Where’s the Mental Health First-Aid Kit?

Programs like Mental Health First Aid are elevating mental health in the national discourse.

We’re seeing new resources in the workplace when it comes to First Aid. Next to the metal box with a red cross are defibrillators to treat heart attacks and workplace classes to instruct employees on how to use the devices properly. But there’s a gap in mental health and substance use that is ignored and simply seems too complex. Not anymore. That’s where Mental Health First Aid comes in.


Why is addressing mental health so difficult?

If we see someone bleeding, we know we should stop the bleeding. If someone breaks an arm or leg or has chest pains, we call 911. Mental health issues can be complicated and not as easy to detect. Oftentimes, we are reminded that we’re not a trained psychologist or simply don’t recognize the signs. We often conclude someone is “just having a bad day.”


Bad days add up

Psychological health and physical health are equally important, and have a synergistic relationship. Someone who is physically sick can feel depressed. Someone who is depressed can be predisposed to become physically sick. Poor heart health can make your lethargic. Diabetes can affect your performance and attendance at work. An auto-immune disease can significantly compromise your ability to perform on many levels. A mental health or substance use concern can often lead to these issues, as well.


Mental Health First Aid is a step forward

A program called Mental Health First Aid is designed to give managers, human resources professionals and others the ability to identify potential mental health and substance use concerns. The publically available, skills-based, in-person training outlines a five-step action plan that equips employees with the tools they need to notice the signs and symptoms of a possible mental health or substance use concern and identify the tools and resources available to respond to a crisis, refer to supportive services, or deescalate a situation, if necessary. Employers can implement Mental Health First Aid as part of an employee engagement or workplace wellness program focused on improving whole health and wellness, as well as to address the effects of mental illness on productivity and associated costs.


Mental Health First Aid is a global initiative available in 23 countries with origins in Australia. It was adapted for the United States in 2008, where it is administered by the National Council for Behavioral Health in partnership with the Missouri Department of Mental Health and the Maryland Department of Health and Mental Hygiene. The program is available in two different packages: an 8-hour Mental Health First Aid Certification Program and a 4-hour Mental Health First Aid Course.


In July 2015, the National Council established a groundbreaking corporate collaboration with Aetna, one of the nation’s leading diversified health care benefits companies, to provide Mental Health First Aid training opportunities to Aetna and its customers.


According to Hyong Un, M.D., chief psychiatric officer for Aetna Behavioral Health, “Mental Health First Aid supports the effort to fight mental health stigma in the United States. By acknowledging the issue of mental health in the workplace, the training program gives employees the tools they need to quickly identify when a fellow coworker is having an issue.”


And the Federal Government has also taken notice of Mental Health First Aid’s value and efficacy by introducing The Mental Health First Aid Act of 2015.


If enacted, the legislation (S. 711/H.R. 1877) would authorize $20 million for Mental Health First Aid. Under this funding, participants would be trained in:


  • Recognizing the symptoms of common mental illnesses and substance use disorders
  • De-escalating crisis situations safely
  • Initiating timely referral to mental health and substance abuse resources available in the community


Approximately $15 million was appropriated in 2014 and 2015 for Youth Mental Health First Aid – a figure which must be protected moving forward. To top it off, approximately 30 peer-reviewed studies from across the globe demonstrate the value of Mental Health First Aid. In 2014, research published in the International Review of Psychiatry showcased how Mental Health First Aid increased participants’ knowledge regarding mental health, decreased negative attitudes and increased supportive behaviors toward individuals with mental health disorders. Additionally, the Substance Abuse and Mental Health Services Administration honored Mental Health First Aid with inclusion in its National Registry of Evidence-based Programs and Practices.


Mental Health First Aid is growing

More and more individuals are embracing the program. In fact, the National Council has trained 430,000 Mental Health First Aiders to date in the United States. The training offers some basic foundations for a new way of thinking about mental health including:


  1. Awareness of the range and types of conditions.
  2. Understanding of the fact that many of these conditions are genetic or simply a function of how someone’s brain is “wired.”
  3. Education as to how and why some individuals are challenged by mental health issues.
  4. Sensitivity to the person as a patient who needs treatment on the same level as someone with a physiological condition.
  5. Inclusion of the treated person or patient following an effective course of treatment in the same way we would embrace someone recovering from a surgical or other course of physical treatment and therapy.


It’s about time


Approximately 1 in 5 adults in the U.S.—43.7 million, or 18.6% of the population—experiences mental illness in a given year. That’s why Mental Health First Aid is long overdue. Hopefully, programs like these will advance the sensitivity and treatment of mental health to the same level as conditions affecting physical health.


Taking Mental Health First Aid is a common sense, simple step every adult can take to support those who may be dealing with a potential mental illness or substance use concern. To learn more or to find a Mental Health First Aid training near you, please visit http://www.mentalhealthfirstaid.org/



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The Extinction of the American Dream

The poor are confronted with two choices: stay poor or get poorer. Here’s why the American Dream is a continuing nightmare for so many.


More than 46 million Americans live in poverty in the U.S. And that’s based on census data that usually doesn’t record the homeless or many immigrants who are simply missed or avoid a census survey every 10 years.


The question from many lawmakers, particularly conservatives, is why they won’t simply boot-strap themselves to the great American Dream. The fact of the matter is that those entitlements most conservatives are most concerned about actually have an unintended consequence.

Poverty is a two-edged sword.

You could also call it a catch-22 or someone between “a rock and a hard place.” The metaphors abound but they’re built on actual fact.  If you’re poor enough you are eligible for benefits from the federal, state and local governments. If you’re not, you’re not.

And that’s the problem. For many people, making as much as $1 more a month will eliminate them from programs like food-stamps (now called the Link card in many states), government housing, grants from utilities, financial assistance beyond food stamps to pay for things like toilet paper and soap, educational assistance and Medicaid.

The result is that incentive is diminished. Why would anyone take a job that pays them $200 a month more if that increase means they will lose $1,000 in monthly benefits defined by a poverty line? It’s a bottomless pit and a logical dilemma. Benefits from federal, state and local governments continue to be measured against a fixed dollar amount measured monthly and or annually. If you exceed either by as much as $1, you are no longer eligible for that benefit.

It doesn’t get any better for people on Social Security.  If you take your Social Security at age 62 which many people must do, you can’t continue to succeed without penalty. For the year 2015, this limit on earned income is $15,720 ($1,310 per month). If you are collecting Social Security retirement benefits before full retirement age at 66, your benefits are reduced by $1 for every $2 you earn over the limit. Once you reach full retirement age, there is no limit on the amount of money you may earn and still receive your full Social Security retirement benefit.

The assumption is that you have other retirement options like a big pension or fat 401k, but thanks to some past mistakes by Wall Street and the pure greed of financial markets -how many people still have a 401k or IRA that’s worth anything? For most people their Social Security income is sustenance income at age 62 and they will be punished if they try to make more money beyond fixed limits. That puts most of them at poverty level and their numbers will increase.

Why is that legitimate? I mean think about it: A person has invested in Social Security throughout their work history whether they like it or not, and now that investment has limitations? Why? And what is the rationale for that decision? If anyone has a clue, please share because it’s not in the public domain. I never signed an agreement when I applied for a Social Security card that said there would be limitations on my ability to generate income in the future. How did this happen now?

Here’s the fundamental question. How can the federal government bail out banks and financial institutions for horrorific and egregious errors that wiped out the investment savings of millions of Americans, and then turn around and fine them for Social Security payments if they continue to work after they’ve taken their benefits at age 62?

The whole conundrum is confounded by the number of people with mental health issues who struggle to understand benefits let alone viable employment. How many of them wander our streets and live in misery in our jails? The result is a poverty trap that keeps people in a cycle of poverty with little incentive to pursue anything approaching the American dream. They’re also not included in our census audits. How many homeless people are contacted let alone volunteer information to a census-taker?

This is not a Democratic or Republican party problem. It’s a fact of life and these federal, state and local programs are both necessary and important, but they have unintended consequences. The poverty-pit is an unintended consequence of compassion and necessity.

So how do we boot-strap from the poverty-pit?

For one, lift the Social Security penalty. Many Boomers lost it all when their companies or investments were vanquished by Wall Street speculation. The Federal government bailed out the banks, but for those people who counted on their retirement savings -there’s nothing left but Social Security and a penalty if you have to still work to maintain a better quality of life if you take your benefits at the minimum age of 62.

Two. Create a sliding scale that allows someone to transition to a better wage, and increased monthly income without the abrupt loss of benefits because of a fixed dollar amount cutoff based on a monthly income increase or a tax return AGI that exceeds the limit by $1.

The current argument is for the lifting of the federal minimum wage. It’s surprising more conservatives aren’t supporting it because it will most likely disqualify many Americans from poverty level benefits.

There’s also a question related to the Earned Income Tax Credit. This offers some relief from federal taxes, but it does nothing for someone who once again faces the $1 cutoff for monthly benefits.

We should also think in terms of the lost, hopeless and homeless. The Smarter Sentencing Act would apply a more intelligent approach to an individual’s challenges rather than the blind assumption that they are a pox upon the public.

There are some politicians who want to revoke “entitlements” or programs like food stamps or government assisted housing. The caution is that a starving population is not happy. The French learned that very well long ago.

On the other hand, a population that is caught in the vise-grip of subsidies and fixed monthly and annual ceilings for benefits feel the same, simmering frustration. We need a sliding scale that allows people to transition from poverty to productivity without the penalty of cruel, dollar-amount cutoffs. We need to be wise with regards to how we treat our homeless and people with mental health issues. We need to be sensitive rather than cruel. Without some relief and a good dose of wisdom, it will be the extinction of the American dream.

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I Am Not A Victim

People have varied and sometimes misconstrued perceptions of disability. Often times they don’t see people as having a disability unless it is physical. Physical disabilities are grave and problematic for those with them, but often just as with mental illness people with these disabilities are able to do amazing things. Disability is not an inability; it just means those of us with a cognitive or physical disadvantage have to strive harder to outperform our peers.

Having a disability is much like the story of The Ugly Duckling by Hans Christian Andersen whereby the duck is abused and humiliated by his peers and then to his surprise he becomes a swan, and not just any swan, the most beautiful swan in the world. That story tells of the transformation of people, in my mind, with disabilities. At first, people with disabilities will feel abused and imagine it is somehow their fault due to the perceptions of stigmatization, but then when they realize that none of it is their fault, they grab the reigns of strength and vitality and expect more of themselves than what they first perceived they were capable of.

Disability is not an inability; disability is innate ability to persevere. It is within all of us to persevere against all odds. In 2008 when I was diagnosed with schizophrenia the doctors at Shands and the VA medical facility in Gainesville, Florida said I’d never be able to live on my own again, but thankfully doctors can be proven wrong. Years of hard work, medication, and working to balance oneself can prove them wrong.

Generally, I’m upfront about my disability. I first came out about my mental illness when I saw an advertisement late at night that was sponsored by the organization BringChange2Mind.org. That television ad brought to mind the activist spirit in myself, and at that point I told myself, “I am not a victim.” Together with the phenomenal work of other organizations such as SARDAA (Schizophrenia And Related Disorders Alliance of America) and with the help of Linda Stalters I’ve been able to truly say, “I’m not a victim.”

Perceptions around mental illness and disability are changing. But no matter what the perception is, first and foremost, one has to say to their self that they will not become a victim or a statistic, and that they will survive against all odds. It’s the only way to move forward, and reinvent one’s life to align with new goals that help one manage the illness or disability.

So, when people ask me about my disability, I’ll tell them I have one and I’ll also say, “I am not a victim to it.”

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The Nightmare of Prison for Individuals with Mental Illness

The treatment of prisoners with mental illness is often barbaric if not medieval. Here’s what needs to stop.


At some point in the 1970’s the decision was made to close state-run mental health institutions. Reports at the time indicated significant abuse of patients and a general lack of credible mental health care. The idea was that funds would be redirected from the states to local communities to manage and monitor the needs of individuals with mental health issues. Unfortunately, this transfer of funds never happened and local communities were simply overwhelmed.


The result was that many people with mental illnesses found themselves in the prison system. Systems underfunded and understaffed without training who were primarily focused on incarceration rather than the needs of anyone with a health condition defined by mental illness.


To make matters worse, prisoners suffering from mental illness often found their condition exacerbated and amplified by their incarceration.   Imagine a person suffering from depression or Bipolar disorder in a hostile and restrictive environment. The new solution in fact created significant problems and ignored a landmark ruling from the Supreme Court.


What has essentially happened is the trans-institutionalization of mental illness from hospitals to prisons. And the prisoners with mental health conditions suffer greatly. Some become withdrawn and others find themselves in solitary confinement intended as a protective measure. According to a report submitted by the University of Pennsylvania in February, 2011:
“Incarceration has a robust relationship with subsequent mood disorders, related to feeling “down”, including major depressive disorder, bipolar disorder, and dysthymia.”


The fact of the matter is that anyone in solitary confinement is treated the same way. They are ignored and only allowed one hour a day to walk into a walled or caged area. They are given their meals in their cell, and windows are small and rare. Solitary is often used as a punishment room, but in many prisons it’s used as way to keep mentally ill prisoners away from the general prison population while imposing the worst punishment a manic-depressive or schizophrenic person could endure.


To make matters worse, many people incarcerated are not properly diagnosed before sentencing. If someone appears to have a substance-abuse issue they are assumed to tolerate withdrawal from that addiction cold-turkey when denied access to substances in prison. Most tough-it-out. Unfortunately, undiagnosed individuals with serious mental disorders like Schizophrenia or Bi-polar disorders are often sent into prisons without proper diagnosis or any plan for treatment or medications. The result is their condition worsens.


Based on a range of studies done by the National Institute of Mental Health, The American Journal of Psychiatry, the U.S. Department of Education and other sources:

  • One in four adults−approximately 61.5 million Americans−experiences mental illness in a given year. One in 17−about 13.6 million−live with a serious mental illness such as schizophrenia, major depression or bipolar disorder.
  • Approximately 20 percent of youth ages 13 to 18 experience severe mental disorders in a given year. For ages 8 to 15, the estimate is 13 percent.
  • Approximately 1.1 percent of American adults— about 2.4 million people—live with schizophrenia.
  • Approximately 2.6 percent of American adults−1 million people−live with bipolar disorder.
  • Approximately 6.7 percent of American adults−about 14.8 million people−live with major depression.
  • Approximately 18.1 percent of American adults−about 42 million people−live with anxiety disorders, such as panic disorder, obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), generalized anxiety disorder and phobias.
  • About 9.2 million adults have co-occurring mental health and addiction disorders.
  • Approximately 26 percent of homeless adults staying in shelters live with serious mental illness and an estimated 46 percent live with severe mental illness and/or substance use disorders.


The fact of the matter is that our prisons are populated by people in desperate need of caring and sensitive psychiatric care. Unfortunately the opposite is true. Both police officers and prison guards receive very little training with regards to interactions and managing individuals with mental illness. Programs need to be initiated to increase that awareness and sensitivity, and most importantly – how to approach and manage someone who has a severe mental illness.


Currently, the prison solution is the worst. Solitary confinement continues to be the method of choice in U.S. prisons for anyone demonstrating perceived or misunderstood mental illness. It is perhaps the most severe and cruel form of punishment for anyone suffering from a severe mental illness. The result is that many people who enter prison with a mental illness, leave prison with a condition that is worse. “The lack of treatment for seriously ill inmates is inhumane and should not be allowed in a civilized society,” Dr. E. Fuller Torrey, founder of the Treatment Advocacy Center said in a recent report.


The result is that many people with mental illness who are incarcerated find themselves back in prison again. The fact of the matter is that our mental health system has failed as the federal government continues to deny and ignore the promises made to improve the system by taking responsibility from the states.


The result is that recidivism rates among the mentally ill is soaring. Any hopes of rehabilitation based on any criminal activity are outweighed by the intense and long-lasting affects of incarceration on mentally ill individuals.


It seems obvious that the best recourse is to return responsibility for the management of mental illness to the states. This appears on the surface to be problematic given the fiscal distress so many states are enduring, but with adequate federal funding the solution is workable. There is also a need for both federal and state funds to be allocated to communities.


On a fundamental level we must overcome our fundamental fear and intolerance of mental illness. We all know someone among our family and friends who struggles with an addiction or a mental disorder and we need to extend that same compassion and care we feel towards them to others.


As potential employers we should not stigmatize people with a police or prison record. Without the potential for employment they will forced to a vicious cycle of hopelessness and potentially crime.


Most importantly, we need to do something about the failure of our prisons as a repository for the mentally ill.   Through a series of unintended consequences we’ve sabotaged our mental health system and relegated the management of mental illness to a penal system designed to imprison and punish.


In a controversial statement made on March 10, 2011, Martin Harty, a member of the New Hampshire state legislature, was asked what could be done for the state’s mentally ill homeless people. Harty replied that the state should “Rent a spot in Siberia for them.”  The media was indignant but ironically, mentally ill homeless persons now receive better care in most parts of Siberia than they do in most parts of New Hampshire.

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How the Federal Government Can Step Up to Relieve the Suffering from Mental Illness

More than 50% of Americans in penal institutions suffer from a severe mental illness. Here’s what the Federal Government needs to do.


In the 1970’s there was a sweeping decision to close state-run institutions and move responsibility for mental health care to communities. This was driven by shocking revelations related to how patients were abused and essentially ignored in state-run mental health hospitals. It seemed like a great idea and the federal government and the states pledged to support a new initiative for mental health. It never happened.


Hundreds of thousands of mental health patients were released onto the streets with the assumption that local communities would provide them with counseling and support. Some were lucky and had the support of family and friends, but most simply found themselves in a world that was both unknown and uncaring.


The result was that many mental health patients found themselves institutionalized once again only this time if was not in a mental health facility, but prison. Once again, mentally ill people found themselves at the mercy of a system ill-equipped and insensitive to their needs and their conditions.


The idea was that funds would be redirected to support communities but most states simply sold the facilities and have simply walked away from an future responsibility for mental health.

The failure point


Prisons on the county, state and federal level are notoriously lacking in treatments for mental health issues. If you get stabbed or bludgeoned in prison they can treat you quickly and expediently, but if you need meds for schizophrenia or a balanced plan to manage bi-polar disorder you may be out of luck. Most prisons at every level are overwhelmed and incapable of managing the effective treatment of any mental illness.


And that’s where the Federal government has failed. There’s a lot of talk out there and some action from Vice-President Joe Biden to President Barack Obama. They’re aware of the problem and want to make changes, but it was Congressman Tim Murphy from Pennsylvania who finally put a bill into action that might make some changes.

Congressman Tim Murphy


According to Congressman Murphy:

“In no other discipline of medicine is care denied to a patient when, because of the very nature of their disease, they can’t voluntarily seek help on their own. We don’t deny treatment to a stroke victim or a senior with Alzheimer’s simply because they are unable to affirmatively articulate their need for care. Yet, in cases of serious brain disorders such as schizophrenia, a chaotic patchwork of laws prevents us from acting even when we know that we must. Patients with serious mental illness have the right to get treatment especially when they are most vulnerable – when they are unable to understand the gravity of their condition and cannot voluntarily seek help.


It is upon this fundamental belief that I am advancing the Helping Families in Mental Health Crisis Act (HR3717). My legislation honors the legacy of President John F. Kennedy by building upon the strengths of his groundbreaking community-based-care model. The bill also meets the needs of those requiring more intensive inpatient medical care by ending the critical shortage of psychiatric beds that has resulted in overcrowded emergency rooms where patients in distress languish for days or even weeks on end.”


The legislation would:

– Allow families to work with patients’ doctors as part of a front-line care delivery team;

– Increase funding for research to better understand the underlying causes of neurological and psychiatric conditions; and

– Train law enforcement on intervening when responding to a seriously mentally ill patient in crisis.


The bill also provides incentives for communities to adopt assisted outpatient treatment programs such as California’s Laura’s Law to help the 1 percent of the 1 percent with serious mental illness who are likely to end up imprisoned or living on the streets, where they suffer violence and victimization, and cycle in and out of the emergency room without family input or support.


This represents good progress but the question is how quickly many of these initiatives can be implemented.   Currently, the Federal governments approach to mental health in general is a convoluted and disjointed mess.

Tip of the iceberg

And it’s worse in our prisons where basic rights are essentially stripped from anyone incarcerated and only fundamental medical treatment is provided. In other words, if you need a bandage for a cut or wound they have one -if you need medication or therapy for a mental condition there’s nothing in the medicine cabinet to help you and the staff is not trained to manage your condition

According to a California prison psychiatrist:

“We are literally drowning in patients, running around trying to put our fingers in the bursting dikes, while hundreds of men continue to deteriorate psychiatrically before our eyes into serious psychoses. . . . The crisis stems from recent changes in the mental health laws allowing more mentally sick patients to be shifted away from the mental health department into the department of corrections.”


Progress is measured in steps and Tim Murphy’s bill is a good step. The real question is whether or not our prison systems will simply accept that they have a new responsibility passed on to them by a systemic series of bad decisions going back to 1970. Until that happens, our prisons will continue to be prison camps for the mentally ill that simply amplify and worsen their conditions rather than the standard mantra of “rehabilitation.”

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Why the States Have Failed Our Mental Health System

It’s a fact. There are 10 times as many people with a serious mental illness in prisons rather than psychiatric care facilities. Here’s why the states have failed.

Throughout the 20th century, states across the country designed and built mental institutions to house people with varying levels of mental illness. Over time it became apparent that the conditions in these mental health facilities were antithetical to the curing of any mental health condition. To put it bluntly, the conditions were often described as barbaric if not indifferent to the needs of the patients.

The abhorrent conditions in state-run institutions.

The continuing failure of these faculties led to sweeping changes that began in the 1970’s. In many respects, this poorly managed decision is the root-cause of the problem confronting not only our prison systems, but the people at the mercy of a system that simply can’t help them. The false hope was that these state facilities would be closed and that communities would assume the responsibility for continuing care supported by both the states and the federal government.

The decision to close state-run psychiatric care facilities

None of this happened. The states closed their facilities, gave little money as subsidies to communities and the federal government not only stopped funding the states, but made a community petition for funds an exhausting and complex process.

The result is that people with mental illness found themselves back in society and often that meant back-on-the-street with nowhere to go. Eventually many of them found themselves in trouble with the law and the great migration began.

The criminalization of mental illness

It was the beginning of the criminalization of mental illness. People who no longer had easy access to counseling and medications didn’t know where to turn.

As they turned more and more to solutions on the street rather than managed care they found themselves in continuing trouble with the legal system and recidivism rates soared. Only now they were going to prison instead of a psychiatric institution.

The community-care assumption

A significant factor in this turn of events was the assumption that local communities would absorb the responsibility for mental health care when the states surrendered their responsibilities and closed their state-run institutions. Unfortunately, the states did not re-direct their mental health funding to communities within their state. The funds were diverted to other state programs and the communities were left to deal with the problem with their meager funds and resources. The outcome was inevitable as more and more people with serious mental illness emerged from institutions back into local communities. They had little direction with regards to where to go or how to seek help, and even those who did seek community support often found small staffs overwhelmed with little training and limited resources.

Ultimately, many people released from institutions found the street to be their only home and recent revelations in Los Angeles point to this growing problem. The fact of the matter is that many people with mental illness simply don’t seek treatment and just as many don’t have the income nor insurance to cover the care.

There is some hope that the recently instituted Affordable Care Act could help, but street people don’t do taxes and many people with serious mental illness simply can’t navigate the complexity of the program in person or on the Internet.

The lack of Federal funding to the states

One of the incentives offered to states to surrender their mental health facilities was the promise that federal support would offer new solutions. They never happened. In fact, it’s hard to know if any federal support provided to states for mental health ever trickled down to the community level where the final support was supposed to reside. The Affordable Care Act could offer some hope, but here again it’s still more of a promise than a result at this time.

The facts and the current situation

The end result is that our prisons have assumed responsibility for most individuals with mental health issues. Prisons that are not designed to treat mental illness; understaffed and undereducated for mental illness, and under-funded for the counseling and basic pharmaceuticals to manage someone with a serious mental health condition.

Here are the facts:
• “Nationwide, people with mental health conditions constitute 64% of the jail population, according to the Federal Bureau of Prison Statistics.”

• “The number of individuals with serious mental illness in prisons and jails now exceeds the number in state psychiatric hospitals tenfold.”

• Bureau of Justice Statistics, July, 1999
“More than a quarter million prison and jail inmates are identified as mentally ill”

• Department of Corrections’ Central Detention Facility,
DC Department of Corrections, September, 2013
“…correctional officers that are assigned to the mental health unit …in the Central Detention Facility do not receive any specialized mental health and/or suicide prevention training.”

Justice Policy Institute, October, 2011
“Too many people found not competent to stand trial are unnecessarily locked in a secure setting for treatment and, on average, confined for longer periods than research demonstrates is clinically reasonable.”

• Office of Juvenile Justice and Delinquency Prevention, February, 2009
“Almost half (48.1 percent) of the suicides occurred in facilities administered by state agencies, 39.2 percent took place in county facilities, and 12.7 percent occurred in private programs.”

• Bureau of Justice Statistics, July, 2001
(None of the prison systems have any idea how many mentally ill prisoners they have. Using the BJS reports for anything other than whether or not prisoners identified as mentally ill are actually receiving services would be a mistake.)

Steps towards a solution

1. The states need to allocate funds to communities as was promised in the 1970’s when they started to shut-down their state-run mental health facilities. This is unlikely given the fiscal and financial challenges confronting so many states and the new administrations who have become accustomed to the status-quo of current state funding.

2. The Federal government needs to support states with funding for mental illness, but the big question is whether or not this state funding will trickle down to the community level to accommodate the current assumptions about how mental health is supposed to be managed and addressed.

3. Communities need to apply to both state and federal agencies to seek support and funding. Unless there is a bottom up petition for aid, it will not be forthcoming.

4. The criminal justice system and prisons need to increase both their sensitivity and response to the growing number of people entering the criminal justice system who have mental illness. This needs to occur on the local, state and federal level.

If only it were so easy. The fact of the matter is that change will probably occur slowly if at all. States are continually strapped for funds and more and more federal funding is diluted by growing international tensions and economic woes. Congressmen like Tim Murphy are trying to propose legislation to address the issue, but everyone’s attention seems stretched a bit thin by the latest war, terrorist attack and celebrity faux pas. Hopefully Murphy’s bill will pass and some steps will be taken to get our mental health system and funding to a level of reasonable sanity.

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I Am Not a Maniac Because I Am Mentally Ill

In the topsy-turvy world of media it is meritorious to say things off the cuff without thinking of the impact of words or the impact of stigmatization. These things that are said generate publicity, coverage, and ratings. Countless times the media has put a face on the mentally ill with particular regard to schizophrenia. Every shooter and every lone gunman somehow without equivocation turns out to be mentally ill which in turn is deemed “schizophrenic.” Schizophrenic is then this nasty term to describe someone and terrorize 1% of the population living with this illness.

I propose to change the term “schizophrenic” in the media today to regard a shooter or someone who has committed a terrible act. Instead, let’s call them “demon possessed” or any other term antithetical to science and psychology. If when media talks about a person and calls them “demon possessed” it will be because the media knows just about as much about demon possession as they know about schizophrenia. The media could even interview Pat Robertson of the 700 Club to get a good take on what demon possession is, what leads to it, and how to overcome it. It would certainly improve ratings to term the mentally ill as having demon possession. It wouldn’t be any different than how schizophrenia is seen today without regard for sensitivities in the production of news, and without educating the general public on the signs and symptoms of the illness.

If you’re going to throw 1% of the population under a bus for ratings then try to have enough moral integrity to dispel myths and rumors about that 1%. Ethical behavior is the true moral fiber of journalism yet it seems to always evade the issues of mental health, and the stigmatization of people in the general public dealing with these issues.

Changing the paradigms of the emphasis on ratings versus integrity would be a broad shift for 24 hours news, but it is a shift that needs to be made. The media often gets things wrong and jumps to conclusions. It’s okay though as no human or organization has ever been perfect, but logically inclinations for taking the high road and educating the public would seem to happen at some point. Media used to be a tool for education and dissemination of intelligent thought, but unfortunately as ratings are concerned the spectrum of thought must have taken a backburner to the issues of a 24-hour news cycle.

Watching the news when the fear-inducing clamor of pseudo-experts on television tell others and myself that I am a danger and that I have a tendency towards violence as a result of my illness is more cringe-inducing than fear-inducing. The 24-hour news cycle is to blame because the fear inducing produces no sustainable results other than the stigmatization it causes. The 24-hours news media can destroy stigmatization by educating the public. After all that has been said and done in the name of fear inducing isn’t it about time to educate the public before the next shooting? That way there can be treatment before tragedy.

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No Greater Love Documentary Shows Promise

Those who’ve been in deployed locations know the importance of faith in the middle of stressful missions. As I was deployed to South Korea, after North Korea had shown its ability to use crude nuclear bombs on its own land for testing purposes, I knew in some way that we were protected. Nevertheless faith played an important role when sirens were going off and you had to get in MOPP (Mission Oriented Protective Posture) gear.

Fortunately, in my military career I was always protected from the rigorous chaos of combat. I never deployed to an active combat zone but faith played an enormous role in my military career. It’s a faith that can’t be communicated to someone that has not been in a situation that is beyond stressful. That’s why I am excited to see Captain Justin Roberts’ film as a chaplain in the Kunar province of Afghanistan from 2010 to 2011, the experiences of his troops, and how faith played a part in the survival of the deployed unit of the famed No Slack Battalion of the 101st Airborne.

The Kunar province is home to some of the most feared terrorists, and the 101st Airborne infantry battalion fought heavily, lost many members, and came out heroic in the face of their obstacles. Just the first five minutes of the initial preview of the film will bring military supporters and veterans to tears thinking about those who’ve served in these combat zones, their family, and loved ones. The harrowing ordeals these young men went through are something they’ll have to live with forever. The immediate effects of which is something a chaplain is there to counsel them about and help them reflect on their faith in those moments.

Captain Justin Roberts filmed this while deployed. As a chaplain he couldn’t carry arms so he filmed his soldiers. Three years later he spoke to them about their experiences. As he spoke to them after their experiences, the reality of PTSD, family problems, and the face of war is exposed for those who want to see what it looks like through the eyes of the soldiers.

Captain Roberts did what few chaplains would do in a deployed location by venturing outside the wire to be with his men and understand their experiences firsthand rather than just be counsel to them in their darkest moments. By nature of that act alone he became one with his men. By filming the experiences and giving artistry to the experiences of war, he transcended the nature of war and gave it a face to humanize what the costs really are.

While Hollywood hypes and glamorizes war for mass consumer consumption, it is documentaries like these that give voice to the heroes of this generation by letting them tell the story as it is. No Greater Love is a story of survival, faith, and redemption of the warrior as told by the warrior.

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Coming Out About My Mental Illness

Each of us has a unique story, something that will be etched in our tombstone, and quintessentially a set of core values that will define us. I’ve done many things that I can be proud of. I worked on the F-117A Stealth Fighter, have written a number of ebooks (some of which you won’t find under my name), earned a bachelors degree and currently working on a master’s degree. But these aren’t what I am proud of. I’m proud of being a mental health advocate. Advocating for those of this generation and a population that has long been stigmatized as though we’re living in the lower rungs of a caste system.

Society reinforces a caste system whereby people are governed by their individual ability to manifest themselves within a set of protocols that forces one to become chameleon-like or be shamed into the lower rungs of that caste system. As a man with a mental illness I find that this caste system is emasculating. Notice I pay no attention to mental illness because it is the caste system that enslaves society, both subtly and overtly.

The standard protocol of the societal caste system are that one never admits faults, never begs to question the caste system, or manifests anything outside the chameleon-like trickery. Living within the caste system you’re never supposed to admit having a mental illness. Because I’ve not mastered the chameleon-like inverted ethics of this system opportunities become noticeably different, both professionally and personally. But this stems from a larger problem, and it isn’t my problem, it’s society’s.

One of the core values of the Air Force is integrity. I’ve always viewed integrity as something you either have or don’t. Society doesn’t, especially when it comes to admitting mental illness. I tried living my life under the veil of inauthenticity for years, and it achieved nothing for me. Finally, as the light bulb was going off in my mind about the inauthenticity of staying in the closet about my mental illness I saw a commercial by BringChange2Mind. As soon as I saw the commercial with Glenn Close and her family I made a Facebook post about my mental illness. I honestly don’t remember if anyone even said anything to me about it.

As I have battled with schizophrenia and probably a fair amount of depression I’ve wondered whether this openness about my battle has estranged me from friends, loved ones, and neighbors. I’ve noticed fewer real friends and fewer loved ones that I can call on. My fear has changed from “maybe they don’t get me” or “I probably shouldn’t care” to realizing they probably have just as hectic yet boring lives as me.

I’ve wondered about my initial reaction to come out about my mental illness, how it has shaped me, and whether it was the right decision. I know it hasn’t helped me in certain areas, but I’m proud that I can live with integrity when other people are drowning in the world trying to find themselves and trying to save themselves from inauthenticity because of this chameleon society. I know that it has made me more self-confident, given a new found sense of freedom, and enabled a resiliency within. I’m proud that I’m able to live with integrity in a world of shadows.

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Dealing with the Side Effects of Medication

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All medications have some form of side effect. Whether or not a patient will experience all, some, or any of them depends on the individual and is hard to predict. A person’s age, weight and gender may be a factor as well. A patient’s medical history may also play a role in how their body will react to a certain medication. When a doctor prescribes medication to a patient, they should discuss the possible side effects, so the patient can prepare for them. The patient should be informed of how soon they may experience side effects, how long they will last and how to cope with them when they do occur. Some may be minor and some may cause more discomfort. It is important to watch and observe for symptoms and to stay in communication with the doctor or pharmacist. If side effects occur that cause discomfort, there are steps that can be taken to reduce them. A change in the dosage is an obvious place to start.

When the Good Outweighs the Bad

The benefits of medication should outweigh the discomfort of any side effects. If side effects are being experienced, patients should not stop taking medications without first consulting with their doctor. However, if any medicine is making it difficult to breath or causes swelling of the throat, tongue, lips or other part of the face, this is a sign of a severe allergic reaction and medical attention should be sought immediately. Aside from this extreme example, many side effects are temporary and can be coped with.

Side Effects of antidepressant Medications

The side effects of taking antidepressant medication can be difficult to deal with, especially when coping with the already unpleasant symptoms of the disease itself. However, such additional symptoms caused by the medication can include headaches, nausea and feelings of nervousness or unease. These symptoms may dissipate or completely disappear after a few weeks. Some, however, do not.

The problem with these unpleasant side effects is that it can tempt the sufferer to stop taking the medication in order to relieve themselves of the additional discomfort. In this, there is a danger of reversing any positive results the medication may have instigated, and this could also cause harmful withdrawal effects as well.

Here are a few possible negative side effects of antidepressant medication and some suggestions on what to do if you experience them.


The increased energy that some medication causes can make sleeping at normal times difficult. This will result in tiredness the next day. There are several ways that people cope with insomnia. Diet and exercise are important. Caffeine and other stimulants should be avoided. Meditation helps some patients. Your doctor may prescribe a sedative as well.


Some patients who are taking antidepressant medication may feel fatigued throughout the day. This may be a result of a lack of sleep the previous night due to insomnia. Patients who are experiencing fatigue should try taking their medication a few hours before bedtime each night and stay active during the day, although a nap when needed may also help correct the problem.


An upset stomach is often reported in the first week patients begin treatment with antidepressant medications. To combat this effect, the medication should be taken with food and the patient should stay hydrated. Antacids may help as well. If the problem persists, the patient should consult with their doctor.

Weight Gain

Some antidepressant medications can cause water retention and weight gain in patients. A proper, healthy diet should always be maintained, before, after and during treatment. If the sufferer was experiencing symptoms of depression that included a loss of appetite, and their appetite has returned as a result of treatment, they should take special care to avoid overindulging on sweets and other fattening food.

Side Effects of SSRIs

The class of antidepressants known as SSRI (selective serotonin reuptake inhibitors) help regulate mood by acting on the serotonin in the brain.In addition to the more common side effects listed above (weight gain, nervousness, fatigue, insomnia and nausea), SSRIs can also cause dry mouth, tremors, dizziness, diarrhea and constipation. They can also induce an agitated or anxious state.

When a patient has decided to stop taking antidepressants they should do so under the care of their doctor. It should be gradual and the chosen time to stop should be a less stressful time for them. For example, the days or weeks leading up to the holiday season would not be a good time to stop taking these medications.

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