Mental Health

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Diverting Mentally Ill to Treatment, Not Jail

Officers Ned Bandoske (left) and Ernest Stevens are part of San Antonio's mental health squad — a six-person unit that answers the frequent emergency calls where mental illness may play a role. (Jenny Gold/KHN)

Officers Ned Bandoske (left) and Ernest Stevens are part of San Antonio’s mental health squad — a six-person unit that answers the frequent emergency calls where mental illness may play a role. (Jenny Gold/KHN)

This week, Julie Small has reported on this blog about court-ordered overhauls in caring for mentally ill inmates in California prisons. About one-fourth of California’s inmates — 37,000 people — have mild to severe mental illness.

As Small reported, U.S. District Judge Lawrence Karlton ordered the California Department of Corrections and Rehabilitation (CDCR) in April to draft new policies for use of force and has signed off on CDCR’s plans. Now the department is working on plans to comply with Karlton’s orders to change how it handles segregation for inmates with mental illness.

So, I was riveted by a report this morning from NPR and Kaiser Health News about a different approach — a coordinated, comprehensive approach — to a county-run mental health system. The story was set in Texas’ Bexar County, (pronouced “bear”) home to San Antonio and the Alamo, and the program is now a model for the nation. Continue reading

California Prisons Begin ‘Use-of-Force’ Reforms for Mentally Ill Inmates

A psychiatric segregation cell at Sacramento Prison. (Julie Small/KQED)

A psychiatric segregation cell at Sacramento Prison. (Julie Small/KQED)

By Julie Small

The number of inmates with mild to severe mental illness has grown to 37,000 in California, about a quarter of the prison population.

A series of lawsuits brought by inmates against the state over the last two decades has exposed a correctional system poorly equipped to handle their extraordinary needs.

Now California is trying to comply with a federal court order to change when and how correctional officers use pepper spray to force uncooperative inmates to leave their cells or follow orders.

Pepper spray may have contributed to three inmate deaths and an unknown number of injuries — unknown because the California Department of Corrections and Rehabilitations doesn’t consider the effects of pepper spray an injury. Continue reading

As Aging White Man, Robin Williams Was Particularly at Risk for Suicide

An Instagram photo that comedian and actor Robin Williams posted on his last birthday, July 21. The caption: ‘Happy Birthday to me! A visit from one of my favorite leading ladies, Crystal.’

An Instagram photo that comedian and actor Robin Williams posted on his last birthday, July 21. The caption: ‘Happy Birthday to me! A visit from one of my favorite leading ladies, Crystal.’

You don’t really expect a professional baseball player to be the one person to articulate the effect Robin Williams had on much of the general public, but that was my feeling when I read this quote in today’s San Francisco Chronicle from Giants pitcher Tim Lincecum, who had once been thrilled to receive a congatulatory handshake from Williams. Said Lincecum:

He made things feel like they weren’t so bad.”

Remembering some of Williams’ early manic groundbreaking appearances on television and movies, the statement rang true, as did the chilling irony in its description of a man who seemingly had everything but clearly thought that things were that bad, after all.

The suicide rate for white men increased almost 40 percent between 1999 and 2011.

Considering his suicide, it’s not surprising that Williams’ publicist said Monday that the comedian suffered from severe depression. Williams also struggled with substance abuse issues for decades. Since his death, a national conversation has ensued on the insidious effects of depression, and how it can prove fatal even in those who, to the outside world, seemingly have everything to live for.

Around the country, media organizations have been interviewing mental health experts on the subject. The Chronicle talked to some who worried about the impact of Williams’ suicide on those struggling with depression. “I get concerned about people wondering if people as promising as him with all these resources available can’t make it, what are the chances for them?” Patricia Arean, a UCSF clinical psychologist and psychiatry professor, told the paper.

She said many people who are depressed often can’t find their way to the appropriate treatment if what they’re currently doing to address their condition isn’t working. Continue reading

California Prisons to Restrict Pepper Spray, Segregation of Mentally Ill Inmates

 Bunk of an empty segregation cell at California State Prison-Sacramento. (Julie Small/KQED)

Bunk of an empty segregation cell at California State Prison-Sacramento. (Julie Small/KQED)

By Julie Small

California prison officials proposed major policy changes Friday to curtail when and how correctional staff use pepper spray on mentally ill inmates or segregate them from the general prison population.

The California Department of Corrections and Rehabilitation (CDCR) planned to vest mental health clinicians with greater say in whether correctional staff may use force or segregate inmate patients. The agency also set strict time limits on the segregation of mentally ill inmates who had committed no serious violations or crimes in prison.

CDCR proposed these changes to comply with a court order issued by U.S. District Judge Lawrence Karlton. Judge Karlton ordered the changes to California’s policies in April, after a lengthy evidentiary hearing. Continue reading

Mental Health Training for Police Officers Helps Defuse Crises

An impromptu memorial in Isla Vista, Calif. for a victim of the mass shooting May 23, 2014. (Diane Block/KQED)

An impromptu memorial in Isla Vista, Calif. for a victim of the mass shooting May 23, 2014. Incidents such as these have raised the issue of how well law enforcement officers are trained to deal with people with severe mental illness. (Diane Block/KQED)

By Stephanie O’Neill

Debbie is a Ventura County mother of a 23-year-old son diagnosed with bipolar disorder. At times his condition becomes so severe that he gets delusional and requires hospitalization.

“They weren’t threatening; they didn’t scare him. It stayed really, really calm.”
“He doesn’t understand that he’s ill and that he needs help,” Debbie says. “He thinks he’s fine.”

Debbie, who asked that her last name be withheld for privacy reasons, says when that happens, she calls the sheriff’s department for help — as she did earlier this year. Their response, she says, was heartening.

“The police officers … were so great, because they kept telling him, ‘You’re not in trouble, we’re here to help you,’ ” she says. “So they weren’t threatening; they didn’t scare him. It stayed really, really calm.” Continue reading

Kaiser Therapists, Patients Allege Long Waits for Mental Health Care

Kaiser Permanente’s newly opened medical center in Oakland. (Lisa Aliferis/KQED)

Kaiser Permanente’s newly opened medical center in Oakland. (Lisa Aliferis/KQED)

One month, three months, even five months.

That’s how long some Northern California Kaiser patients wait to see an individual therapist — according to many Kaiser patients and therapists.

KQED’s Jon Brooks has reported extensively on this issue over the last two months. He talked to close to two dozen therapists and patients who said that they were experiencing long wait times. One therapist whose specialty is geriatric care told him that she had written to her superiors saying, “I can’t tell a patient that has six months to live that I’ll see them in five months.” Continue reading

Therapists, Patients Criticize Kaiser Over Long Delays for Therapy

Kaiser Permanente's newly opened medical center in Oakland. (Lisa Aliferis/KQED)

Kaiser Permanente’s newly opened medical center in Oakland. (Lisa Aliferis/KQED)

This is the second of two parts about mental health services at Northern California Kaiser.

In January 2013 a woman named “Nina” had a terrible falling out with her father. Soon after, she found out he had incurable cancer and was going to die. In the ensuing weeks, she tried to patch things up, but with the pressures inherent in the last months of a dying man, was unable to attain any form of closure. Some six months after their fight, he was gone.

“People are suffering, and I fear some of my patients will commit suicide for lack of ongoing treatment.”

“Nina,” who did not want us to use her real name for reasons of privacy, had been prone to depression. Zoloft had helped, but the now irreparable family rift left her severely depressed, with occasional thoughts of suicide. “I was in a state of constant emotional pain and confusion,” she says. “It was affecting all aspects of my life.”

She went for an intake appointment at the psychiatric department at Kaiser Permanente’s Oakland Medical Center, with the expectation she’d be able to see a therapist for individual appointments during this severe emotional crisis. She requested those sessions, but the intake therapist told her Kaiser only offered group therapy.

“I said I’m not comfortable talking about my situation with a bunch of strangers,” Nina says. “She very kindly tried to make me aware of the value of group therapy. But I knew in my heart it wasn’t where I wanted to be.” Continue reading

San Francisco Supes Approve Laura’s Law, Can Compel Mentally Ill Into Treatment

(jivedanson/Flickr)

(jivedanson/Flickr)

Update 10pm by Isabel Angell

San Francisco Supervisors passed a version of Laura’s Law today that compels treatment for certain mental health patients. Supervisor Mark Farrell, who sponsored the legislation, said Laura’s Law will be an “important tool” for the city.

“I do believe we need to do more as a city and we need to do more to help those who are clearly suffering and cannot help themselves. In order to make a difference here at the local level, we have to continue to challenge ourselves and the status quo,” Farrell said before the vote.

A last-minute amendment from Supervisor Jane Kim that added an external evaluation after three years helped the ordinance pass 9-2. Supervisor Eric Mar, who cast one of the “no” votes, called mental health treatment a civil rights issue.

Continue reading

Fresno Community Garden is Sanctuary for Hmong Refugee

smile in crops

Cha Deng Vang, 68, tends to the community garden at Fresno Interdenominational Refugee Ministries. Working in the garden helps Vang, a refugee from Laos, relieve anxiety and get exercise. (Annabelle Beecher/KQED)

Editor’s Note: Refugees face unique challenges building lives in the United States. Cha Deng Vang fled Laos in 1987 after fighting as soldier in the US-backed forces. As part of our ongoing health series, Vital Signs, we hear from 68-year-old Vang who has found that a community garden for Hmong refugees at Fresno Interdenominational Refugee Ministries has helped him build community and relieve stress. Chong Vang and Sam Chang helped to translate his story.

By Cha Deng Vang

On this side we are growing Hmong pumpkin. They’re very round and very big compared to the American version.

Growing up my parents taught me how to garden and farm. As soon as I turned 18, I became a soldier, and that was basically my entire life.

When I first came to America, I had no education. I couldn’t find a job which equals no money to help my family. So with no financial support, it was a lot of stress on the entire family. And on top of that we also had a lot of illness in the family, which also caused a lot of stress on me as well. Continue reading

Sonoma Co. Supervisor Takes Issue with Kaiser over Mental Health Services

(Ted Eytan/Flickr)

(Ted Eytan/Flickr)

This is Part 1 of a series on issues surrounding Kaiser Permanente’s mental health services.

Sonoma County Supervisor Shirlee Zane is frustrated with Kaiser Permanente.

“Kaiser better change the way they do business when it comes to mental health services.” — Shirlee Zane, Sonoma Co. Supervisor

“I can tell you I have heard a lot of stories within the last few days about these types of incidents over and over again,” she says, “of people who were so wronged by their treatment, by either being referred out of the system or by saying, ‘We don’t have the appointments.’”

She’s referring to allegations of long delays for mental health services at Kaiser Permanente, accusations the health plan has been dealing with for several years. Now, Zane is trying to leverage a very personal tragedy — the suicide of her husband — into pressing Kaiser on reforming its mental health practices. Continue reading