Saturday, December 8, 2007

Scientists say teen brain, still maturing, is key to understanding behavior

Scans show that the brain doesn't mature until age 25; increasingly, courts are considering such findings as they decide what punishments fit teen crime.

By Malcolm Ritter
ASSOCIATED PRESS

Sunday, December 09, 2007

NEW YORK — The teenage brain, Laurence Steinberg says, is like a car with a good accelerator but a weak brake. With powerful impulses under poor control, the likely result is a crash.

And, perhaps, a crime.

Steinberg, a Temple University psychology professor, helped draft an American Psychological Association brief for a 2005 case in which the U.S. Supreme Court outlawed the death penalty for crimes committed before age 18.

That ruling relies on the most recent research on the adolescent brain, which indicates the juvenile brain is still maturing in the teen years and reasoning and judgment are developing well into the early to mid-20s. It is often cited as state lawmakers consider scaling back punitive juvenile justice laws passed during the 1990s.

"As any parent knows," wrote Justice Anthony Kennedy for the 5-4 majority, youths are more likely to show "a lack of maturity and an underdeveloped sense of responsibility" than adults. " These qualities often result in impetuous and ill-considered actions and decisions."

He also noted that "juveniles are more vulnerable or susceptible to negative influences and outside pressures, including peer pressure," causing them to have less control over their environment.

Some child advocates have pointed to the Supreme Court decision and the research as evidence that teens — even those accused of serious crimes — should not be regarded in the same way as adults in the criminal justice system.

Dr. David Fassler, a psychiatry professor at the University of Vermont College of Medicine who has testified before legislative committees on brain development, says the research doesn't absolve teens but offers some explanation for their behavior.

"It doesn't mean adolescents can't make a rational decision or appreciate the difference between right and wrong," he said. "It does mean, particularly when confronted with stressful or emotional decisions, they are more likely to act impulsively, on instinct, without fully understanding or analyzing the consequences of their actions."

Experts say that even at ages 16 and 17, when compared to adults, juveniles on average are more impulsive, aggressive, emotionally volatile, reactive to stress and vulnerable to peer pressure. They also are more prone to focus on and overestimate short-term payoffs and underplay longer-term consequences of what they do. And they're more likely to overlook alternative courses of action.

Violence toward others also tends to peak in adolescent years, says psychiatrist Dr. Peter Ash of Emory University. It's mostly likely to start about age 16, and people who haven't committed a violent crime by age 19 only rarely start doing it later, he said.

The good news, he said, is that a violent adolescent doesn't necessarily become a violent adult. About two-thirds to three-quarters of violent youth grow out of it, Ash said. "They get more self-controlled."

Some of the changes found in behavioral studies are paralleled by changes in the brain itself as youths become adults. In fact, in just the past few years, Steinberg said, brain scans have given biological backing to common-sense notions about teen behavior.

It's one thing to say teens don't control their impulses as well as adults, but another to show that they can't, he said. As for peer pressure, the new brain research "gives credence to the idea that this isn't a choice that kids are making to give in to their friends — that biologically, they're more vulnerable to that," he said.

Consider the lobes at the front of the brain. The nerve circuitry there ties together inputs from other parts of the brain, said Dr. Jay Giedd of the National Institute of Mental Health.

This circuitry weighs how much priority to give incoming messages such as "Do this now" versus "Wait! What about the consequences?" In short, the frontal lobes are key for making good decisions and controlling impulses.

Brain scans show that the frontal lobes don't mature until age 25, and their connections to other parts of the brain continue to improve until at least that age, Giedd said.

The inexplicable behavior and poor judgments teens are known for almost always happen when teens are feeling powerful emotions or intense peer pressure, conditions that overwhelm the still-maturing circuitry in the front part of brain, Giedd said.

Giedd emphasized that scientists can't yet scan an individual's brain and draw conclusions about how mature he is, or the degree of responsibility he takes for his actions.

Brain scans do show group differences between adult and teen brains, he said, "but whether or not that should matter (in the courtroom) is the part that needs to be decided more by the judicial system than the neuroscientist."

There's nothing particularly magic about age 18 as a standard dividing line between juveniles and adults in the courtroom. Different mental capabilities mature at different rates, Steinberg notes. Teens as young as 15 or 16 can generally balance short-term rewards and possible costs as well as adults, but their ability to consider what might happen later on is still developing, he said.

A dividing line of age 18 is better than 15 and not necessarily superior to 19 or 17, but it appears good enough to be justified scientifically, he said.

Steinberg said he thinks courts should be able to punish some 16- or 17-year olds as adults. That would be reserved for repeat violent offenders who have resisted rehabilitation by the juvenile justice system and who could endanger other youths in the juvenile system if they returned. "I don't think there are a lot of these kids," Steinberg said.

For the rest, he says it makes sense to try rehabilitating young offenders in the juvenile justice system. That's better than sending them through the adult system, which can disrupt their development so severely that "they're never going be able to be a productive member of society," Steinberg said. "You're not doing society any favor at all."

Most experts conclude that rehabilitation works better for juveniles than for adult offenders, Ash said. And just as parents know how irrational juveniles can be, he said, they also know that rehabilitation is a key goal in punishing them.

"What we really want," he said, "is to turn delinquent kids into good adults."

Additional material from Associated Press writer Sharon Cohen.

Younger suspect in murder had 'mental problems'

Brother arrested in separate bat attack

BY AUSTIN L. MILLER
STAR-BANNER

FORT McCOY - Born prematurely at six months, William Myers weighed only a pound. At age 4, he was diagnosed as a schizophrenic with suicide rage disorder. He lived in several foster homes while his parents went through a bitter divorce, his family said. And now, at age 16, he stands charged with being an accomplice in the baseball bat slaying so brutal, a prosecutor has suggested it was done for "entertainment" or "pure meanness."

"He always had mental problems and issues," Irma Smith said about her stepson, whose 17th birthday Thursday was spent at the Juvenile Assessment Center.

Such was the life of Myers, as told by Smith and the boy's father, William, in an interview with the Star-Banner at Fort McCoy park.

Friday's arrest was yet another shock for the family. Myer's 18-year-old brother is in jail in an unrelated case on charges of beating someone with a bat. Now, the family says they are receiving phone death threats and someone tried to run Smith off the road.

On Friday, Myers and his 18-year-old cousin, James E. Roberts, were arrested by Ocala police and charged with the murder of 44-year-old Robert T. Leigh behind a Western wear store on Northwest Blitchton Road Police say Roberts swung the bat so hard that part of Leigh's head was lopped off.

Both Smith and Myer's father insist the teenager is "not a bad person." They conceded that he is a follower and not a leader.

"Growing up, he always craved attention," Smith said.

Myer's father and stepmother, who said they have received death threats, dispute the claims of the teen's aunt, Sherry Ann Mahle, that young Myers was kicked out of the home. Both said the situation that caused Myers to leave was spurred by two things.

On Oct. 20, the family hosted a birthday party at their Salt Springs home for Mahle and he wanted to drink. Because he was only 16, Smith told him no. After that, Myers decided he wanted to live with his mother, a person they say he seldom sees.

"I wasn't going to deprive him of his mother, so he went there," Myers' father said.

Not long after he went there, however, Myers got into trouble. The couple said Myers did not want to return home because he wasn't going to obey their rules. He then went to live with his aunt, Mahle, her husband and his cousin.

Mahle said in a Tuesday interview with the Star-Banner that Myers told her that he had been kicked out of the house.

Like Smith, Mahle believes her son also has had problems too big to handle. Mahle said Roberts never got over the death of his older brother six years ago, who was struck and killed by a car. He got into trouble, despite her efforts to get counseling for him and a general education diploma, she said.

The bat allegedly used in the slaying had belonged to Roberts' brother, and was a gift on his 12th birthday.

So far, the State Attorney's Office has not made a decision on whether Myers will be charged as an adult. They also have not made a decision on whether Roberts will face the death penalty. Myers is, by law, too young to face the death penalty, if convicted of first-degree murder.

Smith said there is another reason her stepson should be treated differently.

"He doesn't have a mental capacity of an adult," Smith said. At the time of the slaying, Myers was attending GED classes.

Myers' family hopes William will be transferred to a mental facility "to get help," his father said.

While the family is dealing with one son facing the possibility of a long time behind bars, they are also coping with Myers' brother, Michael, who is currently at the Marion County Jail in an unrelated case for allegedly beating someone with a baseball bat.

According to a Nov. 16 Marion County Sheriff's Office report, 18-year-old Michael Myers reportedly barged into a Salt Springs home and hit a 20-year-old man in the face and several areas of his body with a bat. The victim received a total of 12 stitches for lacerations to his upper lip and the back of his head. In an interview with the Star-Banner, Michael Myers denied hitting the man. He said the man was drunk and fell down the stairs. He declined to answer any questions about his brother.

Mahle said her son's bat was not used in that incident. Smith and the elder Myers didn't want to talk about Michael Myers' case.

The younger Myers cannot be reached for comment.

As for Myers and Roberts, Myers' father and stepmother said "they will stand by them."

"We will go to every visit, be at every court date, and be there every step of the way," they said.

They said "they're sorry for Leigh, his children and his family."

To keep his memory alive, the Leigh family has created a Web site in his honor. A section of the site read: "During the final months of his life, all he wanted was to reunite with his children, Rob and Illaena Kaye Leigh. While it is tragically too little, too late, we hope to honor his memory by doing something."

Austin L. Miller may be reached at austin.miller@starbanner.com or 867-4118.

Common Thread of Shooters' Desperate Isolation Suggests Need for Early Intervention

Dec. 7, 2007

As the shocked residents of Omaha, Neb., struggle to pick up the pieces after Wednesday's massacre by a gunman at an area mall, psychological experts say the incident is yet another reminder of the inadequacies of the U.S. justice and health care systems when dealing with mentally troubled individuals.

In past incidents -- including the Virginia Tech massacre in April and the Trolley Square Mall shooting in February -- the perpetrator was later described as a loner, an outcast.

"All have that same theme of alienation and isolation," said Beverly Hills-based forensic psychiatrist Dr. Carole Lieberman. "Many of these shooters have been picked on by their peers or felt 'out of the loop.'"

"I think much of this stems from how we've become a much more isolation-oriented society," said Carolyn Wolf, senior partner at Abrams, Fensterman, Fensterman, Eisman, Greenberg, Formato & Einiger, LLP -- a mental health law practice in New York. "With computers and all of the technology that we now have available, people are much more easily able to be isolated, and with isolation comes withdrawal -- withdrawal from friends and family, as well as withdrawal from the medical system."

But mental health experts say these tragedies have something else in common -- they all point to a mental health system that minimizes the chances that these outsiders can get access to proper psychological services, which would possibly stop the tragedies before they occur.

"The gamut of mental health services has been lacking severely across the country," Wolf said.

"There are many dollars that are allocated for physical services, but mental health has been significantly overlooked," she said. "What all of this highlights is a very significant need for increased funds to help people who suffer from mental illness."

And it's not just a funding problem, they say. The set of laws governing intervention for mental health concerns are a patchwork across the country. New York, Wolf notes, has a state law providing for mental health warrants in which people can go through the courts to have their loved ones ordered to mental health treatment if they fear that they could become dangerous.

In Florida, legislation known as the Baker Act allows judges, law enforcement officials or mental health professionals to order individuals to receive mental health care if they are determined to pose a danger to themselves or others.

But not all states have such laws. And even in these states, admitting an individual in a potentially dangerous state of mental health is no simple task.

"You always have to meet certain legal standards in order to admit someone for mental treatment," Wolf said. "A person has to be deemed dangerous to themselves or others before they will intervene."

The solution, Wolf said, appears to lie in a combination of improvements, both within and outside the system, from increased funding, to better legislation, to a better overall understanding among the public of mental health issues.

"People need to become more educated as to what some of the signs of illness are, as well as the options for treatment," she said.

With this in mind, let's take a closer look at the Westroads Mall shooting, as well as other high-profile cases of mass shooting in the past.


Dec. 5, 2007: The Westroads Mall Shooting

The first hint that something terrible was happening at an Omaha mall came in the form of a 911 call received at 3:42 p.m.

Shortly afterwards, nine people at the Westroads Mall were dead -- including 19-year-old gunman Robert A. Hawkins.

Hawkins had reportedly been fired from his job at a McDonald's in the previous week, and had recently broken up with his girlfriend. According to reports by The Associated Press, Hawkins left a note in the home of his adopted family before the shooting spree. In it, he said he was "sorry for everything" and would not be a burden on his family anymore.

He also wrote, "Now I'll be famous."

"Robert was a desperate young man, who felt unseen and unloved by his parents, his girlfriend, his boss and the rest of the world," Lieberman said. "The only way he knew to become 'somebody' that others paid attention to was by creating news of his wreaking violence.

"Since he felt he wouldn't become famous for positive contributions to society, he settled for infamy as a mass shooter. Because he felt powerless and weak, he wanted to go out as someone who could inflict mass hysteria, fear, injury and death."

Indeed, those who knew Hawkins say he was an "introverted, troubled young man."

Hawkins, from Bellevue, Neb., was kicked out by his family about a year ago. He moved in with a friend's family, and Debora Maruca-Kovac and her husband welcomed him into their home and tried to help the teen.

In a TV interview, Maruca-Kovac described Hawkins as "a troubled young man who was like a lost pound puppy that nobody wanted."

And Hawkins had also experienced run-ins with the law -- missed opportunities, Lieberman said, for the detection and proper treatment of his mental problems.

"One difference between Robert and Cho Seung Hui [the gunman at Virginia Tech] and the Columbine shooters is that he had been convicted for felonies and misdemeanors," she said. "While he had the attention of the court, he should have been ordered into psychiatric treatment, or even juvenile detention."

April 16, 2007: The Virginia Tech Massacre
In some cases, however, the mental problems displayed by a shooter are too vivid to ignore.

Such was the case with Virginia Tech student Cho, whose disturbing video he shot of himself before he went on a shooting rampage sweeps away any doubt about his disturbed state of his mind.

The video, which Cho mailed to NBC News in a two-hour hiatus during the horrific shooting spree, features a violent and disorganized diatribe which psychological experts say offers a glimpse into a mind twisted by psychosis and rage.

"It appears that this was not schizophrenia, but some form of severe mental illness accompanied by paranoid delusional thinking, as reflected in his rantings on the video about people with trust funds and cognac and vodka," Dr. Redford Williams told ABC News shortly after the incident. Williams is director of Duke University's Behavioral Medicine Research Center in Durham, N.C.

Dr. Kathyrn Moss, attending psychiatrist in the Personalities Disorders Clinic at NewYork-Presbyterian/Weill Cornell, agreed that a combination of mental distress and isolation likely led to Cho's behavior.

"This is a mix -- a constellation of factors that came together in a horrific way," Moss said. "It's not just one thing. It can't be."

But his grave isolation -- as well as spotty access to mental health services -- could have played an important role in the student's rampage, which left 32 people dead and another 25 injured.

Records show that there were several instances during which Cho could have received the mental health help he needed. The police brought Cho to a mental health center in December 2005, where social worker Kathy Godbey determined that he represented a danger to himself or others, and that he could be put in temporary custody.

After another evaluation, psychologist Roy Crouse concluded that Cho was "mentally ill but did not present an imminent danger to himself or others, and did not require involuntary hospitalization."

As a result, a court magistrate released Cho, ordering outpatient treatment and follow-up. It is not clear whether Cho was ever contacted or participated in such treatment.

Moreover, questions linger as to whether Cho's mental health records were allowed to be released to his parents before the shooting took place.

Feb. 12, 2007: The Trolley Square Mall Shooting
Much like the most recent rampage in Omaha, the February shooting that occurred in Salt Lake City, Utah, took place in a bustling mall.

The Trolley Square Mall tragedy was the first mass shooting at a mall in 2007. In total, nine people were shot -- five of them fatally.

And the profile of the killer bears some similarities to others who have committed these types of shootings. Sulejman Talovic was an outsider, 18-year-old Bosnian immigrant who lived with his mother in Salt Lake City.

According to local reports, Talovic had a history of minor run-ins with the law. He was also a high school dropout.

But despite his past problems, for most there was little warning that he would show up at the Trolley Square Mall on a busy evening and start shooting people.

Though no clear motive for the rampage was ever established, a local newspaper reported shortly after the incident that Talovic claimed to be involved with a local gang.

Marie Smith, 23, a manager at a Bath & Body Works in the mall, later told The Associated Press that she had seen the gunman raise his gun and fire at a young woman during the incident.

"His expression stayed totally calm," Smith told the AP. "He didn't seem upset, or like he was on a rampage."

Feb. 13, 2005: The Hudson Valley Mall Shooting
According to local reports, Robert Bonelli Jr., age 24 at the time, was a shy outsider who lived in constant fear of being picked on for his nearly 300-pound physique.

And after his shooting rampage at the Hudson Valley Mall in Kingston, N.Y., which left two people wounded, mental health experts believe that it was this insecurity and isolation that may have been a key part of what drove him to the act.

"It is that same theme of alienation and isolation," Lieberman said. "Many of these shooters have been picked on by their peers or felt out of the loop."

According to a report in the Poughkeepsie Journal, Bonelli walked into a Best Buy holding an AK-47 rifle replica loaded with 60 rounds of ammunition. He began firing randomly, and he didn't stop until he had expended all of his ammunition.

His family would later reveal that they believed Bonelli had a death wish -- and that he wanted the police to do the job.

''It drove him to have himself killed by law enforcement that wasn't there in time,'' his uncle, John Bonelli, told the Journal. ''Because if they were there in time, this kid would have been in a body bag.''

Bonelli pleaded guilty to committing the shooting on May 20, 2006, and he was subsequently sentenced to 32 years in prison.

April 20, 1999: The Columbine Massacre
The school shooting at Columbine High School took place at the hands of students Eric Harris and Dylan Klebold on April 20, 1999. Many have pointed to the tragedy as both a template and catalyst for future shootings.

Indeed, Cho referenced the killers in his chilling video. And Bonelli reportedly had a picture of the killers taped to one of his bedroom walls.

But the case also raised awareness among many parents that the social isolation and brooding rage that can lead to such an attack could develop at home -- and largely unnoticed.

"In this case, the shooters were living with their parents, but their parents didn't have a clue who they really were," Lieberman said, adding that the episode shattered the illusion of the safety and security of an upper-middle-class upbringing.

"What matters is the attention and the love that the child is getting from their parents," she said.

In total, the rampage by the two students claimed the lives of 12 students and a teacher. The attacks wounded 23 others, and both of the boys committed suicide following the incident.

Lieberman said that if there is any lesson to be learned from Columbine -- as well as other more recent tragedies -- it is that parents and others should be on alert for the signs of dangerous mental health conditions -- and intervene before it is too late.

"People should report their suspicions to family members, the police, doctors, teachers and others in authority," Lieberman said.

Information from The Associated Press was used in this report.

Sunday, December 2, 2007

Orlando-area judge frees mentally ill woman who killed her parents in '88

She has been in state mental hospitals most of the time since their deaths in '88.

Rene Stutzman

Sentinel Staff Writer

December 2, 2007

SANFORD

When Stephanie Gardner stops taking her medication, things go very wrong. For months in 1988, she heard voices in her head, telling her to kill her parents. One night, she stood up from a card game, walked into another room and shot her father and mother with a .38-caliber handgun.

Since then, she's spent most of her days locked in state mental hospitals.

Soon that will end. A judge ruled Friday that Gardner is well enough to be set free. Circuit Judge O.H. Eaton Jr. ordered her released from the state hospital in Chattahoochee and into a privately run home for the mentally ill in Miami.

There she'll be supervised, but she won't be locked up. That, said Assistant State Attorney Chris White, makes her a risk.

Gardner has been diagnosed with bipolar schizoaffective disorder.

She doesn't believe she's mentally ill, however, according to three medical experts who testified Friday in Seminole Circuit Court. If Gardner stays on her medication, she should be fine, said psychiatrist Jeffrey Danziger. If, however, she walks away from the Miami facility, she's almost certain to stop taking her medicine, he said.

Gardner doesn't like taking her medication and can't be trusted to take it, White said.

"This woman killed two people," he said.

He pleaded with the judge to leave her locked in the state hospital.

Gardner was a 30-year-old mother of two in June 1988 when she got up from her card game and killed Daniel Dinda, 66, and Carolyn Dinda, 60, at the couple's home near Oviedo. During her trial, witnesses testified to her strange beliefs, such as radio transmitters in her teeth were tracking her and that microwaves from satellites were displacing the souls of her children.

A jury found her not guilty by reason of insanity. Eaton later ordered her hospitalized indefinitely.

Gardner has been released before, always under supervision, but things did not go well.

About a year after she was released to a group home in Jacksonville in 2000, she went off her medicine, became unmanageable, stopped going to treatment sessions and bought a car.

When a different judge found out, he ordered her to jail for several weeks then into a more restrictive group home.

Four years later, in late 2005, she went off her medication again and disappeared for weeks. She traveled from Jacksonville to Tampa then flew to Washington, where she was taken into custody. No one had reported her missing.

Since then, she's been locked up.

For months, medical experts at the hospital in Chattahoochee and her lawyer have argued that she's stable enough to release.

Dr. Bruce Chlopan, a psychologist, testified Friday that in the year or so he's treated her, she has had no delusions or hallucinations.

Defense attorney Tim Caudill argued that the law does not allow the state to keep a mental patient locked up just because she might stop taking her medicine and become unstable.

The judge agreed.



Rene Stutzman can be reached at rstutzman@orlandosentinel.com or 407-324-7294.

Wednesday, November 21, 2007

Legislation Improves Mental Health Services For Mentally Ill Prisoners

19 Nov 2007

The American Psychiatric Association (APA) applauds recent Congressional efforts to acknowledge and improve treatment for the large number of people with mental illnesses and substance use disorders who are currently incarcerated in U.S. jails and prisons.

According to a 2006 report by the United States Department of Justice (DOJ), entitled "Mental Health Problems of Prison and Jail Inmates," more than half of the population incarcerated in U.S. prisons and jails - including 56 percent of state prisoners, 45 percent of federal prisoners and 64 percent of local jail inmates - were found to have a mental illness. Many of these inmates suffer from treatable disorders such as major depression, bipolar disorder and substance use disorder.

On November 13, the U.S. House of Representatives passed, by a vote of 347 to 62, the Second Chance Act, legislation sponsored by Congressman Danny Davis (D-Ill.). The legislation would provide transitional assistance to ex-offenders in an effort to reduce recidivism. Additionally, the legislation would extend and provide a full continuum of care for treatment of substance use disorders. The legislation also seeks to improve mental health screening and treatment and provides grants for family treatment programs. In August, the U.S. Senate Judiciary Committee approved similar legislation, sponsored by Senator Joseph Biden, Jr. (D-Del.).

The Mentally Ill Offender Treatment and Crime Reduction Reauthorization and Improvement Act (H.R. 3992 and S. 2304) aims to improve services for mentally ill prisoners by reauthorizing and boosting funding for a grant program that provides treatment for inmates and training for law enforcement officers who treat them. The House bill is sponsored by Representative Robert Scott (D•Va.) and the Senate bill is sponsored by Senators Edward Kennedy (D-Mass.) and Pete Domenici (R-N.M.). On November 7, the House Judiciary Committee passed H.R. 3992, which will now head to the full House for a vote. On November 5, the Senate introduced S. 2304.

In response to the legislative actions, the APA issued the following statement:

"It is a national tragedy that jails and prisons have become the primary mental health care facilities in the United States today.

"People with mental illness, left untreated, can develop symptoms and behaviors that lead to their arrest and incarceration. Mental health and substance use disorder treatment in appropriate settings is often the answer, and adequate funding for such treatment is urgently needed.

"Ending the 'criminalization of the mentally ill' and the inappropriate incarceration of persons with mental illness could prevent unnecessary building of correctional facilities and make room for violent and repeat offenders.

"Providing more adequate funding and cooperative programs between mental health care professionals and correctional agencies is a step in the right direction. Providing these cooperative resources could, in the end, help improve overall public safety."

"We applaud the bi-partisan action taken by both the House and Senate. If enacted, the legislation would represent significant steps forward in improving access to mental health services and substance abuse treatment programs in the United States for those incarcerated within the prison system."

About the American Psychiatric Association

The American Psychiatric Association is a national medical specialty society whose more than 38,000 physician members specialize in diagnosis, treatment, prevention and research of mental illnesses including substance use disorders. Visit the APA at http://www.psych.org and http://www.HealthyMinds.org.
--------------------------------------------------------------------------------

Article URL: http://www.medicalnewstoday.com/articles/89196.php

Main News Category: Mental Health

Also Appears In: Psychology / Psychiatry,

Psychiatric overhaul urged

Gov. Charlie Crist and the chief justice of the Florida Supreme Court called for a major overhaul of the state's mental health system on Wednesday to better address the needs of the severely mentally ill.

Crist and Chief Justice Fred Lewis released a 170-page report that lays out an ambitious plan to help the mentally ill who end up in jails and prisons because they haven't received the treatment they need.

Florida leaders say it's time to change the system to ensure that the mentally ill get the help they need before they get in trouble with the law and wind up incarcerated. Not only will it help the troubled, it will save money and better protect the public.

The report, sponsored by the Supreme Court, envisions using money now spent on mental health treatment for prisoners deemed incompetent to stand trial. Instead, those individuals would be targeted for intensive community-based mental health treatment before they get arrested.

Money for the project would also come from Medicaid, which doesn't cover people in institutions but can pay for treatment before they're institutionalized.

"What we're doing is focusing on this very small group of people who are costing the state a ton of money and are recycling through the criminal justice system," said Miami-Dade County Judge Steven Leifman, chairman of the Supreme Court's mental health subcommittee. "About 80 percent of those people can live comfortably and safely in the community."

Leifman said the project will need about $20-million in general revenue to get started, but after that, it will be able to sustain itself with Medicaid money and the $48-million now being used for the extra forensic mental health beds that he says will no longer be needed.

"You need to have the money up front to develop a system of care for them to move them into the community," he said. "We have people in there on third-degree felonies that don't have to be there."

Leifman said the plan eventually will save money. The state currently spends $250-million per year on 1,700 beds for mentally ill inmates. At this rate, the state will be spending $500-million per year by 2015.

That money is designed to restore competency to inmates so they can be tried for their crimes and then sent to jail or prison, where they continue to cost the state money.

Leifman said treating mentally sick people earlier will prevent them from becoming high-cost inmates.

Leifman led a subcommittee that studied the state's mental health system after the state Department of Children and Families found itself overburdened with the mentally ill. It got to the point the agency couldn't get inmates into treatment beds within the 15 days required by state law. In some cases, inmates languished in jails for months, straining jail guards' resources and, in some, cases harming themselves.

Hillsborough County sued the DCF in an effort to get the agency to follow the law.

Pinellas Circuit Judge Crockett Farnell threatened to fine and even jail then-DCF Secretary Lucy Hadi if she didn't follow the law.

Eventually the Legislative Budget Commission called a special meeting and allocated nearly $17-million to create more beds and $48-million annually to cover the costs.

But the Supreme Court recognized that wasn't the ultimate solution and directed a mental health subcommittee, led by Leifman, to study the issue and seek solutions.

"It's extremely positive, and it's recognizing the impact mental health issues are having on the criminal justice system," said Pinellas-Pasco Public Defender Bob Dillinger, who pushed for the DCF to
address the inmate issue last year. "It can be done in a way that eventually saves a ton of money."

But the push to revamp how Florida deals with the mentally ill is coming during one of the worst economic downturns for the state in more than a decade.

Even Chief Justice Lewis acknowledged the challenge of Florida's budget situation on Wednesday. "Today I hope we are going to discuss plans and programs and ideas that may be implemented without creating unrealistic expectations," he said.

Crist had not reviewed all the recommendations included in the report, but said that the budget situation won't keep him from pushing for changes in the mental health system.

"We have some difficult times, but my heart is there," Crist said.

Rep. Bill Galvano, a Bradenton Republican and chairman of the House committee that deals with mental-health legislation, said lawmakers would likely consider the recommendations during the 2008 session. He said that despite bad financial times it was apparent to him that the current "system is broken."

"Even in a bad economic year, it may well be worth the fight," Galvano said.

Times staff writer Chris Tisch contributed to this report.

Tuesday, November 20, 2007

Gassed Behind Closed Doors

Michele Gillen (CBS4) Necessary discipline or cruel and unusual punishment?

A controversial practice regarding the treatment of the mentally ill in Florida's maximum security prisons has some attorneys and mental health experts raising concerns over its use.

"Here they are just gassing him. You can see they are just spraying him in the face," said Miami attorney Leon Fresco. "I would describe it as the eighth amendment does - cruel and unusual punishment."

According to lawyers representing mentally ill prisoners who have been incarcerated in Florida prisons, the state allegedly allows guards to spray inmates suffering from mental illness with chemical agents to "discipline them."

"They call these inmates bugs. They say these inmates are bugs. A bug is a term they use for a crazy person. And they gas them and it's just shocking and it's just something we can't allow it to continue anymore," said Fresco who has been investigating the treatment of the mentally ill behind bars.

"If they see behavior they don't like they gas them, just like you'd gas a bug that you don't like," said Fresco.

"They're acting out because of their mental illness and as a result of that they're being punished, pure and simple," said Randy Berg, co-counsel for Florida Justice Institute. "This certainly by anyone's definition, I think, is torture. This is a practice of the Florida Department of Corrections currently to gas known mentally ill inmates who are acting out by banging on their cells."

Jerome Maxime Thomas of Lauderhill says he prays every day that his son Jeremiah, who has been diagnosed with severe mental illness, will survive his incarceration at Starke Prison and the alleged chemical gassings he has been subjected to over a period of years, despite orders from the medical staff that he was not to be gassed given his severe mental illness.

"My son has told me he should have died many times, but the Lord has kept him alive," said Thomas, "Something must be done, because it's going too far."

Lawyers say Thomas, who was convicted of second degree murder and robbery and is scheduled to be released in 2018, has been gassed with an arsenal of chemical agents including pepper spray and CN gas, which is prohibited in many prisons because of a link to inmate deaths.

"He (Jeremiah) was gassed twice a day, sometimes as many as eight days in a row," said Berg.

After the gas, prisoners are usually asked if they would like a shower to wash the toxic chemicals. The water apparently doesn't always do the trick and some inmates suffer burns.

According to Department of Corrections written instructions guards are only allowed to use one second bursts of a chemical agent, but that rule is reportedly not always followed.

Lawyers for former inmate Curt Massie, who suffered second degree burns across his body, says he was gassed with OC and CN gas for making a funny face at a nurse who failed to give him his anxiety medication. Massie's attorneys say he has second degree burns over more than 60-percent of his body from the procedure.

Massie allegedly was gassed repeatedly in his cell despite pleading with the guards to stop. Records show that one guard admitted that his "use of force report" was altered by adding the words "kicking his cell door" to justify the use of the gas on Massie.

"From a taxpayer standpoint it makes absolutely no sense that we're wasting our resources to gas the guy, make him decompensate, send him to the hospital where we are spending tax dollars to attempt to bring him back to mental competency or stability bring them back and gas them again," said Berg.

Attorneys suing the state over the procedure have been able to obtain videotapes of a handful of gassings. Videotaping gassings was instituted to monitor the use of the chemicals but several wardens prohibited the filming.

"It's certainly inappropriate to use chemical agents for mentally ill people who are acting out solely because of their mental illness," said Berg. "We should be sympathetic to their treatment because they're going to get out. If you treat human beings like animals and literally like rats they're going to be that way when they get released to society so it's in our best interest to treat these people like human beings while they're in there."

Curt Massie was freed from prison last month. Jeremiah Thomas is set to be released in 5 years.

"I hope that someone is listening. I hope that those who are viewing will take account. And will tell themselves we can not allow this to continue," said Thomas.

"I would submit that these people are much worse off than when they went in when we release them," said Berg "and some of these people frighteningly enough get released directly from close management from solitary confinement to the street, that as a citizen frightens me quite frankly. We're making these people more and more angry, more and more mentally ill, and then releasing them directly to the street, it makes no sense."

Given the pending lawsuit against the state, the current secretary of corrections cannot discuss any particular cases involved; however, he met with Michele Gillen to address the overall policy of chemical gassing the mentally ill.

According to James McDonough, Secretary of Corrections, "We do not use chemical agents for punishment. We do not use chemical agents for discipline. We only do it to insure the security and reduction of harm."

"The fact that the videotaping was discontinued in prior administrations a concern to you:" asked Gillen.

"Enough of a concern that we have a policy that says you sure as hell better videotape," said McDonough. "We are seeing the incidents of chemical agents and physical force going down, not slightly but deeply."

Monday, November 19, 2007

Council seeks alternatives in treating the mentally ill

Circuit Judge Janet Ferris remembers a case when a mentally ill man was charged with battery on a law enforcement officer.

The man was sleeping on a bench at Florida State University when the officer came up him and told him he was trespassing. The man, thinking the officer was the devil and trying to hurt him, struggled with the officer.

He ended up in jail.

Ferris said she's concerned that many people who are mentally ill, like this man, end up languishing in the Leon County Jail without really getting the treatment they need.

"The county jail has become like a mental-health facility," Ferris said. "And that's hard because it's a jail. It's not a mental-health facility. So I think the idea is to try to move them out of the jail as quickly as possible."

The Criminal Justice Mental Health and Substance Abuse Advisory Council, created in mid-September, met last week to discuss its plans to create a mental health court to make treatment more accessible and effective for people who are mentally ill and to reduce their length of stay in the jail. Similar courts have been created in Miami-Dade, Sarasota and Gainesville.

"The big thing is linking them to services in the community," said Kendra Brown, court mental health coordinator. Such services include housing, transportation, treatment plans and medication.

A mental health court would put all criminal cases that involve mental health issues on the same docket, which would be heard by the same judge trained to deal with these issues, said Merribeth Bohanan, assistant public defender.

Council members say many of the mentally ill who have not received the treatment they need are repeat offenders and they place a strain on resources. This population is rapidly growing in Leon County.

In a report, the council showed that the jail's annual expenditures on mentally ill inmates increased from about $128,000 in 2004 to $162,000 in 2006.

In any given month between 20 and 30 percent of the jail's 1,200 inmates are treated by its mental health staff, said Colleen Meringolo, health services administrator for Prison Health Services, which has a contract with the jail. Their conditions range from depression to schizophrenia.

"We do not charge people for services," Meringolo said. "If they don't have the money, they don't have the money. We still see them."

In October, the jail spent about $16,000 on prescription drugs, she said. Staff members include a licensed psychiatrist, who works 12 hours a week, a licensed clinical social worker who works 40 hours a week and a mental health coordinator, who works 30 hours a week.

The council put together a state grant application, which it submitted Nov. 1. The members won't find out if they will receive any money until early next year, but they plan to move forward with the mental health court proposal with or without the money.

In order to establish the mental health court, the council will need Chief Judge Charles Francis to sign an administrative order.

Ferris said the mental health court would be similar to the drug court model in that it would put more of an emphasis on treatment.

"We're trying to lead them to sobriety as opposed to just punishment," she said.

Saturday, November 17, 2007

A sick system: Reform Florida's treatment of mental illness

State prisons and county jails throughout Florida are filled with people who suffer from mental illnesses.

That says as much about the condition of our society as it does the inmates.

"On any given day in Florida, there are approximately 16,000 prison inmates, 15,000 local jail detainees and 40,000 individuals under correctional supervision in the community who experience serious mental illness," according to a state report issued Wednesday.

Those troubling statistics were compiled in a report by a legislative Mental Health Subcommittee that recommends substantial changes in the treatment of mentally ill Floridians, especially those accused of crimes. Indeed, radical reform is needed.

The Florida Supreme Court called for the report. As a result, the subcommittee produced a 180-page document that exposes ineffective and outdated systems, treatments and practices.

"The first state psychiatric hospitals were opened in the United States during the 1800s, and were intended to serve as more appropriate and compassionate alternatives to the neglect and abuse of incarceration" that befell the mentally ill, according to the report's executive summary.

Asylums became crowded, lacked staff and "turned into houses of horrors."

By the mid-1900s, a half-million people were held in such places. A belief emerged "that people with serious mental illnesses could be treated more effectively and humanely in the community."

There was some logic in that belief. But mental hospitals released thousands of people and "unfortunately," the subcommittee report says, "there was no organized or adequate network of community mental health centers to receive and absorb these newly displaced individuals."

Promises of sustained increases in community-based funding evaporated. With limited options available, mentally ill men, women and juveniles struggle to cope. Inappropriate behavior, homelessness, substance abuse and minor crimes often lead to arrest and incarceration. Now, the report says, "jails and prisons once again function as de facto mental health institutions for people with severe and disabling mental illnesses. In two centuries, we have come full circle, and today our jails are once again psychiatric warehouses."

The report calls for Florida to develop a system that effectively and humanely treats mentally ill people for their illnesses and prevents them from getting stuck in costly, dangerous jails. Taking these steps won't be easy or inexpensive but they are the right steps to take

Sunday, November 11, 2007

Mentally Ill Prisoner Could Be Executed

Insanity On Death Row

Nov. 11, 2007
--------------------------------------------------------------------------------
(CBS) When it comes to prisoners on death row who are insane, the law is very clear: you cannot execute them. The Supreme Court has ruled it unconstitutional and deemed it "cruel and unusual punishment."

But can medication make a prisoner sane enough to be executed? That question is being asked in the case of convicted killer Greg Thompson.

As correspondent Lara Logan reports, Thompson was originally found competent to stand trial, but prison doctors have concluded he is mentally ill and they give him medication every day.

Thompson's lawyers argue that he is still insane on the medication, which he was taking the day 60 Minutes met with him.


--------------------------------------------------------------------------------

Thompson told Logan he had to stab his food to eat it. "Especially eggs. They be popping up," he said. "Hit me in the face. You got to stab it. And then you gotta eat it quick. Real quick."

60 Minutes met Thompson inside a maximum security prison in Nashville.

He has been diagnosed as schizophrenic and psychotic by both prison doctors and those hired by his lawyers. And he has been medicated by the state for most of his 22 years on death row. Thompson receives a daily cocktail of anti-psychotic mood-stabilizing pills, and injections twice a month.

Asked if he knows why he's getting medication, Thompson told Logan, "Yeah, I’m nuts."

He says he only takes 10 pills a day now.

"What happens if you don’t take them?" Logan asked.

"I go lulu," Thompson replied.

"Tell me what going lulu is for you," Logan asked.

"In a few days I would like lose my mind and it would be trying to explode on me," he replied. "I got in a fight with the guards a lot of times, you know. Tried to kill a few."

"Did you kill any of them?" Logan asked.

"No," Thompson said. "But at the time they was turning into insects. And I wanted to kill them."

"The guards were turning into insects?" Logan asked.

"Yeah, they were giant insects," Thompson said. "They was acting just like the guards, but they were aliens. And I had to kill the aliens. They were attacking the world."

A psychologist who has been evaluating Thompson for nine years says he sees, hears and smells things that aren’t there, and suffers from extreme paranoid delusions and hallucinations.

But when Thompson was put on trial for murder 22 years ago, his lawyers did not raise insanity as a defense. He confessed, was convicted and sentenced to death for killing Brenda Lane. She was 28 years old, well-liked in her community and she had been married just a few months.

The facts of what happened on New Year's Day in 1985 have never been in dispute. Thompson and his girlfriend, a juvenile, wanted to get from Tennessee to Georgia, so they kidnapped Brenda Lane, stole her car and then drove around for an hour and a half on remote country roads, as Thompson searched for a place to kill her.

They stopped along a rural country road near a field. Thompson then stabbed Brenda four times in the back and drove off, leaving her to die alone in the cold and the dark.

"I thought I had to kill to survive," Thompson told Logan.

Thompson told 60 Minutes he heard voices in his head that night.

"You thought people were after you," Logan remarked.

"Yes," he replied.

And then in chilling detail, he described exactly how he killed Brenda Lane.

"She got into the front seat driver's seat. And I had the knife on her. And I sat in the back seat. And…," Thompson said.

"You jumped in the car and pulled a knife on her?" Logan asked.

"Yeah. Uh-huh," Thompson acknowledged. "Knife was already out. It was a butcher knife."

"She must have been scared," Logan remarked.

"Yeah, she was crying," Thompson said.

"She was terrified for her life," Logan said.

"I know. I know," Thompson replied.

Asked what he felt, Thompson said, "She knows she’s going to die."

Why did he kill her?

"There was no reasoning at that point," Thompson said. "It was just get away."

"Tell me how it happened. Describe it for me," Logan asked.

"Just turned her around and she didn't move and I stabbed her four times," Thompson recalled. "I wanted her to die quickly."

Asked why he wanted her to die quickly, Thompson told Logan, "Not in pain. I didn't want her to be suffering in pain."

"You think if somebody stabbed you four times in the back you're not gonna suffer?" Logan asked.

"Not really, no," Thompson said.

"You know she was still alive when you drove away," Logan pointed out.

"I heard her scream," Thompson said.

Thompson managed to escape to Georgia but was arrested there after setting Brenda Lane's car on fire. Frankie Floied, an investigator in the case back in Tennessee, says it could have taken months to find the body if Thompson -- over the telephone - hadn't given such precise, intricate, directions to the place he killed her.

"What was going through your mind at the time when you were talking to him on the phone?" Logan asked Floied.

"How calm he was," the investigator remembered. "There was no remorse. There was no passion. It was just matter of fact. 'If you'll take, you take this road, this road, this road and this road.'"

"So exact," Logan remarked.

"It’s like you telling me how to find a Frisbee that you've tossed and lost," Floied said.

"So what did that mean to you?" Logan asked.

"Cold, impassioned. Just a cruel person," Floied replied.

That was the picture prosecutors painted of Thompson at his trial. But it wasn't a complete picture, according to Thompson’s current lawyers, Dana Chavis and Steve Kissinger, who are appealing his case. They say Thompson had severe mental problems dating back to his childhood and they are fighting to keep him alive.

"If he knew what he was doing at the time, and he was competent to be executed at the time that sentence was given, why shouldn't he die for what he did?" Logan asked.

"I think the evidence points overwhelmingly to the fact that he was insane at the time," Kissinger said.

"But it was never proved," Logan said.

"Of the offense," Kissinger said.

"And it wasn’t raised at the trial," Logan said.

"Right," Kissinger said.

"He told them exactly what he’d done. He even told them where he’d thrown out the murder weapon, so they could find that on the side of the road," Logan remarked.

"I think the fact that Greg Thompson can remember things does not detract from the fact that at the time of the crime he was suffering delusions and he was hearing voices," Chavis said.

"Never brought up at the trial," Logan pointed out.

"That’s correct, never brought up at the trial because the trial attorneys did not consult with the proper people that would have seen those clear signs of Greg’s psychosis at the time, the clear signs of psychosis that everybody agrees about right now," Chavis said.

Three years ago, a federal appeals court ruled that a lower court should examine evidence that Thompson was mentally ill at the time of the crime. One judge called it "powerful mitigating evidence." But then the Supreme Court narrowly overruled the decision, saying it was too late to raise that issue. Barbara Brown, Brenda Lane’s only sister, who sat through every day of Thompson’s trial, is frustrated by the lengthy legal process.

"I don't believe that he was insane at the time he killed her. Uh, now I don't know. He's been sitting on death row 22 years. Almost anyone might be insane after this period of time," Barbara said. "It's just not right that he was given a death sentence and it not carried out."

Brenda Lane is buried on a hillside about a mile from her sister Barbara’s house. Every Sunday, Barbara goes back to the same church where she and her sister played piano, sang and prayed together. Barbara thinks the legal system is protecting Thompson and has forgotten her sister.

"It destroyed my family basically. My mother certainly never got over it," she said. "And my dad absolutely wanted to see him executed."

Both parents and Brenda's husband have all died since she was killed. "Even my husband has now passed away," Barbara said.

"I think our hearts go out to the sister," Chavis said. "And of course, what happened is a terrible tragedy. But the point now is that Greg Thompson is psychotic, that he's delusional, that he does not have a rational understanding of why the state seeks to execute him."

In what could be a last-chance appeal, Thompson's lawyers only have to prove he is insane now and doesn't understand what's happening to him, even when he is on medication, as he was during the 60 Minutes interview. He appeared most of the time to be delusional.

"Well, see I wrote some songs and sent them to Hollywood," Thompson told Logan.

Asked who he'd written them for, he said, "Garth Brooks, Reba McIntyre."

Thompson told Logan he likes country music, and that the first song he wrote was "Dirty Dishes in the Sink."

He also said he had gotten paid twice, and that the last check that was sent to him was for $444,000.

"$444,000? What did you do with that money?" Logan asked.

"I sent it to Brenda Lane's family," Thompson said.

"You sure about that?" Logan asked.

"Yeah," Thompson said.

"What if I said to you there was no check?" Logan asked.

"It’s in my name," Thompson insisted.

"What if I said to you, though, there was no check, it’s in your head, not in your name?" Logan asked.

"No, there was a check. It wasn’t in my head, you know," he claimed.

"Are you a con man? Are you acting for me?" Logan asked.

"No. I’m serious. This is me. This is who I am," Thompson replied.

"How can you be sure that Greg Thompson is not just acting up, that he’s not just pretending?" Logan asked attorney Dana Chavis.

"For over 20 years, prison doctors have administered very powerful anti-psychotic drugs to Greg Thompson. I don’t know of any doctor that would prescribe or force that type of medication upon a person unless they believed they were truly psychotic," Chavis replied.

Asked what the effect of that medication is, Chavis said, "It doesn't take away his mental illness. He's always insane. But what it does is that it hides that insanity."

"But it doesn't actually make him normal?" Logan asked.

"Not at all," Chavis replied.

But does Thompson understand that taking the medication may make him appear sane enough to be executed?

"Well, I had a -- I made a choice years ago. That if I were to get to that point I'd rather be normal than insane," Thompson told Logan.

"Why is that?" she asked.

"Because it hurts. I’m tired of being mentally ill, you know. So if they want to kill me at the end, then they kill me at the end," he replied.

"I think I have to forgive him," Brenda Lane's sister Barbara Brown said. "I am a Christian and we are to forgive people. It's hard."

"But you want him to die for what he did," Logan remarked.

"Yes, I do want to see him executed," Barbara said.

Thompson's lawyers are going back to federal court this month and hope eventually to get a ruling that Thompson -- despite his medication -- is mentally incompetent and should not be executed. The Tennessee attorney general, who declined 60 Minutes' request for an interview, is expected to argue that Thompson understands why he is being punished, is not insane, and therefore should be executed.

Asked if he's afraid to die, Thompson said, "I'm on drugs right now. And I feel good. I'm not afraid. When I -- when these drugs wear off a little bit I'll be afraid again."

"If you were executed what do you think would happen to you afterwards? What comes next?" Logan asked.

"Well, I know that the dead can speak," Thompson said.

"The dead can speak? You think you would die?" Logan asked.

"I think it'd be a horrible ending," Thompson said. "Because if the dead can speak that means you got thought in the grave. You got thoughts going on in the grave. I don't know about that."

Monday, October 22, 2007

Our Brush with Homeland Security: Can Better Understanding of Mental Illness be Legislated?

Posted October 22, 2007 | 12:26 PM (EST)

June 21, 2002. JFK airport in New York. Just nine months after September 11th, my friend and I have just been asked to disembark our flight to California by the airline's head of security. My jaw is a vice. I grind my teeth. It's 9:00 a.m.

My friend, Sam, is also the subject of my first feature-length documentary, A Summer in the Cage. The film chronicles Sam's battle with manic-depressive illness, also known as bipolar disorder. I'm traveling with Sam that June of 2002 while he is in the midst of a delusional, paranoid manic episode. He has spent the last two hours with his shirt off, genuflecting in front of the jetway, praising God, and swaying back and forth. He's 6'7" and weighs 300 pounds.

When we finally board another flight, I spend the next seven hours trying to contain his psychological torrent. Sam praises Osama bin Laden (in the context of fighting for what he believes, however unpopular). He accuses passengers of being armed federal air marshals sent to capture him. The in-flight film, I Am Sam, unglues him as he begins to audibly bawl over the coincidence and poignancy of Sean Penn playing a mentally challenged father named "Sam." Eventually, we finally arrive in Los Angeles where five policemen are waiting to take Sam into custody for his alarming behavior.

Fortunately, I was with Sam that day to explain what was going on to flight attendants, passengers, and eventually the LAPD (they took Sam to a mental health facility instead of to jail and possibly worse with the climate of federal legislation on terrorism). It was one of many moments throughout the course of shooting my film where being a filmmaker was sacrificed so that I could help Sam as a friend. Had I not been accompanying Sam, the episode could very well have ended up like the bloody gun battle that happened to Sam's beloved Oakland Raiders player, Barrett Robbins, who also suffers from bipolar disorder. During a manic episode in Miami, Robbins was shot by the police after he took on several Miami policemen who wanted to arrest him for trespassing. It is imperative that we better educate both the police and medical responders of the symptoms and manifestations of mental illnesses so tragic conflicts and misunderstandings like these can be avoided in the future.

In addition, a better understanding of mental illness needs to extend beyond first-responders to the criminal justice system that is faced with a growing number of people with mental illnesses. According to Human Rights Watch and Bureau of Justice Statistics (BJS) report, "Mental Health Problems of Prison and Jail Inmates" (2006), "the rate of reported mental health disorders in the state prison population is five times greater (56.2 percent) than in the general adult population (11 percent)." The stresses involved in navigating the penal system can severely exacerbate the symptoms of a mental illness. The pressures of lock-up, confinement, isolation, intimidation, sanitary conditions, and the mercurial pace of adjudication create an environment where detainees with mental illnesses are set to fail. Unfortunately, these symptoms of mental illness are often not recognized or understood by the prison staff, leading to violent outbursts or unnecessary harsh treatments and punishments for the unstable inmates. If we want to instill proper rehabilitation and start breaking the cycle of recidivism that faces those who suffer from mistreated mental illnesses, our prisons must be better equipped to recognize and properly treat mentally ill inmates. (Pete Earley's Crazy: A Father's Search Through America's Mental Health Madness is an excellent personal and journalistic inquiry into the penal and court systems' failings, contradictions and inhumanities).

Sam and I were lucky that day when we got off the plane. I was educated on bipolar disorder and the symptoms of mania. I know Sam as a loving and peaceful person who suffers from a mental illness and I was able to convey that to the LA police officers. But I have witnessed and read about countless instances of first responders who misunderstand the symptoms of mental illness to tragic results. I hope that my film, and others like it, can help spark interest and motivate people to better educate themselves about the symptoms and signs of mental illnesses. With that knowledge, I hope that viewers will encourage legislators to support increased education and training for the first responders and correctional officers that are increasingly coming into contact with people suffering from mental illnesses.

A Summer in the Cage will air on Sundance Channel at 9 p.m. EST Monday, October 22, 2007 check local listings. More information about bipolar disorder and the film can be found here.

Monday, October 15, 2007

Early treatment works for those with mental illnesses

By Ella Kaple
Guest Columnist

Mental illnesses are medical conditions that disrupt a person's thinking, feeling, mood, ability to relate to others, and daily functioning. Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life. Serious mental illnesses include major depression, schizophrenia, bipolar disorder, obsessive compulsive disorder (OCD), panic disorder, post traumatic stress disorder (PTSD), and borderline personality disorder. The good news about mental illness is that recovery is possible.

Mental illnesses can affect persons of any age, race, religion, or income. They are not the result of personal weakness, lack of character, or poor upbringing. Most importantly, mental illnesses are treatable. Most people diagnosed with a serious mental illness can experience relief from their symptoms by actively participating in an individual treatment plan.

In addition to medication treatment, psychosocial treatment such as cognitive behavioral therapy, interpersonal therapy, peer support groups, and other community services can also be components of a treatment plan and that assist with recovery.

In Crawford County, those services are provided each day by Community Counseling Services, Inc., and funded by the Crawford-Marion Board of Alcohol, Drug Addiction and Mental Health Services. Last year alone, over 4,000 individuals received services from our system of care.

Here are some important facts about mental illness and recovery:

Mental illnesses are biologically based brain disorders. They cannot be overcome through "will power" and are not related to a person's "character" or intelligence.

Mental disorders fall along a continuum of severity. Even though mental disorders are widespread in the population, the main burden of illness is concentrated in a much smaller proportion -- about 6 percent, or 1 in 17 Americans -- who suffer from a serious mental illness. It is estimated that mental illness affects 1 in 5 families in America.

Mental illnesses usually strike individuals in the prime of their lives, often during adolescence and young adulthood. All ages are susceptible, but the young and the old are especially vulnerable.

Without treatment the consequences of mental illness for the individual and society are staggering: unnecessary disability, unemployment, substance abuse, homelessness, inappropriate incarceration, suicide and wasted lives.

The best treatments for serious mental illnesses today are highly effective; between 70 and 90 percent of individuals have significant reduction of symptoms and improved quality of life with a combination of pharmacological and psychosocial treatments and supports.

With appropriate effective medication and a wide range of services tailored to their needs, most people who live with serious mental illnesses can significantly reduce the impact of their illness and find a satisfying measure of achievement and independence. A key concept is to develop expertise in developing strategies to manage the illness process.

Early identification and treatment is of vital importance. By ensuring access to the treatment and recovery supports that are proven effective, recovery is accelerated and the further harm related to the course of illness is minimized.

Stigma erodes confidence that mental disorders are real, treatable health conditions. We have allowed stigma and a now unwarranted sense of hopelessness to erect attitudinal, structural and financial barriers to effective treatment and recovery. It is time to take these barriers down.

According to the president's New Freedom Commission on Mental Illness, the annual cost of untreated mental illness is $70 billion in the United States. Untreated depression alone costs the nation a staggering $40 billion a year. While anyone who's ever suffered from a mental illness, or had a family member of friend suffer from a mental illness, can easily understand the human cost of untreated mental illnesses, there is also strong evidence for the financial tolls involved. Recent research indicates that mental health treatment can more than pay for itself through sustaining a healthy workforce -- enhancing what can be viewed as "human capital."

Here are some startling facts:


Approximately 50 percent of students with a mental illness aged 14 or older drop out of high school. This is the highest dropout rate of any disability group.

Twenty-four percent of state prisons and 21 percent of local jail inmates have a recent history of a mental disorder.

An estimated 65 percent of boys and 75 percent of girls in juvenile detention have at least one diagnosable mental disorder.

Between 2000 and 2003, emergency department visits with a primary diagnosis of mental illness increased at four times the rate of other emergency department visits.
We know that treatment outcomes for people with even the most serious mental illnesses are comparable to outcomes for well-established general medical or surgical treatments for other chronic diseases. Early treatment success rates for mental illnesses are 60 to 80 percent. This is well above the estimated 40 to 60 percent success rates for common surgical treatments for heart disease.

As a nurse who has worked with individuals with serious mental illness and substance abuse disorders and as a long time member of the Crawford-Marion ADAMH Board, I know that treatment works and that people recover. Recovering people work. Working people pay taxes. Investing in good mental health services is an investment in our community.

Sunday, October 7, 2007

Death penalty: Eye for eye

But opponents want moratoriumS to halt 'murder of murderers.'

Sunday, October 07, 2007
By TONY NAUROTH

The Express-Times

The Supreme Court of the United States will soon be considering one of the most important death penalty cases in decades.

The issue centers on the use of lethal injection as the executioner's tool in a case involving two inmates on Kentucky's death row.

Ralph Baze and Thomas Clyde Bowling Jr. sued the Bluegrass State in 2004, claiming the needle amounted to cruel and unusual punishment.

Locally, some say any form of capital punishment is just plain wrong.

Lehigh University Chaplain Lloyd Steffen is a longtime opponent of the death penalty. He's even written a book about it -- "Executing Justice: The Moral Meaning of the Death Penalty."

Steffen is a professor of religion and a minister with the United Church of Christ, which is taking a strong stand against the death penalty.

Karen Berry, head of the Social Action Committee of the Unitarian Universalist Church of the Lehigh Valley, says her church adopted a moratorium resolution earlier this summer and is hoping for formal action from the Pennsylvania Legislature to make some type of death penalty moratorium official statewide.

And during the weekend of Oct. 19-20, Amnesty International is sponsoring the 2007 National Weekend of Faith in Action on the Death Penalty when churches throughout the country will hold events to bring attention to the issue.

The fight is in the courts

This connection between religious and secular organizations is at the forefront of the struggle to rid states of what organizers see as a barbaric and unfairly administered penalty for the crime of murder.

The courts are where the fighting has begun.

All 37 states that perform lethal injection use the same three-drug cocktail, but at least 10 of those states suspended its use after opponents alleged it was ineffective and cruel, according to the Death Penalty Information Center.

The three consist of an anesthetic, a muscle paralyzer, and a substance to stop the heart. Death penalty foes have argued that if the condemned prisoner is not given enough anesthetic, he -- or she -- can suffer excruciating pain without being able to cry out.

Baze, 52, has been on death row for 14 years. He was sentenced for the 1992 shooting deaths of Powell County Sheriff Steve Bennett and Deputy Arthur Briscoe.

Bennett and Briscoe were serving warrants on Baze when he shot them. Baze has said the shootings were the result of a family dispute that got out of hand and resulted in the sheriff being called.

Bowling was sentenced to death for killing Edward and Tina Earley and shooting their 2-year-old son outside the couple's Lexington, Ky., dry-cleaning business in 1990.

Lethal injection is just one battle; the war consists of opponents fighting against all forms of capital punishment.

'Seamless garment of life'

When asked if churches have any business getting mixed up in the politics of whether states should, or should not, execute criminals for the most heinous crimes, Steffen says, "Sure they should. All the mainline churches have taken positions opposing the death penalty, and Pope John Paul II has said the death penalty is inimical to the 'seamless garment of life.' "

Steffen is not encouraging the justice system to let the most vile criminals out onto the streets, he's just looking for the same kind of consideration parents use when their kids act out -- give them a time out.

"If people took a time out to study the problem," he says, "they would be against the death penalty."

Perhaps the Bible verse from Hebrews 10:30 applies here: "'Vengeance is mine,' saith the Lord." And from Deuteronomy 32:36: "For the Lord will be judge of his people."

But what do the people do when a Timothy McVeigh blows up an office building in Oklahoma City, snuffing out 168 souls? Or -- much closer to home -- when Martin Appel robbed the bank in East Allen Township, executing three to leave no witnesses. Appel was sentenced to death, but got off death row through appeals.

Death for 'horrific crimes'

Northampton County District Attorney John Morganelli still chafes at that decision.

"We need to keep the death penalty on the books for any horrific crimes that come along," Morganelli says. He maintains Appel is one of those criminals. Besides, Morganelli says Pennsylvania has had a "de facto" moratorium on death sentences for decades.

"We've only had three executions, and all of those came after they stopped appealing their cases.

Steffen refers to those same three cases as "voluntary" executions. He has visited death rows in Pennsylvania and Tennessee and says death row confinement usually means solitary confinement for years.

"There are a lot of suicides," he says. "It's torturous for them. All three executions have been volunteers. They drop all appeals; it's a mental illness situation."

Pennsylvania's primary method of execution is by lethal injection which, according to Amnesty International, is the same method used by China, Guatemala, the Philippines and Thailand.

New Jersey's method of execution is also by lethal injection. However, The Garden State does have a formal moratorium on executions, due to legislation passed in 2006.

Steffen says too many convicts who were innocent slip through the cracks.

"There have been 124 nationwide," he says.

Return to Martin Appel case

When Illinois Gov. George Ryan commuted his state's death sentences in a blanket order in January 2003, he was making a statement against the death penalty. He was nominated for a Nobel Peace Prize for that action and has stumped in Harrisburg for a moratorium on the death penalty in the Keystone State.

Morganelli, who authored his own book about the Appel case, says those seeking a death penalty moratorium in Pennsylvania "are all do-good organizations that don't believe in punishment and that everybody can be rehabilitated. They're just anti-law and don't carry much credibility."

Morganelli's book is titled "The D-Day Bank Massacre: The True Story Behind the Martin Appel Case."

Morganelli says he's more concerned about inmates who manage to get paroled and end up killing again. He names Reginald McFadden and "Mudman" Simon as two examples.

He also says the American justice system already has a built-in safeguard against making mistakes -- a jury of 12 who must vote unanimously for the death penalty.

"We just had a case where it went 11 to 1," Morganelli says, citing the Andrew D. Paschal verdict. Paschal was convicted of gunning down Marcellus McDuffie outside Larry Holmes Ringside Restaurant and Lounge, in Easton on May 14, 2006.

Death penalty not logical

Maria Weick of the Lehigh Valley Committee Against Killing and the Pennsylvania Death Penalty Abolition Coordinator for Amnesty International, says "Pennsylvania is a really hard case when it comes to the death penalty."

Both she and Steffen say the single most difficult roadblock to a moratorium is politicians.

"Pennsylvania politicians," Weick scoffs, "are married to the idea that supporting the death penalty means they're tough on crime."

Weick says Pennsylvanians are split 50-50 for and against the death penalty.

She admits, "Moratoriums are an act of desperation. But they are a way of getting people to think about the issue."

Steffen says they act to increase public awareness.

Weick adds that the death penalty makes no logical sense.

"Think about it," she says, "Do we drug the drug dealer? Do we rape the rapist? Then why do we murder the murderer?"

Tony Nauroth is a features writer with The Express-Times. He can be reached at 610-258-7171 or by e-mail at tnauroth@express-times.com.

The Associated Press contributed to this report.

Saturday, September 29, 2007

Mental health courts and activism are topics of conference

09/28/07
WMNF Evening News Friday

By Seán Kinane

Today was the final day of this week’s Mental Health Conference at the TradeWinds Island Resorts in St. Pete Beach.

The three-day conference was co-hosted by the Florida Council for Community Mental Health and the Florida Psychiatric Rehabilitation Association.

This morning’s plenary speech was by David Shern, president and CEO of the advocacy group Mental Health America.

A year ago Shern left his tenured position as Dean of USF’s Florida Mental Health Institute because he felt he could be a more effective advocate for people with mental illness from outside of academia. Shern said that his decision had a lot to do with frustration that his nephew Kyle could not receive adequate mental health care.

The title of Shern’s plenary was "Mental Health In America: Where is the Outrage?" Shern feels that the topic of mental health is so important but that people don’t care enough about it.

Shern said that another reason people should be outraged is because the U.S. has the worst mental health in the developed world.

The high rates of mental illness in the United States contribute to the overall healthcare crisis in the country, according to Shern.

One of the meeting’s breakout sessions dealt with Mental Health Courts -- How to provide recovery and hope. Mental Health Courts attempt to take people with mental health issues out of the criminal justice system to get them the care they need.

Ginger Lerner-Wren has been the judge of the nation’s first mental health court since its establishment in Broward County in 1997. Lerner said the purpose of court-based diversion models such as a mental health court was to stop the criminalization of mental illness and there are several questions that can be asked to see if mental health courts are successful.

Judge Lerner shared in David Shern’s outrage and said that motivated her community to form Broward’s pioneering Mental Health Court.

Lerner told the mental health professionals in the audience some of the reasons why she and her coworkers are so committed to the goals of the mental health court.

Lerner said that the rate of repeat arrests of people who have gone through her misdemeanor court is between 9 and 12 percent. Even though the court doesn’t receive funding, Judge Lerner is able to brag about its success.

For more information:

Mental Health America

Broward / 17th Circuit

FCCMH

Friday, August 10, 2007

Mentally ill offender re-entry: silent crisis in our communities

By GARY BEMBRY
guest columnist

Friday, August 10, 2007

On May 22, Department of Corrections Secretary James R. McDonough announced a subtle, but significant, change to the agency's mission statement. Normally, such a change would not be compelling, but to those concerned with the safety of our communities and the well-being of its citizens, it is indeed an important — and noteworthy — change of direction.

The revision, according to McDonough, places a "renewed emphasis on the preparation of inmates for re-entry into society as part of our mission. This is an anti-crime measure of the utmost importance to our state."

We commend the secretary's vision, understanding of the problem and firm commitment to address the issue of offender re-entry. But this is not a battle he — or any one person — can win on his own. He will need the help of our Legislature, other state agencies and Florida's communities to accomplish this ambitious goal.

Here's why.

Too many ex-offenders leave prison unprepared for life on the outside and eventually return. In fact, in April 2007 there were almost 92,000 inmates in Florida's prisons, and more than 44 percent of them had been in prison before.

The issue of recidivism is especially troublesome for those incarcerated with a mental illness. It is estimated that 20 percent of the prison population has a serious mental illness and that almost three-fourths of inmates with a mental illness have a co-occurring substance-abuse disorder. Mentally ill offenders also have a higher-than-average rate of recidivism, cycling in and out of criminal justice and corrections settings with alarming regularity.

As McDonough moves forward with his progressive plans, we hope that he focuses on issues such as having transitional housing for ex-offenders with a mental illness when they are released. If we don't, then we are placing them directly into homelessness, for which they can be sent back to jail.

Those with a known mental illness also should be connected to local mental health and substance-abuse counseling services before they are released. We need to maintain some sort of tracking that may include a period of parole and a way to know if they are treated in a hospital emergency room or have an encounter with police. In fact, we need to work directly with law enforcement to explore additional means of intervention that can resolve issues in ways other than re-incarceration.

In addition to being a public-safety issue, our lack of success in keeping ex-offenders from re-entering the corrections system costs Florida taxpayers millions each year. With 20 percent of the 10,000 ex-offenders released every year having a significant mental illness, we are paying $120 million annually for their re-entry into the prison system.

That is more than our state spends on all children's mental-health services in a year.

Investing in community-based mental health programs that can provide transitional centers and support staff is the key to tracking, counseling and guiding ex-offenders with mental illness toward safe and healthy actions and away from our prison gates.

It's what is best for them and our communities, and we applaud McDonough for taking the first steps to address this complicated issue. Now it is up to all of us to ensure that he is successful and that some of our most vulnerable citizens have a fighting chance to succeed.

Bembry is chair of the Florida Council for Community Mental Health and CEO of the Lakeview Center in Pensacola. E-mail: gbembry@bhcpns.org

Tuesday, August 7, 2007

Mentally ill ex-cons need help in order to adjust

On May 22, Department of Corrections Secretary James R. McDonough announced a subtle, but significant, change to the agency’s mission statement. Normally, such a change would not be compelling, but to those concerned with the safety of our communities and the well-being of its residents, it is indeed an important — and noteworthy — change of direction.

The revision, according to Secretary McDonough, places a “renewed emphasis on the preparation of inmates for re-entry into society as part of our mission. This is an anti-crime measure of the utmost importance to our state.”

We commend the secretary’s vision. But this is not a battle he — or any one person — can win on his own. He will need the help of the Legislature, other state agencies and Florida’s communities to accomplish this ambitious goal. Here’s why.

Too many ex-offenders leave prison unprepared for life on the outside and eventually return. In fact, in April 2007 there were nearly 92,000 inmates in Florida’s prisons, and more than 44 percent of them had been in prison before.

The issue of recidivism is especially troublesome for those incarcerated with a mental illness. It is estimated that 20 percent of the prison population has a serious mental illness and that nearly three-fourths of inmates with a mental illness have a co-occurring substance-abuse disorder. Mentally ill offenders also have a higher-than-average rate of recidivism, cycling in and out of criminal justice and corrections settings with alarming regularity.

It is easy to see why this is such a problem. In prison, those with mental illness often experience rapidly declining physical and mental health, which makes a life of homelessness, poverty and a pattern of recurring crime, arrest and re-incarceration all the more likely.

So what happens to them? The sad truth is that unless they are arrested again, we often have no idea. Because those with a mental illness are the most ill equipped to succeed in re-entry to society, we are indeed setting them up for failure.

We hope Secretary McDonough focuses on issues such as transitional housing for ex-offenders with a mental illness when they are released. If not, then we are placing them directly into homelessness, for which they can be sent back to jail.

Those with a known mental illness also should be connected to local mental health and substance abuse counseling services before they are released.

We need to maintain some sort of tracking that may include a period of parole and a way to know if they are treated in a hospital emergency room or have an encounter with police. In fact, we need to work directly with law enforcement to explore additional means of intervention that can resolve issues in ways other than re-incarceration.

Establishing this tracking system is crucial as the highest risk of recidivism of mentally ill ex-offenders is in the first six months after release from prison.

In addition to being a public safety issue, we are paying $120 million annually for their re-entry into the prison system.

That is more than our state spends on all children’s mental health services in a year.
Investing in community-based mental health programs that can provide transitional centers and support staff is the key to tracking, counseling and guiding ex-offenders with mental illness.

— Gary Bembry is chairman of the Florida Council for Community Mental Health and CEO of the Lakeview Center in Pensacola. He can be reached at (850) 469-3702 or gbembry@bhcpns.org.

Wednesday, July 25, 2007

Mental Disabilities

The ABA assessment team concluded:

The State of Florida has a significant number of people with severe mental disabilities on death row, some of whom were disabled at the time of the offense and others of whom became seriously ill after conviction and sentence.@ ABA Report on Florida at ix.

And, while Florida has recently excluded individuals suffering from mental retardation from the death penalty, it has not extended its logic to those suffering from severe mental disabilities. Id. at xi.

The ABA assessment team recommends that the logic regarding those with mental retardation be extended to those with severe mental disabilities, noting that mental illness can effect every stage of a capital trial. Id at xxxviii.

Certainly, the distinction between the mental impairment of the mental retarded and the mental impairment of the mental ill and corresponding culpability of those inflicted with each condition appears to be arbitrary.

Furthermore, even in the case of the mentally retarded, Florida has created a procedure that will produce arbitrary results, as ABA assessment team acknowledges.

The legislation and rule governing mental retardation procedures makes a distinction between those individuals whose cases are final and those who are not. See Fla. Stat. ' 921.137; Fla. R. Crim. P. 3.203. Those whose cases are final receive none of the protections as those whose cases are not final, including, but not limited to a jury`s consideration of the issue and the sixth amendment guarantee to effective assistance of counsel. These distinction depending on where a defendant is in his criminal process are arbitrary.

The ABA assessment team also criticized the burden of proof imposed on capital defendants and recommended that the State be required to disprove a defendant`s substantial showing that he is mentally retarded. ABA Report on Florida at xxxviii.

The imposition of the burden of proof on the defendant will undoubtedly cause the decision as to who is mental retarded and does not get executed and who is not retarded and gets executed to turn on arbitrary factors, such as whether records demonstrating onset before the age of 18 exist, are family members still alive who can advise mental health experts as to the defendant=s adaptive skills, etc.

Sunday, July 8, 2007

The Wrong Place to Treat Mental Illness

By Marcia Kraft Goin

Sunday, July 8, 2007

Last month the Supreme Court rightly blocked the execution of Scott Panetti, a Texas man who was convicted of a double murder and who suffers from delusional schizophrenia. The case drew public attention to the intersection between mental illnesses and executions.

But what about those who are mentally ill and imprisoned but not on death row? A national conversation on this issue is urgently needed.

There is a pervasive attitude in this country that such people are getting what they deserve: After all, like Panetti, they are in jail for something.

But did you know that the Los Angeles County Jail houses the largest psychiatric population in the country? That's not justice. That's emblematic of a national emergency.

Before the 1960s, people with mental illnesses were generally cared for in institutional settings, mostly state-run psychiatric facilities. Many advocates correctly saw this as "warehousing" people who could be cared for in less restrictive settings. Federal legislation and the courts powered a move toward deinstitutionalization, calling on states and counties to provide resources for social services, vocational rehabilitation and treatment services. The introduction of effective antipsychotic medications also drove the trend toward deinstitutionalization.

In the decades since, community-based services have helped many people. But the situation today constitutes a national failure.

What's gone wrong?

Most important, the necessary community resources didn't materialize in anywhere near the level that was needed. Also, antipsychotic medications, while powerful treatments, don't work in isolation. Patients need a relationship with a psychiatrist, clinic or other stabilizing force to ensure adherence to drug regimens and achieve the best possible recovery.

Deinstitutionalization has succeeded in decreasing the overall number of hospital beds, but an unforeseen consequence has been the proportional increase in the number of people with mental illnesses housed in the criminal justice system. Worse, once imprisoned, people with mental illness are shown to have much longer incarcerations than other inmates, primarily because a prison environment and lack of treatment aggravate the very illness that has led to their objectionable or antisocial behavior.

While no one would argue that Scott Panetti belongs on the streets, his case compels us to consider the justice system's role: Is it to mete out punishment that seeks retribution, or are there cases where real justice means effective treatment that seeks rehabilitation?

Consider again Los Angeles County: In 2002 there were 38,600 psychiatric evaluations at the inmate reception center of the Twin Towers jail. Of these, 23,190 people (60 percent) were found to be in need of mental health treatment. A reasonable person could not fail to see the correlation between decreased funding for mental health resources, the closure of hospital beds, homelessness and the criminalization of mental illnesses. Untreated and lacking access to long-term care, people with mental illnesses often end up with symptoms and behaviors that result in jail time.

Cuts in state Medicaid budgets promise to exacerbate these problems. Not only is this shift in funding a blight on our society, it also costs money -- a lot of money. Corrections officials, mental health workers, medication, amortization of buildings and time spent by police in court all cost more than treating patients appropriately in their community. This doesn't make financial sense, much less humanitarian sense.

When considering the direction of public policies that affect those with mental illnesses, politicians and other officials must be guided by the latest research.

Government-funded studies have shown in recent years that jail-diversion programs, which help people get the treatment they need, result in positive outcomes for individuals, communities and the criminal justice system. While jail diversion does generally result in lower criminal-justice costs and greater treatment costs, studies are underway to analyze the differential.

The question the court answered in the Panetti case was about one's fitness to be executed, but in many more cases, the question is about the appropriateness of incarceration at all.

The writer is a past president of the American Psychiatric Association and director of residency training in the Psychiatric Outpatient Department at Los Angeles County General Hospital/University of Southern California School of Medicine.

Thursday, July 5, 2007

Coping with Mental Illness: Help Is Here

COURT HOUSE— More than 44 million Americans suffer from a mental health disorder according to the National Institutes of Mental Health, 80 percent of which also have a sub-stance abuse problem.

“He’s been through counseling, seven rehabs, overdosed four of five times,” said the North Wildwood resident and mother of a schitzo-affected adult son suffering from severe anxiety, bi-polar disease, and substance abuses.

The Herald is withholding the names of mother and son to protect their privacy.

What this mother described is termed by psychiatric professionals as a dual diagnosis, oc-curring when an individual is affected by both an emotional or psychiatric illness and chemical dependency.

The woman describes her son as a shy boy, who experienced extreme emotional highs and lows and delusions of grandeur.

“He doesn’t listen,” said the North Wildwood resident, “he does not think logically.”

She said she feels alcohol and drug use was what escalated the situation with her son’s mental health.

“We had a lot alcoholism in our family, mostly functioning alcoholics, but in those days we didn’t know. People didn’t talk about their problems.”

At 14, her son had his first suicidal overdose.

Afterward, she sought assistance from Cape Counseling Center in Court House.

“It’s very hard for kids,” she said. “He came out of rehab and re-entered school at 16 so-ber, but his friends were drinking and smoking pot. Of course he wanted to do what they were doing.”

Her son, now in his thirties, was in the Ancora facility last year where he connected with Rachel Parzio-Corso, an advocate with New Jersey Protection and Advocacy, Inc. (NJP&A).

Designated by Gov. Christine Todd Whitman in 1994, NJP&A serves as a free service agency of attorneys and advocates who monitor investigations, respond to cases and teach people to be self-advocates.
Parzio-Corso, who also has a son with mental health issues, attends a jail task force monthly and responds to cases such as when a person is in jail and doesn’t have access to proper medication, or in the case of this North Wildwood mother’s son, assists patients in receiving the best treatment for their particular situation and assuring their rights are pro-tected.

Parzio-Corso said issues she comes in contact with are overmedication in psychiatric hospi-tals and extended incarceration for offences that may have been escalated into extended is-sues because the person is mentally ill.

She said she also deals with more minor issues in psychiatric hospitals such as laundry be-ing returned to a mentally ill person with holes and burns, or not returning at all.

“We’re trying to put an end to issues like that,” Parzio-Corso said.

The Group for the Advancement of Psychiatry reports that 320,000 people who suffer from severe mental illness are incarcerated in our jails and prisons today.

Parzio-Corso told the Herald that 15 to 20 percent of inmates are mentally ill, and they will spend an average of eight times longer incarcerated than other inmates due to infrac-tions stemming from response to lack of proper treatment and medication.

Cape Counseling is working to change this situation by heading it off before mentally ill individuals get into trouble.

The non-profit group provides mental health education programs throughout the county, support groups for patients and families, and a free service program, Families F.I.R.S.T., which provides education and support for family members of loved ones with mental ill-ness, to assist them in situations such as this North Wildwood mother and her son.

Cape Counseling also provides psycho-educative services to local police departments in how to interact with a mentally ill suspect, or just in an everyday situation.

“Lower Township has been wonderful,” said Samantha Knocke, a family support special-ist at Cape Counseling’s center in Court House.

Some police departments in Gloucester and Camden counties employ special agents to handle situations with mental health issues because they can be so particular and difficult to manage.

“I’ve seen the police beat my son,” the North Wildwood mother said. “He gets scared, you back him in to a corner, and he reacts. But you have to look at both sides. The person is afflicted and afraid, those interacting with them don’t know how to properly handle them.”

It’s situations like these that called for the creation of the Families F.I.R.S.T. program.

The program defines mental illnesses as physical brain disorders that profoundly disrupt a person’s ability to think, feel, and relate to others and their environment.

Mental illnesses, according to their literature, are more common than cancer, diabetes, or heart disease.
The program has over 40 active participating families in this county; another 60 participants are what the program terms “inactive.”

“But they are always welcome. Once you are a part of Families F.I.R.S.T, you are always welcome to come back,” program manager Jodi Hynes told the Herald.

“You just have to hope you get the right kind of help. It’s scary,” the North Wildwood mother said.

“We work to protect what we call the patient bill of rights,” Parzio-Corso said. “We focus on making sure these people are treated with dignity and respect.”

She told the Herald the three biggest problems she has seen through her work are; lack of housing, affordable and also availability of half-way house situations, safety, because of hos-pital incidents, and mentally ill patients continually being incarcerated, instead of receiving proper treatment.

“It (mental illness) comes in so many shapes and forms. As long as a person gets the treatment, they can live a normal life,” said Parzio-Corso.

Contact Gillin-Schwartz at (609) 886-8600 Ext 24 or at: mschwartz@cmcherald.com