When will we recognize the need to treat individuals who suffer from severe mental illness? With each tragic mass shooting, I think – maybe now we’ll do something. I was especially optimistic after the Newtown tragedy as legislators talked about gun control and addressing mental health reform. The gun legislation has been defeated in the U.S. Senate, but there is still an opportunity to focus on untreated severe mental illness and not allow it to fall through the cracks.
After each such tragedy – whether it be the elementary school in Newtown…the Aurora shooting at the movie theatre, the shooting at the shopping center in Tucson…the Virginia Tech massacre, I hear people say – “now those parents knew their sons were ill…why didn’t they do something to prevent that tragedy?” You’d be surprised how many people don’t realize that once your child reaches age 18, parents can’t force them to take their meds or be treated.
According to the National Institute of Mental Health, there are in this country an estimated 7.7 million people who suffer from the most severe mental illnesses – schizoaffective disorder, bipolar disorder and schizophrenia. Among them, only a small fraction ever become violent, and then, usually when they fail to get treatment. Catching the problem early is crucial. Yet parents seeking help are often turned away, or lose control when their children turn 18.
State laws vary, but all states set strict controls regarding involuntary hospitalization, limiting it to circumstances when a person is an imminent danger to self or others, or likely to become so. These laws give people with severe mental illness the right to decide when, where, how, or even if they will receive care. Yet some serious mental illnesses make it difficult for those affected to assess their need for treatment. When patient rights exceed necessary protections, individuals with a severe untreated mental illness can die because we’ve protected their civil liberties to remain mentally ill and refuse treatment. Many do die. And, sometimes they harm others along the way. The general public also has rights…the right to be protected from the consequences of non-treatment.
I’m the mother of a son who suffered from severe and persistent bipolar disorder. Despite the extraordinary and loving efforts of his family, my son’s bipolar ruined his life; his downward course was aided by a completely ineffective legal system that continually protected his civil right to remain severely mentally ill.
Medication compliance is the key to living with bipolar disorder or any mental illness. My son was not medication compliant. I don’t know why he would stop taking his meds…he just did. I’m not even sure he knew why. He, at times, lacked insight and used poor judgment. When this happened, the map for his recovery was full of dead ends, and both he and his family suffered the consequences.
It’s important to point out that there are many people who have a diagnosis of bipolar disorder whose illness is less severe than my son. They are medication compliant and manage their illness. These people are role models.
During a manic episode, my son lacked the ability to recognize he was ill. If you don’t understand you’re sick, how can you be expected to make rational decisions regarding your treatment? You can’t. Severe mentally ill adults are in no condition to see the severity of their illness or control the direction of their medical treatment. Families are – or they can be – the early warning system. They see the fuse burning long before the bomb goes off, but there is nothing concerned families can do until their loved one reaches the crisis stage.
Untreated bipolar disorder took my son on a 13-year roller coaster ride. It destroyed two marriages, his career, and ultimately his life…all this in the name of protecting his civil right to refuse treatment. Each time he was allowed to go untreated for long periods of time, he sustained further brain damage. This untreated illness over time destroyed his short-term memory and his thought process. Toward the end, he could not even remember what he had done the day before. Pre-bipolar disorder…a very successful entrepreneur…owned his own company with six employees…now, an unemployable person.
Bipolar disorder is a complex medical illness of the brain involving episodes of serious mania and depression. It’s a lifelong illness with recurring episodes. There is currently no cure…but the good news is…bipolar is a treatable illness.
Mental illness is not going away. We must find a balance between protecting the rights of mentally ill people and also acquiring the much-needed treatment they require to recover and not be a threat to society. Mental illness is not a state of freedom to be protected at all costs from involuntary treatment. The right to live supersedes the right to not be involuntarily treated. Those who are suicidal when ill, but want to live when well should have the safety net of a family member and/or their psychiatrist to intervene in treatment decisions to allow them to return to their lives and be well.
If we want to prevent the next Newtown, we must reform our involuntary commitment laws that impose barriers to treatment of serious mental illness. I’ve spoken with many judges who tell me that the laws as currently written are inadequate to allow even judges to do what families and doctors need them to do.
Dottie Pacharis, Author, Mind on the Run – A Bipolar Chronicle