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Kenneth Paul Rosenberg, MD
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"For centuries, we, individuals and families living with serious mental illness, have suffered in silence and shame. We can no longer be ashamed, and we can no longer stay silent."

— Director, Kenneth Paul Rosenberg

 
 

Bedlam

An Intimate Journey Into America’s Mental Health Crisis

 
 
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What we as advocates need to fight for:

you are not alone.

Through no fault of our own, we struggle with diseases that merit just as much attention, empathy, and support as cancer, AIDS, diabetes, or any other serious ailment. This means that if we want to change the mental health care system, we need to go public and demand more. Then what? We know from decades of experience that reversing 150 years of neglect will not come swiftly or easily. If there is a permanent solution to America’s mental health crisis, it is found not in a flurry of legislation or finger-pointing. The puzzle of cancer is not being unraveled by a single act of legislation. Infectious diseases have not been eradicated by a single antibiotic or public-health intervention.

Change can’t be accomplished by the election of a single mayor, governor, or president. Making change depends not on elected officials, doctors, or hospitals but on us stepping out of shame and fear and marching as a united community of advocates who continually demand something more. We are not sociologists or policy wonks, but here are the changes we want to see:

  • Four times the current number of treatment beds, including at public facilities, and an end to outdated laws (i.e. the IMD exclusion), which dis-incentivize the creation of psychiatric and treatment beds.

  • Access for individuals with serious mental illness (SMI) to decent housing, vocational opportunities, and opportunities for socialization and growth.

  • Focusing treatment on role of substance abuse, which is itself a potentially fatal disorder, is 100% preventable and treatable, and complicates and contributes to serious mental disorders such as depression, bipolar disorder, and schizophrenia.

  • Crisis Intervention Training for police and other first responders to foster treatment, not imprisonment or punishment.

  • Judicial reforms like mental health courts with legal options allowing for leveraged treatment before tragedy and diverting people with SMI from jail.

  • Prioritization of services based on who is sickest, not based on who can pay.

  • Emphasize continuity of care and caregivers (e.g. Assertive Community Treatment teams to ensure regular treatment and medication compliance).

  • Including people with mental illness in our dialogue about treatment and social reform and keeping from shutting them out with the attitude of they just don’t know what’s good for them.

  • Expand and improve scientific research because the best solution would be to have prevention and cure.

 
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What to do for yourself and/or a loved one with a serious mental disorder:

First and foremost, connect with the National Alliance on Mental Illness (NAMI)! For solidarity, education, advice, connection with service providers, etc, call the NAMI, the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness.

The NAMI HelpLine (800-950-6264), operated by NAMI staff and volunteers, provides lots of information and resources including:

 
  • Symptoms of mental health conditions

  • Treatment options

  • Local support groups and services

  • Education programs

  • Helping family members get treatment

  • Programs to help find jobs

 
 
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7 rules for finding good treatment:

1

Treatment must be affordable.

Throwing a lot of money at the problems of SMI will not quickly resolve them. Mental illness requires long-term treatment. While a very expensive hospitalization may help diagnose the problem and be money well spent, it’s important to conserve funds for long-term outpatient and inpatient care. Mental illness is a war, not a battle.

2

Get good insurance.

Parity laws have enabled people with psychiatric conditions to receive benefits for outpatient and inpatient care comparable to those folks with medical issues, provided that medical and psychological care is provided by the in-network providers who accept the insurance plan’s payment. However, good outpatient care is often provided on a fee-for-service or cash basis by out-of-network providers. Therefore, if available and affordable, I prefer health care insurance policies that also generously reimburse out-of-network care at reimbursement rates of 70-80 percent of the “usual and customary fees.” Out-of-network reimbursement can even climb up to 100 percent after you reach your total out of pocket payments. Your insurance carrier and/or employer can explain these options.

3

Find a provider with whom you have good chemistry.

Because of the lack of uniform treatment protocols in psychiatric care, choosing the right psychiatrist, medical doctor, or nurse practitioner for medications and finding the correct psychiatrist, psychologist, social worker, or nurse for talk therapy may take some due diligence. Aside from making sure that your healthcare provider is affordable and convenient, you want a provider who is well-regarded by their medical peers and patients, is honest and ethical, and who employs today’s scientifically-based best practices. You may want someone who works within a medical school or university setting and has other peers looking over their shoulder. But most of all, as in any relationship, you want someone can you trust. You want good interpersonal chemistry: a good fit, someone you can get along with, someone you can tell your truth to, to whom you can say nearly anything, and someone whose opinions you can respect.

4

Less is more.

In medical and psychiatric diseases, multiple medications are often required, and high doses may be needed, but always seek the lowest dose and the least invasive treatment as prescribed by a reputable, licensed clinician. However, if lower medication doses fail, if your meds need to be higher, and/or if your talk therapy need to be more intense and frequent, please be ready to increase the level of care to treat the illness.

5

Be open.

Many of us make up our minds about what is acceptable and unacceptable without the benefit of due diligence and scientific data. For instance, electroconvulsive therapy (ECT) is often dismissed because of its reputation. Clozapine, a very effective antipsychotic, is underutilized because of the fear of side effects. We need better treatments to be invented, but, until we have newer approaches, please don’t dismiss a medication or a scientifically-proven therapeutic approach because you don’t like the sound of it.

6

Get psychotherapy.

With all mental illnesses, from mild to the most severe, psychotherapy (talk therapy) can help and can change your brain for the better. Individual therapy, family therapy, group therapy, and self-help groups can make a world of difference. And, unlike meds, no side effects!

7

Commit to self-care.

Too often we rely on doctors and therapists only. Doctors are useful, but they’re no substitute for healthy living. Good nutrition, exercise, meditation, time with friends, good sleep habits, laughter, religious affiliations, and meaningful work and play activities can make a world of difference. Conversely, excessive alcohol use, taking recreational and unprescribed drugs, gambling, and other risky behaviors, as well as engaging in dysfunctional romances and relationships — all of these may mess with you mind. Whether you are a patient or family member, self-care is crucial for the wellness of you and your family.

 
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A FILM BY KENNETH PAUL ROSENBERG

Directed, Produced and Written by KENNETH PAUL ROSENBERG Produced and Written by PETER MILLER Edited by JIM CRICCHI Director of Photography JOAN CHURCHILL, ASC Location Sound ALAN BARKER Cinematography BOB RICHMAN Additional Cinematography BUDDY SQUIRES, ASC Original Music DANNY BENSI, SAUNDER JURIAANS Executive Producers SALLY JO FIFER and LOIS VOSSEN Co-produced by JOAN CHURCHILL and ALAN BARKER A production of UPPER EAST FILMS, LLC

A CO-PRODUCTION OF INDEPENDENT TELEVISION SERVICE (ITVS) WITH FUNDING PROVIDED BY THE CORPORATION FOR PUBLIC BROADCASTING

Funding provided by JOHN D. AND CATHERINE T. MACARTHUR FOUNDATION, PEG’S FOUNDATION, SCATTERGOOD FOUNDATION, FLEDGLING FUND, PETER & ELIZABETH TOWER FOUNDATION, DON SANTEL & KELLY McGINNIS, ALTA MIRA, GREENBURGER CENTER FOR SOCIAL AND CRIMINAL JUSTICE, FIDUCIARY FUND

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© UPPER EAST FILMS, LLC, 2019 ALL RIGHTS RESERVED

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