Search Results for: violence

Dr. E. Fuller Torrey rips into NIMH, its advisory board and NAMI

(6-8-20) Dr. E. Fuller Torrey is again accusing the National Institutes of Mental Health of virtually abandoning clinical trials that could help Americans with schizophrenia and bipolar disorder in the short term.

Instead, NIMH, the main federal government agency for research into mental illness with a budget of almost $2 billion, has made basic brain research its priority. The results of such research will take three or four decades to show results, if then.

What’s the difference between “clinical trials” and “basic research.”

Elizabeth Sinclair Hancq, the director of research at the Treatment Advocacy Agency, which Dr. Torrey helped found, provided examples for me in an email.

• Basic research: growing cells in petri dishes and testing the effect of a particular drug on cellular mechanisms, like stopping their growth or activity. Basic research also includes animal model studies when trying to understand underlying cellular or system biology.
• Clinical trials: Testing the effect of a particular drug on symptoms and disease processes.

Perhaps the best way to see the marked difference between the two is by looking at clinical trials the NIMH is not funding. TAC listed 16 examples in a press release all of which are listed at the end of this blog.

Here is a sampling:

• Efficacy of generic drugs: Psychiatric patients being switched from brand-name to generic psychiatric medications frequently complain about loss of efficacy. NIMH should support studies of generic drug efficacy for psychiatric illnesses.

• Long-term injectable antipsychotics: In recent years, several new long-term injectable antipsychotics have been introduced. Although each was approved by the FDA for being better than a placebo, almost nothing is known about their comparative efficacy against each other. NIMH funded trials on these medications would help physicians make more informed decisions on medications for their patients.
• Long term effects: Many of the psychotropic drugs commonly administered to millions of patients in the United States were only studied for their acute effects. Very little is known about the long-term effects of treatment with these medications regarding side effects, maintenance dose, and use of blood levels. These should be systematically studied. The results of such studies might enable treatment using doses which are lower than those currently used, reducing side effects and improving medication compliance.
• Duration of treatment: Current guidelines are not clear regarding how long patients should be treated after a first episode of psychosis. In practice, many clinicians recommend stopping after one year, often increasing risk of relapse. (Studies) should be done randomizing patients to continuation of low dose antipsychotic treatment 1, 2 and three years after their first psychotic episode, to see if continued treatment reduces risk of relapse, while monitoring side effects.
• ECT: Electroconvulsive therapy (ECT) is underused in the United States compared to other developed nations. Randomized, sham–controlled studies using modern research designs should be conducted in the United States testing the efficacy and safety of ECT. This might encourage the use of this unpopular, but safe and efficacious evidence-based treatment.

Dr. Torrey wrote that NIMH funding is now skewed with 90 percent going for basic research, versus a fifty-fifty split.

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(6-2-20) Guest blog by Joseph Meyer.

We Need To Thank the Black Lives Matter Movement

The Black Lives Matter movement is leading the protests about the death of George Floyd in Minneapolis at the hands of police officers.  Obviously, BLM is primarily laser-focused on the experiences of persons in the African American community, as its name indicates.  But, on the BLM website, its leadership asserts “we work vigorously for freedom and justice for Black people and, by extension, all people.”

The site specifically mentions ageism, expresses support for the broad membership of the GLBTQIA community, and in a summary statement acknowledges the problems faced by other groups: “We are guided by the fact that all Black lives matter, regardless of actual or perceived sexual identity, gender identity, gender expression, economic status, ability, disability, religious beliefs or disbeliefs, immigration status, or location.”

There it is—disability—and, although BLM does not specifically mention mental illness, the BLM movement has time and again been outspoken and active in standing up for the rights of persons with mental illnesses when other advocacy organizations have been mostly silent.  So I want to thank the BLM movement because I believe it has done a better job than any of the mental health advocacy organizations at peacefully, yet emphatically, calling attention to deadly threats faced by the seriously mentally ill – especially persons of color – in our communities at the hands of the police. Click to continue…

(4-24-20) “IT HAS BEGUN. ANGELS OF LIGHT STAND UP. OUR TIME IS NOW.”

That message was posted by Jared Robert Kuntz on his Facebook page an hour before he allegedly attacked four hikers on the M Trail near the University of Montana in Missoula earlier this month.

The 38 year-old Kuntz has been charged with first attacking a woman who was hiking with her teenage son. The boy had fallen behind his mom. The woman suffered a fractured skull. The boy said Kuntz spotted him and chased him down the trail. Kuntz reportedly then removed his clothing, hid in bushes and when two brothers hiking on the trail spotted him, demanded their clothes. The brothers claim Kuntz charged at them. One of the brothers stabbed Kuntz with a buck knife but that didn’t stop him from continuing to chase them.

Since that arrest, Kuntz’s brother has detailed how he and his mother repeatedly warned authorities that Jared’s mental health had deteriorated and that he had threatened them. Yet, no one listened even though  Kuntz already was on probation for a previous incident.

Dr. Gary Mihelish, President of NAMI Helena, forwarded me Jacob Kuntz’s narrative about his brother’s illness. Dr. Mihelish wrote, “Although I wasn’t surprised, it was especially difficult and painful to read right after watching “Bedlam,” and “The Definition of Insanity” documentaries this week on PBS. We can and must do better for our fellow citizens.”

Here is Jacob Kuntz account.

“My name is Jacob Kuntz. The perpetrator of the heinous and senseless acts of violence committed on the “M” hiking trail in Missoula, MT on Friday April 10th, 2020 is my brother, Jared Kuntz. I am writing this in the hopes that the victims, their families, friends, and the community of Missoula, Montana will find true justice.

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LATE BREAKING NEWS: The Cuomo administration has agreed to remove the ‘significant mental illness’ disqualifier and review all parolees who were previously disqualified to confirm whether any of them now qualify for release.” The question now is: where will they go?

(4-23-20) Many jails across our country are releasing prisoners vulnerable to Covid-19, but New York Gov. Andrew Cuomo’s administration has decided not to extend that mercy to inmates with “significant mental illness.”

The governor announced several weeks ago that he would begin freeing prisoners who were in jail because of “technical parole violations.” Technical violations are instances where a parolee fails to follow the rules of his/her release, such as maintaining employment, paying court fees, and showing up for appointments with parole officers.

The seriously mentally ill often have trouble following such rules, violate their parole, and end up back in jail.

The state has added the seriously mentally ill to a no early release list with inmates convicted of sex crimes, domestic violence, violent crimes involving weapons, and homeless prisoners who don’t have an “existing” residence.

Jennifer J. Parish, Director of Criminal Justice Advocacy at the Urban Center, a civil rights advocacy nonprofit based in New York City, called the administration’s actions “blatant discrimination,” and noted: “This exclusion of people with serious mental health concerns is just the latest example of New York incarcerating people with mental health challenges instead of providing for their needs in the community.”

New York already is being sued for keeping seriously mentally ill prisoners in jails and prisons after they have completed their sentences.

That’s right – after they’ve done their time they remain incarcerated because there are no programs for them if they were released. No shelter, no evidence based recovery efforts.

The state justifies its actions by claiming the seriously mentally ill continue to be a danger to themselves and others.  So instead of providing services to help those who are sick, the state is punishing them for being ill.

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Photo courtesy Wikipedia

(3-24-20)

What should a psychiatrist do when a patient, who has had symptoms of a serious mental illness but is currently stable, refuses further treatment?

Dr. David Kantor, a Canadian psychiatrist, sent me an email addressing this question. He explained there is a process in Ontario that permits doctors to override the patient’s choice before that patient regresses.

Please share your thoughts on my Facebook page about his email.

Evaluating An Individual’s Ability To Give Consent

By Dr. David Kantor, MD FRCP

Successful treatment of people with severe mental illness (SMI) such as schizophrenia, is inarguably a problem everywhere in the world. The primary reason for this is the fact that many of these patients (estimate by various literature accounts as between 40%-90%) lack insight into their illness. That is, they do not appreciate the fact that they suffer from the illness and/or that adequate treatment is necessary.

Different geographic jurisdictions worldwide have different mental health laws. A major aspect of how these laws differ is the degree to which the particular jurisdiction allows for involuntary treatment in this patient populations.

I am a psychiatric specialist in the province of Ontario, Canda. In Ontario, all medical treatment is dictated by the patient’s willingness or unwillingness to undergo the advised treatment – i.e consent to treatment.

However, Ontario laws demand that a patient’s capability to consent to treatment be assessed when there is reason to believe the patient may not be capable.

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