Thursday, March 28, 2013
Mental illness and gun control in the United States

By Dr. Anthony Policastro
There has been a lot of discussion about individuals with mental illness and gun control. As is frequently the case, a review of some history is important. Up until the 1950's, individuals with mental illness were frequently placed in institutions. That sometimes happened for many years. There were a number of factors that changed that. None of them had to do with the ACLU as people frequently think. As new psychiatric medications were developed, the need for institutions became less and less. People could be released to spend time with their family. The key was making sure that they continued to take their medication. A second reason was related to payment for services. Insurance companies did not often pay for services. Families had problems paying for services. It was a lot more cost effective to treat these patients at home. For example in the mid 1990's insurance companies made a unilateral decision that they would pay for only 28 days of inpatient psychiatric care. Their contention was that the hospital should be able to figure out a long term plan in that period of time. All of a sudden, psychiatric hospitalizations were no longer than 28 days. Community hospitals with inpatient units found that they were no longer profitable. The result was that there became even fewer inpatient services available. Insurance companies have continued to provide obstacles to inpatient psychiatric care. Patients now must have serious psychiatric symptoms to be hospitalized. Usually that means that they must be a danger to themselves or others. Even then there is reluctance to hospitalize them. A third contributing factor was that we had an alternative place to send these individuals. In that location, payment for services did not matter. The state paid for it. That location was prison. I have a friend of mine who is an adolescent psychiatrist. He once told me that he had two groups of patients that he saw. The ones with rich parents went to psychiatric hospitals. The ones with poor parents went to jail. That was for the same offenses. The estimate based upon studies that have been done is that about one quarter of individuals in prisons are there because of mental illness. They are not really criminals. They engaged in criminal activity because of their mental illness. We often fail to forget that there are many different kinds of mental illness. Not all individuals with mental illness have severe symptoms. Not all of them are schizophrenic. A last point to be made is the perception that individuals with mental illness are prone to violence. While there is no question that they certainly get a lot of the press, they do not commit most of the violent crime that occurs in this country. A very good study compared a large group of individuals who had been released into their community. It compared them to other members of the community. There was no difference in the rate of violent crimes between the two groups. There was only one significant finding related to violence. It did not matter which group you were in. If you had substance abuse as a diagnosis, you were more likely to be violent. That was the key factor. So as all the rhetoric goes on about mental illness and violence, it is important to have some understanding of how we got to where we are. It is also important to know some of the facts surrounding the debate. Often opinions are stated as if they were facts. That is not always the case.

Hospice Lunch Bunch lecture Delaware Hospice's Family Support Center will hold a Lunch Bunch Lecture from noon to 1:30 p.m. on Friday, April 5, at the Delaware Hospice Center in Milford. Dr. Judy Pierson, clinical psychologist, will discuss, "But Enough About You: Dealing with a Narcissist." Dr. Pierson will examine common characteristics and behavior to help identify narcissists (people who tend to focus on themselves) and offer suggestions for coping with these difficult relationships in your life. Register by Wednesday, April 3, by contacting Vicki Costa at 856-7717, ext. 1129, or Cost of lunch is $5 per person.

Family support workshop Delaware Hospice will hold a Family Support Workshop on "Living Your Best Life" on Friday, April 5, from 2 to 5 p.m., at the Delaware Hospice Center, Milford. The workshop is free and open to the public but reservations are required as space is limited. Dr. Judy Pierson, clinical psychologist, will focus on the keys to unlock our best life. Register by Wednesday, April 3, by contacting Vicki Costa at 856-7717, ext. 1129, or

Journaling workshop Delaware Hospice invites anyone coping with a loss to a "Write Your Heart Out" journaling workshop from 5 to 6:30 p.m., on Thursday, May 9, at the Delaware Hospice Millsboro office, 315 Old Landing Rd., Millsboro. The workshop will focus on examining your grief journey through this safe, non-judgmental and therapeutic activity of journaling. There is no charge to attend but registration is required as space is limited. To register, contact Midge DiNatale, bereavement counselor, by May 6, at or 302-416-0581.

Hospice offers grief workshop Delaware Hospice will offer a "Grief 101: Introduction to Grief" workshop for adults from 5 to 6:30 p.m. on Wednesday, April 24, at the Hospice Center in Milford. This workshop will provide up-to-date information about what to expect when grieving the loss of a loved one, why we grieve differently even though there are many similar experiences, common misunderstandings, and ways to support yourself and others who are grieving. The workshop is free and open to the public but registration is required as space is limited. To register or learn more, contact Chet Carbaugh, MDiv, at 302-353-8345 or

Grief support group offered Delaware Hospice will hold a six-week support group for widows, widowers, and life partners on Tuesdays, from 5:30 to 7 p.m., beginning April 9 through May 14, at the Delaware Hospice Center, 100 Patriots Way, Milford. Many people find that a group experience just for those who have lost a husband, wife or life partner is a very beneficial way to give and receive support. One way to know that you are normal with your grief is to be with others who share the same heartaches. There is no fee for this service which is provided as a community outreach by Delaware Hospice. Registration is requested by April 4, by contacting Midge DiNatale, bereavement counselor, at or 302-416-0581.

Southern Delaware Kidney Walk The National Kidney Foundation of Maryland (NKF-MD) will hold its fifth annual Southern Delaware Kidney Walk, Sunday, April 14, at Cape Henlopen State Park in Lewes. Check-in and festivities begin at 9 a.m. at the Picnic Pavilion. The dog-friendly walk will kick off at 10 a.m. Participants can choose from a 3.2-mile trail or a shorter trail for strollers and wheelchairs. There is no registration fee, but Cape Henlopen State Park charges an entrance fee of $4 per vehicle registered in Delaware and $8 for vehicles registered outside the state of Delaware. For pre-registration, or information about sponsorship or volunteer opportunities, call 443-235-8407 or visit

Latina Health Forum is April 13 The Delaware Breast Cancer Coalition (DBCC) and the Arsht Cannon Fund present the 3rd Annual ÁVIDA! Latina Breast Health Forum on Saturday, April 13, at Grace United Methodist Church, 7 King St., Georgetown, from 9 a.m. to 2 p.m. This one-day conference is free and open to the public. ÁVIDA! is a bilingual (Spanish/English) educational event that focuses on breast cancer screening, treatment and survivorship. This year's event will feature free health screenings and information about breast health and healthy living. Lunch will be provided for all attendees, but space is limited so those interested are encouraged to register by calling toll-free, 1-888-672-9647. The State of Delaware's Women's Mobile Health Screening (WMHS) Van will be on-site to provide screening mammograms for women over 40 (with a prescription from a doctor). To schedule an appointment for a screening mammogram, call 1-888-672-9647. There will also be free screenings for blood pressure, cholesterol, glucose, bone density, skin cancer, clinical breast exams, HIV, and body mass index (BMI). In addition, the Food Bank of Delaware's Mobile Pantry will be on-site. To sign-up to receive food on the day of the event, call 1-888-672-9647 to pre-register. Quantities are limited and all food recipients must pre-qualify for benefits ahead of time. For more information, contact Patty Vivo-Aucoin in DBCC's Dover office at 302-672-6435.

DPH addresses drug recall The Delaware Division of Public Health is reviewing a drug recall to determine if Delaware received any of the recalled product from Med Prep Consulting Inc. of Tinton Falls, N.J. Med Prep is voluntarily recalling all lots of products compounded at its facility. The recall resulted from the pharmacy being notified by a Connecticut hospital that it observed visible particulate contaminants in 50 ml bags of Magnesium Sulfate intravenous solution that were confirmed to be mold. In an abundance of caution, the pharmacy included all compounded products in the voluntary recall due to lack of sterility assurance. Although administration of an intravenous product found to be contaminated with mold could result in a fatal infection, it is uncertain whether the mold found in these products can cause illness in humans. "DPH is working with our partners in New Jersey and the FDA to determine if any recalled products were shipped to Delaware," said Dr. Karyl Rattay, DPH director. "If any products were shipped to medical facilities in the state, DPH staff will be contacting each facility and instructing how to dispose of the product. In the event recalled products were used, DPH will be working with medical facilities to monitor patients."

Asthma Awareness Day is May 11 The American Lung Association in Delaware, Bayhealth Medical Center, and Nemours Health and Prevention Services will host a carnival-themed asthma awareness day, "Asthma Under the Big Top," on Saturday, May 11, from 10 a.m. to 1 p.m., in Pavilions I & II at Bayhealth Kent General Hospital in Dover. Snacks and beverages will be provided. Families, children and caregivers are encouraged to attend this free event. To register or for more information, contact Nicole Goldsboro at 302-737-6414, ext. 16 or

Community Health Promotion awards The Governor's Council on Health Promotion & Disease Prevention announces a call for submissions for Recognition of Community Health Promotion. The goal is to recognize the efforts of municipalities that are championing the health and well being of their local residents. Recipients will be communities that have demonstrated effective planning and implementation of best practice and/or creative and visionary programs to improve physical activity, nutrition/healthy eating, tobacco-free lifestyles, healthy environments; promote healthy lifestyles and integration of the needs of individuals with limited mobility and disabilities. All applicants must represent an incorporated municipality located within the State of Delaware and must focus on policy and practice changes related to improving the overall health of its respective community members. For more information and an application, contact Dr. Milton Delgado at or 302-444-9142. The deadline to submit an application is April 12. Upon submission, all applications will be reviewed by a subcommittee of the Governor's Council on Health Promotion & Disease Prevention.

Alzheimer's Caregiver Support Group Cadia Rehab Renaissance near Millsboro is hosting and facilitating an Alzheimer's Association Caregiver Support Group that meets the fourth Tuesday of each month at 6 p.m. All meetings are open to the public and interested parties are invited to attend. Alzheimer's disease is the sixth leading cause of death in the United States. One person out of eight who reaches the age of 65 will develop Alzheimer's, as will one person out of every two who reaches the age of 85.

2013 Walk MS dates The Delaware Chapter of the National Multiple Sclerosis Society has announced the 2013 Walk MS dates and is inviting all Delawareans to join the movement. Each year thousands of loved ones, friends, and neighbors throughout Delaware – from Wilmington's Riverfront to Sussex County's Baywood Greens – lace up and step out in solidarity, with hopes of creating a world free of MS. Last year, over a quarter million dollars was raised to help out the 1,550 Delawareans living with multiple sclerosis. The Twilight at Heritage Shores walk in Bridgeville will be held on May 31 and the walk at Baywood Greens will be held on June 7. To register, visit or call 302-655-5610.