This morning’s *Oregonian* includes an article: “Families of mentally
ill face daunting challenges” by Jerry Casey.

Here are some excerpts:

[begin excerpts]

Imagine your brother had a severe chronic illness. Imagine it messed
with his ability to realize how sick he was and made him act a little crazy.

Imagine he resisted getting treatment and insisted he was fine. Imagine
he threatened you when you tried to help. Imagine his caregiver nearly
went bankrupt. Imagine you found out he was off his meds again and about
to be evicted. Imagine you were scared, desperate and clueless what to
do — but decided to visit him one more time.

Imagine, in other words, you were Theresa Rockwood last month.

Her dilemma played out with horrific consequences: She was found stabbed
to death in her brother’s apartment. Her brother, Joseph F. Rockwood,
54, who has schizophrenia, is charged with murder.

“One of the things our system is not well prepared to do is engage
families,” said Chris Bouneff, director of marketing and development for
DePaul Treatment Centers and president of the National Alliance on
Mental Illness of Oregon.

With a physical illness, Bouneff said, caregivers are more insistent on
bringing family members into discussions about treatment. “Typically, in
mental health, that doesn’t happen.”

There are many reasons: fear, stigma, denial, ethical concerns about
privacy protection.

“It’s not uncommon for family members to struggle with trying to get
care for their loved ones,” Bouneff said. The problem gets especially
dicey when the loved one has schizophrenia, which plays havoc with self-
awareness and logic.

“It doesn’t work to say to them, ‘Why don’t you just get help?’ Their
frame of reference will never be that they need help,” Bouneff said.

Like Theresa Rockwood, clinical psychologist Xavier Amador had a brother
diagnosed with schizophrenia. Amador’s book, “I Am Not Sick, I Don’t
Need Help: How to Help Someone with Mental Illness Accept Treatment,” is
based on his own frustration, starting when he confronted his brother
Henry and accosted him for tossing his medicine into the trash can.

“With every dose of ‘reality’ I tried to give him, Henry countered with
more denials,” Amador writes. “And with every go-round we both became
angrier and angrier.

“My natural instinct to confront his denial was completely ineffective
and made things worse.”

<snip>

Even if the law made it easier to confine mentally ill people against
their will — a controversial move — there’s little capacity to take
care of them.

“You can’t get into the state hospital, and you can’t get out of the
state hospital,” Bouneff said. “There’s nowhere to go. Cascadia is
overwhelmed.”

<snip>

“We have a system that’s chronically underfunded,” Bouneff said.
“Situations like this put providers in a bind. The problem is much more
complex than pointing a finger at the provider.”

[end excerpts]

The article is online at:
<http://tinyurl.com/6y5hh5&gt;.

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