Wednesday, January 12, 2011

Discussing the Arizona Tragedy on NPR

By Dr. Ken Duckworth, NAMI Medical Director
Listen to NAMI Medical Director Ken Duckworth discuss the Arizona tragedy on NPR.

The tragedy in Arizona raises many more questions than it answers. One key area under discussion is the role of unassessed and untreated psychiatric disorders in the lives of young adults, who are already undergoing multiple life stressors. NPR’s popular program, The Diane Rehm Show, as well as Wisconsin NPR and Minnesota NPR,  devoted an hour to this crucial discussion this week. NAMI was well represented in these discussions. Pete Earley, a NAMI  father and author of Crazy: A Father's Search Through America's Mental Health Madness; Lisa Dixon, M.D., leading researcher and NAMI  scientific advisory council member; E. Fuller Torrey, M.D., of the Treatment Advocacy Center and I  participated in the Diane Rehm NPR show. I encourage you to click on the link to the recording of her show from Jan. 11.

Mr. Earley spoke eloquently about a parent’s conundrum—how hard it can really be to get mental treatment for one’s child, in part due to the fact that our health care system has not learned how to dance gracefully between the demands of privacy versus the demands of personal and public safety. Any catastrophic outcome gives us all pause to reflect what we can learn, and some facts will emerge over time to understand decision points in the Tuscon tragedy. If there is one positive note, it’s that tragedy can sometimes inspire public discourse about an often silent problem—the failure to have an accessible and well resourced mental health system. When we see evidence of how high the stakes can be when it happens that someone in crisis does not receive timely intervention, it can help focus attention on improving culture of help seeking, and the need for diagnosis and treatment. Because treatment does work—it comes down to investment in college, public and private mental health and substance abuse services and to our collective acceptance as a culture that getting help is positive and healthy. Such an investment ends up being less costly—in dollars and heartache—in the long run. 

There are likely many things we can learn as the data comes in on this tragedy. In the meantime, I encourage parents and friends of people they are concerned about to follow your gut.  When parents find themselves waking up in the early morning, worrying about their child, I recommend that they talk to their loved one and see if they can discuss their experience, and get an evaluation. Maintaining your support and connection with the person is key—if that is impossible then work to get help to understand why. That step has it own resource challenges of course, and this is another hurdle to getting help.  Many people trust their general practitioner, who may help or find a psychiatrist or mental health professional who can.  He or she can help you figure out what is normal adolescence and what is a mental health problem. This can be the hardest thing you will ever do--getting a loved one help who does not know he or she has a mental illness—and as many as 50 percent do not when living with schizophrenia or bipolar disorder. This can be one of the most difficult, and more important, acts of love you may ever have to perform.  Get support for yourself as you engage in this challenge to find the right path with people you trust or in a NAMI support group.  Always see if you can find a way to get your loved help with consent and collaboration.  But that can be impossible in some psychiatric situations. If you do need to put someone into an evaluation or treatment against their will, they may not thank you. But you may make a difference.

Call the department of mental health in your state to get information about resources for services.  Substance abuse can increase the risk of violence and complicates treatment efforts,  regardless of whether someone is living with a mental illness. Contact the Substance Abuse and Mental Health Services Administration (SAMHSA) for a substance abuse treatment facility locator. You may have to fight to find a bed if you live in one of the many states where hospital beds are being closed (while more prisons are being built).

There is a saying, “Pain shared is pain halved.” Families and communities need to work together to create a situation where there is no prejudice against seeking mental health treatment or towards people who live with mental illness. Join NAMI—we are the focused advocates for change that can help make this happen.  NAMI is one of the key authors of material improvement in the opportunities for people living with mental illness and their families. Our national network represents the change we long to see in our culture and our care systems. The mental health care system needs transparency, and NAMI wants to hand as many service and treatment tools as possible in the hands of individuals and families. We need to have a national conversation about mental illness —both on possible lessons from this tragedy and also for the thousands of young adult Americans who are not encouraged, willing or able to get the help that could promote their recovery. Because treatment often  works—if you can get it.

16 comments:

Anonymous said...

I feel so badly for Jared Loughner's family. I am the parent of two adults with mental illness. I received a crash course in mental illness in a time of crisis. The thing that struck me the most was how little the "professionals" really understand it. It's very hard to get time off work because your child is suffering some vague mental issues that you don't even have a diagnosis for - and you don't know how long it will take them to get better and you've been told not to leave them alone. The mental health system is beyond broken (in many places almost non-existent), and tragedies like the one in Arizona create more stigma toward the mentally ill and their families. When a child gets cancer, the media doesn't surround their parents' home and ask "How could they have let this happen?". It's very hard to tell the difference between adolescent moodiness and mental illness when you have no training. The child may not talk openly to their parents about thoughts they are having. Even if they do, if they don't want help or won't comply with treatment it's heartbreaking. If they are adults, nobody can make them get treatment unless they become a danger to themselves or others - and by that time it may be too late to prevent a tragedy. Unfortunately, the only site where people are speaking about the issue with compassion is a website utilized by people that have experience with mental illness. For those with no experience that are unsure about the stability of a friend or family member - they may be alone and afraid, watching news reports about a "monster", and hoping they don't see their loved one on the nightly news some day.

Michael said...

Parents and family are all too often faced with a choice of not seeking help out of fear of jail time or sending their own children to prison. A good first step might be to privude for some prosecutorial immunity against drug related charges for anyone seeking help (or reported by friends and family) for issues with mental illness - which so often accompany substance abuse.

Anonymous said...

I fear we are preaching to the choir here. Others who know nothing of mental illness seem determined not to learn, and worse yet to use this horrible situation to make some completely unrelated point. Actual compassion for the mentally ill seems nonexistent, and as usual the family will be blamed.

Anonymous said...

I, too, pray for Jared's parents and for all of the victims of Saturday's tragedy.
I was comforted by reading that "Gabby" was a "friend" of NAMI-Arizona and had participated in events held.
I am frustrated, still, by the lack of understanding and the poor choice of words aimed at this very ill young man and his family.
I pray the professional community will rise to this occasion and speak out as to the lack of available mental health agencies and treatment for those in crisis and their family members. Changing the notion that having a mental illness is a bad thing is of utmost importance.
Seeking and staying in treatment brings health.

Michael said...

I think the tragedy in Tucson, AZ was horrific. Unfortunately, this country has a great health care system only if you can afford (e.g have health insurance, have money to pay for it, etc.) I have run into a lot of stigma regarding my only mental illness, especially from my own parents. People need to be educated about mental illness too. The more people are educated about mental illness, the more likely people will get help because of the reduced stigma.

It's too bad that some politicians are put politics and their own self-interest ahead of the physical and mental health of people in this country.

Anonymous said...

I too am a mother of a mentally ill son. It saddens me to hear the ignorance of our media and our society. I asked myself where is our voice, to talk of a person who is ill as if they are a monster, or that they had a choice to stop there illness is really very sad. And even worse to blame a parent for an illness of the mind is inexcusable. Even the mentally ill are deserving of respect, and love,and our prayers for their healing.

Anonymous said...

Once again, a tragedy has underscored a widespread lack of understanding of the nature of mental illness and challenges to its treatment.
Individuals and organizations that advocate for those with brain disorders need to be "front and center" in discussions about the Arizona tragedy and in my opinion, that is not happening nearly enough. NAMI should provide relevant information through newspapers, magazines and TV in addition to the NPR interview.

Anonymous said...

my husband is mentally ill. he was also able to buy a gun legally. he wasnt suppose to be able to buy a gun. he was in a crimally insine hospital. he tells me that he hates the people that bullied him&made fun of him in school. that he wish they where dead. i made him sell his gun. i felt like i needed to speek out. i want to be a voice not just for mental illness for victims.

Contributors: said...

Hi Anonymous. NAMI has been active in all sectors of the media. You can see a summary of these media appearances and articles on our twitter feed: http://twitter.com/NAMICommunicate

Anonymous said...

Anonymous asked where is our voice. NAMI was supposed to be our voice, however it has not been a very strong one. I have not heard from NAMI in the media. If something involving a more socially accepted and "in-vogue" illness had happened it would make all the news. Where has NAMI been? - they should be knocking the doors down reacting to the harsh and ignorant comments by some Congressmen in regards to the Arizona tragedy. We, NAMI, have been afraid to be assertive in our advocacy. NOTHING, NOTHING, NOTHING will change unless we change. I feel like I am going to wait perhaps another 30 years for NAMI to act. NAMI needs to be strong, assertive, relentless in advocating for SERIOUS mental illnesses. We have waited far too long. Please, please NAMI really, truly be our voice. The time is now. We are so tired of waiting.

Contributors: said...

Hi Anonymous #2,

We're sorry that NAMI has not lived up to your expectations. If you could only see the mobilization of forces it has taken to answer the phones, educate the media, and make media appearances since the tragedy, you might understand the number of paid and volunteer hours that went into the impact we were able to make.

Malcolm Varner said...

How can we be more proactive with regard to these incidents rather than being reactionary to such major and unfortunate circumstances when they do occur?

Anonymous said...

Hi Contributors. I have no doubt that there are many hard working, dedicated NAMI advocates and that many hours have been spent on reacting to the recent tragedy. That is my point. We timidly react. We need to do much more than react. We need NAMI to be our strong voice so that everyone finally gets the message and there will be no more excuses for the ignorance and injustice that continues to plague the lives of the mentally ill and their families. I do not apologize for my impatience. That is what it will take to make the changes that must, MUST occur. We cannot be satisfied with NAMI until much more is accomplished.

Anonymous said...

Stop mis-representing the Laughner case as a purely biological disorder. This is an extremely complicated case and a full assessment has not been performed.

This has major implications for the perceptions people have of mental illness and its etiologies as well as the impact on Laughner's legal case.

norma said...

Has there been any indication that Jared or his parents had tried to get help and were unable to get adequate help or treatment? This is so often the case. If so, this should be shouted loud and clear so the public hears!

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