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Experts Discuss Removing Stigma of Mental Illness 
'It's a Community Affair' looks at topics of effective treatment and prevention of suicide.  

Appearing in the Portland Press Herald
November 20, 2010 

 PORTLAND - Ann Pringle recalled being nervous about talking to her new friend, who suffered from manic depression and chronic alcoholism, worried that something she said might send him over the edge.

Instead, her friendship and concern helped him get control of his illness. He hasn't been hospitalized or had a drink in eight years, said Pringle, a former Portland mayor.

Such involvement, one-on-one without the benefit of mental health training, is one way that a community can help to remove the stigma of mental illness, encourage people to take advantage of effective treatments and reduce suicides, according to a panel of experts who gathered Friday at the University of Southern Maine.

The presentation, titled "It's a Community Affair," was put on by Spring Harbor Hospital in partnership with USM's School of Social Work and Maine Medical Center.

Recent high-profile suicides and suicide attempts have heightened interest in mental health.

Last month, a Portland man hung himself in Fort Allen Park soon after being discharged from Spring Harbor Hospital. He left a suicide note that was critical of the care he received.

In September, a 24-year-old Portland man set himself on fire in Longfellow Square. He remains in a Boston hospital. His father wrote a poignant column for The Portland Press Herald describing the family's efforts on behalf his son and his commitment to care for him in the future.

Some in law enforcement are lobbying for the ability to hold a person for as long as three days for evaluation and stabilization if they have been taken into protective custody.

At the same time, mental health providers in southern and coastal Maine are pooling resources with a goal of creating a more coordinated, effective and efficient system of delivering mental health care. Maine Mental Health Partners includes Spring Harbor, Maine Medical Center, the Community Counseling Center and the Mid-Coast Mental Health Center in Rockland, as well as other nonprofits. Pringle is the new chair of the groups' board of directors.

Friday's presentation drew about 150 people: students, health care providers and policy-makers, as well as people who have mental illness and family members of people who are or were mentally ill.

Central to the presentation was the importance of removing the stigma associated with mental illness, so that people will be more comfortable reaching out for help for themselves or loved ones.

"Can you imagine feeling ashamed for having cancer or having to face that devastating illness without being able to confide in friends and family or seek support from neighbors or colleagues?" asked Dennis King, chief executive officer of Spring Harbor Hospital and president of Maine Mental Health Partners.

Dr. Douglas Robbins, director of child psychiatry at Maine Medical Center, told the gathering that suicide is the No. 3 killer of young people in the United States, after accidents and homicides. Ninety percent of youths who commit suicide have diagnosable mental illness, he said, and 80 percent do not receive treatment.

"Part of the treatment is to work through the isolation and silence," Robbins said. "Stigma works against that."

People in the community -- primary care physicians, clergy members, educators and parents -- should get familiar with risk factors and trouble signs, he said.

Follow-up outside the hospital setting is important because suicidal thoughts can come and go, he said. A patient can be calm and reasonable and show no warning signs during an evaluation, but deteriorate later.

Most young people who commit suicide make prior attempts, abuse substances and have access to lethal means like guns, he said.

One woman in the audience, a social worker whose son suffers from untreated mental illness, asked how to get people older than 18 into treatment when their illness prevents them from recognizing that they are sick.

Dr. John Campbell III, medical director for inpatient psychiatry at Maine Medical Center, said that is a question for the Legislature. He favors the approach taken in states like Michigan, where a person who is incapable of making sound judgments about his health can be compelled to take medication.

"We really celebrate the right of the psychotic person to be psychotic," Campbell said, referring to Maine's liberal laws on the rights of people with mental illness. "Forced medication, done right, is therapeutic."

In Maine, people are entitled to refuse medication, and as long as they don't pose an imminent risk of harm to themselves or others, they cannot be hospitalized involuntarily.

During Friday's question-and-answer session, Superior Court Justice Nancy Mills, who was in the audience, announced the formation a special court in Cumberland County for offenders who have mental illness and substance abuse problems.

The Co-Occurring Disorders Court in Kennebec County has been operating for 5½ years and has shown good results, Mills said, so such a court is being started here.

Someone who has committed crimes and is accepted into the program can be given a much more lenient sentence in exchange for a commitment to get treatment and hold down a job, schooling or volunteer work after release, she said.

The court is scheduled to open next month, she said.

By David Hench,
Staff Writer






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