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What the Media Should Be Saying About Mental Illness

Posted: 01/01/2013 9:40 am

Hopefully, the horrors of the Newtown, Connecticut shooting will lead to a more sensible attitude to violence and mental illness and to improved treatment for the hardest to treat. Whenever a tragedy like this occurs, mental health bureaucrats repeat their mantra that violence is not typical for the mentally ill who are more often the victims rather than the perpetrators.

But, as I pointed out in an earlier post, the Mental Health Commission of Canada's usual response is to try to convince the media not to report these violent acts for fear of increasing stigma towards the mentally ill. The Commission has been quiet about Newtown but not Dr. Catherine Zahn, the CEO of the Centre For Addiction and Mental Health in Toronto. In her Christmas blog, she stated:

"In the rare instance when violence arises from an acute mental illness, it's a health problem. We need to help people in this situation to master their illness rather than condemn them.  They, along with everyone who has a psychotic illness, deserve a well-resourced system of mental health care with services based on recovery principles, bolstered by policies of social inclusion that reduce prejudice and discrimination.  When harm comes to innocent people, it must be acknowledged and addressed.  But, the goal is to move toward better health care, not amplified rejection and exclusion."

D. J. Jaffe, the executive director of Mental Illness Policy Org, writing in the National Review wondered just who is crazy. He points out that, "In the wake of incidents such as the one at Newtown, the experts immediately issue press releases claiming that people with mental illness are no more violent than others." He then added that "Studies of the 5 per cent subgroup of the most seriously mentally ill who are not in treatment and are psychotic, delusional, or hallucinating, or are off treatment that has previously prevented them from being violent, are in fact more prone to violence than others. When people ask whether the mentally ill are more violent, they usually mean this group of severely ill individuals and not about their friends on Zoloft, Prozac, etc."

Lumping in a small potentially violent untreated group with a larger non-violent group statistically eliminates the tendency for violence. How to lie with statistics 101.

Writing in the Washington Post, Asra Q Nomani, described how her own mother lived in fear of her son's violence from untreated schizophrenia "taking blows through the years, one time landing in the emergency room with cracked ribs" as many mothers do who struggle to help their psychotic kids when society will not. Today, Nomani's brother is treated and is doing well.

Paul Steinberg, a psychiatrist writing in the New York Times stated, "Too many people with acute schizophrenia have gone untreated. There have been too many Glocks, too many kids and adults cut down in their prime. Enough already." He added:

"Medication and treatment work. The vast majority of people with schizophrenia, treated or untreated, are not violent, though they are more likely than others to commit violent crimes. When treated with medication after a rampage, many perpetrators who have shown signs of schizophrenia -- including John Lennon's killer and Ronald Reagan's would-be assassin -- have recognized the heinousness of their actions and expressed deep remorse."

Dr Steven R. Pliszka in the Statesman said that, "Today we have thousands of mentally ill persons wandering our streets or living in decrepit boarding homes, refusing to take needed medications and, in some cases, committing acts of aggression against themselves, their families and the community. Many people have 'a state hospital in the back bedroom' -- a child or sibling who withdraws from society and shows signs of serious mental illness."

He ended his article with:

"Some patients need long-term care. This is not denying liberty to any person; it is freeing a mind enslaved by mental illness. Most critically, legislators should reject those who seek to put restrictions on psychiatric hospitalization or treatment with psychiatric medication. If we will place more barriers to treatment of the mentally ill, then the tragedy of Newton may be repeated many times more."

And, again in the New York Times, Joe Nocera wrote that rules about involuntary treatment "are built upon a delusion: that the sickest among us should always be in control of their own treatment, and that deinstitutionalization is the more humane route. That is not always the case."

But, in light of two recent murders on the New York subway system when innocent people were pushed in front of trains, we should give a final word to infamous subway pusher Andrew Goldstein who killed Kendra Webdale in 1999 and ushered in New York State's Kendra's Law.

As Goldstein said in a New York Post article, "Should you let a mental patient like myself be in freedom so an incident like train-pushing can occur? If you are a harm to anyone, even yourself, you should be hospitalized." Goldstein is now lucid because he's forced to take his medication.

Let us not allow the deaths of so many innocent young lives to be wasted without some good coming of this loss. Maybe this tragedy can force our lawmakers and mental health bureaucrats to start working to ensure that those who live in an untreated psychotic hell and have the potential to cause harm to themselves, their families and to innocent bystanders can be treated.

 
 
 

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09:38 PM on 01/09/2013
My Comment - Part 2

In his Op-Ed for the N.Y. Times, Paul Steinberg states “Medication and treatment work” (for "schizophrenia"). Why then, does director of the NIMH, psychiatrist Thomas Insel, state, “Treatments, especially pharmacological treatments, have been in wide use for nearly half a century, yet there is little evidence that these treatments have substantially improved outcomes for most people with schizophrenia.” http://www.nimh.nih.gov/about/director/publications/rethinking-schizophrenia.shtml

Even if treatment DID work, there is no way to predict who is “dangerous.” Psychiatrist Allen Frances, chair of the task force for the current DSM-IV says, “Psychiatry has no way to predict mass murder and no way to prevent it. . . . Violent thoughts are not uncommon among psychiatric patients, but vanishingly few will ever act on them.” http://www.huffingtonpost.com/allen-frances/mass-murderer-psychobabbl_b_1733243.html
09:37 PM on 01/09/2013
My Comment - Part 1

What the media should be examining after a mass shooting is the link between psychiatric drug treatment and violence. The L.A. Times reported that Adam Lanza had received psychiatric treatment since childhood. Did his treatment work? Of the top ten prescription drugs linked to violence, all but one are psychiatric drugs! http://healthland.time.com/2011/01/07/top-ten-legal-drugs-linked-to-violence/ That's why they carry an FDA black box warning.

When advocates for the “severely mentally “ill” promote treating people they fancy “potentially violent” with drugs that INCREASE the risk of violence, then we should indeed be wondering just who is crazy.
12:07 PM on 01/03/2013
"Paul Steinberg, a psychiatrist writing in the New York Times stated, "Too many people with acute schizophrenia have gone untreated."

Paul Steinberg is a superb propagandist. Why go for the small lie when you can pull off the big lie. Since when has it been reported that Adam Lanza had a diagnosis of schizophrenia? Apparently, when Paul Steinberg raised it, cleverly spreading rumours. Adam Lanza was reported to be on the autism spectrum, probably Aspergers, and had anxiety issues. Steinberg by his own admission did something highly unethical for a psychiatrist. He publically diagnosed someone he has never met. I believe that his hidden agenda was to argue for forced treatment, and he couldn't do this with autism community which isn't lobbying for forced treatment of autism, so he went for the fear factor - the perennial scapegoat, schizophrenia. And, the public couldn't take him to task for his sleight of hand, because no direct comments were allowed on his Op-Ed piece.
12:06 PM on 01/02/2013
A very cogent article. It deals with why we must address this subject truthfully, rationally and provide timely appropriate interventions which often require inpatient treatments and observations . Thank you. Patricia Forsdyke
11:13 PM on 01/01/2013
Might I point out that Catherine Zhan's much beloved CAMH was just strongly sanctioned for failing to report that they had put a man into solitary confinement, in a room with a dirty mattress and stained bed linens, for two months, without informing the Ontario Review Board? Putting a mentally ill person into solitary confinement for such a long period of time, is a sure way to produce both psychosis and dangerous behaviour. He was on a forensic unit, which has an unusually high staff to patient ratio, and there are no reports that he had harmed anyone.

In this age, when hospitals are supposed to be enlightened, and CAMH calls itself "patient centred" and humane, the inconvenient mentally ill, without advocates, are still being locked into small, dirty rooms, without dignity, endangering their recovery chances. Do you seriously wonder why we resist forced hospitalization? Why we fight against forced treatment, and a loss of rights?

CAMH is the best-case scenario, and horrific things like this are still happening.

In the meantime, the media will sensationalize every act of violence committed by a crazy person - let's be realistic, all people are talking about is how crazy the CT shooter was, how he has aspergers, how he must have been on meds, how his mother must have known. I'll take it with a grain of salt, and wait for a splashy front page expose on the women who have died at the hands of their intimate partners in 2012.
03:27 PM on 01/02/2013
I think that you are likely a little of the mark with your comments. Patricia Forsdyke
01:19 PM on 01/03/2013
Ephena, I think you are spot on with your comments. Thank you.
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Nancy Stewart Cockburn
05:47 PM on 01/01/2013
I hope governments will finally admit that closing down long term care centres (mental institutions) if you will has not worked. A young boy was stabbed and killed by a mentally ill homeless man in Victoria.

If I had an adult child that was an endangerment or him/herself or society would I rather them live on the street and not take their meds and be cared for or would I rather they live in a proper mental health facility where they are fed, clothed, have a warm bed and have their medication.
07:29 AM on 01/02/2013
If proper facilities resources, with humane treatment, it is more likely that people would be accepting of treatment, but many of the long-term care facilities were nightmarish. There are still people alive today who were treated with insulin comas. When the facilities were closed down, we were promised funding for community-based treatment, and supports for the mentally ill who were now living in the community. That funding never came, or came in such small amounts that the people who needed it were rarely served. Long-term incarceration is not the only answer. Community-based treatment and support is also effective, and much more humane.

I really feel for the family of the boy who was stabbed (which is truly horrific, and nothing makes that better, and I don't want to pretend that that doesn't happen). But this goes both ways. I'll leave you with this story, from CNN, about a homeless, schizophrenic man who died 5 days after being beaten by the police http://edition.cnn.com/2012/05/08/us/california-police-beating/index.html
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Nancy Stewart Cockburn
01:57 PM on 01/02/2013
Well it is clear these people are vulnerable. I am in Victoria BC and there are so many homeless. A well known doctor quite a short-term care facility in disgust as he said they come in for treatment and are let out to the horrors of the street with no support.
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brm74
11:49 AM on 01/02/2013
Had a distant relative who lived in a mental hospital in the 1960s and 1970s. Place was dark and scary but at the least she had a warm place to sleep,three meals a day and a proper drug treatment seriously wonder how many people with mental health issues have those advantages in 2013
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Nancy Stewart Cockburn
02:01 PM on 01/02/2013
Well also it is 2013 and hopefully the care facilities are would not be like the 60s and 70s. There was apparently a long term care facility in Victoria (where I live) and it was "nice". As nice as a government run mental health facility could be. There were gardens where the people could work and many activities. Movie night. It was closed down in 85 under the premise that people should have freedom for their own mental health care and many ended up on the street.
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June Conway Beeby
11:46 AM on 01/01/2013
Another of Marvin Ross' well researched cogent articles on the complexity of serious brain diseases. His voice brings a better understanding to Huffington Post readers. He helps to untangle the many myths and misunderstandings that cloud the reality of these cruel brain diseases.

My only disagreement here deals with Dr. Catherine Zahn's concept of services based on "recovery principles" . We should not be seduced by promises of recovery. To recover or prevent a disease you first have to have some theory how it is being caused and then how to intefere with the theoretical causal chain of events.

It will take much more scientific brain research to achieve this goal.
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baizhongtang
Reality has an anti-neoliberal agenda
02:01 PM on 01/01/2013
Wow, really? I'm always fascinated how the ignorant are so easily led into foolishness by the semi-literate but well-spoken, and yet always want to ignore what the truly brilliant have to say.

You, and the author, are suggesting the permanent forced incarceration of those arbitrarily judged to be dangerous or potentially dangerous. With no possible way out. Life without parole because you were born dysfunctional or had crazy parents.

Why? So you can have the illusion of security.

You have Guantanamo, martial law, jail for victim-less crimes like prostitution and weed smoking, and now you wanna go back to the era of asylum jails? How about we bring back trepanation too? Why don't we just eliminate everyone we don't agree with? Maybe we can bring gladiators back too, and debt prisons.
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arachne646
No more hurting people--Peace
03:15 PM on 01/01/2013
You can be "in recovery" from a disease or disorder without being anywhere near to being cured from it. I have both an addiction and a chronic depressive disorder, from both of which I'm in recovery, but I take several anti-depressants still. Cure of either of these disorders isn't possible, especially when the presumably brain located neurochemical cause of neither of them is really fully understood, so functional recovery is a reasonable goal--one that has a long way to go for the many people with psychotic disorders that aren't as amenable to treatment as mood or anxiety disorders.
11:26 PM on 01/01/2013
Let's be honest about this though. You are "in recovery", which is a process, and a life-long thing, but tell me, how likely are you to snap and mow down a room full of first graders?

I'm in recovery too, and I have had episodes of psychosis, but I have never been a danger to anyone else. Poverty and substance abuse are better indicators of violence than psychosis, research shows this, but the media focuses on psychosis as the danger sign. This makes life much more dangerous for the mentally ill, but that is never really addressed.