Shattering the Many Myths of Mental Illness

For most of my life, I knew nothing of mental illness. I knew no one who suffered from it and, as far as I knew, my family had never been touched by it.

This relative state of bliss exploded when my normally rock-solid 74-year-old father fell into a depression so severe that he was suicidal and needed hospitalization. When my mother mentioned “mental illness,” I cringed. Wasn’t she overstating the problem? After all, he was only depressed.

“Only depressed” became a lethal condition when, at his insistence and against my mother’s urgings, the doctors let him walk out of the hospital doors and, shortly thereafter, kill himself.

Since then, I’ve been a lightning rod for people with mental illness. In fact, I guess you could say I’ve gathered them like asphalt gathers skid marks. What I’ve learned in this eight-year saga could fill a book. What I want to convey is this:

Too many people who suffer brain disorders want so desperately to be regarded as normal that they would rather fall to the street or be criminalized than seek help for a problem they are not capable of recognizing or owning. Because of their lack of insight into their illnesses, the stigma and the lack of resources, as many as two-thirds of people with schizophrenia are at risk of becoming homeless.

Where did I learn these statistics? Dr. Stephen Seager’s book, “Street Crazy: The Tragedy of the Homeless Mentally Ill,” has branded the numbers into my consciousness. But looking back at the skid marks on my life, I’ve seen these statistics played out in my circle of friends and family. My son, my son’s girlfriend and two close friends all experienced homelessness because of their mental illness. I offered shelter to them for different periods at my home in Ojai. But when their problems became unmanageable, everything around them spun out of control.

The most compliant of the four found assistance at the Transition House in Santa Barbara. At the 11th hour of a three-month-stay limit there, the compliant one found a miraculous opening at Sanctuary House. Regrettably, this example of a safety net working with just-in-time precision is more the exception than the norm.

The three others all ended up rejecting medications and treatment--and after a series of failures, breezed through the Salvation Army, slept in vacant office buildings as far north as San Luis Obispo and inhabited the winter shelter at Santa Barbara’s Veteran’s Memorial building. One landed in a sleazy downtown Ventura hotel after a number of hospitalizations, due to the lack of transitional facilities and county resources for people suffering brain disorders. With the other two, I’ve painfully had to sever contact because of their inability to accept their illnesses and their need for treatment, a course other friends and family members have also found necessary.

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What prevents ill people from seeking or receiving treatment? What causes lives and family relationships to deteriorate to the point that ill people walk our streets, sleep in doorways and haunt our jails? What happened to the community resources that were promised to replace our state hospitals when they began closing 30 years ago?

These are the questions we will address at A Call to Action, a regional conference and luncheon to be held Friday at Four Points Sheraton at Ventura Harbor. The keynote speaker will be Dr. Seager, a psychiatrist who has worked for more than nine years treating the homeless mentally ill in a neighboring county. He calls the circumstances that have brought our homeless mentally ill to this point a moral outrage.

As organizer of the event, I’m delighted that advance reservations have topped 200. I’m equally disconcerted at the myths and misconceptions I’ve encountered in talking to people about the problems of the homeless mentally ill. I think some of them are worth exploring.

‘Not in My Town’

Myth: We don’t have a homeless problem. Our interests are to support problems related to our community, and these don’t include mental illness and homelessness.

Facts: Lack of services doesn’t mean lack of neighbors who suffer from mental illness and resulting homelessness. Because one in 100 people suffers schizophrenia and 1.2 in 100 suffer bipolar disorder, I would estimate that even a small enclave such as the Ojai Valley with its population of nearly 25,000 has 725 people with these major brain disorders. I have not begun to consider the number of individuals suffering major depression. That figure would include one in four people at some point in their lives.

Because Ventura County has no residential facilities or transitional services for the mentally ill, all stricken residents find themselves desperately looking outside their community--and the county--for assistance. When hospitalized patients lose their capacity to care for themselves or become too combative for families to care for at home, they frequently end up homeless.

Beggars vs. Businesses

Myths: Although panhandling is one of our top problems in downtown areas, there are those who think that because they don’t have a business downtown, it’s not their problem. If they do have a business downtown, the problem is too gargantuan, and business organizations don’t get involved in mental health issues--and neither can they open up such a messy can of worms without looking uncaring. After all, panhandling is basically a lifestyle choice, is it not?

Facts: One-fourth to one-half of homeless panhandlers suffer mental illness, treatable brain disorders. With appropriate treatment, as many as 80% of them could function at a much higher level. The 80% who can respond to treatment and the 20% who cannot are not being given the protections and safeguards that we offer to any other category of people suffering no-fault disabilities. For many mentally ill homeless, the only sanctuary from rape, muggings and alcohol abuse is time spent in jail. And treatment is not available there either.

The cost of incarcerating people who have committed crimes no more serious than loitering is twice the cost of appropriate levels of supervised residential care. This makes for a financial shell game in which the taxpayer loses. Downtown businesses, families and ill individuals lose too.

At the same moment Dr. Seager addresses the Call to Action conference, Ventura Mayor Jim Friedman will deliver his State of the City address to Ventura’s Chamber of Commerce. The mayor will no doubt explain why the city chose to eliminate funds to help the homeless last year. Uncaring as its actions resonate, Ventura has accomplished two important things with its unpopular stand:

* It has fairly called the county on its failure to address long-term solutions for the homeless.

* It has exposed the county’s reprehensible policy of dumping mentally ill people--even people from your community--into the downtown motels and hotels.

There are approximately 1,000 homeless mentally ill in Ventura County. They didn’t all originate in downtown Ventura.

Civil Rights

Myth: The Lanterman Petris Short (LPS) Act, California’s involuntary treatment law, protects the civil rights of people suffering mental illness.

Facts: Frank Lanterman, author of this law, which was enacted 30 years ago, has publicly said that he never intended it to prevent people suffering mental illness from receiving treatment, as it now does. Those who read Dr. Seager’s book or hear him speak will learn alarming details about how the LPS law prevents people with no insight into their illness from receiving treatment and how this abuse of the law has contributed to the problems of the homeless mentally ill.

According to the LPS law, doctors cannot involuntarily detain someone in the hospital for more than 72 hours without obtaining a legal conservatorship. What that meant for my father was that the law and time to heal were not on his side. As a result, my father--and, I should add, a number of Dr. Seager’s patients--are not alive today. Ironically, my father’s illness, depression, responds better to treatment than most other illnesses when given enough time. Dr. Seager maintains that he could have saved many of the casualties passing through the Los Angeles system.

I understand that much of the opposition to changes in the law stems from deep-seated fears of mental hospitals and well-publicized abuses that have occurred. People suffering mental illness hate the stigma associated with psychiatric hospitals, even when treatment there has helped save their lives. In addition, county health care systems fear an overflow of patients whom their bare-bones facilities are ill-equipped to serve.

Yet other states effectively handle involuntary treatment with outpatient programs. In Dane County, Wis., rehospitalization rates dropped 75% with enactment of outpatient commitment laws.

Because some lawmakers have begun to wake up to the problems created by current interpretations of the involuntary treatment laws, there is a statewide movement to change or repeal the law. This issue will be discussed March 4 at a public forum at the Ventura County Government Center.

Few subjects carry more myths than mental illness. I hope to help shatter these myths. That is why I encourage all concerned citizens to join our efforts at the Call to Action conference and luncheon to raise awareness and to show united community support for reforms needed in the system of care for our mentally ill brothers and sisters, friends and parents.

I encourage all citizens and community organizations to become informed enough to lobby our city, county, state and federal representatives for a comprehensive plan that will do more than make homelessness illegal and offer the mentally ill homeless more than a temporary winter shelter. If you can’t attend the conference, the Mental Health Players will bring a program to your group or organization.

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Two Ways to Learn More

FRIDAY

* A Call to Action, regional conference and luncheon, 8:30 a.m. to 1:30 p.m. at Four Points Sheraton at Ventura Harbor. Keynote speaker will be Dr. Stephen Seager, author of “Street Crazy: The Tragedy of the Homeless Mentally Ill.” For $18, conference participants who register by Monday will receive lunch and a copy of Dr. Seager’s book. Admission at the door will be $23. For information, call 648-2006.

MARCH 4

* Public forum on California’s involuntary treatment law, the Lanterman Petris Short Act, from 4 to 7 p.m. at the Hall of Administration, Ventura County Government Center, Lower Assembly Plaza, 800 S. Victoria Ave., Ventura. Written comments may be submitted to the Mental Health Board at 300 N. Hillmont Ave., Ventura, CA 93003. Admission is free. For information call 652-6737.