Why Climate Change Could Create a Mental Health Crisis

Regions of the brain affected by PTSD and stress.

Regions of the brain affected by PTSD and stress. (Photo credit: Wikipedia)

Why Climate Change Could Create a Mental Health Crisis

by Kristina Chew
December 12, 2013
10:00 am

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At 6 am on Tuesday, my phone rang and an automated voice announced that my son’s autism school was closed all day due to “inclement weather.” It’s not unusual for it to snow in December in New Jersey but, as a result of climate change, the past few winters have been for the most part mild with only a snowstorm or two. We, and quite a few New Jerseyans, have gotten out of the habit of numerous snow days. For Charlie, who (like many autistic individuals) struggles with change, an unexpected day off from school is an anxiety-creating disruption.

The erratic weather and extreme weather events like last year’s Hurricane Sandy (which shut down schools across the state for, in some places like my town, more than two weeks) can be unsettling for many, and any, of us. A report from the National Wildlife Federation specifically says that the “uncertainty and upheaval caused by erratic weather might cause more Americans to become depressed, anxious and even suicidal.” Could climate change be creating a mental health emergency?

Psychiatrists, psychologists and public health and climate experts all contributed to the NWF report. The recent prolonged drought in the Southwest, major wildfires in the West and flooding, hurricanes and tornados in the Midwest and East have been taking their toll on Americans:

The panel predicted a rise in depression, anxiety, post-traumatic stress disorder, substance abuse, suicide and violence. The burden will fall especially on children, the elderly and those with existing mental problems, as well as the poor and disadvantaged who are, for example, less able to pay for air conditioning during a heat wave.

Climate change can be especially challenging for the elderly to cope with, as they find themselves living in a world in which familiar parameters have shifted. Children are also very much affected as they will be living for a longer time in a hotter, wetter world. The age-old practice of playing outdoors isn’t the same when days are weirdly wet or intensely hot and (even for those of us not in China where dangerous levels of pollution in many cities have become the norm) the air is heavy and breathing difficult.

It’s enough to give us “solastalgia” — a word coined by Australian philosopher Glenn Albrecht in 2003, in the midst of a deep drought in New South Wales – according to the NWF report. This condition refers to the melancholy and distress caused by experiencing one’s home environment being ineluctably altered into, as Forbes puts it, a “disquieting new normal.”

Treehugger cites research (pdf) by Ashlee Cunsolo Willox of Cape Breton University about how global warming is impacting Inuit communities in northern Canada. Warmer winters and thinning ice are changing the habits and way of life for those in the remote, coastal community of Rigolet. Already affected by forced relocation and involuntary assimilation after being placed in boarding schools, for many in this Inuit community, traveling over the ice has been a crucial coping activity. Residents who have found themselves stuck inside describe feeling bored and depressed and losing their connection with nature.

One individual indeed says that he is “like a caged animal” when he cannot get outside. That is, it is not just the disruption in our routines or even the damage and destruction done to property due to erratic and extreme weather that addles us. Climate change is connected to people’s whole connection to the land, to the natural world, being severed, leaving them feeling something like a loss of their selves.

Other research, including a 2009 study from the American Psychological Association, (pdf) has linked climate change to increased anxiety and stress. Global warming has also been suggested to be at the root of societal unrest and even a factor in global insecurity and political conflict, including the recent uprisings in the Middle East.

It’s the loss of that connection to nature that is perhaps at the heart of any distress, any solastalgia, that we experience. For my son, a snowstorm doesn’t just mean he has to spend a weekday at home rather than being among the other kids and teachers at his school. He loves to be outdoors on his bike and snow, slush and ice can make bike riding challenging. Nonetheless, he and his dad have still attempted it; they’ve never let a brutally hot day in a summer of record highs stop them either.

The NWF report is a reminder of how, even though many of us live in urban and suburban communities, nature and our connection to it are fundamental for our mental as well as our physical well-being. Fighting climate change is good not only for our bodies but our minds too.

Read more: http://www.care2.com/causes/why-climate-change-could-create-a-mental-health-crisis.html#ixzz2nLs7bIGm

Reports Condemn Solitary Confinement in New York City´s Jails…

2600cfbfad1f68fc7449328b128e1d15Reports Condemn Solitary Confinement in New York City’s Jails, As Officials Weigh Its Future

November 6, 2013  By

rikers wireTwo recent reports provide a scathing picture of the how solitary confinement is employed as a routine disciplinary measure on Rikers Island and in other city jails. The reports are particularly critical of the use of extreme isolation and deprivation on individuals with psychological disabilities, including mentally ill teenagers.

The two reports were prepared for the Board of Correction (BOC), which functions as the oversight agency for the New York City jail system, ensuring that all city correctional facilities comply with minimum regulations of care. In recent months, under pressure from local activists, the BOC has been reconsidering the liberal use of solitary confinement in the city’s jails, and conducting fact-finding on the subject.

The first of two reports commissioned by the BOC was released in September 2013. Dr. James Gilligan and Dr. Bandy Lee authored the report, addressing the use of solitary confinement in the city’s jails.  This past June, Dr. Gilligan and Dr. Lee were asked to assess whether the city’s jails were in compliance with the current Mental Health Minimum Standards set forth by the Board of Correction.

On Rikers Island, which houses more than 10,000 of the 13,000 women, men and children in the city’s jails, 1 in every 10 people is in isolated confinement at any time.  Many are placed there for nonviolent offenses at the discretion of corrections officers.  This distinguishes New York as a city with one of the highest rates of prison isolation in the country–about double the national average.

The report’s findings are a resounding criticism of the current use of punitive segregation, and point both to violations of the Mental Health Minimum Standards as well as to practices within the jail system that are harmful to those who suffer from mental illness. The report’s authors point to snapshot data in which the number of people with mental illness in solitary confinement is almost double the number of those with mental illness in the jail population generally. The authors conclude that mentally ill people in the jail system are being disproportionately placed in solitary confinement.

The report also claims that the nation’s prisons and jails have become “de facto mental hospitals,” pointing to the fact that roughly 95% of people with mental illness who are currently institutionalized are in correctional facilities, while only 5% are in mental hospitals.

The Mental Health Minimum Standards mandate that mental healthcare be provided in a setting that is conducive to care and treatment. The report contends that prolonged use of solitary confinement for mentally ill people violates these Standards, because it has been used punitively, to create a stressful environment and to remove social contact, rather than to provide therapeutic services.

Moreover, the report holds that the Standards should be amended to emphasize that those with mental illness should not be held in segregation.  As the report states, “The goal of mental health treatment (and also of correctional practice) should be to do everything possible to foster, enhance and encourage the inmates’ ability to…behave in constructive and non-violent ways after they have returned to the community from jail.”

The city responded to the report with a point-by-point rejection of its findings, claiming that the principal conclusions drawn by Drs. Gilligan and Lee were based on an erroneous legal interpretation of the Mental Health Minimum Standards and that the report’s conclusions and further recommendations were unsupported by sufficient evidence. This response was put forth by a multiple agencies, including the Office of the Mayor, the Department of Corrections and the Department of Health and Mental Hygiene.

Drs. Gilligan and Lee responded in turn, claiming that a strictly legal interpretation ignored the changing conditions of the current prison system as well as a misunderstanding of human psychology and behavior.  In order to reach a true understanding of the harm caused by punitive segregation, the authors say, we need to take into account the psychological effects of isolation, as well as the recent influx of people with mental illness into our prisons and jails.

One week after Drs. Gilligan and Lee published their report, the BOC voted unanimously to begin rulemaking to limit the use of solitary confinement in New York City.

These events follow a meeting held in June, in which the Board of Correction voted against limiting solitary confinement in the city’s jails, rejecting a petition put forth by the grassroots group known as the Jails Action Committee (JAC). The petition, if it had been accepted, would have limited solitary confinement as a last resort punishment for violent behavior only, and banned it entirely for children, young adults, and those with mental and physical disabilities.

BOC member Dr. Robert Cohen, a Manhattan physician and expert on prison health and mental health care, vocally supported JAC’s petition. At this June meeting, he called the use of solitary “dangerous,” especially for people with mental illness and adolescents, who are confined in punitive segregation at particularly high rates.  “During the past three years,” he pointed out, ”the percentage of prisoners languishing in solitary confinement has increased dramatically, without benefit in terms of decreased violence or increased safety on Rikers Island,” either for corrections officers or the prisoners themselves.

Dr. Cohen’s statement rings especially true after the release of the most recent BOC report in October, one month after the first report was published. Providing new information about the suffering of mentally ill youth placed in solitary confinement, the report describes the experiences of three adolescent boys at Rikers Island, each held in punitive segregation for more than 200 days, each suffering from mental illness. Youth and adolescents are among the most vulnerable populations in New York’s jail system; the report makes clear, however, that segregating mentally ill youth as a form of punishment is both negligent and dangerous.  The city has yet to respond to this latest criticism of solitary confinement.

The consequences of time spent in solitary confinement are lengthy and harmful, Cohen and other experts say; they include negative effects on mental health, including severe depression, anxiety, hallucinations, paranoia, insomnia, and panic attacks. Furthermore, studies have shown that common patterns of depression, anxiety, anger, and suicidal thoughts often leave individuals more prone to unstable and violent behavior, which can in turn lead to higher rates of recidivism.

Thank You to:  http://solitarywatch.com/2013/11/06/reports-condemn-abuse-solitary-confinement-new-york-citys-jails-officials-weigh-future/

50 Years After the Community Mental Health Act, the Best Reporting on Mental Health Care Today

50 Years After the Community Mental Health Act, the Best Reporting on Mental Health Care Today

How far have we come? Journalists take a hard look at our nation’s system of caring for the mentally ill.

President John F. Kennedy signs the Community Mental Health Act into law on Oct. 31, 1963. (Bill Allen/AP Photo)

    by Christie Thompson ProPublica,  Nov. 5, 2013, 10:57 a.m.

Fifty years ago last week, President John F. Kennedy signed the Community Mental Health Act. The law signaled a shift in thinking about how we care for the mentally ill: instead of confining them into institutions, the act was supposed to create community mental health centers to provide support.

But studies on the prevalence of mental illness among inmates [1] and the homeless [2] (PDF) show many patients are ending up on the street or in jail, instead of served by the treatment centers envisioned in the law. The homes that do exist are often subject to loose laws and regulations, leaving already fragile patients vulnerable to further abuse and neglect.

How far have we come? Here are some important reads on the state of mental health care today. Additions? Tweet them with the hashtag #MuckReads, or leave them in the comments below.

Milwaukee County mental health system traps patients in cycle of emergency care [3], Milwaukee Journal Sentinel, June 2013

In Wisconsin, psychiatric patients are often put through a revolving door of treatment: Experience a breakdown. Get arrested and brought to the emergency ward. Be released just a few days later. Repeat. Overall, “one of every three persons treated at the [psychiatric] emergency room returns within 90 days.”

Schizophrenic. Killer. My Cousin. [4], Mother Jones, May 2013

When a parent is faced with an ill, potentially violent child, where can they turn? Journalist Mac McClelland details how community outreach in the 1970s and 1980s allowed her aunt to stay “independent until the very end.” Thirty-four years and billions of dollars in mental health cutbacks [5] later, her cousin’s battle with schizophrenia came to a much more tragic conclusion.

Nevada buses hundreds of mentally ill patients to cities around country [6], Sacramento Bee, April 2013

Psychiatric patient James Flavy Coy Brown got off a bus in Sacramento [7] with no money, no medication, and no idea why he was there. He’d been sent to the California capital from a hospital in Las Vegas, who had regularly been discharging patients and busing them across the country. Patients are only supposed to be sent to other states when there’s a clear plan for their care. But stories like Brown’s show how many patients fall through the cracks….

PLEASE; READ WHOLE ARTICLE HERE: http://www.propublica.org/article/50-years-after-the-community-health-act-the-best-reporting-on-mental-health?utm_source=et&utm_medium=email&utm_campaign=dailynewsletter

Jam-Packed or Alone: Overcrowding and Solitary Confinement, in California and beyond…

Jam-packed or alone

Overcrowding and solitary confinement, in California and beyond

It’s cramped in here

JEFFREY BEARD, California’s prisons chief, boasts that the number of inmates in the state’s prisons has fallen by 43,000 since 2006. But unlike other states that have seen big drops, California’s hand was forced: in 2009 federal judges were so concerned by overcrowding that they ordered the state to cut prison occupancy to 137.5% of design capacity (at one point it exceeded 200%). The ruling has been upheld over the laments of officials, most recently by the Supreme Court on August 2nd. An appeal is pending.

California has not reduced numbers simply by setting people free. Rather, it has sent lots of non-serious offenders to county jails instead of state prisons (a policy called “realignment”). To meet the court-decreed target by the end of the year, the state must find another 7,000 or so prisoners to offload, says Mr Beard. His department hopes to do this mainly through “capacity options”, such as dispatching prisoners to costly private lock-ups in other states….

Please, read more:  http://www.economist.com/news/united-states/21583657-overcrowding-and-solitary-confinement-california-and-beyond-jam-packed-or-alone?utm_source=buffer&utm_campaign=Buffer&utm_content=buffer2062d&utm_medium=twitterblog-stopsoltry-iachr-500x280-v01

AlterNet: Is New York Lying in Diagnoses So it Can Lock Mentally Ill Inmates in Solitary Confinement?

Published on Alternet (http://www.alternet.org)
Home > Is New York Lying in Diagnoses So It Can Lock Mentally Ill Inmates in Solitary Confinement?

ProPublica [1]             /               By Christie Thompson [2]


Is New York Lying in Diagnoses So It Can Lock Mentally Ill Inmates in Solitary Confinement?

          

August 16, 2013  |

  When Amir Hall entered New York state prison for a parole violation in November 2009, he came with a long list of psychological problems. Hall arrived at the prison from a state psychiatric hospital, after he had tried to suffocate himself. Hospital staff diagnosed Hall with serious depression.

In Mid-State prison, Hall was in and out of solitary confinement for fighting with other inmates and other rule violations. After throwing Kool-Aid at an officer, he was sentenced to seven months in solitary at Great Meadow Correctional Facility, a maximum-security prison in upstate New York.

Hall did not want to be moved. When his mother and grandmother visited him that spring, Hall warned them: If he didn’t get out of prison soon, he would not be coming home.

“There was somebody who looked defeated, like the life was beat out of him,” said his sister Shaleah Hall. “I don’t know who that person was. The person in that video was not my brother.”

Multiple [3] studies [4] have shown that isolation can damage inmates’ minds, particularly those already struggling with mental illness. In recent years, New York state has led the way in implementing policies to protect troubled inmates from the trauma of solitary confinement [5].

A 2007 federal court order [6] required New York to provide inmates with “serious” mental illness more treatment while in solitary. And a follow-up law [7] enacted in 2011 all but bans such inmates from being put there altogether.

But something odd has happened: Since protections were first added, the number of inmates diagnosed with severe mental illness has dropped. The number of inmates diagnosed with “serious” mental illness is down 33 percent since 2007, compared to a 13 percent decrease in the state’s prison population.

A larger portion of inmates flagged for mental issues are now being given more modest diagnoses, such as adjustment disorders or minor mood disorders.

The New York Office of Mental Health says the decrease reflects improvements to the screening process. Efforts to base diagnoses on firmer evidence “has resulted in somewhat fewer, but better-substantiated diagnoses” of serious mental illness, said a spokesman for the office in an emailed statement.

In Hall’s case, prison mental health staff never labeled his problems as “serious.”

Instead, they repeatedly downgraded his diagnosis. After three months in solitary — during which Hall was put on suicide watch twice — they changed his status to a level for inmates who have experienced “at least six months of psychiatric stability.”

Two weeks after his diagnosis was downgraded, and two days after he was transferred to solitary at Great Meadow, guards found Hall in his cell hanging from a bed sheet.

As part of a report issued on every inmate death, the Corrections Department’s Medical Review Board found no documented reason behind the change in Hall’s diagnosis [8].

A 2011 Poughkeepsie Journal investigation detailed a spike in inmate suicides [9] in 2010, which disproportionately took place in solitary confinement. Death reports from the state’s oversight committee obtained by the Journal [10] suggest several inmates who have committed suicide in recent years may have been under-diagnosed.

Hall’s family is suing the Corrections Department and the Office of Mental Health, among other defendants, for failing to treat his mental illness and instead locking him in solitary.

New York State’s Office of Mental Health, which is in charge of inmates’ mental health care, declined to comment on Hall’s case, citing the litigation.

Amir Hall (or Mir, as his family calls him) was originally arrested in October 2007, for the unarmed robbery of a Verizon store. He made off with $86. Released on parole, he lived with his sister Shaleah Hall and her two sons while working at a local Holiday Inn and studying to become a nurse.

“Sometimes I sit there thinking that he’s going to walk through the door and make everybody laugh,” said Shaleah, who has “In Loving Memory of Amir” tattooed in a curling ribbon on her right bicep. “He was the life of the party. If you met him, you would just love him.”

But Hall’s mood could shift in an instant, Shaleah said. He was often paranoid, worried that people judged him for being gay. He would snap, then apologize repeatedly for it afterward.

“You had to walk on eggshells sometimes, because you never knew if he was going to be happy or sad that day,” Shaleah said. “It was like this ever since we were kids.”

One of those outbursts landed Hall back in prison for violating parole, after he got into a fight with Shaleah’s friend.

Knowing her brother’s history of mental illness, Shaleah said solitary confinement must have “drove him crazy.”

“I feel like they treated him like an animal,” she said. “They just locked him away and forgot about him.”

The lawsuit over Hall’s death claims mental health and prison staff ignored recommendations that he receive more treatment, and that staff members failed to properly assess his mental health when he arrived at Great Meadow.

In a response [11] to the state oversight committee’s assessment of Hall’s case, the Office of Mental Health said they were retraining staff on screening for suicide risk. The Corrections Department said they were working to improve communication when inmates are transferred to new facilities.

Sarah Kerr, a staff attorney with the Prisoners’ Rights Project of the Legal Aid Society, noted Hall’s case during a Senate hearing on solitary confinement [12]. “The repeated punitive responses to [Hall] as he psychiatrically deteriorated in solitary confinement exemplify the importance of vigilance and monitoring, and the need for diversion from harmful solitary confinement,” she wrote.

Kerr points out that significant improvements have been made for inmates diagnosed above the “serious” mental illness line. The new mental health units provide at least four hours of out-of-cell treatment a day, and speed up an inmate’s return to the general population.

“I don’t think those improvements should be taken lightly,” said Kerr. “In terms of mental health policy, we’re way ahead of the country.”

But when it comes to solitary confinement, “New York is among the worst states,” said Taylor Pendergrass of the New York Civil Liberties Union, which is suing the state [13] over its use of isolation. “Even if you’re totally sane and you go into solitary, it’s incredibly hard to deal with the psychological toll of that,” he said.

Solitary confinement is used in jails and prisons across the country, though there’s no reliable data to compare its prevalence among states. Experts say New York stands out for sentencing inmates to solitary for infractions as minor as having too many postage stamps or a messy cell. A report from the NYCLU [14] found that five out of six solitary sentences in New York prisons were for “non-violent misbehavior.”

Under the state’s new law, all inmates housed in solitary — known in New York as Special Housing Units, or SHU — receive regular check-ins from mental health staff. The screenings are meant to catch inmates not originally diagnosed with a disorder who develop problems in isolation.

But Jennifer Parish, director of criminal justice advocacy at the Urban Justice Center, said she thinks many staff members still view inmates’ symptoms as attempts to avoid punishment. “If you don’t believe that being in solitary can have detrimental effects to a person’s mental health, you’re going to see someone who just says, ‘I want to get out of here,'” she said.

Beck has seen the same skepticism in conversations with some prison staff. “There’s a bias in the system that looks at the incarcerated population as anti-social, malingerers, manipulators,” Beck said. “I hear that all the time.”

When inmates ask to see mental health staff, “we have found far too often that it appears security staff really resent people asking for these interventions,” Beck said. “We have in a few facilities what I think are credible stories of individuals being beaten up when they want to go to the crisis center.”

As Sarah Kerr sees it, “if mental health staff are overly concerned that people are feigning illness, that they’re conning their way out of special housing … that will lead to tragedies.”

The Corrections Department says any unusual behavior by inmates or attempts to hurt themselves are reported to mental health staff. A spokesman for the Office of Mental Health said “inmates reporting psychiatric symptoms are taken seriously and assessed carefully.”

Donna Currao said prison staff ignored her and her husband, Tommy Currao, when he attempted suicide at least 10 times over the course of 10 months in solitary confinement. According to his wife, Currao had been sent to solitary after testing positive for heroin.

Currao’s first suicide attempt in solitary was in July 2012, when he tried to overdose on heroin. That October, guards found him attempting to hang himself in his cell. While on suicide watch after he tried again to overdose, Currao broke open his hearing aid and used the metal inside to cut his wrists. (He received a bill of $500 for “destruction of state property,” Donna said.)

Both the Corrections Department and the Office of Mental Health declined to comment on Currao’s case.

According to the Corrections Department, an inmate can be returned to solitary confinement after being on suicide watch if they’re cleared by the Office of Mental Health. In 2011, 14 percent of the 8,242 inmates released from New York’s mental health crisis units were sent to solitary confinement.

After just three weeks in isolation, Donna noticed a dramatic change in her husband. He “was withdrawn, all he would do is apologize,” Donna said. He was no longer laughing with her, playing cards or chatting with other inmates. She watched him drop from 240 pounds to 160.

Currao stopped writing the almost daily letters he’d sent for 13 years. When Donna persuaded him to start again, as a way to escape, he talked of an overwhelming sadness.

Donna says she repeatedly called the prison. She faxed them copies of Currao’s suicidal letters. But he remained in isolation.

“I don’t know if they don’t want to spend the money, or think it’s a joke,” she said. “They still thought he wanted out of solitary. He wanted out of the picture is what he wanted.”

A survey [15] by the state’s independent oversight committee found many family members who said prison officials didn’t listen to concerns about inmates’ psychological wellbeing. None of the mental health files reviewed by the oversight committee contained information from family members about a prisoner’s psychiatric history.

The Office of Mental Health says it’s working on creating new procedures to “insure that the call is responded to promptly and in a manner that addresses the family member’s concern as best as possible.”

Prisoner rights advocates are also working on a new legislative proposal to ensure that mentally ill inmates get the treatment they need. A coalition of groups [16] is drafting a new bill, which would expand protections from solitary for inmates with mental illness, and put a limit on solitary confinement sentences for any prisoner, whether or not they’re diagnosed with a disorder.

“Even though there’s a law that says you can’t do this for people with serious mental illness, it hasn’t stopped [Corrections] from using solitary,” said Parish. “I think they just replaced it with lower-level tickets instead of some of the most serious ones.”

In May, Donna’s persistence in trying to get her husband treatment finally saw results. Currao met with a psychologist, and was diagnosed with “serious” anti-social personality disorder and dysthymic disorder. He was moved out of solitary confinement and into one of the 170 Residential Mental Health Treatment beds created under the recent law.

Currao “seems to be 1,000 times better” since entering treatment, Donna said. He talks about wanting to become a counselor when he’s released.

But Donna wonders why it took so many suicide attempts and nearly a year of pressure to get her husband a proper diagnosis and the treatment he was legally owed. “They are not enforcing this law,” she said. “Why do we have to fight so hard to get them evaluated?”

Hall’s family is left with the same questions as they search for answers about his death. “How many more people have to die?” Shaleah asked. “They need help. Locking them away is hurting them more.”

         


Boy, 10, to remain in custody – Daily Inter Lake: Local/Montana

Boy, 10, to remain in custody – Daily Inter Lake: Local/Montana.

Boy, 10, to remain in custody

Boy, 10, to remain in custody – in another article boy is 9 year old

Public defender Steve Eschenbacher makes his case to the court Wednesday with his young client Isaiah Nasewytewa beside him.

Posted: Thursday, May 9, 2013 10:00 pm

POLSON — Lake County District Court Judge Kim Christopher on Wednesday said she is keeping a 10-year-old boy in custody on $500,000 bond until he can receive a mental health evaluation that had been scheduled and missed three times in the past 14 months.

Isaiah Nasewytewa of St. Ignatius has been cited for disorderly conduct at school, violating the conditions of a deferred prosecution agreement (for his role in a 2012 burglary) and felony theft, according to court records.

Christopher did not back away from Nasewytewa’s unusually high bond, explaining that the court wants to maintain custody of the boy to ensure he receives a mental-health evaluation upon which future legal proceedings will be based….Read more

“Backbone” of mental illness stigma common in 15 countries studied

Rethink Mental Illness

Rethink Mental Illness (Photo credit: Wikipedia)

‘Backbone’ of mental illness stigma common in 16 countries studied
April 11th, 2013 in Psychology & Psychiatry

An international study found that despite widespread acceptance that mental illness is a disease that can be effectively treated, a common “backbone” of prejudice exists that unfairly paints people with conditions such as depression and schizophrenia as undesirable for close personal relationships and positions of authority.

This backbone, say the Indiana University sociologists who led the study, spanned the 16 diverse countries examined. While the findings might be discouraging to mental health advocates, the data can be used to reconfigure public health efforts to reduce stigma and to determine important issues for treatment providers to consider.

“If the public understands that mental illnesses are medical problems but still reject individuals with mental illness, then educational campaigns directed toward ensuring inclusion become more salient,” the authors wrote in “The ‘Backbone’ of Stigma: Identifying the Global Core of Public Prejudice Associated With Mental Illness,” published online early in a special issue of the American Journal of Public Health.

The researchers analyzed data from the IU-led Stigma in Global Context – Mental Health Study, which talked with 19,508 study participants about customized vignettes. The vignettes portrayed someone suffering either from depression, schizophrenia or, the control group, asthma. The countries represented a diverse range geographically, developmentally and politically, with at least one country on each inhabitable continent.

Even in countries with cultures more accepting of mental illness, the “backbone” of stigma was detected, encompassing issues involving caring for children, marriage, self-harm and holding roles of authority or civic responsibility. The stigma was even stronger toward people with schizophrenia.

Stigma is considered a major obstacle to effective treatment for many Americans who experience these devastating illnesses. It can produce discrimination in employment, housing, medical care and social relationships, and have a negative impact on the quality of life for these individuals and their families and friends.

“The stereotype of all people with mental illness as ‘not able’ is just wrong. No data supports this,” said Bernice Pescosolido, sociology professor in the IU College of Arts and Sciences and an internationally recognized expert in the field of mental health stigma. “With the prevalence of mental health problems being so high, no individuals or families will go untouched by these issues. They need to understand that recovery is not only possible but has been documented.”

Pescosolido chairs the international advisory council for Bring Change 2 Mind, a not-for-profit organization established by actress and activist Glenn Close to reduce the prejudice and discrimination associated with mental illness. BC2M was cited in the journal article, along with Mental Health First Aai, an organization that helps people understand and assist others who might be experiencing a mental health crisis.

“Forward-thinking organizations base their work both on community ties and science—this works best in terms of making change efforts realistic, effective and resonate with individuals, families, providers and policymakers,” Pescosolido said. “Hopefully the work of organizations like these can find the support necessary to create personal and institutional social change.

Provided by Indiana University

“‘Backbone’ of mental illness stigma common in 16 countries studied.” April 11th, 2013. http://medicalxpress.com/news/2013-04-backbone-mental-illness-stigma-common.html

Mental Illness Soars In Prisons, Jails While Inmates Suffer

Rethink Mental Illness

Rethink Mental Illness (Photo credit: Wikipedia)

trauerkerze  Rest in Peace, Tony Lester!

http://www.huffingtonpost.com/2013/02/04/mental-illness-prisons-jails-inmates_n_2610062.html?view=print&comm_ref=false

Mental Illness Soars In Prisons, Jails While Inmates Suffer

Posted: 02/04/2013 12:58 pm EST  |  Updated: 02/04/2013  3:33 pm EST

Mentally Ill Inmates

Tony Lester committed suicide while incarcerated.

Armando Cruz tied a noose around his neck and hanged himself from the ceiling of his prison cell. He left a note that ended in two chilling words.

“Remember me.”

His mother Yolanda, who was shown the note after her son’s death, wants to make sure no one forgets.

“They took away my only son,” she says, her voice breaking.

Cruz killed himself on Sept. 20, 2011, during his incarceration at California State Prison in Sacramento, after a long history of mental illness. His story, first reported by the blog Solitary Watch, is an example of how the criminal justice system is ill-equipped to handle people with mental health issues.

Cruz spent years in solitary confinement and died while locked in a tiny solitary cell. The rates of suicide in solitary confinement tend to be higher than in the general prison population.

Suicide is the number one cause of death among inmates in local jails and in the top five for state prisons, according to a federal report.

Yolanda Cruz describes her son as a warm, funny person who was an easy child to raise. When he became a teenager, he began to change. He started to experiment with drugs and alcohol. Then, he was arrested for stealing tools from his neighbor’s garage.

When he was 15, he admitted that he heard voices in his head. Psychiatrists first diagnosed him with psychosis. Later, he would be diagnosed with schizophrenia.

A 2006 study by the Bureau of Justice Statistics found that over half of all jail and prison inmates have mental health issues; an estimated 1.25 million suffered from mental illness, over four times the number in 1998. Research suggests that people with mental illness are overrepresented in the criminal justice system by rates of two to four times the normal population. The severity of these illnesses vary, but advocates say that one factor remains steady: with proper treatment, many of these incarcerations could have been avoided.

“Most people [with mental illness] by far are incarcerated because of very minor crimes that are preventable,” says Bob Bernstein, the Executive Director of the Bazelon Center for Mental Health Law. “People are homeless for reasons that shouldn’t occur, people don’t have basic treatment for reasons that shouldn’t occur and they get into trouble because of crimes of survival.”

Bernstein blames these high rates on a lack of community mental health services. In the past three years, $4.35 billion in funding for mental health services has been cut from state budgets across the nation, according to a recent report. Because of the cuts, treatment centers have had to trim services and turn away patients.

State hospitals have also been forced to reduce services. A report by the Treatment Advocacy Center even found that there are more people with severe mental illness in prisons and jails than in hospitals.

Yolanda Cruz tried for years to get her son the right kind of care. But it wasn’t easy. She says that the first doctor she took him to refused to prescribe him any kind of medication, saying that he was only getting into trouble because he was using drugs and hanging out with the wrong kind of people. Other doctors would later prescribe him a host of medications but the one that eased his symptoms the most left him nearly catatonic.

In 2000, when Armando Cruz was 17, a local police officer was attacked with a knife from behind. His throat was cut but he survived. Cruz confessed to the crime and was arrested. To this day, his mother swears he was manipulated by the voices in his head or by the real perpetrator.

The courts didn’t see it that way. Cruz was convicted of the attempted murder of a police officer and sentenced to life in prison, with the possibility of parole after 8 years. Three years had passed between his arrest and his sentencing, most of which he spent in county jail.

Eric Balaban, an attorney with the ACLU’s National Prison Project, said that mentally ill people who have contact with the criminal justice system are too often incarcerated while awaiting trial, rather than sent to hospitals or treatment centers.

“There has been a very disturbing recent trend to keep them in jails and not send them to a hospital which is done as a money saving measure,” said Balaban. “They’re not receiving the appropriate level of care.”

Once people with mental illness are incarcerated, Bazleon’s Bernstein says, it becomes a tough cycle to break.

“Most people are there for minor crimes but then they deteriorate,” he explains. “They can’t follow the rules there and so they stay a long time, and they become difficult to release.”

According to the Bureau of Justice Statistics report, most inmates with mental illness don’t receive treatment while in prison.

Patti Jones’ nephew Tony Lester was sent to state prison in Tucson, Ariz., for aggravated assault. Like Armando Cruz, Lester heard voices. He told his aunt that before he was incarcerated, he had only heard two voices. After he was admitted, there were seven.

Lester was diagnosed with schizophrenia. He was prescribed medication but didn’t always take it while in prison, Jones said. Lester was placed among the general prison population with little treatment available.

His symptoms grew worse.

“He started saying he thought his attorney was the Antichrist,” Jones says. “He thought Obama was an alien. He thought he was a time traveler.”

Jones says she begged the jail to force him to take his medication, but staff told her he was allowed to refuse treatment.

In June 2010, Lester stopped taking his medication completely. After he told a guard he was contemplating ending his life, he was placed on suicide watch. On July 9, he was deemed stable. On July 11, his roommate woke up to Lester’s blood dripping on him. He had stabbed himself vigorously in the neck, wrist and groin with a razor.

“Treating the mentally ill is different than acting with a normal population,” says Joe Baumann, a corrections officer at the California Rehabilitation Center. “The problem is there’s so many of them either self-medicating or not taking medication at all. No one monitors whether inmates take their medication.”

Corrections employees are not properly taught how to recognize and handle mental illness, he says.

“There’s a lack of any real training to identify specific issues and how to deal with them,” says Baumann, who says he only receives a few hours of mental illness training each year and it isn’t enough. “There’s a lack of direction from management.”

Corrections officers on staff at the time of Tony Lester’s death said that when they arrived at his cell, they weren’t sure what to do, according to a state investigation of the incident. One officer said that he “was never trained on how to apply pressure to a wound.” Lester bled to death while the officers struggled to deal with the situation.

Donn Rowe, president of the New York State Correctional Officers and Police Benevolent Association, says that mentally ill inmates place a huge strain on the corrections facilities and their employees.

“It’s very challenging on our members,” he says. “They need much more attention than your average inmate population. It’s a very expensive and very demanding job to manage these people.”

The expense is high, to be sure. The average inmate in New York costs the state over $60,000 per year, according to a report by the Vera Insitute of Justice. That figure doesn’t take into account the extra resources that mentally ill inmates require. Experts say that funding mental health services for these inmates would cost less than imprisoning them and could help prevent many incarcerations in the first place.

According to a Bazelon Center report, the annual cost of case management for mentally ill people in Michigan is $2,165 per person. A more intensive program, the popular Assertive Community Treatment, costs the state $9,029 per person per year. In contrast, the average Michigan inmate cost the state over $34,000 last year.

But mental health services are dramatically underused. Over half of inmates with mental health problems never received treatment prior to incarceration, according to a Department of Justice report.

“We’re paying criminal justice and other costs, we’re investing there and we really should be investing in the services that could prevent that whole trajectory to begin with,” says Bernstein.

Not all mentally ill inmates’ stories end like Lester’s or Cruz’s. But the figures are too high to ignore. In 2010, 520 inmates committed suicide in local jails and state prisons. To the loved ones and advocates of these inmates, their deaths were avoidable.

“When Tony was on his meds, he was our Tony,” says Jones. “If he’d had access to care, he would have lived.”

              

“Inmate Suicide Rate is Focus in Court Fight over California Prisons” Sacbee

sacbee.com

This story is taken from Sacbee  / here on some lines to read

Inmate suicide rate is focus in court fight over California prisons

sstanton@sacbee.com

Published Sunday, Mar. 17, 2013

Shortly after 5 p.m. on May 2, 2011, an inmate at California State Prison, Solano, was found dead in his cell, hanging from the upper bunk, a torn bed sheet around his neck.

The inmate, who was approaching his 65th birthday, had spent much of his life bouncing in and out of prison. Four hours earlier, he had an eight-minute phone conversation with his mother, and ended it by telling her he loved her.

After his death, officials found a note to his mother atop his belongings.

“Mom I am so very sorry that I am a selfish and inconsiderate piece of garbage,” it read. ” … Thank you for loving me thru all these years. I been here much too long and I am so tired of my stoopidity.”(sic)

The dead man, who is identified in federal court papers as “Inmate HH,” is one of 437 inmates since 1999 ruled to have committed suicide in a state prison.

Together, those suicides are now a focal point in a fierce legal fight between state officials and inmate advocates over whether California is ready to once again control its own prisons.

Eighteen years after a federal court found that the mental health care inside state prisons was grossly substandard and a major factor in inmate suicides, California will return to a Sacramento courtroom March 27 to argue that the problems have been solved.

“Our suicide rate is less than the general population, less than federal prisons,” Gov. Jerry Brown said in an interview with The Bee this month. “In fact, few countries in the world can match our numbers.

“The money we’re spending to defend ourselves in court could be spent on rehabilitation programs for inmates, where it’s really needed.”

Brown publicly proclaimed in January that years of effort by state prison officials finally had solved the mental health care and overcrowding problems plaguing the state’s 33 adult prisons, and that he wanted control returned to the state and court oversight terminated.

The state says it has spent millions of dollars building mental hospitals and attendant facilities, buying suicide-resistant beds, hiring psychiatrists and training staff.

In the months since Brown’s proclamation, the legal back and forth has devolved into all-out guerrilla warfare.

Thousands of pages of pleadings, declarations and experts’ depositions have been filed in recent weeks by both sides, including reports and depositions from prominent psychiatrists and prison officials from around the country.

The state contends that lawyers for the inmates and a court-appointed special master in the class-action lawsuit on behalf of mental health patients are prolonging the case to line their pockets.

Attorneys for the inmates deny that accusation and say conditions inside the prisons are still woefully inadequate, contributing to high suicide rates.

Last week, the special master, Matthew A. Lopes Jr., filed his latest suicide report in federal court, concluding that the numbers remain high because the California Department of Corrections and Rehabilitation has refused to adopt recommendations for reform advocated since at least 1999.

“It is absolutely unacceptable that such recommendations have not been implemented and realized by CDCR,” Dr. Raymond F. Patterson, a nationally known suicide expert and a member of the special master’s team, wrote in papers filed Wednesday.

“No matter how many times these recommendations are reiterated, they continue to go unheeded, year after year, while suicides among CDCR inmates continue unabated, and worsening, as manifested by suicide rates that inch ever higher over the past several years.”

Patterson wrote that he has repeatedly sought – to no avail – improvements in staff training, the way welfare checks are conducted on inmates in their cells, and how follow-up checks are done on suicidal inmates.

Patterson, who has compiled 14 annual reports on suicides in California prisons for the court’s special master on mental health, wrote that his latest would be his last, because “continued repetition of these recommendations would be a further waste of time and effort.”

Suicide rate debate

Patterson’s latest annual report, covering 15 suicides in the first half of 2012, found the suicide rate in California prisons last year was 23.72 per 100,000 inmates, an increase over the previous year and a rate substantially higher than the national average of 16 per 100,000 inmates. Most of the 2012 deaths were a result of hangings.

These suicide rates and the level of mental health care provided in the prisons are expected to be the subject of furious argument in court later this month as the two sides square off before U.S. District Judge Lawrence K. Karlton in Sacramento….Read more…

Last sentence:

The acting director of the hospitals department also met with the staff there earlier this month to reassure them, the statement said, adding that “there is currently no anticipated staffing crisis at DSH-Salinas Valley.”

Call The Bee’s Sam Stanton, (916) 321-1091. Follow him on Twitter @stantonsam.

© Copyright The Sacramento Bee.  All rights reserved.

Patterson's Curse

Patterson’s Curse (Photo credit: thewebprincess)

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