Stigma and Serious Mental Illness: What is the Relationship?


(August 26, 2014) Stigma is one of the most important problems encountered by individuals with severe psychiatric disease, lowering self-esteem, contributing to disrupted relationships and negatively impacting the ability to socialize, obtain housing and become employed.

stigmaAnd it’s getting worse, recent studies report.

The Treatment Advocacy Center’s backgrounder, “What is the main cause of stigma against individuals with serious mental illness?” updated in March 2014, explores three topics:
•    Increased stigma against individuals with mental illness
•    The association of violence and stigma
•    How stigma can be decreased

According to the backgrounder, it is “self-evident that stigma will not be decreased until we decrease violent behavior committed by mentally ill persons, and this can only be done by ensuring that they receive treatment.”

Treatment Advocacy Center backgrounders are useful tools for raising awareness about mental illness and treatment issues. For a complete list of backgrounders, visit the “Reports, Studies, Backgrounders” page of our website. To see the Treatment Advocacy Center’s original research, visit our site.

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If I Could Turn Back Time, Part II – personally speaking


(August 22, 2014) My beautiful son deserves to receive help in his life and a chance for happiness. But instead, we feel like second class citizens, neglected by friends, neighbors and law makers who slash funding and block access to care.

ninamcdanielpart2My name is Nina McDaniel and I am the proud mother and advocate to my 32-year-old son, Michael, who has schizoaffective disorder.

Michael asked us to drive him to the hospital on his grandmother’s birthday in 2010.

“I feel like I am a burden on society and I have no purpose in life, I want to kill myself,” he told the emergency room. I received a phone call from the hospital 12-hours later that they had discharged him and he will be waiting for us on the curb outside.

We went home with Michael and 4 days later, he asked to be taken back to the hospital, getting there via ambulance and finally being admitted. The diagnosis was still chronic paranoid schizophrenia and he was hospitalized for only 7 days. Again and again the same cycle, the hospital has become the revolving door yielding no results toward insight or recovery. Just like other discharges, Michael stopped taking his medicine.

It was obvious that Michael was deteriorating at a rapid rate. Because of mental health laws and falling through the cracks, there was nothing that we could do to intervene. We watched this internal torture and endured the verbal abuse while praying to God to end all our pain. Michael stopped watching television, spent all of his time in the pool room or bathroom and talked to himself continuously.

Michael’s enduring torture is just one symptom of this disease.

It is not a political issue, it is a humanitarian issue. Thousands are being lost every single day and families are falling apart due to the challenges of being a caregiver. Every tragedy that involves severe mental illness makes me wonder if anyone in Washington is listening.

I respectfully challenge members in government and advocacy groups to set aside their differences and take a UNITED stand for mental health.

Nina McDaniel
Mother of Michael
Part I of Nina’s story ran last week.

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GET HELP: When Mental Illness Leads to Criminal Justice Involvement


(August 20, 2014) More than 40% of individuals with severe mental illness end up behind bars at some point in their lives.

gavelAs a resource to family members whose loved ones become involved in the criminal justice system, the Treatment Advocacy Center has created a web page of steps caregivers can take both before and after a family member or friend becomes involved with law enforcement, the criminal justice system or both.

For example, if a loved one is untreated and has a pattern of unpredictable behavior, visiting your local zone or police precinct station during business hours and explaining the circumstances with the community resource or other officer may help officers be better prepared to respond appropriately if a psychiatric crisis erupts.

If your family member is arrested and charged with a crime, determining whether his or her charges would merit consideration for mental health court will equip you to be more effective in advocating for jail diversion.

Links are provided to Treatment Advocacy Center reports that will help you determine what mental health diversion programs exist where you live.

For more resources for use in a mental health crisis, visit the Get Help section of our website.

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RESEARCH: Minorities Less Likely to Get Care After Hospitalization

(August 19, 2014) National Minority Mental Health Month is over, but the dual discrimination against minorities with severe mental illness goes on.
In the July issue of Psychiatric Services, a team of researchers looked at outpatient follow-up after hospitalization for mental health crisis and found that “blacks were less likely than whites to receive any treatment or begin adequate follow-up within 30 days of discharge” (“Quality of follow-up after hospitalization for mental illness among patients from racial-ethnic minority groups”).

“Hospitalization serves a crucial function in mental health systems by providing treatment for individuals with acute psychiatric needs,” the authors wrote. Timely follow-up after hospitalization can reduce the duration of disability and, for certain conditions, the likelihood of rehospitalization.”

Rates of follow-up (defined as being seen in a follow-up appointment within 30 days of hospital discharge) were abysmal for the whole population: Less than 26% of hospital dischargees – an extremely fragile population considering how difficult it is to get into a hospital in the first place – received follow-up treatment, the study found.

After adjustment for need and socioeconomic status, the analyses found that blacks were “significantly less likely than whites” to receive follow-up with 30 days and “also less likely to receive adequate care beginning within 30 days of discharge.”

Bias against minority patients by their providers was found to heighten barriers to recovery.

“When patients from racial-ethnic minority groups perceive provider discrimination or bias during inpatient treatment, the negative impacts on mental health and follow-up can be profound and potentially debilitating,” the researchers said.

Their results “reassert the need for interventions to improve continuity of care for all acuity levels of mental health services, especially for black patients,” they concluded.

Read an abstract of “Quality of follow-up after hospitalization for mental illness among patients from racial-ethnic minority groups” here.

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The Brain on Antipsychotic Drugs: What Happens?

(August 18, 2014) Antipsychotics like clozapine and mood stabilizers like lithium are a part of recovery for people with severe mental illness, and they also cut violent crime, according to a study published in the Lancet (“Antipsychotics cut violent crime, study finds.” May 8).

antipsychoticsAntipsychotic drugs are an important part of the picture in most people’s journey to recovery from serious mental illness. They are also a complex piece of an approach to address the biology of these illnesses. The Treatment Advocacy Center’s backgrounder, "Do antipsychotic drugs change brain structure? ” updated in April 2014, demystifies the way these drugs act on the brain.

As the backgrounder explains, “changes in brain structure are caused both by the disease process of schizophrenia and bipolar disorder and by the antipsychotic drugs used to treat these diseases.”  Moreover, that these drugs produce changes to the structure of the brain should not surprise anyone. The backgrounder describes the following structural brain changes the drugs cause:
  • Decreased brain volume with associated increased volume of the ventricles;
  • Increase in size of the striatum; and
  • Increased density of glial cells in the prefrontal cortex.

It is important to apply an informed perspective to understanding treatment for serious mental illnesses like schizophrenia and bipolar disorder. One area of controversy remains the safety and impact of antipsychotic drugs – and with justification. However, not all criticisms are created equally, and as we know, antipsychotic drugs both require careful monitoring by physicians and have the potential to help change lives for the better for those experiencing psychosis.

The backgrounder can be an important tool towards informing community members, politicians, and media about antipsychotic medications, along with education about the many devastating consequences of non-treatment of serious mental illness.

For access to more of our backgrounders, which summarize information about severe mental illness, policies and programs related to its treatment, and the consequences of lack of treatment, visit the “Reports, Studies, Backgrounders” page on our website.


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