Archive | October, 2013

“A Reader Complains: You’re Insulting Me By Writing About Jails, Prisons, and Homelessness: I Am Not Like Them” by Pete Earley

28 Oct

Dear Mr. Earley,

Why do you always assume mentally ill people either are homeless or in jail?

That’s insulting.  I have a serious mental illness but hold down a job, have a family and am dong fine. If I break the law, then I deserve to go to jail. If I end up homeless it will be because I’m lazy and don’t work or because I don’t take my meds.  Either way, it will be my fault.

People with mental illnesses should be held accountable and treated no differently from anyone else. To do otherwise is to promote stigma and make all of us look like we are criminals or bums.


Alan M.

Dear Alan M.,

I am thrilled that you are doing so well. When my son was sick, I ached for success stories such as your’s. I wanted hope. I wanted to know that persons with severe mental illnesses could and do recover and live regular lives. Please share your personal story with others, especially those who are struggling, because they need to be inspired.

Sadly, I do not agree with much else that you have written.

Individuals with serious mental illnesses have a brain disorder that impairs their thinking. There are different levels of impairment. With meaningful treatment, whether that be therapy, medication or some other assistance, most do well. But getting meaningful mental health care is difficult and even then, some individuals with the most severe disorders will not fully recover.

Obviously, most people who get sick do not break the law or end up on the streets. Statistics show that. But some do and I believe the majority of those individuals end up in trouble because of their illnesses, not because of some character defect, immorality or laziness.

Does my focus on jails and homelessness encourage stigma?  I hope not. I hope that most readers realize that I write about these issues because our system is broken and there are ways to fix it so that we can stop turning our jails into our asylums and end homelessness.

Why do I focus on persons with mental illnesses who are in jails and prisons?

The obvious answer is because of what happened to my family, specifically to my son. If you have read my book, you will know that I tried to get my son help when his psychosis first surfaced. I ran into barriers that kept me from helping him. When his delusions became worst, he broke into an unoccupied house to take a bubble bath. He was bitten by a police dog when officers responded, could have easily been shot and was charged with two felonies. I was outraged because my son is not a burglar or thief.

My son is doing great now, but I continue to focus on jails and prisons because the number of  persons with mental illnesses getting entrapped in the criminal justice system is growing. I have just returned from speaking in Oregon where more than 8,000 persons with severe mental illnesses pass through the county jail in Portland every year. These folks are not psychopaths. Most are there for minor offenses such as trespassing related to their illnesses or co-occurring problems.

Dr. Fred Osher spoke at that  same conference and talked about a recent study that he performed with public policy researcher Hank Steadman, using a very narrow definition of serious mental illness. They found that 17% of all prisoners in American jails and prisons today have a serious mental disorder. That equals 750,000 prisoners, or nearly twice the number from when I did the research for my book less than ten years ago. Their study found that  1,250, 000 people with mental disorders are on probation or under community control.

Many of these prisoners are held under the worst possible conditions despite the minor charges filed against them.  Ron Honberg, legal policy director of the National Alliance on Mental Illness,  told a Senate subcommittee last year that severely mentally ill inmates are three times more likely to be put into solitary confinement than other inmates.

While conditions in jails are improving, most prisoners do not receive any mental health care while they are incarcerated. Under the 8th amendment, if a serial killer in prison gets a tooth ache, he is entitled to decent dental care. If a rapist needs to have his appendix removed, he gets the operation. But under that same amendment, if a prisoner has a serious mental illness, there is no guarantee that he will get medical help. He is more likely to be put in segregation and punished for his bizarre behavior.

That doesn’t mean that I am ignoring the harm and damage that some delusional defendants have done. But I believe their actions, no matter how horrific, need to be viewed through the lens of their illnesses.

I understand why you do not like being lumped together with prisoners or the homeless. However, I would think that someone who has experienced psychosis would be more understanding, not less, of how easy it can be for someone in the midst of a mental breakdown to end up being arrested or homeless because of impaired thinking and a lack of decent health care services.

I hope you will join me in demanding better community services and a return to when mental illness was a health issue, not a criminal justice one.

“Why Anxiety is So Common for Those Diagnosed with Bipolar Disorder” by Natasha Tracy

19 Oct

Anxiety disorders are very common in people with bipolar disorder. In fact, in a major study (the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD)), lifetime prevalence for a comorbid anxiety disorder reached 51.2% while rates for a current anxiety disorder reached 30.5%. It may be that anxiety is, inherently, a part of some people’s experience of bipolar or it may be entirely comorbid. Anxiety disorders are also known to exist even when the bipolar disorder is subsyndromal (with less that clinical symptoms).

People with bipolar disorder have been shown to frequently suffer from more anxiety subtypes as well. People with bipolar disorder commonly also experience generalized anxiety disorder, obsessive-compulsive disorder, simple phobia, social phobia, posttraumatic stress disorder, and panic disorder. (Note: Obsessive-compulsive disorder will no longer be considered an anxiety disorder in the Diagnostic and Statistical Manual of Mental Disorders 5; rather it is considered its own type of disorder.)

What is An Anxiety Disorder?

Anxiety disorders come in many shapes and sizes (subtypes) and each type comes with its own list of symptoms. Symptoms of an anxiety disorder can include:

– Sleep disturbance

– Palpitations

– Trembling

– Chest pain

– Dizziness

– Feeling of detachment from the surroundings and from others

– Difficulty concentrating

– Exaggerated startle response

– And many others See: Symptoms of Anxiety Subtypes

What Impact Does an Anxiety Disorder Have on Bipolar?

Anxiety tends to have a worsening effect on bipolar disorder course and treatment. Bipolar symptoms appear to be intensified when anxiety is present. Those with comorbid anxiety also appear to have a lower age of disease onset, decreased response to standard treatments like lithium, increased rates of suicide and substance abuse, and a decreased quality of life. Impacts of anxiety disorder with existing bipolar disorder can be seen at school, work, and home.

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