The City Wire special report: Mental illness hits one in five persons

Editor’s note: This is the first in a series of stories on mental illness issues. Throughout 2010 The City Wire will attempt to post at least one story a month on this often hidden affliction.

story by Marla Cantrell
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Mental illness is something we whisper about, hoping the neighbors don’t hear. We skirt around the issue at family gatherings when we’re asked why Jennie is still living at home, why Sam refuses to leave his room, why Joe keeps ending up on the news.

But it’s out there on every corner, and if it hasn’t yet visited your family, it probably will.

The National Alliance on Mental Illness (NAMI) reports thats one in five people will be diagnosed with a mental disorder at some time in his or her life, and that 5% to 9% of the population will develop a serious mental condition.

Arkansas Rep. Tracy Pennartz, D-Fort Smith, spent more than two decades in behavioral health care. She understands the problem.

“I challenge you to find any family, during a family’s lifetime, that doesn’t have some kind of mental health problem,” Pennartz said. “Not a mental illness maybe but a mental health problem. For example, here in Fort Smith, we had a lot of people laid off from work. To expect them not to be depressed about that is unrealistic. And in some cases, if the depression is prolonged, they may seek out mental health counseling for that.”

FAILING GRADE
The issue crosses every socioeconomic boundary. But its prevalence is not enough to crush the stigma attached to it, or keep Arkansas from getting a failing grade in corralling it. In March, NAMI gave the state an F, citing problems such as lack of implementing evidence-based practices to treat mental illness, no mental health courts — which would work in much the same way as drug courts — and a deficiency in law enforcement training. In 2006, Arkansas was given a D- from NAMI. Arkansas was one of six states receiving a failing grade. Oklahoma received a B. No state received and A and the national average was a D.

Kim Arnold, executive director of NAMI Arkansas, said they appreciate the challenges officers face in dealing with the mentally ill.

“We’re not saying the police aren’t doing what they’re trained to do, but we are saying the police are losing one valuable piece in this,” Arnold said. “How do you recognize mental illness? How do you treat a person who has a mental illness? Crisis Intervention Team, which was developed in Memphis, pairs up mental health professionals and police officers to actually do this together. It’s about a 40-hour course that trains a police officer how to recognize symptoms or situations where a person could be experiencing a mental illness or episode where the person is behaving in an erratic or very disorganized way.”

In 2007, the Arkansas Legislature passed an act that required the Criminal Justice Institute to write a curriculum and help train officers. NAMI didn’t understand why another program was being developed when the Crisis Intervention Team program already existed. And that bill did not make the training mandatory.

The Fort Smith Police Department does receive training both at the academy and in follow up refresher courses.

“We’ve sent a division commander to training and he teaches a refresher course on it every three years,” Fort Smith Police Sergeant Jim Harris said. “There’s no set standard on how much training we get, so it’s up to the academy on how much they present. … “We could always use more training in everything. We just don’t have enough time in the day. The fact that we do it every three years is more than some agencies get to do.”

Lt. Brent Grill, with the Van Buren Police Department, said his department struggles because the city doesn’t have a facility for those with mental illnesses.

“The problem we, as law enforcement deal with, is there is no place in Van Buren to take someone that may need help with their mental illness,” Grill said. “If the person is a threat to him or herself at the time that makes things a little different. The average person who is mentally ill probably will not get assistance from law enforcement. … I will say that this subject is often discussed and what law enforcement needs to do.  Recognizing the problem and what area law enforcement has the authority to do, is the question that has not been answered.”

A report by the Brazelon Center released in June found 14.5% of men and 31% of women in the jails they studied had serious mental illnesses. It’s a large number. In 2007, 13 million Americans spent time in jail.

FAMILY COSTS
Jack Baker, facilitator for the Fort Smith NAMI support group, has met a police officer or two since his son was diagnosed with schizophrenia. Fourteen years ago he and his wife Lisa Huckelbury realized one of their five sons was mentally ill. There were episodes of violence. And he was a strong boy — 6’4” and 240 pounds. The couple didn’t know what to do. They searched for help, but found little. The teen was eventually diagnosed with schizophrenia. Today, he lives in a facility in Hot Springs and is doing well.

While dealing with the chaos, the family also had to worry about their bank account.

“We saw real quick we were going to have to take advantage of state funding through Social Security Disability,” Baker said. “He had numerous files and so it was a fight getting him on there. That allows you to take them to different facilities and have them in-house treated. It’s about the only way to afford mental illness. Otherwise, you’re spending ten grand ($10,000) a month.”

Arnold said the burden for families like Baker’s are great.

“There are many in our state that will accept pay sources such as insurance, Medicaid or Medicare but very few that will accept persons with no insurance and then offer a fee reduction or a sliding fee scale,” Arnold said. “Those places that are federally mandated to do so are the Community Health Centers in our state and they are throughout the state in 15 catchment areas.”

STATE COSTS
The state tries, Arnold said, but falling revenues continue to be a problem.

“Community Mental Health Centers are mandated to see and treat persons who have no pay source, but they have not had many, if any increases in what they receive in funding to do that for quite some time,” Arnold said. “Yet they have endured cuts in funds and increases in those who fall into that category.”

Pennartz believes Arkansas is doing a good job addressing the issue and Fort Smith is doing particularly well.

“We are fortunate in Fort Smith. We’re the state’s second largest city and a health care provider not just for the city but for the region,” Pennartz said. “We provide services for people within 60 minutes from the city. We have two major medical centers.  … And there are in excess of 60 mental health care clinics across the state.”

The Arkansas Division of Behavioral Health Services, which includes the Arkansas Health Center, reports its total biennial budget for 2009-11 as $165.34 million the first year and $166.02 million the second. The division also runs the Alcohol and Drug Abuse Prevention Program.

SUICIDE REPORTING
NAMI said mental disorders are the leading cause of disability and without treatment the effects are staggering. NAMI estimates the cost of untreated mental illness is $100 billion dollars per year in the U.S. Further, those affected can face homelessness, incarceration, substance abuse and suicide.

Baker cringes at the thought of those lost lives. Just two weeks ago he lost his first group member to suicide.

“I lost my first one two weeks ago after twelve years,” Baker said, wiping away tears. “I helped her every day. She was like a kid. A 46-year-old kid.”

The Van Buren man has a radical idea for local newspapers. He wants them to report suicides so that the breadth of the problem can be brought to light.

Baker and Arnold are watching the health care reform bill closely. Arnold said NAMI supported the House bill and is waiting to see what changes evolve in the Senate’s version.

In the meantime, Baker is offering help of his own. It’s called the Family to Family program he now helps teach during NAMI support meetings in Fort Smith.

“It changed our life,” Baker said. “It educated us about mental illness, not only the different types but the characteristics of each disorder. If we hadn’t gone to that we probably would have lost it. It was a very frustrating five year period there. We got through it, but it was a living hell.”

The NAMI support group meets at 6:30 p.m., the third Thursday of each month in the Western Arkansas Guidance and Counseling Center in Fort Smith. For more information, contact Baker at 883-1212. He answers his phone 24 hours a day.