Let’s start talking about mental illness

A letter to the editor (BDN, May 10) in response to the recent police shooting of a man with schizophrenia suggests that citizens need guns in their homes to protect them from people with mental illness. Recent news coverage about people with mental illness who have been shot by police because of violence or threats of violence reinforces the public perception that mental illness and violence are linked. How can we reduce the ongoing stigma connected with mental illness when tragedies like this occur?

Some states react by passing new laws – like Kendra’s law – enacted after a man with mental illness pushed a young woman under the subway in New York. Research shows, however, that laws like this are not effective. In fact, it is the availability of community-based services that makes the difference. Fear can lead to calls to “get tough on crime,” place additional restrictions on people with mental illness, build more hospital beds or more prisons, and to remove people with mental illness from the community. These responses, though understandable, respond to common misperceptions and fears about mental illness. They perpetuate the stigma that keeps most people with mental health problems from ever seeking the treatment they need. Here are some facts:

1. One in five people and 1 in 10 children has a mental illness or emotional disorder. Most of these individuals will never be violent.

2. Only 16 percent of people with mental illness ever seek treatment. Stigma is one of the primary reasons why people do not seek help – particularly true for parents of children with mental health needs.

3. Violence is not statistically linked with mental illness. Studies show that most violence is carried out by “normal” people. Only 3 percent of violent crimes are linked to mental illness; 40 percent to use of drugs or alcohol.

4. A higher prevalence rate for violence is found in people who are experiencing a psychotic episode and people who are abusing drugs or alcohol. Why? Because both of these events are associated with lower inhibitions, poor judgment and higher impulsivity. Most people with mental illness will never experience a psychotic episode.

5. Since 1985, Maine police officers have shot and killed 21 people. Half of the victims suffered from some type of mental illness.

6. The numbers of people with mental illness and substance abuse disorders in our jails and prisons has skyrocketed in the last 10 years – overburdening the staff and budgets of these institutions and placing people with recognized medical/mental health needs in locations least able to help them. With recidivism rates as high as 70 percent, we know that putting people in jail is ineffective. They return to our communities in worse shape.

There are better and more productive approaches to this issue of adequate and necessary treatment for people with mental health and substance abuse problems. And they include:

. Increased training for communities in how to effectively respond. There are national models which result in fewer arrests, shootings, hospitalizations and injuries including the Memphis Police Department’s Crisis Intervention Team (CIT) model, recently adopted in Portland. Funded by a grant from the Margaret Burnham Charitable Trust, this program brings the police, the emergency rooms and NAMI Maine together to develop a consistent and effective response to psychiatric emergencies.

. Multisystemic Therapy is a program which the surgeon general calls one of the top six in the country. This program, designed to intervene with children who have criminal justice histories, shows great success in reducing arrests, hospitalizations and recidivism for young people. Currently, there is one MST program in Southern Maine – run by Sweetser.

. ACT programs, 24-hour access to a mental health team, provide outreach to people with mental illness who have traditionally been treatment resistant. These programs, when funded adequately, have been shown to be successful in assisting people with mental illness to live safely in the community. Maine currently runs a number of ACT programs across the state – but none have been adequately funded.

Often, when tragedies connected to mental illness occur, there is finger-pointing and blame. Why didn’t the mental health system do the right thing? Why didn’t the hospital emergency room do the right thing? Why didn’t law enforcement lock up this person sooner? Don’t those parents know how to discipline their children? These responses, though understandable, are harmful.

Community responses are needed. All members of the community pay the price when a preventable tragedy occurs. Those who pay the biggest price are the families of the victims and the perpetrator.

What would help? Police officers need to understand mental illness and work closely with the emergency room. Emergency room and other mental health staff need to work more closely with police officers. Families of and people with mental illness know much about what works and what doesn’t – they need to be included. Schools need improved understanding about mental illness and emotional disorders and a strong link to the families and community service providers w ho have expertise to share. And, because early intervention is crucial, all of us need to be able to recognize the early warning signs of an impending psychosis and know who to call. Finally, each call for help must result in an appropriate response.

I encourage community leaders to join together, roll up their sleeves and start talking. NAMI Maine is available. We will come to any community that asks us. We will bring training, information about what works, and will sit at the table in any community that asks us.

Carol Carothers is the executive director of NAMI Maine in Augusta.