This place has gone mad!

[welsummerchicks]

I don't think more arguing about nature or nurture will do any good. People have been arguing about that for at least 4000 years.

And even today when many diseases are being shown to be genetic people are still arguing that they aren't. The researchers could research for another couple hundred years and prove these things again and again, and people would STILL be arguing about it.

The argument is emotional and people have personal reasons for arguing what they do, not scientific ones. People ignore science. They read head lines instead.

The key, I think really is to just treat the illnesses. it is very, very obvious what works with severe mental illness and what signs to look for that a person is becoming violent. Those signs are usually there for months or even years.

The risk factors for violence are very, very well recognized and the same risk factors pop up in study after study. There is no mystery.

There is no mystery at all about what we should be doing. We just aren't doing it. The VA Tech killer checked himself in to a hospital and begged for help. Andrea Yates told people a year before the tragedy, what was going to happen.

Nobody did anything. Officials can't, family can't and no one will help family anyway, even if they are brave enough to ask for help.

The VA tech killer was sent back out on the street. Why? To save money. And the worst irony of it is what happened cost a WHOLE lot more than putting that kid in the hospital and giving him treatment, counseling and some encouragement. He lost every single hope of getting better and just sank into hell. If he had been kept in the hospital when he begged for help none of it would have happened.

Some people can't be in the community. There needs to be a place for these people. Not a warehouse where people get put naked on a concrete floor, but a place where people help them and make sure they're taking their medication and that it's working for them.

We already know what's going on. We already know what to do. We just have to do it. It really is very simple.

No country has a perfect solution. There's a basic conflict - many sick people avoid help (out of fear) and citizens have a right to decide if they want medical care or not. There's a basic legal problem in that. But it's not that hard to solve.

But for example, in Germany, if a person is getting irrational or violent, they stay in the hospital. And the doctors and officials are in a world of hurt if they don't take action.

You would be surprised to know that our state laws give AMPLE room for officials to hospitalize people, not just if they are violent or a danger to self or others, but even, if they are IRRATIONAL. Our laws aren't usually the problem.

 

[PineappleMama]

One thing I've seen repeatedly is that if you check yourself in you can check yourself out, AMA, but still. I lost count of how many times my mom's done this... but when she was committed, then she couldn't leave until "they" decided she was 'safe'.

Donno if the same applies to violent folks, or if that only goes for her particular type, or if that's just Texas, just our county, etc. But it's a little weird to me that you can be suicidal one day and then walk out the next and there's nothing can be done. Likewise though, it's scary that you can be committed on pretty sketchy evidence, in a couple instances it was just the hubby saying "she needs help" no doctor no nothing and the judge signed her in... now I know she needed it, but it was still surprising that with no documentation and no episode (police/paramedics called) that it was done so quick... didn't even 'waste' time ordering in for medical records... weird. And yet that same swiftness is not available on a self checked in patient... doctor's can't push the paperwork through fast enough to keep them there WITH documentation... seems very chaotic to me. And when it comes to helping people chaos is the last thing we need... just my opinion, clearly biased by what I've seen in the last 20 or so years, so take it with a grain of salt.

Between the financial stuff, and the mess our courts are in, and all the confusion about the illnesses (as Wel said some of that confusion is purposely ignoring facts) and not to mention the "embarrassment" of admitting you or someone you are related to has an illness, that's still a major issue too I think, no one likes to talk about it or be painted with that brush, guilty by association... that sort of thing?... Well it's no wonder that so many slip through the cracks... we've got a LOT of work to do if we want to actually see progress in this area... and mostly it's the folks themselves/their families that care... with so many hot button issues this one sort of gets put on the back burner... and unfortunately has been for a long time... but so has abuse in its many forms... we're making progress, that's a fact, but still a long way to go before all the folks that need it get help.

Personally I think folks getting help helps everyone... even if you don't know someone, don't have a problem... well it's STILL your problem because someday you might and which would you rather meet up with? A person who's under care and stable, or one who's been ignored, shuffled, ostracized and is unstable? Seems pretty clear to me...

But then I've also seen first hand just how hard it can be to keep a person on their meds when they decide they don't want/need them... so, yeah even THAT is a battle some days. I can't blame the docs because they did their part, testing, bloodwork, giving meds... but they can't hold a person down 1-4x a day and force pills down their throats, particularly once the person's been released/left... pfft bloody mess that's what it is.

 

[welsummerchicks]

'Committing' someone in the US is very, very difficult. Family members have an awful time even if their loved one is violent with them. Mostly nothing will be or can be done.

Let's say there is a blow up. The police can be called, and when they arrive, they often decline to transport the person to the hospital. They are more likely to transport to jail but only if a law has been broken.

Then, say the person actually ever gets taken to the hospital. A doctor has to decide if the person will be kept in the hospital. Usually the person is out in 45 minutes.

The longest the doctor can hold the person without a court order in most states is 72 hours. There will be an immense amount of pressure on the doctor to release the person as soon as possible.

If he DOES keep the person the full 72 hr, during that time he cannot compell the person to take medication. If the person is violent he needs a court order to use restraints. In some cases the doctor may be able to give the person emergency medication, such as an antipsychotic that has some sedative action.

But that is not common. At most psychiatric units I visit, the entire nursing staff is found cowering at the front desk, trying to stay as far away from violent, angry patients as possible.

Typically, the 'in trouble' folks stay for the 72 hour hold and then walk out. Sometimes the hospital gives them a bus token. Many of them are too sick to get on the bus.

In the shelters, keep in mind that the shelters get paid based on how many people they have in the shelter. They are quite often less motivated to send people to the hospital. A lot of shelter staff has specific biases that make it less likely they will identify psychiatric disorders. Street outreach tends to have biases as well. They are volunteers generally and poorly trained. They do not reliably identify people and most people on the street are aware of that.

In one case very sick people were in the shelter, so sick they did not have the awareness to put on winter clothes when they left the shelter in ten degree weather. The shelter got written up by the city's mobile crisis unit, but the same thing continued to happen.

Handouts from 'helpful volunteers' don't really work, despite its popularity and how good it makes the community feel, all smug and warm. We found one guy collapsed, unconscious and soaking wet in a wind chill of about 15 degrees - pouring rain, wind, out in the open under no cover. He was surrounded by unopened, still packaged sleeping bags - five of them. Why wasn't he using them? He was afraid of them. Half measures don't work when people are that sick.

 

[PineappleMama]

^Good example of the 1/2 measures thing... all they're allowed to do, even if they knew he was terrified of them it's still all they can do... but then you have to have a court order to take full measures... seems like the patients are derned if they go in and derned if they don't??

And there are folks who truly want to help, but their hands are tied. I can't imagine being forced by law to ignore someone in need. I can't begin to imagine what I'd do in that situation... don't think I could handle it at all. Fear of being harmed plays in as well. If you know someone is violent and can't restrain/medicate them do you still risk getting within arms reach? I don't envy the Docs and Nurses (and volunteers and such too) that are in that position one whit... I admit it, bit of a coward when it comes to facing violent people. You're a braver person than me by far.

Any advice for those of us too chicken to lend a literal hand? Is there anything we can do, as voters?, petitions?, etc to help? Any pending legislation we could support? Not much I realize, but supposedly the ones in office work for us... seems we outta be able to do something?

 

[Dunkopf]

Money is the real God. It sounds like even in societies like Sweden that have fantastic social safety nets the mentally impaired don't have their needs met. Do I have that right?

 

[noodleroo]

I think lots of the problem is nature and lots is nuture. I think we know more about the crazy things that people do these days because of mass media and as we know, the outrageous things make the news. More people abuse drugs to the point of not being able to keep their wits about them. There are lots of reasons that we see so much and it seems like so much more than it used to be.

What I want to know is what is the deal with the new behavior (I assume its new) where derainged or disgruntled people in china are going into elementary schools and attacking little children with knives. Stabbing and cutting children? Is that a nature, culture or nurture thing? It seems to be a disturbing trend...

 

[welsummerchicks]

No I would say Sweden and most of the scandinavian countries have much better mental illness policy than we do.

I believe all of those people in China that have recently attacked children are mentally ill. Over there, I think mental illness is a huge embarrassment and people often try to hide it. If it is hidden it is not being treated. So one day the person is finally so sick they hurt someone. People get to that point, they are usually in a very, very bad way. And when they realize what they did...that is an even worse hell.

I've met a couple people who have a particular hostility for children when they are not taking their medication. It's no different than if you had a seizure. It's a neurological thing. It's not like they have some kind of complex about kids or some secret hatred for them from some childhood tragedy. It's just the disease making them think that.

People who were never religious start thinking they are Jesus, people who never hated African Americans start to obsess about them. Sometimes it's something great (being Jesus or God), sometimes it's something terrible (someone trying to plot and hurt them).

It's a disease that affects how a person will perceive and think. That's really hard for a lot of people to get their arms around. It's a brain disease. It's just like having a heart condition or asthma or diabetes. Except this disease goes for the brain. You can see what it's doing in there on the new MRI's, PET scans.

Brain cells just stop working and fade away, the brain actually loses tissue. Doctors first discovered that hundreds of years ago with autopsies.

 

[noodleroo]

I heard a dr. explain mental illness really well one time. He compared it to having the flu. He said that the symptoms of the flu are diarrhea, fever, aches etc. The symptom of mental illness is bizarre behavior. Just as we wouldn't be angry at a loved one if they had to throw up or have diarrhea with the flu, we should apply the same feelings about the symptoms of mental illness. A mentally ill person can't 'just get over' or stop the bizarre behavior any more than a person with flu can just 'stop' the diarrhea.

 

[welsummerchicks]

That is just a perfect description.

 

[Three Cedars Silkies]

I live here in Gainesville! Although we have our share of crime...this was unusual. My understanding is the young man had a strong history of drug addiction (crack).