Tardive Dyskinesia

Tardive dyskinesia is a persistent movement disorder that can result from a prolonged use of antipsychotics and is more prominent with the use of atypical antipsychotics. My preceptor decided to start the patient on Clozapine because of its effectiveness with previous clients that had tardive dyskinesia. According to my preceptor, Clozapine has shown signs of minimizing symptoms of tardive dyskinesia. Treatment did not start immediately as the patient had to get baseline labs, which included absolute neutraphil count, blood glucose, and lipid levels. Patient's weight, height, and BMI were also obtained. AIMS scale was not used with this patient as it does not include tremors. Effectiveness was based on the patients subjective account, and physical observation. Clozapine was started at a low dose and titrated up to 125mg PO QHS. Patient is getting weekly lab work for absolute neutraphil count. To date, there is no sufficient data available that suggests a cure for this movement disorder. However, the question is, among adults, what available treatments have shown the greatest effectiveness in minimizing the symptoms of tardive

Since our justice system is designed to punish those who have deliberately chosen to do something wrong, there is a defence for those who have a “disease of the mind” (Verdun-Jones, Criminal Law in Canada, 2015, p. 206) because they, technically speaking, did not choose to do so in their right mind. Such defence is the defence of “not criminally responsible on account of mental disorder” (Verdun-Jones, Criminal Law in Canada, 2015, p. 204). As stated in section 16(1) of the Criminal Code (Carswell, 2015):

5. What is tardive dyskinesia, and how does it respond to a reduction in the dose of an antipsychotic drug? Rhythmic, repetitive sucking and smacking of the lips and thrusting of the tongue in and out; movement of arms, fingers and toes, reversal is possible if lower dose is given immediately. (Hart & Ksir, p. 173)

This capability might just incorporate pertinent protests to the utilization of organic treatments. Studies have shown that schizophrenia, to name only one illustration, is in no way, shape or form an all inclusive impeding condition for which the capacity to agree to treatment must be consequently addressed or denied. It goes ahead to state a "mental hindrance is a mental or mental issue. Cases incorporate mental impediment, passionate or psychological instability, and natural cerebrum disorder." law) (in England, as indicated by the Mental Health Act 1983) a condition of captured or inadequate advancement of brain, which incorporates critical weakness of insight and social working and is related with unusually forceful or genuinely untrustworthy lead the most minimal standard of "dominance of the confirmation.

Entering the taboo world of mental illness, stigmatized as the crazy and psychotic by decades of

In 2011 New York made law known as the “SHU Exclusion Law”. The law states that if there are 200 inmates have been moved from solitary into special mental health units’ hundreds of others remain in isolation because of questions over their diagnosis. The law 's prohibition applies only to those with “serious mental illness,” including schizophrenia, bipolar disorder and major depressive disorder. The prisoners can’t pay for the treatment that they are getting because they are in jail so they can’t work so the taxpayer has to pay for their treatment that they need. For the people that have a mental illness that are in prison there is not that many that are diagnosis. There is a lot of them that have a mental illness that is not diagnosis.

This was the first effective antipsychotic medication. Most of those who were deinstitutionalized were severely mentally ill. Between 50 and 60 percent of them were diagnosed with schizophrenia. Another 10 to 15 percent were diagnosed with manic-depressive illness and severe depression and an additional 10 to 15 percent were diagnosed with organic brain diseases, such as epilepsy, strokes, and Alzheimer's disease. Deinstitutionalization further worsened the situation because, once the public psychiatric beds had been closed, they were not available for people who later became mentally ill. This situation continues up to the present. As a result, approximately 2.2 million severely mentally ill people do not receive any psychiatric treatment. Patients were kicked out with no choice. Many untreated mentally ill patients were incarcerated instead of being placed in asylums. The goal of deinstitutionalizing was that these patients should be treated in the least restrictive settings. But the settings ended up being on the streets or behind

In fact. soon after the passing of this act and other similar ones, the amount of mentally ill being labeled as criminals doubled. Prison psychiatrists reported more and more mentally ill patients in prisons after deinstitutionalization, yet they were legally restricted from providing medication or registering them into institutions where they could be treated. To further explain why institutions and involuntary commitment is necessary, Torrey states, "in examining records of these arrests [of mentally ill patients], researchers often find a direct relationship between the person's mental illness and the [awkward] behavior that led to apprehension” ("Deinstitutionalization: A Psychiatric Titanic"). Out of the people diagnosed with schizophrenia, some especially have trouble dealing with others in public because they may unintentionally view others as a threat during episodes of "delusions of persecution" in which they become paranoid thinking people are hunting them down. Specific case studies on severely mentally ill individuals living without hospital monitor show repetitive arrests for “disorderly conduct” due to their lack of ability to control their own behavior during these

D.D. is a 50-year-old, African American male presenting with a number of anxiety and depressive symptoms. The client reports that he came to counseling for “extra support and someone to talk to.” D.D. has been struggling with mental health issues since he was young. Since the age of 15 he has been hospitalized on and off for “hearing voices.” In the early 1980’s he was diagnosed with schizophrenia and prescribed Risperdal to treat the symptoms. Since then, D.D. has been in a variety of mental health settings, including hospitals, day programs, and outpatient treatment. The client has an extensive alcohol and drug use history that he believes impacted his Schizophrenia. In the early 1980’s the client would use alcohol every day “to avoid the voices,” drinking “anything he could get his hands on.” He was also heavily involved with drugs at that time and regularly used marijuana, PCP, cocaine, and heroine. In 2000, the client was sentenced to eight years in jail for four bank robberies. While in jail, D.D. received mental health treatment and alcohol and drug treatment, which was greatly beneficial. When the client was released from jail in 2008, he was drug and alcohol free and was taken off of Risperdal.

As a mental health advocate, for someone that is mentally ill, that has been caught in a criminal activity that was committed at the time the offense it has to be proven that the person who had committed the crime has been declared mentally ill at the time the crime was committed.

Deinstitutionalization states that instead of allowing “a seriously mentally ill patient [to stay] indefinitely in state hospitals, public policy [requires] either treatment in the community or release into the community after brief periods of hospitalization” (Erickson and Erickson 25). This policy “assume[s] that mentally ill individuals [will] take prescribed medications and seek outpatient counseling” (Erickson and Erickson 25). This is problematic because as stated previously, severely mentally ill individuals are not likely to take medication regularly on their own or seek outpatient counseling either because they do not desire help though it is needed or because access to these services has an unreasonable wait list and they do not receive help in time. Being released from the hospital after receiving an insufficient amount of care is dangerous both for the individual being discharged because they can become a danger to themselves, and for the public because the individual can impose danger onto the people they come

In this case, the patient John Rennie, a former pilot, had been in and out of mental health facilities in the state of New Jersey since his twin brother died in 1973 in an airplane accident. Between 1973 and 1977 he had been treated both inpatient and outpatient, numerous times, per the court record, at least 11 times. He had been diagnosed with various mental health issues which included paranoia, schizophrenia, and manic depression. He had even suffered from delusions and had made threats to kill the President. During the series of treatments, Rennie would occasionally refuse to take the prescribed medication given to him by the treatment staff. The record also indicated that during his treatment Rennie had been in frequent fights with other patients as well as the staff, and had gone through suicidal and delusional stages.

The ethics of research can be complicated in any case, but become especially hard to work through regarding the inclusion of people without mental competency to make their own decisions. This is particularly true in the case of mental illness because the loss of competency isn’t always as easy to define for a mentally ill person. As a result of this, researchers must be cautious when considering how to go about testing drugs on the mentally ill. Any drug trial, even one with possible therapeutic benefits, is potentially harmful to its participants. Further consideration is needed to determine if the possible harms of placing a potentially non-consenting participant outweigh the benefits of the trial.

One other limitation is using coercion to get the patient to do what he or she needs to do. Some finds this controversial, however with every action or decision there is a consequence that follows whether the consequence is positive or negative. Depending on the person’s mental illness the higher the severity the higher the risk of making harming and detrimental decisions. While many may say coercion is not the way to go there are also many that believe the mentally ill should be safe and protected while being able to integrate in society.

Roger Scruton states all of this in his article, “Mental Illness”, from the Journal of Medical Ethics.” Scruton gives multiple examples of what is considered a mental illness really could be a physical illness, and visa versa. “For the only way of fully describing its horror is in terms of that loss of intention and judgement to which I referred. In extreme cases, their loss may amount to the disappearance of the 'self,’” (Scruton 38). In this quote, scruton is explaining how there is a physical treatment for a mental disease. As Scruton is saying, in a rather extreme case, the mental disease has taken over the person and they are now viewed as an object. Therefore, the patient really isn’t able to give consent to any of the treatments, but that it can only be inferred. This relates to the show Stranger Things when Will is saved from the Upside Down. When Will gets the flashbacks or hallucinations he can’t seem to break out of the hold that the forces have on him. He is only able to break from them when the forces let him. Will, at that point, has lost the sense of himself and could be treated like an