This Is Serious

Image from http://agathoi.wordpress.com/2012/12/02/stoic-week-and-a-trip-to-the-er/ambulance/

Why HR 3717 “Helping Families in Mental Health Crisis Act” is so critical to care

It’s 3:00 in the morning. I’m sitting in a brightly lit waiting room at the ER, cuddling my then-three year old son, who can’t stop screaming and tugging at his ears. His cheeks are bright red; his duck-fuzz white hair stands up in all directions. I rub his green crocheted blankie—he calls it “Biss” for reasons still unknown—against his forehead, trying to sooth him.

I’m exhausted. The whole night has been like this. But it looks like we’re next in line for treatment.

Then my son's cries are drowned out by wailing sirens. An ambulance pulls up to the bay; we hear (but cannot see) a flurry of activity, intercoms buzzing. It’s a car accident, severe trauma. We wait, but without resentment. The Emergency Room is not like a grocery store checkout line, with first come, first served. It’s constant triage, assessing the most urgent needs first.

Ten years later, it’s my son, now 13, in the ambulance, held in restraints to keep him from bolting or striking people. Ten years later, it’s my son at the front of the line for treatment when we reach the emergency room. But once he’s calm and rational again, they send us home with five days’ worth of Zyprexa. There are no beds in the psychiatric hospital.

My emergency room story ended better than Virginia State Senator Creigh Deeds’s, whose beloved son Gus stabbed his father and shot himself.  My story ended better than Jared Loughner’s, who fired on Congresswoman Gabby Giffords. My story ended better than Eric Belluci’s,who (despite the existence of Kendra’s Law) killed both his parents with a hunting knife. My story ended better than Kelli Stapleton’s, who became so frustrated with the lack of support that she took her daughter to the woods without planning to return.

I still fear, as every parent of a child with a serious mental illness fears, that my son’s story may end like Kelly Thomas’s—that he will be beaten or shot by law enforcement officers who lack training in dealing with people who have mental illness.

These stories—my own and millions of others—are why I strongly support Representative Tim Murphy’s proposed comprehensive legislation to overhaul a broken mental health system. I was one of the parents who testified in an initial fact-finding forum, where Rep. Murphy and his colleagues asked what families need to help our children. You can read my op-eds in the Idaho Statesman and  Hartford Courant, both of which outline briefly why this legislation is so important for families like mine.

But the critics of HR 3717 are out in full force. Their position is pretty well summarized on psychcentral.com author Jon Grohol’s blog post, “The Lie of Focusing onThose with Serious Mental Illness,” written in response to mental health advocate DJ Jaffe, who dared to address the opposition’s elephant in the room: funding. Representative Murphy’s bill would restructure SAMHSA and require accountability through evidence-based outcomes. And some people are afraid of that.

I actually agree with Grohol about a few things. There’s no question that ADHD or anxiety or OCDs can make life difficult for those who have these conditions. And he’s right about arbitrary lines drawn in the mental health community—I cannot tell you how often I have heard the phrase, “Well, my son has autism. That’s just a developmental disability, not a mental illness like what your son has.”

But Grohol is incorrect in stating that supporters of Murphy’s legislation don’t think everyone with any kind of mental illness—not just serious mental illness—deserves treatment. As for the “lie” of serious mental illness? Here’s the thing. People with serious mental illness are NOT treated better or with different resources, as Grohol contends. Too often, they are not treated at all—at great cost to individuals, families, and communities. There are ten times as many people with mental illness in jails as in hospitals—read author Pete Earley’s excellent response, calling this fact “a national scandal.”

My biggest problem with Grohol’s argument is this statement: “What’s not needed is cramming forced treatment laws down state’s throats — even if their own citizens don’t want them.”

Forced Treatment. Wow, that sounds horrible! Kind of like the Death Tax—remember how the Republicans so brilliantly re-branded the estate tax, which affects a very small percentage of Americans, and made us all afraid that we would have to pay it?

We’re not talking about “forced treatment” here. We are talking about saving lives of people who, as a symptom of their illness, may not be aware of their condition. And the correct term is Assisted Outpatient Treatment or AOT. Already in the U.S., 45 of 50 states have AOT laws on their books, because they recognize that these laws help people with serious mental illness, save money, and improve communities. The fact is that AOT laws work. They improve the lives of people with mental illness and help their families. They reduce recidivism. Most important, they keep people with mental illness out of prison.

Let’s go back to my first night in the emergency room with my son. He had a double ear infection. The doctor was able to soothe his pain with a topical solution and sent us home with a prescription for antibiotics. The next day, he was a (mostly) cheerful preschooler again.

But the person who was in the car accident likely faced many months of recovery. I see mental illness in the same way—no “arbitrary lines,” no “Balkanization,” just sound, medical treatment decisions about urgency of care. I’m not saying my son’s bipolar disorder is somehow “better” or “more important” than your child’s ADHD. But the reality is that your child’s ADHD probably won’t land him or her in jail.

That’s not my reality.