Let's have the conversation about mental illness

[MrsAxilla]

I posted this in the other thread but I'll repeat it here. If it's true that he was a med student, then he DID have access to mental health services. CO has a program that all med students (and doctors) are enrolled in that provides services. Not to mention that he would have been require to carry pretty comprehensive health insurance, and there is a psychologist available on staff, as well.

In this particular case, I'm assuming resources and support was available. Denial is a whole other ball of wax, though.

[copzgirl1171]

Jul 20, 2012 11:16:43 GMT -5 MrsAxilla said:

I posted this in the other thread but I'll repeat it here. If it's true that he was a med student, then he DID have access to mental health services. CO has a program that all med students (and doctors) are enrolled in that provides services. Not to mention that he would have been require to carry pretty comprehensive health insurance, and there is a psychologist available on staff, as well.

In this particular case, I'm assuming resources and support was available. Denial is a whole other ball of wax, though.

I believe he was in the PhD program..same thing apply?

[downtoearth]

Edited...

Wow, if he was a med student or PhD (even if he dropped out) how did he get from that to a random gunman in a theater? It's baffling and so, so sad.

[Darn work meetings now...]

[laurenpetro]

DH's uncle is a paranoid schitzophrenic who was institutionalized for over 15 years after trying to cross the canadian boarder because the CIA was after him. i went to visit him a couple of times before i had the kids. a few years ago he was released to a half-way house and soonafter relapsed. none of us were surprised as his "treatment" wasn't a treatment as much as just drugging. i don't blame them and i don't think much more can be expected of doctors and therapists when someone is at that level, but i do think there's a point where you say they're never going to get better and to keep him (and others) secure.

because of this i won't bring my kids up there to see him. grace has minimal knowlege of him and we're probably going to keep it that way for the foreseeable future. it's not that we're hiding any info about him from her but she'll never "know" him and everyone has agreed that he's too unpredictable to reliably say whether or not he'll interact on any level with any of us.

the only way to pay for treatment was to put him on SSDI and have him declared impovrished.

every part of this posts reflects a complete breakdown in the system. it's awful for DH's family and it's awful for his uncle.

[Deleted]

Jul 20, 2012 11:16:03 GMT -5 downtoearth said:

Wow - being a parent or spouse of a person with mental illness sounds very tough. Are there support groups or guidance for helping those who support mentally ill family members through hospitals/treatment/insurance?

Not really. A friend and I started one in my area, but so far it's just us. There are groups for the sufferers themselves, but very little for friends and family members. I really don't know what I would do without the Psychologist. She has been by far my biggest supporter and best resource. I wish I could clone her and make sure everyone had someone as knowledgeable as her in their corner.

[MrsAxilla]

Jul 20, 2012 11:18:22 GMT -5 @copzgirl1171 said:

Jul 20, 2012 11:16:43 GMT -5 MrsAxilla said:

I posted this in the other thread but I'll repeat it here. If it's true that he was a med student, then he DID have access to mental health services. CO has a program that all med students (and doctors) are enrolled in that provides services. Not to mention that he would have been require to carry pretty comprehensive health insurance, and there is a psychologist available on staff, as well.

In this particular case, I'm assuming resources and support was available. Denial is a whole other ball of wax, though.

I believe he was in the PhD program..same thing apply?

Yeah, damn 24 hour news rushing to report and getting shit wrong! No, PhD programs do not have access to those same resources. MD/DO only.

[donnamartingraduat]

I am usually just a lurker, but feel compelled to respond to this thread.

People with mental illness, even serious mental illness (SMI; schizophrenia, bipolar, severe depression, etc.) are no more likely to commit a violent crime than people without SMI. In fact, some estimates show that people without SMI are MORE LIKELY to commit a violent crime. I can dig up some citations if someone is really dying for them -- but I do need to do some work...

I 100% agree that the mental health system is beyond broken in this country and that serious reform is needed, but tying that conversation to horrific violent acts (such as the one in CO today) only serves to further the negative stereotype that already exists. It also contributes to the stigma that prevents people from seeking much needed help (although studies are mixed as to whether perceptions of stigma actually limit seeking treatment) -- the belief that people with SMI are scary and dangerous.

::stepping off soapbox::

Edited for clarity.

[summer]

Did anyone else read the long NYT article a few weeks back about the impossible time this woman had getting services for her father?

It's long, but very interesting.

www.nytimes.com/2012/06/24/magazine/when-my-crazy-father-actually-lost-his-mind.html?pagewanted=all

[heyjude]

YES! We need to change the stigma around mental illness and I'm happy to hear people feel the same way. But just yesterday people on this board found it unseemly and TMI that a couple in a NYT wedding announcement would even mention they met in a mental hospital. This attitude has to change.

[Deleted]

I hate threads like this because in a way, they increase the stigma of being mentally ill. Aka, if you're mentally ill, you are more likely to hurt people. I've heard a number of times, though I can't remember where, that the mentally ill are far more likely to suffer harm than to hurt others.

[bluestreet]

Jul 20, 2012 11:30:17 GMT -5 donnamartingraduat said:

I am usually just a lurker, but feel compelled to respond to this thread.

People with mental illness, even serious mental illness (SMI; schizophrenia, bipolar, severe depression, etc.) are no more likely to commit a violent crime than people without SMI. In fact, some estimates show that people without SMI are MORE LIKELY to commit a violent crime. I can dig up some citations if someone is really dying for them -- but I do need to do some work...

I 100% agree that the mental health system is beyond broken in this country and that serious reform is needed, but tying that conversation to horrific violent acts (such as the one in CO today) only serves to further the negative stereotype that already exists. It also contributes to the stigma that prevents people from seeking much needed help (although studies are mixed as to whether perceptions of stigma actually limit seeking treatment) -- the belief that people with SMI are scary and dangerous.

::stepping off soapbox::

Edited for clarity.

I'm very interested in knowing more. Because to me, the moment you go on a shooting spree, you have SMI, even if undiagnosed. That's not me being sassy, but that's really what I've always assumed.

[wawa]

Jul 20, 2012 11:30:17 GMT -5 donnamartingraduat said:

I am usually just a lurker, but feel compelled to respond to this thread.

People with mental illness, even serious mental illness (SMI; schizophrenia, bipolar, severe depression, etc.) are no more likely to commit a violent crime than people without SMI. In fact, some estimates show that people without SMI are MORE LIKELY to commit a violent crime. I can dig up some citations if someone is really dying for them -- but I do need to do some work...

I 100% agree that the mental health system is beyond broken in this country and that serious reform is needed, but tying that conversation to horrific violent acts (such as the one in CO today) only serves to further the negative stereotype that already exists. It also contributes to the stigma that prevents people from seeking much needed help (although studies are mixed as to whether perceptions of stigma actually limit seeking treatment) -- the belief that people with SMI are scary and dangerous.

::stepping off soapbox::

Edited for clarity.

I understand what you (and hab) are saying.

But "a person with SMI is more likely to be violent" is not the same thing as "somebody who walks unprovoked into a crowded place and opens fire is probably suffering from a SMI"

[bluestreet]

It took me years to find the right treatment for my mental health problems, and I do feel passionately about the need to legitimize and recognize the reality of mental health problems like we do diabetes.

That said, I don't think we should equate mental illness with other physical illnesses, because mental illnesses respond to socially constructed abstractions in a way diabetes does not. Depression, anxiety, OCD, etc. are manifested and perceived differently at different times in different cultures. I'd love to be seen as a priestess in my life, but that ain't gonna happen for me.

Why the fuck am I bringing this up? Well, I just wonder why I've yet to read a cohesive analysis of why so many mass shooters are white males who grew up in the burbs. To what extent does suburban lifestyle and school culture, or whatever common social factors surround these incidents, interact with the mental illness these individuals are suffering? To what extent has our culture created these tragedies?

Too abstract and dopey for this thread?

[Chirp]

Jul 20, 2012 11:24:41 GMT -5 @mairzydoats said:

Jul 20, 2012 11:16:03 GMT -5 downtoearth said:

Wow - being a parent or spouse of a person with mental illness sounds very tough. Are there support groups or guidance for helping those who support mentally ill family members through hospitals/treatment/insurance?

Not really. There are groups for the sufferers themselves, but very little for friends and family members.

I agree with this. My H has depression and anxiety. He been working on it for a few years now.

Luckily, I'm very good at navigating insurance and provider networks. I work for an insurance company, so I have an advantage there. But even if you know what you're doing when it comes to navigating the technical stuff, sometimes it's still just exhausting to live with.

[pescalita]

Thanks for starting the conversation.

First, I do agree that part of the problem about talking about it at all is that it increases the stigma to jump to the conclusion that all people with mental illness are violent. It took about 2.4 seconds in the other thread for someone to revoke the second amendment rights of people with depression and anxiety. So I think there does need to be a serious emphasis that we are talking about a tiny minority of those suffering with mental illness, and that what we're fighting is violence, whatever it's impetus.

OTOH, while most (even severely) mentally ill people will not commit violent crime, it's also extremely rare for a 100% sane person to complete these random mass acts of violence (I'm talking about something like CO here, not everyday violence, which is a separate issue IMO). So I do think the conversation is worth having.

Something I didn't see mentioned a lot is how the disease itself hinders treatment, in addition to stigma and access to care. You're dealing with a whole different animal than say, cancer, when the illness can convince the victim to avoid treatment.

I honestly don't think a bunch of armchair psychologists have the answer. I think this is something very smart people with tons of knowledge and training struggle to help their patients with daily. I also don't think it's hopeless that there's an answer outside of "institutionalize them".

The state of mental health care and support services is abysmal at present. This is one area where I think a "task force" could really do good - getting the drs and patients and loved ones together who have experience, and see what they can come up with.

[donnamartingraduat]

I'm very interested in knowing more. Because to me, the moment you go on a shooting spree, you have SMI, even if undiagnosed. That's not me being sassy, but that's really what I've always assumed.[/quote]

Nope. Violence does not equal SMI (even a shooting spree). People commit violent acts for a number of reasons that may or may not have to do with symptoms of mental illness. For example, someone who feels as though they were wronged by someone at a movie theater and then shoots up movie goers as revenge would not be deemed mentally ill based on that alone. (BTW -- I'm not suggesting that is what happened in this case and I don't know if this person has SMI).

Violent acts are not a criteria for any SMIs -- meaning that a violent act alone would not get you a diagnosis (except for antisocial personality disorder -- but that is a different conversation). If you commit a violent act because your hallucinations were telling you to do so, then you might have an SMI -- but b/c of the voices, not the violent act.

Hope that makes sense -- it is hard to explain in a relatively brief thread!

[downtoearth]

Edited to say that this was to discuss violence = higher incidence with SMI patients...lost the other quote somehow

Jul 20, 2012 11:42:51 GMT -5 bluestreet said:

I'm very interested in knowing more. Because to me, the moment you go on a shooting spree, you have SMI, even if undiagnosed. That's not me being sassy, but that's really what I've always assumed.

I can only answer from a mental health professional that we talked with after my coworker incident, but from his individual standpoint, from the detailed police reports (not talking with the individual) he said that a paranoid mentally unstable person would try to back out of situations that trigger their paranoia and are often not the agressors unless they feel attacked.

It was a big part of why we did not file a restraining order against the person b/c we hadn't seen them in over a year and that he was exhibiting paranoias that were most likely more a concern for his own safety than hurting others (according to that one mental health doctor with 35 years experience).

I don't have studies to show this.

[donnamartingraduat]

I understand what you (and hab) are saying.

But "a person with SMI is more likely to be violent" is not the same thing as "somebody who walks unprovoked into a crowded place and opens fire is probably suffering from a SMI"
[/quote]

I admittedly don't know the stats if you limit the violence to mass shootings, such as todays. But, I still think there is a risk of assuming that violence equals SMI and I personally believe it moves the conversation about mental health care reform backwards, rather than forwards.

[donnamartingraduat]

Jul 20, 2012 11:59:15 GMT -5 sonrisa said:

Jul 20, 2012 11:30:17 GMT -5 donnamartingraduat said:

People with mental illness, even serious mental illness (SMI; schizophrenia, bipolar, severe depression, etc.) are no more likely to commit a violent crime than people without SMI.

Good point - but they are more likely to commit crimes that can be prevented with medication and management. And much more likely to be victimized.

I completely agree!

[Deleted]

I think the thing is we can sort of understand someone killing for the "classic" reasons of revenge or money or jealousy. The idea that someone will behead someone else because he thinks he's fighting an alien*? That's really hard to understand. And so, yes, we really want paranoid schizophrenics on their meds, removed from society, or both. We all feel like we won't be killed for any "good" reason, but the random nature of stuff like this makes us feel really unsafe.

And yet we're unwilling to provide care for people like that that really, really need it.

*http://www.cbc.ca/news/canada/manitoba/story/2012/05/22/mb-vince-li-schizophrenia-interview-manitoba.html

[sillygoosegirl]

So many of you mention the stigma as if this is not something you stigmatize. Yet in the same breath, you say that people who have never committed any crime other than being suspected of having an illness should be forced to take mind-altering drugs with long term serious side effects against their will.

I think some of you need to reexamine your own prejudices. Do you also think we should force people with high blood pressure to take drugs for that? Do you think we should castrate suspected future sex offenders? Do you think we should force women who can't afford children to have abortions?

You can't lump all mentally ill people together. What happened this morning in CO was tragic. I cried when I heard it on the radio this morning. But you can't prevent all crimes without losing all freedom.

[mominatrix]

Jul 20, 2012 12:32:34 GMT -5 sillygoosegirl said:

So many of you mention the stigma as if this is not something you stigmatize. Yet in the same breath, you say that people who have never committed any crime other than being suspected of having an illness should be forced to take mind-altering drugs with long term serious side effects against their will.

I think some of you need to reexamine your own prejudices. Do you also think we should force people with high blood pressure to take drugs for that? Do you think we should castrate suspected future sex offenders? Do you think we should force women who can't afford children to have abortions?

You can't lump all mentally ill people together. What happened this morning in CO was tragic. I cried when I heard it on the radio this morning. But you can't prevent all crimes without losing all freedom.

...you don't see the difference somebody who's refusing to take their heart medication and somebody who's refusing to take medication because, without it, they're prone to violence against others?

Can't we analogize to vaccines?

You don't want to take your meds for your disease, fine. You don't want to vaccinate, and that impacts herd immunity that impacts me and mine... not so fine.

[sillygoosegirl]

Jul 20, 2012 12:35:22 GMT -5 mominatrix said:

Jul 20, 2012 12:32:34 GMT -5 sillygoosegirl said:

So many of you mention the stigma as if this is not something you stigmatize. Yet in the same breath, you say that people who have never committed any crime other than being suspected of having an illness should be forced to take mind-altering drugs with long term serious side effects against their will.

I think some of you need to reexamine your own prejudices. Do you also think we should force people with high blood pressure to take drugs for that? Do you think we should castrate suspected future sex offenders? Do you think we should force women who can't afford children to have abortions?

You can't lump all mentally ill people together. What happened this morning in CO was tragic. I cried when I heard it on the radio this morning. But you can't prevent all crimes without losing all freedom.

...you don't see the difference somebody who's refusing to take their heart medication and somebody who's refusing to take medication because, without it, they're prone to violence against others?

Can't we analogize to vaccines?

You don't want to take your meds for your disease, fine. You don't want to vaccinate, and that impacts herd immunity that impacts me and mine... not so fine.

But we don't know who will become violent someday and who will not. Even the professionals really don't know. For every person who went on a shooting spree like this, there are probably 1000 individuals who seem similar mentally but never would. And then there are plenty of people who never exhibited warning behavior and then turned violent. Are you proposing that we all take mind-altering to vaccinate us against becoming violent?

[donnamartingraduat]

Jul 20, 2012 12:45:32 GMT -5 sillygoosegirl said:

Jul 20, 2012 12:35:22 GMT -5 mominatrix said:

...you don't see the difference somebody who's refusing to take their heart medication and somebody who's refusing to take medication because, without it, they're prone to violence against others?

Can't we analogize to vaccines?

You don't want to take your meds for your disease, fine. You don't want to vaccinate, and that impacts herd immunity that impacts me and mine... not so fine.

But we don't know who will become violent someday and who will not. Even the professionals really don't know. For every person who went on a shooting spree like this, there are probably 1000 individuals who seem similar mentally but never would. And then there are plenty of people who never exhibited warning behavior and then turned violent. Are you proposing that we all take mind-altering to vaccinate us against becoming violent?

My read of this thread was not that people thought meds should be FORCED on the mentally ill. That was certainly not my position. Rather, it should be easier, cheaper, and faster to get appropriate MH services for those who want it. Reducing stigma is one of the potential ways to accomplish those goals.

I have sat on panels whose job it is to approve / disapprove requests from psychiatrists to force meds on people with SMI who are refusing. I can assure you, at least in my state, that this process is taken very seriously and the health and well-being (including potential side effects) of the patient is of the utmost importance.

[pescalita]

Jul 20, 2012 12:45:32 GMT -5 sillygoosegirl said:

Jul 20, 2012 12:35:22 GMT -5 mominatrix said:

...you don't see the difference somebody who's refusing to take their heart medication and somebody who's refusing to take medication because, without it, they're prone to violence against others?

Can't we analogize to vaccines?

You don't want to take your meds for your disease, fine. You don't want to vaccinate, and that impacts herd immunity that impacts me and mine... not so fine.

But we don't know who will become violent someday and who will not. Even the professionals really don't know. For every person who went on a shooting spree like this, there are probably 1000 individuals who seem similar mentally but never would. And then there are plenty of people who never exhibited warning behavior and then turned violent. Are you proposing that we all take mind-altering to vaccinate us against becoming violent?

So let's research it more and find out. On what other topic do we just throw up our hands and say "whelp, we don't know so oh well"?

I don't think it's a good idea to not talk about it at all and just ignore it because it can increase the stigma. We should absolutely be cognizant of that. But it's a reason to talk about it MORE, not less.

[emmybean]

Jul 20, 2012 13:03:14 GMT -5 pescalita said:

Jul 20, 2012 12:45:32 GMT -5 sillygoosegirl said:

But we don't know who will become violent someday and who will not. Even the professionals really don't know. For every person who went on a shooting spree like this, there are probably 1000 individuals who seem similar mentally but never would. And then there are plenty of people who never exhibited warning behavior and then turned violent. Are you proposing that we all take mind-altering to vaccinate us against becoming violent?

So let's research it more and find out. On what other topic do we just throw up our hands and say "whelp, we don't know so oh well"?

I don't think it's a good idea to not talk about it at all and just ignore it because it can increase the stigma. We should absolutely be cognizant of that. But it's a reason to talk about it MORE, not less.

I agree that talking about it more reduces stigma, especially because it seems as though these mass killings are anomalies, regardless of the mental state of their perpetrators. Anyone who makes a connection that all SMI patients are violent or can easily become violent are being willfully ignorant.

[lvhorses]

There seems to be, what I call, "acceptable" mental health problems and "unacceptable" mental health problems.

If you're a kid and your mother died, people are more sympathetic to you getting help. If someone close to you was murdered or you were in a natural disaster or you're in a mass shooting or you've been raped or you're a man who lost his wife and children--all scenarios where people are more sympathetic and understanding towards mental health services and therapy.

However, if you're diagnosed with depression or bipolar disorder or any other of the multitude mental health disorders-- than its your "fault" for being that way and you should "snap" out of it. Hell, PPD has come a long way and still women get crap if they tell others.

[basilosaurus]

I think people pull a no true scotsman fallacy when talking about mental illness and shooting up a place.

We define that as an insane thing to do, therefore anyone who does it, by definition, is insane.

I think this is harmful in a couple ways. First, it really demonizes those with mental illness. The vast majority of those with schizophrenia (or fill in the blank illness you want to blame) don't go on shooting rampages.

It also allows us to deny culpability. With the Gabby Giffords shooting, you couldn't mention the GOP talk of targets b/c, well, that's ok, and this guy was just insane. So, nothing wrong with violent imagery in campaign speeches, nope. It also shuts down a lot of the gun control arguments with people saying that an insane person will still do insane things, so why make weaponry harder to get if the sane reasonable folks aren't the problem.

And for anecdote in response to the first page, I've tried to get counseling through basically an EAP. The program calls on my behalf. Not one of 4 docs called ever called me back.

[Deleted]

Jul 20, 2012 12:32:34 GMT -5 sillygoosegirl said:

So many of you mention the stigma as if this is not something you stigmatize. Yet in the same breath, you say that people who have never committed any crime other than being suspected of having an illness should be forced to take mind-altering drugs with long term serious side effects against their will.

My stance is that people who cannot consent to treatment should have a representative allowed to make medical decisions for them (even one appointed by the state if needed). A person with a severe mental illness is unlike someone with high blood pressure or diabetes because in many cases they can't objectively understand a diagnosis, prognosis, or treatment plan. If your brain is functioning, you get the consequences of not taking your bp medication. Obviously I'm talking about severe cases, but I think that includes people who have already shown violent tendencies.

My stance has less to do with predicting violent behavior and more with getting people with legitimate illnesses legitimate treatment. And my side hope is that the more people are involved in the illness, by representing or being part of treatment planning, the more people will understand it, and fewer people will stigmatize.