planning and, when necessary, an appointment with a mental health professional in the community … and sufficient mental health medications prescriptions to bridge the period between discharge” until the mental health provider assumes care. The law also applies to inmates with mental illness who have refused care.

Our study reported that few corrections systems release prisoners to psychiatric follow-up. With the enactment of S.7818, New York is among them.

That’s good for state prison inmates with mental illness and good for the communities they return to. Even better would be if other corrections systems followed suit.

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(Dec. 23, 2014) Below are the top five most widely shared blogs of 2014. We appreciate those supporters who helped spread our message and shared our blogs via Facebook and Twitter.

"Mental Illness Makes Families Sick - personally speaking"
"Mental illness makes mothers cry. It makes siblings fight," writes Stephanie Mignon. "It makes fathers afraid in their own homes, afraid of loved ones who refuse to keep psychiatrist appointments and who refuse to take meds." READ IT ALL....

"The Brain on Antipsychotic Drugs"
Antipsychotics like clozapine and mood stabilizers like lithium are a part of recovery for people with severe mental illness. They are also a complex piece of an approach to address the biology of these illnesses. READ IT ALL....


"Schizophrenia Treatment: Before and After"
For those who haven’t witnessed the torment of someone in the throes of psychosis, or seen someone recover from their symptoms, a new video provides an opportunity see both. READ IT ALL....

"Fifteen Years After Tragedy"
Multiple studies have documented the effectiveness of Kendra’s Law in improving outcomes for its target population, enhancing public safety, and conserving scarce mental health resources. READ IT ALL....

"My Nephew Was Not a Bad Person, Just a Sick Person"
In the days before the attack that ended his mother's life, Derek Ward had become increasingly unstable. He was unable to get his medication because he couldn’t find a doctor that accepted Medicaid. His mother reportedly begged to have her son visit the emergency room but he refused. READ IT ALL....

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(Dec. 22, 2014) David McBrayer was already well-known to Alabama law enforcement for his potential mental illness before he was fatally shot by the police after refusing to drop a knife and walking toward a police officer last November in Jacksonville (Father of Jacksonville man killed by police hopes for reform of mental health laws,” the Anniston Star, Dec. 22).

“We already knew that this guy had a problem. We had enough to do a commitment on him, but not enough to do an emergency commitment,” Lt. Jon Garlick, a mental health officer, told the Anniston Star.

In Alabama, a person must pose danger to themselves or others and be unable to rationally decide for themselves if they need medical treatment in order to qualify for court-ordered treatment. But many other states allow court-ordered treatment when either of those conditions are met.

Because of this, “we have to wait for the person to attack someone or hurt themselves. That’s a terrible situation for the family and the person to be in,” said John Snook, deputy executive director at the Treatment Advocacy Center.

Now McBrayer’s father, Brad, says he wants to see changes in the way Alabama handles people with mental illness. He also worries about the use of force that police officers use in their encounters with people with mental illness.

“David was paranoid. He didn’t want help. He just wanted to be left alone.”

It should be easier for family member to help someone with a mental illness, McBrayer said. “This way people like David will receive treatment and live.”

The good news is that "at the end of the day, it's a really easy fix," according to Snook. Most states allow court-ordered intervention when fewer criteria are met. Alabama should follow their lead.

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(Dec. 19, 2014) I pause at the holiday display of chocolate covered cherries and am overcome with emotion. That is what dad used to give me, until a severe mental illness and anosognosia stole my dad from me when he was fifty-three. Now Dad is seventy-one and homeless.  While I sit in my warm house, I think of him. Is he outside in the cold or worse — dead?

Things did not have to turn out this way, but legal barriers made it this way.

Dad is still married to my stepmom Hilda. They still own a house in West Virginia where he left her fifteen years ago after frightening hallucinations and grandiose delusions caused him to cash out his 401K, travel the world as a prophet of God, and return to American streets, homeless.

Before he left, Hilda tried to help him. Rather than admit Dad for a fourth involuntary hospitalization, the authorities said my father was fine — he had gotten pretty good at passing these superficial evaluations. They then suggested Hilda was the one who needed therapy.  

Hilda and I could not get a hold of his previous medical records—blocked by HIPAA.

On Veteran’s Day two years ago, she got an ominous phone call. A stranger with all of Dad’s personal information warned her that some people were taking advantage of him and urged her to do something immediately. Then he abruptly hung up.

Hilda went to the police. They would not take a report. Hilda went to the Social Security office to have his account flagged (my dad is one of the lucky ones who gets a monthly pension and social security retirement check—although he probably gives the money away). They did nothing.

I filed a report, even after the sheriff discouraged me, asking me what good I thought would come of it, telling me that he sees it all time — a report filed for a family member who disappears with an untreated severe mental illness only to be found homeless then taken off the Missing Persons List. The cycle continues.

My brother and I have submitted DNA to the national database. We are being realistic.

As I wrap my children’s boxes of chocolate covered cherries, I think of Dad and feel powerless to bring him home.

Other families should be spared from this pain. We need to do better. The laws must change.

Amanda LaPera
Author of Losing Dad, Paranoid Schizophrenia: A Family's Search for Hope

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(Dec. 18, 2014) A comedy group from Texas will donate the proceeds from this Saturday’s show to the Treatment Advocacy Center (“Local comedy show takes a stand for mental health,” Midland Reporter-Telegram, Dec. 18).

“It’s personal to me,” Vanessa Hope told the Reporter-Telegram. As the show’s producer and a comedian, Hope has teamed up with other local comic acts to create the show. “I think comedy brings people together, and this show has developed pretty well and easily.”

Robin William’s recent suicide brought both comedy and mental illness to the fore, a connection that is not lost on Hope.

“He was such a force of nature,” she said. “I’ve thrown around the idea of doing something for charity and learned about the Treatment Advocacy Center which has changed laws in this state for those receiving mental health care.”

The Monsters of Comedy show will include local comics Joe Christy, Will Olguin, Ruben Bueno, Doug Reeves and Hope on Saturday at Kamiposi. The show also will feature a silent auction and door prizes to benefit the Treatment Advocacy Center.

“I think we can make something happen,” Hope said.

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(Dec. 17, 2014) “Two years after Newtown, the nearly 14 million Americans with serious mental illness must navigate the same patchwork system that failed the nation on December 14, 2012," reports CNN about Rep. Tim Murphy’s continued efforts to reform the mental illness treatment system (“I ask members of Congress to look those Newtown families in the eye,” CNN, Dec. 13).

“I ask members of Congress to look those Newtown families in the eye,” Murphy said.

“Why has mental health care abandoned those who it is meant to help the most,” Murphy asked. Speaking about Lanza, Holmes and Loughner, he says, “In each of these cases, the family knew their son had a serious mental illness, and they couldn’t get him help.”

In the last two years Murphy has held dozens of public forums across the country on how to improve our mental illness treatment system for the most severely ill. Based on information gathered at these hearings, nearly a year ago he introduced the “Helping Families in Mental Health Crisis Act,” which would markedly improve access to treatment for those who are too sick to seek treatment on their own.

Among the most important provisions are those that would allow more family involvement in the patient’s care and make it easier to order someone into treatment.

"We need to bring mental health treatment into the 21st century," Murphy said. "Our bill really pushes for solutions to help address the unique needs of not only those with serious mental illness, but families and communities and caregivers."

Murphy expects to reintroduce his bill early next year. He already has 115 cosponsors and 40 democrats on board.

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