The News Courier in Athens, Alabama

July 14, 2013

Symptoms of mental illness vary in adults, children

By Kim West

Editor’s note: This is the first in a three-part series examining the state of mental health services in Limestone County and in Alabama. Part two will appear in next Sunday’s edition of The News Courier.

On a recent Friday evening, two reports on the local police scanner called for assistance with people apparently suffering from the effects of mental illness — one incident involved a young teenager reportedly suffering from an anxiety attack at a restaurant, while the other was a possible suicide attempt by a middle-age adult at a residence.

Once emergency responders treat the physical effects of a mentally ill person involved in an incident, what happens next in the treatment process? In Limestone County, patients with serious cases can be referred to Decatur Morgan West Campus, a 64-bed psychiatric facility, while those arrested for a crime are booked into the Limestone County Jail. Others can seek private assistance or be referred to a community service provider that contracts with the Alabama Department of Mental Health.

To address the growing need for more information about mental health needs and resources, The News Courier is partnering with Athens State University to sponsor a Mental Health Forum at 6 p.m. Tuesday, July 30, in the Sandridge Student Center ballroom on the ASU campus. Education, health, government and law enforcement officials will participate in the forum, and the public is invited.

“First and foremost, we want to bring awareness about the services that are available. It will be the responsibility of all those involved in the forum to identify mental health issues, and to identify what can be done,” said Lisa Coleman, clinical director of the Mental Health Center of North Central Alabama and a participant in a mental health forum workshop held Feb. 28 in Athens.

By the numbers

Coleman said Limestone adults are among the one in four Americans nationwide that suffer from psychiatric disorders each year. Coleman said 61.5 million people are expected to experience mental illness in any given year.

In a study spanning 2005 to 2011, the Centers for Disease Control reported that as many as one in five children ages 3 to 17 have a specific mental disorder, with the top five listed as attention-deficit/hyperactive disorder, behavior or conduct problems, anxiety, depression and autism spectrum disorders.

The ADMH’s Division of Mental Illness Services serves more than 100,000 Alabama residents annually, with state-operated facilities treating approximately 5 percent and certified community providers handling the 95 percent remaining cases.

The Mental Health Center, which serves Lawrence, Limestone and Morgan counties, is a state-contracted community provider and a nonprofit agency based in Decatur that operates satellite offices in Moulton and Athens.

The Athens-Limestone Counseling Center, located at 1307 E. Elm St., serves more than 250 children and nearly 800 adults in a typical month, according to ALCC data. Coleman, who has worked in the mental health field for 22 years, said there has not been a noticeable spike in the number of Limestone residents seeking assistance in the past three years.

“In Athens, the population we serve has grown significantly over the years, and we’re very proud that people are seeking services. When we saw the recession in 2008, we did see numbers going up, but now that people are losing jobs and have no funding sources, there’s hasn’t been much change in the month-to-month numbers,” she said. “In the past three years, the numbers have been pretty stable but this year we’re seeing a lower number of admissions. It’s on our radar to find out why, and we want to bring awareness about our services during the forum because approximately half of the (general population) do not seek mental health services, and 60 percent of adults with mental illnesses receive no help.”

Mental illness background

Mental illness is defined by the ADMH as a biologically-based brain disorder that can disrupt a person’s thoughts, feelings, moods, ability to relate to others and capacity to cope with day-to-day living.

Attention deficit hyperactive disorder (ADHD) and oppositional defiant disorder (ODD) commonly occur among children in Limestone County, Coleman said. She said ODD can cause children to have a short temper, defy and disobey adults and deliberately annoy others. Children with ODD blame others for mistakes and misbehaviors, regularly become angry and resentful and often display a spiteful and vindictive nature.

Coleman said counseling is a staple in the Mental Health Center’s process for treating children, which includes case management, day treatment, in-home intervention and outpatient services.

“Behavioral counseling is typical for most all children, and I don’t know of any children in our three counties that’s not in therapy with a psychiatrist,” she said. “How often they see a psychiatrist is based on individual needs, and most of the time with children, they are only allowed so much medication before their next counseling appointment.”

Among Limestone adults, Coleman said examples of the most common and serious mental illnesses are schizophrenia, bipolar disorder, depression and anxiety disorders.

Coleman, who emphasized the Mental Health Center only treats people willing to seek assistance and are fully committed to their treatment process, said depression in particular is often untreated because of the stigma of mental illness, and the possibility of symptoms being attributed to other factors.

“It is often not diagnosed or it can be overlooked, especially with the elderly,” she said. “Key indicators of depression are being isolated, not wanting to go out, staying in bed all day with no physical reason, and having no energy.

“To mention mental illness to an elderly person is not well-received because of the stigma tied to mental health. What people can do for a relative that does not want to seek help is to try and build family and external support systems. Especially if you’re an older person, it’s helpful to have regular outside activities, such as going to church, or doing something for other people.”

Removing the stigma

The Alabama chapter of the National Alliance for Mental Illness is a nonprofit network of local support and advocacy groups dedicated to improving the quality of life for people with mental illnesses.

NAMI Alabama forecasts the economic cost of untreated mental illness will total more than $100 billion in the U.S., and major depressive illness will be the leading cause of disability for women and children worldwide by 2020.

“Early identification and treatment is of vital importance. By getting people the treatment they need early, recovery is accelerated and the brain is protected from further harm related to the course of illness,” according to a NAMI public statement. “Stigma erodes confidence that mental disorders are real, treatable health conditions. We have allowed stigma and a now unwarranted sense of hopelessness to erect attitudinal, structural and financial barriers to effective treatment and recovery. It is time to take these barriers down.”