Thoughts for a Rainy Day

It's flooding two blocks from my front door and the rain is coming down. I can't think of a better thing to do than share my thoughts on serious mental illness and advocacy.

COMMENT: Treating serious, disabling mental illness is difficult. Having a family member living with serious, disabling mental illness is more difficult. Living with a serious, disabling mental illness is most difficult.

QUOTE FROM THE NAMI FAMILY-TO-FAMILY EDUCATION CLASS: Perhaps the best definition of advocacy was voiced by Eleanor Roosevelt (quote): "You must do things you think you cannot do." In facing the stigma and shame that still surrounds mental illness, we are tested by many challenges Each of us has to break through boundaries of fear and convention to help our family members; each of us has felt the discrimination that exists against people who have brain disorders. In our struggle to "stand with" and "stand up for" our loved ones, we are all advocates.

FRIDAY, JUNE 10, 2011: I received a call from a women in Colorado whose brother-in-law is receiving mental health services at the Center for Mental Health in Helena. He has been diagnosed as suffering from schizophrenia and/or bipolar disorder. He has received services at the Montana State Hospital and the Montana State Prison. He was a part of the ACT Team in Helena, but was released from the ACT Team because he was probably non-compliant and the ACT has recently undergone structural changes. Several days after being released from the ACT Team he attempted suicide and was committed to the Montana State Hospital. After six days in the MSH he was scheduled for release. With the help of NAMI National she was able to compose a letter and he was kept in the hospital for sixty days. He has been released, but not returned to the ACT Team. He tried independent living, but was unsuccessful. "He was living in deplorable conditions." He has since been living in a foster care facility and doing relatively well. She would like to find a private therapist because she does not think one hour a month is adequate for therapy and has asked me to help her find a private therapist.

SATURDAY, JUNE 11, 2011: I received a call from a mother in California whose son has been receiving services at the Western Montana Mental Health Center in Bozeman. he has been diagnosed with schizophrenia and substance abuse disorders. He has been non-compliant and was sentenced to the WATCH Program at Warm Springs after his 4th DUI. He also was in the prerelease program, but was non-compliant because he was not responsible and accountable. He has been transferred to the Montana State Prison because he has failed to comply with the goals of the program. He has not contacted his mother and his mother has been told she may not visit him for 45 to 120 days until he is processed. If the underlying mental illness is not treated appropriately, prerelease and substance abuse treatment will never be successful.

DISCLAIMER: I have been in the Montana mental Illness treatment system for almost 27 years and realize emotional family members do not always relate events as they actually occur. However, this is their perception of events as they unfolded.

The treatment of serious, disabling mental illnesses is very difficult. But, a definition of insanity is: "Doing the same things over and over again and expecting different results." Last Thursday the census at the Montana State Hospital was 156. This is the lowest census in years. Those with an optimistic view would say this is due to improved community services and transition services out of the hospital. Some of us with a skeptical point of view would point to the fact that it has been more and more difficult to commit individuals with mental illnesses, who are in psychiatric crisis, to the Montana State Hospital. Commitment laws make it more and more difficult to accomplish early intervention and treatment. It may also be that more people at the Montana State Hospital are being transferred to the Montana State Prison and thereby lowering the census. The questions is? Does the Montana State Prison have the resources to adequately treat and care for those mentally ill individuals who are being transferred to their care. The Department of Corrections has the obligation to protect our society from those who might harm us. But, do they have the resources and training to treat the increased numbers of mentally ill they are receiving?

We are approaching a time of limited resources and funding to treat those who live with serious mental illnesses. We are rationing treatment and medication although it is not called that. Maybe we should spend our resources on those who suffer from mental illnesses in their teens and twenties when recovery is more possible. Then we would spend our funds to just maintain individuals in their 30's, 40's 50's and 60's who are so much a part of the "revolving door" that is characteristic nature of these illnesses. Just a provocative thought!

NAMI family members need to advocate for their mentally ill family members who live with serious, disabling mental illnesses because there are very few out there who are capable of understanding our lived experiences.
Dr. Gary Mihelish, President
NAMI-Helena