Why people with mental illness often struggle to find help

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SALT LAKE CITY — Two recent murders, in the Avenues and in Cottonwood Heights, have been blamed on mentally ill family members, who their loved ones and neighbors say didn't get the treatment and medications they needed.

Mental health professionals observe only a very small fraction of the mentally ill ever commit crimes, but some of the problem cases highlight the larger issues facing people and families who struggle to get help.

"I remember thinking to myself I just want to die," recalled Kerri Ernstsen, a mentor at the National Alliance on Mental Illness of Utah.

Ernsten said abuse set her on a path that included depression, obsessive compulsive disorder, delusional thoughts and drugs. She was hospitalized twice. Only extensive treatment over years and strong support from her family brought her back to a functional state.

Today, she helps to ensure others get the care they need while also talking about the challenges she faced in the system. To her, people don't get help fast enough.

People suffer and they start self-medicating with drugs and alcohol as a way to survive.

–Kerri Ernstsen

"What happens is people suffer and they start self-medicating with drugs and alcohol as a way to survive," Ernstsen said. "I understand what it's like to have to have some sort of relief."

NAMI Utah Executive Director Rebecca Glathar said Utah has made significant strides in mental health care, but significant challenges linger because of frequently poor insurance coverage and gaps in communication.

Insurance Issues

"People are put in terrible situations," Glather said. "It's an inability to even cover those basic needs."

Glathar said one person recently told her he had $5 in his pocket and $100 worth of needed prescriptions after being released from in-patient treatment.

Insurance challenges, Glathar said, can lead to people not getting the medications they need, and that can create problems in terms of out-patient visits.

"Some insurance companies will say you can have eight visits that are covered," Glathar said. "If you think about that - eight visits over a 12-month period of time - if there's an individual who has a serious and persistent illness or a serious need for intervention then those eight visits will be used up very quickly."

Communication is key

Various entities also do not always communicate effectively, leading to a lack of needed meds and treatment.

"NAMI's concern is that they get the care that they need," Glathar said. "One of the ways to help do that is by increasing the communications between these different systems."

"So if someone is taken into jail," she continued, "are they receiving information from their physician, are those within the jail making sure that they're getting that information and getting those prescriptions to the individual on a regular basis so there's not a lapse in the care that they're receiving?"

Glathar said it's also important when people are leaving an in-patient or jail setting for those entities to notify healthcare providers.

Commitment and in-patient treatment

Sometimes because of the challenges, families are forced to deal with antagonistic, combative and even violent family members struggling with illness. And in occasional cases, commitment and in-patient treatment is a recommended option.

Getting to that point can be challenging, especially when seeking involuntary commitment. It requires a written application to a district court that includes a certification from a licensed physician or examiner, or a written statement sworn under oath from the applicant that the person has refused to submit to an examination. Even then, there are no guarantees.

Mental Health Problems
  • One in four adults deals with a mental health problem in a given year
  • One in 17 adults copes with a serious mental illness in a given year
    Source: National Alliance on Mental Illness

"Many individuals are assessed and determined to not be an imminent danger to themselves and to others and so are released," Glathar said.

Glathar said that can be another problem - frequently those people do not get further treatment once they are turned away from the hospital.

Glathar said many agencies in Utah do respond better to mental health issues than their counterparts in other states. An ever-increasing number of law enforcement officers are trained in crisis intervention, and within the past year the University of Utah launched a Mobile Crisis Outreach Team.

"I think that there have been big strides that we've been making as far as communicating better," Glathar said. "But I think there's a lot more that we could be doing and I think we need to continue to look at where are the gaps and what can we be doing better."

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Andrew Adams


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