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David Baxter

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Mental health care faulted
The Bradenton Herald, Fla.
January 13, 2008

SARASOTA -- Millions of people suffering from mental illness could be cured if the gap between research and access to treatment were closed, the nation's top scientists said Saturday.

"We have to close that gap to make sure people get the treatment they so badly need," said David L. Shern, president and chief executive of Mental Health America, a growing movement of Americans who promote mental wellness for the health and well-being of the nation.

"As a society we accept pathetic mental health treatment in this country," said Shern, one of three researchers who spoke at the annual symposium sponsored by the National Association for Research on Schizophrenia and Depression. All three scientists are among about 2,500 recipients of $219 million in NARSAD grants awarded since 1987.

"We know mental illness can be cured, but patients who so desperately need help have little or no access to treatment," Shern said.

As an example, he cited a nephew, now in his 20s, who developed symptoms of bipolar disorder at age 15.

"My sister called me asking for help," said Shern, who at the time was a professor and dean at the Louis de la Parte Florida Mental Institute at the University of South Florida. His sister's family lived in Colorado.

"Although I knew everyone in Colorado's mental health system, I could not get help," Shern said. "All of my connections did not make a difference.

Shern's sister pursued a solution with dogged determination, finally finding a residential program in Utah. But the search took years -- a gap in time between diagnosis and treatment during which the young man's condition worsened.

Shern blames a top heavy, bottom-down bureaucracy that siphons off critical funding that should be spent on building local treatment support networks to help those in need.

He was so angered by the system's failure to treat his nephew in a timely manner that he recently resigned his post at USF to become Mental Health America's top spokesman.

The need for action, Shern said, is far greater than people imagine.

"The United States has the highest rate of mental illness in the world, 26 percent of our population. The lifetime risk of mental illness affects 50 percent of our population," he said.

In many minds, mental illness connotes images of pharmaceuticals and hospitals, but it's more widespread than that. To mental health professionals, mental illness includes everything from mild depression, post-partum depression, attention deficit and hyper activity disorders to more severe forms of schizophrenia, bipolar disease, and many other forms of brain disorders and behavioral problems.

The high U.S. rate of mental illness is due in part to the early onset of symptoms and a slow response in providing treatment which creates a delay that too often results in increased disability and even death.

On average, it takes nearly 10 years from the onset of symptoms to treatment, during that period, the afflicted -- many adolescents -- resort to violent behavior to get attention and drug abuse to self medicate. That's been known since a study that too place in 1934, Shern said.

"It's time for us to take prevention seriously as a society," said Dr. James F. Leckman, an expert in Tourette's Syndrome and Obsessive Compulsive Behavior or OCD, who also spoke Saturday. "We can not let it sit on the shelf in a library journal."

Leckman's work on OCD led to a discovery that the same chemical present in people afflicted with the disorder is also found in expectant mothers and even expectant fathers.

"I first noticed this with my wife, Hannah, when she was pregnant with our daughter Emily. Hannah is not a meticulous person, but while she was pregnant, she was mopping the floor, moving the refrigerator and always cleaning. I found myself buying wood, building a cradle. Our behavior was compulsive and I asked myself if there was a link."

His research proved there was -- an alternation in brain chemistry that produced what's commonly called the nesting syndrome.

"It was as if this compulsive behavior was part of the evolutionary development of the brain to make sure the baby would survive," Leckman said.

The same alternation of brain chemistry occurs in the obsessively compulsive, but in an exaggerated way due to a malfunction of brain chemistry.

"It's as if our brains are wired for certain abnormal behaviors to protect ourselves, so we can survive," said Leckman.

His studies also found environment can have a profound effect on genetic coding.

Early intervention programs that give poor mothers help from conception through two years after the birth of their babies result in improvement not only of mother's life but also the child's and the whole family -- improvements that continue to influence outcomes for more than 15 years after the child's birth, Leckman said.

NARSAD scientists lead in mental health research because the organization funds projects because they are too cutting edge, said Geoff Birkett, NARSAD'S president and chief executive.

"We fund research when no one else will fund it," Birkett said. He looked out across the audience of more than 400 people.

"Eighty-two people in American will commit suicide today. Statistics tell us that 10 percent of the people in this room have clinical depression and 70 percent will have some kind of depression at some point in their lives. Twenty percent are bipolar. We need to find a way to address this crisis. People don't understand how big it is."
 

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