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

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

The Associated Press contributed to this report.