Discussion of Schizofrenia on the TV machine right now (Sharpton)

[nadinbrzezinski]

Nope, it does not shock me... and yes, it has to be seriously considered.

Lesson would be... Cho, Loughner, now Holmes... say with me... ACCESS to mental health care, as in VERY EASY and affordable access to it. In fact, as easy as ... currently getting a gun.

[soccer1]

1. I agree but

I bet Holmes had access to mental health services if he wanted it.

[nadinbrzezinski]

4. Not necesasily

even being from the right side of the tract does not mean such. Read medical insurance policies regarding mental health. (One of the things the ACA actually tried to adress)

[soccer1]

8. Yes, maybe.

I'm sure that will come out eventually.But, we do know that many people will not go for help...sometimes the sickest are the ones who refuse help and don't get it until they have been committed to a psychiatric facility for a couple of days.

[amandabeech]

17. I agree with you.

I did mental hospital legal services when I was in law school, and I saw young adult schizophrenics and people with bipolar disorder show up after having done something very dangerous to themselves or to others, or having been involved in an assault and battery and were taken to the hospital because the local jailers couldn't get them under control.

Parents can't force their adult children into treatment.

The adult child has to want treatment, and many, many do not.

A lot of them would rather live on the streets than go into treatment voluntarily.

[soccer1]

24. Yes, very difficult situations, at times.

And, I believe you can only hold someone for 2-3 days if they have been put in a facility involuntarily. The hope is that once stabilized they will cooperate with mental health professionals to get the long term help they need. But, it doesn't always work out that way.

No matter what insurance you have, they usually will not pay for extended stays in a mental health facility. Meds, maybe some outpatient therapy...that's about it. I've seen this with my husband's friend...and other people.

[nadinbrzezinski]

19. Yeah, but that's partly the culture too

We don't like the crazy and demonize them. Access is part of the issue, a large part, but also cultural attitudes

[soccer1]

25. Yes.....people can be afraid of being stigmatized if they have mental health issues, for good reason

and certainly people can feel uncomfortable around people with obvious mental health symptoms and therefore they keep their distance. I am encouraged though, with how mental health issues are being discussed openly today......which goes along way in removing the stigma attached to mental illnesses. But, it's still out there and as has been mentioned, some insurance policies don't cover or inadequately cover mental health care.

[nadinbrzezinski]

41. That is part of it

And I hope it changes soon, so a kid with the best access in the world will not fear it.

Foucault's history of madness is a very good, albeit complex read on this.

[Fawke Em]

15. My husband is bi-polar.

Diagnosed in the Army, so already manageable; however, my employer doesn't offer mental health coverage. He has a reduced rate (a "whopping" $20 difference) to visit the psychiatrist to get his meds.

So, you're correct. Mental health coverage lags.

[Posteritatis]

18. And there can often be a *lot* of pressure to deny or avoid treatment for mental illness

Especially in graduate level studies, especially in a day and age where schools are starting to feel comfortable removing students who get a diagnosis.

[nadinbrzezinski]

20. Oh very correct

[HereSince1628]

26. He did at U of Colorado

from their website....

UCD Student and Community Counseling Center
Support. Growth. Solutions.

The UC Denver Student and Community Counseling Center provides mental health counseling services to the UC Denver student body as well as the Denver Metro community

from the window on the side of their home page...

Walk In
UCD Students, faculty, staff with an urgent mental health concern may walk in to our center during our hours of operation for a consultation. An on call counselor is available to respond to your immediate needs and to help with a follow up plan. When you arrive at the center tell the receptionist that you have an urgent concern and would like to speak to the counselor on call.

[Care Acutely]

29. On our campus, those were unlicensed student counselors who could do nothing for serious conditions

like schizophrenia, or bi-polar or clinical depression. There were I think one or two licensed therapists to guide and supervise the students, but even they could only refer an ill student who required medical management. I imagine it's fairly rare to have a university counseling office staffed with psychologists who have the power of prescription.

[HereSince1628]

33. Yes, this all varies from campus to campus, but the minimum service provided

is typically an assessment and assistance developing a 'plan' for dealing with the problem.

Some Universities, I taught at didn't have a staff of their own but had psychologists available who dealt with crises and helped students and parents create arrangements for treatment, other large schools had full blown clinics that offered services not only students but community members. The description at the University of Colorado website sounds like the later.

Not knowing Holmes it's quite hard for any of us to know how he felt about seeking counseling. To get mental health care a person must meet with a mental health care provider. I may have missed things about Holmes but it's unclear to me whether there are reports that he had attended a mental health clinic for counseling.

[soccer1]

43. Yes.....

All colleges and universities offer health services for mental health issues and physical ailments on a limited basis. If further treatment is needed, they refer you to medical services outside of the university to receive the care you need.

[Care Acutely]

46. It does no good to refer someone to services they cannot afford. I'm not saying this was the case

with this young man - I am saying that access to a university counseling center is not the same thing as access to adequate mental health care. That's all.

[soccer1]

47. Yes, good point.

[nadinbrzezinski]

31. Urgent actually is different from acute

And I did not invent this problem with lack of access or demonization. These are well known issues in the US.

I hope that out of tragedies like this...some of the culture will start to change...that is part of the solution actually.

[HereSince1628]

34. My point is only to communicate the information available at the university's website.

I am not arguing that American society does not have many issues that discourage people from seeking mental health care.

I am not suggesting or parsing others suggestions about the nature of any need that Holmes may, or may not, have had.

I am not proposing that Holmes was for one reason or another discouraged or dissuaded from seeking care as many Americans are.

It's just pretty clear from the University of Colorado's Student life website that the University has a clinic that provides services to students, faculty and the community.

Consequently, even though many people don't have mental health services nearby, and many people do not have insurance coverage for meaningful mental health care, the availability of assessment and counseling leading to whatever care might have been appropriate for James Holmes while he was a student was present at the University.

The specific circumstance surrounding Holmes isn't a denial of common problems across America.

[soccer1]

27. That's right.....colleges and universities do provide mental health services

So, it was available.

[nadinbrzezinski]

32. So he had access to acute care?

And while available, how many colleges have a psychiatrist on staff, who can actually prescribe meds?

I love psychologists, but this actually needs meds, most psychologists I know off (actually, unness something major has changed) none can prescribe meds. They can refer to a psychiatrist, an actual MD, who can do that.

Yup, what most colleges have works great for depression and "more run of the mill" matters that do not require acute care. A few, bless their hearts, have screened a student and call EMS and referred patient for an involuntary hold...but those are actually not that common. Usually those end up in police, emergency services, local ED contact...

[HereSince1628]

35. Sliding scale services from psychiatrists are available in Denver.

I just did a google to confirm that.

Sliding scale fees for psychological services including psychiatrists is available in most major cities.

Holmes had a car and so had mobility to go to a clinic if he chose. And Holmes was on a fellowship paid in the mid 20 k for one year, and he somehow had access to funds to buy weaponry.

That seems to support the idea that Holmes could have probably received care from a psychiatrist who had a sliding scale cost based on patient means. Had he sought it. The University counseling center would almost certainly have helped Holmes identify a psychiatrist.

You state quite firmly that 'this' needs meds.

I haven't actually heard or read an actual diagnosis for Holmes. What dx did he receive?

[nadinbrzezinski]

36. Oh the access to funds is easy as pie

I am positive you have used it too...it's called a credit card, not a new invention.

You are still missing this. Even if in theory you have access to care, that s not necessarily the case...we have recognized issues with access to mental health services around the country. I did not invent this reality.

[HereSince1628]

37. No I am not missing it. I've acknowledged the general problem

I'll say it again. There are many things which discourage or dissuade people from seeking mental health care. I know you are concerned about the role of stigma. Fear of the consequences of being labelled mentally ill is very real because the consequences are very real and easily observed all across America. I think we are actually in the same place on that thought.

Then again factors besides stigma may contribute to an individual not seeking mental health care, including denial of the presence or severity of a mental illness, availability of care, affordability of care, belief in that the care works, mobility, lack of support/encouragment and others.

What bugs me is that on DU there is a meme at work that says the American mental health care system must be fixed to prevent more James Holmes from causing more Auroras. No doubt the American mental health industry needs attention in many places, but the evidence isn't yet available that the mental health care system failed Holmes thus leading to the massacre of innocents.

My initial entry in this was in response to soccer1's reply. That was reply #1 in this thread; it specifically is about Holmes and availability of care.

Your response in #32 was about Holmes access to psychiatrists.

My responses have been related to Holmes because the replies I'm responding to have been about Holmes' and his apparent access to care.

Why my interest in that? Because the evidence seems to point to Holmes being positioned in society to have access to some of the best mental health care in the country. Better access than many Americans.

Maybe he isn't mentall ill, maybe he is. I'm not in a position to say.

But the implication on DU that an underfunded or dysfunctional mental health system failed Holmes seems to be a miss. With the limited information available it seems to that if anything failed Holmes it was something outside mental health care available in the Denver area.

[slackmaster]

45. A guy who has $6,000 to spend on guns and ammunition has no shortage of funds

[Marrah_G]

38. Often when you are deep into a mental illness you are incapable of asking for help.

[loyalsister]

2. Say it with me

Dx from TeeeVee commentators perpetuates stigma against people who have mental illnesses.

[nadinbrzezinski]

3. You mean they actually speaking of this

and addressing the fact that we need that accessible care perpetuates the stigma? Ok.

[loyalsister]

7. I mean the instant dx by people who have never been in the same room with him

is not helpful in promoting anything but stigma. Certainly the idea of better access to health care is lost as the "lock them all up" response emerges among the masses.

[nadinbrzezinski]

13. That was not my impression

they were having a pretty mature discussion on this

[loyalsister]

23. You're missing the point

Even the most civil discussion about mental health is only perpetuates stigma when it is done with an "evil doer" in mind as he becomes the primary example of who needs mental health. As opposed to your aveage friend or neighbor.

[nadinbrzezinski]

30. So how or when should we talk about it?

I fear by your logic is...never.

[loyalsister]

39. How about....

With health professionals and policy makers listen to people who are affected- including the person with the illness. Not many want to do that and the public discussion usually leaves them out.
I have friends who have pushed their way into the dialogue here. We have mental health parity in MO because we had a republican rep along with many citizen advocates putting pressure on the state assembly. It was signed by a republican governor.
I know for a fact that the state law enforcement and court system interact with the state council with disabilities. Both are paying attention to the problem of incarceration and legal representation.

In my city, we have a mental health court. The state NAMI interacts with primary health professionals, law enforcement and security personnel, teachers, etc to train them in mental health first aid.

What good does it do to demonize on television and say we need more adequate care? Do you really believe people all across the nation are going to suddenly have sympathy for people who share experiences with the man who committed this kind of crime.

This is a problem that needs to be addressed locally, on the ground. Primary health professionals, education leaders, law enforcement and others are key players.

[nadinbrzezinski]

40. And it also needs to be talked about on tv

And the media need to deal with it. This reminds me of suicide...(which is a failure of mental health). I am betting stories run on what it is and resources help save lives. Yet, we have some. And I mean a very small number of folks who insist not even those articles should NOT run. I m sensitive to the issues with it and creating demons. The crazies are coming is indeed that, but saying, responsibly, that we may have a mental health issue. Or lack of access, or what have you...it needs to be discussed.

I am sorry to make the comparison to the NRA, which benefits from...the code of omertà. People with disabilities do not really benefit from it.

[loyalsister]

42. Do you not see the difference?

between a sympathetic family who has lost a son, daughter, parent and a person who has just murdered 12 people? The people with schizophrenia who are totally successfully treated as well as those who experience moderate symptoms despite medication are ignored. No one invites them to speak during these program.

People with disabilities are usually not included in the conversation and certainly don't have the kind of money gun owners have. One challenge we have is trying to get people to even listen to us without making assumptions. It's more like gay activists. We have both been legislated against, and the features of our existence has been attributed to moral and mental failings. With few individual exceptions among the opposition, the gun lobby has not been accused of mental disregard and moral failings.

[The empressof all]

5. He could also have a brain tumor

Speculation about mental health or medical diagnoses always sets me a little on edge. Without qualified examination we really just don't know... May as well just call him possessed by the devil at this point....We have no evidence to claim otherwise....

[nadinbrzezinski]

6. That is why they will do that testing regardless

THey also mentioned a tumor, and they said that this is speculation but testing and all that has to happen.

Remember though, people said that Loughner was also acting when he first saw the judge. We have had no more than a competency hearing or two so far...

[zappaman]

9. I thought you said it was because of Rush Limbaugh?

And that is was terrorism?
Are we supposed to forget that?
http://www.democraticunderground.com/1002982043

[SidDithers]

12. It's stochastic schizophrenia...nt

Sid

[zappaman]

16. oooooooooooooooooooooh

[Fawke Em]

21. You don't know that and you don't know if he's really schizophrenic, either.

Neither do I, for that matter.

[zappaman]

22. It's been proven

here
http://www.democraticunderground.com/1002982043

[ananda]

10. This is one type that falls through the cracks..

.. the isolated, shy, studious, seemingly perfect student.

How would he even be noticed, much less diagnosed and
given the therapy he needs?

[nadinbrzezinski]

14. That is part of it

the other part is that mental issues are stigmatized in the country, and even the real, horror, medical issues, that we need to treat, asre still demonized in the country

[demtenjeep]

11. I had to laugh at TV machine

I tend to use the least number of words possible

[slackmaster]

28. Students at UC Denver have very easy access to mental health care, at very low cost

http://www.ucdenver.edu/life/services/counseling-center/Documents/Financial%20Agreement%20Form.pdf

The problem with getting some mentally ill people into treatment is that they don't realize that they are mentally ill, even when their behavior problems are spelled out by people they trust. And sometimes they have simply given up hope.

[HereSince1628]

44. Yes.

It's my understand that's all true.

[Marcia Brady]

48. No matter how accessible mental healthcare is

you can't force someone to access it!

there could be a free clinic on every street corner, and if a delusional person doesn't want to go there, there is nothing that can be done about it.

Remember Loughner? And Cho? Everyone--teachers, families, friends, roommates, everyone knew there was something not quite right going on, but their hands were all tied.

The problem is that years ago we decided that delusional people should be in charge of their own mental healthcare decisions. Stupid, stupid, stupid.

[nadinbrzezinski]

49. 72 hour holds are done regularly

Last edited Wed Jul 25, 2012, 12:33 PM - Edit history (1)

Trickly phrase, person has to be a danger to self and/or others.

The problem we have is that most of the time there is no follow up.

But you are wrong, to say tat you can never do that. Loughner, before the shooting, could have been a candidate for one from what post forensic interviews have revealed. If this kid was as delusional as he seems to have been, again, the forensics will point to it.