What are your reactions to this report? Would you agree that America’s community-based mental health care system is a disaster?
Jessica Schwartz -- I worked with an ACT Team as a Case Manager -- we did not have good results ..a ll the things you suggest are provided, are only provided if you have a small enough caseload.
Unfortunately, as with all things in this country, I am afraid it is a function of funding. Again, Ohio seems to be ground zero in the meltdown.
There needs to be more media coverage on this issue. I have been employed as a mental health worker during the closures of state institutions, the emergence of group homes, and the dwindling insurance funded treatment centers. Ironicly I have a senior relative living with me who was never properly diagnosed and is currently under medication for bipolar disorder. Maintaining stabilization is devastatingly difficult. The general lack of knowledge/available support in society including law enforcement, medical professionals, social services leaves one feeling isolated/a trapped victim. Am in search of an affordable general community based assisted living alternative, one that could provide self supporting productivity, safety and dignity. Until this subject becomes more popular my search, like many others, may just continue indefinitely. Thank you for airing this well done documentary.
Thank you for showing a glimpse of problems in community mental health. As a psychologist with 19 years experience working for a community mental health center I must commend the mental health workers on the front lines for their successes. Community mental health workers cope with limited resources, unmanageable caseloads and nonsensical paperwork demands to maintain services for the most needy. Public dollars for community mental health are shrinking at a time when needs are increasing. In Wyoming the costs to maintain a prison inmate easily exceed ten times the amount of money available to treat individuals in the community. Programs like ACT and group homes require resources such as money, medications, and professionals willing to work with persons who have a serious and persistent mental illness. If we don't want to warehouse people in prisons or institutions, we have to provide the community resources to support them with the honor and respect they deserve.
I am so amazed and impressed with the coverage and discussion of a critical issue facing our communities. I am a mental health therapist in a community re-entry program designed to reintegrate severely and persistantly mentally ill felons back into the community and we were developed and designed to address all of the issues facing SPMI offenders that this program highlighted. There is still great fear about working with/treating individuals with such pervasive issues (SPMI, substance dependence, criminal thinking/behavior) and I believe this program offered a humanistic approach to battle the stereotypes affecting this population. The more knowledge that is offered about this population, the more empowered communities will feel to offer resources and solutions that in the long run will save time, money, and resources by reducing recidivism and stopping the revolving door from jails/prisons to the streets. Kudos.
Thank you so much for airing this program which brought the plight of the seriously mentally ill to the forefront. My husband and I have a son who is 26 and has Schizo-affective Disorder. He was diagnosed at 19 after three years of using alcohol and marijuana. He has been in and out of the hospital many times, and spent extended time at the state mental hospital on three occasions. He has delusions and religious preoccupation ... sometimes thinking he is a prophet or special messenger for Jesus. He goes in cycles of taking his medicine, stabilizing, going off his medicine, and then decompensating which causes him to eventually go back to the hospital. Our county has the CIT program (Crises Intervention Team) which offers 40 hours of specialized training to police officers, sheriff's deputies and jail keepers so that they can defuse situations when people are in crises instead of escalating them. Our county is also prepared to begin Mental Health Courts which will divert the mentally ill from jail to mandatory treatment during probation.We hope more of the group homes will be formed in the future because they would be less expensive and much more caring and compassionate than jail.
This was a wonderfully done program! I thought it addressed the issues of those faced with severe mental illness who do not have supportive families very well. Something that wasn't mentioned that I would like to have seen discussed was how many of individuals with severe mental illness not only have substance abuse problems but because of these abuse problems they have been convicted and now have felonies. Having a felony and a severe mental illness makes it incredibly difficult to survive. For instance, they do not qualify for food stamps & they cannot work at many of the basic, entry level jobs. Overall, this was an eye-opening program for anyone who wasn't aware of these issues. And it strengthened my belief that we need more community-oriented programs for these individuals.
I am concerned that by presenting a selective picture of the use psychiatric medication, FRONTLINE has left its viewers ill-informed about the limitations of these drugs. These are powerful drugs with powerful side-effects, and unfortunately they do not work for everyone. By depicting only people who have responded well, and failing to include commonly insufferable side-effects among the reasons that some people stop taking medication, viewers are left with the inaccurate impression that psych drugs would be a panacea if only people could be forced to take them. By presenting William Stokes, who is glad to have been force-medicated, without a countervailing example of one of the many people who's experience of being force-medicated left them traumatized, humiliated, and much angrier than before, FRONTLINE has missed an opportunity to start a much needed conversation about the appropriateness of psychiatry-by-force. By portraying lack of medication as the root of recidivism ... FRONTLINE shortchanges the social supports that are desperately needed in balance with pharmacological intervention to successfully tackle this crisis.
I am so glad to see the story of deinstitutionalization told on your program, and I applaud the work of Sherri Sullivan and the staff of Bridgeview Manor. I would like to also highlight a relatively new outpatient treatment approach called Assertive Community Treatment (ACT) that has been shown to be successful in reducing the in-and-out, revolving door effect of the mentally ill to prisons and state hospitals. ACT brings services directly to the client: personal medication delivery up to three times a day daily, regular appointments with a psychiatrist on the team, hands-on assistance in navigating appointments and social service benefits, job support, substance abuse support, and on-going education. It is, finally, an appropriate and effective response to the needs of the mentally ill who are discharged from short-term inpatient care (or prison) back into the community. I had the privilege of serving as a case manager on an ACT team in Elkhart, Indiana, which also offered on-site housing for clients. I wish such services as ACT and Bridgeview were available in every community in this country.
An interesting show, but I was concerned there was too much emphasis on medication and institutional care. When you are poor, isolated, homeless, and unemployed medication and close supervision are not your primary daily priorities. Thresholds in Chicago had had great success serving people with severe mental illnesses and extensive criminal justice histories. In our experience, medication makes a difference and a hospital is necessary on occasion. What really reduces re-arrest, however, is assertive and supportive outreach to people, a decent place to live, and a reason (like a job) to get up in the morning. If we want to help people stay out of corrections, let's get focused on doing the things that help people to get their lives back. ...
I appreciate your coverage of "The Released" and educating the American public of the problems that individuals diagnosed with mental illness face due to the deinstitutionalization of state hospitals. I have worked in a community health center for 15 years and am well aware of the problems that these people face. I think you however, that you did not address the increasing role of the community health centers to help these individuals maintain stability and functioning. The only group home that was addressed in this program was the one in Ohio and it seems that state is lacking in outpatient services to care for this population. The center I work for in Indiana is one of many community health centers in Indiana that provides residential and many outpatient services such as case management, group and medication maintenance for people with chronic mental health disorders. These services help these individuals function independently and decreases the need for multiple state hospitalizations as well as incarcarations.
Thanks so much for the program. My husband and I have a 39 year old son with Paranoid Schizophrenia. He lives with us and as we age I just don't know what will happen to him after we are gone. I know he will be in the prison system some day because he has a history of noncompliance with his meds. There needs to be some law that will make these seriously mentally ill comply to take their meds. The only way he keeps on his meds now is he gets a shot every 2 weeks. If he refuses he will be put out of house and he has no place to go so he goes for his shot. It is a very hard for him to go because he thinks everyone is out to hurt him. The system is very frustrating to me because there is not place for these people to go and live and be monitored. I hope the public see how serious this issue is.
As a Mental Health clinician in a state correctional facility I am actuely aware that prisons have become the "holding tank" for people with mental illness. After arriving at our facility and receiving medication and mental health follow-up, many of the inmates are able to move into general population, are assigned a job, and function within the prison community. Two or three weeks before release, I will often see these same individuals begin to decompensate, get into fights, exhibit erratic behaviors, increased paranoia and anxiety. And why should we expect otherwise, as they already know what is in store for them. They are released without a place to live, the ability to stay connected to mental health, no job or support sytem. It is a sad commentary that we find the funding to continue to incarcerate people, build new prisons, or stuff out of date prisons to unsafe levels, but cannot find our way to fund group homes or supported living options, free mental health care and case management. Everyday we risk the safety of our families, our communities, and the individuals themselves due to the lack of resources. The economic, spiritual, and emotional cost far supercedes the cost of fixing a degrading, unsafe, and inhumane system.
Thank you so much for airing such a critically important show. I work in a community mental health center as a social worker, and work very closely with the chronically mentally ill. I have seen first hand the "broken" system that my clients, as well as co-workers have to work with. It is heartbreaking and devestating. The lack of funding, as well as the mountains of paperwork and poorly run mental health system are just the tip of the iceberg. I hope that by seeing this show, others will join in the fight to advocate for the needs of the mentally ill.
Arlington Heights, Illinois
I very much appreciated "The Released," your episode on people with mental illness in the prison system. I know that one of your goals is to educate, and for this population, helping us all find respect, understanding, and compassion is essential. But I fear that your labeling people as "schizophrenics" and "paranoid schizophrenics" perpetuates a stigma and takes away from them being people first.
We don't call people with cancer or heart disease "cancers" or "heart diseases", we say they are people who have cancer or heart disease. We are not totally defined by our diseases. Please help our society see people with mental illness as people first, so we realize that they deserve respectful treatment for a serious illness, just as those with cancer and heart disease do.
Our brain is the most complicated organ we have; why are we so afraid of people with brain disease but find endless compassion for those with illnesses like cancer and heart disease?
I suffer from paranoid schizophrenia and live with my aging parents who worked hard all their lives but can longer afford to take care of me. I am intelligent and stable.I am neither amoral or asocial but I need to be taken care of because I can't care for myself. I take my medicine but even still prison or the streets is a real possibility for me. I had more automony and sometimes wish I never left the institue of Pennsylvania hospital. ... I thank PBS for this story because I felt so alone today and needed to see other people like me.
Drexel Hill, Pa.