Editorials / Opinion

We can create change through education and increased awareness

I want to commend The Seattle Times and columnist Jonathan Martin for a very thoughtful and powerful piece on peer bridgers. The column helped increase the public’s understanding of mental illness and the mental-health system’s shortcomings [“The rare mental-health fixers,” Opinion, Nov. 21].

We need more outpatient mental-health support to assist individuals with transitions and throughout their recovery journey. Peer bridgers provide such support and also reduce demand on an overburdened psychiatric inpatient system that leaves too many people with inadequate and inhumane care.

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Ensure early diagnosis to prevent needless suffering

In his column, Jonathan Martin wrote about correctional facilities trying to fill cracks caused by a broken mental-health system [“Mental health in prisons: It’s a crime,” Opinion, Oct. 19]. That’s not the way it should be.

We as a society need to recognize that mental illness is a brain disease that should be treated like any other disorder of a vital organ. Providing early and effective intervention and continuity of care well before the potential for incarceration is critical. This approach would certainly be more economical and humane than incarceration. The people falling through those cracks, after all, are our relatives, neighbors, friends and colleagues.

Medical experts agree mental-health recovery is achievable, but patients and their families often do not realize that mental illness is treatable. Even after diagnosis, many patients become “lost” during the transition from inpatient to outpatient treatment. According to a 2010 Medicaid study, 41 percent of patients with schizophrenia didn’t receive psychiatric follow-up in the month following hospital discharge.

It impacts the bottom line: People with schizophrenia represent 1 percent of those with mental illness but account for 4 percent of health-care spending. To be more cost-effective, tax dollars would be better spent on the front end — on prevention, treatment and services — as opposed to incarceration.

But it’s not just an economic issue; it’s about how we define ourselves as a society. Our ultimate goal must be to ensure early diagnosis, and access to treatment and services to prevent needless suffering. Only by ensuring that all patients receive the services and treatment they need, can we offer these individuals a chance to become functioning, contributing members of society.

Michelle Kramer, Titusville, N.J.

Lawmakers in Olympia must focus on mental health issues

Kudos to Jonathan Martin for a great column on the issue of mental health in our state’s prisons [“Mental health in prisons: It’s a crime,” Opinion, Oct. 20].

The issue has been swept under the rug for far too long, and something needs to be done about it. For the offenders who will be released one day, it is vital for them to receive mental-health treatment before they are released. If they don’t receive that kind of treatment, the odds of them ending up back in prison is very high.

I hope some of our lawmakers in Olympia have read his column and use it as a tool to focus on mental-health issues.

Jeff Swanson, Everett

Psychiatric hospitals need resources to keep staff and patients safe

Thank you for your recent article “Report: Violence on the rise again at Western State after decline,” (NWThursday, Oct. 10).

I was concerned with the tone the article took on violent behavior among patients receiving inpatient psychiatric treatment. Describing “patient-on-staff” assaults without providing context contributes to the false stereotype that acute mental illness is strongly correlated with violent behavior, when in fact it is not.

I acknowledge that people experiencing mental illness do sometimes act out violently, and mental-health workers should not experience violence as part of their job. However, the portrayal of the patient as perpetrator and hospital staff as victims is damaging and whitewashes other important issues, including circumstances that might compel patients to act out violently — as well as how lack of staffing and resources affect patient care.

Again, I thank you for your article, and I wholeheartedly agree that our psychiatric hospitals should be allocated the resources necessary to keep both staff and patients safe. I hope that in the future you will also consider the story from the patient’s point of view and actively speak out against the false narrative that mental illness is a predictor of violent behavior.

Sara M. Gall, Seattle

Thank you for bringing attention to this problem

Thank you for you timely and much-needed articles on the crisis in mental illness [“Boarding mentally ill becoming epidemic,” page one, Oct. 6].

Lack of resources, treatment facilities and other issues raised in the articles are vitally important.

However, there is another issue. Mental illness is different from other illnesses because one of its symptoms is the failure to know or acknowledge oneself as being ill. Delusional thoughts are reality.

Imagine if someone were told that something he or she knew as reality were not actually real, he or she was just sick and need help. That person wouldn’t react well. Under our current law, meant to protect the civil liberties of mentally ill people, people can refuse treatment until they are an imminent threat to themselves or others.

Even with better treatment facilities, there is a crucial missing element to help those with mental illness. It is truly heartbreaking to helplessly watch a loved one deteriorate, knowing treatment is available to make huge improvements in his or her life.

It is crucial that we modify our civil commitment standards to save the lives of those with mental illness and others. We’ve seen way too many tragic consequences resulting from untreated mental illness. We can do this in two ways: change the civil commitment standard from “imminent” to “substantial likelihood” and adopt a lower standard for required outpatient treatment, in which the deprivation of personal liberty is much less.

Tim Osborn, Seattle

Mental illness does not predict violent behavior

I wanted to thank you for your coverage of the “boarding” problem in Washington state in the article “Boarding mentally ill becoming epidemic”. [page one, Oct. 6].

This article turned a spotlight on the damage caused by keeping involuntarily detained patients with mental illnesses in chaotic and confusing emergency departments for long periods of time, aka “boarding.” This is a serious problem that the public needs to be aware of, causing trauma to the patient and incurring serious expenses.

I was concerned, however, that the article may have contributed to a common misperception that people with mental illnesses are prone to violence — a stigma that those with mental illness must live with everyday. While scared and confused people, including those with and without mental illness, sometimes act out in violent ways when facing a crisis, the reality is that mental illness alone does not cause one to be violent and the vast majority of those with mental illnesses are not violent.

I understand that this article was highlighting some instances of violence to demonstrate how the problem of boarding can lead to acts of violence by some people with mental illness. But I think it is worth pointing out that most people with mental illness are not violent and that mental illness alone does not predict violent behavior.

Thank you again for your reporting on this important topic.

Kyle Czeh, Bellevue

Psychic disorders allowed to languish on streets

It has been 34 years since the Church Council of Greater Seattle sponsored its first conference on mental illness and the plight of the mentally ill. [“Caring for mentally ill: how a community succeeds,” page one, Oct. 7].

Seattle University provided the venue for the event. The program was an ambitious one highlighted by speakers and workshops. At that time, numerous individuals with obvious serious psychological impairments were showing up in Seattle’s old Skid Road areas and the city jail. Back then it was a new phenomenon.

In the wake of state hospital closures, exacerbated by a woefully ill-funded treatment system, people with profound psychiatric impairments were often simply left to fend for themselves. The abysmal lack of adequate housing and comprehensive, consistently funded treatment resources guaranteed that Seattle and communities throughout the state would be unprepared to meet the needs of the mentally ill.

Thus it has been and continues to be. Aside from periodicly reported incidents in which a disturbed individual precipitates horrific violence on unsuspecting strangers or family members, the majority of those with severe psychic disorders go unnoticed, unremarked and are allowed to languish in our jails and on our streets.

The Times is right to call for change that is long overdue. Is our city, county and state ready at last to create a just and decent system of care commensurate with this ongoing tragedy?

Joe Martin, Seattle

Involuntary commitment should be last resort

The article about boarding the mentally ill sheds light on a huge social injustice done to people whom are being involuntarily committed for a mental illness. [“Boarding mentally ill becoming epidemic,” page one, Oct. 6].

The ethics of having someone involuntarily committed raises questions about basic human rights and freedom, as well as whether law-enforcement officers are qualified to decide when someone should be involuntarily committed.

The practice of “warehousing” is denying people with mental illness their basic right of being treated with decency. Involuntary commitment should be the last resort of first responders and every involuntary case should be treated with the utmost urgency.

If law enforcement plans to continue to use involuntary commitment, then adequate funding for facilities is crucial. Additionally, funding should be allocated to law-enforcement officers to be trained in identifying people with high-risk mental-health issues who need immediate care versus people who can be de-escalated on the scene and returned to a safe environment.

Jamie Lee, Seattle

Focus on mental health

According to a police report, Aaron Alexis was hearing voices. [Fort Worth Police Department via Getty Images]

The two men both had serious mental-health problems and, evidently, they were not getting the help needed for those problems.

Lawmakers and others focus on gun control, which may be needed. But no focus is given to the problems that beset many people, including these two.

I suggest that law changes need to put as much focus on helping people with mental illness as there is on gun control.

Further, it was not a gun but a knife that was used in the Seattle killing.

Edith Keenan, Lake Stevens

Learn about mental illness, de-escalation

DeLoy Dupuis, the King County Metro bus driver who was involved in the shooting in downtown Seattle. [John Lok, The Seattle Times.]

It seems nothing short of a miracle that the Metro driver who recently suffered an armed assault survived, let alone with relatively minimal physical injury. [“Metro driver recalls terror, riders who rushed to help,” page one, Aug. 14.]

It is fortunate that this occurred in an area with a high concentration of law-enforcement personnel, who were able to respond quickly.

I am a fellow Metro transit driver, and dealing directly with persons affected by mental illness is just one part of our job. However, situational de-escalation training provided by Metro Transit is modest — I received far more training in a previous tech-support job.

The gunman in this incident was obviously a person with long-standing, deep-seated issues with mental health and substance abuse. As mental-health services at all levels of our governments are stretched to the breaking point, and as King County is not likely to spring for additional training in these budget-challenged times, I would like to propose we, as both a transit workforce and as a community, move forward at a grass-roots level.

There is a national movement afoot called Mental Health First Aid (MHFA). MHFA is designed to provide an informed method for dealing constructively with individuals in a heightened state of distress.

A small tool may be better than no tool. Even with the fastest possible police response time, the seconds that transpire before police can arrive can be a few seconds too long.

Ann Ziegler, Metro Transit operator, Seattle

Guns are too easy to get

A fraction of the 716 guns obtained by Seattle during the city’s gun buyback in January. [Ken Lambert, The Seattle Times.]

The recent article on the Seattle Police Department’s investigation of the bus shooting states that “among the unanswered questions is how Duckworth obtained the revolver used to shoot Dupuis. A felon with a history of drug offenses and mental-health issues, he was not allowed to carry a firearm.” [“Around the Northwest: Long probe seen in bus shooting,” NW Friday, Aug. 16.]

For anyone who was on the street during the city gun buyback this January, the answer to “how” is an easy one. I was at the buyback to get rid of one of my grandfather’s old guns, and as I walked the three blocks from my car to the collection point, I was approached by no less than five individuals offering to buy my gun.

I was stunned to learn that it would have been entirely legal for me to have sold my gun to one of these guys.

[Editor’s note: According to the United States Bureau of Alcohol, Tobacco, Firearms and Explosives: “A person may sell a firearm to an unlicensed resident of his State, if he does not know or have reasonable cause to believe the person is prohibited from receiving or possessing firearms under Federal law.”]

The lesson here is that buying guns in this state can be quite simple and free of paperwork and background checks, no matter what the state of your mental health is, or your criminal history.

If you want to stop this sort of ridiculous and dangerous market, sign and support Initiative 594 to the state Legislature. Supported by the Washington Alliance for Gun Responsibility, the initiative would require background checks for all gun sales.

Matt Huston, Seattle