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“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.

“More Mentally Ill Persons Are in Jails and Prisons Than Hospitals: A Survey of the States” by E. Fuller Torrey et al

22 Jul
The Treatment Advocacy Center and the National Sheriffs’ Association released this report in 2010:

Executive Summary

(a) Using 2004–2005 data not previously published, we found that in the United States there are now more than three times more seriously mentally ill persons in jails and prisons than in hospitals. Looked at by individual states, in North Dakota there are approximately an equal number of mentally ill persons in jails and prisons compared to hospitals. By contrast, Arizona and Nevada have almost ten times more mentally ill persons in jails and prisons than in hospitals. It is thus fact, not hyperbole, that America’s jails and prisons have become our new mental hospitals.


(b) Recent studies suggest that at least 16 percent of inmates in jails and prisons have a serious mental illness. In 1983 a similar study reported that the percentage was 6.4 percent. Thus, in less than three decades, the percentage of seriously mentally ill prisoners has almost tripled.


(c) These findings are consistent with studies reporting that 40 percent of individuals with serious mental illnesses have been in jail or prison at some time in their lives.


(d) It is now extremely difficult to find a bed for a seriously mentally ill person who needs to be hospitalized. In 1955 there was one psychiatric bed for every 300 Americans. In 2005 there was one psychiatric bed for every 3,000 Americans. Even worse, the majority of the existing beds were filled with court-ordered (forensic) cases and thus not really available.


(e) In historical perspective, we have returned to the early nineteenth century, when mentally ill persons filled our jails and prisons. At that time, a reform movement, sparked by Dorothea Dix, led to a more humane treatment of mentally ill persons. For over a hundred years, mentally ill individuals were treated in hospitals. We have now returned to the conditions of the 1840s by putting large numbers of mentally ill persons back into jails and prisons.


(f) Any state can solve this problem if it has the political will by using assisted outpatient treatment and mental health courts and by holding mental health officials responsible for outcomes. The federal government can solve this problem by conducting surveys to compare the states; attaching the existing federal block grants to better results; and fixing the federal funding system by abolishing the “institutions for mental diseases” (IMD) Medicaid restriction.


Full Report:

“Delusional Bipolar Depression More Common Than We Think?” by Natasha Tracy

16 Jul

From the blog Breaking Bipolar:

Delusions are false beliefs that are held in spite of a lack of evidence or even evidence to the contrary. For example, a delusion might be believing that the FBI is surveilling you every day or that you can predict the future. Delusions are a part of psychosis which can be present in bipolar depression or bipolar mania.

Delusions are easiest to spot when they’re exaggerated, like in the above examples, but I would suggest that delusions are much more common when we give them credit for. I would suggest that delusions are present in most cases of severe bipolar depression.

I’m the Worst Person in the World

People with bipolar depression often believe things that are decidedly untrue. Examples of this are:

I’m the worst person in the world.
The world would be better off without me.
I’m the ugliest person on the planet.
Everyone hates me.

These things are clearly untrue but can be staunchly held beliefs anyway. I don’t think these statements would get you diagnosed with psychotic delusions, but I would argue they certainly are. Even when a person can state they know they aren’t true, they will frequently also admit to believing in them anyway. That’s a delusion plain and simple. It doesn’t involve the FBI, but it’s a false belief nonetheless.

Dealing with Psychotic Delusions

In bipolar disorder we fight our brains on what we know to be real in many ways. We fight the hypomania when we know it’s not a good idea to paint our living room purple at 2 o’clock in the morning and we fight the depression when we don’t kill ourselves. Fighting delusions is, in some respects, the same. We have to fight the poor signals coming from our brain with what we know is real. And once we can grasp that our beliefs truly are delusional, this can be easier to do.

Treating Bipolar Depression Delusions

As the name implies, antipsychotics were developed to treat psychosis, traditionally in schizophrenia, but many antipsychotics are now prescribed for bipolar disorder whether recognized psychosis exists or not and they work quite well. And maybe the reason they work in the cases of severe bipolar depression is because what we’re really experiencing is delusions, is psychosis, but is not recognized as such. Maybe the reason why they work is because that end of bipolar disorder is closer to schizophrenia than we think.

(And, by the way, research on the brain supports the link between bipolar disorder and schizophrenia. It’s pretty common to see similar brain deficits between the two disorders only, in the case of schizophrenia, it tends to be more pronounced.)

I could be wrong about this, but I don’t think I am. I think what we’ll find as brain research matures is that the underlying problems in severe depression where these kinds of false beliefs are held are similar to the problems in the brains of people with schizophrenia.

So maybe it’s time for some of us to recognize that what we’re experiencing is delusions and not just garden variety depression. It might help to put things in a new perspective and make those beliefs easier to handle.

Free Online Course: “The Social Context of Mental Health”

12 Jun

This is a free, 6-week course offered by the University of Toronto. Register for it here:


About the Course

Mental health and mental illness used to be something that people didn’t talk about, but now it seems every time we open a newspaper we are hearing about the importance of mental health, or the consequences of mental illness. At this point in our history we understand mental illness and mental health to be largely influenced by biological factors, specifically, workings of the brain. At the same time, we have always known that social factors play a very strong role in promoting mental health and can make big differences in who gets mentally ill, who gets treated for mental illness, and how people can achieve good quality of life after a mental health diagnosis.

This course is an opportunity to explore how social practices and ideas contribute to the ways in which society, families and individuals are affected by mental health and mental illness. We will look at issues like why some people think mental illness is a myth, how people think about mental health and illness in different cultures, who gets mentally ill and why, how families are affected by mental illness and what interventions are available to treat mental illness and promote mental health.

Course Syllabus

Week One: A brief history of madness
Week Two: What is mental health and what causes mental illness?
Week Three: The social context of diagnosis and treatment of mental illnesses
Week Four: Culture, mental health and mental illness
Week Five: Families, caregiving and mental illness
Week Six: Society, communities and mental health

Recommended Background

A basic background in introductory psychology is recommended.

Suggested Readings

Although the class is designed to be self-contained, students wanting to expand their knowledge beyond what we can cover in six weeks can find a much more extensive coverage of this topic in the books listed below. Please note: These books are not required for completion of the course.

Mental Health Social Work Practice in Canada by Cheryl Regehr and Graham D. Glancy, published by Oxford University Press.

Mad Travelers: Reflections on the Reality of Transient Mental Illnesses by Ian Hacking, published by University Press of Virginia

A Sociology of Mental Health and Illness by Ann Rogers and David Pilgrim, published by McGraw-Hill Ryerson

The Provincial Asylum In Toronto: Reflections on Social and Architectural History edited by Edna Hudson, published by The Toronto Region Architectural Conservancy.

Mental Health, Race and Culture by Suman Fernando, published by Palgrave MacMillan


Course Format

The class will consist of lecture videos, which are between 8 and 12 minutes in length. These contain 1-2 integrated quiz questions per video. There will also be standalone homework assignments that are not part of video lectures, and a final exam.


Will I get a certificate after completing this class?

Yes. Students who successfully complete the class will receive a certificate signed by the instructor.

What is the coolest thing I’ll learn if I take this class?

Mental health plays a role in every facet of life and if you know more about it, you can do more to keep yourself and the people you care about mentally healthy.


About the Instructor

Charmaine Williams, University of Toronto

“The Boston Marathon Bombings: You Don’t Have to Watch the Media Coverage” by Julie Fast

18 Apr
From the blog Bipolar Happens by Julia Fast:

“Regarding the bombings at the Boston Marathon in the United States

It’s so important to remember that we don’t have to follow the news if
it upsets us. We can read about it next week- or ask others for an

A 24 hour CNN stream of the aftermath of this event is detrimental if you are not doing well.

If you are upset right now, I highly suggest staying off the internet
and turning off the TV. That is what I do. Anxiety, especially OCD,
paranoia, fear, depression and worry about the future can be triggered. I
always remind myself that I can learn about a world event and then let it
go. If donations are needed, I always find it helps to support an
organization like the Red Cross.”


9 Apr

I have a quote from Martin Luther King Jr. on the cover of the binder I use for all of my mental health info. It reads:

If you can’t fly, then run.

If you can’t run, then walk.

If you can’t walk, then crawl.

But whatever you do, you have to keep moving forward.

Woke up from an unpleasant dream with the image of a helpless baby seal with a broken flipper (don’t ask) stuck in my head. Began my morning ritual: coffee, news, Facebook. My instincts said: you should not go on Facebook today. I ignored my own advice and am now working to gain control over the second panic attack of the day.

I have family issues and the very first post on my feed was a picture directly reminding me of them; people I dearly love but have had to remove from my life because they were detrimental to my mental equilibrium. Like a shot in the solar plexus: oof. My heart rate ramped up almost immediately. I breathed diaphragmatically to try and slow it down. Having just consumed a cup of coffee didn’t help.

Normally, my response when this sort of thing happens in the morning is to surrender and hide for the duration of the day. But today I thought of that quote. I remembered the excellent discussion in yesterday’s support group about how working towards your own recovery shows others that it can be done, and how managing your illness fights stigma.

I continued breathing diaphragmatically and turned to the mountain of laundry dominating my bedroom. I tackled the laundry, then the dishes. Doing something tactile and repetitive that doesn’t involve higher order thinking can be very soothing. Some people knit to calm down, others bead jewelry.

The panic began to recede. Encouraged, I turned to other things that needed cleaning (there are usually many) and occupied myself for several hours. My anxiety abated.

Then I logged onto Facebook again and immediately confronted a post from a friend about gun control in which he referred to the Sandy Hook shooter as a “drooling loony” and said that a few crazies make life interesting, like an ugly sweater in your wardrobe, but that there are a lot of psychos out there.

I don’t think he meant any harm by it. Many people without mental illness are unfamiliar with the issue of stigma, and disparagement and fear of the mentally ill are ingrained in our culture. The “psycho killer” trope is omnipresent in films, music, and literature. Even our vocabulary reinforces it. The word “crazy” has overlapping meanings–it can mean mental illness,  someone who is unpredictable and volatile, or someone or something that flies in the face of logic. Like everyone, I use it to describe the latter all the time. There’s no getting away from that word or separating its multiple meanings. This is a slippery issue.

But we react emotionally before we react intellectually. Once again, my heart started beating that familiar tattoo within my chest. More breathing. I already had momentum, and that made it easier to keep going.

I thought writing about it would help. It does. Later, I’ll hit the gym, and that will help more. I’m taking a week-long break from social media to better concentrate on all of the things that need doing, and there are many because I’ve always shut down when the world bitch-slaps me into an anxious depression. However incremental my progress, I must keep moving forward.

“Free PTSD Webinars Help Families and Friends Cope”

31 Mar

“A free webinar is available to military families and friends with information about ‘Family of Heroes,’ an avatar-based resiliency and post-traumatic stress disorder training simulation.

It’s hosted by the Virginia Wounded Warrior Program and the Virginia Department of Health. The Family of Heroes program is free to all vets and their families in Virginia through June 30.

Webinars will be held from noon to 1 p.m. April 9 and 9 to 10 a.m. April 24. Sign up: www. For information, call: 212-675-9234 or”

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