Tag Archives: mental illness

“What is Normal?” by Peter Kramer

11 Jan
Peter Kramer is a professor of psychiatry at Brown University. His article “What Is Normal,” first published in 2009, attempts to address concerns about the impending fifth edition of the Diagnostic Statistical Manual, primarily that expansions in psychiatric diagnostic labels and criteria would result in pathologization of “normal” human affect and behavior. You don’t have to subscribe to antipsychiatry to conclude that some of these concerns have been validated, an oft-cited example being the removal of the “bereavement exclusion” from the diagnostic criteria for major depressive disorder.
Still, Kramer offers a fresh perspective on the issue, arguing that expansions of psychiatric diagnoses not only have the potential to vastly improve people’s quality of life, but can  also alleviate isolation and stigma, provide insight into our sociocultural context, and enhance our understanding of the human condition. He also sheds light on some of these expansions’ epistemological origins.
I’ve included and emphasized what I consider the most salient excerpts from the article, which you can read in its entirety here.

 

I have been thinking a good deal about normality lately. It’s a concern in the medical world. The complaint is that doctors are abusing the privilege…to define the normal. Ordinary sadness, critics say, has been engulfed by depression. Boyishness stands in the shadow of attention deficits. Social phobia has engineered a hostile takeover of shyness.

….

The fate of normality is very much in the balance. The American Psychiatric Association is now revising its diagnostic and statistical manual—the next version, DSM-V, should preview in 2011 and become official the following year. It may, indeed, be that as labels proliferate, mental disorders will annex ever more territory. But claims of a psychiatric power grab are overstated. The real force behind a proliferation of labels is the increasing ability of technology to see us as we’ve never been seen before. Still, the notion of a shift in the normal invites unease: To constrain normality is to induce conformity. To expand diagnosis is to induce anxiety. Is anyone really well?

It’s a short hop from critiquing narrowed normalcy to claiming that we are an overmedicated nation. As [Christopher Lane, author of Shyness: How Normal Behavior Became a Sickness] writes, “We’ve narrowed healthy behavior so dramatically that our quirks and eccentricities—the normal emotional range of adolescence and adulthood—have become problems we fear and expect drugs to fix.” Psychiatry’s critics also complain that doctors medicate patients who meet no diagnosis, who practice what I have dubbed “cosmetic psychopharmacology,” to move a person from one normal, but disfavored personality state, like humility and diffidence, to another normal, but rewarded state, like self-assertion.

Labels matter even when medication has no role in treatment. A wife complains that her husband lacks empathy. Does he have Asperger’s syndrome, a lesser variant of autism, or is he simply one of those guys who “don’t get it,” who simply don’t see social interactions as ordinarily perceptive women do?

Diagnosis, however loose, can bring relief, along with a plan for addressing the problem at hand. Parents who might have once thought of a child as slow or eccentric now see him as having dyslexia or Asperger’s syndrome—and then notice similar tendencies in themselves. But there’s no evidence that the proliferation of diagnoses has done harm to our identity. Is dyslexia worse than what it replaced: the accusation, say, that a child is stupid and lazy?

The question of normality creates strange paradoxes in the consulting room. Often it is relatively healthy people who feel defective. In psychotherapy, patients may perseverate over vague complaints, feeling off-balance and out of sync. The worriers may believe that they have too much or, more often, too little ambition, desire, confidence, spontaneity, or sociability. Their keen social awareness (a strength), when tinctured with obsessionality, causes them to fuss over glitches in the self. For them, a sense of abnormality precedes any diagnosis and may persist even when none is proffered.

In contrast, seriously ill patients may have no such concern. Those who manifest frank paranoia will insist on their normality; anyone would be vigilant in the face of plots directed at them. Anorexics and alcoholics may profess certainty that they’re fine; the degree of “denial” is something of a marker for severity of disorder.

People afflicted by disabling panic or depression may fully embrace the disease model. A diagnosis can restore a sense of wholeness by naming, and confining, an ailment. That mood disorders are common and largely treatable makes them more acceptable; to suffer them is painful but not strange.

In other words, in the clinical setting, the proliferation of diagnoses has diverse effects, making some people feel more normal, some less so, and touching others not at all. There is no automatic link between a label and a sense of abnormality.

Still, diagnosis can seem to confer stigma. I recall a patient, Roberta, who consulted me because her marriage was in trouble. Her husband resisted couples therapy. Might she see me alone?

In my office, Roberta was listless and slow of thought. Her memory was vague. Was the problem thyroid disease—or an occult cancer? Roberta willingly submitted to a workup by an internist. She was devastated when she was referred back for treatment of depression.

To Roberta, the mood disorder label confirmed her husband’s complaint that something was wrong with her as a person. To be called depressed rather than, say, anemic constituted double jeopardy: She was in pain and she was flawed, in judgment and in character. She was unloved—and, now, abnormal.

Despite her misgivings, I asked Roberta to consider psychotherapy, exercise, bright lights (for winter in New England), and medication. I wanted her to be functioning well quickly, before she made irreversible decisions about her marriage.

The case had a memorable outcome. Only when she was better did Roberta reveal that at her low point she had contemplated suicide. Her summary comment was, “The fights with my husband saved my life.” They caused her to be diagnosed—and treated.

When she first spoke with me, Roberta seemed to display normal sadness, that is, emotional disruption in the face of a life crisis. Psychiatry’s critics are right: Roberta experienced the diagnosis as stigmatizing, and it led to her taking medication. But the case also illustrates why, for doctors, making diagnoses and educating patients about them is not a matter of choice; diagnosis can be lifesaving.

Just where does the impetus to expand diagnosis originate? A recent public flap highlights how categories proliferate. Raymond DiGiuseppe, a psychologist who researches anger, made headlines last spring when, at a scientific meeting, he argued that the DSM should add anger disorders, to parallel depression and anxiety disorders. There is a point at which anger becomes harmful, he contends. When scholars immerse themselves in an area—carefully observing research subjects, making note of differences and attendant harm—new sets of diagnosis seem obvious and inevitable. It doesn’t matter whether treatment for the condition is medication or psychotherapy, or indeed, any treatment at all.

….

Critics of psychiatry complain that many patients fit no clear category and, at least on insurance forms, are given labels like “anxiety disorder not otherwise specified.” Such patients nevertheless often remain at risk for an array of bad outcomes, studies indicate—findings that tend to broaden diagnostic categories.

Research technology is transforming understanding of mental disorders. New, more finely grained ways of looking at brains, neurons, and even cell connections, as well as powerful computer models, correlate many observed variations in function with disease and disability. The nerve connections you form, the neurotransmitters you elaborate, the symptoms you suffer—each may be linked to vulnerability to disorder.

One way psychiatry has responded to expansionist pressures is to turn to the concept of dimensions. Imagine compiling a list of all the factors ever associated with depression: irritability, a metallic taste in the mouth, a variant of a relevant gene, a change in size of a part of the brain. The list grows to 300 factors—symptoms, personality styles, gene variants, gene configurations, family histories, protein elaboration, and anatomical differences. Say, you rate a person on each of them.

Then you identify clusters of factors (extreme irritability, mild complaints of “off” taste, moderate levels of brain abnormality) that predict recurring episodes of mood disruption. A computer could identify varying degrees of severity for each of the hundreds of factors, with differing prognoses and treatment options. And then at some point, it becomes logical to dispense with the discrete, categorical have-it-or-don’t-have-it view of depression.

In time, and in future manuals, dimensions may push categories aside. If for many of the factors, difference confers some degree of vulnerability to dysfunction, then we will find that we are all defective in one fashion or another. DSM-V may turn out to be conservative and postpone the inevitable, but it is hard to imagine a future in which abnormality is not much more prevalent than it is today. The shift in perception may become more marked as researchers identify subtle neuron- or gene-based variations with modest psychological consequences—increased risk for one or another condition—in the way that high blood pressure signals increased risk for stroke.

How will it feel to live in a culture in which few people are free of psychological defect? Well, we’ve been there before, and we can gain some clues from the past. The high-water mark for diagnosis occurred in the heyday of psychoanalysis. The Midtown Manhattan Study, the premier mental health survey of the 1950s, found that over 80 percent of respondents—more than triple our own abnormality rate—were not normal. “Only 18.5 percent of those investigated were ‘free enough of emotional symptoms to be considered well,'” the New York Times reported. It even cited a psychiatrist who reasoned that, since health includes awareness of conflict, subjects who express no neurotic anxiety must also be abnormal.

In a forthcoming book, Perfectly Average: The Pursuit of Normality in Postwar America, American Studies scholar Anna Creadick reports that the U.S. hungered for a return to normality in the wake of World War II. Articles asking, “Is Your Child Normal?” appeared regularly in the press.

But being deemed neurotic was hardly a cause for distress. If anything, the affliction seemed to signal opposition to mass culture, as if emotional sensitivity were a protest against Eisenhower-era dullness and conformity. Popular essays and books such as The Man in the Gray Flannel Suit made normal men and women out as saps.

The lesson of mid-century is clear: When everyone is abnormal, diagnosis loses its sting. I suspect that we are entering a similar period in which diagnosis (or dimensional defect) spreads—while its gravity, in terms of social stigma, diminishes. Or else we will redefine normal to include broad ranges of difference.

To some degree, that is already happening. The deaf, anorexics, people with Asperger’s syndrome—groups whose members might otherwise be considered impaired or deviant—have made vigorous claims to represent “the new normal.” The Hearing Voices Network advocates liberation, not cure, for those who hallucinate. Where once people pursued normality through efforts at self-reform, now they proudly redraw the map to include themselves. In this context, diagnostic labels confer inclusion in a community. Today, an emotional or behavioral state can be understood both as a disorder and a unique perspective.

As the experience of mid-century shows, we can hold two forms of normality in mind—normal as free of defect, and normal as sharing the human condition, which always includes variation and vulnerability. We may be entering a similar period of dissociation, in which risk and pathology become separated from abnormality—or an era in which abnormality is universal and unremarkable.

We are used to the concept of medical shortcomings; we face disappointing realizations—that our triglyceride levels and our stress tolerance are not what we would wish. Normality may be a myth we have allowed ourselves to enjoy for decades, sacrificed now to the increasing recognition of differences. The awareness that we all bear flaws is humbling. But it could lead us to a new sense of inclusiveness and tolerance, recognition that imperfection is the condition of every life.

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“First Dr. Phil, Now NBC’s Brian Williams: Stigmatizing Mental Illness” by Peter Earley

2 Aug
From peteearley.com:

I’ve been warned that fighting stigma is a bit like tilting at windmills, but I find it difficult to keep silent when I see blatant examples. Dr. Phil’s comments about how “insane” individuals “suck on rocks and bark at the moon” were especially offensive since he is a psychologist. Last night, I flipped on the news and heard NBC Anchor Brian Williams make remarks that were just as stigmatizing.

Williams announced that Ariel Castro, the Cleveland kidnapper/rapist who held three women captive for a decade, was “arguably the face of mental illness.”

Not content to toss millions of Americans who have mental health issues under the bus, Williams spoke with contempt about how Castro had given a rambling, difficult to hear speech, during which he justified his actions by  ”appropriating the language of the addiction and treatment culture” and declaring himself “sick.”







What exactly is the “language of the addiction and treatment culture” Mr. Williams?

As a former reporter for The Washington Post, I would never have jumped to the conclusion that Ariel Castro has a mental illness simply because he committed heinous crimes.

In an email this morning, my friend, Bob Carolla, director of media relations for the National Alliance on Mental Illness, pointed out that Williams violated a recently approved standard in the Style Book of the Associated Press. Style books are the “bibles” of journalism, establishing the rules that responsible reporters are supposed to follow when writing stories. On March 7th, of this year, the AP added new guidelines that reporters should follow when writing about mental illnesses.

Clearly, Brian Williams didn’t get that memo.

In June, The White House held a mental health summit during which President Obama declared that our nation has to rid ourselves of the “embarrassment” associated with mental illnesses. “We’ve got to get rid of that stigma,” President Obama said.

If you wish to know how difficult that is going to be, turn on Dr. Phil and NBC Nightly News.

The question is: how do we go about changing this? [One easy thing is to sign a petition demanding NBC apologize.]

Here are the guidelines that Brian Williams ignored. Someone needs to read them to him, especially the bold faced paragraph!

(Thanks to Jeremy Lincicun for providing YouTube of Brian Williams.)

Entry on mental illness is added to AP Stylebook

March 7, 2013

Associated Press today added an entry on mental illness to the AP Stylebook.

“It is the right time to address how journalists handle questions of mental illness in coverage,” said AP Senior Vice President and Executive Editor Kathleen Carroll. “This isn’t only a question of which words one uses to describe a person’s illness. There are important journalistic questions, too.

“When is such information relevant to a story? Who is an authoritative source for a person’s illness, diagnosis and treatment? These are very delicate issues and this Stylebook entry is intended to help journalists work through them thoughtfully, accurately and fairly.”

The entry, which was immediately added to the AP Stylebook Online and will appear in the new print edition and Stylebook Mobile, published in the spring, reads as follows:

mental illness Do not describe an individual as mentally ill unless it is clearly pertinent to a story and the diagnosis is properly sourced.

When used, identify the source for the diagnosis. Seek firsthand knowledge; ask how the source knows. Don’t rely on hearsay or speculate on a diagnosis. Specify the time frame for the diagnosis and ask about treatment. A person’s condition can change over time, so a diagnosis of mental illness might not apply anymore. Avoid anonymous sources. On-the-record sources can be family members, mental health professionals, medical authorities, law enforcement officials and court records. Be sure they have accurate information to make the diagnosis. Provide examples of symptoms.

Mental illness is a general condition. Specific disorders are types of mental illness and should be used whenever possible: He was diagnosed with schizophrenia, according to court documents. She was diagnosed with anorexia, according to her parents. He was treated for depression.

Some common mental disorders, according to the National Institute of Mental Health (mental illnesses or disorders are lowercase, except when known by the name of a person, such as Asperger’s syndrome):

– Autism spectrum disorders. These include Asperger’s syndrome, a mild form of autism. Many experts consider autism a developmental disorder, not a mental illness.
– Bipolar disorder (manic-depressive illness)
– Depression
– Obsessive-compulsive disorder (OCD)
– Post-traumatic stress disorder (PTSD)
– Schizophrenia

Here is a link from the National Institute of Mental Health that can be used as a reference:

http://www.nimh.nih.gov/index.shtml

Do not use derogatory terms, such as insane, crazy/crazed, nuts or deranged, unless they are part of a quotation that is essential to the story.

Do not assume that mental illness is a factor in a violent crime, and verify statements to that effect. A past history of mental illness is not necessarily a reliable indicator. Studies have shown that the vast majority of people with mental illness are not violent, and experts say most people who are violent do not suffer from mental illness.

Avoid unsubstantiated statements by witnesses or first responders attributing violence to mental illness. A first responder often is quoted as saying, without direct knowledge, that a crime was committed by a person with a “history of mental illness.” Such comments should always be attributed to someone who has knowledge of the person’s history and can authoritatively speak to its relevance to the incident.

Avoid descriptions that connote pity, such as afflicted with, suffers from or victim of. Rather, he has obsessive-compulsive disorder.

Double-check specific symptoms and diagnoses. Avoid interpreting behavior common to many people as symptoms of mental illness. Sadness, anger, exuberance and the occasional desire to be alone are normal emotions experienced by people who have mental illness as well as those who don’t.

Wherever possible, rely on people with mental illness to talk about their own diagnoses.

Avoid using mental health terms to describe non-health issues. Don’t say that an awards show, for example, was schizophrenic.

Use the term mental or psychiatric hospital, not asylum.

About AP
The Associated Press is the essential global news network, delivering fast, unbiased news from every corner of the world to all media platforms and formats. Founded in 1846, AP today is the most trusted source of independent news and information. On any given day, more than half the world’s population sees news from AP. On the Web: www.ap.org.

 

http://www.peteearley.com/2013/08/02/first-dr-phil-now-nbcs-brian-williams-stigmatizing-mental-illness/

“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: http://www.treatmentadvocacycenter.org/storage/documents/final_jails_v_hospitals_study.pdf

“Providing Mental Health Care Lowers Arrest Rates, Saves Money”

14 Jun

http://www.medicalnewstoday.com/releases/261744.php

From Medical News Today‘s website, reblogged from Trauma’s Labyrinth :

Research from North Carolina State University, the Research Triangle Institute (RTI) and the University of South Florida shows that outpatient treatment of mental illness significantly reduces arrest rates for people with mental health problems and saves taxpayers money.

“This study shows that providing mental health care is not only in the best interest of people with mental illness, but in the best interests of society,” says Dr. Sarah Desmarais, an assistant professor of psychology at NC State and co-author of a paper describing the research.

The researchers wanted to determine the extent to which treating mental illness can keep people with mental health problems out of trouble with the law. It is well established that people with mental health problems, such as schizophrenia or bipolar disorder, make up a disproportionate percentage of defendants, inmates and others who come into contact with the criminal justice system.

The researchers identified 4,056 people who had been hospitalized for mental illness in 2004 or 2005 and then tracked them from 2005 to 2012. The researchers were able to determine which individuals were receiving government-subsidized medication and which were receiving government-subsidized outpatient services, such as therapy. The researchers were also able to determine who was arrested during the seven-year study period.

“Our research shows that people receiving medication were significantly less likely to be arrested,” Desmarais says. “Outpatient services also resulted in a decreased likelihood of arrest.”

The researchers also compared criminal justice costs with mental health treatment costs. Individuals who were arrested received less treatment and each cost the government approximately $95,000 during the study period. Individuals who were not arrested received more treatment and each cost the government approximately $68,000 during the study period.

“It costs about $10 less per day to provide treatment and prevent crime. That’s a good investment,” Desmarais says.

“Effects of Outpatient Treatment on Risk of Arrest of Adults With Serious Mental Illness and Associated Costs”

Abstract: Objective: This study examined whether possession of psychotropic medication and receipt of outpatient services reduce the likelihood of posthospitalization arrest among adults with serious mental illness. A secondary aim was to compare service system costs for individuals who were involved with the justice system and those who were not. Methods: Claims data for prescriptions and treatments were used to describe patterns and costs of outpatient services between 2005 and 2012 for 4,056 adult Florida Medicaid enrollees with schizophrenia or bipolar disorder after discharge from an index hospitalization. Multivariable time-series analysis tested the effects of medication and outpatient services on arrest (any, felony, or misdemeanor) in subsequent 30-day periods. Results: A total of 1,263 participants (31%) were arrested at least once during follow-up. Monthly medication possession and receipt of outpatient services reduced the likelihood of any arrests (misdemeanor or felony) and of misdemeanor arrests. Possession of medications for 90 days after hospital discharge also reduced the likelihood of arrest. Prior justice involvement, minority racial-ethnic status, and male sex increased the risk of arrest, whereas older age decreased it. Criminal justice and behavioral health system costs were significantly higher for the justice-involved group than for the group with no justice involvement. Conclusions: Routine outpatient treatment, including medication and outpatient services, may reduce the likelihood of arrest among adults with serious mental illness. Medication possession over a 90-day period after hospitalization appears to confer additional protection. Overall, costs were lower for those who were not arrested, even when they used more outpatient services.

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:

https://www.coursera.org/course/mentalhealth

From coursera.org:



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.



FAQ

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


“No Longer Silent: Man with Bipolar Disorder Speaks Up about His Illness, Inspiring Others” by Loren Grush

14 Mar
From foxnews.com:

“Just two days after moving to California for a job transfer, [Logan] Noone nonchalantly told his new Craigslist roommates his biggest secret – that he had been diagnosed with bipolar disorder. Then something incredible happened.

Nothing changed.

His roommates did not discriminate against him and embraced Noone for who he was.

“I’ve been able to teach them what bipolar disorder is and change their misconceptions about it,” Noone said. “…They also taught me the lesson that I’m just a normal guy, and I can still fit in with everyone else. We all have something wrong with us; no one’s DNA is perfect.”

Since then, Noone has purposefully gone against the ‘keep quiet’ mentality, making the choice to step up and speak out about his experience with mental illness. Having recently been hired by the California Speakers Bureau, Noone travels to different colleges throughout the state, giving speeches about his life story and how people can help erase the stigma surrounding mental illness. He has since posted a video of his speech on YouTube, which is quickly gathering views and enormous support.

Now, Noone and others are poised on the brink of what they are calling a mental health civil rights movement, aimed at encouraging those with mental illness to break their silence and talk about their experiences as something positive – and not something to hide.”

Read more: http://www.foxnews.com/health/2013/03/07/no-longer-silent-man-with-bipolar-disorder-speaks-up-about-his-illness-and/#ixzz2NXqzwpx7

 

Policing the Mentally Ill, Part 2

7 Mar

On March 4th, the Portland Police killed a veteran with PTSD. It was the second fatal shooting by the police this year. His name was Santiago Cisneros. He was thirty-two years old and had served in Iraq from 2002 to 2005.  In an interview with a Seattle TV station in 2009, Santiago said, “I fought a war over there in Iraq. I didn’t know I was going to have to fight a war back here in the United States within myself” and “it took awhile to realize I was dealing with PTSD because I didn’t know what post-traumatic stress disorder was.” I don’t know what precipitated his confrontation with the police. All the Oregonian reported was that he shot at the officers first, and they returned fire. He’d been speaking to his mother on his cellphone directly before the police arrived. She was still on the line when the shooting started.

http://www.kgw.com/news/local/Armed-man-killed-by-Portland-police-was-Iraq-vet-195543251.html

The first man killed by the Portland PD this year was named Merle Hatch. His mother said he had a terrible drug habit and that neither she nor his father had seen in him in more than ten years. The police shot him a few weeks ago in the parking lot of the hospital where I attend my bipolar recovery group meetings.

http://www.oregonlive.com/portland/index.ssf/2013/02/federal_fugitive_merle_hatch_h.html

I was at the hospital roughly two hours before Merle died. I stood in that parking lot chatting with fellow members of the recovery group as we wandered out to our cars. It’s a strange and sobering juxtaposition.

In both cases, the police had no other option. Merle threatened to shoot them with what turned out to be a black phone receiver. He taunted them and told them he was going to kill them. The term for it is “suicide by cop.” Santiago started shooting when he saw the police. It’s possible that he also chose that route.

The parallels between Santiago’s mother and Jay Swift’s mother are heartbreaking. I cannot even begin to imagine the pain that woman is feeling. I don’t want to imagine how many parents can empathize with her suffering. BTW, here’s an account of the shooting Jay’s mother posted in response to the media coverage of her son’s death:

http://samanthabeaudette.com/jasonswift/

In a previous post about this subject, I called out the police for their use of excessive force and tendency to shoot first and ask questions later when they respond to a call involving a person with mental health issues. It’s a serious problem and it’s the responsibility of law enforcement to address it. But I cannot deny the fact that this wouldn’t be happening nearly as often if there were adequate resources and treatment for people who have mental illness, particularly when those people are in crisis.

For a good overview of the problem, check out this article from the Charlotte Observer:

http://www.charlotteobserver.com/2013/03/09/3904455/when-a-mental-health-emergency.html

I wish I could drum up some optimism about this, but quite frankly I can’t. Cut after cut has been made to programs that would avert these kinds of tragedies. Our economy might be in for another recession and the sequester is set to decimate these programs even more. I do know that I see the imperative now more than ever to become an advocate and an activist. We are facing a spike in fear and stigma because of last year’s mass shooting in Newtown CT and the fear-mongering groups like the NRA engage in because they want people to blame us instead of guns. Resources for treatment and management grow scarcer with each financial crisis, and given the current state of our federal government I’m not holding my breath for things to improve on that front any time soon.

But we do have advocacy groups, and the Internet grants us access to information and means to mobilize. We must educate ourselves and others. We must make our voices heard in our communities and seats of government. And we must do it now, not only for ourselves but for our family members who also suffer from mental illness and the loved ones whose lives are ruined because a person they love can’t get the help they need. We must do it for the people with mental illness and the police who die when this broken system of ours engenders yet another avoidable crisis. This is literally a life-or-death issue.

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Kate McKinnon

explorer | ingenieur

Shapely Prose

2007-2010

The Rhubosphere

Ro Smith's writing blog and review site

Sunny With a Chance Of Armageddon

The Beta Project in Textual Stimulation

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