(I posted this originally on my campaign site but I wanted to carry it here as well. Mental illness and the people who suffer from it are so thoroughly misunderstood, but for those of us who work with them so darned interesting at the same time.)
Mental illness is a bigger problem than people who don’t work with the mentally ill are willing to admit. Part of the problem is the lack of awareness to how much of a problem we are facing. For most of us, the mentally ill are those people wandering around downtown with multiple layers of clothing and muttering to themselves. But the mentally ill include high school honor roll students who are cheerleaders and commit suicide. More people die from suicides than from car crashes, but we always see Public Service Announcements on TV that tell us not to drink and drive, or to drive carefully. How many public services ads do you see about mental illness?
In Montana, we suffer from a shortage of available mental health caregivers. Professionals who are trained to diagnose, treat and care for the mentally ill deserve our greatest appreciation. But we don’t have enough. Right now, if someone is suffering from severe depression in Missoula, they will either have to wait for up to four months to get an appointment to see a psychiatrist, or the county attorney will have to get a court to order that they be involuntarily committed to Warm Springs, which is also understaffed and overcrowded.
What we need are regional crisis beds that can be used to provide protection and care for someone who is a potential risk to themselves or others for up to ten days. Believe it or not, there is actually a cost savings in having these kind of facilities, because many county budgets are being depleted by transporting the mentally ill to Warm Springs for incarceration up to 90 days. Plus, keeping the patient in the vicinity of family and friends can be enormously beneficial to long term treatment in the community.
We also need to examine if there should be more people who can provide care. Specifically, I am thinking that PhD. psychologists should be trained and given the authority to prescribe drugs to help the psychotic, the schizophrenic and the manic-depressives that exist in our community. We should also look at trying to recruit psychiatric nurses who could function under the supervision of an M.D. and provide care to those who need it.
While this cause is important to me, I have delayed posting on it waiting for the Supreme Court to rule on an appeal that I filed that involved a hopelessly psychotic individual who thought he was being attacked by the devil in the form of an 86 year old woman. After his arrest, he was sent to Warm Springs, where he was medicated to the point that he could stand trial.
In Montana, we do not have an insanity defense. If it is your conscious object to swing your fist, even though you may honestly believe that you are swinging at the devil, you are guilty of the crime. As a result, the client, who also became my friend was sentenced to be in custody for 40 years. He first went to Warm Springs, where they verified that he was still doing well while under medication, and they transferred him to the Montana State Prison to serve out the remainder of his sentence. At least he won’t be alone. Some estimates put the number of inmates in Deer Lodge on psychotropic medicine to be near half.
I would like to propose a change to the law that would allow someone who if found Guilty but Mentally Ill to be given another hearing before the sentencing judge when the maximum medical benefit has been reached to review the appropriate sentence. It may be that keeping the defendant under supervised probation that requires he maintain his drug treatments is more effective for the defendant and the community than simply replacing lunatic asylums with prisons.