A Baffled Look

The straight dope on mental health

Month: July, 2013

Released

I went to the local drop-in center where I volunteer. I got there about 11:20 am. They open at 11:00 am the people there were still eating and everyone was very subdued. It was the end of the month and that’s the hardest time for them because by then their Social Security money runs out. A bald man of about 30 was talking on the client phone trying to arrange services for himself and a way he could get a buck to pay for one night at the Coalition for the Homeless’ shelter. He had just been released from prison and was trying to get food stamps and emergency assistance. I didn’t think to tell him that Catholic Charities might give him money. I wish I had thought of it. He was trying to get SSI too, I think, but that takes months. I wasn’t about to ask him questions just to satisfy my curiosity. He urgently needed help. Without emergency assistance he’ll probably roam the streets at night and have to crash at the drop-in center during the day in the TV room or try the labor pool to get the money to stay at the coalition.
In Florida, where I live, there are no services for mentally ill inmates released from jail or prison. They are often no shows at community mental health clinics. According to a Washington state study they are perceived as violent – even though very few of them are – many mental health practitioners consider them too much of a liability to take on as clients. Even if they do get services from community mental health they often run out of medication before they can get an appointment. There’s a report to a Florida state senator about how to improve access to services such as getting on Social Security, food stamps and Medicaid, but nothing came of it. The Florida Department of Corrections, Florida’s Department of Children and Families (DCF) and county mental health providers don’t communicate with one another about how to provide inmates services when they get out so they don’t reoffend or wind up in a hospital. That guy at the drop-in center that day had to arrange all of these services himself. This guy was lucid. I wonder how the sicker ones can do this for themselves. There’s a lot out there about jails and prisons being the new asylums but not about aftercare once they are released. In Florida they get a months’ worth of medication but at my county’s mental health provider it’s often 90 days before they can get in to get care. The Bazelon Center, which is an organization specializing in legal matters about mental illness, issued a brief about what’s needed for aftercare. They suggest screening for mental illness upon entry to jail or prison, suspending rather than terminating benefits while mentally ill inmates are incarcerated, providing specialized parole supervision and helping prisoners apply for benefits before their release. With all the states facing budget shortfalls it’s unlikely these offenders are going to get these services. Frontline made a documentary about the system in Ohio. The inmates there get 2 weeks’ worth of medication. At least the guy at the drop-in center was persistent. I should’ve suggested Catholic Charities for emergency financial aid, but he was on the phone the whole time and I didn’t want to interrupt him. I should have handed him a note about it while he was on hold. I haven’t seen him since.

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Reefer Madness

Some studies suggest marijuana triggers psychosis in genetically vulnerable individuals. I’ve included a link to a Canadian documentary called The Downside of High that examines this, but overall the evidence is contradictory. In one study in Britain 600,000 people from 16 – 44 years old were evaluated. Even though pot use increased considerably rates for schizophrenia were stable or declined. Another NIH study found no link between marijuana use and schizophrenia. Correlation is not causation. People with psychotic disorders also smoke cigarettes and cigarettes don’t cause psychosis. They actually help schizophrenics think more clearly. And schizophrenics use more alcohol and illicit drugs than the general population. So this may be a case of reverse causation. If you began to worry about losing your mind pot might appeal to you to ward off anxiety.
Still, another NIH study reports, “What does appear to be consistent is that in individuals with a predisposition for schizophrenia, ingesting cannabis exacerbates symptoms and worsens the schizophrenic prognosis…” But it also points out that a number of animal and clinical studies suggest that the non-psychoactive constituent cannabidiol (CBD) has antipsychotic properties and that it may protect against some pro-psychotic effects of THC. and, according to a study published in Translational Psychiatry, CBD has few side effects. A big obstacle in using it for treatment is that CBD is a natural compound, so it can’t be patented. Without a patent, drug companies have no incentive to develop it because without a patent they can’t make money. Some researchers are trying to develop synthetic versions of the compound. Let’s hope they succeed.