Tuesday, September 04, 2007

Mental Health Problems - Symptoms, Diagnosis and Treatment

I’ve held off on blogging about this subject although it is of deep personal concern to me. When I attended The National Association of Counties Legislative Conference in Washington, DC in March 2007, I selected “The Non-Violent Mentally Ill in Jail: Solving the Growing Intergovernmental Crisis” as one of the presentations to attend. One of the documentaries we all viewed showed the mentally ill in confinement in Dade County. Prior to and since then, I’ve understood the criminality of putting the mentally ill behind bars. Some of you may have seen the TV two hour presentations of the mentally ill in the Los Angeles County Jail.

A panel (Massengill) was created to study the killer in the Virginia Tech Massacre with a report due next week. Reports say that “Cho" had no record of violence in 23 years.” Quite believable but other symptoms were detected such as his expulsion from a classroom for failure to remove his cap and sun glasses. Refusals to accept authority should be sure signs of a disturbed individual. I’m afraid the report will not shed much insight into his personal life that hasn’t already been reviewed, digested, speculated on, and written in journals. By using “not politically correct preventative action” perhaps Cho would be alive today as a contributor to society or in a place where he could not kill a lot of people and a lot of people, who shouldn’t be dead, would be alive today.

That we have a massive problem; the chairman elect of the National Association of County Behavioral Health and Disability Directors calls “the lack of community care for mentally ill is a “national tragedy”. We had our own trauma when Zeller was closed because it was said “costs appeared to outweigh benefits”.

Preventative actions are ALWAYS CHEAPER than actual destructive happenings. The VT murders have cost and will cost that community untold millions of dollars. Had Cho lived his trial and incarceration might have been enough to bankrupt a less affluent community.

On July 30 and 31st, the JSEB talks about how armed authorities should respond in a confrontation with mentally ill people. That’s a separate but important problem. The major problem is how to get him or her to recognize they need help with a problem that is getting out of hand and then take corrective or preventable action. This usually takes some community observation and input as the distressed or sick person can always act reasonably normal around family of authorities. Authorities and Crisis Intervention can not commit a person without some real proof of disorder. And then commit he or her to what if they are of legal age and don’t consent?

I twice talked to Senator Dick Durbin about what to do before mental health disturbances evolve into a lethal force standoff or some innocent people are slain by a mentally stressed person who “breaks” after a particular highly stressful (to him or her) event. This I believe is what the panel will describe during testimony. Durbin said the Federal Government understands the problem, are seriously concerned and things are happening in DC. I’m not sure enough is happening at any level, county state or federal. Some local officials do not seem to be too concerned. Others, lip concern is SOP for many politicians.

Most of us know, as Angie Ulrich of Peoria stated in her recent letter the JSEB Editors that way too many “not” normal people are warehoused away from us “normal” people. Angie believes we should spend more money on “community based services instead of building more bridges.” Unfortunately, the bridge collapse in Minnesota quickly revealed the need of least $1.6 trillion dollars to prevent physical bridge tragedies. And that’s just bridges. Maybe the figures are embellished a little by engineers who need jobs too. But Angie is correct in her letter.

It’s past time for hand wringing and 2nd guessing. It is time for some serious dialogue and some serious spending. Many programs are working across the country and some are in development study stage such as “CBT” as described in Forbes and the WSJ this spring. The article reads that “health insurers are especially attracted to CBT since it aims to heal a person after 10 to 25 visits in contrast to lifelong conversation with therapists as depicted in Woody Allen movies.” Integrated Behavioral Health claims over half of their cases involve CBT up from 10 to 20% a decade ago.

Who among us elected and high profile people are looking for preventative measures? In January 2004, Present Bush said the following “This year, some 600,000 inmates will be released from prison back into society. We know from long experience that if they can’t find work, or a home, or help, they are much more likely to return to prison…” What I don’t believe he said that most people and they are people, coming home have histories of drug or alcohol dependence. An increasing number have mental health problems; without treatment, relapse is likely. Figures ranging from 20% to 70% are deemed mentally ill in our jails and prisons. Coming back to their neighborhoods without treatment of some kind, no money, and no job, no real family, often times is disastrous.

Experience shows that it is difficult to get many mentally distressed people to admit they have a problem, similar to many not wanting to admit to have a drinking or drug problem.

Some will say the government will try to commit all people that act differently than the expected norm. Some will try to commit relatives for access to their money. It is my belief that most of my family and friends feel that we must often take actions to save someone from themselves and to protect others such as the once terrified and now dead Virginia Tech attendees. Most laws never please everybody.

I do not profess to know all the preventative sources that are available in Peoria. I know there are programs available for those who can afford substantial billings. The problem is most people can’t afford or even know about the proper treatment for their condition.. The police and crisis intervention can only go so far.

A one hundred million dollar bill was making its way thru congress for year 2008. 2008?? We should have programs in place years ago and needs properly defined and agreed upon by the community. Not much money for 50 states. The money is to help the mentally ill within the county health and human services systems.

I am a great believer in letting communities keep more tax dollars to service each local communities particular needs and build our local relationships of determining our priorities, reaching reasonable agreement with each other by open and honest dialogue.

We are talking serious corrective action money but I believe the costs can be sold to a community easier than a new ball park, a new zoo, a new museum and bricks and mortar for unsupervised computers in our public libraries.

A consortium with roots going back to 1993 or 4 is attempting to gain support and money to attack the homeless problems in our community. My involvement from 1993-9 in efforts to solve this issue gave me the insight to see that many deemed perpetually homeless were mentally ill and did not want to come “in from the outside”. Many felt that they were denied or shunned by the community and refusing a permanent lifestyle was their way of telling us that they too had rights and they had the right to continue to lead the lifestyles they were living. And some were satisfied to have little responsibilty.

We always have problems sorting out the problems of our personal lives and the life of the community in which we reside. We need stronger leadership to help us sort PRIORITIES OUT and BETTER LEADERSHIP to HONESTLY SELL the well researched real needs of this community. All with abnormal mental health affect the entire community. Just ask the surviving families, loved ones, acquaintances, or the entire community affected by what happened at Virginia Tech...


John clinton said...

Great Blog....You can also give your valuable answer in Health Questions.

AdamB said...

well said.

merlewidmer@msn.com said...

Thanks Adam.

John, I've clicked on your site but I do not know how to transfer this blog or blog site to Health Questions?

Or perhaps you can refer your readers to my site?

Advise and thanks for reading me.

Alisa Vernom said...

Sometimes, anxiety may be generalized, expressed through symptoms of restlessness, being easily fatigued, difficulty concentrating, irritability, muscle tension and sleep disturbance.
About Us Page of Sydney Clinical Psychologist Centre