The Mental Health Minute

Articles and news about mental health issues

Groups cast doubt on validity of state hospital’s electrotherapy consent forms

Here’s an article I found on the Austin American-Statesman that talks about the efficacy of the consent forms for controversial treatments on mentally ill patients.  I have often wondered about the use of consent forms on the floridly psychotic and the legalities of such use.  It seems others are wondering also.  Please read this article and tell me what you think.


By Andrea Ball
Updated: 11:25 p.m. Thursday, May 31, 2012
Published: 8:05 p.m. Thursday, May 31, 2012

Texas’ public psychiatric hospitals never should have used a controversial treatment on more than 120 aggressive patients because the consent forms they signed did not spell out potential side effects and other information required under state rules, mental health watchdogs said this week.

Patients who received cranial electrotherapy stimulation at North Texas State Hospital in Vernon were not told in writing that the treatment can cause headaches, nausea, dizziness and skin irritation, said Beth Mitchell, a lawyer with Disability Rights Texas, a federally funded mental health advocacy group. The consent form — a copy of which was obtained by the Austin American-Statesman — also fails to mention alternative treatments and the condition that is being targeted.

But state officials say the form was adequate and is just one piece of the informed consent process.

“The form alone may not be the full picture,” said Carrie Williams, spokeswoman for the Department of State Health Services, which oversees the 10 public psychiatric hospitals. “Risks, benefits and alternatives could have been laid out verbally and documented in the progress notes.”

Challenges to the validity of the consent forms come several weeks after health department officials said they learned that a North Texas State Hospital psychiatrist had conducted unauthorized research on the use of cranial electrotherapy stimulation on violent, mentally ill patients.

The consent forms go to the heart of the questions advocates have posed on the issue: Did the patients understand and willingly agree to the treatment? Or were they being used as research subjects without regard to their civil rights?

“Honestly, I just don’t understand how this could happen,” Mitchell said. “I think there was a breakdown across the board here.”

State officials say they are still trying to determine whether …[read more]

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June 1, 2012 Posted by | Mental Health | , , , , , , | Leave a comment

Dead at 47: homeless people are exposed to much worse than cold

Although written for the UK, I felt this article was both  timely and useful for us here in the USA.  Homelessness is an insidious blight to our society.  That we allow this to be says quite a lot about us as a people, I think.

This is an interesting article from the Guardian on Facebook.  I highly recommend you check them out and read other interesting articles they have there.  This article, for me, is just too sad.  It’s also sad to see, here in print, that this is a global issue, not a local one.  With our global economy in the tank, homelessness is on the rise.  What do we plan to do about it?  Anything?


Wednesday 21 December 2011

 By Pem Charnley

It’s not the weather that tends to kill homeless people – it’s a descent into addiction and a dearth of services catering to them

A new report from Crisis highlights the short life expectancy of people who live on the streets – just 47 years, which is 30 fewer than the general population. How can we start to unknot the various and intricate threads that lead up to someone finding refuge in a car park at three in the morning, trying to find a safe place for the night?

In a relatively temperate climate such as ours, not having a roof over your head seldom is the killer. Not in my experience anyway. The homeless people I’ve once known who passed away either drank themselves to a jaundiced death, or hanged themselves because they couldn’t set themselves free from heroin. When you appreciate that waiting lists for help with addiction are frustratingly lengthy for those who do have a home, then you begin to understand how precious little it amounts to when a homeless person has a brief moment of clarity in a sleeping bag. You can’t just hang in there until 8am and call your GP. There’s no referral letters for treatment through the post, no phone calls from a key worker confirming an appointment for the following week. No peck on the cheek from a relieved spouse as you have a quick shave and disappear off to an AA or NA meeting, hope restored.

Homelessness and addiction, the perennial Catch-22. It’s nigh on impossible to separate these two; you’d call them bedfellows, only in this instance, there is no bed. And when there’s no bed, it’s hardly down to a lack of willpower if you’re going to use drugs or drink to numb your sense of helplessness and isolation: four out of five people start using at least one new drug after becoming homeless. That’s some bleak statistic.

The Crisis report finds that a third of all deaths amongst the homeless are attributed to alcohol or substance abuse. Can those numbers ever be brought down? Well, how can you realistically turn your life around under such circumstances? We are always told that health should come first, but is this possible when you haven’t got a fixed address? Specialised services catering to those on the streets do exist in some places, but just as postcodes can be pivotal in our children’s education, they also play a part in support for the homeless. It’s a rather cruel irony when you haven’t actually got a postcode to begin with.

Speaking to my local homeless charity here in Exeter, it was pleasing to know that the centre organises GP visits, which are scheduled on a regular basis – an encouraging fact, yet you can’t help but wonder why this can’t be a given regardless of where you are living. Immediate health advice (including mental health – homeless people are nine times more likely to kill themselves than the general population) and reliable support is of paramount importance to those living on the streets. When you’ve experienced how hopeless addiction can feel, it’s more than likely that substance abuses and suicides are one and the same statistic, and it desperately needs to be addressed holistically.

So, where to start? Sadly, the downturn has brought with it an almost inevitable increase in homelessness. Never was there such a poor time to cut back on budgets, yet with our government-led savings of up to 65% in key services who cater to vulnerable people, it seems unlikely that we’ll see any kind of improved outreach or support any time soon.


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December 22, 2011 Posted by | Mental Health | , , , , , | 3 Comments

A story about Peer Specialists

The use of Peer Specialists is controversial at best, but studies are finding that using peer specialists in patient  care gives hope and a message of possibilities.  The fact that there are real mental health consumers who have lives and are productive is a very powerful message.  Too often, the messages we send to our patients is that they are “broken” and cannot be fixed.  We don’t do that on purpose, but we still do that.  When you introduce a peer specialist into your program, you get someone who relates to your patients in a completely different way and who understands what they face daily.  You get  someone who inspires and brings hope back into their lives.

Peer Specialists must undergo significant training and certification to be allowed onto mental health units, but even that is not enough to prevent these wonderful people from “giving back” and staying healthy.

Please read this article entirely at the site, The New York Times.  You won’t regret reading it and you will learn quite a bit about who a peer specialist is.

After Drugs and Dark Times, Helping Others to Stand Back Up

Dual Diagnosis: Antonio Lambert, diagnosed with a mood disorder and addiction, manages through faith, medication and companionship – leaning the same “peer specialist” skills he teaches.

Published: December 19, 2011

SMYRNA, Del. — The taste of cocaine and the slow-motion sensation of breaking the law were all too familiar, but the thrill was long gone.

Antonio Lambert was not a young hoodlum anymore but a family man with a career, and here he was last fall, high as any street user, sneaking into his workplace at 9 o’clock at night, looking for — what, exactly? He didn’t really know.

He left the building with a few cellphones (which he threw away) and a feeling that he was slipping, falling back down into a hole. He walked in the darkness, walked with no place to go, and then he began to do what he has taught others in similar circumstances to do: turn, face the problem, and stand back up.

“I started talking to myself, out loud; that’s one of my coping strategies, and one reason I relapsed is I had forgotten to use those,” said Mr. Lambert, 41, a mental health educator who has a combined diagnosis — mood disorder with drug addiction — that is among the scariest in psychiatry.

He texted a friend, someone who knew his history and could help talk him back down. And he checked himself into a hospital. “I know when it’s time to reach out for help.”

The mental health care system has long made use of former patients as counselors and the practice has been controversial, in part because doctors and caseworkers have questioned their effectiveness. But recent research suggests that peer support can reduce costs, and in 2007, federal health officials ruled that states could bill for the services under Medicaid — if the state had a system in place to train and certify peer providers.

In the years since, “peer support has just exploded; I have been in this field for 25 years, and I have never seen anything happen so quickly,” said Larry Davidson, a mental health researcher at Yale. “Peers are living, breathing proof that recovery is possible, that it is real.”

Exhibit A is Mr. Lambert, a self-taught ex-convict who is becoming a prominent peer trainer, giving classes in Delaware and across the country. He is one of a small number of people who have chosen to describe publicly how difficult it is to manage such a severe dual diagnosis, including the sudden setbacks that often come with it.

“He is an extreme example of how much difference passion and commitment can make, given where he’s come from,” said Steve Harrington, the chief executive of the National Association of Peer Specialists, a group devoted to promoting peer support in mental health care.

Mr. Lambert, who has climbed out of a deep hole with the help of religious faith, medication and his own forms of self-expression, puts it this way: “There are a lot of people dealing with mental illness, drugs, abandonment, abuse, and they don’t think there’s a way out. I didn’t. I didn’t.”

Bean Bean in Spider City

His grandmother was the first person to call him Bean Bean, and the boy was so skinny that he couldn’t shake it.

He couldn’t avoid the older toughs in the Brighton section of Portsmouth, Va., either, and he spent some of his school-age years taking beatings. That was Brighton back in the day, and at least those fights taught survival skills. Not everything did: He remembers being sexually abused at age 6, by an older boy in the neighborhood — brutally.

He had no one to tell, even if he had known what to say. His mother and father were split, living blocks apart, each a fixture in the neighborhood’s social swirl of house parties, moonshine “shot shops,” card games and other attractions. His mother, called Chucky, was often out, sometimes leaving the boy at a friend’s house for “a few hours” that turned into an entire weekend. For much of that time, he waited on the porch.

He idolized his father, a truck driver and warehouse worker who lived nearby but spent his free time out, too, drinking and playing cards.

“During that time I was an alcoholic, but I would go out and try to find him when I heard he was out,” said his father, Edward Lambert, in a recent interview at his house in Brighton. He gave up drinking years ago for God, and father and son would eventually become close…[read more]

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December 20, 2011 Posted by | Mental Health | , , , , | 4 Comments

California overhauls mental health department

Here is an article from that talks about a change in the way mental healthcare will be handled in an attempt to balance the budget.  Once again, staff to patient ratios become a focus and in this article the California governor wants mental health to be staffed in such a way as to cut staffing patterns by up to one-third of the staff.  The pilot program proposes to put more psychologists and psychiatrists with the aggressive patients, which is nice, but those are not the people who will be dealing face-to-face with the aggression.  They will be sitting in the nurse’s station during most emergent situations.

Here’s some of this article.  I suggest you click over to read the full article if this story scares you as much as it does me.


By JUDY LIN Associated Press
Posted: 12/12/2011 11:52:37 AM PST
Updated: 12/12/2011 04:52:14 PM PST

SACRAMENTO, Calif.—California has begun transitioning its mental health services program to concentrate care on the most serious patients residing in state mental hospitals and prisons, but the cost-cutting move is raising concerns about patient care from state workers.The state announced last week it will hand off more responsibility for public mental health programs to counties as part of Gov. Jerry Brown’s ongoing push to move services to California’s local governments. The administration says the reorganization will allow the state to form a new Department of State Hospitals that focuses exclusively on 6,300 patients in state hospitals and prisons.

“We think that as a package we’re providing a set of proposals that saves money but doesn’t change the quality of care and also increases safety,” Department of Mental Health acting-chief deputy director Kathy Gaither said in an interview Monday.

Earlier this year, state mental health officials assigned a committee to come up with a plan to improve care and safety while also finding places to cut costs within the state’s mental hospital system. The committee returned with a blueprint for overhauling the department’s policies and procedures. It cuts 346 positions in the current year to save $122.6 million and eliminates 620 positions to save $193 million next year.

The administration says it does not plan layoffs because many of those positions are already vacant or can be done through attrition.

The department currently has a $1.3 billion general fund budget.Safety Now!, a coalition of psychiatric technicians, physicians and other state hospital workers, warns that the plan would reduce staffing ratios by nearly one-third.

“It is clear that only short-term monetary goals are driving the state’s decision to cut staff,” Stuart Bussey, a doctor and president of the Union of American Physicians and Dentists said in a statement. “We know that if treatment staff are cut, patient safety will certainly deteriorate further, and assaults will increase—and that will ultimately cost the state of California more money in lawsuits than these proposed cuts will save.”

The new structure reduces patient-to-staff ratios, a move state officials say is needed to cut down on the use of overtime and contract staff—the two single biggest drivers of increased hospital spending. The department plans to modify staff levels based on the patients’ needs, putting more psychologists and psychiatrists with the most serious and aggressive patients and fewer with the more stable patients.

This week the Department of Mental Health will start with a pilot program at Atascadero State Hospital to treat its most aggressive patients together. If successful, that approach could expand to the state’s four other mental hospitals, Metro, Napa, Coalinga and Patton, along with two psychiatric programs at Vacaville and Salinas Valley state prisons.

Felisa Hamman, a nurse at Atascadero State Hospital, said it’s good the state is testing out the enhanced treatment unit, but she worries about other patients with personality disorders who have assaulted staff…[read more]

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December 18, 2011 Posted by | Mental Health | , , , , , | 1 Comment

Childhood disorder prompts study of infection link to mental illness

Here’s yet another article from the Los Angeles Times about mental health.  Is California just more aware of the problem we have in society with mental disorders, or do they have a higher number of mentally ill people?  Just a question.

I thought this article was interesting and felt it needed to be posted here for your perusal.  Won’t you read this article and then let me know what you think?  Is there a connection between infection and mental illness?


By Shari Roan, Los Angeles TimesDecember 5, 2011

Brody Kennedy was a typical sixth-grader who loved to hang out with friends in Castaic and play video games. A strep-throat infection in October caused him to miss a couple of days of school, but he was eager to rejoin his classmates, recalls his mother, Tracy.

Then, a week after Brody became ill, he awoke one morning to find his world was no longer safe. Paranoid about germs and obsessed with cleanliness, he refused to touch things and showered several times a day. His fear prevented him from attending school, and he insisted on wearing nothing but a sheet or demanding that his mother microwave his clothes or heat them in the dryer before dressing.

So began a horrific battle with a sudden-onset mental illness that was diagnosed as pediatric autoimmune neuropsychiatric disorder associated with streptococcus, or PANDAS. The puzzling name describes children who have obsessive-compulsive disorder that occurs suddenly — and often dramatically — within days or weeks of a simple infection, such as strep throat.

“He washed his hands over and over and was using hand-sanitizer nonstop,” said Tracy Kennedy, who has home-schooled her 11-year-old son since early November. “He had never been like this before. Ever. He just woke up with it.”

The bizarre illness, first recognized in the mid-1990s, has been cloaked in controversy. Now, however, studies are reinforcing the belief that some psychiatric illnesses can be triggered by ordinary infections and the body’s immune response. While the theory remains unproved, the research raises the possibility that some cases of mental illness might be cured by treating the immune system dysfunction.

“Some people get sick with whatever infection, and they recover and they’re fine,” says M. Karen Newell Rogers, an immunologist at Texas A&M Health Science Center College of Medicine in Temple, Texas, who studies such illnesses. “Other people get sick and recover, but they are not the same.”

PANDAS is thought to be caused by antibodies generated as a result of an infection, usually strep. Normally, an infection causes the body to generate antibodies that fight the infection and promote healing. But in PANDAS, the antibody response is thought to go awry, attacking brain cells and resulting in OCD symptoms.

A greater understanding of the link between strep and OCD has opened the door to the study of other psychiatric or neurological illnesses that may be linked to improper immune response, including cases of autism, schizophrenia and anorexia.

“The whole area of mental illness caused by infections is being looked at more closely because of PANDAS,” says Dr. Michael A. Jenike, a professor of psychiatry at Harvard Medical School and chairman of the International OCD Foundation’s scientific advisory board. “If you can prevent lifelong suffering by using antibiotics or some acute intervention, that would be huge.”

Little understood disorder

PANDAS is generally poorly understood in the medical field, said Dr. Margo Thienemann, a Palo Alto child psychiatrist who has treated several cases. There is no test to help doctors diagnose it, although the National Institute of Mental Health says that PANDAS can be identified after two or three episodes of OCD or tics that occur in conjunction with strep infection — a vague guideline that results in much confusion.

Thienemann says patients tend to fall between the cracks of psychiatry and immunology. But early diagnosis is important.

“In psychiatry, we generally spend our time treating diseases without knowing the reason they happen,” she says. “With PANDAS we are able to see the cause of a problem rather than the downstream effects. This is the exciting part.”

OCD affects about 1% of people and can feature a fear of contamination by germs or other substances, hoarding, intense anxiety over one’s moral behavior, tics, compulsive skin-picking or body dysmorphic disorder (obsession with some perceived bodily imperfection). The disorder tends to run in families and usually appears around the ages of 10 to 12, with a later spike in rates from age 18 to 22.

No one knows what portion of obsessive-compulsive disorder cases may be tied to PANDAS — or even how prevalent the condition may be, Jenike says.

“I used to think it was exceedingly rare,” he says. “Now I think it’s exceedingly common.”

Recent research has strengthened support for PANDAS. For instance, one study demonstrated that in mice prone to autoimmune disorders (in which the immune system attacks healthy cells), exposure to strep led to OCD-like behavior. The study was published in 2009 in the journal Molecular Psychiatry.

A 2010 Yale study found that tic symptoms worsened somewhat in children with OCD following a strep infection. That study, published in Biological Psychiatry, suggests some children are vulnerable to flare-ups of OCD symptoms when stressed by infections.

Another paper, published online in August in the Journal of Pediatrics, found that, compared with children with typical OCD, children diagnosed with PANDAS were more likely to have biological evidence of a recent strep infection, a sudden onset of psychiatric symptoms and an easing of those symptoms while taking antibiotics…[read more]


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December 10, 2011 Posted by | Mental Health | , , , , | Leave a comment

UCLA: Little or no treatment for 2 million Californians with mental health problems

One and Other-Mental Health

Image by Feggy Art via Flickr


Here’s an article that describes just how poorly we, as a society, are doing in helping those who have a mental illness or are having emotional/psychological issues that are situational.  California leads the nation in the healthcare field.  This article is based on a study funded by the California Department of Mental Health.


The statistics in this article are certainly eye-opening.  If we continue to ignore this problem, it obviously is not going to go away.  Many people are suffering unnecessarily because of stigma, money, lack of availability of care, or just lack of knowledge about mental illness.


Do we really want to be ostriches with regard to the issue of mental health?  It seems we do.  Please read this article from the Central Valley Business Times and then let me know your opinion on this topic, won’t you?




December 5, 2011 10:42am


Serious psychological distress, event difficulty functioning, are commonplace


•  ‘There is a huge gap between needing help and getting help’

Nearly two million California adults need mental health treatment, but most receive no services or inadequate services, says a new report by the UCLA Center for Health Policy Research.


The lack of treatment is in spite of a state law mandating that health insurance providers include mental health treatment in their coverage options, the report says.



How bad are the problems? The UCLA researchers say one in 12 Californians reported symptoms consistent with serious psychological distress and experienced difficulty functioning at home or at work.



Over half of these adults reported receiving no treatment for their disorders, and about one-quarter received “inadequate” treatment, defined as less than four visits with a health professional over the past 12 months or using prescription drugs to manage mental health needs.



The study draws on data from the 2007 California Health Interview Survey (CHIS), which is conducted by the Center.



“There is a huge gap between needing help and getting help,” says David Grant, the study’s lead author and director of CHIS. “The data also shows large disparities in mental health status and treatment by demographic, economic and social factors. These findings can help direct the state’s limited resources to those in greatest need of help.”



Unsurprisingly, says the report, uninsured adults had the highest rate of unmet needs (87 percent), which includes receiving no treatment or receiving less than minimally adequate treatment; 66 percent of these adults received no treatment.



By contrast, 77 percent of privately insured and 65 percent of publicly insured Californians reported unmet needs. Although poverty and mental health needs are strongly correlated, the lower rate of unmet needs by public program participants suggests that these programs are more likely to effectively offer mental health services than even private insurance policies.



Other findings include:



• Single adults with children had more than double the rate of mental health needs (17 percent) when compared with all adults (8 percent). Single adults without children had the next highest rate (11 percent). Married adults with or without children had the lowest rates of mental health needs (6 percent and 5 percent, respectively.)



• Nearly 12 percent of Hispanics born in the U.S. needed mental health treatment, almost twice the level of Hispantic immigrants.



• Approximately 17 percent of American Indians and Alaska Natives had mental health needs, the highest of all racial and ethnic groups. Native Hawaiian, Pacific Islander and multi-racial groups had the next highest rate, at 13 percent.



• Nearly 20 percent of these adults needed mental health treatment — more than double the statewide rate.



• Compared to the general adult population, those with mental health needs had higher rates of chronic diseases such as high blood pressure, heart disease, diabetes and asthma. They were more than twice as likely to report fair or poor health status and five times more likely to report poor health.



The report was supported by a grant from the California Department of Mental Health.


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December 6, 2011 Posted by | Mental Health | , , , | 1 Comment

Obsessive compulsive disorder commonly coupled with depression and bipolar disorder

Person washing his hands

Image via Wikipedia

Here’s an interesting article I found on DailyRx about research investigating the incidence of two or more disorders being present at one time.  I have often wondered about OCD and Bipolar in my 20 years of psychiatric nursing.  They seem to share common characteristics.  Although with a bipolar, the OCD may not express itself quite as obviously as it does in someone who only has OCD; there are, however, many similarities to the behaviors expressed by both groups.

Please read this article and visit the site for more interesting articles.  Let me know your views on the topic if you care to.  I am always open to hearing other people’s ideas about mental health issues.


The prevalence of mental health disorders along with a recent increase in mental health awareness is beginning to help researchers understand how these disorders develop.

Considering the rarity of mental health diseases such as obsessive compulsive disorder (OCD) and bipolar disorder, one would think it would be quite uncommon for such diseases to occur concurrently in an individual. However, a new study shows very high rates of comorbidity in mental health disorders, increasing the severity of some diseases.

Inform your therapist if you have more than one health issue.

A recent study, available through the Anxiety Disorders Association of America’s journal Depression and Anxiety, investigated the role of comorbidity in the expression of OCD. Kiara Timpano, Ph.D., an assistant professor of psychology at the University of Miami, led the study.

The Structured Clinical Review for DSM-IV was used to evaluate 605 OCD patients. Split into three groups, 13.1% of the group was bipolar, 64.1% were largely depressed, and 22.8% had OCD alone.

Comparisons among the groups analyzed comorbidity patterns, OCD symptoms, and impairments in order to determine the severity of their ailments.

Bipolar disorder patients revealed the most severe symptoms, followed by depression, and finally those with OCD alone. Fortunately, bipolar comorbidty represents a smaller segment.

Timpano explains, “those individuals with comorbid affective disorders, particularly BPD (bipolar disorder), represent a clinically severe group compared to those without such comorbidity.”

Treatments are available for obsessive compulsive disorder, bipolar disorder, and major depression and show great results to many sufferers.

Talk with your doctor if suffering from a mental health disorder.

All information on this site is provided “as-is” for informational purposes only and is not a substitute for medical advice or treatment. You should consult with a medical professional if you have any questions about your health. The use of any information on this site is solely at your own risk.

Copyright © 2008-2011 Patient Conversation Media, inc. All Rights Reserved.

Comments, questions or concerns, please email:

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December 5, 2011 Posted by | Mental Health | , , , , , , , | 3 Comments

Man sentenced to psychiatric hospital still waiting for bed

Here’s an article from the Bangor Daily News that is just unbelieveable!  I found this article while reading a Squidoo lens called Lunatic Asylums which I recommend to anyone who has any interest in the history of mental health care in the world.  Sad story, I have to say.  Not much improved today; just more humane.

Please read the article but do visit the Squidoo lens and read about the history of mental health care globally.


By Nok-Noi Ricker, BDN Staff
Posted Oct. 25, 2011, at 2:18 p.m.
Last modified Oct. 25, 2011, at 6:57 p.m.Clinton E. Grubbs.
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Courtesy of Penobscot County Jail
Clinton E. Grubbs.

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BANGOR, Maine — Several people called police Tuesday to report a possible escapee after seeing a man who was sentenced on Monday to time at the Riverview Psychiatric Hospital in Augusta for his involvement in a stabbing nearly two years ago.

Clinton Grubbs, 49, of Bangor went to the library at University of Maine at Augusta, Bangor campus, just before noon and to other locations where people recognized his picture from a Bangor Daily News story about his sentencing Monday by Superior Court Justice William Anderson.

“People had read [the] article and seen the picture and saw this guy walking around,” Michael Roberts, deputy district attorney for Penobscot County, said Tuesday. “They were wondering, ‘Did he escape?’”

Bangor had a murder suspect who escaped from Dorothea Dix Psychiatric Center in June and was on the lam for a day before he was caught after he swam to Brewer.

Grubbs, who has been out on bail since shortly after his arrest in January 2010, was sentenced to time at Riverview Monday after Anderson found him not guilty by reason of insanity in the stabbing of a man who lived in the same Essex Street boarding house.

Roberts said he was told at court on Monday that “Riverview did not have a bed for him” and the decision was made to send him to the facility in two weeks.

“He’s suffered from this mental illness since the early ’90s at least and this was the one instance” when he reportedly caused harm to another, Roberts said.

Riverview Superintendent Mary Louise McEwen said Tuesday that she couldn’t talk specifically about patients, but added, “We do have a bed.” She noted that “NCR (not criminally responsible) patients are our top priority for a bed.”

When criminal defendants are sentenced to Riverview, a judge must sign an order that is sent to the State Forensic Service, which then coordinates with Riverview about setting a date for admission.

“We have had no referral for NCR clients in the last few days,” McEwen said. “We do have a bed today. If we had received the appropriate paperwork, we would have been able to coordinate an admission.”

Grubbs has not been involved in any known crimes in the nearly two years he has been out on bail, Roberts said.

Grubbs was accused of stabbing a 57-year-old man in the side of his abdomen and his right hand with a 4-to-5-inch chopping-style knife on Jan. 6, 2010. Frederick Pond of Bangor underwent emergency surgery that same day. He died on April 27, 2010, according to an obituary published in the Bangor Daily News.

Grubbs entered a no contest plea to elevated aggravated assault at the hearing Monday at the Penobscot Judicial Center.

“I know he is out on bail. We don’t have a hold on him,” Penobscot County Sheriff Glenn Ross said Tuesday.

While McEwen said Riverview had a bed available on Tuesday, Ross noted “capacity is a big issue. Capacity is something I’m very concerned about,” especially with recent talks about closing Dorothea Dix, one of three facilities that can take Penobscot County Jail inmates who are mentally ill.

The jail and Riverview have an agreement to have one bed on hand if needed. “It’s almost never available,” Ross said.

It’s easy to blame facilities when the spotlight should be placed on the rules, the sheriff said.

“Let’s look at the system,” he said, adding that without fundamental changes, “I don’t see it getting better. I only see us digging the hole deeper.”

A librarian at UMA Bangor called security at about noon Tuesday to say Grubbs was in the library. Campus security then called Bangor police to investigate.

“I can confirm we went to the library and that Mr. Grubbs was there and that no criminal action was taken and we cleared,” Bangor police Sgt. Paul Edwards said in a statement.

Grubbs also was seen at other locations by people who called police, Roberts said.

BDN writer Judy Harrison contributed to this report.

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October 27, 2011 Posted by | Mental Health | , , , , , | Leave a comment

Mentally ill behind bars

This was an article I found in the Springfield News-Leader.  It eloquently portrays the tasks facing the prison system in Missouri.  It is almost as if the prison system has become the “new” mental health system.

This trend is continuing at an alarming rate.  Prison is not equipped to help mentally ill people.  There is no treatment except medications there.  They have no one to help them hook up with services when they are released.  Granted, there are many mentally ill people in prison who need to be because they are too dangerous to leave unattended in the population.  But the majority of the mental patients in our jails have been unlucky enough to have fallen through the cracks of a seriously cracked mental health system.

Please read this entire article, even though it is long.  It is worth the time and effort and will give you some insight into what the prison employees are having to deal with daily without any prior or special education.


Melissa Ussery, mental health coordinator at the Greene County Jail, interviews an inmate. / Bob Linder / News-Leader


Written by
Jess Rollins
Missouri State Hospital No. 3 at Nevada, shown in May 1925, housed 1,200 at its peak. / File photo, 1925


A slender young man in glasses sits at a small plastic table in the observation wing of the Greene County Jail.

Across from him, Melissa Ussery, mental health coordinator at the jail, asks if he is doing better.

Last week, he surprised Ussery by handing her something in a handkerchief. He had pulled out all 10 of his toenails.

“I’m actually content now. I’ve just been in there reading,” he says, pointing to his cell.

A few questions later, Ussery asks how often he thinks of harming himself or hurting guards. He says he wouldn’t but he sometimes has “the urge to do it all over again.”

This young man, who has borderline personality disorder, is one of about 50 inmates in the jail at any given time diagnosed with a serious mental illness like schizophrenia, bipolar or major depression.

Many involved in the area’s mental health system say the Greene County Jail has become the largest mental health care facility in southwest Missouri — the de facto mental hospital.

Meanwhile, the cost to house someone with a mental illness is nearly double the cost of housing a healthy inmate. According to officials and advocates, it’s an expensive, frustrating, dangerous problem.

Although mentally ill inmates receive some services in jail, they are often released without a path to continue treatment. With what many perceive as a lack of community resources, the cycle continues.

As cuts to programs for those most at risk persist, many see no end in sight.

Nowhere else to go

Every day, Ussery, the only licensed psychologist at the jail, makes her rounds.

In the female pod, Ussery talks to a young woman with straight blond hair.

“Have you thought of hurting yourself?”

“Are you seeing anything?”

“What year is it?”

At each question, the young woman pauses. She looks to the left, then to the ceiling, to the right, back to the left.

“We think she is hearing voices,” Ussery explains later.

The long pauses and wandering eyes are a type of screening of what the woman hears, according to Ussery; that’s common among those diagnosed with schizophrenia…[read more]

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October 21, 2011 Posted by | Mental Health | , , , , , | 1 Comment

Police training addresses suicide, domestic violence, road rage, DWI

Calgary police brutality cover-up?

Image by thivierr via Flickr

Here is an article from the Poughkeepsie Journal that illustrates the frustration felt by ill-equiped police when faced with a mentally ill person.  In the past, that person was either ignored or thrown in jail.  Current trends are to train the police in more “politically correct” treatment for the mentally ill.

While I wholeheartedly agree that police could stand to learn more about dealing with the mentally ill since they do it regularly, I doubt that the training is going to change anything in a major way.  The problem is that police have a totally different mindset than that of a social worker or psychiatric nurse.  They have no patience for hand-holding people who are endangering the lives and livelihood of others.  Their initial police training is in containment and arresting.

I applaud the Poughkeepsie police for their forward thinking and willingness to extend themselves.  I think there is some aspect of self-defense involved also, because, as this article states the police are frequently the first line in dealing with a mentally ill person; and with budget cut-backs, there doesn’t look to be any relief for quite some time.


Written by
Shantal Parris Riley
Poughkeepsie Journal

They’re often the first to arrive on the scene in a mental health crisis.

Police and other law enforcement serve as public protectors — but, at a moment’s notice, when confronted with a situation involving a mentally disturbed person, they become social workers.

“Mental health issues are prevalent on the job,” Town of Poughkeepsie Police Chief Thomas Mauro said. “They occur with regular frequency.”

Regional police are preparing for an upcoming training series, titled “Responding to Situations Involving Emotionally Disturbed People: An In-Service Curriculum Orientation,” to be held in Orange County in February.

The curriculum, offered through the state Division of Criminal Justice Services and Office of Mental Health, will provide police with training on suicide assessment and intervention and a host of topics covering mental illness. The training course is designed to supplement the mandated training provided to police recruits.

From incidents of road rage and driving while intoxicated, to emotionally charged incidents of domestic abuse, police are faced with issues of mental health daily, Mauro said.

“Sometimes, there’s a conflict between our role as law-enforcement officers and the secondary social work aspect of law enforcement,” he said. “You’re trying to draw a balance between your responsibilities to maintain public safety and trying to do what is in the best interest of the person you’re dealing with.

“The difficulty can often be with communication.”

Mauro, who has decades of training in suicide intervention, crisis negotiation and stress management, said “talk tactics” often involve putting time into a conversation to calm or slow a person down.

Town of Poughkeepsie police had training in 2010 on “de-escalation techniques” to include listening with empathy and focusing on behavior, not the person.

This and other training was put to critical use in August 2010 when a 22-year-old man threatened to jump from a ledge of the sixth floor parking lot at Saint Francis Hospital after escaping from family members who drove him there for a mental health evaluation…[read more]

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October 19, 2011 Posted by | Mental Health | , , , , , , , , | 4 Comments