We can thank Reagan and the ACLU for closing the old Mental Health hospitals and not funding a realistic alternative.

Thanks for this very thoughtful, well-researched article about the difficulties of treating the mentally ill. Between the HIPPA laws protecting individuals' rights and the scarcity of effective community-based programs and practitioners, those with severe mental illness often end up as the folks you describe in your article. If, indeed, a society is measured by how well it treats its least fortunate citizens, the U.S. deserves a failing grade.

Note: Any individuals or families affected by mental illness who are looking for information or support can contact the Santa Clara County NAMI chapter at www.namisantaclara.org, or by calling the NAMI county office in San Jose at (408) 453-0400 between the hours of 10 am and 2 pm.

>> Inability to provide shelter is one of the criteria, along with food and clothing. I was told that sleeping under a tree or in a doorway can be considered shelter, so my mother did not meet that requirement," she said.

That is ludicrous, really ridiculous! Whatever authority gave that answer should be responsible for it.

I'd have to guess that this is all about just not wanting to provide the funding and infrastructure for this effort. I can understand that because we as a society can spend all kinds of money and end up with abusive hell-hole institutions that imprison people, abuse them and from which they can never be released. Maybe what we have is a bit better than that, and maybe the only alternative is to maintain places where these people can get free food, shelter and some kind of health care or assistance if they want it on a voluntary basis. It would be hard to run these places because homeless people are famous for not wanting to go to them. No one is looking at it from their point of view or trying to satisfy them as "customers" because that is not what we are used to seeing it as.

Thanks Palo

Alto community for posting this article part one hoping to read part 2,3,4,5.
I find it very stressfull dealing with three crazy relatives who should be in a mental facility in 2015 [Portion removed.]

Thank you for this article.In the 1950s and 1960s I worked in a very progressive private psychiatric hospital. We had a significant number of patients who would never have admitted themselves voluntarily. Family members went through commitment procedures on their behalf, and then they could be in a locked facility for long enough to become stabilized and amenable to treatment. They would never have been helped on a 72 hour hold and most, after "talk" therapy and sometimes medication (which was in its early days then) were successfully discharged after several months and were grateful to their relatives for helping them. Yes, the system was widely abused, but that is no excuse for trashing it completely and leaving these folks on the street to fend for themselves. I look forward to the follow up articles. We need to address this problem humanely.

Ongoing illnesses require ongoing, flexible care. Until individuals experiencing mental illness are given the same services offered for other medical illnesses, recovery largely depends on availability of family members and the compassion of the police. I am unaware of any other serious illness treatment that relies largely on these types of support systems.

Imagine telling your loved one who just experienced a life-threatening medical illness such as cancer or diabetes, "Oh, have your family find out what to do for you and call 911 if you feel you can no longer function."

This article provides great insight to the struggle surrounding mental illness. It is so sad that there is no straight-forward or easy fix to this problem. Hopefully we can innovate as a society and learn how to accommodate individuals with severe mental disabilities.

we can blame Reagan or whatever else we want to blame, but blaming anyone or thing is not going to solve the issue. The truth is, is that this is a serious problem in our community that needs to be fixed.

Mental illnesses should be classified as BRAIN illnesses, for that is what they really are. The latest imaging equipment can see brain damage due to emotional and physical trauma, child abuse, malnutrition, disease, injury, etc.

The term " mental" implies that the problem is imaginary and self-inflicted, and can be treated by simply deciding not to be mentally ill any longer.

The same goes for autism: most insurance companies do not consider it the brain/neurological disease that it is, and will not provide monetary compensation for treatment, no matter how effective it is ( and it IS, if started early enough). They class it as something beneath mental illness.

When it comes to the treatment of sick brains, we really are in the Dark Ages!

When I was in college, a few years after Reagan closed down all the mental hospitals such as Agnews and released the " inmates", unmedicated, into society, several "halfway houses" were opened near schools and inner-city colleges where housing was inexpensive.

Apparently, these people had very little supervision, because they would walk the city street day and night, doing bizarre things ( such as dancing barefoot in crosswalks in heavy traffic during freezing winters, or urinating on the floor of a Mc Donald's during peak lunch hours, etc)

Anyway, one night, long after my roommates and I were asleep in our apartment, one of them broke in and put one hand over my mouth and another down the top of my nightgown! He then took the one hand off my breast, and unzipped his pants. I was in a small bedroom by myself where my roomies were not awakened. knowing what would come next, I rolled out of bed, stood
up, picked my art history book off the foot of my bed and screamed, "Get out, NOW!" This both freaked the guy out and woke my roomies, who called the cops.

Thanx, Mr Reagan!

to Scrofula: how do you know this wasn't a regular criminal rather than a mentally ill person? I don't care for your assumption that mentally ill persons are perverted criminals. I know some Palo Altans have a superior attitude towards just about everyone, but that assumption really is not helpful to this story of a situation that afflicts some families. Don't assume criminality with mental illness.

After reading this article I see that things have still not changed. Providers who think it's about giving patients what they want instead of giving them what they need to be well, was clearly demonstrated by the comments from the head of a non-profit county mental health system. Mental health care is about understanding the nature of brain based mental diseases. This being said, you can not reason with a psychotic brain. The nature of the psychotic illness is not being able to think rationally. So giving the patient what they need becomes paramount. I struggled with the Santa Clara County mental health system for 20 years for my daughter. The only way she got care was through my persistence. I sent mass faxes to county officials, I joined NAMI, I sat on the county mental health board for 10 years, advocating for change! I was unrelenting. Things have not changed in 20 years,people and their families are being destroyed. What do patients need? They need competent treatment, they need the support of their families, they need good nutrition and exercise, they need competent, compassionate care.
The Mental Health Services Act was passed to deal with these issues that are being discussed in this article. Unfortunately , the money has not gone for treatment of the severely mentally ill, but rather to planning, meetings, high priced consultants and PR material for the public. Let's step back and take a good look at the where all the money has gone. If it were being used for it's intended purpose we wouldn't be hearing these horror stories.
Speak up people, demand the money be used solely for treatment of the mentally ill.

to Scrofula: I gave a pretty good description of the guy to the police, and this young man, not thinking clearly, was caught hanging around my apartment building, a few days later, still wearing the exact same smelly clothing. The police informed me that they knew him pretty well, he had been pulled in for several acts of lewd behavior in public previously, and he lived in a halfway house less than one block away from my building, on the same side of the street.

I was seventeen years old and it shook me deeply. I felt very violated and did not sleep well for six months. Originally I thought he was a vagrant, or homeless, because he was so smelly--I did not immediately think he was an unmedicated, schizophrenic resident of a halfway house ( in my youthful innocence I thought they were better cared for than THAT).

Please do not be judgmental or vilify the victim! This actually changed my thinking about mental health!

Great article Mrs. Dremann - it gives a face and a story to those who are forgotten and have no voice.

there are pl;aces where people are force injected drugs against their will and they now have permanent physical damage that has not gone away for years. they have problems walking perfectly . these people had never hurt anyone .you could be in shock from something and cannot communicate well. so they give or force drugs on you. you didn't know that was going on because they keep it hushed. your friends or kids could be in danger with that attitude of ''drugs'' for every problem. there are also people who've attempted suicide and are now severely injured for life. these people were on some form of chemicals. but their attempted suicide is only known to people who know them. it wasn't officially declared an attempted suicide. only few know this. it was a very beautiful person that was once known in town. its something palo altans don't realize. its kept quiet for obvious reasons. there are hidden things going on with any person you might see anywhere. they may have experienced things they don't tell people even acquaintances. people are scared these days and should be. you cannot trust too many people. many don't ''seek help'' because they are afraid of coercion. better to be free than under ''care'' of someone who wants to drug you. bottom line. the ''mental health'' system is all drug oriented. some people don't even drink alcohol but they want to drug people? that is truly insane. contact mental health dept and ask them do they force or encourage people to take drugs. they did it years ago now is a rote practice. thats why many don't ''seek help'' ''help'' is a relative term.

I think you forgot to close a tag guys! You open a bold tag on line 572 of this page's source and never close it!

I'm an adult psych/mental health clinical nurse specialist and LCSW who has worked as a jail psych RN, private practice, in community mental health as well as in the general acute hospital setting and as a clinical psych nursing educator. This is a very thoughtful article about complex issues, including the restrictiveness of HIPAA in sharing practical information that can be beneficial in treatment....Very sadly, correctional facilities and short-term acute treatment is the treatment of "default". The only "treatment plan" most of the time is temporary stabilization....which doesn't include long term mentoring and 1:1 encounters or group therapies and rehabilitation including life skills, housing and financial management (including, but not limited to payee services and in some cases, conservatorship). See an interesting Sacramento Bee newspaper link: <Web Link

Hopefully this is the accurate Sacramento Bee web link:

Web Link

Thank you Sue and Palo Alto Weekly for publishing this artcile! I think we really need raise the awareness of the predicament of the people, and the family suffering from the devastating effect of mental illness. I hope we realize that we as a community really have to come together, discuss and debate, and find better solutions to help this group of people among us.

1) I just want to raise a few points that perhpas we can do something to change:

As mentioned in Sue's article, "The Health Insurance Portability and Accountability Act (HIPAA) prevents hospitals from releasing any information about an adult's medical condition unless they sign a waiver; and their son has not signed a consent form, she said." This seems utterly unreasonable. For a person who had been regarded as unable to make reasonable decisions on his or her welware, and had been committed involuntarily, how could the law expect he or she still be able to make a reasonable decision about her privacy? The effect of the above requirement of HIPAA is that it helps to cut the ties of the committed patient to the family. It excludes the family from the patients treatment. It makes the treatment process all the more scary and excruciating for both the patients and the family. Can we please change this part of the law? Give the immediate family (spouse or parents) the right to be informed when a patient is committed involuntarily. This is consistent with person's indivdiual right. It is also consistent with the right of patient when he or she can not make medical decisions for himself or herself.
Let the family be involved. Help the family take care of the mentally ill. Don't make it even more difficult for them. Don't isolate the patients from their family.

2) Have separate mental hospitals and general "behavior" hospitals for people with substance abuse problems. Substance addiction is not a disease. Mental sickness is a brain sickness, like Alzheimer, Autism, not very much different from Leukemia or Cancer. It needs dedicated research, it needs special treatment. I believe a jail like environment is not approprate for people with minor or severe mental illness. it really should be treated in a hospital like environment. A change in how we treat mental illness would make both the patient and the family less afraid or less ashamed of seeking professional treatment.

3) Train the police and emergency personnels about how to treat people with mental illness. People with mental illness are different from criminals with a gun. I understand how dangerous it is to be a policeman, but please dont just come and shoot a mentally ill person who look crazed or who resist arrest. Make a clear, guideline and train our police on how to react.

Further more, start a discussion on how business, schools, services, and we as a community should treat people with mental illness. I personally believe that isolating the mentally ill, locking them up at home or at the hospitals is not the solution. It is not good for the patients, it is not good the society.

4) NAMI and other organizations could do more. When is the last time you see a NAMI ad or any ads for mental illness awareness on TV? National or local? Never for me. In the last 20 years, I didn't see a single one. Every time there is a sensational tragedy involving a mentally ill person, this topic would be all over the media. However very rarely the media would get into any depth of it. Every little attempt was made to educate people about what mental illness is, and how we could improve how we treat is. On this side, I hope NAMI could do more. Have a TV ads compaign. Have a donation compaign. Send volunteers to the streets. It is not a topic that the society can stay hush-hush about.

Sue, thanks again for doing this article. I hope more people will participate in this discussion and we will be able to do something to change the status quo.