No news locally, but here’s a good read on mental health issues...

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The Wall St. Journal

Mental Illness Shouldn’t Be Kept Out of Sight

A writer who witnessed his brother’s lifelong struggle learned that sustained personal relationships are crucial for people with mental illness

By Jay NeugeborenDec. 29, 2022 at 10:51 am ET

Jay Neugeboren (right) and his brother Robert ca. 2000.Photo: Jay Neugeboren

A week or so later, Robert called me one evening and began shouting, “Alan’s gone! Alan’s gone! Alan’s gone!”, after which he hung up. When I called back, he refused to come to the phone, and when I called Dr. Pam the next morning, he informed me that Alan, Robert’s social worker, with whom he had an excellent relationship, had been transferred to another state hospital without warning. In the days and weeks that followed Alan’s departure, Robert began having tantrums, hallucinations, bodily tremors, irrational fears and panic attacks, and he became, by turns, dangerously manic and depressed. It would be more than a year before the hospital would again prepare him for discharge.

Robert was deprived of a relationship that had been a crucial element in his life and, thus, in his recovery.

Why did the medication that worked so well on Tuesday stop working on Wednesday? I’m convinced that one reason is that Robert was deprived of a relationship that had been a crucial element in his life and, thus, in his recovery.

Due to the patience and kindness of the staff at Bronx State and to the treatment plan that Dr. Pam organized for him, Robert did eventually recover after Alan’s departure. He was discharged in 1999, and after nearly 40 years in city and state psychiatric facilities, he was able to live in a supervised residence for a dozen consecutive years. He got around the city on his own, held down part-time jobs and enjoyed the best years of his adult life.

According to the National Institute of Mental Health, more than 14 million Americans suffer from a mental illness that “results in serious functional impairment,” and more than three million experience this impairment on a long-term, chronic basis. Recently, the media has paid abundant attention to America’s mental health crisis, discussing the role of politics and funding, the medical establishment, new treatments for depression and teenage mental health. Politicians and the media often blame people with mental illness for the recent rise in violent crime and homelessness (it is estimated that a third of individuals experiencing homelessness have serious mental illness). In fact, people with mental illness are much more likely to be victims of crime than perpetrators; crimes by those with a mental disorder usually have something to do with drug addiction.

Largely ignored in this discussion is what to do about the millions of people who, like Robert, suffer chronic, severe mental illness. The longer they are “out of their minds,” the more they remain “out of sight” to their family and friends, often abandoned in psychiatric institutions, prisons, halfway houses or on the street.

During the years after Robert’s discharge from Bronx State, I worked on a book about people who had been institutionalized for mental illness, some for more than a dozen years, but who, unlike Robert, had recovered into full lives. They were doctors, teachers, lawyers, custodians, movie producers and social workers. Some attributed their recovery to medications or a particular program; some said that they had found God.

But they all, without exception, said that the key element in their recovery was an ongoing relationship with an individual human being. Most of the time this person was a professional—a social worker, psychologist, nurse or doctor. Sometimes it was a clergyman or a family member. But in every instance, recovery was made possible by an individual who said, in effect, “I believe in your ability to recover—to have a better life—and I am going to stick with you until you do.”

During Robert’s two years at Bronx State, Dr. Pam assigned a psychiatric resident to see him for basic, old-fashioned talk therapy, for at least an hour every week. In other hospitals and residences, I pleaded with the administrators for any form of psychotherapy for Robert—to have someone talk to him regularly and get to know him in all his complexity and uniqueness. Every time I received the same answer: “No resources.”

Thanks in large part to the excellent treatment that Robert received at a critical point in his life, he managed to survive, with his mind, spirit and sense of humor largely intact, to the same age that our father reached. Millions of others—mad, homeless, abandoned, neglected, drugged, confused—are far less fortunate. Yet they remain at least as complicated and human as the rest of us, and if we can find the resources to provide them with the care that they need, they might have a chance to lead what we too often take for granted: our gloriously imperfect lives.

Mr. Neugeboren is a writer whose books include “Imagining Robert: My Brother, Madness, and Survival.”