Tuesday, 25 January 2011

It Gets Nuts When the Sane Are Crazy Too

Written by 

Ralph Reiland“On any given day in the United States, the number of people with severe mental illness in prisons is estimated to be three times higher than the number in hospitals, according to a new report from the Treatment Advocacy Center and the National Sheriffs’ Association,” reported Seena Fazel recently in the Wall Street Journal (“The Line Between Madness and Mayhem,” January 15-16).

“Interestingly,” continued Fazel, “they found that Arizona and Nevada had the highest ratio of prisoners with mental illness, with 10 times more mentally ill people in jails and prisons than in hospitals.”

Arizona has 5.9 psychiatric beds per 100,000 population, or one-tenth of the recommended level to meet public needs (only Nevada had a worse ratio), reports the Treatment Advocacy Center in Arlington, Virginia, a national organization seeking to eliminate barriers to the treatment of severe and persistent mental illnesses, such as schizophrenia and bipolar disorder.

An estimated 4.5 million people in the United States have those two illnesses, with reportedly 2.3 million and 2.2 million people, respectively, afflicted with bi-polar disorder and schizophrenia.

Some 40 percent of those people are going without treatment, i.e., 1.8 million, reports the National Advisory Mental Health Council.

In Arizona, there are more than 50,000 people with schizophrenia and a minimum of 25,000 are untreated, according to E. Fuller Torrey, M.D., a research psychiatrist specializing in schizophrenia and manic-depressive illnesses, the Executive Director of the Stanley Medical Research Institute, and the founder of the Treatment Advocacy Center.

This is where Jared Loughner comes in and his reported behavior over the past year or so. Schizophrenia is characterized by the following: a noticeable deterioration in the level of functioning in everyday life, a withdrawal from reality, illogical patterns of thinking, bizarre delusions, and social and/or occupational dysfunction.

What preceded the shooting in Tucson was a job that Loughner no longer held, a school that he no longer attended, a girlfriend who was no longer around, the shooter’s bizarre anger about the nation’s allegedly lousy skills in grammar, and the shooter’s reported fascination with the idea that Bush and Cheney planned the 9/11 attacks. Hollywood couldn’t have written a script more in harmony with the Dictionary of Symptoms.

“The proven link between untreated mental illness and violence is indisputable,” asserts a statement from the Treatment Advocacy Center. Pointing to the aforementioned numbers in Arizona regarding the number of people suffering from schizophrenia and the lack of psychiatric hospital beds, the Center warns that “untreated mental illness is a public safety issue of significance in the state.”

More broadly and explicitly, the Treatment Advocacy Center points to the consequences of non-treatment:

• People with untreated psychiatric illness comprise one-third of the nation’s 600,000 homeless population. “Eight percent used garbage cans as a primary food source,” while “28 percent of homeless people with previous psychiatric hospitalizations obtained some food from garbage cans.”

• Approximately 1,000 homicides are committed each year by people with untreated schizophrenia and manic-depressive illness.

• The suicide rate for schizophrenics is 10 to 13 times higher than in the general population.

“A 1998 MacArthur Foundation study found that people with serious brain disorders committed twice as many acts of violence immediately prior to their hospitalization, when they were not taking medication, compared with the post-hospitalization period when most of them were receiving assisted treatment,” reports the Treatment Advocacy Center. “Important to note, the study showed a 50 percent reduction in rate of violence among those treated for their illness.”

Bottom line, what’s crazy is how this society lets the mentally ill fall through the cracks.

Ralph R. Reiland is an associate professor of economics at Robert Morris University in Pittsburgh.