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Stigma surrounding mental-health care lessens

Local officials say getting mental health help is vital

By Melissa Borden / Reporter-News Staff Writer
January 8, 2005

Mental health is on the minds of many people who are taken aback the recent court ruling to overturn Andrea Yates' 2002 conviction for killing three of her five children.

A three-judge panel on Thursday agreed with Yates' lawyers, who claimed false testimony from a prosecution expert witness contributed to the conviction. The Houston mother, who was not tried in the deaths of her other two children, is serving a life sentence in a psychiatric prison.

Despite the overturned conviction, Yates' attorney has said the woman still needs medical help.

Yates reportedly was seen by a mental health professional and did not stick with the antidepressant drugs she was prescribed.

If she had, the death of her children may not have occurred, said Patricia Dodson, director of adult services at the Abilene Psychiatric Center. Dodson is a licensed clinical social worker and a certified addiction specialist and has been in the mental health-care field for more than 15 years. Dodson, who is familiar with the case from having followed it in the media, said she believes it's possible that Yates might not have killed her children if she had gotten mental-health care and stayed with it.

It's a decision many face today - seeking treatment for mental illness is an important decision that needs to be made early, mental health professionals say, to prevent further brain damage, psychological problems and even crime.

''There's a tremendous consequence for not getting treatment,'' said Dr. G. Paul Kula, Abilene Psychiatric Associates' staff psychiatrist. ''Drinking, divorce, estranged relationships with children, criminal activity - a great percentage of the population of prisons have mental illness. Because they've never been treated, they failed in school, can't make it in society, etc.''

Becoming educated about the symptoms, signs and types of depression is important to ensuring mental health, Dodson said.

n Situational depression occurs after a specific event, such as the holidays, death of a loved one, or divorce. It's a process that people need to work through, Dodson said - one that could take up to a year.

* Clinical depression is a biochemical disease and can be genetic.

- Dysthymia, a form of clinical depression, is a chronic, mild to moderate underlying depression that could be made worse by a situation.

- Major depression, another form of clinical depression, can improve with time or may require medication. It also can be debilitating to the patient and family.

* Bipolar disorder is a genetic disorder that causes distorted, rapid thinking. Sometimes called manic depression, the disorder caused extreme highs and lows, but some patients can be treated with medicine.

It was a combination of these types of depression that led Yates to kill her children, Dodson said. Yates had a family history of depression, she was suffering from post-partum and situational depression, and Yates neglected treatment. All of these factors exacerbated her depression to a state of hallucinations and violence.

''It's a lot different feeling really sad after a death or divorce and thinking about hurting yourself'' or others, Dodson said.

It's at that point, she said, that people need to seek immediate attention.

''There was a buildup in Andrea ... holding a knife to her throat, thinking about hurting her newborn son,'' Dodson said. ''It's the individual's responsibility to notice symptoms in themselves and seek help. Family members may need to intervene as someone sinks down.''

Watching for signs of mental instability is especially important now, said Kermit Klaerner, director of the local Mental Health Association. The Mental Health Association is an advocacy group that also handles a crisis hot line. Klaerner said the hotline's busiest months are January and February.

''The trend is that usually after the holidays, depression is more prevalent,'' he said. ''People become more depressed after the holidays because they get that holiday high, and then once it's over, depression and loneliness can set in.''

Loneliness and isolation are the most-common signs of depression, Klaerner said.

''The blues is usually temporary. Everybody gets the blues,'' he said. ''I'd say if it lasts more than a week and, especially, goes into two weeks, you should get help. One of the worst mistakes you can make is if they sit in the house, the doors and windows closed and just want to be alone.''

The first step once someone recognizes symptoms of depression is to get a professional assessment, Klaerner said.

A family doctor, a licensed therapist or counselor, a psychologist or a psychiatrist can conduct the assessment, Dodson said, and tell where someone falls on the scale of depression based on the intensity of symptoms. Situational depression can be treated with counseling alone. Clinical depression may require medication. Only a medical doctor or psychiatrist can prescribe medication.

Hospitalization occurs in extreme cases, but the majority of depressed people are treated on an outpatient basis. The Abilene Psychiatric Center houses patients needing short-term psychiatric intervention.

''The people we usually see are the people that waited until they were very ill or are not responding to medication on the outside,'' Dodson said.

Antidepressants may be needed for a short time if the depression is situational. If it's genetic, a patient may have to take drugs continually.

''I compare it to diabetes,'' Dodson said. ''Some people can control it with diet, and some people require insulin shots to control diabetes.''

Maintaining mental health requires adequate sleep, food and exercise and staying on course if medicated.

''Once there seems to be a pattern,'' Dodson said, ''it's important to keep on the medication.''

Contact staff writer Melissa Borden at bordenm@reporternews.com or 676-6736.

source: http://www.reporter-news.com/abil/nw_local/article/0,1874,ABIL_7959_3455451,00.html