Friday, August 17, 2012

Appearance Versus Substance; Hide It Or Light It Up.

There are often great discussions in life that only when we look back do we see how much they mattered.  I had such a discussion with Jean McGrew when he ran district #225 and I was on the board.  The basic issue was whether appearance or substance is the more important element in all things north shore.  While that may seem like an odd sentence, those that live here will either immediately understand or no amount of explanation will help.

Jean's position was firmly that appearance ruled the day and I, of course was a substance fan.  We agreed that having both was preferable but if only one could be had, then we deviated.

I've often seen that same discussion played out in all sorts of area's in life.  A slight derivation on the topic is the phrase "lace curtains" as in all appears tranquil and in it's place from the outside but inside can be quite different.  As you can imagine I see that most days in my work.  Often it takes the form of expensive cars, big home and living paycheck to paycheck.  It can also play out in social position and perceived power.  The made for TV show "Boss" is but one example of this.  All the power in the World, family in ruins.

It's also of interest that when the two worlds of appearance and substance begin to collide how aggressive and controlling behavior can become in trying to right the ship back to appearance and away from substance.  I've said previously the movie "Ordinary People" sheds an extraordinary and insightful light on this topic.  In writing this Blog I've run into it on a few occasions and I expect even more of it, if I do it correctly.  Besides, I have standing in that I grew up here and still work here. 

For example, lets say you've got a person who shows obvious signs of odd behavior, extreme emotion out of context and thinking that appears to have little to do with reality (those who've read previous posts know this as mental illness).  Lets say this person disrupts those around him or her to the point that authorities are asked to manage the situation and do a piss poor job of it.  Apparently what I'm supposed to do is turn a blind eye to the situation and ignore it.  Heaven forbid it's openly discussed or pointed out.  For God's sake don't place a light on it; it doesn't appear as it should.

Today I was on the receiving end of some of that controlling behavior.  My response is the animals have already left the barn so rushing to close the doors is of little help.  I realize those closest to the situation want the nightmare to end but hushing me up won't do that.  History is already written and published in the local papers and the tribune as well.  The best possible end to this story is a change in direction and the mental health system actually working; working on the substance and altering it rather than changing the appearance.

You really have to ask yourself at some point (if you're a substance person) how it comes to be that a governmental body with an approximate budget of $73 Million results to banning people from Village Hall and charging them with misdemeanor telephone harassment instead of getting a good, solid, and contributing family in the community the help they need to deal with an apparent mental health issue.

The next installment of my Blog will spell out, according to known law, how to get the help that's needed.


In honor of an old friend who will be missed I think this passes the test.

Is it the truth?  Yes

Is it fair to all concerned?  I think so if "all" really does mean everyone.

Will it build good will and better friendship?  Not in the beginning but in the long run.

Wednesday, August 15, 2012

Making The Ilinois Mental Health System Work For You

In my previous post I talked about the definition of a mental illness and the fact that thousands in every community are being successfully treated.  The question becomes more difficult when and individual is either unwilling or incapable of accepting the need for treatment.  What can be done then?  And who can do whatever it is that can be done?

Here's the answer. 

(405 ILCS 5/3-701) (from Ch. 91 1/2, par. 3-701)
      Sec. 3-701. (a) Any person 18 years of age or older may execute a petition asserting that another person is subject to involuntary admission on an inpatient basis. The petition shall be prepared pursuant to paragraph (b) of Section 3-601 and shall be filed with the court in the county where the respondent resides or is present.     (b) The court may inquire of the petitioner whether there are reasonable grounds to believe that the facts stated in the petition are true and whether the respondent is subject to involuntary admission. The inquiry may proceed without notice to the respondent only if the petitioner alleges facts showing that an emergency exists such that immediate hospitalization is necessary and the petitioner testifies before the court as to the factual basis for the allegations.     (c) A petition for involuntary admission on an inpatient basis may be combined with or accompanied by a petition for involuntary admission on an outpatient basis under Article VII-A.
(Source: P.A. 96-1399, eff. 7-29-10; 96-1453, eff. 8-20-10.)

So anyone 18 years of age or older can attempt to get someone the mental health help they need.  The petition is normally presented at the emergency room of a hospital where the subject has been taken for help.  Family members can usually get their local ambulance to transport the subject if they know its for a mental health reason and that a petition will accompany the subject to the hospital.

There are however three possible reasons for hospitalization, one or more of which need to be met before hospitalization will occur.  The first two are; 

(1)   A person with mental illness who because of his or her illness is reasonably expected, unless treated on an inpatient basis, to engage in conduct placing such person or another in physical harm or in reasonable expectation of being physically harmed;

(2)   A person with mental illness who because of his or her illness is unable to provide for his or her basic physical needs so as to guard himself or herself from serious harm without the assistance of family or others, unless treated on an inpatient basis; or

These first two reasons had been the law of the land for maybe 25 plus years until a significant change around 2008.  In fact they were in place for so long that many of today's practitioners may not know or understand that a third reason now exists.  The third reason is; 

(3)   A person with mental illness who:
            (i) refuses treatment or is not adhering adequately to prescribed treatment;
            (ii) because of the nature of his or her illness, is unable to understand his or her need for treatment; and
            (iii) if not treated on an inpatient basis, is reasonably expected, based on his or her behavioral history, to suffer mental or emotional deterioration and is reasonably expected, after such deterioration, to meet the criteria of either paragraph (1) or paragraph (2) of this Section.

In determining whether a person meets the criteria specified in paragraph (1), (2), or (3), the court may consider evidence of the person's repeated past pattern of specific behavior and actions related to the person's illness.

So, in essence the three reasons are (1) serious identifiable threat to harm self or others, (2) an inability to care for ones self without significant help and oversight of another to keep one safe or, (3) an identified and untreated mental illness that is expected to deteriorate to the point that either 1 or 2 above would become probable.  Plus, we can now introduce past known mental health issues that are thought to be related to the persons current condition.  No longer are we hand cuffed to the last 72 hour time frame to prove a problem exists.

Reason 3 is a significant change for the positive if people know about it and understand it.  Sadly many people (and professionals) are unaware and simply throw their hands up in the air when faced with a person suffering from a mental illness who does not want treatment of who is failing to comply.

Part 3 of this series will cover obtaining a court order for treatment and a court order for medication use.

Tuesday, August 14, 2012

Untreated Mental Illness; Making The System Work In Illinois

The local newspaper entry read....."___________ was arrested and charged with harassment by telephone after he allegedly called Village Hall and left several extended messages, according to police. Police had warned him in the past to have no further contact with Village Hall unless it was for legitimate purposes."

The above is a common occurrence when Villages have persons thought to suffer from mental health illness living untreated within their community.  I think starting with a definition of mental illness will aid in this discussion.

In Illinois a mental illness is defined as....

(405 ILCS 5/1-129)Sec. 1-129. Mental illness. "Mental illness" means a mental, or emotional disorder that substantially impairs a person's thought, perception of reality, emotional process, judgment, behavior, or ability to cope with the ordinary demands of life, but does not include a developmental disability, dementia or Alzheimer's disease absent psychosis, a substance abuse disorder, or an abnormality manifested only by repeated criminal or otherwise antisocial conduct.

(Source: P.A. 93-573, eff. 8-21-03.)(405 ILCS 5/3-601) (from Ch. 91 1/2, par. 3-601)

So the idea of people with mental illness living within a community shouldn't be news to anyone.  In fact, based on the above definition, there are likely thousands of community members who fall under that definition but who are receiving appropriate treatment and are fully and positively engaged in the process; they are for all practical purposes said to be in remission.

What happens however when an individual meets the above standard but is not fully engaged in treatment or feels they are not in need of treatment?  Practically speaking, as long as they aren't affecting others, they tend to pretty much stay to themselves and suffer more or less in silence.  However, in the example from the newspaper above, sometimes these folks do affect others and in very potentially damaging ways.  What happens then?  And who decides the person needs mental health treatment of some kind?  That'll be the subject of section two of this post later this week.

Monday, August 13, 2012

The Illinois Mental Health System is Broken

"A 77-year-old man is dead and his son is being held at Cook County Jail following a fight the son had with a neighbor at their Northbrook home on Thursday.

Ronald Christensen, 77, of the 1900 block of Thornwood Lane in north suburban Northbrook, was pronounced dead at 8:30 p.m. Saturday at Glenbrook Hospital, according to the Cook County medical examiner’s office.

An autopsy Sunday ruled Christensen died of heart disease and his death was ruled natural, according to the medical examiner’s office.

On Thursday Christensen and his 48-year-old son Ronald M. Christensen, Jr. fell at the home on Thornwood while the elder man was trying to pull his son away from a neighbor who the son had struck in the face, according to police and the medical examiner's office.

Police responded and arrested Ronald Christensen, who was charged with felony aggravated battery." Chicago Tribune

This is a tragedy that could have and should have been avoided.

Getting Help For Mental Illness, Part 1.

Getting Help For Mental Illness, Part 2.

Appearance Versus Substance; Hide It Or Light It Up?

Sunday, August 12, 2012

Police and Firefighter Suicides; Getting Help For First Responders.

Police, Firefighters and Dispatchers can get quality psychological help in the Chicago and suburban Chicago area.  Psychological help for Chicago area Police, Firefighters and Dispatchers is almost always covered by major insurance carriers with very little "out of pocket" expense.

I work as both a police psychologist and as a psychologist to Police Officers, Firefighters and dispatchers.  Sometimes I'm a first responder and sometimes I ride a desk back in the station; it depends on the type of call and if I'm in the station or on the road in a squad when it comes in.  I work inside the system but I am not the system; I am independent from the system.

It is estimated that 12 out of every 100,000 people kill themselves in the USA each year.  Breaking down the statistics further reveals that approximately 18 out of every 100,000 police or firefighters take their life each year.  By way of comparison it estimated that 33 out of every 100,000 military members take their lives and that 36 out of every 100,000 prison and jail inmates takes their lives.

Here in the Chicago and the Northern Illinois suburbs it is hard to reach out to find quality psychological help for first responders.  Most departments have EAP's as a first response to emotional and behavioral issues but concerns remain involving confidentiality and quality.  EAP's work for the department and not the individual first responder and they are often minimally educated and entry level practitioners at best.  Once emotional or behavioral issues rise to the level of supervisory intervention (because help has not been found), the issue of fitness for duty arises and potentially a job is then on the line.

Family's and friends try to reach out and often there is some success.  Most of the police or firefighters in my practice are getting the help they need because of concerned friends or family that did reach out.  No formal interventions, just straight out communications about the concern and a business card of mine or my telephone number.

Roughly half of my first responder clients called me themselves and came by themselves to their first appointment.  The other half had spouses or other family members who wanted help on how to approach the one they cared about.  They sought me out because they knew I was inside the system and know the culture but that I am also outside the system in that I work for my clients and not their employer's.

The choice really is yours.  First Responder, spouse or friend?  Pick up the phone (my direct number is on my website) and call me.  Just what is it you are waiting for?  Things to get worse or the Hail Mary occurrence that makes it all better?  The latter would be great but the former is the norm.

Sunday, August 5, 2012

Police Once Again Put Down an Active Shooter; What We Do Know

"CNN) -- At least seven people, including a gunman shot by a police officer, have been killed in an attack on worshipers at a Sikh temple in the Milwaukee suburb of Oak Creek, Wisconsin, on Sunday, police said.

The wounded officer, a 20-year veteran, was in surgery Sunday afternoon after being shot multiple times, but was expected to survive, Wentlandt said. He was sent to the Sikh Temple of Wisconsin in Oak Creek, south of Milwaukee, after a 911 call about 10:25 a.m. (11:25 a.m. ET)."

What we do know is a 911 call at 1025 hours sent a 20 year veteran officer with tactical experience into harms way.  The officer was first on the scene and engaged the shooter in a gun battle which resulted in the officer being wounded and the shooter dead.  That officer had maybe 60 to 90 seconds between the call and the gun battle with an active shooter.  He risked his life in traffic to get there and then on scene to save the lives of others.

Police and Fire professionals are paid for what they might have to do.  Today Milwaukee residents got a bargain as once again a lone police officer faced off with certain death and stepped up to protect people not even known to him.

It's a tragedy for all concerned but once again a police officer goes down in the line of duty and it gets less coverage so far than any other aspect of the situation.

Friday, August 3, 2012

Group Therapy in The Northbrook, Glenview, Winnetka and Northfield Area

Dr. Conlin is now forming group therapy groups starting this fall in  the Northbrook, Glenview, Winnetka and Northfield area's of northern Illinois.  Participation is open to all and the only exclusionary criteria is current and severe mental illness that is not in remission.
Group therapy provides psychotherapy treatment in a format where there is typically one therapist and six to twelve participants with related problems. A psychologist may recommend group therapy over individual psychotherapy for a variety of reasons. It may be that the group format is better suited for the person or the concern they are dealing with, or that the specific type of treatment has a group therapy component (such as dialectical behavior therapy).

People in group therapy improve not only from the interventions of the therapist, but also from observing others in the group and receiving feedback from group members. The group format, while not providing the one-on-one attention of individual formats, has several advantages.

The advantages of group therapy include:
  • Increased feedback
    Group therapy can provide the patient with feedback from other people. Getting different perspectives is often helpful in promoting growth and change.
  • Modeling
    By seeing how others handle similar problems, the patient can rapidly add new coping methods to his or her behaviors. This is beneficial in that it can give the patient a variety of perspectives on what seem to work and when.
  • Less expensive
    By treating several patients simultaneously, the therapist can reduce the usual fee.
  • Improve social skills
    Since so much of our daily interaction is with other people, many people learn to improve their social skills in group therapy (even though such an issue may not be the focus of the group). The group leader, a therapist, often helps people to learn to communicate more clearly and effectively with one another in the group context. This is inevitably leads to people learning new social skills which they can generalize and use in all of their relationships with others.
Participants can try out new behaviors, role play, and engage with others in not only receiving valuable feedback and insight from other group members, but also in giving it. 

Contact Dr. Conlin today to learn more about our groups starting in September.  Costs are $25 per session and insurance often covers the fee.  Groups are forming for men, women, co-ed grief groups and co-ed adolescent groups.

Thursday, August 2, 2012

The Epic Failure of Colorado University's Behavioral Evaluation and Threat Assessment Team

James Holmes is in custody for allegedly killing 12 people and injuring 58 others when he opened fire in a packed midnight screening of the latest Batman movie, "The Dark Knight Rises" in Aurora Colorado.  Dressed in full riot gear, Holmes allegedly entered from an emergency exit in the front right corner of the theater before releasing something that witnesses identify as tear gas or a smoke bomb. From there, he allegedly sprayed the sold-out theater with a storm of bullets, injuring and killing both adults and children.  Holmes, sporting hair dyed red, reportedly told arresting officers he was "The Joker" in apparent reference to a well known villain in the Batman series.

In a previous post, Someone Knew, I pointed out that the shooter was likely known to be having mental health problems.  Apparently his school did know and and he was in fact the patient of Dr. Lynne Fenton, Head of the Campus Mental Health Service, a founding member and current adviser of the UC Campus Behavioral Evaluation and Threat Assessment team.

According to reports from the Denver post, Dr. Fenton gave the BETA team the name of James Holmes as early as the first week in June, a full month prior to the massacre.  It has been reported that the team took no action and failed to contact local police on the basis that James Homes was in the process of dropping out of school.  If all this turns out to be true, look for beneficial legal action, the result of which will make it more likely that future warnings will be more readily dealt with.

Currently the "Tarasoff Warning" dictates that only where a known target is identified, does a therapist have a duty to warn.  Because the University of Colorado had a mechanism in place to handle threats (their BETA Team) and failed to take any action to do so (rather than simply failing to stop Holmes through their action), they will be held responsible for the killings and Tarasoff will be enlarged.  In fact, I fully expect Holmes to initiate civil action on his own part over CU's failure to prevent the massacre.  He is very likely to prevail and the loss's that CU will ultimately become responsible for will be staggering.

It's one thing to fail to stop an action through error but, it's entirely another to simply fail to act when one has voluntarily taken on the responsibility to do so and has even marketed that ability on ones own website in an attempt to bolster their claims of campus safety.  This is bad for CU and they should be held accountable.  

The legal action will take years but the fall out should result in greater safety for all through an expansion of Tarasoff to include society as a whole to some degree.  

It will also force the mental health system to begin to trust law enforcement, something it should have been doing all along.  If you trust us when the shots start to fly by calling 911, it seems silly that you failed to do so, prior to that point, while James Holmes began collecting weapons and ammunition.  

CU is as guilty as Penn State.  They had a responsibility which they voluntarily chose to take on and instead, they chose to ignore it and pretend it wasn't their job.  Shame on them.