Mental Illness in the US

Untreated Mental Illness

New word to learn:  Anosognosia*

Ignorance, ignoring, and dismissing, the massive problems caused by untreated mental illness is costing us Billions of dollars.

In olden times, in the days when people didn’t know any better, those living in their own alternative reality were hidden away. For awhile things changed and Mental Institutions were founded to house the formally hidden. As most people know “one size fits all” diagnosis is impossible for mental illness. Some individuals are profoundly delusional or lost in their own world. It is considered shameful to even admit that someone in your family might suffer from some sort of mental illness.

Bipolar disorder also known Manic Depressive disorder is one mental disease that is slowly coming into the public’s awareness with several well known individuals coming forward to share their struggles with this disease, Patty Duke is one such hero. Those who have had diagnosis of Manic Depression have come to realize that they have a brain chemistry imbalance and that often Lithium is used the successfully treat this disease.

E. Fuller Torrey has written several books about Mental Illness for the non professionals. Two of Torrey’s recent books deal specifically with the problems of untreated mental illness and the major impact that a tiny minority can have on all of us. Some of us rarely go to cities or walk downtown because of the huge increase of homeless, many of whom are mentally ill. Many libraries have been invaded by mentally ill patrons who frighten off the ‘normals”. ERs are often overwhelmed by mentally ill patients.

Not everyone who has a mental illness is dangerous. But a tiny minority with overt symptoms of untreated mental illness are hard to miss.

But several individuals of this tiny minority have acted on their alternative reality and with the aid of guns and rifles have killed and injured too many innocent people. The fact that several of these mentally ill killers have been able to buy the weapons to act out their delusional fantasies has been made into a political debate — where nothing gets done and a lot of politicians on both sides of the issue get face time.

Two of E. Fuller Torrey’s books are must reads for everyone: The Insanity Offense, How America’s Failure to Treat the Seriously Mentally Ill Endangers Its Citizens and his most recent book: American Psychosis; How the Federal Government Destroyed the Mental Illness Treatment System.

President John F. Kennedy’s sister, Rosemary was mildly retarded and also had symptoms of what we now know as Schizophrenia. For those who have carefully looked at Rosemary Kennedy’s history there are suggestions that Rosemary began exhibiting cognitive disorders as early as age 10. Her siblings would have noticed the changes, in fact my guess from my own experience is that siblings are bound to notice mental abnormalities sooner than adults. Often the official diagnosis for Schizophrenia isn’t made until around 19 years of age.

Torrey begins American Psychosis with the Kennedy’s family hidden secret about the problem child — Rosemary and Joe Kennedy’s decision to resort to a surgical lobotomy because of Rosemary’s ability to escape from the clinic and wonder at night — perhaps even becoming pregnant — horrors for a Catholic man who would be president. The lobotomy was a failure and Rosemary lived out her days hidden away. That was how mental illness was treated in the early part of the last century.

So how is mental illness treated in the 21st century? First we need to learn and understand a new word — Anosognosia

*Anosognosia (/æˌnɒsɒɡˈnziə//æˌnɒsɒɡˈnʒə/) is viewed as a deficit of self-awareness, a condition in which a person who suffers certaindisability seems unaware of the existence of his or her disability. The word comes from the Greek words nosos, “disease”, and gnosis, “knowledge”, with an- or a- as a negative prefix. It was first named by the neurologistJoseph Babinski in 1914.[1] Anosognosia results from physiological damage on brain structures, typically to the parietal lobe or a diffuse lesion on the fronto-temporal-parietal area in the right hemisphere.[2][3][4] Whilst this distinguishes the condition from denial, which is a psychological defense mechanism, attempts have been made at a unified explanation.[5] from Wikipedia

Many of the perpetrators of recent shocking mass murders in the US have been diagnosed as having an untreated mental illness. Torrey books above give us the identified killer’s behavioral  background of several notable headline. In many cases it was obvious that the individuals should have been hospitalized and receiving medication. But the problem is that many of the mentally ill do not believe that they are ill. They think that they are normal and everyone else is crazy. However, the cops get called when individuals act crazy enough for normal folk to get scared. Today jails and jailers have become the default for mental health treatment. Torrey takes an in depth look on the jail house treatment of mental illness.

Torrey reviews  the old way of locking up the crazy people — crazy aunt Lulu or uncle Fred used to be dumped in a county mental hospital. These hospitals were exposed as horrible warehouses by human rights activists and photographers until the answer came with the invention of early drugs (1950s) to treat the symptoms of mental illness. Suddenly the mental hospitals were closed — drugs were the answer. Except that the drugs have side effects and with no staff to make sure that patients take their meds — the mental patients spilled out into the Urban environment. Torrey reviews California’s experiment with closing the mental hospitals and the attempt to privatize the mental health “problem”. It turns out that a whole lot of people got really rich — meanwhile the mental illness problem hasn’t gone away and has in fact gotten much much worse.

Prisons and jails are where the crazies are now locked away. In some cases the old mental health hospitals are now reopened as jails for prisoners with mental illnesses. So on one hand the beds in mental hospitals have decreased while on the other hand the beds in jail used to house mental patients has increased. It’s a mathematical problem — a certain percentage of beds for the treatment of mental illness will be required and by closing mental hospitals or decreasing the number of beds for mental patients will not make the reality of mental illness go away.

At one time when the newness of meds to treat mental illness was all the rage the politicians decided that mental patients could be treated “in the Community”. This community model never did work out. Apparently the for profit system of the government throwing money at a problem with no real community treatment structure in place means that a whole lot of former mental patients live on city streets and can’t or won’t take their meds.

A community mental health system might work on small islands where a nurse can go around to make sure that the mental patients are taking their medications and that their behavior is within the accepted norm for the community. When a mental patient goes to church nude (just as God made him, he claims) that sort of behavior is out of the accepted norm and the nurse is called to take care of her patient. (True story from a psychiatric nurse on a Caribbean Island).

Torrey uses simple math to show the current methods of ignoring mental illness is costing tax payers Billions of dollars. There is also the dilemma of the individuals with severe mental illnesses but who simply can’t rationally see that they are ill. Does a mentally ill person who could be a danger to self or others have the “right” to refuse appropriate medicate? Then there is the means used to diagnose mental patients — simply medicating without supporting “talk” therapy often means that medication prescribed might not be correct for the specific mental illness. Those of us who have family members with mental illness are well aware of conflicting diagnosis by the fly by psychiatrists.

What happens when the psychiatrists are trained to diagnose and write the prescriptions but basically untrained in the follow up/ supportive care of the patients. Psychiatrists often have huge patient loads and must rely on others in order to make a correct “diagnosis”. What happens when patients are frequently shifted from one doctor to the next? What about the mentally ill in jails who have even fewer opportunities to see treating doctors?

The treatment of mental illness in the US is still very primitive unfortunately many of the “first responder” police have little or no training to handle individuals with acute symptoms of mental illness. To show the new reality mental illness in the 21st Century,  Torrey gives many positive examples of police jurisdictions that are aware of the new role of the police in mental health. Unfortunately there are far too many stories of police shooting first and then trying to cover up why the killed or injured someone who belongs in a mental hospital (except there are very few beds for mental patients in the US.) Police must be trained how to deal with and recognize mental illness in individuals.

Torrey’s books are not merely about everything that is wrong with mental illness treatment in the US — he also has many practical solutions for the seemingly impossible task of waking up the politicians to the needs of the mentally ill.

Some religions (Scientology, and some Fundamentals sects/cults) believe that mental illness is a myth — that the current medications used are poison. How can Americans be educated about the realities of mental illness — when at the same time they are being bombarded with the lies and disinformation by political and religious bigots?

Update #1 — cops who can’t shot straight. In NYC an unarmed, untreated, mentally ill person who was acting “un-normal” by talking to his dead relatives was shot at by the cops. The NYC key stone cops very often shoot and hit innocent by standers — so the idiot DA blames the mentally ill person for the cops inability to shoot straight. 

In other news — we are more 8 times more likely to be shot or injured by cops than by terrorists. It would seem that for the unarmed mentally ill their chances of getting shot by cops would be far higher. So while the rare armed untreated mentally ill individuals make the headlines — the cops who we hope are not mentally ill are more likely to shoot first and ask questions later. 

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Schizophrenia (/ˌskɪtsɵˈfrɛniə/ or /ˌskɪtsɵˈfrniə/) is a mental disorder characterized by a breakdown of thought processes and by impairedemotional responses.[1] Common symptoms are delusions including paranoia and auditory hallucinationsdisorganized thinking reflected in speech, and a lack of emotional intelligence. It is accompanied by significant social or vocational dysfunction. The onset of symptoms typically occurs in young adulthood, with a global lifetime prevalence of about 0.3–0.7%.[2] Diagnosis is based on observed behavior and the patient’s reported experiences.

Genetics, early environment, neurobiology, and psychological and social processes appear to be important contributory factors; some recreational and prescription drugs appear to cause or worsen symptoms. Current research is focused on the role of neurobiology, although no single isolated organic cause has been found. The many possible combinations of symptoms have triggered debate about whether the diagnosis represents a single disorder or a number of discrete syndromes. Despite the origin of the term from the Greek roots skhizein (σχίζειν, “to split”) and phrēn, phren- (φρήν, φρεν-; “mind”), schizophrenia does not imply a “split personality”, or “multiple personality disorder” (which is known these days as dissociative identity disorder)—a condition with which it is often confused in public perception.[3] Rather, the term means a “splitting of mental functions”, because of the symptomatic presentation of the illness.[4] [Wikipedia entry for Schizophrenia].

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