The Breaking Point: 3-part series on mental health care in Medford

The Breaking Point, Part 1

KDRV.com, Nov. 8, 2015

In the middle of creating Divine Lunacy, Peter Quince found out his son was schizophrenic. A surprising turn of events because the musical comedy is about mental illness and because Peter says he had no warning.

“He seemed like the most well-adjusted easy going person on the planet,” explained Peter, “He had several hospitalizations. He’s been arrested several times and he’s done some property damage. It was touch and go on if he was going to make it.”

Peter’s mother was his original inspiration for Divine Lunacy but now his son’s experience provided another dimension to the show. Co-writer David Gabriel also composed the music for Divine Lunacy. David has fought his own battle with mental illness and watch his two brothers succumb to its clutches. “I was hurting for them. They each had a very small life.”

Divine Lunacy’s script shows a story that plays out in southern Oregon every day. Police, advocates, clinicians and those with a mental illness struggle and suffer because there are not enough resources.

The National Institute on Mental Illness says one in four Americans have a diagnosable mental illness in any given year. This includes dozens of diagnoses and sub-diagnoses as defined in the Diagnostic & Statistical Manual of Mental Illness or DSM-5. All can run from mild to severe in manifestation but the most pervasive are schizophrenia, bipolar disorder, and major depressive disorder.

Despite the increase in those seeking care, which is largely attributed to the expanded reach of the Affordable Care Act, most experts and advocates agree the percentage of people with mental illness has not changed over the past several decades. What has changed is how our society provides care for those with mental illness.

From the 1960’s through the 1990’s, a shift occurred as State Hospitals, charged with caring for people with mental illness, started to close. The overrun hospitals discharged patients back into their communities. Federal funding and resources were supposed to follow but largely never materialized. This left communities, families, and individuals fending for themselves for decades. With not enough resources people started falling through the cracks. Many self-medicated with drugs and alcohol. Others masked their symptoms until a mental episode left them behind bars or in the emergency room.

While the lack of funding, providers, programs, and knowledge took its toll, stigma prevent mental illness from becoming a focus in American health. Often, family members wouldn’t address it with each other, much less with coworkers, friends, or even professionals.

Stigma and lack of knowledge contributed to Stu Whittemore’s spiral into deep depression. Stu, a once successful businessman drove himself to a secluded place, put a rifle to his face and pulled the trigger.


The Breaking Point: Part 2

KDRV.com, Nov. 9, 2015

In the late 1980’s Stewart Whittemore was enjoying a six figure salary, a wife, and a new daughter. Despite the stable exterior, Stu was falling apart on the inside. He was an alcoholic and very depressed. The successful businessman was laid off in 1990 and things quickly spiraled out of control. By the time Super Bowl XXVI rolled around Stu was suicidal. The day after the big game he kissed his baby girl and left her with the nanny. With a rifle in hand he drove to a secluded spot, put the gun to his chin an pulled the trigger. As he laid there drowning in his own blood, Stu says it was if God asked him, “Do you want to live or die?” Despite the suicide attempt, Stu wanted to live. Decades later and after more than 17 facial reconstruction surgeries, he is now an award winning author, advocate and volunteer chaplain.

Stewart is one of tens of millions of Americans with depression. The most pervasive form is major depressive disorder. The National Institute on Mental Illness estimates 15 million Americans suffer from this debilitating form each year. These men and women make up just a portion of the 25% of Americans who have a diagnosable mental illness. This includes dozens of diagnoses and sub-diagnoses as defined in the Diagnostic & Statistical Manual of Mental Illness, or DSM-5. All can run from mild to severe in manifestation but the most pervasive are schizophrenia, bipolar disorder, and major depressive disorder.

Despite the increase in those seeking care, which is largely attributed to the expanded reach of the Affordable Care Act, most experts and advocates agree the percentage of people with mental illness has not changed over the past several decades. What has changed is how our society provides care for those with mental illness.

From the 1960’s through the 1990’s, a shift occurred as State Hospitals, charged with caring for people with mental illness, started to close. The overrun hospitals discharged patients back into their communities. Federal funding and resources were supposed to follow but largely never materialized. This left communities, families, and individuals fending for themselves for decades. With not enough resources people started falling through the cracks. Many self-medicated with drugs and alcohol.

Clyde Tankersly used whiskey and meth to deal with symptoms from bipolar disorder. Before long he found himself in a full blown addiction and, like Stu, lost the wealth he had accumulated. Clyde found himself involved with a white supremacy group and admits to being homicidal more than once. A year and a half ago, Clyde found himself with a unique offer. Judge Pat Wolke offered him a place in Mental Health Court. Josephine County is one of just a third of Oregon counties with the unique alternative to incarceration. Mental Health Court pairs a participant with a team that helps with diagnosis, medicine, therapy, housing, rehab, legal issues and financial hurdles. Months after his last manic episode, which Clyde attributes to caffeine, he has been given a graduation date of November 13.

In Jackson County, Mental Health Court is just in its infancy. It would benefit many people Medford Police run into everyday while responding to calls. As of this fall, the entire Medford Police Department has been certified in Crisis Intervention Training. The goal of CIT is to change the interaction between authority figures and those who have a mental illness. Officer Stephen Meador can see several calls involving some level of mental illness each night. During the call he touches base with a liaison from the Jackson County Mental Health who is on duty 24/7. Often, the officer has to make a judgment call. If a person is brought in on a mental health hold there is only one place for them to go but the Psychiatric Care Unit, or PCU at Rogue Regional Medical Center is almost always full. The 18 beds in the Behavioral Health Unit upstairs are also constantly occupied. Sometimes police officers are forced to wait in an ER room, the hall, or even the ER waiting room with a person on a mental health hold. This can be for hours. MPD says there just isn’t enough room for the volume of people who are taken into custody on a mental health hold.


The Breaking Point, Part 3

KDRV.com, Nov. 10, 2015

The National Institute on Mental Illness estimates 25% of Americans have a diagnosable mental illness. This includes dozens of diagnoses and sub-diagnoses as defined in the Diagnostic & Statistical Manual of Mental Illness, or DSM-5. All can run from mild to severe in manifestation but the most pervasive are schizophrenia, bipolar disorder, and major depressive disorder. Many people with these disorders have crises and end up needing acute inpatient care. There is only one facility in southern Oregon capable of that kind of treatment.

Asante’s Behavioral Health Unit, or BHU, is an acute crisis stabilization facility inside the Rogue Regional Medical Center in Medford. There are 18 beds and they are always full. Patients come in from civil commitments, voluntary check-ins, and the ER’s Psychiatric Care Unit. The PCU has three beds used for preliminary consultation and it is also, always full.

Laurel Nickles is the BHU’s clinical manager. She oversees the staff of doctors, nurses, aids, social workers, and case workers who all specialize in psychiatric care. Nickles was hesitant about letting cameras inside. The BHU is extremely protective of its patients which vary widely from homeless men and women to CEO’s, teachers, doctors, stay-at-home parents, community leaders and law enforcement officers. Nickles agreed to allow our cameras in because she says the unit has been shrouded in shadows and stigma for far too long.

The Behavioral Health Unit loses $1.5 million dollars a year. Part of this is because of the cost of care and lack of reimbursement. Another factor is the lack of options following a stay at the BHU. There is a severe lack of respite housing and transitional housing. There are also few peer orientated organization to help with the transition. Nickles says the BHU could stabilize a patient but without the support and housing outside the unit releasing that person is not ethical. Meaning beds are occupied by stable but at-risk people who often are staying for free or at a severely reduced cost.

Despite the increase in those seeking care, which is largely attributed to the expanded reach of the Affordable Care Act, most experts and advocates agree the percentage of people with mental illness has not changed over the past several decades. What has changed is how our society provides care for those with mental illness.

From the 1960’s through the 1990’s, a shift occurred as State Hospitals, charged with caring for people with mental illness, started to close. The overrun hospitals discharged patients back into their communities. Federal funding and resources were supposed to follow but largely never materialized. This left communities, families, and individuals fending for themselves for decades. With not enough resources people started falling through the cracks. Many self-medicate with drugs and alcohol. Others find themselves in the ER after a suicide attempt or in the middle of psychiatric break. Either way it takes a toll on an already taxed mental health care system.

As of this fall, the entire Medford Police Department has been certified in Crisis Intervention Training. The goal of CIT is to change the interaction between authority figures and those who have a mental illness. Officer Stephen Meador can see several calls involving some level of mental illness each night. During the call he touches base with a liaison from the Jackson County Mental Health who is on duty 24/7. Often, the officer has to make a judgment call. If a person is brought in on a mental health hold there is only one place for them to go but the Psychiatric Care Unit, or PCU at Rogue Regional Medical Center is almost always full. The 18 beds in the Behavioral Health Unit upstairs are also constantly occupied. Sometimes police officers are forced to wait in an ER room, the hall, or even the ER waiting room with a person on a mental health hold. This can be for hours. MPD says there just isn’t enough room for the volume of people who are taken into custody on a mental health hold.


The Breaking Point: Getting Help

KDRV.com, Nov. 8, 2015

The National Institute on Mental Illness says one in four Americans have a diagnosable mental illness in any given year. There are lots of resources across southern Oregon. The list below can help you or a family member live a safe, fulfilling and successful life with mental illness.

Jackson County Mental Health – For Jackson County residents covered by OHP or Medicaid.

Options of Josephine County – Support and resources for residents in Josephine County including housing, case work, addiction recovery, and crisis intervention.

The Compass House – Medford clubhouse for those with mental illness. Members can access resources, create relationships and learn to advocated for themselves in a stigma free environment.

NAMI of Southern Oregon – Local chapter advocating for people with mental illness. Offers multiple resources, studies, statistics, and articles.

Karios – Helps families and youth with diagnosis and treatment of mental illness in Josephine and Jackson Counties.

WinterSpring – Grief counseling and suicide prevention organization in southern Oregon.

National Institute of Mental Illness – Promotes treatment and prevention. Offers multiple resources, studies, statistics, and articles.

National Alliance on Mental Illness – Advocacy and education organization. Offers multiple resources, studies, statistics, and articles.

Mentalhealth.gov – Federal site on Mental Health. Contains some policy information.

Bring Change 2 Mind – Advocacy and education organization focused on ending stigma.

American Foundation for Suicide Prevention – Support and resources for those who impacted by suicide. Promotes suicide prevention programs.