August
20, 2010 - News of the Week
CAN
THERE BE RECOVERY
WITHOUT A SAFE PLACE TO LIVE?
(2 articles)
A
sharp rise in brutality against homeless individuals, many of them
mentally ill, adds new urgency to the longstanding need for safe
housing.
KUDOS to Clint Zweifel, Missouri's state Treasurer, who this week
presented state officials with a plan to prioritize mental health
housing.
By
Eric Lichtblau
New York Times
August 18, 2010
By
Bob Watson
For the Fulton Sun
August 20, 2010
When the Missouri Housing Development Commission meets this morning,
state
Treasurer Clint Zweifel wants its members to approve his plan to direct
a third
of the state's annual low-income housing aid to mentally ill
Missourians.
"The $127 million investment that I am proposing provides a place to
call
home for sons, daughters, moms and dads and military veterans who
suffer from
mental illness and are homeless -- or at a very high risk of suffering
from
homelessness," Zweifel told reporters in his Capitol office.
"My proposal would provide an estimated 400 homes that would provide
safe,
stable housing to help our friends and neighbors get back on their
feet, and
fight chronic homelessness right here in Missouri."
The treasurer would couple the new housing with "critical, supportive
services that are so important ... that these individuals ultimately
need to be healthy and well and thrive," including on-site care, crisis
help and case management.
Zweifel said his plan would not require any new spending nor does it
mandate
a specific model for developers to follow.
"It's not a one-size-fits-all-approach government mandate," he
explained. "It's instead a way to use the best of what Missouri has to
offer -- community-based organizations, local governments, state
government and businesses really coming together to provide real
solutions that deal with the issue of homelessness."
He said several housing commission members already support his idea.
But Housing Commission Chairman Jeffrey Bay told The Associated Press
Wednesday that he didn't have enough information about Zweifel's
proposal to decide whether to support it -- and he didn't expect
Zweifel's idea to be resolved at today's meeting.
"I am not aware that the staff has investigated it adequately and fully
to know all of the ramifications of it," Bay said.
NAMI of Missouri supports Zweifel's plan.
"We've seen increases in homelessness in Missouri in the last few years
and, with resources being more and more strapped, we just expect that
trend to continue," said Cynthia Keele, the group's director. "It's
also real important that people with mental illness have stable
housing, because how can you recover?
"We know, today, what it takes for people to recover from mental
illness and how to help people get back and get back into society. But
how can anyone start that process, if they don't have a place to live?"
Keele said some developers already have said they'd be interested in
such a project, using tax credits the MHDC already has the authority to
give to developers.
Though he promoted his plan at a Wednesday morning news conference,
Zweifel sent Bay a letter on July 2 of his request for the commission's
vote on his idea.
"This is consistent with the MHDC's commitment to fighting homelessness
in Missouri," the treasurer wrote. "Focusing on mental illness and
homelessness should be a critical strategic function of the MHDC."
The commission's members include Zweifel, Gov. Jay Nixon, Lt. Gov.
Peter Kinder, Attorney General Chris Koster and six Missourians
appointed by the governor.
The meeting is set to begin at 9 a.m. today at the Capitol Plaza Hotel.
-
End of Article 2 -
Reprinted using Fair Use standard
August
8, 2010
- News of the Week
For
people who have psychiatric vulnerabilities, an emergency room visit
can be prohibitively traumatic. An extreme example is the
death-by-neglect of Esmin Green, a woman who collapsed and died
unnoticed on the floor of a psychiatric waiting room after a 24-hour
wait for
help. June 18, 2008, at
the Kings County Hospital Center in Brooklyn, New York City.
Psychiatric peer counselors have become a fast-growing source of
valuable assistance in programs that provide psychiatric
services. They can also contribute valuable help in emergency
rooms.
Phyllis Vine (www.miwatch.org)
explores this innovative services model, now expanding nationally,
in Peer Counselors Support
Consumers in
Emergency Rooms
_____________________________________________
Update on Kings County
Hospital Psychiatric
Center
Source: NYAPRS Enews, August 10, 2010
Following Esmin Green's
tragic death in
the Kings County Hospital psychiatric emergency room in 2008, a legal
settlement
prompted New York City's Health and Hospitals Corporation to
increasingly hire peer staff in their inpatient and outpatient programs
at Kings County and other HHC public hospitals. Here
is a promising account of this
welcome new direction: Peers
Bring Hope To The Mentally Ill by
Erin Durkin, New
York Daily News, August 9th, 2010.
August
1, 2010 - News of the Week
A
BRITISH CLINICAL PSYCHOLOGIST MAKES STRONG CASE FOR SHIFT IN
PSYCHIATRIC
TREATMENT
"Arguing passionately for a
future of mental
health treatment that focuses as much on patients
as individuals as on
the brain itself, this is a book set to redefine our understanding of
the treatment
of madness in
the twenty-first
century." (Quote
from book jacket)
Doctoring
the Mind: Why Psychiatric Treatments Fail
by Richard P. Bentall
Book Review by Lesley McDowell
Published June 13, 2010 The Independent
The end of the 20th century saw powerful indictments of the way we
treat people with mental-health problems, not from those in the
psychiatric profession but from those on the receiving end.
Psychiatry's increasing reliance on pharmaceuticals was coming under
attack, and a more caring, less drug-dependent way was being advocated
by the newer strand of mental-health specialists: clinical
psychologists.
One of the many fascinating things that Richard P. Bentall's excellent
book flags up is the lack of progress we seem to have made in the past
200 years. Ironically, knowing far more about how the brain works than,
say, the 18th-century's William Cullen, or even Freud, seems barely to
have improved our ability to treat mental problems. If anything,
neuroscience, in emphasising the brain's failures, has advocated a more
simplistic approach: a chemical imbalance in the brain? Here, pop a
pill. We may no longer chain "mad" people to walls or apply leeches to
their skin, but the moment in the early 19th century when more holistic
methods were advocated was quickly eclipsed when the emerging study of
psychiatry sought to establish itself as a science, and did so by
becoming as authoritative as possible.
Many of us may not know about the opposition between psychiatry and
clinical psychology, but, given that mental illness is apparently on
the increase - "the lifetime risk of suffering from any kind of
psychotic disorder may be as high as 3 per cent, [which] means as many
as 1.8 million British citizens" we had perhaps better start becoming
educated about them. Bentall, a professor of clinical psychology
himself, can hardly be the most disinterested commentator on these
arguments, but he has produced a lucid and accessible account of a
tricky but endlessly absorbing subject.
-
End of book review: Doctoring
the Mind: Is Our
Current Treatment of Mental Illness Really
Any Good? -
- Reprinted
using Fair Use
Standard -
July
18, 2010 - News of
the Week
5
Communities Re-examine
Use of Police to Intervene in Mental Health Crises
Source: Bazelon Center for Mental
Health Law
Press release: July 6, 2010
ARTICLE:
More
frequently, news
outlets across the country, like the ones below, are reporting shocking
stories about tragic outcomes stemming from police involvement in
mental health emergencies.
·
“Camden County Man Dies
After Struggle with
Police,” Philadelphia
Inquirer 4 May 2010
·
“Autopsy Links Taser to
Cardall’s
Death,” Salt
Lake City Tribune 19 November
2009
Recognizing
the
devastating impact of cyclic arrest, incarceration and hospitalization
on people with serious mental illnesses and their communities, the Bazelon
Center for
Mental Health Law has launched
an initiative designed to reduce
reliance on local law enforcement to intervene in psychiatric
emergencies. The goal of the initiative, called the Performance
Improvement Project (PIP), is
to enable community mental health
systems to take a more active role in preventing the scenarios whereby
people with serious mental illnesses are subject to police intervention.
Five
sites were selected
to participate in the Performance Improvement Project--Travis County
(Austin), TX, Wayne County (Detroit), MI, Allegheny County
(Pittsburgh), PA, Multnomah County (Portland), OR, and Westchester
County (White Plains), NY. The Bazelon Center, with support
from
the Open Society
Institute and others, is the
lead organization. The Bazelon
Center will coordinate the initiative and provide partial funding to
each project site.
The
project relies on
local expertise and a systematic process of observation and analysis to
track down the “root causes” that leave people with
mental
illnesses vulnerable to police involvement. From this
information, project sites will be able to uncover service
shortcomings, assess social and fiscal costs, and identify any needed
systems improvements. A compilation of findings across sites
will
reveal structural obstacles faced by public sector providers as they
attempt to meet the needs of the most vulnerable people with serious
mental illnesses.
“For too long, we have viewed people with serious mental
illnesses cycling through jails and emergency rooms as routine, when
this is, in fact, a clear signal of failing public systems,”
said
Robert Bernstein, executive director of the Bazelon Center for Mental
Health Law.
“Although
the
results of the Performance Improvement Project will lead to better
performance by community mental health providers, the greater goal of
this initiative is to illuminate barriers to improvement that stem
directly from regulations and policy made at various levels,”
Bernstein said.
“Establishing
an
engaged, coherent and fully-resourced community mental health system
improves outcomes for people with serious mental illnesses, reduces
costs, and reduces the burden on law enforcement to serve as the social
service safety net,” he added.
“This
project could
represent a giant step forward for community mental health”
said
Linda Rosenberg, President and CEO of the National Council for
Community Behavioral Healthcare. “Applying a
performance
improvement model to quantify how policies and practices are actually
affecting services makes a lot of sense. Data from this
project
can fuel long-needed change,” added Rosenberg.
The five sites selected by the Bazelon Center have a history of making
efforts to provide coordinated community services and supports designed
to help avert mental health crises that lead to contact with law
enforcement. Each has also demonstrated interest in pursuing
policy reforms that support better outcomes for individuals and
improved accountability for government investment in mental health and
other human services.
#
# #
The Bazelon
Center for
Mental Health Law is the leading
national legal-advocacy organization representing people with mental
disabilities. It promotes laws and policies that can enable people with
psychiatric or developmental disabilities to exercise their life
choices and access the resources they need to participate fully in
their communities.
June
12, 2010 - News
of the Week
NEW
JERSEY ADOPTS "HOUSING FIRST" PROGRAM
AS COST-SAVING WAY TO HELP MENTALLY ILL HOMELESS INDIVIDUALS
ARTICLE: Community mental
health saves
lives and tax dollars
Source: The Times
©2010 Times of Trenton
© 2010 NJ.com All Rights Reserved
(from Google Alerts Email)
State budget planners have a daunting task. How do they save tax
dollars without throwing to the wolves society's most vulnerable?
One strategy is to invest in more programs like community mental
health, which not only pays for itself and returns to the taxpayer $1
billion each year in savings, but also each year improves the quality
of life for 500,000 New Jersey residents.
Thirty years ago, the state began investing in community mental
health's statewide network of community prevention and treatment
programs. These programs replaced high-cost inpatient care as the
treatment of choice for those with disabling mental health conditions.
By investing in community mental health programs, the state has reduced
the number of public psychiatric beds from 15,000 in 1970 to roughly
2,000 in 2010. Thanks to this 87 percent reduction, the taxpayer
avoided a $2 billion price tag in FY 2010 for public psychiatric beds.
Instead, investing in community mental health has allowed the state to
finance the entire community treatment system and remaining public
psychiatric beds at a combined cost of $1 billion.
In FY 2010 alone, this provided the taxpayer a net savings of $1
billion. Now, multiply that by 20 or 30 years and we get a sense of how
much has been saved over the past few decades. So, what will be the
impact of the proposed cutbacks in the FY 2011 budget?
Whenever there are community mental health cutbacks, there is always
the risk of increased high-cost emergency care, hospitalizations,
community incidents, incarcerations, etc. Any
cutback to these
services is always a high-cost gamble for short-term budget savings
(emphasis added).
Instead of cutbacks, the state should focus on applying community
mental health's cost-saving strategy to other problems. For example, we
should focus on reducing the high cost of homelessness by implementing
community mental health's Housing
First model throughout New
Jersey, as numerous other cities and states have done.
Housing First
is a triumph of common sense. It looks
first to correct the homeless person's housing problem and then address
the other problems that have contributed to homelessness.
Housing First
programs provide housing, treatment
and 24/7 support to ensure that the formerly chronically homeless stay
healthy enough to be good tenants and good neighbors.
Housing First
studies have shown that by providing
an apartment and community treatment to the chronically homeless with
mental illness, we can reduce their use of high-cost services (e.g.,
emergency room visits, hospitalizations, incarcerations, etc), and
thereby reduce the taxpayer's burden.
Greater Trenton Behavioral HealthCare operates the state's first Housing
First program. A consortium of
government agencies, the Greater
Mercer United Way and the Mercer Alliance to End Homelessness jointly
funds this pilot project. Researchers from Tufts University provide
program evaluation.
Of the 55 chronically homeless adults and families served by the
Greater Trenton program since it began 30 months ago, none has been
evicted or hospitalized. Although one was incarcerated briefly, he is
back in the program and doing well.
These results are better than expected. Most studies found success
rates of 70 percent to 90 percent. These studies also found that Housing
First not only paid for itself
but also produced net savings during
the study period of $4,745 per person in Denver, $9,400 per person in
Massachusetts, and $8,839 per person in Rhode Island. It is too early
to count the savings from the Greater Trenton program, but we are
clearly headed in the right direction.
The human cost savings, however, may be even more important. For
example, Anthony, age 35, who was homeless for six years, has been in
his own apartment for two years for the first time in his life. He has
also been in recovery for 18 months from substance use, actively
engaged in mental health treatment and working part-time.
After being homeless for 10 years, Marie, age 47, has been a Housing
First tenant for 14 months.
Although she still uses alcohol, it is
much less frequent. She is working with her psychiatrist and housing
counselor to find an alternative to drinking to reduce her distress.
Also with help from her counselor, she is addressing for the first time
post-traumatic stress from early childhood sexual abuse. Marie has
returned to photography and has had several shows at local galleries.
She says this is the first time she has felt happy and has hope for her
future.
Investing in community mental health helps people like Anthony and
Marie recover lost hope and get a second chance. Such investments save
tax dollars and solve community problems by saving lives.
Cutbacks and over-regulation of community providers weaken their
cost-saving capacity and ultimately lead to hospitalization,
incarceration and other higher cost outcomes.
Rather than whittle away at community mental health's capacity to
reduce the taxpayer's burden, let's continue to invest in what works
and focus budget reductions on what does not.
End
of Article
April
18, 2010 - News
of the Week
HOUSING WORKS!
ARTICLE:
Graying
in a Home, Not an Institution
by Michael Winerip
New York Times, April 18, 2010
____________________
GRAYING IN A HOME,
NOT AN INSTITUTION
By Michael Winerip
BALDWIN, N.Y.
SVETLANA GOMELSKY, 61, who has schizophrenia, is the beneficiary of one
of the quietest, least-heralded social revolutions of her generation.
Starting at about 18, she began hearing voices. "The first time, I
thought it was an accident," she said. "They went away." She married,
had two children, lived in the Long Island suburb of Lawrence and
worked as a secretary at a Hebrew school. But eventually the voices
returned, growing more intrusive. "I got scared," she said. "Not only
was I hearing voices, I could talk to them. I started to feel God gave
me these powers because he had a special plan for me."
Her husband divorced her; her children, by then young adults, moved out
of the house into an apartment. In 1992, she wound up in a psychiatric
hospital for six months. "I couldn't function, I lost my house, all
these bad things happened to me," she said.
But her timing was lucky. By then, New York State had taken notice of
all the mentally ill being discharged from hospitals and winding up
homeless on the streets, and was paying for the first supervised
community residences and apartment programs. Ms. Gomelsky got a place
on a quiet suburban street, in a new group home of 10 residents that
had 24-hour supervision, oversaw her medications, provided therapy and
job training.
In the 18 years since, there have been setbacks, but many more gains.
She has moved to a subsidized apartment where a caseworker visits just
once a month. She works 20 hours a week as an office clerk. Sweetest of
all, three days a week, she's able to baby-sit her three grandchildren,
ages 10, 9 and 2, so her daughter can work.
There is no miracle here. Ms. Gomelsky's schizophrenia has not gone
away, nor have the voices stopped, even with meds. "I do find if I'm
busy, I hear them less," she said. "If they become a problem I speak to
my therapist and psychiatrist and they adjust my meds, so I can
manage."
Ms. Gomelsky's is the first generation with serious mental illness to
largely escape the state hospitals. In the 1950s, there were 93,000
long-term patients in New York mental hospitals, some who had lived
there for decades. Today there are 4,000.
By 1978, New York had financed just 308 group-home and apartment beds
for the mentally ill in the entire state; today, there are about
30,000.
When Marjorie Vezer, 57, executive director of South Shore Association
for Independent Living — the nonprofit agency that houses Ms.
Gomelsky — opened her first group home in the late 1980s, she
said, "we were looking for young people, in the 18 to 35
range."
She found them. They've largely stayed and now, as they gray, they
dominate state-financed community housing. In 1999, 56 percent of the
state's group-home and apartment population was in the 41 to 70 age
range; today, 72 percent is.
The 18- to 30-year-olds now make up just 11 percent of the state total.
Twenty-five years ago, Ms. Vezer's group-home counselors kept an eye
out for sexual promiscuity issues, drug and alcohol abuse, fighting.
Now the added worry is residents' health: hypertension, heart issues,
diabetes, obesity. Ms. Vezer recently hired her agency's first two
nurses.
Between the psychiatric disorders — 70 percent of the 308
people
Ms. Vezer houses have schizophrenia — and middle-age problems
like high cholesterol, some residents can take 20 pills a day.
One reason more young adults are not entering the housing system is
that state funds have failed to keep pace with the need.
The state has not done as well for the mentally ill as it has for the
developmentally disabled. Though community beds paid for by the State
Office of Mental Retardation and Developmental Disabilities cost two to
three times as much as beds for the mentally ill — because of
higher supervision levels — New York has financed 7,000 more
beds
for that population.
We have very different attitudes about the two groups. In the late
1990s, when 26 developmentally disabled adults were found living in
homeless shelters in Westchester, there was outrage. Indeed, Gov.
George E. Pataki was so embarrassed by the press reports, he created an
extra housing program for the developmentally disabled.
There is no similar outrage about homeless shelters being full of
people with schizophrenia. Patrick Markee of the Coalition for the
Homeless said surveys indicate about half the 7,900 people in New York
City's single-adult shelter system have serious mental illness.
That, of course, is the story we know too well: the ragged people on
the corner talking to themselves.
The story we hardly know at all, because it's hidden from view, is the
30,000 seriously mentally ill New Yorkers like Dennis and Pat Siegel
(shown in the photo) who live in quality state-financed housing. Both
have schizophrenia, both have been hospitalized for long stretches and
both have been homeless.
In the years before the couple met, Mrs. Siegel, 62, worked as a
secretary. When her illness flared, she left her parents' home and
lived in her car on Long Island. "I stayed in a parking lot in East
Meadow," she said. "I'd walk to a soup kitchen in Hempstead for lunch
— they'd let you take extra rolls, so that was my dinner."
After
selling the car, she said, she slept outside. "In Garden City, by the
fancy stores, I stayed in a bush." Asked how long, Mrs. Siegel said, "I
didn't have a calendar, I was day by day."
The schizophrenia first hit Mr. Siegel, who's now 60, when he was in
his 20s and working as a salesman. After that, he said, he couldn't
hold a job. "I tried, please put that in the article," he said. "King
Kullen, Petland, a Shell station, cleaning."
He was hospitalized repeatedly and tried killing himself twice. Mostly
he lived in illegal rentals. "I stayed in a little house in Elmont," he
said. "There was a different family on each floor, and I was in the
basement."
In 1997, he moved into an apartment run by Ms. Vezer's agency. He saw a
caseworker regularly, and his hospitalizations went way down. "I
haven't been hospitalized in five years," he said.
That's a big savings for taxpayers. It costs $250,000 for a year at a
state hospital; $30,000 for a month on the psychiatric unit of a
community hospital; and $14,500 for a year in the cheery apartment
where Mr. Siegel now lives.
He met his future wife at a social club paid for by a mental health
agency.
"Dennis said, 'Here's my number, give me a call,' " Mrs.
Siegel
said.
"I played it cool," Mr. Siegel said.
Once a month they went out to dinner. "One day Dennis said to me, 'Oh
my God, do you want to marry me?' "
"That's what I did," Mr. Siegel said.
She borrowed $200 to buy a dress along with five pizzas, chips and
sodas for 20 friends at the boardinghouse where she lived. They were
married Dec. 6, 1999, at Long Beach City Hall.
Within a month, the agency found another place for Mr. Siegel's male
roommate, and Mrs. Siegel moved in.
Their apartment is a sunny one-bedroom with lots of windows, on the
second floor of a house, along a quiet side street in Valley Stream.
"You can walk to the railroad station," Mr. Siegel said. "The bus
stop's a block away."
"Pat keeps it spotless," he added. "She scrubs the toilets with bleach,
the floors. Cooks meals for me."
"Look at this belly," Mrs. Siegel said. "He's gained weight."
"I don't really know what else to say, except thanks," Mr. Siegel said.
"What do you like about the place, Pat?"
"Exactly what you said, honey," Mrs. Siegel said.
End
of Article
E-mail: generationb@nytimes.com
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April
11, 2010 - News
of the Week
IT
CAN BE DONE! TORONTO LAUNCHES A MODEL
HOUSING PLAN
ARTICLE: Toronto
Hospital's 'Urban Village' Integrates Mentally Ill Patients, The
Canadian Press, April 5, 2010
By Sheryl Ubelacker
Canadian Press
April 5, 2010
TORONTO — Originally erected in 1850 as the Ontario Lunatic
Asylum and enclosed on all sides by a solid brick wall, Canada's
largest hospital for treating mental illness is undergoing a radical
transformation that could make it a model for the rest of the country.
The Centre for Addiction and Mental Health is tearing down walls both
literally and figuratively, revamping its 10.9-hectare site in Toronto
to create an urban village that will integrate its buildings and the
people it cares for into the surrounding neighbourhood.
"It reflects changes in the understanding of what's necessary for
people who have mental illnesses and addictions to live their best
life, to fulfil their potential in life, which in some cases can be
limited by their illness," says Dr. Catherine Zahn, president and CEO
of CAMH.
That means helping a person struggling with a mental illness and-or
addiction to reintegrate into society - to return to their home, hold
down a job, to be a good family member and friend, says Zahn.
"And the best way to do that is when and if an individual who has
mental illness is capable of it, to start right away, to have them in
an environment that most closely resembles the real world."
The multi-phase process of overhauling the nine-square-block CAMH site
in the city's vibrant Queen Street West neighbourhood began two years
ago with the building of four "alternative milieu" units that provide
transitional housing for in-patients prior to discharge.
On Tuesday, the hospital breaks ground for three buildings that
comprise the next phase of its rebuild, among them a 60-bed
Intergenerational Wellness Centre for youth and geriatric patients that
includes Canada's first in-patient facilities for teens with both
mental illness and addictions.
But the revamp isn't just about new buildings.
New streets wend their way through the site, connecting and blending
CAMH with the neighbourhood's local cafes, businesses and residences.
"The idea is that there is very little value in closing people with
mental illness off from the community and vice versa," says Zahn.
"The opening up to the community from the perspective of our patients
just carries that metaphor forward that to fully recover they have to
be rehabilitated, that the community has to be part of their healing
process."
Zahn says the integrated CAMH campus, dotted with plenty of green
space, trees and gardens, is meant to help erase the stigma that
isolates people suffering from such illnesses as schizophrenia, bipolar
disorder or severe depression.
"It includes transforming attitudes about people with mental illness,
so reducing stigma but also reducing prejudice," she says. "The unknown
is always a stimulus for prejudice. So getting to know the organization
better, opening it up, is an important stimulus to reducing prejudice
and subsequently reducing discrimination."
Angela Foot has already felt the power of that inclusiveness.
In early 2006, she was referred to CAMH because she had hit her "own
personal rock bottom" and was suicidal. Her diagnosis of bipolar
disorder finally explained the many years she had struggled with
violent mood swings - alternating between long periods of mania when
she couldn't sleep and then weeks to months plunged in the depths of
depression - that destroyed relationships and finally left her unable
to work.
As an out-patient, Foot was prescribed a number of treatments,
including various group therapy sessions that took place in one of
CAMH's institutional buildings. But recovery was slow, she says.
In December 2008, she was admitted to one of the new alternative milieu
units, a street-front apartment-like building that provides a
home-like, stepping-stone residence for patients before discharge back
into the community.
"It was so different than what my experience was in the day-treatment
program, which is in one of the older buildings," says Foot, 36.
"Because those four new buildings are on the street, with sidewalks and
trees and benches and so on, it feels like you're a part of the
community and a part of the outside world."
Designed to be airy and light-filled, each floor includes a shared
kitchen, dining area and TV lounge, with individual rooms for residents
fitted out with private bathrooms and showers.
The living quarters are a long way from the outdated notion of a huge
room lined up with beds, says Foot. "You have this sense of dignity, I
guess, over taking control of your illness but not feeling like you're
a complete freak show."
"If you create an environment that is not so isolating, it may in fact
speed up your recovery or enable you to take better advantage of all of
the treatments that are available to you," says Foot, who lived in the
unit for a month before being discharged back home as an out-patient.
"Had I at that point been in the new building ... my experience could
have been very different."
Alice Liang of Montgomery Sisam Architects Inc., part of a consortium
of architectural firms hired to refine the master plan and erect the
first phases of the rebuild, says brick, residential-type windows and
other materials were used to make the new buildings harmonize with
existing structures in the neighbourhood.
The designs also incorporate energy-saving elements such as green roofs
and are meant to be sustainable, she says. "Thirty years from now, if
the hospital no longer needs those buildings they can easily be
converted into private residences or apartments."
"The important aspect to really stress from our architectural
perspective is that we took this on not to create a monumental building
(like) the ROM museum or the (Ontario) Art Gallery," Liang says of the
recently redesigned iconic Toronto landmarks. "We really see these
buildings as good solid designs that are good neighbours that really
work with the community and support the whole notion of integration."
But CAMH didn't rely only on professionals when deciding how to make
its buildings more patient-friendly. It went right to the source.
Alex Bustos, a 20-year-old out-patient who's been receiving therapy for
depression and substance abuse since early 2009, says he and other
young people at CAMH were consulted about what would make "kids of our
age feel most comfortable, to feel like they're at home ... not like an
institution, which is kind of scary and cold."
That included everything from room design and paint colour to the type
of flooring and furniture style, says Bustos, who has been free of his
marijuana habit and alcohol addiction for three months.
Bustos, who will soon get his high school diploma and is considering
going into social work, calls his treatment and recovery at
CAMH "awesome."
"There's more hope in my life, more purpose to live. Before I was
struggling, so I felt hopeless. Life is good."
Of course, notes Zahn, CAMH is a hospital and will still provide
long-term care, as it has all along.
"We have patients here who are very, very ill and they do require
secure environments ... And there's no intention to diminish the care
of people who require that type of an environment."
It will take another five to 10 years before the entire campus has been
completely transformed to conform to the urban village vision, she says.
But as antiquated structures are demolished to make way for the new,
the blurring of lines between those being treated for mental illness
and the rest of the world has already begun, says Zahn, quoting one
patient's reaction.
"Finally we can see out - and they can see us."
ARTICLE:
http://www.google.com/hostednews/canadianpress/article/ALeqM5h5jdcPUqHOnxJ7VFEsSpvKwpcacw
Reprinted
Using Fair Use Standard
March
21, 2010 - News
of the Week
DOES
THE TREATMENT ADVOCACY CENTER HELP OR HARM?
See 'more information' (below) for A
Factoid in the Making
Kendra's
Law, New York's
controversial statute permitting compulsory medication of psychiatric
outpatients, is due to expire at the end of June. Already we are seeing
efforts to make it permanent by the law's chief proponent, the
Treatment Advocacy Center in Arlington, VA. Recent quotes by key
spokespeople suggest that a new wave of fearmongering may be in the
making.
Seventeen
years ago, D.J. Jaffe, an
advertising executive, advised mental health advocates that "from a
marketing perspective it may be necessary to capitalize on violence" to
pass laws compelling psychiatric outpatients to take psychotropic
medication. Soon Jaffe joined forces with Dr. E. Fuller Torrey, a
psychiatrist who shared Jaffe's compulsory medication agenda. Thus was
launched an intensive public relations campaign linking mental illness
with violence. Since then, factoid-laced, sensationalistic articles,
op-eds and television features have appeared with depressing frequency
in the national media. For an example, see "Will
The Damage Be Doubled?"
What's a financially-strapped advocacy movement to do? Advocates'
protests requesting fairness fall on deaf ears at "60 MINUTES," "48
HOURS," "The Washington Post," and other national media. For nearly 20
years the Torrey/Jaffe team, unimpeded, has relied on a scare strategy
to win public support for compulsory medication.
The fact is that there are no violence studies that focus on people
with untreated schizophrenia and bipolar disorders, the Torrey/Jaffe
team's target population. The Treatment Advocacy Center copes with this
problem by lifting phrases out of context from work by others. The
result is self-serving misinformation with respectable citations.
Does this twisted form of advocacy help or harm those it purports to
assist ? Could this be a reason researchers are finding the public to
be less tolerant toward people with psychiatric disabilities and
decreasingly willing to accept housing and community support programs?
See
"Study Finds Fear Tactics Win Public Support for Coercion"
Below are examples of *factoids
circulated by the Treatment
Advocacy Center. They are available online in the archive of the
Anti-Stigma Home Page, http://www.stigmanet.org
The Torrey/Jaffe
team wrongly interpreted conclusions
concerning stigma in the Surgeon
General's Report on Mental Health
(1999). See "Torrey
Twists Meaning of Surgeon General's Report"
The Torrey/Jaffe
team distorted research concerning the
effect of the news media on public opinion. See "Selective
Reporting of News Skews Views"
and "The
Most Important Cause of Stigma?"
The Torrey/Jaffe
team selectively reported violence
estimates (in research based on a study investigating medication
effectiveness) to inflate the result. See Treatment
Advocacy Center Reduces Research on Violence to a Stigmatizing Soundbite
The Torrey/Jaffe
team added incorrect interpretations
to findings of a U.S. Department of Justice report on homicide. See "Just
the Facts, Please!"
The Torrey/Jaffe
team summarized research involving 49
subway pushings and attempted pushings over a 17-year period
(1975-1991). The researchers (Martell & Deitz) chose to gather
data
only on assailants who were psychotic at the time of the offense (20
individuals - 1 of these rejected ). Torrey's 1-sentence summary of
this study is nonsensical:
"Among 20 individuals who pushed or tried to push another person in
front of the subway in New York, all except one was severely mentally
ill and offered motives directly related to their untreated psychotic
symptoms." Who would guess the study found that such pushings occur
once or
twice a
year in a city of (then) 7 million people?
The Torrey/Jaffe
team mislabeled Andrew Goldstein (of
Kendra's Law fame) a "treatment refuser" even after his psychiatric
records proved he had repeatedly tried to get treatment from a
downsizing mental health system. See "More
About Kendra's Law"
Four prominent and
respected research organizations,
The Lewin Group, the U. S. Department of Justice, the National Advisory
Mental Health Council (NIMH), and the MacArthur Foundation on Mental
Health and the Law have confirmed that their work does not support
findings attributed to them by the Torrey team. See "Just
the Facts, Please!" and "Ten
Top Stories of 2007 Continue Fearmongering"
As the Kendra's
Law expiration date draws near (June,
2010), the Torrey/Jaffe team has doubled its earlier 5% estimate of
homicides committed by people with "untreated schizophrenia and bipolor
disorders" to a frightening 10% of all homicides in the U.S. The
doubled (10%) figure, however, misuses research and homicide numbers
from data spanning 1990-2002.
See Dr.
Torrey Doubles Bogus Homicide Estimate
*Editor's note: "A
factoid is a questionable or
spurious
- unverified, incorrect, or fabricated - statement formed and asserted
as a fact but with no veracity. The word appears in the Oxford
English Dictionary as 'something
which becomes accepted as fact,
although it may not be true.' "
Quote
is from Wikipedia, the free
encyclopedia.
MORE
INFORMATION
A FACTOID IN THE MAKING
A quote from Dr. Torrey
In an ABC News interview
last week, Dr. Torrey stated: "The
most recent data would suggest
that about 10 percent of the homicides in the United States are
committed by people who are bipolar or schizophrenia -- when they are
not on medication."
Where's the evidence?
The Treatment Advocacy Center's most recent briefing paper on violence
(updated April 2009) states that Individuals
with severe mental
illnesses are probably responsible for approximately 10 percent of
homicides in the United States.
They cite the following study.
"In Indiana, researchers examined the records of 518 individuals in
prison who had been convicted of homicide between 1990 and 2002. Among
the 518, 53 (or 10.2 percent) had been diagnosed with schizophrenia
(n=27), bipolar disorder (n=12), or other psychotic disorders not
associated with drug abuse (n=14). An additional 42 individuals had
been diagnosed with mania or major depressive disorder. It should be
emphasized that the study included only those who had been sentenced to
prison and did not include those individuals who had committed
homicides and were subsequently found to be incompetent to stand trial
or not guilty by reason of insanity and therefore sent to a psychiatric
facility instead of prison. Thus, the 10.2 percent is an undercount.
The authors also noted that 80 percent of the mentally ill individuals
who committed homicides had received past psychiatric treatment but
that "many of the offenders were not receiving treatment" at the time
of the homicide." Matejkowski JC,
Cullen SW, Solomon PL. Characteristics of persons with severe mental
illness who have been incarcerated for murder. Journal of the American
Academy of Psychiatry and the Law 2008;36:74â€"86
Quoting Dr. Torrey: "In 2007, there were 16,929 homicides in the United
States. If individuals with severe psychiatric disorders were
responsible for only 10 percent of these, that would be approximately
1,690."
What's Wrong With This
Picture? Torrey is either deceptive
or very careless.
In fact, the research shows there were 27 people with schizophrenia and
12 people with bipolar (39 people). There's no information on their
medications status. Torrey's "preventable tragedies" file (2008) showed
that homicides sometimes are committed while the assailant is on meds.
Problem #1:
Torry has included 14 people with "other psychotic disorders" to bring
his total number to 53. He can't do that and then apply the figure to
"untreated people with schizophrenia and bipolar."
Problem #2:
Torrey can't assume that none of the 39 assailants with schizophrenia
and bipolar were on meds. The study confirms this. An analysis I did of
his preventable tragedies showed 1/3 of homicide assailants were on
meds at the
time of the crime. (Also, some years ago in a NYTimes article about
rampage killers, of 24 assailants who were prescribed meds 10 were
taking them at the time of their rampage murders.) If we speculate that
13 of the 39 assailants could have been on meds, then Torrey's estimate
is reduced to 4.4%.
Problem #3:
Torrey uses an outdated figure for total homicides in the U.S, 16,929
(2007). The most recent figure is 14,180 (2008). This lowers his
already unsubstantiated estimate (1,690) committed annually by people
with untreated schizophrenia and bipolar illness
March
12, 2010
-
News of the Week
! DR. TORREY DOUBLES
HIS BOGUS HOMICIDE ESTIMATE !
Dr.
E. Fuller
Torrey's obsession with homicide figures dates back to the 1990s when
the media were quick to accept his unsubstantiated estimate that "1,000
homicides are committed annually" by an unmedicated group of people
with schizophrenia or bipolar illness. Last week, in a startling claim
in an ABC News feature, Torrey raised the estimate to 1,690 annually--
that would be 36 per week every week committed by an extremely small
group of individuals.
Dr. Torrey's new
'discovery' about homicides is clearly
as bogus as his previous guesstimates. The new number (10% of all
homicides!) doubles his earlier estimate (5%), a figure based on six
clippings from the Washington Post and some deceptive tinkering with
research done by others. (Note: authors of the studies have confirmed
that their work does not support Torrey's conclusions.)
Torrey's source of
the 10% figure, which he projects to
1,690 homicides annually, seems even more shakey. Oddly, Torrey's
website file of "Preventable Tragedies" showed only 179 homicides
during the peak year of 2003.
It is alarming
that the most visible, articulate, and
engaging psychiatrist in the business has successfully promoted facts
and figures tailored to suit his narrow agenda of coerced medication.
Continuous repeated references to violence by the Treatment Advocacy
Center can't fail to affect public attitudes. And this is after all the
Torrey/Jaffe team's goal
March
9, 2010 - News of the Week
"SCHIZOPHRENIA" AND THE
UPCOMING DSM-5
Now
is an ideal time,
while
the DSM-5
authors are open to public comment on their new version of the APA's
diagnostic manual, to recommend change to the much-misused diagnostic
term “schizophrenia.” An excellent place to start
is
Phyllis
Vine's “Should
the Term Schizophrenia Be Changed?”
Phyllis tells of a
lively
discussion on the topic last summer among 75 psychiatrists and
psychologists from 25 countries. Of special interest is work being
done outside the United States to find alternatives to a term that
all seemed to agree is deeply stigmatizing. Her article's links and
video clips add useful information.
There
is
no evidence in the APA's Proposed
Revisions that
“schizophrenia” might be replaced. Quite
the
contrary, a list of 16 non-specific labels (e.g. “mood
disorders”)
includes a odd 17th ,
“schizophrenia and other
psychotic
disorders.” Why not just “psychotic
disorders?” Why
include a
term that is universally confusing? Why give it special billing over
every other psychiatric condition?
Schizophrenia
is a popular choice of
people, sometimes even psychiatrists, who rush to judge an assailant
on hearing a news report of violence. Schizophrenia is a term
lawyers sometimes drop when they are concerned about a future
criminal trial. Beyond hope of correction at this point is the
popular misuse of schizophrenia to suggest
“self-contradiction.”
Let
us
hope the confusion surrounding
schizophrenia will be given serious attention before the DSM-5 goes
to press.
February
24, 2010 - News of the Week
IS "SHUTTER ISLAND" A
SOURCE OF TOXIC
STIGMA?
For
thirty
years I've watched the horror-entertainment industry exploit and
distort mental illnesses to titillate their audiences. Shutter
Island, filmmaker Martin
Scorsese's murky new whodunnit, appears to
fit this pattern with Leonardo DiCaprio starring as a delusional
murderer whose therapy is to investigate the crime he committed.
Shutter
Island
is the latest product of a popular trend launched in 1960 by Alfred
Hitchcock's "Psycho." This lucrative genre of films, also known as the
Hollywood psycho-trough, features slasher movies catering to a huge
audience of horror fans and teens. Mental health advocates contend that
these pseudo-psychiatric characters fuel the public's misunderstanding
of clinical terms such as psychosis and schizophrenia, over-emphasize
violence and dangerousness, and erase the distinction between psychotic
and psychopathic disorders.
More
than ever, millions of Americans
are plagued by
the stigma of a psychiatric diagnosis. Studies have found that the
public's fear of mental illnesses has intensified since 1950. Suggested
causes include Hollywood's exploitation, the emptying of psychiatric
hospitals without providing community supports, and a violence-focused
public relations campaign initiated in 1993 by proponents of forced
psychotropic medication.
For
more than thirty years, mental
health advocates
have worked hard to reduce the toxic stigma and discrimination that
plague millions who have psychiatric labels. Unfortunately, the end is
nowhere in sight.
But
all is not doom
and gloom. See the research results of a middle-school education
project described below in the newsletter of a progressive NAMI chapter.
MORE
INFORMATION
New
York Times review of "Shutter Island" by A. O. Scott, February 19, 2010.
"Shutter
Island" plot
and
information posted by Wikipedia
Pathways,
a NAMI Queens/Nassau Newsletter with five excellent stigma-related
articles
February
21, 2010 - News of
the Week
RESEARCHERS
FIND LITTLE DATA CONCERNING ATTITUDES OF PROFESSIONALS
Researchers
Otto Wahl and
Eli
Aroesty-Cohen, University of Hartford, after searching for literature
concerning the attitudes of mental health professionals toward those
they treat, report a serious lack of scientific data on this
important topic. Their findings appear in the Journal
of
Community Psychiatry, Vol. 38 No. 1 (2010), Attitudes
of Mental Health Professionals About Mental Illness: A Review of the
Recent Literature. View Online at http://www3.interscience.wiley.com/cgi-bin/fulltext/123215869/PDFSTART
For
decades, social
scientists have
sought to understand the general public's attitudes toward mental
illnesses. The result is a significant body of research concerning
the public's views of psychiatric disorders; most has been negative.
Little scientific data is available, however, about the attitudes of
mental health professionals. Yet the attitudes of mental health
practitioners are important for good treatment outcomes and good
quality of life for their patients. Further, in their roles as
educators and members of their communities, professionals' views
shape the opinions of future practitioners and other influential
community members. Not least, the growing emphasis on recovery-oriented
psychiatric programs calls for mental health professionals to
understand and adapt if need be to those programs.
Researchers
Wahl and Cohen
focused
their study on how psychiatrists, psychologists, and psychiatric
nurses view and respond to the people they treat. After a
comprehensive worldwide search, the researchers found 19 articles
published since 2003 that met all their criteria for review. These
19 studies, though few in number, show that professionals' attitudes
are a topic of concern around the globe. Coming from Scandinavia,
Australia, Japan, Brazil, the U.S., Switzerland, the U.K., Austria,
Turkey, Italy, and Singapore, the studies reflect unique cultures and
conditions within each country. The researchers note,
Conclusions
about
prevailing attitudes in any one country will need a greater number of
studies from each country than currently exist. For example, the
three studies that employed U.S. samples are hardly sufficient to
draw firm conclusions about the attitudes of U.S. Practitioners.
Overall, Wahl and Cohen's
review of the
existing literature suggests that while psychiatrists, psychologists,
and psychiatric nurses are generally more positive in their attitudes
toward people with psychiatric diagnoses than the general public, the
researchers found negative attitudes present even in studies with
overall positive results.
The
failure to
find consistent positive results for the attitudes of mental health
professionals and the substantial number of mental health
professionals expressing negative views is troubling... It is easy
to see how the negative views expressed by many professionals may
perpetuate stigma and interfere with practitioners' ability to
respond helpfully to their patients' needs or to establish successful
therapeutic relationships. It is easy to see how those negative
attitudes may provide models for continued public negativity related
to mental illness. … At the very least, we may need to
include
more discussion of attitudes about mental illnesses within our
training programs
Worth special attention: Wahl and Cohen provide a useful guide to
the challenges that confront future researchers in a section titled
“Implications and Directions for Future Study.”
They chart
the
pitfalls as well as the fruitful directions needed to advance this
fledgling field of study. Hopefully, the article will inspire
researchers and advocates alike to give the topic its due attention.
Correspondence
to: Otto
Wahl, Department of Psychology, University of Hartford, 200 Bloomfield
Ave., West Hartford, CT 06117. E-mail:owahl@hartford.edu
Article
published:
JOURNAL
OF COMMUNITY PSYCHOLOGY,
Vol. 38, No. 1, 49-62 (2010)
Published
online in Wiley InterScience (www.interscience.wiley.com)
Copyright
2009 Wiley Periodicals, Inc. DOI: 10.1002/jcop.20351
January
17, 2010 - News
of the Week
GOVERNOR
PATERSON, NEW YORK
LEGISLATORS: PLEASE RESTORE HIJACKED MENTAL
HEALTH FUNDS
Unfortunately,
New York never
found the funds to build a promised
community support system for people with psychiatric disabilities. Now
more than ever, the missing community programs are needed.
Advocates' hopes soared in 1994 when the hard-won Community
Mental
Health Reinvestment Act (CMHRA)
was signed by Governor Mario Cuomo.
The CMHRA promised that savings from a massive shutdown of inpatient
psychiatric beds would be used to finance community support programs.
As reported in 2002, this downsizing of the state's psychiatric beds
saved $242 million dollars annually. But most of those savings did not
reach the community mental health system as promised.
The 2002 report states that Governor George E. Pataki, who became
Governor in 1995, transferred a large percentage of the psych center
savings to the state's general fund. The governor reportedly also found
other ways to move mental health funds to his higher priorities. In
another blow to hoped-for progress, the governor let the Community
Reinvestment Act expire in
September 2001 and stonewalled attempts
to revive it.
The severely hobbled system reached meltdown in 1999 when a fatal
encounter between a prematurely-discharged hospital patient and an
aspiring young writer in a Manhattan subway station sent shockwaves
across the state. Albany's leaders responded by quickly passing a new
state law permitting coerced community treatment of 'treatment
refusers' (Kendra's Law).
But the essential community programs were rare in 1999 and are still
rare today.
As for the subway assailant, his futile search for psychiatric
treatment was revealed in a meticulously-documented cover story in the New
York Times Magazine by Michael
Winerip (May 23, 1999). Despite this
revelation, his 'treatment refuser' label lives on in the press.
A scathing report of shortchanged funding and system failure was
released on October 31, 2002 by Assemlyman Martin A. Luster, who was
then the chairman of the State Assembly's mental health committee. It
seems that copies of the report, titled Broken
Promises, Broken
Lives: A Report on the Status of the Mental Health Delivery System New
York State, are in no official
archive.
For a single xeroxed copy of the 49-page Luster report, email
stigmanet@webtv.net Please include a postal mailing address.
We urge Governor Paterson, the Legislature, the media, and the public
to review this still-relevant report.
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