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December 10, 2006 - News of the Week


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Also recommended: "Off to College on Their Own, Shadowed by Mental Illness," an article by Lynette Clemetson, New York Times ( front page story, Friday, December 8, 2006. Or, Click here

This week, a fresh approach to easing the painful isolation of people with psychiatric disorders was launched by federal mental health agencies working with The Advertising Council. The multi-million dollar campaign will reach out to those closest to the individuals, their friends and associates, with information about how they can help.

This promising project is described below in (1) an article from ADWEEK, and (2) a joint press release from THE AD COUNCIL and SAMHSA (U.S. Substance Abuse and Mental Health Services Administration)
Source: ADWEEK (
(1) Spots Tackle Stigma of Mental Illness
December 07, 2006

By Kamau High

The U.S. Health Department and the Ad Council are kicking off a multi-million-dollar, multi-year effort designed to remove the stigma attached to mental illness. WPP Group's Grey provided the creative on a pro-bono basis.

SAMHSA is supporting the campaign with nearly $3 million in media spending over the course of 3 years.

The TV, radio, interactive and outdoor initiative stresses acceptance and the fact that mental illness is often highly treatable.

"The whole notion that people with mental illness can recover is a powerful message," said Heidi Arthur, svp, campaign director at the Ad Council.

One spot shows two young men playing a video game. A voiceover explains how awkward it can be when someone reveals they are mentally ill. One young man turns to the other and says, "I'm here to help, man, whatever it takes." The clip ends with the tagline, "Mental illness. What a difference a friend makes."

Rob Baiocco, evp, creative director at Grey, said, "Many times when someone is diagnosed with mental illness, their friends abandon them. We felt that by challenging them we could say 'You can take this on.' It shouldn't be a burden, it should be something you want to do."

Previous campaigns addressing this topic from the Ad Council ran from 1956-1964 and 1985-1997. Those ads encouraged people to seek help and treat employees fairly.

The Health Department's Substance Abuse and Mental Health Services Administration is supporting the campaign with nearly $3 million in media spending over the course of 3 years.

The next SAMHSA-sponsored Ad Council campaign will focus on suicide prevention, said Arthur. That work from DDB is scheduled to debut in the summer.

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(2) SAMHSA and Ad Council Unveil National Mental Health Anti-Stigma Campaign

Only One in Four Americans Believes People are Sympathetic Towards Those with Mental Illnesses

Washington, DC, December 04, 2006
/PRNewswire/ - The Substance Abuse and Mental Health Services Administration (SAMHSA), in partnership with the Ad Council, today launched a national awareness public service advertising (PSA) campaign designed to decrease the negative attitudes that surround mental illness and encourage young adults to support their friends who are living with mental health problems.

"We took a new approach to de-stigmatizing mental illness with this campaign," said Assistant Surgeon General Eric B. Broderick, SAMHSA Acting Deputy Administrator. "Instead of telling people why they shouldn't discriminate against people with mental illnesses, we are showing how friends can be supportive of those who have disclosed they are having a mental health problem and the critical role that friendship plays in recovery."

Despite the fact that an overwhelming majority of Americans (85 percent) believe that people with mental illnesses are not to blame for their conditions, only about one in four (26 percent) agrees that people are generally caring and sympathetic toward individuals with mental illnesses, according to a new HealthStyles Survey released today. The survey data, licensed from Porter Novelli by SAMHSA and the Centers for Disease Control and Prevention, also found that only one-quarter of young adults believe that a person with a mental illness can eventually recover, and slightly more than one-half (54 percent) who know someone with a mental illness believe that treatment can help people with mental illnesses lead normal lives.

"The advances made in treatments and services for mental illnesses offer the hope of recovery for all," said Acting Surgeon General Dr. Kenneth Moritsugu, M.D., M.P.H, who helped to kick off the campaign. "Mental illness is not something to be ashamed of. It is an illness that should be treated with the same urgency and compassion as any other illness. And just like any other illness, the support of friends and family members is key to recovery."

According to SAMHSA, in 2005 there were an estimated 24.6 million adults aged 18 or older who experienced serious psychological distress (SPD), which is highly correlated with serious mental illness. Among 18 to 25 year olds, the prevalence of SPD is high (18.6 percent for 18-25, vs. 11.3 percent for all adults 18 years of age and older). But this age group shows the lowest rate of help-seeking behaviors. Additionally, those with mental health conditions in this segment have a high potential to minimize future disability if social acceptance is broadened and they receive the right support and services early on.

Created pro bono by Grey Worldwide, the PSA campaign aims to reach 18- to 25-year-old adults who have friends living with mental illnesses. It highlights the importance of their providing support.

Featuring a voiceover by Tony award-winning actor Liev Schreiber, the television and radio spots illustrate how friendship is the key to recovery. The campaign also includes print and interactive advertising that directs audiences to visit a new comprehensive Web site, to learn more about mental health and what they can do to play a role in their friend's recovery.

"The prevalence of mental illness among young adults in our country is staggering. We need to reduce the widespread stigma and provide a greater opportunity for recovery," said Peggy Conlon, President and CEO of The Advertising Council. "The compelling PSAs show young adults the critical role they have in supporting friends with mental illnesses, and will help reduce the stigma. Additionally, this age group can be a great catalyst for the rest of the population."

In addition to collaborating with the CDC, SAMHSA's National Mental Health Anti-Stigma Campaign has partnered with other federal agencies, including the National Institute of Mental Health (NIMH), State mental health agencies, leading researchers on stigma, and a broad coalition of stakeholders, including organizations that represent provider organizations and consumer and family member groups. The Campaign held a series of regional meetings to develop a grassroots network to support the Campaign and provide assistance with anti-stigma efforts to States and local communities.

A resource guide entitled, "Developing a Stigma Reduction Initiative," was also recently released and is based on the evaluation and lessons learned from the Elimination of Barriers Initiative. The guide provides information on how to mount a statewide anti-stigma campaign, examples of outreach materials, reports on the best practices for stigma reduction, and lists important resources for technical assistance. Copies of the guide can be obtained by calling SAMHSA's National Mental Health Information Clearinghouse at 1-800-789-2647.

To view the ads, please visit The PSAs were distributed to more than 28,000 media outlets nationwide earlier this month and will air in advertising time that will be donated by the media.

SAMHSA is a public health agency within the Department of Health and Human Services. The agency is responsible for improving the accountability, capacity and effectiveness of the nation's substance abuse prevention, addictions, treatment and mental health services delivery system. SAMHSA can be reached at

The Advertising Council is a private, non-profit organization that has been the largest producer of PSAs in the nation since 1942. To learn more about the Ad Council and its campaigns, visit
Contact Info
Ellyn Fisher
The Ad Council

SAMHSA Press Office
Contact: 240-276-2130
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November 12, 2006 - News of the Week


Webdale Family is Spared Pain and Uncertainty of a Third Trial

Seven years after Andrew Goldstein pushed Kendra Webdale to her death in a Manhattan subway, the case is finally closed. A negotiated agreement has spared the Webdales the agony of a third trial. On November 2nd, Goldstein was sentenced to 23 years in prison and five years of post-prison supervision.

So why is there a sense of unfinished business? Perhaps the cause is remorse that Goldstein was falsely labeled a "treatment refuser" to clinch the passage of New York's compulsory outpatient treatment law. Or it may be a sense of lost opportunity: Goldstein's true story could have moved Albany to provide crucial psychiatric housing and treatment programs.

Some answers may be found in an editorial written by Michael Winerip in 1999, "Behind One Man's Mind," (reprinted below from the New York Times). The editorial describes how the Goldstein case propelled Kendra's Law through the legislature in record time. Never mind that the facts about Goldstein were wrong; they had ceased to matter.


Behind One Man's Mind


Published: New York Times, December 26, 1999

Treating mental illness is not one of society's big priorities, and public policy in the field often gets made in strange, circuitous ways. Last June the president held the first White House conference on mental illness; this month, Dr. David Satcher released the first surgeon general's report on the subject.

But it is the states that are responsible for funding and treatment. And in New York, which has the nation's largest mental health budget, recent policy changes come courtesy not of the president nor the surgeon general, but thanks to one violent schizophrenic man, Andrew Goldstein.

When the president and surgeon general discuss mental health policy, they sound cautious. They are not looking to commit new federal money to a problem that has been the states' burden for 150 years. The surgeon general's key conclusions -- that one in five Americans suffer some mental illness and that stigma is a main obstacle to seeking care -- have been common knowledge for years.

But when Mr. Goldstein pushed Kendra Webdale to her death on the subway tracks last January, it set loose fear and outrage among the public and forced state politicians to take action.

Public policy ginned up in the heat of battle is often a mixed blessing. Something gets done, though it may not have anything to do with the crisis at hand. In the Goldstein case, some changes -- $215 million budgeted for more supervised housing, more case managers and more beds for long-term state hospital care -- fit the facts of the case. Other changes -- like the passage of tougher legislation to force resistant mentally ill people to comply with treatment -- may or may not be a good idea, but had little to do with Mr. Goldstein.

From the early news accounts of the murder it appeared that Mr. Goldstein had repeatedly been offered mental health services, but had refused treatment and medication. So the solution to preventing future Andrew Goldsteins seemed to be an aggressive new commitment law -- ''Kendra's Law'' -- and both the Republican governor and Democratic attorney general quickly drafted legislation.

Then an article in The New York Times in May examining Mr. Goldstein's psychiatric record revealed a whole new set of facts.

Mr. Goldstein had frequently and voluntarily sought long-term and short-term hospitalization, as well as supervised housing programs, but was repeatedly rejected because there were no vacancies in a system short of beds, programs and money.

Whether tougher commitment laws even make a difference in getting dangerous people off the streets is a hard public policy question that has divided experts for years.

In a mental health system with scarce resources, to make room for an Andrew Goldstein do you wind up pushing out into the street someone else who is equally troubled? In 1995, in an effort to assess whether New York needed to change its laws, the state financed a three-year pilot program at Bellevue Hospital with tougher commitment rules aimed at the resistant mentally ill.

The results of that study, completed a month before the murder of Ms. Webdale, were inconclusive. Recently-released documents make it clear that the same Bellevue pilot program had two chances to get Mr. Goldstein off the streets but let him go. By sheer coincidence, he had visited the emergency room at Bellevue twice during the pilot program. And even though this was the period when he was regularly attacking strangers -- 13 in two years' -- the psychiatrists did not enroll him in the program. Each time, after a few days at Bellevue, he was released to live on his own, unsupervised. A tougher commitment standard had made no difference for the real Andrew Goldstein.

In the end, the facts did not matter. Certain personal tragedies so unnerve the public -- the death of a Megan Kanka in New Jersey, the shootings at Columbine High School in Colorado -- that it becomes almost impossible for politicians not to act, and in a legislative instant new laws get made to register sex offenders, to expand gun control, to commit more mental patients. On Aug. 27, Gov. George E. Pataki signed Kendra's Law.

That was just the beginning. By last summer the newly disclosed facts of the Goldstein case justified what mental health advocates had been arguing for years: a lack of state spending was crippling the system. To cut costs, the state had set quotas for reducing the patient population at every public hospital in New York, making it extremely difficult to get long-term care. Mr. Goldstein was a perfect example.

In 1992, after assaulting three staff members at a mental health crisis program, he was hospitalized for eight months at Creedmoor state hospital in Queens. But when he attacked 13 people in 1997 and 1998, his psychiatrists could not get him into a state hospital for long-term care. Instead, he was admitted to short-term hospitals, and usually discharged within three weeks.

The low point came in June 1998 -- six months before he killed Ms. Webdale. Mr. Goldstein was admitted to Brookdale, a short-term hospital, after he struck a woman on a subway car. On his third day at Brookdale, he attacked four hospital workers. Two weeks later he struck a nurse's assistant. The Brookdale psychiatrists applied to have Mr. Goldstein transferred for long-term care at Creedmoor.

But the hospital put him on a waiting list, a common stalling tactic used at the time. Within days he was back on the streets.

During the fall, Mr. Goldstein's trial kept public interest high and encouraged the news media to seek changes in state policy. In a rarity, The Times, The Daily News and The Post agreed in editorials on the need to put a moratorium on the reduction of state hospital beds, to finance more community housing programs and to support Kendra's law. And Governor Pataki listened.

For a while the shark attack effect prevailed: if a mentally ill person committed a violent act it was perceived as part of a pattern -- another Goldstein -- and received prime news coverage.

But there are dangers when journalists instantly try to cast news events in a public policy context. Last month, for example, New Yorkers were riveted by accounts of the search for a mentally ill homeless man who attacked a woman with a brick in midtown Manhattan. It seemed like another tragic failure of the mental health system -- another Goldstein! -- until the police arrested a career crook with a drug habit who was neither homeless nor mentally ill.

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November 5, 2006 - News of the Week


Battling substance abuse and mental illness
Massachusetts State Legislature

Stoneham Sun
Tuesday, October 31, 2006

Throughout the mid-80s, there was not a more dominant pitcher in baseball's National League than Dwight Gooden of the New York Mets. Armed with a riding fastball that topped 9 mph and a sweeping curveball that froze batters in their cleats, "Doc" won 194 games, posted a career 3.51 ERA and struck out 2,293 batters over 16 scandalous seasons in the majors. To these exceptional numbers, Gooden also added a "NL Rookie of the Year Award" in 1984 and the "NL CY Young Award" in 1985. He was, in his first three seasons, arguably the most feared major leaguer since the legendary Bob Gibson some 18 years earlier.

After the infamous 1986 World Series, Gooden would go on to pitch several effective seasons for the Mets; however, he never again mirrored the pitcher he was in 1985. Friends and teammates have their theories as to what factors led to Gooden's demise-early overuse of his arm, batters catching on to his pitches, coach Mel Stottlemyre urging him to alter his delivery. Still, most baseball insiders agree it was the double-edged sword of cocaine addiction and depression that ultimately undermined his career.
In 1987, years of speculation finally gave way to fact when a positive test for cocaine landed Gooden in rehab. His career would never be the same. Shoulder injuries in 1989 and 1991 hampered his production throughout the early 90's, and he earned two consecutive suspensions in 1994 and 1995 for continued cocaine use.

Years later, Gooden vowed to turn his life around, briefly reviving his career with the New York Yankees. In 2002, owner George Steinbrenner praised him for showing that people can indeed overcome substance abuse. Several hours later, Gooden was arrested for driving while impaired.
Gooden's story illustrates just how difficult it is for those individuals who are addicted to drugs and or suffer from mental illness to get their lives back on track. As in "Doc's" case, both diseases often complement one another-depression and other mental disorders leads to chemical dependency, which in turn throws the individual into a further downward spiral of illness and substance abuse. To quote an old adage, it is a vicious cycle.
The state Legislature realizes the importance of providing services to combat both substance abuse and treat mental illness. Formerly falling under the purview of the Committee on Public Health, recent alarming upward trends in drug use warranted more in-depth scrutiny. Accordingly, my colleagues and I formed the new Joint Committee on Mental Health & Substance Abuse during the 2005-2006 session. Working hand-in-hand with committee members, local advocacy groups and medical professionals, the Legislature increased funding for vital mental health and substance abuse services and launched several new initiatives in the past year.
Among our accomplishments was $21 million for the Bureau of Substance Abuse Services, which included appropriations for the establishment of sobriety high schools, an increase in rates for recovery homes and the placement of substance abuse counselors at houses of correction. The Legislature earmarked another $5 million for step down services assisting individuals coming out of detox, and allocated $500,000 for a new grant program that will create "jail diversion" programs in five communities across the state. These new facilities are designed to help keep mentally ill and addicted individuals out of the criminal justice system, thereby allowing them to get the help they so desperately need and freeing up space in our crowded prison system.

Doc Gooden's superstar status ensured that his battle with depression and cocaine addiction would make the front-page news. After all, privacy is one luxury that most celebrities cannot afford.

However, chances are that each of us knows someone, whether it is a family member, friend or neighbor, who is quietly and privately struggling with his or her own addiction or illness. These individuals often do not turn for help until they hit rock bottom, if ever. From the state level down to our local communities, we must continue to work together to strikeout the fearsome one-two combination of substance abuse and mental illness. There is too much at stake.

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October 9, 2006 - News of the Week


Thoughtful psychiatrists have long regarded the term "schizophrenia" as a catch-all of conditions. A lack of scientifc evidence continues to cloud the term, leaving it open to speculation and manipulation.

Below, three British news articles describe a new protest against the imprecise label and its detrimental effect on the people labeled. These were forwarded by NYAPRS E-News:

  • Reuters: Experts Urge Dropping of Schizophrenia 'Concept', 'Label'

    'Schizophrenia' Stigmatizes and Should Be Abolished

    Spotlightingnews   October 10, 2006

    Experts claim that the 'Schizophrenia' term should be dropped as it has a negative impact on patients diagnosed with this mental disorder.

    Mental health officials claim that abolishing the term is vital considering the fact that it is imprecise and describes patients as violent, unsociable, untreatable or strange. A new campaign entitled "Campaign for the Abolition of the Schizophrenic Label" was launched to support the idea that "it is a harmful concept."

    "It groups together a whole range of different problems under one label — the assumption is that all of these people with all of these different problems have the same brain disease," said Marius Romme, professor of social psychiatry.

    "I think schizophrenia as an illness does not exist. The schizophrenia concept is harmful because it mystifies the patient's social emotional problems, and it makes it impossible to solve the patient's problems because within the diagnostic process no-one is asking what has happened," Marius Romme added.

    Statistics indicate that nearly 1 percent of people in UK and US develop Schizophrenia. Schizophrenia is usually linked to hallucinations and delusions.

  • Call to Wipe Out Schizophrenia as Catch-All Tag
    by Sarah Boseley, Health Editor   The Guardian   October 10, 2006

    Schizophrenia should be abolished as a concept, a group of mental health experts say today, because it is a catch-all term which does not define a specific illness and carries a stigma that destroys people's lives.

    So poorly understood and inadequately treated are the conditions lumped together under the label that those said to be suffering from it do better in Africa, where psychiatric services are under-developed, than in the UK, said Richard Bentall, a professor at the school of psychological sciences at Manchester University.

    "In our country the recovery rate is about 30%," said Prof Bentall. "It is better to have schizophrenia in Nairobi, where there is a 50% chance of recovery."

  • 'Schizophrenia' Should be Dropped, Say Experts
    By Patricia Reaney  REUTERS   October 9, 2006

    LONDON – Mental health experts called on Monday for the term schizophrenia to be dropped, saying it has no scientific validity, is imprecise and stigmatising.

    'It is a harmful concept,' said Professor Marius Romme, a visiting professor of social psychiatry at the University of Central England in Birmingham.

    He added that symptoms such as delusions, hearing voices and hallucinations are not the results of the illness but may be reactions to traumatic and troubling events in life.

    Speaking at a news conference, Richard Bentall, a professor of clinical psychology at the University of Manchester, said the concept of schizophrenia is scientifically meaningless.

    'It groups together a whole range of different problems under one label – the assumption is that all of these people with all of these different problems have the same brain disease,' he added.

    Schizophrenia affects about 1 percent of people in the United States and Britain. Treatments such as atypical antipsychotic drugs focus on eliminating the symptoms. But the drugs can cause side effects such as weight gain, an increased risk of diabetes and sexual dysfunction.

    Paul Hammersley of the University of Manchester who recently helped launch The Campaign for the Abolition of the Schizophrenia Label (CASL), said there is no agreement on the cause of the illness or its treatment.

    CASL argues that the term schizophrenia is extremely damaging to those to whom it is applied and implies unpredictability, being dangerous, unable to cope and someone in need of life-long treatment.

    'It is like cancelling someone's life,' said Hammersley. 'We generally believe this word has to go.'

    Other psychiatrists agree that schizophrenia is an unsatisfactory term that conveys bizarreness but they are concerned that discarding the term could lead to problems classifying patients with psychosis.

    'If we don't have some way of distinguishing between patients, then those with bipolar disorder or obsessional disorder would be mixed up with those currently diagnosed as having schizophrenia and might receive treatments wholly inappropriate for them,' said Robin Murray, a professor of psychiatry at the Institute of Psychiatry in London.

    He suggested replacing the term schizophrenia with the label dopamine dysregulation disorder, which he said more accurately reflects what is happening in the brain of someone who is psychotic.

    Source:  Reuters
    Source:  The Guardian

    This 'Mental Health E-News' posting is a service of the New York Ass'n of Psychiatric Rehabilitation Services

  • September 10, 2006 - News of the Week


    Let Andrew Goldstein's Record Speak

    The background of Kendra's Law, now under intense scrutiny in New Mexico, is well documented. For this reason, attempts by to rewrite the psychiatric history of Andrew Goldstein are easy to refute. For those unfamiliar with the case, Goldstein acquired notoriety as a "treatment refuser" after he pushed Kendra Webdale to her death in a New York City subway on January 3, 1999.

    Posted online are reports by impartial investigators:

    REPORT #1: "Bedlam on the Streets," by Michael Winerip, New York Times Magazine, May 23, 1999. Magazine cover blurb: "Long Before Andrew Goldstein pushed a woman in front of a train, he pleaded for help. He couldn't get it. The Crisis of the Mentally Ill" . Click and enter search for Michael Winerip Bedlam on the Streets.

    (If you don't have access to the NYTimes archive, we'll send a hard copy. Email and give us your postal mailing address.)

    REPORT #2: "In the Matter of David Dix (pseudonym)," A Report by the New York State Commission on Quality of Care for the Mentally Disabled, November 1999. Click

    In pro/con commentaries in the Albuquerque Tribune, September 7 2006, critics of Kendra's Law contended that if there had been adequate resources, including stable housing, treatment, and case management, the subway tragedy would not have occurred. The reports cited above confirm that view, showing that Andrew Goldstein knew he needed help and committed himself to psychiatric hospitals 13 times, perhaps expecting to be stabilized and discharged to a supervised setting where he had done well for 4 years.

    In a recent blog, ignores these positive signs and instead accuses the Albuquerque advocates of "recycling an old fallacy" about Goldstein's search for supervised treatment. Psychlaws also dismisses the premature hospital discharges, dead-end waiting lists, administrative mixups, and endless broken promises that plagued this former honor student.

    Three weeks before Kendra Webdale's death, Goldstein was prematurely discharged from a hospital with a one-week supply of medication. Although Psychlaws made Goldstein the poster boy for compulsory treatment, he more fittingly symbolizes the dangerous gaps in an uncoordinated underfunded mental health system. Of the few homicides commited by people diagnosed with psychiatric disabilities, 1 in 8 follows an assailant's premature discharge from or refused entry to a treatment facility (See's "Preventable Tragedies, July-Dec 2004).

    August 20, 2006 - News of the Week


    Rethink Severe Mental Illness Makes Point with Winston Churchill Statue in a Straitjacket

    Source: Press Release, Monday, July 17, 2006

    Rethink severe mental illness today (July 17th) published the successful results of its month-long Anti-Discrimination Site pilot in Norwich in March this year. The campaign, which included the controversial media stunt of a statue of Winston Churchill in a straightjacket, aimed to shift people's attitudes towards mental illness through thought-provoking advertising, fundraising, local themed activities, publicity events and PR campaigns.

    The statue symbolised the way people with mental illness are stigmatised in society and was a celebration of the life of a man who triumphed over mental health problems.

    Speaking about the campaign's results, Rethink Director of Public Affairs, Paul Corry said: "People with severe mental illness consistently report the stigma and discrimination surrounding their condition as a major barrier to social inclusion, access to services and recovery. While there are major PR-led campaigns to combat stigma in Scotland and New Zealand and plans to introduce them in the United States, the Westminster government has rejected the approach.

    The campaign clearly demonstrates that such approach in England, Wales and Northern Ireland can prove successful in raising awareness and shifting negative public attitudes to mental illness and help solve the three biggest mental health problems; prejudice, ignorance and fear."

    A benchmark and post-campaign public opinion survey carried out by an independent company showed the following:

    Pre-campaign: 15 per cent of people said they had experienced a mental health problem.
    Post campaign: 30 per cent of people said they had experienced a mental health problem.

    Pre-campaign: 35 per cent of people said they cared for someone with a mental health problem.
    Post campaign: 54 per cent of people said they cared for someone with a mental health problem.

    Pre-campaign: 32 per cent of people thought a person with the early signs of schizophrenia would go on to do something violent to someone else.
    Post campaign: 24 per cent of people thought a person with the early signs of schizophrenia would go on to do something violent to someone else.

    Pre-campaign: 40 per cent agreed strongly that they wouldn't want anyone to know about a personal mental health problem.
    Post campaign: 22 per cent agreed strongly that they wouldn't want anyone to know about a personal mental health problem.

    On Churchill, 21 per cent said unprompted that they had seen or heard something about the Churchill statue; 59 per cent said that it was OK to use the statue.


    EXECUTIVE SUMMARY: Rethink Anti-Discrimination Site (RAS) Pilot Evaluation


    The primary objective of the month-long campaign in Norwich was to raise public awareness of the stigma associated with mental illness and the discrimination that people with mental health problems face in their daily lives.

    A secondary objective of the pilot was to increase awareness of Rethink which is known to be poor among the general public. It is important to emphasise that the month long campaign was seen as a beginning of a set of activities, not an end point. It will take years to "stamp out stigma," however research does demonstrate that a key component of any programme of activities is a well co-ordinated launch linking public promotional activities such as advertising) and targeting initiatives (such as face to face meetings). We will use our Norwich experience to help inform the planning and delivery of the second Rethink RAS in Northern Ireland January 2007.


    The evaluation team tracked the impact of the month long campaign using four data sources: A commissioned public attitude telephone survey at baseline and follow-up run by Marketry; Media coverage monitoring; Rethink management information; Interviews with Rethink staff and volunteers.


    Public attitude data was collected from 104 people at baseline and 125 at follow-up. Some of the key results are listed below:

  • Awareness of Rethink. There was a 7% increase in awareness of any mental health organisation across the sample (63% to 70%). Unprompted awareness of Rethink rose from 2% to 9%. When asked of whether they had heard of Rethink, prompted awareness rose from 13% to 31%.

  • Mental health awareness. Double the number of people (15% to 30%) said they had experienced mental health problems after the campaign.

    Post-campaign, only 2% compared to 14% pre-campaign said they couldn't remember any mental health problems. The biggest shift was of 19% more people naming depression, 16% anxiety, 14% Alzheimer's, 12% dementia, 11% schizophrenia. There was also a 10% increase of people who had heard of psychosis.

  • Attitudes to people with mental health problems. Before the campaign, 40% people agreed strongly that they wouldn't want anyone to know if they had mental health problems. This decreased to 22%.

    Fewer people held strong views that people with mental illness are often dangerous after the campaign (21% as compared to 33%) and should not be allowed to do important jobs (14% as compared to 24%).

    Fewer people strongly agreed that people are generally sympathetic and caring to people with mental health problems (5% after the campaign 13% before). This may be the result of a campaign highlighting the role of stigma and discrimination affecting the lives of people with mental health problems.

    The post-campaign-reported key messages in marketing activities were:

    Mental illness can happen to anyone
    Mentally ill people are ordinary people
    Mentally ill people are not dangerous
    Mentally ill people can do a job
    Mentally ill people can recover
    People shouldn't be scared of dealing with mental health

    Feedback on Churchill statue from the public:

  • 80% of all respondents had heard about the Churchill statue, but only 18% of these were aware that it was associated with Rethink.
  • 59% of people thought that it was OK that Rethink used the statue.
  • 49% of people thought it was wrong to take the statue down.
  • 52% of people thought charities using controversy to raise awareness was acceptable, 10% felt it was not, and the rest were undecided.

    Rethink information:
    We saw increased contacts to Rethink via the web site during the RAS, but not to our Front Door telephone service.

    We received 123 new members to Rethink for Norfolk March 2006 compared to 0 in January and 2 for February 2006.

    486 new donors were recruited and have started contributing to the work of Rethink.

    For more information contact: Lana Savic, Media Manager: tel 020 7330 9129, mobile 07967 398566 or Alita Howe, Media Officer: tel 020 7330 9149, mobile 07918 660760

    About Rethink severe mental illness

    Rethink, the leading national mental health membership charity, works to help everyone affected by severe mental illness recover a better quality of life. We aim to provide hope and empowerment through effective services and support to all those who need us and campaign for change through greater awareness and understanding. For further information on the charity and its work, visit: or call 0845 456 0455.

    © 2006

    -End of RETHINK Press Release>

  • August 13, 2006 - News of the Week


    What boosts recovery best? The answers are as diverse as the people seeking them, but high on everyone's list is how to continue what works best for them. Advance directives record an individual's preferences based on that person's unique past experience with symptoms and treatments. Advance directives can reduce the very real hazards of mis-medication, mis-diagnosis, and fear of treatment.

    A new website now brings advance directives into sharper focus for people who use mental health services, and for those connected in any way to the mental health field. The site, a joint venture of the Department of Psychiatry, Duke University Medical Center and the Bazelon Center for Mental Health Law, is the National Resource Center on Psychiatric Advance Directives (NRC-PAD), at

    The NRC-PAD offers mental health consumers, family members, clinicians and policymakers timely information about PADs, including:

  • Introduction to PADs
  • Forms to complete PADs
  • Links to state statutes
  • Educational webcasts
  • Discussion forums
  • Frequently-Asked-Questions
  • Past and up-to-date research

  • The NRC-PAD will be a key gathering place for stakeholders to learn about psychiatric advance directives and how to complete these legal documents. The NRC-PAD aims to assist in implementing laws that support patient self-determination and high-quality mental health care.

    Twenty-two states have created specific forms for PADs, available through the NRC-PAD. The resource center also links to healthcare directive forms for the remaining states, or consumers can use the Bazelon Center's template for a PAD at

    For more information, visit the National Resource Center on Psychiatric Advance Directives at

    July 9, 2006 - News of the Week

    The year 1999 in New York City began with a brutal murder in the subway. Andrew Goldstein, a man diagnosed with schizophrenia, pushed Kendra Webdale, a vibrant aspiring writer, to her death as a train approached. Goldstein had been discharged from a psychiatric hospital 3 weeks earlier. Perhaps the most tragic aspect of Kendra's death is how nearly it never happened.

    The what-ifs are agonizing. What if North General Hospital had not discharged Goldstein too soon? What if they had discharged him to a supervised residence and escorted him there? What if they had given him a month's supply of medication, rather than a 1-week supply? What if they had assigned a mental health worker to accompany him to clinic appointments? What if the pleas for supervision from both Goldstein and his mother had been heeded?

    A search of the Treatment Advocacy Center's ( record of "Preventable Tragedies" shows that cases like Goldstein's are not uncommon. Over a 6-month period, data shows that at least 1 in 8 homicides followed premature hospital discharge or refused entry. In Goldstein's case, a state investigation found that a clinic sent him a letter saying his case would be closed if he did not respond. Did he get the letter? Was he too sick to respond?

    The Psychlaws database contains 1,387 newspaper descriptions of homicides by "people with severe mental illness" from 1989-2006. We looked at the 66 descriptions for July-December, 2004. Only 25 of them mention whether or not the assailant was taking medication at the time of the homicide. Surprisingly, 9 were taking medication; 16 were not. If this is a representative sample, 36% of homicides in the database may have been committed by people taking medication.

    To summarize our homicide findings in the psychlaws database:

  • Only 25 of 66 newspaper reports (Jul-Dec 2004) give medication status. According to these 25 reports, 9 assailants were taking medication, 16 were not.

  • 8 assailants had been discharged prematurely from a facility or were turned away when they asked for help.

  • 27 had histories that included brutal assaults, drug and alcohol disorders, child abuse, and restraining orders.

  • None of the above findings justify new legislation. Although Andrew Goldstein was made the poster boy for harsher laws, he really symbolizes public indifference to an uncoordinated, underfunded mental health system.

    July 2, 2006 - News of the Week


    The National Stigma Clearinghouse has often deplored the Treatment Advocacy Center's (*TAC) habit of bending the truth to promote its controversial agenda (see "Fear Tactics in Advocacy").  Why do we bother? 
    TAC's statements are unfortunately considered authoritative by the press.  For example, the Washington Post recently published a TAC "finding" that contradicts Department of Justice (DOJ) data about how often people with mental illnesses kill police officers. The "finding" on police killings appears in an TAC briefing paper titled "Law Enforcement and people with severe mental illnesses" that states: "In 1998, people with mental illnesses killed law enforcement officers at a rate 5.5 times greater than the rest of the population."
    To make such a calculation, TAC used their own record of how many police were killed by people with mental illnesses from 1990-2004. They chose 1998 as their sample year; perhaps because it was an exceptional year, with their record showing a whopping 8 killings. But if one checks TAC's cited sources (footnote 8), they turn out to be highly contradictory. For example, the DOJ report referenced by TAC shows zero (0) shootings of police by "mentally deranged" individuals in 1998. Further, the most recent DOJ report shows that police killings by "mentally deranged" individuals averaged 2 per year for the years 1995-2004. 
    Despite its obvious exaggeration, the TAC statement shown above has appeared in the national media (e.g.The Washington Post).
    Another example: A TAC press kit dated June 29, 2006, illustrates TAC's talent for misleading statements.  The press kit states: "Of participants in New York's assisted outpatient treatment program, for instance, 83% fewer experienced arrest and 87% fewer experienced incarceration."
    Here TAC arrives at a seemingly phenomenal improvement in incarceration and arrest rates. There were 2,745 participants in New York's outpatient commitment program. New York State's official evaluation of outcomes issued in March 2005 shows that 549 of the 2,745 participants experienced less incarceration, and 686 of the 2,745 participants experienced less arrest than before they entered the program.  By dividing 549 and 686 by 2,745, my calculator indicates that 20% of the program's participants experienced less incarceration and 25% experienced less arrest. Those figures are very different from what TAC reported. TAC may have found the truth too cumbersome, so simply ignored half of the information.  In the process, they nearly quadrupled the improvement rates.
    A third example: A TAC press release dated May 11, 2006, gives a skewed view of a new study linking violence and schizophrenia, ("A National Study of Violent Behavior in Persons with Schizophrenia," by Swanson, Arch Gen Psychiatry, 63, 490-99).

    TAC describes the study as showing 19.1% of patients violent in six-month period, but omits the finding that 15.5% of the patients committed minor violence without injury or weapon use, and only 3.6% were involved in serious violence. Further, as we described in the previous example, the press release uses highly inflated patient improvement rates for New York's outpatient commitment program. This distortion raises improvement rates as much as 10-fold.  Our figures and TAC's figures are below, based on the NYSOMH Final Report on the Status of Assisted Outpatient Treatment, dated March 2005. The report looked at 51 categories of behavior and services.

    Percent of 2,745 Kendra's Law Program Participants Showing Improvement in Six Categories

    Suicide attempts and harm to self - NSC 5%, TAC 55% 
    Physical harm to others - NSC 7%, TAC 40%
    Damaged or destroyed property - NSC 6%, TAC 46%
    Threats of physical harm - NSC 12%, TAC 43%
    Services engagement - NSC 21%, TAC 51%
    Medication adherence - NSC 35%, TAC 103%.

    * A clarification concerning names: The Treatment Advocacy Center ( is the guiding force behind compulsory psychotropic medication for outpatients. Led by Dr. E. Fuller Torrey, the group is based in Arlington Virginia. The Treatment Advocacy Center is not connected in any way with a Boston-based not-for-profit organization, the Technical Assistance Collaborative, the first group to be called TAC.

    The Technical Assistance Collaborative assists in the planning and financing of affordable housing, human services, and healthcare delivery systems. For more information, visit their website at or E-mail them at

    June 22, 2006 - News of the Week


    From: Jean Arnold, National Stigma Clearinghouse

     RE: ARTICLE: "Rules Separate Mentally Ill From Treatment with 'Imminent Danger' Requirement and Scant Resources...", Washington Post, May 29, 2006 (article is posted below)

    Letter to the Washington Post:
    Tom Jackman deserves praise for his exposure of the dangerous shortage of mental health treatment facilities in Virginia (May 29, 2006). 

    In his opening paragraphs, Jackman lays the groundwork to promote compulsory medication by describing spectacular homicides. Such over-emphasis on violence has been found to decrease public support, however, making a bad situation worse (Corrigan, Psychiatric Services, May 2004).

    Oddly, the article is laced with seriously misleading statements. Where were the editors?

  • The article states: The danger is particularly acute for law enforcement officers.
    FACT: Official data on the deaths of uniformed officers refute this statement. The FBI Uniform Crime Report, published yearly since 1929, reports 2 felonious deaths of law enforcement officers during "handling of deranged persons" in 2004. There were only 12 such deaths over a 10-year period (1995-2004) out of a total of 594 deaths in action.
  • The article states:  A Justice Department study once found that people with a history of mental illness committed more than 4 percent of all homicides and 25 percent of all homicides in which a parent was killed.
    FACT: The Justice Department study that was presumably referenced was based on data that was collected in 1988 from 30 large urban counties. The study contains no information specific to people with severe psychiatric conditions. It makes no mention of diagnosis, severity of illness, or treatment status.

    Further, since at least 22% of the nation's adult population has a diagnosable mental illness, it would be reasonable to expect that 22% of homicides are committed by this population; so 4% would therefore be remarkably low.  The 4% figure would strongly refute the article's implication that people diagnosed with mental illnesses are more dangerous than the rest of the population.

  • The article quotes "some experts" as saying that most states require proof of a person's imminent danger to self or others before giving treatment.
    FACT:  The "some experts" are misleading the public. Forty-two states have outpatient commitment laws that permit relatives, caregivers, roommates, and others, to enter psychiatric outpatients into treatment by court order. The "imminent danger" criterion is being weakened and replaced by a broader "gravely disabled" criterion in some outpatient commitment laws, alarming advocates and legal experts.

  • The article quotes "an expert" as stating that New York's involuntary outpatient commitment law, Kendra's Law, caused New York City's jail population to drop by half.
    FACT:  This figure seems to have come out of thin air. About 15,000 New York City residents are imprisoned in jails. According to the state's official analysis of Kendra's Law results (March 2005), 631 statewide program participants had had previous incarcerations. During six months in the program, 82 were incarcerated. It requires a huge leap of imagination to suggest that Kendra's Law could reduce New York City's jailed population by 7,500 prisoners.
  • The article states that a series of violent incidents in New York State caused lawmakers to pass Kendra's Law instituting involuntary outpatient commitment.
    FACT:  Jackman here rewrites well-documented history. Kendra's Law passed in the emotional aftermath of Kendra Webdale's death from Andrew Goldstein's assault in a New York City subway. Ironically, in this case and other cases of violence, the assailant often was aware of escalating symptoms and tried in vain to get help from over-burdened budget-squeezed mental health facilities.   

    REFERENCES (Click to view)

    FBI Uniform Crime Report,
    Dept. of Justice Report "Murder in Families," by John M. Dawson & Patrick A. Langan,
    Surgeon General's Report on Mental Health, 1999, Chapter 2, Section 2, "Epidemiology,"
    Gotham Gazette, "Imprisoned in New York,"
    Newsday, "Law for Kendra" by Matthew Cox, Wednesday, August 4, 1999
    A Report by the New York State Commission on Quality of Care for the Mentally Disabled, November 1999,

    - End of open letter to the Washington Post -


    The Washington Post article is reprinted below under the Fair Use Standard

    View article on website with free subscription

    With "Imminent Danger" Requirement and Scant Resources Keeping Help Out of Reach, Some Become Violent


    Washington Post Staff Writer
    Monday, May 29, 2006
    Page B01

    There are discussions about mental health, debates about dollars, demands for more beds, mostly in general terms at the top of political and policy food chains.

    Then there is real life -- and real consequences. Check out the first two weeks of this month:

    May 1: A mentally ill 22-year-old man is convicted of murder for beheading his aunt in Arlington.

    May 8: A mentally ill 18-year-old man drives into a police parking lot in Fairfax County, fatally shoots two police officers, then is shot and killed by police.

    May 12: A mentally ill 24-year-old man allegedly stabs his mother to death in Fairfax City, then uses duct tape to seal the bathroom, where her body is found.

    May 14: A mentally ill 18-year-old man in Anne Arundel County stabs himself, then menaces police and demands that they shoot him, which they eventually do. He dies.

    The pace of violence hardly surprises those who deal with the mentally ill every day: social workers, police, parents, lawyers. They know how hard it is to get a sick person treatment, how few resources are available, how the money for help has declined.

    And when a Michael Kennedy sprays a police parking lot with bullets, or a Matthew Pahno chokes his aunt to death and decapitates her, the veterans of the system bite their tongues and hope that the money and resources will somehow materialize.

    Where once getting treatment for mental illness was almost too easy, causing psychiatric centers to become dumping grounds for the healthy and the sick, some experts said the pendulum has swung too far the other way, with most states requiring proof of a person's "imminent danger" to themselves or others before giving them treatment.

    "Right now, we only deal with the extreme cases," said John C. Whitbeck Jr., a Leesburg lawyer who oversees a George Mason University law school program that helps families seeking help from the courts for mentally ill relatives in civil commitment hearings. "And that's not getting anything done because so many people need to be addressed at the middle level."

    Whitbeck said a busy treatment center such as Fairfax County's Woodburn center in Annandale might evaluate 25 or 30 people in a single night but recommend perhaps four for further help. "There's nothing to address all these other people," he said.

    "There've been increasing pressures to reduce beds everywhere," said Robert W. Keisling, former head of emergency psychiatric services in the District. "And there's been a dumbing down of the hospital system. Some of the folks doing assessments are not psychologists or psychiatrists, and there are a lot of stupid assessments being made."

    Keisling said he recently referred a man to a hospital who thought he was a secret agent. A hospital official asked the man whether he had a problem. He said no, Keisling said, and was promptly sent away.

    "We have a system that is unsophisticated," said Joanmarie I. Davoli, a former Fairfax public defender and longtime advocate for the mentally ill. She said that the law does a poor job of defining who is mentally ill, that judges are poorly trained to decide how to handle such people and that a lack of public awareness results in underfunded resources.

    Davoli defended Alfred L. Head, who in 1998 repeatedly threatened his parents and slashed his own throat in Reston. Six months later, he beat his mother to death with a baseball bat shortly after walking out of a string of mental health facilities.

    Head was found not guilty by reason of insanity and placed in a state psychiatric hospital for seven years, where he responded extremely well to treatment. He eventually was found fit to be released by doctors and a Fairfax judge. Today he attends college, has a job and lives on his own, his lawyers said.

    "The tragedy there is," Davoli said, "had the civil commitment laws not been so restrictive, his mother might be alive."

    In Maryland, mental health advocates recently succeeded in getting the legal standard for treatment relaxed, according to Evelyn Burton of the Maryland chapter of the National Alliance for the Mentally Ill. "Getting rid of that 'imminent' part made a difference," she said, but Maryland also does not provide for formal outpatient treatment under the law, unlike Virginia and the District.

    The National Alliance on Mental Illness estimates that the most serious mental illnesses afflict 5 million to 10 million adults and 3 million to 5 million children. Most of those people don't pose a danger to anyone. Many of those illnesses, such as schizophrenia, begin to appear in the late teenage years or early 20s, experts said.

    Numerous studies show those who go without medication or treatment are more dangerous than the general population. A Justice Department study once found that people with a history of mental illness committed more than 4 percent of all homicides and 25 percent of all homicides in which a parent was killed.

    The danger is particularly acute for law enforcement officers, often the first people to encounter a mentally ill person during a psychotic episode. In 1998, according to the Treatment Advocacy Center, people with mental illnesses killed law enforcement officers at a rate 5 1/2 times greater than the rest of the population. In the Washington area alone since 1998, eight officers have been killed by mentally ill people, including Fairfax Detective Vicky O. Armel and Officer Michael E. Garbarino on May 8, by Kennedy.

    Kennedy's parents tried repeatedly to get treatment for him in recent months, only to be told by various mental health professionals that he didn't qualify, said Richard F. MacDowell Jr., their attorney. MacDowell said the mental health system in Virginia was "essentially broken," particularly in Northern Virginia, where population has increased as state funding decreased.

    "Unless we do something about this problem now," MacDowell said, "tragedies like this are inevitable in the future."

    Virginia has been trying to shift its resources away from state hospitals to local community services boards. But in 2003, for example, $12.5 million was cut from the community budgets, and the boards have about 3,000 adults waiting for services, according to the state mental health department.

    In Northern Virginia, the number of private psychiatric beds available has plummeted, from 402 in 1990 to 196. There are none in Alexandria, forcing officers there to drive to Fairfax, or farther, to obtain help. The one state hospital in the region, in Fairfax, is nearly always full, experts said. Only 20 beds remain in Arlington for a population of 195,000.

    James S. Reinhard, a psychiatrist who is head of Virginia's mental health department, acknowledged the diminished funding. But he pointed out that the state is about to pour $290 million into state facilities and another $170 million into community services, and that mobile community teams -- psychiatrists and social workers who make house calls -- which already are in use in Fairfax, should have an impact.

    Reinhard noted that Virginia's mental health spending per capita -- it ranks 30th nationally -- doesn't compare to its income per capita (12th nationally). Cases such as the Fairfax police shooting "show how much of a need there is out there," Reinhard said. "People in our system are pedaling as fast as they can with the resources they have."

    James Kelly, manager of emergency psychiatric services in Fairfax, noted that there have always been bed shortages. But he said Fairfax conducts crisis interventions around the clock, both at its mental health centers and in the community, and finds beds for those most in need. "I have no doubt that we see a lot of high-risk clients," Kelly said, "and we make a difference. But you're not going to catch every one."

    Hospitalization shouldn't be the only option, said Mary Zdanowicz, executive director of the Treatment Advocacy Center. She said courts should be ordering more "outpatient commitments," in which mentally ill people are required by court order to take medication or other treatment -- and face legal sanctions if they don't.

    Meanwhile, law enforcement officers continue to be the ones on the front lines. They receive training to deal with the mentally ill, and Fairfax Deputy Chief Suzanne Devlin said people should call police rather than let a loved one act out violently.

    "It is frustrating," Devlin said. "But law enforcement is a funny thing; we do a lot of everything."

    And so, people wind up in the jail instead of in hospitals.

    "When I first started," Fairfax Sheriff Stan G. Barry said, "it was very, very rare that someone who was clearly mentally ill ended up in jail. Over the years, I've watched that change drastically. Now, people with mental illness get routed through the jail quite frequently. It's a game of hot potato. Nobody wants to deal with the problem."

    State Sen. Ken Cuccinelli (R-Centreville), a friend of Garbarino's, proposed laws in the last legislative session that would have provided for more outpatient commitments and more legal help for families of the mentally ill. Both proposals failed, he said.

    In New York state, a series of violent incidents caused lawmakers to institute involuntary outpatient treatment for certain people, under "Kendra's Law." The jail population in New York City dropped by half, Keisling said. "The shooting incident in Fairfax may result in some changes being made," he said. "It takes something like this to get the politicians motivated."

    Source:  Mental Health E-News posting, NYAPRS

  • May 12, 2006 - News of the Week


    System Reform Requires High Quality Programs, Not Coercion Laws

    The guru of forced psychotropic medication for outpatients, Dr. E. Fuller Torrey, recently acknowledged in a National Public Radio interview that although 42 states have court-ordered treatment laws, they are rarely used. Why? Perhaps Torrey's organization, the Treatment Advocacy Center (, is itself at fault.

    Psychlaws has linked coercion laws to brutal deaths, winning their passage in the glare of highly emotional publicity. When the full facts emerge, however, they often reveal a trail of negligence by budget-squeezed poorly-coordinated mental health facilities.

    "Bad case, bad law," is a cliche that may explain states' caution in applying their court-ordered treatment laws.

    Psychlaws perfected its "public safety" approach to legislation in 1999, after the fatal encounter of Kendra Webdale and Andrew Goldstein in a Manhattan subway station.

    Under Psychlaws' guidance, a family's overwhelming loss came to symbolize a menace to every New Yorker.

    To launch "Kendra's Law," the Torrey group first shoehorned Goldstein into the role of a "medication refuser" who lacked insight into his psychosis.

    Several months of intense publicity overwhelmed the actual facts of Goldstein's record, including findings by the New York Times that he had tried in vain to get the help he knew he needed. As the truth emerged, Goldstein's psychiatric history is an appalling account of mistakes made and opportunities missed by the psychiatric facilities he turned to, often voluntarily, for help. In spite of all this, a vengeful tone at his trials helped put him in prison, possibly for life, and his mislabeling continues to re-surface in the press.

    Innovative states are proving that high quality programs are successful without a law enforcement approach. The appeal of Psychlaws' coercion campaign will fade further as states shift to treatments developed in consultation with people with first-hand knowlege of psychiatric conditions. These programs are promoted by the Bazelon Center for Mental Health Law, The Presidents' Commission on Mental Health, and SAMHSA.


    Are forced treatment laws redundant? Has the Treatment Advocacy Center's aggressive and fearmongering stance on forced medication hindered system reform?

    Here are two critics' views on the law's redundancy:

    1999 - "The focus of coercion upon the patient is, I submit, a misdirection of energy. Coercion is needed, but to enforce the laws already on the books that are routinely disregarded with impunity, either because of the scarcity of resources or because of conflicting pressures." Source: Clarence J. Sundram, former Chairman (for 20 years), NYS Commission on Quality of Care. "Misdiaagnosis and Non-Solutions," May 20, 1999, a statement in opposition to the then-proposed Kendra's Law.

    2006 - " 'Kevin's Law' [Michigan's forced-treatment law] is unnecessary because we judges already had the authority to order medication on an outpatient basis." The quote is from Judge Patrick J. McGraw, Saginaw County Circuit Court Family Division.

    The article notes that "Mr. McGraw, who handles nearly all mentally ill committments in the county, says he occasionally orders outpatient medication but has yet to use 'Kevin's Law' for any person." Source: "Forced Drugging," by Scott Davis, The Saginaw News, March 1, 2006.

    A Comment on the Treatment Advocacy Center's (Psychlaws) Inflation of Kendra's Law Outcomes:

    In March 2005, the New York State Office of Mental Health released an analysis of outcome data on 2,745 recipients of New York's outpatient commitment program, Kendra's Law.

    Psychlaws, led by E. Fuller Torrey, has selected data out of context and is using it to win support for similar laws in other states.

    The Torrey group is publicizing high rates of improvement without explaining that only a modest number of the program's 2,745 recipients improved significantly between the time they entered the program and 6 months later.

    For example, Psychlaws reports that IOC recipients experienced 87% less incarceration after 6 months in the program.

    What Psychlaws doesn't explain is that prior to entering the program, 23% of recipients experienced incarceration, and after 6 months in the program, 3% experienced incarceration. The state's official report describes this as an 87% improvement for 23% of 2,745 program recipients. (To complicate matters, some data analysts would consider this a 20% improvement.)

    How does Psychlaws' skewing of outcomes poison the IOC debate? Consider the preposterous claims of a forced treatment proponent in Maine:
    "In New York, 91% of those who were not taking medications began taking them, just because that law was on the books" and "arrests for petty and violent crimes involving people with mental illness dropped 78% and millions of dollars in hospital costs were freed up for community services." Source: Maine Times Record, March 10, 2005

    We welcome readers' comments. Email

    May 7, 2006 - News of the Week


    See Below for Open Letter from Allen to Satel re Article in National Review Online


    Have you noticed the recent upsurge in the media campaign for forced treatment? 

    Fuller Torrey appeared on NPR's Fresh Air  on April 17, (
    Click here). He talks a lot about "lack of insight" and the intersection of outpatient commitment and homelessness and criminal justice. 

    The program's host challenges Torrey with Bazelon's position about "dangerous coercion" and the failure to fund real services.  Torrey agrees that it is important to fund adequate services, but says crazy people won't come in for services.  He also mentions mental health courts.

    For Sally Satel's article criticizing the SAMHSA Consensus Statement on Mental Health Recovery, Click here.

    Pete Earley, whose book provides the basis for much of the conversation, is a former Washington Post reporter whose son was diagnosed a few years ago.  His new book is CRAZY: A Father's Search Through America's Mental Health Madness, Click here.

    I finally got frustrated enough to compose an "open letter" to Sally Satel and have submitted it to National Review (see below), but don't think it will get printed.  So I share it with you, and ask your help in distributing it, through your own channels or by recommending a place that you think it might get published.

    Thanks in advance.

    Michael Allen
    Senior Staff Attorney
    Bazelon Center for Mental Health Law
    1101 15th Street, NW, Suite 1212
    Washington, DC  20005-5002
    Phone: 202/467-5730, ext. 117
    FAX:  202/223-0409
    FROM:   Michael Allen 
    SENT:   Friday, May 05, 2006 10:22 AM
    TO:     ''

    SUBJECT: An Open Letter to Sally Satel,
    Responding to "A Statement of Madness,
    "National Review Online, April 5, 2006

    Dear Sally:
    I've noticed over the past couple of weeks that you and your allies had renewed your media campaign to undermine the rights of people with mental illnesses, and to suggest to the public that forced treatment is the only kind that will work for large numbers of people.  I wonder whether decisions by the New Mexico and Maine legislatures to reject involuntary outpatient commitment might be fueling some anxiety on your part that the tide was turning against forced treatment.
    We can all agree on the objective:  helping people with serious mental illnesses lead stable, productive lives in the community.  Beyond medication, that will require stable housing, employment opportunities, and the chance to live, love, and learn with friends and family.  Research suggests that these supports yield better results, for individuals and for society.  Those states with higher rates of hospital and outpatient commitment don't necessarily produce the best outcomes for people with mental illnesses.
    There is a lot of good, hard science available about what works in terms of mental health treatment, but reading your recent article belittling the Consensus Statement on Mental Health Recovery from the federal Substance Abuse and Mental Health Services Administration ["A Statement of Madness," National Review Online, April 5, 2006], I was convinced I had arrived in the Land of Oz. 
    Why?  Because, in oversimplifying mental illnesses and SAMHSA's response, you constructed a straw man with no brain, no heart and no courage.  That's why knocking him over was so incredibly easy.  But your criticism gets us no closer to a solution for the many poor people in this country who rely on the public mental health system for the services and supports they need to succeed in the community.

    NO BRAIN.  Your article revives that old canard about half the people with psychotic disorders lacking "insight" into their illnesses.  I've never understood where you found that statistic, or how you can insist on its validity given the remarkable success of programs like Pathways to Housing [see] and the so-called "AB 34" programs in California [see], that are successfully engaging "the most severely disabled" (to use your term) people with mental illnesses.  Employing the very conservative principles of self-direction, empowerment and personal responsibility that you deride in the Consensus Statement, these programs are producing much better outcomes than those that feature compulsory medication. The recovery model is alive and well in this country; you would do well to acknowledge its successes.

    NO HEART.  You were appointed to the Advisory Council for the Center for Mental Health Services at SAMHSA by a president who champions "compassionate conservatism," but your article trashes the "recovery" orientation of his New Freedom Commission on Mental Health.  What would you recommend in its place?  Your published writings suggest you favor a broad spectrum of programs that involve involuntary treatment, including court orders for outpatient commitment, mental health courts and other forms of "leverage" to overcome the "treatment resistance" of people with severe and persistent mental illnesses.  In your willingness to inject coercion into mental health treatment, you ignore the creative ways in which mobile outreach and assertive community treatment (ACT) are being coupled with supportive housing to yield good life outcomes without force. 

    NO COURAGE.  The seminal contribution of the New Freedom Commission was its articulation of an unspoken truth:  "millions of dollars are spent unproductively in a dysfunctional service system that cannot deliver the treatments that work…."  [see ].  We can't—as your article advocates—reduce mental health to the question of whether someone "takes his medications."  But we've tried it your way, and it doesn't work. 

    Thinking people realize that real mental health depends on a broad array of personal relationships, personal strengths and professional support.  Any new vision of public mental health will upset some apple carts.  And I understand how unsettling it must be to you, as a psychiatrist, to be faced with a paradigm shift that reduces the role of medical experts in the field of mental health.  We all need to display more courage in our willingness to look at new treatment modalities that might actually work better.
    Americans are hungry for new approaches to government programs.  In areas like public education, conservatives have championed school vouchers, arguing that it is important to put purchasing power in the hands of the consumer.  This, they point out, would have the salutary market effect of improving good schools and driving bad ones to reform or fail.   Putting mental health dollars and decision making in the hands of people with mental illnesses makes the same good public policy sense, and SAMHSA's Consensus Statement on Recovery sensibly recognizes that.
    Sally, I invite you to join us in building a public mental health system that is as good as the American people it is meant to serve.  We're not in Kansas anymore.  We're perched on the edge of a new world, and a new vision of public mental health.

    Michael Allen
    Senior Staff Attorney
    Bazelon Center for Mental Health Law
    1101 15th Street, NW, Suite 1212
    Washington, DC  20005-5002
    Phone: 202/467-5730, ext. 117
    FAX:  202/223-0409

    March 20, 2006 - News of the Week

    2nd ANNUAL "VOICE AWARD" NOMINATIONS DUE FRIDAY, APRIL 14th (previous deadline: Apri 7th)

    Sponsored by SAMHSA as part of National Anti-Stigma Campaign

    Voice Awards recognize the creators of films, television and radio programs who give "voice" to people with mental health problems by portraying them accurately in positive, respectful roles.

    Slowly but surely, the media are depicting people with mental health-related conditions in more realistic and innovative ways. Sensationalism is giving way to realistic situations. Writers and producers have begun to use more complex characters and plots. Characters are shown as rounded individuals rather than one-note stereotypes.

    The most authentic "voices" -- the people who experience psychiatric vulnerabilities first-hand -- are joined by all segments of the mental health community in their quest for non-stigmatizing treatment by the media.

    If you know of a film, TV show or radio program that originally aired in 2005 that depicts persons with mental health problems in a positive and accurate way, you are encouraged to submit a nomination. It's free and easy - and appreciated.


    Nominations should include (if known):

  • Name of film, TV program, or radio program that originally aired in 2005

  • Air date if TV or radio

  • Where seen? (name of station or network)

  • Names of producers and writers

  • Nominations are due April 14, 2006. E-mail your nomination TODAY.


  • E-mail (Barbara Demming Lurie) or (Voice Awards)


    VOICE AWARDS are sponsored by:

    Substance Abuse and Mental Health Services Administration
    U. S. Dept. of Health and Human Services

    Program Partners:

    Ad Council
    American Psychological Association
    Mental Health Media Partnership
    NARSAD (Mental Health Research Assoc.)
    NASMHPD (Nat'l Assoc. Mental Health Program Directors)
    United Behavioral Health
    WGA (Writers Guild of America, west)


  • View excerpts from last year's Voice Awards ceremony

    March 5, 2006 - News of the Week


    Are Forced Treatment Laws Redundant?

    Are TAC's Claims of Kendra's Law Success Misleading?

    The article below looks at a controversy that has polarized advocates and, arguably, has hindered basic reform of the nation's dysfunctional mental health system. (Comments and a footnote follow article.)

    The Saginaw News (
    Saginaw, Michigan, USA
    March 1, 2006

    Forced Drugging

    Do you like my arts and crafts?
    Is it time to take a nap?
    Donahue is coming on.
    Time for medication.
    -- [from the song] "Psychos in the Dayroom" by Gabriel J. Hadd
    Gabriel J. Hadd is strumming away on his guitar, finding his rhythm and making up for lost time.

    An unfailingly polite man with "Schizo" tattooed across his right arm, the 26-year-old likes to talk about his budding music career and ambitions to write cutting-edge rock songs.

    The Saginaw man's lyrics speak to the medication-induced fog and insanity that once disrupted his life.

    But they also hint at newfound autonomy — freedom from years of psychiatrists, state mental hospitals and court-imposed medications that he blames for driving him crazy.

    Nineteen months ago, Hadd climbed into a broken-down Oldsmobile and fled Saginaw — and the doctor's syringe — to Colorado. Now he's back, trying to rebuild his life without the needle.

    "I'm the same person I ever was before, but I'm a hundred percent better," says Hadd, who doctors once diagnosed as schizophrenic and now say is bipolar. "I lost a lot of time, and I lost a lot of ground."

    Hadd is an example of a growing number of mentally ill people who flee their communities to escape court-ordered medications.

    In recent years, a rising number of states, including Michigan, have adopted laws designed to make it easier for judges to forcibly medicate the mentally ill on an outpatient basis, and it's spurred a backlash by civil libertarians who call it a form of "chemical lobotomy."

    "The monster of forced drugging inside the back wards of state institutions has crawled out over the wall into our communities," says David W. Oaks, director of Eugene, Ore.-based MindFreedom International, an advocacy group for the mentally ill.

    "You can break a person's spirit, and that's what forced drugging does. It terrorizes the person."

    But judges, mental health professionals and other advocacy groups say anti-psychotic or antidepressant drugs — even on an involuntary basis — sometimes are the best way to treat mentally ill people who pose a danger to others or who can't care for themselves.

    "The dilemma is that we want to protect consumers' rights, but while we want their rights protected, we don't want them to wind up in prison," says Judith A. Hutchins, director of the state chapter of the National Alliance on Mental Illness, an advocacy group, and an Ossineke mother of two children with bipolar disorder.

    An act of violence

    Driving these new state laws is the Virginia-based Treatment Advocacy Center, headed Dr. E. Fuller Torrey, a psychiatrist.

    Since 1998, the group has helped push through legislation in a number of states — including California, Florida and Michigan — calling for forced treatment of mentally ill persons who refuse medication.

    Last year, Michigan lawmakers enacted "Kevin's Law" after a schizophrenic Vietnam veteran beat to death Kevin Heisinger, a 24-year-old college student, at a Kalamazoo bus station in 2004. The veteran, who was not taking medication, told authorities that voices made him pummel the student.

    Proponents say the state law is designed to make it easier to allow Michigan judges to order medication or substance abuse treatment on an out-patient basis, even in cases when the mentally ill are a danger only to themselves.

    But Oaks argued that blind fear drives these new laws, saying proponents grossly exaggerate the danger posed by violent schizophrenics or psychotics.

    Even Saginaw County Circuit Court Family Division Judge Patrick J. McGraw, who sees medication as a vital part of treatment for some mentally ill people, believes "Kevin's Law" is unnecessary because judges already had the authority to order medication on an outpatient basis.

    McGraw, who handles nearly all mentally ill commitments in the county, says he occasionally orders outpatient medication but has yet to use "Kevin's Law" for any person.

    "It was a political gem for somebody to get the law passed," McGraw says. "It was passed without input from mental health professionals or judges. I don't think it helps us at all."

    Family Division court typically has 120 to 150 people on either 90-day or one-year mental health commitment orders, says Nancy P. Johnson, supervisor of crisis intervention services for the Saginaw County Community Mental Health Authority, which aids the court during the commitment process.

    In some cases, subjects have exhibited threatening behavior or attacked others; at other times, they are homeless on the street because of a debilitating mental illness.

    Those committed are housed in a psychiatric ward — often at HealthSource Saginaw in Saginaw Township — but many also serve part of the commitment on an outpatient basis in which McGraw retains authority over them. Generally, the patient's family or county prosecutors petition for commitment, and three psychiatrists evaluate the person.

    "I rely on the testimony of medical professionals," McGraw says. "I have to find (patients) are a danger to themselves or they can't provide for their basic needs."

    Eye of the needle

    Regina Brown, formerly of Saginaw Township, never guessed that one day, she would ask a judge to commit her son, Gabriel, to a mental institution.

    Early on, Her son showed a gifted intelligence by talking at a very young age, says Brown, who now lives in Las Cruces, N.M. The toddler said his first words at 7 months, and spoke in rhyming sentences 11 months later.

    Later in elementary and middle schools, signs of trouble emerged, Brown says. Hadd had trouble concentrating on school assignments. and became perfectionist about many tasks. His performance varied wildly from well to poor.

    Both Hadd and his mother agree that his major downward spiral began at about age 19 — perhaps fueled by his use of drugs. Living at home with his parents after dropping out of Ferris State University, Hadd says he attended a rave party in Detroit and likely mistakenly took some ketamine, a depressant with dissociative effects.

    He passed out at the party, then couldn't sleep for three days. Hours slipped by as he lost his job at a video store and then locked himself in his bedroom with a bottle of liquor.

    Still unable to sleep, Gabriel ran from his home to a friend's house and eventually wound up on a church pew. His mother finally persuaded him to seek psychiatric help.

    A Bay City psychiatrist diagnosed him as having schizo-affective disorder, a form of schizophrenia, and placed him on anti-psychotic drugs, a treatment Hadd says worsened his condition during the next several months.

    "I went from the dean's list to not being able to complete my sentences," Hadd says. "I tried to play my guitar and my fingers didn't work."

    Despite the medication, Brown says her son's behavior worsened at times, and he became threatening and agitated, sometimes kicking a bedroom door. She says she had to make a hard choice.

    She convinced a judge to commit her son involuntarily for a few days to a state psychiatric hospital, where doctors ordered anti-psychotic medication. That began a series of involuntary commitments during the next few years.

    "It was very painful, very frustrating," Brown says. "You want the best for your child. It's every parent's hope that their child will be an independent, happy, functioning member of society with the gifts they've been given."I wanted that for Gabriel. While he was having those problems, he couldn't do it."

    A new diagnosis

    As the months wore on, Hadd's disillusionment with psychiatry increased. He felt the drugs made him more tense and heightened his facial tics. He often felt lethargic.

    His last hospitalization was in 2003. Doctors finally diagnosed him as having bipolar disorder, a condition in which a person may experience attacks of depression and mania. He received lithium.

    Brown noticed a big change in her son.

    "It was like a light bulb went on," she says. "He was his old self. His mind was clear. He had his great sense of humor back. He could take care of himself."

    Although the lithium seemed to help, Hadd says he continued researching psychiatric medications on the Web and concluded the "cure" was worse than the disease. He set a goal of weaning himself from the drugs.

    He developed a plan.

    More than medication

    For decades, medication has remained at the heart of much psychiatric treatment — both in institutions and an out-patient basis — but groups such as MindFreedom International contend mental health professionals should focus on using less-invasive methods, such as peer counseling, to treat mental disorders.

    Since the 1950s, however, researchers have documented the behavior-stabilizing properties of anti-psychotics and antidepressants. Torrey a chief proponent of medicating the mentally ill, has contended some anti-psychotics work by changing the brain's structure, compensating for the abnormalities causing psychosis.

    Oaks, MindFreedom's director, considers it "brain damage," but he also agrees mental health clients should receive anti-psychotic medication if they choose.

    "Many of our members say they benefit from prescribed psychiatric drugs," says Oaks, a diagnosed schizophrenic forced to undergo medication in the 1970s.

    Johnson, the Saginaw County crisis intervention supervisor, says medication is not suitable for every patient — noting side effects in some cases — but is the only way for some to take control of their illness.

    "In some situations, it's the only effective treatment," Johnson says. "In some situations, it has to be a combination of therapy, or a structured living arrangement. You have to get the right treatment and the right dosage."

    A new life

    Hadd carefully plotted his escape.

    Through several Web searches, he finally stumbled across, an Ignatio, Colorado group that offers shelter to mental health clients fleeing forced medication. After exchanging e-mails, he arranged with the group founder to stay at a home in Ignatio when the time came. First Hadd would need money.

    For several months, Hadd worked as a cab driver to save money for the journey. He paid $200 for a 1992 Oldsmobile Cutlass Sierra and $125 to fix an axle.

    In July 2004, during a fireworks show in Bay City, Hadd figured it was time. Without saying goodbye to anyone, he climbed in the Oldsmobile and drove West.

    For two months, Hadd stayed at the residential home run by WelcomeWorld, participating in peer counseling free of drugs — recreational or prescribed — and doing odd jobs around the house.

    He eventually found jobs as a bartender and caterer in nearby Durango, Colo., and he developed a relationship with a woman — his first in many years. He says his mind cleared from the haze of prescribed medications.

    "I started to feel a lot better," Hadd says of a drug-free life. "You begin to feel like a human being again."

    Meanwhile, Hadd did not contact his mother. She agonized over his fate.

    "You worry constantly," Brown says. "You worry because you just don't know. There are a lot of homeless people. They are there because they're mentally ill and not treated."

    Ten months later, work dried up, and Hadd finally phoned his mother. After learning she was moving to New Mexico, he decided to return to Saginaw. He returned in May.

    Hadd now lives in a Saginaw apartment, but he's leery about giving out his address because he's afraid authorities will show up at his door with a straitjacket cq.

    Even so, he says life is returning to normal — or some version of it. He's unemployed and collects a disability check, but he's writing several songs, and is recording demo tracks that he hopes will launch a music career.

    He dates occasionally and sees friends. His only drug now is a couple of cups of java a day, but he swears he'll cut back. He now has reconciled with his mother and talks with her weekly long-distance.

    "I'm not angry at my family anymore," Hadd says. "I feel we were all misled."

    Brown, for one, worries that her son stopped taking medication, and she attributes his improvement partly to a lack of stress in his life. Still, she's glad the warm, engaging son she knew before has returned.

    "He seems happy," she says. "That's the Gabe that I have back, and it feels wonderful."

    Meanwhile, Oaks fears that more states will adopt laws calling for forcible medication of those with signs of mental illness. He says these laws play on stereotypes of the mentally ill as violent, and they strip away the element of self-empowerment crucial to mental recovery.

    "People forget it may be their loved one at the end of a sharp needle," Oaks says. "I wish that America's problem with violence was as easy to fix by spreading magic fairy dust."

    Hutchins, the woman who runs the state mental illness alliance, acknowledged that prescribed drugs aren't perfect and don't work every time. But she argued that mental illness typically is a biological disorder that often only medication can treat.

    "The brain is an organ like any other," she says. "It's important for the public to understand that (mental illness) is no different than an illness of any other organ of the body."

    Scott Davis is a staff writer for The Saginaw News. You may reach him at (989) 776-9665. E-mail:

    To submit a letter to the editor of The Saginaw News:

    - End of Article -


    The article above was received by e-mail from MindFreedom International. For concerned readers, MindFreedom suggests the following ACTIONS.

  • Please forward the article to all appropriate places on and off the Internet.

  • To e-mail your support to Gabriel Hadd: Gabe is a member of MindFreedom and is on the MindFreedom-USA member e-mail list for those who would like to discuss these issues with him and others.

  • To read the _Wall St. Journal_ article about Gabe see: date.html
    or use this smaller link:

  • For more information on forced drugging and to join MindFreedom see:

  • ____________________________________________________
    Footnote from National Stigma Clearinghouse (Jean Arnold):

    Are forced treatment laws redundant? Has the Treatment Advocacy Center's aggressive and fearmongering stance on forced medication hindered system reform?

    Here are two critics' views on the law's redundancy:

    1999 - "The focus of coercion upon the patient is, I submit, a misdirection of energy. Coercion is needed, but to enforce the laws already on the books that are routinely disregarded with impunity, either because of the scarcity of resources or because of conflicting pressures." Source: Clarence J. Sundram, former Chairman (for 20 years), NYS Commission on Quality of Care. "Misdiaagnosis and Non-Solutions," May 20, 1999, a statement in opposition to the then-proposed Kendra's Law.

    2006 - " 'Kevin's Law' [Michigan's forced-treatment law] is unnecessary because we judges already had the authority to order medication on an outpatient basis." The quote is from Judge Patrick J. McGraw, Saginaw County Circuit Court Family Division.

    The article notes that "Mr. McGraw, who handles nearly all mentally ill committments in the county, says he occasionally orders outpatient medication but has yet to use 'Kevin's Law' for any person." Source: "Forced Drugging," by Scott Davis, The Saginaw News, March 1, 2006.

    Comment on New York's AOT Analysis and TAC's Inflation of Outcomes:

    In March 2005, the New York State Office of Mental Health released an analysis of outcome data on 2,745 recipients of New York's AOT program, Kendra's Law. The information came largely from the program's case managers.

    Unfortunately, the Treatment Advocacy Center (TAC) has selected data out of context and is using it to win support for similar laws in other states.

    It is misleading to publicize high rates of improvement without explaining that only a modest number of AOT's 2,745 recipients improved significantly between the time they entered the program and 6 months later.

    For example, TAC states that after court-ordered treatment, AOT recipients experienced 87% less incarceration.

    What TAC doesn't say is that prior to AOT, 23% of recipients experienced incarceration, and after 6 months in the AOT program, 3% experienced incarceration. The state's report describes this as an 87% improvement for 23% of the AOT recipients.

    By taking the figure out of context, TAC grossly inflates the improvement picture.

    This confusing aspect of the data applies to 51 categories of services and behaviors analyzed in the report.

    How does TAC's inflation of outcomes poison the AOT debate? Consider the preposterous claims of a forced treatment proponent in Maine:
    "In New York, 91% of those who were not taking medications began taking them, just because that law was on the books" and "arrests for petty and violent crimes involving people with mental illness dropped 78% and millions of dollars in hospital costs were freed up for community services." Source: Maine Times Record, March 10, 2005
    TAC oddly ignores a disappointing improvement in substance abuse, a strong contributor to violence. 52% of AOT recipients entered the AOT program with substance abuse problems. 24% received substance abuse services prior to AOT, and 40% were receiving such services 6 months later. (This is an increase of 16%, or as the state calls it an increase of 67%.)

    It is likely that the low rates of improvement in categories such as substance abuse stem from a dire shortage of programs in communities throughout the state.

    Interestingly, a just-released "grading" of the states' mental health achievements (Click here) gave the highest mark to Connecticut, a state without AOT, and Ohio.

    A second evaluation of New York's AOT experiment will presumably use a non-coerced control group for comparison.

    For those interested in New York State's analysis of Kendra's Law outcomes, Click here.

    For current data updates, Click here

    We welcome readers' comments. Email

    January 15, 2006 - News of the Week


    Many have committed minor offenses that adequate community mental health services would have prevented

    Article Source: NAMI-NYS News
    December 5, 2005, Issue No. 88


    By Joy McIntosh

    They come for you with handcuffs. They come to your cell, to the yard, to the hearing room. Your hands are locked together behind your back, and you are led away by three officers to the Special Housing Unit, prison-speak for solitary confinement, commonly known as "the box."

    Inside, the cuffs come off and you are surrounded by more officers who scream at you all at once, all together: "You are now in our house. You do not speak unless asked to. You do not make any sudden moves or gestures. If you move without being told, we will interpret that as a sign of aggression and protect ourselves accordingly. Follow my every direction. Any variation will be interpreted as a sign of aggression..."

    While the chorus of abuse continues, one officer directs you in a precise, perverse choreography of a strip tease: "With your head to remain in the corner and your right hand on the wall, with your left hand, without turning around, take off your left sock first and hand it back, then put your hand back..."

    Hard to follow, hard to concentrate in the din, and one turn of the head, one movement of the wrong hand and the blood from your beating adds to the spatter on the wall.

    Is this happening in some foreign enemy stronghold; a Taliban prison, some dictator's disappeared persons holding tank, or perhaps Abu Ghraib?

    Unfortunately, it is happening right here in New York State, where 1,000 mentally ill prisoners are being held in solitary confinement, many for years at a time and many others with little access to mental health services.

    Their stories are in a new publication, Stories from the SHU: Psychiatrically Disabled Inmates in Solitary Confinement in New York State. The stories were assembled by Mental Health Alternatives to Solitary Confinement, a coalition of 63 mental health, human rights and prison reform organizations, including NAMI-NYS and 15 NAMI-NYS affiliates.

    The stories come from a number of sources, including mentally ill prisoners who have been incarcerated in solitary confinement, their families, and those who work to help them. The description that begins this article comes from one of these stories.

    What does an inmate have to do to be sent to a SHU? To be isolated for 23 hours a day in a 56-square-foot concrete cell with little light and almost no human contact? To be fed "the loaf," a pound of compressed yeast, flour and potatoes with a side of cabbage that is pushed through a slot in the door? And to be punished even more for not following rules he or she has never been told about?

    SHU confinement in New York State is open-ended and, according to one of the inmates writing in this publication, can begin after being caught smoking in a non-smoking area, for having too much personal property, or for helping another inmate with his legal work, or sometimes, for apparently no reason at all. Mentally ill inmates are often sent to SHU after exhibiting symptoms of their diseases.

    A family member describes how a judge ignored a relative's bipolar disorder and sentenced him to a lengthy term, saying that he would "get the treatment he needed in prison."

    Instead, his condition has become worse.

    The family member describes what happened when his relative experienced the bipolar episode that led to his confinement in keeplock, the Fishkill prison's version of a SHU. During the 140 days he spent in solitary confinement, he only saw a doctor twice. When the family member tried to get help for him, his counselor said, "he isn't on my caseload anymore."

    His psychiatrist said, "We will put our input into the hearing but we cannot do more for him... We are short staffed... I have a caseload of more than 150."

    And the psychiatric nurse said, "He's fine in the box, he stopped yelling after three days."

    If a mentally ill prisoner gets completely unhinged, he will be sent to Central New York Psychiatric Center until he is stabilized and then, in a vicious cycle, he will go back to SHU to finish the punishment, where he usually relapses.

    This is what happened to "Sam," who began showing signs of mental illness while he was in college and he eventually had a breakdown that resulted in hospitalization and a diagnosis of schizophrenia. Left untreated, Sam's illess was the real cause of his arrest several years later for a non-fatal shooting.

    According to the friend who tells his story, Sam was not treated for his psychiatric condition during his first four years in prison. The behavior caused by his schizophrenia led him to the SHU. Finally he was sent to Central New York Psychiatric Center where he spent nine months and was successfully treated. Then, despite his progress, he was sent back to SHU to serve his extraordinary more-than-20-year sentence. Originally sentenced for four to ten years, Sam will now be lucky to be released after 14 years.

    Sam's friend says, "The mentally ill in prison are incapable of good behavior. They can never get parole. In fact, they just rack up more prison time. They initially can't even get fair sentences because they are in no condition to defend themselves."

    Included in Stories from the SHU is an information sheet produced by the Correctional Association of New York. It says that:

  • 23 percent of NYS prisoners in disciplinary segregation are on the mental health caseload. Nearly one third of those with mental illness in SHU's have had prior psychiatric hospitalization.

  • Mentally ill inmates have reported an average SHU sentence of 38 months, seven times more than that of SHU prisoners in general.

  • Fifty percent of prison suicides occur in SHU's, although fewer than seven percent of the prisoner population is housed there.

  • 53 percent of mentally ill inmates in SHU's report previous suicide attempts while in prison.

  • 40 percent of mentally ill inmates in SHUs report committing acts of self-mutilation in prison.

  • The Department of Correction Services punishes those who attempt suicide or who harm themselves.

  • The prison system's sole psychiatric hospital has space for only 200 inmate patients. Its capacity has not increased since it opened in 1980, although the prison population has tripled.

  • There are only 534 intermediate care program beds, enough to accomodate only one third of the inmates who need them.

  • About 20 percent of all mental health positions in the prison system are vacant. The rate of vacancy is 35 percent for psychiatrists, 25 percent for psychologists and 11 percent for nurses.

    Last year, a bill was introduced in both the state Senate and Assembly (A3926/S2207) to end the solitary confinement of psychiatrically disabled prisoners. This bill, which has the backing of the Correctional Association, will be reintroduced in both houses this year. Please help advocate for an end to this barbaric practice.

    Tanisha Jackson spent eight years confined either in Central New York Psychiatric Hospital or in an observation or SHU cell in the women's prison in Bedford Hills. This is part of a poem, published in Stories from the SHU, written by Tanisha:

    There is no way to fix
    What has been broken for so, so long,
    even regaining freedom could not heal
    this gaping wound...

    To hear, to see, just to speak to another person
    is the only thing that will ultimately assuage
    the hurt that fills my soul.

    Stories from the SHU was published in a limited edition. Copies were given to all state legislators. Referring to it when visiting state legislators would be appreciated.

    To inquire about receiving a copy of Stories From the SHU, please call Mental Health Alternatives to Solitary Confinement (MHASC) at 212-780-1400, ext. 792.

    We understand that the first edition of this publication has now run out, but Robert Corliss, Associate Director for Criminal Justice of NAMI-NYS, asures me that NAMI-NYS will help to publish a second edition.

    - End of Article -

    Reprinted with permission from NAMI-NYS News

  • Footnote from National Stigma Clearinghouse: New York confines prisoners to SHUs at a rate 4 times the national average, according to a MHASC press release in 2004. Legislative findings in 2001 stated that 80% of SHU prisoners had spent more than 6 months in the "box" and about 50% had been confined for more than 5 years.

    January 4, 2006 - News of the Week


    His TV Violence Studies Spurred Antistigma Advocacy

    Obituary: The Associated Press
    Source: New York Times (
    Published: January 3, 2006

    George Gerbner, 86, Researcher Who Studied Violence on TV, Is Dead - Philadelphia AP

    George Gerbner, a researcher who for decades studied violence on television and how it shapes perceptions of society, died on Dec. 24 at his home here. He was 86.

    The cause was cancer, his daughter-in-law Kathie McDermott said.

    Mr. Gerbner, who was dean emeritus of the Annenberg School for Communications at the University of Pennsylvania, studied television for more than three decades.

    He founded the Cultural Indicators Research Project in 1968 to track changes in television content and how those changes affect viewers' perceptions of the world. Its database has information on more than 3,000 television programs and 35,000 characters.

    Mr. Gerbner said people no longer learned their cultural identity from their family, schools, churches and communities but instead from "a handful of conglomerates who have something to sell."

    He coined the phrase "mean world syndrome," a phenomenon in which people who watch large amounts of television are more likely to believe that the world is an unforgiving and frightening place.

    "Fearful people are more dependent, more easily manipulated and controlled, more susceptible to deceptively simple, strong, tough measures and hard-line postures," he testified before a Congressional subcommittee on communications in 1981.

    "They may accept and even welcome repression if it promises to relieve their insecurities. That is the deeper problem of violence-laden television."

    Born in Budapest in 1919, Mr. Gerbner intended to study folklore at the University of Budapest but was forced to flee fascist Hungary in 1939.

    With the help of his brother, the filmmaker Laszlo Benedek, he came to the United States. Mr. Gerbner graduated from the University of California, Berkeley, with a journalism degree and worked briefly at The San Francisco Chronicle.

    He joined the United States Army in 1942 and served in World War II.

    Mr. Gerbner worked as a professor and researcher at the Institute for Communications Research at the University of Illinois from 1956 until 1964, when he accepted a position at Penn. After leaving Penn in 1990, he founded the Cultural Environment Movement, an advocacy group working for greater diversity in media.

    He taught at Temple University and Villanova University.

    Mr. Gerbner is survived by two sons, John and Thomas, and five grandchildren. His wife of 59 years, Ilona, died Dec. (Reprinted using Fair Use Standard)

    Footnote from National Stigma Clearinghouse:

    George Gerbner's influence on the National Stigma Clearinghouse was strong, and his encouragement was deeply gratifying.

    Television is, in Dr. Gerbner's words, "the wholesale distributor of the stigma of mental illness."

    Gerbner's research showed that TV characters cast as "mentally ill" were depicted as violent in 60% of their roles, as compared to about 20% for other sociological groups. He blamed these distorted portrayals for some of society's most damaging assumptions about mental illnesses.

    "Humankind may have had more bloodthirsty eras but none as filled with frightful images of 'madness' as the present," Dr. Gerbner wrote in 1993 (The Journal, 1993, Issue #1).

    With deep sadness, we mourn the loss of an astute theorist, a passionate activist, and a kind and reassuring presence. Jean Arnold, Co-founder and Chair, National Stigma Clearinghouse


  • Article: "Images That Hurt: Mental Illness in the Mass Media," by George Gerbner, Ph.D., The Journal, 1993 #1. To request a hard copy, e-mail Please include a mailing address.

  • Link: "Hollywood Violence Formula-Driven," by National Stigma Clearinghouse, News of the Week, Sept. 3, 2000.

  • Link: "Television Dramas Perpetuate Stigma of the Most Damaging Kind," by National Stigma Clearinghouse, News of the Week, Nov. 28, 1999.

  • Link: "Casting the American Scene: A Look at the Characters on Prime time and Daytime Television from 1994-1997," by George Gerbner. Screen Actors Guild report, 1998.






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