What to do - mental illness???


Traveler
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More and more we see incidents in the news of individuals with mental illness engaged in threatening activity. Historically the treatment of mental illness or what society has attempted is now looked upon as draconian.

I realize that mental illness is not a threshold that someone crosses. We have come a long way from the craziness associated with treatments - but are we making progress towards any possible solution?

Any views on the forum?

I have one particular view but it is incomplete. My view it that the first purpose of law in a society is to protect its citizens. But in discussions about mental illness I seem to lose favor suggesting that I believe the first responsibility a society has in determining how to deal with mental illness is to protect the productive elements and desirable elements of society. I see helping those burdened with mental illness as secondary but still important. However, I am very open to other opinions and suggestions.

The Traveler

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Just a few questions:

- your opinion as stated seems to imply that those with mental illness are not productive members of society. Is that correct?

- mental illness is a very wide spectrum. Does your opinion apply to all of it?

- so I understand you more clearly, can you site any day to day examples?

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Mental illness is a broad term that covers an expanse of behaviours within the human condition and does contribute to a desirable society. There are extreme ranges that are considered within that category, but as always, 99% of those people will never be criminals.

There is no solution as you seem to rudely suggest, as your notion of justice seems rather rigid for you to suggest that you are open to suggestions as to how to resolve your own ignorance on the topic.

I interpret your remarks as wanting a debate between society versus those you term mentally ill, but your initial points will only infuriate anyone suffering or anyone with a family member who is suffering, which means nearly everyone but yourself.

Ignoring cause and effect can lead to dangerous assumptions.

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My concern with mental illness is slightly off the "crazy guy with a gun" path. At the end of the spectrum where those with a mental illness are useless to society (as in, unable to contribute to society in any way, requiring extra resources due to having no family/friend/community support system, etc.), what is to be done with them?

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... your initial points will only infuriate anyone suffering or anyone with a family member who is suffering ...

On the nose. I have a 10-year old daughter struggling with mental illness since the age of five. I was far from pleased after reading the original post and will refrain from further participation in this thread.

Edited by Swiper
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The phrase "Walk a mile in my shoes" applies here. One needs to ask themselves how they would want to be treated if they suffered with mental illness. Another question to ask is How would the savior treat people with mental illness.Does someone suffering from mental illness bring to mind the lost sheep that saviors goes to rescue leaving the ninety and nine?

Also, a society that ostracizes a segment of the population(such as the mentally ill) is probably more dangerous then a society that deals with the consequences of a small percentage of a growing yet minority part of it's total population. Where does ostracizing end? I think history shows us that Humans are not good at stopping that ball once it gets rolling.

It is easy to be afraid of problems and people we do not understand. It is difficult to develop empathy for those who are different from us. As a society we should be more aware of mental illness and help those who deal with it day to day.

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The reason I asked traveller to clarify what he was referring to when it came to mental illness is because taking into account every single definition of mental illness, he is essentially referring to society as a whole - all of us. Depression and anxiety are good examples here.

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More and more we see incidents in the news of individuals with mental illness engaged in threatening activity. Historically the treatment of mental illness or what society has attempted is now looked upon as draconian.

I realize that mental illness is not a threshold that someone crosses. We have come a long way from the craziness associated with treatments - but are we making progress towards any possible solution?

Any views on the forum?

I have one particular view but it is incomplete. My view it that the first purpose of law in a society is to protect its citizens. But in discussions about mental illness I seem to lose favor suggesting that I believe the first responsibility a society has in determining how to deal with mental illness is to protect the productive elements and desirable elements of society. I see helping those burdened with mental illness as secondary but still important. However, I am very open to other opinions and suggestions.

The Traveler

Thought 1

The Qur'an teaches that those with mental illness (and retardation, poor, elderly, infirm... Anyone unable to care for themselves etc.) are under the protection of God, and that we must therefore honor that protection and aid in it.

In fact, Ramadan -one of the biggest/best known outside of Islamic circles- is much like our FastSundays... The meals that are skipped are not only to remind each what it is like to go without, but what would have been spent is to go to the needy. For those who cannot complete a proper fast, there are several alternatives (including feeding and caring for the infirm for XYZ amount and days, if you are kept from "making up" those fasts at a later date. Obviously I'm simplifying things for brevity. The passages / suras that command charity and action are numerous, and the book is replete with them. For anyone interested in reading the Qu'ran in English... I highly recommend Tarif Khalidi's translation... Which keeps the passion and poetry more than any other translation I've every come across. Amazon.com: The Qur'an: (Penguin Classics Deluxe Edition) eBook: Tarif Khalidi, Tarif Khalidi: Books. Another interesting read is Reza Aslan's 'No God But God found here . Amazon.com: No god but God (Updated Edition): The Origins, Evolution, and Future of Islam eBook: Reza Aslan: Books.. There are also lots of academic and government papers on the subject, in situ, in Islamic countries... But they're difficult reads, as the few readily available translated into English are either Congressional Reports type long, ie 1500+ pages, or the English is torturous. The following link is to one of the shorter and not as badly translated papers from the Tehran University Payame Noor. It deals more with a broad overview of govt. management, in following the commands of justice, kindness to subordinates, patience, et cetera. This is more of an example of why I'm not posting other links/ social science journals/etc.as its fairly pedantic and eye crossing even as short as it is. http://ecisi.com/wp-content/uploads/2012/04/159-167.pdf, Instead, I highly recommend the translation by Tarif Khalidi and Reza Aslan's books. For a more in depth study, the Oriental Colleges, or Middle East Studies departments at local universities have great resources. ).

Back on target... I've always loved this view "Under the Protection of God".

To me, in a nutshell, this wraps up my entire belief structure surrounding mental illness and our responsibilities as a society for those have no or limited agency.

Q

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Thought 2

No or limited agency.... Is a HUGE spectrum... And I think we need to be exceptionally careful of how much we usurp and how much we let lie..

By and large most of the laws in the US at least attempt to do this once something has made it INTO the court system.

For example; postpartum psychosis is handled differently, than drug induced psychosis, which is handled differently than psychopathy. & ADHD is handled differently than paranoid schizoaffective disorder with violent tendencies.

It's BEFORE things progress to the courts where most of the country, in my less than humble opinion, falls flat on its tukus. But social programs designed to spot, recognize, help... Are not only not "sexy" (aka are hugely expensive and don't show immediate bang for their buck... So even when they get set up, the next politician to get voted in tends to scrap them immediately... But people in this country are the most fearful, uncharitable, short sighted of any country I've ever lived in.

There seems to be a real and deep abiding terror that someone, somewhere, might get something you "worked for".

Ahem. NOT to say that the people in this country aren't intelligent, amazing, et cetera. And most -as soon as they have an actual case IN FRONT OF THEM leap to help, be of service, etc. But that's exactly the problem. It shouldn't be the photogenic kid on channel 6 who gets help, while 5,000 other kids in identical circumstance don't.

But we just can't seem to, as a society in the US, take ourselves off the durn auction block. We can't seem to stop having the need to PERSONALLY "check the teeth" of each and every single person who needs help... Instead of realizing that

- people need help

- that means funding programs (aka professionals I can trust to "check the teeth FOR me")

- and it's okay if I work for something and someone else doesn't WITHOUT needing to sit in Judgement over them... Because the thing that I worked for has intrinsic value and worth to me, myself. And, actually, it's something I want others to have. I am not afraid that if they have, I will have not.

(It's a cyclical fear... If people don't have basic inks like food, housing, medical care, medications, education,etc ... Then those that do have will fear losing them... So they guard against everyone having them. The closer you get to the line of "not having", the more violent people get about others not being given those things. That's just pure history. Across countless cultures and times. It's one of those "they didn't really HAVE to fund a study to prove that desperate people jealously guard what they have, and actively prevent others from getting what they have", did they? Be it scraps of bread in a concentration camp, or the $440 a month of counseling. If everyone doesn't have "it" they're afraid of others getting it. INSTEAD, when everyone does have it, the cyclical fear gets killed.

In this country... We have lots and lots of food programs... Because most people eat well. So they're not afraid of losing it. But step it up to free counseling and meds? Not until EVERYONE has access to counseling and meds without sacrificing for them, will people gladly help others get them.)

But to continue on... We have fairely decent case law surrounding mental health... As everyone can get arrested and go to court. But we have LOUSY spot & assist programs , because those are programs people want for themselves and cannot afford.

Which brings me back to the spectrum bit:

- Not only do we have to be careful about usurping power from the powerless (oxymoron much)... We ALSO have to be careful about those on the spectrum who are on the "still needs help" end but their problems are undervalued and it's a COMPETITION for help. Which creates a really violent jealousy reaction that -time and again- kills these programs dead dead dead.

Q

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If you are scared of those that are mentally ill then stop supporting people who keep cutting government funding for the mentally ill.

There is a kid (I call him a kid, he's probably in his mid 20s) who walks the street of a town I visit/drive through when visiting family. I sort of know him. He has mental problems or is part retarded. He can't hold a job except take out the trash at a gas station. I don't know much about him. He might or might not be getting disability. Anyway, the state or city government should have jobs for people like him. Something to make them feel important and something they can do and receive a check at the end of each week. Instead those types of programs have been cut.

We should be funding programs for the mentally ill. Instead some cities are outlawing homelessness, ignoring and handing the problems off to some one else.

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Time for a "mentally ill" point of view, (from one who is mentally ill-by definition) always just lovely to see how people think anyone with a "mental illness" of any sort are dangerous psychopaths who need quarantined.

Oh but helping them is secondary, because that costs money and no one wants to help anyone in this day and age, if they are at all different. Just want to lock them up and let them die.

Edited by skippy740
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If you are scared of those that are mentally ill then stop supporting people who keep cutting government funding for the mentally ill.

There is a kid (I call him a kid, he's probably in his mid 20s) who walks the street of a town I visit/drive through when visiting family. I sort of know him. He has mental problems or is part retarded. He can't hold a job except take out the trash at a gas station. I don't know much about him. He might or might not be getting disability. Anyway, the state or city government should have jobs for people like him. Something to make them feel important and something they can do and receive a check at the end of each week. Instead those types of programs have been cut.

We should be funding programs for the mentally ill. Instead some cities are outlawing homelessness, ignoring and handing the problems off to some one else.

And don't tell me there aren't jobs those like this kid can do!

And I will never understand outlawing homelessness.

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After spending a month on the inpatient psych ward in a local hospital followed by time in the outpatient clinics, my views on mental illnesses have changed a lot. First, from a purely observational standpoint, It was remarkable to see people be admitted who would literally talk to walls get better over a few weeks- to the point where I could have a perfectly normal conversation with them and discuss what their future plans were, etc. One woman with postpartum psychosis was particularly memorable in this regard. It's unfortunate that society stigmatizes mental illness because I'm sure there are lots of people out there who really could use help (either counseling or pharmacologic), but choose not to seek it out of fear of the consequences. On the ward, there were plenty of frequent flyers- the typical cycle was that they would stop taking their meds, become floridly psychotic, eventually meet the criteria for involuntary hospitalization (mainly a threat to themselves or others), and a judge would finally order them to submit to treatment- they would get better as an inpatient and then be released on a court-ordered LRA (least restrictive alternative) which would last for 90 days while requiring them to take their medication.

Here's where things get messed up- as long as the LRA as in effect, the State pays for the medication, but as soon as 90 days roll around, the meds are no longer covered- you can guess the most common reason why people stop taking their meds- few people can afford the $1k+ monthly cost for their invega sustenna (or whatever other expensive psych drug they're on). So rather than continuing to pay for these meds, the public ultimately chooses (by virtue of the lack of any other option) a much more expensive option by waiting until these people relapse and require costly inpatient treatment.

My main take away from my time on the psych wards were that many mental illnesses are treatable these days to some degree, but that med cost and perception are the main barriers to treatment. For whatever reason, society has placed little value on assisting people with psych illnesses and has therefore underfunded it as a whole- our local multi-county inpatient treatment area has very few beds, and the State hospital has a pretty long waiting list for admission (this is where people who need 30+ days of treatment go- it's not a psych warehouse).

The methadone clinic was also illuminating- lots of people WANT to get clean, but can't afford the $350/mo for treatment at the public clinic.... that's another topic though.

It's disappointing that the public discussion has centered so much on "how can we keep these crazies away from guns" instead of "why aren't these people receiving the treatment they need?" More databases designed to restrict the rights of people with diagnosed illnesses is not the answer- in fact, the existence of them merely serves to deter people from seeking treatment in the first place. I've had several patients decline antidepressants because they didn't want to appear in just such a database. What a wonderful system we've created.

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. . . few people can afford the $1k+ monthly cost for their invega sustenna (or whatever other expensive psych drug they're on). So rather than continuing to pay for these meds, the public ultimately chooses (by virtue of the lack of any other option) a much more expensive option by waiting until these people relapse and require costly inpatient treatment.

I wonder whether it might not be a good idea to set up some kind of program that offers to buy the patents for pricey, in-demand drugs, and then puts the formulas for those drugs into the public domain. Put a little honest-to-gosh competition back into the world of Big Pharma, and see how the market responds.

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I personally have wondered of ways to improve our understanding. My personal experiences have been wide and for the most part positive. During my college days I was a member of a musical group that once performed at the Utah State hospital for the Mental ill in Provo Utah. I was somewhat touched and though my group only performed once for several years I returned on my own to provide a program. To be honest I seemed to find a lot in common with the patients; I found them generally kind and in many cases hard to distinguish from the professional staff.

Later in my life mental illness became a part of my family as a sister in-law struggled with a bipolar disorder. This was hard for me and took years for me to adjust to outburst of character that to me at the time seemed deeply rooted in evil. But I saw a different person as she was finely able to find treatment and a perception cocktail that settled her down. It was informative to talk to her over the following years of her struggle during those difficult times and learn that those times were actually more difficult for her than anyone else - including myself.

I had a mother-in-law recently pass that struggled with bipolar disorder but with her I never experienced any pleasant moments with her until she was on her deathbed and sedated. Never the less I was able to get along with her better than any of her children with perhaps the one exception of my wife.

In addition I have known neighbors and ward members with various mental problems all of which are in essence happy or worthwhile experiences. But there was one experience that does not have a happy ending. A son was playing a baseball game at the Alta Canyon public park. As is often the case with youth leagues the ump was not highly skilled. In fact the ump was a youth himself and about 16 or 17. One of the parents on the opposing team grew agitated with the ump as the game continued. After a while this dad placed himself behind the plate and began to protest the call of almost every pitch. I think this affected the young ump negatively and it almost seemed as though the boy called everything he could against the team of the agitated parent.

The situation escalated between the two til the parent became quite angry and went onto the field and began screaming (very bad language) and pushing the ump. I walked over to the coach of the opposing team and got the coach - telling him we needed to do something. The coach was reluctant and informed me that this was a very common occurrence with this particular parent. Undeterred I led a small delegation on to the field to try and calm the parent so the game could continue. Unfortunately this did not help and the parent grabbed a bat and started to threaten us. The police were called and the man had to be dragged away in handcufs. The game was not finished and I could not believe that the incident had gone so far.

Sadly this story did not end yet. About 3 weeks later this parent armed himself with a shotgun and shot and killed a nurse in a doctor's office (a doctor I knew well that treated my wife) not far from that baseball field and made national news during a following standoff with police. This incident has ruined more than a few families and has been devastating to several individuals. One thing it has not done is convince me that citizens should not be involved if they know of or observe individuals becoming treating or abusive in public despite personal risk. But at the same time I believe we need to be better informed.

One thing I think I have learned is that logic and reason is not helpful with such circumstance. It appears to me that under such conditions it is best to agree with everything that seems to disturb such an individual and not to confront them or tell them anything they should not be doing. What I should have done with Mr. Worthington was tell him he was right to get angry at the ump for the bad calls and then encourage him to come over to the side lines and off the field to discuss the matter with the coaches. This likely will not solve the problem but may provide an opportunity of safety for more individuals and for help and reinforcements to come. Police and authorities should be called sooner - like as soon as the parent entered onto the field and before we get involved.

I believe that part of the problem is that we see evil rather than someone with difficulties. My instincts are to confront the person and point out that they are out of hand and need to be reasonable. In essence I am still not sure if I could have personally done anything to help prevent the loss of life of a nurse with a family. This greatly concerns me. I understand that there are many individuals that can and should be helped. But I also understand that allowing unnecessary death is not an easy thing to forget the regret.

The Traveler

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Commendable that you feel guilty that you could not prevent a tragedy, but unrealistic to blame yourself for another ones behaviour. I can understand that you associate mentally ill people with this traumatic event, but believing all mentally ill people are dangerous to society is a gross generalization and a disservice to everyone needing compassion.

In Canada, a gun application will be denied if the applicant is depressed or found to be depressed as the RCMP will call the references that are provided. This is to prevent more suicides, as the easiest and most common way to commit suicide is to use a gun. On the extreme spectrum, one could speak of the mass shootings that happen, generally because they shooter is mentally ill, but as always that is an extreme minority, just like terrorism is conducted by a minority. Its as if some suggest a TSA approach should be used for everyone to screen mental illness, with the irony being that everyone would be apprehended as it would be assumed that mentally ill people would dangerous.

Medication is not the sole answer, but in some cases with careful dosage control and monitoring it can benefit the patient and provide the patient with stability, but generally speaking, I have seen medication abused and treated like a catch all solution with ignored consequences. The answer for most people suffering from mental illness, therapy first and medication should be considered second in isolated cases. Therapy is far more expensive and time consuming than simply offering a convenient pill that is pushed by the profit driven pharmaceutical companies, so most people see it as unavailable.

Mental illness is a broad term that covers psychosis, epilepsy, depression, mood disorders, etc. that can strike anyone from stress, family issues, loss and social isolation. I am a trained infantry soldier, I have not seen combat, but I understand the stresses and strains of that field. I would suggest that nearly all veterans who see combat and even those who were just trained, suffer from some version of mental illness as a consequence of the extreme stress or seeing someone's life taken. Its sort of ironic to ignore those who are termed "heroic", a term applied to them by civilians and rarely applied to themselves, are generally left to fend for themselves or are seen as weak for seeking help.

It leaves a problem, in that a huge number of people seen as hero's, who are asked to perform a service for their country, are then considered dangerous to society on their return.

If one walked a mile in their shoes, just as Jesus teaches, one could have compassion for those we deem mentally ill. My whole family suffers from depression in some form, myself included. Nature is assumed to be the root cause, but ignoring nurture is a grave mistake, as if someone walked in our shoes and our parents shoes, I highly doubt anyone could judge us for who we are.

Treat people with compassion and it will create far more peace than condemning them through ignorance. Be prudent for self protection, but kindness prevents far more hostility than fear ever will.

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I am close to two people who suffer from various mental illnesses. They both own firearms. One has a concealed carry permit. I'm not the slightest bit worried about this, because as numerous folks have stated on this thread, mental illness is a wide range of conditions. The specific struggles of these two folks make them no more likely to commit acts of violence (against others or themselves) than anyone falling into any other demographic.

Psycotics, schizophrenics, sociopaths, folks with uncontrolled anger or broken impulse controls - everyone is best served by keeping firearms away from these people.

But ADD/ADHD, controlled PTSD, high-functioning IDD, even most mild forms of depression, - they're only a threat if they're a threat - their illnesses don't make them any more or less of a threat than anyone else. That's not to say that someone with PTSD cannot become dangerous. It means their PTSD is not the cause of the danger, any more than a broken leg would be.

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I think that making an effort to help those with mental illness a higher priority than it is would go a long way to supporting those who need support.

It is sad to hear that the only way a person can get help is if they can pay for the help, which help usually amounts to more money than the person makes per month, or if the person commits a crime. And then if a crime is committed there is no guarantee that the court will order they get mental health care, they may just say throw the person in jail and hope they reform by the time their sentence is over.

There need to be programs that can actually help someone in need of help before a crime is committed.

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