Mentally Ill Are Often Locked Up In Jails That Can’t Help

That is the title of the article I am writing about click on the link above to read the full story.  “Cook County, Ill., Sheriff Tom Dart walks the halls of his jail every day.  With 10,000 inmates, this place is a small city –except a third of the people here are mentally ill.  Dart has created some of the most innovative programs in the country to handle mentally ill inmates, hiring doctors and psychologists, and training staff.  But if you ask anyone here, even this jail is barely managing. ‘I can’t conceive of anything more ridiculously stupid by government than to do what we’re doing right now.’ Dart says.   Fifty years ago, states began shutting down asylums in favor of community mental health centers.  It was a major policy shift in mental health, allowing patients to go home and live independently.  Over the past decade, though, states have cut billions from their mental health budgets, shuttering clinics across the country.  The result is thousands of mentally ill people funneling in and out of the nation’s jails. In many cases, it has sent the mentally ill right back where they started –locked up in facilities that are ill-equipped to help them.”   For me personally I am glad that they let everyone go.  I hate the state hospital to many games.  People there are not real like they are in prison.  When I first was locked up in the county jail there were not as many homeless as there are today.  Back then the homeless came to jail in the winter to get off the streets they usually received six month sentences.  We knew who they were.

Now mentally ill are put in county jails with the regular population unless they mess up. “It’s staggering’ Elli Petacque Montgomery is the deputy director of mental health policy for the sheriff’s office.  She and her staff screen all of the inmates for mental illness.  It’s not hostile, angry men at the front of cages, bickering with jail staff and pushing each other for more elbow room that interest her.  It’s the men in the corners –men who come to jail and manage, despite the noise and commotion, to fall asleep. I’m kind of curious about this guy in the blue, ‘says Montgomery, pointing to a man sitting quietly on a bench.  Now, is he dazed because he’s on drugs or because the voices in his head are louder than what’s happening around him?’  On this morning, one inmate after another has a problem.  One man tells her he’s going to kill himself because he thinks he’s already dead.  Another guy explains that the voices tell him to hurt people.  To walk in and feel like every other person I’m interviewing [is] mentally ill on any given day, I can’t wrap my brain around it, she says. It’s staggering what we’re dealing with. Most of these men are here on minor offenses. Police have picked them up for small crimes like acting out in front of restaurants, sleeping in abandoned buildings or possessing drugs. They’re people with nowhere to go and nowhere to get medication.  Some of them will stay for a few days; some for a few weeks.  But statistically almost all of them will be back.  While these men are here, the jail’s responsibility is to keep other inmates from hurting them and them from hurting themselves.  But jail staff say what really happens deep inside this jail is a far cry from actual treatment.”  I know that from being in the county jail before I was sent to the state hospital that jail is no place to be mentally ill.  I did a lot of my time that time being in the infirmary and that being in protective custody a place I should have never been.  I had a mental illness when I was there.
The article goes on to say: “Sometimes I would even commit a crime just to make sure I would get my meds, says inmate Joseph DeRiggi.  Here, there’s a little more understanding because they know us: ‘OK, DeRiggi, we know what you’re on. You’re good.’  That’s just the way it is.  But jail is an expensive place to get medication. It costs almost $200 a night to house a mentally ill person here; health clinics cost a fraction of that.  Plus, their cases clog the courts with largely minor offenses.  That lengthens jail time for everyone.  The average stay is now eight days longer than it was a few years ago.  Adding eight days cost county taxpayers $10 million more every year.  He says he understands that money for community health centers is tight. But he says doing it this way is costing more.  Clearly, our society had determined that state-run mental hospitals were abhorrent, that my God, our society cannot tolerate this, we’re much more advanced than that, Dart says. ‘I just find the irony so thick that same society finds it OK to put the same people in jails and prisons.’ But then he shakes his head and changes his mind. ‘ I know people care, ‘ he says, pausing ‘ I don’t think they know’”  How would you know unless you at some time were locked up.  I know that people from the old days were ashamed that they broke down and had a mental illness.  I know it happen to me and one other person I knew in prison my friends were ready to stand by me.  Although I could not face them knowing that I was not strong enough to finish my time even though I was waiting on my appeal.

Severe Mental Illness Ups Risk for Substance Abuse

That is the title of this article I am writing this blog about. “A new study finds substance abuse is higher among individuals with severe mental illness. Researchers discovered people with schizophrenia, bipolar disorder and similar conditions have a higher risk for substance use—especially cigarette smoking – and protective factors usually associated with lower rates of substance use do not exist in severe mental illness.  Studies exploring the link between substance use disorders and other mental illnesses have typically not included people with severe psychotic illnesses. Estimates based on past studies suggest that people diagnosed with mood or anxiety disorders are about twice as likely as the general population to also suffer from a substance use disorder.  Researchers used data from the 2012 National Survey on Drug Use and Health to show that close to 8.4 million adults in the United States have both a mental and substance use disorder.”  That is a lot of people that have mental illness and substance use disorder. It takes a person wanting to quit in being able too.  You have to see that not everyone always does substances and quitting only helps you to know yourself.

People do not believe by smoking it does not harm them it will only happen to someone else they will develop lung problems not me. “However, only 7.9 percent of people receive treatment for both conditions, and 53.7 percent receive no treatment at all, the statistics indicate.  Drug use impacts many of the same brain circuits that are disrupted in severe mental disorders such as schizophrenia, said, National Institute on Drug Abuse (NIDA) Director, Dr. Nora D. Volkow.  While we cannot always prove a connection or causality, we do know that certain mental disorders are risk factors for subsequent substance use disorders, and vice versa. In the current study, 9,142 people diagnosed with schizophrenia, schizoaffective disorder, or bipolar disorder with psychotic features, and 10,195 controls matched to participants according to geographic region, were selected suing Genomic Psychiatry Cohort program. Mental disorders diagnoses were confirmed using the Diagnostic Interview for Psychosis and Affective Disorder (DI-PAD) and controls were screened to verify the absence of schizophrenia or bipolar disorder in themselves or close family members. The Di-PAD was also used for all participants to determine substance use rates.”  It must be hell to live with both substance use and a mental illness.  When I was in my mental illness the farthest thing in my mind was getting high.  It was hard enough trying to figure what was going wrong with me.
The article goes on to say: “Compared to controls, people with severe mental illness were about 4 times more likely to be heavy alcohol users (four or more drinks per day); 3.5 times more likely to use marijuana regularly (21 times per year); and 4.6 times more likely to use other drugs at least 10 times in their lives. The greatest increases were seen with tobacco, with patients with severe mental illness 5.1 times more likely to be daily smokers.  The association is a concern because smoking is the leading cause preventable death in the United States.  In addition, certain protective factors often associated with belonging to certain racial or ethnic groups – or being female – did not exist in participants with severe mental illness.  In the general population, women have lower substance use rates than men, and Asian-Americans have lower substance use rates than white Americans, but we do not see these differences among people with severe mental illness, said Dr. Sarah Hartz, first author on the study.  We also saw that among young people with severe mental illness, the smoking rates were as high as smoking rates in middle-aged adults, despite success in lowering smoking rates for young people in the general population.  Previous research has shown that people with schizophrenia have a shorter life expectancy than the general population.  Chronic cigarette smoking has been suggested as a major contributing factor to higher morbidity and mortality from malignancy as well as cardiovascular and respiratory diseases.  These findings indicate that the rates of substance use in people with severe psychosis may be underestimated.  Researchers call for additional investigation to improve understanding of the association between substance use and psychotic disorders, so that both conditions can be treated effectively.   Lower life expectancy that would make me think about changing my life if I had something to live for.  I am glad that I do.  I told this story of how I was coughing pretty much when I was smoking and it did not stop until I quit.  I did it for my granddaughter not because it was killing me already.

Cellular Process Gone Awry Tied to Schizophrenia

That is the title of this article I am writing about.  “Researchers have discovered a molecular process that may contribute to the development of schizophrenia, according to new research published in the journal Molecular Psychiatry.  The research team from Tel Aviv University discovered that a process called autophagy is reduced in the brain of a person with schizophrenia.  Authophagy – a ‘cell-maintenance’ mechanism – clears out the dysfunctional and needless parts of a cell.  When this process is blocked, cells die.  The findings show that patients with schizophrenia have reduced levels of a protein called beclin-1 in the hippocampus (a brain region linked to learning and memory).  Beclin-1 plays an important role in autophagy, the researchers note.  This finding suggests that autophagy may be blocked in the brains of schizophrenic patients.”  Cell maintenance we need that whether or not were schizophrenic.  Both learning and memory we need.  When I went to junior high and high school, I was good at math, but when I went to college my tutor will say “he gets it and as soon as he walks out the door he forgets all we learned.”

I hope before I die that they find out what really went wrong with me. “The researchers believe that creating drugs that increase beclin-1 levels and trigger autophagy may lead to a new treatment for schizophrenia.  It is all about balance.  Paucity in beclin-1 may lead to decreased autophagy and enhanced cell death.  Our research suggests that normalizing beclin-1 levels in schizophrenia patients could restore balance and prevent harmful brain-cell death, said lead author Illana Gozes, Ph.D., of Tel Aviv University.  When researchers measured beclin-1 in the blood of schizophrenic patients, however, the levels were normal.  They say this suggests that reduced levels of protein are confined to the hippocampus.  They also found that patients with schizophrenia have increased levels of a protein called activity-dependent neuroprotective protein (ADNP) in their white blood cells.”  Hopefully they find out soon what is wrong.  I do know that balance they are on the right track everything has to find a balance.
The article goes on to say: “This protein, discovered by Gozes in 1999, is crucial for function and formation of the brain.  The team notes that previous research had also shown that ADNP is abnormal in the brains of schizophrenics.  They hypothesize that when beclin-1 levels drop and autophagy is slowed down, the body increases ADNP levels to help protect the brain. Therefore, ADNP could be used as a biomarker – meaning a blood test could be used to diagnose schizophrenia.  The investigators hope their research will lead to further knowledge that will help them better understand the mechanisms and treatment of schizophrenia.  We discovered a new pathway that plays a part in schizophrenia.  By identifying and targeting the proteins known to be involved in the pathway, we may be able to diagnose and treat the disease in new and more effective ways, said Gozes.” That is what we need better treatment options and to find out why we developed schizophrenia in the first place.  I do know that environmental factors did play a role in my developing schizophrenia.  How did I get it in the first place?  I would like that answer.

Alcohol, Tobacco, Drug Use Far Higher in Severely Mentally Ill

That is the title of this article I am writing about. “In the largest ever assessment of substance use among people with severe psychiatric illness, researchers at Washington University School of Medicine in St. Louis and the University of Southern California have found that rates of smoking, drinking and drug use are significantly higher among those who have psychotic disorders than among those in the general population.  The finding is of particular concern because individuals with severe mental illness are more likely to die younger than people without severe psychiatric disorders.  These patients tend to pass away much younger, with estimates ranging from 12 to 25 years earlier than individuals in the general population, said first author Sarah M. Hartz, MD, PhD, assistant professor of psychiatry at Washington University.  They don’t die from drug overdoses or commit suicide -- the kinds of things you might suspect in severe psychiatric illness.  They die from heart disease and cancer, problems caused by chronic alcohol and tobacco use.”  Those two things are a wakeup call to stop using and live a long life.  Twenty three years sober is what I have in April it will be twenty four and I do not miss going to jail never knowing what I did the night before.  Fifteen years not smoking which I do not miss the high prices or the smell.

We all want to live a little bit longer if we can.  “The study analyzed smoking, drinking and drug use in nearly 20,000 people.  That included 9,142 psychiatric patients diagnosed with schizophrenia, bipolar disorder or schizoaffective disorder – an illness characterized by psychotic symptoms such as hallucinations and delusions, and mood disorders such as depression.  The investigators also assessed nicotine use, heavy drinking, heavy marijuana use and recreational drug use in more than 10,000 healthy people with mental illness.  The researchers found that 30 percent of those with severe psychiatric illness engaged in binge drinking, defined as drinking four servings of alcohol at one time.  In comparison, the rate of binge drinking in the general population is 8 percent.  Among those with mental illness, more than 75 percent were regular smokers.  This compares with 33 percent of those in the control group who smoked regularly.   There were similar findings with heavy marijuana use: 50 percent of people with psychotic disorders used marijuana regularly, versus 18 percent in the general population.  Half of those with mental illness also use other illicit drugs, while the rate of recreational drug use in the general population is 12 percent.”  It would be nice to know if they continued doing what they always did or did they just start after their mental illness.

The article goes on to say: “I take care of a lot of patients with severe mental illness, many of whom are sick enough that they are on disability, said Hartz.  And it’s always surprising when I encounter a patient who doesn’t smoke or hasn’t used drugs or had alcohol problems.  Hartz said another striking finding from the study is that once a person develops a psychotic illness, protective factors such as race and gender don’t have their typical influence.  Previous research indicates that Hispanics and Asians tend to have lower rates of substance abuse that European Americans.  The same is true of women, who tend to smoke, drink and use illicit drugs less often than men.  We see protective effects in these subpopulations, Hartz explained.  But once a person has a severe mental illness, that seems to trump everything.  That’s particularly true, she said, with smoking.  During the last few decades, smoking rates have declined in the general population.  People over age 50 are much more likely than younger people to have been regular smokers at some point in their lives.  For example, about 40 percent of those over 50 used to smoke regularly.  Among those under 30, fewer than 20 percent have been regular smokers.  But among the mentally ill, the smoking rate is more than 75 percent, regardless of the patient’s age.  With public health efforts, we’ve effectively cut smoking rates in half in healthy people, but in the severely mentally ill, we haven’t made a dent at all, she said.”  With drinking I believe you have to hit your bottom to quit.  I do not care how many A.A meeting you go to until something happens that is too much for you it will not be successful.  For smoking to quit you have to have a reason other than the cost.  You have to it is not an option to smoke any more.
My major in college was a drug and alcohol counselor.  I went on to go for my Master’s in Public Administration because I could not help a teenager that I believe they were suspending wrongly so I quit and went on to my get my Masters instead.  “Until recently, smoking was permitted in most psychiatric hospitals and mental wards.  Hartz believes that many psychiatrists decided that their sickest patients had enough problems without having to worry about quitting smoking too.  There were also concerns about potential dangers from using nicotine-replacement therapy, while continuing to smoke since smoking is so prevalent among the mentally ill. Recent studies, however, have found those concerns were overblown.  The question, she said, is whether being more aggressive in trying to curb nicotine, alcohol and substance use in patients with severe psychiatric illness can lengthen their lives. Hartz believes health professionals who treat the mentally ill need to do a better job of trying to get them to stop smoking, drinking and using drugs.  Some studies have shown that although we psychiatrists know that smoking, drinking and substance use are major problems among the mentally ill, we often don’t ask our patients about those things, she said.  We can do better, but we also need to develop new strategies because many interventions to reduce smoking, drinking and drug use that have worked in other patient populations don’t seem to be very effective in these psychiatric patients.”  It is probably because they say my life is messed up right now and that is all I have.  I am lucky I have things that I want and a family that I love and want to succeed so that helps me.  Also I know I touch alcohol again and it is back to prison because it will be soon that I do something stupid.