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Schizophrenia pay now or pay later

Schizophrenia is a very costly disease — and we will pay now for the treatment or later for ignoring the elephant in the living room.

  • schizophrenia costs $33 billion per year;
  • arthritis costs $38 billion per year; and
  • coronary artery disease costs $43 billion per year.
  • The costs included both direct costs of treatment as well as indirect costs such as lost productivity:

Consequences of non treatment of Mental Illness:

The National Institute of Mental Illness (NIMH) in 2010 estimated that 7.7 million Americans suffer from schizophrenia and severe bipolar disorder – approximately 3.3% of the US population when combined. Of these, approximately 40% of the individuals with schizophrenia and 51% of those with bipolar are untreated in any given year.

Homelessness (the vast majority of homeless people are individuals with untreated mental illness). An estimated 216,000 of the homeless population with untreated mental illness.

Violence (both from persons with untreated mental illness and TO persons with untreated mental illness).

Jails and prisons are filled with mentally ill individuals — who in the past would have been in mental hospitals.

People with untreated serious brain disorders comprise approximately 16 percent of the total jail and prison inmate population, or nearly 300,000 individuals. These individuals are often incarcerated with misdemeanor charges but sometimes with felony charges as a result of behaviors caused by their psychotic thinking. People with untreated psychiatric illnesses spend twice as much time in jail as non-ill individuals and are more likely to commit suicide.

There are several major factors behind why not every person who needs help or who asks for help before or during a major psychotic event cannot get help.

Ignorance of the signs and symptoms of mental illness. Denial that what is happening or the way someone is behaving could be signs of a psychotic episode. Stigma of mental illness — return to the era of putting the mad ones back in the attic. Laws, Lawyers and PC that the mentally ill can choose not to take medication or any treatment — even though some mentally ill have no awareness that they are mentally ill. Lack of beds for mental patients in hospitals — although the family and the potential patient have taken all the steps necessary for the mentally ill — there is no room. In a worse case the mental patient is turned away and sent home and becomes aggressive, someone is injured and the mental patient kills himself. (State: Virginia, Austin Deeds, son of State Senator Deeds. One would assume that State Senator Deeds was aware of how the “system” works but even then he was unable to get help for his son.)

Today the Boston Globe has a new theory for the Boston Marathon Bombing — seems like the oldest of the brothers was “hearing” voices. Since is the Boston Globe — I’ll need a whole lot more valid evidence about any new hypothesis about who, what, where, and when. There are far too many unknowns and lies from “official sources” which makes it impossible to know what the true and honest facts are in this case. If the lone individual charged happens to be innocent — then the individuals or organization who caused the deaths and injuries is getting away. Perhaps one day the truth will be revealed. But today is not that day.

Fast Facts about untreated mental illness. 

7.7 million ~ Approximate number of U.S. adults with severe mental illness (3.3% of the population)*

Mental illness is a disease — it is not chosen nor is it a life style. On the surface the USA is a civilized Nation — under the surface there is the ugliness of the homeless mentally ill. There is the ugliness of a white rich politician in Hawaii taking a sledge hammer to shopping carts of the homeless — most of whom are mentally ill. When the mental hospitals were closed down starting in the 50s no provision were made for the severely mentally ill patients.

In California (early 1970s) the mental hospitals were emptied out to what was cheap student apartments in University towns like San Jose. At this same University some of the Behavioral Science class reading included Thomas Szasz*  — who was claiming that mental illness is a myth — and yet this PhD shrink had never had any experience with the chronically mentally ill. Rather than spend time among the chronically mentally ill as part of his PhD program — he run to another college. So much for the “expert” who has done so much harm to the mentally ill and their families. Szasz claims that mentally ill are not mentally ill but “that they are defined as all because they hold ideas that are not popular.”

This experiment in mental health treatment has proven to be a massive failure. This experiment has been costly in terms of cost to taxpayers but also the needless deaths. Most of the mass murderers in the last few decades individuals with untreated mental illness. Also many mentally ill are essentially used for target practice by the police. Harsh? No at all when one pays attention to the death by cop reports which tell us that cops have been called because family or friends are concerned that a mentally ill individual might be a danger to him/herself or others. Not all cases turn out this way — but far too many have in recent years.

Schizophrenia by the numbers – The Consequences of Non Treatment – E. Fuller Torrey’s website.

The Justice system and jails are now how potential violent or just merely crazy people are gotten off the streets and we taxpayers are footing the bill for the failure of the state legislatures in nearly all states and territories to redo the involuntary commitment laws.


Anosognosia is a lack of Awareness of their own illness. One lesson we psychology students were taught early and often is that there had to be participation from the client in the treatment process — in other words the individuals would be counseling had to recognize that their behavior was abnormal. I don’t know if Anosognosia is a new word for the symptom of unawareness of illness or lack of insight of one’s illness. All the well meaning folk who managed to close the mental hospital without considering the population of mentally ill who are incapable of even knowing that they are mentally ill are the unforgivable monsters and they are responsible for the needless deaths of thousands. In the battle of the “cause” of mental illness Nurture was found to be at fault — families were blamed for creating mental illness like Schizophrenia.

Most people would rather just ignore the elephant in the living room — but that elephant is costing us all a whole lot of money. The elephant of course is untreated mental illness in the US. On one extreme there are those like Szasz and R.D. Lang and the church of Scientology who claim that mental illness and schizophrenia is a myth — made up. Ironically neither of these so called experts like Szasz have ever lived with or had any contact with real people who are psychotic. These would be the mentally ill who are hearing voices and living in an alternative reality. On the other hand there are thousands of parents and siblings who have lived with children or sibling who slowly developed what we now know as the symptoms of Schizophrenia.

The outdoor experimental laboratory of —  let’s see what happens if we let mentally ill people take care of themselves — can be found in most urban centers and under bridges and in alleyways. That would be the mentally ill who are homeless, pushing shopping carts and talking to themselves or exhibiting other even more bizarre behavior. These are the people freezing to death and suffering physical aliments that should not be happening in the 21st century.

Jails vs Hospitals

“Most people [with mental illness] by far are incarcerated because of very minor crimes that are preventable,” says Bob Bernstein, the Executive Director of the Bazelon Center for Mental Health Law. “People are homeless for reasons that shouldn’t occur, people don’t have basic treatment for reasons that shouldn’t occur and they get into trouble because of crimes of survival.”

Bernstein blames these high rates on a lack of community mental health services. In the past three years, $4.35 billion in funding for mental health services has been cut from state budgets across the nation, according to a recent report. Because of the cuts, treatment centers have had to trim services and turn away patients.

State hospitals have also been forced to reduce services. A report by the Treatment Advocacy Center even found that there are more people with severe mental illness in prisons and jails than in hospitals.

. . .

The expense is high, to be sure. The average inmate in New York costs the state over $60,000 per year, according to a report by the Vera Insitute of Justice. That figure doesn’t take into account the extra resources that mentally ill inmates require. Experts say that funding mental health services for these inmates would cost less than imprisoning them and could help prevent many incarcerations in the first place.

According to a Bazelon Center report, the annual cost of case management for mentally ill people in Michigan is $2,165 per person. A more intensive program, the popular Assertive Community Treatment, costs the state $9,029 per person per year. In contrast, the average Michigan inmate cost the state over $34,000 last year.

But mental health services are dramatically underused. Over half of inmates with mental health problems never received treatment prior to incarceration, according to a Department of Justice report.

“We’re paying criminal justice and other costs, we’re investing there and we really should be investing in the services that could prevent that whole trajectory to begin with,” says Bernstein.




*Who was Thomas Szasz?

Today, of course, Szasz is mostly remembered, if he is remembered at all, as the great silly, a flat-earth adherent in the time of telescopes and globes. Most medical students graduate without ever hearing his name. Peers who once grappled fiercely with his ideas are now surprised to find out he is still alive. His voluminous writings largely gather dust in libraries and used book stores. At a 1996 debate, well-known psychiatrist E. Fuller Torrey summed up the sentiment nicely with a joke that began: “Let me ask an important question. And this is a question that will be asked by future generations. The question is: Who was Dr. Szasz?” Few in the audience needed a punch line. The question itself was dénouement enough. “If he is unable to acknowledge his big mistake,” Torrey finished, “I think the answer to the question will be: ‘Dr Szasz was the man who wrote The Cat in the HatHop on Pop and Horton Hatches the Egg.’” The audience roared.

Thomas Szasz the libertarian is one of the PC mental health “professionals” who is responsible for the great experiment that put the mentally ill back into the dark ages. (in the no so humble opinion of Northwestrain.)


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