Monday, October 23, 2006

Off to Alternatives

Daniele and I will be launching a Wikipedia project, which actually has its own blog www.mhselfhelp.org/wiki. It's a collaborative effort, so if you're there please come help us start documenting the consumer/survivor movement on Wikipedia. We need your help!!

Wikipedia is a really exciting resource, and if you're already keeping tabs on the blog then I'm sure you'll be able to give a hand.

posted by jen

Thursday, October 12, 2006

Andrew Goldstein Pleads Guilty to Manslaughter

Andrew Goldstein has just pleaded guilty to manslaughter for pushing Kendra Webdale to her death in front of a New York City subway train in January 1999. It is expected that he will serve 23 years in prison with five years of supervision after his release ("Nearly 8 Years Later, Guilty Plea in Subway Killing." New York Times, 10/11/06.)

Unless you have been living on the moon, you know that it is widely acknowledged that this tragedy resulted from Andrew Goldstein’s untreated mental illness.

However, it seems to be less well known that Andrew Goldstein desperately sought treatment – often – in the years before his symptoms overwhelmed him and he killed Kendra Webdale. For example, according to a great article by Michael Winerip in The New York Times Magazine (“Bedlam on the Streets,” 5/23/99), Goldstein voluntarily signed himself in for all of his hospitalizations, numbering more than a dozen. And he more than once asked to be hospitalized long-term at Creedmoor State Hospital.

Of course, there would have been a far better alternative to long-term hospitalization. According to another article by Winerip in the Times (“Report Faults Care of Man Who Pushed Woman Onto Tracks,” 11/5/99), Goldstein could have lived in supervised, state-financed housing “with day services, clinic visits and an intensive case manager” – services that might have helped him work toward recovery – for $25,310 a year. This would have been a bargain compared to the $95,075 that taxpayers shelled out in 1998 alone to pay for Goldstein’s care, mostly in Medicaid payments to hospitals.

Reading this gives me terrible cognitive dissonance. What were they thinking?! By the way, Winerip places Governor Pataki and the State of New York at the top of the list of those “who should be held accountable for what happened to Goldstein and Webdale.”

You probably also know that, as a result of this tragic incident, Kendra’s Law was signed into law, despite tireless efforts by the New York advocacy community to prevent its passage. Kendra’s Law provides for requiring individuals with psychiatric diagnoses who are living in the community to accept outpatient mental health treatment (usually involving medication)

At the risk of preaching to the choir, I just want to note that involuntary outpatient commitment is a bad idea.

First, force and coercion have been proven to drive people away from treatment, and are expensive and ineffective. In addition, involuntary outpatient commitment is impossible to enforce and impossible to implement in a manner consistent with due process and human rights.

What happened to Kendra Webdale was tragic. What happened to Andrew Goldstein is also tragic. And Kendra’s Law simply compounds these two tragedies.

I feel compelled to add here that such tragic incidents involving people diagnosed with mental illnesses are extremely rare. People with mental illnesses are far more likely to be the victims than the perpetrators of violent crime and, according to a study by well-known researcher John Monahan, “Clearly, mental health status makes at best a trivial contribution to the overall level of violence in society.” (I know I’m preaching to the choir here too.)

posted by Susan Rogers

Tuesday, October 10, 2006

A call for better mental health services around the world

Today is World Mental Health Day, and the World Health Organization (WHO) is calling on all nations to focus on mental health and ramp up efforts to prevent suicide. According to a press release, approximately 873,000 people die of suicide each year. The release also states that 450 million are at any time affected by mental, neurological or behavioral problems, a rate that is steadily rising.

Read the press release, which includes a list of resources.

Thursday, October 05, 2006

Happy National Depression Screening Day!

Screening for Mental Health, Inc., has established sites around the country to screen people for depression on Oct. 5. To find the site nearest you, call 781-239-0071, or visit www.mentalhealthscreening.org. The Web site also offers anonymous online screening.

posted by Daniele Sadres

Monday, October 02, 2006

On mental illness, diabetes and fasting for the holidays

Sorry I didn’t post on this topic in time for Yom Kippur, especially because my family was Jewish and I probably should have realized it was coming, but I figure at least I can provide information for our Muslim people who have mental illness and are observing Ramadan.

I found an article that includes guidelines as to which people who have diabetes should fast, and addresses issues related to taking medication. Because people who live with mental illness are more likely to have diabetes than people in the general population, I thought the story would be helpful.

I also spoke to the executive director of the Islamic Society of North America for information about taking psychotropic medications during the holiday. The director, Louay Safi, said that people who can take their meds between sunset and dawn, when fasting stops, should do so. If you regularly take meds during the day, Safi said, you should consult your doctor about the potential effects of altering your regimen during the holiday. Ultimately, however, the mental health consumer, if capable, should decide whether to break the fast by taking meds, Safi said. Forcing that person to take meds interferes with his or her observance of the holiday, he added.

I couldn’t find anything on the Web on the topic of taking psychotropic meds during the fast, but here are some links related to diabetes:

Diabetes and fasting on Ramadan

Bipolar Disorder and schizophrenia and diabetes

Depression and diabetes

National Diabetes Information Clearinghouse

posted by Daniele Sadres