(May 30, 2014) Many of us have been in the same shoes as the Rodger family. I am the mom of a very sick son who has no idea he is ill. He doesn’t believe he needs medicine and is currently in one of the only two hospitals in our state that can help him. I get chills reading the accounts of Elliot Rodger’s story. We too have called the police and the crisis teams for help time and time again, only to have our son politely say he is just fine.

I have always said, “I don't want to be one of those families in the news someday!"

Everyone else who lives around us knows what is going on with our son, but the laws prevent people from actually helping him. Laws need to change so that families can get assisted outpatient treatment (AOT) for their loved ones. We need more beds and facilities so that when people do get access to treatment, there is a place for them to go.

Our son ended up in jail for a minor situation, so let’s also point out that jails have become our new psychiatric hospitals because there is nowhere else for parents to turn. Our son should have been in a hospital. Instead, we had to fight to prove that he was ill. If he had cancer or kidney issues, he would have received treatment in a hospital. Can you imagine a heart patient ending up in jail?

Until people wake up and understand that the mental health system needs a complete overhaul, people with mental illness will continue to get hurt themselves, or hurt someone else.

Right now, families are given the responsibility for caring for their sons and daughters, but their hands are tied when a psychiatric crisis strikes. Then, when someone does get hurt, the family is always the first to get blamed. Yet, in many cases, the family was screaming for help long before the tragedy occurred.

There are many of us who are suffering this awful system. It makes no sense. This shouldn't be a political issue. Our mental health system is in true crisis and yet nobody does anything.

Meanwhile we have more and more people getting hurt or worse.

What will it take to change the laws? Is this the best we can offer to those who need help the most? It’s outrageous. What is it going to take?

Laurel
Pennsylvania

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(May 29, 2014) High-profile tragedies make the news and call into question the best ways to ensure access to treatment for people with severe mental illness. But often overlooked are the smaller, everyday tragedies that don't make national headlines.

Joann Kennedy, a 51-year old who has battled schizophrenia, homeless and multiple jail stays has cost Texas nearly $1 million dollars in care, reports Andy Pierrotti for ABC News. She is one of the frequent fliers revolving between the criminal justice system, homelessness and psychiatric hospitals who most likely will never become violent but needs help nonetheless (“Defenders investigation: The cost of troubled minds,” May 29).

Over a 20-year period, Kennedy spent nearly 1,500 days behind bars and was admitted to the emergency room 326 times - at a cost to taxpayers of $676,472. This total doesn't even include court costs, medical services costs or law enforcement costs.

Kennedy’s story once again demonstrates that putting people with mental illness in jails isn’t saving taxpayers any money. It also isn’t surprising that when she did get help, it came from the criminal justice system or other places that the chronically mentally ill end up when they are locked out of treatment.

Texas has only 19 percent of the beds necessary to meet the needs of its population. Texas was awarded a C for its ability to divert people with serious mental illness from jail and an F for its use of laws that would allow people with severe mental illness to receive mandatory treatment.

We have said over and over again, the institutions most likely to be treating people with mental illness are not hospitals, but jails and prisons. In fact, our recent study on the subject found the largest mental health institutions in 44 of 50 states are jails or prisons.

With one million dollars at stake for patients like Kennedy, isn’t it time we look at real solutions to helping the most vulnerable among us? We must begin by maintaining a functional public mental health treatment system so people with mental illness do not end up in prisons and jails.

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(May 28, 2014) The series of murders by Elliot Rodger that left six people and Rodger dead in Isla Vista have renewed calls for statewide expansion of Laura’s Law, California's court-ordered outpatient treatment program for people with severe mental illness.

Prior to the deadly rampage, Rodger had extensive contact with both mental health professionals and law enforcement. Rodger’s parents had long been concerned about his erratic behavior and had notified the police. But California law doesn’t allow private individuals to petition the court for an emergency evaluation.

Now, “society must move more boldly toward providing and requiring treatment for the mentally ill,” says the Los Angeles Times editorial board (“Isla Vista and the case for Laura’s Law,” May 27).

“It's not hard to get started: All counties in California should adopt Laura's Law, which allows courts to order outpatient mental health treatment in exceptional cases,” writes the board. “Though 12 years old, the law was, until this month, embraced fully only by tiny Nevada County. Two weeks ago, Orange County became the first populous county to adopt it. Now, San Francisco is considering doing the same.”

But there are still 54 counties in California and a majority of counties nationwide where individuals with mental illness, their families and their communities are not benefiting from their assisted outpatient treatment (AOT) laws.

“Laura's Law will not stop every tragedy or protect every person in need of care. But it will save some lives and prevent some suffering. That's reason enough.”

Read the entire editorial.

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(May 27, 2014) The deadly consequences of failing to heed red flags for violence from young men known by their families to be psychiatrically unstable and dangerous are on tragic display in the May 23 rampage attacks that left six young men and women dead and 13 others wounded near the University of California Santa Barbara.

The parents of Elliot Rodger, 22, and a social worker alerted law enforcement that Rodger appeared to be a danger to himself and/or to others after he had posted disturbing videos on YouTube. But California law doesn’t allow private individuals to petition the court for an emergency evaluation. Even Rodger’s private mental health providers were excluded. When responding officers found Rodger shy but “polite” and “kind,” they were left without grounds for referring him to evaluation. That left his family without a means of intervening.

"Once again, we are grieving over deaths and devastation caused by a young man who was sending up red flags for danger that failed to produce intervention in time to avert tragedy," said Doris A. Fuller, executive director. "In this case, the red flags were so big the killer's parents had called police - a desperate step of last resort for any parent - and yet the system failed.”

Like every state, California has civil commitment laws designed as a last resort for intervening when qualifying people with mental illness are unable or unwilling to help themselves. Like the laws in nearly all states, California’s need improvement. In 34 other states, Rodger’s family would have been able to ask a court to order an emergency psychiatric evaluation. In California, they couldn’t.

"We cannot predict who will be violent, and we will never prevent all violence," said Fuller. "But that’s no excuse for disregarding the means we have available to reduce tragedy – and all the consequences of untreated mental illness.”

Fuller said these means include making sure treatment laws recognize the crucial role of families, teachers, colleagues, neighbors and other private citizens in identifying red flags for danger and then using the laws as they were intended – to protect the individuals suffering symptoms of untreated mental illness and those around them.

(May 23, 2014) Legislatures across the country are considering ways to help the countless individuals who have fallen through the cracks of our mental health system. This week San Francisco decided to put assisted outpatient treatment (AOT) on the November ballot. Early reports indicate a majority of voters approve the measure. Last week, California’s third-largest county decided to opt into assisted outpatient treatment for qualifying residents.

At the federal level, legislation proposed by Rep. Tim Murphy would focus taxpayer dollars on programs for the severely ill rather than for broader programs for people with less serious mental illnesses. All of these moves bode well for families who have a loved one suffering with severe mental illness.

But if you live in a state that currently has court-ordered outpatient treatment, understanding the many options for assisted treatment can be daunting and even confusing.

Often a variety of options, which are generally not mutually exclusive of one another, are available when assisted treatment is needed. As the backgrounder states, “assisted treatment for individuals with severe psychiatric disorders can be achieved by different methods.” Further, it adds, “more than one are often being used at the same time.” As a starting guide to these many options, our backgrounder can be a powerful tool for reference and advocacy alike.

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 “Reports, Studies, Backgrounders” page on our website.

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(May 22, 2014)”Families wish someone would protect their severely ill family members from groups that advocate for their right to be severely psychotic,” Susan Inman writes in the Huffington Post (“How Nancy Pelosi broke my heart,” May 20).

To help families in crisis, Representative Tim Murphy proposed the Helping Families in Mental Health Crisis Act (HR 3717), but the issue has become partisan and Democrats have been slow to show support for his bill.

“Now the lack of Democratic support has morphed into something even more dangerous,” Inman writes. “Under the guidance of House Minority Leader Nancy Pelosi, the Barber bill has been introduced. It guts every important change proposed in the Murphy bill.”

To make matters worse, “there has been a lack of leadership from groups that should be actively lobbying to get the Murphy bill passed,” Inman says. “This might come as quite a shock to the many American families … who can’t get treatment for their very ill sons and daughters whose psychotic states aren’t passing.”

Inman wonders why the party that “mostly has been consistent in its support of the value of science” has turned its back on the only piece of legislation that would make a difference for the millions of Americans living with severe mental illness who are now filling jail cells or homeless, victimized or cycling in and out of the emergency room.

“I urge Ms. Pelosi to get the Democratic leadership to endorse a sensible approach in responding to the reality of severe mental illnesses.”

We couldn’t agree more.

Read the entire piece by Susan Inman.

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(May 20, 2014) Miami-Dade County Judge Steve Leifman pleads in the Miami Herald for Florida to treat its mentally ill residents in an op-ed in the Miami Herald (“Give people with mental illness treatment, not a jail cell,” May 17).

Leifman describes a University of South Florida study that examined the costs of 97 people with severe mental illness over a five-year period in Miami-Dade County.

Almost all of the subjects were homeless. They also experienced 2,200 arrests, 27,000 days in jails and 13,000 days in hospitals and emergency rooms. The total cost to taxpayers was estimated to be $13 million dollars.

“Shocking? Yes. Surprising? No,” Leifman writes. “Florida ranks 49th nationally in funding for community mental-health treatment.”

We certainly are not surprised. According to our 2012 bed study, the miserable national average is 14 beds per 100,000 people, but Miami-Dade musters only 3. This means that of the 185,000 people diagnosed with serious mental illness in the county, only a tiny percentage receives treatment through the public mental health system.

Of course, the scarcity of psychiatric treatment means that “the county jail has become the largest psychiatric institution in Florida.”

“If we treated people with primary healthcare needs the way we treat people with mental illnesses, there would be rampant lawsuits and criminal indictments,” Leifman says. “But people in a psychiatric crisis without financial means who are admitted to a hospital receive treatment only as long as they are considered dangerous to themselves or others . . . . Such people are then discharged, often to homelessness, and eventually find their way into the criminal-justice system again — and again and again.”

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(May 19, 2014) Until we make treating people with severe mental illness a priority, we will continue to see people with psychiatric disease flock to the country’s emergency rooms, prisons and streets, advocates tell reporter Paige Cunningham in her examination of Rep. Tim Murphy’s efforts to change the way we treat severe mental illness (“Pushing to help the severely mentally ill," Politico, May 19).

Prior to the introduction of Murphy’s bill, the Helping Families in Mental Health Crisis Act, “much of the focus on mental health issues has been directed at removing stigma for the millions of individuals who need help for milder conditions" Cunningham writes. "That has shifted public attention from those with more severe problems.”

“We’re talking about people who don’t have a voice for themselves, who don’t make poster children for mental health because they are living under bridges or eating out of trash cans or they’re behind bars,” Doris A. Fuller, executive director of the Treatment Advocacy Center tells Cunningham. This is the “first piece of federal legislation in 50 years that’s really looked at this population.”

Murphy’s bill would redirect federal mental health funds to those who need them the most and prioritize initiatives backed by solid evidence and track their success, like assisted outpatient treatment (AOT). The legislation intends to change the way Medicaid pays for certain mental health treatments. His proposal would also clarify HIPAA so that doctors can more easily share information about people in a psychiatric crisis with their family and caregivers.

Learn more about the Helping Families in Mental Health Crisis Act.

Please contact your representative in Congress and tell him or her how important this legislation is to you and your loved ones. Use the sample letter on this page.

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(May 16, 2014) “The mentally ill who have nowhere to go and find little sympathy from those around them often land hard in emergency rooms, county jails and city streets. The lucky ones find homes with family. The unlucky ones show up in the morgue,” reported USA Today earlier this week (“The cost of not caring: Nowhere to go,” May 12).

As we know, the costs and consequences of non-treatment for severe mental illness are huge. But how many Americans are currently suffering from a serious mental illness without treatment?”

Among the individuals in the U.S. with schizophrenia or bipolar disorder, studies consistently estimate that between 40 and 50 percent are receiving no treatment, according to a Treatment Advocacy Center backgrounder called “What percentage of individuals with severe psychiatric disorders are receiving no treatment?”

The newly updated backgrounder cites studies performed using data from a number of sources, including, among others:

·         The National Institute of Mental Health;

·         Medicaid claims data;

·         The National Comorbidity Survey; and

·         The five-site Epidemiologic Catchment Area survey.

According to some of these sources, approximately 3.0-3.5 million individuals with schizophrenia or bipolar disorder are not being treated on any given day in the US, the backgrounder says.

Untreated severe mental illness is a problem with wide-ranging and devastating consequences for individuals, families, and communities. Disturbingly, as our backgrounder indicates, evidence supports an estimate that millions of adults in our country with these diagnoses are not receiving treatment and thus are vulnerable to these consequences.

Our backgrounder can be a tool for educating fellow community members, press, politicians, and others with influence about the great need for meaningful intervention in our laws and services.

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 “Reports, Studies, Backgrounders” page on our website.

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(May 15, 2014) It was on this day in 1817 that the Asylum for the Relief of Persons Deprived of the Use of Their Reason was founded in Philadelphia. It was the first private mental health hospital in the United States. The Asylum was founded by a group of Quakers, the Philadelphia Yearly Meeting of Friends, who built the institution on a 52-acre farm. It is still around today, but goes by the name Friends Hospital.

At the time that Friends Hospital was founded, mental illness was widely misunderstood and treated as criminal behavior. Mentally ill people were tied up, put in chains, isolated, or beaten. The Quakers wanted to model a new type of care. They wrote out their philosophy in a mission statement for the hospital: "To provide for the suitable accommodation of persons who are or may be deprived of the use of their reason, and the maintenance of an asylum for their reception, which is intended to furnish, besides requisite medical aid, such tender, sympathetic attention as may soothe their agitated minds, and under the Divine Blessing, facilitate their recovery."

The group purchased the 52-acre farm for less than $7,000, and tried to create a beautiful place with gardens and lots of outdoor space.

These days, the hospital occupies 100 acres, which include flower gardens and about 200 varieties of trees. Much of this was the work of one man who started out at the hospital as a bookkeeper in 1875 and ended up working there and managing the grounds until his death in 1947. One day, he found an azalea that a family member had brought for a patient and tossed out. He tended it in the greenhouse until it was healthy again, took cuttings, and planted those, and from that one plant more than 20 acres of the Friends Hospital are now planted in azaleas.

Excerpted from the Writer’s Almanac.

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