By Ana Swanson
The Washington Post
Originally published April 30, 2015
Here is an excerpt:
For various reasons, these community treatment plans proved inadequate, leaving many of the mentally ill homeless or in jail. According to the Department of Justice, about 15 percent of state prisoners and 24 percent of jail inmates report symptoms meet the criteria for a psychotic disorder.
In its survey of individual states, the Treatment Advocacy Center found that in 44 of the 50 states and the District of Columbia, the largest prison or jail held more people with serious mental illness than the largest state psychiatric hospital (see map below). The only exceptions were Kansas, New Jersey, North Dakota, South Dakota, Washington and Wyoming. "Indeed, the Polk County Jail in Iowa, the Cook County Jail in Illinois, and the Shelby County Jail in Tennessee each have more seriously mentally ill inmates than all the remaining state psychiatric hospitals in that state combined," the report says.
The entire article is here.
Showing posts with label Chronic Mental Illness. Show all posts
Showing posts with label Chronic Mental Illness. Show all posts
Monday, May 25, 2015
Thursday, April 30, 2015
Most Prisoners Are Mentally Ill
By Olga Khazan
The Atlantic
Originally posted April 7, 2015
Here is an excerpt:
The numbers are even more stark when parsed by gender: 55 percent of male inmates in state prisons are mentally ill, but 73 percent of female inmates are. Meanwhile, the think-tank writes, "only one in three state prisoners and one in six jail inmates who suffer from mental-health problems report having received mental-health treatment since admission."
An increasingly popular program might help thin the ranks of these sick, untreated inmates. What are known as "mental-health courts" have sprung up in a number of states as an alternative to incarceration. A shoplifter who has, say, schizophrenia might be screened and found eligible for mental-health court, and then be sentenced to judicially supervised treatment. These types of courts have expanded rapidly since 2000, and there are now hundreds around the country.
The entire article is here.
The Atlantic
Originally posted April 7, 2015
Here is an excerpt:
The numbers are even more stark when parsed by gender: 55 percent of male inmates in state prisons are mentally ill, but 73 percent of female inmates are. Meanwhile, the think-tank writes, "only one in three state prisoners and one in six jail inmates who suffer from mental-health problems report having received mental-health treatment since admission."
An increasingly popular program might help thin the ranks of these sick, untreated inmates. What are known as "mental-health courts" have sprung up in a number of states as an alternative to incarceration. A shoplifter who has, say, schizophrenia might be screened and found eligible for mental-health court, and then be sentenced to judicially supervised treatment. These types of courts have expanded rapidly since 2000, and there are now hundreds around the country.
The entire article is here.
Monday, March 23, 2015
The Best-Selling, Billion-Dollar Pills Tested on Homeless People
How the destitute and the mentally ill are being used as human lab rats
by Carl Elliott
Matter
Originally posted on July 27, 2014
Here are two excerpts:
If you’re looking for poor people who have been paid to test experimental drugs, Philadelphia is a good place to start. The city is home to five medical schools, and pharmaceutical and drug-testing companies line a corridor that stretches northeast into New Jersey. It also has one of the most visible homeless populations in the country. In Philly, homeless people seem to be everywhere: sleeping in Love Park, slumped on benches in Suburban Station, or gathered along the Benjamin Franklin Parkway, waiting for the free meals that a local church gives out on Saturdays.
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Not long ago, such offers would have been considered unethical. Paying any volunteer was seen as problematic, even more so if the subjects were poor, uninsured, and compromised by illness. Payment, it was argued, might tempt vulnerable subjects to risk their health. As trials have moved into the private sector, this ethical calculus has changed. First came a hike in the sums that volunteers could be paid: Many clinical trial sites now offer over $6,000 for an inpatient drug study. Eligibility requirements have changed, too. For years, trial sites paid only healthy volunteers, mainly to test new drugs for safety. These days people with asthma, diabetes, kidney disease, liver disease, and other conditions can be paid take part in trials.
The entire article is here.
by Carl Elliott
Matter
Originally posted on July 27, 2014
Here are two excerpts:
If you’re looking for poor people who have been paid to test experimental drugs, Philadelphia is a good place to start. The city is home to five medical schools, and pharmaceutical and drug-testing companies line a corridor that stretches northeast into New Jersey. It also has one of the most visible homeless populations in the country. In Philly, homeless people seem to be everywhere: sleeping in Love Park, slumped on benches in Suburban Station, or gathered along the Benjamin Franklin Parkway, waiting for the free meals that a local church gives out on Saturdays.
(cut)
Not long ago, such offers would have been considered unethical. Paying any volunteer was seen as problematic, even more so if the subjects were poor, uninsured, and compromised by illness. Payment, it was argued, might tempt vulnerable subjects to risk their health. As trials have moved into the private sector, this ethical calculus has changed. First came a hike in the sums that volunteers could be paid: Many clinical trial sites now offer over $6,000 for an inpatient drug study. Eligibility requirements have changed, too. For years, trial sites paid only healthy volunteers, mainly to test new drugs for safety. These days people with asthma, diabetes, kidney disease, liver disease, and other conditions can be paid take part in trials.
The entire article is here.
Tuesday, March 10, 2015
Identifying mentally ill 'frequent fliers' first step to reducing police contact
Press Release
Oregon State University
Originally published February 11, 2015
Identifying the population of people with mental illness who have frequent contact with police could help law enforcement officials and community agencies allocate limited resources to those with the highest needs, new research from Oregon State University indicates.
These individuals, often referred to as “frequent fliers” because of their repeated interaction with law enforcement, can consume a large amount of police time and resources, according to researchers in the School of Public Policy in OSU’s College of Liberal Arts.
Identifying and understanding the population can aid policymakers as they work to reduce the frequent and time-consuming interactions, sociologists Scott Akins and Brett Burkhardt said.
“This contact is rarely criminal in nature at the outset,” said Burkhardt, an assistant professor of sociology. “It’s usually a peace officer custody arrest, which is a type of arrest that occurs because a person is believed to be a danger to themselves or others due to a suspected mental illness. But there’s a limited amount of resources, so if we identify people with the highest needs, we can focus resources on those folks.”
Once a local region has identified its population of frequent fliers, community agencies and policy-makers can use the information to change or implement policies to assist those with the highest needs, the researchers said.
“It’s a strategic way to create a more cost-effective and humane way to assist the mentally ill,” said Akins, an associate professor of sociology.
The entire press release is here.
Oregon State University
Originally published February 11, 2015
Identifying the population of people with mental illness who have frequent contact with police could help law enforcement officials and community agencies allocate limited resources to those with the highest needs, new research from Oregon State University indicates.
These individuals, often referred to as “frequent fliers” because of their repeated interaction with law enforcement, can consume a large amount of police time and resources, according to researchers in the School of Public Policy in OSU’s College of Liberal Arts.
Identifying and understanding the population can aid policymakers as they work to reduce the frequent and time-consuming interactions, sociologists Scott Akins and Brett Burkhardt said.
“This contact is rarely criminal in nature at the outset,” said Burkhardt, an assistant professor of sociology. “It’s usually a peace officer custody arrest, which is a type of arrest that occurs because a person is believed to be a danger to themselves or others due to a suspected mental illness. But there’s a limited amount of resources, so if we identify people with the highest needs, we can focus resources on those folks.”
Once a local region has identified its population of frequent fliers, community agencies and policy-makers can use the information to change or implement policies to assist those with the highest needs, the researchers said.
“It’s a strategic way to create a more cost-effective and humane way to assist the mentally ill,” said Akins, an associate professor of sociology.
The entire press release is here.
Monday, January 19, 2015
Early Death for Severe Mental Illness?
By Allen Frances
The Huffington Post Blog
Originally published December 30, 2014
People diagnosed with serious mental illness -- schizophrenia, bipolar disorder, or severe depression -- die 20 years early, on average, because of a combination of lousy medical care, smoking, lack of exercise, complications of medication, suicide, and accidents. They are the most discriminated-against and neglected group in the U.S., which has become probably the worst place in the developed world to be mentally ill.
In many previous blog posts I have bemoaned the shameful state of psychiatric care and housing for people with severe mental illness. My conclusion was that the United States has become the worst place, and now the worst time ever, to have a severe mental illness. Hundreds of thousands of the severely ill languish inappropriately in prisons. Additional hundreds of thousands are homeless on the street.
The entire blog post is here.
The Huffington Post Blog
Originally published December 30, 2014
People diagnosed with serious mental illness -- schizophrenia, bipolar disorder, or severe depression -- die 20 years early, on average, because of a combination of lousy medical care, smoking, lack of exercise, complications of medication, suicide, and accidents. They are the most discriminated-against and neglected group in the U.S., which has become probably the worst place in the developed world to be mentally ill.
In many previous blog posts I have bemoaned the shameful state of psychiatric care and housing for people with severe mental illness. My conclusion was that the United States has become the worst place, and now the worst time ever, to have a severe mental illness. Hundreds of thousands of the severely ill languish inappropriately in prisons. Additional hundreds of thousands are homeless on the street.
The entire blog post is here.
Thursday, January 15, 2015
Decarceration of u.s. Jails and prisons: where will persons with serious mental illness go?
By H.R. Lamb and L.E. Weinberger
J Am Acad Psychiatry Law. 2014;42(4):489-94.
Abstract
Decarceration (decreasing the number of persons incarcerated in U.S. jails and prisons) has begun. It is estimated that more than 350,000 persons with serious mental illness (SMI) are among those incarcerated in the United States and that many thousands of them will probably be among those released. Currently, the prison population in general is being reduced as a consequence of concerns about overcrowding and of policies and programs such as reclassification of drug possession, which would affect many persons with mental illness. Court-ordered diversion and changes in sentencing guidelines are also serving to reduce prison populations. In recent years, the mental health system did not have to manage as large a number of persons with SMI, especially those who were among the most difficult and expensive to treat, because many of them were incarcerated in jails and prisons. Now, with decarceration and the release of many such persons, the mental health system may be expected to assume more responsibility for them and should be prepared and funded to meet their needs. This population of persons with SMI needs structure and treatment that, depending upon their individual needs, may include 24-hour supportive housing, ACT and FACT teams, assisted outpatient treatment, psychiatric medication, and psychiatric hospitalization.
The article is here.
J Am Acad Psychiatry Law. 2014;42(4):489-94.
Abstract
Decarceration (decreasing the number of persons incarcerated in U.S. jails and prisons) has begun. It is estimated that more than 350,000 persons with serious mental illness (SMI) are among those incarcerated in the United States and that many thousands of them will probably be among those released. Currently, the prison population in general is being reduced as a consequence of concerns about overcrowding and of policies and programs such as reclassification of drug possession, which would affect many persons with mental illness. Court-ordered diversion and changes in sentencing guidelines are also serving to reduce prison populations. In recent years, the mental health system did not have to manage as large a number of persons with SMI, especially those who were among the most difficult and expensive to treat, because many of them were incarcerated in jails and prisons. Now, with decarceration and the release of many such persons, the mental health system may be expected to assume more responsibility for them and should be prepared and funded to meet their needs. This population of persons with SMI needs structure and treatment that, depending upon their individual needs, may include 24-hour supportive housing, ACT and FACT teams, assisted outpatient treatment, psychiatric medication, and psychiatric hospitalization.
The article is here.
Tuesday, August 19, 2014
California Revises Policy on Mentally Ill Inmates
By Erica Goode
The New York Times
August 2, 2014
Here is an excerpt:
The increasing number of mentally ill prisoners in prisons and jails across the country — in 2013, mentally ill prisoners made up just over 28 percent of California’s prison population — has raised questions about their treatment in corrections systems poorly equipped to deal with psychiatric symptoms. Mentally ill inmates, whose challenging behavior often leads to their placement in solitary confinement, are frequent targets for a cell extraction — the forcible removal of an inmate from a cell by a tactical team equipped with Tasers, pepper spray or other less-lethal weapons — or for other uses of force by guards.
Judge Karlton, in his April order, ruled that the use of force and lengthy solitary confinement of seriously mentally ill inmates was unconstitutional and ordered the department to revise its policies.
The entire article is here.
The New York Times
August 2, 2014
Here is an excerpt:
The increasing number of mentally ill prisoners in prisons and jails across the country — in 2013, mentally ill prisoners made up just over 28 percent of California’s prison population — has raised questions about their treatment in corrections systems poorly equipped to deal with psychiatric symptoms. Mentally ill inmates, whose challenging behavior often leads to their placement in solitary confinement, are frequent targets for a cell extraction — the forcible removal of an inmate from a cell by a tactical team equipped with Tasers, pepper spray or other less-lethal weapons — or for other uses of force by guards.
Judge Karlton, in his April order, ruled that the use of force and lengthy solitary confinement of seriously mentally ill inmates was unconstitutional and ordered the department to revise its policies.
The entire article is here.
Sunday, August 3, 2014
Do Smoking Policy Interventions Affect Suicide Risk?
By Richard A. Grucza, Andrew D. Plunk and others
Nicotine Tob Res (2014)
doi: 10.1093/ntr/ntu106
First published online: July 16, 2014
Introduction:
Smokers exhibit elevated risk for suicide, but it is unknown whether smoking interventions reduce suicide risk. We examined whether state-level policy interventions—increases in cigarette excise taxes and strengthening of smoke-free air laws—corresponded to reduction in suicide risk during the 1990s and early 2000s. We also examined whether the magnitude of such reductions correlated with individuals’ predicted probability of smoking, as would be expected if the associations stemmed from changes in smoking behavior.
(cut)
Results:
Cigarette excise taxes, smoke-free air policies, and an index combining the two policies all exhibited protective associations with suicide. The associations were strongest in segments of the population where predicted smoking prevalence was the highest and weaker in segments of the population where predicted smoking prevalence was the lowest, suggesting that the protective associations were related to changes in smoking behavior.
The entire article is here, behind a paywall.
Editor's note: While it is unclear if smoking itself leads to suicidal behavior (doubtful) or makes existing mental impairments worse (either through sustained use or trying to quit), clinicians need to know that this could be an important part of evaluating suicide potential.
Here is an article of nicotine and mental illness.
Nicotine Tob Res (2014)
doi: 10.1093/ntr/ntu106
First published online: July 16, 2014
Introduction:
Smokers exhibit elevated risk for suicide, but it is unknown whether smoking interventions reduce suicide risk. We examined whether state-level policy interventions—increases in cigarette excise taxes and strengthening of smoke-free air laws—corresponded to reduction in suicide risk during the 1990s and early 2000s. We also examined whether the magnitude of such reductions correlated with individuals’ predicted probability of smoking, as would be expected if the associations stemmed from changes in smoking behavior.
(cut)
Results:
Cigarette excise taxes, smoke-free air policies, and an index combining the two policies all exhibited protective associations with suicide. The associations were strongest in segments of the population where predicted smoking prevalence was the highest and weaker in segments of the population where predicted smoking prevalence was the lowest, suggesting that the protective associations were related to changes in smoking behavior.
The entire article is here, behind a paywall.
Editor's note: While it is unclear if smoking itself leads to suicidal behavior (doubtful) or makes existing mental impairments worse (either through sustained use or trying to quit), clinicians need to know that this could be an important part of evaluating suicide potential.
Here is an article of nicotine and mental illness.
Monday, October 21, 2013
The New Asylums: Jails Swell With Mentally Ill
By Gary Fields and Ericka Phillips
The Wall Street Journal
Originally published September 25, 2013
Here is an excerpt:
America's lockups are its new asylums. After scores of state mental institutions were closed beginning in the 1970s, few alternatives materialized. Many of the afflicted wound up on the streets, where, untreated, they became more vulnerable to joblessness, drug abuse and crime.
The country's three biggest jail systems -- Cook County, in Illinois; Los Angeles County; and New York City -- are on the front lines. With more than 11,000 prisoners under treatment on any given day, they represent by far the largest mental-health treatment facilities in the country. By comparison, the three largest state-run mental hospitals have a combined 4,000 beds.
Put another way, the number of mentally ill prisoners the three facilities handle daily is equal to 28% of all beds in the nation's 213 state psychiatric hospitals, according to the National Association of State Mental Health Program Directors Research Institute Inc.
The entire story is here, hiding behind a paywall.
The Wall Street Journal
Originally published September 25, 2013
Here is an excerpt:
America's lockups are its new asylums. After scores of state mental institutions were closed beginning in the 1970s, few alternatives materialized. Many of the afflicted wound up on the streets, where, untreated, they became more vulnerable to joblessness, drug abuse and crime.
The country's three biggest jail systems -- Cook County, in Illinois; Los Angeles County; and New York City -- are on the front lines. With more than 11,000 prisoners under treatment on any given day, they represent by far the largest mental-health treatment facilities in the country. By comparison, the three largest state-run mental hospitals have a combined 4,000 beds.
Put another way, the number of mentally ill prisoners the three facilities handle daily is equal to 28% of all beds in the nation's 213 state psychiatric hospitals, according to the National Association of State Mental Health Program Directors Research Institute Inc.
The entire story is here, hiding behind a paywall.
Friday, October 11, 2013
Lacking Rules, Insurers Balk at Paying for Intensive Psychiatric Care
By REED ABELSON
The New York Times
Published: September 27, 2013
Here is an excerpt:
Melissa’s treatment did not come cheap: it ultimately cost hundreds of thousands of dollars, Ms. Morelli said. Patients often find themselves at odds with health insurers, but the battles are perhaps nowhere so heated as with the treatment of serious mental illness.
It was not supposed to be this way. A federal law, the Mental Health Parity and Addiction Equity Act of 2008, was aimed at avoiding fights like this over coverage by making sure insurers would cover mental illnesses just as they cover treatment for diseases like cancer or multiple sclerosis.
The entire story is here.
The New York Times
Published: September 27, 2013
Here is an excerpt:
Melissa’s treatment did not come cheap: it ultimately cost hundreds of thousands of dollars, Ms. Morelli said. Patients often find themselves at odds with health insurers, but the battles are perhaps nowhere so heated as with the treatment of serious mental illness.
It was not supposed to be this way. A federal law, the Mental Health Parity and Addiction Equity Act of 2008, was aimed at avoiding fights like this over coverage by making sure insurers would cover mental illnesses just as they cover treatment for diseases like cancer or multiple sclerosis.
The entire story is here.
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