CA DUers: Why did Lashaun Harris quit taking her meds?

[usregimechange]

Can it be attributed to policy? In MO a schizophrenic patient might not be taking them because of a certain GOP Governor who cut Medicaid. Whats up in CA?

[Howardx]

1. theres no law that can force them to take it

i need to get junevox on this one, she has personal knowledge due to a shizophrenic relative.

[usregimechange]

2. Yes, but if they can't afford them and the state cuts Medicaid...

[EFerrari]

5. You'd have to check the local laws. She lived in Alameda Co.

In SF County, people can get free psych meds if they can't afford them.

[EFerrari]

3. AB 1421 is only now being implemented. Link:

http://www.psychlaws.org/StateActivity/California.htm

[JuniperLea]

8. Doooood... changed my handle, remember?

Yeah, I have a close relative who is schizo... part of the symptoms of this odd disease is that patients are almost always in denial that they have the disease and almost all of them stop taking their meds and announce themselves "cured", which is impossible. There has never been a documented case of being cured of this horrific disease. While properly medicated, most of these people are completely normal in all regards, even genius. Off the meds... too unpredictable and can become violent, even with people they love dearly. Sad, sad thing.

Hearing voices is a common symptom. And they believe the voices. There is no reasoning with them on this count.

[CottonBear]

4. You can't force someone to take their meds.

I have a good friend who had a mom w/ schizophrenia. She rarely ever took meds. It was awful. There was nothing the family could do. She died a few years ago. It was a terrible way to live for her and her family.

[usregimechange]

6. Has CA cut Medicaid? I agree but you need more than meds to

treat a schizophrenic. Therapy, casework, etc.

[EFerrari]

9. The point is, I guess, you can't do casework or therapy

in many cases without meds first.

[usregimechange]

13. They help.

[EFerrari]

15. Your larger point about this being, at bottom, a political issue is

right as far as I'm concerned. These people are extremely vulnerable and unless they have a dogged advocate or treatment team, their interests are not represented in many situations.

Funding is political and mental health services in CA are (or can be) horrendous. Look at how her family tried to intervene and got NO support from Social Services?

[JuniperLea]

23. Exactly

There is nothing a family member can do to get help for the mentally ill. It all falls under "patient's rights". You can't force a person to take meds, can't take their kids away, can't force them to see a doctor...

[EFerrari]

25. Well, there are advocates who are changing that.

Mostly family members or people who have stablized themselves and want to give back to the community.

Doug's doctors used to slime out of giving him care by saying they had no release to talk to me. So,finally I told them they didn't need a release to listen. (They also got a little nervous when they found out I was writing a book about our family. :evilgrin:)

You'd be surprised how much you can do, once someone shows you the trickbag. :hi:

/typin

[JuniperLea]

30. You might be surprised to know how little can be done in some cases

Some people do not respond to some medications, period.

[EFerrari]

7. That's so terribly sad. In fact, there is one group I know of

who advocates for assisted out patient treatment for those times when people go off their meds. They've been successful in many states.

[CottonBear]

14. The end of her life was somewhat better.

She developed lung cancer and her family was able to convince her to stay in an apartment near her grown children and ex-husband. A social service agency helped to find funding assistance for the apartment. She didn't take her meds but she received treatment for the cancer and was able to stay in one place. Previously, she traveled around in a van and was prone to dropping in on relatives unannounced. That was stressful.

[EFerrari]

16. I bet it was.

My hubby is borderline and until we found good care for him, life was nearly impossible for both of us.

[CottonBear]

36. Oh wow. I hope you and your husband are doing OK.

It is a difficult thing to live with mental illness. Depression runs in my family. So much of mental illness is genetic.

Peace to you both. CB

[EFerrari]

37. We're very lucky.

And back atcha. :)

[proud2BlibKansan]

19. You are right

but the state can sure step in and take her kids away.

[EFerrari]

20. Actually, we now have "Laura's Law" on the books.

And it is just now being implemented, county by county. So, yes, the state can make you take your meds in very special circumstances. I believe this case would have fallen within the parameters of this law.

[proud2BlibKansan]

21. That's good to hear

but sad it didn't come about in time to help save these kids.

[EFerrari]

22. I know. Reform takes a long time. We just have to keep at it. nt

[JuniperLea]

24. It's like having a stalker....

until they actually do something, there is nothing you can do. And by then it can be far too late. And even if you get that person into a hospital and medicated, they can't be held forever and as soon as they are on their own, the whole denial thing starts all over again. Trust me on this. I've been dealing with it for over 30 years.

[EFerrari]

28. Yep, I have a dear friend who goes through this with her

brother every now and then.

The key is usually the medicating doc. If the cocktail is right, those episodes can be vastly reduced. My partner hasn't decomped in five years or so -- as opposed to once or twice a week.

[JuniperLea]

31. In some people, you are correct

Not all people respond well at all.

[Gormy Cuss]

10. She moved.

According to either a Contra Costa Times or an SF Chronicle story (I can't remember which) she had been living in FL this summer and was diagnosed and medicated there. When she came home to Oakland, she announced to her family that she was cured.

She and the boys were living in a shelter and the staff there had no clue that she was in such a precarious state. She dressed the boys and left the shelter that morning as if there was nothing different about that day.

Apparently she talked to a relative in Oakland and said she was going to feed the kids to the sharks, which set off a search by several family members but they didn't find her in time.

[JuniperLea]

11. There ya go...

announced herself as cured... see my post above.

There is a terrible stigma these poor people feel. No one wants to admit they are "crazy".

[EFerrari]

12. Here's a link to a good fact sheet on the loss of insight:

I've no idea if this is what happened but it's a fairly common problem:

http://www.psychlaws.org/StateActivity/California/factsheet4.htm


Fact Sheet:
LACK OF INSIGHT—a Barrier to Voluntary Treatment

"Lack of insight" (the inability of a person to realize, or accept, that he is suffering a mental illness) has long been believed to stem from defensive denial, partly because of the stigma associated with these diseases. While denial no doubt contributes to some people with mental illness refusing treatment, research shows that lack of insight just as frequently results from the underlying brain disorder itself. The brains of those who suffer from this particular symptom of mental illness are often structurally different from those who do not. Treatment refusals stemming from lack of insight are thus not "informed medical decisions." It is the malfunctioning of the brain itself that causes the impaired decision-making. There is nothing civilly right about denying treatment to people with impaired decision-making who are too sick to obtain help for themselves.

more at link

[Mend]

17. She was given the very nasty Haldol that has lots of

side-effects instead of the new, vastly improved anti-psychotics such as Abilify which people don't mind taking. Of course the new drugs cost hundreds of dollars a month and generic Haldol is probably ten bucks. It would be interesting to know why she got that old crap when private patients almost universally are getting the new medications.

[EFerrari]

18. Sloth, pure and simple.

If I didn't assert myself with Doug's docs, he'd still be decompensating twice a week -- on the wrong meds. It took me five YEARS to get someone to even prescribe a neuroleptic for him in the first place. It's sloth because there are no consequences for neglecting poor, sick people.

[JuniperLea]

26. I resent your remark!

Not everyone does well on those meds. My relative only did well on haldol, which is a horrid drug. We've tried at least five drugs in different combinations. We've had her in and out of hospitals for over thirty years and there is nothing we can do to keep her on the meds. It's a constant cycle of medication, denial, off the meds, do something stupid, get arrested, 72-hour hold, medicate, hospital stay, get out, go into denial, get off meds... etc. etc. etc.

Just because your case is manageable it doesn't mean all cases are. My family and I have dealt with this far too long and too hard to be given a sloth label, and you have no right to say that about this woman's family either!

[EFerrari]

32. Wait! I wasn't talking about the family!

Not all cases are manegeable, that is true. However, there is evidence here that this woman was not being properly monitored by her treatment team. That is what I was getting at, if you look at the post again.

Believe me, I've talked to exhausted families for over a decade. If it weren't for us sometimes I think the world would just stop.

[JuniperLea]

33. What evidence?

I have a 30-year history with dealing with this disease and I've read every article I can get my hands on. I've not seen one shred of evidence that this woman was not being properly treated. It appeared to me that she took the situation into her own hands and announced herself "cured", which is impossible, and yet another symptom of the disease.

[EFerrari]

34. Okay. Where is her team? Since they are paid

to ***KNOW*** this is a symptom of this disease, how did they handle it? Ignoring missed appointments?

And what about Social Services? They were approached by her family. They ***COULD HAVE HAD HER EVALUATED***. How did they handle it? Telling the family to go to Civil Court?

And what about the shelter staff? Why didn't they know she was schizophrenic and off her meds? They do intakes, don't they?

Please.

[Gormy Cuss]

41. Partial answers in this SF Chron article

http://sfgate.com/cgi-bin/article.cgi?file=/c/a/2005/10/21/MNG3OFC2701.DTL

The shelter staff saw nothing out of the ordinary. It's unclear whether they had access to info that she was a diagnosed schizophrenic --see post 10 above -- it sounds as if Alameda social services knew she had problems from the family only but the diagnosis and medication occurred in Florida.

[EFerrari]

43. I read those articles. In fact, one of those reporters is a friend.

Shelter staff did an inadequate intake. About 3 in 10 homeless people have serious mental health issues and shelter staff needs to screen for that.

The family has a potential case against Alameda County. The family was forthcoming and had a wealth of information that was pretty much refused -- which is common. So, yes, the professionals in Alameda Co. had access but they didn't do their job.

If we're going to prevent these cases, we have to hold people accountable.

[JuniperLea]

44. Shelters do not do intakes

Social Services will not get involved unless the person is proven to be harmful to herself or others.

You cannot force a person to be evaluated unless the person is proven to be harmful to herself or others.

You cannot force a person to keep their appointments. Read the California Patient's Rights Act.

The only way to have full control over a mentally ill person is to get conservertorship over that person, that is where civil court comes in. It costs thousands of dollars to proceed in that action.

Please your own damn self. You have experience with ONE person for five years and I don't know how bad off that person is. I have battled social services, courts and care givers for over thirty years in California and Washington state. Where do you get your information? It seems to me your post, the one I'm responding to, shows very little knowledge in this area. And I still resent your "sloth" comment. WE don't know this woman's family. WE don't know what they have gone through or for how long.

To top it all off... this is a disease that is inherited genetically!! Most show symptoms by the time they are in their late teens or early twenties. Some not until they are thirty. The shear terror of waiting for a son or daughter to grow a little and start showing symptoms too... jeebus h. cripes.... this is gawdawful.

[EFerrari]

45. Ah, the shelters in our area do intakes.

"Harm to self or others" is subjective and if you are dealing with responsible professionals, they will find a way to facilitate an eval.

I have read the California Patient's Rights Act, and Doug and I worked hard to get Laura's Law passed.

I have also worked with thousands of families all around the world, btw.

You seem to have misread my post. I was making the opposite point: this family was not served well by the very people they should have been able to rely on. So, I'm afraid your resentment is misplaced.

It sounds like you have had a long hard battle. I wish you all the peace you can garner.

[JuniperLea]

46. Harm to oneself or others is not subjective

it is part of the law.

In California and Washington state, all you can hope for is a 72-hour hold... BY LAW! When health care providers go beyond that, they put themselves at risk of being sued. Period. Yes, the laws can be bent, but until they are changed, it is damn hard to get help.

You can't blame the health care professionals. They have their hands tied. And you need to be careful giving advice to those thousands of people all over the world. Even in a support group situation, you can be sued.

I still take offense at ANYONE who calls another names when they don't know the whole story. And I especially take issue with anyone who claims to know so much about a disease that is still very much a mystery. There are no pat answers. Not all answers are good for all patients.

[EFerrari]

47. We disagree. n/t

[JuniperLea]

50. I still think you are dangerous

If you assume you know it all and can disagree with all of the open-ended statements I know to be true by law, then you are dangerous. You assume you know it all.

And the "evidence" you gave is bogus bullshit.

[EFerrari]

53. We disagree. n/t

[Gormy Cuss]

48. Subjective, yet shelter is responsible?

Do you know something specific about the Salvation Army shelter in Fruitvale in making this statement, or are you saying that based on your knowledge responsible professionals are always able to do a proper evaluation? I'm curious, this is not a subject area where I understand the approach in the Bay Area.

That social services let down the family doesn't surprise me even though I have no direct knowledge of Alameda County services, but that's because I've dealt with enough understaffed, sometimes underskilled, and usually overwhelmed public social service agencies.

[EFerrari]

51. Sort of both. I don't know that particular shelter.

When Doug was homeless in the Bay Area, they screened him all the time.

Also, families in our situation have to get very creative. You have to find ways to get care from an overburdened system when you family member is probably at their worst and when you are exhausted. (Now, sing!)

The best pros, I've worked with or heard about anecdotally from the families I brainstorm with, find a way to facilitate an eval particularly if there is a history AND if there are kids involved.

Alameda County Social Services seem to be worse than San Francisco but much better than Los Angeles. I do have direct experience with all three, as well as experience with folks who tried to get services from all three.

[JuniperLea]

29. "MOST" people don't mind taking it

There are still some who cannot and will not. You can't make blanket statements about this disease.

There are many reasons she was prescribed haldol. It may be the only one that worked for her. WE don't know and it is totally unfair to her and her family and her medical helpers to make such assumptions.

[tlsmith1963]

27. Sometimes They Just Quit Taking Them

My sister's ex-husband was always trying to quit taking his meds. And he would mix them with alcohol & drugs, too. It caused the end of their marriage. Since you can't force them by law to take them, what can you do? It's hard.

Tammy

[EFerrari]

35. It is hard. And getting some people to stay on their meds is

only a piece of the battle. Finding an effen doctor who is skilled enough to properly prescribe and diligently monitor is another big piece.

Some people go off their meds BECAUSE THEY'RE THE WRONG MEDS and they are not working. And, that gets missed a lot in these conversations I notice.

Lots of tough puzzles, for sure.

[redacted]

38. Hey SFexpat, do you know a good resource that explains psych laws for

every state. Thanks if you do.

[EFerrari]

39. www.psychlaws.org is the best one I know

and great guys, too. :)

[redacted]

40. Thanks. I need to do some research on Illinois and Missouri.

Someday over a stiff drink in the city I'll tell you all about it. ;-)

[EFerrari]

42. Ah. Good, I look forward to it.

:)

[carolinalady]

49. It is a documented fact that patients diagnosed with

schizophrenia are notorious for not taking their meds. They become suspicious of them as they do most things. When I did my psych nursing rotation in the hospital we had to check their mouths, because they would stash them to the side and spit them out when they thought no one was looking. I am not surprised that she did not take them. However, I do wonder where family services was in all of this. Not sure whether it was a safe situation to leave the children in her care unsupervised if she was clinically diagnosed.

[JuniperLea]

52. You can't take the kids away unless the patient shows signs of being`

harmful to herself or others.

There are new drugs that are effective with some that can be taken once a month. But there again, there is no law that says the patient MUST take the drugs unless they are in a hospital situation and a judge has ruled them to be a danger to themselves or others.

I've spent hours in court rooms on this issue. It is frustrating as hell. And then to have people look down on the family for not helping the patient. It just sucks out loud.