Mental Illness and Stalking February 25, 2010Posted by Crazy Mermaid in Delusions, Hearing Voices, mental illness, Psychotic, Stalking.
Tags: Delusions, Hearing Voices, Insanity, mental illness, Psychotic
Stalking is a matter of perspective. From the standpoint of the stalker stalking a celebrity, the stalker is convinced that he has a very real, very personal connection to the person he’s stalking. He would be shocked to learn that what he’s doing- trying to fulfill the celebrity’s perceived request for that contact- is viewed by law enforcement as well as the celebrity in question as stalking. How can it be stalking, he reasons, when the person he’s accused of stalking wants desperately to see him? It must be a misunderstanding.
When I was slipping into the final stages of my delusion (right before I was involuntarily committed to a mental hospital) I was absolutely convinced that I had ESP, and that Bill and Melinda Gates were among my many friends-including the Dalai Lama and Oprah Winfrey- who talked with me via ESP (voices in my head). I used to make beaded jewelry, so it wasn’t surprising that (as part of my delusion) Bill and Melinda Gates had heard of my jewelery-making prowess, and begged me to make some jewelry for them.
I agreed to their request, provided they give me direction on their tastes. One of the capabilities of people who shared ESP with me was their ability to see the world through my eyes. Literally. It’s kind of complicated to explain, but suffice it to say that they saw everything that I saw. So it was natural for Bill and Melinda to wander around the bead shop with me, picking out beads for their own special necklaces as if they were actually in the room with me. When Bill began picking out expensive stones, I balked. But Bill assured me that price was no object, since he (the richest man in the world) would be reimbursing me in the very near future for the money I spent. Payment from Bill established for sometime in the near future, “we” roved the store selecting expensive stones for their necklaces.
“We” returned to my home where I spread the expensive loot out on my kitchen table and began putting the necklaces together with “their” direction. When “we” finished the jewelry, “we” discussed how they were going to get the necklaces from me. Should I mail them? Should I send them via UPS? Should I send them to their house in Medina? Or to Microsoft’s campus in Redmond? At first, “they” directed me to mail them to the Gates’ in care of their (real) nonprofit organization, The Bill and Melinda Gates Foundation. After further discussion, “we” agreed that I would give the necklaces to them when I met them in person, which was going to be in the very near future. Fortunately, I ended up in the mental hospital before I could do any real damage.
It is easy for a delusional person to cross the line into what appears to the real world as “stalking”. I had lost touch with reality to the point where I was convinced that the Gates’ wanted their jewelry so badly that had “they” insisted, I would have, without question, driven to their home in Medina (about 20 minutes from my home) with the intent of personally delivering the necklaces to them as they had requested. I would have been absolutely convinced that they were desperate for my jewelry, and wouldn’t have believed anyone who tried to tell me differently. Had I followed that plan of action (rather than wait to meet them as we finally agreed), I would have been carted off to jail, labeled a stalker. But in my mind, I would have been absolutely certain that the Gates’ were dying to see me, and I would have insisted that this was so.
In revealing this very personal and embarrassing episode that was part of my psychotic delusion, I hope to show how easy it is for someone suffering from delusions to become a stalker. I ask for the law profession to understand that when they are investigating a stalker, in reality they’re likely with a delusional mentally ill person. I ask for them to show that “stalker” some compassion by getting an immediate psychological evaluation before sending him off to jail. With proper medical intervention, their delusion, like mine, will evaporate and the psychotic individual will return to the real world. And when it’s all over and they’re medicated and back in their right mind, they, like I, will be extremely embarrassed and ashamed of their behavior.
Mental Illness Medication and Slower Thinking February 18, 2010Posted by Crazy Mermaid in Disability Claim, mental illness, Recovery, Therapy.
Tags: Disability Claim, mental illness, Recovery, Therapy
Yesterday, I had a “Flowers for Algernon” moment. Or rather an hour and a half. Let me explain.
Distilled into the Readers Digest Condensed Version, Flowers for Algernon, the 1958 story by Daniel Keyes, is about a man with an IQ of 68 who is given an operation to increase his IQ to genius level. He maintains that genius IQ for a relatively short period of time and then reverts back to his former self.
In my case, although I never had my IQ tested, I performed work that was intellectually challenging. I managed many projects over my 25 year career, and they all required the ability to simultaneously process large quantities of information. My last job, project managing the construction of a $55 million ice hockey rink, was no different. Building a project of that magnitude requires some heavy duty brain power.
Thinking quickly, making snap decisions, and processing vast quantities of information in the blink of an eye, skills that I developed from a very early age, were all second nature to me. My intelligence allowed me to walk into any meeting or presentation and do the “Vulcan Mind Meld” with any presenter, routinely asking the presenter a barrage of questions allowing me to acquire an accurate understanding of exactly what the presenter knew and, more importantly, what he didn’t know. That knowledge allowed me to make the kind of decisions I needed to make in order to perform my job as efficiently as possible. That ability made me very good at my job.
I regarded my talent as normal, and was routinely disappointed in people when they couldn’t perform according to my standards. I had difficulty relating to many people, since I believed that they simply weren’t putting their God-given abilities to work. It never occurred to me that they might not have the ability to process the same quantities of information as rapidly as I could.
When I was hospitalized in May 2008, the medication that I was given began the process of bringing me back to reality. But the side effect of that medication was what I call the “Flowers for Algernon” effect. The speed that I process information severely slowed down. Immediately. One minute I thought quickly, the next I thought slowly. That fast. I now think about ½ to 1/3 as fast as I used to. Unable to hold four thoughts at a time, I have had to re-learn how to think. More importantly, I have had to re-think exactly who I am, since my identity is tightly tied to the speed with which I think.
Generally speaking, I have come to accept the new terms of my existence. The further away I get from my past, the easier it is to forget how fast I used to think and how much information I could absorb. Very few incidents in my relatively cocooned existence occur that renew my sense of frustration and shame at losing part of my brainpower. Yesterday was one of those days that reminded me of what I have lost.
In consulting an attorney about a personal matter, I was obliged to have an hour and a half consultation in the attorney’s office. As the attorney talked, I found it surprisingly difficult to keep up with the conversation. My brain just couldn’t process the concepts the attorney spoke about. I took notes, but they were too nonsensical to help me retain any information. Despite the fact that I had ample opportunity to ask the attorney any questions I wanted to at any point, I felt, at the end of the visit, as if I hadn’t even been present for the majority of the consultation. This happened, I should add, through no fault of the attorney’s. I’m the one who can’t comprehend relatively simple concepts. That’s virtually unheard of in my universe. Until now.
The woman who ran the meetings and made the snap decisions is gone. In her place is a much more humble, much slower-thinking person who vaguely remembers what it used to be like to have some heavy-duty brainpower. Flowers for Algernon.
Mental Illness: Short Term Care Facilities February 17, 2010Posted by Crazy Mermaid in Mental Hospital, mental illness, Psych Ward, Recovery.
Tags: Mental Hospitals, mental illness, Psych Ward, Recovery
With the advent of the changes wrought by the new Parity law that just went into effect January 1, 2010, one of the consequences will be that short-term hospital stays will be lengthened beyond the standard 2 weeks period now in effect, since this 2 week period of time is currently driven by insurance requirements rather than patient need.
As the parity law increases the length of visits, demand for hospital beds, which are already in short supply, will be increased. I’d like to think that the end result of the new parity law will be that more facilities will be built to house those patients not ready for discharge. But building those new facilities will be difficult since anyone trying to build them will run smack dab into neighborhood NIMBY’s (Not In My Back Yard).
The communities where these new facilities will be built are already up in arms about siting short-term mental health care facilities in their neighborhoods because of misunderstandings about the nature of medical care for mental illness. They don’t understand the concept of short-term care. Encouraged by the entertainment world, they perceive those receiving short-term psychiatric care as a bunch of crazies running around killing and/or maiming people, especially young children. Thus is the picture the entertainment world has provided to society at large regarding the nature of those afflicted with mental illness. So if they’re not the psychos of the world, then just exactly who are those people receiving short-term care?
A vast majority of short-term patients are people who are severely depressed. So depressed, in fact, that want to and/or try to commit suicide. They have either been talked into seeking help themselves (voluntary commitment) or have been taken to the hospital by others (involuntary commitment) for short-term inpatient treatment. The treatment is designed to alleviate their depression and get them to a point where they no longer desire to kill themselves.
The second group of patients are those who have psychotic breaks with reality in some form. In some cases (like me) they believe they are Mermaids. In others, they hear voices. Or they believe people are out to get them. Or they believe they can fly. Like their severely depressed brethren, they have been talked into seeking help themselves or have been taken to the hospital by others for short-term inpatient treatment. The purpose of their treatment is to bring them back to reality.
A handful of patients are previously stabilized mentally ill people who have, for whatever reason, become de-stabilized. They have either stopped taking their medication for a short period of time and need to get re-stabilized, or their medications have stopped working through no fault of their own. Either way, they are readmitted for some intensive care as they receive the care needed to restabilize their medication, thus enabling them to be re-released back into society.
One group of mentally ill people not found in these short-term care facilities are the “forensic” mentally ill people. “Forensic” in this usage designates a mentally ill person who has committed a crime. Forensics are under the strict supervision and control of the Criminal Justice System, and have a snowball’s chance in hell of winding up in a short-term care facility.
Besides the fact that the criminally insane cannot get treatment in short-term psychiatric care facilities, people should take comfort in the fact that nobody can just walk out of a mental health hospital. In fact, unlike any other medical care they will ever receive in the world, patients check their civil rights at the desk when they walk through the door to get treatment.
If the neighbors think they’ll have some lunatics loose on them, I challenge them to visit one of those facilities. The razor barbed wire, locked gates, and other security measures taken by the staff of these facilities virtually guarantee there will be no loose “loonies” in the neighborhood. No more likelihood of violence than your average suburban neighborhood, in fact.
So the NIMBY crowd should take comfort in the fact that only the “good” loonies are treated in these facilities, and that it’s almost impossible for these “good” loonies to get out of the facilities and wander around the neighborhood unsupervised. It’s okay to have a short-term mental hospital in your neighborhood. Nobody will bite you. Or stab you. Or whatever. They’re only there to get better.
New Mental Health Parity Law February 9, 2010Posted by Crazy Mermaid in Healthcare, mental illness, NAMI.
Tags: Healthcare, mental illness, NAMI
Sunday’s Wall Street Journal article by Jillian Mincer, Mental-Health Benefits, heralded the new Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, which took effect January 1, 2010. Paul Wellstone, Democratic Senator from Minnesota, and Pete Domenici, Republican Senator from New Mexico, formed an unlikely bond through their personal family stories of mental illness, coming together to ultimately pass a new law designed to make the world a better place for people suffering from mental illness.
The forerunner of this new act, The Mental Health Parity Act of 1996 (MHPA), was the first such effort. Basically, it said that a group health plan couldn’t impose annual or lifetime dollar limits on mental health benefits that are less favorable than any such limits imposed on medical surgical benefits. This act was necessary because it was common practice for insurance companies to pay more for medical illnesses than mental illnesses.
For example, if Harry required open-heart surgery, an insurance company limited the amount of money it would pay a provider to $2 million over the course of Harry’s lifetime for his heart. That same insurance company would turn around and limit the amount of money it would pay a provider for Tom’s depression to $750,000 over the course of his lifetime. The MHPA of 1996 mandated that if the insurance company allowed Harry $2 million in insurance for his heart, then Tom got $2 million for his mental health treatment. But that law didn’t go far enough. The insurance industry still managed to heap tons of discrimination on the treatment of mentally ill patients. So we went to work, cutting away some of the insurance industry’s wiggle room. The result was the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008.
The Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 went into effect in October 2009. But the new coverage wasn’t available until only a little over a month ago (January 1, 2010), which is when new insurance policies went into effect.
The MHPAEA still allows companies to decide whether to offer mental health and substance abuse disorder (MH/SUD) benefits in their benefits package. They don’t automatically have to offer them when they offer medical health policies. So that means that the only groups that are affected by the new law are those that already have mental health and substance use disorder (MH/SUD) benefits in their benefit packages and choose to retain those benefits.
Key changes made by MHPAEA, which is generally effective for plan years beginning after October 3, 2009, include the following:
• If a group health plan includes medical/surgical benefits and mental health benefits, the financial requirements (e.g., deductibles and co-payments) and treatment limitations (e.g., number of visits or days of coverage) that apply to mental health benefits must be no more restrictive than the predominant financial requirements or treatment limitations that apply to substantially all medical/surgical benefits;
• If a group health plan includes medical/surgical benefits and substance use disorder benefits, the financial requirements and treatment limitations that apply to substance use disorder benefits must be no more restrictive than the predominant financial requirements or treatment limitations that apply to substantially all medical/surgical benefits;
• MH/SUD benefits may not be subject to any separate cost sharing requirements or treatment limitations that only apply to such benefits;
• If a group health plan includes medical/surgical benefits and mental health benefits, and the plan provides for out of network medical/surgical benefits, it must provide for out of network mental health benefits;
• If a group health plan includes medical/surgical benefits and substance use disorder benefits, and the plan provides for out of network medical/surgical benefits, it must provide for out of network substance use disorder benefits;
• Standards for medical necessity determinations and reasons for any denial of benefits relating to MH/SUD, must be disclosed upon request;
• The MHPA parity requirements under existing law (regarding annual and lifetime dollar limits) continue and are extended to substance use disorder benefits.
While these new requirements are getting us all closer to a more just mental health system, we still have a long way to go.
Note: Check out Time Inc.’s interview with Senator Pete Domenici. Senator Donenici, whose daughter suffers from schizophrenia, worked closely with National Alliance on Mental Illness (NAMI) in order to get his bill passed into law. A fascinating read. http://www.time.com/time/nation/article/0,8599,1848887,00.html.
Shortness of Mental Hospital Beds February 3, 2010Posted by Crazy Mermaid in Mental Hospital, mental illness.
Tags: Mental Hospitals, mental illness
Society seems to think that if we eliminate the places people can go for help managing their mental illness, then we can eliminate the illnesses themselves. We can say to ourselves “Look! The places we used to treat mental illnesses at are all gone! That must be because there are no more mental illnesses requiring hospitalization! Yay!”
In 1973, Washington State shut down Northern State Hospital in Sedro Wooley, which is about an hour’s drive from Seattle, due to budget cuts. Back in its heyday, Northern housed 2,700 patients. Despite the substantial increase in population from 1973 to the present (almost 40 years), there has been no increase in the number of mental hospital beds. In fact, they keep decreasing.
Shutting down the facilities is society’s way of trying to make the problem go away. If there’s nowhere to treat the problem then the problem must be gone.
It’s interesting to look at the presidential familial histories of the presidents in office when certain actions were taken regarding mental illness. For example, when John F Kennedy, whose sister was lobotomized, was in office in the early 1960’s, the secrecy of mental illness was blown wide open. Mental hospitals were built, programs for mentally ill were implemented, cruel practices like lobotomies were stopped, and mental illness finally came out of the deep recesses of the closet.
Then, when Ronald Reagan, a man with no public ties to mental health, took office in the 1980’s, politicians were looking to shrink government and reduce spending. With the advent of new medications, the people governing the nation got the (wrong) impression that mental hospitals were suddenly passé, no longer needed because new medication took the place of hospitalization. The general idea behind the shuttering was that the new drugs made hospitalization obsolete, and that those housed in the facilities were fairly long-term residents who would be better served outside the state-run hospitals rather than inside them.
The sad truth is vastly different. The true effect of this bed shrinkage is felt most clearly on two groups of people: those needing long-term care and those looking for short-term care . People seeking short-term care need specialized supervision and care in order to get their medications started or under control under strict medical supervision. They and their families suffer from the shortage of hospital beds. They go untreated, unable to get to a place where they can manage their illness.
Those needing short-term care but not finding it soon turn into those needing long-term care. Unable to find long-term care either, they take to the streets. We know them as the homeless population.
The medical community acknowledges that there is a need for more beds, but the reality is that there is no movement afoot to do anything about it. Especially in this cash-strapped time, there is no room in our budgets for building new mental hospitals, despite our increased population. That’s sad.