Ex-reporter says U.S. mental health system has failed us

Published: Friday, April 25, 2014 at 7:52 p.m.
Last Modified: Friday, April 25, 2014 at 7:52 p.m.

"Dad, how would you feel if someone you loved killed themselves?"

That startling question, which begins veteran journalist Pete Earley's book "Crazy: A Father's Search Through America's Mental Health Madness," is the same question that set the investigative reporter on the path to understand the mental health care system in America.

What Earley found is that the mentally ill are often criminalized rather than treated; the country's biggest mental health care provider is not a hospital, but the Los Angeles County Jail, Earley told an audience primarily made up of psychiatrists at the McKnight Brain Institute on Friday during a grand rounds lecture.

Earley, 62, who was a reporter for the Washington Post, investigated the treatment of mentally ill prisoners at Miami-Dade County Jail, practicing what he calls "pitbull journalism."

"You hang in there so long that people get used to you being there," he said.

Earley focused his attention on the jail's ninth floor — known as "the forgotten floor" — where the severely mentally ill are kept and the most troublesome employees work, none of whom have been trained to work with the mentally ill, Earley said.

He added that on that floor, the staff psychiatrists spent an average of 12.7 seconds per patient.

What he witnessed, he said, was a fractured system: men kept naked, six-to-seven in a one-person cell — some drinking out of the toilet to take their medications because the prison's overall conditions were so poor.

"The biggest reporting challenge," Earley said in an interview, "was trying to be impartial … going into the jail and seeing people who could have been my son, or could have been his future."

Earley said his son Mike was in his 20s when he was struck by mental illness involving severe psychotic episodes. Mike fought against taking his medications, but in the end, they helped him, Earley said, adding, "Medications help many people but by itself are not the answer."

"My son has had seven psychiatrists, and only two bothered to learn anything about him beyond his name and his symptoms," he added. "Treating brains requires treating the heart."

Mentally ill people want the same things that the rest of us want, Earley continued: a safe place to live, a purpose in life and someone to love them.

Mike, now 34 years old, is doing well and living on his own. He became a peer-to-peer counselor for the mentally ill in Fairfax County, Va., and has a weekend job working at a movie theater.

"Apart from his weight gain (caused by his medications), you would never know that he is mentally ill," Earley said.

Earley challenged the doctors at Friday's lecture to improve America's mental health care system: "You are doctors. Use your skills to unlock the brain's mysteries," he told them. "Use your voices."

Earley pointed out that in most places of the world, doctors decide how to handle patients with mental illness, whereas in the U.S., police officers, judges and lawyers seem to have far more influence with how mentally ill patients are handled.

"Because the mental health system has failed us, we are turning to the criminal justice system to save us," Earley said.

He said another difference is that doctors have different criteria for treating people and housing them in safe treatment centers, which in many European countries boils down to the need to treat. In the U.S., patients have to exhibit dangerous behavior — either threatening to kill themselves or someone else — before intervention becomes mandatory.

To repair the fractured system, more needs to be done at the community level throughout the U.S., Earley said.

Dr. Laurie Joshi, a psychiatrist at UF Health Shands Hospital, wiped her eyes and called Earley's lecture "very touching."

Joshi said that she is currently treating a couple of patients who are emblematic of some of the problems that Earley addressed, namely mentally ill patients who have no place to go in the community once they are stable enough to be released from the hospital.

One patient is from South Florida and does not have a home in Gainesville.

"We have to discharge him even though he has no place to go," she said, adding that group homes for the mentally ill are expensive — and fill up quickly.

"We'll see what happens," she said.

Contact Kristine Crane at 338-3119 or kristine.crane@gvillesun.com.

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