(March 7, 2014) Margie Warrell shares her sorrow over her brother Peter’s passing and calls on all of us to view individuals with severe mental illness as the vulnerable human beings they are in a heartfelt opinion piece (“Mental Illness: Extend Compassion, Not Judgment,” Forbes, Mar. 2).

In the heartfelt opinion piece, Warrell describes her brother, Peter, who suffered from paranoid schizophrenia and spent ten years with his illness before taking his life. A once talented athlete with a vibrant wit, Peter became overweight and was tormented by shame of his illness, withdrawing from seeing old friends.

“When Peter took his life . . . it was because he had given up any hope that life would ever get better,” Warrell writes. “While none of us liked to admit it, we all had.”

Warrell says she wishes that instead of judgment, people would extend compassion to individuals with mental illnesses and that they would recognize the heartache they and those who love them endure.

“Next time you hear of an innocent person who is murdered by someone with a mental illness, I would love you to think about the perpetuator not as the brutal heartless villain, but as a victim also,” Warrel requests of her audience.

We echo this plea. Psychosis is a terrible state of twisted reality that truly creates a prison within one’s own mind. It is inhumane that society often views mental illness as a reflection of someone’s character, or as a choice.

Unfortunately, the stigma associated with severe mental illness is made worse by acts of violence related to it. It is our job as a society to act in ways that protect those among us suffering frailty of mind, and to take collective responsibility when they lack treatment or moral support from their communities.

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

(March 6, 2014) Sometime last summer I got to visit the traveling Vietnam memorial while it was in nearby Fort Bridger. I looked up the only fatality from my hometown. He and I had played in the same backfield on our high school football team the year I was a junior and he was a senior.

When I got home I wrote a short essay about the day and the thoughts it had inspired. In my essay I wrote that I had not served in Vietnam mostly because of my schizophrenia. I wondered who got the better deal-those who served or me.

That would really be hard to determine by any means. I have lots of friends who served. None of them had a good time over there. I never knew anyone with a serious mental illness who wouldn’t have preferred to be spared. With the thought that at least I didn’t die in the jungle, I put aside a question next to impossible to answer. But it kept bugging me.

Today I decided to look up mortality statistics. What I found follows:

• 2.6 million Americans served in Vietnam in a capacity wherein they might be exposed to enemy fire.
• Of these 58,156 died.
• That’s a mortality rate of 2.2%

Ten years after a diagnosis, 10% of schizophrenics are dead.

I can’t help but think the war in Vietnam ended in part because the public demanded its end. Imagine how many lives could be spared or improved if there was even a fraction of the public demand for better mental illness research and treatment.

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

(March 5, 2014) Nearly one-third of incarcerated women are currently suffering serious mental illness and 43 percent of women in jails and prisons meet criteria for having ever had a serious mental illness, concludes a new report published in the journal Psychiatric Services in Advance (“Mental illness highly prevalent among incarcerated women,” Psychiatry Online, Mar. 7).

The researchers examined a sample of 491 women in jails in Colorado, Idaho, South Carolina and the District of Colombia metropolitan area over the course of nearly a year ending in March 2012.

Over a quarter of the women met criteria for having ever suffered a serious mental illness, substance use disorder, or post-traumatic stress disorder in their lifetime. This includes major depressive disorder, bipolar disorder, and schizophrenia spectrum disorders. Among the women who met criteria for a severe mental illness, 45 percent showed signs of severe functional impairment.

“The prevalence of serious mental illnesses . . . suggests the critical need for comprehensive assessment of mental health and impairment level at the point of women’s entry into the criminal justice system and for increasing alternatives to incarceration, such as mental health and drug courts, and for programs that can address the complexity of female offenders’ treatment needs,” the researchers said.

More and more, evidence demonstrates that jails and prisons have become the new psychiatric hospitals.

For many of these men and women, adequate treatment can be key to avoiding contact with the criminal justice system in the first place. Better treatment standards to allow for court-ordered treatment when necessary can help avoid the very crises that often lead to arrest.  

And for those who need it, assisted outpatient treatment (AOT) is identified by the U.S. Department of Justice as an effective method of reducing crime and violence.

Read our study, “More Mentally Ill Persons Are in Jails and Prisons than Hospitals.”

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

(March 4, 2014) A powerful new tool for advocates to use in making the case for assisted outpatient treatment (AOT) is now available in Current Psychiatry Reports, a journal that reviews “published papers of major importance” on “current and emerging approaches to the diagnosis, treatment, management and prevention of psychiatric disorders.”

Authored by Treatment Advocacy Center Policy Director Brian Stettin, the report takes direct aim at critics of court-ordered outpatient treatment who claim its effectiveness is unproven.

“In my work for the Treatment Advocacy Center promoting AOT across the United States, I am often puzzled by the wide gulf between the perceptions of AOT among dedicated mental health professionals and the findings of researchers on the effectiveness of AOT in improving treatment outcomes for the most challenging subset of psychiatric patients,” writes Stettin.

“The research is good enough to lead one to expect a near-universal embrace of AOT within the mental health field, and yet this is hardly the case. While 45 states and the District of Columbia have laws authorizing local mental health systems to practice AOT, implementation of these laws remains spotty in all but a few. Many professionals I encounter seem to have absorbed anti-AOT messages emanating from various mental-health consumer organizations who reflexively oppose any infringement on patient autonomy.

“Among these messages are patently false claims that the research on AOT is ’mixed or inconclusive,’ or that the research only suggests AOT might be worthwhile in an exceedingly well-funded system of community-based care,” he says.

In the article, Stettin sets the record straight “by summarizing the mountain of positive data, placing the purportedly inconclusive or negative findings in a more intellectually honest context, and putting to rest the pervasive myth that impressive results achieved in New York are rooted in anomalies of that state.”

“An advocate’s observations on research concerning assisted outpatient treatment” is available for a fee from Current Psychiatry Reports (2014) or upon request by emailing This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

(March 3, 2014) When Mississippi Clarion-Ledger reporter Jerry Mitchell takes on mental illness, you know you’re going to get the full story.

That’s once again the case in his new article about the discovery of graves from the Old Mississippi State Lunatic Asylum that were uncovered during a university construction project (“More than 2,000 bodies of mental patients buried on grounds of UMMC,” Clarion Ledger, March 1).

The original state hospital was built at the urging of mental illness treatment reformers for $175,000 and completed in 1855. The first patient listed in the Registry of Admissions, Evelyn Seastrunk, was admitted at the age of 29 in 1857. She was discharged 35 years later. The reason given for her discharge? Death. Seastrunk was among the 2,000 bodies discovered on the grounds of the old hospital.

One in five of the patients died in those days. Dr. Luke Lampton, chairman of the state Board of Health, who has written about the history of the hospital calls them “forgotten twice — when they were originally sent there for treatment and after they were buried there.”

Today, patients with severe mental illness are vastly less likely to be forgotten in this way because there are few psychiatric beds left for them, and individuals who occupy the few that exist typically spend only a few days in treatment. Instead, people with severe psychiatric diseases are more likely to be forgotten as members of the homeless population or left in jails and prisons when they are pushed off the grounds of psychatric treatment hospitals.

Mitchell’s story is a poignant orientation to the landscape of psychiatric hospitalization over the last 150 years. For the most up-to-date data on its condition today, see our 2012 study, “No Room at the Inn: Trends and Consequences of Closing Public Psychiatric Hospitals” on our TACReports.org website. 

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

(Feb. 28, 2014) A new study published in the journal JAMA Psychiatry suggests that children born to middle-aged men are more likely to develop mental health problems, including schizophrenia (“Mental illness risk higher for children of older fathers, study finds,” New York Times, Feb. 26).

The research team analyzed medical and public records from 2.6 million Swedes born between 1973 and 2001 and found that children born to men age 45 or older had nearly twice the risk of developing psychosis than children born to fathers aged 20-24. The results also showed a strong link between paternal age and likelihood of bipolar disorder.

The increased risk of mental health problems linked to older fathers “is most likely a result of the accumulation of genetic mutations in sperm cells,” the researchers said.

This is not the first study to link paternal age and mental illness. Previous studies have suggested the risk of schizophrenia or bipolar increased among children born to men over the age of 55.  But this new study lowers the bar to 45, increasing the the number of children potentially at risk because of paternal age.

The onset of severe mental illness is multi-factorial and includes both genetic predisposition and environmental factors. Being aware of genetic risk factors can alert families to the heightened importance of controlling for environmental facts that could be triggers.

To comment, visit our Facebook page.

(Feb. 27, 2014) The US Department of Health and Human Services (HHS) this week issued new guidance intended to clarify when providers may share information related to a patient’s mental health with family members and others. 

While this guidance does not change the law it provides a great tool for families and caregivers by undercutting some of the excuses health providers use to withhold information from families dealing with psychiatric crisis.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) created a national standard for the protection of certain types of health care information. The US Department of Health and Human Services issued a “Privacy Rule” in 2002 to implement the requirements of HIPAA.

Most families who have dealt with serious mental illness are familiar with the hurdles this act and its rule can present when trying to get treatment for a loved one. ERs, hospitals, doctors, nurses and just about everyone else in the treatment stream routinely withhold critical health information on the basis of HIPAA.

However, in a House subcommittee hearing last spring examining whether HIPAA prevents people with severe mental illness from receiving timely and effective treatment and puts the public at risk as a result, testimony made it clear that HIPAA is being widely “misinterpreted and over interpreted” to create hurdles not authorized by the law. Representative Tim Murphy (R-Pennsylvania) subsequently included clarifications to HIPAA’s use in his Helping Families in Mental Health Crisis Act, now pending in Congress.

The guidance appears to take aim at some of the overreaching Murphy’s bill addresses. Among other points, the new clarifications address when HIPAA permits health care providers to: 

• Communicate with a patient’s family members, friends, or others involved in the patient’s care;
• Communicate with family members when the patient is an adult;
• Consider the patient’s capacity to agree or object to the sharing of their information;
• Involve a patient’s family members, friends, or others in dealing with patient failures to adhere to medication or other therapy;
• Communicate with family members, law enforcement, or others when the patient presents a serious and imminent threat of harm to self or others.

Click here to read the new guidance from the US Department of Health & Human Services.

To comment, visit our Facebook page.

(Feb. 26, 2014) A federal investigation into the Pennsylvania corrections system found that depriving inmates with serious mental illness of all human contact by placing them in solitary confinement “violates the constitutional ban on cruel and unusual punishment (“Report criticizes treatment of mentally ill Pa. prisoners,” Feb. 24).”

In a one-year span the Pennsylvania corrections system “kept more than 1,000 prisoners on its mental health roster in solitary confinement for more than 90 days…with nearly 250 of those inmates in solitary confinement for more than a year,” the Department of Justice found.

In a one-month span, “prisoners with serious mental illness were being placed in solitary confinement at twice the rate of other prisoners,” the report also noted.

"Pennsylvania's unconstitutional use of solitary confinement of prisoners with serious mental health illness victimizes one of the most vulnerable groups in our society," said U.S. attorney David J. Hickton.

At the Treatment Advocacy Center we have long said that people with mental illness are ending up in jails in prisons when they should instead be receiving treatment in inpatient or outpatient programs.

Unfortunately, in Pennsylvania, where the standard for mandatory inpatient or outpatient treatment is incredibly high, people have to deteriorate to the point of dangerousness before they become eligible.

This means people with serious mental illness in Pennsylvania are nearly twice as likely to end up in jail than in a psychiatric hospital, and according to the new report, also two times more likely to face solitary confinement upon incarceration.

Confinement is mistreatment, and it must stop.

Read other consequences of untreated severe mental illness. 

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

(Feb. 25, 2014) Following the tragedy that resulted in the death of Sen. Creigh Deeds’ son, Gus, officials said no beds were found during the limited time of a psychiatric hold in Virginia. Three hospitals subsequently came forward saying they could have admitted Creigh Deeds’ son on the night of his psychotic episode.

One of the issues that emerged from the media firestorm was that there are few effective systems for keeping track of the number and location of hospital beds in Virginia, even in an emergency.

But it turns out that Virginia isn’t the only state that lacks the ability to track real-time psychiatric bed availability.

In fact, twenty-four states don’t have the basic tools to identify beds for people in a mental health crisis, according to a survey of state mental health departments (“State of emergency: 24 states lack basic tools to identify open beds for psychiatric patients,” ThinkProgress, Feb. 24).

 “Even in states with active databases, there is no guarantee of an available bed,” Dr. Jeffrey Geller, Treatment Advocacy Center board member told ThinkProgress. “Public sector beds are running 95 percent, plus or minus, filled all the time."

So as we saw with Creigh Deeds, the lack of a tracking system particularly impacts people in a mental health crisis, but until we restore psychiatric beds to meet the needs of the population, a psych bed registry isn’t the final solution to getting people into the treatment they desperately need.

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

(Feb. 21, 2014) People with serious mental illness are significantly more likely to be infected with HIV, according to a new study from researchers at Penn Medicine and other institutions (“Persons with severe symptoms of mental illness are at higher risk for being HIV-infected,” Medical News, Feb. 14).

The researchers provided HIV testing to nearly 1,000 people who were seeking treatment for symptoms of a mental health problem and found that 4.8 percent of the patients were HIV positive. Results also showed that the more severe the symptoms of mental illness were, the more likely a person was to test positive for the virus.

The findings “reinforce how important it is to identify patients and get them into appropriate care in a timely manner while being treated for mental illness," said lead author Dr. Michael B. Blank, associate professor in Psychiatry at the Perelman School of Medicine.

The study is one of the largest studies to date to estimate HIV prevalence among people receiving treatment in mental health settings and suggests additional consequences of untreated mental illness along with a greater need for care for those suffering from psychiatric diseases.

The good news is that a previous study found that people who are receiving treatment for mental illness are also more likely to stick with an HIV treatment plan (“Mental illness and substance use delay HIV treatment,” AIDS Meds, Mar. 18, 2008).

Read other consequences of untreated severe mental illness.

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