Dear Dr. Roach: I’ve seen a number of stories lately about people who’ve been arrested for behavior that doesn’t seem to be criminal, but the behavior is odd. Some of these people are homeless, and I wonder if they are mentally ill and aren’t taking prescribed medication.
— P.L.P.
Dear P.L.P.: Mental illness often leads to behaviors that definitely seem odd. Behaviors like hoarding, which can be found by itself or with several different mental illnesses, often affect the individual but sometimes lead to risks for others who live with them. These behaviors can lead to interactions with police that would be considered a “public nuisance.”
Mental health remains stigmatized, and there are often inadequate resources to help people with mental illnesses. This leads to a situation where there are three to six times as many people with mental illnesses in the criminal justice system than expected. People with mental illnesses are also much more likely to be homeless. Most mental health disorders are treatable, but the treatment received while a person is homeless or incarcerated is often poor.
It’s common for people with mental health disorders to stop taking their medication. These medicines can have side effects that make people feel unwell or just not themselves. Many times, I’ve seen people stop taking them while they feel well, which causes their problems to become much worse.
Substance abuse is also a major issue. Substance abuse can make any mental health condition worse, and it can be very difficult to properly diagnose a person while they are actively using recreational drugs. A prolonged hospitalization is necessary to make a diagnosis for them and receive proper treatment, but this is very expensive.
Odd behaviors in an ideal world should trigger an investigation into whether a person who has a mental health disorder is in need of treatment. In this ideal world, early treatment could lead to improvements in a person’s quality of life and prevent the homelessness or arrests that too often accompany untreated mental illnesses.
Unfortunately, we live in a world that is still pretty far from this ideal one.
Dear Dr. Roach: I’ve read about urolithin A. Is this something I should take for general health?
— D.D.
Dear D.D.: Urolithin A is thought to work by increasing the body’s removal of old and poorly functioning mitochondria. This way, the body makes newer and healthier mitochondria, which are structures inside the cell that provide energy for the cell to work. Mitochondria make ATP, which is the basic unit of energy inside the cell. Nearly all cells contain mitochondria, but cells that intensely use energy, such as muscle cells, have lots of mitochondria.
A 2002 study tested whether urolithin A would be effective at improving function. The primary outcomes of the study were how long a person could walk in 6 minutes and the total amount of ATP that the muscles can make. Subjects in the study had baseline measurements and were treated with urolithin A (1,000 mg) for four months — or a placebo pill that looked identical but didn’t have an active ingredient.
After four months, repeat measurements didn’t show a difference in either primary outcome with the subjects who were treated with urolithin A. However, those who took urolithin A had slightly better muscle endurance at the end of the four-month period. Urolithin A has minimal toxicity at the studied doses.
In my opinion, there is good “biological plausibility” that this supplement might help, and although there seem to be some benefits, there isn’t compelling evidence for me to recommend it yet.Readers may email questions to ToYourGoodHealth@med.cornell.edu.
This article originally appeared on The Detroit News: Dr. Roach: How mental illness, homelessness and crime intersect
Reporting by Dr. Keith Roach, To Your Health / The Detroit News
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