Friday, April 27, 2007


Dangerousness and Mental Illness

Read the study here:

July 18, 2006

New Factors Identified for Predicting Violence in Schizophrenia

A study of adults with schizophrenia showed that symptoms of losing contact with reality, such as delusions and hallucinations, increased the odds of serious violence nearly threefold. The odds were only about one-fourth as high in patients with symptoms of reduced emotions and behaviors, such as flat facial expression, social withdrawal, and infrequent speaking. Results of the study, which was conducted in patients in real-world community settings as part of the NIMH-funded Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE), were published in the May 2006 issue of the Archives of General Psychiatry. Jeffrey A. Lieberman, M.D., of Columbia University, was the principal investigator.
Overall, the amount of violence committed by people with schizophrenia is small, and only 1 percent of the U.S. population has schizophrenia. Of the 1,140 participants in this analysis, 80.9 percent reported no violence, while 3.6 percent reported engaging in serious violence in the past six months. Serious violence was defined as assault resulting in injury, use of a lethal weapon, or sexual assault. During the same period, 15.5 percent of participants reported engaging in minor violence, such as simple assault without injury or weapon. By comparison, about 2 percent of the general population without psychiatric disorder engages in any violent behavior in a one-year period, according to the NIMH-funded Epidemiologic Catchment Area Study.
The researchers found that the odds of violence also varied with factors other than psychotic symptoms. For example, serious violence was associated with depressive symptoms, conduct problems in childhood, and having been victimized, physically or sexually; minor violence was associated with co-occurring substance abuse. Participants who lived alone had lower rates of violence than those living with families. However, participants living with families they felt "listened to them most of the time" had half the rate of violence of those living with less supportive families.
Serious violent behavior, while generally uncommon in people with schizophrenia, can have serious consequences. Knowledge about symptoms and characteristics that increase risk for violent behavior in individual patients is crucial for developing effective ways to manage schizophrenia and allow people with the illness to successfully engage in daily living.
Data from the CATIE project have been analyzed in a number of studies funded by NIMH. This analysis of CATIE-generated data was funded by the Foundation of Hope and an NIMH grant.
Swanson JW, Swartz MS, Van Dorn RA, Elbogen EB, Wagner HR, Rosenheck RA, Stroup TS, McEvoy JP, Lieberman JA. A National Study of Violent Behavior in Persons With Schizophrenia. Archives of General Psychiatry 63:490-499. May 2006.

Thursday, April 26, 2007


Listen to Radio Show on Mental Illness

Go here to listen to program:

or try this:


Saturday, April 07, 2007

ENEWS - TREATMENT ADVOCACY CENTERTREATMENT ADVOCACY CENTERVisit our web site www.treatmentadvocacycenter.orgBlog TAC - 6, 2007******************************1. LEGISLATION NEEDED TO HELP MENTALLY ILL - Daily News, April 4, 20072. MENTALLY ILL NEED MORE THAN PRISON OR THE STREETS, ETHICIST SAYS - Catholic Register, March 13, 20073. HOMELESS MYTHS DIMINISH THEM, AND US - St. Petersburg Times, March 28, 2007 4. WHY MOST OF THE HOMELESS ARE INTRACTABLE IN FACE OF ATTEMPTS TO HELP THEM - Wall Street Journal, January 31, 20075. SHELTERS FOR DICKENS, SHAKESPEARE AND THE HOMELESS - Los Angeles Times, April 1, 20076. MENTAL ILLNESS LINKED TO DISAPPEARANCE, STUDENT SAYS - The California Aggie, March 12, 2007******************************1. DAILY NEWS (Los Angeles), April 4, 2007[Editor's Note: A supervisor of our nation's largest county, an ethicist, an outreach specialist, an economics professor, and a librarian - in this E-news each of this disparate group offers his perspective of homelessness and, more particularly, of those who are so because of untreated and severe psychiatric disorders.First is Los Angeles County Supervisor Michael Antonovich, who clearly understands that helping the 35,000 people in his county who are both chronically homeless and suffer from a severe mental illness or substance addiction requires more than just an ample supply of room keys.]LEGISLATION NEEDED TO HELP MENTALLY ILLOp-ed By Michael Antonovich The solution to the homeless problem in Los Angeles County is not to spread it to other communities but to reduce the number of people who are homeless.Skid Row, near Los Angeles City's downtown, has the highest concentration of homeless individuals. The Los Angeles Homeless Services Authority census revealed that a majority of the nearly 35,000 chronically homeless in Los Angeles County suffer from mental illness and/or addiction to drugs and alcohol. To solve the homelessness problem, fundamental reform of our mental health laws must be accomplished including mandatory psychological, alcohol and drug-abuse treatment. However, these necessary reforms continue to be opposed by groups aligned with the American Civil Liberties Union and like-minded legislators. The solution is not forcing them into neighboring cities and communities, as suggested by the downtown special interests looking to profit on the area's new high property values as evidenced by the ill-advised taxpayer subsidy of the Grand Avenue Project. While community-based treatment facilities, stabilization centers, family access centers, and transitional housing are valuable temporary tools to treat symptoms of homelessness, they must provide proactive access to medical treatment that addresses mental illness and rehabilitation for alcohol/drug addiction. As we roll out new services throughout the county of Los Angeles, facilities need to be established and operated with the support and participation of the community. Long-term success for shelters and treatment centers depends on cooperative working relationships with local government, business, service organizations, faith-based groups and community volunteers.An example of a successful public/private partnership is Pasadena's Union Station Foundation. Since 1973, it has provided emergency and transitional housing for individuals and families, hot meals, job development, health care, case management services, and vital mental health care and substance abuse rehabilitation. The Antelope Valley's Lancaster Homeless Shelter, operated by Catholic Charities, recently added 52 more transitional housing units for adults with the $1 million grant we secured for this project. The proposed St. Joseph's Manor in the Antelope Valley will use county and private contributions to house, support and inspire homeless clients in the Antelope Valley. Penny Lane's new Lancaster center is another superb example of the community working together in a united effort to provide housing and services to emancipated youths at risk of becoming homeless. We initiated the Los Angeles County Emergency Outreach Call Center and hotline at (800) 854-7771 and launched the Network of Care Web site at All of these programs and housing projects fall short of our goal of long-term solutions for ending the homeless problem. The long-term solution requires state legislation to reform the dysfunctional mental health laws. Local experience continues to demonstrate that those suffering from mental illness and/or alcohol or substance abuse require mandatory treatment. ---Michael D. Antonovich is a Los Angeles County supervisor. ******************************2. CATHOLIC REGISTER, March 13, 2007[Editor's Note: It has many names, but our society holds no ideal more sacrosanct - self-determination, autonomy, liberty. Indeed, protecting the right to choose one's own course is indelibly ingrained in our nation's character. Restrictions of individual freedom of action must overcome a rightly intense prejudice against them - doing so solely to help an individual is rarely enough.Take someone who is homeless. If the person, while fully aware of and able to assess the alternatives, chooses to be homeless, few would argue that anyone should be able to dictate otherwise. The scenario shifts, however, when the affects of an acute psychiatric disorder severely impair that person's ability to rationally make that decision. The choice is no longer between whether or not to override the person's right to choose what his best for him; he is no longer able to do so. Instead, the alternatives change to either aid the person or to leave him to the symptoms of his illness.Philosopher and bioethicist Barry Brown's take on the interplay between mental illness and autonomy is described in the article below.]MENTALLY ILL NEED MORE THAN PRISON OR THE STREETS, ETHICIST SAYS By Michael Swan TORONTO, Canada (The Catholic Register) - Putting a person in jail for being sick might sound extreme, barbarous and unreasonable, but 40 percent of the inmates in Canada's prison systems suffer mental illness and approximately 35 percent of the homeless suffer serious forms of mental illness. Philosopher and bioethicist Barry Brown argues that society should do more for the mentally ill than tossing them in jail or out on the street. The problem, according to Brown, is how personal autonomy rules as almost the sole value in the ethics of health care. In the annual Cardinal Ambrozic Lecture presented by the Canadian Catholic Bioethics Institute March 2, Brown argued that doctors and health care administrators have to find ways to continue treating mentally ill patients who refuse treatment or deny their illness. Laws that allow any adult to refuse treatment so long as they do not present a danger to themselves or others, and they show some understanding of the consequences of refusing treatment, have resulted in the social tragedy of vulnerable people sleeping on subway grates and being arrested for nuisance crimes, Brown said. Extreme deference to personal autonomy has meant patients who are only marginally competent routinely refuse treatment for manic depression, schizophrenia and dissociative disorders. So long as patients are violent or delusional, the law says they may be treated against their wishes. As soon as the treatment begins to work, patients may refuse treatment and are routinely returned to the street, Brown said. "The right to refuse treatment when one is marginally competent takes autonomy to an extreme," said the retired University of Toronto professor of philosophy. Brown argues patients should be pressured to continue treatment if non-treatment is likely to result in homelessness, run-ins with police or readmission to hospital in the medium- to long-term future. The health care system has granted mental health patients "an autonomy the exercise of which will lead to the eventual loss of autonomy," he said. Brown said he is not advocating the steamrolling of patient rights or return to the mid-20th-century asylum system. And the health-care system could avoid a constant crisis of having to determine who really is competent to refuse treatment with earlier intervention and by reducing the stigma which prevents two-thirds of mentally ill people from seeking treatment, he said. In a Catholic health care setting the legitimate right of personal autonomy should be balanced against the duty to care for one's own health, said Brown. ******************************3. ST. PETERSBURG TIMES (FL), March 28, 2007 [Editor's Note: Key to assessing how, and even whether, to help those who are homeless is to determine who among that population rationally prefer that lifestyle. No matter how bizarre or foolish choosing a life on the streets might appear, the fully-informed and competent selection of it should be respected. Richard Shireman, an outreach worker, spends his days among this population; he has found few who have chosen to be part of it.]HOMELESS MYTHS DIMINISH THEM, AND US Guest Column By Richard T Shireman Countless times since I began doing outreach work with the homeless, I've heard people say something like, "We should help the truly homeless, but we shouldn't help those who choose to be homeless." The speaker has said or implied that a significant percentage of the people who live on our streets do so by choice. These people are often referred to as vagrants, bums or transients. Regardless of the appellation applied to them, apparently many people believe that this population does not deserve any, or any more, help. In a recent letter to the editor, the writer divided our homeless population into three categories: 1. Those who are genuinely down on their luck and trying to get back on their feet. 2. Those who suffer from mental disorders but won't take their medication. 3. The majority, who have no intention of getting out of their homelessness. His third category, this "majority, who have no intention of getting out of their homelessness," is a fallacy. After working with this population for the past 14 months, I must conclude that the idea of a significant percentage of our homeless population being homeless by choice is a myth. A destructive, denigrating and cruel myth. My partner and I have worked with hundreds of homeless individuals. We have been privileged to hear their stories, hopes, fears, frustrations and pleas for assistance. We have met only one individual we thought might be homeless by choice. If we were to include with him the few people who would not speak with us or said that they didn't want our help, the sum would be less than 2 percent of our total contacts. Of course, that is assuming that not wanting to talk with the Outreach Team equates with being homeless by choice. The reality is that many people who appear to be lazy and irresponsible are suffering from serious, life-threatening addictions, have a mental illness, have been scarred by trauma or abuse in their past, or have some combination of these conditions. Oftentimes the "vagrants" or "bums" that are being decried as people unworthy of our compassion are the homeless alcoholics that populate our streets. Many people believe that these people live and behave the way they do because they freely choose this lifestyle. There is nothing free about their "choice" to live this way. In fact, many of the seriously ill alcoholics (who generate most of the complaints and police calls related to homelessness in our community) are aware of the fact that they are dying on our streets. They are profoundly ashamed of their behavior. They're depressed. They hate going to jail repeatedly. They hate being verbally abused, beat up and robbed. They hate being looked upon as subhuman. They hate being too cold, too hot, wet, and regularly feasted upon by fire ants, spiders and mosquitoes. Most have sought help many times for their addictions. They have had periods of sobriety. Of those who haunt the environs of downtown St. Petersburg, many have responded to the offers of the Outreach Team to go to detox or some other treatment facility. Unfortunately, it is the nature of addiction that the vast majority of people relapse. The homeless addict, with little or no resources and virtually no support network, relapses back to the street, back to "vagrancy." Even those who do not suffer from a life-threatening addiction or serious mental illness often are handicapped in ways that make it hard to describe their decisions as "free." Because of things that have happened to them, things that have been done to them, they lack the emotional and/or rational wherewithal to make free, informed decisions. Abuse, neglect, dysfunctional families and insufficient education are just some of the factors that account for many lacking the life skills that are required in order to make truly free, healthy decisions. When you consider that homelessness is a condition that robs one of self-esteem, motivation, hope and trust, it is not at all surprising that these people have difficulty making the choices that we think are appropriate for them. I am not suggesting that we should ignore or condone illegal, destructive or unhealthy behavior. I am saying that we should not embrace this myth simply because it allows us to ease our moral burden by relegating a significant portion of our homeless population to the "Deserves No Help" category. These sufferers need our help and compassion. Surely, this community has the compassion, resources, patience and integrity to continue reaching out to all of our homeless people. I believe that after a little thought and discussion, we will conclude that we must reject this convenient and destructive myth. Richard T. Shireman is an outreach specialist with Operation PAR Inc. and a member of the St. Petersburg Homeless Outreach Team.******************************4. WALL STREET JOURNAL, January 31, 2007[Editor's Note: Dave O'Neill, an economist, points the readers of the Wall Street Journal to one of the chief reason why 200,000 Americans with a severe mental illness are homeless - deinstitutionalization.] WHY MOST OF THE HOMELESS ARE INTRACTABLE IN FACE OF ATTEMPTS TO HELP THEMLetter to the EditorHow could Julia Vitullo-Martin ("Homeless in America," editorial page, Jan. 18) write a 1,300 word article on homelessness in America and not once mention the term "deinstitutionalization"? Almost every psychiatrist, from those that still think it was a good idea to essentially shut down our mental hospital system once thorazine, haldol and other drugs that control somewhat the symptoms of psychosis became available, to those, like Fuller Torrey who think it was a dangerous and ill-conceived movement, agrees that half or more of the chronic street homeless are severely mentally ill.It is estimated that today there are well over a million people with schizophrenia, major depression and bipolar disorder who, using 1960 standards, would be inside mental hospitals, are outside today. Some, the lucky ones, find treatment in either small private psychiatric hospitals or in special programs usually located in rural or suburban areas with almost a one-to-one counselor patient ratio and where their taking of medication is strictly monitored. But the others have been living lives that make even those depicted in the famous anti-mental hospital movie "The Snake Pit" seem not so bad in comparison. Instead of being released into lives more humane and caring than could be provided in a mental hospital, which was the basic goal of the deinstitutionalists, their fate has been either living in shelters, living in special shabby "hotels" for the mentally ill funded by Medicaid, living in the streets, or in the worst cases, criminal behavior leading to terms in prison orsudden outbursts of psychotic frenzy that lead to deaths of bystanders or themselves either as suicides or at the hands of police trying to subduethem.If this is the character of the major part of the homeless population, what is one to make of the survey of approaches to the problem presented by Ms. Vitullo-Martin? The one actual program described in detail in her article would be ludicrous as an approach to the homeless mentally ill if the problem were not so serious. This is the "Housing First" program in New York City. Its approach is not to watch or be concerned with what the program participants do in private, just their public behavior has to be monitored and sanctions applied. But the central problem of the homeless mentally ill is to get them in a highly monitored situation that will ensure they are taking their medication. Mayor Bloomberg is quoted as promising to take on the problem by getting tough with advocates for the homeless -- whatever that is supposed to mean. Most "advocates" are parents and relatives of the deinstitutionalized mentally ill who try to get better care for them. One wonders if he realizesthat there are between 20,000 to 30,000 street homeless with psychotic mental disease in the city, and that to really provide them with facilities and programs that would ensure they stay on their medications and avoid getting into trouble on the city streets would probably cost $1 billion to $2 billion, a mere 20% to 40% increase in what the city now spends on providing all medical care. Go get 'em,Mike.If President Bush's $4 billion effort to end street homelessness is going to be used for funding many programs like "Housing First," then its chance of making a dent in the huge fraction of homelessness due to deinstitutionalization is nil.Dave M. O'Neill O'Neill is adjunct professor of economics, Baruch College, CUNY; he was formerly a resident economist at the Nathan Kline Institute for Psychiatric Research, 1994-1998.******************************5. LOS ANGELES TIMES, April 1, 2007[Editor's Note: Those who suggest that homelessness is a choice for many seem to suggest that the value of an unbridled existence may, for some, outweigh the appeal of a more comfortable, stable, and healthful lifestyle. Imagine if every day that it rained, snowed, or was too cold that your local library essentially became your prison.]SHELTERS FOR DICKENS, SHAKESPEARE AND THE HOMELESS While We Look Away, Public Libraries Become Warehouses For Those Living On The Streets.Op-Ed By Chip WardChip Ward was, until recently, assistant director of the Salt Lake City Public Library. OPHELIA SITS BY THE FIREPLACE and mumbles softly, smiling and gesturing at no one in particular. She gazes out the window through the two pairs of glasses she wears at once. When her muttering disturbs the woman seated beside her, Ophelia turns, chuckles and explains, "Don't mind me, I'm dead." Not at all reassured, the woman gathers her belongings and moves quickly away. Ophelia shrugs. Verbal communication is tricky. She prefers telepathy, she says. Mick is having a bad day too. He has not misbehaved but sits and stares, glassy-eyed. This is usually the prelude to a seizure. His seizures are easier to deal with than Bob's, for instance, because he usually has them while seated and so, unlike Bob, he rarely hits his head and bleeds, nor does he ever soil his pants. Franklin sits quietly by the fireplace and reads a magazine about celebrities. He is fastidiously dressed and might be mistaken for a businessman or a professional. His demeanor is confident and normal. If you watch him closely, though, you will see him slowly slip his hand into the pocket of his sport coat and furtively pull out a long, shiny carpenter's nail. With it, he carefully pokes out the eyes of the celebs in any photo. These may sound like scenes from a psych ward. But in fact, this is the Salt Lake City Public Library, which, like virtually all the urban libraries in the nation, is a de facto daytime shelter for the city's homeless. It's also the place where I was, until recently, the assistant director. In bad weather, most of the homeless have nowhere to go but public places. Local shelters push them out at 6 in the morning and, even when the weather is good, they are already lining up by the time the library opens at 9 because they want to sit down and recover from the chilly dawn or use the restrooms. Fast-food restaurants, hotel lobbies, office foyers and shopping malls do not tolerate them for long. Public libraries, on the other hand, are open and tolerant, even inviting and entertaining places for them to seek refuge from a world that will not abide their often disheveled and odorous presentation, their odd and sometimes obnoxious behaviors and the awkward challenges they present. "Homeless" may not be a precise enough term for the people we see in the library. These are not the people for whom homelessness is a temporary, once-in-a-lifetime experience. The people we find in the library are those for whom homelessness is a way of life. We see them sleeping in parks, huddled over grates on sidewalks, resting on subway cars, passed out in doorways or panhandling with crude cardboard signs. Social workers refer to them as the chronically homeless, and studies of shelter users indicate that they make up 10% to 20% of the total homeless population. The most salient characteristic of these people is that most of them are mentally ill. The data on how many homeless are estimated to be mentally ill vary widely, between 10% and 70% - depending on whether all the homeless or just the chronically homeless are included and depending on how illness or disability are defined. How, for example, do you categorize alcoholics and drug addicts? When Crash is sober, for instance, he reasons like you or me and converses normally. Unfortunately, he is rarely sober. In one of his better moments, he petitioned me to let him stay in the library even though he had recently been caught drinking - an automatic six-month suspension. "C'mon, give me another chance," he pleaded. Crash was sitting in his wheelchair in the foyer outside my office. It was always hard for me to address Crash without staring at the massive scar on his face - a deep crease that divides it from his scalp to his chin. Unfortunately, his nose is also divided and the sides do not match up, giving him an asymmetrical appearance like a Picasso painting on wheels. "Alcoholics pass out in the library's chairs," I explained. "If you piss your pants or puke, the custodians have to clean that up, and they hate that. You guys fall down and knock things over. You're unpredictable when you drink. You disrupt others. Public intoxication is against the law.. " "OK, OK," he interrupted me, "I get it. Hey, just thought I'd try to get back in is all - no hard feelings, man." No hard feelings, I assured him. We shook hands. I wished I could cut him some slack, but I couldn't afford to establish a precedent I couldn't keep. The rule is clear: No drinking in the library, and no exceptions. As he waited for the elevator, I asked, "I know it's none of my business, but how did you get that scar?" "Car accident," he replied. "Same one as put me in this wheelchair. That's why they call me Crash." "Were you drinking?" I ask. He shakes his head "yes" and sighs. "Drunk as a skunk . drunk as a skunk." THE STRONG odor of mouthwash on the breath of the transient alcoholics is often masked by the overwhelming odor of old sweat, urine-stained pants and the bad-dairy smell that unwashed bodies and clothes give off. It can take your breath away. The library wrestles with where to draw the line on odor. The law is unclear. An aggressive patron in New Jersey successfully sued a public library for banning him because of his body odor, and that has had a chilling effect on public libraries ever since. Library users frequently complain about the odor of transients, and librarians usually respond that there isn't much they can do about it. Lately, libraries are learning to write policies on odor that are more specific and so can be defended in court: The criteria for ejection must fit within a clear legal standard so that it won't be perceived by the court as a violation of the person's right to have access to the library. Even so, such rules are hard to enforce because odor is such a subjective thing - and humiliating someone by telling him he stinks is an awkward experience that librarians prefer to avoid. None of this was covered in library school. So where are we to turn for help? Social workers are too few, underfunded, overworked and overwhelmed. In the dead of winter, they struggle to get people who are sleeping in alleys or passed out on sidewalks indoors so they don't freeze to death. If a homeless guy is inside the library, then the view is, "Hey, mission accomplished." Local hospitals also are uncertain allies. They have little room for the indigent mentally ill and often can't get reimbursed for treating them. So they deal with the crisis at hand, fork over some pills and send them on their away. Paramedics are caught in the middle. In winter, we call them almost every day. Once, when I apologized for calling twice in one day, one emergency worker responded: "Hey, no need to explain." He swept his arm toward the other paramedics, who surrounded a disoriented old man. "Look at us," he said. "We're the mobile homeless clinic. This is what we do. All day long, day after day." The cost of this mad system is staggering. Cities that have tracked chronically homeless people estimate that a typical transient can cost taxpayers $20,000 to $150,000 a year. You could not design a more expensive, wasteful or ineffective way of providing healthcare to individuals who live on the street than by having librarians dispense it through paramedics and emergency rooms. Ultimately, the indigent mentally ill are criminalized, and we librarians are complicit. When we have no good choices, in the end, we just call the cops. Take, for example, the case of a young man who entered the library spouting racial and ethnic slurs. He loudly asked some Latino teenagers doing their homework when they had crossed the border, and they reported his rude behavior. When a security guard approached, the young man started yelling obscenities and then took a swing at him. The guard tried to calm him, but on the next lunge, the guard took him down, cuffed his hands behind his back and called the police. They recognized the man. He had been let out of jail just two days earlier. That man's behavior, of course, was not a measure of his character but of his psychosis. He was sick, not bad. If we accept that schizophrenia, for instance, is not the result of a character flaw or personal failing but of some chemical imbalance in the brain - an imbalance that can strike a person regardless of his or her values, beliefs, upbringing, social standing or intent, just like any other disease might strike one - then why do we apply to that mental illness a kind of moral judgment we wouldn't use in other medical situations? We do not, for example, jail a diabetic who is acting drunk because his body chemistry has become so unbalanced that he is going into insulin shock. BY WINTER'S end - our "homeless season" - those of us at the library often find ourselves hard put to cope with our own feelings of depression and frustration. As one library manager told me, "I struggle not to internalize what I experience here, but there are days I just go home and burst out in tears." She is considering leaving the profession. America is proud of its hyper-individualism. We glorify the accomplishments of inventors, entrepreneurs, pioneers and artists. Although some individuals thrive, the plight of the chronically homeless tells me that our communities are also fragmented and disintegrating. The Penan nomads of Sarawak, members of an indigenous and primal culture in Borneo, have no technology or material comforts that compare with our mighty achievements. But they have six words for "we." Sharing is an obligation and is expected. An American child is taught that homelessness is regrettable but inevitable because some people are bound to fail. A child of the Penan is taught that a poor man shames us all. Ophelia is not so far off after all - in a sense she is dead and has been so for some time. She is neglected, avoided, ignored, denied, overlooked, feared, detested, pitied and dismissed. She waits in the library, day after day, gazing at us through her multiple lenses and mumbling to her invisible friends. She is our shame. We pay lip service to her tragedy - then look away fast. As a library administrator, I hear the public express annoyance more often than not: "What are they doing in here?" "Can't you control them?" We hear you loud and clear, we answer. Please be patient; we are doing the best we can. Are you? Chip Ward was, until recently, assistant director of the Salt Lake City Public Library. A longer version of this article appears at******************************6. THE CALIFORNIA AGGIE (Davis, CA), March 12, 2007[Editor's Note: About one-third of those who are chronically homeless have a severe psychiatric disorder; a many times greater preponderance than in the general population. That, in of itself, should be enough to dispel that for these individuals homelessness is a lifestyle choice.It is also important to remember that the symptoms of the most common forms of schizophrenia and bipolar disorder arise suddenly in the late teens or twenties - at a point of life where many of those who will later become homeless have already established promising track records, ones that give no suggestion of what lies in the future. Many, like James Banks, are in college when their illness first strikes. Mr. Banks appears to have responded well to his medication and attained the mindset to maintain his treatment. Many do not.]MENTAL ILLNESS LINKED TO DISAPPEARANCE, STUDENT SAYS First-Year's Bipolar Disorder Diagnosis Prompts Awareness Of DiseaseBy: Talia Kennedy When first-year student James Banks, 19, left his residence at Thoreau Hall on the evening of Feb. 26, he thought the "world was coming to an end," he said. Banks couldn't sleep and he didn't feel tired, and he barely remembers leaving his Cuarto residence hall, the international agricultural development major said. When his parents didn't hear from Banks for a day -- and roommates noticed his cell phone, identification card and credit card had been left in his room -- they filed a missing person report with the UC Davis Police Department. Banks doesn't remember much of what happened between the time he left his residence hall and when Yolo County sheriff's officers located him walking on county roads 31 and 97D, but a diagnosis made at a hospital soon thereafter helped clarify the experience -- Banks has bipolar disorder, and he was experiencing his first episode of the mental illness. Though the police searched the UC Davis campus and surrounding area for Banks until Feb. 28, even soliciting media and public help in locating the student, sheriff's officers had already found Banks, he said, just west of Davis on Feb. 26 -- the same day he was last seen at Thoreau Hall. "They found me on the road without any clothes on," Banks said. "I don't remember anything. There were periods of consciousness and unconsciousness." The officers took Banks to Woodland Memorial Hospital and then to a Kaiser hospital in Sacramento, where he remained for about a week to recover. Campus police, friends and family didn't know Banks had been found because he did not give permission to have the news released until Wednesday, he said "They probably were asking me [to release the information]," Banks said. "I don't remember anything." Banks spent his time in the hospital taking medication, which he'll have to take for the rest of his life to treat the disorder, and attending group sessions, including arts and crafts workshops, he said. The experience has changed how some see him, Banks said. "My family realized how precious I was to them," he said. "My roommates were glad to see me back. People aren't as silly around me now -- it's helped people become more mature, including myself. "On the whole, I think the experience was good for me -- but it's also a dangerous thing," he said. Now back to his normal routine, Banks said he meets with a social worker and a psychiatrist on a regular basis. While he is not seeking attention because of his illness, Banks said his experience could help make other students aware of mental illnesses and their symptoms. "If I raise some awareness about bipolar disorder, that would be fine with me," he said. ****************************** Treatment Advocacy Center E-NEWS is a publication of the Treatment Advocacy Center.This E-NEWS is provided as a public service by the Treatment Advocacy Center. There is no fee. If you would also like to receive a free subscription to the Catalyst, our periodic hardcopy newsletter, please forward your mailing address to Center does not accept donations from pharmaceutical companies. Support from individuals who share our mission, however, is essential to our ability to effectively help our most vulnerable citizens. The Treatment Advocacy Center is a 501(c)(3) not-for-profit organization. All contributions are tax-deductible to the extent allowed by law. Donations to the Treatment Advocacy Center should be sent to: Treatment Advocacy Center200 North Glebe Road, Suite 730Arlington, VA 22203703-294-6001 (main no.)703-294-6010 (fax)

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