by: Joseph M. Bowers

One of my pet peeves is anti stigma PR campaigns. Much money that could go into treatment is spent uselessly. This is not to say that stigma is not a problem, but not just stigma among the general public but stigma among mental health professionals and, most damaging self-stigmatization among those of us with a serious mental illness diagnosis.

Too many people with a diagnosis of paranoid schizophrenia once so diagnosed lose all hope for the future. I have heard of professionals telling such patients that they will never be capable of taking care of themselves.

I recently read The Center Cannot Hold by Dr. Elyn Saks. Dr. Saks experienced severe and persistent symptoms of paranoid schizophrenia and tried with great gusto for more than a dozen years to get off medication. Meanwhile she graduated valedictorian from Vanderbilt, earned a masters degree from Oxford and a law degree from Yale. She is now a professor at USC.

This is a rare case and Elyn had the good fortune of coming from a reasonably well-to-do family. Dr. Saks obviously has a very high IQ. I don’t want to say that this is always possible or cast blame on those with extremely treatment resistant diseases who don’t respond significantly to any currently available treatment. Of those unable to recover to any appreciable degree, most often it is nobodies fault. There is no shame there.

Our self awareness is affected by feedback from those around us. Too often when led to believe we have no chance we do believe it and it becomes self fulfilling. I have encountered too many people with serious mental illnesses who are convinced they have no chance. Usually, this is just not so.

My story is in many ways similar to Dr. Saks and in significant ways very different. I did not come from an affluent family-quite the opposite and did not achieve nearly as much as she. But despite a diagnosis of paranoid schizophrenia shortly after turning seventeen and more than twenty years of recurring psychotic episodes, I have lived a reasonably successful and normal life. I realize that I am an outlier but my story is a story of hope.

I am very disappointed that my book, Life Under a Cloud. The Story of a Schizophrenic sold so few copies and had no major impact but feel it was worth the time and effort I gave to it. A friend and former coworker who read it told me he told a young man with schizophrenia about me and his face lit up thinking for the first time since getting the diagnosis that he might have a chance at a life worth living. I know of two people who have read it numerous times because it inspires them and gives them hope. A mental health professional I know tells me that she tells most of her patients about me and my story.

Getting to an advanced stage of recovery is not easy for anyone. My life has been very hard, but it has also been productive and rewarding. It’s simultaneously true that I wouldn’t want to ever go through it over again and that I wouldn’t have missed it for anything. A diagnosis of paranoid schizophrenia is not the end of hope for a decant life.

by Joseph M. Bowers

Tomorrow I’m scheduled to testify to a Colorado legislative committee on proposed legislation to fund more psychiatric beds in our state. Lacking confidence as a public speaker I like to have something prepared to read from in such instances so I wrote proposed testimony and ran it by two advocates I respect for feedback.

In my text I wrote that virtually everyone with a severe mental illness who doesn’t beforehand get needed care will sooner or later become involved with the criminal justice system. It might be a minor incident like trespassing or lighting a fire in the wrong place for cooking or warmth or it might be something serious like what happened at the Kings Sooper in Boulder a year ago.

One respected advocate wrote back that he loved my honesty and transparency but I should delete any reference to the Kings Sooper incident. After all the mentally ill are more likely to be victims than perpetrators. I couldn’t disagree more. There is little in this world more dangerous than paranoia or fear. People suffering with paranoid delusions live in a very scary world. NAMI and even the Treatment Advocacy Center have been saying that we are more often victims than perpetrators for years, but that turns out to be a widespread and deeply entrenched myth.

Because of my respect for NAMI and TAC I believed it and when D.J. Jaffe posted otherwise a few years ago, I called him on it. He sent me links to all the studies that had been done on the subject. Only one reached the politically correct conclusion. It was an outlier and seriously flawed. They had only considered people in treatment for a mental illness. This is less than half the population with a severe mental illness. Data says that those in treatment are indeed less likely to act out violently than the general population. Those not in treatment are more likely to.

DJ argued as he did because he believed spreading this misinformation was doing a disservice to families with a mentally ill member and the mentally ill themselves. I agree. Advocates want to believe that the mentally ill are not dangerous fearing demonizing and mistreatment. That is already too widespread. Perhaps if the general public saw severe mental illness as a threat they would be more inclined to try to do something about this crises we have created through years of neglect. Particularly if they were led to understand two other important facts.

That most people with mental illnesses properly treated will achieve some degree of recovery and many will achieve an advanced state and that the words and actions of a mentally ill person suffering from symptoms like paranoid delusions are not characteristic of who they are when not suffering from a severe illness of a major organ. Most people, I think, would agree that to punish someone for getting sick is barbaric and inhumane yet we do that to the mentally ill routinely.

Joseph M. Bowers

A blog I follow regularly is Mind You usually written by Marvin Ross or Dr. David Dawson. In a recent blog Marvin pointed out that society has more compassion for and better treatment of elderly people with Alzheimer’s or other forms of dementia than for people with schizophrenia. A person who commented on this blog believed that many people feel that somehow people with schizophrenia are culpable for their illnesses.

In a later blog Dr. Dawson speculated that this may be in some part because of mental illness and substance abuse being to such a degree lumped together. There is choice involved in substance abuse. There are many reasons why people become addicted to cigarettes’, alcohol, opiates and other addictive substances. Often it doesn’t feel like much choice is involved, but people can and sometimes do choose to get clean and stay clean. One can not choose to try mental illness or to recover from it. Some can with help learn how to keep symptoms at bay and deal with them effectively. Some can not improve much with any currently available method of treatment.

I think there are more reasons for many feeling little compassion for the severely mentally ill.

The thought of one’s brain seriously malfunctioning is very scary. Some assuage this fear by telling themselves that they are better than those with severe illnesses. They have more will power, stronger character. A coworker whose job was in jeopardy once told me that I had never experienced anything as bad as what he was going through. When I mentioned being institutionalized with severe mental illness, his comment was that he had never let something like that happen to him.

Many of these superior people will never experience a challenge as daunting as what many with severe mental illnesses deal with every day.

Then there is the belief among some that people get what they deserve in life. Good things happen to good people and vice versa. Wouldn’t that be nice! When going through more than twenty years of recurring psychotic episodes, I sometimes wondered if I was being punished for doing something just God awful in a previous life. I couldn’t think of anything I had done in this life to deserve what I was going through. Most of us I suspect have seen people get undeserved good or bad fortune.

I maintain that those of us with severe mental illnesses are not culpable and deserve as much compassion and care as the elderly with Alzheimer’s and other forms of dementia. Both conditions are tragic and undeserved.

by Joseph M. Bowers

Christian scholars and Popes have tended toward a narrow and negative view of sex. Augustine believed it the method by which original sin is passed on from one generation to another. Jesus has been thought of as asexual. Catholic priests have been expected to be celibate. Many of us were raised to be ashamed and leery of our sexual desires. Even as with the concept of original sin, there has been a lot of misogynism and double standards involved. Fathers proud of sons sowing wild oats while thinking of sexually active daughters as sluts.

A son recently observed that most of his male friends were getting a lot more sex with their wives when they were dating than after getting married. A female counselor, attempting to tell if a girl I was attracted to was attracted to me, asked if she had made any sexual advances. Women have and do tend to use their sexuality to attract someone they see as a potential mate. Traditionally most have sought a strong, aggressive, even sometimes violent person. Men have competed to establish themselves as alpha males.

Our most popular male movie stars have been people like Clint Eastwood, John Wayne and others who portray aggressive heroes often violently vanquishing evil doers. Gangster portrayals like “The Godfather” and “The Sopranos” are extremely popular. Our most violent sport is by far our most popular. In the country music song “The Coward of the County,” the protagonist is thought of as a coward until he abandons his principals and kicks the shit out of someone. My daughter recently admitted to her dismay that to see a man cry was a huge turn off for her. I could write a book full of examples.

All this is because of the traditional survival and mating advantages of aggression and dominance.

For most or our existence as a species, women have had to depend on a man to provide for and protect her and any children she might have in a dangerous world . Aggressive, even violent men have been more successful at mating and procreating. The ideal woman has been thought of as nurturing and submissive. As women become less dependent on men, I think, that is changing.

I agree with the Gloria Steinem statement that women’s liberation is men’s liberation. As our society becomes less misogynistic and more civilized, assertive women will become more welcome and accepted in the workplace. More and more women are taking leadership roles. More men are becoming comfortable displaying vulnerability and emotion other than anger. This and being nurturing are becoming less of a mating disadvantage for men.

Contrary to canonical and Christian tradition, Gnostic gospel depicts Jesus as kissing Miriam of Magdala on the lips and loving her more than the other disciples. He is depicted as being fully Devine and fully human-one with normal sexuality and desires. These gospels rejected by the early church but rediscovered in 1947 do not support the views on sexuality and healthy humans alluded to above. They suggest that far from being undesirable, sex acts can be the physical embodyment of holy union.

I have a friend who believes that intent is irrelevant. If something good comes of one’s action, his motivation doesn’t matter. I understand his line of reasoning but disagree. Intent is everything.

Men and women often engage in sex acts for profane reasons. When two people connect physically, spiritually and emotionally out of love for who and what the other is rather than what they can do for oneself in sexual union, it is in my opinion the most spiritual and holy act a human can engage in. As close to being Gods and Goddesses as we can get in this life. Truly connected to other than self. If God is love what could be more Godly?

Joseph M. Bowers

Many Americans believe that our government has been stolen from us. It wasn’t stolen. It was bought and paid for. It’s not that great a leap in logic to think that it has to be taken back by force if necessary. For Trump and many Republican leaders to incite this kind of violence through misinformation, lies and silence was not nearly as difficult as it might have been had both parties not ceased to serve and represent the common citizen some time ago. For Democrats to be all shocked and self righteous is wrong and unjustified. Democrats have as much to learn from this as Republicans.

Not every person who supported Trump was a racist, white supremist, misogynous, Qanon follower, conspiracy theorist, or deplorable of any sort. Many were solid citizens attracted by the fact that Trump wasn’t part of either political establishment, both of which they believed justifiably had deserted them. To them he might be someone who would give them back a voice.

It is time to transform our oligarchy back into a representative democracy. In this country we have often made major changes to our government through elections. May this last election and the violence following it prove to be sparks that return our government to all the citizens. The Republicans guilty of allowing their leaders to mislead Trump supporters have the most to feel guilty about. But leaders of both parties have much to learn from this.

Joseph Merlin Bowers

I suspect I would have gotten into recovery eventually with well executed outpatient treatment the times I was in mental institutions or psych wards because of acute psychoses, but I believe it would have taken longer. This is because of the asylum itself.

When we push for everyone who possibly can to be in community and not in an institution, we are forgetting the value and nature of asylum. When I was a patient at Middletown State Mental Hospital twice in the sixties, I was in a very bucolic peaceful setting. We patients would maintain among ourselves that yes the asylum protected society and the outside world from us, but it also protected us from society and the outside world.

When they take away one’s freedom, they also take away one’s responsibility for oneself. Freedom comes with much responsibility. In an asylum one need not worry about study, work, family responsibilities, the needs and wants of friends or anything that free people need to deal with on a daily basis. The virtually stress free environment used to be an important and valuable aid in getting into recovery.

I’m not advocating for a return to institutions where people were warehoused and abused. I’m advocating for the establishment of institutions where people are well cared for.

In my case stays in hospitals were a question of weeks or months in duration. My longest stays were about two and a half months. Today with the remaining state hospitals being almost entirely forensic institutions rather than civil institutions, the stays are much longer. No longer a matter of weeks or months but years and often many years.

This creates a problem. After years incarcerated, people struggle to adopt to life on the outside and the responsibilities that come with freedom. At CMHIP, the Colorado Mental Health Institution in Pueblo, professionals and staff are aware of this problem. They work to prepare people for life on the outside and to support them when outside. but some just can’t make the adjustment. In the interest of humaneness there are some who should never be released. Some who are don’t last long outside.

Almost everyone at CMHIP wants to get out and as soon as possible, but a small number are ambivalent about it and a few never want life outside again.

In a perfect world, in my opinion, we would have plentiful well run asylums much more civil institutions than the current case where people mentally ill and needing a respite from the demands of normal life could rest and get care until ready to rejoin the rat race. Those needing long term care or permanent asylum would get it.

The word asylum carries negative connotations today. That was not always the case.

by Joseph Merlin Bowers

My gym is closed. The golf courses have been closed. We are under stay at home orders with exceptions. I can no longer work out at the gym most days, play basketball on Wednesday mornings or go golfing several times a week like I had been doing. My board meetings are by Zoom as well as Friendly Harbor supervision and community meetings. The Suicide Prevention Coalition hasn’t held at meeting since this started. I can no longer volunteer at the homeless shelter. My communication with my son in New York, his wife and children is by Google Duo. I had never heard of that or Zoom before this started.

I have enough equipment downstairs to work out fairly well three or four times a week. I stretch extensively each morning. While the weather held, I was doing a lot of hiking. walking and bike riding. The weather has been ugly the last two days. My lower back is giving me a lot of trouble. I’m conflicted between getting out of shape and risking type 11 diabetes (a common side effect of the antipsychotic I’ve been taking more than thirty years)  by resting it or continuing my fitness regimen. My wife and I have been spending more time at home together than at any other time in our 44 years of marriage. So far there has been no domestic violence! We have enough food stored up to get by shopping about every ten days. More people are wearing the recommended masks but still not much more than 50% by my observation.

I have decided to use this time to rewrite my book witting about a lot more of my life than just the mental illness stuff and bringing it up to date. It was e published in 2013 and a lot has happened since.

I’ve always known that I’m much more productive when extremely busy than when I have a lot of time. As this goes on, I’m having a harder and harder time staying motivated enough to do anything. I’ve always been pretty active and get bored pretty easily, but I need more variety in my activities to want to do anything. Social isolation is probably the worst thing possible for someone living with a serious mental illness.

Other than my wife, there are only three people I have willingly allowed within six feet. The first is a dear friend who about a year ago was released from the state hospital after 13 years of incarceration due to serious mental illness. I’ve known her about five years now and never seen her exhibit any symptoms. She possesses uncommon organizational skills, leadership and an amazing work ethic. The fact that this young lady gets a second chance at life will prove a real boon to society. She became trained in cosmetics in the hospital and will graduate from college with a degree in welding this semester. She comes over every other Saturday mostly to visit my wife and watch a taped episode of Outlanders. She cut my hair a couple weeks ago and gave me a brief huge Saturday.

Another is a very dear friend I first met at the Friendly Harbor about five years ago. She has been out of the state hospital more than two years now after a five year stay. I’ve heard many sad stories in my time on this earth. Hers is the saddest. Because of serious mental illness, she lost her husband, her child, her home, her friends, her career and her freedom. Still she goes on and has committed her life to helping others. She earned her Masters in psychology while in the hospital. Currently she is pursuing a second masters and was working full time is behavioral health services at a local hospital until this pandemic hit and her hours were cut.

She and I get together to walk and talk about every two weeks. We haven’t maintained six feet between us though we have both started wearing masks.

These two young ladies are major inspirations for me-living proof that anything I can possibly do to help in the field of mental health reform is well worth doing.

The third is a middle aged man I’ve known about five years. He was taken from abusive parents at age five and believes this literally saved his life. He worked for FEMA for fifteen years. He was part of the World Trade Center response, post Katrina New Orleans, a bad hurricane in the Southeast and has done a lot of tornado chasing. Despite many mental health issues, he refused to go on disability insurance until recently trying with limited success to hold down a job.

He has been threatening suicide off and on since early in our relationship. He has made a decision to go on living for the sake of his children that he dearly loves so far. It’s hard to judge how serious a suicide threat he really is, but I decided some time ago that I will always take him seriously. We have a long established relationship and I think I’ve earned his trust. So far whenever possibly suicidal he has always eventually responded to me as I’ve reached out to him. I  have s lot of respect for this badly damaged individual and feel our society owes him much. I’ll always do anything i can for him. His last suicide threat was about two weeks ago. I went to his apartment and we talked. We will talk face to face whenever he wants..

This morning has been pretty productive. I worked on my book over an hour and wrote this, but I had to force myself. Writing is a real chore for me because I’m terrible at keyboarding. I keep reminding myself of someone’s quote that writing is 10% inspiration and 90% percent perspiration and I keep thinking if I keep at it my keyboarding will get better.

Our local golf courses opened to county residents with many restrictions this morning. I’ll have something fun to do so long as people follow the rules well enough to keep them open. That will help. Time is on our side with regard to the weather as well.

 

 

 

 

by Joseph Merlin Bowers

After moving to Pueblo Colorado more than five years ago, I became heavily involved in mental health volunteer work. I’m retired and in recovery from a serious mental illness. i’m on the boards of the Friendly Harbor. a peer run community center for people with mental health and/or substance use issues, NAMI Southeast Colorado, and Mental Health America Pueblo. I’m a peer specialist at the Friendly Harbor and a trained connections facilitator and In Our Own Voice presenter for NAMI. I care about speaking out on the issues surrounding serious mental illness enough to have overcome a lifelong morbid fear of public speaking. I’m now fairly comfortable doing that.

More than just speaking out and supporting people face to face, individually and in small groups, my passion is advocacy. I want policy change at every level of government and within the mental health industry-changes that would positively affect every family dealing with serious mental illness.

To that end, with the help of Bonnie Bowman, possessor of two pHD  degrees, NAMI Southeast Colorado board president and family member of seriously mentally ill individuals, I put together a local advocacy committee. It consisted of professionals, peers and family members, but didn’t stay together long. Unlike Bonnie and I, most of these people still have jobs demanding a lot of their time and attention. It was next to impossible to schedule things around most people’s obligations. By mutual consent we disbanded. Now the NAMI Southeast Colorado advocacy committee is mostly Bonnie and I.

We have been busy. Over the last couple of years I have scheduled numerous meetings with County Commissioners, state legislators and the current Lt. Governor while with some help from me, Bonnie put together a white paper of our five top mental health priorities for Southern Colorado.

I’ve established a bit of a connection with Dianne Primavera our Lt. Governor. We have met together on four occasions and discovered that we are both cancer survivors and while I suffer from what is probably bipolar disorder she had a brother who was a very successful lawyer but developed serious bipolar disorder and committed suicide. When I was telling Dianne about the Friendly Harbor and mentioned that the value of peers is controversial of some quarters she said that when she was diagnosed with breast cancer, the first people she wanted to talk to were survivors of breast cancer.

Bonnie and my five priorities are civil commitment beds at the Colorado Mental Health Institute at Pueblo, supported housing, Assertive Community Treatment, improved Assisted outpatient treatment laws and diversion from the criminal justice system. These are mostly state level priorities. In the Colorado legislature they passed legislation allowing anyone 12 and over to seek professional mental help without parental consent. We fear this allows minors to refuse needed treatment and want that amended.

I also have a connection with Andrew Romanoff. He has a decent chance of becoming one of our state’s two federal senators. The main thing we want at the federal level is the repeal of the IMD exclusion.

At the county level we seek commitment to a program called “stepping up.” This is a county level program intended to divert people into treatment rather than into our overcrowded county jails.

I have several friends now who have adult sons and daughters with serious mental illnesses who lack awareness or in one case refuses medication because of past bad experiences. A friends daughter is currently held in a facility in Northern Colorado where for some time they have been trying to restore her to competency so she can stand trial for some serious charges. She has been through the system so many times over so many years that the likelihood a her ever again getting into recovery is very slim. That ship may have sailed.

Another friend has a son with schizophrenia who refuses to take medication I think because of side effects. It may have been a previous bad experience. He is currently in jail. Rita didn’t tell me what happened. She had texted me some months before asking where she could take him to keep him our of trouble. She had been through the 72 hour hold process which just alienated him and made it harder for her to help. Now he is in jail for the long haul.

If there had been a  place I knew of near where she lives like the Friendly Harbor I would have suggested that. We are a peer run support facility somewhat similar to the clubhouse model like New York’s Fountain House. We do not treat people, but we support them in many useful ways.

That the priorities mentioned above of Bonnie and I are needed seems obvious to me. It also seems much less complicated than rocket science how to prevent tragedies like those that befell my friends with adult mentally ill children and many other families as well.

It needs to be easier to get people into treatment when needed-involuntarily if necessary. Once in treatment they need to be kept in treatment until truly stabilized. If in a hospital or institution there must be adequate support for them upon release. If these simple things were in place, the benefit to these families and society in general would be enormous. It is unspeakably frustrating to me that they are not.

 

Joseph Merlin Bowers

This morning I started reading The Great Pretender by Susannah Cahalan. It was recommended by a mental health advocate I have a lot of respect for, DJ Jaffe. Susannah also wrote Brain on Fire which I have read previously.

An autoimmune encephalitis caused her to experience psychosis and other symptoms of serious mental illness.  So diagnosed, she was fortunate enough to have the true cause of her symptoms discovered and get properly treated and cured.

Her first book described this experience. She also discusses the experience in the first chapter of the second book. Her discussion has motivated me to write this blog. Though cured, Susannah lives with an unshakable fear that psychosis may return. So it is for everyone who has ever experienced psychosis.

I first became psychotic before turning 17 and went on to experience more than 20 years of recurring psychotic episodes with periods in between of seemingly complete remission. I haven’t had a major episode in more than thirty years and my last minor experience with psychosis was nearly twenty years ago now. Nevertheless, the first part of the title of the book I wrote about my experiences is Life Under a Cloud. The cloud represents the inescapable, ever present fear that psychosis could return at any time for reasons no one really understands at this point in our history,

There is nothing more terrifying short of impending painful death than the realization that one’s brain has been malfunctioning-that you can’t depend on it to tell you what is real and what is not-to be your most valuable tool in navigating life in an often dangerous and challenging world.

Living under a cloud of apprehension that I may again experience symptoms that render me incapable of escaping a fantasy world long enough to complete a homework assignment, fill out a form or perform a routine job task is a constant for me. I’m not constantly thinking of these things, but the cloud never leaves.

Almost as bothersome an apprehension and sometimes fear is uncertainty. I just don’t know for sure anything of real importance.

Is my disease physical, a medical condition? How important is genetics as a cause? I know prevailing theories and a lot of statistics but no facts or scientific laws that explain my illness.

I was a science major in college and I try to be very open and honest with others and, most difficult of all, with myself. I wonder did my episodes end because of effective treatment or is the nature of my illness such that they would have ended eventually anyway running their course perhaps in a similar amount of time. I’ve had episodes that were short lived and didn’t get aggressively treated but nevertheless went away.

Do I really need the medication? I once did fine for about six years without any. The last time I tried going off, I didn’t get psychotic. I experienced brain malfunctions of a different nature. Why was this? Was it bad timing-my being under too much stress at the time for this major  a change? Was it withdrawal symptoms from a powerful drug?  Antipsychotics have disagreeable side effects. Mine comes with about five pages listing things that, though in many cases extremely rare, have happened to people taking  this medicine. Nobody should take anything longer than necessary and not needed. Do I need mine? I think so but I’m not sure.

Who is the real me? My daughter was prescribed Ritalin in second grade for attention deficit. She did well on the Ritalin and graduated valedictorian from high school. She had been thought slow by kindergarten and first grade teachers. One day she asked me very concerned, were the good grades her or the Ritalin. When one takes a drug that affects the functioning of the brain, one has to wonder if this fundamentally changes who they are. Is it the real me I was meant to be on the drug or off it? I told my daughter that the disease fundamentally changes who you are and the medication brings back the real you. I believe this, but I’m not sure.

I have experienced grandiosity and a messiah complex. Among many other delusional things, I have believed I was Jesus in a different life in a different place. Today my brain is not racing or absorbed in delusional fantasy. I am perfectly capable of functioning normally. But still sometimes I have to wonder: was there ever any truth to any of those things my delusional brain has told me so convincingly so often in the past? Some believe in reincarnation. Some believe we all play different roles in different lives on different worlds and maybe different universes. This is all highly unlikely I acknowledge, but technically possible given the current state of scientific certainty. So sometimes I wonder. I believe these fantasies were the product of a diseased brain. I’m not absolutely sure.

Partly because of the state of the art and science surrounding mental illness, these are some of the apprehensions, fears, uncertainty and doubts I live with.

I don’t really seek pity or even empathy. I’m truly a very lucky man having been able to live a pretty normal, successful life in spite of my illness. Comfortably retired on a medication that has been very effective, having learned a lot of coping skills, with a good support system and a loving family, I am free to do exactly what I want to do with the rest of my life.

I recently read an introduction to a book of short novels by John Steinbeck. The writer of the introduction said that Steinbeck’s avowed purpose in writing was to help people get to understand each other better. I thought to myself “what a noble purpose.” I hope that I can help people who have never experienced psychosis better understand those of us who have.

What I have been doing since retiring and intend to continue to do for the rest of my life is to wage war on the scourge of mental illness and combat widespread public ignorance about it.

 

I

 

 

Joseph Merlin Bowers

 

I think most of us would agree that our brains are the most important part of our bodies. Yet, as a society, we don’t handle brain issues nearly as well as issues with all other body parts.

When someone calls 911 because of a crises like a heart attack, a diabetic shock, a seizure, a broken leg or anything like that, the first responders are medical professionals usually EMTs. When 911 is called because of a mental health crises, the first responders are almost always policemen. Why is that? In a healthy society wouldn’t one expect mental health professionals?

With almost any type of problem like cancer, heart disease or diabetes at the first sign of trouble, aggressive treatment is started. When someone becomes psychotic and lacks awareness, aggressive treatment doesn’t begin until the disease progresses to stage four and the patient is deemed a danger to himself or others or is gravely disabled. What?!!? Given the known value of early intervention, would that happen in a healthy society? I think not. If a professional did that with cancer, heart disease or any such thing, he or she would be sued for malpractice and probably loose their license to practice.

From cancer to measles with any type of problem with any other part of the body, we have worked long and hard seeking prevention and treatment. In virtually every area of medicine, for virtually every type of illness or injury we have made tremendous advances. Not so much for serious mental illnesses. Until we do, our society can not be considered healthy.

For a lot of reasons, there are very few long term civil commitment beds in Colorado. Our state mental institution in Pueblo now is entirely forensic. We have been sued twice and will be again because of a huge backlog of people awaiting competency hearings so they can stand trial for minor and sometimes major crimes.

When I meet with a policy maker, I usually tell them about an event that took place in 1964 in upstate New York and explain why that is meaningful to modern day Colorado: Believing that the Devil had forcefully removed my grandmother’s soul from her body and was inhabiting it himself waiting for an opportunity to destroy me, I went upstairs one night with a loaded shotgun to her bedroom. The plan was to kill the body. As the devil left the lifeless body, my waiting spirit friends would capture him and imprison him in inescapable confinement. The battle of good versus evil would soon be over with us good guys victorious! I probably had a plan for restoring my grandmother to life.

Reaching the top of the stairs, I looked through the open door to my grandmother’s bedroom directly across the hallway and saw her knelling at bedside obviously praying. Confused I went on down the hall. The Devil praying? I told myself that somehow he had been warned and was trying to fool me. I went into the room, cocked the shotgun and pressed the end of the barrel against her chest as she faced me.  I hesitated as time seemed to slow way down, and she reached out to me and said, “Joe don’t. You’ve never been mean to me.” Maybe there was too much doubt in my mind. Maybe I had one of those brief lucid moments that sometimes happen when one is in the midst of psychosis. Whatever the reason, I pointed the gun away from my grandmother and carefully released the hammer uncocking the weapon without firing it. I unloaded the gun and we went downstairs, I put the gun away and we waited for my uncle to come home.

That night they took newly 17 year old me to Middletown State Hospital where they began treating me as well as they could in 1964. I responded well to treatment and was released after about two and an half months in pretty good shape. There would be more episodes and more incarcerations, but partly because of this early intervention and fairly long stay in an asylum, I have gone on to live a fairly normal and successful life.

The galling thing is that in Colorado today in order to get into our state mental institution and stay for the needed two and a half months, I would have had to pull the trigger. Short of that there would be no room in the asylum for me.

How can we expect to ever get on top of the competency hearing situation when people often don’t get the psychiatric care they need before they become involved with the criminal justice system? Without proper care, almost everyone with a serious mental illness will sooner or later.

Could that situation exist in a healthy society? Because we have so ignored serious mental illness there have been and continue to be too many totally preventable tragedies, lives needlessly wasted, and people experiencing a quality of life much worse than what is possible.

A sports team or any team is only as good as its weakest link. A society is only as healthy as its sickest members.