On Schizophrenia

What causes schizophrenia?  We really don’t know.

A new hypothesis suggests that schizophrenia is a developmental disorder, which involves epigenetics—that switching business. Our brain with its 100 billion neurons begins developing in utero but is not fully formed until age 25 or so. Brain development involves neurons migrating from their place of origin to their destination (neuron pruning is also involved). The trip is set in motion by a gene switching on. If there were a glitch in this switching mechanism, it would not become apparent until adolescence, when brain development goes into high gear, and also when schizophrenia commonly flares up. This new insight is promising, but it doesn’t quite capture Susanne’s case, since she was in her early 30s when the disaster arrived.

Thanks for the link, John.

Confronting Mental Health Realities

Storm Exposes Fragility of Mental Health System in City

“When you have the most vulnerable folks, all you need is one chink in the system and you lose them,” Dr. Rosenthal said. “Whether they lost their housing, or the outpatient services they usually go to were closed and they were lost to follow-up, they have become disconnected, with predictable results.”

Those predictable results? For the mentally ill who’ve landed inside the correctional system, 2/3 will re-offend.  Frontline‘s “The Released” gives an excellent look at the revolving door of mental health challenges with America’s bursting-at-the-seams prison population.

It’s a public policy problem with no easy solutions, but it’s still one worth tackling.  If it’s less expensive to provide mental health support to convicts to keep them from returning to prison than it is to house and patrol them on the inside, then I think that we have a financial and a moral incentive to make that change.  Blanket public policy changes regarding the mentally ill can have disastrous consequences, but we can try some things.  That’s the beauty of a multi-level governmental system: we get small populations where we can experiment with good governmental solutions.  More of the same just won’t cut it.

In the confusion, some patients lost contact with their families and caseworkers. At Community Access, the same case managers who struggled to get hospital treatment for the young woman with the meat cleaver had to hunt for an elderly female tenant who had been taken to Bellevue by the police before the storm. The police had picked up the older woman for public urination near a schoolyard. But two weeks after the storm, which knocked out Internet access and telephone service at the apartment building, neither the staff nor her sister could find her.

Dorca Rosa, the elderly woman’s case manager, eventually located her at Gracie Square Hospital on the Upper East Side, behind several locked doors.

“I cried when I saw her,” Ms. Rosa said. “I found her in horrible conditions. She was lying in her own feces, she had a fractured leg and the provider could not explain how her leg was fractured.”