Severe Mental Illness: The Ignored Public Health Crisis
Authored by Beth Brelje via The Epoch Times (emphasis ours),
"I'm afraid to die." "What happens to my son when I die?" Treatment Advocacy Center (TAC) Executive Director Lisa Dailey says she will never forget that testimony from a Virginia mother in her 80s who had spent much of her life caring for her son, now in his 50s, with severe mental illness.
He was unstable, but she couldn’t get him into treatment because he didn't think anything was wrong with him.
“The difference between a person with a heart attack and a person who has psychosis is that a person with a heart attack is willing to receive care, and they want the care," Ms. Dailey told The Epoch Times. "The person in psychosis might be actively fighting against it. They might have to be tied down to receive care, and that is perceived differently by the medical system.
"There doesn't seem to be a full acknowledgment on the part of the medical system that a person who is refusing care may not have the capacity to be refusing care.”
The Treatment Advocacy Center is a national nonprofit dedicated to eliminating barriers to the treatment of mental illness. In the United States, 8.8 million people—roughly the size of the population of New York City—suffer from severe mental illness, and nearly half of them go untreated in any given year, according to TAC data.
In 1963, President John F. Kennedy signed the Community Mental Health Act, which was supposed to decrease the number of institutionalized individuals in psychiatric hospitals by creating local mental health care centers. The local centers weren't funded; most were never built. But many psychiatric hospitals closed anyway.
Since 1955, when the United States had its most psychiatric beds, the number of state hospital beds had fallen by 97 percent by 2016, according to TAC. That's left few beds for people in need of care.
No Meaningful Support
Today, there isn't a clear path for those with severe mental illness. Care is left to family members, for those who have someone able to help. Others often end up alone, homeless, or in prison as they try to find their way while living with a thought disorder.
Each year, 21 percent of total law enforcement staff time is used to respond to and transport individuals with mental illness. For example, in 2020, the family of a Lancaster, Pennsylvania, man called the police to remove a loved one from their home during a mental health episode. Ricardo Miguel Munoz, 27, was holding a knife to his neck when the police arrived. Mr. Munoz charged at an officer and was about to stab the officer, a police body camera recording shows, when the officer fatally shot him.
Mr. Munoz had been awaiting a court date on an alleged previous stabbing of four people and had a stalking incident in his history. His family said in news reports that they wanted mental health help for him.
“Our entire medical system for people with severe mental illness is predicated on the idea that family is responsible for providing the majority of the care, in their homes, at their own expense, without any support, and without any of the tools they would need to be able to make that actually work,” Ms. Dailey said.
Severe mental illness involves psychosis, or a patient losing touch with reality. Often, these are people with schizophrenia or bipolar disorder. While in psychosis, the behavior is unpredictable and sometimes dangerous. They may walk out into traffic, fear others are trying to harm them, or find a weapon and harm the public. About half of them have anosognosia, or lack of insight into their illness. That is, they don't understand that they have a mental illness, refuse to take medication, and won’t go for treatment.
The laws governing mental health are different in each state, but there are some common problems nationwide, including limited psychiatric bed space in hospitals, a shortage of psychiatrists, a high bar toward getting into a hospital for treatment, and often the release of patients with a chronic mental health condition with no plan after release.
The Medicaid Institutions for Mental Disease (IMDs) Exclusion is one barrier to finding in-patient care. The IMD Exclusion prohibits states from using Medicaid to pay for care provided in psychiatric hospitals or other residential treatment facilities that have more than 16 beds.
“It's the only kind of illness that has that, so that's one policy thing we should get rid of,” Ms. Dailey said. “It's totally discriminatory, and it discourages the building of facilities.”
Loved Ones Watch and Worry
While neither the details nor a specific diagnosis are publicly known, police have reported that Robert Card, the suspect in the Lewiston, Maine, fatal shootings of 18 people, had recently reported mental health issues, including hearing voices. He had threatened to shoot up the National Guard base in Saco, Maine, and during the summer, was admitted to a mental health facility for two weeks.
“I know exactly what [families of those with severe mental illness] think when they see these things," Ms. Dailey said. "You're angry at the system that discharged him after two weeks because that was your opportunity to get somebody treated and prevent something like this from happening.
“That's what family members are always thinking about—this could happen. It is very difficult to predict what psychosis might cause a person to do. But when there is an opportunity, the medical system isn't doing what it can to try to take that opportunity.”
A Pennsylvania mother in her 60s watching the news worries about her son, who has a severe mental illness and was recently released from the hospital but is still showing symptoms.
“Will my loved one do such a thing? I know the possibility is there," said the woman, whose name The Epoch Times is withholding for privacy reasons. "We all know it. It is an uncontrollable condition caused by their mind not functioning right."
She feels numb from fear and anger, and also a sense of helplessness every time she hears of mass killings by someone with a mental illness.
“Must this fear always be there?” she asks, adding that people wonder why the family doesn’t get them help. “It’s not there. The system doesn’t care.”
Read the rest here...
