its really easy to have people locked up for being nuts. the secret service had someone i know locked up as insane because they said something bad about president bush

http://www.azcentral.com/arizonarepublic/arizonaliving/articles/0903mentalhealth07.html

Know when, how to seek help for mentally ill

Connie Midey
The Arizona Republic
Sept. 3, 2004 12:00 AM

The shootings of three Phoenix police officers Saturday raise questions about when and how to intervene when a person appears to be dangerous.

Douglas M. Tatar, described by his family as mentally ill, killed two officers at a Phoenix apartment complex, wounded a third, then killed himself.

Co-workers had heard him say he "wouldn't think anything" of shooting a cop, and in June, family members tried unsuccessfully to have him committed for a mental-health evaluation.

Some of Tatar's behaviors before the incident were obvious warning signs, said Phoenix psychiatrist Mark Wellek. According to media reports, Tatar thought the police were bugging his apartment, for example.

"If somebody starts talking in a strange way," Wellek said, "saying there's somebody watching them or there's somebody on the television talking to them or the FBI is in a car across the street, these are paranoid ideas, and that requires immediate attention."

It's also important to act quickly if people barricade themselves inside a room or building, or threaten to hurt themselves or others, he said.

In the workplace, co-workers should report troubling behavior to a supervisor or their human resources department.

"More and more, human resources people are set up to call people in to do mental-health counseling," Wellek said. "They're also commonly making referrals, and that's a good start."

Neighbors have little recourse except to urge relatives to seek treatment for the troubled family member.

When it comes to situations that don't involve immediate danger to anyone, Wellek said, "It doesn't do any good to call the police. Their hands are tied, because treatment is voluntary in this country. The only thing a neighbor really can do is get to the person's family."

He advises not to confront a seriously troubled person.

ValueOptions operates a crisis line that can be helpful in these situations, said Cynthia Gattorna, program director of the Arizona Alliance for the Mentally Ill in Phoenix. Crisis workers at ValueOptions are trained to evaluate a situation and call police if that is warranted.

Gattorna has seen the consequences of not intervening in the right way.

"Usually when people don't get the (mental-health) services they need, it ends in suicide, not homicide," she said.

Gattorna helps the mentally ill and their families and friends every day, but she also speaks from personal experience.

Her son, Sean, 17, was diagnosed with bipolar disorder when he was 12.

Sean said he is "in a really good recovered place right now," taking classes at a Glendale high school and a community college, and enjoying his social life.

That came after years of searching for reasons for his troubling behavior - attention-deficit hyperactivity disorder, obsessive-compulsive disorder and anxiety were the original diagnoses - and trying various medications and therapy to alter it.

"He was becoming increasingly violent," Gattorna said. "He lost all his friends and he would do bizarre things, like go out and write my name on his punching bag and stab it with a butcher knife."

Under the right circumstances, talk is a good first step if someone you care about is displaying signs of a mild mental illness, she said.

But in people with brain-based conditions such as bipolar disorder, schizophrenia, clinical depression and post-traumatic stress disorder, "that conversation can become explosive," Gattorna said. "You need to back off in that case and look at other options, because they don't realize they have a problem."

That can mean calling the ValueOptions crisis line or using de-escalating techniques to try to calm the person. These include avoiding direct eye contact or standing beside rather than in front of the person. Even smiling, a baring of the teeth, can be interpreted by a mentally disturbed person as aggression, she said.

Gattorna and her husband turned to a psychiatrist for their son, but she also recommends seeking help and information from organizations like hers and from ValueOptions.

"The important thing is to pay attention to the signs of depression or paranoia," Wellek said, "and to persist in getting help."

That's not always easy. Documenting instances of the troubled person's bizarre behavior is important to help convince mental-health practitioners and agencies that services are indeed needed, Gattorna said.

Reach the reporter at (602) 444-8120.