Brad Byrd In-Depth: Dr. Louis Cady Talks Dealing with Mental Illnesses

Last week, authorities shot and killed 55-year-old Ricky Ard outside the federal building in downtown Evansville.

The Evansville Police Department released surveillance and body cam video which showed Ard breaking the glass with a baseball bat. An EPD officer arrived at the scene and tried to use a taser, but officers fired their weapons after they said Ard continued to act aggressively.

Vanderburgh County Coroner Steve Lockyear later revealed ard suffered from a schizophrenic episode. Ard's family said he had a long documented history of mental illness.

Brad Byrd talks with Dr. Louis Cady, who is the founder of Cady Wellness Institute, about how to determine if a person is suffering from a mental health disorder, and how to get that person the proper help.

Transcription of interview:

Brad Byrd: Having a member of your own family, a close friend, who may have a mental health issue. What do you do if you see signs of it? What can you do? Last week, Ricky Ard died after police say and video showed ard did not obey repeated officer commands in front of the federal building after he had taken a bat to the front door. Ard was shot to death by officers after video showed he was charging one of them with the bat. His family said in a public statement he had mental issues they could they could not get help for. Joining me tonight is Dr. Louis Cady, psychiatrist, founder of the Cady Wellness Institute. Dr. Cady, it is good to see you again. Let's get to the question of how do you determine if someone is suffering from a mental illness."

Dr. Louis Cady: "Brad, there are only two ways. And that is you talk to a person with what we call a history, and you examine the person. If you're a psychiatrist or a mental health physician, you do a mental status examine. If you're a family member, you talk with them. You get a sense of where they're coming from, and you kind of do a mental check and see if they are firing on all cylinders, if they're tracking, or if they're saying things that don't make sense or vaguely."

Brad Byrd: "Is biological in nature?"

Dr. Louis Cady: "Yes, this type of mental illness is biological."

Brad Byrd: "And examples of mental illness, it is a very broad term. We use derogatory terms to describe it in layman's terms, but examples?"

Dr. Louis Cady: "Okay, mental illness is anything listed and defined as a mental illness in our current diagnostic bible. So, some of those diagnosis can include things like attention deficit disorder, depression, anxiety, obsessive compulsion disorder. Those are all mental disorders."

Brad Byrd: "Schizophrenia."

Dr. Louis Cady: "Schizophrenia and bipolar, the two most severe."

Brad Byrd: "And how do you recognize this especially schizophrenia and bipolar especially if this individual is under the age of 18?"

Dr. Louis Cady: "The usual manifestation of schizophrenia is a young person that's had a perfectly normal life up until their late teens or early 20's and has what's called a psychotic break, suddenly or sometimes not so suddenly. But they go from someone who's totally rational to a person who has vague, paranoid ideas. I have several in my practice. One of them a fine young man talked about he was was great until the latter part of high school, and he just became convinced that people were talking about him."

Brad Byrd: "It's as old as the hills in Indiana and Kentucky and probably throughout the country that some of the first, well right here in our neck of the woods, the state hospital. When it was built, it was out in the country, and Evansville grew around it. The urban area grew around it. But looking at the new state hospitals, certainly a more modern facility. But it is much smaller than the original. The matrix has shrunk. Is that part of the problem, the number of treatment centers and how big they are?"

Dr. Louis Cady: "Yes, statistics show that the appropriate amount of public psychiatric beds, in other words places where people can go for treatment, is 50 per 100,000. And from 2010 to 2016, that number dropped 90 in Indiana. So, we're now at 12.4 beds 100,000 or about one-fifth of where we should be."

Brad Byrd: "I've had people like Vanderburgh County Coroner Steve Lockyear at this table. I've had Vanderburgh County Sheriff Dave Wedding. And law enforcement and first responders have often said in many ways for example the Vanderburgh County Jail has not by it's own doing in certain parts of the jail has turned into a mental health harbor. And what's your take on that?"

Dr. Louis Cady: "Well, in the old days when there were most state hospitals and those state hospitals had more beds, people who were sick would stay there for prolong periods of time. Since the 1960s, there has been this move that has been called the deinstitution of the mentally ill, least restricted environment, get them out of the state hospital, get them out of society which is all good and wonderful in theory. But in practicality, when you get someone from a state hospital where they are getting their medication everyday and they go out on the streets where there are sometimes poor living circumstances as well as poor support systems, sometimes they just can't get their medication. When you have a biological disorder, you need the biological treatment for it."

Brad Byrd: "And this is medication everyday prescribed."

Dr. Louis Cady: "Yes, it's either medication orally or there are some long acting shots that can be given every four to six weeks."

Brad Byrd: "So, if you were a family member and you were explaining to me if your loved one or friend is under the age of 18 especially if you're a parent or a guardian, you say we're taking you in to see the doctor."

Dr. Louis Cady: "Right, or we're taking you into the patient adolescent psych unit."

Brad Byrd: "But after the age of 18, it some of these issues have been latened overtime and that individual has not possibly snapped into a psychotic episode, what choices do you have? Say like it is a brother, a mother, a father, what do you do?"

Dr. Louis Cady: "There are basically two ways. One is a hard way. One is a soft way. The soft way is you approach the person and say 'Look, I'm really concerned about you. These are the things I'm seeing from you, and I really thing we should go get you some help. I'll go with you, I'll find someone for you, but talk to the priest, talk to the rabbi, talk to the imam, talk to a counselor, but go and talk to someone.'"

Brad Byrd: "And if they refuse?"

Dr. Louis Cady: "And if they refuse and if they are dangerous, and the Indiana law says by the way the only way someone can be defined against their will is if they have a mental illness where it is demonstrable and it shows they are at risk of harming themselves or someone else and they cannot be treated on an outpatient basis."

Brad Byrd: "But you're technically not being charged when you're being held, so how long can you be held in a situation?"

Dr. Louis Cady: "72 hours with up to a judicial hearing, and sometimes the judicial hearing while they are impatient, the judge says 'You know, I think you can go now.' Other times the judge says 'Yes, I'm completely convinced that you need to stay here and receive further treatment.'"

Brad Byrd: "Dr. Louis Cady, thanks again for joining us tonight to talk about a tough issue, and we appreciate your time. And we'll be keeping in touch. Thank you so much."

(This story was originally published on September 5, 2017)

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