October 05, 2005

How Mentally Ill in Norway are Treated

An excerpt from a column written by Steve Lopez, of the Los Angeles Times:

"The timing was perfect. I had just asked a Yale professor why there are no mentally ill people living on the streets of Norway, where he helped design some of the most progressive mental health treatment in the world. Then a colleague mentioned she was working on a story about Los Angeles County sheriff's deputies dumping a mentally ill man on skid row in downtown Los Angeles, where thousands of chronically ill people sleep on filthy, rat-infested streets. ...

I have to say I don't quite follow the logic. You take a man who can't fend for himself and dump him in one of the most dangerous corners of the city? Only after an LAPD captain confronted the deputies was the man taken in for psychiatric evaluation.

The fiasco serves as a snapshot of a shamefully inept system beset by
lack of coordination and resources and made worse by a societal penchant for treating mental illness as if it were a bad lifestyle choice. But the good news is that for the first time in decades, there's a chance for Los Angeles and all of California to pay penance by building a national mental health care model that eases suffering for thousands. ...

Southard meets regularly with researchers at USC, UCLA and other
schools to stay abreast of the latest mental health developments from around he world, in part so that he can take full advantage of the nearly $200 million a year that will eventually flow into the county from Proposition 63. It was Southard who referred me to a UCLA psychiatrist named Tyrone Cannon, whose specialties are the genetics and neuroscience of mental illness. His research is aimed at predicting serious brain disorders so they can be treated before they're full-blown.

... Cannon told me the reason he's focusing on early intervention is that the treatment of chronic patients .. so difficult.

"We just don't have the cures for these illnesses once they've fully
taken hold," he said.

The reason schizophrenia first strikes in adolescence and early adulthood, Cannon said, is that a pruning process takes place at that time, as the brain disposes of unused tissue between cells in an attempt to make the brain more efficient.

In young people with a genetic predisposition — roughly 1 person in 100 develops schizophrenia — there's an over-pruning, so that fewer brain cells are left that function normally.

"In the earliest phases … you get the classic picture of someone who
goes from an A and B student — plays with peers and plays in the school band — to a kid who is holed up in his room, not responding to friends or social activities," Cannon said.

"What the patients themselves tell us is that they're attending to some very low-level auditory phenomena you'd call hallucinations, but
they're not full-blown. There's a voice calling their name, but at that point they understand the voice is coming from inside their own head."

Cannon and others are trying to ensure that Proposition 63 funding
takes this line of research into consideration so that money goes to
programs for early identification and treatment of high-risk patients through counseling, family education and medication.

Such intervention is no panacea, Cannon admitted.

"But it helps immediate functioning, so you find that people are able
to go back to school or engage in social network…. I think what we're
doing is giving people the skills to cope with these problems and giving them internal models of what the symptoms mean, so that they don't have to go at such a right angle to the rest of society."

The Yale professor I mentioned at the top of the column, Thomas
McGlashan, is a friend of Cannon's, and he is leading similar research in Connecticut and Norway. That country has a destigmatization program unlike anything in the United States, he said, so that people know what warning signs to look for and exactly where to get immediate help.

When I asked if the mentally ill populate skid rows in Norway,
McGlashan said it was unheard of.

"There is no homelessness," he said. "It's banned."

Then what happens to the Nathaniels of Norway?

"They would have him connected with an outpatient clinic," McGlashan
said. He'd have a regular doctor, a nurse who visited him at home and a day-care worker who checked to see if he needed help managing his life.

With a national healthcare system in Norway, McGlashan said, there are no questions about who is covered and for what. Another key difference, the professor added, is a Norwegian philosophy that favors involuntary treatment rather than protecting the civil rights of patients who aren't well enough to know how sick they are.

None of this makes all suffering disappear for patients or their loved ones, McGlashan said, calling schizophrenia "one of the worst disorders known to man." But it's a far cry from a set of handcuffs and a ride to skid row."


America is the richest country in the world and we still do not have a health care system that takes care of the poor and disabled properly.

I don't understand why countries in Europe, with less domestic product and exports, smaller tax bases can still be prosperous and have nationalized health care systems. When I think of it, I am ashamed to be an American.

The problem is that the issue is not in front of the public daily and when it is you have some republican spokeshole saying that it "would bankrupt our system" - that is BS.

Posted by: Steve Lister at October 5, 2005 01:51 PM

I spent a few months in America and what a disgraceful heath care system!! there were people who have been waiting for hours and hours sleeping on the floor in the hospital waiting room and at least four of them,were puking there guts out into the garbage can next to them.I was horrified at how rude the Nurses were to those who could not pay,there bill.I'am from Canada and fourtunatly
we have a health care system that works for the poor and the rich.God Bless Canada!

Posted by: jaedann at October 7, 2005 06:03 PM

We are in great need of group homes for the mentally ill in our community. My daughter is in one here in Milwaukee, WI and it is in the worst area of town. There is no monitoring of their meds, these people are exposed to street people trying to sell drugs to them, and there was a young man murdered one yr. ago just in front of the group home. These people are not throwaways!
When are we going to provide some decent care for these victims of a disease, not of their doing.
If you are interested in raising funding for decent and caring group homes, please contact me at my e-mail. Thanks,Kathleen

Posted by: Kathleen Droese at October 8, 2005 03:46 PM

It seems likes more and more nations on this planet understand people come first. Here in America we cherish wal-mart and tv shows. We look ignorant.

Posted by: Barbara Lewis at October 21, 2005 02:10 AM

This is how its supposed to work in Norway.. But it does not necessarily work like that always.. Atleast ONE person in my town is mentally ill and living on the streets.. I see him walk around with the same clothes all the time, rain or snow, dirty and dishevelled.. And not to speak of the appalling conditions for drug addicts.. Many of which have one form of mental illness or other. However id say were atleast 20 times better than the US system. (However they do have a psychotic as president :-P )

Posted by: D. Jacobsen at October 23, 2005 01:24 PM

My daughter is schizophrenic and lives here in the Fort Worth area in Texas. She is fully psychotic and I am at my wits and financial end. I am also battling Stage 4 cancer. Isn't there anyone anywhere who cares and will help? What are we supposed to do? This nightmare needs to end. Do I shoot her so her suffering ends? Or do I just die because I'm so depleted from trying to help her?

Posted by: K. Wilson at October 29, 2005 11:10 AM

I *am* from Norway and got no help for my schizophrenia. One doctor told me i had split personality, another that i had schizophrenia a year later - but they didn't offer to treat me! They didn't offer me medication, just money from the state.

I had to go to the US before I got a doctor who could treat me. Here i get medication and other help.

Posted by: Lena Adams at January 21, 2006 09:13 PM

My mother has been sufferring from SCHIZOPHRENIA for about 40 years.She is dabetic too and one of her feet is severely affected by ulcers. I love my dear mother very much and have spent much money on her medication. She will be very grateful if a generous heart who cares about an elderly woman anywhere in the world likes to visit her and helps her.

Posted by: D.Mohan at October 27, 2006 04:16 AM

I was expecting more about this article. I was hoping to read the clinic treatment and program available to schizophrenic patient more than the comparison of better management on dumped patients.

Does someone know if there is any recommended specialist or program or source to assist people with schizophrenia?

I am looking doctors for my sister.

Posted by: Hellen at March 31, 2008 04:43 PM

Are there any in house facilites in southern ca where a sczhoprenic canget observation by a tesm of doctors to stabilize his condition to a point where he could talk and function better. My son was diagnosed two years ago and is having no improvement with medication and therapy, he is 22 yrs of age, I am at my wits end trying to get him better treatment, he does have medicare and medicade . we live in so california . Can you recommend some help?

Posted by: Harold Hulsen at May 30, 2008 06:52 PM

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