Mental Health, Prozac, Holding Pens, Children & Sheriffs – (why nurses, teachers, social workers & foster / adoptive parents need to speak out)

April 19, 2016 in CASA, Child Death, Guardian ad-Litem, Health and Mental Health, Politics and Funding, Public Policy, Resources, Wonderful People by Mike Tikkanen

mn fall panorama leaves turnedToday’s Star Tribune article about hospitals without the capacity to deal with the surge in emergency psych visits relates directly to the sheriff’s (Washington, Ramsey and Hennepin Counties) threat to sue because their departments had become mental health service providers as a result of the state’s failing to honor the 48 hour rule.

It would be useful if more educators, social workers, police officers & public health nurses would speak up on this topic also.  The levels of suffering, violence and disruption caused by not addressing mental health in our community has lead to unmanageable public institutions and prisons larger (almost ten times larger per capita) than in other industrialized nations).

Minneapolis experiences 900 to 1000 emergency psych visits to Hennepin County Medical Center every month, many of them children (this is just one of many city hospitals).  In 2014, 20,000 one and two year old’s were proscribed Prozac and other psychotropic medications in our nation (think about this – we’ve come from lobotomies and Thorazine to Prozac and now we’re giving it to babies).

Johnson & Johnson was recently fined 4 billion dollars for illegally selling these drugs to pediatricians for use on children with 5000 cases still pending.  Glaxo Welcome was fined 3 Billion dollars for the same things.

About 1/3 of state ward children, 2/3 of youth in the juvenile justice system and 1/3 of prison inmates  take these drugs.  Instead of facing the realities of generational child abuse (10 – 18 million traumatized children/year*) who later become dangerous to themselves and others without our help, we feed them powerful psychiatric medications until they don’t work anymore and then live with the consequences that now fill our prisons, schools and Emergency Rooms – suicide is the 2nd leading cause of death for ages 10-24).

I attended Syl Jone’s play BECAUSE at the Mixed Blood Theatre recently.  It’s a moving piece that explores living with mental health issues from multiple perspectives leaving the audience with a personal sense of what it’s like to be this person, live with this person and understand this person.   Syl is now the Resident Fellow for Narrative Health at HCMC (I think every hospital should have such a position – how else can these stories be told?)

I asked Syl at the play if he would consider writing about the mental health issues of children in child protective services, he seemed interested.  If you know Syl Jones, please let him know what a great idea this is (maybe send this article to him).

Back to Sheriffs and Children (the title).

At the end of the play, Syl Jones & a panel (moderated by Eduardo Colon, the new Psychiatry Chief at HCMC)  of professionals & one very articulate person living with serious mental health, issues further explored the realities of mental health and mental health services in our community.


While I’m all for providing services to inmates in need of psychiatric beds, I am appalled that state ward children are suffering because of the shortage of beds and the use of psychotropic medications in place of therapy.  

If social workers were to threaten to sue the state for the same thing could they get the same results as the sheriffs?

The depth and scope of children’s mental health in this community is profound.

As a long time CASA guardian ad-Litem I have accompanied many children on long trips for mental health services because there were no beds or services here & I know that much of what is provided here is inadequate (this was stated by Dee Wilson from the Casey Foundation in his report to the County Commissioners).

I’ve experienced my CASA guardian ad-litem children on multiple medications (way too many), suicide attempts & other terribly self destructive behaviors.  These children need our help.

Remember what Pliny the Elder said 2000 years ago?  “What we do to our children, they will do to society“.  Spot on.

Thank You Dr Colon, HCMC and Syl Jones for starting this conversation – it may be the only way our community can begin to understand the profound depth and scope of mental health issues and their impact on children, providers and our quality of life.

*Child abuse in the U.S. vastly under-reported; the three million reports represent 12 million abused children every year not the six million calculated by including the 150 million families with 0 to 2 children.

Please share this post with policy makers and your contacts in foster/adoption, education, health, policing and social workers.


related Star Tribune Opinion Page article;

As a community mental-health worker, I see the need for safe spaces for transitional care.


I am supposed to be a part of the solution. But I am also part of the problem.

One of my clients is referenced in the article. He could be a poster child for a broken system. He faces four criminal charges in four metro-area counties, all related to behaviors from being un- or undermedicated. He is chemically dependent and homeless.

I check hospital and jail rosters frequently to see where he will surface next. He would benefit from having a permanent home, but due to his extensive record, few if any landlords will touch him. The overcrowded hospitals resort to “catch and release” to ease their logjam of patients.

As a result, the hospitals are quick to discharge clients who have case-management teams like mine. But once my client has been returned to the street, he will often use drugs, become more symptomatic, and end up doing something illegal that lands him back in jail and/or the emergency room. There he sits until he is released and the cycle continues. He’s not getting any healthier. We struggle to be effective for him, and it costs all of us.

While our interdisciplinary team is an effective model, there are not yet the structural supports to assist us in stabilizing these high-need clients. Each of us has thought momentarily of strapping a client to our bodies to keep them safe and accessible while we try to facilitate keeping them in the community.

I am a proponent of more options for transitional-care community beds. We need someplace where people can safely restabilize on their medications, with supervision, be accessible to service providers and be off the street. This is not the end answer, but it would give everyone a chance to take a deep breath and coordinate their efforts.

I am grateful that the governor is finally allocating real money to help these problems. I believe keeping as many people in the community as possible is the right thing to do and more fiscally responsible in the long run.

Molli Slade, of Roseville, is a social worker.


Youth suicide and self-inflicted injury are serious public health concerns. Suicide is the second leading cause of death among young people ages 15-19 in the U.S., according to 2013 data (1). A recent national survey found that nearly 1 in 6 high school students reported seriously considering suicide in the previous year, and 1 in 13 reported attempting it (2). In addition, approximately 157,000 youth ages 10-24 are treated for self-inflicted injuries in emergency rooms every year (2). Self-inflicted injuries are not necessarily the result of suicide attempts; in fact, self-harm without the intent to die is more prevalent than self-harm with such intent (3). In total, suicide and self-inflicted injury in the U.S. cost an estimated $45 billion annually in medical expenses and work loss; actual costs may be higher as many suicides and attempted suicides are not reported due to social stigma (4, 5).

Some groups are at a higher risk for suicide than others. Males are more likely to commit suicide, but females are more likely to report attempting suicide (1, 2). Among racial/ethnic groups nationwide, American Indian/Alaska Native youth have the highest suicide rates (1, 2). Research also shows that lesbian, gay, and bisexual youth are more likely to engage in suicidal behavior than their heterosexual peers (6). Several other factors put teens at risk for suicide, including a family history of suicide, past suicide attempts, mental illness, substance abuse, stressful life events, low levels of communication with parents, access to lethal means, exposure to suicidal behavior of others, and incarceration (1, 2).

Find more information and research about youth suicide and self-inflicted injuries in’s Research & Links section.

Youth Suicide Rates from Kids

Sources for this narrative:

1.  Child Trends Databank. (2015). Teen homicide, suicide, and firearm deaths. Retrieved from:

2. Centers for Disease Control and Prevention. (2015). Suicide prevention: Youth suicide. Retrieved from:

3. Swahn, M. H., et al. (2012). Self-harm and suicide attempts among high-risk, urban youth in the U.S.: Shared and unique risk and protective factors. International Journal of Environmental Research and Public Health, 9(1), 178–191. Retrieved from:

4.  U.S. Surgeon General, & National Action Alliance for Suicide Prevention. (2012). 2012 national strategy for suicide prevention: Goals and objectives for action. Retrieved from:

5.  Centers for Disease Control and Prevention. (2015). Understanding suicide: Fact sheet. Retrieved from:

6.  Marshal, M. P., et al. (2013). Trajectories of depressive symptoms and suicidality among heterosexual and sexual minority youth.Journal of Youth and Adolescence, 42(8), 1243-1256. Retrieved from:

How Children Are Faring

In 2011-13, nearly a fifth (19%) of California public school students in grades 9, 11, and non-traditional classes reported seriously considering attempting suicide in the past year. Reported suicidal ideation was higher among female (vs. male) students and among students from multiracial and Native Hawaiian/Pacific Islander backgrounds.

In 2013, 481 California children/youth ages 5-24 were known to have committed suicide: 29 children ages 5-14, 150 ages 15-19, and 302 ages 20-24. The state’s youth suicide rate in 2011-13 was 7.7 per 100,000 youth ages 15-24, slightly higher than previous years, but substantially lower than the rate in 1995-97 (9.4). National comparison data are available from 1999 to 2013; during those years, California’s youth suicide rate remained below the U.S. rate, which has risen above 10.0 per 100,000 youth in recent years. Statewide and nationally, many more male youth (ages 15-24) than female youth commit suicide. In 2013, males accounted for almost 80% of youth suicides in California (354 of 452).

In 2013, there were 3,322 hospitalizations for non-fatal self-inflicted injuries among children and youth ages 5-20 in California. While the statewide rate of self-inflicted injury hospitalizations has fluctuated over the last two decades, rates have declined since 2001, from 46.5 per 100,000 to 39.8 per 100,000 in 2013. Most counties with available data saw a similar decline. County rates ranged from 18.8 to 56.4 per 100,000 in 2013. Statewide, the majority of hospitalizations for self-inflicted injuries involve youth ages 16-20: 2,050 (or 62%) of all hospitalizations for self-inflicted injuries in 2013.




Leave a Reply

Your email address will not be published. Required fields are marked *

Secured By miniOrange