Love the new site!

In order to answer the question “Why in the hell aren’t we doing it?” in the 60 seconds I have, we must first define “we”. In other words, “Who” are “we”? We are the Local Management Entities who are too caught up in the sea of bureaucracy to be creative, the consumer is rarely if ever heard (which always amazes me) and/or the family advocate who is not taken seriously or too exhausted to care (which is why NAMI is good). To me, the Mecca and the models of care are amoung the University systems…find researchers and schools like UNC Chapel Hill, Yale and Duke and you will find those who are most passionate about mental illnesses—hence more compassionate about consumer care. Also, the ‘crazy’ system will change when the focus on treatment, not discharge. “We” will do it when our voice is loud enough and “we” use models like the Woodley House across the board. Gotta go—good job on the site and best of luck.

Woodley House has a Facebook site: http://www.facebook.com/pages/Woodley-House/132179454183

I have the feeling that when the nursing home industry moved away from the ‘institutional’ model, it humanized. So can the State mental health agencies.

Hope that’s not a rhetorical question, Pete. I hope the answer isn’t “we don’t help because we’re a bunch of uncivilized yahoos (oxymoron?)primarily interested in what we can get for ourselves.”
I think that part of the answer is funding. Helping the mentally ill is expensive. Providing case management and supportive housing is expensive.
I think another part of the answer is stigma. Rather than making a fuss over the issue, politicians tend to sidestep the discussion. Agencies that could be advocating for healing by including the mentally ill in their programs are exclude them out of fear of liability.
Then there’s the civil rights issues that you know all too well.
Right now, in Oregon, we are voting on two budget measures to confirm a legislative request for a tax increase we need so as not to cut education, public health and public safety issues. Out-of-state interests are spending millions fighting its approval, apparently on principle, because the actual tax increase is extremely minimal. Individual citizens who argue against it do so because “the state spends more money every year — they need to decrease their spending.” Applying this to mental health care, these people are saying that they don’t want to help the mentally ill because they think the people administering the state programs earn too much and have overly-cushy benefits.
Then they complain about the psychotic homeless “cluttering” downtown near the soup kitchens and health clinics….
Hmmm….maybe the “yahoo” answer is the right one, after all!

Hi, Pete, thanks for including me in your new blog. It has been a busy 3 years and I have not done much to personally push the cause for change in the mentally ill. My son who burnt down our house 3 years ago trying to eliminate his demons, is still in the State Mental Hospital. He is slowly improving and expected to start transitioning this summer under supervision. Between battling the homeowner’s insurance as they were deciding whether or not to pay our claim and then our contracter, who we had trusted explicitly, as he decided his personal expenses were more important than paying for our house (around $100,000), keeping track of my son, who was overmedicated at one point with his liver enzymes increasing and his thyroid destroyed, and being a Mom to two other children, a wife, and working, it has been a very busy 3 years. Sometimes I question my sanity.

I did talk to our hospital administrator about offering a Mental Health Awareness day where we could possibly sponsor a fun walk/run with T-shirts printed with mental health agencies and signs/symptoms of mental illness, then lectures people could attend and set up booths with various agencies where people could ask questions and gather information. But our economy tanked and the budget at the hospital became very tight.
1. It has been reported 1/5 and possibly 1/4 suffer from some kind of mental disorder. That is a huge chunk of the population. Yet we hide it and pretend these issues do not exist until they rear their ugly head in some sort of catastrophe. We need to start educating the public, parents, teachers, siblings about the early signs and symptoms of mental illness and seek early evaluation and treatments. People who are treated early do well.
2. HIPPA blocks family members from information and from helping their loved ones. This needs to change.
3. Insurance companies need to pay for mental health claims and let the psychiatrist determine the course of treatment instead of denying payments and demanding patients be released from inpatient programs even when they are unstable. My son was very unstable when released and the psychiatrist wanted him to stay as inpatient for 2 more weeks, but insurance refused to pay for any more inpatient days. He was released and he burnt down our house. Like you say, Pete, most of the time, people only receive treatment when they have committed a crime. If someone has a heart attack or breast cancer, they are immediately given short term and long term treatment as prescribed by their physicians. What do mentally ill people get once they are diagnosed? Basically shunned. Psychiatrists need to be stronger in Washington and support their ability to be able to treat their clients. Insurance companies can no longer be allowed to play doctor or God and determine how many treatments a mentally ill person gets to have. People talk about the expense of treatment–well our house cost $690,000 to replace. It would have been a whole lot cheaper to adequately treat my son. What about human lives–there are some students in Virginia who would be alive if Cho had been treated. What price can you put on this, public safety? People who are mentally ill can potentially be a great danger to themselves, to their families, and to the public at large. Isn’t it worth treating these people early, instead of having them commit crimes and being sent to jail first or self-medicating with street drugs? Jails cost a ton of money–money which could be certainly be better spent.
The road to adequate interventions for our mentally ill is a long one, because our legislature cannot even decide on a healthcare program. Hopefully, with enough people speaking up, mental illness will get the attention it needs and our loved ones will get the treatments they deserve. Thank you, Pete, for being such a strong advocate and so well-spoken.

“We know that 70 percent of persons can be helped by medication, according to the National Institutes of Mental Health.” It is sad to think of the individuals who are harmed by psychiatric medications that are completely disregarded by the National Institute of Mental Health. Psychiatric medications can be very harmful and this fact should never be ignored. For example, Deidra Sanbourne, a person who suffered symptoms of schizophrenia and was mentioned in the book Crazy. Deidra had a very tragic situation and death. Her death was from complications of a bowel obstruction while being treated in a psychiatric ward of a hospital, not while being homeless and living on the streets. The medication Clozapine is used to treat severe cases of schizophrenia. Clozapine has caused bowel obstructions leading to death in schizophrenic patients. Deidra Sanbourne could very well have died from the medication she was administered while being treated for her symptoms of schizophrenia under the care of medical professionals.

Here are some of the studies on the correlation between clozapine and fatal bowel obstructions.

Aust N Z J Psychiatry. 2008 Dec;42(12):1073-4.
Rapidly fatal clozapine-induced intestinal obstruction without prior warning signs.
Leung JS, Lee CC, Lee WK, Kwong PP.
PMID: 19031643 [PubMed - indexed for MEDLINE]

J Clin Psychiatry. 2008 May;69(5):759-68.
Life-threatening clozapine-induced gastrointestinal hypomotility: an analysis of 102 cases.
Palmer SE, McLean RM, Ellis PM, Harrison-Woolrych M.
Te Korowai Whariki Mental Health Services, Capital and Coast District Health Board, Wellington, New Zealand. [email protected]
OBJECTIVE: To raise awareness of potentially lethal clozapine-induced gastrointestinal hypomotility (CIGH) by reviewing cases from the literature and unpublished pharmacovigilance data and to offer strategies aimed at prevention and early treatment. …RESULTS: We compiled a database of 102 cases of suspected life-threatening CIGH. There was a mortality rate of 27.5% and considerable morbidity, largely due to bowel resection. Within Australasia, at least 15 patients have died of CIGH. Probable risk factors are identified as recent instigation of clozapine, high clozapine dose or serum level, concomitant anticholinergic use, or intercurrent illness. CONCLUSION: The paucity of literature on CIGH suggests that the significance of this uncommon but important and frequently fatal side effect has not been recognized. Clozapine can affect the entire gastrointestinal system, from esophagus to rectum, and may cause bowel obstruction, ischemia, perforation, and aspiration. The mechanism is likely to be anticholinergic and antiserotonergic. Clozapine prescribing should be accompanied by regular physical monitoring, appropriate and timely use of laxatives, and early referral of constipated patients–before life-threatening pathologic processes develop.

Ryan Ehlis, is another example of an individual, along with his family who were harmed by psychiatric medications. 10 days after Ryan began taking Adderall to control his Attention Deficit Disorder and to help him with his college studies, he slipped into a psychotic fog, shot and killed his infant daughter, then shot himself in the stomach. He said God told him to do it. The criminal court found him innocent after testimony by a psychiatrist and by the manufacturer of the drug that the “psychotic state” was a very rare side effect of Adderall use. Various doctors testified Ehlis suffered from an “Anphetamine-Induced Psychotic Disorder”. This is a DSM label for a psychotic disorder caused by medication prescribed to help a less severe disorder. Medical experts and Shire US, Inc., the manufacturer of Adderall, commented that “despite the slaying, Adderall remains a safe and effective drug for controlling AD/HD. “

In a later civil court case, the United States Court of Appeals, District Court of North Dakota, affirmed the lower courts decision to dismiss a lawsuit brought by Ehlis against Shire. Ehlis contended Shire knew Adderall could induce psychosis and failed to adequately warn of the associated risks. The court ruled the “learned intermediary doctrine” barred the claims of failure to warn. This doctrine provides that a pharmaceutical manufacturer has a duty to warn a physician of the risks involved with a drug, and the physician acts as a “learned intermediary” between the manufacturer and the patient. “Thus, a warning to the physician is deemed a warning to the patient; the manufacturer need not communicate directly with all ultimate users of the perscription drugs.”

The treating psychiatrist for Elhis stated he (1) knew substance-induced psychosis was “within the DSM-IV,” meaning diagnostic criteria exist for this condition, regardless of the psychosis was caused by stimulant or other medication; (2) was aware some people can become psychotic without overdosing on certain medications, including Adderall; (3) knew the risks of psychosis was listed and identified in the package insert as a side effect for Adderall when he prescribed Adderall for Ehlis; (4) believed the statement in the insert was accurate; (5) continues to prescribe stimulant medications for adults since the incident involving Ehlis; and (6) continues to prescribe Adderall, because Adderall is a good medication. Good for some people, unfortunately kills others.

20 year old Desirae Crandall, from Syracuse New York is another example of an individual who was not helped by psychiatric meds. Desirae had 12 psychiatric hospitalizations in a 21/2 year struggle with symptoms of mental illness. She was released from her last hospitalization and put in a cab from the hospital to a group home where she lived, she then took a bus to the Carousel Shopping Mall and went to the second-floor atrium. She climbed over the railing, leaned back and plunged 35 feet to the basement floor. She was released from the psychiatric hospital for only a few hours before taking her life. For Desirae the medical model treatment approach was her only option, she was compliant under supervised care, and still ended up committing suicide in public.

The overuse of psychiatric medications caused Florida’s Department of Children and Families Secretary, George H. Sheldon, to appoint the Gabriel Myers Work Group in April 2009 to analyze and make recommendations regarding Gabriel Myers, a 7-year-old in foster care who apparently hanged himself on April 16, 2009 at the home of his foster parents in Margate, Florida. In the weeks before Gabriel died, he was prescribed psych drugs Lexapro, Vyvanse and Symbyax by psychiatrist Sohail Punjwani

The final report from this panel can be found here: http://tinyurl.com/ndeyxx A few excerpts are included below:

“Florida, through Governor Crist and Secretary Sheldon, should take a leadership role in raising this issue to national prominence in order to develop a comprehensive nationwide approach to the use of medication to treat our children”

“The prescribing physician too often fails to meet the legal and ethical duty to obtain informed consent before psychotropic medication is administered”

“Psychotropic medications are at times being used to help parents, teachers, and other caregivers calm and manage, rather than treat,children”

“Judges can more effectively meet the needs of children in foster care if:· They receive more education on treatment alternatives available to address behavior disorders and psychiatric symptoms.”

Scientologists like Tom Cruise are not the only people who know that their are successful and safer alternatives to medication management for treating symptoms of mental illness. Dr. Abram Hoffer and Dr. Linus Pauling also used vitamins supplements very successfully in an Orthomolecular Approach. The Road Back Program, CEO James Harper, has also focused on safer alternatives to treating symptoms of mental illness.

Here is a press release on psychiatrists who now support alternative treatments:
Psychiatrists Support Alternative Treatment For Mental Illness

Three noted psychiatrists share their views on the effectiveness of the mineral and vitamin supplement, EMPowerplus, for alternative treatment of mental illness.
FOR IMMEDIATE RELEASE
PR Log (Press Release) – Sep 18, 2009 – In a recent Health Professional Guide released by TrueHope, three noted psychiatrists shared their experiences prescribing the vitamin and mineral supplement, EMPowerplus (EMP), to their patients, some of whom had been on the supplement for as many as 8 years

Each specialist was asked to comment on his or her experience with the supplement. Dr. Lawrence E. Cormier, psychiatrist and integrative holistic health care practitioner in Denver, Colorado, was asked about any initial concerns he had in treating patients with EMP. “The difficulties reported in patients taking both medication and EMP … raised safety concerns for me. Finally, the risks to my standing as a credible licensed physician weighed on me for several years before I started treating patients with EMP in 2005. Recognizing that these are concerns that many doctors have, I want to share my clinical experience with the product and related medical knowledge. There is a growing body of bona fide medical evidence published in peer-reviewed journals on the use of EMP to treat mental disorders in adults and in children. More research projects are currently underway or in planning. EMP contains vitamins, minerals and nutritional supplements that have been widely used for many years. Most of these ingredients can be found in lesser amounts in the average diet. The full dose of EMP is well within safe levels as established by the Institute of Medicine and government regulatory bodies.” For full article go here:
http://www.prlog.org/10347105-psychiatrists-support-alternative-treatment-for-mental-illness.html

Psychophramacologist Dr. John Tanquary from Syracuse wrote this in an letter published in the American Journal of Psychiatry in regards to Homelessness Not a Mental Health Problem? “The concept of mental illness is fraught with difficulty, and some have argued that it be abandoned altogether. It reinforces the power of psychiatrists to “diagnose” and treat “patients” often against their wills…the concept of mental illness constitutes a power play in the role of a psychiatrist is evident in the next claim made, namely that the homeless “need” psychiatric treatment. Who determines this “need” and who profits from it? Many alledgely insane people have very sane reasons for not seeking psychiatric treatment. Tardive dyskinesia, renal damage, brain dysfunction from lobotomy and ECT are but a few reasons for not submitting to psychiatric intervention…The fact reveals the real threat to organized psychiatry. By excluding “legitamate” psychiatric treatments, an alternative to psychiatry is created. This alternative could substantially erode the power base of psychiatric authority in this country.”

An authority that creates stigmatizing labels and a marginalized population.