by Gayle Flanigan*

When employees of any organization achieve their mission, there is a sense of accomplishment. Such is the case for the staff at Rose Hill, a Michigan residential treatment and rehabilitation center for adults diagnosed with serious mental illness. When a graduate is discharged to the community, the Rose Hill team considers it a job well done. It is confirmation that the person achieved an appropriate level of independence, exhibits an understanding of his diagnosis, demonstrates medication compliance, and displays an ability to work and give back to society.

Last September, unfortunately, there were those who disagreed about a decision that was carefully made about a Rose Hill graduate, and they did so in inflammatory and uninformed ways that lead to distorted news and panic. Reporters did not check facts, headlines were sensationalized, politicians spoke out of line, and ignorant bloggers created an ugly cacophony that maligned an individual, criticized the mental health community, questioned the legal system, and further perpetuated the stigma of mental illness.

Thirteen years earlier, during a psychotic episode, this individual's actions resulted in the death of a good friend. After a trial, he was found "not guilty by reason of insanity." The judge ordered that he receive appropriate mental health treatment, the last five years of which were spent in the treatment program at Rose Hill Center in Holly, Michigan. In September, when the court was satisfied that residential supervision was no longer required, he was discharged to other services in the community.

Before leaving Rose Hill, this man developed a discharge plan outlining where he would live and affirming that he would continue to work at a job he held for three years while living in transitional housing on the Rose Hill campus. He selected an agency that agreed to provide case management services and a psychiatrist who agreed to oversee his on-going medication regimen.

In many respects he was an example of what can happen when people with mental illness receive the proper treatment and have the proper supports. The staff believed that he had a full understanding of his illness and had every expectation that, with the oversight of his aftercare team, he would continue to maintain the level of mental health he had achieved.
But people who didn't know him, and clearly don't know much about mental illness, thought differently. When he was discharged,The Oakland County (Michigan) Executive boldly told a reporter, "Some people are beyond the pale of rehabilitation and this man may well be one."

Misunderstanding widespread
All too often, the general public links mental illness to violence, fear and hopelessness. It is a link that is promoted by the news, entertainment media and, apparently, county executives such as L. Brooks Patterson! How often do we see on television or in the movies, people with mental illness portrayed as violent or committing crime? According to the Substance Abuse and Mental Health Services (SAMHSA), "Surveys have shown that characters in prime time television portrayed as having a mental illness are depicted as the most dangerous of all demographic groups." Even more troubling is the fact that "The average citizen finds these images persuasive."

Belief that people with mental illness are violent and dangerous persist despite evidence to the contrary. Over a decade ago, U.S. Surgeon General David Satcher reported: "The overall contribution of mental disorders to the total level of violence in society is exceptionally small." SAMHSA's Understanding Mental Illness Factsheet reports, "[T]he absolute risk of violence among the mentally ill as a group is still very small and . . . only a small proportion of the violence in our society can be attributed to persons who are mentally ill." Furthermore, studies have shown that, without symptoms of substance abuse, there is no significant difference between the prevalence of violence by people discharged from acute psychiatric inpatient facilities and the prevalence of violence by others living in the same neighborhoods who were also without symptoms of substance abuse.

In Michigan, the response of the community was irrational. The local police chief demanded that Rose Hill release this man's address; the county sheriff announced he would be "antsy" if he lived in the same town; and the township manager expressed his "concern for the safety of our community." This was further fueled by blaring headlines: "Killer Released in Holly," "Shovel killer leaving psych hospital," and "Murderer Moves In." And all of it was sensationalized in living color on the evening news.

One voice of reason was Jeffrey L. Brown, Executive Director of Oakland County's Community Mental Health Authority, who said,

"Living in a safe community is important to all of us. But we need to be careful not to create hysteria or give the impression that all persons with mental illness are criminals or violent...Our duty is to provide services and supports to persons with mental illness, the vast majority of those who have not been violent, and also to those who have a history of violence with the treatment and support to reduce or eliminate the risk of future violence."

The best treatments for serious mental illnesses today, such as the program at Rose Hill Center, are highly effective. Although it is true that mental illnesses cannot be cured the way a broken leg or infection can be, there are medications and treatments to help people develop insights, life skills and attitudes needed to manage their illness in the same manner that other medical problems are managed. And, in fact, according to the National Alliance on Mental Illness (NAMI), between 70 and 90 percent of people with a mental illness have significant reduction of symptoms and improved quality of life with a combination of pharmacological and psychosocial treatments and supports.

We at Rose Hill are very aware of the importance of treatment for individuals as well as the impact that it has on their families and the larger community. And, yet, we recognize the personal dilemmas facing people who not only are living with mental illness but who are also affected by the fears perpetuated by misunderstanding. As J.M. Grohol said in an essay, "Most people who suffer from a mental disorder are not violent -- there is no need to fear them. Embrace them for who they are -- normal human beings experiencing a difficult time, who need your open mind, caring attitude, and helpful support." It is our hope that the benefits of recovery and the achievements people make during treatment will not be minimized or compromised by stigma and ignorance.

*Gayle Flanigan has been a member of the staff of the Rose Hill treatment and rehabilitation center in Holly, Michigan, since 1996. She oversees communication and publications and is the Director of Development & Special Events .