May 14, 2014|
Garland talks about America's non-existent treatment for the mentally ill with Dr. Ron Manderscheid of the National Association of County Behavioral Health and criminologist Dr. George Capowich.
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Automatically Generated Transcript (may not be 100% accurate)
Number of months ago where neuroscience and it is on its -- and spoke of several lot of and basically do what he says what he's come to leave as a lot of blows. Or we or -- bring him not a 100% but thinks. A large or. And what he pointed out and urged simplistic way for review obviously. Is that though often -- your approach should take to YouTube. That he knows how to goes. You change the brain chemistry. And he pointed out that he thought it and not the near future but in the future. If he's right we may come -- A process of which we can test chemicals. Indices -- And it is so fuel cores so bloated that doesn't couldn't elaborate groups -- -- And will be able to replace -- chemical and bring them back into the -- soon spree. And his is. -- wall if you look at our prisons. You should you'll see the whole lot more mentally ill people. -- -- room our conference in particular when it's being tired in the bird conservancy. Landslide I've picked up polo article from -- as -- dude they're doing USA today. They're doing ago multi actually report on mental illness. They claim. It's about. Pollutes the ten million people. Suffering for middle fill those in this country. And more record was we have replaced the hospital bed with the shields now. The homeless shelter. And the coffin. And the person -- psychologist who was quoted as saying this the portion Howell is that compassion. Veteran send if we're gonna talk to the experts and thankfully we've got it's from the bird he won't talk and a doctor -- manager tried. Executive director natural series for you shouldn't tell the -- Hebrew health and developmental disability directors. Also immediate past president. College for -- -- brutal held leadership. Doctor -- sure appreciate your time during. Allan thank you very much am delighted to join you today. That you. Are we seeing a lot of -- let me digress a little bit I've been broad enough long enough. Remember a young reporter in New York by the name of for all the ribeiro would -- -- big xmas -- how horrible. Middle -- in this hospital he put salute these were sort shutting them all over the country. A lot of them turned up homeless is is that still the case. That there's still a problem in our ability to have sufficient. Clinics in our communities to offer community based care. And what the story that -- referring to made a major difference in New York -- actually moving resources from the state hospitals in New York. Into the community. The -- also comment on your earlier comment on the brain. The very best latest research on the brain. Indicates. What's called the plants tested the in the brain meaning that. The brain is very plastic. In interaction with its environment. So I guess I would dispute the idea that you could address increasing by taking appeal. Very important in WB haven what you do is the -- -- -- and house support of that environment is and so on. In behavioral health care we've learned that. Many of the behavioral health problems that people have. Originate regionally. In trauma that people have experience sexual trauma physical trauma emotional trauma. Therefore. Part of the remedy for this is what we call trauma informed care of that recovery oriented. Getting you back in the communities in which you can have a full light in the community. But -- also comment and that is the issue of jail so. Tonight they're going to be -- body underneath 5000 people in the county jails of the United States. 50% of those people are going to be people -- substance use conditions. And about twenty to 25%. Are going to be people have serious mental illness that you were referring to before. Many many many of those people should never be in criminal justice settings so. If you were asking me what we should do about that we would say well it's much better you build a clinic. And be built in jail built a clinic in your community and you'll have fewer people. In your county jails and your city jails who probably should not be there in the first place. So let me get -- give you word in edgewise here. A couple of portions of personable. Would you explain to oral -- and -- places city of the boring me. Class that it. Of the brain simply means that. Your brain doesn't develop in a vacuum your brain develops in the environments in which you live and in effect through your body your brain interacts with the environment and develops in particular directions. Depending on the stimulation in your environment. Depending upon the emotional support you getting your environment and so on it. That is essentially the idea that the brain does not develop in the back -- Calendar and the -- you viewed explosion back then -- it's good question. This sciences said it was talking about didn't say doubled in the taking pills will be okay. If Ford was that we're gonna work a whole lot more on the chemicals in the brain and when you when you say that trauma. Often causes the middle -- illness in the problems of Wednesday's. On a personal basis. When I was young. -- like football with her there renovate this flight of low -- club played -- through. There was there was nothing in -- That was drawn towards violent went through a little thing -- war in Vietnam came back totally different. Totally changed confrontation with something. Why didn't -- bring chemicals changed via the troll. Yes absolutely your brain chemicals changed by the -- that's exactly a very good example of what I mean by the classed as city in the brain -- Doesn't that mean that a lot of these middle you people whether -- be. Pointed pursuit of the 885000. It's it's their fault and some former fashion but have they also not. Have their brain chemical changes that we could find a way. To minimize that or limited the -- Libya our biggest portion of the -- I think part of the answer here is the pathways through which you address those issues. What we mean by trauma informed care is that that -- takes into account. The fact that you've been exposed to trauma in your case you were exposed to trauma in Vietnam might also was in Vietnam -- know -- abuse speak. Or you may have been exposed to trauma in your neighborhood you may have been born in poverty and exposed to sexual -- in your -- neighborhood whatever the case may -- We believe that. Part of addressing that then is to make sure that person gets care. That's promised informed and that may be care that it involves various forms of psychotherapy. Various group interventions it may involve taking medication. But it needs to have the framework of being trauma informed care you mentioned yourself as a child. Out. There's very uninteresting or search in California. And a sample of about 171000. Children. By the medical director of the Kaiser. Kaiser Family Foundation I believe. And the find in the basic finding wise. Bet that more. Adverse events a child is exposed to the greater the likelihood is that that child will develop deeper problems by the time that child becomes -- ago. And the fact that work went to the point where. For people who were exposed to six or more. Adverse childhood events and I mean extreme event by. Sexual problem emotional trauma. Physical violence on the part of your -- That. Detonated almost a 100% predictable. That that person by the time they became an adult would be. Exposed to and have behavioral health conditions that. Potentially would reach the level where they would require treatment so I think what we're working on here is kind of the combined approach. To say we gotta pay attention to -- environment. We got to pay attention to your brain. And we need to build the system out there that isn't fully having the capacity to do what we need to do including. In New Orleans and including in the Louisiana. You have a great opportunity to be -- service to all of your WW Al listeners. He and trying to break the cycle that we're talking about so the cycle that we're talking about here in New Orleans. Someone. Has mental illness there homeless there on the street they're picked up by the police there in the jail for a few days. Their background on the street maybe they get a few pills from their local provider. They go -- there -- -- they're back out on the street and they cycle we need to break that cycle. A huge part of breaking that cycle between. Is getting the person. The appropriate resources. So that they can get the care they need to break the cycle. One way of doing that in Louisiana. And New Orleans is by. Adopting. The Medicaid expansion of the Affordable Care Act which would bring insurance. To a lot of the very people were talking about who today do not their resources to receive. -- tubular governor's phone number and -- All right blue and pick up first rate curable -- Ten minutes left and I've got 2000 question or outraged they would come right back of the that topic. In the opening during Tuesday his mental illness. The figure Paula and it causes country at least to Britain with the 444. Billion. Dollars a year away about a quarter of that goes to medical care. And that figure does include the caregivers. Loss to earnings or the tax dollars spent to build prisons to put me in Leo people. We're talking to a real expert on this doctor -- and drug. With the national institution of county behavioral health and developmental disability. Hello also immediate past president and CM each day the college for behavioral health leadership. Doctored is is it. She tore. Through to put these people in the hospital in in medical care than it is justice to commend itself. So let me answer than a little more complex way it's cheaper to have them having a full life in the community with clinic care. That it is to have them in a jail cell or prison cell. Or even in a hospital. -- And soul we've been working for many years in this field to develop our group. Capacity for what we call community based care that. Wherever you live in the United States that you should be -- in. Typical commuting distance of a behavioral health facility. That can deal with emergencies. They can't deal with routine care and so on and go back to what I said in the earlier segment of your program it's better to build clinics. But it is to build jails basically. Let me also had a couple of dimensions we didn't talk about earlier. I would add another. Concept here it's better to prevent something -- to treat it. So I think one of the things we are also working on in this field is to try to move up stream. And to identify. Problems much earlier before they become acute so. It may be that it in your particular mental health problems developed. While you were a team. Or they may have developed in your very early adult years for which frequently happens. The earlier we can understand pitcher having some difficulty and engage you here. Various preventive interventions or treatment itself. The better you'll turn now -- and the less likely you are to become someone who has a very severe disorders so. Early engagement early recognition. Training teachers in the classroom to recognize these types of problems and -- to know what to do about it when they recognize them. Are very important. Another dimension or working very hard and as what we call integrated care putting. Behavioral health care in two primary care clinic so when you go to see your local doc. Bet if you have behavioral health problems whether they be alcohol problems or drug problems or you have depression or you can make society. Bet that office will be able to address those problems as well. -- an interesting fact here in that regard is that even today. Of all the people who get the April -- scared the vast majority who get behavioral health care. Get it from their local doctor they don't get it from a specialty. Mental health clinic coral local community mental health center. And the distribution is about 75%. To the local doctor. And about 25%. To these specialty clinics so. We're trying to empower those local doctors in those local practices so that they. Have appropriate staff that can address the April -- problems. They can address that very early what you come in for your pediatric visits. If the mother is snapping -- postpartum depression etc. etc. etc. so. The many exciting things going on I don't believe that your listeners with simply the ideas that. You know we have intractable problems here. We we have problems but we're trying to address them and make things better for people. You certainly your and the people who work in your profession won't blow accords should not not fortunes statement made. Blog author warned of the reports are broke live weakened this was quotes. Right there have been recognized the need to pain now all appeal later. We've operated the big third option where we say. I prefer not to pay taxes in just ignore the problem. Right do I think that's pervasive then and so Heidi Heidi it adds that. I think you know what we're dealing with here is a basic issue. How we all live and our own communities so. If I go on in my house and your -- neighbor. And I see that you need help in some way you know party group has blown off or you fell down and broker like -- frontier house. I want to go over and help you. There should be no difference between me coming over to help you as my neighbor. And me being willing to put some in my resources. In to helping people who live more broadly in my community. And I he's those things as being exactly the same thing and I think America became great and strong and who it is. Based upon the fact that we all lived in communities. We all cared about each other in these communities and we cared what happened to our neighbors our children. And our elders. You know as we developed as a society so I think. We need to try to rekindle that spirit of community concern. In our society. And I think you can play a very important role in that in. Bringing these messages to your listeners -- I -- feel very similar to what I'm just saying right now. Doctor the earlier in or -- conservation and it is a mega important problem. Love to have you back on the show maybe 3400. Okay I'm glad to com 3400 times I love this work and I think it just so important to thank you very much. They go in there should be doing the work and thank you didn't have. Aren't covered up the actual we'll talk to a former policeman is now criminologists. At Loyola. And then get stake on this from. Prisons and -- prone. The people wouldn't -- been jailed is that it good idea of that is it more expensive bullets that doesn't. Governor objective view of -- of comments Gibbs call. Turner's exit row 172036. Fixated and zero -- We build a number of shows over the years and think -- concerning mental illness and the variety borders. Couple of days ago so -- USA today -- series series is really really detailed reports. On middle illness and there there -- issues says we've got a -- Ten million people. Suffering from severe mental and -- men. Would not totally severe but certainly problematic. And one of the quotes by more than the experts whose child psychologist he says. We've replaced the hospital bed with the jailed sale. Also with a homeless shelter but not nearly but it would trails. And any -- the question or is that compaction. Get a better handle on this some particular role in the chrome all -- side of the -- -- called side of the doctor George capital which is given as some of his valuable time once again former policeman cruel blow engines departments whose algae. Oil Ian Robertson talked to welcome back we sure appreciate it done. The beauty of figures cited in the -- suited report says. It cost this country at least 444. Billion dollars a year. Concerning middle illness solely -- a quarter of that goes -- medical care. Of rests that goes to prisons and homeless shelters. And that cause of foreign reported four billion dollars a year. Does include the caregivers lost earnings. Of the tax dollars spent to build more prisons. Is this -- on the financial side. The Smart way to do this with the middle you put them in prison. -- actually now we've -- for decades. Duties. It's more expensive to do that way. -- suffer from the public. It's not as effective. It doesn't produce an exchange shoot. The families -- the people affected. Mental illness. In terms of trying to helped him improved situation. And that figure you quoted issues indicated it is. Great. Under estimate that we -- and a possible there. -- in terms of not only a -- starting time. Of the mentally ill person. Their families damages to businesses. Community. Isn't enormous cost. Bond defaults. I'll work on. Putting. Battery telephones. And the resources into the final and to do you Wear treatment. In an effort to combat the problem. Looked up figures who has -- in the -- leaders triggers a component states in America. Have -- middle oil services between 2002003. Short years by five billion dollars. And it does seem to and eliminate reported 500 public psychiatric. Hospital bed -- Did you lobby and in Baton Rouge have talked to legislators and say. -- your your cutting costs and having across all of its into. Well I haven't personally talked with the marketing mr. few questions. Over the ear shot from. From legislators. -- And you know I think it's it could -- a couple of things one news. You know -- -- here it is city's social stigma attached -- that question appropriately viewed that some people who are currently Google could somehow of interest take care of Rome which we will. Matter shall disciplined. And you know. It is all changed. Iran and we don't. Have happened unfortunately tar and political. And social. We are achieved Q what is necessary shall we end up making decisions. Social change this year. And then especially when you've been in true. Economic downturns. Church. We experience. Essential I don't know ignorant you know line. In these kinds of areas that get cut first. -- Christie's political constituency. Shall we could there are a lot of it is actions taken believe such -- acquitted. And that just doesn't get the public resources. -- me. The public still paying board. Campaign war in necessary we upfront it's just hidden. Prison costs in jail costs. And the other things that. Yeah -- that occurred because it obviously isn't being treated. And we know crimes that we do you have. Well you know we we reject the situation rule potentially capture -- attention in the mass shootings. But there's the over kinds of crimes and cost of imprisonment the law enforcement. Factually. Exe. Those those kinds of course. That are associated with -- tragic of times actions. I'll aliens -- it's sort of it's almost hidden from view from legislators from political officials from the public doesn't think it's gone. Did you George's were thinking about a series very detailed -- neighbors searched probe will surge. Series other -- say ten day about the middle old -- in this 110 million people plots. As the doctor just said minimum cost that solicit 444. Billion dollars year actually. More expensive than that money were wasting putting him in prison. And said -- getting them help. What do you think it was called 260187. Toll free 86 exhilarated nines year old he says. Couldn't have a better guests today it would -- doctored George cup we're truths of former policeman and a criminologists. And with the department about sociology. Quarterly numbers. If you just joined those were worth thinking about mental illness. There -- there a whole lot more coverage in the media lately or at least I'm finding which -- Google is subject. And have been fascinated by it for a long time. Because. In this sound against kind of silly. Well whenever there's a mass shooting. Prince of laws and penalties people who call the show go in -- what was that kid thinking he went to the the the children's elementary school we killed thirty kids what was he thinking you went to the military base and killed forty people. And always says he. Why didn't anybody over and the question. You have twelve on the Libby blew me back remarkable bit suppose you'll brand said Q you know. I think regardless of elementary school in -- Blanche -- what would be the first thing you said. Or you crazy. And boy and when I look at these -- killings. And so many of the criminal that I interviewed over the years or met personally. A -- Document three years ago it -- forensic unit for the criminally insane in there and cola. And the person can -- mama was not violence or. Or scary it was mentally -- Doctor won one of the of the questions. -- -- it's starting unit -- -- to Georgia as excellent. That belonged quote. Providing comprehensive middle -- servicers -- middle you involved in criminal justice system. Cut the number of days that participants spent in the hospital by ignorance of 89%. And the number of days spent in jail by 78%. -- what's comprehensive. Middle helped surface what what happens there when they were acts. I mean -- that -- there -- -- according to whatever Richard and well for treatment and that it radically changed. And infrastructure. It's you know complete physical. And mental health. Assessment. Medication. Might be appropriate for the portion UKQ. Collector the chemical imbalances that you referred to earlier. On a solemn we're able involved in the so. Eight MB power. The to treatment. Columns and in -- has -- the ship should. Economics so all it's been less expensive. It can't stay home or on the length of treatment and touched down on the column. -- of imprisonment. The other thing that many of these programs comprehensive programs. Just follow up at work. One of the challenges. The issue. War. People that are their families. If -- meditation is appropriate. That. Stay on. Optional you. And we supervision and others counselor should provision in your community based programs which we struggle -- cutting. So after that we also got it. The community. System sure that there isn't. Community based -- -- I'll call and work with people after they released either from Christian or problem cop from the hospital. That the ways of doing it. Clear. -- -- -- For thirty years in the search from psychiatry criminology and sociology culture. And yet we don't. Doctor Earl always blizzard have real show -- is topic we're gonna do a lot moron because. Part of me being sullen and one of these settlement. A lot of people just sort of -- about a month for -- makers are leaders. Or where the putting her in prison for -- -- with the you'd think. Middle Leo pupil when people were just people. Would no will power it's just way more expensive. And it didn't create anything other than more problems. It took out an extra. Completely term agreement few years. And I think one of the reasons people perhaps including elected officials or more -- it is comfortable earlier. A lot of the public safety issues people's personal safety issues criminal justice expenses all the solutions. Or hit. -- beat news they're not the sensational cases. How people see on the news in the morning and yet those costs. Or -- real. Doctor you think you drew wrote Sherman says educating us on this you have -- do appreciate your time. I thank you don't know which. Coach Lloyd WW.