Horrific deaths, brutal treatment: Mental illness in America’s jails

The Linden Lodge Foundation would like to share a ground-breaking report “Horrific deaths, brutal treatment: Mental illness in America’s jails,” published by The Virginia Pilot.

In a nine-month investigation, reporter Gary Harki and several Marquette University students tracked the deaths of 404 inmates with mental illnesses since 2010.

The Treatment Advocacy Center worked extensively on this piece, which reveals the brutal treatment many people suffer in our criminal justice system. The article, available here, includes disturbing images, but I encourage you to read it in its entirety.

Here are some of The Virginia Pilot‘s findings:

  • At least 33 times inmates’ family or friends had warned the jails of their loved one’s mental illnesses prior to their death.
  • More than 178 inmates with a mental illness died by suicide while behind bars.
  • In 70 cases staff at the jail subjected the prisoner to shock, pepper-spray, restraint, or some combination thereof.
  • In more than half of the deaths, families sued either the facility or the medical provider.
  • In more than 40 percent of deaths, The Virginian-Pilot found that inmates with mental illness were segregated from other inmates when they died.
As shocking as it is that 404 people with mental illness died behind bars since 2010 (more than 50 per year), the paper concedes that the actual number of deaths for the period is likely significantly higher than what they could document. If you know of a case they may have missed, additional cases may be reported here.

Without accurate data, those in charge cannot be held responsible for the inhumane treatment of the mentally ill in our nation’s jails. We urge you to share this story with your public officials and policy makers to force this accountability.

I know that reports like this are difficult to read, but they are critical for shedding light on the abuses inherent to a broken mental health treatment system. Moreover, they strengthen our resolve to eliminate barriers to treatment for people with severe mental illness. Only together can we implement reforms that prevent senseless tragedies like these.


Sincere thanks to John Snook, Executive Director of The Treatment Advocacy Center for  alerting us all to this.


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Can We Stop Labeling Ourselves With Our Mental Illnesses?

Hattie Gladwell

You are not OCD. You have OCD. That’s an important distinction.

I really wish people would stop labelling themselves – and others – with their mental illness.

What I’m talking about is discussing mental illness as though it’s something that you are – and not something that you have.

How many times have you heard someone describe themselves as being ‘ao OCD’ or ‘so Bipolar’? My guess is lots.

Labeling yourself with a mental illness not only overshadows how serious it is, portraying it as a personality trait or a passing mood, but also hammers home the difference in the way we view physical and mental illness.

You wouldn’t say you are a broken leg, now would you? What you’d say is that you have a broken leg. And we should be discussing mental illness in the same manner.

Describing yourself as your mental illness rather than saying you have it suggests that’s all you are. It takes up your identity. I worry that if I were to label myself as someone who is bipolar as opposed to who has bipolar, the person I’m describing myself to may never be able to see beyond that.

While I want my mental illness to be acknowledged, I want every other part of me to be recognized too.

I understand that everyone, at least everyone with a mental illness, is entitled to speak about it in a way they feel most at ease. But it worries me that not doing so properly will hold up the unfortunate idea that invisible illnesses don’t affect you as much as physical ones.

It’s unfortunate that it’s the people with mental illness who are forced to educate those without. It shouldn’t be up to us. In a perfect world people would accept that mental illness is a real, debilitating thing (well, in a perfect world mental illness wouldn’t even be a thing, but you get my point).

As a person with a mental illness who feels as though it’s my duty to educate those around me, I think it’s important that I refer to it properly. When I tell people about my bipolar disorder, I tell them that it’s something I have. That I live with. That I’m treated for.

I talk about it in the same manner that I would a physical illness. I never, ever refer to myself as a ‘bipolar person’, because this will only further increase the assumption that a mental disorder is something that you are, and not what you’ve been diagnosed with.

I feel treating a mental illness the same as a physical when being vocal about it is an important way to gradually express that mental illness is real. That mental disorders warrant a diagnosis and they shouldn’t be treated in the same way as natural emotions.

And that’s the thing – talking about mental illness as something that we are and not that we have does this. People have got it into their heads that it’s okay to refer to their moods and personality traits as a mental illness.

When someone goes off into a fit of rage because someone’s upset them, after having been quite content beforehand, someone will label them ‘so bipolar’. This is only adds to the stigma and misunderstanding around mental illness.

But how can people fully understand why this is wrong if they see people with mental illness speaking as though mental illness is something they are and not what they have?

I get it, mental illness is hard enough to deal with without someone telling you how you should or shouldn’t refer to it.

But I think that if we really want to get across how debilitating and life-consuming it can be, we can all make an effort to make sure we say it’s something we have, not something we are.

We need to make it clear that mental illness deserves the same respect as any other physical illness. We need to make it clear that our mental illness does not define us.


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6 reasons why people commit suicide

Though I’ve never lost a friend or family member to suicide, I have lost a patient.

I have known a number of people left behind by the suicide of people close to them, however. Given how much losing my patient affected me, I’ve only been able to guess at the devastation these people have experienced. Pain mixed with guilt, anger, and regret makes for a bitter drink, the taste of which I’ve seen take many months or even years to wash out of some mouths.

The one question everyone has asked without exception, that they ache to have answered more than any other, is simply, why?

Why did their friend, child, parent, spouse, or sibling take their own life? Even when a note explaining the reasons is found, lingering questions usually remain: yes, they felt enough despair to want to die, but why did they feel that? A person’s suicide often takes the people it leaves behind by surprise (only accentuating survivor’s guilt for failing to see it coming).

People who’ve survived suicide attempts have reported wanting not so much to die as to stop living, a strange dichotomy but a valid one nevertheless. If some in-between state existed, some other alternative to death, I suspect many suicidal people would take it. For the sake of all those reading this who might have been left behind by someone’s suicide, I wanted to describe how I was trained to think about the reasons people kill themselves. They’re not as intuitive as most think.

In general, people try to kill themselves for six reasons:

1. They’re depressed. This is without question the most common reason people commit suicide. Severe depression is always accompanied by a pervasive sense of suffering as well as the belief that escape from it is hopeless. The pain of existence often becomes too much for severely depressed people to bear. The state of depression warps their thinking, allowing ideas like “Everyone would all be better off without me” to make rational sense. They shouldn’t be blamed for falling prey to such distorted thoughts any more than a heart patient should be blamed for experiencing chest pain: it’s simply the nature of their disease.

Because depression, as we all know, is almost always treatable, we should all seek to recognize its presence in our close friends and loved ones. Often people suffer with it silently, planning suicide without anyone ever knowing. Despite making both parties uncomfortable, inquiring directly about suicidal thoughts in my experience almost always yields a honest response. If you suspect someone might be depressed, don’t allow your tendency to deny the possibility of suicidal ideation prevent you from asking about it.

2. They’re psychotic. Malevolent inner voices often command self-destruction for unintelligible reasons. Psychosis is much harder to mask than depression — and arguably even more tragic. The worldwide incidence of schizophrenia is 1% and often strikes otherwise healthy, high-performing individuals, whose lives, though manageable with medication, never fulfill their original promise.

Schizophrenics are just as likely to talk freely about the voices commanding them to kill themselves as not, and also, in my experience, give honest answers about thoughts of suicide when asked directly. Psychosis, too, is treatable and usually must be for a schizophrenic to be able to function at all. Untreated or poorly treated psychosis almost always requires hospital admission to a locked ward until the voices lose their commanding power.

3. They’re impulsive. Often related to drugs and alcohol, some people become maudlin and impulsively attempt to end their own lives. Once sobered and calmed, these people usually feel emphatically ashamed. The remorse is usually genuine, and whether or not they’ll ever attempt suicide again is unpredictable. They may try it again the very next time they become drunk or high, or never again in their lifetime. Hospital admission is, therefore, not usually indicated. Substance abuse and the underlying reasons for it are generally a greater concern in these people and should be addressed as aggressively as possible.

4. They’re crying out for help and don’t know how else to get it. These people don’t usually want to die but do want to alert those around them that something is seriously wrong. They often don’t believe they will die, frequently choosing methods they don’t think can kill them in order to strike out at someone who’s hurt them—but are sometimes tragically misinformed. The prototypical example of this is a young teenage girl suffering genuine angst because of a relationship, either with a friend, boyfriend, or parent who swallows a bottle of Tylenol—not realizing that in high enough doses Tylenol causes irreversible liver damage.

I’ve watched more than one teenager die a horrible death in an ICU days after such an ingestion when remorse has already cured them of their desire to die and their true goal of alerting those close to them of their distress has been achieved.

5. They have a philosophical desire to die. The decision to commit suicide for some is based on a reasoned decision often motivated by the presence of a painful terminal illness from which little to no hope of reprieve exists. These people aren’t depressed, psychotic, maudlin, or crying out for help. They’re trying to take control of their destiny and alleviate their own suffering, which usually can only be done in death. They often look at their choice to commit suicide as a way to shorten a dying that will happen regardless. In my personal view, if such people are evaluated by a qualified professional who can reliably exclude the other possibilities for why suicide is desired, these people should be allowed to die at their own hands.

6. They’ve made a mistake. This is a recent, tragic phenomenon in which typically young people flirt with oxygen deprivation for the high it brings and simply go too far. The only defense against this, it seems to me, is education.

The wounds suicide leaves in the lives of those left behind by it are often deep and long lasting. The apparent senselessness of suicide often fuels the most significant pain survivors feel. Thinking we all deal better with tragedy when we understand its underpinnings, I’ve offered the preceding paragraphs in hopes that anyone reading this who’s been left behind by a suicide might be able to more easily find a way to move on, to relinquish their guilt and anger, and find closure. Despite the abrupt way you may have been left, those don’t have to be the only two emotions you’re doomed to feel about the one who left you.

Alex Lickerman is an internal medicine physician at the University of Chicago who blogs at Happiness in this World.  He is the author of The Undefeated Mind: On the Science of Constructing an Indestructible Self.

Image credit: Shutterstock.com



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Taking on Stigma Through Mental Illness Awareness

9 Ways To Fight Mental Health Stigma

By Laura Greenstein | Oct. 11, 2017


Most people who live with mental illness have, at some point, been blamed for their condition. They’ve been called names. Their symptoms have been referred to as “a phase” or something they can control “if they only tried.” They have been illegally discriminated against, with no justice. This is the unwieldy power that stigma holds.

Stigma causes people to feel ashamed for something that is out of their control. Worst of all, stigma prevents people from seeking the help they need. For a group of people who already carry such a heavy burden, stigma is an unacceptable addition to their pain. And while stigma has reduced in recent years, the pace of progress has not been quick enough.

All of us in the mental health community need to raise our voices against stigma. Every day, in every possible way, we need to stand up to stigma. If you’re not sure how, here are nine ways our Facebook community responded to the question: “How do you fight stigma?

Talk Openly About Mental Health

“I fight stigma by talking about what it is like to have bipolar disorder and PTSD on Facebook. Even if this helps just one person, it is worth it for me.” – Angela Christie Roach Taylor

Educate Yourself And Others

“I take every opportunity to educate people and share my personal story and struggles with mental illness. It doesn’t matter where I am, if I over-hear a conversation or a rude remark being made about mental illness, or anything regarding a similar subject, I always try to use that as a learning opportunity and gently intervene and kindly express how this makes me feel, and how we need to stop this because it only adds to the stigma.” – Sara Bean

Be Conscious Of Language

“I fight stigma by reminding people that their language matters. It is so easy to refrain from using mental health conditions as adjectives and in my experience, most people are willing to replace their usage of it with something else if I explain why their language is problematic.” – Helmi Henkin

Encourage Equality Between Physical And Mental Illness

“I find that when people understand the true facts of what a mental illness is, being a disease, they think twice about making comments. I also remind them that they wouldn’t make fun of someone with diabetes, heart disease or cancer.” – Megan Dotson

Show Compassion For Those With Mental Illness

“I offer free hugs to people living outdoors, and sit right there and talk with them about their lives. I do this in public, and model compassion for others. Since so many of our homeless population are also struggling with mental illness, the simple act of showing affection can make their day but also remind passersby of something so easily forgotten: the humanity of those who are suffering.” – Rachel Wagner

Choose Empowerment Over Shame

“I fight stigma by choosing to live an empowered life. To me, that means owning my life and my story and refusing to allow others to dictate how I view myself or how I feel about myself.” – Val Fletcher

Be Honest About Treatment

“I fight stigma by saying that I see a therapist and a psychiatrist. Why can people say they have an appointment with their primary care doctor without fear of being judged, but this lack of fear does not apply when it comes to mental health professionals?” – Ysabel Garcia

Let The Media Know When They’re Being Stigmatizing

“If I watch a program on TV that has any negative comments, story lines or characters with a mental illness, I write to the broadcasting company and to the program itself. If Facebook has any stories where people make ignorant comments about mental health, then I write back and fill them in on my son’s journey with schizoaffective disorder.” – Kathy Smith

Don’t Harbor Self-Stigma

“I fight stigma by not having stigma for myself—not hiding from this world in shame, but being a productive member of society. I volunteer at church, have friends, and I’m a peer mentor and a mom. I take my treatment seriously. I’m purpose driven and want to show others they can live a meaningful life even while battling [mental illness].” – Jamie Brown

This is what our collective voice sounds like. It sounds like bravery, strength and persistence—the qualities we need to face mental illness and to fight stigma. No matter how you contribute to the mental health movement, you can make a difference simply by knowing that mental illness is not anyone’s fault, no matter what societal stigma says. You can make a difference by being and living StigmaFree.


Laura Greenstein is communications coordinator at NAMI.


Note: An earlier version of this blog appeared on NAMI.org in October 2015.

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A Complicated Relationship: Anxiety, Depression or Something More?

Vinay Saranga MD

Saranga Psychiatry -Child, Adolescent, Adult Psychiatrist

People often refer to ‘anxiety and depression’ as if they are the same illness. They share some similar symptoms like fatigue, increased irritability and worthlessness. Yet, even with their similarities, they are two different disorders and should be treated individually. Sometimes it’s not easy to identify the difference. So, how do you know if you’re suffering from depression or just having a bad day? Are you nervous for a big upcoming event or is it something more? Here’s a few tips…

Identify You Emotions 

Keep track of how you are feeling each day. Life is full of daily stressors for all of us. It’s normal to feel burdened by a work deadline. However, once the task is complete, you should experience relief- not ongoing anxiety. Anxiety often manifests in an abundance of energy whereas depression often shows as lethargy. Keep a journal for a week and write down your emotions to help you better understand your feelings and symptoms.

The Past, Present and Future 

Though there is no sure way for you to self-diagnose your condition, understanding the difference between the two disorders starts by identifying your symptoms. Anxiety often focuses on what could go wrong in the future. Those suffering from anxiety fixate on worrying. They may avoid certain situations that could cause further anxiety or fear. A person suffering from anxiety often experiences a ‘fight or flight’ response accompanied by increased heart rate, trouble breathing and shaking or sweating.

Alternatively, depression can be linked to a painful past. Thoughts, ideas and daily triggers can send someone into a depressive state. Consequently, even good memories can bring on depression when you realize that time is over. At this point, we start to see symptoms like guilt, emptiness and loss. Someone suffering from depression might experience lack of energy, headaches and hopelessness.

A Complicated Relationship 

Furthermore, since depression and anxiety have many commonalities, it’s not always easy to understand what’s going on. Depression and anxiety have a complicated relationship. Your condition could be something more like mania or bipolar disorder. The only way to be properly diagnosed and treated is by seeking professional help. Depression and anxiety are not weaknesses! Don’t try to “muscle” through feelings of despair, hopelessness, or overwhelm. Reach out and let us help!



Vinay Saranga MD

Saranga Psychiatry -Child, Adolescent, Adult Psychiatrist

  • Published on October 19, 2017
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Linden Lodge Joins With NAMI in Grieving the Loss of a Staunch Mental Health Ally

NAMI Mourns the Loss of Senator Pete Domenici

Sep 13 2017

ARLINGTON, Va., September 13, 2017 – NAMI, the National Alliance on Mental Illness, is saddened to hear the news that former-Senator Pete Domenici of New Mexico has passed away. Senator Domenici served in the U.S. Senate for 35 years. Along with his wife Nancy, the senator worked tirelessly to educate his colleagues about mental illness and the need to improve mental health services and supports.

NAMI Chief Executive Officer Mary Giliberti expressed her heartfelt sorrow to Mrs. Domenici and the entire Domenici family: “Today, we mourn the loss of one of our staunchest allies. Senator Domenici has been a longtime advocate fighting for equal treatment for mental illness. He leaves behind a legacy in Congress on behalf of people with mental illness and their families that will never be forgotten. NAMI offers our deepest condolences to Nancy and their family.”

Senator Domenici’s legacy includes legislative accomplishments like significantly increasing the budget of the National Institute of Mental Health, passing a major bill to help homeless individuals with mental illness and co-occurring substance use disorders, and establishing priorities for biomedical and clinical research.

Senator Domenici had a remarkable capacity to work across the aisle with Democratic colleagues on legislation of mutual interest. Perhaps the best example of this was the federal mental health and addictions parity bill in 2007. Against great odds, Senator Domenici reached out to his Democratic colleagues—Senator Paul Wellstone of Minnesota and Senator Edward Kennedy of Massachusetts—to pass this landmark federal law. It is fitting that the law’s title is “Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008.”

“Parity of insurance is almost a civil-rights issue,” Senator Domenici once said. “We take care of people with heart trouble, we operate on them, we have great learning centers where we study all there is to know about the heart. And insurance companies have paid for all those surgeries. And yet, if you have schizophrenia, which is an illness of the brain instead of the heart, because we started off early on saying it wasn’t an illness, we kept it and they wouldn’t let us change it.”

Senator Domenici was the father of eight children. One of his children began to show symptoms of schizophrenia in her late teens. After attending a NAMI support group, the Domenici family attended NAMI conventions and gave back to the NAMI community with words of wisdom and comfort. Mrs. Domenici even served on NAMI’s National Board of Directors between 1989 and 1992.

Although much progress has been made, Giliberti reflected that many barriers remain in achieving true parity in mental health care: “We all owe it to Senator Domenici to honor his legacy by continuing his hard work to achieve systems of care that are truly fair and just for people with mental illness and their families.”


Copyright © 2017 NAMI. All
Rights Reserved.
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Linden Lodge Bear Hugs Program is a Big Hit

Emily receives a THANK you card from Pinecrest StudentsOne of our Linden Lodge residents, Emily, who started our Bear Hugs program received this thank you card from the students in the Exceptional Family Member Program at Pinecrest High School where she volunteers. As we always say, “a little kindness and thoughtfulness” and caring about others,  goes a long way in this world!Emily's Pinecrest Students made a THANK you card
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Let’s Talk About Suicide – NYTimes.com

People adding posters to a memorial for Chester Bennington. His band, Linkin Park, has set up a suicide-prevention web page in his memory.
Edgard Garrido / Reuters


Chester Bennington, the lead singer of the band Linkin Park, was found dead on Thursday in his home near Los Angeles. The coroner’s office has confirmed that the 41-year-old died of suicide. That’s something I — and so many millions of other Americans suffering from mental illness — have considered.

The platinum-selling lead singer was open about his depression and anxiety. In Linkin Park’s single “Heavy,” Bennington sings: “I don’t like my mind right now / Stacking up problems that are so unnecessary / Wish I could slow things down.” And the lyrics in their hit single “Crawling,” deal with substance abuse: “There’s something inside me that pulls beneath the surface / Consuming, confusing.”

Bennington suffered, but he was not alone. In the United States, nearly one in five adults have some form of mental illness in a given year. That means that 43.8 million adults, nearly twice the population of Australia, experience a mental health disorder every year.

Yet more often than not, we don’t talk about mental health. And shows like Netflix’s “13 Reasons Why” or artists like indie pop singer Lana Del Rey have sensationalized or glamorized mental illness and suicide rather than taking it seriously.

Worldwide, 350 million people (that’s 5 percent of the population) suffer from depression every day. And they are suffering – and sometimes dying – in silence because we can’t seem to talk openly about mental health. Middle and high school health classes are the perfect place to begin the dialogue but mental health education in the classroom is essentially nonexistent.

When I began self-harming I was in sixth grade. In my middle school health class we learned about nocturnal ejaculations and how pubic hair would soon be growing all over our bodies but we never talked about our mental health. In high school, as I was becoming more withdrawn, we learned how to put condoms on a banana, we discussed alcohol and drugs while watching a few episodes of “Freaks and Geeks” but we never defined illnesses like depression, anxiety, personality disorders, suicide or PTSD, or learned that 50 percent of lifetime cases of mental illness begin by age 14.

In college, I became even more depressed. I would cry myself to sleep. My weight fluctuated by 10 to 20 pounds each semester. I would drink to forget and in my drunken blurs I leaned far too heavily and unfairly on friends who were just as lost and scared as I was. During what felt like the worst period of my depression, I took a health and wellness class my junior year. In that class, we discussed nutrition, healthy relationships and conflict resolution skills. We even had a unit on “stress management and resiliency.” But we never talked about mental illness or how to recognize or treat it.

And the truth is that everyone can benefit from learning about mental health. It shouldn’t scare us; it should light a fire under us to ensure that people across the United States and the world can recognize these illnesses like they would high cholesterol or asthma or any other health condition.

We should not be afraid to put a name to these illnesses. Chester Bennington wasn’t. We should not be afraid to come forward or tell our stories about our struggles with these issues. We should be open to learning the symptoms and the signs of mental health disorders. We should encourage everyone (not just those with mental health issues) to seek therapy because therapy is good for your mind just as exercise is good for your body.

If it was not for my family and friends, who knows what would have happened to me. But I do know that if I had learned about depression and anxiety, or even that therapy is an option, when I was 11, I wouldn’t be staring at my faded scars as I write this. We must push the conversation about mental illness forward whether it be in the classrooms of public schools or with our families and friends. These issues are real and lethal, and the first means of prevention is acknowledging their existence.

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Mental Illness Affects About 10 million Adults

More than a third aren’t getting help, federal study says

WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

MONDAY, June 12, 2017 (HealthDay News) — Nearly 10 million American adults have a serious mental illness, and a similar number have considered suicide during the past year, according to a new government report on the nation’s behavioral ills.

The report also said that 15.7 million Americans abuse alcohol and 7.7 million abuse illicit drugs.

The nation’s growing opioid epidemic was also a focus in the report. The researchers found that 12.5 million people are estimated to have misused prescription painkillers such as oxycodone (OxyContin, Percocet) or hydrocodone (Vicoprofen).

Despite the growing number of Americans with mental health problems, about a third of those who need help aren’t getting it, said researcher Dr. Beth Han. She’s from the Center for Behavioral Health Statistics and Quality at the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA).

“These are real increases,” Han said. The reasons people aren’t getting the help they need are varied. They include not having health insurance and not knowing where to go for help, she said.

Han believes that stigma continues to play a part in why people with mental health problems don’t seek help. “They are afraid that other people may find out,” she said.

Among teens, marijuana use has gone down slightly, from nearly 8 percent in 2011 to 7 percent in 2015, though with more states legalizing its use, more people continue to accept the drug as safe and discount its potential harms, the researchers said.

“For teens, marijuana is a substitute for other behaviors like binge drinking,” said Dr. Scott Krakower. He’s the assistant unit chief of psychiatry at Zucker Hillside Hospital in Glen Oaks, N.Y.

Often, substance abuse is driven by other mental problems such as depression or bipolar disorder, Krakower said. These mental problems may also be a product of the substance abuse, he said.

On the bright side, fewer teens are smoking cigarettes. And fewer teens started using marijuana, drugs or alcohol in 2015 than in previous years, the researchers said.

Mental illness is a growing problem among adolescents. Three million teens from 12 to 17 had major depression in 2015. The problem is particularly acute among girls, the researchers found.

Among teens, depression increased from 2 million in 2011 to 3 million in 2015, Han said.

Among adults, 9.8 million Americans reported having serious thoughts about suicide in the past year. This continued an upward trend that started in 2012. In 2011, 9 million adults reported thoughts of suicide, Han said.

These numbers are rising along with the opioid epidemic, she said.

In addition, 9.8 million adults have a serious mental illness. That number has remained about the same since 2011, Han said.

Despite this, only about two-thirds of those who need it are getting treatment for mental health problems.

Poor people have less opportunity for treatment, Krakower said.

People who are uninsured or who have insurance with large deductibles may be more likely to deal with a physical problem rather than a mental problem, he said.

In addition, wait times for treatment can be very long — up to a year, Krakower said. That’s because of the lack of trained staff and resources.

“The country needs to figure out a better model so people get the mental health care they need,” he said.

The prescription drug abuse epidemic also continues, Han said.

Many of these people get their drugs from a friend or relative or from a doctor, the researchers said.

People without health insurance were nearly twice as likely to have misused a prescription painkiller as those with insurance in the past year, according to the report.

In 2015, more than 1 million Americans were being treated for substance abuse. From 2011 to 2015, the number of people receiving medication-assisted therapy, mostly methadone, as part of a narcotic treatment program has increased about 16 percent.

Looking for an explanation for the behavioral health problems in the country, Krakower speculated that the mood of America is feeding mental health and drug issues.

“The morale of the country has been down,” he said. “The economy drives a lot of people’s mood. I don’t think people feel comfortable in this country. When that kind of morale happens, it has an effect on people’s psychology,” Krakower said.

The findings are published in the Behavioral Health Barometer — United States, 2016, which was released June 12 by SAMHSA.

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Thalamus-Targeted Drugs Could Treat Schizophrenia

 Thalamus plays a larger role in memory than previously thought.

Published Online: May 15,2017
Laurie Toich, Assistant Editor
American Journal of Pharmacy Benefits


Three groups of collaborating researchers discovered that the thalamus, an egg-shaped structure in the brain, is involved with thinking circuitry. Previously, the structure was thought to only relay information, but has been observed to help distinguish categories and keep thoughts in the mind, according to new study published by Nature and Nature Neuroscience.

The authors manipulated neurons in the thalamus to control an animal’s ability to remember how to receive a reward. These findings could lead to a targeted treatment to reduce cognitive problems associated with various psychiatric disorders, such as schizophrenia.

“If the brain works like an orchestra, our results suggest the thalamus may be its conductor,” said researcher Michael Halassa, MD, PhD. “It helps ensembles play in-sync by boosting their functional connectivity.”

Previous studies have suggested that the thalamus had a relay-like role in the brain due to its connections to portions of the brain that process sensory input. However, the authors of the new study state that the thalamus has connections to many other parts of the brain.

Specifically, the authors investigated the circuit that connects the mediodorsal thalamus with the prefrontal cortex (PFC), which controls thinking and decision making. Brain imaging has suggested that patients with schizophrenia often have decreased connectivity in this circuit.

The authors discovered that neurons in the thalamus and PFC communicated back and forth in mice, according to the study. Then, they monitored neural activity in mice performing an activity requiring working memory – the mice were tasked to follow cues to determine which door had a reward behind it.

Interestingly, when the neuronal activity in the thalamus was suppressed, mice were unable to choose the correct door, but when neuronal activity was stimulated, the mice had improved performance, according to the study.

These findings confirm previous notions about the role for the thalamus and also demonstrated a specific role in maintaining information in working memory.

The authors noted that sets of PFC neurons held memory regarding information about the correct door choice. The thalamus did not relay this information, but increased functional connectivity of PFC neurons, which was deemed vital for sustaining memory of the category, according to the study.

“Our study may have uncovered the key circuit elements underlying how the brain represents categories,” Dr Halassa said.

The second group of investigators found similar results when testing mice’s ability to find a reward in a maze. The authors also discovered the differentiated roles for subgroups of PFC neurons and how they communicate with the hippocampus.

They found that thalamus input to the PFC maintained working memory by stabilizing activity during a delay before the mice received the reward. Signals from the PFC to the thalamus sustained memory retrieval and action, according to the study.

These findings confirm that input from the hippocampus was required to encode the reward location in PFC neurons, according to the study.

“Strikingly, we found 2 separate populations of neurons in the PFC. One encoded for spatial location and required hippocampal input; the other was active during memory maintenance and required thalamic input,” said researcher Joshua Gordon, MD. “Our findings should have translational relevance, particularly to schizophrenia. Further study of how this circuit might go awry and cause working memory deficits holds promise for improved diagnosis and more targeted therapeutic approaches.”

The third group of investigators observed that the thalamus plays a role in short-term memory as well. The authors found that the thalamus cooperates with the cortex through bi-directional interactions, according to the study.

Before the mice received the reward, they needed to remember where to move after a delay. The authors found that the thalamus was communicating with the motor cortex when the mice were planning to move.

There was electrical activity in both structures during this time, which indicates that they work together to sustain information predicting the movement of the mice. An additional analysis revealed that the activity of the cortex and thalamus was dependent on one another, according to the study.

“Our results show that cortex circuits alone can’t sustain the neural activity required to prepare for movement,” said researcher Charles Gerfen, PhD. “It also requires reciprocal participation across multiple brain areas, including the thalamus as a critical hub in the circuit.”

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