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
United States." The piece begins, however, with two troubling
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
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
THIRTY-SIX ADVOCACY GROUPS
PRESS FOR FAIR REPORTING
recent 60 MINUTES segment
hosted by Steve Croft focused on a national disgrace --
the nation's undisputed neglect of Americans who
swings, fears, voices, and visions. 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,
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: firstname.lastname@example.org
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
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
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.
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
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
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.
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
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
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
the Surgeon General’s Report on Mental Health in 1999 and the
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.
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
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
inaccuracies and omissions in “Imminent Danger” create a
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.
Association of People with Disabilities
Association on Health and Disability
Home Page/National Stigma Clearinghouse
Housing and Development
of Programs for Rural Independent Living
Self Advocacy Network
Street AEH Inc.
Center for Mental Health Law
Legal Rights Project
Consumer Recovery Coalition
Rights Education and Defense Fund
People of America
Health Association of Nebraska
Health Association Orange County, Inc.
Health Association Suffolk County
Association for Rights Protection and Advocacy
Coalition for Mental Health Recovery
Council for Community Behavioral Healthcare
Council on Independent Living
Disability Rights Network
Mental Health Consumers’ Self-Help Clearinghouse
York Association for Psychiatric Rehabilitation Services, Inc.
Family and Consumer Services
County United Veterans
Program for Recovery and Community Health
October 4, 2013 - News of the Week
NEW VIOLENCE STUDY
SHATTERS POPULAR BELIEFS
Psychiatric Factors Not Linked To Multiple Homicide Victims
Clinical and Research news; Mark Moran; September 17, 2013
Source: Thank you Briana Gilmore,
Characteristics of Homicide Defendants” is posted at http://ajp.psychiatryonline.org/data/Journals/AJP/927544/994.pdf.
Factors Not Linked to Multiple Victims” is posted at http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=1739096
Though more than a
the defendants had prior psychiatric treatment, few received treatment
in the three months preceding the crime of which they were accused.
Psychiatric factors do
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
appearing in the SeptemberAmerican Journal of Psychiatry that
assessed the association between homicide and a wide range of
demographic and clinical variables.
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.
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,
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
Fifty-eight percent of
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
Steven Hoge, M.D., says
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
Steven Hoge, M.D.,
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.
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
Hoge also said the
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.
Characteristics of Homicide Defendants” is posted athttp://ajp.psychiatryonline.org/data/Journals/AJP/927544/994.pdf.
Factors Not Linked to Multiple Victims” is posted athttp://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=1739096
1, 2013 - News of the Week
A PLEA TO MAINSTREAM MEDIA
(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
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.
commentary by Linda Rosenberg
President and CEO, National Council for Community Behavioral
A Commentary and Source Materials from
Director, National Mental Health
Consumers' Self-Help Clearinghouse
find it surprising that “60 Minutes,” which has a history
serious investigative journalism, would do such a slipshod job on the
segment “starring” E. Fuller Torrey.
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
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
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.”
did they include any information about the Hearing
which helps people learn to cope effectively with the experience of
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
the psychiatrist who will lead the larger trial, said that if the
study is successful, the therapy could be widely available within a
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
. . [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.”
“60 Minutes” producers made a serious error in relying upon
E. Fuller Torrey as its main source. Torrey
admits to fabricating
“evidence” to further his goal of making it easier to
people who have psychiatric diagnoses. Toward this end, he has for
years engaged in “an intensive public relations campaign linking
mental illness with
contrary, according to a NY
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.
Minutes” should do a follow-up piece in which it strives for
accuracy, as opposed to sensationalism.
Mental Health Consumers’ Self-Help Clearinghouse
Health Association of Southeastern Pennsylvania
Chestnut Street, 11th Floor
National Mental Health Consumers’ Self-Help Clearinghouse
consumer-run national technical assistance center funded in part by
Substance Abuse and Mental Health Services Administration.
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
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.
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
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
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
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.
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
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
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.
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:
Community Organizer, Community Access
(212) 780-1400, ext. 7726
August 19, 2013 – News of the Week
PEERS AT WORK
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
At Work: My Schizophrenia Helped Me Find A Job (VIDEO)
July 5, 2013 - News
of the Week
MALAJUSTMENT WEEK HAS ARRIVED !!!
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
REFORMS ARE HAVING AN "INCREDIBLY POSITIVE IMPACT" ON VERMONT'S MENTAL
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
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)
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
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
June 16, 2013 - News
of the Week
(Changes made on June 20)
BAD RAP CONTINUES...
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
the ability to lighten such unwarranted penalties. But simply
of violent acts is not enough.
One way to help is to support patients and ex-patients. Dr. Satel
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
-- 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
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
Saks, and David
Oaks, who were
diagnosed and hospitalized for schizophrenia in their teens or early
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
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'.
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
CENTER ALERT: Stigma Wins, Privacy Loses in HHS Proposal
Source: Judge David L. Bazelon
Center for Mental Health Law www.
bazelon.org Washington DC
Proposal Would Diminish Privacy Protections
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.
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.
You Can Do
comments to HHS here on or before Friday,
can use our comments as a template.
May 7, 2013 - News of
PSYCHIATRIC LABELS SAID TO LACK VALIDITY
Countless millions of Americans suffer from their
diagnostic label more than from symptoms that can often be dealt
Helped by self-awareness and supporting communities, many
become experts at coping with their symptoms.
Unfortunately, the popular misuse of psychiatric labels over many
years has a penalizing effect on those who seek help.
The fifth edition of the Diagnostic
and Statistical Manual of Mental
Disorders (DSM), often called the psychiatists' bible, will be
in book stores within weeks. Key leaders of the
psychiatric establishment say the DSM lacks scientific validity;
still, most will continue to accept its clinical usefulness for
Plans for the next decade will shift NIMH research
funds to a search for biological underpinnings of
'mental illnesses'. If successful, the project is likely to
require new diagnostic terms.
Today's psychiatric labels lead to exclusion and
rejection. Will the discovery of biological markers end the
prejudice that too often deters people from seeking help?
in Crisis..." (by JOHN
HORGAN, SCIENTIFIC AMERICAN, May 4, 2013)
ARTICLE: New York Times, May 7, 2013
(reprint protected by Fair Use Standard)
Guide Is Out of Touch With Science, Experts Say
By PAM BELLUCK and
Published: May 7, 2013
Just weeks before the long-awaited publication of a new
edition of the
so-called bible of mental disorders, the federal government’s
most prominent psychiatric expert has said the book suffers from a
scientific “lack of validity.”
The expert, Dr. Thomas R. Insel, director of the National
Mental Health, said in an interview Monday that his goal was to reshape
the direction of psychiatric research to focus on biology, genetics and
neuroscience so that scientists can define disorders by their causes,
rather than their symptoms.
While the Diagnostic and Statistical Manual of Mental
D.S.M., is the best tool now available for clinicians treating patients
and should not be tossed out, he said, it does not reflect the
complexity of many disorders, and its way of categorizing mental
illnesses should not guide research.
“As long as the research community takes the D.S.M.
to be a
bible, we’ll never make progress,” Dr. Insel said, adding,
“People think that everything has to match D.S.M. criteria, but
you know what? Biology never read that book.”
The revision, known as the D.S.M.-5 and the first since
stirred unprecedented questioning from the public, patient groups and,
most fundamentally, senior figures in psychiatry who have challenged
not only decisions about specific diagnoses but the scientific basis of
the entire enterprise. Basic research into the biology of mental
disorders and treatment has stalled, they say, confounded by the
labyrinth of the brain.
Decades of spending on neuroscience have taught scientists
they do not know, undermining some of their most elemental assumptions.
Genetic glitches that appear to increase the risk of schizophrenia in
one person may predispose others to autism-like symptoms, or bipolar
disorder. The mechanisms of the field’s most commonly used drugs
— antidepressants like Prozac, and antipsychosis medications like
Zyprexa — have revealed nothing about the causes of those
disorders. And major drugmakers have scaled back psychiatric drug
development, having virtually no new biological “targets”
to shoot for.
Dr. Insel is one of a growing number of scientists who
think that the
field needs an entirely new paradigm for understanding mental
disorders, though neither he nor anyone else knows exactly what it will
Even the chairman of the task force making revisions to
the D.S.M., Dr.
David J. Kupfer, a professor of psychiatry at the University of
Pittsburgh, said the new manual was faced with doing the best it could
with the scientific evidence available.
“The problem that we’ve had in dealing with
the data that
we’ve had over the five to 10 years since we began the revision
process of D.S.M.-5 is a failure of our neuroscience and biology to
give us the level of diagnostic criteria, a level of sensitivity and
specificity that we would be able to introduce into the diagnostic
manual,” Dr. Kupfer said.
The creators of the D.S.M. in the 1960s and ’70s
heroes at the time,” said Dr. Steven E. Hyman, a psychiatrist and
neuroscientist at the Broad Institute and a former director at the
National Institute of Mental Health. “They chose a model in which
all psychiatric illnesses were represented as categories discontinuous
with ‘normal.’ But this is totally wrong in a way they
couldn’t have imagined. So in fact what they produced was an
absolute scientific nightmare. Many people who get one diagnosis get
five diagnoses, but they don’t have five diseases — they
have one underlying condition.”
Dr. Hyman, Dr. Insel and other experts said they hoped
that the science
of psychiatry would follow the direction of cancer research, which is
moving from classifying tumors by where they occur in the body to
characterizing them by their genetic and molecular signatures.
About two years ago, to spur a move in that direction, Dr.
started a federal project called Research Domain Criteria, or RDoC,
which he highlighted in a blog post last week. Dr. Insel said in the
blog that the National Institute of Mental Health would be
“reorienting its research away from D.S.M. categories”
because “patients with mental disorders deserve better.”
His commentary has created ripples throughout the mental health
Dr. Insel said in the interview that his motivation was
disparage the D.S.M. as a clinical tool, but to encourage researchers
and especially outside reviewers who screen proposals for financing
from his agency to disregard its categories and investigate the
biological underpinnings of disorders instead. He said he had heard
from scientists whose proposals to study processes common to
depression, schizophrenia and psychosis were rejected by grant
reviewers because they cut across D.S.M. disease categories.
“They didn’t get it,” Dr. Insel said of
reviewers. “What we’re trying to do with RDoC is say
actually this is a fresh way to think about it.” He added that he
hoped researchers would also participate in projects funded through the
Obama administration’s new brain initiative.
Dr. Michael First, a psychiatry professor at Columbia who
last edition of the manual, said, “RDoC is clearly the way of the
future,” although it would take years to get results that could
apply to patients. In the meantime, he said, “RDoC can’t do
what the D.S.M. does. The D.S.M. is what clinicians use. Patients will
always come into offices with symptoms.”
For at least a decade, Dr. First and others said, patients
continue to be diagnosed with D.S.M. categories as a guide, and
insurance companies will reimburse with such diagnoses in mind.
Dr. Jeffrey Lieberman, the chairman of the psychiatry
Columbia and president-elect of the American Psychiatric Association,
which publishes the D.S.M., said that the new edition’s
refinements were “based on research in the last 20 years that
will improve the utility of this guide for practitioners, and improve,
however incrementally, the care patients receive.”
He added: “The last thing we want to do is be
apologetic about the state of our field. But at the same time,
we’re not satisfied with it either. There’s nothing
we’d like better than to have more scientific progress.”
April 12, 2013 - News
of the Week
A CALL FOR INFORMATION
CONCERNING KENDRA'S LAW (AOT)
York Safe Act Mental Health Section
Should Be Suspended and Reconsidered
(Assisted Outpatient Treatment)
Why extend a law that is not due to expire until
2015? Why are Kendra's Law's creators still quoting outcome
statistics gathered in 2003, a decade ago? Where are the Assisted
Outpatient Treatment (AOT) program's original recipients now, ten years
later? Is a longitudinal study underway so that concrete lessons
can be learned? What evidence supported moving the law's
expiration date to 2017 instead of 2015?
In 2003, a Kendra's Law interim report showed the progress
of 2,745 AOT participants after six months in the program. Issued by
the NY Office of Mental Health, the in-house report analyzed outcomes
from Kendra's Law's first six months of operation, based on interviews
with multiple stakeholders including staff and AOT recipients. Two
years later, that outcome data was reused in a "Final Report
2005." More recently, three independent evaluations found a
widely variable pattern of statewide use and program design. Although
the independent research teams noted the benefits of priority access to
housing, questions about involuntary participation were unanswered.
Law Updates for more...)
New York SAFE
Act Mental Health Section
Clarification is urgently needed concerning the New York SAFE Act's sweeping new
statute that assigns an informant role to the entire New York mental
health system and related agencies. The loosely-defined new
rules have already spawned a wrongful accusation
a buck-passing response. In Erie County this week a man was
mistakenly targeted under the SAFE Act provision by police but
responsibility for the error is
unclear. See news reports below.
Claims State Officials Intentionallhy Violated HIPPA to Enforce SAFE
Police Mistakenly Enforce SAFE Act Provision" more...
SAFE Act notification under fire" more...
March 29, 2013 - News
of the Week
FLAWS IN KENDRA'S LAW
Have independent evaluations of Kendra's Law been ignored?
have passed since the terrible day in January 1999 when Kendra Webdale
was pushed onto the track of an oncoming Manhattan subway train by a
man who had been recently discharged from a psychiatric facility with a
one-week supply of medication. A recent opinion piece by Patricia and
Ralph Webdale in the NY Daily News, "Our
Daughter Did Not Die in Vain," is a moving statement explaining the
family's resolve to end such tragedies. Left unsaid, though, is that
the man in the subway, Andrew Goldstein, had searched in vain for
services now on the Webdales' poignant "if only" list of life
savers. He had even requested a supervised treatment setting.
from the Webdales' opinion piece: "If only he had received
followup by a caseworker. If only he had been able to stick with his
medication without supervision. If only... Kendra would be alive and he
would not be in prison."
Reading the Webdales' article took me back to 1999 when a
deluge of inflammatory publicity spurred the speedy passage of Kendra's
Law, a statute allowing the mandatory medication of psychiatric
outpatients. Its creators now call the law flawed and recommend
strengthening it. But the flaws may be insurmountable. A trial now in
progress in Manhattan involves a homicide committed in 2008 by a
Kendra's Law participant. According to his father (New
York Times, 2/20/2008), the assailant simply eluded the caseworkers
assigned to him. This case raises questions about compulsory
medication's inherent monitoring problems.
A quote from a New York Times investigation by Michael
Winerip: "What I
found most haunting about Goldstein's 3,500 page file was his repeated
pleas for services that had no vacancies."
A major culprit in the fatal subway encounter, mostly ignored in 1999,
was New York State's downsizing policy that derailed Andrew Goldstein's
repeated tries to get the help he knew he needed. The true story of
Goldstein's futile search for help was detailed by Michael Winerip in
York Times Sunday Magazine cover story, May 23, 1999.
The Webdales' commentary confirms their compassionate
intentions and moral credibilty, but it fails to show that Kendra's Law
can put a dent in the crisis of funding and services we face today. New
options include non-coercive ways to engage people who have 'given up'.
Just a few promising examples are Emotional CPR promoted by the
National Coalition for Mental Health Recovery; the WRAP program developed by
Mary Ellen Copeland; and a deceptively simple program that helps
patients make best use of today's typical 15-minute medication consult,
created by Patricia Deegan, the founder of Common Ground.
Let us hope that with
constructive input from open minds, progress is possible.
Law Updates: 2006-2013
whirlwind response to the killing of 26 people (20 children) in
Newtown CT, Governor Andrew Cuomo signed a new package of firearm and
mental health regulations, the NY SAFE Act on January 15, 2013,
intended to control
gun violence. The act extends Kendra's Law from 2015 to
2017, expands some aspects of the law, and adds rules requiring
professionals to inform authorities when one of their patients exhibits
signs of potentially harmful behavior. The Safe Act has raised
questions so far unanswered and treatment barriers such
as patient/professional trust. Further, the extension of
Kendra's Law is premature,
considering the cautionary findings of independent evaluations in
2009 and 2010. A new independent evaluation is needed to
update the in-house report of 2003 which the Legislature
found insufficient. Ten-year-old outome data from 2003 and
"Final Report 2005, quoted
often as though current, is misleading.
11, 2013 - News of the Week
A HARVARD STUDENT PROPOSES
IMPROVEMENTS IN MENTAL HEALTH SERVICES
The Harvard Crimson recently ran a
of his failed search for mental health services. For months after
seeking help for disabling symptoms, the student was met by a series of
stone walls while his or her 'voices' worsened. If there is a
side to this disturbing story, it's the student's courage in recounting
the experience with the hope of saving others from succumbing to the
spirit-breaking obstacles he or she faced. Kudos to The Harvard
for airing this important issue and for provoking a discussion of
"You do not become schizophrenic
overnight. When I began to hear voices, I told myself that it was
some peculiar coping mechanism that was benign and would soon go away....(more)
(Article forwarded by
Bill Lichtenstein, LCMedia.com)
7, 2013 - News of the Week
RECOVERY IS FOR
EVERYONE! (Conference Announcement)
April 4, 2013
Marriott, Albany, NY
Recovery is about doing things differently.
It’s about having hope and making changes.
conference, “Recovery is for Everyone!,” will include
information that persons in recovery, providers, and others can use to
make recovery “real.” Speakers will discuss recovery
principles and concepts and how they can be put into practice, what a
recovery facilitating system looks like, measures for
recovery-promoting environments, and tools that support recovery.
The conference is
intended for people in recovery from mental health conditions and/or
addiction as well as their families,
educators, social workers, psychologists, psychiatrists, peer
specialists, community staff, and other behavioral health stakeholders.
This conference is offered
free of charge. Continuing education credits will be available.
You can register
for “Recovery is for Everyone!” by Friday, March 22, 2013
using the form included in the attached brochure (link is below).
Sponsored by: Community Care Behavioral
Health Organization and Western Psychiatric Institute and Clinic of
For more information, please visit www.ccbh.com --
and/or view the descriptive brochure linked below.
February 18, 2013 - News of the Week
Tragic mass shootings have
led to a welcome national focus on violence prevention. It is
troubling, though, to see the diagnostic term 'schizophrenia' used as a
catchall word for violent behavior. Schizophrenia affects just
over 1% (1.1
of the adult population (National Institute of Mental Health, NIMH
website) and of these people, 99.97% of them will not be convicted of serious violence
given year (Walsh et al, 2002 and Wallace et al, 1998). Also
noteworthy is a research finding that violence
rates for those who did not abuse
substances were indistinguishable
from their non-substance-abusing neighbors.
With misuse of mind-altering substances (found to double violence
rates), those with schizophrenia had
"the lowest occurrence
of violence over the course of a year" compared with bipolar disorder
or major depression.
How did schizophrenia acquire its inflated link to
violence? Experts point to decades of media misrepresentation.
Its catchy name and air of mystery were a gift to the advertising and
entertainment media, and confusion with "split personality" added to
its allure. An example is a tabloid column about flip-flopping
politicians, headlined, "The Schizophrenics Are Loose -- Public
Nuisances," (The New York Post, 1991).
The media's persistent misrepresentation of 'schizophrenia'
has clearly influenced public opinion. Twenty years have passed since a
public awareness booklet noted that "violence has been exaggerated in
movies and television, increasing irrational fears of persons with
schizophrenia." ("Facts About Schizophrenia") The media's active
role in shaping opinion was best summed up by a Robert Wood Johnson
Foundation survey: "Mass media is, far
and away, the public's primary source of information about mental
illnesses." (Yankelovich, 1990)
It is possible that 'schizophrenia' filled a void in
psychiatry's diagnostic jargon when the term 'psychopath' was dropped
by psychiatrists. Psychopathy (as it was called) is a psychiatric
condition that has a known association with violent behavior. This
condition has most recently been labeled 'antisocial personality
disorder', a diagnosis mired in confusion and controversy. Lacking a
usable word, the mass media may be using 'schizophrenia' as a fallback
choice when reporting unexplained violence. If so, it's a
terrible mismatch. 'Antisocial
personality disorder' and 'schizophrenia' are not the same, and the
terms are not interchangeable.
With few exceptions, a 'schizophrenia' label penalizes
forever the life of the person who receives it. One would expect such a
punishing label to be based on scientific evidence, but there is no
such evidence. Calls for a name change come and go. An
excellent discussion of this idea is Phyllis Vine's "Should
the term schizophrenia be changed?"
Our vocabulary shapes attitudes, policies, and even
laws. Surely we can head off further distortion of
'schizophrenia' by protesting its use as a blanket term in violent
"Facts About Schizophrenia". A booklet issued by NYS Office
Mental Health, Gov. Mario Cuomo's administration (1983-1994)
National Institute of Mental Health, "Schizophrenia,
12-month prevalence," website (2013)
Stuart, Heather, "Violence and mental Illness, an overview,"
policy paper, pages 122-123, Queens University, Ontario Canada, (2003)
The New York Post. "The schizophrenics are loose - public
nuisances," R. Emmett Tyrrell Jr. October 8, (1991)
Vine, Phyllis. MIWatch.org "Should
the term schizophrenia be changed?, website (2009)
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)
Yankelovich (DYG, Inc.). "Public Attitudes Toward People
with Chronic Mental Illness," prepared for Robert Wood Johnson
Foundation, April (1990)
8, 2013 - News of the Week
COURAGEOUS YOUNG MAN SPEAKS OUT
a string of mass shootings shook America. Ian Stawicki took five lives
at Cafe Racer in Seattle, James Holmes opened fire in a crowded
Colorado theater and, most disturbing, Adam Lanza killed 26 people,
including 20 children, in Newtown, Conn.
mental health of each of these perpetrators was immediately questioned,
which has led to a renewed call for better mental-health treatment.
afraid that no substantive change will occur because we are discussing
mental health in the abstract sphere of politics rather that in the
intimate communities where we live day to day — places like our
homes, jobs, schools, faith communities and social gatherings.
society, we don’t talk about these issues, at least not in the
personal ways that raise awareness, foster advocacy and lead to
meaningful change. We talk about the dangers of mental health in a way
that causes those who are actually living with mental-health challenges
to gather in hushed circles and share their struggles, wisdom and
perspective with only a select few.
stories, front-line experiences and insights are the key to a more
holistic societal understanding. But they don’t speak because
they are scared of losing respect, trust and relationships, and being
viewed as another mentally ill person who might go on a violent
In 2003 I
was diagnosed with bipolar disorder, type 1. I’ve felt the cold
exclusion of stigma. In the months after my first manic episode many of
my friends withdrew; one friend told me that her boyfriend didn’t
feel it was safe for her to be around me. There are times when I
hesitate to reveal my diagnosis for fear that new people I meet will
subtly distance themselves from me — the shifty look of distrust,
unsure what erratic thing the guy with bipolar might do.
times, though, I share my story, because I don’t want their
picture of mental illness to be a mad man with a gun.
begins with education and conversation. Most people know very little
about mental health. Society at large seems to be mostly ignorant,
informed predominantly by popular media and gruesome news stories.
Rather than a disease of the brain — the same way diabetes is a
disease of the pancreas — we see a disease of character.
in language that perpetuates stigmas, referring to moody people as
“being bipolar.” We foster fear by putting the word
“schizophrenia” in print most often with the words
“violence,” “untreated” and “risk to
themselves and others.” We discourage transparency by
removing trust and responsibilities from those who choose to speak
openly about their depression or anxiety.
that for real change to occur, our communities must push against the
flood of bigotry and misunderstanding. fear and labeling. We must
initiate space for safe conversation that invites those living with
mental health challenges to share their stories of struggle and
might this look like? Religious leaders might consider devoting
time in their services to educate their members. Medical and
nursing schools might consider providing more robust mental-halth
training that includes firsthand testimony from those who live with
mental-health challenges. Business owners might make
mental-health education a part of new-hire orientation.
administrators might build mental-health education into the curriculum.
Media outlets might produce positive stories about mental health
that expose society to a more balanced and accurate view of this issue.
Those who live with a brain disease might share their story,
accepting the invitation to discuss and educate.
we need better funding for mental-health treatment, but we also need a
shift in the basic way we talk and think about matters of mental
health. This shift won't take place in Olympia or Washington,
D.C. It will take place in our office, our favorite retaurant,
our church, mosque, or temple and our family gatherings.
Alan Taylor works as a
peer counselor at a community mental-health clinic in Puyallup.
January 15, 2013 -
News of the Week
Stop Blaming The Mentally Ill
Lollie Butler Arizona Daily Star
January 15, 2013
(courtesy of NYAPRS.org)
is a bloody
war being waged in America; gun advocates versus those who would ban
guns. This "civil" war may go on for a long time.
suffering from mental illnesses unfairly shoulder the blame for
atrocities committed against the innocent.
unreasonable situation. Armed persons firing into crowds, whether at
schools or shopping malls, defies reason and causes all of us to feel
vulnerable. It also takes its toll on those with mental illnesses.
Words like "crazy" and "deranged" fly across the
front pages, and the mentally ill in treatment, saddled with severe
funding cuts and ongoing social stigma, take it on the chin.
study in the
Archives of General Psychiatry states, "If a person has severe
mental illness without substance abuse and a history of violence, he
or she has the same chance of being violent during the next three
years as any other person in the general population."
unproductive to besmirch a whole group of people recovering from
(mental) illnesses as if they are all dangerous - when in fact,
they're not," says Duke University medical sociologist Jeffery
kills? Do guns
kill or do people kill? The NRA would have us believe that the
Newtown murderer could have carried out his massacre of 26 people
including 20 children with any weapon, and that a semiautomatic rifle
is no more effective in a crowd than a cleaver. They would have us
believe that video games have created a cadre of psychotic
individuals and that the proliferation of combat rifles has no
bearing on these murders.
focus of late
has been on mass murders, but every day in this country people are
killed by gunfire either by others, by their own hand or by accident.
When a child finds an unlocked gun and through natural curiosity
fires it - accidentally killing himself - the argument that it is
people, not guns who kill, falls flat.
drama, someone profits and someone loses. In this regrettable
situation, the NRA and its members and manufacturers profit while the
public at large and those in and out of mental-health recovery lose.
the recent tragedy that sent 20 children to their early graves and
killed teachers and others at the school who attempted to defend
them, the sales pitch of gun advocates that "freedom equals a
gun placed in the hands of every American" will probably
we cry "never
again!" from the rooftops, unless we stop criminalizing everyone
with a mental illness and lift the burden of too many guns from our
shoulders, America's war with itself will continue and the body count
the director of the program Heart to Heart, through the National
Alliance for Mental Illness of Southern Arizona.
October 9, 2012 - News of the Week
'I GOT BETTER' CAMPAIGN
Have you heard about MindFreedom International's new website, 'I GOT BETTER' ?
This campaign has the potential to 'go
viral – imagine first dozens, then hundreds, even thousands
of people sharing their videos...Celebrities and other public figures
coming out of the 'mad closet'...This could not only bring hope to
people in pain, but also change attitudes toward us...”
SHARING YOUR STORY IN A VIDEO
COULD MAKE ALL THE DIFFERENCE
Now it's up to you -- do you have a story about
discovering and nurturing hope while in and out of the mental health
system, and mental and emotional problems?
Sharing your story could make a huge difference to someone
in the depths of their own struggle, especially young people.
Getting a psychiatric label can feel isolating. When they
see you and others sharing your stories about how you found hope and
defined recovery and wellness for yourself, you will encourage them and
give them ideas about how to make their own lives better.
Whether or not you share your story, think about people in
your life who may have such a story, and see if they would like to
IT'S EASY TO SHARE YOUR VIDEO
One of the best ways to really reach people today is with
video, so they can see your face and hear your voice. Try to keep it
short. Go ahead and share the worst of your struggles, but make sure to
follow that up with your recovery from hopelessness and positive
information about how you're achieving wellness in your life.
You don't have to be "fully recovered" (however that's
defined!) to participate. Whatever steps you've taken towards wellness,
and to get out of any oppression in the mental health system, you've
got a story to tell and we want to hear it!
Here's how to make and
submit a video:
We are also accepting
See those new video
stories with a link to more videos here:
Thanks for your support in
making I GOT BETTER a success!
Please email us
with questions, feedback, or anything else about I GOT BETTER at email@example.com
Sophie and John
With your help, people
will get the message that there is hope, even in situations of extreme
mental and emotional distress... or even when someone feels trapped
forever in a mental health system with no exit, say Sophie
Faught and John Abbe, MindFreedom's Communications
Co-Coordinators. Read on for how-to!
26, 2012 - News of
EXPLORES LANGUAGE OPTIONS
Years ago, David Oaks, the founder and director of
MindFreedom International, urged the mental health community to stop
using the term mental illness He
believes (and I agree) that the term spawns the public's misperception
of little-understood human conditions, and supports the medical model's
undeserved domination of the mental health field As David
explains it, My call is about
opposing domination by any
model in this complex field. My call is about opposing bullying
in mental health care.
To explore language options, David created an open-forum
online website, "Lets Stop
Saying "Mental Illness"! He emphasizes this is not
about political correctness or finding the perfect words, but sending a
message of respect about the diversity of perspectives in mental health.
In an email this week, David wondered why I (Jean Arnold)
continue to use mental illness
on my website. At first I thought he must be overstating. To
check it out, I did a word-search of www.stigmanet.org
by pressing ctrl+f (at the same time), then entering mental illness in
the FIND box that popped up. There were 143 finds for mental illness/illnesses on my home
page alone. (A number of these were in articles by other people.) I
intend to replace my use of mental illness/illnesses with language that
doesn't presume that the etiology of human behaviors has been
"Let's Stop Saying "Mental Illness"!
is an informative and thought-provoking online essay-in-progress about
the pitfalls of language inaccuracy and bias. David
welcomes feedback suggestions regarding this "living essay." Email:
SEE THE ESSAY:
20, 2012 - News of the Week
FINDS FAULT WITH MEDIA DEPICTION OF PSYCHIATRIC VULNERABILITIES
we continue as a society to let the media define mental illness, the
cycle of stigma and fear will only compound the problem." These
words are from Devan Munn, a Canadian who is a member of the
Community Editorial Board of GuelphMercury.com
Munn's insightful editorial ,"Media's approach to
mental illness doesn't help us understand it" (8/18/2012), drew
response from a concerned reader.
18, 2012 12:38 PM
It saddens me that the only time Mental Health gains much traction in
the media is in the event of a horrible tragedy. After such times, we
usually do get calls to address the systemic problems that are
symptoms of our failure as a society to prioritize getting help to
something that affects one in five Canadians. However, often what is
overlooked is that many people who have serious mental illnesses do
not get help because they fear being identified as mentally ill. Not
only that but our society has a particular picture of those with
someone says the words "paranoid
schizophrenia" they tend to think of someone like Vincent Li
rather than someone like me: A multiple scholarship winner who was
told that his illness would prevent him from returning to university
but defied such odds to pursue his education. One of the reasons I
struggled so much in the beginning with my diagnosis was that I
thought that my life would be spent on a couch because that was one
of the better expected outcomes.
after more than a few false
starts and much hardship, I discovered that I may not be able to
control all my symptoms, but I chould choose whether I accepted my
fate or not. A few years after such an epiphany, I am near complete
my M.Sc. in Mathematics. There is great pain and sorrow with mental
illness, but there is also hope in such darkness. It is my hope that
the media and we as a society do a better job at encouraging such
hope for those that may so desperately need it.
2012 - News of the Week
SURVIVOR MAKES PLEA
14, 2012 - News
of the Week
Article Reprinted using Fair Use Protection
The News Tribune
dialogue can tear down walls of misunderstanding about mental illness
Our communities are filled with people who are living
silently with mental illness, and most of us are terrified to share our
stories. We are afraid of being judged and labeled, relegated to the
edges of society.
We fear that we will be locked out of the inner circle
of community, the place where life is shared over good food, camping
trips, church events and baseball games. The place where meals are
brought to those experiencing tragedy, where money is raised for those
experiencing catastrophe, and where community support surrounds those
in need of healing. We fear that we will be on the outside looking in.
We are afraid that if we talk about our illness we will
be the subject of rumors questioning our stability, integrity, worth
and competency. We fear that when we share our diagnoses –
bipolar, depression, schizophrenia, obsessive compulsive disorder,
anxiety disorder or something else – we will be held at
arm’s length and will no longer be trusted to participate in the
responsibilities of the community; to teach young people; to manage the
finances of our local church; to organize the community benevolence
program; or to hold our position as accountant, city councilman,
barista or CEO.
Our community must do better than this, and I believe
we will. We will do better when we have eyes to see, eyes to see that
they are us. Who among us doesn’t have a mental illness or know
someone who has a mental illness?
We will do better when our communities hold forums and
town halls where we can talk openly about mental illness and stop
speaking in language that evokes fear. There is great power in sitting
in a room with someone and taking the time to hear that person’s
Until we make this a priority, people living with
mental illness will continue to be cast as unstable villains, teetering
on the edge of some violent explosion, fit only to be locked away,
pushed out of the life of our community.
As a community, we have an opportunity to grow, to
bring to light a group of illnesses that are misunderstood, whose
treatment and research is underfunded, and whose effect reaches into
nearly every home. It’s time to inform the misunderstanding,
better fund the treatment and research, and open the lines of
communication that will lead to reconciliation and healing.
Allow me to start the conversation.
I have bipolar disorder, type 1. In 2003, I ran through
Lakewood in my boxers carrying an American flag. I received inpatient
treatment at the psychiatric unit of St. Francis Hospital and
outpatient treatment Greater Lakes Mental Health. I attempted suicide.
I spent weeks, on two different occasions, wrapped in a world of
delusions that caused erratic behavior. That’s a piece of my
I have also been the valedictorian of my high school,
leader in my church youth group, a server at Red Lobster, an employee
of Merrill Lynch, a minister and a graduate student at the University
I’m a father, a husband, a resident of Pierce
County. These are also pieces of my story.
What’s your story?
Alan Taylor of Milton is a
state-certified peer counselor who works in the behavioral health field
in Pierce County as a peer specialist. He will start a master’s
of social work program at the University of Washington Tacoma in the
MINDFREEDOM PRESS RELEASE
New Campaign Defies Hopelessness In Mental
International launches the "I Got Better"
campaign with an invitation for you to participate in this "Survey on
Hope in Mental Health": https://www.surveymonkey.com/s/mfi-igb-intro
This brief, confidential introductory questionnaire takes
less than five (5) minutes to complete.
"I Got Better" is an ongoing project defying the
all-too-common message that recovery from mental and emotional distress
is impossible. The "I Got Better" campaign will make stories of
recovery and hope in mental health widely available through a variety
Your Participation Could Save a Life
Any and everybody with a stake in mental health in our
society is welcome to participate, including people who have used
mental health services, psychiatric survivors, as well as their
friends, family members, colleagues, and mental health workers. Please
share the survey link - https://www.surveymonkey.com/s/mfi-igb-intro
- freely via email, facebook, twitter, blogs, etc.
Respondents to the survey wishing to share additional
knowledge will be invited to take an optional follow-up survey about
impressions of hope and hopelessness in mental health care, and
successful strategies for recovery. Some survey respondents will be
asked to share their story on video.
David Oaks, Director of MindFreedom International, said,
"When I was in psychiatric care in college, I was told it was forever.
Your experience of hope and hopelessness in mental health care could
help youth and young adults receiving a psychiatric diagnosis for the
first time. Hope could save a life."
The Story Behind "I Got Better"
The title of the campaign is inspired by the successful "It
Gets Better" viral media effort led by columnist Dan Savage that "shows
LGBT youth the levels of happiness their lives will reach." While these
two campaigns are independent, Dan Savage has enthusiastically endorsed
"I Got Better."
The "I Got Better" campaign is funded by a grant from the
Foundation for Excellence in Mental Health Care to MindFreedom
International. MFI is an independent nonprofit coalition founded in
1986 to win human rights and alternatives in mental health. For more
information contact firstname.lastname@example.org,
or call the MFI office at 541-345-9106.
To take the brief, confidential introductory "I Got Better"
survey, which will be active through 15 October 2012, click here now:
- end -
May 20, 2012 - News
of the Week
"Before Healing Can Occur, People Must Feel Safe"
by Maggie Bennington–Davis, M.D., MMM
Recovery to Practice Highlights April 26, 2012
HEALING CAN OCCUR, PEOPLE MUST FEEL SAFE
There is an old medical school adage that says "first, do
no harm." In acute hospital settings, people describe all-too-frequent
experiences of fear and panic, loss of control, loss of
self-determination, seclusion, restraint, and unwanted medications.
Inpatient units can seem downright dangerous, not only to those
hospitalized, but to staff as well. Before healing can occur, people
must feel safe.
During my tenure as the medical director of psychiatry at
Oregon's Salem Hospital, I was part of the miraculous transition to a
trauma-informed environment. Seclusion and restraint were eliminated,
and there was a substantial decline in the administration of
involuntary medications (as well as a 30 percent decline in the use of
routine medication). People became more involved in psychoeducational
groups and therapeutic exchanges with staff. Injuries sustained by
staff and those hospitalized dropped dramatically, lengths of stay
decreased, and financial performance improved. It was a wonderful
example of parallel process—recovery for those coming into the
hospital and for the hospital itself.
had a phone call from a psychiatrist who specialized in organizational
consultation. He asked me, "After you quit doing restraint, what did
you do when someone was really upset and out of control?"
I had to
pause before I answered, because there wasn't a simple way to respond.
Staff in the program were never told not to use seclusion, restraint,
medication, or other means of control. Restraint went away because it
was no longer necessary, not because it was "banned." If a situation
required restraint or seclusion to prevent serious harm, appropriate
measures would be taken. But the environment had drastically changed,
and those situations didn't occur very often.
the people we served as we began our transformation and philosophical
shift. We immersed ourselves in understanding the neurobiology of
trauma, fear, fight-or-flight response, and the realization that
traumatized people perceived our clumsy attempts at "safety" as
predatory and controlling. We were astonished to learn virtually
everyone who came (or was brought) to us had suffered through difficult
childhood experiences. It humbled us to think about our past reactions
to these folks and the pejorative language we had used to explain what
suddenly seemed like perfectly rational behavior (manipulative,
aggressive, help-seeking, belligerent, difficult, etc.). Suddenly,
power struggles made a lot of sense, disengagement seemed
self-preserving, and the minor events that precipitated catastrophic
reactions didn't seem so minor after all. When we changed the lens to
one that was trauma informed and started asking "What happened to you?"
instead of "What is wrong with you?", everything else changed too.
(highlighting added by ja)
In essence, when we changed ourselves and the hospital to
be really, truly "safe," the people we were serving also felt safe.
Independent of diagnosis, symptoms, age, sex, or history, we were by
far the most significant variable.
Then the fun really began. We started using our
environment to regulate certain physiological responses of people at
the hospital. We used drumming techniques to normalize heart rates,
music to soothe, colors to evoke calm, and artwork to inspire (instead
of posted rules forbidding balloons and knives). We asked ourselves and
those we were serving, "What helps us feel safe?" The answers were
friendly greetings, calm voices, beauty in our surroundings, constant
information, sharing meals, and talking openly about upsetting events.
We changed our language, our assumptions about recovery, and our
expectations, and made a point of including families and friends. We
educated ourselves about customer service. Putting people's fears to
rest as soon as possible became our business.
We also realized that staff interactions completely set
the tone for everyone else, so we became mindful about communicating
and working with one another.
Dr. Sandra Bloom, creator of the Sanctuary Model,
taught us how to hold daily community meetings to discuss safety with
those we were serving as well as staff (doctors, administrators,
janitors, cooks, security, etc.). The twice-daily meetings became the
anchors of our serenity. If something happened that shook our
sanctuary, we spent the next community meeting determining how to
return to safety. We knew when something frightening happened to one
person in the community, everyone was affected.
Every now and then, we still experienced an upsetting
event. I will never forget the woman who repeatedly banged her head
against the hospital wall. She had been restrained many times before,
always to keep her from harming herself. We mulled over how we could
help her in our new environment. In a community meeting, another
hospitalized woman told the newcomer, "Honey, when you bang your head
like that, it hurts my head." The group suggested we move the bed to
the center of the room, away from the walls that facilitated her head
banging. Finally, the banging stopped and the woman began to heal.
There was the man who paced the unit's perimeter, talking
frenetically to himself and occasionally banging his fist on the wall.
During a community meeting, folks who had been in the hospital for a
few days kindly told him they were frightened of him. He looked shocked
and apologized, saying he would never hurt anyone. His pacing stopped,
his fear and anger seemed to subside, and he began to pursue the
opportunities we offered to support his healing process.
We learned to have a different threshold for upsetting
behavior. Staff were constantly encouraged by managers to do what was
necessary to keep things safe, but the word "safe" became much more
inclusively defined. Our staff created an environment where everyone
really did feel safe, and the outbursts, anger, and violence mostly
All of these changes created completely different roles
for staff—jobs that focused less on maintaining order and
policing the unit, and much more on healing and partnering with people
to initiate and support their recovery journeys. The transformation
exemplified recovery more than any treatment plan I have ever
witnessed. It was truly a highlight of my career.
Dr. Bennington–Davis is the Chief
Medical and Operating Officer at Cascadia BHC in Portland, Oregon.
7, 2012 - News of the Week
DARK SIDE OF KENDRA'S
eight-year-long court case concerning Kendra Webdale's terrible death
at the hands of Andrew Goldstein ended abruptly when both sides agreed
to avert a third agonizing trial. It wasn't a perfect closure, but an
understandable one. However, the two earlier failed trials
spurred lawyer/advocate Patricia Warburg Cliff, then a board member of
national NAMI, to express her dismay in a thought-provoking article,
Railroading of Andrew Goldstein." This informative commentary
(below) was published in the Journal of California AMI, vol.11,
remain. Key among them: Why does the press often call Andrew
Goldstein a 'treatment refuser'? Doesn't this libel a man who
knew his diagnosis was severe schizophrenia with uncontrolled violent
outbursts, and for two years had requested a supervised treatment
setting? Looking back, it is also clear that Kendra's Law
proponents missed an opportunity to point out that rare disasters are
more likely to occur when insufficient mental health services are the
they focused their call-to-action on a man trapped by and ultimately
destroyed by draconian policy decisions.
still the myth goes on. Just last week, Albany's Legislative Gazette
reported a new push to make Kendra's Law permanent, wrongly describing Andrew Goldstein
as "a man diagnosed with, but not seeking treatment for,
fading facts become harder to verify, the insights, observations, legal
experience, and personal views of a witness can be a valuable
resource. Thank you, Patricia Warburg Cliff, for "The
Railroading of Andrew Goldstein"
an investigative report of Goldstein's downward spiral, click:
on the Streets" New York Times,
by Michael Winerip, May 23, 1999 (This Times Magazine cover
story appeared 5 months
after Kendra Webdale's death. New York's Kendra's Law passed 3
months later, despite then-known circumstances)
RAILROADING OF ANDREW GOLDSTEIN
Patricia Warburg Cliff
Source: (with publisher's permission)
V.11,1.3 (September 2000)
The failure of the
legal profession, the court system and the public to grasp the vital
concepts involved in the two trials of Andrew Goldstein further
reinforce the fact that we at NAMI have much work to do.
January 1999, Andrew Goldstein, an unmedicated, delusional person
with paranoid schizophrenia who had been unsuccessfully seeking help
at various hospital emergency rooms, pushed Kendra Webdale to her
death on the tracks of the New York City subway. Unfortunately the
terrible tragedy of this young woman's death clouded public
perception of the situation which allowed this to occur: the failure
of the public system to offer the required state-financed housing
with day services, clinic visits and an intensive case manager, to
this seriously ill young man.
It was, however, not the system
which was on trial, but the other "victim" of this tragedy,
Andrew Goldstein himself. The first trial ended in a hung jury,
because two jury members had had some limited experience with the
mental health system and consequently understood the nature of
Goldstein's illness and his inability to form the necessary intent to
commit murder in his psychotic state. The public's outcry for
revengeful punishment did not, however, cease.
February, 2000, a second trial was commenced. After hearing the
evidence, the judge instructed the jury that they had the option of
convicting the defendant of manslaughter in lieu of the second degree
murder charges, if they found that he had acted with "depraved
indifference," but without the requisite intent necessary for a
conviction of second degree murder. It took the jury only two hours
to reach the verdict of second degree murder.
The irony of
the situation should not be overlooked: Andrew Goldstein was being
held at Bellevue Hospital following his arrest where he was willingly
receiving treatment for his illness and consequently would not be
able to appear sufficiently psychotic at his trial to demonstrate to
the jury the disabling effect of this illness on his judgment. The
defense pinned its hopes on taking Mr. Goldstein off his
antipsychotic medication and putting him on the stand, to better show
the jurors his mental state at the time of the attack. This novel
concept was thwarted when Mr. Goldstein struck a social worker,
further indicating his violent state of mind when unmedicated. Judge
Berkman insisted that Mr. Goldstein be offered the choice of taking
his antipsychotic medication, which he chose to do. The result was
that the jury was able to see a passive, sedated individual and not
the person whose delusions caused his violent behavior.
suggestions to the defense counsel to utilize the virtual reality
videos produced by pharmaceutical companies which demonstrate the
psychotic state of mind, as well as comparisons to the diminished
capacity suffered by individuals who are experiencing the onset of a
diabetic coma or an epileptic seizure, fell on deaf ears. The
subsequent result demonstrates the ignorance of the judge, jury and
defense counsel with respect to paranoid schizophrenia. Andrew
Goldstein never got a fair chance.
At the conclusion of the
trial, the jurors were convinced that punishment, not treatment, was
warranted. Mrs. Webdale, the victim's mother spoke at the sentencing
hearing: "It is my contention that if Andrew Goldstein had been
held responsible many incidents ago, there would not have been 13
assaults and one homicide committed by him. His ongoing aggression
was tolerated and acceptable." The presiding judge concurred
saying that the attack stemmed from the state mental health system's
failure to punish Mr. Goldstein for past assaults.
On May 5,
2000, Judge Berkman gave Andrew Goldstein the maximum sentence of 25
years to life in prison for the murder of Kendra Webdale. What is
wrong with this picture? Has the "justice system" reverted
to a witch hunt to punish the violent mentally ill whom the public
system has dismally failed? Are we, as a society, going to be content
with the gross misunderstandings of mental illness which were
demonstrated in this trial? How are we going to educate the judiciary
about these issues?
The ultimate irony is that the New York
State legislature, ever reluctant to provide sufficient funding for
treatment for the mentally ill, hastily passed a bill, commonly
referred to as "Kendra's Law," allowing for court ordered
treatment or commitment of the mentally ill under certain
circumstances. Andrew Goldstein who is now rotting in the state
prison system, had tried repeatedly to get help before the attack. He
even sought his own commitment when he realized that he was out of
control. The misnomered "Kendra's Law" would not have
prevented this tragedy.
attorney and mental health advocate in New York City, serves on the
national board of NAMI as well as on the board of NAMI-NYC Metro. Her
only child, Kenneth Johnson, succumbed to depression in 1995, as a
result of the private health care system's failure to adequately
diagnose and appropriately care for his illness.
2012 - News of the
YALE PSYCHOLOGIST EXAMINES
can we help people who won't
treatment, people who deny they need
can the concept of recovery be
people who say there is nothing wrong with them?
Why would someone
refuse psychiatric help? Obvious answers might be a harrowing
treatment experience, a lack of appropriate programs, or the
stigmatizing label. A more problematic reason is "lack of
insight," a loss of awareness that can occur in schizophrenia
and related disorders.
A timely article
Davidson, PhD of the
Department of Psychiatry at Yale, asserts
that people who
appear to lack insight may be best suited to treatment
use a recovery-oriented approach. Harvey Rosenthal of NYAPRS agrees:
people who are perceived to lack insight either reject any help or
end up in varying degrees of treatment against their will. Dr.
Davidson offers very practical and sophisticated guidance,
with concrete examples, towards understanding and successfully
people in a person-centered approach to care."
the past several years,
recovery-oriented practice has gained momentum throughout the mental
health field. This promising trend is supported by people who
psychiatric services and the federal agency that oversees mental
health and substance abuse services, SAMHSA
insight has been used as a key
argument for coerced medication, and one might assume that forced
treatment is necessary for all 'treatment refusers'. Actually,
Davidson points out that recovery-oriented, person-centered
treatments have been successful regardless of the individual's
,"The Insight Issue," is posted on the temporary
for the Recovery to Practice group, SAMHSA
Recovery to Practice
Larry Davidson -- http://www.yale.edu/PRCH/people/davidson.html
NYAPRS, Harvey Rosenthal, Executive Director
October 1, 2011 -
News of the Week
FACTOIDS FILL GAP AND SHAPE ATTITUDES
factoid is a questionable or spurious -
unverified, incorrect, or fabricated - statement
asserted as a fact but with no veracity. The word
appears in the Oxford English
as 'something which becomes accepted as fact, although it
may not be true'."
Quote is from
Wikipedia, the free
In the field of
psychiatry, the lack of facts is a major
obstacle to understanding. This leaves the field open to
inventive adaptations of the existing information. For
studies designed for a specific purpose are often mined inappropriately
for data to support a different purpose. Authoritative research
findings are cherry-picked for statements to support a cause.
Facts become grossly distorted when statistics reported by researchers
are presented as absolute
to bolster a cause.
Unfortunately, these methods have produced a new body of psychiatric
factoids about violence that now are becoming entrenched, with the
media acting as catalyst.
ago, an in-depth study of public attitudes
toward psychiatric disabilities by the Robert Wood Johnson Foundation
concluded that "Mass media is, far and away, the public's primary
source of information about mental illnesses." Concerned
the media's vast influence, mental health advocates nationwide began in
the late 1980s to monitor media coverage of mental illnesses. In
the mid-1990s, the advocates saw and
recorded a surge of violence-loaded television features, op-eds, and
articles. Most if
not all promoted compulsory medication
for psychiatric outpatients, and most of them involved or referred to
Dr. E. Fuller Torrey, forced-medication's most visible
It was soon clear that the violent media features were part of a
well-funded campaign to legalize forced meds that continues to this
day. By 1993, when Torrey's chief supporter (D.J. Jaffe) instructed
advocates that "it
necessary to capitalize on fear of violence to get the law passed," the
swung into action.
recent addition to this scene is a website headed
by D. J. Jaffe, a newly-retired adman. Judging from
a sampling of Jaffe's 'fact' sheets, he has appropriated briefing
papers developed over the years by the Treatment Advocacy Center (which
Jaffe co-founded with Dr. Torrey in the late 1990s). The papers consist
of summarized findings of original studies from many sources.
Unfortunately, the Torrey/Jaffe summaries present self-serving
interpretations of the original studies. This led authors of at
authoritative studies to state that the Torrey/Jaffe team did not
accurately represent their study's findings.
inaccuracies live on. In 1999, an abbreviated version of the
popular but bogus statistic, "1,000 homicides are committed annually by
untreated individuals with bipolar disorder or schizophrenia,"
reportedly made the Congressional Record. Shortened and
by 20 years of use, the 1,000-homicides factoid has morphed
meaningless and is now applied to people with any history of mental
illness, or half the American public.
the twenty-year focus on violence affected the
public's view of mental illnesses? Former Surgeon General
Satcher found that the public's exaggerated fear of individuals labeled
'mentally ill' raised discriminatory barriers to their health and
well-being. In his groundbreaking report on mental health in
(Introduction and Themes, page 8), Dr. Satcher underscored his concern:
most people should have
little reason to fear violence from those with mental illness, even in
its most severe forms, why is fear of violence so entrenched?
Most speculations focus on media coverage and deinstitutionalization.”
There can be little doubt that the two-decade emphasis on violence by a
determined group of controversial 'advocates' has contributed to the
public's misperception of conditions called 'mental illnesses'.
New York Times
Print Edition: October 4, 2011
using Fair Use
Lifts Severe Schizophrenics
People with severe schizophrenia
who have been isolated, withdrawn and considered beyond help can learn
to become more active, social and employable by engaging in a type of
talk therapy that was invented to treat depression, scientists reported
These new findings
suggest that such patients have far more
capability to improve their lives than was previously assumed and, if
replicated, could change the way that doctors treat the one million
patients for whom the disorder is profoundly limiting.
The therapy —
a variant of cognitive behavior therapy,
which focuses on defusing self-defeating assumptions —
motivation and reduced symptoms. In previous studies, researchers have
used cognitive techniques to help people with schizophrenia manage
and sharpen their attention and memory. The new study is the first to
rigorously test using the therapy to combat so-called negative symptoms
— the listlessness, exhaustion and emotional flatness that
many people in solitary lives, playing out their days smoking in front
of the TV or holed up in their homes.
Dr. Bob Buchanan, a
psychiatrist at the University of
School of Medicine who was not involved in the study, said the results
looked impressive. “This is a group of patients who have
just about everything — drug treatments as well as
ones — and many clinicians and systems of care have
given up on them. If there’s an intervention out there that
make a difference, I think that’s an incredibly important
study, appearing in the current
issue of The Archives of General
Psychiatry, researchers at the University of Pennsylvania enrolled 31
people from community health clinics in Philadelphia in a therapy
program that included weekly sessions, each about an hour in length, in
addition to their normal medication regimen. Each person set a goal,
whether to find a job, start a relationship or go back to school. Aided
by the therapist, the person then took incremental steps toward that
goal, going out for coffee, visiting a local bookshop or volunteering
at a community center.
“It took a
long time to get patients engaged,”
Dr. Aaron T. Beck, a psychiatrist and one of the authors. “We
used video games a lot at the beginning, just to give them a sense of
some mastery.” Dr. Beck invented cognitive therapy decades
about the same time another therapist, Albert Ellis, was developing
The therapists in the
study, all either psychiatrists
or Ph.D.’s, all working from manuals guiding the technique,
helped their patients correct self-defeating beliefs, like
“taking even a small risk is foolish because the loss is
to be a disaster,” and “making new friends
worth the energy it takes.” After about six months, the
began to show measurable improvement. After 18 months the benefit was
clear, on the Global Assessment Scale, a standard scale tracking
“They made a
jump of about 10 points on that scale, on
average, which we consider to be moving a whole level up in terms of
functioning,” said Paul M. Grant, the study’s lead
A comparison group of 29 patients who received standard treatment
— medication, and case management services as needed
showed no such improvement.
co-authors were Gloria A. Huh, and Dr.
Stolar, along with Dr. Beck, of the University of Pennsylvania, and
Dimitri Perivoliotis for the Veterans Affairs San Diego Healthcare
Measures of emotional
vitality and sociability were not
much. But motivation improved significantly, and some who got the
cognitive therapy altered their lives for the better, in significant
ways. One woman, who had been frequently hospitalized before the study,
began making coffee at the clinic as a part of therapy, then took her
cart to a community clinic, parlaying that into a job as a cook. She
has not returned to the hospital since.
Still, the course of
therapy was extraordinarily long
with what is usually offered. A standard course for depression lasts
three or four months. That may make the approach difficult for strapped
institutions to provide, some experts said. And it is not clear whether
community therapists will be as effective as the University of
Pennsylvania’s highly trained team.
“You have to
understand that this is not like therapy
depressives,” who usually get better sooner or later anyhow,
Beck said. “These people do not get better; no one had any
therapy for them.”
26, 2011 - News of the Week
VOICES USA' JOINS WORLDWIDE MOVEMENT
September 14, 2011,
was International Hearing Voices Day!
To celebrate, the
USA network of voice-hearers launched
their new website,
) Already the site offers a wealth of
information including resources and links to a network of websites
across the globe -- in Australia, Greece, England, Wales, Denmark, the
Netherlands and more.
In growing numbers, people who hear voices are breaking a silence
imposed by negative social attitudes (stigma). This
movement, aided by the Internet, eases the pain of misunderstanding
and isolation. Learn more with a visit to About
Below is an excerpt from the National
Empowerment Center press
What is World Hearing
World Hearing Voices Day
celebrates hearing voices as part of the diversity of human experience,
increasing awareness of the fact that you can hear voices and be
healthy. It challenges the negative attitudes towards people who hear
voices and the incorrect assumption that hearing voices, in itself, is
a sign of illness.
Don’t Forget to Join
the Hearing Voices Network USA on Facebook, too…
In addition to the
new Hearing Voices USA website,
we’ve also found a home on Facebook so come join us there as
and take part in making the Hearing Voices USA Facebook page an
informative and interesting place to be! Click here to join the Hearing
Voices Network USA on Facebook.