Date: 2nd Thursday of every month starting May 10, 2012

Time: 6:30 – 8:00 pm

Place: Crawfordsville First United Methodist Church, 212 East Wabash Avenue, Crawfordsville, Indiana

Group type: For people with serious mental illness and family members and friends who have loved ones with serious mental illness

More info: Visit the Crawfordsville NAMI website for additional information.

(I posted the following when we were training to become NAMI support group facilitators and added the information above as we geared up to actually start our support group.)

My wife and I and one of our neighbor friends spent part of our weekend in Lafayette, Indiana training to become NAMI (National Alliance on Mental Illness) support group facilitators. We’re planning to start a support group in our town, Crawfordsville, Indiana later this spring and offer a Family-to-Family course in the fall.

I’ve been to several NAMI support group meetings in Lafayette (and Indianapolis when we lived there), and I’ve found them to be very helpful. Even when everything is going well in my family and I don’t really need the support, spending time with others who’ve struggled with mental illness in their families and having an opportunity to help someone by sharing the knowledge I’ve acquired over the years feels great.

The meetings always start and end on time, and the facilitators have been very good about giving everyone a chance to speak and not allowing any attendee to monopolize the meeting.

If a loved one with mental illness or suspected mental illness is arrested, the goal is to transition the person as quickly as possible from the legal system to the healthcare system. The Los Angeles NAMI Criminal Justice Committee has posted a very thorough seven-step guide to help families navigate the criminal justice system in Los Angeles County when a family member who suffers from a brain disorder (mental illness) is arrested. It’s called “Mental Illness Arrest: What do I do?”

This post changes the process a bit, removes details related to the Los Angeles jail, includes some additional notes and tips, and presents everything in more of a checklist format.

Mental illness carries a stigma, no doubt about it. Recently, however, I began to wonder just how deep this stigma really is and how much of it is self-imposed. In other words, do we feel stigmatized mostly because people stigmatize us or because we fear that they would if they knew we were living with mental illness? (And when I say “we” I mean members of the bipolar community, including people who have loved ones with mental illness.)

Two events triggered my thoughts on this.

I just read an article on the FOX News website entitled, “Judge Rules Prison Doctors Can Forcibly Medicate Loughner.” The article says that the key question is whether prison officials or a judge should decide whether Loughner should be forcibly medicated.

Loughner’s attorneys also are fighting the forced medication at the 9th Circuit. The key question is whether prison officials or a judge should decide whether a mentally ill person who poses a danger in prison should be forcibly medicated. Prosecutors say the decision is for prison officials to make, while Loughner’s lawyers say it’s up to a judge.

My immediate thought was “Shouldn’t the doctors be deciding that?” and “Why would Loughner’s attorneys be fighting against the forced medication?”

We distinguish between mental and physical illness. Why? Many illnesses we consider physical have a mental component, including ulcers, asthma, hypertension, irritable bowel syndrome, heart disease, urticaria (hives), and sexual dysfunction. And the illnesses we consider mental all have a physical aspect to them, namely the brain. Yes, the brain is physical. It’s not just some nebulous collection of emotions, thoughts, and brain waves concentrated in a person’s head. In addition, some so-called mental illnesses – anorexia, for instance – have readily observable physical symptoms.

Whenever we use the phrase “mental illness,” regardless of whether we intend to do so, we reinforce the false dichotomy of mental vs. physical, mind vs. body. This leads many people to question whether brain dysfunctions such as depression and bipolar disorder are truly illnesses, even when they have no trouble recognizing that that certain so-called mental illnesses, such as autism, epilepsy, and Alzheimer’s are physical.

Cathi asks…

My friend’s 9 year old has had severe behavioral problems and several alternating diagnoses. The Dr. has prescribed Focalin, Trileptal, Lamictal, and Seroquel. She has no concentration, violent outbursts, hallucinations, etc. She has been diagnosed, at present, with ADHD, Bipolar, ODD, and PDD. She will not do work at school; instead, she sits and picks at her skin. She has been violent and tried to choke other individuals. Mam says she can’t even leave the house with her.

My friend has no money. The state has removed an older child due to DMH reasons. She is afraid of the state agencies, but has nowhere to turn. Court appointed attorney said to call if she won the lottery. What happens to these children? These medications seem excessive and risky considering her age, the possibility of adverse interaction, and off label usage. Any advice or help. We are desperate. Thank you.

Dr. Fink answers…

This is an all too common situation in children with multiple levels of developmental, emotional , and behavioral symptoms, especially when the family’s resources are limited. The first place to start is with the current doctor to get a clearer picture of the reasons for the current medications and to express clearly the ongoing symptoms that are not being addressed.

As a psychiatrist, every day I encounter families struggling with mental illness, especially in their children whose lives range from disrupted to shattered as a consequence of these challenges. In these daily battles I’m most frustrated and saddened by the jaw-dropping lack of compassion surrounding me and my patients regarding their family struggles and their child’s distress.

Unfortunately, many people still view mental illness as a moral rather than a medical or developmental issue. As a result, they readily dispense judgment when someone is struggling with emotional and behavioral symptoms – shutting down open discussion and squashing attempts to problem solve rather than blame.

Even worse, stigma and misunderstanding paralyze many people who might consider seeking help but don’t because they’re afraid of being judged or feel somehow to blame. Families are told they’re being manipulated by their loved one who’s suffering or that their parenting is impaired. Just “try harder” says the teacher, the coach, the neighbor, and the in-laws.

I’ve  just read an interesting article by Brandi Grissom first published in The Texas Tribune entitled “Mental Health Cuts Would Strain Local Texas Jails.” This article does an excellent job of calling attention to two of the main problems with cost-cutting plans that target community-based mental health treatment – people suffer while funding cuts cost more money than they save.

Cutting those services would take a devastating human toll, Schwartz said, but it would also come at an enormous financial cost. When people with untreated mental health problems fall into crisis, it is much more expensive to provide care in an emergency room, jail or crisis center.

Betsy Schwartz, president and chief executive of Mental Health America of Greater Houston

Paul Heroux recently penned an op-ed piece entitled “Can we help them before they hurt us.” To be fair, Heroux admits the poor choice of words in the title in his response to a reader’s comment:

“I write op-eds all the time. I don’t choose the titles of my op-eds, the editors do. That said, I don’t think the editor meant anything malicious by it but you do raise a good point.”

Unfortunately, malice is rarely the motive that drives stigma. Ignorance and insensitivity are the primary culprits. Also, I don’t believe Heroux’s admission gets him completely off the hook. Although he attempts to write a balanced piece, his approach tends to lean toward fueling fear and reinforcing an us-vs-them mentality.

I encourage you to read Heroux’s op-ed in its entirety before reading my comments on it, so you can see the quotes I reference in their context. It’s only fair.

While I understand that writers need to be a little dramatic or controversial to hook readers, I think the hook in this article goes a little too far in inciting fear:

In an article in The New York Times entitled “Mental Health Needs Seen Growing at Colleges,” Trip Gabriel explores the increasing demand for mental health services on college campuses across the country.

The college years have always been vulnerable to mental health issues – partially due to the stresses of academic demands and the transition to living more independently and partially because late adolescence/early adulthood is the most common time to see full blown first breaks of major mental illnesses, including depression, bipolar disorder, and schizophrenia.

But in recent years it has become clear that more and more students are coming to campus with previously diagnosed psychiatric conditions and taking medications. While this may be a sign of over-diagnosed and over-medicated youth, I see it in a more positive light for three possible reasons: