Monday, January 21, 2013

The Catastrophe of Mental Illness Treatment in America

Whenever I think about mental health,
I remember the book,
"Flowers for Algernon".
After the Sandy Hook Elementary shootings, I decided to do a little research into the history of mental illness and society, specifically how society treats people with mental illness.  I found a long, quite dirty history that tells the familiar tale of people wanting to help and ending up causing potentially more harm.

Travel with me back to the first half of the 1900s.  I haven't found an unbiased source to explain the why, but the decision was made to put people with any sort of mental irregularity into permanent facilities.  By the 1950s, we had one bed per 300 Americans in these mental institutes or hospitals.  The good news was we had room for someone to go if he or she needed a bit of space and treatment.  The bad news was abuse and neglect were rampant in several of the institutes.  So the decision was made to close the mental hospitals and transition to a community-based treatment system.

That's were is all falls apart. The community-based treatment system required some fundamental changes to communities that cost money and time, as well as a change in how we as a society view people with a mental illness.  I'm not certain if it was the money, time, or societal attitude that prevented the community-based treatments from getting created, but either way most people were released from the mental institutes with no place to go.

Here's where the story goes from bad to even worse.  While some people with mental illness can function in society, a lot of people cannot.  So these people ended up getting into trouble with the law and going to prison, where they have less ability to cope because they literally cannot follow the regular rules.  This leads to mentally ill inmates serving more time, costing more money, and needing more help when they get released back into society because they lost whatever social coping skills they previously had.

The influx of mentally ill people into the prison system has a brighter side and a darker side.  As of this moment, one of the best psychiatric treatment systems is the Ohio Department of Rehabilitation and Correction.  One of the prison's facilities is the Franklin Medical Center, which houses mentally ill inmates in an environment designed to help them cope.  The Franklin Medical Center employs psychiatrists, psychologist, has a fully-stocked pharmacy, and an attitude that mental illness can be treated.  On top of this, the staff regularly visit inmates in segregated areas in other prisons to see if a mental illness is involved in the segregation.

The dark side of so many people with mental illness getting incarcerated is the effect of society's attitude toward mental illness.  We already have a problem of treating the mentally ill as though they are a lesser version of humanity, sending scores to prison because of a condition outside of their control sadly reinforces this stereotype.  Also, the time and money spent in the prison system to simply house and feed the extra inmates leaves little money or time to help with the real problem, the mental illness. (Caveat - Except Ohio.)

I think that we can change the situation.  First, we need to change society's attitude and make mental illness acceptable as a condition, like the flu or pink eye.   Second, we need to create a combination of community-based treatment centers for people who can cope unescorted in society, and full-time homes for people who cannot cope unescorted in society.  While the second idea needs the support of government and probably legislation, anyone and everyone can work on the first idea by actively talking about mental illness differently, teaching our children about mental illness differently, and treating people with mental illness differently.  No one should be ashamed of feeling less than perfect, no one should feel the need to lie about a problem to avoid social backlash.  It's time we acted, each and every individual, because this is how we can make the world a better place.



2 comments:

  1. One of my sisters has suffered with mental illness for 40 years now (since she was in her early 20s). During the Carter administration, it became all about patient rights, but was poorly constructed as the patients themselves were given the ability to decide whether they needed hospitalization. The families testimonials no longer entered into the decisions.
    http://www.presidency.ucsb.edu/ws/index.php?pid=45228
    As a result, only if we could show that she may have presented immediate harm to us or herself could she be committed. And when we were successful in getting her admitted, as soon as she stabilized with medication, she was released. Often after 3 days. As a result, she of course argues that there is nothing wrong with her and mistakenly blames her medication for any issues. This has kept her in harm's way as she is allowed to wander off, hitchhike, beg, sleep on the street, or whatever she wishes since we cannot always be there to control her. This is putting her in harm's way. Facilities that cater to these types of illnesses are extremely expensive and therefore, her daughter cares for her at home the best she can while caring for her own family. She lives in constant worry that a teapot will be left to boil out, doors might be left open to the street, and that her mother is wandering about the neighborhood in her pajamas not to mention many other behavioral problems that cannot be controlled except by restraint or locked doors which are not an option.
    Yes, they deserve patient rights as there was abuse in the past they did not deserve and sometimes the families abused the system. But using rules for the normal to apply to those who cannot decide for themselves is not an answer. And so many of our homeless are actually mental ill. What about their rights to safety and comfort?
    Obviously this is an emotional issue that has spanned decades for us. If nothing else, let's hope the Sandy Hook incident will result in a positive result of calling attention to those who are so sorely neglected for lack of being understood. Thank you for posting about this.

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    Replies
    1. Dear bizcommunicator,

      I sympathize with the nightmare you live when dealing with your sister, always wondering if you'll get a phone call saying she's in jail or worse. I know too many people in her situation, which is why I wrote my post. Maybe if enough of us speak up, we can get something done.

      Thank you.
      Kathryn

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