To reform mental health, rethink our approach to care

When responding to the horrific events at the University of Virginia and a Chesapeake Walmart in November, Gov. Glenn Youngkin stated he was going to propose legislation during the next session of the General Assembly to strengthen mental health resources. In November, he told reporters, “It’s extremely important. We know that we have been in a mental health crisis and there are some very immediate actions that we need to take,” according to a Virginian-Pilot story.

I am very encouraged by Youngkin’s response because he has committed to address the issue of mental health and how it relates to these outbursts of violence.

But overhaul of Virginia’s mental health system must focus on more than “day of ” treatment and removing police from the streets to monitor aggressive and suicidal patients waiting to be hospitalized.

My personal experience with the mental health industry is from watching my son Richard become a victim of it. Richard was inappropriately diagnosed with ADHD in 2008, after successful academic, athletic and social experiences in high school and college. His diagnosis came with a prescription of Adderall. His initial prescription of 15-20 milligrams a day by a nurse practitioner in North Carolina progressed to 90 milligrams per day under the care of Virginia Beach psychiatrists.

Adderall is an amphetamine, essentially identical to illegal methamphetamine, known as “meth” or “speed.” With so much amphetamine running through his system, Richard’s sleep deteriorated, so his psychiatrist added a medication to help him wind down. During this time, Richard began exhibiting behaviors I had never experienced with him in the previous 22 years of his life.

My wife and I fought with his doctor and with the system to get him appropriate help, but this resulted in additional inappropriate mental health diagnoses (bipolar disorder and schizophrenia) and more medication. When a psychiatrist added an antipsychotic drug (Seroquel XR) to the mix, Richard’s mental state worsened. This led to more aggressive behavior, an arrest for domestic violence, and a brief involuntary psychiatric hospitalization. A few months later in November 2011, while suffering the agony of acute psychiatric drug withdrawal, Richard committed suicide.

I know our mental health system needs a total overhaul. Routine psychiatric “care” needs to be more than a 5-7-minute med check to justify prescription refills. Before a psychiatric diagnosis or medication is ever given, time should be (but rarely is) taken to identify the true root causes of each person’s presenting problem. Root causes must drive treatment, not the simplified concept that mental illnesses are caused by chemical imbalances and can be cured by chemical interventions.

The psychiatric establishment now admits that the notion of chemical imbalance explanations never represented a valid theory, but too few people know this fact. There needs to be a proper balance in treatment, using medication when necessary, and for the short durations.

Psychiatric prescriptions must include exit plans, de-prescribing protocols and therapy that is vital for patients and families to create health environments, relationships and lifestyles.

A friend told me, “Change will not come from the medical profession or Big Pharma. Change must come from us.” We, as a community, must push for change. We must be relentless and have our voice heard. We must ask ourselves, as a society, are we doing the right thing by heavily relying on psychiatric drugs to fix all things that bother us?

Our community has a rare opportunity to address that question. On Thursday, the film “Medicating Normal” will be shown for free at the Sandler Center and a panel of experts will respond to audience questions and concerns.

I hope Youngkin’s plan for reform will address the potential harm of overuse and inappropriate use of psychiatric drugs. This is vital for meaningful mental health reform.