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"Mass media is, far and away, the public's primary source of information about mental illnesses."---Survey of public attitudes, Robert Wood Johnson Foundation


NEWS & LINKS to Battle Bias
Editor: Jean Arnold

National Stigma Clearinghouse, 245 Eighth Ave #213, New York, NY 10011
The National Stigma Clearinghouse is an independent, volunteer, anti-bias project.
Click here for more about the National Stigma Clearinghouse

To find a word, name, or phrase 
First, press
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(together)  or cmd and f (together) on your keyboard.
In the find box that appears, type a word or name, then  scroll down to highlighted locations.  

The 'word find' also works for archives. First, click INDEX link:
NEWS ARCHIVE INDEX (chronological) for years 2002-2010 click item needed)
NEWS ARCHIVE INDEX (chronological) for years 1999-2005 (click item needed)

Stigmatizing Fear Tactics

- Click an item to view.  (Skip down for TOPICS)

NEWS ARCHIVE (chronlogical) INDEX for years 2002-2010 (click item needed)
NEWS ARCHIVE (chronological) INDEX for years 1999-2005 (click item needed)

TOPICS - Click item to view:
Kendra's Law Updates (2006 - Current)
Kendra's Law Controversy 2005
National Criminal Background Check System (NICS)
Archive concerning use of straitjackets to sell products
Stigmatizing Fear Tactics (16 items, a small sample)


April  20, 2015 - News of the Week


Article forwarded by NYAPRS E-News

 NYAPRS Note: Thank you to RECOVER-e Works and their April, 2015 newsletter authors for the two excellent articles below on CBT for people experiencing extreme states and with serious diagnoses.  Link: http://www.coalitionny.org/the_center/recovere-works/RECOVERe-works114-1April2015.html#Jack


CBT for schizophrenia? You don't know Jack.

by Abigail Strubel, MA, LCSW, CASAC


I met Jack in a dual diagnosis/re-entry program for parolees. All had fascinating stories about survival in prison (Got a little tinfoil? You can make a decent grilled cheese sandwich in a holding cell with a radiator). Most were symptomatic, because the policy was to take people off their medication as they neared release and were transferred to special barracks.

Jack told our admission coordinator his voices had advised him to skip intake. However, wary of returning upstate, he endured the appointment and met me. "I think I'll be able to work with you," he said. "You have intelligent eyes."

So did he, along with a glorious James Brown-esque pompadour. Jack was meticulous about his appearance. “Even when I was shooting ten bags of heroin a day, I made sure to shave, bathe, and wear clean clothes.”

"Ten bags a day?" I asked.

"Heroin makes the voices stop," he told me. "Better than any medication I ever tried."

Jack entered my office one day in a funk.

"I went to public assistance, and I know that lady's going to mess up my case," he said. "I could tell by how she looked at me. She made this face"—he pursed his lips and narrowed his eyes—"and the voices started saying, 'She hates you, she's not going to help you—she's going to get you all twisted.'"

"I wasn't there," I responded. "I don't know how she looked at you or what she thought. But there may be another way to interpret her expression—it could have been about something that happened before you even came into her office, or maybe she thought about something going on in her personal life.

"So the way she acted wasn't because of me?" he asked.

"Look," I said. "If you're right and she tries to mess with your case, you know I'll go to bat for you, make sure you get what you need. But it's possible something else was going on."

Jack nodded, then cocked his head to the side, listening. "The voices don't believe you," he said.

"Let me tell you about 'automatic thoughts,'" I said, and explained how almost everyone experiences a barely conscious stream of thoughts throughout the day. Some thoughts are positive, but many are negative. We can train people to become aware of their negative thoughts, and then dispute them.

"Your voices," I said, "are just a louder version of automatic thoughts. They're not real people; they're your own fears and doubts. When a voice says something negative, you can disagree. Ask, 'How likely is it that the welfare lady hated me on sight and wanted to make my life miserable? Could she have been having a bad day, and taking it out on me? If she did try to mess up my case, can my counselor help me straighten it out?'"

Jack thought that over. "You know," he said, "that makes a lot of sense. Because sometimes I can tell the voices are wrong right off the bat."

"And sometimes you might need to think about it a little more," I said, "or discuss it with me."

As treatment progressed, Jack's P/A case was resolved favorably, and he began contesting the negative voices on his own. Ultimately, he became a drug and alcohol counselor. His medications may never eradicate his voices, but now he knows how to dispute them.

Ms. Strubel is a clinical supervisor at Services for the Underserved/Palladia Comprehensive Treatment Institute-Bronx.  

Cognitive Behavior Therapy (CBT) for Recovery: The Cutting Edge

by Elizabeth Saenger, PhD

Aaron Beck et al showed that cognitive therapy can promote clinically meaningful improvements in people with schizophrenia, even if they have significant cognitive impairment. That finding was published in Archives of General Psychiatry (now JAMA Psychiatry), America’s journal of record for the discipline. It surprised clinicians who thought of CBT as a treatment only for patients who were high-functioning.

But that discovery was three years ago. What have CBT researchers done for us lately?

Here are some advances from the last six months.

CBT as an Alternative to Drugs: A Proof-of-concept Study

When it comes to schizophrenia, the British seem to make a habit of upsetting the medical model. First they rejected auditory hallucinations as psychopathology, set up a hearing voices movement, and imported the concept to the US. Now researchers across the pond suggest in The Lancet: Psychiatry, the British journal of record, that CBT might get rid of persecutory delusions.

A small study focused on people with schizophrenia spectrum disorders. All had persecutory delusions, and had not taken antipsychotic drugs for at least six months. Researchers randomly assigned subjects to treatment as usual, or to a package of brief therapy including four CBT sessions focused on the subject’s specific delusions.

The goal of this package was to change people’s reasoning about their delusions. Investigators taught subjects to become more aware of their thinking processes, and to identify and inhibit jumping to conclusions. Researchers also encouraged subjects to be more analytical. These interventions increased subjects’ sense that they might be mistaken about their persecutory beliefs.

The results indicate that people were comfortable with therapy, and the intervention worked. Follow up data collected two months afterwards suggested the model was definitely useful.

Clinicians frequently use CBT as an adjunct to psychopharmacology for delusions, but they rarely use CBT alone. If further research confirms the results of this proof-of-concept study, perhaps people with schizophrenia will have more choices in the future. Given the common, generally unpleasant, side effects of antipsychotic drugs—such as weight gain, metabolic problems, movement disorders, and an increased risk of cardiac death—having a meaningful treatment choice in the journey toward recovery would be most welcome.

Merging CBT with Other Evidence-based Treatments

A recent tendency to mix and match evidence-based therapy has led to instances where CBT has been successfully merged with other psychosocial treatments. Here are three examples.

Social skills training. CBT material, such as that described above, can be presented using social skills training techniques, for example, waving a big flag in group to identify ("flag") beliefs that do not have evidence to support them. This treatment merger helps clients with cognitive and social deficits improve their negative (but not positive) symptoms, and is helpful for clients regardless of the severity of their cognitive impairments. Further, because the treatment is repetitive, new clients can join the group at any point.

Family psychoeducation.  Data strongly show that CBT with family psychoeducation reduces stress, increases medication adherence, and decreases re-hospitalization. Modules are available that teach parents how to use CBT techniques with clients in recovery, and in other areas of their own lives.

Supported employment. CBT can help clients improve coping skills and challenge distorted beliefs about their vocational abilities. CBT is now being melded with supported employment to test the effectiveness of the combination. Preliminary results suggest people who received CBT in addition to supported employment might be more likely to work more hours per week.


March 29, 2015 - News of the Week



Kudos to the Huffington Post's Healthy Living Staff for giving us a concise, doable and user-friendly list of "do's" for talking about a Germanwings airline crash that killed all who were aboard a flight to Dusseldorf on March 24.

"When tragedy strikes, it's a natural human inclination to want an explanation to help get closure for our feelings of anger and loss. When such information is unavailable to us, our grief remains in this limbo of sorts -- or worse, we search for our own answer to help us move forward." 

ARTICLE: "The Way We Talk About Mental Illness After Tragedies Like Germanwings Needs To Change"
The Huffington Post  /  By Healthy Living Staff  
Published 3/27/2015

Media reports erupted today with news that Germanwings co-pilot Andreas Lubitz may have been suffering from depression or another mental illness when he crashed the aircraft in the French Alps, most likely killing 150 people, including himself.

While headlines like U.K. tabloid The Sun's "Madman In Cockpit" are hardly surprising, such sensational links between mental illness and horrific tragedies can have an undesired outcome when it comes to stigma.

Here are five ways to have a more productive conversation about the complex interplay between mental health, violence and tragedies such as this one.

1. Depression doesn't cause violence.

The public's perception of mental illness -- which is largely fueled by movies featuring mentally-ill individuals turned violent and news headlines that thread mental illness into every story about mass killings -- needs a readjustment.

People who are depressed are not likely to be violent. If they were, we'd all be in trouble: One in five of us will experience a serious mental health issue at some point in our lives, but only 3-5 percent of violent acts in the United States are committed by an individual with serious mental illness -- a tiny fraction of the country's violent crimes.

"If we were able to magically cure schizophrenia, bipolar disorder, and major depression, that would be wonderful, but overall violence would go down by only about 4 percent," said Dr. Jeffrey Swanson, an expert on mental health and violence and a professor in psychiatry and behavioral sciences at the Duke University School of Medicine, in a recent interview with Pacific Standard.

What makes this misrepresentation even worse is that individuals who suffer from mental illness are 10 times more likely than the general population to be the victim of violent crime, an under-reported issue that is overlooked in favor of misleading depictions of depression as a violent condition.

2. Suggesting mental illness as the root cause of violence stigmatizes those who live healthy, full lives with conditions like depression.

Approximately one in four U.S. adults in a given year suffer from a diagnosable mental illness, making it highly likely that you know someone who has been affected. However, only 25 percent of people who have mental health symptoms feel that others are understanding toward people with mental illness, according to the CDC. And it's no secret why.

Public diagnoses, such as the discussion surrounding the Germanwings tragedy, plague every single mental illness sufferer. The truth is, the majority of those who have a mental health problem live healthy and complete lives. They are reliable at work and beloved by their families. Yet many people categorize them as "abnormal" because of unsubstantiated scapegoating during these types of tragedies, which can have a real impact: Studies have shown that knowledge, culture and social networks can influence the relationship between stigma and access to care. When people feel stigma, they are less likely to seek the help they need.

The vast majority of people with mental illnesses are law-abiding, responsible and productive citizens.

3. Mental illness disclosure policies can push people further into the closet.

Lubitz was seeking treatment for an undisclosed medical condition that he kept from his employers, alleged the public prosecutor’s office in Dusseldorf, Germany. They didn’t say whether it was a mental or physical condition, but investigators did note that they found a torn-up doctor’s note declaring him unfit for work, reported CNN. Employees in Germany are expected to tell their employers immediately if they can’t work due to an illness, according to Reuters, and that doctor's note would have kept Lubitz grounded and out of the cockpit.

Lubitz had passed special health screenings, including psychological ones, before he was hired on as a co-pilot in 2013, reported ABC News, but unlike in the U.S. airline industry, annual mental health screenings for pilots aren’t a requirement in Germany. Additionally, per Federal Aviation Administration rules, U.S. pilots must disclose all “existing physical and psychological conditions and medications” or face fines of up to $250,000 if they’re found to have delivered false information. That means if he were an American pilot, Lubitz would have been obligated to disclose any and all conditions, as well as the medicines he was taking, in order to remain in good standing at his job. Because of these and other policies, U.S. airline standards are regarded as the strictest and safest around the world (though not without their flaws).

But just because the FAA requires full health disclosure to an FAA-designated Aviation Medical Examiner doesn’t mean that pilots may feel completely safe disclosing their conditions, according to Ron Honberg, director of policy and legal affairs at National Alliance On Mental Illness.

“If a person feels that it’s safe to disclose, and that they’ll have an opportunity to get help -- that there won’t automatically be adverse consequences like being prohibited from ever flying again -- then they’re going to be more likely to disclose [a mental illness],” said Honberg. “But I think historically pilots have known that if they admitted it, they’d never be able to fly again.”

Generally speaking, barring industries where a person may be responsible for public safety (like a pilot or a police officer), one is not obligated to disclose any of this information to his or her employers in the U.S. Just as people don’t have to tell their bosses about diabetes, cardiac disease or HIV diagnoses, employees can’t be forced to discuss their mental health history beyond anything that may interfere with a person’s function at the job, explained Honberg. And employers can’t ask job candidates about their medical records or medical history except to ask about whether something might impact a person’s functional limitation in a job.

“It has to be focused on if they’re capable of doing the job,” said Honberg. “Are there physical or mental health factors that may preclude them from being able to do that?”

The FAA does not track rates of dismissal for pilots who disclose mental illnesses versus other conditions, or the number of pilots who continue to fly after disclosing a mental illness. But until we have all the facts about Lubitz’s situation, it’s important to hold off on any policy changes that might attempt to close up perceived loopholes, he said.

“It’s really important to have all the facts, particularly before we decide on any policies to prevent anything like this from happening again,” said Honberg. “We want to somehow create a proper balance that on the one hand protects public safety and on the other hand encourages people to seek help if needed."

4. The conversation surrounding mental illness and mass violence reveals our ingrained ethnic and racial biases.

Lubitz allegedly committed mass murder and, as many people have pointed out, it is troubling that his acts are ascribed to mental illness when, if he were Muslim or a racial minority, he would likely be assigned a two-dimensional ideological motivation.

Yes, this is a disturbing expression of the dominant culture's racial pathologies, but rather than trying to correct the balance by referring to white mass murderers in an un-nuanced fashion, as some have suggested, perhaps the more productive action would be to view the underlying mental health problems among everyone who carries out mass violence -- regardless of race, religion or country of origin.

Again, most people with mental illness will never be violent, but those who are violent often do have an underlying trauma or condition. "More and more evidence from around the world is suggesting that many of the terrorists wreaking havoc both in America and abroad are racked with emotional and mental trauma themselves," wrote Cord Jefferson in The Nation in 2012:

To be clear, nobody’s saying that all -- or even most -- terrorists aren’t cold, bloodthirsty killers who know exactly what they’re doing every time they commit another heinous act. But there is reason to believe that a significant number of foreign and domestic terrorists are suffering from the exact same mental distresses by which we quickly assume men like James Holmes and boys like Eric Harris and Dylan Klebold, the Columbine killers, to be afflicted.

Indeed, Jefferson went on to note a study of Palestinian men who had signed up to be suicide bombers that found 40 percent showed suicidal tendencies by traditional mental health measures, and recruiters admitted looking for "sad guys" to carry out mass violence.

More generally, the way we view mental health and race has a lasting public health impact: Minority and immigrant communities in the U.S. are dramatically underserved, according to a government report (and corroborated by the American Psychological Association). One major problem, according to the Surgeon General's report, is misdiagnosis or lack of diagnosis due to cultural biases on the part of mental health practitioners.

5. We may never have a diagnosis, and we have to be okay with that.

When tragedy strikes, it's a natural human inclination to want an explanation to help get closure for our feelings of anger and loss. When such information is unavailable to us, our grief remains in this limbo of sorts -- or worse, we search for our own answer to help us move forward.

In a recent article for The New Yorker, Philip Gourevitch aptly explained this phenomenon:

To be told that a scene of mass death is the result of an accident of terrorism is to be given not only an explanation of the cause but also an idea of how to reckon with the consequence -- through justice, or revenge, or measures meant to prevent a recurrence.

According to CNN, a physician did declare Lubitz unfit to work the day of the flight, and instead of sharing that information with Germanwings, Lubitz disposed of the note and boarded the plane. But even in light of such information, it's highly unlikely that we will ever know exactly what was going on in the mind of this pilot, and it is far from our place to speak as though we have a definitive answer.

In the words of Gourevitch, we are left with a sense of "cosmic meaninglessness and bewilderment" when horrific events such as this one occur, and while that is one of the toughest collections of emotions to grapple with, there is no credible alternative in cases like this.

MORE ARTICLES (The Atlantic and The Boston Globe)





March 23, 2015 - News of the Week


NYAPRS Note: Register today for the April 3 BRSS TACS First Fridays with NYAPRS’ own Edye Schwartz, where she will be describing concrete ways to build effective and sustainable peer run organizations. This webinar will be relevant for national groups looking to build peer service options, and for New York agencies exploring partnership with or expansion to peer run organizations. See more information and the registration link below!




Welcome to the March 2015 BRSS TACS monthly update from SAMHSA’s Bringing Recovery Supports to Scale Technical Assistance Center Strategy (BRSS TACS). This month’s update includes: April’s First Fridays with BRSS TACS event, registration information for the next BRSS TACS webinar, new SAMHSA grant opportunities, a virtual learning community on adolescent substance use prevention and treatment, resources about African-American Behavioral Health, and information about how to request technical assistance from BRSS TACS. 




SAMHSA Grant Opportunities Announced


The Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT) is accepting applications for State Adolescent and Transitional Aged Youth Treatment Enhancement and Dissemination Planning [State Youth Treatment - Planning (SYT-P)]. The purpose of SYT-P is to support states, territories, and tribes to develop a comprehensive strategic plan to improve treatment for adolescents (ages 12-18) and/or transitional aged youth (ages 16-25) with substance use disorders and/or co-occurring substance use and mental health disorders. The plan will help strengthen the existing infrastructure system to assure that youth have access to evidence-based assessments and treatment models and recovery services.  

Anticipated Award Amount: Up to $250,000


Application Due date: Monday, April 6, 2015


Click here for more information.


Additionally, CSAT and SAMHSA’s Center for Mental Health Services (CMHS) are accepting applications for the Cooperative Agreements to Benefit Homeless Individuals for States (CABHI-States). The purpose of this program is to enhance or develop the infrastructure of states and their treatment service systems. The program hopes to increase capacity and provide accessible, effective, comprehensive, coordinated/integrated, and evidence-based treatment services; permanent supportive housing; peer supports; and other recovery support services to:

  • Individuals who experience chronic homelessness and have substance use disorders, serious mental illnesses (SMI), or co-occurring mental and substance use disorders; and/or 
  • Veterans who experience homelessness/chronic homelessness and have substance use disorders, SMI, or co-occurring mental and substance use disorders.


Anticipated Award Amount: Up to $250,000


Application Due date: Monday, April 6, 2015


Click here for more information.



First Fridays with BRSS TACS


Friday, April 3, 2015


Building Effective and Sustainable Peer Run Organizations


Register here 



Edye Schwartz, D.S.W., L.C.S.W.R., 


Director of Systems Transformation Initiatives, New York Association for Psychiatric Rehabilitation Services


Click here to learn more about Dr. Schwartz.


Did you miss March’s First Fridays event, “Shared Decision Making: Empowered; Informed; Engaged” with Laurie Curtis?


Click here to review the slides.


Save the Date


The next BRSS TACS webinar, “Motivational Interviewing for Peer Support Workers” is scheduled for Thursday, April 9, 2015 from 2:00-3:30pm ET


Click here to register.


Click here to learn about the presenters.



Screening, Brief Intervention, and Referral to Treatment (SBIRT) Youth Learning Community Webinar


The American Academy of Pediatrics and other organizations recommend SBIRT as part of routine care to prevent or reduce adolescent substance use. This learning community, sponsored by the Institute for Research, Education & Training in Addictions, will focus on implementing SBIRT for youth. It is scheduled for Tuesday, March 31, 2015 from 1:00-2:30pm ET.


Click here for more information.


Click here to register.



Recovery Resource Library Update


This month highlights resources about African American Behavioral Health that have been added to SAMHSA’s Recovery Resources Library. Featured links are listed below:

Click here to find more resources on this topic.

BRSS TACS is dedicated to promoting wide-scale adoption of recovery-oriented supports, services, and systems for people in recovery from substance use and/or mental health conditions. The BRSS TACS team can assist you in your work to promote recovery through free training opportunities, telephone consultations, email resources, peer learning, webcasts, and distance learning. If you are interested in receiving technical assistance please fill out a TA request form and submit it to brsstacs@center4si.com.


Questions or comments about this email? Let us know!


SAMHSA's mission is to reduce the impact of substance abuse and mental illness on America's communities.


1 Choke Cherry Road • Rockville, MD 20857 • 1-877-SAMHSA-7


February 27, 2015 -  News of the Week


See her article: 

Article Source
: New York Daily News, February 26, 2015

Background Note by Briana Gilmore, NYAPRS (New York Association of Prychiatric Rehabilitation Services )

NYAPRS Note: As NYC First Lady increasingly becomes a champion for mental health community members, she promotes solutions to complex problems that the recovery field has worked towards for decades: increased access, local community services, culturally competent and linguistically appropriate providers, and the integration of people with lived experience into treatment. She advocates for an honest public health dialogue around mental health in order to combat stigma. Her passion for mental health awareness may make immeasurable strides in not only the perception of psychiatric diagnoses, but the way people access and receive services. But how else can a public health dialogue combat stigma? How can we as a community get ahead of the negative images perpetuated about us in the media and among our family and friends? How do we change the statewide and national language of mental health, in a time where we are incarcerated, victimized, and criminalized more than any other unique population? Join the conversation and offer your solution on our facebook community here.

How We Will Shatter the Mental Illness Stigma

By Chirlane McCray

‘I’m sorry, but the doctor isn’t taking new patients right now.”  It took me a moment to grasp what the receptionist was telling me. After hours of internet research, innumerable phone calls, and frustrating discussions with some well-meaning but distant professionals, the psychiatrist we had identified as a good fit for Chiara wouldn’t be able to help us.

I hung up the phone and put my head down on the table. My first impulse was to leave it there until the world started making sense again, but there was no time for that. My daughter needed help. Our search had begun weeks earlier, when Chiara, then 18 years old, bravely revealed to Bill and me that she was suffering from anxiety, depression, and addiction.

I felt everything you’d expect a mother to feel: love, sadness, fear and a great deal of uncertainty. Our child was in terrible pain, but because it originated in her brain and not another part of her body, there wasn’t an established series of steps to follow. We had to trust the recommendations of people we didn’t really know and make some major decisions on our own. Our family got lucky. We eventually found the right doctors and program for Chiara, and I’m happy to report that she is kicking butt at recovery.

But even after our crisis ended, I couldn’t forget how scared and helpless I felt during those first frantic weeks. So I continued my research, wanting to understand how other people manage in these situations, especially those who don’t have the same advantages as us.

The more I learned, the harder it was to avoid a troubling conclusion: Our mental health system is broken — and as a result, we are facing a national mental health crisis.

Just look at the numbers. All told, 25% of American adults — one in four — deal with mental illness in a given year. That means it’s pretty much impossible to go through life without you or someone you love being touched by mental illness.Tragically, our system doesn’t even begin to address the problem. A remarkable 61% of New York State adults who need mental health services aren’t getting them. And it’s not just adults who are suffering — 35% of New York’s children also go without the mental health services they need.

The situation is even worse for people of color and those who are living in poverty. Here in New York City, research by our Health Department indicates that African Americans experiencing serious psychological distress are significantly less likely than their white counterparts to have received treatment in the past year — 30% compared to 48%. And numerous studies have found that the stresses of low economic status are often a catalyst for poor mental health.

The first step to solving the crisis is to simply acknowledge that it exists. We must start a real public conversation about mental illness, and we must start connecting people to appropriate services. That is how we will shatter the stigma.

Over the next few months, I will visit New Yorkers in all five boroughs to hear some of the stories behind the troubling statistics. I will meet with teenagers, mothers, people without a home, people in jail, senior citizens and veterans. I am also going to sit down with service providers and advocates. From them, I will learn what is working — and what needs fixing.

The stories I hear will inform the plan the de Blasio administration is developing to build a more inclusive mental health system. This effort will be led by the Mayor’s Fund to Advance New York City, which I oversee as chair; the Department of Health and Mental Hygiene, and the Fund for Public Health.

When I say a “more inclusive” system, I mean one that meets — and treats — people where they live. That addresses the most pervasive and burdensome conditions. That promotes the most effective treatments. That features caregivers who understand the language and culture of the people they serve.

The good news is that the building blocks of this system already exist. I’m thinking about the family resource center that I recently visited in the Bronx, where advocates with experience raising a child with special needs are sharing that hard-won knowledge with their neighbors.

I’m also thinking about all the public servants I’ve met, from line staff to commissioners, who are convinced that there has never been a better time than now to fix a problem that has been building for generations.

And I’m thinking about everyone who helped Chiara regain her equilibrium. She has built a support network that has grown to include not just doctors and therapists, but an entire community of people helping each other walk the long and winding path toward recovery. With their help, Chiara is stronger than ever.

As I said, our family was lucky. But luck should have nothing to do with it. Together, we can create a mental health system that meets the needs of all New Yorkers.


Note: Chirlane McCray is the wife of New York City's Mayor Bill de Blasio

February 19, 2015  - News of the Week


Article Source:  Mad in America ( http://www.madinamerica.com )
Click article:     http://www.madinamerica.com/2015/02/return-asylums-lets-not/


by Susan Rogers

Susan Rogers is director of the National Mental Health Consumers’ Self-Help Clearinghouse, and director of special projects of the Mental Health Association
of Southeastern Pennsylvania. A writer, editor, and advocate, she has been active in the c/s/x movement since 1984.

A recent JAMA opinion piece calling for a return to asylums – not the bad kind, the authors (three Penn bioethicists) insist, but a “safe, modern and humane” kind of asylum – led to a radio debate between co-author Dominic Sisti, associate professor of medical ethics at the University of Pennsylvania, and Joseph Rogers, chief advocacy officer of the Mental Health Association of Southeastern Pennsylvania (MHASP) and executive director of the National Mental Health Consumers’ Self-Help Clearinghouse. The debate, on WHYY’s Voices in the Family, was moderated by the show’s host, Dr. Dan Gottlieb. To listen to the archived program, click here.

Dr. Sisti began by insisting that “we do not want to return to those asylums ... that are now infamous for incarcerating thousands of Americans ... What we were calling for is a rehabilitation of the term ‘asylum’ ... [as] a safe sanctuary where they may be able to heal and reclaim their lives in recovery.” Asked about the reason for the widespread use of chemical restraints, Dr. Sisti responded that it is “a lot easier to maintain control and safety in an overcrowded institution when individuals are chemically controlled. We’re seeing this now in prisons,” where individuals with mental health conditions who are often without access to adequate treatment are “oftentimes given large doses of drugs to keep them both safe and comfortable” (emphasis added).

Throughout the hour-long program, Joseph Rogers was the voice of reason, debunking Dr. Sisti’s arguments. After establishing his credentials – “I’ve been in hospitals; I’ve been in jails; I’ve been homeless; I have a diagnosis of bipolar disorder which at times has left me incapacitated” – Rogers talked about his experience in a state hospital: “When I hear the term ‘asylum’ I get my back up because there was no asylum. These places ... are not safe places ... You were warehoused.”

“We can create alternatives” such as peer-run crisis respites, he continued. This model, he said, “has had wonderful success, even with people with some very difficult challenges.”

Rogers also noted that, although Dr. Sisti is based in Philadelphia, he didn’t talk about the Philadelphia experience, when “we closed down Philadelphia State Hospital and years later they found that those individuals” who had been released from the hospital when it closed were living successfully in the community.

“We know how to do it,” Rogers said. The key is providing for people’s individualized needs. The question, he continued, is whether we have the power politically. It’s a matter of funding community-based, evidence-based programs that we know work for even individuals with the most serious mental health conditions. “And we need to fund them fully and not let them become budget basketball.”

Among those who called in to the program, the most compelling was “Christy,” who said she had recently been released from Norristown State Hospital after six days. “I ended up there for some severe depression. I was forced to take medication against my will; I was disrespected; any time I tried to advocate for myself, I was told to cooperate or threatened with a longer stay,” she recalled. “I thought it was completely unethical. I think it goes to show how few rights you have when you are deemed mentally ill. I don’t think it was set up to help people succeed. Many people were just drugged. I didn’t get any therapy. I repeatedly told them about myself and how meds affect me – and I was forced to take medication. I went in voluntarily and was forced to stay longer. I’m a college-educated person and I tried to advocate for myself and I was not listened to. I’m seeing an outpatient therapist but the experience at Norristown scarred me for life. It was very extreme.”

In response to the moderator’s question about what works and what doesn’t, Rogers responded: “We have to treat people as individuals.” Perhaps referring to the fact that the moderator consistently avoided the use of “people first” language, Rogers said, “We don’t like to label people as ‘the mentally ill’; we talk about people with mental health challenges.”

“What we have found here in Philadelphia,” he continued, “is that we have to really meet the person where they are at.” Referencing some of the individualized outreach efforts in the city, including a street outreach program called ACCESS (operated by MHASP), he said that “we learned early on” that you can’t set up a big community mental health center and put the counselor on the fourth or fifth floor and expect people with serious problems to make an appointment and come to the fourth or fifth floor. “You need to be on the street, to work with people where they are at, to find out exactly what they are concerned about that you can address, and by addressing those issues you gain their trust.” That is how you are able to help a person seek and gain the support they need, he said.

“One thing that doesn’t work is overmedicating people,” Rogers noted. “Many people do much better on small amounts of medication or no medication at all.” Some people’s behavior may be the result of heavy medication, he added.

To the moderator’s question about people who don’t have loved ones who can help them, Rogers responded, “A lot of times family members burn out or aren’t around ... We’ve got to create an artificial family. One of the things peer-run crisis respites do is use peers who have been trained to work one on one with individuals in crisis and provide a homelike environment and prevent hospitalization or going into a jail. You thus prevent further trauma.”

Rogers also talked about Housing First, a program in Philadelphia and elsewhere: “You provide decent, affordable housing for that person and you build the supports around the person based on their needs….You can help the person get involved in the community.”

In response to Dr. Sisti’s continued insistence that institutions can be effective, Rogers countered that with large, congregate living situations, even with 15, 20, or 30 people, “the rights situation is problematic. At 3 in the morning, when there are no advocates around and no chance to make a phone call to an advocate, that’s when the abuses take place. This model of a ‘safe congregate living place’ is not one that is borne out, with years of research into it.”

Rogers emphasized the need for adequate resources, saying that Philadelphia probably needs 3,000 or 4,000 more supported housing units than the city currently has. “That would just address people rotating in and out of hospitals and jails, just in Philadelphia alone, not the whole region.” MHASP is advocating for additional resources with the Pennsylvania state government.

Asked by the moderator to define his dream, Rogers responded that his dream would be to create a massive movement of individuals with lived experience, families, and allies. “That’s the only way we’re going to change things.”

News of the Week - January 8, 2015

This thought-provoking article can be found at   


Explaining Away Empathy - Mental Illness and Reduced Compassion

by Jennifer Gibson, PharmD

Empathy is critical for health care providers. Especially in mental health care, empathy and compassion improve outcomes and enhance overall patient well-being. Thanks to innovative explorations into the way the brain works, mental illness is increasingly defined by biological mechanisms. But, new research claims that these biological explanations lead to less empathy for patients.

A recent trend in mental health has focused on offering biological and genetic mechanisms for mental illness. Experts believed that such explanations would decrease the blame that patients receive for their illnesses since genes, cells, and chemicals are named as culprits. Feelings of compassion should increase for the patients since the illnesses are not their faults, right?



In a series of studies, clinicians expressed less empathy and compassion for patients when symptoms of mental illnesses were explained with biological mechanisms. The authors of a recent analysis indicate that biological explanations do decrease patient blame but, albeit unintentionally, also dehumanize patients. The biological explanations for mental illness seem to enhance the perception that patients are abnormal or deserving of social exclusion. In additional studies, clinicians indicated that they believed psychotherapy would be less effective and medication would be more effective when mental illness was explained by biological mechanisms instead of psychosocial reasons. (Most mental health experts agree that psychotherapy is effective in many mental illnesses, despite the cause of the illnesses.)

Biological explanations also affect the perspectives of the patients themselves. Patients who attribute their conditions to biology are more pessimistic about their prognosis than patients who accept psychosocial explanations for their illnesses.

Many questions still remain about causes, predictive factors, and prognosis of mental illness, and biological features should not be ignored as one piece of the mental health puzzle. The biological conceptualization of many conditions is a significant step toward the safe and effective treatment of mental illness. But, like patients with any other condition – cancer, autism, asthma, or even high blood pressure – patients with mental illness deserve respect and compassion. Treatment for all patients and all diseases should focus on the whole patient and consider biology, psychosocial, and emotional factors.


*Ahn WK, Proctor CC, & Flanagan EH (2009). Mental Health Clinicians’ Beliefs About the Biological, Psychological, and Environmental Bases of Mental Disorders. Cognitive science, 33 (2), 147-182 PMID: 20411158

         *Kvaale EP, Gottdiener WH, & Haslam N (2013). Biogenetic explanations and stigma: a meta-analytic review of associations among laypeople.

Social science & medicine (1982), 96

, 95-103 PMID: 24034956         *Kvaale EP, Haslam N, & Gottdiener WH (2013). The ‘side effects’ of medicalization: a meta-analytic review of how biogenetic explanations affect stigma. Clinical psychology review, 33 (6), 782-94 PMID: 23831861

         *Lebowitz MS, & Ahn WK (2014). Effects of biological explanations for mental disorders on clinicians’ empathy.

Proceedings of the National Academy of Sciences of the United States of America, 111

(50), 17786-90 PMID: 25453068         *Lelorain S, Brédart A, Dolbeault S, & Sultan S (2012). A systematic review of the associations between empathy measures and patient outcomes in cancer care. Psycho-oncology, 21 (12), 1255-64 PMID: 22238060

         *Schlier B, Schmick S, & Lincoln TM (2014). No matter of etiology: biogenetic, psychosocial and vulnerability-stress causal explanations fail to improve attitudes towards schizophrenia. Psychiatry research, 215 (3), 753-9 PMID: 24485063

          *Shashikumar R, Chaudhary R, Ryali VS, Bhat PS, Srivastava K, Prakash J, & Basannar D (2014). Cross sectional assessment of empathy among undergraduates from a medical college.

Medical journal, Armed Forces India, 70

(2), 179-85 PMID: 24843209        *Speerforck S, Schomerus G, Pruess S, & Angermeyer MC (2014). Different biogenetic causal explanations and attitudes towards persons with major depression, schizophrenia and alcohol dependence: is the concept of a chemical imbalance beneficial?

Journal of affective disorders, 168

, 224-8 PMID: 25064807


Here's another article describing how the current emphasis on biological aspects of mental illnesses affects the way diagnosed individuals are viewed and treated: "Downside of Treating Mental Illness Like A Physical Problem" by Lindsay Holmes, Huffington Post, December 1, 2014


December 18, 2014 - News of the Week

CORRECTION added by Jean Arnold on December 20-21, 2014

When I posted this item on Dec. 18, I assumed,
mistakenly, that DJ Jaffe meant SAMHSA when
he told a NAMI audience, "
The federal government
spends $130 billion mental health dollars, much
on improving the lives of all Americans."  ja

Mr. Jaffe was NOT referring to SAMHSA's budget ($3 to $4 billion dollars)
My mistaken assumption has been deleted.


Does SAMHSA's mental health budget favor people with minor needs?

Does the term "mental health" exclude individuals with "serious mental illness" ?

These questions and more have led psychiatrist Allen Frances to suggest there is a civil war among mental health advocates. In an ongoing dialogue with Mad in America's Robert Whitaker, Dr. Frances seems to be siding with those who say SAMHSA, the federal oversight agency for substance abuse and mental health programs, has neglected the seriously mentally ill. Frances also appears to have joined forced meds advocates such as the Treatment Advocacy Center in Arlington VA. and D. J. Jaffe, an activist who in 2011 founded the Mental Illness Policy Org, an offshoot of the Treatment Advocacy Center.
SAMHSA's annual budget stays close to $3.6 billion. Two-thirds of the SAMHSA budget is spent on substance abuse, one-third is spent on mental health. Eighty percent of SAMHSA's Center for Mental Health Services budget targets individuals with serious mental illnesses. ( Note: SAMHSA is the nation's Substance Abuse/ Mental Health Services Administration. SAMHSA's budget for 2014 and its budget request for 2015 are posted online at http://www.samhsa.gov/budget

Mr. Jaffe faults SAMHSA's use of the term "mental heath," claiming that it excludes people diagnosed with serious mental illnesses. To the contrary, SAMHSA encourages experienced former inpatients diagnosed with serious mental illnesses to join efforts to avoid the egregious mistakes of the past. Ex-inpatients are likely to know best what can reduce an escalation of symptoms.  Efforts to intervene early with user-friendly recovery-oriented methods are rightly included on SAMHSA's list of goals.

Polarized advocates are bound to disagree about words. Some people use "assisted" for what others call "compulsory," or "treatment" when "medication" is the mandatory treatment. Despite their differences, most members of the mental health constituency agree on similar goals but have opposing ideas about reaching them. The choice of words reflects their differences. 

October 18, 2014 - News of the Week


San Francisco Honors Psychiatric Survivor Carmen Lee

Vivid accounts tell us how Winston Churchill and Abraham Lincoln battled disabling depression even as they made history. But before the general public can truly empathize with people who have psychiatric vulnerabilities, we need people of our own time and environment to tell us what they experience.

Today's easy access to videos and social media allows the public unprecedented views of how mental illnesses affect a life. Every story is unique. A recent example comes from Carmen Lee, a Californian whose suicide attempts in her early 20s prefaced 20 years of hospitalizations. In a remarkable 6-minute video on Facebook, "No Longer Pretending ....."  (https://vimeo.com/105064330)  Lee explains the essence of her survival.  Put most simply, Lee used her positive energy to refute the stereotypes that misrepresent the mental health community, thereby aiding progress toward social justice.  This public awareness gem  (a discussion ice-breaker) captures Lee's transition from 20 years of hospitalizations to 28 years of tireless community outreach...and still counting.

In 1985 Carmen Lee began the Peninsula Network of Mental Health Clients, and in 1990 she developed the Stamp Out Stigma program (SOS) (www.stampoutstigma.net). Traveling throughout the bay area and beyond, SOS teams have delivered over 2,600 presentations to organizations and agencies of every description, having directly reached well over 500,000 people and many more by ripple effect. Lee's advocacy includes participation in statewide planning forums.

Carmen Lee's video premiered on September 25th for a large crowd in San Francisco's new Levi Stadium, home of the 49ers. It was a gala event honoring mental health activism and educational outreach in Northern California and beyond. The event was sponsored by Caminar, a San Francisco Bay Area mental health agency that helped Carmen Lee recognize her strengths and encouraged her work.

October 1, 2014 - News of the Week


The 28th annual national conference organized by and for individuals with psychiatric histories will be held on October 22-26 at the Caribe Royale Hotel in Orlando, Florida.  This annual event has been a prime catalyst in the building of an active and effective movement for social justice for people with psychiatric labels.
Register now!  Below are links to more information, speakers list,  and registration forms.

Article: Mad in America  (http://www.madinamerica.com/2014/09/alternatives-conference-helps-movement-grow ) :  The Alternatives Conference Helps Our Movement Grow, by Susan Rogers.

Registration forms:  http://alternatives2014.mhasp.org/registration

Speakers: http://alternatives2014.mhasp.org/plenary-session-speakers

August 11, 2014 - News of the Week


Popular misperceptions must be replaced with facts

A new study by an international team of leading researchers suggests that an infusion of evidence-based data could jump-start a reduction in U.S. gun violence.  The study focuses on gun assaults involving suicide and people with behavioral disorders.  It proposes that effective, fair, and feasible policies can be applied to the tiny portion of the U.S. population where gun violence and mental illness intersect.  Forbes correspondent Todd Essig describes the research as a "comprehensive, critical survey of the available data ... that pulls together the facts we need to consider if we really want to adopt evidence-based policies to reduce random gun violence."

An introduction (excerpt below) explains how misconceptions have complicated the policymaking process.  The full article is FREE ONLINE, click here.

The massacre of schoolchildren in Newtown, Connecticut, in late 2012 stirred a wrenching national conversation at the intersection of guns, mental illness, safety, and civil rights.  In the glare of sustained media attention and heightened public concern over mass shootings, it seemed that policymakers had a rare window of opportunity to enact meaningful reforms to reduce gun violence in America.  And yet, the precise course of action was far from clear; competing ideas about the nature and causes of the problem -- and thus, what to do about it -- collided in the public square.

On the one side, public health experts focused on the broader complex problem of firearms-related injury and mortality in the United States, where each year approximately 32,000 people are killed with guns -- about 19,000 of them by their own hand -- and another 34,000 are injured in nonfatal gunshot incidents.  more...   


Title:  Mental illness and reduction of gun violence and suicide: bringing epidemiologic research into policy   (Article in Press)

Jeffrey W. Swanson, Duke University
E. Elizabeth McGinty, Johns Hopkins University
Seena Fazel, University of Oxford UK
Vickie M. Mays, Univerity of California at Los Angeles

July 15, 2014 - News of the Week


Article Source: The Independent, July 15, 2014  http://www.independent.co.uk

For article and a video, click title:
SCHIZOPHRENIA: the most misunderstood mental illness?

By Rachel Hobbs

"While mental health stigma is decreasing overall ... people
with schizophrenia are still feared and demonised."

Earlier this year Jonny Benjamin set up a nationwide search to #findmike, the stranger who
talked him out of taking his own life on Waterloo bridge. People told him he ‘didn’t look like a
schizophrenic’ - so what do people imagine?

Let’s face it, when most people think about schizophrenia, those thoughts don’t tend to be
overly positive. That’s not just a hunch. When my charity, Rethink Mental Illness, googled
the phrase ‘schizophrenics should...’ when researching a potential campaign, we were so
distressed by the results, we decided to drop the idea completely. I won’t go into details,
but what we found confirmed our worst suspicions.

Schizophrenia affects over 220,000 people in England and is possibly the most stigmatised
and misunderstood of all mental illnesses. While mental health stigma is decreasing overall,
thanks in large part to the Time to Change anti-stigma campaign which we run with Mind,
people with schizophrenia are still feared and demonised.

Over 60 per cent of people with mental health problems say the stigma and discrimination
they face is so bad, that it’s worse than the symptoms of the illness itself. Stigma ruins lives.
It means people end up suffering alone, afraid to tell friends, family and colleagues about
what they’re going through. This silence encourages feelings of shame and can ultimately
deter people from getting help.

Someone who knows first hand how damaging this stigma can be is 33 year-old Erica
Camus*, who was sacked from her job as a university lecturer, after her bosses found out
about her schizophrenia diagnosis, which she’d kept hidden from them.

Erica was completely stunned. “It was an awful feeling. The dean said that if I’d been open
about my illness at the start, I’d have still got the job. But I don’t believe him. To me, it was
blatant discrimination.”

She says that since then, she’s become even more cautious about being open. “I’ve
discussed it with lots of people who’re in a similar position, but I still don’t know what the
best way is. My strategy now is to avoid telling people unless it’s comes up, although it can
be very hard to keep under wraps.”

Dr Joseph Hayes, Clinical fellow in Psychiatry at UCL says negative perceptions of
schizophrenia can have a direct impact on patients. “Some people definitely do internalise
the shame associated with it. For someone already suffering from paranoia, to feel that
people around you perceive you as strange or dangerous can compound things.
“I think part of the problem is that most people who have never experienced psychosis, find
it hard to imagine what it’s like. Most of us can relate to depression and anxiety, but a lot of
us struggle to empathise with people affected by schizophrenia.”

Another problem is that when schizophrenia is mentioned in the media or portrayed on
screen, it’s almost always linked to violence. We see press headlines about ‘schizo’ murderers
and fictional characters in film or on TV are often no better. Too often, characters with
mental illness are the sinister baddies waiting in the shadows, they’re the ones you’re
supposed to be frightened of, not empathise with. This is particularly worrying in light of
research by Time to Change, which found that people develop their understanding of mental
illness from films, more than any other type of media.

These skewed representations of mental illness have created a false association between
schizophrenia and violence in the public imagination. In reality, violence is not a symptom of
the illness and those affected are much more likely to be the victim of a crime than the

We never hear from the silent majority, who are quietly getting on with their lives and pose
no threat to anyone. We also never hear about people who are able to manage their
symptoms and live normal and happy lives.

That’s why working on the Finding Mike campaign, in which mental health campaigner Jonny
Benjamin set up a nationwide search to find the stranger who talked him out of taking his
own life on Waterloo bridge, was such an incredible experience. Jonny, who has
schizophrenia, wanted to thank the man who had saved him and tell him how much his life
had changed for the better since that day.

The search captured the public imagination in a way we never could have predicted. Soon
#Findmike was trending all over the world and Jonny was making headlines. For me, the best
thing about it was seeing a media story about someone with schizophrenia that wasn’t linked
to violence and contained a message of hope and recovery. Jonny is living proof that things
can get better, no matter how bleak they may seem. This is all too rare.

LINK   http://www.independent.co.uk/life-style/health-and-families/features/schizophrenia-the-most-misunderstood-mental-illness-9546654.html

June 15, 2014 - News of the Week


In September of last year, 60 Minutes infuriated many viewers by portraying people with schizophrenia and similar conditions as individuals at high risk of committing violence. Viewers deluged CBS with angry protests.

On Sunday, June 8, the feature, "Imminent Danger" was aired for the second time. Clearly, 60 Minutes showed bias by repeating a one-sided feature that was full of inaccuracies.

Following the September broadcast, the Bazelon Center for Mental Health Law outlined the viewers' objections and pointed out the segment's inaccuracies in a letter to CBS (for the full letter skip down to More Information)

Excerpt: "Imminent Danger" portrays individuals diagnosed with schizophrenia as people with hopeless futures whose primary life options are hospitalization, homelessness, or incarceration.  The segment provides no indication that individuals with schizophrenia can and do live fulfilling lives, start their own families, work, live independently, and participate fully in their communities.  Instead, such individuals are painted as consigned to a life of misery and as ticking time bombs with the potential to become violent at any time." 

"Imminent Danger" was hosted by Steve Croft and featured Dr. E. Fuller Torrey, the nation's leading proponent of compulsory antipsychotic medication and preventive hospital commitment.  Both men showed a strong commitment to coercive treatment, and both were willing to distort facts to win public support for  regressive practices.  As one angry viewer wrote,

"It's time to get another 'reporter' to do some real investigation and offer a balanced story rather than what seems like a personal mission by Mr. Croft to further disenfranchise people who have received psychiatric diagnoses.  Ten years ago in October 2002 and June 2003, Mr. Croft did a story called "Armed and Dangerous" that, like this segment, relied mostly on the singular opinion of Dr. Torrey ... he's obviously not done any more real research in the past decade as this piece is as uninformed, biased and journalistically irresponsible as the last one... "

Steve Croft's flowery introduction made clear that Dr. Torrey had determined the program's direction.  Dr. Torrey and Dr. Jeffrey Lieberman, leading proponents of compulsory antipsychotic medication, used the time to convince viewers that meds, forced if necessary, will end "preventable tragedies." 

Oddly, Dr. Torrey's collection of well over 3,000 "Preventable Tragedies" holds some surprises.  After downloading the collection's homicide summaries years ago, the National Stigma Clearinghouse found that medication failed to deter homicide in many cases.  Further, a New York Times series analyzing 50 years of mass murders (April 2000) reported that among the 24 slayers who had been prescribed medication, nearly half (10) were taking medication at the time of their rampage.

And regarding violence, Dr. Torrey's guesstimates have media appeal, but more to the point are figures from authoritative sources.  Schizophrenia affects just over 1% of the adult population (National Institute of Mental Health-NIMH) and of these people, 99.97% of them will not be convicted of serious violence in a given year (Walsh et.al. 2002. "Violence and Schizphrenia: Examining the Evidence," British Journal of Psychiatry, 180: page 494)

"Imminent Danger's" lack of balance is easily confirmed in its online transcript.  The over-emphasis on schizophrenia was particularly misleading.

An insightful observation was made by Tom Dart, the Cook County Sheriff, after he described the petty offenses of most incarcerated mentally ill inmates:

"This is a population that people don't care about and so as a result of that there are not the resources out there for them."

What effect has Dr. Torrey's 20-year over-emphasis on violence had on public opinion?


A Plea to Mainstream Media

The Case Against Schizophrenia

(Time to relinquish the diagnosis of schizophrenia)

For still more information, read a New York Times 4-part series on "Rampage Killers" (link is below)

April 9, 2000 News of the Week

"Rampage Killers Chart a Well-marked Course to Their Unraveling"

A New York Times 4-part series on "Rampage Killers," launched on Sunday, April 9, attempts to replace opinions and hype with what is actually known about multiple murderers. After scouring 50 years of records, the Times investigators found 102 rampage killers and 425 victims of mass homicide. (Military style weapons had not become commonplace.)

The first article of the Times series is crammed with food for thought. It provokes several quick observations.
  • Contrary to the popular assumption that mass murders are the work of people with mental illness, of the 102 "rampage killers" recorded over a span of 50 years, only 25 were diagnosed with mental illness before the murderous incident; another 23 were diagnosed in hindsight. (Troubling questions about mis-diagnosed schizophrenia in earlier decades will perhaps be examined later in the series.)

  • Of the 102 "rampage killers," 24 were individuals who had been prescribed medication for a mental illness. Only 14 of these were not taking their prescribed meds. The fact that 10 out of the 24 diagnosed mentally ill "rampage killers" were taking their medication surely calls into question any quick-fix solutions based on medication.

  • Easy access to rapid-fire assault weapons is the underlying factor in mass murders. The focus on mentally ill assailants, though not irrelevant, does not warrant finger-pointing and the creation of new laws specifically directed at them.

  • People who commit mass murders are always caught, says the Times, mainly because they want to be. They signal their intent in many ways before acting. This series may well heighten public interest in recognizing the precursors of violence.

    The Times series is well worth saving for study. Click www.nytimes.com/library/national/040900rampage-killers.html 


    May 2, 2014 - News of the Week


    Recent articles and briefing papers by supporters of forced treatment assume that patients who refuse psychiatric treatment do so because of  structural brain abnormalities that block awareness. They say nearly 50 percent of people with schizophrenia and bipolar disorder require forced anti-psychotic medication to combat the assumed cause of treatment refusal.  Although the faulty brain lesions have not been found and their response to anti-psychotic medication is unknown, supporters expect these hurdles to be cleared by advanced brain imaging techniques within a few  years.
    A thought-provoking article below addresses the "lack of insight" concept and approaches to treatment.  This analysis is a valuable resource for understanding the variety of ways to view "lack of insight.".  With pressure building for a major expansion of forced meds, an informed public is crucial..


    by Larry Davidson, Ph.D.
    Yale University School of Medicine
    The Issue of Insight
    February 6, 2012

    But what about people who won't accept having a mental illness?

    How can a person recover if he or she won't even acknowledge being ill?

    How is recovery relevant for people who say there is nothing wrong with them?

    But what about people who won't accept any treatment, who deny they need any help? How does recovery-oriented care apply to them?

    These questions—and others like them—are frequently posed by frustrated practitioners and distressed family members trying to assist people who appear not to want help. One concern, or assumption, about these questions is that they point to a key limitation of the recovery paradigm, implying recovery and recovery-oriented practices are only for people who readily acknowledge having a mental illness. After all, how can a person be "in recovery" if he or she has nothing to recover from? One of the major differences between mental illnesses and other medical conditions is the issue of insight. People with diabetes know they have diabetes; people with asthma know they have asthma, etc., but some will argue that most people with serious mental illnesses (or at least those with schizophrenia) lack insight into having the illness. Therefore, they will not participate in the treatments needed to manage their conditions. Such perceptions lead some people to argue that coercion and involuntary treatments are necessary, at least for those who refuse any or all treatments. The lack of insight also poses a major challenge to person-centered care planning and recovery-oriented practice, if both presume the person will take responsibility for driving his or her own care and overall recovery process. Is not insight, therefore, required for recovery?

    While it may sound contradictory at this point, I intend to show in the following two sections not only that recovery-oriented practice is possible for people who appear to lack insight, but that it may also be precisely these people who most need recovery-oriented care. (Click for full article)


    February 24, 2014 - News of the Week


    Visit http://www.madnessnetworknews.com
    to view samples of the MNN archive, and more...

    Madness Network News (1972-1986) began as an open forum for young people people facing the social isolation that comes with a psychiatric label.  Happily, these historic quarterly publications have now been re-issued in two formats: seven hard copy books averaging 170 pages each and 45 digital e-books.  Each decades-old issue of MNN teems with personal experiences, commentary, poems, letters, cartoons, photos, and calls for action -- resulting in a kaleidoscope of artwork, emotion, and observation. 

    A recurring theme throughout the 45 issues is angry protest against dehumanizing psychiatric practices and the loss of civil rights. Today, those grievances are legitimized by experts such as journalist/activist Robert Whitaker (www.madinamerica.com) and Dr. Thomas Insel, Director of the National Institute of Mental Health (Q & A: Dr. Insel and Dr. Suzanne Koven, The Boston Globe, 12/16/2013), to name just two of many critics of current psychiatric practices. 

    In the summer of 2013, two determined long-time activists, David Gonzalez (Brooklyn NY) and Ron Schraiber (Los Angeles CA), received the support and approval from MNN's co-founder, Leonard Roy Frank, to reprint the complete set of original issues.  Working from home due to medical problems, David first re-sized the original 11"x17" newsletter format to 8.5"x 11", then assembled the complete collection of 45 issues into seven handsome soft-cover 8.5"x 11" books.  Each of these, on average, contains approximately 170 pages of resized original material (6 MNN issues) except for Volume 1, which combines MNN's first and its final issues (9 issues).   

    To further enhance access, David then turned each of MNN's 45 issues into a high-quality e-book.  Plans for distribution of the seven hard copy volumes and the digitized e-books are undeway. 

    Suggestions are welcome!  Please visit http://www.madnessnetworkinews.com , click "Misc."  and scroll to the "Questions and/or Comments" box.

    The project's two sponsors hope to recover the considerable expense of preserving this unique moment in cultural history.  Please visit http://www.madnessnetworknews.com for more information about how to purchase all, or parts of the Madness Network News archive.


    January 18, 2014 - News of the Week


    Dr. E. Fuller Torrey's latest book. "American Psychosis," begins by describing the events, shortsighted decisions, and inertia that led to the present quagmire we call the nation's mental health system.  The book's main message, however, promotes Dr. Torrey's solution: more psychiatric hospitals and court-ordered medication. This is Torrey's mantra.  What's galling is his continuing reliance on lurid stories to win public support for his controversial - many say regressive - agenda.  A book review by Richard A. Friedman, M.D. notes that Dr. Torrey "does not shy away from recounting one horror story after another."

    National Stigma Clearinghouse files show that for at least twenty years, Dr. Torrey has relied on the fear of violence to win new laws forcing psychiatric treatment.  In 1994, D.J. Jaffe, an advertising executive and Torrey supporter, wrote: "From a marketing perspective, it may be necessary to capitalize on the fear of violence to get the law passed."  This was not a passing comment.  Five years later, Mr. Jaffe advised a national NAMI audience, "Laws change for a single reason, in reaction to highly publicized incidents of violence."  And later that year, 1999, the passage of NY's Kendra's Law proved Jaffe right.  (It didn't matter that Kendra Webdale's assailant was the opposite of a 'treatment refuser', a label he carries to this day as he serves his prison term).

    Just as disturbing is the Torrey/Jaffe team's "ends justify the means" approach.  After advising his NAMI audience to use violence to attain their goals, Jaffe added, "I am not saying it is right, I am saying this is the reality."  The media welcomed the Torrey/Jaffe team's sensational approach, and from the 1990s onward,  Dr.Torrey enjoyed a lion's share of media coverage concerning mental illnesses.  The consequences?

    Blame for the nation's horrific amount of gun violence now falls on a minority with little means of defense. Injustice against innocent people is condoned.  And many who need help are afraid to ask for it.

    A tragic example:  "Dad! Dad! Learning from the Kelly Thomas Tragedy" 


    Source: NYAPRS (New York Association for Psychiatric Rehabilitation Services)

    An Orange County California jury’s acquittal last week of Fullerton police officers charged with causing the brutal death of Kelly Thomas, a homeless man with a mental health history, has set off a national uproar amongst human rights and mental health advocates.  In the wake of the court’s action, the County DA’s courage to prosecute the case has been cited and the FBI has opened an investigation to see if Thomas’ civil rights were violated.

    Kelly Thomas had struggled for years with mental health issues and homelessness. His pointless, tragic death has devastated his family, community, and the national and international mental health community. His death also brings attention to the misconception that people with a psychiatric diagnosis are violent, whereas evidence shows that they are far more likely to be the victims of violence than the perpetrators of it.

    Sunday’s 7 pm Albany vigil has been getting a lot of national attention and support as advocates from around the country call for justice and accountability of our law enforcement to the rights and protection of each and every citizen.  (Vigil Announcement:  Mental health and human rights advocates gather to grieve and decry police killing, First Unitarian Church, Albany, NY, 7:00 pm, Sunday, January 18, 2014)

    Relevant Links:



    January 11, 2014 - News of the Week



    NYTimes columnist David Brooks recently expressed misgivings concerning recreational marijuana use, based on his own experiences.  A displeased pro-marijuana advocate, Joe Dolce, was quick to counter Mr. Brooks online.  For his takedown, Mr. Dolce interviewed Dr. Lester Grinspoon, a well-known longtime promoter of smoking cannabis.  The interview gives an enticing glimpse of Dr. Grinspoon's idyllic view of marijuana, while dissing David Brooks as uninformed.  

    May I suggest a bit of balance.

    While there is little conclusive research on pot's hazards, many studies done over the past decade, mostly in the UK and Europe, have found brain changes among young users.  Findings from British researchers ten years ago are now being confirmed by studies in the US.  CBS News "Marijuana use linked to schizoprenia risk in teens" 

    A quote in 2008 from the UK's Guardian indicated pot's harmful potential.  "Last year, a review of all the studies to date, published in The Lancet, was able to assert that even having tried cannabis once can be shown to increase the risk of developing schizophrenia.  And it is estimated by Murray [Robin Murray, a British researcher] that at least 10 percent of all people with schizophrenia in the UK would not have developed the illness had they not smoked cannabis."   "My brother's first joint and his descent into a mental war zone"

    Many families with a 'seriously mentally ill' family member will attest that pot-smoking has led to family tragedies.  Last week, a NYTimes editorial stated that "Roughly 36 percent of 12th graders reported having used marijuana in 2013." "The Marijuana Experiment," NYTimes 1/3/2014


    "Smoking Pot Doubles Mental Illness Risk" (Christchrch New Zealand

    "Marijuana linked to brain-related memory woes, schizophrenia risk in teens" (CBS News)

    "The Marijuana Experiment" (New York Times editorial)

    "Continued Cannabis Use and Risk of Incidence...10 Year Follow-Up Cohort Study" (Medscape signup needed)


    December 15, 2013 - News of the Week


    A proposed Congressional Bill is described as helping families in mental health crisis.  Unfortunately, the bill includes onerous provisions that would halt effective wellness programs designed by patients and ex-patients.  This alarming Bill would "slash funding for recovery oriented services--including peer-run services and family supports--in exchange for regressive and involuntary treatment" (NYAPRS).   Further, it would "restructure federal funding to heavily encourage the use of force and coercion..." (NDRN).   
             (NYAPRS, New York Association for Psychiatric Rehabilitation Services;  NDRN, National Disability Rights Network)

    The "Helping Families in Mental Health Crisis Act" was introduced on December 12 by Rep.Tim Murphy of Pennsylvania. 

    Read the following links and learn more about this threat to progress.

    By David Sherfinski, The Washington Times, 12/12/13

    Alert: Urge Congress to Protect SAMHSA and Consumer Programs!

    NYAPRS News: This comes from the National Coalition for Mental Health Recovery, an organization that NYAPRS supports. We urge you to contact your representatives to demand that budget cuts do not impact mental health recovery services that keep people engaged and working toward their well-being. Along with the Congressional deal to tighten the budget and restrict mental health spending, an act submitted by Representative Tim Murphy would favor involuntary services and reduce funding for rehabilitation services, including peers and family support. Contact your representative today, sign the petition at change.org, and get on the NCMHR action list!

     SAMHSA Grants for State Networks, The Alternatives Conference and  the 5 Mental Health Technical Assistance Centers Are At Risk!


    YOU can help.

    Educate your Senators and your Representative about these vital programs.

    They need to hear from YOU now.

    Here’s why:

    Budget negotiators in Congress just reached a deal that squeezes dollars for all health funding including mental health. Most members of Congress don’t know about the life-saving work and value of state mental health consumer networks and national TA centers.  It is up to you to educate them.

    Yesterday, Representative Tim Murphy of Pennsylvania released a mental health bill that—among many other disturbing changes-- would reorganize SAMHSA and end funding for state networks, the Alternatives conference and technical assistance centers.

    What to do now:

    Right now, send emails and make phone calls to you members of the House and Senate appropriations committees telling them why they should protect funding for state mental health networks, the Alternatives conference and the five mental health technical assistance centers and how important they have been in your life, the life of people you love and for citizens of your state.  (See How to do it below and the attached document on what to say).

    NextSign our petition on Change.org:  Go to http://ncmhr.org and look for the Action Alert with a link to the petition and more background.

    Stay tuned for instructions on how counter Tim Murphy’s bill that you will be receiving in a few days.

     How to do it:

    1.     FIND your U.S. Senators at  http://www.opencongress.org/people/zipcodelookup.  Click the name of each Senator, scroll down to “ Contact Webform” to send them an email. Before sending, copy and save your message. Request a reply.  You can also call their office and leave a message.

    2.     The attached document includes a list of Senators and Congressmen on Appropriations Committees. If they represent you it’s doubly important to educate them.  If your Senators/Congressman is not on this list, don’t worry--It’s still vital that contact them.

    3.     TELL your Senators to RESTORE the 20 percent cut in funding for  SAMHSA grants for statewide mental health consumer networks that the Senate Appropriations Committee agreed to.  ASK them to resist any further cuts. TELL them these grants, which total just $2.5 million now, teach people with serious mental health conditions to stay well and recover. TELL them how YOUR state network (and the local peer-run centers it supports) have changed your life as a person with a serious mental health condition and how you now help others. If your state doesn’t have a mental health consumer network yet tell them you need one.

    4.     TELL your member of the House of Representatives to fully fund SAMHSA grants for statewide mental health consumer networks, mental health technical assistance centers, the Alternatives conference, and protection and advocacy programs.  TELL them state network grants, which total just $2.5 million now, teach people with serious mental health conditions to stay well and recover. TELL them how YOUR state network (and the local peer-run centers it supports) have changed your life as a person with a serious mental health condition and how you now help others. If your state doesn’t have a mental health consumer network yet tell them you need one.

    5.     If your representative is listed on the attached document, it is doubly important that they hear from you.

    6.     Email 
    raymond.bridge@ncmhr to get on our action list. Like us on Facebook (National Coalition for Mental Health Recovery)   Find us at http:ncmhr.org -

    Note from Jean Arnold: I regret that the lists (referred to above) of  Congressional Committee members did not transfer to this


    November 20,  2013 - News of the Week

    Tanya M. Luhrmann's opinion piece "The Violence in Our Heads" (NYTimes, 9/19/13) is a thought-provoking discussion of the effects of culture on auditory hallucinations.  Deserving wide attention is her description of intriguing and effective ways to relieve distressing symptoms of psychosis.   For example, the 'hearing voices' movement in Europe has discovered ways to alleviate voices that "flies in the face of much clinical practice in the United States."  Luhrmann's piece begins, however, with two troubling assumptions: (1) that people who hear voices have schizophrenia, and (2) that schizophrenia carries a risk of violence "significantly greater than it is in the broader population."  

    Professor Luhrmann, an anthropologist at Stanford University, begins by speculating about recent mass murderers, Adam Lanza and Aaron Alexis.  (Neither, to my knowledge, has been given a professional diagnosis.)  She suggests that these assailants were fueled by tormenting 'voices' and concludes that they were suffering from schizophrenia. 

    But auditory hallucinations occur in conditions other than schizophrenia.  Several readers' comments posted by clinicians explain that 'voices' are not confined to schizophrenia. Their lists include bipolar disorder, psychotic depression, PTSD, seizure disorders, brain tumors, hallucinogenic drugs, multiple personality disorder...and one clinician wrote that 'voices' occur most often during manic episodes with psychotic symptoms.

    Further, 'schizophrenia' is not a descriptive diagnosis like 'depression' or 'chronic lymphocyctic leukemia'.  The public's perception depends largely on context.  For years, schizophrenia's violent image has been shaped by sensationalist images in the media, and by advocates who have promoted a forced-medication agenda by fanning public fear.  Few people know that violence rates for people diagnosed with schizophrenia (minus complications) are similar to, or lower than violence rates for the general population.  Schizophrenia affects 1% of the population (NIMH) and of this one percent, 99.97% will not be convicted of serious violence in a given year (Walsh et.al. 2002 and Wallace et.al, 1998).

    Balanced portrayals of schizophrenia are rare; help from authoritative spokespeople is badly needed.

    NIMH (National Institute of Mental Health), "Schizophrenia, 12-month prevalence," website (2013)
    Wallace et al. "Serious criminal offending and mental disorder," British Journal of Psychiatry, 172, 477-484. (1998)
    Walsh et al. "Violence and schizophrenia: examining the evidence," British Journal of Psychiatry, 180: page 494 (2002)

    Link to Luhrmann article:  http://www.nytimes.com/2013/09/20/opinion/luhrmann-the-violence-in-our-heads.html?_r=0

    October 12, 2013 - News of the Week


    A recent 60 MINUTES segment hosted by Steve Croft focused on a national disgrace -- the nation's undisputed neglect of Americans who are diagnosed with serious psychiatric conditions.  Ignoring an opportunity to discuss the scarcity of user-friendly treatments, the segment focused on  psychotropic medications and forced treatment.  The coercion proponents' marketing strategy,  "fear of violence," dominated the segment -- note its (shortened) title, "Imminent Danger".

    Below is a letter from the Bazelon Center for Mental Health Law to 60 MINUTES protesting "Imminent Danger's" harmful bias.  The letter is signed by 36 mental health organizations, and it joins many other protests from individuals and organizations.  (E-mail: 60m@cbsnews.com  and  audsvcs@cbs.com)


    NYAPRS Note: This week, the Bazelon Center for Mental Health Law drafted a letter to the Executive Producer of CBS 60 Minutes, in regards to the September 29 segment “Imminent Danger”. The views expressed in that program were regressive; the segment falsely portrayed persons with mental health diagnoses as hopeless, futureless individuals at high risk for committing violence. NYAPRS—as well as numerous other organizations indicated below—have signed this letter in protest of the unacceptable and misguided views expressed in the show that not only go against our mission, but also the consensus priorities of our mental health services system. Please read the full letter below.

    Dear Mr. Fager:

    The undersigned organizations, together representing tens of thousands of individuals with psychiatric disabilities, family members, service providers, and advocates, write to express our great disappointment that CBS’ 60 Minutes chose to offer a dismal and inaccurate portrayal of individuals with psychiatric disabilities in the September 29, 2013, segment “Untreated Mental Illness an Imminent Danger?” We call on 60 Minutes to devote a future segment to presenting a different perspective than that offered by E. Fuller Torrey, the psychiatrist whose highly controversial views are featured in “Imminent Danger.”

    Imminent Danger” portrays individuals diagnosed with schizophrenia as people with hopeless futures whose primary life options are hospitalization, homelessness, or incarceration.The segment provides no indication that individuals with schizophrenia can and do live fulfilling lives, start their own families, work, live independently, and participate fully in their communities. Instead, such individuals are painted as consigned to a life of misery and as ticking time bombs with the potential to become violent at any time.

    The segment perpetuates false assumptions that there is a significant link between mental health conditions and violence. Indeed, the point of the segment seems to be that mass shootings would be preventable if it were easier to hospitalize individuals with psychiatric disabilities. Apparently relying on Dr. Torrey’s inaccurate statement that half of mass killings are committed by individuals with serious mental illness, the report states: “It's becoming harder and harder to ignore the fact that the majority of the people pulling the triggers have turned out to be severely mentally ill—not in control of their faculties—and not receiving treatment.” Research shows that this is far from accurate. One survey of mass shootings between 2009 and 2013 found that perpetrators had a known mental health condition in only 11 percent of these incidents.1 A recent study of the psychiatric characteristics of homicide defendants found that psychiatric factors do not appear to predict whether a homicide defendant used a firearm or killed multiple victims.2

    Imminent Danger” also inaccurately suggests that the primary need in our mental health system is for more involuntary hospitalization. In fact, we have a long history of national and state reports—including the Surgeon General’s Report on Mental Health in 1999 and the 2003 report of the President’s New Freedom Commission on Mental Health—indicating that our mental health system is broken because we are failing to invest in effective community services (such as supported housing, supported employment, mobile crisis services, peer supports, and mobile community support teams).6Dr. Torrey’s focus on hospitalization and forced treatment as the primary need in mental health systems is at odds with a virtual national consensus that the focus should be community services.

    Finally, the segment incorrectly suggests that the requirement that individuals be dangerous before they can be involuntarily committed to a psychiatric hospital is a significant barrier to treatment. Dr. Torrey states in the segment that due to this requirement, in most states, it is “almost impossible” to commit people. This is a gross misstatement of fact. In fact, more than 52,000 individuals were involuntarily committed to psychiatric hospitals last year. Moreover, the vast majority of individuals who come before courts on involuntary commitment petitions are committed.7

    These inaccuracies and omissions in “Imminent Danger” create a harmful portrayal of Americans diagnosed with schizophrenia and other psychiatric disabilities. This portrayal is likely to lead to further discrimination and scapegoating of these individuals and to suggest misguided policy solutions. Moreover, this segment misses the opportunity to highlight the need for greater investment in effective community services. We hope that 60 Minutes will devote a segment to presenting a different perspective and we stand ready to work with you on making that happen.


    American Association of People with Disabilities

    American Association on Health and Disability

    Anti-Bias Home Page/National Stigma Clearinghouse

    Arbor Housing and Development

    Association of Programs for Rural Independent Living

    Autistic Self Advocacy Network

    Baltic Street AEH Inc.

    Bazelon Center for Mental Health Law

    Clubhouse of Suffolk

    Community Access

    Compeer Programs

    Connecticut Legal Rights Project

    Delaware Consumer Recovery Coalition

    Disability Rights Education and Defense Fund

    Disability Rights International

    Equip for Equality

    Little People of America

    Maine Center, Inc.

    Mental Health America

    Mental Health Association of Nebraska

    Mental Health Association Orange County, Inc.

    Mental Health Association Suffolk County

    National Association for Rights Protection and Advocacy

    National Coalition for Mental Health Recovery

    National Council for Community Behavioral Healthcare

    National Council on Independent Living

    National Disability Rights Network

    National Mental Health Consumers’ Self-Help Clearinghouse

    New York Association for Psychiatric Rehabilitation Services, Inc.

    Parsons Family and Consumer Services

    Sacred Creations

    Suffolk County United Veterans


    Venture House

    Witness Justice

    Yale Program for Recovery and Community Health

    October 4, 2013 - News of the Week


     Study Finds Psychiatric Factors Not Linked To Multiple Homicide Victims

    Article:  Clinical and Research news; Mark Moran; September 17, 2013
    Source:  Thank you Briana Gilmore, NYAPRS

    Psychiatric Characteristics of Homicide Defendants” is posted at http://ajp.psychiatryonline.org/data/Journals/AJP/927544/994.pdf.

    Psychiatric Factors Not Linked to Multiple Victims” is posted at http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=1739096

    Though more than a third of the defendants had prior psychiatric treatment, few received treatment in the three months preceding the crime of which they were accused.

    Psychiatric factors do not appear to predict whether a homicide defendant used a firearm, killed multiple victims, or is convicted of the crime, a finding that would seem to counter the popular notion—prevalent in the wake of recent mass killings that have made the news—that perpetrators of mass gun violence are invariably mentally ill.

    The finding is from a study appearing in the SeptemberAmerican Journal of Psychiatry that assessed the association between homicide and a wide range of demographic and clinical variables.

    Key Points

    • Researchers found no relationship between the presence of psychiatric disorders and the use of firearms. Also, the presence of a psychiatric disorder was not related to offenses involving multiple victims.

    • Although 37 percent of the sample had prior psychiatric treatment, only 8 percent of the defendants with diagnosed Axis I disorders had outpatient treatment during the three months preceding the homicide.

    • Individuals with an Axis I disorder were overrepresented in homicide defendants, but this was due to the high rate of substance use disorders found in this population.

    It is notable that clinical variables, such as Axis I diagnoses, were not associated with offense characteristics or case outcomes when demographic and historical characteristics of the cases were included in the models,” wrote lead author Edward Mulvey, Ph.D., of the University of Pittsburgh Medical Center, and colleagues. “In particular, while age and race were significantly related to the use of a firearm, the addition of clinical variables to demographic and historical variables did not improve model fit. Furthermore, a model including demographic/historical and clinical variables did not significantly predict a guilty verdict, suggesting that case-specific factors were more salient in these determinations.”

    In the study, defendants charged with homicide in a U.S. urban county between 2001 and 2005 received a psychiatric evaluation after arrest. Demographic, historical, and psychiatric variables as well as offense characteristics and legal outcomes were described. The researchers examined differences by age group and by race; they also looked at predictors of having multiple victims, firearm use, guilty plea, and guilty verdict.

    Fifty-eight percent of the sample had at least one Axis I or II diagnosis usingDSM-IV criteria, most often a substance use disorder (47 percent). Axis I or II diagnoses were more common (78 percent) among defendants over age 40. Although 37 percent of the sample had prior psychiatric treatment, only 8 percent of the defendants with diagnosed Axis I disorders had outpatient treatment during the three months preceding the homicide.

    That suggests limited opportunities for prevention by mental health providers, Mulvey and colleagues said. “The rate of previous treatment observed in this sample raises issues relevant to mental health policy,” they wrote. “Although 53 percent of the sample were diagnosed with an Axis I diagnosis (including substance use disorders), less than half of these individuals had ever been hospitalized. Also, among those with an Axis I diagnosis, only 8 percent had received any treatment in the three months preceding the homicide offense. Moreover, this low frequency of recent psychiatric treatment differed markedly by race….Widespread disparities in access to care and cultural differences regarding help seeking are likely explanations for this difference. The low rate of treatment in the months preceding the offense, however, highlights the need for enhanced engagement of high-risk individuals (especially during times of emotional crisis) if mental health care providers expect to have an impact on serious violence.”

    Steven Hoge, M.D., says that study findings showing low rates of treatment in the period prior to a crime suggest that crime-prevention strategies relying on psychiatrists’ reports regarding treatment encounters will not be effective.

    Steven Hoge, M.D., chair of APA’s Council on Psychiatry and Law, reviewed the report. “Individuals with an Axis I disorder were overrepresented among homicide defendants,” he told Psychiatric News, “but this was due to the high rate of substance use disorders found. The relationship between substance use and serious criminal behavior is well established. The study identified only 15 individuals—just 5 percent of the sample—who had a mental disorder and no co-occurring substance use disorder. Identification and treatment of substance use disorders are important not only to alleviate individual suffering, but also to improve public safety.

    The study findings address current concerns regarding gun use and mass killings by those with mental illnesses,” he continued.“There is widespread belief that mental illness is an important cause of firearm violence and mass murder. In fact, the researchers found no relationship between the presence of psychiatric disorders and the use of firearms. Nor did the presence of a psychiatric disorder relate to offenses involving multiple victims. These findings suggest that policies designed to keep firearms out of the hands of individuals with a history of mental illness will not prove to be effective as a targeted strategy.”

    Hoge also said the study underscores the need for better access to psychiatric treatment, particularly substance use treatment. However, crime-prevention strategies that rely on psychiatrists’ reports are likely to be ineffective because most of this population is not in treatment or getting timely treatment.

    Psychiatric Characteristics of Homicide Defendants” is posted athttp://ajp.psychiatryonline.org/data/Journals/AJP/927544/994.pdf.

    Psychiatric Factors Not Linked to Multiple Victims” is posted athttp://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=1739096

    October 1, 2013 -  News of the Week


    (See more information below)

    "Imminent Danger" is the now-shortened title of a recent "60 MINUTES" segment about violence and mental illnesses.  The segment aired on September 29th and was followed by an onslaught of online viewer comments and criticism.

    Most mental health advocates are seeking expansion of high-quality community programs and safe housing.  They deplore "Imminent Danger's" sole emphasis on a national disgrace that no one disputes.  The program reminds us of  the "walking time bomb" imagery often used in CBS features during the 1990s.  The segment's original title, "Untreated mental illness an imminent danger?", implied an open-minded, solution-seeking approach -- but no balance was seen, and there was an appalling over-emphasis on "schizophrenia" 

    As many advocates point out, Dr. E. Fuller Torrey, a primary guest on the show, is known for his disparagement of community programs favored by many people with diagnoses of serious mental illnesses.  These user-friendly programs that promote good outcomes deserve publicity as much, if not more, than programs that have failed. 

    This is a plea for the mainstream media to give national exposure to user-friendly, high-quality community programs and safe housing.


    A commentary by Linda Rosenberg
    President and CEO,  National Council for Community Behavioral Healthcare 

    LINK: http://www.thenationalcouncil.org/lindas-corner-office/2013/09/60-minutes-highlights-need-for-excellence-in-mental-health-act/

    A Commentary and Source Materials by Susan Rogers
    Director,  National Mental Health Consumers' Self-Help Clearinghouse

    I find it surprising that “60 Minutes,” which has a history of serious investigative journalism, would do such a slipshod job on the segment “starring” E. Fuller Torrey.

    The producers apparently saw no reason to include the fact that people diagnosed with schizophrenia can and do recover. Significantly, a decades-long study by the World Health Organization found that individuals diagnosed with schizophrenia usually do better in countries in the developing world – such as India, Nigeria and Colombia – than they do in such Western nations as Denmark, England and the United States. According to an analysis of results, “Patients in developing countries experienced significantly longer periods of unimpaired functioning in the community, although only 16% of them were on continuous antipsychotic medication (compared with 61% in the developed countries). . . . The sobering experience of high rates of chronic disability and dependency associated with schizophrenia in high-income countries, despite access to costly biomedical treatment, suggests that something essential to recovery is missing in the social fabric.

    Nor did they include any information about the Hearing Voices movement, which helps people learn to cope effectively with the experience of hearing voices.

    In addition, in a small British pilot study, 16 individuals diagnosed with schizophrenia were able to control their auditory hallucinations with an experimental treatment called “avatar therapy.” The treatment involves creating a computer-based representation – including a face and a voice – of the entity they believe is talking to them. The individual’s therapist is then able to speak through the avatar, encouraging the individual to counter the voice and to take control of the hallucinations. Three of the 16 people who participated in the study completely stopped hearing their voices as a result of the therapy, and almost all of the participants reported a reduction in frequency and in the severity of distress the voices caused, according to a published report. Because of the pilot’s success, The Wellcome Trust will fund a larger study, to be led by researchers at King’s College London’s Institute of Psychiatry. Thomas Craig, the psychiatrist who will lead the larger trial, said that if the study is successful, the therapy could be widely available within a few years.

    Although Dr. Torrey believes that individuals diagnosed with mental health conditions should be force-medicated if they refuse to take medication voluntarily, award-winning journalist Robert Whitaker believes that medication contributes to chronicity. In the era that followed the introduction of Thorazine in 1955, there has been an exponential rise in the numbers of individuals disabled by mental health disorders, he reports in his book “Anatomy of an Epidemic.” Whitaker told Behavioral Healthcare, “. . . [U]nfortunately I’m afraid psychiatry no longer knows how to get back on track with honest reporting of what it does and does not know, and honest investigations of psychiatric medications. . . . Ultimately, I think we need a new paradigm built on the framework of psychosocial and recovery practices.”

    The “60 Minutes” producers made a serious error in relying upon Dr. E. Fuller Torrey as its main source. Torrey admits to fabricating “evidence” to further his goal of making it easier to lock up people who have psychiatric diagnoses. Toward this end, he has for years engaged in “an intensive public relations campaign linking mental illness with violence.” 

    To the contrary, according to a NY Times article, only about 4 percent of violence in the United States can be attributed to people with mental illness.” And the 4 percent statistic is about violence of any kind – which, according to the study cited, would include something as relatively innocuous as threatening threatening behavior – as opposed to just homicides. Also, since the fears of the general public largely focus on strangers with mental health conditions, it is significant to report another study, which estimated that there is only one stranger homicide per 14.3 million peopl year.

    60 Minutes” should do a follow-up piece in which it strives for accuracy, as opposed to sensationalism.

    Susan Rogers, Director
    National Mental Health Consumers’ Self-Help Clearinghouse
    Director of Special Projects
    Mental Health Association of Southeastern Pennsylvania
    1211 Chestnut Street, 11th Floor
    Philadelphia, PA 19107

    267-507-3812 (direct)
    800-553-4539, ext. 3812
    800-688-4226, ext. 3812

    Fax: 215-636-6312

    The National Mental Health Consumers’ Self-Help Clearinghouse
    is a consumer-run national technical assistance center funded in part by
    the Substance Abuse and Mental Health Services Administration.


    The views, opinions, and content on the Clearinghouse website and in anything posted on the website or in these e-mails or attached to these e-mails donot necessarily reflect the views, opinions, or policies of the Center for Mental Health Services (CMHS), the Substance Abuse and Mental Health Services Administration (SAMHSA), or the U.S. Department of Health and Human Services (HHS).

    September 23, 2013 - News of the Week

    CRISIS INTERVENTION TEAMS : Will New York City Act At Last?


    Welcome to the online home of Communities for Crisis Intervention Teams (CCIT-NYC). If you’d like to share this website with others, the web address is: http://www.ccitnyc.org.

    CCIT-NYC seeks to improve police responses to 911 calls involving individuals with mental health concerns – often referred to as “Emotionally Disturbed Person” (EDP) calls. (The NYPD gets more than 100,000 EDP calls per year.)

    By establishing a new community-police approach to EDP calls, we hope to divert mental health recipients away from the criminal justice system, and thereby avoid traumatic encounters and injuries to police and mental health recipients.

    Current State of Affairs

    At present, the NYPD are insufficiently prepared to deal effectively with 911 calls involving individuals with mental health concerns – often resulting in traumatizing and sometimes tragic encounters between the police and individuals experiencing emotional distress.

    Shereese Francis

    In 2012, the family of 30 year-old Shereese Francis called for an ambulance as she was showing signs of emotional distress. When the police arrived on the scene, they chased Shereese around her home, amplifying her distress. Instead of de-escalating the situation, four police officers finally laid on top of Shereese in an attempt to subdue her, and she died.


    NYPD police beat Dustin so badly they broke his nose and injured his eyes. The 23 year-old was waiting with police because his family had called for an ambulance when he was in emotional distress. There was no claim he was holding a weapon or being threatening.

    Change for the Better

    Statistics show that a large percentage of the calls fielded by the NYPD involve a person facing an emotional crisis. By recognizing the challenges and realities of this fact, we can make our streets safer for people with mental illnesses and for the police officers who respond to their calls.

    Crisis Intervention Teams are vital to reversing the trend of criminalizing people in crisis and depriving them of the human rights that they deserve. Instead of being incarcerated, people in crisis need treatment, housing, respite, and support in order to recover and live to their potential.

    We believe that a successful plan to address issues regarding the policing of people in crisis depends on a multi-part program and the successful cooperation between many different entities: the NYPD and the community; the courts and activists; mental health consumers and healthcare providers.

    CCIT-NYC is committed to a citywide approach. Real change will only be achieved when a program is up-and-running 24 hours a day, seven days a week, in all five boroughs, and accessible to every New York City resident. Our plan for such change consists of three parts:

    1. Community Crisis Intervention Teams

    Our proposal calls for a pilot project establishing at least one specially trained Crisis Intervention Team in every borough. These teams would operate out of existing facilities and be ready 24 hours a day to respond to calls involving mental health crisis.

    2. Training

    Training police officers to respond more effectively to mental health recipients in crisis will result in the successful de-escalation of more EDP calls, and will therefore empower the NYPD to more efficiently deploy their time and resources while maintaining better community relations.

    3. Oversight/Development Committee

    In a city as large and complicated as New York City, it is imperative that a committee be formed to ensure that consistency is maintained across the precincts, and that best practices are effectively identified and shared. Such a committee would also be responsible for directing and vetting training programs, hiring, and compliance.

    The Communities for Crisis Intervention Team will call for a model that works in NYC through the introduction of a NYC Council resolution and NYS legislation. See the Proposals section of this website for more info.

    Who We Are

    We are a coalition of activists, advocates, and other community and non-profit members working to promote human rights, dignity and safety for people in New York City who come in contact with the NYPD.

    How You Can Get Involved

    (1) Please join with over 22 organizations on Wednesday, September 25, at noon, on the steps of City Hall in Manhattan as we call for needed change. Visit the Events section of this website to find out more.

    (2) We are also seeking organizations to join our campaign. Join Nami Metro NYC, 100 Blacks in Law Enforcement, Community Access, and others as we advocate for Crisis Intervention Teams in NYC.

    For more info, please contact:

    Carla Rabinowitz
    Community Organizer, Community Access
    (212) 780-1400, ext. 7726

    August 19, 2013 – News of the Week


    A striking video (Huffington Post, 8-15-13) explains how Lisa Halpern, a young woman diagnosed with schizophrenia, helps others cope with this much-misrepresented diagnosis. Ms. Halpern is Director of Recovery Services at a mental health services facility where she oversees 18 peer recovery coordinators. By sharing her lived experiences, she helps to reduce the isolation that nearly everyone with a serious psychiatric vulnerability faces or will face.

    Here's the link for the video:


    Mental Illness At Work: My Schizophrenia Helped Me Find A Job (VIDEO)

    July 5, 2013 - News of the Week


    Long ago, David Oaks and his staff at Mindfreedom International chose the week of July 7, 2013 to celebrate the role of 'creative malajustment' in ending social injustice through non-violent revolution.  Then, six months ago, David suffered a near-fatal fall followed by complications. 

    Yet this ambitious first-time-ever event moved forward (as has David Oaks's recovery) as seen in a beautiful description at http://www.cmweek. org


    June 27, 2013 - News of the Week



    (Thanks to advocate Morgan Brown (http://beyond-vsh.blogspot.com/) for forwarding a Times Argus article by Peter Hirschfield, 6/22/13  "Good News is reported in mental health care in Vermont")


    "Nearly two years have passed since the historic floods inundated the state's 52-bed psychiatric hospital, crippling the state's ability to care for its most acutely ill residents..." (more)

    The need for urgent action unleashed a strong, united push for more community-based care.  In 2012, the state passed a wide-ranging mental health bill intended to increase options for early-stage intervention, and to spare many patients from involuntary in-patient committals.

    "We are able to do things today that we would not have been able to do two years ago, and it's having an incredibly positive impact on our ability to intervene in meaningful ways..." (more)

    Julie Tessler, executive director, Vermont Council of DMH Services, praised the community-based model while suggesting that change won't be easy. "The system is still one that reacts to crisis, instead of trying to prevent it in the first place.  Rectifying shortcomings in the system will mean allocating to mental health care the same level of financial resources being directed to more conventional health care services. We have made tremendous headway..." but "We really need a whole lot more to make a difference."

    June 16, 2013 - News of the Week 
             (Changes made on June 20)


    The most useful  diagnostic terms describe a condition; 'schizophrenia' does not

    Dr. Sally Satel, author and psychiatrist, continues to raise eyebrows. A recent After Words interview on C-Span with Dan Vergano glued me to the screen for the entire hour.  She was a perfect guest -- engaging, charismatic, thoughtful -- as she cautioned us to avoid premature and unrealistic expectations of emerging brain imaging technology, and explained her views on addiction treatment (her field of expertise).

    I am concerned, though, about how she used the word 'schizophrenia'.  Yes, I'm over-sensitive about it, but today the label alone can punish patients with a presumption of violence and social rejection.   Dr. Satel and other psychiatrists have the ability to lighten such unwarranted penalties.  But simply mentioning the rarity of violent acts is not enough. 

    One way to help is to support patients and ex-patients.  Dr. Satel and other critics have dismissed ex-patients' lived experience with the mental health system as irrelevant and anti-psychiatry. Yet survivors of schizophrenia can share valuable insights about managing symptoms and improving treatments.  Encouraged by the federal agency SAMHSA, individuals who have 'been there' are at last being heard.
    During the C-Span interview, Dr. Satel listed a group of what she called chronic and relapsing brain diseases -- multiple sclerosis, schizophrenia, Alzheimer's, and Parkinson's disease. Such illnesses, she said, can't be modified by a person's desire to be well because they require interventions such as medication.  (Her point was to differentiate brain diseases from addictions.)

    But Dr. Satel's premise is flawed.  Schizophrenia is fundamentally unlike Alzheimer's and Parkinson's disease. The most obvious difference is schizophrenia's lack of conclusive biological brain markers.  Further, many experts believe that a patient's psychological attributes can influence a physical affliction. This is certainly true for schizophrenia, where patients who have hope and support tend to fare better than those who rely on meds alone.

    Dr. Satel's description of schizophrenia as a 'chronic and relapsing brain disease' also contradicts well-documented histories of full or partial recovery.  While researchers continue to search for biological underpinnings in the brain, a growing number of schizophrenia survivors have gone public with wellness stories.  Among prominent survivor leaders are Pat Deegan, Daniel Fisher, Elyn Saks, and David Oaks, who were diagnosed and hospitalized for schizophrenia in their teens or early 20s.  They and their colleagues find innovative, resourceful ways to lessen despair and enlighten the public.

    Over decades, the word schizophrenia has been co-opted and distorted by entertainment and marketing industries that find its air of mystery both appealing and exploitable.  Even academics who should know better sometimes confuse it with split personality.  And a 20-year emphasis on violent behavior -- disproportionate to its incidence -- has left its mark on public opinion.

    The most useful diagnostic terms briefly describe a condition.  Just as the Japanese chose to use a descriptive term,
    integration disorder, we too must search for an appropriate word to replace the fanciful and hopelessly corrupted 'schizophrenia'.


    Recovery From Schizophrenia: With Vews of Psychiatrists, Psychologists,
    and Others Diagnosed With This Disorder.  

    by Frederick J. Frese, Edward L Knight and Elyn Saks

    Schizophrenia Bulletin (2009) Vol. 35, Issue 2, pp 370-380

     Click for full article.. http://schizophreniabulletin.oxfordjournals.org/content/35/2/370.full#sec-4

    Beginning with a historical recap,  this article traces the current shift toward recovery as experienced by individuals diagnosed with schizophrenia.  Nearly a dozen individuals contributed varied views of what recovery means.  The result: a barrier-breaking boost toward public understanding.  

    June 6, 2013 - News of the Week

    BAZELON CENTER ALERT: Stigma Wins, Privacy Loses in HHS Proposal

               Source:   Judge David L. Bazelon Center for Mental Health Law   www. bazelon.org     Washington DC

    HHS Proposal Would Diminish Privacy Protections

    June 4, 2013 -- The Department of Health and Human Services (HHS) proposes to change the Health Insurance Portability and Accountability Act (HIPAA) in a way that singles out the records of people with mental illnesses. The changes would apply different rules to certain mental health records for the purpose of ensuring that more records are reported to the FBI's gun database.

    We believe this is unnecessary, will not achieve the intended purpose of reducing gun violence, and will only further stigmatize people with mental illnesses and mental health treatment.