Thursday, January 13, 2011

Some thoughts on mental illness and the Arizona shooter

I was watching the news and I just saw a report about the Arizona shooters parent, asking how could they not know? Why didn't they get him help? Why didn't they see?

I'm furious.

How do we know his parents DIDN'T try to get him help? How do we know they didn't see that their son was ill?

I work in the mental health field, and every day I deal with families who are going though the pain of watching a loved one suffer from a mental illness. Here's some of the things I've learned:

Families don't always see that their loved one is ill. You'd be amazed at how well some people can hide their illness, and at how easy it is to not see what you don't want to see. How many of us would want to look at our son or daughter and think they might be a danger to others? How many of us would say "Oh they're a little odd, but they'd never hurt anybody"?

Many, many people with an undiagnosed mental illness will self medicate with drugs and alcohol. Doing this can mask their symptoms for a while, quiet the voices, calm the nerves, but over time it actually makes the illness worse.

Mental illness doesn't happen overnight. It's a decline from normal functioning, and the descent into delusion and paranoia can be a slow process, building slowly over months or even years. In many cases, by the time that families realize how ill their loved one is, it's taken a catastrophic event (an assault, or a suicide attempt) for them to see it.

You cannot force someone to get help if they refuse to do so. At the request of family members, I have sent the police out to clients homes on several occasions, or had Mobile Crisis visit them, only to find out that they had refused to be seen, refused to even let anyone in the door. Unless the person has committed a crime, or has threatened to hurt themselves or someone else, they cannot be forced to come in for treatment. If we can get them in to see a doctor, we can have them placed on a 72 hour hold, but after that, they cannot be held unless declared incompetent and involuntarily committed, which is NOT an easy thing to do.

Getting a newly diagnosed patient with a major psychiatric disorder to take their meds consistently is extremely difficult. It takes a long time to get many clients to understand that the illness they have is chronic, it's life long, and they will be on some form of medication for the rest of their lives. Part of my job consists of giving injections of long acting antipsychotic medications to some of our clients. These are usually clients who have not been compliant with taking pills, have had multiple hospitalizations, and for some of them, multiple imprisonments. Once these clients are on a regular schedule, and their symptoms are under control, they're VERY consistent about coming for their shots. They can feel the difference that the medications make for them, some of them are even able to hold down jobs, and have healthy, loving relationships. But it can take a very long time to get to that point. In some cases it can take involuntary committal, and being on probation before they get it.

What happened in Arizona is horrible beyond words. I'm heartbroken for the victims and their families. I have a son who is just a year older than the youngest victim. I also have a son who is a year younger than the shooter, and as a mother, my heart is also breaking for the parents of the shooter. I can't imagine the hell they're living in right now, and the idea of blaming them for what happened is just sickening to me.

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