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<DIV dir=ltr><FONT size=4>November 1. 2019...Phila.</FONT>
<DIV><FONT size=4> It would seem to me that with all the stress and
pressures of out time <FONT size=4>that we need to keep our energies focused on
positive ideals and values <FONT size=4>in order to avoid falling into
depression and other mental illnesses.</FONT></FONT></FONT></DIV>
<DIV><FONT size=4> Focus on mental work and heart felt compassion
and empathy keeps <FONT size=4>our energies "high" which helps us to cope with
today's difficulties. <FONT size=4>Various spiritual practices; such as
meditation,yoga, affirmation work, <FONT size=4>therapies, self help, group
work...and especially helping others, as we can, all <FONT size=4>aid our growth
and development, keeping us away from so many negative <FONT size=4>diversions
today...</FONT></FONT></FONT></FONT></FONT></FONT></DIV>
<DIV><FONT size=4> Kenneth Rosenberg's perspectives help us to understand
mental illness <FONT size=4>today, and ways to work with it...well interviewed
</FONT></FONT></DIV>
<DIV><FONT size=4><FONT size=4>by Sandy Bauers, <FONT size=4> Phila.
Inquirer newspaper.</FONT></FONT></FONT></DIV>
<DIV><FONT size=4>Arn Specter, Phila.</FONT></DIV>
<DIV><FONT
size=4>______________________________________________________<BR></FONT></DIV>
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<H1>5 questions: Kenneth Paul Rosenberg on why mental illness is ‘the greatest
social crisis of our time’</H1>
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<DIV><FONT size=4><SPAN>by Sandy Bauers, For the Inquirer</SPAN><SPAN>,</SPAN>
</FONT><SPAN><SPAN><FONT size=4>Updated: October 23, 2019
</FONT></SPAN></SPAN></DIV></DIV></DIV></DIV>
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<LI><SPAN>
<H3><SPAN> <FONT
size=4> In 1946, Life magazine published an exposé on mental
hospitals, focusing on the Philadelphia State Hospital at Byberry. The title:
“</FONT><A
href="https://www.pbs.org/wgbh/americanexperience/features/lobotomist-bedlam-1946/"
target=_blank><FONT color=#0066cc size=4>Bedlam 1946</FONT></A><FONT
size=4>.”</FONT></SPAN></H3></SPAN></LI></UL></DIV></DIV></DIV></DIV></DIV>
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<P>That dreadful facility, like so many others, eventually closed. A good thing?
Not completely, according to Kenneth Paul Rosenberg, who maintains that people
simply went from one horrific situation to another, from the grossly inadequate
institutions to the dangerous streets. In neither case is psychiatric care even
close to sufficient.</P></DIV></DIV>
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<DIV>Editor's Picks</DIV>
<HR>
<UL>
<LI><A
href="https://www.inquirer.com/opinion/commentary/pennhurst-asylum-haunted-house-tours-2019-20191009.html"
target=_blank><FONT color=#0066cc>Pennhurst Asylum is exploitation, not
entertainment | Opinion</FONT></A> </LI></UL></DIV>
<DIV>
<DIV>Related stories</DIV>
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<H4><A
href="https://www.inquirer.com/opinion/commentary/pennhurst-asylum-haunted-house-tours-2019-20191009.html"
target=_blank><FONT color=#0066cc>Pennhurst Asylum is exploitation, not
entertainment | Opinion</FONT></A></H4>
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<DIV><SPAN><SPAN>by Rachael Miroddi and Allison Beck, For The Inquirer</SPAN>
</SPAN></DIV></DIV></DIV></DIV></DIV>
<HR>
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<P>Rosenberg, who grew up in Philadelphia, is a Manhattan psychiatrist and a
distinguished fellow of the American Psychiatric Association. He teaches at New
York-Presbyterian/Weill Cornell Medical Center. He’s also a Peabody
Award-winning filmmaker and now, an author. His book, <A
href="https://www.amazon.com/Bedlam-Intimate-Journey-Americas-Mental-ebook/dp/B07MYKWM9B"
target=_blank><I><FONT color=#0066cc>Bedlam: An Intimate Journey Into America’s
Mental Health Crisis</FONT></I></A><I>, </I>was published this month. The result
of a seven-year investigation into a system that has failed the one in five
Americans who experience mental illness, it includes harrowing patient tales and
prescriptions for change.</P></DIV></DIV>
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<P>Earlier this year, his full-length movie <I>Bedlam</I> premiered at the
Sundance Film Festival. It, too, looks at the public-policy failings.</P>
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<DIV id=gmail-m_-8798703007773006562gmail-m_3371172828294443932gmail-ad1870>We
spoke to him recently about his book.</DIV></DIV></DIV></DIV></DIV>
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<DIV><SPAN>Courtesy of Hank Gans </SPAN>
<DIV>Kenneth Paul Rosenberg's book, "Bedlam: An Intimate Journey Into America's
Mental Health Crisis," was published in October.
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<DIV>Inquirer Morning Newsletter </DIV></DIV>
<P> Currently, the major provider of mental-health services in this country
is not the hospital system, but the jails and the prison system. Because
psychiatric care beds are few and far between, the front lines of treating
people is not in hospitals, but in the emergency rooms. These are the de facto
mental institutions of our day. The greatest gathering of people with serious
mental illness is not in a day hospital or community treatment center. It’s on
the streets.</P></DIV></DIV></DIV>
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<P>If all that weren’t enough, Big Pharma has largely pulled out of
neuropsychiatric drug development. Some of the medicines that people are getting
are new, but the fundamental molecules were developed 70 years ago.</P>
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<DIV id=gmail-m_-8798703007773006562gmail-m_3371172828294443932gmail-ad419>When
you look at the cost burden of mental illness globally, it will soon exceed,
according to the World Health Organization, the cost burden of cancer, cardiac
disease, and all noncommunicable diseases
combined.</DIV></DIV></DIV></DIV></DIV>
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<P>Mental illness affects one in five families. And it remains poorly diagnosed,
poorly treated, poorly understood, and therefore, in my view, the greatest
social crisis of our time.</P></DIV></DIV>
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<H6>You have a personal connection with serious mental illness.
</H6></DIV></DIV>
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<P>My sister, Merle, lived and died as a consequence of serious mental illness.
She developed that illness when I was 14 years old, and that is why I became a
psychiatrist later. She was 21. People with serious mental illness often develop
it in young adulthood. Like many people with serious mental illness, she was not
aware that she was ill. She lived, as did my family, in denial of her illness.
She availed herself of treatment in a limited way, but her treatments were poor
and her compliance was terrible.</P></DIV></DIV>
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<P>Merle had a psychotic disorder, most likely schizophrenia. Hard to say
exactly what mental illness my sister had because the problem with psychiatric
illnesses is that diagnoses are phenomenological. It’s not like when you have a
sore throat and you get a swab and the test results show you have strep throat.
Her illness manifested itself in delusion, hallucinations, and in being
disconnected from reality, having magical thinking. She was unable to function
in the world.</P>
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<P>When she died, at age 55, the official cause of death was a heart attack.
But, in my estimation, the cause of her death was serious mental illness. On
average, people with serious mental illness live nearly 30 fewer years than the
rest of the population.</P></DIV></DIV>
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<H6>One of the most upsetting chapters of your book was about the
criminalization of serious mental illness. </H6></DIV></DIV>
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<P>I think it’s fair to say that it becomes a crime to have a mental illness in
America today. The first thing that often happens is that the police are called.
There aren’t many diseases for which, when you have an acute episode, you call
the police. So already, they’re in the law enforcement system.</P></DIV></DIV>
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<P>Then, there aren’t enough treatment center beds to take them to. So the
police often have the option of taking someone to an emergency room or a jail.
If they take the person to the jail, they can leave them there immediately. If
they take them to the emergency room, they have to wait — for them to be
triaged, accepted as patients, and so on.</P>
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<DIV id=gmail-m_-8798703007773006562gmail-m_3371172828294443932gmail-ad694>Also,
people with serious mental illness often commit petty crimes. That brings them
more to the attention of the criminal justice system. Then they get put on
probation and they don’t show up, because they don’t follow the rules. In some
states, if you have a mental illness, you’re 10 times more likely to be
incarcerated than in a hospital.</DIV></DIV></DIV></DIV></DIV>
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<H6></H6></DIV></DIV>
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<P>What people say is that we have not deinstitutionalized the mentally ill. We
have<I> transinstitutionalized</I> them — from the asylums to the streets and
jails. What would be better is a multipronged approach. We need community
mental-health centers that are properly funded and equipped and engineered to
handle people with serious mental illness. There are fairly good models for
this.</P></DIV></DIV>
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<P>Secondly, we need changes in the laws. We have to weigh personal autonomy
against letting people die as a consequence of their mental illness. We can’t
have draconian treatment — a psychiatrist throws someone in an institution for
their life — but we also can’t have people deteriorating and dying on the
streets, living desperate lives, and often the victims of violence much more
than the perpetrators.</P></DIV></DIV>
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<H6>You say there have been no blockbuster drugs in psychiatry for
decades.</H6></DIV></DIV>
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<P>First of all, the brain is very complicated. So it’s not easy to develop new
drugs. Secondly, as a society, we have not made serious mental illness a
priority. We have not been marching in the streets demanding a cure, the way it
has happened with breast cancer and HIV. We are at a moment when we are saying
that this is absurd.</P></DIV></DIV>
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<P>We have good medications, but they are not the best. They have serious
effects; 50% of people stop their medications because of the side effects.</P>
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<P>Also, we have left it to the pharmaceutical companies to develop new drugs.
And they haven’t because there are no recent breakthroughs in neuroscience that
companies can leverage to readily develop new medications. I understand pharma
companies have an obligation to their shareholders. But as a society, we have an
obligation to our citizens. We need more basic science into serious mental
illness. That’s the job of government-funded and university-based research.
Then, pharmaceutical companies could come aboard with the
medications.</P></DIV></DIV>
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<H6>At the end of the book, you offer tips for those with serious mental illness
and their loved ones. What did your experience with your sister teach
you?</H6></DIV></DIV>
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<P>We cannot fix this problem alone. We can’t fix ourselves alone. We can’t fix
our relatives alone. And we can’t fix our broken system alone. If you’re a
person with serious mental illness, you need help — the help of a family, the
help of a community, the help of doctors and health-care providers you can
trust. You need to reach out to support networks — the <A
href="https://nami.org/" target=_blank><FONT color=#0066cc>National Alliance on
Mental Illness</FONT></A> is one.</P></DIV></DIV>
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<P>We need advocacy. We need to talk about it. It doesn’t matter who you are.
You could be a public official, a billionaire, the smartest person on Earth, but
you can’t invent new medications on your own. You can’t find a hospital bed for
yourself or a loved one where there is none.</P>
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<P>What my sister taught me most of all is to be humble. I had the belief that
when my parents passed away — they were loving and kind, but they were in denial
— I could help my sister. I would be able to fix it. Well, I wasn’t. She taught
me the message of the book: You can’t do it alone. You need help on every level
— personally, in a family, in society.</P></DIV></DIV>
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<P><A href="mailto:sandybauers10@gmail.com" target=_blank><I><FONT color=#0066cc
size=4>sandybauers10@gmail.com</FONT></I></A></P></DIV></DIV></DIV></DIV>
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<DIV
id=gmail-m_-8798703007773006562gmail-m_3371172828294443932gmail-timestamp-published><FONT
size=4><SPAN>Posted: October 23, 2019 - 8:00 AM </SPAN></FONT></DIV></DIV>
<DIV><FONT size=4><SPAN>Sandy Bauers, For the Inquirer</SPAN> </FONT></DIV>
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<DIV style="FONT: 10pt arial">
<DIV style="BACKGROUND: #e4e4e4; font-color: black"><B>From:</B> <A
title=arnpeace@gmail.com href="mailto:arnpeace@gmail.com">Arn specter</A> </DIV>
<DIV><B>Sent:</B> Friday, November 01, 2019 9:18 PM</DIV>
<DIV><B>Subject:</B> Mental illness is ‘the greatest social crisis of our time’,
by K. Rosenberg; S. Bauers</DIV></DIV></FONT></DIV>
<DIV><FONT size=4></FONT> </DIV>
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