News of the Week - January 8, 2015
This thought-provoking article can be found at
Explaining Away Empathy - Mental Illness and Reduced Compassion
by Jennifer Gibson, PharmD
Empathy is critical for health care providers.
Especially in mental health care, empathy and compassion improve
outcomes and enhance overall patient well-being. Thanks to innovative
explorations into the way the brain works, mental illness is
increasingly defined by biological mechanisms. But, new research claims
that these biological explanations lead to less empathy for patients.
A recent trend in mental health has focused on
offering biological and genetic mechanisms for mental illness. Experts
believed that such explanations would decrease the blame that patients
receive for their illnesses since genes, cells, and chemicals are named
as culprits. Feelings of compassion should increase for the patients
since the illnesses are not their faults, right?
In a series of studies, clinicians expressed less empathy and
compassion for patients when symptoms of mental illnesses were
explained with biological mechanisms. The authors of a recent analysis
indicate that biological explanations do decrease patient blame but,
albeit unintentionally, also dehumanize patients. The biological
explanations for mental illness seem to enhance the perception that
patients are abnormal or deserving of social exclusion. In additional
studies, clinicians indicated that they believed psychotherapy would be
less effective and medication would be more effective when mental
illness was explained by biological mechanisms instead of psychosocial
reasons. (Most mental health experts agree that psychotherapy is
effective in many mental illnesses, despite the cause of the illnesses.)
Biological explanations also affect the
perspectives of the patients themselves. Patients who attribute their
conditions to biology are more pessimistic about their prognosis than patients who accept psychosocial explanations for their illnesses.
Many questions still remain about causes,
predictive factors, and prognosis of mental illness, and biological
features should not be ignored as one piece of the mental health
puzzle. The biological conceptualization of many conditions is a
significant step toward the safe and effective treatment of mental
illness. But, like patients with any other condition – cancer, autism,
asthma, or even high blood pressure – patients with mental illness
deserve respect and compassion. Treatment for all patients and all
diseases should focus on the whole patient and consider biology, psychosocial, and emotional factors.
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
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
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
R, Chaudhary R, Ryali VS, Bhat PS, Srivastava K, Prakash J, &
Basannar D (2014). Cross sectional assessment of empathy among
undergraduates from a medical college.
Medical journal, Armed Forces India, 70
(2), 179-85 PMID: 24843209
*Speerforck S, Schomerus G, Pruess S, &
Angermeyer MC (2014). Different biogenetic causal explanations and
attitudes towards persons with major depression, schizophrenia and
alcohol dependence: is the concept of a chemical imbalance beneficial?
Journal of affective disorders, 168
, 224-8 PMID: 25064807
Here's another article describing how the current emphasis on
biological aspects of mental illnesses affects the way diagnosed
individuals are viewed and treated: "Downside of Treating Mental
Illness Like A Physical Problem" by Lindsay Holmes, Huffington Post,
December 1, 2014
December 18, 2014 - News of the Week
Correction added by Jean Arnold on December 20-21, 2014
When I posted this item on Dec. 18, I assumed,
mistakenly, that DJ Jaffe meant SAMHSA when
he told a NAMI audience, "The federal government
spends $130 billion mental health dollars, much
on improving the lives of all Americans."
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" ?
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
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
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
October 18, 2014 - News of the Week
SURVIVOR STORIES SHATTER STEREOTYPES
Honors Psychiatric Survivor Carmen Lee
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.
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)
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
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
2014 - News of the Week
TO REDUCE GUN VIOLENCE AND SUICIDE
misperceptions must be replaced with facts
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
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
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."
introduction (excerpt below) explains how
complicated the policymaking process. The full article is FREE
ONLINE, click here.
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.
2014 - News of the Week
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:
the most misunderstood mental illness?
By Rachel Hobbs
"While mental health stigma is
decreasing overall ... people
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
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
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
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
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
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
“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
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
schizophrenia and violence in the public imagination. In reality,
violence is not a symptom of
the illness and those affected are much more likely to be the victim of
a crime than the
We never hear from the silent majority, who are quietly getting on with
their lives and pose
no threat to anyone. We also never hear about people who are able to
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,
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
#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.
2014 - News of the Week
A "60 MINUTES" BIAS HARMS
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.
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.
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
"Imminent Danger" portrays individuals diagnosed with schizophrenia as
people with hopeless futures whose primary life options are
hospitalization, homelessness, or incarceration. The segment
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
are painted as consigned to a life of misery and as ticking time bombs
with the potential to become violent at any time."
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,
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
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
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."
Dr. Torrey's collection of well over 3,000 "Preventable
Tragedies" holds some surprises. After downloading the
homicide summaries years ago, the National Stigma Clearinghouse found
that medication failed to deter homicide in many cases. Further,
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.
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)
Danger's" lack of balance is easily confirmed in its online
transcript. The over-emphasis on schizophrenia was particularly
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."
effect has Dr. Torrey's 20-year over-emphasis on violence had on public
MORE LETTERS AND INFORMATION
For still more
information, read a New York Times 4-part series
on "Rampage Killers" (link is below)
9, 2000 -News of the Week
NEW YORK TIMES ATTEMPTS TO UNDERSTAND "RAMPAGE
"Rampage Killers Chart a Well-marked Course to
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.)
article of the Times series is crammed with food for thought. It
provokes several quick observations.
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.)
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.
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.
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.
Times series is well worth saving for study. Click www.nytimes.com/library/national/040900rampage-killers.html
May 2, 2014 - News of the Week
CLOSER LOOK AT "LACK OF INSIGHT"
articles and briefing papers by supporters of forced treatment assume
that patients who refuse psychiatric treatment do so because of
abnormalities that block awareness. They say nearly 50 percent of
and bipolar disorder require forced anti-psychotic medication to combat
the assumed cause of treatment refusal. Although the faulty brain
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.
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
University School of Medicine
Issue of Insight
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?
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.
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?
February 24, 2014
- News of the Week
"MADNESS NETWORK NEWS"
samples of the MNN archive, and more...
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
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
& A: Dr. Insel and Dr. Suzanne Koven, The Boston Globe,
12/16/2013), to name just two of many critics of current psychiatric
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
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
the digitized e-books are undeway.
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
more information about how to purchase all, or parts of the Madness
Network News archive.
January 18, 2014 - News of the Week
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
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
A tragic example: "Dad!
Dad! Learning from the Kelly Thomas Tragedy"
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
to prosecute the case has been cited and
the FBI has opened an investigation to see if Thomas’ civil
rights were violated.
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.
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)
Source: NYAPRS (New York
Association for Psychiatric Rehabilitation Services)
2014 - News of the Week
TAKES HEAT FOR HIS VIEWS ON MARIJUANA
THE PUBLIC NEEDS FACTS ABOUT POTENTIAL HARM
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
Mr. Dolce interviewed Dr. Lester Grinspoon, a well-known
longtime promoter of smoking cannabis. The interview gives an
glimpse of Dr. Grinspoon's idyllic view of marijuana, while dissing
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
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
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"
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
Experiment," NYTimes 1/3/2014
Doubles Mental Illness Risk" (Christchrch New Zealand)
linked to brain-related memory woes, schizophrenia risk in
teens" (CBS News)
Marijuana Experiment" (New York Times editorial)
Use and Risk of Incidence...10 Year Follow-Up Cohort
Study" (Medscape signup needed)
2013 - News of the Week
HEALTH CONSUMER NETWORKS ARE IN JEOPARDY
proposed Congressional Bill is described as helping families in
health crisis. Unfortunately, the bill includes onerous
provisions that would halt effective wellness programs designed by
ex-patients. This alarming Bill would "slash funding
recovery oriented services--including peer-run services and family
supports--in exchange for regressive and involuntary treatment"
(NYAPRS). Further, it would "restructure federal funding to
encourage the use of force and coercion..." (NDRN).
(NYAPRS, New York Association
Rehabilitation Services; NDRN, National Disability Rights Network)
"Helping Families in Mental Health Crisis Act" was introduced
on December 12 by Rep.Tim Murphy of Pennsylvania.
following links and learn more about this threat to progress.
By David Sherfinski, The
Washington Times, 12/12/13
Urge Congress to Protect SAMHSA and Consumer
News: This comes from the National Coalition for Mental Health
Recovery, an organization that NYAPRS supports. We urge you to
contact your representatives to demand that budget cuts do not impact
mental health recovery services that keep people engaged and working
toward their well-being. Along with the Congressional deal to tighten
the budget and restrict mental health spending, an act submitted by
Representative Tim Murphy would favor involuntary services and reduce
funding for rehabilitation services, including peers and family
support. Contact your representative today, sign the petition
and get on the NCMHR action list!
Grants for State Networks, The Alternatives Conference and the
5 Mental Health Technical Assistance Centers Are At Risk!
your Senators and your Representative about these vital programs.
need to hear from YOU now.
negotiators in Congress just reached a deal that squeezes dollars for
all health funding including mental health. Most members of
Congress don’t know about the life-saving work and value of state
mental health consumer networks and national TA centers. It
is up to you to educate them.
Tim Murphy of Pennsylvania released a
mental health bill that—among many other disturbing
reorganize SAMHSA and end funding for state networks, the
Alternatives conference and technical assistance centers.
to do now:
now, send emails
and make phone calls to
you members of the House and Senate appropriations committees telling
them why they
should protect funding for state mental health networks, the
Alternatives conference and the five mental health technical
assistance centers and how important they have been in your life, the
life of people you love and for citizens of your state.
(See How to
do it below and the
attached document on what to say).
our petition on
Change.org: Go to http://ncmhr.org and
look for the Action Alert with a link to the petition and more
instructions on how counter Tim Murphy’s bill that you will be
receiving in a few days.
to do it:
FIND your U.S. Senators
Click the name of each Senator, scroll down to “ Contact
to send them an email. Before sending, copy and save your message.
Request a reply. You can also call their office and leave a
The attached document includes a list of Senators and Congressmen on
Appropriations Committees. If they represent you it’s doubly
important to educate them. If your Senators/Congressman is not
on this list, don’t worry--It’s still vital that contact
your Senators to RESTORE the 20
percent cut in funding for SAMHSA grants for statewide mental
health consumer networks that the Senate Appropriations Committee
agreed to. ASK them to resist any further cuts. TELL them
these grants, which total just $2.5 million now, teach people with
serious mental health conditions to stay well and recover. TELL them
how YOUR state network (and the local peer-run centers it supports)
have changed your life as a person with a serious mental health
condition and how you now help others. If your state doesn’t have
mental health consumer network yet tell them you need one.
TELL your member of the House of Representatives to fully
fund SAMHSA grants for statewide mental health consumer networks,
mental health technical assistance centers, the Alternatives
conference, and protection and advocacy programs. TELL
them state network grants, which total just $2.5 million now, teach
people with serious mental health conditions to stay well and
recover. TELL them how YOUR state network (and the local peer-run
centers it supports) have changed your life as a person with a
serious mental health condition and how you now help others. If your
state doesn’t have a mental health consumer network yet tell them
you need one.
If your representative is listed on the attached document, it is
doubly important that they hear from you.
Email raymond.bridge@ncmhr to
get on our action list. Like us on Facebook (National Coalition for
Mental Health Recovery) Find us at http:ncmhr.org -
Note from Jean Arnold: I regret that the lists (referred to above) of
Congressional Committee members did not transfer to this
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." Luhrmann's piece begins, however, with two
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
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
'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
spokespeople is badly needed.
NIMH (National Institute of Mental
12-month prevalence," website (2013)
Wallace et al. "Serious criminal
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
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 are diagnosed with
serious psychiatric conditions. Ignoring an opportunity to
discuss the scarcity of user-friendly treatments, the segment
focused on psychotropic medications and forced treatment.
The coercion proponents' marketing strategy, "fear of
violence," dominated the segment -- note its (shortened) title,
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.
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
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
PATRICIA WARBURG CLIFF, an 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
End of article
2012 - News of the Week
YALE PSYCHOLOGIST EXAMINES SCHIZOPHRENIA'S "INSIGHT
can we help people who won't accept any
treatment, people who deny they need any help?
can the concept of recovery be relevant for
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 by Larry
Davidson, PhD of the
Department of Psychiatry at Yale, asserts that people who appear to
lack insight may be best suited to treatment programs that use a
recovery-oriented approach. Harvey Rosenthal of NYAPRS agrees: "Currently, 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 engaging 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 use psychiatric services and the federal agency that
oversees mental health and substance abuse services, SAMHSA .
of 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, Dr. Davidson points out that recovery-oriented,
person-centered treatments have been successful regardless of the
individual's level of insight.
,"The Insight Issue," is posted on the temporary website
for the Recovery to Practice group, SAMHSA
Recovery to Practice -- http://www.dsgonline.com/rtp/resources.html
“The Insight Issue” -- http://www.dsgonline.com/RTP/special.feature/2012/2012.02.12/SF.2012.02.12.html
Dr. Larry Davidson -- http://www.yale.edu/PRCH/people/davidson.html
NYAPRS, Harvey Rosenthal, Executive Director -- http://www.nyaprs.org
October 1, 2011 -
News of the Week
WITH FACTS LACKING,
FACTOIDS FILL GAP AND SHAPE ATTITUDES
factoid is a questionable or spurious - unverified, incorrect, or
fabricated - statement
and asserted as a fact but with no veracity. The word appears in the
as 'something which becomes accepted as fact, although it may not be
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 example, 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 as relative 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.
Media's Primary Role
Years 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 about 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 proponent. 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 may be necessary to capitalize on fear of violence to get the law
passed," the campaign had swung into action.
A 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 least four authoritative studies to state that the Torrey/Jaffe team
did not accurately represent their study's findings. But the
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 twisted by 20
years of use, the 1,000-homicides factoid has morphed to meaningless
and is now applied to people with any history of mental illness, or
half the American public.
Has the twenty-year focus on violence affected the
public's view of mental illnesses? Former Surgeon General David 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 1999
(Introduction and Themes, page 8), Dr. Satcher underscored his concern:
“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? 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'.
September 26, 2011
- News of the Week
VOICES USA' JOINS WORLDWIDE MOVEMENT
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 breakthrough
movement, aided by the Internet, eases the pain of misunderstanding and
isolation. Learn more with a visit to About Us: Hearing
Below is an excerpt from the National
Empowerment Center press release:
What is World Hearing Voices Day?
From the Intervoice Website (http://www.intervoiceonline.org):
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.
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 well 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.
September 2, 2011
- News of the Week
HOW FICTION BECOMES FACTOID
"A factoid is a questionable or spurious - unverified, incorrect, or
fabricated - statement
formed and asserted as a fact but with no veracity. The word appears in
the Oxford English
Dictionary as 'something which
becomes accepted as fact, although it may not be true.'"
Quote is from Wikipedia, the free
Fuller Torrey is perhaps psychiatry's most visible spokesperson. He is
also the nation's most active proponent of forced psychotropic
medication for psychiatric outpatients. Unfortunately, Dr. Torrey has
often stretched or misquoted outright the research findings of others
to win support for his controversial agenda.
most recent example of Dr.Torrey's self-serving work appears in an
article, Stigma and Violence: Isn't It Time To
Connect the Dots, which
first appeared in July in the advance publication of Schizophrenia Bulletin (SB), and is
now in the September 2011 issue.
SB article, Dr. Torrey contends that actual acts of violence are the
basis of stigma against people who are labeled mentally ill. Torrey
says this cause of prejudice and discrimination can be eliminated by
accepting and acting upon his assumptions about violence (named
'dots'). In discussing these assumptions, Torrey cites studies to
support his views.
some of the studies quoted in Torrey's SB article are on file at the
National Stigma Clearinghouse. In every one, Torrey has either
cherry-picked, or worse, altered the study findings to suit his purpose.
examples of errors in the connect-the-dots article:
Dr. Torrey misstates former Surgeon General David Satcher's conclusions
about stigma and violence described in Dr. Satcher's groundbreaking
report on mental health in 1999 (page 8). Dr. Torrey mistakes
"perception of violence" to mean "evidence of violence" and thus twists Dr.Satcher's conclusions to agree
with his own opinion that violence causes stigma. In fact, Dr.
Satcher concludes that the public's fear is disproportionate the the
low risk of violence; his report states: "Because most people should
have little reason to fear violence from people with mental illness,
even in its most severe form, why is fear of violence so entrenched?"
Dr. Torrey misrepresents research
1996) of Matthias C. Angermeyer and Herbert Matschinger, University
to support his view that violence committed by
mentally ill people is a major cause of stigma. In fact, the
researchers concluded that media
coverage of mental illnesses promotes stigma by focusing selectively on
incidents of violence
. They noted that such selective coverage
has a detrimental effect on public opinion and “important
implications for public policy issues," and to correct this they
proposed that "Having demonstrated the detrimental effects of selective
reporting, we must focus our attention on the inevitable question of
how to counteract such reports." In sharp contrast, the Torrey
article's opening paragraphs deride advocates' attempts to balance the
media's coverage of mental illnesses. For
20 years, Torrey's focus on "walking time bombs" has taken precedence
over features that could show voluntary treatment programs that work
for hard-to-treat individuals, and articles that reflect a growing
recognition that despite serious psychiatric conditions, people can
achieve fulfilling lives.
In a later paper (International Journal of
Law and Psychiatry, 2001 Vol. 24, pp 469-486) Dr. Angermeyer and Beate
Schulze state that "deviance is a prime component of 'newsworthiness'.
The marked over-representation of forensic cases in press reporting
about mental health is clearly the product of impact-maximizing and
complexity-reducing selection routines in news production."
(3) Dr. Torrey implies that his views are confirmed by a
study by Jason C. Matejkowski et al (2008)
. This study does not
support and is not relevant to Dr. Torrey's opinion that violence is
increasing among people who have a serious mental illness. In fact, the
reseachers' findings discredit the familiar stereotype that Dr. Torrey
has so often promoted. The article by Matejkowski et al is an analysis
of violence committed by persons who have a mental illness, and is free
of Persons With Severe Mental Illness Who Have Been Incarcerated for
, The Journal of the
American Academy of Psychiatry and the Law,
Could the public's
unwarranted fear of people labeled with mental illnesses, described by
Surgeon General David Satcher and others, be fallout from Dr. Torrey's
20-year public focus on violence to attain his medication goals?
30, 2007 News of the Week (National Stigma
TAC'S "TOP 10
STORIES OF 2007" CONTINUE A PATTERN OF FEARMONGERING
Last week, the Treatment Advocacy Center, the nation's leading
proponent of compulsory neuroleptic medication, issued a list of ten
"under-reported stories of 2007." Eight of the ten stories involve
crime or dangerousness. Clearly, http://www.psychlaws.org
intends to continue its pattern of fanning fear to win public support
for its controversial agenda.
Also troubling are errors of fact. For example, by lifting a phrase out
of a research study published by Jeffrey Swanson et.al. (Archives of
General Psychiatry, May 2006), TAC created an astounding rate of
violence for patients with schizophrenia, 10 times greater than the
general public, (or 19.1% vs 2%).
Acts considered violent by TAC range from a brief threatening gesture
to a physical assault causing injury. TAC fails to mention that the
Swanson team found two levels of violence: only 3.6% of research
participants were involved in serious violence. This rate is similar to
the general population rate of 2% (ECA data circa 1980).
For the public, violence means danger. But Swanson's research team uses
the word to mean involvment in a fight whether or not the respondent
was the aggressor or defending himself. The researchers called such
fights assaults by the respondents. The fights involving 15.5% were
called "minor violence" (no injury and no use of threat or knife). The
remaining 3.6% were called "serious violence" (a weapon was used or
there was some injury, at least a bruise.) Quoting from Heathcote
W. Wales, Georgetown U., letter to the Washington Post, "Hype Won't
Help The Mentally Ill," 6/4/06.
The Treatment Advocacy Center also ignored the Swanson team's finding
that the odds of violent behavior varied with factors other than
psychotic symptoms. Further, the data used for the Swanson study was
designed for a different project, the Catie study on medications. This
raises questions about the data's findings
Read interesting comments by Dr. John Grohol about pitfalls and
variations that plague research on violence. Go to
End of excerpt
from NSC Archive (Dec 30, 2007)
August 9, 2011 - News
of the Week
A CLOSER LOOK AT HEARING
continues his remarkable New York Times series on mental illnesses with
to Cope With the Mind's Taunting Voices" (Times Front Page, August
7, 2011). The series' first article ("Expert
on Mental Illness Reveals Her Own Fight,” June 23) described
in detail a therapist's successful battle against against suicidal
Clearly, Mr. Carey is attuned to a growing
willingness among psychiatric survivors to explain their experiences of
living with disabling psychiatric conditions.
It's worth noting that many Europeans do not
automatically link hearing voices to schizophrenia -- a common
assumption in the US. Below are links to more information.
You Live With the Voices in Your Head?, by Daniel B. Smith March 25,
Voices of the Heart Facilitator Training
of Mental Illness Provides Good Cheer , by Robert David Jaffee, August
to Cope With the Mind's Taunting Voices, by Benedict Carey, August 7,
on Mental Illness Reveals Her Own Fight. by Benedict Carey, June 23,
Wikipedia: Hearing Voices Movement
July 18, 2011 - News
of the Week
Article Source: NYAPRS Enews
Metabolic Conditions In People Diagnosed With SMI
by Ed Knight,
Ph.D., Mental Health Weekly From the Field July 18, 2011
conditions like weight gain, hypertension and diabetes, are common in
populations with serious, persistent mental illnesses. People are dying
25 years younger than average, mostly from cardiovascular illnesses.
This problem is made worse by the most common side effect of
psychiatric medications: weight gain, diabetes, high blood pressure and
high cholesterol. There are two related issues in prescribing:
off-label use against FDA recommendations; and unnecessary use of
multiple psychiatric medications (documented by Lloyd Sederer, M.D.,
medical director at the New York State Office of Mental Health, in
journal articles and blogs).
Despite widespread knowledge, addressing
metabolic side effects beginning with monitoring is low among mental
health practitioners and providers. Well-researched psychiatric
rehabilitation strategies to increase wellness and reduce the number
and doses of psychiatric medications tend not to be followed much. Even
very obvious strategies like changing medications to medications that
cause fewer metabolic complications are not widely practiced. Why?
Mental health providers are not financially incentivized to prevent
costly side effects that are causing a Medicaid funding crisis and
increased mortality. Changing medications or implementing medical or
psychosocial practices create costs for mental health organizations. To
address this issue, some mental health organizations are becoming
licensed to bill for medical services. This provides funding for
metabolic management. However, this extra billing creates no
disincentive for causing metabolic problems in the first place and to
date does not lessen them.
Attempts were made to solve this issue of
perverse incentives for over a year within ValueOptions where I served
as vice president of recovery. Those attempts failed. At one small
Colorado clubhouse 30 people on psychiatric medications have died in
the last three years below the age of 62. Three were suicides likely
due to their friends dying. Research shows increased suicide rates
associated with metabolic side effects.
I resigned from ValueOptions to devote my time
to solving this crisis with advocacy, research and consulting on
managed care issues. Unless these issues are solved recovery is
unlikely. In advocacy, I am providing information to Medicaid
authorities and actively lobbying. If providers were accountable for
pharmacy costs, mental health costs and medical costs for their
clients, this would financially incentivize providers to detect and
prevent metabolic side effects and lower medical costs. Savings could
then be used to provide the evidence-based psychiatric rehabilitation
practices needed to reduce the number and doses of medications.
Accountable Care Organizations (ACOs) could be structured to address
the metabolic side-effects. There is now a division between acute and
well care and long-term care. A disease caused in the acute treatment
could then be billed in long-term care. This would carry perverse
financial incentives driving side effect disease into health care
reform [efforts]. Extending the period of acute and well care to
include sufficient time to make ACOs responsible for the side effects
from improper use of psychiatric medications would create incentives to
lessen them and save monies which could be used to pay for medical
monitoring and rehabilitation interventions.
I am working with a UCLA team led by Alex Young,
M.D., psychiatrist and health services researcher, to address the
prescribing issues with simple shared decision-making techniques and
the lifestyle issues with some new psychosocial interventions to deal
with symptoms and concrete skillful means to motivate change. The
lowering of doses and numbers of medications is interrelated with
lifestyle issues in complex ways. We have developed a “stages of
change” model moving from learned helplessness to a healthy
lifestyle which may allow for medication reductions. The UCLA pilot is
about Mindfulness Based Self-Directed Rehabilitation (MBSDR). We are
seeking grants to support this work. In consulting I am working with
Peer Links, a peer-run technical assistance center funded by the SAMHSA
at the Mental Health Association of Oregon to bring MBSDR in webinars
to the larger peer recovery movement. I am available to consult about
managed care to advocate for wellness and recovery.
Ph.D., is a national consumer leader. He resigned in May as vice
president of recovery and resiliency at ValueOptions. For more
information on MBSDR visit www.professored.com . Knight
can reached at
- End of Article -
Hopes were high when Ed Knight joined Value Options in 2001. At the
, December 3, 2001, wrote, "What Ed Knight has
demonstrated is that you can give people new medication and they will
have fewer symptoms, but their lives won't change until you change the
approach to treatment.." As it happened, efforts to point the delivery
system toward recovery and mutual support lost favor after a Goldman
Sachs company, Crestview Investments, gained the controlling interest.
Read Full Article
July 6, 2011 - News of the
PLAN TO REDUCE STIGMA DISTORTS DATA
In the July
issue of Schizophrenia Bulletin,
Dr. E. Fuller Torrey, founder of the Treatment Advocacy Center and
chief proponent of compulsory psychotropic medication, proposes a way
to reduce stigma. Dr. Torrey outlines his plan in an article
titled, "Stigma and Violence: Isn't It Time to Connect the Dots?"
For those who are unfamiliar with Dr. Torrey's
views concerning stigma, he believes that a primary cause of stigma is
violence committed by mentally ill individuals. A basic flaw in Dr.
Torrey's argument concerns his merging of perception and evidence. The public's perceptions may not accurately
reflect reality – as any advertiser knows.
Dr. Torrey suggests six 'dots' as follows:
(quote - bold type added)
(1) Stigma against individuals
with mental illnesses has increased
over the past half century.
acts committed by mentally ill persons have increased
over the past half century.
(3) The perceptions
of violent behavior by mentally ill persons is an important cause of stigma.
(4) Most episodes
committed by mentally ill persons are
associated with a failure to treat them.
people with serious mental illnesses significantly decreases episodes of violence.
violent behavior among individuals with mental illnesses will reduce stigma.
and 'Treatment' are code words for antipsychotic medication. ja)
Unfortunately, Dr. Torrey misinterprets the
findings of researchers to promote his plan.
(1) Dr. Torrey misstates former Surgeon
General David Satcher's conclusions about stigma and violence described
in Dr. Satcher's groundbreaking report on mental health in 1999 (page
8). Dr. Torrey mistakes "perception of violence" to mean "evidence of
violence" and thus twists
Dr.Satcher's conclusions to agree with his own opinion that violence
causes stigma. In fact, Dr. Satcher concludes that the public's
fear is disproportionate the the low risk of violence; his report
states: "Because most people should have little reason to fear violence
from people with mental illness, even in its most severe form, why is
fear of violence so entrenched?"
(2) Dr. Torrey misrepresents research findings (article
1996) of Matthias C. Angermeyer and Herbert Matschinger, University
of Leipzig to support his view that violence committed by
mentally ill people is a major cause of stigma. In fact, the
researchers concluded that media coverage of mental illnesses promotes
stigma by focusing selectively on incidents of violence. They noted
that such selective coverage has a detrimental effect on public opinion
and “important implications for public policy issues," and to
correct this they proposed that "Having demonstrated the detrimental
effects of selective reporting, we must focus our attention on the
inevitable question of how to counteract such reports." In sharp
contrast, the Torrey article's opening paragraphs deride advocates'
attempts to balance the media's coverage of mental illnesses. For 20
years, Torrey's focus on "walking time bombs" has taken precedence over
features that could show voluntary treatment programs that work for
hard-to-treat individuals, and articles that reflect a growing
recognition that despite serious psychiatric conditions, people can
achieve fulfilling lives.
In a later paper (International Journal of Law
and Psychiatry, 2001 Vol. 24, pp 469-486) Dr. Angermeyer and Beate
Schulze state that "deviance is a prime component of 'newsworthiness'.
The marked over-representation of forensic cases in press reporting
about mental health is clearly the product of impact-maximizing and
complexity-reducing selection routines in news production."
(3) Dr. Torrey implies that his views are confirmed by a
study by Jason C. Matejkowski et al (2008). This study does not
support and is not relevant to Dr. Torrey's opinion that violence is
increasing among people who have a serious mental illness. In fact, the
reseachers' findings discredit the familiar stereotype that Dr. Torrey
has so often promoted. The article by Matejkowski et al is an analysis
of violence committed by persons who have a mental illness, and is free online. “Characteristics
of Persons With Severe Mental Illness Who Have Been Incarcerated for
Murder”, The Journal of the
American Academy of Psychiatry and the Law, 36:74-86, 2008.
June 28, 2011 - News of the
RESEARCHERS EXPOSE MYTHS ABOUT VIOLENCE
decades people with mental illnesses have been unjustly blamed for the
nation's extraordinary amount of gun violence. The truth about
violence, long distorted by violence-prone media and forced-medication
advocates, is the topic of an article by Jonathan Metzl of
Vanderbilt University, Focus
on mental illness in gun debate is misleading.
essay has been
published on the website of The
by Jim Patterson
ESSAY by Jonathan M. Metzl
The excerpt below, from the National Stigma Clearinghouse archive, is
just one example of distortion by the media and forced-treatment
advocates. Ignoring protests, CBS aired this 60 Minutes segment for a second time
in 2003 when Congress was considering changes to the National Instant
Criminal Background-check System.
October 13, 2002 - News of the Week
CBS RUSH TO
JUDGMENT SENSATIONALIZES MENTAL ILLNESSES (AGAIN)! (first
Assumes unknown "sniper on a killing spree" has
a mental illness
Using bogus homicide numbers and a bumbling choice of archive
materials, "Armed and Dangerous," (a 60 Minutes segment on
October 13), tried to link a proposed federal gun law amendment, a
series of sniper murders, and mental illness. Not enough time was spent
on opposing facts and views, and people with mental illnesses were made
to seem like one of society's most dangerous populations.
This is just the latest example of "walking time bomb" stories aired by
CBS on 48 Hours, 60 Minutes, and 60 Minutes II.
The earliest example in our CBS News file is a report in 1987 by
Bernard Goldberg. Mr. Goldberg mentioned some form of "killing" 20
times in the 4-minute "news" piece, which concerned five violent
incidents committed by "deranged" people over an unspecified number of
Last night, "Armed and Dangerous" tried to weave together stories about
the present sniper killer in Maryland; a proposed gun law to add
involutarily-committed psychiatric patients to federal criminal
databases; and high-profile shootings by Colin Ferguson (1993), Russell
Weston (1995) , Michael McDermott (2000), and Peter Troy (2002). Only
Mr. Weston and Mr. Troy had any history of involuntary
institutionalization, meaning that the gun law amendment would not have
red-flagged the other two men for gun checks.
The important story missed is that Weston and Troy are prime examples
of dismal mental health system failure. Mr. Weston was known both to
the system and the FBI as someone who desperately needed help. Mr. Troy
was also well-known as deeply disturbed and needing intensive care. Both
cases show negligence at all levels of government to fund the required
Most outrageous were the lead-in statements by Steve Croft: "Why is it
so hard to stop deranged gunmen from terrorizing American communities,
like the sniper who has terrorized Maryland?" And, "Every year across
the United States, nearly 1,000 homicides are committed by people with
severe mental illness."
The initial statement has two flaws. First, it assumes that the
Maryland sniper is "deranged," at a time when there is absolutely no
evidence to that effect. The killer could equally as plausibly be a
sociopath, or an El Queda terrorist, or simply an angry boy of the
Columbine type. Secondly, it implies that such activity is going on
almost routinely across America, when anyone who reads the newspapers
knows it is not.
The second statement includes the infamous "1,000 homicides" statistic
that originated in the imagination of Dr. Fuller Torrey, and is
unsupported by any scientific evidence.
In addition, the program failed to stress the existence of various
sub-populations in this country that are far more violence-prone than
people with mental illnesses.
One has to express dismay at such a sloppy, misshapen piece of
journalism. It certainly falls far below the standards we have come to
expect from 60 Minutes.
This segment must not be repeated. Contact 60 Minutes and
executives at CBS.
E-mail Viewer comment: email@example.com
Mail: Don Hewitt, 60 Minutes, CBS News, 524 West 57th Street, New York,
David F. Poltrack, Senior V.P., Research & Planning, CBS, Inc., 51
West 52nd St., New York, NY 10019
For a transcript ($9 + $3 fee for tel.), call 1-800-777-8398
End of excerpt from NSC archive (Oct. 13, 2002)
June 16, 2011 - News of the Week
MATTER: A BRITISH WEBSITE AIMS FOR CHANGE
health organizations in the UK have joined in launching a
beautifully-designed, well-organized new website, WordsMatter. Their aim
is to establish a systematic process for encouraging people to praise
good, and challenge poor, reporting on mental health issues.
To guide their work, the group has chosen simple
criteria that are in keeping with standards set by the UK's Press Complaints Commission.
American mental health advocates should check out the Commission's Code of Practice guidelines
and Discrimination. To our knowledge, the US lacks a similar
national standard for the press, and media entities here
'self-regulate' their content using their own standards of practice.
This innovative response system shows vitality,
determination, and ingenuity. KUDOS TO ALL INVOLVED!
Link to WordsMatter
June 2, 2011 - News of the Week
STATISTICS CAN TWIST THE SIGNIFICANCE OF MEDICAL TREATMENTS
A New York Times column ("Translation
Matters In Choices On Data" (5/31/2011) by Nicholas Bakalar reports
a recent study of how treatment choices are typically made by health
professionals, patients, students and the general public.
Dr. Elie A. Akl, University of Buffalo, who led the researchers,
cautioned journalists to "be careful about press releases with 'new' or
'groundbreaking' studies presenting a relative risk reduction." Relative risk differs from absolute risk in important ways
seldom understood by the public, and the difference between them is a
major source of confusion.
For example, a "50 percent reduction" in relative risk could mean a drop
from "20 percent to 10 percent," (impressive), but it could also mean a
reduction from "2 percent to 1 percent," (unimpressive). This curious
fact can be important in making treatment decisions.
According to the researchers' plain language summary (Cochrane
Reviews), "there are strong logical arguments for not reporting relative values alone, as they do
not allow a fair comparison of benefits and harms as absolute values do."
be necessary to right-click the link, then click "open in new window"
May 11, 2011 - News of the Week
THOUGHTS ABOUT LANGUAGE,
ATTITUDES, AND DISCRIMINATION
attitudes toward any minority group can be measured by how willingly
the public accepts discrimination against that group. But surely an
equally valid measure of public attitudes is everyday language. The
idea that the way
we talk about people is the way we treat them seems
self-evident. Take the case of derisive words like "faggot" and
"nigger." They have become off-limits to everyone except the members of
the group involved. But similar progress has eluded the mental health
Psychiatric slurs are so common that they go
unnoticed in our everyday speech. Even a standard-setter for language,
the New York Times, lets columnists vent their frustration by calling
opponents "crazies," and "certifiables."
It would be comforting to think that psychiatric
slurs have taken on such broadened usage that they no longer denigrate
mental illnesses. Sadly, that hasn't happened. Take for example Alfred
Hitchcock's use of the prefix "psycho" (the original meaning is "mind")
as a movie title. Hitchcock would surely be pained to know that his
creation is a lucrative favorite of product merchandisers who twist the
word to mean violence. A recent example is the 2011
calendar cover of Psycho Donuts in Silicon Valley.
Offensive language is
bias having a good time (paraphrasing
Michael Wood, 1995)
To the detriment of the mental illness community, "psycho" has become
so popular that dictionaries now list as its colloquial meanings
"psychotic" and "psychopathic." This causes major confusion since
clinically these are very different conditions.
Is there a solution? Suggestions are welcome. For starters, the
following quote is from Michael Wood, historian and educator. Source:
"We Are What We Write," New York Times, May 21, 1995.
language is more than bias; it's bias having a good time.
reason we can't get rid of it is that people like to be offensive.
Just received, May 15:
An astute and thought-provoking essay on language by David Oaks,
Director, MindFreedom International, click "LET'S
STOP SAYING "MENTAL ILLNESS" !
Announcing a new peer-reviewed open access
Stigma Research and Action is an open-access not-for-profit journal
with no article-processing charge. It provides immediate open access to
its papers on the principle that making research freely available to
the public supports a greater global exchange of knowledge.
SRA's online journal is a multi-disciplinary forum for the
dissemination of information advancing both research and practice as
applied to any stigmatizsed condition or group.
To learn more and to read the first
issue, visit http://www. stigmaj.org
April 8, 2011 - News
of the Week
HOUSING CRUCIAL TO TREAT MENTAL HEALTH
By M. J. Bright, The Daily News, Nanaimo
(British Columbia, Canada)
April 4, 2011
via Google Alerts
waffle on housing plan' (Daily News, March 31)
I am a senior who volunteers three times a week
on the psychiatry in-patient unit. I have been doing that volunteer
work for over three years and have never felt concern for my safety.
The truth is that the vast majority of people
with a mental illness are not threatening or dangerous. Rather, they
are much more likely to be victims of crime.
It saddens me that so many people have
stigmatized those with a mental illness as being bad or weak-willed, or
scary or dangerous. That simply is just not true. People with mental
illnesses are just like you and me. Chances are, someone you know has a
diagnosed or undiagnosed mental illness.
Councillors need to educate themselves on the
realities of mental illness and become true leaders in Nanaimo. They
must allow the housing for people with mental illness to proceed.
M. J. Bright
© Copyright (c)
Reprinted using Fair Use standard
Jauary 23, 2011 - News of the
MUST-SEE VIDEO: SEVEN INSIGHTFUL PATIENTS DESCRIBE BOUTS WITH PSYCHOSIS
In brief videotaped portraits, seven
courageous young people open their lives to the public, showing that
self-understanding can be both rewarding and distressing.
This is a timely, must-see segment in a New York Times health series titled
Voices of Schizophrenia was created by Tara Parker-Pope (September
Link to video: http://www.nytimes.com/interactive/2010/09/16/health/healthguide/te_schizophrenia.html
January 16, 2011
OUTPATIENT COMMITMENT (IOC) IS NOT THE SOLUTION
It is now clear that forcibly medicating
psychiatric outpatients will not prevent mass murders. When rare
rampages have occurred, very few assailants had predictive histories
that would have qualified them for involuntary outpatient commitment
(IOC). IOC laws give the public a false sense of security rather than
Kendra's Law, said to be the nation's model IOC statute, was quickly
passed in August 1999 by the New York State Legislature and signed by
Governor George Pataki following an intense campaign of scare tactics
and false information. There was never doubt that Andrew Goldstein was
guilty of Kendra Webdale's death on January 3, 1999, in a Manhattan
subway. But for two previous years Goldstein had searched in vain for
the help and supervision he knew he needed. Yet the forced-treatment
proponents, ignoring Goldstein's 13 voluntary admissions to psychiatric
facilities, proclaimed him a "treatment refuser." Anger overwhelmed
facts and an outpatient forced-treatment statute (Kendra's Law) was
enacted with record speed.
Thus was lost a singular opportunity to focus public attention on New
York's dangerously broken system and scarcity of effective programs.
Has Kendra's Law met its promise to successfully treat patients who
have histories of violent behavior (description not available) ? An
internal report in 2005 showed that 85% of the program's participants
had NO such history. A brutal murder in Manhattan (2008) was commited
by a man who, according to his father, was in treatment under Kendra's
Law. The Arizona version of Kendra's Law failed to deter the Tucson
tragedy. And although the Treatment Advocacy Center claims spectacular
success, a close look at the figures (elevated
by basing outcome results on percentages-of-percentages) show a
self-serving interpretation of the program's outcomes. Two recent
independent evaluations found that the program's flaws are serious
enough to postpone its expansion or permanence.
Oddly, forced treatment proponents say next to nothing about the
well-known dangerous combination of alcohol, street drugs, and
psychiatric diagnoses. One would expect the Treatment Advocacy Center
to be in the forefront of developing and promoting integrated treatment
programs aimed at treating a population whose rates of violent behavior
far exceed those who have a mental illness alone. The Treatment
Advocacy Center's narrow focus on medication for close to 20 years is
inexplicable when safer, more acceptable treatment methods are
available but lack the resources to expand.
Below are excellent
Ignore Key Perspective About Arizona Tragedy A statement by David
Oaks, Director, MindFreedom International
Warn Against Stigmatizing Mental Illnesses A video interview with
Harvey Rosenthal, Director, New York State Association of Psychosocial
Rehabilitation Services (NYAPRS)
the Stigma That Deters Mentally Ill From Seeking Services by
Eduardo Vega, Executive Director, Mental Health Association of San
Francisco. Source: San Francisco Chronicle (Jan 14, 2011)
January 12, 2011
COALITION SUGGESTS WAYS TO AVERT FUTURE TRAGEDIES
For Immediate Release:
National Coalition of
Individuals with Mental Health Conditions Calls for Reasonable Response
to Arizona Tragedy
– The National
Coalition for Mental Health Recovery (NCMHR), an organization of statewide
networks of persons in recovery from mental health conditions as well
as individual members, joins the nation in grieving the shooting of
Rep. Gabrielle Giffords and other Arizonans. “We especially
understand the impact of violence because, contrary to popular belief,
research has shown we are no more violent than the general population
and in fact are 11 times more likely to be victims of violence,”
said NCMHR steering committee member Daniel B. Fisher, M.D., Ph.D.
not scapegoat and stigmatize an entire group for the actions of a
single individual,” Fisher said. “A literature review has
shown that the homicide of a stranger by a person with severe mental
health issues occurs to 1 in 14 million persons. This is so rare that
the authors concluded it was impossible to predict violence by
individuals with mental health issues (Nielssen
et al., Schizophrenia Bulletin, 2009).”
The NCMHR urges
decision makers to focus as much on Arizona’s and the
nation’s climate of violent discourse and the need for gun
control as on controlling persons labeled with mental illness.
“We know from our personal experience that recovery from trauma
is nurtured by respectful dialogue and blocked by vitriolic diatribe
such as we see today,” Fisher continued. “We have developed
the values and skills to heal the anger we believe causes much of our
discord. We have learned that anger and hopelessness can be transformed
to a passion for life when people are listened to and understood,
especially by peers,” he said.
there are calls for forced treatment,” he continued. “Yet
Arizona already has involuntary outpatient commitment (IOC)”
– which allows the compulsory treatment of individuals with
mental health conditions who live in the community – “and
that did not prevent this violence. In fact, IOC makes people afraid to
seek treatment, fearing services that are stigmatizing and
The NCMHR supports
the provision of hopeful, compassionate services and support, and
research into holistic, non-pharmaceutical approaches instead of the
system’s over-reliance on psychotropic treatment. “We know
from experience that peer support can reach isolated, frightened
persons,” Fisher said. “So we call for a national
initiative to provide peer support services at colleges and high
schools to help troubled students through respectful, mutual
assistance. We need to infuse recovery and support into our mental
health care systems, our first responders and the criminal justice
system through innovative programs such as emotional-CPR (a
preventative public health program) and peer-run alternatives to
NCMHR member Harvey
Rosenthal, a leading spokesperson for the peer movement, was Rep.
Giffords’ classmate in 2003 at Harvard's Kennedy School for
Policy Leadership. “Gabby has a long record of fighting against
discrimination on behalf of Americans diagnosed with mental health
issues,” said Rosenthal. “We don’t believe
she’d want stigma and discrimination to be fueled by this
In March 2008,
Giffords praised passage of the parity legislation designed to end
discrimination against persons seeking treatment for mental health
issues. "Discrimination has no place in our society," said the Tucson
NCMHR supports the
federal Substance Abuse and Mental Health Services Administration
(SAMHSA), which works to promote hope and recovery for individuals with
even the most severe mental health conditions. “We appreciate the
groundbreaking work SAMHSA is supporting to expand innovative outreach
and engagement services, to improve service responsiveness and raise
standards of care,” said NCMHR director Lauren Spiro.
B. Fisher, M.D., Ph.D., cell: 617-504-0832, firstname.lastname@example.org
Spiro, email@example.com, 877-246-9058
Rosenthal, executive director, New York Assoc. of Psychiatric
Rehabilitation Services, firstname.lastname@example.org, 518-527-0564
Coalition for Mental Health Recovery, 877-246-9058, email@example.com
January 10, 2011 - News of the Week
Excellent Article from Slate.com
ILLNESS' NOT AN EXPLANATION FOR VIOLENCE
shooter's psychiatric condition reveals little about propensity or
motive for criminal behavior
by Vaughn Bell, Slate.com
Shortly after Jared Lee Loughner had been
identified as the alleged shooter of Arizona Rep. Gabrielle Giffords,
online sleuths turned up pages of rambling text and videos he had
created. A wave of amateur diagnoses soon followed, most of which
concluded that Loughner was not so much a political extremist as a man
suffering from "paranoid schizophrenia."
For many, the investigation will stop there.
No need to explore personal motives, out-of-control grievances or
distorted political anger. The mere mention of mental illness is explanation
enough. This presumed link between psychiatric disorders and violence
has become so entrenched in the public consciousness that the entire
weight of the medical evidence is unable to shift it. Severe mental
illness, on its own, is not an explanation for violence, but don't
expect to hear that from the media in the coming weeks.
Seena Fazel is an Oxford University
psychiatrist who has led the most extensive scientific studies to date
of the links between violence and two of the most serious psychiatric
diagnoses -- schizophrenia and bipolar disorder, either of which can
lead to delusions, hallucinations, or some other loss of contact with
reality. Rather than looking at individual cases, or even single
studies, Fazel's team analyzed all the scientific findings they could
find. As a result, they can say with confidence that psychiatric
diagnoses tell us next to nothing about someone's propensity or motive
A 2009 analysis of nearly 20,000 individuals
concluded that increased risk of violence was associated with drug and
alcohol problems, regardless of whether the person had schizophrenia.
Two similar analyses on bipolar patients showed, along similar lines,
that the risk of violent crime is fractionally increased by the
illness, while it goes up substantially among those who are dependent
on intoxicating substances. In other words, it's likely that some
people in your local bar are at greater risk of committing murder than
your average peson with mental illness.
Of course, like the rest of the population,
some people with mental illness do become violent, and some may be
riskier when they're experiencing delusions and hallucinations. But
these infrequent cases do not make "schizophrenia" or "bipolar" a
helpful general-purpose explanation for criminal behavior. If that
doesn't make sense to you, here's an analogy. Soccer hooligans are much
more likely to be violent when they attend a match, but if you tell me
that your friend has gone to a soccer match, I'll know nothing about
how violent he is. Similarly, if you tell me your friend punched
someone, the fact that he goes to soccer matches tells me nothing about
what caused the confrontation.
This puts recent speculation about the Arizona
suspect in a distinctly different light: If you found evidence on the
Web that Jared Lee Loughner or some other suspected killer was obsessed
with soccer or football or hockey and suggested it might be an
explanation for his crime, you'd be laughted at. But do the same with
"schizophrenia" and people nod in solemn agreement. This is despite the
fact that your chance of being murdered by a stranger with
schizophrenia is so vanishingly small that a recent study of four
Western countries put the figure at one in 14.3 million. To put it in
perspective, statistics show you are about three times more likely to
be killed by a lightening strikc.
The fact that mental illness is so often used
to explain violent acts despite the evidence to the contrary almost
certainly flows from how such cases are handled in the media. Numerous
studies show that crimes by people with psychiatric problems are
over-reported, usually with gross inaccuracies that give a false
impression of risk. With this constant misrepresentation, it's not
surprising that the public sees mental illness as an easy explanation
for heartbreaking events. We haven't yet learned all the details of the
tragic shooting in Arizona, but I suspect mental illness will be
falsely accused many times over.
Reprinted using Fair Use protection
7, 2011 - News of the Week
FROM FEARMONGERING DEFEATS GOALS OF ADVOCATES
Associating mental illness with violent
behavior creates a huge barrier to funding services adequately ... a
larger concern is about the long-term consequences of stigma aroused by
the report [see below], especially when reinforced by prevailing
media images of mental illness. Stigma sets up barriers to housing,
jobs, forming relationships -- it really sets people back. And
individuals who are ill won't seek help because they don't want to be
considered one of 'those' people. Jennifer Stuber, Washington State
Coalition to Improve Mental Health Reporting. From
by Judy Lightfoot, Crosscout.com, Jan 05, 2011
Bad news came this week from Washington state. Facing cuts to mental
health services, a healthcare union hoped to win more funds from the
state legislature by playing a violence card. Union spokespeople told
protesting advocates that tight competition for scarce funds drove them
to use a violent cover image and caption on a report they submitted
to the legislature.
The downside is that fearmongering results in
less public support, not more. (Study
Finds Fear Tactics Win Public Support for Coercion, Segregation, and
Avoidance -- But No Increase in Resources) Source:
Patrick Corrigan et.al., Implication
for Educating the Public on Mental Illness, Violence, and Stigma, Psychiatric Services 55-577-580 May
See the crude and deeply stigmatizing report
cover, and read the excellent article by Judy Lightfoot concerning the
advocates' vehement protest, Can
scare tactics sell the state on mental health funding
December 18, 2010 - News of
THOUGHTS ON A HUFFINGTON POST BLOG AUTHOR
marketing perspective, it may be necessary
to capitalize on violence to get the law
Memo from D.J. Jaffe to NAMI
D.J. Jaffe, an advertising executive, worked for seventeen years to
secure state laws permitting the forced psychotropic medication of
psychiatric outpatients. Eventually, his fearmongering strategy
delivered New York's Kendra's Law after just six months of intense
Jaffe told a national NAMI audience in July of 1999 that "laws change
for a single reason, in reaction to highly publicized incidents of
violence." He urged his audience to focus their advocacy on law
enforcement agencies. Looking for help from their state's mental health
systems, he said, was a waste of time.
That fearmongering leaves lasting effects on
public attitudes was clearly not Jaffe's concern. Jaffe first took his
coercive medication law to the law enforcement sector and won its
support. Then on January 3, 1999, a fatal encounter between Andrew
Goldstein and Kendra Webdale gave Jaffe the highly publicized violent
incident he needed. The anguish of a shocked and grieving family was
transformed into a threat to every New Yorker. Andrew Goldstein was
*railroaded into the role of "treatment refuser." (*term used by a
former NAMI board member)
Jaffe's strategy worked. As he described it,
he approached the Webdale family a few days after Kendra's death and
told them that "her killer was mentally ill, and that her death
happened because he wasn't getting treatment, and we've been working to
get treatment, and why don't you come and join us... And what happens
is the media goes and interviews these people and because we've seen
them first, they are telling our story."
But has the end justified the means?
During its first three years of operation
Kendra's Law drained vital resources from new York's scarce community
programs. The public-safety selling point that won Kendra's Law seemed
hollow when a participant committed a brutal murder, and even more
hollow when statistics showed that only 15% of program participants had
committed a violent act before entering the program.
The upside is that many families have been
able to negotiate alternatives to court orders, putting their family
members first in line for scarce enriched programs. For others,
Kendra's Law is a way to obtain a beneficial discharge plan (a prior
law exists but is often broken for lack of community services).
Three evaluations of the law are available
Despite a strong push by supporters of Kendra's
Law to make it permanent, New York's lawmakers voted in June 2010 to
extend the law for five years and further test its effectiveness. The most recent
evaluations (see list below) of the controversial law found that the
key issue of voluntary vs. involunary psychiatric medication was far
from resolved due to insufficient data. Researchers also found
troubling disparities in the law's implementation across the state.
1st evaluation of Kendra's
Final Report on the Status of Assisted
March 2005 by the New York State Office of Mental Health. The findings
of this internal report did not justify making the law permanent.
2nd evaluation of Kendra's
New York State Assisted Outpatient Treatment Program Evaluation
An independent evaluation issued June 30, 2009 by the New York State
Office of Mental Health.
This independent evaluation, led by Marvin S. Swartz et. al, was
required by the New York State Legislature when it extended the law in
3rd evaluation by Jo C. Phelan et. al,
published in Psychiatric Services:
Effectiveness and Outcomes of Assisted Outpatient Treatment in New York
independent evaluation was published in February 2010 after its initial
presentation at the annual conference of the Internationals Association
for Forensic Mental Health Services, Vienna, Austria, July 14-16, 2009.
The article abstract is free. The full article might be free for a
first-time request (it was for me-j.arnold).