Sunday, December 16, 2012

It's Not Just About Guns, It's Also Got To Be About Autism

I've had a difficult time reading some of the coverage on the Newtown mass killings.  Part of it is my heart is torn between the parents of all the murdered children, the heroic deaths of the female staff who tried to stop or mediate the carnage, and then finally, Adam Lanza and his mother.  I've found myself getting really frustrated with commenters and pundits who seem to think Adam Lanza was a product of video games, or goth interests, or demonic influence.  I've been just as frustrated with all the talk about gun control when in point of fact too many of these mass shootings are equally products of poor mental health services and the stigma surrounding mental illness and the increasing prevalence of autism.  Maybe it's just too soon after the event for people to start thinking productively.

I did come across one powerful piece of writing that I want to share with readers.  Call it part of my campaign to get some compassion moving about a mental health issue that is not going away, is getting worse and is truly a parent's worst nightmare.  Originally written for The Anarchist Soccer Mom, I found it on Huffington Post.  It's brilliantly written by Liza Long.

"I am Adam Lanza's Mother"

 By Liza Long
Three days before 20 year-old Adam Lanza killed his mother, then opened fire on a classroom full of Connecticut kindergartners, my 13-year old son Michael (name changed) missed his bus because he was wearing the wrong color pants.

“I can wear these pants,” he said, his tone increasingly belligerent, the black-hole pupils of his eyes swallowing the blue irises.
“They are navy blue,” I told him. “Your school’s dress code says black or khaki pants only.”
“They told me I could wear these,” he insisted. “You’re a stupid bitch. I can wear whatever pants I want to. This is America. I have rights!”

“You can’t wear whatever pants you want to,” I said, my tone affable, reasonable. “And you definitely cannot call me a stupid bitch. You’re grounded from electronics for the rest of the day. Now get in the car, and I will take you to school.”
I live with a son who is mentally ill. I love my son. But he terrifies me.

A few weeks ago, Michael pulled a knife and threatened to kill me and then himself after I asked him to return his overdue library books. His 7 and 9 year old siblings knew the safety plan -- they ran to the car and locked the doors before I even asked them to. I managed to get the knife from Michael, then methodically collected all the sharp objects in the house into a single Tupperware container that now travels with me. Through it all, he continued to scream insults at me and threaten to kill or hurt me.

That conflict ended with three burly police officers and a paramedic wrestling my son onto a gurney for an expensive ambulance ride to the local emergency room. The mental hospital didn’t have any beds that day, and Michael calmed down nicely in the ER, so they sent us home with a prescription for Zyprexa and a follow-up visit with a local pediatric psychiatrist.

We still don’t know what’s wrong with Michael. Autism spectrum, ADHD, Oppositional Defiant or Intermittent Explosive Disorder have all been tossed around at various meetings with probation officers and social workers and counselors and teachers and school administrators. He’s been on a slew of antipsychotic and mood altering pharmaceuticals, a Russian novel of behavioral plans. Nothing seems to work.

At the start of seventh grade, Michael was accepted to an accelerated program for highly gifted math and science students. His IQ is off the charts. When he’s in a good mood, he will gladly bend your ear on subjects ranging from Greek mythology to the differences between Einsteinian and Newtonian physics to Doctor Who. He’s in a good mood most of the time. But when he’s not, watch out. And it’s impossible to predict what will set him off.

Several weeks into his new junior high school, Michael began exhibiting increasingly odd and threatening behaviors at school. We decided to transfer him to the district’s most restrictive behavioral program, a contained school environment where children who can’t function in normal classrooms can access their right to free public babysitting from 7:30-1:50 Monday through Friday until they turn 18.

The morning of the pants incident, Michael continued to argue with me on the drive. He would occasionally apologize and seem remorseful. Right before we turned into his school parking lot, he said, “Look, Mom, I’m really sorry. Can I have video games back today?”
“No way,” I told him. “You cannot act the way you acted this morning and think you can get your electronic privileges back that quickly.”

His face turned cold, and his eyes were full of calculated rage. “Then I’m going to kill myself,” he said. “I’m going to jump out of this car right now and kill myself.”
That was it. After the knife incident, I told him that if he ever said those words again, I would take him straight to the mental hospital, no ifs, ands, or buts. I did not respond, except to pull the car into the opposite lane, turning left instead of right.

“Where are you taking me?” he said, suddenly worried. “Where are we going?”
“You know where we are going,” I replied.
“No! You can’t do that to me! You’re sending me to hell! You’re sending me straight to hell!”
I pulled up in front of the hospital, frantically waiving for one of the clinicians who happened to be standing outside. “Call the police,” I said. “Hurry.”

Michael was in a full-blown fit by then, screaming and hitting. I hugged him close so he couldn’t escape from the car. He bit me several times and repeatedly jabbed his elbows into my rib cage. I’m still stronger than he is, but I won’t be for much longer.
The police came quickly and carried my son screaming and kicking into the bowels of the hospital. I started to shake, and tears filled my eyes as I filled out the paperwork -- “Were there any difficulties with… at what age did your child… were there any problems with.. has your child ever experienced.. does your child have…”

At least we have health insurance now. I recently accepted a position with a local college, giving up my freelance career because when you have a kid like this, you need benefits. You’ll do anything for benefits. No individual insurance plan will cover this kind of thing.

For days, my son insisted that I was lying -- that I made the whole thing up so that I could get rid of him. The first day, when I called to check up on him, he said, “I hate you. And I’m going to get my revenge as soon as I get out of here.”
By day three, he was my calm, sweet boy again, all apologies and promises to get better. I’ve heard those promises for years. I don’t believe them anymore.

On the intake form, under the question, “What are your expectations for treatment?” I wrote, “I need help.”
And I do. This problem is too big for me to handle on my own. Sometimes there are no good options. So you just pray for grace and trust that in hindsight, it will all make sense.

I am sharing this story because I am Adam Lanza’s mother. I am Dylan Klebold’s and Eric Harris’s mother. I am James Holmes’s mother. I am Jared Loughner’s mother. I am Seung-Hui Cho’s mother. And these boys—and their mothers—need help. In the wake of another horrific national tragedy, it’s easy to talk about guns. But it’s time to talk about mental illness.

According to Mother Jones, since 1982, 61 mass murders involving firearms have occurred throughout the country. Of these, 43 of the killers were white males, and only one was a woman. Mother Jones focused on whether the killers obtained their guns legally (most did). But this highly visible sign of mental illness should lead us to consider how many people in the U.S. live in fear, like I do.

When I asked my son’s social worker about my options, he said that the only thing I could do was to get Michael charged with a crime. “If he’s back in the system, they’ll create a paper trail,” he said. “That’s the only way you’re ever going to get anything done. No one will pay attention to you unless you’ve got charges.”

I don’t believe my son belongs in jail. The chaotic environment exacerbates Michael’s sensitivity to sensory stimuli and doesn’t deal with the underlying pathology. But it seems like the United States is using prison as the solution of choice for mentally ill people. According to Human Rights Watch, the number of mentally ill inmates in U.S. prisons quadrupled from 2000 to 2006, and it continues to rise -- in fact, the rate of inmate mental illness is five times greater (56 percent) than in the non-incarcerated population.

With state-run treatment centers and hospitals shuttered, prison is now the last resort for the mentally ill -- Rikers Island, the LA County Jail and Cook County Jail in Illinois housed the nation’s largest treatment centers in 2011.

No one wants to send a 13-year old genius who loves Harry Potter and his snuggle animal collection to jail. But our society, with its stigma on mental illness and its broken healthcare system, does not provide us with other options. Then another tortured soul shoots up a fast food restaurant. A mall. A kindergarten classroom. And we wring our hands and say, “Something must be done.”

I agree that something must be done. It’s time for a meaningful, nation-wide conversation about mental health. That’s the only way our nation can ever truly heal.
God help me. God help Michael. God help us all.


First, I want to thank Liza Long for writing this piece.  It needs to be read by as wide an audience as possible.  This country will never truly understand what happened in Newtown and Aurora and Virginia Tech and on and on,  unless we are willing to go inside the families of these boys and inside the minds of the boys themselves.  Their brains do not function like our brains and because of that, they do not live easily in our world.  The mental health establishment can provide fairly safe environments but consistently applicable treatment is another story.  In the meantime families become prisoners of their children, they turn inward, they isolate, and they burn out.  By the time too many of these boys reach 18, if some form of therapy hasn't mitigated their symptoms, there aren't very many alternatives, especially if their families are burned out. They are now considered independent legal adults and with high functioning IQ's, quite able to buy guns, strategize with acumen, and yet they are far from adults in most meaningful ways.

In a very real sense, they don't have ego personalities.  They have avatars.  They are just as easily their video gaming personality as they are their 'social' personality, and for a minority of them, they are much more comfortable and secure in their video gaming avatar, in which they have a real sense of control and where their focus is strong enough to filter out external stimuli and where they succeed,  than they are in their 'social avatar' where an innate inability to filter out external stimuli makes them feel highly vulnerable, inclined to OCD behaviors, and where they need of a lot of repetitive structure.  It's like getting lost in the woods for a normal person, except for these boys, until a situation becomes totally and completely the same, they will continually be lost in the woods.  They act out in frustration and uncontrolled rage is just one second away.

Descriptions of Adam Lanza in high school illustrate some of this.  He was known to wear the same types of clothes buttoned up the same way every day.  He would walk down halls hugging the wall and carrying a brief case 'like and 8 year old carries a teddy bear'.  He was known to be unable to detect physical pain and in his high school that became a planned for safety issue.  Imagine not being able to detect physical pain because your can't focus on that particular perceptual stimuli.  The pain signals were probably there, he just couldn't filter out everything else to identify them.  His tech club coach also stated he would 'fly off', meaning Adam would go into a sort of catatonic state,  and they would have to call his mother to bring him out this state. This is sensory overload resulting in disassociation. I've seen this happen with adults that have high high anxiety levels. It's either full blown panic attacks or disassociation.

Adam was also at the age, late teens to early twenties,  where we generally see the onset of full psychosis in schizophrenia.  A childhood diagnosis on the autism scale can be a precursor to full blown adult schizophrenia.  This is the same profile shown by the Aurora shooter and the Gifford's shooter.  Pyschosis makes a great deal of internal logical sense to the person experiencing it and not much sense at all to outside observers.  Unfortunately there is usually enough survival skill in the psychosis that observers blow off a lot of strange behavior and don't connect the dots until after it's too late. Monday morning quarterbacking is pretty useless.

We need to get serious about tracking these kids because if they move into full psychosis how they will play out that psychosis is as idiosyncratic as they are as individuals.  We need to get very serious about giving their families some legitimate help because treatment is astronomical, especially when it involves meds whose cost can be one thousand dollars or more a month for one med, and most of them are on a cocktail of meds.  We need to explore other treatment avenues and spend serious bucks on researching why autism is becoming so prevalent.  1 in 88 kids are now diagnosed with some form of disability on the autism scale.  That's a 78% increase in nine years.  This story is not just a wake up call for gun control legislation.  It needs to be a wake up call for a serious mental health issue that keeps increasing in our children.  If we really care about our children and their families we need to put the same kind of intense effort into autism that we did for HIV/AIDS.  Or our mentally confused kids will keep killing our kids.


  1. Thank-you for this Colleen. I've bookmarked it.

    John Fremont

  2. Our society has thrown the mentally ill out into the streets and the homeless shelters, where they are left to fend for themselves, without medication or psychiatric care. This was often done under the guise of individual rights, but really wasn't it to save money? I am increasingly convinced that our inability to address pressing social issues like - providing effective care for those with mental illness, or providing basic medical care for all citizens, or valuing education and and providing ideal learning environments for our children - really boils down to greed. As the obscenely wealthy skim, no, hoard more and more of the profits from every commodity, including health care, education, pharmaceuticals, oil, information, etc., and refuse to pay back their fair share, we are all left with inadequate, dwindling resources necessary for a humane and organic society. The havoc being created by the social darwinism (too benign a term) so prevalent today has only just begun. I fear it will get worse, rather than better. Perhaps the love of money is truly the root of all evil.

    1. I can remember the original California proposal, which most of the country then followed, was as much about money as it was individual rights and cleaning up institutional abuses. That too is a Reagan legacy.

    2. Absolutely, greed is at the heart of the problem. Psychiatrist E. Fuller Torrey has noted that we seem to have abandoned any attempt to treat the mentally ill and are contempt to let the mentally ill suffer on the streets or in jails. I know historically it was possible to abuse the mental health commitment process to dump an unruly person, or an inconvenient wife or relative into a mental hospital, but now it is very difficult to get mental health treatment for someone who is actively psychotic. See Ruth Seegrist's interview in today's Philly Post. Ruth's daughter Sylvia has paranoid schizophrenia, and Ruth desperately and unsuccessfully tried to get Sylvia committed before Sylvia harmed others. Unfortunately, Sylvia shot 3 people at a PA shopping mall in 1985 before she could get committed. Sylvia is now serving a life sentence for 3 murders. It is almost as if we have reverted to a time before enlightened treatment of the mentally ill. The only thing we don't do is chain them or torture them for public sport, but I hardly think letting them exist on the streets or languish in jails without treatment is any more compassionate.

  3. This is the same woman that on her blog discusses how her husband had their son--this same child- committed to prison 4 times at the tender age of 11 for not cleaning his room, and then it turned out that he and his new wife were also physically abusing the boy.... but she still shares custody with him? Read the whole blog before you champion her call for locking up autistic children.

    You take a brilliant, fragile child and abuse it long enough and yes... it can become "defiant", suicidal, or enraged. That doesn't mean that every person on the autistic spectrum needs to be "tracked".

    1. Maize I was using tracked in a different sense and probably should have explained it better. I work with these individuals in the adult system, usually out a prison or State Hospital system and getting complete records is sometimes impossible. In that sense we 'track' them so we can see the progression or the improvement. When they come without parents, siblings, or other contacts we can't track them and we can't legally force them to give us any information. And so we have to start from ground zero having no idea what meds they have taken, therapies they've been through or trauma they might have experienced.

    2. Maize: Unless the 2 parents agree to a specific custody arrangement, a judge decides. She may not have any choice at all about sharing custody. Unless you are suggesting she just totally give up custody herself to this abusive father?

      Colleen: Would this tracking you are suggesting be accomplished by the electronic health care record that is supposed to be set up across the country for all patients?

    3. It most certainly could be. However, there are other regulations in place which thoroughly protect client confidentiality, and so there would be other hurdles to cross. I'm speaking in context of continuity of care, but this same system could also be abused for other purposes. Access laws would have to be very carefully and tightly written.

    4. It is the confidentiality that I am concerned about. Access laws are one thing. Putting the confidentiality into practice is something else entirely.

  4. As a mental health therapist I see families broken by a child with a mental illness, including autism. Marriages fail as one partner leaves. Other children in the household grow up in a war zone, become angry that a parent has no time for them and always on alert at being attacked by a sibling. Services are shrinking fast and mostly are little more than warehousing and sedation.
    As a parent, I have an adult son who is mentally ill and self destructive. We did not get guardianship before he was 18, because he seemed to be improving then. Now he will not allow us to do so and a court fight would cost thousands of dollars we do not have.
    As a volunteer at the jail for nearly 18 years I have seen the huge increase in mentally ill inmates. The corrections officers fear being attacked without warning, as do the other inmates. The sheriff asks for help, stating that neither he nor his staff are equipped to be a mental health facility. Treatment is solitary confinement or "chemical restraints" that leave them like zombies.
    I don't know what to say or do.

    1. I've seen the same things, but from a different position. I have the problem of dealing with them as independent adults, mostly with no family connections what so ever at all, and because of that no history or 'questionable history'. I recently did an intake with an individual who claimed this incredible family history which I eventually figured out actually described the voices he heard in his head. We have zero idea about any real family or any past history.

      I've also seen the influx in mentally ill clients in the jail system, but will give my town some credit for paying for pretty extensive training amongst law enforcement. But still, incarceration is not generally effective treatment except for the occasional addict.

      We have a bigger problem with children as the juvenile system is not really set up to deal with the numbers and the alternatives are scarce. This situation is a nightmare and what surprises me is the rareness of these kinds of violent acting out events directed at others. I have certainly seen my share of violence directed at themselves. Our other real issue is the lousy transitional services between the children's system and the adult system. If it gets screwed up everything, including medicaid eligibility, starts from scratch and it gets screwed up alot.

  5. This is a gut wrenching story unfolding and this helps take the blinders off to reveal the underlying dynamics of the care that was needed for Adam Lanza but was not available to him or his mother. How sad to find this out through this awful tragedy of beautiful children & teachers being killed. The failure is in a current system which is not working, needs upgrading to the 21st Century.

    This issue is compounded by the economic decisions made by our representatives in Washington, D.C. which forces people into such tragedies, or will see the light to the way to prevention of such atrocities and come up with the money needed to take care of the problem. We're in a war zone here with little kids and teachers getting killed.

    Prisons ought not to be a warehouse for the mentally ill. That doesn't serve anyone's best interest, especially if they say they are for family values and don't want to see this type of thing happen again. And that cost a lot of money too with sad or even sadder results. Prison is not even a band aid. It's pathetic. What century is this? I have to check periodically, because we need to make progress, not support regression into ignorance.

    I wish that this story would be on the front page of every major news outlet & blog until the cows come home and people get it; the importance to not cut back on social services for people in need, provide medicaid and medicare, invest in research and build schools for the autistic, lower the cost of meds, hire qualified professionals who need the work & want to help, know how to help, and get going already to a compassionate program for the mentally ill. We can't get it done if we don't get what needs to get done. And darn, there are always the obstacles that don't want to budget outside their own narrow interest of greed.

    In NJ there is a facility for the autistic. It might just be for the wealthy though, I don't really know. The interior of the building looks like a town. I guess the way they have designed it is to familiarize them with the "real" world. There are many activities for them too. What a brighter world we would have if we took care of the weakest.

    It makes me wonder if there are any other time bombs about to go off like Adam Lanza, which is a terrible thing to ponder, and yet it is almost inevitable, especially with the higher incident rate per hundreds, that it will unless measures are taken to track, ensure early diagnosis and treatment and an affordable supply of meds, a place where they can get the help they need professionally and with care. A trauma unit or something in a hospital for any severe episode of psychosis from autism and schizophrenia might be helpful and not a prison for crying out loud! When are we going to learn to not put sick people in prison? The prison system is a wreck. How many in the prisons are mentally ill persons? Is the rise in autism just in the US, or is this a worldwide phenomenon?

    We do need to research why so many are autistic in such a short period of time. That needs to get done.

    Families need help for their kids with mental illness and for the entire community to be healthy. The economic decisions to throw mentally ill people into jail and then after they serve their time they are living in the streets sounds like the old Roman times and not the 21st Century. We really can do better and it's always money/greed and/or ignorance that seems to get in the way of progress for the good of the people.

    Liza Long's writing on this is very helpful to understanding this tragedy.

    Thanks for posting this. Very helpful.


  6. Thanks for the comment Fran. It's impossible to predict if even one more autistic kid will morph into a killer. The statistics show the mentally ill are significantly less violent than the normal population, and then kids like Harris and Klebold were not on the autism spectrum. Columbine is also unique for the fact there were two shooters.

    However, Adam Lanza's case is also a little different. Apparently his mother was a survivalist, hence all the military weapons, and that kind of environment could very easily have pre loaded some of the content of Adam's psychosis.

    1. She was a survivalist who did not survive and was done in by her own son, her own weapons. Having all those guns around was not too bright.

    2. True enough, and we have talk show hosts and television networks (yes, Rush, Glenn and Fox, I am speaking of you) that encourage a belief that whites need to arm themselves to the teeth to protect themselves from "undeserving" citizens of color, and spread nasty, untrue and belittling rumors about a president they dislike primarily because of his skin color. People were running around buying ammo before and after the election because of an unfounded and untrue claim that the President was going to confiscate their guns. Colleen, you are right that the mentally ill are as a rule less violent than others. The problem is the people who are willing to harm themselves and others, whether mentally ill or not.

  7. I would use exceptional caution when reading this story and attempting to draw parallels between Adam Lanza, any other mass murderer and anyone having autism.

    "Autism is characterized by delays or abnormal functioning before the age of three years in one or more of the following domains: (1) social interaction; (2) communication; and (3) restricted, repetitive, and stereotyped patterns of behavior, interests, and activities" (DSM-IV)

    Autism is seen in the boy who screams at the hint of light because of the pain it causes him. It is also in the girl who never seems to get the joke or misses sarcasm entirely. it is also in the fella who lives down the road who never learned to speak, as well as (most likely) Einstein and Tesla. As has been repeated to me more times than I can count "Once you've met one person with Autism, you've met one person with Autism."

    Autism isn't a disease to be cured like polio or something which is contracted like AIDS, but rather an entire spectrum of different behavioural anomalies which _seem to_ center around heightened/different sensory awareness and learning how to develop coping mechanisms and strategies. Key among these strategies is early detection and management. It is also important to note that the body of knowledge regarding ASD (autistic spectrum disorder) is radically changing.

    May we see the world through others eyes, may we walk in others shoes. May we touch the lives of others and, though them, feel the touch of the Divine.

    1. Personally I think ASD is just another example of professionals inventing a catch all diagnosis for behaviors they don't understand causality. The sensory awareness component is a good place to begin in ruling out a whole bunch of other issues.

      I don't mean to suggest that we will find a 'cure' for autism. I mean to suggest if we put the kind of money and focus into autism we did for HIV/AIDS research we would get much further along. We need some sort of central organization, like the CDC, that has the necessary power, influence, and financial resources to pull all the disparate information into some coherent whole.

      Even in the different major systems, the children's system vs the adult system, the same behaviors are diagnosed differently or prioritized differently because of funding issues as much as diagnostic beliefs about adult vs children's brains and behaviors.

      I can't tell you how many kids we've transitioned into adult services who have gotten the same soup of diagnosis that 'Michael' has had. Our problem is not one adult funding source will pay for treatment for any those labels, so in our system 'Michael' would be most likely be diagnosed as rapid cycling Bi Polar with an additional personality disorder--until the next clinician came along and decided differently.

    2. Disorders and syndromes are normally as you describe. They don't know the cause or even if there is a single critter involved (consider breast cancer, for instance).

      T'would be really brilliant to have a single organization to collect, analyze and disseminate valuable and useful information about ASD, but my wish list is full for this Christmas already.

      Well, the 'Michael' described above has a lot more issues than just ASD and saying that they've got 'whiz-bang disorder-du-jour' won't do the trick any more than "take two Zoloft and call me in the morning".

      I guess my original point is that autism (in Adam Lanza's case, a possible diagnosis of Asperger's) is NOT the causative agent for being a serial killer, any more than having green eyes, blue skin, pink hair, being female, gay or left handed.

      Being bullied, singled out and made to feel ostracized, on the other hand, DOES seem to have very strong links to self-destructive/annihilator/serial killer behaviour and by promoting/perpetuating the myth that seeing the world differently means you are 'a bad seed that will meet a bad end' fuels a self-fulfilling prophecy which ends in naught but tragedy.

    3. Of course he was singled out. The school system itself would single him out precisely because the level of his disability was such that it had to, if only for his own safety. I have zero doubt that if we ever learn the true extent of his disability he will have been way beyond the Asperger's diagnosis.

      I'm not saying that seeing the world differently is the issue. It is without a doubt the other way around. It is when the consensus world sees you differently, which is why I am such a hard ass proponent of practical compassion.

    4. I have Asperger's, which seems to run in my family (my father had it, his father seems to have had it, my youngest son has it, my twin brother has it and his daughter has it). We manage to cope, more or less. My father, grandfather, brother and myself have all had successful careers -- doing highly technical jobs extremely well. None of us has done very well in our social interactions; neither my son nor my niece have never gone on a date, and cannot say they has any friends. I con't really have any either; my father's funeral was attended by his family and no one else.

      One way that it has affected me is that I have only a rudimentary conscience. It is not wholly absent -- I see such things as rape, torture and mass murder abhorrent, but it is not developed as it should be. I have compensated for this by becoming a student of ethics; I have a masters in moral theology from a Catholic university (I wrote my thesis on Augustine's views on lying). Do I feel like taking a gun and shooting people? No. When I was in the army in Vietnam, I was a sniper. I was able to shoot people, and slept soundly afterwards. But I do abhore the thought of shooting children.

      I cope. That's the best I can hope for. Am I happy? At times, yes; and the rest of the time I am not actively unhappy. Is it difficult? Yes.

      I should stop now. You are not my psychotherapists nor a support group.

    5. Don't stop. Consider yourself very welcome here. Doesn't sound like you need a psychotherapist, and we all need support groups--which is what this blog sort of is for all kinds of people. Please join our little group and keep contributing.

  8. I think we are witnessing a deadly cocktail of our collective dysfunction; a maelstrom of overstimulation, the media driven glorification of violence, unsupported mental illness, easy access to combat weaponry, historical amnesia and political/corporate driven collective paralysis... It's going to take allot of willpower and effort toward transformation within our whole society to get beyond these trends and if we don't, I fear we are heading toward another dark age...

  9. We should remember the work of Dorothea Dix who lobbied state Legislatures for the treatment of the mentally ill. She was responsible for the beginning of over thirty state mental hospitals. Because these institutions were able to put patients to work doing certain farming chores, they became known as funny farms. Metropolitan State Hospital in Norwalk, CA was one of those "funny farms." In the 70's this funny farm provided all the food for city needs including pubic schools and jails.

    One movie and one foolish governor, are part of the reason this system failed. It was torn town by Ronald Reagan in Ca.. Out patient Community Mental health Centers were promised to deal with the problems of the mentally ill. It was calculated to save money over the previous system. It costs about 1/4 to run a mental health bed that it does to run a jai bed. As we know none of the Community Centers were build in California and virtually all these patients now end up in jail. The movie "one Flew over the Cuckoo's nest" was influential in telling a rather false story about these mental health hospitals.

    Now it is extremely hard to get any form of good inpatient mental health care. If you have a child with a severe eating disorder, it is almost impossible to find an inpatient care center and to get an insurance company to adequately cover it. Little coverage for long term mental health anywhere.
    We do need the Dorothea Dix of the 21st century. It is the only solution to get a Madison Ad. mentality to tell the truth about these diseases. dennis

    1. That is the truth about eating disorders. There are only maybe a dozen such centers is the US and they are astronomically expensive. Another connection these latest shooters have in common is that they didn't qualify for medicaid type services and their parents would have had to rely on private insurance, which pays for very very little and for which there are far fewer resources. Generally private insurance pays about half for psychiatric services as it does for medical services. This is a big problem, because early intervention to be useful, has to be wrap around services and that calls for far more professional help than just a psychiatrist or therapist.

      We do need a Dorothea Dix at least to get the word out that our mental health services are actually far worse for middle class parents than they are for poorer families.

  10. Mental health is very bad for the poor as well. I was once affiliated with county USC and it was the pits medically and psychiatrically for these patients in the mind 90's. My sense is that it has only gotten worse. dennis

    1. Our county mental health center is also 'the pits.' Being all I could afford I went there for help with major depression. They changed their psychiatrists there like you would change your underwear and each new one would change my diagnosis, totally change my meds. They saw you once a month for about 10 minutes. The first therapist I had there decided that I had 'multiple personality disorder' (which I do not) and informed me she was writing a book on the subject and would I mind if she got really involved in my whole story so she could use it in the book. Two weeks later I'm hearing on the radio that she was just arrested for embezzlement and lesbian relationships with her clients. The psychiatrists gave me various diagnoses over time such as Asberger's, schizoaffective disorder, borderline personality disorder, ADD, OCD, PTSD, Panic Disorder (which I only developed after they put me on a horrible benzodiasepine med called Klonopin which at their high doses and long term use made me catatonic). My college age son finally had to take charge with his Bachelor's in Psychology and HE figured out the meds were what were making me so horribly sick. He got me to a wonderful private psychiatrist who realized that what I WAS was bipolar, just like my son, which none of the other shrinks had even considered though bipolar is highly hereditary . Properly medicated now, after five years of a living hell, I am finally beginning to get well, though I have a long row to hoe. It disgusts me that five precious years of my life are gone, four of them to amnesia caused by the ECT it took to get me out of the catatonia. Do you think now, that I would recommend any county mental health center to anyone, no matter how suicidal or depressed they were? It was a chamber of horrors! And the most outrageous, frustrating, shame-inducing part of the whole experience was all the therapists who kept telling me that I was depressed because I didn't 'think enough positive thoughts.' That if I just did that, I would get all better! (Thanks for letting me rant and to warn others)

    2. You are welcome and your rant is dead on in it's description of too many of the community mental health centers. In two years the center I work for has gone through eight psychiatrists, so I know exactly what you experienced. There is no continuity of care in terms of psychiatric medications and usually, but not always, diagnosis. For reasons I won't go into, your Klonipin story was important for me to read. A definite example of synchronicity.

    3. Klonopin is a very dangerous med., way too often mis and over prescribed. My psychologist, an ex cocaine addict, says that trying to get off of Klonopin is as bad as trying to get off of cocaine. I know the withdrawal was a nightmare, so, I'll take his word for it about the cocaine! Related benzos are valium, xanax, ativan, etc., but, I'm hoping they're not as bad as so many people are on them.

    4. The literature indicates Klonipin is sort of off in a world of it's own, which isn't surprising given the chemistry has been tweaked to make it a bit different in effect from other benzos.

      The major problem is people react differently to all psych medication so what might work for some is a major problem for others. Unfortunately when psych meds become a major problem it's often impossible to get through to the provider--for any number of reasons, and even if one does get through, one may not actually get through to the provider--or at least past prejudices towards certain medications or ideological paradigms.