One of my problems with Mad In America is that not enough seem quite mad enough. I would like to encourage more outrage. I feel that if we were talking about a situation in another country, the US would be outraged. If we were talking about a common substance (like Big Macs), there would be outrage. If it were a business, citizens would be outraged and the government would intervene and shut it down. What is the “it” that I’m talking about?
A very troubling health care disparity exists among persons with serious mental illness (SMI). Even among those receiving regular psychiatric care, many individuals experience co-occurring medical conditions that go unidentified and/or untreated, significantly shortening their life spans. About 15 years ago, it was established that 60 percent of individuals with mental illness develop serious medical co-morbidities that result in a lost life span of 15 to 20 years compared to the general population.1 Recently, even more alarming evidence indicates the risk for lost years of life has accelerated to 25 years earlier than the general population.2 Gill (2008) commented:
What does it mean that the life expectancy of persons with serious mental illness in the United States is now shortening in the context of longer life expectancy among others in our society? It is evidence of the gravest form of disparity and discrimination.3
The “it” that I’m talking about is that public mental illness “treatment” is killing us. Too many have died untimely deaths. Rebecca Riley was diagnosed bipolar at age two. She died at age four from the cumulative toxic effect of psychiatric drugs.4 Pioneering advocate Howie the Harp died of a heart attack at age 42.5 Where’s the outrage?
“A series of recent studies consistently show that persons with serious mental illnesses in the public mental health system die sooner than other Americans, with an average age of death of 52.”6
“Adults with serious mental illness treated in public systems die about 25 years earlier than Americans overall, a gap that’s widened since the early ’90s when major mental disorders cut life spans by 10 to 15 years.”7
In addition to “treatment” killing us, we are being killed by “force” even before we’re civilly committed. Last November, in Ohio, a family member called 911 to report that Tanisha Anderson was acting unruly — but non-violent. Police responded, and after some discussion among everyone involved Tanisha agreed to go in for an evaluation. When she arrived at the patrol car, however, the officer went to handcuff her to put her in the back seat (policy). Tanisha, very nervous, anxious and upset, said she changed her mind. She started to walk away, but the officer used a takedown move to body-slam her to the concrete street. She was dead before he could kneel down and put his knee in the middle of her back to handcuff her.8
A family called for force (the police), as they’ve been taught to do. Force arrived. As happens far too often in the presence of force, a life was lost. Is this really what our families want for us? Imagine how different things might have been if the family had been able to call instead for a peer support team. Where’s the outrage?
In light of these facts, I would like to offer some input on HR 2646, sponsored by Congressman Tim Murphy. Murphy’s bill takes aim at those he describes as “the most seriously ill.” My first question is, what gives him or anyone the right to define who are the worst? According to his criteria, “the worst” are those with certain DSM/medical model diagnoses (schizophrenia, bipolar and major depression) that Big Pharma has a drug they claim will mitigate some of the symptoms, sometimes.
However I would define “the worst” as those who are most at risk of death. By this criterion we might include people with unresolved trauma issues9 (who commonly end up labeled as “personality disorders”), veterans (who commit suicide at twice the level of the general population)10 and others with increased risk of suicide. From that perspective, SAMHSA actually does a pretty good job of spending their relatively meager funds to help those who are the “worst.”
So, if people who receive public mental illness “services,” are in fact losing over half of their adult lives — dying, on average, over 25 years younger than the general population — where is the outrage? If congressman Murphy’s plan to extend the reach of these services, adding federally-mandated coercion to their delivery, and thereby halving a significant portion of our citizens’ adult lives by force, where is the outrage?
If the existing services were effective and attractive, wouldn’t we be unable keep people away? Instead, this legislation would force people into the same old tired and ineffective services. Instead of fixing or replacing worn-out services, he would re-tread them and put these killers back on the road, so to speak. Where is the outrage?
The act of refusing “treatment” represents both an act of natural intelligence, a solid deductive reasoning based on past evidence (psychiatry’s grotesque historical record of errors that have had devastating and often disabling and lethal results for otherwise innocent and vulnerable people), and an easy to understand and healthy sense of self preservation.11 Murphy wants to “force” the “worst” into “treatment” for refusing “help.” But, being sentenced to “treatment” (AOT) is basically a death sentence. Is this really what our families want for us? Is that really what legislators and providers want? If we’re diagnosing children as young as two, drugging them, and they’re dying by age four, again; where’s the outrage?
Instead, the Murphy folks are defining the terms and issuing a death sentence, and too many of those in opposition get lost and sidetracked inside issues such as “privacy” and whether SAMHSA is or is not doing a good job. While such issues are important, please don’t forget that too many of us are dying. Privacy and other issues are pretty irrelevant if we’re dead. Where’s the outrage?
I believe your voices will be respected, but in order to be respected they need to be heard. Please contact your legislators and help to stop this nonsense.
Please help. Please give us your outrage.
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- Berren, M. R., Hill, K. R., Merikle, D., Gonzales, N., & Santiago, J. (1994). Serious mental illness and mortality rates. Hospital Community Psychiatry, 45, 604-605.
- Parks, J., Svendsen, D., Singer, P., Foti, M. E., & Mauer, B. (2006, October). Morbidity and mortality in people with serious mental illness [Technical Report]. Retrieved June 12, 2007 from http://www.nasmhpd.org/general_files/publications/med_directors_pubs/Technical%20Report%20o n%20Morbidity%20and%20Mortaility%20%20Final%2011-06.pdf
- Gill, K. J. (2008, July) Quote-of-the-Month. CMHS Consumer Affairs Newsletter. Retrieved January 11, 2009, fromhttp://egov.oregon.gov/DHS/mentalhealth/wellness/resources-reports/cmhs-consumer-affairs.pdf, p.7
- https://en.wikipedia.org/wiki/Rebecca_Riley. Retrieved online November 24, 2015.
- http://www.nytimes.com/1995/02/14/obituaries/howard-geld-42-advocate-for-mentally-ill-dies.html. Retrieved online November 24, 2015.
- Colton, C.W., Manderscheid, R.W. Congruencies in Increased Mortality Rates, Years of Potential Life Lost, and Causes of Death Among Public Mental Health Clients in Eight States. Preventing Chronic Disease. April 2006; Vol. 3(2)
- Report from the National Association of State Mental Health Program Directors, in “Mentally ill die 25 years earlier, on average” in USA Today, May 3, 2007. Accessed Nov. 21, 2015
- http://www.theguardian.com/us-news/2015/jun/05/black-women-police-killing-tanisha-anderson. Retrieved online November 24, 2015.
- R. A. Lanius, E. Vermetten, & C. Pain, The impact of Early Life Trauma on Health and Disease: The Hidden Epidemic (pp. 77-87). Cambridge: Cambridege University Press.
- Kaplan MS, Huguet N, McFarland BH, Newsom JT. Suicide among male veterans: a prospective population-based study. Journal of Epidemiological Community Health. 2007 Jul; 61(7):619-24.
- R. Drake Ewbank, personal correspondence, February 4, 2015
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.