(Aug. 12, 2014) An executive walking near a shopping mall in the posh California suburb of La Jolla was allegedly stabbed 40 times by a man whose father said is suffering from bipolar disorder the family can do nothing to help because the suspect is an adult ("Father says he tried to warn authorities about son," CBS8 San Diego, Aug. 8).

"What I want people to know is that my son has mental illness," father Odie Miller Sr., said. His son, Odie Jr., is "bright, talented, creative and personable," according to the father. "That's on his medication - without his medication - his life becomes unmanageable."

The victim is recovering at home. Miller Jr., 20, has been charged with attempted murder.

The association between violence and serious mental illness is hotly debated in mental health circles but not in the academic or scientific worlds. There, it is almost universally acknowledged that – while most people with severe mental illness are never violent – untreated mental illness is a risk factor for committing violent acts.

"Are people with serious mental illness who are not being treated dangerous?" is one of 15 recently updated Treatment Advocacy Center backgrounders that address important issues in mental health. The paper summarizes research into the association between untreated mental illness and violence and provides references to relevant studies.

When when timely and effective intervention is not available, terrible variety of consequences befall at-risk individuals like Odie Miller Jr., their families and their communities. To raise awareness of the devastating consequences of not treating serious mental illness, including the potential for violence, share "Are people with serious mental illness who are not being treated dangerous? with your local community members, politicians and media.

For more information about mental illness treatment issues, visit the "Reports, Studies, Backgrounders" page on our website and our TACReports.org site dedicated to the Treatment Advocacy Center's original research.

To comment, visit our Facebook page. 
Visit our blog archive to read all our recent posts.

(Aug. 11, 2014) Travis Fendley, 24, confessed to killing his grandmother the day after he was released from jail, but family members say non-treatment for his schizophrenia while he was incarcerated is to blame for the tragedy (“Judge: Mentally ill Fresno man will stand trial for killing grandmother,” the Fresno Bee, July 31).

As a result of "bizarre" behavior, Fendley was committed to an emergency psychiatric evaluation by police following his confession. While previously in jail, he was twice hospitalized for his psychiatric symptoms because he was not psychiatrically competent to stand trial. He has now been ordered to stand trial for murder in his 78-year-old grandmother’s death.

“He was sick and he needed help,” his aunt told the Bee. She and Fendley’s defense attorney said the killing could have been prevented had Fendley received proper medication before being released from jail.

The Treatment Advocacy Center in April published “The treatment of persons with mental illness in prisons and jails,” the first national survey of mental illness treatment practices behind bars. The study found there are now 10 times more individuals with severe psychiatric disease in prisons and jails than in state psychiatric beds, and many receive no treatment.

Fendley was a key figure in a 2013 Bee investigation of treatment provided to mentally ill inmates in the county’s jails. The report found that inmates with mental illness left the jails “in worse shape than when they were taken into custody” in Fresno County. The Treatment Advocacy Center study reached the same conclusion nationwide.

Jails and prisons were never intended to be mental health facilities. As long as they are used as such, tragedies such as the Fendley family experienced will remain common.  

To comment, visit our Facebook page. 
Visit our blog archive to read all our recent posts.

(Aug. 7, 2014) Sharp decreases in psychiatric beds spurred by deinstitutionalization have turned emergency rooms across the country into warehouses for people with mental illness in crisis.

“Psychiatric boarding” is the sanitized term for keeping psych patients waiting in the ER for days, or sometimes months, because no hospital beds are available. But the Washington Supreme Court just made this practice illegal, according to the Seattle Times (State Supreme Court: Dumping mentally ill in emergency rooms illegal,” Aug. 7).

Warehousing patients like this has had far reaching consequences, leaving fewer ER beds available for the public while psychiatric patients do not get the timely and necessary medical care they would have received in a treatment facility.

“The practice traumatizes thousands of mentally ill residents, wreaks havoc on hospitals, and wastes millions of taxpayer dollars,” the Seattle Times has said.

Aside from the suffering and deferred care, psychiatric boarding is expensive. One hospital lost $4 million in revenue because emergency room beds were occupied by people with mental illness who were waiting for a psych bed to open, according to a survey from the Department of Health and Human Services.

Washington’s decision that patients cannot be warehoused in ER rooms is a humanitarian one, but it also means that authorities will have to find a suitable treatment facility for people in a psychiatric crisis.

Currently, the state only has 34 percent of the beds necessary to meet the needs of its population with severe mental illness. To ensure that patients in a psychiatric crisis receive proper treatment and hospitals don’t send patients back to the streets, or worse, the state must begin to restore inpatient facilities so that there are beds available for people when they need them.

To comment, visit our Facebook page.

(Aug. 6, 2014) Disturbing new footage from a Denver prison depicts corrections officials using extreme force on a prisoner with mental illness, according to the Colorado Independent (“Videos show brutal treatment of prisoners with mental illness,” Aug. 1).

In the video obtained by the Colorado Independent, Isaiah Moreno, a prisoner on suicide watch, is shown repeatedly slamming his head against a concrete wall.

The corrections officers on duty are shown entering Moreno’s cell with Taser guns and shocking Moreno until he is motionless on the floor. The officers proceed to strap the motionless inmate to a restraint chair strap him to a restraint chair and leave his cell, the video shows. The footage is from September 2013. Watch the graphic video here.

Perhaps most disturbingly, the brutality occurred at the order Sergeant Ned Germain.

“Sergeant Germain gave the order when the inmate was not physically resisting at the time or immediately before the order was given,” according to the institution’s discipline report. “Moreover, Moreno was not posing a threat to himself or others.”

“They went way beyond the force needed to handle a sick person who’s obviously confused and dazed,” Mike Roque, executive director of the Colorado Progressive Coalition told the Colorado Independent. “How many times does this have to happen? How many videotapes like this have to come out before changes are made?”

Indeed, stories like these are becoming all too common in the media. But until real changes are made to our civil commitment laws to ensure that people with severe mental illness stay out of jail the first place, we will continue to see untrained corrections and law enforcement personnel working on the frontlines of mental health.

Read our previous blog about brutality toward mentally ill inmates at Rikers Island in New York.

Facebook page.

(Aug. 5, 2014) I am angry and I am tired. In a four day span in Helena, two of our young citizens lost their lives due to the consequences of serious mental illnesses. 

One was a beloved son and father whose family will wonder every day for the rest of their lives what they could have done to prevent this tragedy. The other was a former neighbor who was a babysitter for our two sons many years ago. 

Deaths like these remind me that psychiatric diseases are very treatable but not the way our system functions today.

Effective treatments can help improve functioning and allow some people with severe mental illness to begin the road to recovery and re-integrate with their families and communities. But we are still waiting for better antipsychotics that genuinely change the course of the illness and help people avoid some of the major side effects. 

The way I see it, this won’t happen because I live in a world that does not recognize serious mental illness as a legitimate disease and there is no push for better and more effective medicines for the most seriously ill. 

I am angry that people in a psychiatric crisis cannot access respectful, thoughtful, compassionate and caring treatment. I am angry that our jails and prisons are overwhelmed with people suffering from serious mental illnesses. I am angry that there are more people in prison with mental illness because there are no inpatient beds when they become sick and very few treatment options. I am angry at our elected officials, public health servants and mental health professionals who tell me that they understand the problem but don’t do anything to improve the situation.

I am angry at families that do not recognize mental illness or advocate for their family members who are suffering.  I am angry at people who live with serious mental illnesses and - maybe because of shame and discrimination – don’t try to access treatment. 

Finally, I am tired of attending funerals for the children of families who have been lost due to serious mental illnesses. 

Remember, the enemy is the illness.

Dr. Gary Mihelish
President of NAMI Helena

To comment, visit our Facebook page. 
Visit our blog archive to read all our recent posts.

(Aug. 1, 2014) After burning down a local hotel during a suicide attempt in 2012, Pattie Jill Radabaugh, 51, was ordered into treatment for her schizophrenia by a judge in Nevada County, California (“A pioneering county test the limits of Laura’s Law,” the Fresno Bee, July 30).

As a participant in court-ordered outpatient treatment, also called “Laura’s Law,” Radabaugh admits she initially did not enter the treatment program willingly. But now, 4 years later, she lives in a shared home with other people who have severe mental illness and volunteers at a local animal shelter.

“I ruined an apartment building. I’m not proud of that,” Radabaugh told the Fresno Bee. But the assisted outpatient treatment program showed her that “somebody cares.”

My next goal is to get a job, she said.

But for other families living elsewhere in California, it is too late.

George and Carol Allen, residents of Tulare County believe that Laura’s Law could have saved their son’s life, had a judge been able to order him into outpatient treatment. Their son, James Allen, 25, was diagnosed with paranoid schizophrenia and had a long history of violent behavior and a suicide attempt.

But Tulare County is one of 52 counties that hasn’t implemented Laura’s Law. So rather than being in treatment, James was shot by police after threatening his mother.

While it is unknown whether Laura’s Law would have saved Allen’s life, Radabaugh certainly believes it saved hers.

To comment, visit our Facebook page. 
Visit our blog archive to read all our recent posts.

(July 31, 2014) Diego Dietche, a 26-year-old man with schizophrenia struggles to understand why he is behind bars, reports the Daily Astorian (“Jail struggles to house mentally ill,” July 25, 2014).

“Undressed and covered in human waste,” Dietche was arrested in June for violating a stalking order.

But he won’t be transported to a mental health facility for at least another month – which is how long correctional officials estimate it will take for a bed to become available, said Deputy Stephen Johnson, who works at the Clatsop County Jail where Dietche is being held. “Right now, the mentally ill issue is worse than I have ever seen it. There's nowhere to put them and not a lot of options."

But it’s hard to get mentally ill inmates out of the jail and into a treatment facility.

“Once they get in here, it really becomes difficult to unturn the key,” said Clatsop County Sheriff Tom Bergin. “We have to go through the process of finding them a bed somewhere.”

Other employees of the jail also raised concerns. “The folks who are in jail who are suffering from mental illness are not getting the treatment that they need,” Shelley Morgan, Interim Jail Supervisor told the Daily Astorian. “It's a jail. It's not a mental health facility to treat folks. And while they are here waiting to get treatment, they're decompensating for days, weeks, months before they get back in front of a judge to get an evaluation ordered which takes, at minimum, 30 days."

Bergin is tired of his staff working as defacto mental health workers. “My deputies cannot be the caretakers for these individuals,” he said. “We need to get the mentally ill better help that they truly need from doctors and psychologists and psychiatrists, to get them back on their meds or off of whatever drug they may be on."

In the meantime, while waiting to get treatment for his mental illness, Dietche will continue to decompensate in his jail cell, covered in human waste.

For more about the treatment of prisoners with mental illness, Read our study, “The Treatment of Persons with Mental Illness in Prisons and Jails: A State Survey.”

To comment, visit our Facebook page. 
Visit our blog archive to read all our recent posts.

(July 30, 2014) Government-sanctioned discrimination against impoverished mentally ill adults – and minority adults in particular – was detailed today at a Congressional briefing on Medicaid's IMD (Institutions for Mental Disease) exclusion. The briefing was hosted by the Treatment Advocacy Center at the invitation of Representative Eddie Bernice Johnson (D-Texas).

“In addition to all the other forms of discrimination people with mental illness suffer, coverage of their psychiatric treatment in all but the smallest dedicated facilities is banned by federal law,” said Doris A. Fuller, Treatment Advocacy Center executive director and moderator of the briefing. “If these critically ill individuals needed inpatient or long-term care for heart disease or diabetes or dementia: Medicaid would cover their care. But because they are mentally ill, it does not."

Congresswoman Johnson and Congressman Tim Murphy (R-Pennsylvania), along with the Congressional Homelessness Caucus, co-hosted the briefing.

“Medicaid is the only way that many low-income minorities can get healthcare," said Congresswoman Johnson. "But the IMD exclusion creates a barrier to psychiatric treatment for those who need it the most."  

"We allow millions to suffer because of broken commitment standards and a failed Medicaid policy," said Congressman Murphy. "To fix this problem and help the millions who end up on the streets or in jail because of a mental illness, we must pass the Helping Families in Mental Health Crisis Act (HR 3717)."

The ban on Medicaid reimbursement for adults with mental illness was enacted by Congress in 1965 to motivate states to close large mental health institutions. More than 90% of the nation’s public psychiatric beds have since been eliminated, resulting in a shift of individuals with the most severe mental illnesses from residential treatment settings to jails, prisons, emergency rooms and the streets.

“It is not rational, humane or cost-effective to deny Medicaid coverage for medically necessary treatment to a specific population of poor people with mental illness, a practice that falls disproportionately on minorities living below the poverty line,” Fuller testified.

Congresswoman Johnson has led the fight to repeal the IMD exclusion, introducing legislation to fix the problem in the last four Congresses.

The Congressional briefing was the culmination of a series of public awareness events by the Treatment Advocacy Center during July's National Minority Mental Health Awareness month.

Click here to read the testimony of Doris A. Fuller

(July 28, 2014) In my experience, being poor, homeless and African-American landed me in jail instead of in psychiatric treatment.

I developed schizophrenia at age 25 and was put on medication. But shortly thereafter I stopped taking medicine because I was gaining a lot of weight and felt tired all the time. I abandoned my middle-class family and moved into my own house. But without my medication I was unable to take care of myself. My house deteriorated to the point where ants filled the kitchen. I wasn’t able to take care of myself so I thought it would be better to just leave the house. When I eventually decided to return home, the door was locked. I was homeless.

My voices told me I need to get out of town fast. So I climbed on top of a train that was halted for the evening, planning to catch a ride. Someone saw me and called the police. When the police came they didn't even talk to me. If they had spoken to me, they would have known that I was acting on my voices and in the middle of a psychotic episode.

They would have known immediately that I belonged in a psychiatric hospital, not a jail - which is where they took me. For the next 10 days I was with sex workers, a bank robber and a murderer. I was also still off my medicine, but nobody asked if I needed medicine and no doctor came to give me a psychiatric evaluation.

When I am off medicine I have a quick temper so it wasn't long before I got into my first fight inside the jail. I stood in the face of another inmate and told her she was taking too much of the mirror. It never would have happened if I had been on my medicine. The next thing I knew, I was on the floor fighting with the ladies cheering us on.

This might never have happened if the criminal justice system didn't assume that black homeless people are criminals, when actually a lot of us just need treatment.

SAKEENAH FRANCIS
Author of Love's All That Makes Sense
Living with Schizophrenia

(July 25, 2014) “Anyone walking the streets is familiar with the problem of lost souls too disoriented to take care of themselves,” the Los Angeles Times editorial board wrote in an appeal for Laura’s Law. “Though many mental patients seek treatment, others refuse and wind up drifting on the streets, a risk to themselves and others (“Laura’s Law at last for SF,” June 24).”

Approximately one-third of the total homeless population includes individuals with serious, untreated mental illnesses according to a research summary compiled by the Treatment Advocacy Center.

The Treatment Advocacy Center’s newly updated backgrounder, “How many individuals with a serious mental illness are homeless” examines the percentage of homeless individuals with serious mental illness and their abysmal quality of life.

• Approximately 33 percent of the homeless are individuals with serious mental illnesses that are untreated;
• Many of these people suffer from schizophrenia, schizoaffective disorder, bipolar disorder or major depression;
• The homeless population has increased steadily in cities and small towns since the 1970s;
• In Massachusetts and Ohio, 27 and 36 percent of people released from mental institutions became homeless within 6 months;
• Previously hospitalized people were three times more likely to obtain food from the garbage;
• Studies show that psychotic individuals are much more likely to get assaulted or threatened while homeless;

Though officials believe that they are saving money by releasing patients from mental hospitals, there is a significant cost to the patient and to society at large.  “In 2001, a University of Pennsylvania study that examined 5,000 homeless people with mental illnesses in New York City found that they cost taxpayers an average of $40,500 a year for their use of emergency rooms, psychiatric hospitals, shelters and prisons.”

Though homelessness is an accepted part of the urban landscape for city dwellers in public spaces, there are many individuals who suffer and go unnoticed. A substantial number of the psychiatrically ill live in the outskirts of cities, under bridges and even tunnels that carry subway trains beneath cities.

As states continue to close down psychiatric facilities, there will be an increasing number of individuals with serious mental illness who are homeless. In Seattle in 2013, the mayor called the number of untreated mentally ill people on the street “an emergency.” Unless local and national measures are taken to protect and treat the mentally ill, this trend will likely continue well into the future.

For access to more of our backgrounders, which summarize information about severe mental illness, policies and programs related to its treatment, and the consequences of lack of treatment, visit the “Backgrounders” page on our website.

To comment, visit our Facebook page.