There's a family I know who was driving along, coming back from a road trip in southern Utah and the son, Davey, has a very serious mental illness and he asked his Dad to stop at a at a lookout point. And sure enough, Davey made a run for the edge. And, his father was able to grab a hold of him, hold him down. And Davey looked at him and said, " I'm sorry, this is something I have to do", and he broke free of his father's arms. But that image is something that every family that who has a loved one that is struggling with a mental illness can relate to; that feeling of standing on an edge of a cliff and we're holding onto them with all of our might trying to keep them safe.
On that day, a father lost hold of his son, and a family was changed forever.
MENTAL ILLNESS PUTS LIVES ON THE EDGE. FAMILIES ARE PUSHED TO THEIR LIMITS. A CARE SYSTEM IS ON THE EDGE OF FAILURE, A SOCIETY AT THE EDGE OF ITS ABILITY.
So, it is a metaphor for our mental health system which; when people can get help is very effective. But there are so many people who fall through the cracks and who are living on that edge. Mental Illness affects everyone. It affects individuals, families, and whole communities. It flows into every aspect of our society. It's in our healthcare system, our criminal justice system, its everywhere.
Dextroamphetamine. I knew it. Dextroamphetamine. I tell you, that's why he's bouncing off the walls.
This medicine is a central nervous system stimulant used to treat attention deficit hyperactivity disorder.
There you go!
MENTAL ILLNESSES ARE medical conditions that disrupt a person's thinking, feeling, mood, ability to relate to others and daily functioning.
One in 4 adults experience a mental health disorder in a given year
My name's Roger Marcotte. My wife's name is Donna. We have a 17-year-old son named Derek who has been diagnosed with Aspergers Syndrome, ADHD severely, oppositional defiance-the whole myriad of it.
Asperger's Syndrome is a pervasive developmental disorder effecting social skills and communication.
You know life has been a little bit tough getting Derek through the system, or trying to get Derek into the system. His diagnosis came about at age three and a half. Derek was always a very, very happy-go-lucky child, and it seemed like an overnight transition at three and a half, where Derek became very, very defiant, very, very oppositional, very violent. We never had any luck getting Derek into the system. We've tried our best. We've had many doctors look at him. Many doctors have diagnosed him as, you know, the same diagnosis, but the resources to help just aren't there.
How do you get people to understand what you're going through, what your child is going through?
When they relapse, you relapse, and you're right back to square one of the grief and the chaos and the crisis of it all, and, so it's brutal.
What these parents tell me is, I love my kid. This has been a blessing, but I, my overall quality of life, my ability to take care of my other kids, myself, my relationship, you know it just cuts it all in half, and there just are not enough resources and not enough energy, and I become isolated within my community.
Families can easily get lost trying to find mental health services. Those navigating the twists and turns of doctors, treatment programs, AND medications, soon come to realize... the puzzle clearly begins, and ends, with what one can afford.
You know its like they say, in my opinion is, you know, if you're poor you get it for free. If you're rich you can afford it. If you're middle class those doors are just no open to you. First of all you can't afford it, and second of all because of your income, you don't qualify for it. So it's a very, very difficult thing.
On their combined income, Roger and Donna could not afford $500 per month in Derek's prescribed medication, so they opted for a generic brand medication, which proved to be ineffective.
We wound up here in Utah and unfortunately... well actually fortunately we do have Derek some help, but unfortunately where we got it was through the criminal justice system. Derek finally took that step over because of his impulsiveness, and made a very, very poor choice in his personal life that wound him up before the judge.
DEREK IS NOT ALONE. AN INCREASING NUMBER OF PEOPLE ONLY GET THE HELP THEY NEED WHEN THEY FALL INTO THE CRIMINAL JUSTICE SYSTEM. 40% OF ADULTS WITH A CHRONIC AND SEVERE MENTAL DISORDER WILL END UP IN JAIL OR PRISON.ODDLY, IT ALL STARTED WITH THE BEST OF INTENTIONS WITH DEINSTITUTIONALIZATION IN THE 1970'S.
We looked at these huge mental hospitals and we said you know these are bad places. They weren't getting adequate funds. In the 1960's they were compared to Nazi concentration camps. And so, we decided to close them down. But if you look closely, you'll find out it wasn't compassion and concern that lead to the closing of the hospitals. It was money. We were supposed to have community care. They never adequately funded that community care and they still don't do that today. And so people went from institutions onto the streets and into jails and prisons. And the largest public mental facility in the United States today is not a hospital; it's the Los Angeles County Jail.
Jails have become the de facto treatment facilities for people with mental illness.
It's easier for society to incarcerate mental illness than it is to treat and address mental illness.
I know very few people who are mentally ill who wake up in the morning and say "Let me see how many crimes I can go out and commit". Often their criminal conduct is the consequence of their mental illness. So when they don't have access to medication and support, when that infrastructure support is broken in the community, and they find themselves embroiled in the criminal justice system, we start to cycle them through. We are warehousing the mentally ill.
INMATES HAVE A SERIOUS MENTAL ILLNESS RATE UP TO 5 TIMES GREATER THAN THE GENERAL POPULATION.
See, in the past with me, I was thrown in prison instead of getting help inside of a program that is set up for mentally ill people; instead I was getting thrown in prison all the time. You know, I violated my parole 5 times when I was on parole. Instead of putting me in prison, they should have put me in a, in a hospital, you know?
The fact that we have more people with mental illness in jails and prisons than we do in treatment centers and hospitals is insane in our society.
[Liz Felt (classroom)
Okay you guys, so first of all, we're going to talk about Schizophrenia today.]
LIZ FELT KNOWS ABOUT SCHIZOPHRENIA FIRST HAND. SHE'S BEEN LIVING WITH THE ILLNESS FOR THIRTEEN YEARS. AS A PEER MENTOR AND TEACHER WITH NAMI, THE NATIONAL ALLIANCE ON MENTAL ILLNESS, SHE USES HER INSIGHT TO TEACH JAIL INMATES HOW TO BETTER UNDERSTAND THEIR OWN DISORDERS.
I would say that 90 percent of the people typically in my class if not 99% of the people have issues with addiction in general. And that through self-medicating, that's one way where they'll get in into legal trouble and, and end up in jail.
Well I still had heroin stashed on me and knew that if I could just smoke some of this heroin I would be all right, I would be able to calm down and chill out. I kept self medicating and I just kept getting worse and worse. And I could see like, what I was doing you know, I knew it wasn't good and I didn't want to keep participating in it but if I didn't self-medicate like that I just wanted sit in the dark and be alone.
Well, on a neurobiological basis, with mental illness a lot of what we see is imbalance in chemicals. Brain chemistry. Serotonin, dopamine, nor epinephrine.
[Chuck Diviney, (in classroom)
So people that take antidepressants may already have a depletion of some these chemicals.]
And the cost of medication is through the roof. And, so people are suffering. Waiting for an appointment, waiting for funding, waiting for the adequate services. So they turn to illegal substances, which very much you know bond very similarly to the same receptors and, in some instances is even more readily available. And it's cheaper.
The voices actually tell me to take drugs. Like I go off my medication so I use drugs to fill a void to fill a need you know and sometimes I use the drugs to cover up the pain of my mom being gone. I lost my mom when I was eleven years old. I started talking to things that weren't there like, vacuums, just objects, and sometimes people that weren't even there. As time went on and I turned 18, I came here to jail and they diagnosed me as being a paranoid schizophrenic. I keep to myself in jail. I don't really talk to anybody all that much. I just stick out like a sore thumb, you know, because I'm different.
I think that schizophrenia is extremely misunderstood and there's a lot of stigma surrounding it. Just because people can relate to depression, people can relate to anxiety. People can relate to mania. But psychosis is extremely hard for people to be able to relate to.
My first psychotic outbreak happened when I was 22 years old. One day when I was downtown, all of a sudden I was just completely overwhelmed by what I was experiencing. My senses were heightened, so lights were brighter, sounds were louder. I was shading myself from indoor light. And then I had the voices, which were like a constant dialogue, and commentary of what I was doing, how I was feeling. It was not real. It was incredibly frightening to feel that my mind was creating this, and I could lose control or ability.
For me, the stigma was so intense. Once diagnosed I started listening to what people were saying about mental illness. And there's so much negativity out there. A quote that I like is that we have a million words for the word crazy in our language. But I internalized a lot of that stigma, and felt a great sense of shame. And I see the struggle that my students have, with stigma, and especially in the jail, and trying to get them to talk about the experiences they've had.
I just went too far off the deep end. And I grabbed a knife and I like went to stab myself and my sister and my mom attacked me and took the knife, and my Mom says you know, "we're taking you to the hospital, you know, this isn't right, you're freaking out" and I was like "No!" you know? I think it was that stigma in my own head like "no, I'm not going to the crazy hospital, I'm not crazy, you know, just freaking out!" But my Mom is bi-polar and manic-depressive and so it's genetic.
Jail is not conducive for mental illness. You can't just put someone in a box for six months, let them go, and think that anything will change.
The problem here is that trend in recidivism. It's the likelihood that the mentally ill people are going to return to an incarceration setting that we're dealing with.
What I've seen most common here is that they get stabilized and then they leave the jail and they come back and they're up on the acute unit and they're back to active psychotic, off their medications and it's 2 weeks or 3 months later or, and I have to wonder, what's happened? What I do know from the research is the system matters. If we have an individual leaving jail, then we have to wrap services around that individual so that they can be successful. And that's the part I'm not sure is happening.
Unless programs are implemented to bridge these gaps and find resources prior to release, the recidivism rate's going to remain high, it's probably going to escalate. I just don't think we have the patience from a societal perspective to adequately manage mental illness anymore. We're growing impatient with it. And the more impatient we become the more likely we are to lock them up, to put them in a closet.
ON ONE HAND, SOCIETY TENDS TO ISOLATE, HIDE, AND SHUN PEOPLE WITH MENTAL ILLNESS. ON THE OTHER, THERE ARE NEW PROGRAMS AND ATTEMPTS TO BREAK THE CYCLE OF RECIDIVISM.
Utah has people who are really willing to collaborate in a way that I think is unusual, that I don't hear happening in other states. We have people who want to find the right answers, the right solutions. A big part of that is the Crisis Intervention Team. To have law enforcement trained and you know we have one of the best programs in the nation.
We go out and do follow up on any calls for service that involve anybody that's in crisis, has a mental illness, is suspected to have a mental illness, and possibly has a co-occurring disorder with maybe drugs or alcohol on board as well as the mental illness.
We have case load where we will track, follow someone who's been involved, or is constantly involved in the mental health system.
[Ron Bruno (Outreach call)
Hi Alex. How are you doing? So, still sleeping outside huh?]
Mental illness does not necessarily make a person more violent. What it does do is make them less predictable. Because there are some people who have had a mental illness that have acted out so violently that the media's gotten a hold of it, and has given that perception that people with mental illnesses are violent, and that's not the case. It's more apt that a person with a severe mental illness is going to be the victim of a violent crime than the perpetrator of a violent crime.
We've been out to chat with Alexander to kind of find out you know what's up with him, have not really been too successful until a couple months ago we were able to get him up to the hospital to have an evaluation.
[Ron Bruno (Outreach call)
Again, if you could stay in the shelter, that would be really good.]
He wanted to go back out on the street he wanted to go back to his way of life. If he's providing for his own basic necessities and we can't show that he's a danger to himself or others we have no option but to let him take that choice and go back out onto the street.
If you have a serious and persistent mental illness just being able to function to keep housing to make some money to get yourself food, sometimes it you're just not able to do that and so you end up being homeless. Then you fall into that area of well now you're starting to commit some possible homeless crimes such as trespassing, such as petty shoplift that gets you into the criminal justice system, just because you're trying to survive.
That's where our system is kind of broken down is that I think that communities on a whole will sometimes look to law enforcement as you know, fix this. But we can't fix mental health issues. All we can do is basically guide somebody into the right system and then work with that mental health system so that they can find the more permanent resolution.
Day in and day out we constantly are fielding calls from just distraught family members saying, "What should I do with my son? This is what's going on, this is what's happening with him. Can you get us some help? I mean we can't get him to the hospital, he's not a danger to himself or others but his life is just twirling out of control, and now we're afraid that he is going to become a danger to himself or others. What can we do"?
With CIT at least now we can say we are trying to do everything we can think of. We are forming the partnerships; we are trying to get this person the help they need before they do hit that critical end.
BRUNO AND FREDERICK PROVIDE CRISIS INTERVENTION TEAM TRAINING TO OTHER POLICE OFFICERS. CLASSES ARE AVAILABLE IN HALF OF UTAH'S COUNTIES, BUT ONLY 12 PERCENT OF UTAH'S OFFICERS ARE CERTIFIED.
That's one of the benefits of the CIT training is it gives the officers some insight by throughout the entire week dealing with people with mental illnesses, by learning about these disorders, by experiencing it first hand, by talking to people.
[Darren Carr, Officer/ CIT Trainee (Scenario Training)
What have you been diagnosed with sir?]
To get them to understand what a person who has a mental illness who may be going into crisis-what they may be experiencing because with that understanding that's how they can find a safer and a better resolution.
[Simulation Voice Over
This is not a joke. Go ahead, try to do something right. Try to do something right. You can't!]
[Ron Bruno (classroom)
As we spoke yesterday, we are going to allow you to experience what its like to hear voices.]
I can tell you all day long, you know these people have audio hallucinations where they hear whispering or somebody talking about them and I can tell you day in and day out but you're not going to really understand it until you put those headphones on-you start hearing what somebody might hear, and I'm telling you "Go on, you need to go do this activity".
[Simulation Voice Over
You think this is funny don't you? You think that it's some kind of joke? Well it's not a joke. Not a joke! Dirt! Shirt! Alert!]
The background noise, I can concentrate pretty good when that's going on. Where I found I lost a lot of concentration is where they start. "Stop it! Stinky! Stink! Stink! And they just go off the deep end. And that's where it distracts from what you are trying to concentrate on doing.
[Simulation Voice Over
They all smell you all over town. They know what you do!]
I can take these off here in a few minutes and go about my normal life and only choose what sort of input I want to put into my ears. Where obviously these people have to live with it and they don't have that choice.
[Simulation Voice Over
It doesn't go away. It doesn't hide! You can't hide!]
The one thing that we don't get to see is the inner working of people's lives and the issues and struggles that they face. And so it definitely gives you a little bit more empathy and changes your perspectives a little bit.
When you're in 4th-5th grade your teacher says, "What you want to be when you grow up"? Nobody sits in class and raises their hand and says, "I want to be mentally ill".
One of the reasons why I really enjoy being here is that every now and then I can help one of those cries for help.
If we can find some kind of Jail Diversion Program, like, if we can get them onto a JDOT team, if we can get them onto a community team that will go out and make contact with them regularly. Many times that helps them find recovery.
Rick Peay has bipolar or manic depressive disorder. He's spent the last 20 years bouncing between the Streets, jail, and hospitals. BUT A NEW PROGRAM, THE JAIL DIVERSION OUTREACH TEAM, OR JDOT, HAS GIVEN RICK A SECOND CHANCE.
it focuses on wrap around treatment -- providing housing, medication, therapy, and frequent home visits.
[Rebecca Minnick, Case Manager, Valley Mental Health
So how are you feeling today?]
I feel pretty good. It seems for the last couple of months I've been slightly feeling a little bit depressed, I don't know what it is.]
People who are on assertive outreach teams like JDOT have failed traditional mental health typically. They have hard time keeping appointments, a hard time coming into the clinic usually don't have a whole lot of insight into their mental health issues. We keep our caseload very small; it's a one to ten ratio. So we have the ability to see everybody on the team every day if we need to. We're on call 24 hours a day, seven days a week, so that we can meet the client where they are at that time and hopefully intervene before they decompensate to the point where they are needing to be hospitalized or are back out committing crimes that put them in jail.
[Rick Peay, (Therapists office)
Right now I'm just working on, I've started a journal and I write every day in it, some aspect of my life. ]
SO FAR JDOT HAS BEEN SUCCESSFUL AT KEEPING PEOPLE WITH SERIOUS MENTAL ILLNES OUT OF JAIL -- REDUCING AVERAGE BOOKINGS PER CLIENT FROM 21 TO .3. BUT THE PROGRAM IS LIMITED. ITS ONLY AVAILABLE IN SALT LAKE COUNTY AND SERVES JUST 60 PEOPLE.
What's the longest period that you've been stable, on your medications?]
What's the longest period? I think this is the longest period. Two years now.]
I've known rick for almost 20 years and when he goes bad he goes bad, and it's fast. You can be having a conversation with him one day and thinking he's doing so well, and the next morning he can call and his speech can be rapid and pressured.
When his illness kicks in, he is pretty scary too. He can be quite threatening. Which seems impossible when you see him today.
I never perceived anything like mental illness. You know, never perceived anything like that would happen to me, or that I would even be in jail. I was making about fifty thousand dollars a year I had a good job. I was married, and I had a couple kids, and I began to have these feelings of euphoria. I began to really feel lots of energy and I felt a certain understanding of the universe was open to me. I had a special relationship with it, and some kind of like anointing from God or something like that. I can remember one time I was manic and I started to draw a picture. And sometimes I would get so intense that I would keep drawing and coloring until you couldn't even see it any more. It would just be obliterated. And even lately, I haven't had one of these euphoric feelings and I miss it. And I think to myself "If I was in control of my medication I bet I wouldn't take it this week". Just because its such a good feeling to be, to have this manic stuff. I almost think sometimes it's like a drug or something. I don't think until I started actually ending up in jail that I really started to realize that something was really wrong.
Since 1994, Rick has been arrested 10 times and hospitalized 7.
When I would first go to the hospital they would just get me stabilized and just release me. There was never any contact with any organization where I could go for support or anything like that.
Rick, how are you?]
If I would have had now what I have now where I have the treatment plan where I see social workers regularly and see a doctor and yet I still have my freedom. I think life may have turned out differently for me. I think the toughest part was probably the loss. I think losing my family was tough. I must have lost about almost twenty years it seems like, you know, from when I started off with it.
A lot of people with mental illness have lost folks. But the clients that we're dealing with, the clients that are kind of the toughest of the tough, that people may have given up on. Families certainly have. And so you know, we have that morning coffee group, when the clients can come in and have so many things in common. The number of times that they've been in jail, the homelessness, the loss of family, the loss of friends, and have an open forum where they can talk about that and realize that they're not alone in that, and kind of deal with some of that loss. And it's also been exciting because as they get stable they can make some of those connections again.
My mother just recently just called me, and we had a good conversation. I haven't talked to her for like five years. So my family life is improving, and my relationships with people are becoming more stable. Because I've been more consistent, you know? I've been able to stay with the program.
[Food Bank Employee
All right, ready to roll? Back for more?]
[Rick Peay (Food Bank)
I've just got to sign in I guess.]
I've had other clinicians that I've worked for the last twenty years say, "I didn't ever think this was possible. I mean I just felt like this was going to be a revolving door." He's not been in the hospital, he's not been in jail, he's becoming a mentor to the other clients on JDOT, and he's volunteering at the food bank. There's not words really to describe the full circle he's come, it's been an amazing journey to be part of.
[Rick Peay (Food Bank)
I'm catching on! ]
[Volunteer (Food Bank)
Well that's good! ]
If we're ever going to make an impact in a person's life and we're going to transition them away from the criminal justice system, they have got to believe that there is someone worth saving there in the first place. And with our mentally ill people, if they are not ever stabilized they may never get to have that conversation.
So Serena, what are we going to do so you don't end upcoming back here again?
SERENA BLAIN IS IN ALSO JDOT. SHE STRUGGLES WITH SCHIZOPHRENIA AND ADDICTION, AND WAS RECENTLY BOOKED INTO THE SALT LAKE COUNTY JAIL ON DRUG CHARGES.
I've always been a witch I just didn't know how to use my powers. But I do now and I destroyed that brain cell that kept telling me to smoke crack, go get some crack and I'd come back and smoke it and I'd end up in jail.
BUT INSTEAD OF BEING LOCKED UP, SERENA IS FREE ON PROBATION, COURTESY OF A SPECIAL COURT FOR MENTALLY ILL OFFENDERS.
For years and years and years I saw people back again and again and again. They were out in the streets they weren't getting medication. They weren't getting support.
We needed to come up with a better solution than our current model was providing. Because we were spending lots of money and we would continue in perpetuity doing so if we didn't change our model.
THE NEW MODEL IS MENTAL HEALTH COURT. WHERE CRIMINAL JUSTICE AND MENTAL HEALTH AGENCIES WORK TOGETHER TO PROVIDE TREATMENT, HOUSING, AND MEDICATION. DEFENDANTS MUST APPEAR BEFORE THE JUDGE EACH WEEK, AND SUBMIT TO DRUG TESTING.
It really is such a team work approach. We all get together Monday afternoon a couple of hours before court starts and we go through the days calendar and we talk about every single person.
Okay. Serena Blain. ]
Well she's clean. Her UA's have been clean. ]
We talk about whether they've been in treatment, whether they have checked into adult probation and parole, whether they've complied with JDOT, whether they've been using drugs. And we just see the progress; have they gotten a job, has the housing come through, has their SSI come through? And that's how well we know them.
Now keep in mind, all our participants are mentally ill but legally competent. The stigma of mental illness is somehow if I'm mentally ill I'm incapable of making a decision. No. I may have delusions but I'm very rational in being able to make my decisions.
In order to be in mental health court you have to enter a plea of guilty. So we are not going to trial, there has to be an admission of guilt and it's a voluntary program. But they're still held accountable absolutely for their conduct and by way of supervision in mental health court.
I brought your meds and your check. And I wanted to visit with you for a while is that okay?
Mental health court is part of this paradigm shift and there are little changes that make huge differences. The challenges of course, to staying sober, staying on your medications, doing treatment, are dramatically greater if you're living on the street. Housing in the first priority and treatment comes along with it.
Serena grew up in Ft. Duchesne on the Ute Indian Reservation by her grandmother. She definitely has a lot of Native American beliefs and thinking as far as spirit. It's not so much that she hears voices is that they are different spirits of people inside of her which I thought was very interesting. And I'm sure it's culturally based.
[Rebecca Minnick (Home Visit)
Here's your meds for today.]
The voices wont ever really go away but the medicine will help me. That's what the doctor told me. And it's true. They say awful things about me like, I'm a weakling and I'm dirty and that's why I don't like them. I argue with them all the time.
The people who I see every Monday afternoon, they are living with an illness that we who don't have mental illnesses can't understand.
[Rebecca Minnick (Home Visit)
Is there anything behind the snake on the floor? ]
[Serena Blain (Home Visit)
Oh, I bought that for my invisible son. ]
[Rebecca Minnick (Home Visit)
For your invisible son? Does he like it? ]
[Serena Blain (Home Visit)
Serena is a very typical and a difficult case for us. In the sense that there is no magic bullet here and there is no cure for mental illness. What we can hope for is for maintenance. And so you have to change your notion of success. So, Serena sometimes falls off the wagon if you will. But the frequency with which she falls of the wagon is smaller. The frequency with which she is coming back in contact with law enforcement is smaller and the quality of her personal life is much better and we as tax payers are not picking up the bill for extensive jail, we are not picking up the bill for the extensive medical emergency care, and she's getting more sustained long term care at a cheaper cost.
[Rebecca Minnick (Grocery Store)
We just need bread, Ibuprofen and Ding-Dongs. ]
With the model like mental health court you get to see the success but it's also a testament to the failure, a breakdown that is occurring in our society.
THE DEMAND FOR SERVICES FAR EXCEEDS CAPACITY. NEARLY TWO HUNDRED THIRTY THOUSAND UTAHNS ARE IN NEED OF TREATMENT, BUT NOT RECEIVING CARE. UNCERTAIN FUNDING FURTHER ENDANGERS THE SYSTEM.
The source of money that has saved the public mental health system, the last two years, has been the federal stimulus money and without that money, the system would be in dire shape right now. When all of that money goes away, everybody keeps talking about falling off a cliff. You go along and all of the sudden, the drop is going to be monumental. There would be no safety net. Mental health centers and local authorities would be closing lots of programs. So increased suicides, increased incarceration, increased hospital costs; we pay for it, one way or the other you pay for it. And it's a king of, are you going to pay now or pay later?
We will spend the money, and we are spending it typically in the wrong places. If we can focus our funding on these programs that provide early intervention, that provide those wrap around services for people, we can get much better outcomes. The legislature appropriates the funding, and then its up to the agencies to decide how to best work together and what the priorities should be for the funding. And so we have a very fragmented system, and very siloed and the funding is siloed. And that makes it difficult to really build those true system wide changes that we need.
When the budget crisis hit the State of Utah, the very first thing on the table to be cut was prevention. The bulk of the treatment resources are spent on severely, mentally ill adults. I wouldn't want to see those individuals not receive care, but by focusing 70% of the treatment resources on that adult population, that leaves only 30% or so of the resources for children and that is our next generation of adult mental health consumers.
If we could really be focusing on identifying these illness early on in our children and youth, and providing good interventions that will help them achieve good outcomes. We can truly change the whole trajectory of their lives, but also the trajectory of the whole system.
[Sherri Wittwer (Capitol Hill)
Well that's a good point to make with your legislator. That's one of the issues.]
[Camille Houston (Capitol Hill)
We also all need to understand that like, our mental illness can either shape us or it can break us. ]
Camille Houston believes change is possible. She and other youth challenged with mental illness are determined to share their voices... meeting with Utah legislators to remind them that when it comes to mental health... funding matters.
Days like that where we allow the youth to truly tell their own stories and be their own powerful advocates is more than we can do as professionals.
She's one of my heroes. It used to be that she was a little ashamed or embarrassed of her illness and stuff, but she's pretty outspoken now and she wants to be an advocate for other kids that maybe are struggling and going through the same kind of thing.
Mental illness is a young person's disease. Fifty percent of all lifetime mental health cases are diagnosed by age 14, and 75% are evident by age 26. early intervention can save lives.
The intervention from an early standpoint has to do with getting the kid back on the developmental track as early as possible, and then recognizing an untreated mental illness... lets say a kid has re-occurring depression, or has bi-polar disorder, not treating that we find that as a kid get older, untreated, those events, and those, those whether you call them spells or whatever, get harder to treat, more severe.
The earlier you can get treatment and the more stable they are the longer they are, then the more they're able to learn and grow and progress like other kids, you know, but if they're fighting this mental illness all of the time, and especially if it's a thought disorder, and so they're fighting, you know, thoughts and voices, and all this chaos in their head, it's like having 25 different TV channels going all at the same time, you know, they're not able to absorb a lot of things at school, education, social cues, you know, things that other kids just pick up on.
The place that has the most consistent, both experience of, and knowledge of a kid, is the school systems, and we at this point have put a lot of burden on the school systems. The challenge is we don't have the budgets, and the schools don't have the funding.
The waiting list is long, and resources for school-based mental health services in utah are dwindling. but EDUCATING AT-risk mentally ILL students in PUBLIC SCHOOLS WORKS.
We already know what works. We know what supports can be put in place so they actually can do well in their education system, not be pulled out, not have to go to some other school that's not their home-based school, or be put in the state hospital or a residential setting. To truly allow them opportunities to be successful in their own community is huge because all outcome studies show that the kids tend to do better when you keep them in their own community and let the community offer the supports.
Joe what do you think?]
In addition to the school staff, that we have behavioral aides, we have a therapist in that program. If kid needs meds there's a prescriber that's part of that program.
We have an amazing staff here, and they cheer and root these kids on every single day, and it's very, very hard, challenging and demanding sometimes to do that when kids are saying or doing some very offensive things to you because that's part of their, I think their whole defense mechanism and their safety zone. But we do see kids make success. When they're in elementary school we really do circle the wagons and we put so much effort and emphasis into trying to shape behaviors and develop skills. When they move across that bridge to junior high I think there's this expectation that, you know, when you become 12 years old you're more accountable for your behaviors. There are not maybe as much coddling or second chances, and so when kids get into that age range, there's more intervention with the juvenile court system.
I'm doing community service here by boarding dogs, feeding cats, feeding dogs. I was found in possession of a stolen laptop that I bought for thirty dollars, and that's why I'm here.
He turned around and he got himself in trouble and there's no doubt in my mind that if we would have been able to maintain the level of medication that he had, this wouldn't have happened. If Derek were physically handicapped, he would have every resource open to him in the world. He now has the parole officer. After meeting with the parole officer tuned us into this NAMI, and we finally got the resources, and we've got the help. Hopefully this will go in a positive direction, because unfortunately for Derek, if it doesn't, next year he does not go before the juvenile judge anymore. He's 18 years old, and now he becomes a, he's going to become a ward of the state, so to speak.
Derek is only one step away from the hard experience of adult jail. Hundreds of Utah teenagers are in the same situation. UTAH'S small Coordination of Care Court, OR C3, tries to catch young lives falling through the system.
And really the whole premise of the whole program is really to try to catch kids who have mental health issues who have had maybe one or two offenses, so they don't keep cycling farther and further into the juvenile justice system and the criminal system. And we try to do some really innovative kind of things to try to help them, a) minimize their criminality but also to really motivate them to really become more engaged in their therapy and management. So a weekly commitment, both for parents and kids, so if they agree they go through an orientation, they're part of it. Once they're in that can't get out unless the judge lets them go.
The most important thing to remember is that these are, I don't want to use children because they are adolescents and youths, but they are children, and they're going through their developmental stages. You know, a typical teenager is going to have an attitude of some type or another, and, you know, the kids in the C3 program are no different from that. The issue becomes, at some point in time or another, this child is going to grow up and be an adult, and if a child learns to be assaultive and doesn't experience a consequence from that, they may progress into adulthood thinking that that's ok, and then the first time after their 18th birthday when they hit somebody, you know, suddenly have a very, very rude awakening, you know, as in being booked into jail, and yes jail might identify a mental health problem, but they're still going to be into the adult system, and you know, really their life will become a nightmare at that point in time.
Life on the street is life on the edge for mentally ill youth in Salt Lake City. Their lives are shaped by crime, drugs, homelessness, and uncertainty. One third of homeless youth in Utah report attempting suicide. Many average more than three ATTEMPTS.
I was diagnosed with schizophrenia when I was 14 years old. I don't really like to use labels because it's not really beneficial, and to say that I'm a schizophrenic homeless girl, it doesn't define me.
Khearsten Emmons has been struggling with symptoms of schizophrenia since childhood. Although Khearsten has found stability through medication, this year she was arrested for repeatedly riding the UTA trax system without paying. She was booked in the Salt Lake County Jail, psychologically assessed, and medicated.
I actually cut myself while I was in jail, and they ended up taking me up to acute unit, which isn't the most pleasant place to be; they take your clothes, they strip search you when you come in, and then they take your clothes, and depending on your suicide risk they either give you a blanket or a smock to wear. I got the smock because I cut myself. I was a suicide risk. It's just not a place that I really want to be anymore, and I don't want to go again. That was my first and hopefully my only time to jail.
OVER 300 UTAHNS DIE BY SUICIDE EACH YEAR. THE MAJORITY HAVE UNTREATED MENTAL ILLNESS.
Well, I couldn't keep down or hold a job, got out of the hospital, by spending six months at a hospital. I wanted to do anything to get out of that hospital, so I played a good girl for a couple of months, got out, but I was so totally alone. I didn't have any friends, because I pushed them all away, and then they didn't want anything to do with me because of my behaviors. Like I said, one day I'd be fine the next day I'd be in the hospital nobody understood that. But I couldn't hang on any longer, and so I bought a gun and went up the canyons and put the gun to my head, put three bullets in a six-loader gun and was playing Russian Roulette, and the gun went off and woke me up. I thought 'oh my hell, what have I got myself into?' So I drove back down to Salt Lake walked into my old therapists office with a gun to my head, I says 'help!'
FOR EVERY CRY FOR HELP THAT IS HEARD, OTHERS ARE NEVER ANSWERED. MENTAL ILLNESS STILL CARRIES SO MUCH STIGMA, THAT MUCH OF SOCIETY STILL CHOOSES TO TURN AWAY.
It's a hard road, you know, people once they know that you have that sort of condition, they think "oh that person is contagious," and they think it's like a deadly disease, they treat it like that, and it's really not. It's not something that can be passed on except through genetics. But like myself personally, I had a neighbor that lived right across the street from me, and when she found out that I had schizophrenia she wouldn't let me hang out with her daughter anymore because she thought I was crazy, and she thought that somehow that might rub off onto her daughter or something.
Being a teenager with mental illness is ridiculous, really it is. In elementary and junior high it was very rough for me. I was kind of an outcast since day one. I mean they'd get to know you and you'd think you're best friends and then right when they found out you're in Special ED, you're gone, you know, you're like no one, and sometimes it made me feel worthless and other times it made me who I am.
The thing is my dad, loved him dearly, but he was an LDS bishop, he was a full bird colonel in the Marine Corp., he was a state legislator, and he was a stake mission president, what else, just about everything. And back then, oh my goodness gracious don't say mental illness to him or me, Oh! Shh! Don't tell anybody, you know. You're not depressed. You just need to pray harder and go to church and this and this and this.
I was up front I didn't try to hide it because I didn't feel like it was something that should be hidden. It was an illness just like any other it just happened to be above the neck. I remember when she was in the hospital, I told a couple of people in our church community and I mean, not a phone call, not a meal, nothing. And they'd say, "well I don't know if you want me to tell anybody" and they were almost bringing on more stigma to us then was actually there.
When my son was diagnosed with bipolar disorder I was the queen of stigma. And it was, "no one will know that we have this in our family". I didn't know what it said about him and honestly I really didn't know what it said about me as a mother. What had I done wrong? And I went through, you know, what did I eat when I was pregnant? What did I do when he was growing up? Was I different with him than I was with my other children? And I didn't tell anybody. My closest friends didn't know about it. They knew that I seemed to be struggling; they didn't know what was happening.
My younger sister who is about 12 years younger than I am, you know, I tell her things, what Derek has done and this and that and the other thing and, she tells me I'm a bad mother.
A bad mother!
I don't really want to show my Aspergers because then it would be really hard for me to make friends. And I don't want that, I want to make friends easy.
There are some kids who feel the need to hide it. And that's, society's problem. I mean we've kind of made that, that way to feel like they have to hide what's going on with them because they don't want people to treat them differently. Especially if people find out they're on meds or they have been at the state hospital, that's automatic hands-off.
Stigma is a huge factor, and it's a huge factor in general with the fact that people typically don't address issues, don't look at, you know, "don't look at mental illness... don't, you know, don't go there".
We want to say, "You deserve it. You did something". Why do we want to say that? Because if we realize these are illnesses that there are illness like anyone can get them, that means we can get them. And that scares us. These are cruel diseases make no doubt about that. They are like cancer. And not everyone survives.
You always feel so helpless. There's the edge that I face with my own son who struggles with bipolar disorder. And, I do have my arms wrapped around him and I'm holding tightly onto him and doing everything in my power. But I live with that fear every day that it may not be enough.
You do feel like you're on the edge. The edge of sanity, the edge of something that's secure, that's solid, that's safe. And its scary to kind of be at that edge and look down and not know what's coming.
The edge is risky there's a jumping off point, a falling off point if you will, that means the end of a program, the end of a service, the end of someone's treatment, the end of your family members medication being paid for. Who knows what the edge can mean? It's always there though.
At the end of the day, it is about the ideals that we hold, the promises that we make to the most vulnerable in our community. It is about being able to go home at night and saying these are the highest values I have. This is what a civilized society is supposed to be about. This is what my role as an active citizen in my community is about.
It's so important to be educated, because if you're educated you're not going to be afraid of people with mental illness. To see someone change their whole life from living in hell with voices in your head all day long, wanting to commit suicide, to be able to hold down a job, get along with your family. You know they're people out there just like you and me. They need things too. They need love.
Anytime people don't understand things, by and large the majority of people who are mentally ill are not violent, are not criminals, and are just struggling in life.
It's not a character flaw. Mental illness is real and I would like people to realize that and to try and figure out ways to be able to make that somewhat normal for these kids so they don't feel like they stick out like a sore thumb.
The system is broke. That's what I've learned. The system is broke. And from what I can see in Derek and from what I saw from the 15th of July, is the day we went to court, there's a bunch of children out there that are forgotten.
I want just what everyone else wants, just to be happy and have friends, and just have people care about me... to love and be loved.
Oh you have to believe in hope, if for not other reason, because it's your loved one. And we are making advances scientifically, but most important of all, again, we, we're we know how to help people. That's what's frustrating. Let's just do it!