What are your reactions to this report? Would you agree that America’s community-based mental health care system is a disaster?
Your show explained a complex problem in a way that was clear and respectful to the individuals.
I am a public defender. I spend many hours visiting with clients whose crime was caused by their mental illness. Individuals whose behavior is driven by their mental illness and who live in a society that increasingly demands conformity. I advocate for what my clients want which is usually to be out of jail. Unfortunately, there is usually no where for my clients to go other than the streets where many of the mentally ill are as likely to be victims as they are likely to be offenders.
With many states confronting budget problems, the limited mental health services are being cut. Your show brought this little known problem a public forum. Thank you.
After watching your show "The Released" it confirmed what my mother had been telling me for all those years that she had worked at a State run facility in Ohio, about deinstitutionalizing, and about the day that the patients were allowed to refuse meds, would not be good. So it is no surprise the facility houses allot less people than it used to. When it downsized due to budget cuts and decisions made in Columbus (State of Ohio) by people who were not even in the Mental Field. Throughout your program there is a continuing theme "supervision" of mental patient. My mom has since retired many years ago, but all of the flaws with the current system that your program pointed out, are the same flaws the she foretold many years early. And yet the decisions were made, and implemented. The state still pays through incarseration, law enforcement, and yes crime. Hmmm.... At the end of your program several people talked about the system being broken and that maybe the changes that were made, might not have been the best. I would like to suggest that before they make any more changes that they might want to listen to the people who are in the Mental Field.
Dear Frontline- I have a sister who is untreated Bipolar and who has been in and out of the corrections system because of the brick walls we her family hit trying to get her "free" treatment for her mental illness. There plain and simply is nothing adequate available. It is appalling to me that in this country we do not effective, humane treatment for the mentally ill. And I find myself repeatedly asking myself and others, "why is this topic and a solution not on any of the political powers that be's agendas?" And then,"Where do I personally direct myself to move the government forward to make a change?" I have no idea where to begin, but there must be somebody out there who knows enough, cares enough and has the means to figure this mess out?!
I would like to know who is really insane, the ridiculous system in the U.S. that has the inability to set up support systems for people with brain disorders or those afflicted who are at the mercy of the inept care and have no support systems in their communities? I would say that it is both financially ruinous and cruel to have this system that incarcerates the ill. Because people have brain disorders that affect their behaviors, rather than another disease of different organ, makes them no less ill. How can it not be possible to establish systems of care that are humane and effective. It is embarrassing that in this day and age we are still dealing with these problems in such an archaic fashion. This program highlights both the ignorance and the wisdom that change is needed and yet not implemented. Who will effect the needed changes?
I would like to applaud Frontline for your documentary on The Released. You have given a more compassionate view of what the inmates and those who are not incarcerated go through. I believe that our communities need to understand better what it is that these people with mental illness need. The prisons ARE NOT the answer they are apart of the failure of the whole mental health care system. I believe that the mental health care system needs to be redone. And maybe Obama might be able to help if those of us WHO DO have voices advocate for those who do not; the mentally ill. My husband has paranoid schizophrenia and the health care system for him is below standards. The system needs a total revamp in my opinion. Thank you again FRONTLINE
I want to applaud FRONTLINE for both of the very realistic documentaries you have produced portraying the mental health system in this country. As a social worker working in community mental health, unfortunately, these sad scenarios are all too familiar to me. I am also VERY impressed with the Bridgeview Manor program and hope that programs like it will continue to be developed in Ohio (I work in Akron, OH which is not far from Ashtabula) as well as in other areas in the country. Our mental health system needs to have a lot more levels of care/housing for persons who have mental illness. Not everyone fits into just an apartment, just a group home or a nursing home.
Kristi Armbruster, LISW
FRONTLINE's editors respond:
Click here for more on Bridgeview Manor, including extra video and an interview with the program director.
It is abundantly clear from my perspective as an ER physician that our community-based mental health system is in shambles, and Frontline does a wonderful job covering its many failures and the almost impossible odds faced by many of the mentally ill.
While prison is obviously not the place for the mentally ill, at least they can receive services and cannot harm others. The most recent alternative has been to place the mentally ill in nursing homes where they terrorize the elderly and disabled, and have murdered several residents. While it may be politically incorrect to say so, the unmedicated mentally ill are a danger, and incarceration is preferable to the presently available alternatives.
There are other options -- mandatory commitment, a system focused more on long-term hospitalization. We had that system, and many people were uncomfortable with it, concerned that the mentally ill were isolated from society and deprived of their civil rights. Is society willing to return to a time when the mentally ill were institutionalized, often (but not always) against their will for much of their lives? Even the best community-based programs cannot handle the most severe and violent of the mentally ill.
Until we as a society can accept and accommodate the severely mentally ill in appropriate hospitals, prison is (sadly) safer for them and society than a nursing home or the street.
Thank you so much for helping our society to better understand severe mental illness and that we have a serious problem with how we treat people with these illnesses.
I have a 24 year old son suffering from the brain disease Paranoid Schizophrenia. He has been living with this illness for the past 6 years.
His mother and I have lived through this illness with him and have had to strongly advocate with Washington State mental health services and the courts to keep him from becoming very ill and causing harm to himself or others. Our son is currently doing well only because he is required by court ordered "least restrictive alternative" to take anti-psychotic medication.
Unfortunately we have a great deal of difficulty keeping our son on this court ordered "least restrictive alternative". The laws of Washington State and most other states protect the rights of a mentally ill person to refuse medication. It is madness that these laws do not consider the fact that it is common for a mentally ill person to not have any insight that they are seriously ill and must take medication. Therefore, when given the choice do not take medication, become seriously ill again and due to their illness, will likely end up committing serious crimes against society. People then wonder how this happens?
Please continue your work to expose this madness and how our society has chosen to not help mentally ill people. But then we end up sending them to prisons or allowing them to commit mass murders.
Please help our lawmakers to see that they must change the current mental health laws. They must give families and local mental health services organizations the ability to act sooner and make health decisions for mentally ill people that, due to their illness, cannot make health decisions for themselves.
Thank you for shining a bright light on this misunderstood issue.
The Dalles, Oregon
Thank you for airing such an important topic in America. I am completing my graduate studies as a Professional Counselor and Marriage, Family, and Individual Therapist. I would like to see such program as Bridgeview implemented in the Atlanta area.
Again, thank you for such wonderful program.
Lithia Springs, GA
I believe your Program would have been more useful if it had a solution at the end. The program they presented just promoted the feeling of hopelessness that is associated with mental illness. The solution is eliminating stigma by education/ early detection and treatment, and support from family and community. And then successful recovery is possible.
Lake worth , FL
Thank you for the wonderful show highlighting the tragically underdeveloped system of care for people with a serious mental illness. I am a little surprised the take home message was that community mental health has failed and that institutionalization seems like a reasonably good alternative to placing people with a serious mental illness in prison. We appear to have forgotten that by the time de-institutionalization began in 1955 numerous appalling incidents of ineffective care, abuse, neglect, and general squalor had been documented, leaving the public astonished at the cruelty of institutional care for people with a mental illness.
Deinstitutionalization occurred because we were warehousing people rather than treating them. As your show clearly demonstrates, history is now repeating itself in the prison system. Community mental health has appeared less than effective because it was never given the funding or resources needed to fulfill its mission of providing a humane alternative to institutionalization. Despite the constant drumbeat of negative press and being given less than a fair chance to succeed, community mental health has quietly and successfully served a large number of individuals with serious mental illnesses. Unfortunately, this number is still significantly less than the population of people who need help. Instead of denigrating community mental health, maybe we should give the system the resources necessary to succeed before declaring it a failure.
Thanks for the superb presentation on the stupdity, tragedy and waste of the American mental health care non-system.
As an historian of social welfare, I would like to have seen you highlight the fact that Dorothea Dix, the great 19th century social reformer, devoted her life's work to the establishment of state mental hospitals and the release of the mentally ill from prisons to these establishments. So in the 21st century, by relegated the mentally ill to prisons America is merely recreating the inhumane horrors of two centuries earlier.
st. louis, mo.
As a nursing student who just completed his psychiatric clinical rotation, I was glad to see the attention Frontline has focused on the plight of the mentally ill in this coutry. "The Released" is a poingnant depiction of the tragic situations many of these people face. Typical of Frontline, the film is fascinating and revealing -- I've recommended that my school's psych instructor include it in her curriculum.
Thank you, and keep up the good work.
Co Spgs, CO
I am a former state and Federal inmate who was diagnosed for the first time with paranoid schizophrenia shortly after being arrested for threatening and harassing my family. I was hospitalized in a state forensic hospital because my behaviour in jail was so violent. There, I was forcibly medicated and restored to minimal legal competency. My legal journey took me back to jail and then on to Federal custody to resolve further charges of threatening and harassing my family. Seven and a half years after my arrest, I was released from Federal prison to a Federal halfway house. My term of Federal supervision lasted a further three years. During my incarceration, the quality of the psychiatric care that I received varied.
However, what I want to describe is the follow up that the Charlotte Federal courts provided. For the duration of my term of Federal supervision the Feds picked up the tab for my medication, a psychiatrist contracted by the US Probation Office, and a counselor. A condition of my supervision was that I continue to make appointments, take my meds, and generally follow the directions of my care team. I was arrested in 95, was released in 02 and finished supervision in 05. I have been healthy since 96 or so (you do not get over a serious psychotic break overnight, especially when you are recovering in a penal environment). I was on Prolixyn for 3 yrs and have been on Zyprexa since 98. Since my release from prison I have been gainfully employed the entire time, have been married and divorced (the American Experience!) and last year bought a house (the American Dream). Because the quality of the USPO contracted psychiatrist was so good, I continue to see him at my own expense while jumping through a myriad of hoops to afford my meds. I have had no lapses in well over a decade, essentially since I was first medicated. In the midst of an otherwise depressing trend, I just thought I would mention that there are those who make it. Even though I wanted to stay well, the odds of being able to get timely, affordable care on your own after being released from prison are not at all good. The key to my being able to obtain, afford and follow up with psychiatric care was the program that the local Federal District provided. Hope this is of interest to consumers, families and policy makers.
Charlotte, North Carolina
As a current case manager in an out patient mental health center, I work with a variety of wonderful individuals who also have severe mental illness. Especially due to the numbers of people in our country who experience mental health issues, I am thrilled that you have taken the time to put this topic into the forefront of conversation. However, I want to remind PBS and all its viewers that using language like "schizophrenic" is not only no longer acceptable but now atrocious. Using people first language (i.e. "person with Bipolar") is not about being politically correct but about speaking with dignity and respect for the people they are in addition to having a disability.
"The Released" gave true insight to a growing epidemic that affects this country. It truly goes unnoticed when it does not personally "hit" home. Members of each community fail to acknowledge the issues that affect so many individuals who strive to sustain daily living; primarily due to a lack of knowledge.
Budget cuts have impacted the mentally ill as they are institutionalized rather than treated. The correctional system is not a functional system as it fails offenders by creating a sub-culture through its warehousing; therefore, how is it to serve as a form of rehabilitative treatment. The focus of our society is to punish rather than to treat. Countless dollars are wasted on institutionalizing rather than to utilize tax payers dollars to create working programs. If the prison systems were effective systems for the non-mentally ill population of offenders, then why is the recedivism rate so high? The system is not proactive; it is a reactive system that it chooses not to treat but rather to ignore real issues that were addressed through your publication.