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July 1, 2015 - News of the Week

WILL THE MURPHY-JOHNSON BILL, HR2646, HELP STRUGGLING FAMILIES

Or will it arrest progress and turn back the clock on mental healthcare

 
Congressman Tim Murphy (R-PA) has vowed  to conquer a thorny national disgrace: the public's neglect -- many would say abandonment -- of psychiatrically-labeled Americans and their families.

Rep. Murphy and Rep. Eddie Bernice Johnson (D-TX) have proposed a bill, HR 2646, titled "Helping Families in Mental Health Crisis Act of 2015," to rescue suffering families with psychiatrically-labeled members who are unable to find appropriate treatment and housing.

(Link to text of HR 2646 introduced June 4, 2015)
https://www.congress.gov/bill/114th-congress/house-bill/2646/text

But the 173-page bill goes far beyond helping families in crisis.  It proposes a massive restructuring of a system that distributes billions of federal mental health dollars to states and federal agencies. The question is whether HR 2646 would replace an unmanageable system with a worse one.
 

SOME CONCERNS:

1) The bill does not address the negative public attitudes that have derailed attempts to establish community housing and supports.   For forty years, essential housing and supportive programs have been rejected by communities, leaving only a small percentage of  families able to find crucial community support.  This serious impedimentt to community inclusion has caused untold pain and jeopardized the well-being of all concerned.

2) The bill has impressive support from pharmaceutical companies.  It's now become clear, however, that countless lives were damaged by over-diagnosis and over-medication while families were assured by trusted experts that neuroleptics were completely safe.  Many of us see the bill's overwhelming support by big pharma as an ominous sign.  Provisions in HR 2646 assure that forced meds will be expanded.  And progress toward treatments using less medication will be curtailed or defunded.

3) Another concern is the Murphy bill's disabling of SAMHSA, a federal overseer of mental health and substance abuse programs.  HR 2646 culminates an ongoing attack on SAMHSA led by Dr. E. F. Torrey and D. J. Jaffe who have for years disparaged  SAMHSA's encouragement of former patients who favor recovery-oriented practices.   Just as the rise of experienced  ex-patient voices is beginning to shape positive changes in mental healthcare, the bill's dismantling of SAMHSA would make client activism more difficult. 

4) Beyond the "disable SAMHSA" provisions, HR 2646 curtails the ability of patients and their advocates to seek social justice.   It strips Protection & Advocacy agencies of their ability to assist their clients beyond "abuse and neglect."  This gratuitous restriction prevents advocacy for better services.

MORE about the bill....

The Murphy-Johnson bill overlooks a main reason millions of people with psychiatric labels are destitute.  Advocates have for 40 years sought the effective community treatments, safe housing, programs and services that were promised when psychiatric institutions were emptied into unprepared communities. Yet the public has consistently and effectively blocked community housing and support.  Why?  There is an unreasonable amount of fear and rejection of people with psychiatric labels.  This fact was stated most strongly by former Surgeon General David Satcher in his groundbreaking mental health report of 1999:  "Because 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?"   At least some of that unwarranted fear was deliberately spawned by supporters of forced outpatient medication to promote their controversial agenda.


Using a twisted but effective strategy, suppporters of compulsory medication chose to "capitalize on the fear of violence" (their words) for 20 years to win public support for involuntary outpatient treatment and re-institutionalization.  How will Rep. Murphy and Rep. Johnson convince the public that psychiatrically-labeled  people are not to be feared as neighbors and co-workers?   Will they even try, since they need a fearful public's support for HR 2646's restrictive provisions.

At worst, the exhaustively complex Murphy-Johnson bill may be raising false hope among families, proposing programs that alienate the people most in need of help, and reinforcing the public's view that the nation's excessive violence is linked to mental illness.  At least $130 billion federal dollars are spread among eight federal departments and agencies (SAMHSA gets a mere $3-4 billion).  The devil is in the details of HR 2646.  And in the priorties of its authors.



MORE INFORMATION


!!  NEWS ALERT !!  

A U.S. Senate bill will be introduced later this summer by Senator Chris Murphy (D-CT)
http://www.ctpost.com/news/article/Murphy-to-unveil-mental-health-bill-6361306.php


AN ACTIVIST STATES GOALS

Why We Need a Paradigm Shift in Mental Health Care: The Case for Recovery Now!


By Leah Harris 

Mother, storyteller, mental health advocate, and coordinator of the Recovery Now! campaign.

Huffington Post   
June 12, 2015

 

Another "May is Mental Health Month" has come and gone, and it is time to build on years of awareness campaigns and move into action to promote whole health and recovery. People with serious mental health conditions are dying on average 25 years earlier than the general population, largely due to preventable physical health conditions, so why do we still focus on mental health separately from physical health? And when we know that people with serious mental health conditions face an 80 percent unemployment rate, why do we largely ignore the role of poverty, economic and social inequality, and other environmental factors in mainstream discussions about mental health? 

Decades of public health research have clearly shown that access to the social determinants of health -- affordable housing, educational and vocational opportunities, and community inclusion -- are far more important to mental and physical health than access to health care alone. As one recent article explained: "For many patients, a prescription for housing or food is the most powerful one that a physician could write, with health effects far exceeding those of most medications." Yet this wisdom does not generally guide policymaking in the U.S. Among nations in the Organization for Economic Co-operation and Development (OECD), the U.S. ranks first in health care spending, but 25th in spending on social services. Is there something wrong with our very concept of "care"?

This question is not just theoretical for me. As an adolescent, I attempted suicide several times. I found myself in the back of a police car more than once and was frequently hospitalized. At age 16, I was diagnosed with bipolar disorder. Two years later, I found myself sitting in a squalid group home, where I was told I needed to remain for life. I had no high school diploma and no job. My hopelessness and despair were all-encompassing.

I managed to get on a different path when I obtained access to safe and stable housing, education, and social support. Today, I am living life as a mother and a mental health advocate. I train human service providers in suicide prevention, recovery, trauma-informed approaches, and person-centered health care. Every day, I'm grateful that I was able to regain my life, and I want everyone to have this opportunity. 

To help promote a paradigm shift in mental health care, I've been part of starting a new, nonpartisan public awareness campaign called Recovery Now! This campaign seeks to educate all Americans about the kinds of services and policies that promote real recovery and whole health for people affected by mental health conditions. Here are a few key messages of the Recovery Now! campaign.

Recovery is possible for all.

The vast majority of people living with mental health conditions, even people diagnosed with serious mental illness, can enjoy a high quality of life in the community with access to the right kinds of services and supports. Dr. Richard Warner, clinical professor of psychiatry at the University of Colorado, noted: "It emerges that one of the most robust findings about schizophrenia is that a substantial proportion of those who present with the illness will recover completely or with good functional capacity." A slew of other studies have found similar results.

An argument used against recovery is that there are some who can't or won't voluntarily seek treatment or services. Yet there are plenty of evidence-based ways to reach people, such as motivational interviewing, or employing peer-to-peer support or community health workers to do homeless outreach or to engage with persons with complex mental and physical health needs. But these kinds of strategies are vastly underutilized.

We must advocate for recovery-oriented policies.
Hope is essential for recovery. But hope is not enough. Too many people are still unable to access the kinds of services and supports that would help them to recover. In particular, people of color are overrepresented in our jails and prisons, and are underrepresented in community-based mental health and social services.

A prime example is in Chicago, where newly re-elected Mayor Rahm Emanuel closed six community mental health clinics in the most economically disadvantaged parts of the city, which has resulted in an increase in persons with mental health conditions being incarcerated in the Cook County Jail for low-level, nonviolent offenses related to their disabilities. While the recent appointment of a psychologist to head the jail is a step in a better direction, how will this appointment impact upon the lack of availability of community-based services in Chicago for people who desperately need them?

 

Yet Mayor Emanuel is not unique in his choices. Community-based services have been slashed in many state and local budgets. Any short-term "savings" accomplished by such cuts will always be offset by the devastating long-term human and economic costs that result when we deny quality services and supports to the people who are most vulnerable.

Mental health legislation has been introduced in the House and is expected in the Senate. All legislation should be evaluated through a recovery lens and should clearly address the social determinants of health. Policy should seek to end deadly cycles of poverty, homelessness and incarceration in ways that are culturally appropriate, rehabilitative rather than punitive, and community-based. We can't talk about more hospital beds without talking about supportive housing and other programs that will actually help people to stay out of the hospital and out of prison. We need legislation that tackles disparities in access to education and employment, and funds proven programs that prevent crisis and recidivism.

We need sound policies that promote recovery for all Americans affected by mental health conditions. We don't have the luxury of continuing to get this wrong. Too many individuals, families, and systems are in crisis, and it doesn't have to be this way. We need recovery, and we need it now.

 

http://www.huffingtonpost.com/leah-harris/why-we-need-a-paradigm-sh_b_7560446.html

 






April  20, 2015 - News of the Week


THERAPY CAN HELP WITH HALLUCINATIONS

Article forwarded by NYAPRS E-News

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

 

CBT for schizophrenia? You don't know Jack.

by Abigail Strubel, MA, LCSW, CASAC

 

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

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

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

"Ten bags a day?" I asked.

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

Jack entered my office one day in a funk.

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

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

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

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

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

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

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

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

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

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

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

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

by Elizabeth Saenger, PhD


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

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

Here are some advances from the last six months.

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

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

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

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

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

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

Merging CBT with Other Evidence-based Treatments

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

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

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

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

Link:http://www.coalitionny.org/the_center/recovere-works/RECOVERe-works114-1April2015.html#Jack







March 29, 2015 - News of the Week


FIVE TIMELY "TALKING POINTS" WORTH REMEMBERING

http://www.huffingtonpost.com/2015/03/27/andreas-lubitz-mental-health-germanwings_n_6956578.html

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

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


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

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

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

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

1. Depression doesn't cause violence.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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



MORE ARTICLES (The Atlantic and The Boston Globe)

http://www.theatlantic.com/health/archive/2015/03/depressed-doesnt-mean-dangerous/388922/

 

http://www.bostonglobe.com/metro/2015/03/28/will-crash-plane-reportedly-hand-pilot-spark-stigma-anew-over-mental-illness/KJLtkKIbgVoDVZU5e2lh1N/story.html?s_campaign=8315

 










March 23, 2015 - News of the Week


!!!  PASSING ALONG FOR YOUR INTEREST !!!

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

 

 

 

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

 

 

 

SAMHSA Grant Opportunities Announced

 

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

Anticipated Award Amount: Up to $250,000

 

Application Due date: Monday, April 6, 2015

 

Click here for more information.

 

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

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

 

Anticipated Award Amount: Up to $250,000

 

Application Due date: Monday, April 6, 2015

 

Click here for more information.

 

 

First Fridays with BRSS TACS

 

Friday, April 3, 2015

 

Building Effective and Sustainable Peer Run Organizations

 

Register here 

 

with

Edye Schwartz, D.S.W., L.C.S.W.R., 

 

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

 

Click here to learn more about Dr. Schwartz.

 

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

 

Click here to review the slides.

 

Save the Date

 

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

 

Click here to register.

 

Click here to learn about the presenters.

 


 

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

 

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

 

Click here for more information.

 

Click here to register.

 

 

Recovery Resource Library Update

 

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

Click here to find more resources on this topic.

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

 

Questions or comments about this email? Let us know!

 

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

 

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

 







February 27, 2015 -  News of the Week

NYC'S FIRST LADY, CHIRLANE McCRAY, SPEAKS OUT ABOUT MENTAL HEALTHCARE

See her article: 
http://www.nydailynews.com/news/politics/guest-column-shatter-mental-illness-stigma-article-1.2129792

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


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

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

How We Will Shatter the Mental Illness Stigma
 

By Chirlane McCray

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

http://www.nydailynews.com/news/politics/guest-column-shatter-mental-illness-stigma-article-1.2129792

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





February 19, 2015  - News of the Week


'ASYLUM TALK' ALARMS EXPERIENCED ADVOCATES

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

RETURN TO ASYLUMS?  LET'S NOT !

by Susan Rogers

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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





News of the Week - January 8, 2015


This thought-provoking article can be found at   

         
   OR
http://www.printfriendly.com/print/?source=site&url=http://brainblogger.com/2015/01/07/explaining-away-empathy-mental-illness-and-reduced-compassion/#

Explaining Away Empathy - Mental Illness and Reduced Compassion

by Jennifer Gibson, PharmD

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

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

Wrong.

Wrong.

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

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

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

References

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

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

Social science & medicine (1982), 96

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

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

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

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

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

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

Medical journal, Armed Forces India, 70

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

Journal of affective disorders, 168

, 224-8 PMID: 25064807

MORE INFORMATION

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

Link:
http://www.huffingtonpost.com/2014/12/01/mental-health-biology-stu_n_6249056.html?utm_hp_ref=mental-health





December 18, 2014 - News of the Week

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

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

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



ARE POLICY MAKERS LISTENING TO ALL INVOLVED ? 

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

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

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

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

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







October 18, 2014 - News of the Week


SURVIVOR STORIES SHATTER STEREOTYPES

San Francisco Honors Psychiatric Survivor Carmen Lee

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

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

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

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





October 1, 2014 - News of the Week


2014 ALTERNATIVES CONFERENCE CONTINUES QUEST FOR SOCIAL JUSTICE



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

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

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

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




August 11, 2014 - News of the Week


HOW TO  REDUCE GUN VIOLENCE AND SUICIDE

Popular misperceptions must be replaced with facts

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

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

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

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

Article source:  ANNALS OF EPIDEMIOLOGY  

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

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





July 15, 2014 - News of the Week


A BRITISH SURVIVOR CHALLENGES SCHIZOPHRENIA'S BAD RAP

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

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

By Rachel Hobbs

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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





June 15, 2014 - News of the Week

A "60 MINUTES" BIAS HARMS MILLIONS

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

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

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


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


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


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

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

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

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

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

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


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

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


MORE LETTERS AND INFORMATION

A Plea to Mainstream Media


The Case Against Schizophrenia

(Time to relinquish the diagnosis of schizophrenia)



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

April 9, 2000 News of the Week

THE NEW YORK TIMES ATTEMPTS TO UNDERSTAND "RAMPAGE KILLERS"
"Rampage Killers Chart a Well-marked Course to Their Unraveling"


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

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

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

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

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

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


        



    May 2, 2014 - News of the Week


    A CLOSER LOOK AT "LACK OF INSIGHT"

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



    THE ISSUE OF INSIGHT

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

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

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

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

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

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

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

    http://www.samhsa.gov/recoverytopractice/Resources/special_feature/2012/2012_02_12/SF_2012_02_12.html



    February 24, 2014 - News of the Week

    "MADNESS NETWORK NEWS" RETURNS

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


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

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

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

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

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

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


     



    January 18, 2014 - News of the Week

    DR. TORREY'S FIXATION ON VIOLENCE FUELS FEAR AND DISCRIMINATION

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

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

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

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

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


    MORE INFORMATION

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

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

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

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

    Relevant Links:
    http://en.wikipedia.org/wiki/Death_of_Kelly_Thomas

    http://www.latimes.com/local/la-me-kelly-thomas-20140115,0,3003173,full.story#axzz2qlMi6oQ2http://losangeles.cbslocal.com/2014/01/14/fbi-opens-investigation-into-possible-violation-of-kelly-thomas-civil-rights/

    ...




    January 11, 2014 - News of the Week

    DAVID BROOKS TAKES HEAT FOR HIS VIEWS ON MARIJUANA 

    THE PUBLIC NEEDS FACTS ABOUT POTENTIAL HARM


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

    May I suggest a bit of balance.

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

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

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