1 in 6 people has a common mental illness at some point in their life (Psychiatric Morbidity Survey, 2000).
About 1% of the population experience schizophrenia at some point in their lives (Mental Health Foundation, 1999).
About 1% of the population experience manic depression at some point in their lives (Mental Health Foundation, 1999).
1 in 200 people have experienced a psychotic illness in the last year (Singleton, Psychiatric Morbidity, 2000).
The average age of onset of psychotic symptoms is 22 (Department of Health, 2001)
Deprived areas and rural districts have the highest levels of mental health problems and suicides (ONS, 2001).
People from Afro-Caribbean backgrounds are 3-5 times more likely than others to be diagnosed and admitted to hospital for schizophrenia. (Mental Health Foundation, 1999)
About 25% of people diagnosed with schizophrenia will make a full recovery; about 60% of people will have fluctuating symptoms; about 10-15% of people experience long term incapacity (Mental Health Foundation, 1999).
35% of people with mental illness are unemployed but want to work (ONS, 2003), the highest want to work rate of any disability.
Only 1 in 4 employers said that they would knowingly employ someone with a history of mental illness (Manning et al, 1995).
Three quarters of employers say that it would be difficult or impossible to employ someone diagnosed with schizophrenia (DWP, 2003).
Less than 5% of people who kill a stranger have symptoms of mental illness (Department of Health, 2001).
People with mental illness are more likely to be the victims than the perpetrators of violence (Walsh, 2003).
More than 1 in 4 people with severe mental illness report being shunned when seeking help (Rethink, 2003).
30% of GPs’ time is spent with people with mental health problems (Sainsbury Centre for Mental Health (Maudsley Monograph, 2002).
44% of people with mental health problems report discrimination from general practioners, such as physical health problems not being taken seriously (Mental Health Foundation, 2002).
Almost 80% of carers for someone with a severe mental illness say that caring has had an impact on own their mental health (Rethink, 2003).
Almost 80% of carers for someone with a severe mental illness say that caring has had an impact on their own physical health (Rethink, 2003).
Only 48% of mental health professionals know about local policies on sharing information with carers (Rethink/IoP, 2006).
Mental health problems cost the economy untold billions per year through care costs, economic losses and premature death. (Sainsbury Centre for Mental Health, 2003).
21% of people with schizophrenia have a dual diagnosis (Cantwell, 2003).
Up to half of people dependent on alcohol have a mental health problem (Turning Point, 2003).
People with schizophrenia and bipolar disorder die 10 years younger due to physical health problems (British Journal of Psychiatry, 2000) and have double the average rate of heart disease (British Journal of Psychiatry, 2006) and five times the average rate of diabetes (Department of Health, 2004).
People with severe mental illness smoke twice as much as average, do half as much exercise and eat less fruit and vegetables than average (Running on empty report, 2005).
Alien Boy Showtimes
April 23 - 5:30 PM
“Infuriating, tragic, heartbreaking and incendiary in equal measures... plays out like a horror film and leaves you absolutely breathless.”
~ AP Kryza, Willamette Week
HOW: This event is sponsored by: Cascadia Behavioral Healthcare, Central City Concern, Disability Rights Oregon, Empowerment Initiatives, Eyes & Ears, Home Forward, Lifeworks NW, Luke-Dorf, The Lund Report, Mental Health Association of Portland, Portland Hearing Voices, Multnomah County Crisis Line, Telecare, Trinity Episcopal Cathedral, The Skanner News, Street Roots, and others.
When legislators approved the Psychiatric Security Review Board’s (PSRB) budget earlier this year, they attached a string — the board needed to start thinking about ways to move patients out of the Oregon State Hospital into community treatment facilities. That string took the form of a “budget note.”
Budget notes can be written by members of the legislative budget-writing Joint Ways and Means Committee and included in budgets in an effort to direct state agencies to take specific actions, reforms or generate reports that might inform future legislation.
The PSRB’s budget note, which was also included in the Oregon Health Authority’s budget, reads: “The Oregon Health Authority (OHA) is directed to work with the Psychiatric Security Review Board (PSRB) to determine the need for community placements for PSRB patients at the Oregon State Hospital for whom a hospital level of care is not necessary on an on-going basis, and recommendations for meeting this need. The recommendations should address the potential need for additional 16-bed residential treatment facilities as well as other types of facilities. This report should be prepared for consideration in the February 2012 legislative session.”
Next February, when the legislature reconvenes, the board, together with the Oregon Health Authority, is expected to provide more details on the need for more treatment programs so patients can safely move into community settings.
“You could move people more quickly through these higher levels of care if the appropriate step downs were there,” Mary Claire Buckley, the PSRB’s executive director, told legislators recently, referring to care facilities where less intensive care is provided.
There’s an immediate need to increase the number of medical facilities that offer treatment for people with severe mental illness, such as treatment homes where people can live on a permanent basis while receiving mental healthcare and respite care to help people avoid mental health crises and hospitalization. Such facilities are not only less intensive, but also less costly than care at the Oregon State Hospital.
Some counties have secure residential treatment facilities—16-bed group homes that offer mental healthcare where patients are either guarded or not allowed to leave – but those counties lack treatment homes that are less restrictive which means patients must either stay at the facility or move to a different part of the state.
“Anything that we look to develop should first look to the counties where secure facilities are located, and where there are not residential treatment homes,” Buckley said. Some of those counties include Umatilla, Marion, Clackamas, Deschutes, Lane and Jackson counties.
A 16-member work group convened by the PSRB and the Addictions and Mental Health Division has been focused on this issue and will make a report to the legislature next February.
That work group, which has met twice, has been given data about 47 people under the PSRB’s jurisdiction — patients at the Oregon State Hospital. “We believe that this [patient group]…was a basic representative of the needs overall, on any given day” at the hospital, Buckley said.
On May 1, there were 736 individuals under the PSRB’s jurisdiction. Of those, 324 resided in the hospital, and the rest were “conditionally released” into community treatment settings.
The workgroup is looking into what patients may need in a community setting, such as personal care, medication, substance abuse treatment, legal issues and their housing preference.
“We didn’t want the hospital to tell us where someone needed to live, but their specific needs…and what supports would be necessary to have them in the community safely,” said Len Ray, the Oregon Health Authority’s adult mental health services administrator. “It allowed the conversation [of the workgroup] to be very specific.”
The workgroup is not recommending additional secure treatment facilities, Buckley said. Currently, the PSRB has access to 73 such beds outside the Oregon State Hospital, which is sufficient.
The workgroup is composed of 16 people, including mental health advocates, three representatives of community-based providers, two people representing Oregon counties, two people living with mental illness (one of whom has been under the PSRB’s jurisdiction), Buckley, two representatives of the Oregon State Hospital, and two from the Addictions and Mental Health Division of the Oregon Health Authority.
The PSRB, a five-member board, appointed by the governor, has jurisdiction over Oregon State Hospital patients. Essentially a parole board, it holds the power to decide whether patients remain in the state hospital, are released to community-level treatment facilities, or released to live independently. The board, which is charged with protecting public safety, is often criticized by consumers and advocates for being too conservative in releasing patients.
The PSRB is undergoing a substantive amount of reform on top of identifying individuals that could be released out of the state hospital and to less intensive treatment settings. Last session the legislature enacted two laws dealing with that board.
House Bill 3100 requires court-certified psychologists or psychiatrists to evaluate someone before they make a “guilty except for insanity” plea, and that people committing misdemeanor-level crimes and Class C felonies be sent to the hospital only if they need intensive services.
NOTE: Supporters of the Mental Health Association of Portland believe the law is the most expensive and least effective intervention for mental illness, and financial diversions from mental health treatment to police, courts, jails and prisons is a form of government corruption.
Seaside Police Chief Bob Gross is hopeful an expansion plan for the Clatsop County Jail in Astoria now under review will ease the increasing safety problem of dealing with offenders that have mental health issues.
Clatsop County Jail at 636 Duane St. in Astoria
Finding adequate bed space for people with mental health issues at holding facilities is a continuing problem countywide, according to Gross and other Clatsop County officials.
“These people require further evaluation and treatment than what we can provide locally,” Gross told The Signal in July following the arrest of a woman charged with kidnapping. The woman was later ordered to undergo a mental health evaluation.
“There often is no place to put mental health patients in the county system,” Gross said.
Nancy Winters, the executive director of Clatsop County Behavioral Health Care also expressed her concerns about offenders following the Signal’s July story about the kidnapping suspect.
“Someone who has significant mental health issues, has committed major crimes and is a significant danger to themselves and others, is very difficult to place in a psychiatric hospital because the hospitals are reluctant to take the patient,” Winters said. “The only realistic option is placing the patient at the Oregon State Hospital in Salem and that facility has a long waiting list.”
According to Winters, very often someone who has a mental health crisis and has committed a major crime has to wait in jail for a state hospital bed.
Clatsop County Sheriff Tom Bergin is hopeful the jail expansion will give Seaside Police and other community law enforcement a new option to ease the mental health patient offender crisis.
“There are offenders with mental issues that do commit serious crimes,” he said. “What this expansion would do is provide a few holding beds for those offenders until we could get them the help that they would need. That is what we are currently lacking.”
Bergin also believes the expansion will boost inmate bed space from 60 to 160 beds for regular offenders. The current jail was build to offer 29 beds. The expansion would also save the county money by retaining inmates instead of sending them to rented jail space at the Tillamook County Jail. Bergin said the plan is the most fiscally responsible action the county can take to slow recidivism.
This week, the Clatsop County Board of Commissioners was expected to hire an architecture firm that would design the new jail. A dollar amount for the expansion could be made public in January of February.
Voters could see a funding request in May or next fall.
Without the critical voter support for the new jail, Bergin worries that crime will not slow in Seaside or throughout the rest of the county.
“The worst case scenario is that these repeated offenders will continue to be released early from the county jail and continue to commit crimes and raise havoc in our county.”
Dr. Albert Ellis, 1913 – 2007, a psychologist and teacher, crank and unrelenting advocate for mental health, was one of the most influential psychologists of the 20th century; a true psych revolutionary.
The video below is a typical mid-seventies staging of a psychotherapeutic intervention, first called ‘Rational Therapy’ and later, after ‘Rational Emotive Behavior Therapy’ popular in the 50′s, 60′s and 70′s. His process evolved into what is now described as ‘cogitative behavioral therapy,’ or ‘brief therapy,’ and other names, adapted and used by millions to address inter-personal difficulties. The video illustrates what might have been seen at one of Ellis’ ‘Friday Night Workshops’ which he host weekly from Important: these techniques are not singularly useful treatments for mental illness – nor were they intended to be.
Ellis’ work challenged and confronted paradigms of his time. The video, by current standards, is sociopathic and perhaps pornographic, but was de rigor for 1975. It’s current awkwardness expresses the great strides in psychology over the past few decades.
Dr. Ellis wrote dozen of influential books and essays on sex and modern love, including ‘Sex Without Guilt,’ ‘Homosexuality: Its Causes and Cure,’ which he clarified ten years later with,’Sex and the Liberated Man,’ and again with, ‘Sex Without Guilt in the Twenty-First Century.’ He was a skeptic of just about everything, including himself. He also wrote about religion, politics, and self-help for children. He was a prolific speaker, debater and public philosopher. A complete book list is here.
Ellis created the Albert Ellis Institute in New York to teach his methods. After a management dispute Ellis in was dumped from the organization. He filed suit and was later reinstated.
The administrator of the $458 million Oregon State Hospital replacement project will shift to a new job early next year, becoming interim director of the state office of addictions and mental health treatment programs.
Linda Hammond, who steered construction of the Oregon State Hospital replacement project, will become interim director of the state office of addictions and mental health treatment programs.
Linda Hammond, who has steered construction of a soon-to-be-completed state hospital complex in Salem, will succeed Richard Harris as head of the Addictions and Mental Health Division, or AMH.
Harris is retiring in January.
Bruce Goldberg, director of the Oregon Health Authority, announced the looming leadership change in an email circulated Wednesday.
Goldberg credited Harris for providing “innovative, thoughtful and inspirational” leadership “during a time of great change and challenge for our agency.”
Harris’ accomplishments included hiring Greg Roberts, the current superintendent of the state hospital, and overseeing transformation of the 128-year-old psychiatric facility “into a place of hope, healing and safety,” Goldberg said.
He said Hammond is the right person to step in as interim AMH director, citing her “strong administrative experience and a proven ability to lead people through change.”
Goldberg said a national search for a permanent director will be conducted in the summer.
Hammond has received kudos from state leaders for keeping the hospital replacement project on schedule and within its budget.
Completion of a state-of-the-art 620-bed hospital in Salem is scheduled for early next year. After that, construction will start on a smaller mental hospital on state prison land in Junction City.
In 2007, legislators approved construction of two hospitals to replace the crumbling, long-neglected psychiatric hospital in Salem, which opened in 1883 and was deemed obsolete and unsafe by state-hired consultants in 2005.
For the past several months, Hammond has held a dual role — as administrator of the hospital replacement project and interim chief financial officer for the Oregon Health Authority.
In an email to co-workers Wednesday, Hammond said Jodie Jones, deputy administrator of the hospital replacement project, will take the reins as its administrator.
“What I realized while I was in my dual-roles of interim chief financial officer and project administrator is that the project is too important — this team is too important — not to have a full-time, designated leader,” Hammond wrote.
“During my absence, Jodie has done an outstanding job, with support from all of you, as this project’s on-site administrator. I have asked and she has accepted this as her permanent role. She will continue to report to me but in my position as interim AMH administrator.”
It was supposed to cost $4.5 million to renovate Old School at the Children’s Farm Home on Highway 20 between Albany and Corvallis, but an unanticipated septic system upgrade has bumped the cost up another million.
Now Trillium Family Services, which operates the Farm Home as a treatment center for children ages 5 to 18 with behavior and mental health challenges, is launching a capital campaign Monday to raise funds to finance the final phase of the project.
Trillium Family Services officials take a tour of Old School Tuesday morning. From left are Kim Scott, Kristi Cole, Mike Morse, Stan Sawicki and Cheri Galvin.
Previously, Dave and Penny Lowther of Philomath donated $2.8 million, and an anonymous donor contributed $1 million. The rest of the money collected so far has come from smaller donations.
“With an anonymous donor prepared to match new donations up to $500,000, we’ll just need to raise a half-million,” said Cheri Galvin, regional development director for Trillium. “My goal is to raise that by the end of January or by early February.”
Times are tough, she acknowledged, but if people can “give, say, $5 or $10 we’ll get that matched and the campaign will go quickly.”
Trillium’s annual Denim & Diamonds auction on Saturday, Jan. 28, is the event Galvin hopes will push the campaign over the top. It starts at 5 p.m. at the CH2M Hill Alumni Center in Corvallis. Tickets are $55 if purchased before Dec. 31, and $65 if bought by Jan. 18.
Those interested can keep track of how much Trillium has raised by checking a barometer that stands next to a 22-foot tall rocket in front of the school.
Once the $1 million is in hand, the work can be done in about five months, Galvin said.
Architect Bill Ryals of Modern Organic Architecture in Corvallis designed the improvements to Old School, assisted by Endex Engineering.
T. Gerding Construction Co. is overseeing the restoration of the 17,000-square-foot school built in 1925 by the Women’s Christian Temperance Union. Originally, the 300-acre farm home housed orphans, neglected children and children whose parents could not afford to care for them.
Several hundred students attended the school, and when they got older they transferred to Corvallis High School.
Proceeds from a cannery, dairy and slaughterhouse helped cover expenses, as did the sale of fruit, nuts, table grapes, pears and walnuts grown on the property.
The school closed in the 1980s.
Old School is located on Highway 20 east of Corvallis.
When the renovation that began in the fall of 2008 is finished, the main floor will contain a grand entry, a banquet room, classrooms, a café, kitchen, administrative offices and a museum, all available to the public.
The downstairs will be devoted to children staying at Trillium, and areas will be available for them to meet privately with their families.
Contributions to Old School can be sent to Cheri Galvin, 4455 N.E. Highway 20, Corvallis, OR 97330. To make an online contribution or to purchase tickets to Denim & Diamonds, go to www.trilliumfamily.org.
Anyone wanting to donate memorabilia to Old School for the museum can contact Galvin at 541-758-5953.
“The Children’s Farm Home has a rich history of serving children and families most in need,” said Kim Scott, Trillium’s president and chief executive officer in Portland. He toured the school last week. “The Old School is a symbol of this work.”
Mike Morse of Corvallis, who is on the facilities committee also visited the building, showing off its new heating and cooling system along with the newly landscaped area in the back.
Stan Sawicki, the chief development officer, pointed out where various rooms will be.
Walls, finish work, plumbing and appliances have yet to be installed. Galvin said the kitchen appliances are coming from the former Waverly Children’s Home that Trillium operated in Portland until it was sold.
Contributions to Old School can be sent to Cheri Galvin, 4455 N.E. Highway 20, Corvallis, OR 97330. To make an online contribution or to purchase tickets to Denim & Diamonds, go to www.trilliumfamily.org.
Anyone wanting to donate memorabilia to Old School for the museum can contact Galvin at 541-758-5953.
ATHENS, Ohio — She was gone for good, and no amount of meditation could resolve the grief, even out here in the deep quiet of the woods.
Milt Greek pushed to his feet. It was Mother’s Day 2006, not long after his mother’s funeral, and he headed back home knowing that he needed help. A change in the medication for his schizophrenia, for sure. A change in focus, too; time with his family, to forget himself.
And, oh yes, he had to act on an urge expressed in his psychotic delusions: to save the world.
So after cleaning the yard around his house — a big job, a gift to his wife — in the coming days he sat down and wrote a letter to the editor of the local newspaper, supporting a noise-pollution ordinance.
Small things, maybe, but Mr. Greek has learned to live with his diagnosis in part by understanding and acting on its underlying messages, and along the way has built something exceptional: a full life, complete with a family and a career.
He is one of a small number of successful people with a severe psychiatric diagnosis who have chosen to tell their story publicly. In doing so, they are contributing to a deeper understanding of mental illness — and setting an example that can help others recover.
Damon Winter/The New York Times Milt Greek, a computer programmer, helps fill his days with community activism and speaking engagements.
“I started feeling better, stronger, the next day,” said Mr. Greek, 49, a computer programmer who for years, before receiving medical treatment, had delusions of meeting God and Jesus.
“I have such anxiety if I’m not organizing or doing some good work. I don’t feel right,” he said. “That’s what the psychosis has given me, and I consider it to be a gift.”
Doctors generally consider the delusional beliefs of schizophrenia to be just that — delusional — and any attempt to indulge them to be an exercise in reckless collusion that could make matters worse. There is no point, they say, in trying to explain the psychological significance of someone’s belief that the C.I.A. is spying through the TV; it has no basis, other than psychosis.
Yet people who have had such experiences often disagree, arguing that delusions have their origin not solely in the illness, but also in fears, longings and psychological wounds that, once understood, can help people sustain recovery after they receive treatment.
Now, these psychiatric veterans are coming together in increasing numbers, at meetings and conferences, and they are writing up their own case histories, developing their own theories of psychosis, with the benefit of far more data than they have ever had before: one another’s stories.
Mr. Greek is one of the most exceptional, having built a successful life and career despite having schizophrenia — and, he says, because of it. He manages the disorder with medication, personal routines, and by minding the messages in his own strange delusions.
“Schizophrenia is the best thing that ever happened to me,” he said. “I know a lot of people with the diagnosis don’t feel that way, but the experience changed me, for the better. I was so arrogant, so narcissistic, so self-involved, and it humbled me. It gave me a purpose, and that purpose has been very much a part of my recovery.”
The Village Eccentric
Like many idealistic undergraduates, Mr. Greek arrived at Ohio University in Athens on a mission. Only, like many undergrads, he wasn’t completely sure what it was.
“To discover a psychological code that people should live by, to create world peace,” he said. “Something like that.”
The town was ready to listen, regardless. It was the fall of 1981, and Athens still had one sandal planted in the 1960s; communes thrived in the Appalachian foothills to the north, and big ideas were in the air, at least in the streets and bars near campus, where professors and students gathered.
One stood out. “You can’t imagine how intense he was back then,” said June Holley, a friend and business consultant in Athens. “He had this long, very thick, curly chestnut hair and wild eyes; he looked like a lion. He could be loud, and I think a lot of people just didn’t want to deal with it.”
Local residents gave him the sidewalk, avoided eye contact, and generally accepted him as one variety of village lunatic — in a town with a rich history of them.
He knew the role, at some level. The son of a college math professor and a lawyer, progressives both, Milton Thomas Greek grew up in Roanoke, Ill., and neighboring Benson, about two hours southwest of Chicago. He declared himself an atheist early and often, which in a devout Christian community was one way to stir the air — and the boys who ruled the schoolyard.
“They told me I was damned — damned! — and came after me,” Mr. Greek said. “Now I see that it was just an excuse, like picking on the fat kid for being fat, or the nerd for being a nerd. But at the time I thought it was all about religion.”
He did not discover the secret to world peace and, by senior year, was in a troubled marriage, and began seeing and hearing things others did not. One day he saw a homeless man in the Athens bus station with eyes “like landscapes that went back into the man’s head infinitely far, stretching on for eternity.” God’s eyes; who else?
Later, he was hitchhiking, and a man with long hair and sandals pulled over to offer a ride, his eyes rippling with the same eternal light as the street person’s. Jesus? It had to be (“I’d already met God, so it made sense.”) The man said something about a small town in the woods, and Mr. Greek thought that that town had to be heaven.
His marriage collapsed. His friends stopped calling. He was back at home in Illinois when a doctor finally gave him a diagnosis — schizophrenia — and prescribed medication.
It seemed like a charade, from start to finish. The doctor never asked what he thought his hallucinations meant, or whether the strange thoughts were linked to experiences in his life. He stopped taking the pills.
“I became very suicidal,” he said. “I had no idea what’s happening to me during this entire time. I had been this big atheist, but here I am thinking that the rapture is about to start and that I’m the Antichrist — all this religious imagery.”
The answer was obvious and ultimately liberating, but he had to spend a long time wandering in the woods — literally — to find it.
It was 1984, he had begged his way back into Ohio University for graduate studies in sociology, still lost in his own mind, his thoughts turning darker by the day. He was alienating classmates, professors, friends.
About the only exception was Ms. Holley, a graduate student some 15 years his senior who enjoyed his company, and one day he decided to visit the commune where she lived, with her family and several other families. It took him two days to find it, the first spent wandering the misty woods until dark in a waking, delusional dream, and the second stumbling into a clearing just off Hooper Ridge Road, where Ms. Holley and her friends took him in.
Over the next several months they sat with him, accepted him as a member of the tribe, and encouraged his mission to improve the world at face value. And save his life they probably did, in part by suggesting that he seek help.
It was Ms. Holley who delivered the message. “I trusted her completely, so when she said I was hallucinating — when she used the word ‘hallucination’ — I knew it was true,” Mr. Greek said. “I would have to give the medication another try.”
He was lucky. It worked, blunting the psychosis enough that he was able to complete a programming course and find work, first in Illinois and later back in Athens at Ohio University’s Information Technology department. In time he found something more: During a snowstorm in 1996, Mr. Greek knocked on the door of a neighbor he had seen around Athens, a single mother with two teenage children, carrying a full-time job plus graduate classes, who was at that very moment (he would learn later) praying for something to get her through the winter.
The man at the door did not exactly look like a savior, in his beat-up jeans and unruly hair, his soft eyes and half-smile. But he offered to cook dinner — stir fry — on a day when the fridge was nearly empty.
The two neighbors became friendly, then close, and finally fell for each other. Neither can say exactly when it happened, but she remembers looking out her window one day to see Mr. Greek pull up to his apartment across the street, his old Honda coughing white smoke. He popped the hood and backed away from the car in slow motion, staring at the engine, then turned abruptly toward his apartment — and vanished, falling face-first into some bushes. “I thought, ‘Well, O.K., he’s got something,” she said. “I’m not sure what. Absentmindedness, maybe?”
They married in 2003 (Mr. Greek’s wife, an artist, asked that her name not appear in this article, for her own privacy), and she helped him fit his religious delusions, now controlled by medication, into a coherent personal story that has guided his day-do-day life.
The frightening voices and ominous signs saying that he was damned were no more than embodiments of his very real childhood terror of being cast out, as the schoolyard boys threatened. His search for heaven on earth was in part an attempt to escape that fate, to find a secure place. But it also dramatized a longing to put the world right, a mission that may have started as vain fantasy, but in time became an emotional imperative, a need to commit small acts of kindness, like cooking dinner for a snowed-in neighbor.
A Regimen for Coping
“He has this long list of causes that he’s extremely passionate about, and he has strong opinions about almost everything, but he’s also very sensitive to his relations with people and open to other philosophies,” said Melissa Van Meter, who has worked with Mr. Greek at the university and holds very different political views. “It has just impressed me that he could handle so much personally and do so well professionally.”
Damon Winter/The New York Times "When I began to see the delusions in the context of things that were happening in my real life, they finally made some sense," Milt Greek said. "And understanding the story of my psychosis helped me see what I needed to stay well."
“When I began to see the delusions in the context of things that were happening in my real life, they finally made some sense,” Mr. Greek said. “And understanding the story of my psychosis helped me see what I needed to stay well.”
Mr. Greek’s regimen combines meditation, work and drug treatment with occasional visits to a therapist and a steady diet of charitable acts. Some of these are meant to improve the community; others are for co-workers and friends, especially those dealing with a psychiatric diagnosis.
To help others experiencing psychotic delusions, he relies on his own theory of what delusions may mean. In an analysis of 20 delusional experiences, all described by sufferers in the first person, Mr. Greek identifies four story lines.
Among them are the rescuer (on a mission to save a particular group); the self-loathing person (lost in a sense of extreme worthlessness); the visionary (on a journey to spiritual realms to bring back truth); and the messianic (out to transform the world through miracles, or contact with deities) — the last of which is his own psychosis story.
Each, in Mr. Greek’s reading, grows out of a specific fear or trauma, whether isolation, abuse or family dysfunction, in the same way his own delusional story symbolized a fear of being a social reject. He is preparing the study for publication in a psychiatric journal and has put much of his thinking into a manual for families dealing with psychosis, called “Schizophrenia: A Blueprint for Recovery.”
Mr. Greek’s analysis of the story lines in psychosis is certainly not the first of its kind, nor the most comprehensive. Psychiatrists, psychologists, therapists and brain scientists have spun out hundreds of ideas about what goes on during a delusion.
But until recently patients themselves — that is, nonprofessionals who have lived with hallucinations and delusions — had little more than their own strange story to study, in any detail. Now they have dozens, and Mr. Greek is one of a small number of such “native” theorists who argue that the content of a delusion should not be ignored but engaged, carefully, once a person has his or her hallucinations under control.
“By exploring a person’s anomalous beliefs and experiences, we are better able to understand the underlying feeling and needs that give fuel to these experiences,” said Paris Williams, a psychologist who has struggled with psychosis and recently published a doctoral dissertation analyzing the content of six people’s delusions, which has informed Mr. Greek’s work.
For instance, said Dr. Williams, who is working on a book called “Rethinking Madness,” “we can find ways to make them feel safe when they believe they are being persecuted by malevolent forces, or find ways to help them feel empowered when they experience demanding voices.”
Damon Winter/The New York Times Milt Greek practices mindfulness meditation in a clearing in the woods behind his house in Athens, Ohio.
One place Mr. Greek feels safe is in a clearing in the woods behind his house, where on a recent afternoon he disappeared wearing a tie-dyed shirt and old jeans with the knees worn completely through. He practices mindfulness meditation here, tuning in to the rhythms of life that usually pass unnoticed.
Back at home, he runs thoughts and perceptions by his wife. “He says things like, ‘Is that a marching band I’m hearing, or am I just hallucinating?’ ” she said. “I’ll say, ‘Uh no, I don’t hear a band, Milt,’ and he’s fine.”
And he visits a therapist when stress levels are running very high. The therapist has given him diagnoses of schizophrenia and “mood disorder, not otherwise specified,” according to his medical records, and she treats him in sessions and with an antipsychotic drug, adjusting the dosage up or down depending on his mood.
Since his mother’s death, Mr. Greek and his wife have taken several more emotional blows, with other close relatives dying. He has been especially stretched, between his work, various community projects, and traveling to speak, often to police groups about how to understand psychotic thinking when dealing with people on the street.
It was too much, and in August he visited his therapist again, and soon after made a deal with his wife. “She and I signed a contract identifying and limiting volunteer work I will do next year,” he said in an e-mail. “I am being coached on how to say no.”
The world is not yet saved from itself, nor for that matter is Athens. But even a messianic rescuer needs a day off, if only to come back stronger the next.
Washington County has petitioned a federal appeals court to reconsider ordering a trial in a wrongful death lawsuit against the county and two of its deputies.
A three-judge panel of the 9th U.S. Circuit Court of Appeals ruled Nov. 4 that a U.S. District Court judge wrongfully dismissed a lawsuit on behalf of Metzger teen Lukus Glenn, shot and killed by Washington County sheriff’s deputies in 2006.
The panel found that facts of the shooting are in dispute and should have been decided by a jury. The decision overturned U.S. District Court Judge Michael Mosman‘s ruling last year granting summary judgment in favor of the county.
The county’s petition for rehearing, filed by attorney William G. Blair on Monday, says judges overlooked several “material points of fact and law” in their decision. It also requests that a 10-judge panel, excluding the three judges who issued the earlier ruling, rehear the case.
Washington County Sheriff Rob Gordon said Wednesday the county is asking for an en banc review of the case because county legal advisers believe the appellate court’s ruling was made in error.
“I think the first judge was dead on with what the law is,” Gordon said.
In its Nov. 4 ruling, the 9th Circuit panel raised questions about Deputies Mikhail Gerba and Tim Mateski‘s use of force and tactical decisions in the Sept. 16, 2006, incident.
The county’s petition says the officers’ actions were reasonable responses to what they perceived as Glenn’s threatening behavior.
Glenn, “an armed, drunk, suicidal young man in mental crisis who has vented his feelings by breaking windows and kicking in a door,” presented a threat to officers, the petition says.
“The panel decision would set a precedent requiring police to withhold action that would otherwise neutralize an imminent threat of death or serious physical injury.”
The petition also says judges examined the case from an unrealistic perspective.
“A deadly force decision cannot be judged with the benefit of 20/20 hindsight,” it says. “Viewing the undisputed facts in a light most favorable to the plaintiff does not and cannot override the fundamental principle that ‘woulda, coulda, shoulda’ has no place in this Fourth Amendment analysis.”
The petition goes on to say that while the 9th Circuit has decided officers’ conduct leading up to a shooting may be considered in determining whether use of force was reasonable, many other circuits have rejected that position.
The petition also says the panel decision undermines the basis for qualified immunity, which protects public officials from civil liability when their conduct does not violate clearly established constitutional or statutory rights.
The ruling, the petition says, would eliminate “any possibility of a summary judgment based on qualified immunity in a Fourth Amendment use of force case.”
The incident that ended in Glenn’s fatal shooting began in the early morning hours when Hope Glenn called 9-1-1, reporting that her son was drunk, out of control and threatening to kill himself. Officers arrived minutes later to find Lukus Glenn outside his house holding a knife to himself.
Both officers, weapons drawn, shouted at Glenn to drop the knife. When Glenn did not drop the weapon, Tigard police Officer Andrew Pastore shot him with six nonlethal bean bags. Almost at the same time, deputies opened fire with their service weapons after determining that Glenn was moving back toward his house, where his family members were inside. Eight of the 11 shots fired hit Glenn.
In an interview with The Oregonian Wednesday, Gordon called the shooting “such an emotional case for everyone.”
“I feel for the Glenn family,” he said. “I understand what they are doing. I understand completely.”
Gordon said he also feels for the deputies who were involved.
The incident has become “a large part of their lives.” They’ve been through a lengthy court battle, he said.