About ten years ago, I was diagnosed as having bipolar disorder I. To qualify for a diagnosis of bipolar disorder I, you must have experienced at least one manic episode that was not triggered by medication or substance abuse. Most people with bipolar I experience depression, as well, but depression is not required for a diagnosis of bipolar I.

I have been in a Federal Detention Center (FDC) for the past five months. In accordance with my attorney’s advice, I cannot discuss any details of the case. Recently, I have started corresponding with Joe Kraynak, coauthor of Bipolar Disorder For Dummies. He requested that I share my insights from inside the criminal justice system regarding the way medications are prescribed and administered.

Yesterday, I served on a panel of family members who have loved ones with mental illness, where we talked to a room full of police officers (approximately 30 of them) as part of their crisis intervention team (CIT) training. NAMI-WCI (West Central Indiana) provided the training.

As I prepared my story for the presentation, I realized that I am never the one who calls 911 when my wife is experiencing a manic episode. My wife has always been the one to call, usually because she is experiencing paranoia and psychosis and feels the need to call the police for protection.

This made me wonder… why?

In the mental health community, we often find ourselves wringing our hands when our loved ones fall victim to a flawed system. Too often, I hear of stories from family members who do everything right and have everything turn out all wrong.

They take their loved one to the emergency room in a psychiatric crisis, and three hours later, the patient calms down and is released with no follow-up care in place. They contact their Community Mental Health Center only to be told that they need to contact an attorney, instead. They call around to psychiatric facilities and find out that no beds are available.

They call 911, and the police show up, arrest their loved one and file criminal charges.

Last Thursday, my wife and I attended a viewing of Dr. Delaney Ruston’s documentary film Unlisted followed by a panel discussion. The film and panel discussion focused primarily on schizophrenia, but individuals with bipolar disorder and their families face similar struggles.

I was very impressed by the keynote speaker, Dr. Alan Breier, MD, who passionately and compassionately described the struggles of people living with schizophrenia. He called schizophrenia the “quintessential human experience,” because it affects the two qualities most responsible for making a person feel human:

• The ability to work
• The ability to love

The other day, I was looking through a very helpful publication entitled “What To Do in a Psychiatric Crisis in Indiana,” published by NAMI Indiana. I read it before and mentioned it in a previous post entitled “What To Do in a Psychiatric Crisis,” but what struck me this time was the discussion of calling 911. If you call 911 to report a psychiatric crisis, the dispatcher is most likely to send the police, and NAMI cautions:

It is important to note that depending on the police officer involved and other contingencies, s/he may take your loved one to jail instead of to the emergency room. Be clear about what you want to have happen.

That’s excellent advice, but wouldn’t it be better if you called 911 to report a psychiatric crisis, and instead of just the police an ambulance arrived, too? After all, bipolar disorder is an illness, and ambulances have medications that can calm a person down. Also, wouldn’t someone who’s experiencing a major mood episode be more inclined to voluntarily go away in an ambulance than in a squad car? Wouldn’t it be less stigmatizing?

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.