Sunday, August 31, 2008

Fighting Mental Illness and Stigma, same, same

Battling stigma as well as mental illness


If Cindy had a heart ailment, a doctor might have sat her down and walked her through her options for treatment.

Battling mental illness, she says she was locked in a state hospital and told by a staff member she would be lucky if she ever got out.

If she broke a bone, Cindy might have gotten a cast, crutches and a little patience at home.

Grappling with bipolar disorder, post-traumatic stress and substance abuse, her husband said she was lazy and her treatment was just "a vacation."

For decades, most health professionals have accepted that mental illnesses are legitimate, serious medical problems. But for many who suffer from them, they often remain a source of shame and ridicule, and for the public, a cause for fear, suspicion or misunderstanding.

"It's just slow for people to realize it's a real illness," said Iris Carroll, director of Programs for People, a Framingham agency that helps people to recover from mental illness and succeed. "I see it definitely changing, but not fast enough."

Four clients at Programs for People, who agreed to speak with the Daily News without giving their full names, say stigma against the mentally ill is alive and well in many aspects of their lives.

Mark, who was hit by a truck in December, says he believes his diagnosis with mental illness led a doctor not to take his wishes seriously and forego surgery he requested on his badly broken leg.

"I didn't have anybody to sign or advocate for me," Mark said.

For Melissa, her struggles with depression and post-traumatic stress cost her ties with most of her family and wreaked havoc with jobs.

"I feel like people don't understand," Melissa said. "I'm labeled like you should get it, or you should have known better, so snap out of it."

Cindy said she was called a "nutcase" when she called her son's school to iron out a problem with a teacher. She said she encountered bias within the mental health system itself, where her own goals often seemed an afterthought to some of the people treating her.

"We want guidance," said Cindy, "but we also want a voice."

Bill found understanding from some bosses, but was fired by a manager who found out about his battle with depression. When a coworker learned he had been hospitalized, he told Bill he always looked "twilighted."

Research shows these are not isolated stories. A study published online this month in the Social Science and Medicine journal found Americans increasingly believe there are medical and genetic explanations for mental illnesses.

Yet depending on the type of illness, people were no more tolerant toward the people with these ailments than they were 10 years ago, the study said.

A new Canadian survey found only half of respondents would tell friends or coworkers if a family member was diagnosed with a mental illness, compared to 72 percent for cancer. More than a quarter said they would fear being around a person with a mental disorder, despite the fact that most are not dangerous, and 46 percent said people use mental illness as an excuse for bad behavior.

In the U.S., barriers to employment keep an estimated 80 percent to 90 percent of people with mental illnesses out of the workplace, according to the National Alliance for the Mentally Ill.

This is despite the fact that one in four adults suffer from a diagnosable mental disorder in a given year, says the National Institute for Mental Health. Of those with mental illnesses, nearly half suffer from two or more disorders, according to the institute.

There are signs that stigma is changing. Pending federal legislation aims to require more equitable coverage in health plans for treatment of mental illness. Studies show more people are seeking and getting treatment, and all those interviewed at Programs for People described great progress.

"I've grown stronger," Melissa said. "I'm trying to rebuild my life."

They are speaking out against the barriers they have faced.

"I'd like people to know we're real, and we're not different from you or anybody else in the world," Melissa said. "We're equal, and we have a right to be here and not be stigmatized."

Thursday, August 28, 2008

'Nuff Said

This is a good article about the mental illness scene in Canada. They are also still fighting the stigma and the placing of everyone diagnosed mentally ill in the dangerous category. We do need more of the good, successful, and perhaps high profile people in all countries to come forward and be honest about their personal mental illness. I think that would be beneficial for all.

Is having a bout of mental illness something that should result in a police record?

Astoundingly, that is the reality in much of this country.

It is an egregious breach of civil rights, yet the practice continues because people who suffer serious mental illnesses such as depression, bipolar disorder and schizophrenia are all too often voiceless, powerless and victims of well-entrenched stereotypes.

To understand this story, a little background is in order. In the post-9/11 era, police checks have become the norm in our society; it is a simple way of weeding out pedophiles and other "bad" people, or at least giving the illusion of doing so.

If you apply for a job or a volunteer position - fundraising at the local hospital, coaching a peewee hockey team, helping out with the school choir or any other of those innumerable, thankless tasks - you will have to agree to a police check.

These checks come in two forms.

The first is a search of the computerized records maintained by the Canadian Police Information Centre. If you have a criminal record, the information is likely to show up in CPIC.

The second is a police records check. In addition to CPIC, local, municipal and provincial police forces maintain their own computerized records.

These records contain all manner of information about any contact you have with police, whether you are a criminal, a victim or a witness.

When you have a loud party and the neighbours rat you out, both your names are in the system. A Good Samaritan calling 911 is in there, and so are the people they are calling about, even if they are harming no one but themselves.

People who suffer bouts of mental illness tend to have a lot of encounters with police. They make suicide attempts and threats of suicide. Sometimes they starve themselves, drink or drug themselves silly, make paranoia-spewing phone callsand trash their cars. And these are the "respectable" people with nice homes and good jobs, not the stereotypical "crazy" street people.

These encounters all result in a police record.

"So what?" you may ask.

Aside from the principle that we should not accept gratuitous violations of civil rights, there are practical harms being done every day. Take the example of Ontario, where the Mental Health Police Records Check Coalition has done a wonderful job bringing this issue to light.

If you apply for almost any volunteer post in Ontario working with children, the elderly, people with disabilities etc. you must undergo a Vulnerable Person Screening.

This report will tell the volunteer agency if there are red flags on a person's police record. Some police forces simply make the vague statement that there is "information of concern," while others provide details such as "suicide attempt" or "arrest under the Mental Health Act."

(Incidentally, when people are detained under the terms of the Mental Health Act, it is not an arrest. Police have the legal right to take people who are a danger to themselves for treatment at a medical or psychiatric facility, but police tend to use the misnomer "arrest.")

Mental illness is a medical issue. What business do police have disclosing this information to potential employers? Some police forces retain and release this information for up to 25 years after an "encounter."

Police in London, Ont., no longer release mental-health information contained in police records, a change made as part of a settlement of a human-rights complaint.

That should be the norm everywhere in Canada.

Police records contain other sensitive medical information, including whether a person who has encountered police is infected with HIV, hepatitis or other diseases. Police would not dream of releasing this information as part of a background check. So why is it okay to disclose suicide attempts, psychotic episodes and other cries for help?

It's done because of lingering stereotypes about people with mental illness being violent and untreatable.

The reality is that the mentally ill are far more likely to be victims of violence than perpetrators, and it is those with severe, untreated mental illness who tend to be violent, but are unlikely to be applying for work - volunteer or otherwise.

The reality, too, is that the vast majority of people who suffer a bout of mental illness get better. For many, part of the healing process from these horribly isolating and soul-destroying illnesses is reintegrating into the community. That means getting work, volunteering and building social networks anew.

That's what makes these policies doubly horrific. They not only discriminate against people for no good reason, but they can set back their recovery and destroy their hope of being a "normal" citizen again.

Having a mental illness - present or past - is not a crime. But discriminating against people with mental illness in this manner is.

Tuesday, August 26, 2008


This morning on GMA, the politicians were moaning about the fact that some Americans do not have full coverage of medical care. A family was interviewed, both working parents, three children, the example of a "normal" middle class, working family in the USA. This family had medical insurance, but the aderol that one of the children was taking was not covered by their personal insurance. The idea was that this was a Republican/Democrat problem and one reason why we need a medical overhaul in America. My youngest son, 24 years old, was never ADD and only since being in medical school, did he decide to take aderol because of the extremely long hours of studying that is required. His Blue Cross/Blue Shield will not cover this ADD medicine because it is labeled as a "Mental Illness" drug category. The forty years my mother spent taking anti-psychotic drugs, we also paid cash. She had no help with that until she qualified for Medicare at age 65, then when she was 73 years old she died. In my opinion, this is not a Republican/Democrat issue. The issue here is how mental illness is viewed and still the stigma involved. Mental illness as a diagnosis, even if it is just ADD or ADHD, if your insurance covers your medicine for this, then you should add that to the things you are thankful for today.

Thanks, Liz

Monday, August 25, 2008

Good Research

We know that bipolar disorder can be hereditary; this article sites some wonderful research on that topic. It would be wonderful to pinpoint the origin of some mental illnesses and therefore be able to prevent or at least find a more sensible and effective way of treating it.

Mental illness linked to genes, says expert


GENETIC STUDIES are helping to piece together the puzzle of how our genes contribute to mental illness, and are paving the way for more personalised and effective drug treatments. That's according to an expert who was in Cork yesterday to address a major international conference.

"There is a strong genetic component to most psychiatric disorders, with evidence coming from studies of twins and families," said Prof Peter McGuffin from the Institute of Psychiatry at King's College in London, who yesterday spoke about genes, behaviour and mental illness at a European Behavioural Pharmacology Society conference in University College Cork.

Speaking to The Irish Times in advance of his talk, he described the complexities of the interactions between genes and the environment in mental illness, and said that genetic studies were starting to unpick those relationships and highlight the need for an individualised approach to drug treatment.

Prof McGuffin was recently involved in a study - published online last week in the journal Nature Genetics - that newly links two genes to bipolar disorder (manic-depressive illness). The study, to which researchers at Trinity College Dublin also contributed, looked at more than 4,000 people with bipolar disorder and found variations in two "ion channel" genes that function in the transmission of messages in brain cells.

"A lot of inherited forms of epilepsy seem to be to do with defects in ion channels and various anti-convulsants are good mood stabilisers, but we have never known why. It's all coming together now," he said.

His group has also found that an individual's response to antidepressants is affected by their genetic profile: if their genes mean they transport the brain chemical serotonin less effectively, they will have a poorer response to a commonly prescribed type of antidepressant known as an SSRI.

It argues the case for a more personalised approach to treating mental illness, said Prof McGuffin: "The hope is that we will be able to take existing compounds and predict who will actually respond to what."

Behaviour can also be in part down to genes, he added. "There's a lot of evidence from good old-fashioned twin and adoption studies that criminal behaviour is influenced by genes," he said. "It's a touchy topic to talk about but the evidence is consistent."

And the environment also plays a key role, said Prof McGuffin. "In addition to genes and the environment adding up together there's something called gene-environment interaction, which means that some people are more susceptible to stresses than others.

"There's also a strange phenomenon which is less intuitive called gene-environment covariation, which means that to some extent people create or evoke their own environments."

He cited alcoholism as an example: "Suppose you have an inherited predisposition to alcoholism - your parents might also have alcohol problems and you grew up in an environment where you were exposed to alcohol.

"And maybe because you like alcohol you might go out and seek it, so you are creating an environment where you get more exposure to alcohol."

The conference, which runs until tomorrow, will include discussions of the genetic basis of schizophrenia, depression, drug dependence and autism.

© 2008 The Irish Times

Sunday, August 24, 2008

Concerted Effort

I am glad to read that this is a joint effort from a variety of places to dispel the stigma of all mental illness. This is one of the ways that our loved ones who are mentally ill will and can have a better future.

Bike 4 the Brain seeks to dispel stigma of mental illness

Mindy Goldstein (right) of Mission with the Mental Health Association of the Heartland, sped to victory at Bike 4 the Brain in 2006, not knowing her friend and competitor Cherie Bledsoe of Kansas City, Kan., had crashed and burned behind her.
Mindy Goldstein (right) of Mission with the Mental Health Association of the Heartland, sped to victory at Bike 4 the Brain in 2006, not knowing her friend and competitor Cherie Bledsoe of Kansas City, Kan., had crashed and burned behind her.

You probably know someone with a mental illness.

Perhaps that someone suffers from depression or schizophrenia or Asperger’s syndrome. Nearly one in three Americans will endure some form of mental disorder during their lives, research shows. Yet mental disorders remain one of the least talked-about illnesses.

Kenneth Sonnenschein is working to change that.

The Leawood psychiatrist once again is organizing a bike ride to raise awareness and help reduce the stigma that often accompanies mental illness.

The third annual Bike 4 the Brain will take place Sept. 28. It will start at 8 a.m. at the Johnson County Mental Health Center in Mission, 6000 Lamar Ave.

“We started out in the first year with about 120 riders and last year had 250,” Sonnenschein said. “We’ve grown significantly but I hope to grow it even further.”

Bikers can choose routes of 10, 25, 50 or 62.5 miles. Six rest stops will be set up offering refreshments. And volunteers will be on hand with vehicles and gear to help anyone in need.

The rest stops also will serve as centers where bikers can “get a clue about mental illness.” The bikers will be able to learn about the symptoms and treatments for various illnesses by collecting “clues” at the stops. Everyone who takes part will receive a prize.

Besides the ride, the event will feature a one-mile walk, a tricycle challenge for adults and activities for children.

The money raised from the event will help support local non-profit organizations in Kansas and Missouri that provide services to individuals with mental illness. So far, $500 has been donated to ReStart, a center in Kansas City that serves the homeless.

“It’s not a huge donation,” Sonnenschein said, “but it’s the beginning of what we hope will be a larger grant that we will be providing.”

The ride is $20 per biker at the event and $15 for signing up before Sept. 23. To register on-line go to or call 913-323- 6529 for more information.

Friday, August 22, 2008

Nothing More Sad than this

There is nothing more sad than these stories. I do not know this particular woman's story, but from my experience, it's not the fact that they can't get proper medical care; it is the fact that they won't agree to take the prescribed medicine. The mentally ill can be very deceptive in their mania also. If you have not seen this, then you have to see it to believe it or understand. I have seen bipolar loved ones seem perfectly sane one second, then turn around and start babbling about how God is returning and they are His direct messengers. I am not trying to offend anyone of you who are bipolar as I know there are different degrees, my personal experience is with someone who was delusional and she would do whatever God had told her to do. Believe me now, if you tell me that you are getting messages from God I will readily assume that you are delusional. This story is what I want to stop in America. I want the innocent to stop being "killed" because someone did not "want" to take their medicine!!!!!!

Family Of Slain Children Raise Awareness Of Mental Illness

Children Killed When Aunt Walks Them Into Traffic

POSTED: 4:45 pm EDT August 22, 2008
Seven months have passed since a Brentwood mother and father lost their two children in a traffic accident triggered by a woman's mental illness.The children's aunt walked them into oncoming traffic in January, and they were struck and killed. The family is now taking action, hoping to spread an important message.Danielle and Ken Lambert said they remember their children, Kaleigh and Shane, with a mixture of pain and pride. Kaleigh was a happy girl with a big smile, and Shane, although he was just 4, could print his name perfectly.
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Danielle Lambert's twin sister, Marci Thibeault, had taken then children for a sleepover in January, but while driving on Interstate 495 in Lowell, Mass., she took them out of her car and ran with them into traffic."When she picked them up that night, she was the Marci we knew -- happy, the kids loved her," Danielle Lambert said. "There were no sign of the return of her mental illness."Thibeault was battling deep mental illness, although no one knew how severe it was. Her family thought she had an isolated episode and had gotten better."I knew how much she loved the kids and our kids loved her," Danielle Lambert said. "We thought they were safe that night."The Lamberts said they have learned how deceptive mental illness can be."There was a witness account that she thought she was bringing our kids to heaven that night," Danielle Lambert said. "I knew it was her illness."The Lamberts said they often wonder if it could have been prevented if Thibeault had received more help. Because of the questions they still have, the Lamberts founded Keep Sound Minds, an organization aimed at helping people get the mental health treatment they need."There are so many things that could be fixed," Ken Lambert said. "We know it will help down the road to prevent future incidents."

Thursday, August 21, 2008

Another Positive Step

A close friend of mine just called me. Her seventeen year old son was recently diagnosed as bipolar and he is currently in the psy-ward at a local hospital because he became violent and beat her up at home last week. He has been fighting this for over a year. He is also a substance abuse patient. She was very angry and frustrated with the insurance company who will pay for his 30 day drug rehab but will not pay if he is to be admitted under the diagnosis of "bipolar". This friend read my book and lived with me through the last years of my mother's life. But, until you have to personally "live" with bipolar do you or can you understand all the different scenarios that arise. My mother was never insured. My father paid hundreds of thousands of dollars for her to have private care as he never wanted her to go to the charity hospital in Louisiana. If an establishment sees the diagnosis of bipolar; some will not take you for care, and some insurance companies will not pay for that diagnosis to be treated. Very sad. But this article is a brightness in our fight to change the laws and get our loved ones the help they need before it is too late.

New Mass. law aids children with mental illness

BOSTON—When Mary Ann Tufts trekked to the Massachusetts Statehouse in May 2007 to testify in favor a children's mental health bill, her daughter Yolanda tagged along for a "girls' day away."

Yolanda, who'd battled anxiety and bipolar disorder for years, hadn't planned on speaking at the hearing, but at the last minute decided to tell lawmakers about her personal struggles -- putting a young face on the issue.

Eight months later, Yolanda Torres, then 16, committed suicide.

On Thursday, Gov. Deval Patrick signed the children's mental health bill -- dubbed "Yolanda's Bill" by advocates -- saying it strengthened the state's commitment to children living with mental illness.

Yolanda's mother expressed mixed emotions at the news.

"It's extremely bittersweet. I'm thrilled that it passed and I hope and believe that my daughter had something to do with it," Tufts said. "It makes her passing stand for something and that gives us some solace."

Patrick said the new law will make it easier for the state to identify and treat mental illness in children.

The law helps train teachers, guidance counselors and nurses to better identify mental health needs in students. Under the law, the Department of Early Education and Care will provide behavioral health consultation services in early education and care programs to reach children with mental illness earlier.

The new law also encourages behavioral health screening for children during visits to their doctors.

The bill also ensures greater cooperation between agencies by creating a children's behavioral health research and evaluation council, and service teams to collaborate on cases for children who may need services from multiple state agencies.

"Massachusetts has been a leader in expanding health insurance for all of its citizens and now we are focused on meeting the needs of every child," Patrick said in a written statement.

The need for services is acute, according to advocates.

A report by Children's Hospital Boston and the Massachusetts Society for the Prevention of Cruelty to Children, found that of the more than 140,000 young people under age 18 who need mental health services each year, more than 100,000 do not receive them.

Senate President Therese Murray, who lives in the same town as Mary Ann Tufts, said the goal of the bill was to help reach out to other teens suffering from mental illness.

"There are too many children in the Commonwealth who go undiagnosed or untreated for mental illness," Murray said. "This new law will help seal the cracks in our system."

Tufts said that while she would give anything to have her daughter back, she also knows that Yolanda would be pleased to have her name associated with a bill designed to help other children and teenagers facing similar struggles.

"She wanted to help other children like herself," Tufts said. "She was a very powerful young woman."

Monday, August 18, 2008

Been There, doesn't work

When my mother was early diagnosed, my father thought he could "strong arm" her in the old school way to take her medicine. Take my word for it, you can't make a bi-polar person do anything, especially if they are in a hypo-manic phase or manic phase. We learned to live with her with positive reinforcement, give and take, and lots of compassion. We still had to call the police when she was delusional, but I will tell anyone without a doubt that I learned after a lot of years, that their behavior cannot be controlled very much on their own. It, I am sure depends on what level of bi-polar they are, my mother was the worst, of course. I had this conversation just today with a fellow teacher. One of my special ed. students, just starting third grade, is bi-polar. His new teacher said she was just going to tell him that he was too old in third grade to have outbursts and to sometimes run out of the room and around the school when he had feelings of anxiety. I do know that it works to give bi-polar people boundaries, so I just smiled at her and said "Well, you can try it". I will keep you posted, but right now I would bet a million dollars that her idea will not work with this child. I got him a bird feeder and rain gauge that we will put in the inner, outside courtyard, when I see him getting anxious I will ask him to go with me, outside to check the bird feeder. I am going to try to get him outside into nature as much as possible, instead of sitting, closed up in a classroom all day. We will see as the year progresses what will work for him. Thankfully, like everyone else bi-polar, he is very intelligent so his academics won't suffer.

Stigma of mental illness pervasive: CMA head

10% of Canadians think those who are ill could 'just snap out of it' if they wanted to, new survey find

MONTREAL — Almost half of Canadians believe that a diagnosis of mental illness is merely an "excuse for poor behaviour and personal failings" and one in 10 thinks that people with mental illness could "just snap out of it if they wanted," according to the startling findings of a new opinion poll.

The survey, commissioned by the Canadian Medical Association, shows that the stigma of mental illness remains pervasive, making it the "final frontier of socially acceptable discrimination," Canada's top doctor says.

Brian Day, a Vancouver orthopedic surgeon and president of the CMA, said the survey "shines a harsh, and frankly unflattering, light on the attitudes we Canadians have concerning mental health."

But he added that it is best to expose such views and tackle them head-on rather than allow stigma to fester. "It's important that these data be out there and we discuss them," Dr. Day said.

The survey of 1,002 Canadian adults, conducted by Ipsos-Reid, also found that:

One in four Canadians is afraid of being around someone who suffers from serious mental illness.

Only half of those surveyed would tell friends or co-workers that a family member was suffering from mental illness. By contrast, 72 per cent would openly discuss cancer and 68 per cent would talk about diabetes in the family.

Only 16 per cent said they would marry someone who suffered from mental illness, and 42 per cent said they would no longer socialize with a friend diagnosed with a mental illness.

Half of Canadians think alcoholism and drug addiction are not mental illnesses.

One in nine people think depression is not a mental illness, and one in two think it is not a serious condition.

Canadians are split as to whether the increase in the number of people with mental illness is because of better diagnosis, or the result of increasing stresses of modern life.

Jean-Bernard Trudeau, director of professional and hospital services at the Douglas Mental Health University Institute in Montreal, said the attitudes found in the survey are "deplorable but not that surprising."

However, he said, such views are not malicious, but rather the result of ignorance. "People are afraid of what they don't know. It just shows that we have to make a lot more effort to educate the public about mental illness," Dr. Trudeau said.

According to the new survey, three in every five Canadians think that mental-health care is under-funded. And 72 per cent think financing of mental-health treatment and prevention should be on a par with that of physical health.

About one in four Canadians will suffer from a diagnosable mental illness at some point in their lives. Contrary to popular belief, however, the vast majority recover. Mental illness costs the national economy $51-billion a year. according to research from the Centre for Addiction and Mental Health.

The survey on mental health is part of a larger National Report Card on Health Care, which the CMA publishes annually. This year, two-thirds of Canadians accorded the overall quality of the health system a grade of A or B, up slightly from last year. A failing mark was given by 7 per cent.

What doctors say

86 per cent of family doctors say they provide care for patients with chronic mental illnesses.

64 per cent of family doctors rate access to psychiatrists for their patients as being fair or poor.

Only 19 per cent of psychiatrists can see an urgent case within one day.

Psychiatrists are the worst-paid specialists in Canada, earning on average $175,444, about half as much as dermatologists.

The average waiting time to see a child psychiatrist is 5½ months; for adults, it's slightly shorter.

Sources: National Physician Survey; Wait Time Alliance; Canadian Institute for Health Information

Saturday, August 16, 2008

Wishing this proactive pampering of Mental Ilness was done sooner

My mother, twenty years ago, was never taught to log or journal her feelings so she could learn for the future reference. I hope the mentally ill, now, even though it is still very hard, realize that they have a lot more tools for success than there ever was in the past. Please take comfort in the fact that there has been progress, even if it seems like it is very slow.

Fighting the good fight with mental illness

By Tom Stafford

Staff Writer

Sunday, August 17, 2008

Springfield, Ohio — I hadn't considered the strategy.

But Bill obviously had a good suggestion.

I met him in the gym at McKinely Hall, the site of a consumer forum held by the Springfield Chapter of the National Alliance for the Mentally Ill.

Michael Jones, who had invited me to speak, was a little disappointed with the size of the crowd.

But to me, the showing of 120 seemed decent.

A show of hands indicated they all were dealing with mental illness of some sort.

Two more shows of hands indicated most were taking medications and going to counseling.

That and their attendance identified them as people who are trying to fight the good fight.

When told the number of pills some of them have to keep track of each day, I confessed at having trouble remembering to take my one pill a day.

Immediately, someone handed me a pill organizer that had been passed out to everyone attending.

In the course of a half hour, we talked about many things.

All confirmed that mental illness is an equal opportunity ailment, knocking on doors in every neighborhood.

A woman with schizophrenia said many people wrongly think that all people who have it are violent.

Another piped up with this: She's the only one in her family with mental illness, but that doesn't mean she's the only one with problems.

I thought to myself, hmmmm.

And while doing so, I remembered something I'd seen on the national NAMI Web site (

"A key concept," it says somewhat bureaucratically, "is to develop expertise in developing strategies to manage the illness process."

So I asked the folks there a question: What do you do to help yourself out on a bad day?

That's when Bill spoke up.

He keeps a checklist.

He doesn't need it every day, but he looks at it every day.

That way, when bad days come, he has it in front of him.

With it in hand, he then reaches for discipline needed to work the list.

That spoke volumes to me about how serious he is about taking care of himself and about how much work it can be.

Others chimed in about the things they do to help themselves out.

Some knit. Some crochet or do latch hook. Some listen to music.

What tumbled forth was mostly a list of hobbies and activities that had one common element: They produce a feeling of accomplishment.

On my bad days, getting anything done seems to help me even more than beloved caffeine.

So I'm thinking about making a list like the one Bill has.

When I have a bad day, I'll take a look at it and find something to get me in motion.

Like the woman at the forum said, even those who aren't mentally ill have problems.

Friday, August 15, 2008

Needed in Every State

Months after teen's suicide, 'Yolanda's Law' advances

She sought better mental health care for Mass. children

By Kay Lazar Globe Staff / August 15, 2008
Text size +

Nicknamed "Yolanda's Law" after a Plymouth teenager who eloquently testified before legislators about her struggles with bipolar disorder, a bill aimed at improving mental health care for an estimated 100,000 Massachusetts children now awaits Governor Deval Patrick's signature.

State senators yesterday gave final approval to the sweeping measure, which directs an array of changes in a system described by advocates as seriously fractured.

The bill requires pediatricians to routinely screen children for behavioral health problems, with parental consent, and for health insurance companies to cover those screenings. It creates a system for school personnel to receive consultation and guidance to recognize and better understand children's mental health needs. And it attacks the "stuck kids" issue by setting up a process to more quickly move children stuck in hospitals because of bureaucratic red tape into more appropriate community-based settings.

"This is bittersweet," said Mary Ann Tufts, the mother of Yolanda Torres, for whom the bill is named. The 16-year-old committed suicide in January, eight months after testifying on Beacon Hill in support of the legislation. She battled some of the problems the measure aims to fix.

"She was truly powerful in being the visual face of what mental illness looks like. It doesn't have two heads or warts on its face or drool down its mouth. It looks like a typical child," Tufts said in a telephone interview. "Could this bill have changed the outcome for [Yolanda], no one knows. But I think it will impact other children very positively."

In Massachusetts, about 140,000 children age 17 or younger require mental health services, but 100,000 of those children do not get them, according to health advocates. Half of students with a mental illness drop out of school, and of those who commit suicide, 90 percent had a diagnosable and treatable illness, according to advocates.

The substantial unmet need, combined with Torres's powerful testimony and a strong coalition of families and organizations, helped push the bill through Beacon Hill in one legislative session, a remarkable feat given its far-reaching effects, said Marylou Sudders, who is president and CEO of the Massachusetts Society for the Prevention of Cruelty to Children and a former state mental health commissioner.

"We have been able to work with the Legislature on an issue that highlights the crisis in mental health and enact a bill to start to address this," Sudders said.

The Senate Ways and Means Committee estimated the changes called for in the law would cost the state about $5.4 million annually. Patrick now has 10 days to sign the bill.

"The governor has been generally supportive of this important legislation, but we have not seen the final version and the governor will need to review it," said a spokeswoman for Patrick, Cyndi Roy.

Thursday, August 14, 2008

Residual effects of a lifetime of mental illness

This is a personal story. My uncle, my bipolar mother's brother, died; I went to the funeral yesterday. I saw uncles and cousins that I spent some time with growing up but had lost contact with. A lot of tears were shed, then these uncles and cousins wanted to share phone numbers so we could "stay in touch". I must say that my emotions were overwhelmed by this. My father, brothers and I took care of my manic mother until she died with no help from any family. During the times of the deepest darkness of her mental illness, we stood alone. Where were these wonderful family members when we needed them the most? They were no where to be found. My mother and her illness have been dead for four years, if you are living with someone with a severe mental illness listen up. I know the mentally ill are going through extreme emotional highs and lows and sometimes paranoia and delusions; but so are the family who love and care for them. I hold no grudges against the extended family who now want to be close, I welcome the fact that they are still there and do care. But the message to those of you reading this blog is, no matter how severe your personal mental illness is, do not let it seperate the family. Mental illness by its nature causes seperation. I have read about not having friends because of mental illness, but I urge all family members to bond together and not lose contact due to this bipolar condition. It is not worth it. I always felt like my aunts, uncles, cousins, even my own grandmother, shunned us because of the severe condition my mother was in, I know they shunned us. Even when we asked for help, they would not be there for us, but in my humble opinion I will be thankful in my later life to reconnect with these people and enjoy the "golden years" together. I say thank you to my uncle and cousin from yesterday who stepped forward to acknowledge that idea and implement the welcome change. It is never too late to be a close family, don't waste valuable years to a mental illness.

Sunday, August 10, 2008

Info on Kendra's Laws

Here is the description for Kendra's Laws. I have been involved with mental illness forums and sometimes there are, in my opinion, online bullies who are monitoring them to be the flavor they want. I am stating here that this is an open blog, but I will make sure that it stays a safe, and warm, place for all opinions and no bullying will be tolerated. That is the teacher side of me showing. Having said that, this law can be controversial, I know that and I have lived it. I have been through the bipolar loved one who is convinced they don't need the medicine anymore, and I have watched while that person slowly went manic and was taken from the neighbors house by the police in a strait jacket. Those are the hard facts of some of the mentally ill and if I could have prevented my mother from having to go through that embarrassment I would have done so. But her fate was totally in her hands. Then after she agreed to take her prescribed medicine again, she was appalled at the behavior she had exhibited that she did not even remember. Just being arrested is mild in comparison to actually having delusions and taking a gun and killing either yourself or other innocent people. Thanks for reading this.


An Explanation of Kendra’s Law

November 1999
Revised May 2006

In 1999, New York State Enacted Legislation that provides for assisted outpatient treatment for certain people with mental illness who, in view of their treatment history and present circumstances, are unlikely to survive safely in the community without supervision. This law is commonly referred to as “Kendra’s Law” and is set forth in §9.60 of the Mental Hygiene Law (MHL). It was named after Kendra Webdale, a young woman who died in January 1999 after being pushed in front of a New York City subway train by a person who was living in the community at the time, but was not receiving treatment for his mental illness. In 2005, the law was renewed with several changes, which are noted in this article.

Overview of Assisted Outpatient Treatment

Kendra’s Law establishes a procedure for obtaining court orders for certain individuals with mental illness to receive and accept outpatient treatment. The prescribed treatment is set forth in a written treatment plan prepared by a physician who has examined the individual. The procedure involves a hearing in which all the evidence, including testimony from the physician, and, if desired, from the person alleged to need treatment, is presented to the court. If the court determines that the individual meets the criteria for assisted outpatient treatment (“AOT”), an order is issued to the director of community services (DCS) who oversees the mental health program of a locality (i.e., the county or the City of New York mental health director). The court orders will require the director to provide or arrange for those services described in the written treatment plan that the court finds necessary. The initial order is effective for up to 6 months and can be extended for successive periods of up to one year. The legislation also establishes a procedure for evaluation in cases where the individual fails to comply with the ordered treatment and may pose a risk of harm.

This legislation also requires the Office of Mental Health to designate “program coordinators” who are responsible for monitoring and overseeing AOT programs. County directors of community services are required to operate AOT programs, either separately or jointly with other counties. The directors of local assisted outpatient treatment programs report to the program coordinators regarding the operation of their AOT programs and also supply the program coordinators with information on every assisted outpatient treatment order. The Commissioner of Mental Health must approve all AOT programs.


The process for issuance of assisted outpatient treatment orders begins with the filing of a petition in the supreme or county court where the person alleged to be mentally ill and in need of AOT is present (or is believed to be present). The following may act as petitioners:

  • An adult (18 years or older) roommate of the person;
  • A parent, spouse, adult child or adult sibling of the person;
  • The director of a hospital where the person is hospitalized;
  • The director of a public or charitable organization, agency or home that provides mental health services to the person or in whose institution the person resides;
  • A qualified psychiatrist who is either treating the person or supervising the treatment of the person for mental illness;
  • A licensed psychologist or licensed social worker who is treating the person for mental illness;
  • The director of community services, or social services official of the city or county where the person is present or is reasonably believed to be present; or
  • A parole officer or probation officer assigned to supervise the person.

Petition Process

The petition must allege that the subject of the petition meets the criteria for AOT and must be supported by a sworn statement of a physician who has examined the person within the last ten days attesting to the need for AOT. The required physician’s affidavit may state in the alternative that unsuccessful attempts were made in the past ten days to obtain the consent of the person for an examination, and that the physician believes AOT is warranted. In the latter case, the court may request the person to consent to examination. If the person refuses and the court finds reasonable cause to believe the allegations in the petition are true, the court may order peace officers or police officers to take the person into custody for transport to a hospital for examination by a physician. Any such retention shall not exceed twenty–four hours.

Service of the Notice and Petition

Notice of the petition must be served on a number of people or entities, including the person, his or her nearest relative, the Mental Hygiene Legal Services (“MHLS”), the AOT program coordinator appointed by OMH, any health care agent appointed in a proxy executed by the person, and the appropriate county AOT program director.

AOT Criteria

No person may be placed under an AOT order unless the court finds by clear and convincing evidence that the subject of the petition meets all of the following criteria:

  • Is at least 18 years old; and
  • Is suffering from a mental illness; and
  • Is unlikely to survive safely in the community without supervision, based on a clinical determination; and
  • Has a history of lack of compliance with treatment for mental illness that has:
    1. prior to the filing of the petition, at least twice within the last thirty–six months been a significant factor in necessitating hospitalization in a hospital, or receipt of services in a forensic or other mental health unit of a correctional facility or a local correctional facility, not including any current period, or period ending within the last six months, during which the person was or is hospitalized or incarcerated; or
    2. prior to the filing of the petition, resulted in one of more acts of serious violent behavior toward self or others or threats of, or attempts at, serious physical harm to self or others within the last forty–eight months, not including any current period, or period ending within the last six months, in which the person was or is hospitalized or incarcerated; and
  • is, as a result of his or her mental illness, unlikely to voluntarily participate in the outpatient treatment that would enable him or her to live safely in the community; and
  • in view of his or her treatment history and current behavior, is in need of assisted outpatient treatment in order to prevent a relapse or deterioration which would be likely to result in serious harm to the person or others as defined in §9.01 of this article; and
  • is likely to benefit from assisted outpatient treatment.

A court may not issue an AOT order unless it finds that assisted outpatient treatment is the least restrictive alternative available for the person.

Written Treatment Plan

An examining physician appointed by the county director of community services (DCS) prepares the treatment plan submitted to the court. The examining physician must permit the person, his or her treating physician, and, if requested by the person, a relative, close friend or other concerned individual to actively participate in the development of the treatment plan. The treatment plan must include case management or assertive community treatment (“ACT”) team services to provide care coordination. It will also set forth the other categories of services recommended by the examining physician. If the plan includes alcohol or substance abuse counseling, then it may include a provision for relevant testing for alcohol or illegal substances. Such testing may be recommended only if the physician’s clinical basis for the recommendation shows facts sufficient for the court to find that (1) the person has a history of alcohol or substance abuse that is clinically related to his or her mental illness, and (2) testing is necessary to prevent a relapse or deterioration which would likely result in serious harm to the person or others.

A physician (not necessarily the same one who testifies regarding the satisfaction of the AOT criteria) must also explain the treatment plan in testimony to the court demonstrating that the proposed treatment is the least restrictive alternative. If the treatment plan includes a recommendation for medication, the testimony must include the types or classes of medication recommended, the beneficial and detrimental physical and mental effects of the medication, and whether the medication should be self–administered or administered by authorized professionals.

The Court Hearing

Upon receipt of the petition, the court is required to set a hearing date that is no more than 3 days later, although adjournments can be granted for good cause. The examining physician must testify at the hearing and must state the facts and rationale supporting the need for AOT as well as the conclusion that such treatment is the least restrictive alternative. The subject of the petition has the right to legal representation by Mental Hygiene Legal Services (MHLS), or by other counsel at the subject’s expense, at all stages of the proceeding. The person may also testify (but is not required to do so), and he or she may call witnesses and examine any adverse witnesses. A proposed written treatment plan must be furnished to the court before an order for AOT will be issued. If the petitioner is the director of community services operating an AOT program, the treatment plan is required by the court by the date of the hearing. If the subject of the petition has previously refused to be examined, the court may order officers to take the person into custody for transport to a hospital for examination.

Disposition of the Proceeding

If the court concludes that all the criteria for AOT are not met, the petition must be dismissed. If, however, the court finds by clear and convincing evidence that the subject of the petition meets the criteria and a written treatment plan has been filed, the court may order the subject to receive assisted outpatient treatment. If the treatment plan and testimony explaining it have not been provided to the court by the time of such a finding, the court will issue and order to the appropriate director of community services to provide the written treatment plan and testimony within three business days.

The initial assisted outpatient treatment order may extend for a period of up to six months. The order must specifically state findings that the proposed treatment is the least restrictive treatment that is appropriate and feasible, and must state the categories of treatment required. No treatment may be ordered unless the examining physician recommends it and it is included in the written treatment plan. The order must also require the appropriate director of community services to provide or arrange for the services described in the order.

The initial order can be extended for additional successive periods of up to one year. The same procedure used to commence the initial proceeding is used to secure an order for extension. Appeals of AOT orders are taken in the same manner as specified in MHL §9.35 relating to retention orders.

Failure to Comply with AOT Order

If in the clinical judgment of a physician the assisted outpatient has failed or refused to comply with the treatment ordered by the court and may be in need of involuntary admission to a hospital, the physician may request the director of community services, his/her designee, or other physician designated under §9.37 of the MHL to arrange for the transport of the person to a hospital. If requested, peace officers or police officers must take the individual into custody and transport him/her to the hospital. Ambulance services and OMH–approved mobile crisis outreach teams are authorized but cannot be directed to provide such transport. The individual may be held at the hospital for up to 72 hours for care, observation, and treatment and to permit a physician to determine whether involuntary admission under the standards set forth in Article 9 of the MHL is warranted. At any point during the 72 hours, should a determination be made that the individual does not meet involuntary admission criteria, that individual must be released.

Other Provisions of Kendra’s Law

Worth Watching

This topic is worth watching for several reasons. The ordinance seems similar to the England laws that the care of the mentally ill should be partly the responsibility of the community. The community should take an active role in helping the medicated, diagnosed mentally ill stay on their medicine, if that is what it takes for them to be successful members of society. I will restate that I do not want to return to the dark ages of forced medicine, but I am sure there is a happy medium solution to this dilema. Also for those of you who are Obama supporters, there is rumor that Gov. Richardson may be in consideration for the VP select for Obama. If Gov. Richardson is for this ordinance, then he will be worth watching if he joins the ticket with Obama. I will also state here that this blog will not be a platform for politics, I am just stating some facts for those of us concerned about the mentally ill in our society.

Thanks, Liz

Court strikes down Kendra's Law in New Mexico
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NewMexico.jpg After the courts struck down an Albuquerque ordinance requiring forced medication for outpatient treatment, the mayor vowed to return this issue to the legislature. According to the Albuquerque Journal the state has cut back on funding for outpatient programs. According to Nancy Koenigsberg from the advocacy organization, Protection and Advocacy,

The ordinance that was struck (down) acknowledged that for any kind of treatment to achieve its goal, it must be linked to a system of comprehensive care in which state and local authorities work together to ensure outpatients receive case management or special services.

Last year New Mexico ranked last in the nation's states for spending on mental health. StigmaNet has been compiling archives on how the fight over Kendra's Law is played in many of the 42 states that have adopted this law.

The issue pits supporters such as Sen. Pete Dominici, Gov. Richardson, and the state chapter of the National Alliance on Mental Illness against organizations such as the New Mexico ACLU and the Bazelon Center for Mental Health Law in Washington, D.C.

Thursday, August 7, 2008

Still a stigma, very sad really

This article talks about a professional football player here in the U.S. He is suffering from severe depression, another form of mental illness. One of my friend's daughter is a nurse who suffered a lot from post partum depression. She tried everything from nutrition to drugs. I recently had a conversation with her about her decision to take a low dose of Lithium. She says that even her closest friends do not know she is taking this drug. When I asked her why she could not confess this to even her friends, she simply said" I'm embarrassed to admit that I could be mentally ill and not be able to control this without Lithium". We have causes for childhood cancer, breast cancer, MS, and a multitude of all illnesses. This morning in the Denver Post was an article about an individual who had killed several people in a manic rage. I will keep saying that innocent people do not have to keep dying at the hands of someone who is sick. These mentally ill people need and deserve our help and also every victim who is killed by someone who is not-medicated and not able to get the appropriate help for their mental illness. This is an American travesty in my opinion.

Thanks, Liz

Mentally ill still subject to contempt

When an Eagle admitted he suffers from depression, the bashing began.

So how far has America come in taking the shame and stigma out of mental illness? Not very far, at least if the acknowledgment by the Philadelphia Eagles' All-Pro guard Shawn Andrews that he suffers from a mental illness is an indication.

The 335-pound Andrews, who refers to himself as the 'Big Kid,' had not shown up at the Eagles' Lehigh University training camp. No one seemed to know why.

There was talk of a contract holdout. Some suggested Andrews was out of shape. Some of his teammates expressed a lot of irritation that he was not there slogging out exhausting two-a-day practices in the summer heat and humidity, wondering if maybe he just did not want to go through the misery that is an NFL training camp.

Finally Andrews, deeply hurt by all the speculation, broke his silence. He told reporters for The Inquirer and Daily News that he was battling depression.

"I'm willing to admit that I've been going through a very bad time with depression," Andrews said this week in his first public comments about his training camp absence. "I've finally decided to get professional help. It's not something that blossomed up overnight. I'm on medication, trying to get better."

So what was the reaction to Andrews' admission that he has a disabling mental illness keeping him out of training camp?

You would have thought that this giant of a young man had announced that he had stayed out of camp because he was a lazy, overindulged ingrate who just did not happen to feel like playing football right now.

Talk radio in Philadelphia and around the country exploded in anger at the very idea that being sad - the talk-radio interpretation of depression - could keep you out of camp.

There was a fair amount of bashing of mental-health treatment, too, as sports talk hosts dismissed the treatment of anyone with depression as a lot of psychobabble for the rich and the spoiled. One Philadelphia sports talk host wondered why - since all psychiatrists are crazy - anyone would seek treatment from one.

It is not known what Andrews had told his coach, his agent, or the general manager of the team about his illness. But it is possible that, suffering from severe depression, which often means being confined to your house, unable to muster the energy to talk to anyone, much less eat or bathe, that he did not provide many details.

The team was fining the football player tens of thousands of dollars for his absence - a stance presumably they may want to reconsider.

But, the bigger question is: Why is it so hard for us to accept mental illness as being just as disabling and devastating as a physical injury?

Inherent in the nutty reaction to the admission of a football hero that he has a severe mental problem lies the explanation of why we have allowed our system of mental health to fall apart. Mental illness is so humiliating, so embarrassing, that individuals, whether they are in the NFL or on the assembly line, don't want to talk about it.

Families are ashamed when one of their own cannot function because of depression, schizophrenia, addiction or psychosis. The media simply reinforce the shame of mental illness with headlines that scream of nut houses, kooks and looney-bins when a celebrity heads off for mental-health treatment.

No one would dream of calling someone with cancer a malingerer or a deadbeat. But, admit that you have a hard time working because you are depressed, cannot leave your house because you are phobic, or find it difficult to show up at holidays with your family because you are not sure you can control your eating disorder, and just watch the insults fly.

Mental illness is for too many Americans a form of moral failure, whereas physical illness is the result of bad genes, bad luck, or bad working environments.

Unless we can get past dismissing mental illness as the product either of a lack of willpower or a lack of character, we don't stand a chance of helping those and their families who must suffer, often in silence, with the shame and stigma.

The United States barely has much of a mental-health system left. Beyond taking a pill, there is not a whole lot available in most parts of the country if you, your parent or your child suffers from depression or any other severely disabling mental illness.

If an NFL star can barely bring himself to publicly admit that he has a mental illness, then what chance do the rest of us have? And if a bruising NFL football player's admission of a mental illness elicits little except scorn, derision and contempt, then what chance do others with mental illness have of getting the help they need?

Crazy as it may seem - not much.

Saturday, August 2, 2008

Supervised Community Treatment

I have always appreciated the bills and laws that England has been trying with their mentally ill. Below you will find some of the verbage in one of their bills. England also now boasts that the killings committed by the mentally have gone down sharply and dramatically. In my opinion, we need to adopt some of the attitude that England has on the supervision and medication of diagnosed mentally ill patients in America. We don't want to take away their rights and return to the dark ages, but we do want them to take responsibility for their actions that effect their personal communities.

On 17 November 2006 the government announced its plan to introduce a Bill to make a range of amendments to the Mental Health Act 1983. One of the proposals is to introduce supervised treatment in the community to ‘ensure that patients comply with treatment and enable action to be taken to prevent relapse’ (Department of Health, 2006).

Two conditions need to be fulfilled to facilitate continuous treatment in the community. First, there has to be a mechanism to ensure that a patient participates in their treatment (including taking prescribed medication) while they remain in the community. Second, there must be a way to ensure continuity of this without interfering with the patients' status in the community.

Over the past 20 years, the courts in England and Wales have evolved case law governing the treatment of people with mental disorders in the community based on interpretation of the Mental Health Act 1983. What has emerged is that section 17 of the 1983 Act provides sufficient provisions for the supervised treatment of patients while they remain largely in the community.