In the conclusion of this series, Lindsay Galvin Rauch, whose 6 brothers were diagnosed with schizophrenia, says clinicians, families, and law enforcement could benefit from education about the disorder, specifically the comorbid condition of anosognosia. Anosognosia is a condition where a patient is unaware of or unable to perceive their mental health condition and affects a large percentage of patients with schizophrenia.

Throughout the series, Psych Congress steering committee member and CEO of Orbit Health Telepsychiatry, Encino, California, Edward Kaftarian, MD, interviews Galvin Rauch about her journey from victim, to advocate, to champion.

Galvin Rauch and author Robert Kolker were one of this year's featured sessions at  Psych Congress in San Antonio, Texas. Their session "Hidden Valley Road: A Story of Family, Trauma, and Hope" walked attendees through the writing of the critically acclaimed novel “Hidden Valley Road: Inside the Mind of an American Family” that centered around Galvin Rauch's family and their contribution to critical scientific discoveries in schizophrenia.

Watch the rest of the series:

Transcript:

Lindsay Galvin Rauch: Some conditions, they do have a choice. When it comes to anosognosia, they really don't. It's a brain damage that prevents them from being able to recognize.

Dr Edward Kaftarian: That's, overall, one of the biggest challenges in our field, is the brain, when it's not functioning, doesn't know how to take care of the brain. It's unlike any other organ, where in order to heal that organ, that organ needs to function. It's not functioning, so it's not healing.

This is something that you think that we should be more cognizant of, and educate patients and... families, at least, and society.

Galvin Rauch: The criminal justice system. That's at the heart of why we're housing so many people in our prisons and on our streets.

Dr Kaftarian: We're punishing them for their illness, instead of treating them. We're making them worse by throwing them in prison cells.

Galvin Rauch: Re-traumatizing them.

Dr Kaftarian: Re-traumatizing them, which you've pointed out in the past, that it's harmful for psychotic disorders, which I agree.

Galvin Rauch: It's harmful for anybody, much less somebody that suffers from an illness that they don't know they have.

Dr Kaftarian: They have such little margin, anyway, to deal with stress. You blow through that by traumatizing them. In the time we have left, can you tell us...As a psychiatrist, I'd like to know how my community of psychiatrists, colleagues, psychiatric nurse practitioners, PAs, and everyone else that works with mentally ill people, what can we do better?

Galvin Rauch: When I watched that TED talk, I picked up the phone to the guy that had done the TED Talk. His name is Dr Xavier Amador. He was the deputy director of NAMI for a long time, a Columbia professor. He had a schizophrenic brother.

For 20 years, his family was banging their head against a brick wall, trying to convince his brother that he was sick. His brother kept saying, "No, I'm not." He'd go in the hospital and out, and so on, and so forth. I picked up the phone and called Dr. Amador, and had him teach me about what this is.

He has since left NAMI after having created an unbelievable education system within NAMI. He was the director of education and research.

He has started an organization called the Henry Amador Center on Anosognosia. It's a mouthful. The communication technique that he has developed for caregivers and families and practitioners in the criminal justice system, is an amazing technique. It's a tool. It's one of the tools.

We have lots of tools here in medicine, which I'm not anti-medicine. I think we over-medicate because we don't use other psychological tools that are helpful, because it's easier to medicate, "Here's a pill."

It's harder to develop a relationship with those that suffer. That is what is needed to build the trust with that individual, so that they're open to getting the help they need, and learning to agree on the things in their life that is going to make their life better, very simple things that you can agree on.

I'm not an expert on teaching the technique. I'm becoming a trainer, but I'm not a trainer yet. I'm not going to pretend that I can convey how these tools work that Dr. Amador teaches. He travels the world. He goes into governments. He goes into big criminal justice systems, police departments.

He works for a lot of states and goes in and teaches trainers within the police departments, people that are doing training for doctors, into hospital systems, and teaching practitioners how to build this bridge to somebody who is psychotic, to somebody that does have anosognosia.

There's many different blocks in building that bridge, and it's a very systematic approach. That is probably the best thing we can do, is take this information into our communities and teach those that are first responders, and those that are having to interact on a regular basis with those that suffer.

Dr Kaftarian: As we've seen many times in the past, education is the key, getting people educated and understanding how to manage these difficult situations. I just want to say thank you.

Galvin Rauch: Thank you. I'm honored to be here.

Dr Kaftarian: Thank you. It's been an honor for me as well. Lindsay Galvin Rauch, thank you very much. We've spent some time with you today. I encourage the entire Psych Congress Family to check out the book, "Hidden Valley Road: Inside the Mind of an American Family."

Lindsay, thank you.

Galvin Rauch: Thank you for having me. The Psych Congress has been really fun to be here and empowering.

Dr Kaftarian: Thank you. Have a good day everyone.

Lindsay Mary Galvin Rauch is the youngest of 12 siblings, 6 of whom were diagnosed with schizophrenia—becoming one of the first families to be studied by the National Institute of Mental Health and the subject of Oprah's Book Club Selection, “Hidden Valley Road - Inside the Mind of an American Family” by Robert Kolker. Her journey inspired her to evolve from victim, to survivor, to advocate. She is also an accomplished co-owner of a meeting and event company for nearly 30 years, where she partners with industry-leading organizations, hospitals, doctors, and other keynote experts to produce impactful functions designed to engage and educate the public.

Edward Kaftarian, MD, is a nationally recognized psychiatrist and leader in the field of telepsychiatry and healthcare technology. Trained at the Johns Hopkins Hospital, he is board-certified in Psychiatry, Forensic Psychiatry and Addiction Medicine. Dr Kaftarian has served in a variety of executive roles within the California prison system, including chief psychiatrist, senior psychiatrist, medical director, and director of pharmacy. He is the founder of California’s Statewide Prison Telepsychiatry Program, which is the largest correctional telepsychiatry program in the world. Dr Kaftarian is currently the Chairman and CEO of Orbit Health Telepsychiatry, a company that provides telepsychiatry services to jails and prisons.