NAMI_Summer2015_Newsletter

Berks

Bulletin

V2: 1 Summer 2015 The Official Newsletter of NAMI PA, Berks County

Ongoing: NAMI Family Support

Group:

2nd Wednesday of each

month, 7 - 8:30 p.m.

Seasonal: NAMI Peer-to-Peer Recov-

ery Education course:

TBA

NAMI Family-to-Family

Educational course:

TBA

Inside this issue:

Events:

NAMI PA, Berks

County

1234 Penn Avenue

Wyomissing, PA 19610

Phone: (610) 685-3000

Fax: (610) 775-4000

http://namiberkspa.org

Email contact:

[email protected]

Mental Health and the Criminal Justice System

by Dr. Anthony J. Fischetto, Forensic Psychologist

June 1, 2015

Over the

last 30 to 40 years,

we have seen

many more indi-

viduals with men-

tal illness incarcer-

ated. The National

Research Council

Committee stated

that the deinstitu-

t i o n a l i z a t i o n

movement of the

1960s, which shut

down large treat-

ment facilities for

the mentally ill,

(Photo courtesy of Deseret News)

coupled with the lack of community resources to treat them, resulted in some people going to pris-

ons and jails instead. One study found this trend accounts for about 7 percent of prison population

growth from 1980 to 2000, representing 40,000 to 72,000 people in prisons who would likely have

been in mental hospitals in the past. (Source: “The Growth of Incarceration in the United States:

Exploring Causes and Consequences,” The National Research Council, 2014.)

Mental illness among today's inmates consists of 64 percent of jail inmates, 54 percent of

state prisoners and 45 percent of federal prisoners reporting mental health concerns, the report

found. Substance abuse is also substantial and often co-occurring.

According to Torrey and Stieber (1993), “many American jails have become housing for

persons with severe mental illness arrested for various crimes.” Approximately 29% of American

jails hold persons with severe mental illness either on misdemeanors or on no charges at all. A total

of 69% of American jails also reported seeing far more inmates now with severe mental illness

than just ten years ago (French, 1987; Torrey & Stieber, 1993). French contends that criminaliza-

tion and incarceration are an unintended consequence of the deinstitutionalization process. Torrey

states that one of the reasons for criminal behavior is that persons with severe mental illness obtain

discharge from inpatient psychiatric hospitals with no provision for aftercare or follow-up treat-

ment.

"Part of what's really swelled our jail and prison population, especially our jail population,

is our inability to deal with the mental health crisis that we're facing in this country," says Tang-

ney. "We have an enormous number of people who are suffering from very treatable illnesses who

are not getting treatment and who end up getting caught in the criminal justice system as opposed

to the mental health system." (American Psychological Association, 2014)

1,

4-5

2-3

3

6

In association with Greater Reading Mental Health Alliance

Contact us:

Events:

Mental Health and

the Criminal Justice

System

Mental Illness A

Much Bigger Problem

For Poor, New Study

Shows

Farewell Letter from

Director of NAMI

Berks

2nd Annual Walk for

Mental Wellness

Continued on pages 4 to 5

National Alliance on Mental Illness of Berks County, PA

“Researchers also

discovered that about

30.4 percent of

working-age adults

with serious distress

had no health

insurance, compared

with just 20.5 percent

of working-age adults

without serious

distress.”

Mental Illness Is A Much Bigger Problem For The Poor, New

Study Shows

Jonathan Cohn

The Huffington Post. May 28, 2015

If you want to talk about inequality in America, you should be talking about mental illness

-- and the ability of people to get treatment for it.

On Thursday, the U.S. Centers for Disease Control and Prevention released a new study

that demonstrates, in vivid terms, something that public health experts have known for a while:

Mental health problems are far more common among the poor than the rich.

The basis for the study is five years of responses to the National Health Interview Survey,

an in-person poll that the federal government has operated continuously since the late 1950s. To-

day’s version includes questions designed to measure the prevalence of “serious psychological

distress,” a standard that public health experts use as a proxy for certain kinds of mental illness.

Infographic by Cameron Love

According to the new CDC paper, 8.7 percent of people with incomes below the poverty

line, or $20,090 for a family of three, reported serious psychological distress from 2009 to 2013.

For people with annual incomes at or above four times the poverty line -- that’s $80,360 for a fam-

ily of three -- the figure was just 1.2 percent.

Researchers also discovered that about 30.4 percent of working-age adults with serious

distress had no health insurance, compared with just 20.5 percent of working-age adults without

serious distress.

The study, whose lead author is CDC epidemiologist Judith Weissman, does not address

the issue of causality -- in other words, whether mental health problems lead to more economic

hardship or whether economic hardship leads to more mental health problems. But most research-

ers believe the

Studies have shown, for example, that infants and toddlers growing up in low-income

communities are more likely to experience the kind of “toxic stress” (neglect, abuse, seeing vio-

lence in the home) that can hinder brain development and lead to mental illness in adulthood. Ad-

ditional studies have suggested, though not conclusively, that adults who become unemployed are

more likely to develop depression.

“...infants and tod-

dlers growing up in

low-income communi-

ties are more likely to

experience the kind of

“toxic stress” [….]

that can hinder brain

development and lead

to mental illness in

adulthood.”


Letters to the Editor and other

articles and contributions are

encouraged. Please send

them to 1234 Penn Avenue,

Wyomissing, PA 19610, or

email inquiries into

[email protected].

The Berks Bulletin is

published quarterly by

NAMI of PENNSYLVANIA ’ s

BERKS COUNTY

Affiliate.

At the same time, somebody who had mental health problems might have a tougher time

holding onto a job -- or, at least, a good job. And without employment, historically, it’s been tough

to get health insurance or to have enough money to pay for timely detection and treatment of psy-

chiatric problems.

For the people and families that deal with mental illness, the result can be a vicious,

downward spiral that -- in the worst cases -- ends with some combination of medical and financial

catastrophe.

A major goal of the Affordable Care Act, or Obamacare, was to address these problems --

partly by helping millions of additional people to get health insurance and partly by requiring in-

surance plans to provide more comprehensive coverage of mental health care. These regulations

were an extension of bipartisan efforts, dating back to the 1980s and 1990s, to establish parity be-

tween mental and physical health care coverage.

The data in this latest CDC study isn't recent enough to capture most of the Affordable

Care Act’s effects. But another study, focusing on a provision of the law that became effective

back in 2010, found that young adults who obtained insurance were more likely to get mental

health treatment. Studies of past government initiatives with similar characteristics, such as an ex-

pansion of Medicaid eligibility in Oregon, have provided yet more evidence that access to health

insurance leads to better mental health.

Still, many people who obtained insurance under the Affordable Care Act struggle might-

ily to get mental health care -- either because they have trouble finding providers who accept insur-

ance or because they face daunting out-of-pocket costs for every treatment session and prescrip-

tion. That’s why organizations like the National Alliance for the Mental Illness have called upon

officials to find ways of further improving mental health coverage -- whether by providing people

with more protection from high deductibles or strengthening the regulation of networks of mental

health care providers.

Not everybody would favor such an approach. The Affordable Care Act’s conservative

critics frequently call for scaling back the existing requirements on mental health insurance, be-

cause, they say, such mandates tend to drive up insurance premiums. They are probably right about

that, although untreated mental illness can lead to future health problems, both mental and physi-

cal, that can be expensive to treat.

Citation:

Cohn, J. (2015, May 28) Mental Illness Is A Much Bigger Problem For The Poor, New Study Shows. The Huffington Post.

Retrieved from http://www.huffingtonpost.com/2015/05/28/mental-health-coverage_n_7456106.html.

A Message from Our Director of NAMI Services & Programs

It is time to humbly move on from my position as Director of NAMI Berks as I relocate to

be with family. Much gratitude goes out to Greater Reading Mental Health Alliance for giving me

this fantastic opportunity to strengthen and grow NAMI Berks County for our community.

Throughout my 18 months here, NAMI Berks’ programming has indeed strengthened and

grown. NAMI Family Support Group now warrants a second grouping of family members and

facilitators to support one another. NAMI Family-to-Family ran in spring 2014 for the first time

solely by NAMI Berks; through two spring sessions, admirable facilitators Nina and Alan McDan-

iel have graduated 19 committed family members/caretakers of individuals with mental illness.

Additionally, since implementing NAMI Peer-to-Peer Recovery Education in fall 2014, 12 com-

munity peers have graduated onto healthier ways of coping with their mental illness. NAMI In Our

Own Voice has reached hundreds of Berks County consumers, students, professionals, and family

members, emblazoning the reality that mental illness recovery is possible.

NAMI membership has increased by 5 times the active members. For this increase, I

thank our NAMI Berks members for their continued contributions and vouching for NAMI’s in-

credible influence on their lives.

I hope my replacement (as yet unknown) will continue what I’ve established and nur-

tured, carrying on awareness of brain disorders in our families, criminal justice system, and com-

munity. I want to thank my GRMHA coworkers, NAMI peer mentors, class teachers, and support

group facilitators, and Berks County community partners for embracing NAMI and helping to pro-

mote the message of “Find help, find hope”. Take care of each other. --Megan Faulkner



I have seen in my own experience, for example, an individual I treated for kleptomania,

which is a psychiatric diagnosis according to the DSM, who was misunderstood by the legal sys-

tem. The DSM-5 (The American Psychiatric Association, 2013) categorizes disruptive, impulse

control, and conduct disorders as mental illnesses that affect a person’s ability to regulate his or her

emotions and behaviors. Kleptomania is an impulse control disorder characterized by the inability

to resist the impulse to steal. Rather than the legal system recognizing the mental disorder in this

individual I treated, the behavior was treated as a deliberate act of an antisocial type of behavior

resulting in multiple incarcerations. Kleptomania is a rare disorder, and is only diagnosed in 0.3-

0.6% of the population, and there are three females for every one male diagnosed (The American

Psychiatric Association, 2013). This would amount to one to two million people in the United

States who have kleptomania. Kleptomania is treatable to reduce the impulsive urges to steal. (See

references Grant & Odlaug, 2008; Grant, Kim, & Odlaug, 2009; Grant, 2006; Grant, Odlaug,

Schreiber, Chamberlain, & Kim, 2013; Rudel, Hubert, Juckel, & Edel, 2009).

This man that I treated was involved in the legal system for shoplifting and never received

the needed and available help for kleptomania. If he was not finally, properly diagnosed and

treated, he would have most likely continued to be in and out of jail with no improvement of his

acts of shoplifting. Once he was properly diagnosed for his impulse control problem, received psy-

chotherapy, and psychiatric treatment with the appropriate medications, he no longer stole or had

urges to steal. He was extremely remorseful for his behaviors. If he went to prison, again without

the proper treatment, he would be very likely to continue to steal when he would come out of jail

as he did other times. Kleptomania should be distinguished from ordinary acts of shoplifting and

other types of disorders, such as antisocial personality disorder, conduct disorder, mania, psy-

chotic, or major neurocognitive disorders (The American Psychiatric Association).

There are various reasons that people with mental illness who commit crimes do not get

the proper treatment and are instead sent to jail. One reason is the limited mental health training for

police and judges in order to recognize or at least question the possibility of a mental health issues

with the person who committed a crime. Whenever a mental health issue is in question, a forensic

psychiatrist or forensic psychologist should be consulted to evaluate the individual in question as

well as educate the judge as to the mental health mitigating factors if any, with the individual. An-

other reason this procedure may not be enacted is due to limited funding and a lack of time to take

the necessary steps to properly understand one who may have a mental illness contributing to his

or her crime.

In a House Co-Sponsorship Memoranda from PA State Representative Thomas Caltagi-

rone, posted: December 17, 2014, proposing a bill to help in this situation, he states,

This bill allows for training for police and minor judiciary in the identification and

recognition of individuals with a mental health condition or an intellectual disabil-

ity. As a first step to address the significant problem of individuals with mental

health conditions or intellectual disabilities ending up in our prisons, we need to

better equip our police and minor judiciary with the tools and training needed to

identify these individuals at the earliest point in the criminal justice system and

help these individuals get proper treatment. Moreover, with proper training our law

enforcement officers may be able to avoid dangerous situations if they can quickly

identify an individual experiencing a mental break and use proven crisis interven-

tion techniques to de-escalate a situation.

The number of inmates in our state prison receiving mental health services is stag-

gering. More than 21% of all inmates and 49% of female inmates in state prison

receive mental health treatments at a significant cost to the taxpayers. This bill will

provide law enforcement with the tools they need to protect themselves and pro-

vide judges with the wherewithal to divert certain individuals into treatment rather

than prison. (Caltagirone, December 2014)

Conclusions People with mental illnesses are being incarcerated at a greater percentage since the 1960s deinstitutionalization. Some of the current

reasons for the mentally ill not getting the proper treatment, but instead being held in prisons where they are inappropriately diagnosed or

treated are as follows:

Reason: Limited training and education of the police and judges as to mental illnesses of people.

Solution: More training.

Reason: Lack of funding and awareness to retain forensic experts to train, diagnosis, testify to educate the trier of fact (Judge or jury) and

to provide treatment.

Solution: Be aware of and use the forensic mental health services available and provide funding for such.

Dr. Fischetto is a Licensed Psychologist with a specialty in Forensic Psychology. He has performed thousands of forensic evalua-

tions over the last 25 years. He is a Diplomate in Forensic Psychology. Dr. Fischetto is a consulting Psychologist at the Reading

Health System and has a full-time private practice in counseling, consulting, and forensic evaluations for criminal and civil cases.

Email: [email protected]

Office Phone: 610-777-3306

475 Philadelphia Avenue, PO Box 36, Reading, PA 19607

References American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington,

VA: American Psychiatric Publishing.

Collier, L. (2014). Incarceration Nation. American Psychological Association. 45(9), 1-2.

French, R. (1987). Victimization of the mentally ill: The unintended consequence deinstitutionalization. Social

Work, 32(6), 102-105.

Grant, J.E., Kim, S.W., & Odlaug, B.L. (2009). A double-blind, placebo-controlled study of the opiate antagonist, naltrexone, in the treatment of kleptoma-

nia. Biological Psychiatry, 65(7), 600-606.

Grant, J.E., Odlaug, B.L., Davis, A.A., & Kim, S.W. (2009). Legal consequences of kleptomania. Psychiatric

Quarterly, 80(4), 251-259.

Grant, J.E., & Odlaug, B.L. (2008). Kleptomania: Clinical characteristics and treatment. Revista Brasileira de

Psiquiatria, 30(1), S11-S15.

Grant, J.E., Odlaug, B.L., Schreiber, L.R.N., Chamberlain, S.R., & Kim, S.W. (2013). Memantine reduces stealing

behavior and impulsivity in kleptomania: A pilot study. International Clinical Psychopharmacology, 28(2), 106-111.

Grant, J.E., Odlaug, B.L., & Wozniak, J.R. (2007). Neuropsychological functioning in kleptomania. Behaviour

Research and Therapy, 45(7), 1663-1670.

Grant, J.E. (2006). Understanding and treating kleptomania: New models and new treatments. Israel Journal of Psychiatry and Related Sciences, 43(2), 81-

87.

House Co-Sponsorship Memoranda from PA State Representative Thomas Caltagirone. Posted: December 17, 2014 04:47 PM To: All House members. Sub-

ject: Training for law enforcement and minor judiciary to recognize individuals suffering from mental health conditions or intellectual disability.

Odlaug, B.L., Grant, J.E., & Kim, S.W. (2012). Suicide attempts in 107 adolescents and adults with kleptomania. Archives of Suicide Research, 16(4), 348-

359.

Rudel, A., Hubert, C., Juckel, G., & Edel, M.A. (2009). Combination of dialectic and behavioral therapy (DBT) and duloxetin in kleptomania. Psychiatrische

Praxis, 26(6), 293-296.

The National Research Council (2014). The Growth of Incarceration in the United States: Exploring Causes and

Consequences.

Torrey, E. E, & Stieber, J. (1993). Criminalizing the seriously mentally ill: The abuse of jails as mental hospitals. Innovations and Research in Clinical Ser-

vices. Community Support and Rehabilitation, 2(1), 11-14.

Turnquist, K. (2015). Where did the "Deinstitutionalization Movement" take us? Readings in Humanistic Psychiatry, 1-7.

mailto:[email protected]


Conclusions People with mental illnesses are being incarcerated at a greater percentage since the 1960s deinstitutionalization. Some of the current

reasons for the mentally ill not getting the proper treatment, but instead being held in prisons where they are inappropriately diagnosed or

treated are as follows:

Reason: Limited training and education of the police and judges as to mental illnesses of people.

Solution: More training.

Reason: Lack of funding and awareness to retain forensic experts to train, diagnosis, testify to educate the trier of fact (Judge or jury) and

to provide treatment.

Solution: Be aware of and use the forensic mental health services available and provide funding for such.

Dr. Fischetto is a Licensed Psychologist with a specialty in Forensic Psychology. He has performed thousands of forensic evalua-

tions over the last 25 years. He is a Diplomate in Forensic Psychology. Dr. Fischetto is a consulting Psychologist at the Reading

Health System and has a full-time private practice in counseling, consulting, and forensic evaluations for criminal and civil cases.

Email: [email protected]

Office Phone: 610-777-3306

475 Philadelphia Avenue, PO Box 36, Reading, PA 19607

References American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington,

VA: American Psychiatric Publishing.

Collier, L. (2014). Incarceration Nation. American Psychological Association. 45(9), 1-2.

French, R. (1987). Victimization of the mentally ill: The unintended consequence deinstitutionalization. Social

Work, 32(6), 102-105.

Grant, J.E., Kim, S.W., & Odlaug, B.L. (2009). A double-blind, placebo-controlled study of the opiate antagonist, naltrexone, in the treatment of kleptoma-

nia. Biological Psychiatry, 65(7), 600-606.

Grant, J.E., Odlaug, B.L., Davis, A.A., & Kim, S.W. (2009). Legal consequences of kleptomania. Psychiatric

Quarterly, 80(4), 251-259.

Grant, J.E., & Odlaug, B.L. (2008). Kleptomania: Clinical characteristics and treatment. Revista Brasileira de

Psiquiatria, 30(1), S11-S15.

Grant, J.E., Odlaug, B.L., Schreiber, L.R.N., Chamberlain, S.R., & Kim, S.W. (2013). Memantine reduces stealing

behavior and impulsivity in kleptomania: A pilot study. International Clinical Psychopharmacology, 28(2), 106-111.

Grant, J.E., Odlaug, B.L., & Wozniak, J.R. (2007). Neuropsychological functioning in kleptomania. Behaviour

Research and Therapy, 45(7), 1663-1670.

Grant, J.E. (2006). Understanding and treating kleptomania: New models and new treatments. Israel Journal of Psychiatry and Related Sciences, 43(2), 81-

87.

House Co-Sponsorship Memoranda from PA State Representative Thomas Caltagirone. Posted: December 17, 2014 04:47 PM To: All House members. Sub-

ject: Training for law enforcement and minor judiciary to recognize individuals suffering from mental health conditions or intellectual disability.

Odlaug, B.L., Grant, J.E., & Kim, S.W. (2012). Suicide attempts in 107 adolescents and adults with kleptomania. Archives of Suicide Research, 16(4), 348-

359.

Rudel, A., Hubert, C., Juckel, G., & Edel, M.A. (2009). Combination of dialectic and behavioral therapy (DBT) and duloxetin in kleptomania. Psychiatrische

Praxis, 26(6), 293-296.

The National Research Council (2014). The Growth of Incarceration in the United States: Exploring Causes and

Consequences.

Torrey, E. E, & Stieber, J. (1993). Criminalizing the seriously mentally ill: The abuse of jails as mental hospitals. Innovations and Research in Clinical Ser-

vices. Community Support and Rehabilitation, 2(1), 11-14.

Turnquist, K. (2015). Where did the "Deinstitutionalization Movement" take us? Readings in Humanistic Psychiatry, 1-7.

mailto:[email protected]

Funding will also need to be available to provide for the mental health evaluations, for expert witnesses to testify in order to

educate the trier of fact, and for ongoing mental health treatment.

As of now, all of these elements are lacking, hence overcrowding of prisons with a significant percentage of people who

have mental health conditions either are not being accurately diagnosed or not properly treated for these mental health conditions,

which could contribute to their criminal behavior.


Top Reasons to

Join NAMI PA, Berks County You become a part of the nation’s largest grassroots organization dedicated to improving

the lives of individuals affected by mental illness

Your membership extends to the local, state, and national levels

You receive a FREE subscription to The Advocate, NAMI National’s mental health maga-

zine

Member discounts on materials from the online NAMI Store at NAMI.org

Annual National Convention registration discounts

Access to the NAMI online member community to keep up-to-date with research and edu-

cation about mental illness

FREE programming that helps improve the quality of life for individuals and family

members

A network of support

Local, quarterly newsletter entitled Berks Bulletin

To become a member, please send a check or money order—payable to the Greater

Reading Mental Health Alliance—to the mailing address below, or submit your payment

online at NAMI.org.

1234 Penn Avenue, Wyomissing, PA 19610

NAMI has worked for more than 30 years on a national level to become the Nation’s Voice on

Mental Illness. Your membership is vital to this on-going movement.

When you become a member of NAMI Berks County, you become part of America’s largest

grassroots organization dedicated to improving the lives of persons living with serious mental

illness and their families. Join now for just $35, and become a part of NAMI at the na-

tional, state and local levels. Become a member and show your support of our mission in pro-

viding education, support and advocacy to improve the lives of people affected by mental ill-

ness. You can join at the following levels:

Individual/Family – $35

Low-Income – $3

http://www.namiberkspa.org/#!newsroom/c1c1c

http://www.nami.org/Template.cfm?Section=Become_A_Member

NAMI PA, BERKS COUNTY MEMBERSHIP / DONOR CARD

Name______________________________________

Address_____________________________________

Phone_____________ Email_____________________

___Membership dues enclosed: ___Renewal ___New

___Consumer/low income ($3.00)

___Individual/family/community member ($35.00)

___Enclosed please find my tax deductible donation of:

___$100 ___$50 ___$25 ___$10 ___other $___

Please make checks payable to Greater Reading Mental Health Alliance

and kindly send to 1234 Penn Avenue, Wyomissing, PA 19610.

Thank you for your support!

NAMI PA, Berks County

1234 Penn Avenue

Wyomissing, PA 19610

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