Untreated Mental Illness?

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  Upset employee kills five and himself at Accent Signage Systems in Minneapolis after working his shift and being fired on Thursday,  September 27, 2012.

A parent's worst nightmare for a mentally ill loved one came true last month when they learned their son was involved in what police called "Minnesota's deadliest workplace shooting."  The parents told reporters they had tried in vain for nearly two years to get "Andy" to seek treatment.

The parents - Chuck and Carolyn Engeldinger - reported that "Andy" had refuse to have contact with them after they took a 12-week course to understand mental illness.  The free education classes called Family2Family (F2F) are given by the National Alliance on Mental Illness (NAMI) in states around the country.

As far at the parents knew, their son had never received a diagnosis and was not taking medicine; he had been living in his own home since 2004.

On his own and possibly without a viable support network, the 36-year-old workplace shooter apparently isolated himself and began to show signs of mental deterioration; his lateness and performance levels became such an issue that his employers warned him in writing that he needed to improve immediately.  Police say Engeldinger had worked at the sign company since the 1990s.

(credit: Bill Klotz/Finance & Commerce) (July 2012 photo of Engeldinger at work.)
     
According to news reports, when he was told to report to Office of Operations director John Souter at the end of his shift, Engeldinger first went to his car.The shooting began after he returned, was given a final check, and terminated.  Police say he shot and killed the founder of the company - Reuven Rahamim, three employees, and a UPS driver making a delivery.  Souter, one of three injured, remains in critical condition.

In addition to delaying firings until Fridays, employers may want to take other steps to ensure safety on the job when it is necessary to terminate employees like Andy Engeldinger.  One suggestion would be to contact NAMI for short-term education courses on how to handle and recognize mental illness in the workplace.

As a NAMI certified Family2Family (F2F) teacher, I know first-hand the frustration of trying to convince relatives to seek treatment, when their very disease is telling them otherwise.  F2F teaches coping and communication skills, not how to make a mentally challenged person get help.  We can provide the latest research on drugs and treatment, offers crisis management resources, and share various ways of securing voluntary or involuntary commitment; two very big issues that often separate mental illness advocates. F2F also teaches about who is and who is not likely to commit violence.  Research shows, for example, that most mentally ill individuals are not violent. In other words, violence is more likely to come from untreated individuals, those not taking medication and/or receiving treatment for a mental illness.

Treatment works and research shows that the earlier that happens, the more successful and functional a mentally challenged person will be.  Those showing signs of schizophrenia (delusions, paranoia, cognitive deterioration) or bipolar disorder (mood changes) can also be expected to deny having a problem because denial is part of the disease itself. The disease caused by a broken brain itself is called: ANOSOGNOSIA.

According to the Treatment Advocacy Center (TAC), "Anosognosia is believed to be the single largest reason why individuals with the most severe mental illnesses do not take prescribed medications that would diminish or eliminate psychiatric symptoms. It affects an estimated 40% of those with bipolar disorder and 50% of those with schizophrenia."

Click here to read or download “The Anatomical Basis of Anosognosia.”

More information is available at www.treatmentadvocacycenter.org and www.nami.org.

Those of us who advocate for improved mental health services look forward to the day when workplace violence and other kinds of shootings by those needing serious help, will greatly diminish.

Join NAMI and others nation-wide this month in observing:

Telling Your Stories Matter...

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Sunday, June 24, 2012 

http://www.nytimes.com/2012/06/24/magazine/when-my-crazy-father-actually-lost-his-mind.html?ref=magazine

When My Crazy Father Actually Lost His Mind

                                                By JENEEN INTERLANDI

And what it took to get him the help he needed.

Elinor Carucci/Redux, for The New York Times

                         The author with her mother, Patricia, and her father, Joseph.

A REVIEW

No one really understands how a person with a broken brain struggles like those engulfed in the struggle. Here's a daughter who tells a poignant story that captures the "craziness" and myth of a working mental health system in the USA. The leaky social net for treating mental illness is so vividly exposed that it becomes clear even the latest health care reform efforts aren't enough.  It takes ten pages for the author to fully tell what happened to her and her family after her father lost his mind to a bipolar disorder.  As you read her story, remember that in the mental illness political ring there are two ongoing narratives:  those favoring unconditional civil rights for the mentally ill and those favoring helping the mentally ill when they can't help themselves, by committing them to treatment against their will.  There is no middle ground. Mentally ill people have civil rights all the time or they don't under exceptional conditions.

As you read this heart-rendering story, you should be able to identify your position by the end of it.  And it's that position that you will want to make clear when you tell your stories about coping with a mentally ill loved one. When you do you will thus be advocating for either AOT or ACT. Assisted Outpatient Treatment (AOT) allows involuntary treatment with a law that moves beyond the narrow "danger to self or others" standard.  Assisted Community Treatment (ACT) sidesteps the involuntary committment issue by using the courts to order a mental health team to provide treatment BUT only if mentally ill persons volunteer or agree to the court-ordered solution.

Please take time to thank The New York Times for publishing this well-written and deeply personal article about mental illness.  The paper's heroic effort helps to lift the stigma veil and helps to bring attention to mental health illness issues; the article is important because it helps to increase  awareness about the second-class treatment of our mentally ill relatives. Thank you NYT and Jeneen Interlandi. You've both done what Hollywood and the White House haven't been able to do: make real the very real experiences of so many American mental health caregivers and their relatives. Anyone who involuntary treatment is unnecessary because violent incidents by the mentally ill are the exception, rather than the rule, miss the point - each act of psychotic violence probably represents tens of thousands of families already struggling to keep the same from happening with their mentally challenged loved-one.

Mental Illness is a huge and often well-hidden problem.  Instead of being treated like modern-day lepers, the mentally ill need better treatment and respect . No one wants to be mentally ill; recovery when it does occur is often a lengthy process.  It's thus in the public's interest to increase beds and services for those who can't mentally handle their situations.  Would you let a person in shock after an auto accident refuse treatment when you see him bleeding on the side of the road?  Would a physician refuse to treat a child with a broken arm? Wouldn't a parent be held negligent for not taking an injured child to the doctor. Yet because few people recognized the physical symptoms of mental illness of any kind (bipolar, schizophrenia, depression, personality disorder, etc.) it often goes untreated in the initial stages.  What makes a mental illness so insidious is that you can't see a broken brain.  That coupled with the disease itself, often causing its victims to declare that they are not sick and don't need treatment, as Jeneen Interlandi's story so painfully depicts.

As a certified teacher for the Family2Family education course for the National Alliance on Mental Illness (NAMI), I continually teach our mantra - you can't know what no one has told you.  Re-education then is the first key; re-dedication to funding mental health programs and positions, is the second.  Treatment works.  But getting long-term and consistent care to help stabilize a problem in the head, is a major frustration for caregiving families and individuals. Not surprisingly families of the mentally ill become exhausted and stressed as they take on the roles of case managers and protectors.

One of the most revealing and painful facts in When My Father Actually Lost His Mind occurs when it becomes clear that getting their loved-one stabilized is more difficult without long-term coordinated services. While it is fortunate that Mr. Interlandi's bipolar symptoms began to subside, which is sometimes the case after many years, it should be noted that his improvement might have come sooner with a better kind of health care system.  Indeed, it should not be forgotten that much of Mr. Interlandi's improvement may also have been the result of the strong support system provided by his loving family.  I know of hundreds of families providing the same kind of up close and personal, intensive-kind of loving care for a mentally challenged loved one.

Jeneen Interlandi thus makes a significant contribution by so eloquently bringing some very much needed attention to an almost hidden epidemic.  By increasing the awareness of millions about mental illness with her story, I am confident that many more are now aware that mental illness is a family issue and a biological problem. Perhaps now more people in and out of the mental health care system will understand to what extent mental illness is a precusor for the increasing number of individuals who are homeless or in our jails.

Because stigma prevails...  we need to keep telling and hearing about stories involving mental illness.  Stepping Forward2Day is one way to do that.  This Blog is therefore being used to sound an URGENT clarion call for action.  The comments and stories you share will be presented to Congress, state legislators, the President, Governors, and other policymakers in September 2012.  It's time to wake-up America with more stories about real people coping with a mental health care system that often does as much harm, as good in the 21st Century.

Again, thanks to the NYT, magazine editor Vera Titunik, and Jeneen Interlandi for sharing an extraordinary and moving story about the ongoing effect of mental illness in our communities.  Well done!

               

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