Mental Health


Why is Fort Hood Shooter’s ‘Mental Health’ Constantly Reported?

Television news live trucks at the front gate of Fort Hood, Texas. (Joe Raedle/Getty Images)

Television news live trucks at the front gate of Fort Hood, Texas. (Joe Raedle/Getty Images)

To state the obvious, the shooting at Fort Hood is a tragedy. But in press reports the alleged shooter, Ivan Lopez, cannot be mentioned without reference to his recent evaluation and treatment for mental health issues.

As NPR correctly points out, the fact of the shooter’s treatment could not have predicted that the violent event would have occurred. Worse, the press reports wrongly scare people into thinking that mental illness is easily linked to violent behavior.

It’s not. From NPR:

One national survey in 2006 found that most Americans — 60 percent — believed people with schizophrenia were likely to be violent. But the vast majority of people with psychiatric disorders are not violent. In fact, another study found they are far more likely to be the victims of violence, and that 1 in 4 experience violence every year. Continue reading

After Years of Budget Cuts, More Psychiatric Resources Coming

(Getty Images)

(Getty Images)

By Elaine Korry

Don Fox prepared for his late-night rounds. He collected a few warm blankets and protein bars, then hit the streets, seeking out people in crisis who needed food and warmth. “Our principle is, we hang out where people are,” said Fox. “We walk the streets in those areas, make eye contact, and ask if they need help.”

Fox is an Episcopal priest with San Francisco Night Ministry, a program founded by volunteer clergy in 1964 to serve a then-emerging population of mentally ill homeless people. A half-century later, the problem hasn’t gone away.

On a recent night Fox walked San Francisco’s Civic Center, where he met a 53-year-old Navy veteran slumped on the sidewalk. The man, a slight figure in a torn sweatshirt and Oakland A’s cap, said he had been homeless and in and out of jail for about six years.

He said that a few months ago, he had run out of his anti-psychotic medication, Risperdal. Late one night he started to feel suicidal and went to San Francisco General Hospital for help. “I wasn’t well, put it that way,” he told me. He spent the early morning hours in the emergency department, but then said he was told to leave. “I was telling them that I needed to stay a little longer. They wouldn’t let me stay longer, so they made me leave.” Continue reading

How California’s Mentally Ill Children Suffer — Few Hospital Beds Statewide

 (Debora Bogaerts/Flickr)

(Debora Bogaerts/Flickr)

CORRECTION: Due to a reporting error, the original version of this story incorrectly identified John Muir Medical Center, Concord as the facility where Maria Ramirez’s granddaughter was taken. We regret that error.  The post has been edited so that it no longer contains the incorrect information.

By Elaine Korry

Maria Ramirez began caring for her granddaughter when the girl was just a toddler. Her granddaughter began hurting herself — cutting her arms and swallowing things — before she was 10. Soon, says Ramirez, she couldn’t let the girl out of her sight. “She was running in front of cars, just really impulsive,” says Ramirez. “It was out of control, and I was really scared.”

Ramirez has a job and health insurance, so she did what any parent or guardian would do: she took her granddaughter to her local hospital for treatment. But instead of finding help, she always got the same reply, “No beds, no beds.”

Ramirez, a Bay Area artist who loves gardening, says she knew early on that her granddaughter was going to need help. “She was a hard child to make smile. She was very serious,” says Ramirez. Continue reading

Sharp Drop in Psychiatric Beds Leaves Severely Mentally Ill With Few Places to Go

Carole Ford (Elaine Korry/KQED)

Carole Ford of Lakeport, seen here in front of the community health center she runs, was often taken to hospitals far from her Lakeport home to treat her mental illness. (Elaine Korry/KQED)

By Elaine Korry

In  the small town of Clearlake, about a hundred miles north of San Francisco, Carole Ford, a great-grandmother with a mane of silver-gray hair, runs a community mental health center called The Bridge. She leads support groups and prepares meals for her mostly homeless clients. It’s hardly glamorous work, but Ford says this is her dream job. “I know that I’m where I’m supposed to be — and doing what I’m supposed to be doing,” she says.

Employees had to scour the state, looking for a vacant psychiatric bed. “Then it’s another 2 to 3 hour drive.”

But Ford, 71, hasn’t always been so content. She had a traumatic childhood and many bouts of depression. As a younger adult adult she often felt suicidal. She recalls being dragged away to the hospital in Lake County, where she says she felt like she was dumped. There was no psychiatrist or therapist; no peer support or services of any kind. Continue reading

Health Law Nudges Therapists Toward Group Practice

Because mental health is one of the ACA’s required benefits, many therapists are now having to deal with insurance contracts for the first time. (Getty Images)

By Sarah Varney, Kaiser Health News

In the corporate world of American health care, with its consolidating hospital chains and doctors’ groups, psychologists and other mental health therapists are still mostly Mom-and-Pop shops; they’ve built solo practices, hanging their own shingles, not unlike Lucy in the Peanuts gang: “Psychiatric Help 5¢, The Doctor Is In.”

But that business model is shifting from solo practices toward large medical groups, say mental health experts. The shift is propelled by the Affordable Care Act, which mandates mental health benefits in insurance coverage, and the 2008 mental health parity law, which requires private and public insurers to cover mental health needs just as they do medical conditions by charging similar co-pays, for example.

“It’s a big change for us. There is a loss of autonomy that a lot of therapists are frightened about.”  

“It’s a big change for us,” said Barbara Griswold, a marriage and family therapist in San Jose. “I spent all of my life setting up this practice where I choose my clients, I choose my hours.”

In just the last few months, Griswold has weighed a new contract with a giant health insurer, warned other therapists to watch what they’re signing in payment negotiations and considered the extinction of her own solo practice. “The idea of me moving into an interdisciplinary practice where somebody else is taking care of my billing, and someone is choosing my clients for me —there is a loss of autonomy that a lot of therapists are frightened about,” Griswold said. Continue reading

Mental Health Funds Well-Spent or Wasted? Prop. 63 Authors Divided

By Elaine Korry, KQED

Young people with mental health needs find help through art therapy at Daniel's Place, a drop-in center in Santa Monica. (Elaine Korry/KQED)

Young people with mental health needs find help through art therapy at Daniel’s Place, a drop-in center in Santa Monica. (Elaine Korry/KQED)

Remember Proposition 63? The voter initiative known as the Mental Health Services Act was approved in 2004. It imposed a 1 percent surtax on income over $1 million to fund services for Californians with a serious mental illness. Now, nine years later, the state auditor is about to release a long-awaited report, detailing how nearly $9 billion in taxpayer money raised by Prop. 63 has been spent. Whether that money has been spent wisely is being hotly debated, and even the bill’s co-authors are divided.

“What did they do with the money? Where has all the money gone? We would like to know,” said Rose King, one of the initiative’s original co-authors. Lawmakers requested the audit after whistle-blowers including King complained that the funds were being misused.

As written, nearly three-quarters of the money raised by Prop 63 was slated to fund services for people already diagnosed with a severe mental illness. Twenty percent was reserved for prevention and early intervention strategies. The remaining funds would go to oversight, administration, and innovations. Continue reading

Where California Stands in Mental Health Needs and Services

The San Joaquin Valley has rates of mental health professionals far below state average. (Melissa Wiese/Flickr)

The San Joaquin Valley has rates of mental health professionals far below state average. (Melissa Wiese/Flickr)

Two new assessments released Wednesday gave an overview of mental health in California – from suicide rates to access to care to the supply of mental health professionals.

While there are bright spots, they provide a pretty sobering view. The first, Mental Health Care in California: Painting A Picture, details that nearly 1 in 6 adults in the state has “a mental health need” and 1 in 20 has a serious mental illness. The rate in children is even higher: 1 in 13.

And too many people are not getting treatment. According to the analysis, half of adults and two-thirds of adolescents with a mental heath illness do not receive treatment. A big contributing factor is likely the state of the mental health workforce in California which is quantified in both the first report and the second. Both analyses are from the California HealthCare Foundation. They describe a varied and fragmented delivery and financing system in the state.

Steve Schilling knows the issue all too well. He’s CEO of Clinica Sierra Vista which has multiple health centers in southern San Joaquin Valley. He said “scarcity” would be a better word than “variation” when it came to describing mental health services. In the CHCF analysis, the San Joaquin Valley fell well below a state average for all  mental health professions. The Inland Empire also fared poorly. “I really think we have a non-system of behavioral health in California,” he said. Continue reading

A Woman’s Search for Mental Health — Beyond Medication

Editor’s Note: Many Americans seek prescription medication to manage stress, anxiety and depression. But for some, the pills become a problem in their own right. As part of our first-person series “What’s Your Story?” Sabirah Mustafa of Oakland Voices tells how she and her doctor came up with another approach. 

By Sabirah Mustafa

When Sabirah Mustafa was suffering from depression, she found that medication wasn’t the best prescription for her. (Shuka Kalantari/KQED)

I used to wish for a magic pill that would enable me to swallow away my problems, so I could successfully navigate my unfulfilled life. But when I found it, it wasn’t in any pharmacy. For many years I suffered from trauma and abuse, but I saw them as symptoms of a soul struggling to find answers in a question complicated life.

I wasn’t necessarily searching for easy solutions, just a way to cope with it all. When my doctor became aware of the overwhelming helplessness and sadness I felt, he prescribed medication he thought would help. But the debilitating side-effects were terrible. My environment appeared apart and distant from me. My mind and body felt out of sync with how I moved and spoke, which made me feel awkward and self-conscious. Joy, anger, sympathy and other emotions non-medicated people experience routinely were lost to me. I began to doubt not just the meds’ function, but also their purpose. When I complained about their side effects, my medications were adjusted, but the adjustments would transform one problem into another.

Roller coaster treatment finally reached a conclusion one day, when I saw my primary physician for chest pain and difficulty breathing. “Let’s talk,” he said.

Continue reading

State Investigation Reprimands Kaiser Over Mental Health Services

By Mina Kim, KQED

(Getty Images)

(Getty Images)

Kaiser Permanente is failing to provide timely access to mental health treatment for some of its members according to a recent report by the Department of Managed Health Care.

The report says Kaiser’s mental health services are deficient in key areas.

State regulators found insufficient staffing at some clinics across the state — with patients waiting longer than the legal limit of 10 days for appointments. The report also says some patients were being misled due to inaccurate information about Kaiser’s mental health services. Regulators also found that at Northern California facilities staff members were not accurately tracking and reporting how long patients had to wait to get initial appointments or follow ups. Continue reading

Preventing Subsequent Suicide Attempts One Phone Call at a Time

By Lauren M. Whaley, CHCF Center for Health Reporting

Every day in California, nine people die by suicide. Both in California and nationwide, suicide is the 10th leading cause of death. According to a recent study, in 2009, more than a half-million adults in California seriously thought about killing themselves. Last fall, the California Mental Health Services Authority launched a statewide campaign called Know the Signs as part of a larger suicide prevention initiative.

One of the highest risk groups for suicide is people who have previously attempted suicide. In Sacramento, an innovative program seeks to reach that group directly and easily: through the simple phone call.

One of the program’s clients is John, a 29-year-old student at Sacramento’s American River College. Today, he describes himself as happy-go-lucky. But a year ago, he had lost two jobs, was facing bankruptcy and had to move in with friends.

Already feeling “emotionally and mentally stripped,” he was then was diagnosed with HIV. “That took away pretty much the last thing that I had, which I thought was my health,” he recalls.

One day last August, he reached an end. Feeling he was “tired of doing this,” he decided to take his own life.

“In my room, I wrote out my note,” he remembered. “I got all my medication out on my bed and I just started taking it. And … All of a sudden, what I just realized is here I am laying here on my floor. … I think, ‘Oh My God, what am I doing? What am I doing?’”

He called out for help, and his roommates called 9-1-1.

He woke up in downtown Sacramento at Sutter General Hospital’s emergency department with nurses pumping his stomach. He recovered. But before he was discharged, he was visited by a social worker, who told him about a unique program that would match him with a suicide prevention specialist. John signed up. That person would give him a call every few days for a month just to check in.

“Ultimately, I knew that I had a cushion for support,” John said about receiving those calls. “I knew that if I was having a hard time, I absolutely had somebody available there.” Continue reading