National Stigma Clearinghouse
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1, 2009 - News of the Week
DECONSTRUCTING TOXIC STIGMA: SURVIVORS OF
"TREATMENT" SPEAK OUT
Link: Archived radio program produced and
hosted by Anne Barbano with guests Marj Berthold, Nora Jacobson, and
Thanks to TWITTER's spreading-ripple effect, the first Vermont weeky
radio program concerning autism and disabilities has found a national
audience. The show, "The Next Frontier," is produced and hosted by Anne
a Burlington mother who excels at empathetic listening.
Earlier programs on "The Next Frontier" are archived at "Living the
This week Barbano introduces a new documentary, "Tremors
in the System: the help you want or the help you get,". Her guests are the film's co-directors Nora Jacobson and
Marj Berthold, and Laura Ziegler. Beginning gently, the hour-long
program soon becomes intensely illuminating and thought-provoking. A
colorful background enhances the computer screen.
Enlightening moments occur when least expected, so savor every minute
of this moving, stereotype-shattering program.
Note: The TWITTER
link was forwarded to us by
Morgan Brown, a long-time advocate, chronicler of homelessness, and a
veteran blogger: http://norsehorseshometurf.blogspot.com/
For more links to Morgan's work, GOOGLE 'Morgan Brown Norsehorse'
25, 2009 - News
of the Week
CLOSE FAMILY HOPES TO DECONSTRUCT AND ELIMINATE "TOXIC" STIGMA
2 Mind offers encouragement and
help: "This is where the misconceptions stop"
beautiful accomplished celebrity, her close family, a topic often
shunned; start a camera rolling with Ron Howard in charge. Then hope
for good results.
In this case, the result is superb. Last week ABC-TV unveiled a candid
public service announcement featuring Glenn Close and her sister Jessie
followed by an interview on "Good Morning America," where the actress
and her family talked freely about their experiences with serious
mental illnesses. Click
here to view The open
discussion is far more compelling than a script could ever be.
Equally impressive is the Close family's new organization and its
website, Bring Change
This promising project came into being while Glenn Close was working at
Fountain House, a 50-year-old "clubhouse" in New York City (the model
is used internationally) that promotes recovery of people who have
18, 2009 - News of
OF WISDOM FROM JUDI CHAMBERLIN
Interviews (source: NYAPRS E-NEWS)
Talk With Judi Chamberlin;
Facing Death, A Plea For The Dignity Of Psychiatric Patients
By Carey Goldberg
March 22, 2009
"NOTHING ABOUT US Without Us."
That is the motto of a grass-roots movement that has carried various
names over the last generation, but has always revolved around a single
principle: self-determination for people diagnosed with mental illness.
Call them psychiatric patients or consumers or survivors, they are
fighting together to gain more control over their treatment, and more
say in the mental health system overall. And they have won some
striking successes in recent years, gaining more input into official
policy and creating new jobs for people who, 12-step-style, have
recovered from the worst of their illness and now want to help others
The mother of that movement, many people would say, is Judi Chamberlin
Chamberlin was hospitalized against her will for depression in 1966,
and shocked by how she was treated. Her seminal book, "On Our Own:
Patient-Controlled Alternatives to the Mental Health System," came out
in 1978, and became a manifesto for the movement. Chamberlin's activism
for patients' rights spanned the next 31 years, and evolved with the
history of mental health treatment in this country.
At first, in a system that relied heavily on state hospitals, she
focused largely on protecting inpatients' basic rights. As
"deinstitutionalization" took hold and the hospitals emptied, she
focused more on outpatients' needs for services and dignity as well.
She also joined forces with activists for people with physical
disabilities, and extended her reach internationally, helping push a
treaty on disability rights that the United Nations passed in 2006.
Now, at 64, Chamberlin is dying. She has entered hospice care for
chronic obstructive pulmonary disease, an incurable lung disease. (It
is most commonly caused by cigarettes, but Chamberlin never smoked.)
Largely confined to bed, Chamberlin relies on an oxygen mask and works
when she feels well enough, including a blog chronicling her experience
at judi-lifeasahospicepatient.blogspot.com. Her partner, Marty
Federman, figures heroically in the blog, as well as a broad circle of
friends, admirers and helpers. True to form, Chamberlin is using her
final experience as a patient to argue for reform: The hospice system,
she says, with all the autonomy and respect it gives dying people,
could serve as a model for psychiatric care.
IDEAS: Psychiatric illnesses can and sometimes do disrupt things like a
person's judgment, their perception of reality, their ability to think
clearly. So couldn't that possibly, at least sometimes, justify
CHAMBERLIN: I think the only justification for coercion is where
there's actual dangerous, violent or criminal acts. Because we let
people do weird, possibly self-destructive things all the time -
smoking, drinking, jumping out of airplanes. You go into the mental
health system and it sucks you in, and a lot of people who've been in
it in the past are willing to suffer rather than go in again.
IDEAS: What was the experience with the mental health system that got
CHAMBERLIN: I originally went voluntarily. I was extremely depressed,
and I thought I'd get some help. And after a couple of voluntary
hospitalizations, I was sent to state hospital involuntarily and that's
when I really realized, "Hey wait a minute, something is very, very
IDEAS: And from that experience came . . .
CHAMBERLIN: . . . the fundamental conviction that there's something
really wrong here and it needs to be addressed by people who've been
through this experience. And of course, this was the '60s - the civil
rights movement was underway, the women's movement, the gay liberation
movement. And it just seemed to me that we needed that kind of movement
for people with our issues.
IDEAS: I'd have to say that women's liberation and gay liberation and
civil rights have probably moved a lot farther and are a lot more
recognized as legitimate. Why, do you think?
CHAMBERLIN: I think there's still a tremendous amount of social stigma.
I think there's a reluctance on the part of people who've had a
psychiatric past but have become successful in life to identify
themselves publicly because there's no upside to it, there's only a
downside, and there are certainly some people who are fairly well known
and successful who have, but a lot more who are wanting very much to
stay in the closet.
IDEAS: What has been your movement's greatest failure?
CHAMBERLIN: The greatest failure is that we're not seen as an organized
group that can speak for ourselves. Lots of times you read an article
about disabilities and have someone with cerebral palsy speaking about
cerebral palsy or somebody blind talking about being blind, and then
you have a family member talking about what it's like to be mentally
ill and the interviewer seem to think that's the same thing, but it's
IDEAS: What would you highlight as the issue that still most needs to
be taken on in our societal life?
CHAMBERLIN: The issue of mental illness and violence. It's so linked
together in people's minds and it so distorts what most people with
psychiatric disabilities are like. Because while the research shows
over and over again that people with psychiatric diagnoses are not more
violent than anybody else, that's not what people believe, and it's
hammered in all the time with crime shows - that this is what people
with psychiatric disabilities are like: They're unpredictably violent
in a way that justifies all this forced treatment.
IDEAS: What do you think people need? You've talked in the past about
alternative services - mental health services offered noncoercively,
often run by people who've been through the experience of psychiatric
illness, so they're built on a self-help model.
CHAMBERLIN: When people are in emotional distress and they're asking
for help, and a lot of people are - they say "This is awful, I'm in
hell" - we want to make sure that help is provided in a way that meets
people's self-defined needs. And one thing that's useful is the
equivalent of a living will document. "When you see me doing this, try
this or don't try this. Because I know from past experience this makes
me feel good and this makes me feel horrible."
IDEAS: And you see a parallel between that kind of patient
self-determination and hospice care?
CHAMBERLIN: The hospice model puts the patient in the center. What
matters is what the patient wants. And then the various people who are
the staff - the nurses and social workers and others - are there to
support their choices. They're not there to impose their ideas.
IDEAS: I guess the difference may be that hospice amounts to an
agreement that the traditional medical system has little left to offer
you, whereas in psychiatric treatment, sometimes a clinician might
think medicine has a lot to offer while the patient may disagree.
CHAMBERLIN: Right, but again, I think this is the choice part. A lot of
people have used psychiatric drugs in ways that have benefited their
lives and made the trade-off on some of the side effects because the
overall balance is positive. But other people have said, "This drug
doesn't work for me." . . . There's a jokey definition of mental
illness as doing the same thing 10 times and expecting a different
result. I think that can apply to doctors who push the same drug when
10 times it's failed.
Carey Goldberg covers brain science and mental health for the Globe.
End of Boston
Reprinted using Fair
with Judi Chamberlin
Off Our Backs
by Leah Harris
BNET Health Publications
lh: How did you come to do the work that you do?
jc: It was all based on my own experiences with the mental health
system. I saw that something was very wrong and that people needed to
do something about it-especially the people that this was currently
happening to. Five years after I got out of the hospital, I found one
of the [ex-patient] groups in New York. I found out that there were
other people who felt the same way! It just seemed so logical to us
that locking people up and depriving them of their basic humanity
couldn't possibly be good for anybody.
lh: What issues did you focus on when you first organized over thirty
jc: It's the same stuff we're doing now. Just trying to get the issues
across. That this is about rights, it isn't about "better treatment" or
about needing people to take care of us. We're human beings, we're
citizens. Why don't we have these rights that supposedly the
Constitution and the Bill of Rights talk about? Why does it suddenly
not apply to us?
lh: Was there an attempt in the beginning to reach out to the feminist
jc: We tried to reach out to everyone. The early 1970s was a time when
all these movements were growing. We made some good contacts with the
gay rights movement. But I've always felt that the feminist movement
just didn't seem to get it. There are an awful lot of therapists in the
movement, and when you talk to women who identify as feminists, and you
mention that you're involved with mental health issues, they always
mention Phyllis Chesler's book Women and Madness. But Phyllis Chesler's
a psychologist, and it's a book in which somebody else talks for us.
And this comes from a movement that says that women should speak for
themselves, but somehow they think it's OK that a psychologist should
talk for women who are "mentally ill" and getting locked up. She gets
it so wrong in that book, and it really hurts me when that's considered
a feminist classic.
lh: How are women uniquely affected by coercive psychiatry?
jc: Well, there's an assumption that if you have a psychiatric
diagnosis, you couldn't possibly be a good mother. There's also a
distinction made between women who are distressed and women who are
"crazy." You see this in the battered women's' shelters and the crisis
centers, that if you're battered and subsequently distressed to an
"appropriate" level then that's OK, but if you're distressed beyond
that, you get packed off to the mental health system. And that's awful.
A long time ago, a group of women at one of the psychiatric survivors'
conferences said, "we reject the idea that there's an 'appropriate
level for our anger' when we're raped or battered."
lh: Can you talk about the experience of writing On Our Own!
jc: At the time I wrote it, there wasn't anything in print about our
experiences. There's a long history of people writing books about their
mental health experiences, but certainly not about so-called crazy
people getting together and organizing for rights and liberation. I
really wanted to get that message out. Over the years, so many people
have told me, "that book helped me, it came along and let me know I
wasn't alone. I was able to get through what I was going through, and
to hook up with other people and get involved." You couldn't ask for
more than that as a writer.
lh: It seems that some of the advances made by our movement, however
small, are being slowly eroded. Can you speak a little bit more to that?
jc: When I first got involved in the early 70s, the mental health
system was very different than it is today. In some ways it was much
worse, because you had the long-term institutionalization that exists
less today. And in some ways it was much better-because there wasn't
this biological determination, this idea that everybody needs to be on
drugs forever. And so today you may or may not be in an institution,
but you always have to be in "treatment"-engaged with the mental health
system in some way. And the mental health system becomes so
all-encompassing-providing housing, etc. All the services are provided
on the condition of you being "compliant" with the system. And that
didn't really exist before.
lh: And I think it gets back to how psychiatry is so all-pervasive in
jc: Yeah, and how people are so convinced that what we're dealing with
here are "brain diseases," and I'm sure if you asked the average person
on the street what causes mental illness, they would say that it's a
gene, or a chemical imbalance in the brain-all these little slogans
that there's no scientific evidence for! The science isn't there to
back this up, but the PR certainly is.
lh: Can you tell me a little bit about the Bush administration shutting
down the Technical Assistance Centers (TACs) such as the National
jc: It's this little tiny federal program-all five TACs-it's all
together a $2 million dollar program, which doesn't even compute on a
federal level. And here the administration went out of its way to
single out this teensy little program. You'd think on a superficial
level, we would fit in well with their Republican right-wing
agenda-people being self-sufficient and "getting back into society."
The initial attempt was to yank our funding right then and there,
before the end of fiscal year 2003, and that we fought. And I think the
administration saw that we could rally support, and we did rally
thousands of phone calls and emails. So we got our funding for the rest
of the fiscal year, but with a cut.
lh: Can you say more about what the TACs do?
jc: Three out of five of the TACs are run by consumers and survivors.
They provide information, and technical assistance and knowledge, about
self-help, about rights, about connecting up with others who have
experienced psychiatric abuse. There's so much that you can read about
drugs, and institutions, and formal programs. It's much harder to find
information about alternatives, information telling you that people can
get better, and saying "here we are, people who've been diagnosed with
these supposedly lifelong illnesses, who are functioning well." We
provide a lot of hope for people that they can do it too. I think it's
very important to be out there. There are limits to what TACs can do
because they are government-funded. So I think it's important to have
the independent groups out there, it's important to have the
government-funded groups-it's important to have the whole range.
People need hope. When you get diagnosed with a major mental illness,
you're probably also told that you have something wrong with you on a
genetic or chemical level, that you have to be on drugs for the rest of
your life, that you're probably never really going to get better.
That's taking hope away from people. So to provide hope for people-it's
just thrilling. All the letters, the phone calls, the emails we get.
People didn't know, until they found us, that they can recover, that
they can have a good life, that they're not just doomed to being good
little mental patients. That's very important.
lh: On the issue of forced psychiatric treatment, what do you say to
people who tell of friends or relatives who were forced into treatment
and were actually helped by it? The idea that "by criticizing the
mental health system, you're discouraging suffering people from seeking
jc: Help is only help if you think it's help. I certainly don't want to
take any options away from people. I want to increase people's options.
So if somebody has a lot of options, including medication, and they
decide that medication's the right one, that's very different from
medication being the only option, and it being forced on people. It's a
strange kind of reasoning. The one that always gets me is, "if we had
been able to get our relative into treatment, she or he wouldn't have
killed themselves." That might be a way of soothing your pain, and if
you want to soothe your pain that way, OK, but you don't know that.
When I was in the crisis center, I had this real break with reality
kind of situation, and after a couple weeks of being in this totally
supportive and helpful environment, I was OK. And for years afterwards,
I would think, "well, I've had two breakdowns in my life. One was
really severe, because it lasted for so long, and one was pretty mild
because it was over quickly." Then I realized that if the first time, I
had been treated like a human being instead of being hospitalized in
this horrible place and treated as less than human, maybe that one
would have been over in a couple of weeks too. And again, we are not
about trying to take away from people anything that they find helpful,
it's about giving people choices and information. Anyone who's opposed
to giving people more choices and information. I just don't get it!
lh: What is your vision of an alternative to the mental health system?
jc: There's no single model because different things work for different
people. The idea is to give people the space to find what it is that
makes them feel better, and to help them get away from what makes them
feel worse. And to find ways to enable the things the person wants to
happen for her. And ideally there should be multiple settings where
that takes place. It could be in your home, if that's the most
comfortable place for you, or in someone else's home. I would say
probably not in an any kind of institution, because institutions by
their nature are very dehumanizing.
lh: What would you say to women who are going through a crisis and
don't have access to alternative services?
jc: It's very hard. If someone needs something today, to tell them
we're trying to make it possible soon isn't enough. They need to know
that so many people have recovered. And that there are so many people
who still have symptoms, but they are working, they are going to
school, they have a social life, a love life. There's real life out
there. That's our biggest unity with the disability movement. Even if
you have a disability so severe that you can't move your body, you can
still live a full life. And we too may need some extra help or some
extra accommodations. But that shouldn't get in the way of living a
full life. The idea that you can't have these things unless you're
"normal" disenfranchises an awful lot of people. The fact is that
people are living their lives and making choices with disabilities of
all kinds. As a society, we are so fixated on the idea that there's
only one way of doing things. I've learned from my work in the
disability movement that people possess an amazing variety of
capabilities. The human spirit is what's important.
Leah Harris interviewed Judi Chamberlin, who is a psychiatric survivor
and an activist since 1971 in the consumer/survivor/ex-patient
movement. She has been a member of the Mental Patients' Liberation
Front (MPLF), one of the earliest ex-patient groups, since 1975. MPLF
operates the Ruby Rogers Advocacy and Drop-In Center in Somerville,
Massachusetts, a self-help center which she helped to found in 1985,
and which is run by and for people who have received psychiatric
services. Chamberlin is the author of On Our Own: Patient-Controlled
Alternatives to the Mental Health System and has also written numerous
articles about the movement, self-help, and patients' rights.
Chamberlin is affiliated with the Center for Psychiatric Rehabilitation
at Boston University, where she directed studies of people who use
ex-patient run self-help groups, and on personal assistance services
for people with psychiatric disabilities. She is also a co-founder and
associate at the National Empowerment Center, in Lawrence,
Massachusetts, a federally-funded technical assistance center which
serves the consumer/survivor/ex-patient movement.
of Interview by Leah Harris
20, 2009 - News
of the Week
CONFERENCE WILL EXPLORE
"FIRST BREAK" OPTIONS
Rethinking Psychiatric Crisis: Alternative Responses to "First Breaks"
Save this date: November 23 at
New York University's Kimmel Center,
60 Washington Square South in Manhattan
here for the conference program, the presenters, and the list of
workshops. Use this link TO REGISTER, and to download a printable
Present-day treatments for psychiatric crises too often traumatize the
patient and prolong suffering. The successful use of alternative
methods -- mostly outside the U.S. -- has provided a strong catalyst
These advances will be addressed by a distingished group of
practitioners, researchers, and users of such alternatives on November
23, 2009, at New York University's Kimmel Center, 60 Washington Square
South, in Manhattan.
The sponsors of the daylong conference are: The International Network
Toward Alternatives and Recovery (INTAR),
joined by The Center
to Study Recovery in Social Contexts, and Community Access Inc.
Supporters include The Empowerment Center, Mental Disability Rights
International, and SUNY Downstate Medical Center.
this unique opportunity to learn about
treatment alternatives from the field's top experts.
here for the conference program, the presenters, and the list of
workshops. Use this link TO REGISTER, and to download a printable
6, 2009 - News
of the Week
from BBC NEWS:
by Patrick Jackson
Canadian comedians mean to make you
laugh but they are also throwing punchlines at a wall of prejudice.
They all have mental health problems, and all want to rise above them
David Granirer, who takes medication for depression himself, has been
teaching them a course called Stand Up
For Mental Health
He now runs classes in Vancouver, Toronto and Ottawa, as well as
Graduates include Alex Winstanley, 23, who mines for jokes the
schizophrenia with which he was diagnosed three years ago.
The two men talked to the BBC
World Service about passing the
microphone to the mentally ill.
A life of
"The more screwed-up and dysfunctional you are, the better your act is
going to be" is what David tells his students.
"Your life is your act."
Alex, who believes he will probably never stop "hearing voices" but
says he has learnt how to deal with it, feels "more alive on stage than
in real life".
"I'd find that after a show, I'd feel so exhilarated I actually
wouldn't hear voices for a few days or, if I did, they would be
positive," he adds.
David tells of one woman with schizophrenia who came into class one day
wearing a striped blouse.
"She said 'The voices haven't let me wear stripes for eight years but
now that I'm doing comedy, I'm not so afraid of the voices, so I'm
Succeed in stand-up "and you feel like you can do anything", says the
"Having schizophrenia, I spend a lot of time being jealous of so-called
normal people my age.
I've always wanted to have a dead-end job and a divorce.
Sometimes I imagine a so-called normal person being jealous of me:
'Alex, you have, like, a natural gift for, like, hallucinating. I have
to drop two hits of acid to get anywhere close. And I'm so, like,
lonely, I wish I had voices to keep me company.' "
David likes to joke that healthy people are more dangerous because,
undiagnosed, they arouse less suspicion and, free of medication, are
better placed to do damage.
"Being diagnosed with mental illness is like receiving a black mark on
your forehead," he says.
"It changes the way the whole world sees you and reacts to you.
"You feel that all of a sudden everyone is watching you, is afraid of
you and is wanting to do you harm."
He speaks from personal experience having first suffered depression in
his late teens, before being diagnosed in his mid-30s.
"I've been in psych wards, had therapy, the whole nine yards," he says.
Alex likens the stigma to "another illness to deal with at the same
"As people with mental illness, we carry a lot of shame and that shame
thrives in the darkness, in secrecy," says his teacher.
"Then all of a sudden we take these incidents, these things we are
really ashamed of and turn them into comedy.
"We tell a roomful of people, they laugh and applaud, and all of a
sudden the shame starts to dissipate, and you think ' I'm not such a
bad person after all'."
Despite the subject matter, the jokes are not all gallows humour, David
"There is a certain amount, yes, but a lot of it is just really about
everyday life because we people with mental illness have lives, go to
school, have jobs, have families."
His students present an "amazing mix".
"We have every possible diagnosis, age group, socio-economic status,"
Having taught comedy at a Vancouver college for 10 years, David was
inspired to launch the mental health course after occasionally
witnessing students make "amazing therapeutic breakthroughs".
While comedy is not for everyone, with or without mental problems,
those who really want to do it, will get something out of it, he
David says his programme is supported by mental health organisations
and he stresses that it does not conflict with psychiatrists' work.
"We would never say 'This is a replacement for your medication, don't
take your medication'," he says.
He cannot yet offer any empirical evidence of the benefits of stand-up.
However a study due to take place in a few months' time may lend his
form of therapy more weight.
Alex, meanwhile, is happily hooked on humour.
"It's my permanent medicine!" he laughs.
Published: 2009/09/05 00:03:53 GMT © BBC MMIX
using Fair Use doctrine
September 2, 2009
WELLNESS WITH SUPPORT
ARTICLE forwarded by NYAPRS E-News:
Coach - A New Role for Peers
Swarbrick. Peer Connection
Sept. 2009, MHA in NewJersey
There is significant concern that people living with mental illness die
too young and/or live a poorer quality of life due to significant
medical conditions. The Center for Mental Health Services (CMHS) has
issued the "10 in 10 Campaign" seeking to lengthen life expectancy by
10 years in a decade.
In response, the University of Medicine and Dentistry of NJ-School of
Health Related Professions (UMDNJ-SHRP) Department of Psychiatric
Rehabilitation and Counseling Professions and the Collaborative Support
Programs of New Jersey (CSP-NJ) Institute for Wellness and Recovery
Initiatives partnered to design a peer
wellness coach certificate
to address health and wellness needs from a self-management
perspective. This training curriculum educates peer wellness coaches.
These individuals become competent to proactively support peers to
promote wellness through addressing high risk behaviors and health risk
factors such as smoking, poor illness self-management, nutrition, and
This summer, 18 peers in the New Jersey mental health workforce
completed the peer wellness coach coursework at the UMDNJ-SHRP in the
Department of Psychiatric Rehabilitation and Counseling Professions.
This collaborative academic experience included instruction from
faculty in the Department of Psychiatric Rehabilitation, Nutritional
Sciences, Allied Dental Education, Rehabilitation, and Movement
Sciences along staff from CSP-NJ. The coursework was intense, but the
students bonded through the shared experience of learning many new
skills that could empower them to empower others in pursuit of
The following are some student responses:
Louis Blicharz, CPRP, CSP-NJ:
"I am proud to have taken the Peer Wellness Certification Course with
so many dedicated people. It was an intense 8 weeks, but everyone
really bonded and supported each other. I believe that this is an
indication of the caliber of the Wellness Coaches who will be going
forth to serve the people in the community. I personally have battled
with mental illness for most of my life. I hope to use my personal
experience, combined with the knowledge I have gained from this
training, to help promote better health combined with increased
longevity and a better quality of life for my peers".
Robin Weiss, CPRP
"I think that for the consumers/clients who take advantage of this new
service, they will find coaching to be a fun and effective way to
accomplish wellness goals that they couldn't previously achieve on
their own. The excitement and enthusiasm we have about the coaching
method/technique is sure to communicate hope and enthusiasm".
Lori J. Bell, Certified W.R.A.P. Facilitator and Trainer:
"I feel this training directed me to go from a peer 'counselor'
approach, which is a more medical model, to a 'coaching' approach,
which leaves accountability up to the individual themselves".
What is a
Peer Wellness Coach?
A peer wellness coach is someone who can help a peer to set and achieve
a wellness or health goal by offering support and encouragement and
asking questions to see what would be most helpful. A coach does not
provide a prescription, wisdom, or advice, but rather helps a person
seeking coaching to define what is important and set a plan to
accomplish a personally valued goal.
Coaching is not counseling or therapy; therefore a coach is not a
therapist, counselor or mentor. Coaching does not require that you
explore your past experiences or gain insight into the problem or
challenge you encounter. Coaching is a positive supportive relationship
between the coach and the person who wants to make the change. This
positive supportive connection empowers the person seeking change to
draw upon their own abilities and potentials so they can achieve
lasting lifestyle changes. A critical aspect of coaching is
self-responsibility. A person seeking coaching should accept
responsibility for where they are in their own life, including their
health. Through coaching, a person can determine what they are
responsible for and become empowered to take the action to improve
their wellness status, in terms of the many dimensions of wellness:
spiritual, emotional, physical, occupational, financial, environmental,
intellectual, and social.
We believe that there are many possibilities for peers to contribute to
the health and well being of people living with mental illness who are
seeking support in pursuit of recovery. Wellness Coaching is a new
opportunity for people in recovery seeking a career in the helping
professions to explore….
NYAPRS Note: At the September NYAPRS conference, Peggy Swarbrick will
be joined by NYAPRS' Elizabeth Stone and our own new peer wellness
coaches Erin Kennedy and Coleen Mimnagh, who'll be providing details of
our work with Optum Health in Queens.
See this featured presentation at this month's NYAPRS Annual Conference
to be held September 16-8 at the Hudson Valley Resort in Kerhonkson,
24, 2009 - News
of the Week
DOUGHNUT SHOP AND MENTAL HEALTH ADVOCATES
REACH A TRUCE
For over four months, the Psycho Donuts shop in Campbell CA has amused
its customers by pretending to be a 'fun-filled mental institution.'
Advocates who protested the shop's 'fun' at their expense were not
taken seriously. But now that's over. The owner is reported to be
moving toward a music theme and presumably all psychiatric references
will soon be replaced.
The informative article below from Mercury News in San Jose CA was
forwarded by Sarah Triano, an extraordinary advocate who is the
director of the Silicon Valley Independence Living Center and a
founding member of CAUSE (Community Alliance United to Seek Equality).
Emailed August 24, 2009
Dear CAUSE members (formerly FUSE),
I am sending you an article from today's Mercury News covering our
success with Psycho Donuts. This is the result of a lot of time,
effort, hard work, skilled organizing, and persistence by you and the
leaders within CAUSE (Community Alliance United to Seek Equality), the
coalition formed as a result of Psycho Donuts. The biggest success of
this, in my mind, is the coalition we've formed - a united,
cross-disability coalition that is ready to take on stigma and
discrimination against people with disabilities in other areas now!
As the CAUSE t-shirts at our August protest/community rally said,
"Disabilities are nothing to be ashamed of, but stigma and bias shame
Silicon Valley Independent Living Center
2306 Zanker Road
San Jose, CA 95131
Article Source: Mercury News, San Jose CA
By PATTY FISHER
Posted: 08/23/2009 Updated: 08/24/2009
It appears that sanity has come at last to Psycho Donuts. The place
still has a crazy feel. The Bates Motel sign still welcomes visitors,
and the doughnuts have names like "manic malt" and "coco kooks."
But the "bipolar" and "severe head trauma" doughnuts are off the menu.
The décor no longer includes straitjackets and a padded
Something else is missing: protesters.
For the first time since the Campbell doughnut shop opened in March,
mental health advocates aren't waving signs in the parking lot,
complaining that Psycho Donuts' brand of zany humor was an insult to
the mentally ill.
All it took was one meeting, one face-to-face conversation, to bring
peace to the corner of Campbell Avenue and Winchester Boulevard. The
question is, why did that take so long?
When I first visited Psycho Donuts in April, it was obvious that the
owners didn't understand how offensive their mental-hospital theme was.
It's one thing to make jokes about a Hitchcock film, but people who
have been through shock therapy or spent time in a real padded cell
wouldn't find the shop very appetizing. Making light of serious mental
illness only contributes to the stigma, which makes it difficult for
people to admit they need help and seek treatment.
Hey, it's all
Yet when I tried to broach the subject with Kip Berdiansky, one of the
original owners, he just kept saying it was all in fun. He refused to
meet with local mental health groups to hear their concerns. While he
insisted to me that he didn't want to offend anyone, he obviously was
offending people and didn't seem particularly bothered by it.
Perhaps he knew just what he was doing. The protests turned into a
publicity gold mine for Psycho Donuts. All the local papers carried
stories about the shop and the protests. They even made national TV. An
op-ed piece criticizing Psycho Donuts appeared in USA Today. And while
a lot of other businesses that started during the recession were
struggling, lines were out the door at Psycho Donuts.
Then, over the summer, Berdiansky sold his share of Psycho Donuts to
his partner, Jordan Zweigoron. The first thing Zweigoron did was set up
a meeting with the coalition of mental health groups. "The meeting
started out pretty angry," he said, "but within an hour it went from
contentious to a brainstorming session."
A sign of
Coalition member Sarah Triano, who runs the Silicon Valley Independent
Living Center, was relieved to finally have a chance to express her
concerns. She called off the pickets. "We told him we would have a
cooling-off period," she said. "Several of our members went down and
bought doughnuts as a sign of good faith."
Zweigoron wanted to get past the protests, which he said were a
distraction. And he wanted to make Psycho Donuts reflect his own
passion: music. The padded cell is now a mini music studio. There's a
"mellow submarine" doughnut on the menu. And "massive head trauma," a
tasty creation with a totally tasteless name, has become the "head
banger," a nod to heavy metal fans.
Zweigoron plans to keep talking with the advocates. "In the past few
days everything has jelled and I couldn't be happier," he said. "The
key point is: If you can keep a place fun and edgy without offending
people, why in the world wouldn't you do that?"
Makes sense to me. Then again, without all that free publicity, where
would Psycho Donuts be today?
Mercury News article
using Fair Use Doctrine
July 26, 2009 - News
WHY NOT CHANGE
"PSYCHO DONUTS" TO "AMPUTEE DONUTS"?
Kip Berdiansky, co-owner of Psycho
Donuts in Silicon Valley CA,
relies on a marketing strategy that mental health advocates find
unacceptable. The shop attracts and amuses customers by poking fun at
mental illnesses. Berdiansky sees his "lighthearted fun-filled insane
asylum" as a fresh and creative way to sell doughnuts. My friend Tom
disagrees. He suggests that to be more relevant and truly innovative,
Kip should set up his doughnut shop as a hospital ward for treating
people disabled by diabetes. Get rid of the shop's padded cell and
straitjackets and change its name to something like Amputee Donuts.
What could be more relevant than doughnuts and diabetes?
When I first told Tom about Psycho's jelly-oozing donut named "Massive
Head Trauma," he wept, then got angry. (Kip Berdiansky calls people
like Tom humorless and over-sensitive.) Tom, a caring person, is in
extreme pain. His wife had a near-fatal brain hemorrhage in April and
she struggles hourly to regain her life. Although he may be partly
right about Tom's sensitivity, Kip is just plain wrong when he claims
he created a "fresh approach" to sell doughnuts. Doesn't he know that
for decades, marketers of all kinds of commercial ventures have
exploited psychiatric conditions? The huge success of Alfred
Hitchcock's "Psycho" in 1960 spawned the Hollywood psycho-trough, a
prolific source of absurd distortions of psychiatric conditions. The
task of uprooting distorted images and replacing them with fair and
accurate ones has fallen on the impoverished mental health community.
Rampant stigmatization caused 20,000 stigmabusters to join the
Internet-based stigma-fighting network of the National Alliance on
Mental Illness (NAMI). While some progress has been made over the last
30 years to get rid of cultural prejudice against psychiatric
disorders, Kip Berdiansky is a reminder of how much work remains to be
done. Does he not know or just not care that the word "psycho" triggers
an immediate association with violence? Against this backdrop, doughnut
names like Massive Head Trauma, Malted Madness, Cereal Killer, and
Bipolar take on ominous overtones. Posing straitjacketed children in a
padded cell for a "fun" photo reveals a clueless mentality. A Harvard
study in 1998 found that institutionalized children in straitjackets
accounted for 25% of restraint-induced deaths. That study brought calls
for nationwide reform.
While Kip cashes in, people with psychiatric diagnoses suffer the pain
of his marketing strategy. Would any other discriminated-against
minority stand for it? No way.
Article - July
Jose Mercury News, Campbell's
Psycho Donuts Owner To Take On Head
of Mental Health Organization..." July 21, 2009
News Release -
July 23, 2009
Advocates for Children and Families,
Sacramento CA, July 23
/PRNewswire-USNewswire/ -- Mental Health Advocates Call for Psycho
Donuts to Do the Right Thing
Article - July
News, Political Correctness
Watch: Mental Health Advocates Blast
'Psycho Donuts' Shop, July 24, 2009
11, 2009 - News
of the Week
SPREADS STIGMATIZING MESSAGE TO
Does a so-called fun doughnut named 'massive brain injury', decorated
with oozing red jelly and a battered face really exist? Unbelievably,
yes, in the small Silicon Valley town of Campbell CA.
Since mid-March, the owners of Psycho Donuts have claimed their right
to continue their sales gimmick of poking fun at psychiatric
disabilities. The tiny shop is set up to be a 'fun-filled mental
institution'. Children are especially welcome and are encouraged to
pose for photos encased in a straitjacket in a padded cell.
[Straitjacket games at home can be fatal.] Anyone who thinks this isn't
'fun' is labeled humorless. Critics of the shop, who from long
experience know a demeaning message from a benign one (such as Patsy
Kline's signature song "Crazy") are ridiculed. Those who suggest a
choice of alternate themes are accused of aiming to destroy the shop's
Recently the doughnut makers broadened the range of their stigmatizing
message by taking it to a nearby college campus. Students have been
recruited to peddle donuts they buy at wholesale. The implied message:
ridicule of psychiatric vulnerabilities is socially acceptable at
Would any stigmatized minority quietly accept such harrassment? Kim
Hing, a film student who has autism, has voiced her objections to the
college administration and to public officials. So far the college has
not dismissed her legitimate concern outright, but it is unclear
whether she has been taken seriously. Explaining her objection to the
doughnut's 'fun' diagnoses and decorations, Kim likened them to a
doughnut covered with licorice and named 'nigger'. It's an apt
Hing's statement questioning the right
to exploit psychiatric conditions for commercial gain.
I am an Aspie, that's a nickname for someone who has been diagnosed
with Asperger's Syndrome. It means I am on the autistic spectrum. I
also have Major Depression, Anxiety, and ADD. I want to bring the
following incident to your attention.
I am taking a film class at DeAnza College in Cupertino, CA. The DeAnza
Academy of Independent Filmmakers club on campus held an event recently
which I attended. Marc Buckland was the featured speaker. He gave a
great presentation with insights on directing and producing for TV.
Following his presentation, the owner of a new local shop called
"Psycho Donuts" took the stage. Apparently the club invited him.
This man and his donut shop have stirred up huge controversy in Santa
Clara County. This owner decided he wanted to make a "fun, themed
restaurant where parents can take their children and not pay a lot."
The theme is a mental institution. You can eat your donuts in the
"Group Therapy Room" and have your children photographed in a real
straightjacket in the shop's padded cell. The donuts have strange
toppings, such as cereal and candy. Order your favorite - Bi-Polar,
Massive Head Trauma, or any of the DSM IV psychiatritic diagnoses.
Seriously, the owner thinks it is funny to name the donuts after mental
illnesses. So why was this man on DeAnza College's campus? (DeAnza is a
local community college.) He came to encourage students to send him
short films with donuts in them that he will play on monitors at Psycho
Donuts. He apparently has a channel on YouTube, as well. Also, he
offered to help the students with fundraising by providing them Psycho
Donuts at wholesale prices to sell on campus. He will even send over
some "crazy doctors and nurses to help." (His employees wear doctor and
nurses uniforms and lab coats.)
Nice way of marketing, isn't it? Get the students to sell your donuts
and you don't have to pay a dime. Never mind the effect it will have on
students who have diagnoses. When I protested that it wasn't funny, I
was told by an officer of the club to "stop disrupting the meeting."
She also told me, "you're taking this too seriously." And when I
persisted, she told me to "take it outside."
I wrote the college's newspaper and my letter was published in it. My
letter is starting to make the circuit to various organizations (by way
of people forwarding it) such as NAMI (National Alliance on Mental
Illness) and Silicon Valley Independent Living Center. I also wrote the
San Jose Mercury News and my letter was published May 9.
The local NAMI president e-mailed me the press-release that NAMI sent
out on 4/28/09 about the impact this shop is having on the mental
health community. He said I could e-mail it to anyone at the college. I
e-mailed it to the film club members. The officer who told me to "take
it outside" responded by asking if I also would have protested Jack
Nicholson for his portrayal in a mental hospital. She wrote that she
has visited mental hospital 3 times and was in special education. Her
mother has bi-polar. She sees nothing wrong with the donut shop owner's
"creativity" and says "this is a free country."
Clearly there is a difference between "One Flew Over the Cuckoo's Nest"
which dramatized the deplorable treatment of patients in mental
hospitals of that era and the ridiculing of those with mental illnesses
in the guise of "humorously" naming strange looking donuts after
psychiatric illnesses and encouraging students to sell them on campus
regardless of how students with diagnoses might feel.
There is a federal law, ADA, that protects those with disabilities from
discrimination at school. DeAnza College is funded by the State of
California. I do not expect to be publicly humiliated and to have my
disability ridiculed at a school sponsered event. While this is a free
country, not everything that is creative is allowed at school.
I am certain that if the owner covered a donut with black licorice and
named it "Nigger", he would never have been allowed on campus.
I do not feel I should be subjected to this at school.
the website of "What A Difference a Friend Makes."
This is a
ground-breaking campaign to address prejudice and discrimination on
college campuses launched in 2008. It is a cooperative venture of the Ads
Council and SAMHSA,
the federal agency that oversees human
for F.U.S.E (Friends United to Support Equality)
F.U.S.E. is a
newly-formed coalition of mental health advocates and organizations.
with info concerning F.U.S.E.
26, 2009 - News
of the Week
MATTERS: WHAT DOES "TREATMENT" MEAN?
Sally Satel asserted this week in a New
York Times opinion
piece that "treatment" for
mental illnesses is the best way to
fight the stigmas that plague the field. But how does she define
Satel's article makes clear what the word "treatment" means to her. She
applauds a current trend in treatment promotion by noting that
"psychiatric medications are now routinely advertised on television."
She is pleased that the military is taking steps to standardize
"treatment" for combat stress disorders. Is she referring to a
medicated approach which many veterans say does not
work for them?
Most mental health advocates consider housing and a network of
community support services to be crucial to the successful treatment of
psychiatic disorders. To our knowledge, Dr. Satel has never used her
impressive public relations skills to advocate for programs such as the
successful "housing first" program in New York and much needed
veterans' counseling programs. Why?
The pharmaceutical industry must love her.
Health Needs are Stressing Out Veterans Administration
Michel, Buffalo News, November 7, 2008
Fight Stigmas, Start With Treatment
Satel, M.D., New York Times, April 21, 2009
19, 2009 - News
of the Week
DOES FREE SPEECH BECOME HATE SPEECH ?
years ago, a lighthearted attempt at
humor by a small group of firemen in Long Island NY caused public
outrage. In a parade, the men tied an effigy of a black man to the back
of their engine. When accused of racial bias, they claimed the
protection of their right to freedom of speech.
Will public outrage sensitize the lighthearted marketers of a
jelly-filled doughnut they named 'massive head trauma' and decorated
with a battered face and dripping red jam? Or has such crude
exploitation become socially acceptable?
Please read and circulate the eloquent letter below.
April 16, 2009
I am a disabled veteran from the 'Cold War' era. I was medically
retired from the US Army after a training accident left me with a
severe and permanent brain injury. I am speaking to the customers of
"Psycho Donuts" in Campbell. Not only are these entepreneurs
capitalizing on the backs of my fellow disabled veterans, but at the
expense of all decent people who are sensitive to basic human rights
Imagine yourself as a lower-class citizen in England during the Middle
Ages. Now see yourself as the court jester in the town square or a
monkey on the shoulder of a clown meant to amuse the King. You feel the
indignity of the spit, smirks and jeers, all day, every day. Switch to
current day and substitute the jester and the monkey for brave veteran
troops returning from Iraq ...with a severe brain injury from a
roadside bomb or a rocket-propelled grenade.
Twenty miles north from the Campbell donut shop, soldiers at the Palo
Alto PolyTrauma Rehabilitation Center are struggling with a new,
strange version of themselves, struggling with a brain that interprets
colors, sounds, touch, voices and pictures in weird ways...and nobody
can understand this new perspective...the only thing they know is
they're alone and these changes will last forever. When they joined the
military they didn't sign up for ridcule and the butt of public humor.
They didn't expect a greeting like they are recieving from this
seemingly harmless donut shop. But they did have a "Massive Head
Let's protect the dignity of our veterans ... let's not trivialize
brain injury. It's so devastating, so permanent. One of their pastries
is called "Massive Head Trauma" -- this is the kind of scorn that can
send our wounded warriors and their families into a downward spiral of
depression. We feel like outsiders as it is. All survivors of head
trauma are embarrassed by this display. Veterans of all wars are
disgusted. "Support our troops" is the vogue catch-phrase of our
age...let's be true to our convictions.... Tell Mayor Kennedy and the
Campbell City Council that language is a reflection of intelligence,
and Campbell is developing a reputation of callous ignorance.
US Army Airborne Infantry
15, 2009 - News
of the Week
TURNS BACK THE CLOCK
Silicon Valley entepreneurs have discovered
a cool way to market products. They opened a donut shop and turned it
into a fun-filled insane asylum. The store teems with "lighthearted"
ideas based on vulnerable human conditions. Favorites are wrapping
children in straitjackets for fun photos, donuts with clever names like
cereal killer, and a 'head-trauma' donut decorated with dripping red
What's wrong with mocking mental illnesses to sell products? Other
stigmatized minorities (such as GLAAD - Gays and Lesbions Against
Defamation) could answer that question easily. The mental health
community is still not sure.
Perhaps the extraordinary article below, reprinted from 2004, will help
us to rethink our community's goals and how to reach them.
April 18, 2004 - News
PSYCHIATRIC SURVIVOR NAMES BIGGEST
Cruz Sentinel, "Severe mental illness is a tiring challenge, every
waking moment, every waking day. Do not dismiss this essay..."
challenge of mental illness is
By MAEL ANNE DINNELL
April 18, 2004
I belong to a community, a social class and a subculture that, by
necessity, requires that I regularly be categorized for the purpose of
treatment and concrete assistance.
This is a community whose members are familiar with constant challenges
and frequent anguish. People die frequently in this community, from
suicide, drug overdose and physiological complications, which are the
side effects of very powerful medications — side effects like
tumors, heart problems, kidney failure, poor liver function, toxicity,
But for all these high prices, we in this community suffer most
profoundly from stigmatization, derision, misunderstanding and
discrimination that no other minority would allow to pass unchallenged.
Paradoxically, the way we are included in society is by segregation,
which we wearily (and necessarily) allow. We are the "mentally ill,"
the consumers in a system of a particular kind of care.
I feel urgency, in the light of attempts by the governor of California
to minimize and even cap our services, to address the larger society
about what life is like for us. Severe mental illness is a tiring
challenge, every waking moment of every waking day. Do not dismiss this
essay at this point out of an ignorant conviction that we are lazy,
crazy or unsalvageable. You stand to learn something about your fellow
Segregating us allows for specific kinds of treatment the average
citizen does not require, but it also engenders our dismissal. We are
accused often of being dependent on the mental-health services that
provide us with medication, living assistance, payees, programs,
therapy and group support. But you would not judge a diabetic for being
dependent on insulin, or the dependence of someone with kidney failure
on dialysis. These things are matters of life and death to us, not only
health and comfort. At some point we have been judged inappropriate
enough often enough by society to warrant our assignment as members to
this system, but at some point our functioning in it becomes relevant
to the length and quality of our lives. There are many people in this
society with fixed delusions or idiosyncrasies of thought and behavior
that never get diverted into this system, and whose lives are not
affected in terms of length or quality. The quality of our subjective
experience (of ourselves and of the world) then becomes the most
important aspect of being assigned to this system.
The typical image of a mental-health client is one of a client in
crisis. That is when the public notices us, and that is when we come to
the attention of the police. These acute episodes are the subject of
ignorant jokes and the reason for unquestioned prejudices.
In actuality, most of the time we are not visibly distinguishable from
you. But jokes and stereotypes at our expense occur regularly even in
ultra-liberal Santa Cruz, and even in the alternative publications.
Derisive references one would never dare to make toward blacks, for
instance, or women, are commonplace and acceptable. Even now someone
reading this is protesting that I am overly sensitive. I think not.
We joke about or own behavior sometimes. But there is really nothing
funny at all about the experience of serious mental illness. Coping
with it requires an outstanding level of strength, willingness,
motivation and commitment. Most people could not survive it; in fact,
many of us don't. I, personally, thank God every day for the new
generation of "atypical" psychotropic drugs; they have freed me from
the nightmare of cognitive confusion, misperception and emotional
deadness that I lived with for almost half a century, whether acutely
or in relative remission.
But I have paid a price for the use of the drug that changed everything
for me: my body thermostat has been ruined and I suffer regularly from
overheating and feverish states. This long-range effect was not known
when I started on it. This is a typical example of the kind of
trade-offs we are required to make in exchange for the blessing of
being functional and feeling well.
In spite of infighting, we emphasize our segregation by the inclusion
of only each other in our social lives. Why should we struggle
valiantly to blend in with and facilitate the rest of the people in
society? We accept each other as we are and meet each other where we
are. We do not have to constantly explain ourselves or strive for some
vaguely understood kind of appropriateness or redeem ourselves for the
sin of being subjected to a condition we can manage but not cure or
control. We can live, work and socialize within a group in which each
individual is faced with the same dilemma.
It is trite and cliché to say, but the world itself is
World and local events are dominated by acts that are profoundly
inappropriate — that is, inhumane — from genocide
abuse and molestation to wars fought for the sake of territory and
resources. It is almost amusing because the behaviors that find us
relegated to the mental-health system (very early on in our lives)
seldom involve violence against other human beings. As a group, we are
no more violent than society at large; in fact, we are more likely to
be victims of violence.
Sickness and health are determined mostly on the basis of peculiarity
— not a moral standard, not a measure of our respect toward
rights of others. To "fit in" — somewhere — is the
the mantra in this society. It does not pay to stand out. And neither
is it easy to stand out. Thus, our sub-community is open to those who
do not belong, and closed to those who do.
There is beginning to be movement in our community, as there has been
for some time already in the ranks of the physically disabled, toward a
kind of solidarity, political involvement and awareness that we
represent an important voting bloc. My personal mission is to write and
act toward the goal of not only establishing and maintaining concrete
"patients' rights," but educating society at large about the image and
the needs of the mentally ill — in all of their various
circumstances, from life in the larger community to homelessness to
institutions and facilities.
I know without a doubt there are people who have read this far saying,
"This cannot be a person with real mental illness, she is too logical
and articulate." And this is precisely the point I have endeavored to
make. We are talented, we are verbal, we are interested in things; we
struggle with a handicap the majority of people don't have, but you
make a grave mistake to dismiss and outcast us.
In any case, we will be heard, and we are here.
Dinnell is a Santa Cruz resident.
using Fair Use Doctrine
22, 2009 - News
of the Week
HEALTH NEWS' SUMMER ISSUE WILL
SALUTE RECOVERY AND THE CONSUMER MOVEMENT
Ira Minot, the survivor of a serious mental illness, created Mental
Health News in 2001 as a
tentative educational project. Minot had
endured a decade of disability caused by a condition he never
anticipated and did not understand. As he began to recover, he vowed to
turn a spotlight on the shadowy world of mental
called "the last taboo." Mental
Health News quickly expanded
from its small base in New York to become a "source of information,
education, advocacy and resources from the local, state, and national
news scene." Published quarterly, current and back issues of Mental
Health News are available online
"Recovery and the Consumer Movement" is the topic for the Summer 2009
issue. The deadline for articles is May 1. For more information, see
the announcement below (minus pictures) just received by email from Ira
Health News Summer Issue
"Recovery and The Consumer Movement"
a salute to the
people and progams that are
transforming our mental health care delivery system
CALL FOR ARTICLES AND ADVERTISING
Deadline: Friday, May 1st
We Invite Your Participation
Contact Us Today !!
25% ADVERTISING DISCOUNT FOR ALL
PEER-RUN CONSUMER PROGRAMS
TO HELP US SPOTLIGHT YOUR VITAL SERVICES FOR THE CONSUMER COMMUNITY
Here Are A Few Suggested Article Topics Related to Our Theme:
Stories: How My Recovery Has Helped Me
Move On With Dignity & Pride
Recovery Community: How My Peers Have Made
A Difference in My Life
Specialists: I Am Now Helping My Fellow
Consumers in Their Recovery
The Most Important Issues On Our
Providers: How Our Programs Are Making
Providers: Helping Consumers Keep Their
Family Ties Intact
Professionals: Recovery Oriented
Call Us With Your Idea for An Article !!
H. Minot, LMSW, Executive Director
Mental Health News Education, Inc.
Your Award Winning Source of
Evidence-Based Information, Education,
Advocacy and Resources From The Local,
State and National Mental Health and
Autism Spectrum News Scene
16 Cascade Drive
Effort, PA 18330
Mental Health News: www.mhnews.org
Autism Spectrum News: www.mhnews-autism.org
- End of Mental Health News announcement -
1, 2009 - News
of the Week
KIND OF VALOR" TEAM WILL VISIT
As our service members return from the battlefields of Iraq and
Afghanistan, greater numbers than anticipated are finding their
homecoming clouded by mental health difficulties. Many search in vain
for help, and news reports of family breakdown and suicide are
But invisible wounds are easily ignored. Is it possible to raise the
public's understanding of combat-related stress disorders? Can we
prevent the tragedies that lie in store for too many veterans, their
families, and their communities?
Filmmaker Dan E. Weisburd and the California Institute of Mental Health
have created an ambitious public awareness project, "Another Kind of
Valor," designed to illustrate and explain the disabling effects of
post traumatic stress disorder (PTSD). The video kit consists of 3 DVDs
with nine powerful half-hour vignettes based on actual stories of
battle trauma, plus a learning CD that serves both as a learner's guide
and a facilitator's handbook useful for self-study or group
discussions. The kit provides a powerful stimulus for discussion of
problems that are affecting families and communities nationwide. (how
In addition, the VALOR team has scheduled "Learning Day" conferences in
five cities, with more in the planning stages. Each conference will be
tailored to the community's special needs, using the videos for
illustration and guidance as needed. VALOR's "learning CD" will be
augmented by local panelists that may include veterans, family members,
mental health and substance abuse professionals, sheriffs, police,
judges, medical providers, attorneys, civic leaders, and others
selected by the conference planners and VALOR team.
By evening, an ideal Learning Day will have given every voice due
attention, and will find the community's leaders working together,
equipped, inspired, and determined to find solutions to the unmet needs
of its returning service members.
In a review
of "Another Kind of Valor" for www.miwatch.org,
Phyllis Vine, Executive Editor, notes that in the light of evidence of
cavernous gaps in meeting the health needs of vets "it would be
surprising if the next Congress failed to fund essential programs."
Vine suggests, "Before deciding what action to take, elected officials
should be required to see the docudrama "Another Kind of Valor."
Review of "Another Kind of Valor," by Phyllis Vine, Ph.D.
To hear the
VALOR Prologue and meet the cast, go to www.defeatptsd.org
information for "Another Kind of Valor"
1, 2009 - News
of the Week
LAUNCH MULTI-MILLION-DOLLAR 'TIME TO
Don't miss the inviting website! www.time-to-change.org.uk/
Three British consumer-led organizations have united in a massive
effort to defeat discrimination against people with mental illnesses.
They are determined to get across the real story about mental health,
told by those who know. The campaign will appear in 4-week phases over
the coming months.
The first 4-week phase is a straight-talking campaign which runs from
January 21st and includes:
press ads featuring Stephen Fry, Ruby Wax
and Alastair Campbell
uncompromising stunts to grab public attention
A string of
high-profile supporters, from celebs to
The TV ad shows that being told to 'pull yourself together', being left
out of things and treated as 'a problem' can lead people with mental
health problems to despair – tragically for some, they just
go on. TV viewers will be left in no doubt that the way they treat
people with mental health problems like depression can make all the
'Time to Change' is run by leading mental health charities: Mental
Health Media, Mind, and Rethink,
and is backed by £16 million
from the Big Lottery Fund and £2 million from Comic Relief.
Each of these organizations is an established powerhouse. Their united
offers a wide range of excellent resources.
18, 2009 - News
of the Week
HOW 'WONDERLAND' WENT WRONG
'Wonderland,' a television series said to depict an urban psychiatric
emergency room, was cancelled nine years ago by ABC after only two
episodes. Now, with a reprieve from satellite TV, all eight episodes of
'Wonderland' may be shown. The news opens old wounds.
Wonderland's publicists in 2000 touted the show as gritty realism. But
in fact, the show's inspiration was a special unit for forensic
psychiatry where patients were judged to be "criminally insane." Mental
health advocates who saw the two initial episodes were appalled by the
shootings, stabbings, bizarre exaggerations and hyperactive pace.
Former patients with experience in psychiatric ERs faulted the factual
errors, lurid violence and nonstop chaos, and noted that while "doctors
had complex lives, patients were a freak show."
New York Times critic Bernard Weinraub wrote that in researching the
series, writer/director Peter Berg spent nearly 7 months taking notes
in a forensic unit at Bellevue Hospital in Manhattan. A Berg interview
with Ariel Levy of New York Magazine points to Berg's fixation on
atypical cases: "I divided my time between the maximum-security ward
for criminals -- from Goldstein the subway pusher to a guy who
swallowed a couple of batteries at Rikers in a suicide attempt -- and
the psychiatric emergency program, in which people come in off the
street or are brought in by the police or EMT."
Berg, a multi-talented former actor, told interviewers he hoped to
portray a psychiatric hospital more honestly than had ever been done
before. But his result was over the top, even for a maximum-security
(The horror of a genuine psychiatric ER was caught on videotape this
year when Esmin Elizabeth Green, after waiting for help for nearly 24
hours in the eerily quiet waiting area of Kings County Hospital
psychiatric center in Brooklyn, collapsed to the floor and died. The
video shows that as the hours passed, a few staff members or other
patients wandered in and out of the room; finally someone prodded the
body with her foot. Wonderland's contrived and stigmatizing horror is
no match for reality.)
Why did the
mental health community protest
Wonderland? Ellen Gray, a television critic for the Philadelphia
Daily News, explains in an
insightful article that begins,
"Can there be anything worse for a critic than to fall in love with a
piece of work and then find out that some fine people have very good
reasons for hating it?" (read
looking for Wonderland background
information will find eight postings in the NSC
to February 27, 2000, the
For a list of
Wonderland reviews and articles, most
with web links, email a request to email@example.com
7, 2008 - News
of the Week
LOOK BACK AT DUBIOUS JUSTICE
Would A Jury Today Be More Enlightened?
Nearly a decade ago, the year 1999 began in New York City with a
senseless tragedy that shocked and saddened the city and dominated the
news for months. On January 3, Andrew Goldstein, who had been
discharged three weeks earlier from a psychiatric hospital with a
one-week supply of medication, pushed Kendra Webdale, a lovely young
aspiring writer, to her death under an oncoming train.
The Treatment Advocacy Center in Arlington VA quickly declared Andrew
Goldstein a "treatment resister" and made him a poster boy in their
crusade for forced medication. Then on May 23 a different view of
Goldstein emerged in a stunning cover story in the New York Times
Magazine. The article exposed a trail of negligence - mixups, dead-end
waiting lists, premature discharges - by the mental health facilities
where Goldstein had repeatedly asked for the help he knew he needed.
But by then, "treatment refuser" had become Goldstein's destined label.
Latest update: in 2007 a third trial for Andrew Goldstein ended with a
negotiated conviction for murder and a prison sentence of 25 years plus
5 years probation after release.
A decade-old article below by Michael Winerip leads one to ask, Has the
public become more aware of mental health issues since Goldstein's
first jury trial in 1999?
Another article reprinted below, The Railroading of
Andrew Goldstein (2002) shows
how justice was derailed.
New York Times
November 21, 1999
The Way We Live
Now: 11-21-99; The Jurors' Dilemma
By MICHAEL WINERIP
While the jurors tried to figure out what, if anything, was going on
inside Andrew Goldstein's head when he shoved Kendra Webdale to her
death, we reporters stayed busy speculating on what was in the jurors'
heads. Midway through the trial, during a lunch break, half a dozen of
us were sitting around the courthouse press room eating our $3.50 tuna
sandwiches from Lil's when a TV reporter cut right through all the
expert psychiatric testimony. "I'd vote guilty," she said. "I'd want to
make sure Goldstein goes away for a long time."
That of course was not what the trial was supposed to be about. It was
the jurors' job to decide whether Goldstein knew right from wrong when
he pushed Kendra Webdale in front of the subway train or whether he was
insane at the time, and thus not responsible for what he did. Was he
once again in some sort of uncontrollable psychotic fog as he had
repeatedly told psychiatrists in recent years each time he'd punched
and shoved people? Or was he a budding Ted Bundy who craftily used his
schizophrenia as a shield for his rage against women?
If judged sane at that awful moment, Goldstein would be guilty of
murder and most likely would serve at least 25 years in a state prison.
If judged insane, he would go to a secure state psychiatric hospital.
There he would be re-evaluated every two years to determine whether he
was fit for discharge. And that, I believe, scared the hell out of many
New Yorkers -- the possibility that Andrew Goldstein could be back on
the streets in a few years' time. It was, to my mind, the prosecutor's
At the start of their deliberations, the 12 jurors polled themselves.
Five felt Goldstein was guilty of murder; three felt he was not guilty
by reason of insanity; four were undecided.
Hannah McCaughey, 32, a graphics designer, was among the undecideds.
But as the days passed, she and most of the others switched to guilty.
Partly, she said, it was because Goldstein had seemed more rational in
his videotaped confession than she'd anticipated. "I would have
expected him to seem more delusional," she said. "Like he thought
Kendra was a green monster and her head was on fire and he was trying
to put it out."
But there was something else, several of them said in interviews, that
kept eating at them, that they knew, as jurors, they were not supposed
to consider, but that they could not help worrying about. "I was
thinking, What happens if he's found not guilty by reason of insanity
and gets out in a short time," McCaughey said. "I know we weren't
supposed to talk about it, but I brought it up once myself. I said,
"Let's talk about the ramifications of our judgment."
"Having grown up in New York," she added, "I know that people don't
stay in mental institutions very long. I thought to myself, How am I
going to feel in a year or two or five when he's killed somebody else?
The state's record is so bad -- it definitely had an influence on me."
The truth is, if Goldstein was judged insane, he would probably spend
as much or more time locked away. A 1995 study from the journal Law and
Human Behavior looked at the cases of 526 New York defendants in
criminal trials who claimed insanity; most of them, about two-thirds,
were unsuccessful. But those who were judged insane actually wound up
spending more time confined to psychiatric facilities than their guilty
counterparts spent in prisons. Experts I spoke with agreed. Dr. E.
Fuller Torrey [see
footnote by ja], one of the
nation's leading researchers on schizophrenia, has examined John
Hinckley Jr., written a book on Ezra Pound and pushed for tougher
commitment laws for mentally ill people resistant to treatment. But he
has no doubt that if Goldstein was found insane, he'd be locked away
for a long, long stretch: "In these high-profile cases, psychiatrists
know the public is watching. Psychiatrists aren't particularly brave
people. No psychiatrist is going to stick out his neck for someone like
Goldstein. There's too much at stake."
Even a veteran New York City prosecutor told me, "We generally don't
have a problem with criminally insane people being released before we
think they're ready."
After the jury deadlocked, 10-2, and a mistrial was declared, the media
focused on the biases of the two holdouts who felt Goldstein was
insane. It is just as important to look at the biases of the majority.
I am no bleeding heart. The primary victim here is not Goldstein but
the Webdales. They've already been tortured twice this last year. They
lost a beautiful daughter, and now, after forcing themselves to attend
this gruesome murder trial every day for weeks, they will face it all
over again at the retrial. And yet, because they labored to turn
despair into something constructive, George Pataki this month, for the
first time during his five years as governor, was shamed into offering
significant new resources for the mentally ill.
Still, Andrew Goldstein was also dealt a losing hand twice. First, by a
mental-health system that refused his repeated requests for community
care and long-term treatment, that kept dumping him back on the streets
even though he'd attacked more than a dozen people in two years. When I
first obtained his 10-year, 3,500-page record for the article I wrote
in these pages last spring, I was amazed by how clearly a dysfunctional
system was able to document its own failures.
Knowing that 3,500-page record, can we really expect a juror who
suspects that Goldstein was insane to have faith that the system will
someday in the future correctly judge whether or not it is safe to
release him? That is a lot of added pressure to place on a juror. It's
the second bad hand dealt Goldstein: a psychiatric system that has lost
the public's trust lowers the odds that a mentally ill human being will
get evenhanded justice.
Michael Winerip is a staff writer for the magazine. His last article
was "Bedlam on the Streets."
End of New
York Times Article
Fair Use doctrine
Footnote by J Arnold: Dr. E.
Fuller Torrey is the chief proponent of forced psychotropic medication.
In 1999, Dr. Torrey and his supporters labeled Andrew Goldstein a
"treatment refuser" to influence the passage of Kendra's Law.
to "In the Matter of David Dix" : a report by the New York
Commission on Quality of Care which details New York State's negligence
in the treatment of Andrew Goldstein, a man well-known to have violent
episodes who repeatedly and voluntarily tried to get the help he knew
to "Bedlam on the Streets," a New York Times
Magazine cover story by Michael Winerip which recounts Andrew
Goldstein's futile search for psychiatric help.
to a collection of articles and reports concerning Kendra's Law.
Provides a LINK to Kendra's Law Updates.
by Patricia Warburg Cliff, The Journal of
California NAMI V.11,1.3 (September, 2000)
The failure of the legal profession, the court system and the public to
grasp the vital concepts involved in the two trials of Andrew Goldstein
further reinforce the fact that we at NAMI have much work to do.
In January 1999, Andrew Goldstein, an unmedicated, delusional person
with paranoid schizophrenia who had been unsuccessfully seeking help at
various hospital emergency rooms, pushed Kendra Webdale to her death on
the tracks of the New York City subway. Unfortunately the terrible
tragedy of this young woman's death clouded public perception of the
situation which allowed this to occur: the failure of the public system
to offer the required state-financed housing with day services, clinic
visits and an intensive case manager, to this seriously ill young man.
It was, however, not the system which was on trial, but the other
"victim" of this tragedy, Andrew Goldstein himself. The first trial
ended in a hung jury, because two jury members had had some limited
experience with the mental health system and consequently understood
the nature of Goldstein's illness and his inability to form the
necessary intent to commit murder in his psychotic state. The public's
outcry for revengeful punishment did not, however, cease.
In late February, 2000, a second trial was commenced. After hearing the
evidence, the judge instructed the jury that they had the option of
convicting the defendant of manslaughter in lieu of the second degree
murder charges, if they found that he had acted with "depraved
indifference," but without the requisite intent necessary for a
conviction of second degree murder. It took the jury only two hours to
reach the verdict of second degree murder.
The irony of the situation should not be overlooked: Andrew Goldstein
was being held at Bellevue Hospital following his arrest where he was
willingly receiving treatment for his illness and consequently would
not be able to appear sufficiently psychotic at his trial to
demonstrate to the jury the disabling effect of this illness on his
judgment. The defense pinned its hopes on taking Mr. Goldstein off his
antipsychotic medication and putting him on the stand, to better show
the jurors his mental state at the time of the attack. This novel
concept was thwarted when Mr. Goldstein struck a social worker, further
indicating his violent state of mind when unmedicated. Judge Berkman
insisted that Mr. Goldstein be offered the choice of taking his
antipsychotic medication, which he chose to do. The result was that the
jury was able to see a passive, sedated individual and not the person
whose delusions caused his violent behavior.
NAMI's suggestions to the defense counsel to utilize the virtual
reality videos produced by pharmaceutical companies which demonstrate
the psychotic state of mind, as well as comparisons to the diminished
capacity suffered by individuals who are experiencing the onset of a
diabetic coma or an epileptic seizure, fell on deaf ears. The
subsequent result demonstrates the ignorance of the judge, jury and
defense counsel with respect to paranoid schizophrenia. Andrew
Goldstein never got a fair chance.
At the conclusion of the trial, the jurors were convinced that
punishment, not treatment, was warranted. Mrs. Webdale, the victim's
mother spoke at the sentencing hearing: "It is my contention that if
Andrew Goldstein had been held responsible many incidents ago, there
would not have been 13 assaults and one homicide committed by him. His
ongoing aggression was tolerated and acceptable." The presiding judge
concurred saying that the attack stemmed from the state mental health
system's failure to punish Mr. Goldstein for past assaults.
On May 5, 2000, Judge Berkman gave Andrew Goldstein the maximum
sentence of 25 years to life in prison for the murder of Kendra
Webdale. What is wrong with this picture? Has the "justice system"
reverted to a witch hunt to punish the violent mentally ill whom the
public system has dismally failed? Are we, as a society, going to be
content with the gross misunderstandings of mental illness which were
demonstrated in this trial? How are we going to educate the judiciary
about these issues?
The ultimate irony is that the New York State legislature, ever
reluctant to provide sufficient funding for treatment for the mentally
ill, hastily passed a bill, commonly referred to as "Kendra's Law,"
allowing for court ordered treatment or commitment of the mentally ill
under certain circumstances. Andrew Goldstein who is now rotting in the
state prison system, had tried repeatedly to get help before the
attack. He even sought his own commitment when he realized that he was
out of control. The misnomered "Kendra's Law" would not have prevented
PATRICIA WARBURG CLIFF, an attorney and mental health advocate in New
York City, serves on the national board of NAMI as well as on the board
of NAMI-NYC Metro. Her only child, Kenneth Johnson, succumbed to
depression in 1995, as a result of the private health care system's
failure to adequately diagnose and appropriately care for his illness.
using Fair Use doctrine
21, 2008 -
News of the Week
KIND OF VALOR' CAPTURES TORMENT OF
STRESS DISORDERS IN VIDEO VIGNETTES
An Audience Discussion Guide is Included to Promote Public Awareness
For details and
order information, click http://www.cimh.org/Learning/Publications-DVD/Another-Kind-Of-Valor.aspx
Will the grateful American public provide our returning war veterans
with the help they need to cope with combat-related stress disorders
and brain injuries? The public first needs a basic understanding of
these challenging conditions. To bridge the gap in public understanding
of wounds that are disabling but invisible, the California
Institute for Mental Health (CIMH)
has released 'Another Kind
of Valor', an outstanding set of
videos that is both deeply moving
and a powerful stimulus for discussion of problems that affect families
and communities nationwide.
The CIMH video kit consists of 3 DVDs with nine powerful half-hour
vignettes based on actual stories of battle trauma, plus a learning CD
that serves both as a learner's guide and a facilitator's handbook
useful for self-study or group discussions.
A quote from "Help
Is On The Way," by Bob Herbert, New
York Times Op-Ed,
November 22. 2008
to civilian life from combat
is almost always a hard road to run. Studies have shown that a third of
G.I.'s returning from the combat zones of Iraq and Afghanistan - more
than 300,000 men and women - have endured mental health difficulties.
A quote from
David W. Gorman, Executive Director of Disabled
American Veterans, praising Another
Kind of Valor and its creator,
filmmaker Dan E. Weisburd.
most Americans can empathsize
with the challenges faced by veterans suffering from physical injuries
and disabilities, it is often more difficult for civilians to
comprehend the complex emotional and psychological problems confronting
veterans suffering from post-deployment mental health issues - or the
invisible injuries of war - such as post-traumatic stress disorder,
depression, and traumatic brain injury. By bringing these stories to
life through the docu-drama format, Another
Kind of Valor helps
to foster awareness, discussion, and understanding of the struggles our
disabled veterans and their family caregivers face, and contributes to
the development of a more supportive encironment in which they can
begin to heal and recover from the wounds of war.
below typifies a growing trend. It
underscores the urgent need for public action on behalf of men and
women returning from Mideast battlefields.
HEALTH NEEDS ARE STRESSING
OUT VETERANS' ADMINISTRATION
War Veterans Seeking Help In Record Numbers
By Lou Michel
November 7, 2008
Dana Cushing is a disabled veteran who is supposed to receive an hour
of counseling each week through the Buffalo VA. But she shares that
hour of a psychologist's time with 15 others in group therapy. "So you
have 60 minutes divided by 15 people. That's four minutes apiece, and
that's not going to help," Cushing said.
She is not alone.
Returning war veterans are seeking help for depression, anger and other
mental health problems in record numbers in Buffalo Veterans Affairs
Medical Center and similar hospitals around the country.
The most common treatment is medication. In fact, the number of
prescriptions given to local [Buffalo] veterans to help them with
mental problems has increased from about 1,700 seven years ago to
almost 8,000 in the 2007-08 fiscal year.
The problem is that medicine, on its own, does not teach the veterans
how to cope. That is why a campaign is under way to enlist
psychologists and other mental health providers to work with war
There's just one catch. There's no pay. It's volunteered time. Not a
lot. Just one hour a week. "We're appealing to the social and moral
conscience of behavioral providers in the community to reach out and
offer one hour per week," said Thomas P. McNulty, president of Mental
Health Services of Erie County. "Soldiers and their families deserve
nothing but the very best from our community."
The need is pressing and will continue to grow, according to Barbara
Van Dahlen Romberg, national founder and president of Give an Hour. "I
hear from some veterans that it is difficult to get immediate
appointments and frequent appointments," she said.
The effort here and in other states comes at a time when more federal
money is pouring into the Department of Veterans Affairs to treat
psychologically injured veterans. Critics say there is too much
emphasis on medication and not enough on counseling. Antidepressants
top the list of medicines prescribed to returning Iraq and Afghanistan
veterans at the Buffalo VA, which has spent more than $2 million on
psychiatric medications since 2001.
E-mails to Romberg from the loved ones of veterans across the country
often express concern that the vets are "primarily receiving
medications and not enough counseling," she said. A volunteer force of
psychologists is "nimble and fluid" and can fill in the gaps as needed,
The demand for counseling is expected to continue to increase as more
veterans return home, McNulty said. To date, an estimated 1.6 million
service members have spent time in Iraq or Afghanistan. "What we're
hearing is that the wave of veterans returning will put undue stress on
the current system, and new resources must be identified to meet that
need," he said, adding that he is working with VA employees who cannot
be faulted for the growing demands.
And, McNulty says, it's not only veterans who need the care. Their
family members, children especially, need counseling to cope with
extended absences caused by multiple deployments. "Let's say the mom is
the one in the service, and mom's not home two years. The kids feel
bad. They've lost two years. Then mommy, or daddy, returns from the war
into a home that is already stressed by their absence," McNulty said.
"In addition, there's the issues the soldier brings home."
There are others, as well, who could benefit from the planned local
chapter of Give an Hour. Consider Army veteran Christopher Simmance.
Over the last two years, the City of Tonawanda man says he has seen
four or five psychiatrists and is awaiting assignment of a new one. "My
old psychiatrist quit in May. He told me he couldn't stand how the VA
was treating vets. He gave me a bunch of refills," said Simmance, who
developed post-traumatic stress disorder several years after serving in
a Middle East international peacekeeping force.
Medication alone, the vets say, doesn*t heal. Yet it is a big part of
their treatment. And while the VA's mental health staff might appear
sufficient in number to treat the more than 2,000 new war veterans
[from Buffalo] of the last several years, these men and women are not
the only ones who rely on the VA. Each year, the Buffalo VA treats more
than 40,000 veterans, who are all entitled to care from its 11
full-time psychiatrists and 70-plus psychologists, social workers,
addiction therapists and part-time mental health workers.
Working with McNulty to launch the local volunteer effort a few weeks
from now is Christopher M. Kreiger, a disabled Army veteran, who
suffered traumatic brain injuries serving in Iraq and post-traumatic
stress. "I've been out trying to push to see if psychiatrists would be
willing to donate an hour a week to a veteran in need who cannot get it
at the VA," Kreiger said. "Even the staff that works at the VA says
there's a shortage."
Rather than sit at home and complain, Kreiger, of the Town of
Tonawanda, says working to help fellow veterans has helped him. "The
more I get into it, the more my problems don't seem so big," he said,
explaining that idle time is a big problem for psychologically wounded
veterans. "I just sit at home. I just watch TV," Simmance said. At one
point, he said the VA wanted to assign him to a foreign-born
psychiatrist. He refused, claiming his overseas military experiences
would make it difficult for him to open up to that particular doctor.
Simmance said he consumes up to four prescription drugs a day for his
post-traumatic stress. Bret Mandell, an Army veteran who has seen
action in Iraq and Afghanistan, described similar experiences in
dealing with the VA, adding that he has taken up to seven different
medications for post traumatic stress. "Every time I went up there,
they kept switching me around to different people, and I couldn't get a
good relationship with anyone to where it benefited me," Mandell said
of the VA.
Tracy Kinn, a New York State veterans counselor, says vets need to be
proactive if they want to secure VA services. "They work for us, but
they are very overworked," said Kinn, a former Marine. Veterans who
don't take a proactive approach, she said, may wind up only with
medications and "without the care."
Jeremy Lepsch, a psychologically disabled Marine from North Tonawanda,
said he has noticed progress in the level of VA care. "It seems they've
talked to the staff because everyone seems a lot more friendly and
caring," Lepsch said. The VA also has enhanced its day treatment
facility on Main Street at Hertel Avenue, describing it as a
"psycho-social rehabilitation recovery center," according to Buffalo VA
spokeswoman Evangeline Conley. "We're learning and modifying the
programs based on current needs and what seems to be best for
veterans," Conley said.
End of Buffalo News
using Fair Use standard
9, 2008 - News
of the Week
CAN BE DONE! Peer Counselors
Become Agents of Recovery
readers may prefer to substitute the terms "people with psychiatric
disabilities and substance use disorders" instead of "the mentally ill
and drug addicts."
Agency Is Rolling Out A Model For
Clients, Including Addicts, With Emphasis On Recovery
By Don Sapatkin Philadelphia Inquirer October 9,
Recalling Philadelphia's roots as a medical innovator dating to
colonial times, city officials outlined yesterday what they described
as sweeping changes - some completed, others envisioned - in the
treatment of drug addicts and the mentally ill.
Over the last several decades, scientific advances have dramatically
improved the lives of the mentally ill, many of whom are also addicted
to drugs and sometimes homeless. But those discoveries have not always
guided government programs across the nation that are intended to help.
"The question is how do we reorganize our system to deal with the
realization that people get better?" said Arthur C. Evans, director of
the Philadelphia Department of Behavioral Health and Mental Retardation
At a news conference yesterday at a community mental-health center,
Evans said some recovering addicts were being trained as peer
counselors, allowing them to use their experiences to help others in
similar straits. By paying the peer counselors, the program serves
another need - getting people back on their feet and staying connected,
as opposed to what has been described as the treat-them-and-drop-them
Evans described the new longer-term model as the most sweeping change
in the field since hundreds of thousands of mentally ill people were
released from institutions during the deinstitutionalization wave of
The changes, which will be phased in over the next two or three years,
will be accommodated in his department's $1.4 billion budget, Evans
said, noting that peer counselors are not paid like doctors.
The speakers made a point yesterday of describing their new approach as
"recovery" rather than "treatment."
Among them was Robert D. Martin, 42, who said he had bipolar disorder
and was addicted to crack and living on the streets of Center City in
the late 1980s and early '90s. Early in this decade, he said in an
interview, his treatment in "partial programs" - "you sat for eight
hours a day, then were sent back on the street" - gave him "a glimmer
In mid-2007, just as some of the rethinking was being implemented at
Evans' agency, two weeks of intensive training taught Martin how to
support recovering addicts, how to run groups, and how to teach people
the skills that most Americans take for granted, such as applying for
Social Security cards and preparing to go back to school.
He got a job as a peer counselor and has since been promoted. He moved
from the street to a shelter to the three-bedroom house he now rents
with his wife of two years in Logan. And he just traded in an old
clunker for a 2006 Nissan Maxima.
"I'm living life again," Martin said, sitting outside the news
conference at the Philadelphia Recovery Community Center at 1701 W.
The site is the first of several planned centers that will offer a
range of support groups, counseling, education and social events in
In general, Evans said, the changes that he calls "recovery
transformation" - but that may be known to professionals elsewhere as
"recovery-oriented systems of care" - are supported by research.
When he was a deputy commissioner of mental health and addiction
services in Connecticut, Evans implemented what was described as the
first such comprehensive effort, and when he arrived several years ago
in Philadelphia, he set about doing the same thing.
"Over the years, it has become clear that people with addiction
problems also have other mental-health issues," said Joe Troncale,
medical director of the Caron Foundation near Reading, a leading
addiction treatment center.
Troncale had no direct knowledge of the changes in Philadelphia but
said the integrative or holistic model that was described to him
appeared to be the direction in which behavioral health was heading.
Philadelphia, he said, had been known as a leader in humane mental
health services going back to the beginning of the nation, when Dr.
Benjamin Rush sought to classify forms of mental illness and wrote the
first American textbook on psychiatry.
Fair Use doctrine
Source: NYAPRS Enews
New York Times
November 7, 2008
New York City pioneered the strategy of providing homeless people not
just with housing but with drug treatment, psychiatric care and other
services they need to live successfully on their own. Even with all the
add-ons, supportive housing apartment buildings cost substantially less
than shelters and are many times less expensive than jails or beds in
This strategy is taking root all over the country and proving beyond a
doubt that people who were once homeless can be good neighbors and good
citizens. Unfortunately, many neighborhoods are continuing to fight the
developments, believing that they bring down property values. A
long-awaited study from New York University's Furman Center for Real
Estate and Urban Policy should put an end to that misperception.
The study examined the sale prices of apartment buildings, condominiums
and individual homes in New York City neighborhoods where 123
supportive housing developments were opened between 1985 and 2003.
Fear seems to have suppressed property values somewhat while the new
developments, which often replaced vacant lots or eyesores, were being
built. But that evaporated once people saw the buildings and how well
they were run.
In the five years after the developments were opened, the study finds,
the prices of buildings nearest the supportive housing development
experienced "strong and steady growth," and appreciated more than
comparable properties that were slightly farther away. In other words,
the closer property owners lived to these often handsome developments,
the better they fared.
The Furman study confirms what advocates have been saying for years:
well run supportive housing can help both formerly homeless citizens
and the neighborhoods in which they are built. Politicians and business
leaders across the country should pay attention.
End of New
York Times Editorial
Fair Use doctrine
26, 2008 - News
of the Week
CAN BE DONE!
Civic Organizations Join With Advocates
to Develop Housing Opportunities
Massive institutions on Long Island in NewYork once warehoused tens of
thousands of people with psychiatric vulnerabilties. When
deinstitutionalization began to sweep the nation in the 1970s, wave
after wave of patients were dispersed from Long Island's institutions
to fend for themselves. Many sought refuge with families who searched
in vain for needed services. Many others ended up on the streets of
local communities with no housing or supportive services --
impoverished, homeless, with deteriorating health.
By 1990, community care had become a bitter broken promise. As a
result, throngs of destitute patients across the nation are now in
jails and prisons for illness-related offenses. The U.S. Dept. of
Justice reported in 2006 that more than half of all jail and prison
inmates had symptoms of a mental health disorder.
As early as 1972, a Long Island group called Concerned Friends and
Parents of Central Islip State Hospital began to meet in Suffolk
County. The group grew, evolved, and was renamed Concern for
Independent Living. This active, creative group has just celebrated the
opening of its latest outstanding housing project (see News item for
Sept. 30 below), increasing their creation of apartments to
An article from 2006 describes how community
a seemingly doomed project into a success.
NEIGHBOR OF THE YEAR:
Town of Islip and the West Sayville Civic Association, Neighbors of
Pollack Gardens, a project of Concern for Independent Living.
In many areas, local civic associations and community boards provide
the primary opposition
to developing new affordable housing
(emphasis added by by NSC).
But in the case of Concern for Independent Living's Pollack Gardens, an
outstanding new supportive residence in West Sayville, Long Island, the
project would not have moved forward without the help and support of
the West Sayville Civic Association (WSCA) and the Town of Islip
After hearing about the proposal to build Pollack Gardens, Brendan
McCurdy, President of WSCA, didn't object; instead he called Concern to
learn more about both the agency and the program. He brought the
information back to WSCA and convinced its members to support the
project, a ground up, gut rehabilitation conversion of a run-down adult
home. His wife Maura updated neighbors about the progress of the
project through the WSCA newsletter, expressing the view that
supportive housing would be a positive addition to the community.
Equally important, the Town of Islip Community Board played a critical
role in cutting through red tape to save the project's tax credit
funding. Three months before the funding deadline, it was discovered
that part of the property needed to be rezoned to get site plan
approval. This process normally takes more than nine months.
Everyone said it was impossible to secure the necessary approvals in
only three months and the project appeared doomed - everyone except
Eugene Murphy, Planning Commissioner, and Hope Larson, who was then the
Director of the Building Department.
The Town of Islip scheduled an emergency Town Board meeting one day
before the deadline, something that had not been done in at least 25
Ten minutes after they unanimously passed the resolution, Hope Larson
— who happened to be dressed as Wonder Woman for Halloween
— issued the building permit. The very next day, Concern for
Independent Living closed on the tax credit financing five minutes
before the deadline.
The building opened a little over a year later, where it now provides a
wonderful home to fifty individuals with psychiatric disabilities,
thanks to the community leaders of West Sayville and Islip. The Network
is pleased to honor Mr. McCurdy, Mr. Murphy and Ms. Larson as the
Network's 2007 Neighbors of
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30, 2008 - News
of the Week
CAN BE DONE!
Former Adult Home Undergoes Transformation in NY
Rehabilitation Center Opens In
By Jessica DiNapoli Southhampton Press
September 30, 2008
The building at 260 West Main Street features beautiful artwork, crown
molding, high ceilings and a well-equipped gym. These luxurious
amenities would suggest that the building is an apartment complex or a
hotel found in New York City.
But the newly renovated facility is actually located in downtown
Riverhead and owned by Concern for Independent Living Inc., a
not-for-profit housing agency that offers permanent shelter for those
who are recovering from psychiatric disabilities. The facility, called
Concern Riverhead, has been in operation since June and offers its 50
residents apartment-style living as each single-occupancy room comes
with its own bathroom and kitchenette.
The residents of Concern Riverhead range in age from 18 to 60, and
either have low-income jobs or are homeless, explained Elizabeth Lunde,
the associate director of Concern for Independent Living. The
Medford-based organization runs similar facilities across Suffolk
County and, at the present time, provides housing for approximately 550
The Riverhead facility celebrated its official grand opening with a
ribbon-cutting ceremony last Thursday, September 25, that was attended
by local government officials and representatives of the mental health
Concern for Independent Living purchased the building, which was
constructed in 1929 and formerly known as the Henry Perkins Hotel, four
years ago. From the 1970s until 2004, the building housed the Henry
Perkins Adult Home, a facility mostly known for its dilapidated
For the past three years, Concern for Independent Living has invested
close to $15 million in renovating the building, with construction
commencing in August 2007. Work was completed on the facility in June.
The money for the extensive renovation came from three sources,
explained Steve Piasecki, the upstate coordinator for the Supportive
Housing Network of New York, a housing advocacy organization. Mr.
Piasecki said the New York State Office of Mental Health, the Federal
Home Loan Bank and the Community Preservation Corporation all
contributed to the project.
"We absolutely improved the facility," Ms. Lunde said. "We want our
places to look like apartment buildings or hotels because the folks
rise to the level of their surroundings." She noted that there are
staffers at the facility 24 hours a day, seven days a week.
As part of the renovations, Concern for Independent Housing restored
the historical architecture of the first floor of the building,
including the pediments, and added office space. The agency gutted the
second, third and fourth floors of the building, which now house 50
"It was a warren of old rooms from the old hotel," Ms. Lunde said. "The
Henry Perkins Adult Home ... kept almost everything from the old hotel."
Ms. Lunde noted that there might have been some renovations completed
in the adult home in 1920s, shortly after the structure was built.
When Concern for Independent Housing acquired the building in 2004,
there were still 120 people living there as residents of the Henry
Perkins Adult Home, explained Ms. Lunde. The not-for-profit helped
relocate those residents to other mental health facilities in the area
before embarking on their renovation plan, she said.
Riverhead Town Supervisor Phil Cardinale, who attended last week's
ceremony, said the Henry Perkins Adult Home was "not a positive for the
Town of Riverhead." He emphasized during the event that the home, which
had been cited by the state for a variety of violations, was poorly
managed prior to its closure.
As Ms. Lunde explained, the pristine interior of the Concern Riverhead
facility is designed to help improve the mental health of its residents.
"It's nice, it's clean," said Sharon Francis, one of the 50 residents
of the facility. "The staff is nice and helpful." Before moving to her
new home in downtown Riverhead, Ms. Francis said she received treatment
at the Buckman Center at Pilgrim Psychiatric Center in Brentwood.
The Main Street location is also convenient for residents as they are
within walking distance of many small shops and a bus stop, according
to Ms. Lunde. Ms. Francis noted that she takes the bus by herself when
she has to run errands.
Christopher Betts, the vice president of the Albany-based Community
Preservation Corporation, said the former adult home that once occupied
the building had been a blight on the community for years. He said the
former facility provided substandard housing to its residents.
Mr. Betts added that the recent renovations to 260 West Main Street are
not only an investment in the building but in the surrounding
community. "Supporting projects like this has a positive impact on
property values," he said.
Town officials agreed that the new facility, one of the first buildings
that greets drivers who are traveling east on Route 25 in Riverhead,
improves their overall impression of the downtown area, which has seen
a number or retail stores close shop in recent years following the
shuttering of Swezey's Department Store.
"It's a great building to greet everyone," said Riverhead Town
Councilman John Dunleavy.
"The restoration of the site is wonderful," Mr. Cardinale added.
And elected officials were not the only ones to agree with that
"Once upon a time this was a rundown adult home," said William
Polchinski, a therapist at the Peconic Center on East Main Street in
Riverhead, an outpatient clinic of the Pilgrim Psychiatric Center. "But
Concern made it beautiful and it absolutely affects people's mental
Source: NYAPRS ENews
protected by Fair Use Standard
10, 2008 - News
of the Week
SHOCKING RISE IN DEATHS OF FORGOTTEN
Voices: Healthcare for
the Underserved, 9/10/2008
(forwarded by NYAPRS Enews)
Find Dramatic Increase In Suicides
Among Adolescent African-American Males
Experts Call For New Treatment Strategies and Better Access to Care
A significant increase in mental illness and behavioral problems among
adolescent African-American males demonstrates the need for new
approaches to treatment and better understanding of the complex
challenges facing these youths, according to a policy paper issued by
Community Voices: Healthcare for the Underserved, an advocacy group
based at Morehouse School of Medicine.
The paper, titled "The Secret Epidemic: Exploring the Mental Health
Crisis Affecting Adolescent African-American Males," outlines data
indicating that mental health problems are rising among members of this
at-risk group, their access to treatment facilities is relatively low
and treatment strategies must be revamped to address the socioeconomic
issues that confront them.
"Our research found that many young black males are treatable, but they
are going undiagnosed because of failures in America's health-care
system," said Dr. Henrie M. Treadwell, Director of Community Voices, a
nonprofit seeking to improve health services and access to health care.
"Our entire society feels the impact of this failure. Suicides and
homicides have increased for this group, and the residual effect is
impacting communities across the country. This problem must be
Dr. Claire Xanthos, a health services research specialist, wrote the
paper, which cites studies showing that black males ages 15-19 die from
homicide at 46 times the rate of their white counterparts and that from
1980 to 1995, the suicide rate for black adolescents rose from 5.6 to
13 per 100,000 of the population.
Xanthos writes that "these figures should not be surprising since
adolescent African-American males in contemporary American society face
major challenges to their psychological development and well-being. In
addition to dealing with the physical, mental and emotional issues
typically experienced during adolescence, adolescent African-American
males are confronted with unique social and environmental stressors.
They must frequently cope with racism and its associated stressors,
including family stressors, educational stressors, and urban
Moreover, the paper notes that:
-- Racism can affect mental health by reducing socioeconomic status,
diminishing access to desirable resources and contributing to poor
-- When positive adult male role models are absent, many black youths
turn to their peers for help in forming a male identity, an adaptation
that often means absorbing negative influences.
-- Urban stress is an important factor in the psychological development
of young black males because many live in deprived and dangerous
neighborhoods where they are exposed to violence.
-- Significant problems are also encountered by black males who grow up
in predominantly white, middle-class communities where they feel
distanced from the white youths and also from blacks from poorer
Citing these problems, the paper makes a plea for better access to
mental health treatment for young black males, noting that they
currently often confront a "confusing maze" when trying to get help.
The paper notes that when young black youths do find treatment,
depression is often overlooked because their symptoms often differ from
white youths'. For cultural and social reasons, black youths often
express suicidal feelings through somatic complaints rather than
sadness or depression.
Moreover, the paper calls for more "bicultural" training for young
black males. Such training would better prepare them to follow proper
behavior in school and the workplace, while also working with young
black males to get them ready to deal with the discrimination they are
likely to face. Also cited is the need for a significant increase in
the number of black therapists available to work with African-American
Dr. Treadwell said it is essential that new policies be implemented to
address the social and environmental factors that create poor mental
health outcomes for young black males.
"We must increase the capacity of America's mental health system to
help resolve the problems faced by young black males," she said. "There
must be more research in this area, and more people of color must be
trained and hired to help this at-risk group."
Contact: Alicia Ingram, 404.493.1724
Copyright 2008 PR Newswire
Fair Use standard
31, 2008 - News
of the Week
A NEW BOGUS STATISTIC ON HOMICIDE ?
The number of homicides committed by people with unmedicated
schizophrenia, severe depression, and bipolar disorders is not known.
Unfortunately, this lack of data hasn't stopped the Treatment Advocacy
Center in Arlington VA (Psychlaws.org) from creating its own version of
the non-existing information.
If a quote from a recent interview with Dr. E. Fuller Torrey in World
Magazine is accurate, Psychlaws' annual estimate for homicide by
mentally ill persons has unaccountably doubled from 5% to 10% of the
nation's total. Rational estimates, meanwhile, place the rate close to
that for homicide by the general population.
In the past, the Torrey team has re-interpreted research done by others
to support its crusade for compulsory psychotropic medication. Their
most reliable source of data concerning homicide is a Department of
Justice (DOJ) report, Murder in Families, done in 1994 using data from
1988 (twenty years ago!). The report was based on prosecutors' reports
from 33 large urban counties during a decade of crack cocaine-related
violence and high homicide rates. The DOJ found that 64.4 percent of
homicides were committed by people using alcohol at the time of the
murder, 35.5 percent were committed by people who were unemployed, 1.6
percent by people who were homeless, and 4.3 percent by people with
histories of mental illnesses. The mental illnesses were not described
-- that is, the diagnoses were unknown, severity was unknown, and
treatment status was unknown.
In the early 1990's, more than a decade after the Justice Department
report, Dr. Torrey applied the DOJ's 4.3 percent homicide rate to a
very different group of individuals. Although the Justice Department
had studied urban dwellers with unspecified histories of mental
illnesses, Torrey applied the DOJ rate (after rounding 4.3 to 5
percent) to people with schizophrenia, severe depression, and bipolar
disorders whom he labeled unmedicated. Such statistical manipulation is
unethical at best.
A more recent analysis of violence (CATIE project, NIMH 2006) found
serious violence among people with schizophrenia to be only slightly
higher than the general population without psychiatric disorder (3.6
percent compared with 2 percent). Since only 1 percent of the
population has schizophrenia, their homicide numbers, if scientifically
analyzed, would be a tiny blip on the charts.
If Dr. Torrey has bumped the 4.3 percent to 10 percent, when can we
expect 20 percent?
Excerpts from a letter to World Magazine from Jean Arnold, August 25,
RE: "OUR INSANE MENTAL HEALTH SYSTEM," World Magazine, August 23, 2008
Your recent column in World Magazine captured very well Dr. E. Fuller
Torrey's strong views on the mental health system. I suggest, however,
that the article needed input from people who have lived behind the
system's locked doors.
I too have followed for over two decades Torrey's criticism of
America's non-system of mental health treatment. I first met Dr. Torrey
in New York in the early 1980's. He was criss-crossing the country
urging families of mentally ill individuals to fight for the community
services that were promised, but never delivered, by the proponents of
deinstitutionalization. Dr. Torrey admonished the families to "Make it
happen!" because no one else would. In 1986, he exhorted a NAMI
conference audience to fight for community services, research funds,
and regular inspections at state hospitals and psychiatric outpatient
clinics. He urged them to learn about state budgets and about who is
served and who is not. In closing, he told them to advocate for passage
in every state for a bill of rights that guaranteed minimum standards
of care. But despite Dr. Torrey's vigorous efforts, he could not bring
about the miracle needed to reverse the failure of
By the early 1990's, Torrey was disappointed if not embittered by the
snail-like pace of change. Joined by D.J. Jaffe, an advertising
executive, Torrey reached beyond the family movement to create with
Jaffe the Treatment Advocacy Center in Arlington, VA. Their strategy to
bring about change, described by Mr. Jaffe in a candid speech to NAMI
in 1999, was to fan the public's fear of violence and enlist support
from the law enforcement sector. This decision to "capitalize on fear"
(Jaffe's words) produced the swift enactment of a compulsory treatment
law in New York in 1999 (Kendra's Law). Ironically, the mentally ill
assailant who triggered the law's passage was sentenced to prison
despite a state investigation's findings that he had tried, repeatedly,
to obtain the psychiatric treatment he knew he needed.
Since 1999, the Treatment Advocacy Center's fear-based crusade to
further extend compulsory medication has met a number of setbacks. The
quick and easy passage of Kendra's Law surprised even its proponents,
but this success has not been repeated. Although 47 states have laws
allowing psychiatric outpatient commitment, the severe shortage of
community resources and programs, both voluntary and involuntary,
renders the laws unworkable. Medication alone is a false solution,
experts say, considering the problems it can cause. Dosage must be
closely monitored and the patient needs a safe place to live with
access to pre-crisis help and other supportive programs to meet special
needs such as substance abuse problems.
Although Dr. Torrey has railed for decades against civil rights
activists as the source of the system's problems, he surely knows that
the national economy, political priorities, and prejudice, are the real
roadblocks to mental health reform. He seems unaware that his
relentless emphasis on violence contributes to the public's reticence
to fund resources, a finding confirmed by researchers Corrigan et al
(Psychiatric Services, May 2004).
Judging from the responses your article received on the Free Republic
website, there is little compassionate caring among its readers. But I
wonder, if you had interviewed someone less committed to fear
mongering, might these same responders have reacted differently?
Jean Arnold, Co-founder and Chair
National Stigma Clearinghouse
It is not unusual for the Treatment Advocacy Center's statistics to be
inaccurate or misleading.
Its website posts a large number of summarized studies on violence. All
are intended to support a contention that people with psychiatric
disabilities constitute a public safety hazard. But their summaries of
research done by others may or may not be accurate. For example, one
summary claims the researchers found 19 out of 20 subway pushers in New
York to be psychotic. In fact, the researchers (Martell and Deitz, Arch
Gen Psych June 1992) studied only the psychotic assailants. Say again?
The researchers found 49 pushing incidents spanning 17 years, but
studied only those cases that involved a psychotic assailant.
The World Magazine interview quotes Torrey's use of a new
unsubstantiated homicide statistic. This is not surprising since
Torrey's earlier estimate (5%) was also unsubstantiated. Whether he
inadvertently mis-spoke or thinks 10% sounds better than 5%, neither
figure is supported by fact
10, 2008 - News
of the Week
MEXICO COURT RULES OUTPATIENT COMPULSORY
MEDICATION LAW UNENFORCEABLE
City Will Keep
Fighting for Mental Health Law
By Scott Sandlin And Dan McKay Albuquerque
Journal August 7, 2008
Albuquerque officials reacted quickly this week after a second court
struck down the city's Kendra's Law clone, which would have required
forced medication of some people with mental illnesses.
Mayor Martin Chavez said he would pursue remedies in both the state
Supreme Court and the Legislature after the New Mexico Court of Appeals
ruled that the city's Assisted Outpatient Treatment ordinance was
preempted by a raft of state mental health laws, both civil and
"We'll keep fighting," Chavez said Wednesday.
Mental health and civil rights advocates, meanwhile, said the focus
should be on fixing a broken and wholly inadequate mental health
service system. They, too, will be back at the Legislature with
Mental health advocates said existing law has mechanisms for getting a
substitute decision-maker appointed when a person is incapacitated.
Despite "fearmongering" by its backers, the city ordinance would not
have prevented tragic circumstances in which people have died, said
Nancy Koenigsberg, a staff attorney at Protection and Advocacy. The
organization was created to protect the rights of people with mental
In both New York, where Kendra's Law was enacted, and in New Mexico,
people with mental illness were trying to access care in the system and
couldn't get it, she said.
"Even the ordinance that was struck (down) acknowledged that for any
kind of treatment to achieve its goal, it must be linked to a system of
comprehensive care in which state and local authorities work together
to ensure outpatients receive case management or special services.
That's great. We agree with that. And it doesn't exist," she said.
The state Medicaid program has cut back case management services, and
other providers of outpatient mental health services have cut them back
or eliminated them altogether, Koenigsberg said.
"You're talking about a person with a chronic illness who needs help to
get to appointments or address barriers to work getting to an aid
program — and they are few and far between," she said.
Chavez argues the city ordinance is necessary to keep from putting
"innocents at risk." In 2005, a mentally ill man was accused in the
killing of two police officers and three other people.
Asked about criticism that not enough mental-health services are
available, Chavez said opponents can "say that to the widows of the
police officers" and their families.
The ordinance was crafted carefully and applies to "just a narrow slice
of people," Chavez said.
He described opponents as merely a small, vocal group.
Andrew Penn, a senior staff attorney at the Bazelon Center for Mental
Health Law in Washington, D.C., praised the appeals court decision by
Chief Judge Jonathan Sutin for "confirm(ing) the right of an individual
to make his or her own mental health treatment decisions. That is
something we find so important in terms of individual rights and
He said studies have shown that forced treatment doesn't work.
"I don't think the solution in keeping people safe lies in forced
commitment. It lies in more effective community services," he said.
Peter Simonson, director of the ACLU of New Mexico, said the city
ordinance was "overreaching," targeting an overly broad group.
"The city wants to be able to medicate people who refused to consent to
psychotropic drugs, while the Legislature carefully preserved the right
of a person to refuse (treatment). We're talking about drugs that can
have a long-term, permanent effect on your neurological system and can
be very damaging," he said.
Had the law withstood the challenge, there conceivably could have been
a situation where someone forced to accept medication couldn't have
paid for it — and had to be incarcerated, Simonson said.
"The backdrop for this whole thing is a broken system. Not only did the
city law ignore that, but it also penalized a person for being at its
mercy," he said.
Koenigsberg said a newly formed network of mental health advocacy
groups worked to create proactive legislation, including two companion
bills introduced in the last legislative session by Rep. Nathan Cote,
D-Las Cruces. One would have created safe houses for people who need
behavioral health support but not hospitalization. Another would have
recruited and trained quick-response teams statewide for people
experiencing urgent behavioral health needs.
They'll be back with the proposals again.
"I know there will be other things brought forward before the
Legislature again — and that's where it belongs. It is a
statewide issue. ... It shouldn't be in the courts," Koenigsberg said.
Chavez had pushed for a statewide version of the law before Albuquerque
enacted its own. He said the city will continue lobbying for such a law
while pursuing its options for appeal.
Chavez, a lawyer himself, said the city's legal team believes there's a
good chance of success if the city continues litigation.
"I really expected to do better in the Court of Appeals," he said.
Most states already have a version of Kendra's law, Chavez said,
calling the recent court decision "troubling."
Fair Use standard
LAW UPDATES, 2006-Current
August 4, 2008 - News
of the Week
NEW YORK CREATION MAKES NATIONAL NEWS
No More: The Pathways To
By Jay Neugeboren
August 3, 2008
This past week, the Bush administration reported a most welcome 30
percent drop in the number of chronically homeless people living in the
nation's streets and shelters. According to a front page article in The
New York Times, it attributed "much of the decline to the 'housing
first' strategy that has been promoted by the Bush administration and
Congress, and increasingly adopted across the country."
What neither the Times nor the Bush administration reported is that the
"housing first" strategy being adopted was originated, informed, and
guided by a New York City based organization, Pathways to Housing,
which pioneered this approach 15 years ago, and has been successfully
implementing it ever since. The Bush administration has relied heavily
on Pathways, whose program, until 4 years ago, was the only "housing
first" program in the nation.
By taking those homeless people that cities traditionally do not deem
"housing ready"--they are still using drugs, they are not taking their
meds, et cetera--and by giving them their own apartments, and then
wrapping social, psychological, and medical services around them,
Pathways has proven more successful at stably housing these people than
the city has at housing those it deems "housing ready."
88 percent of Pathways' clients have remained stably housed for two or
more years, while the city's housing retention rate for similar periods
is below 50 percent. Add to this the fact that all the people Pathways
finds housing for have, or have had, along with homelessness,
co-occuring conditions of mental illness, and one can only marvel at,
and be humble before, the program's mission, and its successes.
And one reason for its success, according to its director, Sam
Tsemberis, is that the program is "client driven"--i.e., Pathways takes
its cues from the expressed needs and desires of the homeless people it
serves. (Cf. William Osler's advice to his fellow physicians at Johns
Hopkins: "If you listen to the patient, the patient will give you the
When, during its first dozen years, communities inquired about the
Pathways "housing first" program, resistance was widespread. How can
you let those people into housing if they've been drug users, or are
still using drugs--or if they're schizophrenic? What if they stop
taking their meds? The answer, according to Dr. Tsemberis, is that
Pathways serves clients because they fall off the wagon.
"That's what addiction means. We anticipate that people will
relapse--it's part of the recovery process, and the advantage of this
harm-reduction approach is that people are not evicted and homeless
again simply because they've relapsed. They remain housed, and so can
continue to work on curing their addiction or improving their mental
health. What we do, that is, is to separate housing from
treatment--thus, if you relapse, you're still housed. There's treatment
for addiction and for mental illness--and there's housing for
That the Pathways "housing first" model is also less costly than
shelters or traditional supportive housing models has now made it
attractive to the Bush administration, and to many communities.
The Pathways model, however, is based not on economics, or on ridding
the streets of "undesireables," but on the belief that housing is not
something that must be "earned" by "good behavior," but is a
fundamental right. For how can anyone have a decent life without first
having a home?
- End of
using Fair Use standard
21, 2008 - News
of the Week
E. Fuller Torrey is no ordinary psychiatrist. His success at attracting
publicity is legendary. His questionable statistics are accepted by the
media. His made-up statistic concerning 1,000 annual homicides commited
by people with untreated mental illnesses made the Congressional
Record. The National Stigma Clearinghouse file is thick with Torreyisms
that have appeared in the national media and elsewhere.
Most recently, a muddled Torrey statement charged that "as our readers
are well aware, changes in state commitment laws have made it
impossible to treat nearly half of discharged patients after they have
left the hospital." (see Link below) Torrey's seeming amnesia about his
activities over the past 15 years is disconcerting. In 1993, his
newly-created Treatment Advocacy Center (Psychlaws.org) launched a
fearmongering crusade to make outpatient commitment easier nationwide.
Now, nearly every state has a law that permits involuntary outpatient
commitment to psychiatric treatment. The catch: There are far too few
resources to treat involuntary or voluntary patients.
Psychlaws' strategic use of fear to gain public support may have
backfired. Their dire warnings and an obsessive focus on violence may
have had an unintended consequence. A study by Corrigan et al
(Psychiatric Services, May, 2004) found that such tactics produce a
negative effect on public attitudes and less willingness to provide
resources. The system backup we now see -- hospitals overcrowded with
patients ready for discharge with nowhere to go, and long waiting lists
for community housing and programs -- could be fallout from Torrey's
successful campaign to change the laws.
Torrey has spent fifteen years crusading for an untested concept that
over-relies on medication alone. Meanwhile his charismatic domination
of the mental health scene has slowed progress toward more viable
solutions. The good news: Although Torrey denigrates all who disagree
with him -- actually denying the citizenship of
consumers/survivors/ex-patients in the subtitle of his latest book --
his dismissive behavior may have fueled the burgeoning
consumer/survivor movement. The first-hand experience of this group has
become a boon to the mental health community.
Go to www.miwatch.org
for a Book
Review by Sue E. Estroff of Dr. Torrey's latest book
Offense: How America Fails the
Seriously Mentally Ill and Endangers Its Citizens, and What We Must Do
to Stop It
Go to www.psychlaws.org
announcement of Dr. Torrey's book. Top of home page, click Read More
29, 2008 - News
of the Week
CHECK OUT THIS
VALUABLE INTERNET RESOURCE !
A NATIONAL DIRECTORY OF CONSUMER-DRIVEN SERVICES IS ON THE WEB
ALL PEER PROGRAMS ARE INVITED TO JOIN THE LIST
A big boost for consumer/survivor initiatives is an online national
directory of programs and services run by and for people with
psychiatric vulnerabilities. The directory not only guides users to
hard-to-find resources; it is a unique, growing body of information
useful to the mental health community.
These programs, sometimes called peer support programs, not only reduce
hospital stays and emergency visits but improve people's health
outcomes and support their recovery, according to a Canadian study
released in 2005 (see below).
The Directory is an ongoing project created by the National Mental
Health Consumers' Self-Help Clearinghouse, a national consumer
technical assistance center funded by the federal Substance Abuse and
Mental Health Services Administration (SAMHSA).
The Directory's creators have assembled an impressive catalog of peer
support programs from pioneers in the field. This valuable catalog will
inspire more programs and help groups to choose among a wide array of
tested models. As a unique body of information, the Directory offers
limitless opportunities for networking, problem-solving, and research.
Consumer-driven programs (CDS) vary greatly in size and design but
share a vision of consumer participation in all aspects of life,
including meaningful employment, education, and relationships with
friends and family. They may be found in a range of settings from large
mental health service agencies to grassroots volunteer efforts.
The purpose of the Directory is to provide consumers, social scientists
and service-providers with essential resources, including background
materials, contact information, pertinent research findings and
discussion by leaders in the field.
VISIT THE WEBSITE
Visitors to the Directory can search by name, locality, or program type
to find up-to-date information on consumer-driven programs around the
DIRECTORY, CHOOSE CONTACT/APPLY
Any and all consumer/survivor initiative programs in the United States
are invited to apply for inclusion in the Consumer-Driven Services
Article: Canadian study finds
supports for and by people with
mental illnesses are key to recovery
Source: Joint press release, July 28, 2005
Candian Agencies for Mental Health and Addiction Programs
TORONTO, July 28 /CNW/
A report released today shows that consumer/survivor initiatives (CSIs)
play a critical role in promoting recovery for people with mental
illness, but have been historically undervalued.
"Consumer/Survivor Initiatives: Impact, Outcomes and Effectiveness,"
has gathered research which demonstrates CSIs are vital to the mental
health care system; they improve people's health outcomes and support
recovery, as well reducing the use of hospital, emergency and other
expensive services. The evidence the report offers is clear:
demonstrates that the mean number of days
in hospital for the participants dropped from 48.36 to 4.29 after
becoming involved with a CSI.
showed that CSIs saved more than $12
million in reduced hospital stays for three hospitals over the course
of one year.
mental health problems who described
themselves as "lonely" and were partnered with a peer mentor used an
average of $20,300 less per person in hospital and emergency room
services in the year after discharge.
"The provincial government has identified that people need to be
involved in their health care," said David Kelly, Executive Director of
the Ontario Federation of Community Mental Health and Addiction
Programs (OFCMHAP), one of the organizations which developed the
report. "CSIs have been at the forefront of this area for many years."
Shawn Lauzon of the Ontario Peer Development Initiative (OPDI), a
provincial association of CSIs and a partner in the report's
development, said "This report is the first to make the case so
clearly; CSIs are good for people with mental illness, and they're good
for the health care system as a whole."
"Despite the money they save the health care system, CSIs have received
no new investments for many years," noted Karen McGrath, CEO of the
Canadian Mental Health Association (CMHA), Ontario, another of the
report's partners. "The provincial government's goal of moving care
into the community means that increasing support to CSIs is a logical
Paul Garfinkel, CEO of the Centre for Addiction and Mental Health, adds
"We know from our own experience here at CAMH that consumer-run
businesses, training programs, peer support groups are enormously
valuable in developing skills, building social relationships, and
promoting independence. They are making a tremendous difference here at
CAMH. The trouble is there aren't enough of them."
CSIs are run for and by people with mental health problems, or who have
received mental health services. CSIs take many forms, including
employment and training programs, peer support, advocacy, and Patient
Councils at both general and psychiatric hospitals. They support people
in transition from hospital to community and help people with mental
illness take control of their lives and recovery.
The report was developed in partnership with the Centre for Addiction
and Mental Health, the OPDI, CMHA, Ontario and OFCMHAP. The full report
can be found at each organization's web site, including http://www.ofcmhap.on.ca.
For further information: contact: David Kelly, OFCMHAP, (416) 490-8900
ext. 22, (416) 822-0712; Shawn Lauzon, OPDI, (416) 484-8785 ext. 238;
Liz Scanlon, CMHA, Ontario, (416) 977-5580 ext. 4131; Media Relations,
CAMH, (416) 595-6015
Ontario Federation of Mental Health and Addiction Programs
22, 2008 -
of the Week
VICTORY FOR FEARMONGERING IN WALL STREET
Has E. Fuller Torrey's reputation as a maverick psychiatrist dimmed his
appeal as a newsworthy author? Apparently not. Last week, the Wall
Street Journal (6/13/2008) plugged Dr. Torrey's upcoming book by
publishing its preface. Judging from the inflammatory title, "The
Insanity Offense: How America's Failure to Treat the Seriously Mentally
Ill Endangers Its Citizens" and the WSJ excerpt, the book is calculated
to fan the public's fear of people diagnosed with psychiatric
Torrey laces his preface with homicides, a fear-mongering strategy that
has been the trademark of his crusade for more psychiatric hospital
beds and stronger civil commitment laws. For nearly twenty years,
Torrey has played the violence card to frighten the public into
supporting his coerced medication and increased hospitalization agenda.
Torrey's strategic use of fear has been explained by D. J. Jaffe, who
joined forces with Dr. Torrey in 2003.. That
year, in a policy statement widely-circulated by Jaffe, he wrote, "From
a marketing perspective, it may be necessary to capitalize on the fear
of violence to get the [involuntary outpatient commitment] law passed."
A few years later the two men co-founded the Treatment Advocacy
Center in Arlington, VA with funds from the Stanley Foundation.
Even Jaffe's clear statement of intent, however, did not prepare
advocates for Torrey's near-obsessive focus on homicide. Those of us
who have worked for years for balanced and accurate representation of
mental illnesses are incensed that Torrey uses his considerable media
access to dwell only on homicide stories (some of them 30 years old),
violence, and his proposed coercive laws. Further, he has closed his
mind against successful violence prevention alternatives such as
"Housing First" and denigrates anyone who disagrees.
The WSJ excerpt shows, once again, how Torrey fixates on homicide in
his messages to the public. When he refers to his 10-years-and-growing
database of "preventable tragedies," he unfortunately gives the false
impression that the 3,000 tragedies in the file are all homicides. In
fact, the database of "preventable tragedies" sorts Torrey's 10-year
collection of summarized news clippings into 11 categories of violent
Overall, Torrey's data on preventable tragedies holds some surprises.
For example, although the American public commits over 16,000 homicides
annually, only 184 per year (averaged over 10 years) are recorded for
Americans diagnosed with mental illnesses.
We can expect Torrey's new book to call for more coercion and
commitment. Ironically, the "preventable tragedies" show that a broad
set of variables lead to tragedy -- among them are a lack of essential
programs, the little recognized pitfalls of medication, and
dysfunctional social conditions that are unrelated to psychosis and
unresponsive to antipsychotic medication.
A trip through the tragedies is bound to make readers question the
simplistic solutions Torrey has adamantly promoted since 1990.
Psychlaws.org/Treatment Advocacy Center
Book Excerpt by E.F. Torrey
Wall Street Journal, June 13, 2008
Charlottesville Prejudice and Civil Rights Watch
4, 2008 - News
of the Week
HOME RESIDENTS MAKE HOMEGROWN VIDEOS
CIAD Takes Media to Heart
New York NonProfit Press June 3, 2008
article & tech tips below)
Media is no sideshow for the Coalition of Institutionalized Aged and
Disabled (CIAD), a consumer-led advocacy organization of adult home and
nursing home residents. Unlike some groups where
projects and video productions seem somehow disconnected from their
day-to-day work, CIAD has incorporated its Media
Team into each
of its core activities.
Advocacy! Organizing! Empowerment! CIAD now uses media to
strategically enhance and extend its efforts in each of these
In some cases, the payoff is easy to see. Dying
for Air, a
nine-minute video in which adult home residents spoke about their
suffering without air conditioning during that summer's heat wave was a
component in CIAD's advocacy campaign – a campaign which
ultimately win back-to-back State budget allocations of $2 million each
in FY 2007 and FY 2008.
In other instances, the value of media can be found in new and improved
ways of reaching out to adult home residents themselves and in the
empowerment which resident organizers find through the production of
advocacy and training videos.
The Media Team
The CIAD Media Team was launched back in 2004 when Jennifer Stearns, a
former video editor with NBC began working with the organization as
part of her Masters' Thesis in Health Policy. Its first
production – Adult Home Residents Speak Out – was a
minute video filmed at that year's "Speak Out", CIAD's annual rally and
lobby day in Albany NY. The video captured the excitement and
passion of adult home residents at the Speak Out and is now used by
CIAD organizers to encourage residents to attend the annual events.
In the years since, the Media Team has evolved into an integral part of
CIAD's Policy Committee, a dozen-or-so adult home resident leaders who
work alongside CIAD staff organizers to determine policy priorities and
organizing strategies. The Policy Committee guides the Media
project by deciding what to videotape, participates in production and
handles all on-camera roles, including on-site or in-studio reporting,
narrating and conducing of interviews.
"Using media has tremendous value for all groups doing advocacy and
organizing," says Stearns, who joined CIAD's staff on a part time basis
in 2005 and is now Director of the Media Team. Technological
changes have now made this advocacy tool accessible and affordable for
groups of almost any size. "This is so exciting," she says.
I was young I did a lot of work organizing against the war.
we couldn't use media. You couldn't touch it. You needed a
fund to do a documentary."
CIAD has received support for its media activities from two primary
sources. Manhattan Neighborhood Network's Community Media Department
provided an initial $10,250 Training Grant in 2007 and a Community
Media Grant in 2008. New York Community Trust awarded a
grant for the Media Team in 2007.
Advocacy is probably the first thing people think of when contemplating
the role of media for nonprofits. And, at CIAD, the Media
productions have been a valuable component of the organization's
overall, multi-faceted advocacy strategy.
the team's second production was a
short two-minute video about residents' need for a clothing
allowance. Media Team members Alex Kulakis and Robin
filmed the feet of residents at three adult homes as they described
problems with their shoes – the only shoes they could afford
given the lack of a clothing allowance. "My shoes are used
shoes," says one resident. "A girl sold them to me for one dollar. The
bottom is ripped." "I have a big hole in my shoe," says
"They are all turned over, I can hardly walk."
"It is a brilliant and beautiful piece," says CIAD Executive Director
Dying for Air
was filmed at a community meeting
held by CIAD in August of 2005. "It was just a series of
standing at a podium talking about how they were suffering, how they
couldn't sleep, how it was 100 degrees in their room and they were
afraid their friends were going to die during the night," says
Stearns. "Then it showed an adult home where there was only
window air conditioner in the whole building and that was the
administrator's office. It was pretty powerful." In
addition to conveying the pain of adult home residents, it also
captured the reactions of several State legislators who were at the
community meeting to hear them speak.
In September 2005, CIAD staff organizer Noor Alam showed Dying for Air
video at an Albany meeting that included Kelly Hansen, Director of the
Adult Home Quality Initiative, David Wolner of the Governor's office,
and other state government officials. "Alam reported that the
video clearly made an impression on those present," says Stearns.
Who Was That
CIAD also used video in its efforts to collaborate with the NYS
Department of Health which sends inspectors into individual adult
homes. "Using residents to help train DOH inspectors was
something we had done with our nursing home constituency years ago,"
says Lieberman. In 2006, when DOH invited CIAD to lead a
sensitivity training workshop at its annual statewide conference, CIAD
produced Who Was That Guy?,
a 15-minute video capturing adult
home residents' misconceptions about the DOH adult home inspection
process. Residents rarely knew who the inspectors were or why
they were there. Some even thought the DOH officials were
to inspect them, rather than the safety and quality of the adult home
itself. "Typically, we would have just gone to the conference
with some residents and given a traditional panel discussion," says
Lieberman. "Instead, we were able to show this ten-minute
"It sparked a lively give and take between inspectors and residents,"
"It was a little bit provocative and it lead to some good things,"
agrees Lieberman. In 2007, DOH responded to the concerns expressed in
the video by collaborating with CIAD on an informational pamphlet, When
Your Home is Inspected, which
all adult homes are now required to
hand out to residents.
However, CIAD has looked beyond the obvious power of media as an
advocacy tool and tapped into its significant value for organizing and
educating adult home residents themselves.
"One of our jobs as organizers is to go into the homes and educate
people about their rights," says Stearns. "We are doing a series of
residents' rights videos." One covers the pressures which
resident's feel when they first move into an adult home and sign an
"When you move into an adult home you have to sign a lot of papers,"
says Gary Levin, a former adult home resident and now an organizer with
CIAD. "They don't go into a lot of detail. The one thing they drum into
your head over and over again is that you need to give us control over
The video uses a variety of techniques to tell its story and make its
There are brief interviews with adult home residents. "When I
moved in it was really a rush, rush job," Dorothea Harle tells the
interviewer on camera. Harle is a resident of Madison York
Home in Queens and a current member of the CIAD Media Team.
There is a recreation of an admissions interview played out using
puppets. "Welcome to Paradise Manor," one puppet resident tells
another. "It doesn't look like paradise to me," responds the
puppet on the block before sitting down to meet the adult home
And, there is advice from a staff attorney with MFY Legal Services
which provides legal representation for adult home residents throughout
New York City. "Before you sign an admission agreement you
right to look it over," she advises the viewer. "You have a
of rights when you first move in."
In addition to admissions agreements, the Residents' Rights series of
videos cover such topics as the personal needs allowance, how to get
control of your own money, and the rights of residents to make their
own choices regarding treatment programs.
CIAD uses the Residents' Rights videos at Speak Outs and to get
information out to residents at individual adult homes. "We
the tapes and show them at Residents' Council meetings," says Stearns,
who uses a light weight carrier to transport a portable projector.
"Some residents have taken the DVDs into the home and played them on
the TV set in the lobby or a resident may have a TV with a DVD player
and will invite people into their room to watch it," says Levin.
The value of video as an organizing and education tool is further
enhanced by the fact that many adult home residents, a significant
portion of whom may have disabilities of various types, often are more
attuned to learning visually rather than through written
For 2008/2009, the Media Team is planning three more videos for the
series -- Your Resident Council, Your Right to Tenancy and Your Right
to Privacy, Dignity and Respect.
"For organizations like ours -- empowerment groups -- looking to give
people voice, the Media Team does that in as concrete a fashion as you
possibly can," says Lieberman. "The process is as important
– in some ways more important –than the product."
"It is all leadership development," says Stearns. "We used the power of
having a microphone to empower our resident council leaders.
the time you have spoken on mike about air conditioning or some other
issue three or four times, you have become very articulate.
you are much more likely to stand up at a meeting and say the same
things. Plus, you have been exposed to the ideas of 10 other
residents talking about air conditioning in their home. That
why it is a really good organizing tool. Even if you never
a video, just the process of doing it is very effective."
"I get a heck of a lot of fun out of doing it -- as well as learning a
lot," says Harle.
The production and sharing of videos has also been a way to build and
strengthen CIAD's network of resident council leaders. "One
the problems of adult homes is that they are very isolated," says
Stearns. "They often are located in fringe neighborhoods and most
residents don't even have phones. We wanted to get them
to share experiences and talk about their own
way to do that is peer-to-peer interviews." The Media Team
create opportunities for one resident council leader to interview
another on camera – How do you run your resident
What works for you? Then, they switch roles.
An Act of
For the adult home residents of CIAD, participating in the Media Team
has been exciting and empowering. It has also been dangerous.
operate in a very hostile environment," says Stearns. "These homes are
privately owned. For us to videotape on the premises is not
trespassing, it is invasion of privacy. You have no idea how
vulnerable they are and what kind of pressure they are
under." Adult home operators typically control a
living space, money and the programs they attend. "Many adult
home residents have mental health diagnoses," says Stearns, "which
means anyone can say they were acting out, being aggressive and need to
be hospitalized. Adult home operators can pick up the phone,
an ambulance or the police, and have them carted off."
The Team's use of puppets was one way to capture the experience of life
in adult homes without actually shooting there. Similarly,
filming of resident's feet alone – without faces –
Blues was a way to collect resident comments without placing them at
risk. Nevertheless, Media Team members voluntarily step up to
conduct interviews, participate in panel discussions and tell the world
about life in adult homes.
"These videos are a tribute to the courage of the residents you see on
camera," says Stearns.
May 11, 2008 - News
of the Week
ADVOCATES BRING FIRST-HAND EXPERIENCE TO
MENTAL HEALTH DISCUSSION
ENLIGHTENING TREND REPORTED BY NEW YORK TIMES
Article: NEW YORK TIMES - May 11, 2008
Fashion & Style Section
Pride" Fights a Stigma
By GABRIELLE GLASER
In the YouTube video, Liz Spikol is smiling and animated, the light
glinting off her large hoop earrings. Deadpan, she holds up a diaper.
It is not, she explains, a hygienic item for a giantess, but rather a
prop to illustrate how much control people lose when they undergo
electroconvulsive therapy, or ECT, as she did 12 years ago.
In other videos and blog postings, Ms. Spikol, a 39-year-old writer in
Philadelphia who has bipolar disorder, describes a period of psychosis
so severe she jumped out of her mother's car and ran away like a scared
In lectures across the country, Elyn Saks, a law professor and
associate dean at the University of Southern California, recounts the
florid visions she has experienced during her lifelong battle with
schizophrenia -- dancing ashtrays, houses that spoke to her -- and
hospitalizations where she was strapped down with leather restraints
and force-fed medications.
Like many Americans who have severe forms of mental illness such as
schizophrenia and bipolar disorder, Ms. Saks and Ms. Spikol are
speaking candidly and publicly about their demons. Their frank talk is
part of a conversation about mental illness (or as some prefer to put
it, "extreme mental states") that stretches from college campuses to
community health centers, from YouTube to online forums.
"Until now, the acceptance of mental illness has pretty much stopped at
depression," said Charles Barber, a lecturer in psychiatry at the Yale
School of Medicine. "But a newer generation, fueled by the Internet and
other sophisticated delivery systems, is saying, 'We deserve to be
heard, too.' "
About 5.7 million Americans over 18 have bipolar disorder, which is
classified as a mood disorder, according to the National Institute of
Mental Health. Another 2.4 million have schizophrenia, which is
considered a thought disorder. The small slice of this disparate
population who have chosen to share their experiences with the public
liken their efforts to those of the gay-rights and similar movements of
a generation ago.
Just as gay-rights activists reclaimed the word queer as a badge of
honor rather than a slur, these advocates proudly call themselves mad;
they say their conditions do not preclude them from productive lives.
Mad pride events, organized by loosely connected groups in at least
seven countries including Australia, South Africa and the United
States, draw thousands of participants, said David W. Oaks, the
director of MindFreedom International, a nonprofit group in Eugene,
Ore., that tracks the events and says it has 10,000 members.
Recent mad pride activities include a Mad Pride Cabaret in Vancouver,
British Columbia; a Mad Pride March in Accra, Ghana; and a Bonkersfest
in London that drew 3,000 participants. (A follow-up Bonkersfest is
planned next month at the site of the original Bedlam asylum.)
Members of the mad pride movement do not always agree on their aims and
intentions. For some, the objective is to continue the destigmatization
of mental illness. A vocal, controversial wing rejects the need to
treat mental afflictions with psychotropic drugs and seeks alternatives
to the shifting, often inconsistent care offered by the medical
establishment. Many members of the movement say they are publicly
discussing their own struggles to help those with similar conditions
and to inform the general public.
"It used to be you were labeled with your diagnosis and that was it;
you were marginalized," said Molly Sprengelmeyer, an organizer for the
Asheville Radical Mental Health Collective, a mad pride group in North
Carolina. "If people found out, it was a death sentence, professionally
She added, "We are hoping to change all that by talking."
The confessional mood encouraged by memoirs and blogs, as well as the
self-help advocacy movement in mental health, have deepened the
understanding of bipolar disorder and schizophrenia. Books such as Kay
Redfield Jamison's autobiography, "An Unquiet Mind: A Memoir of Moods
and Madness," have raised awareness of bipolar disorder, and movies
like "Shine" and "A Beautiful Mind" have opened discussion on
schizophrenia and related illnesses. In recent years, groups have
started antistigma campaigns, and even the federal government embraces
the message, with an ad campaign aimed at young adults to encourage
them to support friends with mental illness.
Members of MindFreedom International, which Mr. Oaks founded in the
1980s, have protested drug companies and participated in hunger strikes
to demand proof that drugs can manage chemical imbalances in the brain.
Mr. Oaks, who was found to be schizophrenic and manic- depressive while
an undergraduate at Harvard, says he maintains his mental health with
exercise, diet, peer counseling and wilderness trips -- strategies that
are well outside the mainstream thinking of psychiatrists and many
Other support groups include the Mad Tea Party in Chicago and the
Freedom Center in Northampton, Mass., which provides education,
acupuncture, yoga and peer discussions to about 100 participants.
The Icarus Project, a New York-based online forum and support network,
says it attracts 5,000 unique visitors a month to its Web site, and it
has inspired autonomous local chapters in Portland, Ore., St. Louis and
Richmond, Va. Participants write and distribute publications, stage
community talks, trade strategies for staying well and often share
duties like cooking or shopping. The Icarus Project says its
participants are "navigating the space between brilliance and madness."
It began six years ago, after one of its founders, Sascha Altman
DuBrul, now 33, wrote about his bipolar disorder in The San Francisco
Bay Guardian, a weekly newspaper. Mr. DuBrul, who is known as Sascha
Scatter, received an overwhelming response from readers who had
experienced similar ordeals, but who felt they had no one to discuss
"We wanted to create a new language that resonated with our actual
experiences," Mr. DuBrul said in a telephone interview.
Some Icarus Project members argue that their conditions are not
illnesses, but rather, "dangerous gifts" that require attention, care
and vigilance to contain. "I take drugs to control my superpowers," Mr.
While psychiatrists generally support the mad pride movement's desire
to speak openly, some have cautioned that a "pro choice" attitude
toward medicine can have dire consequences.
"Would you be pro-choice with someone who has another brain disease,
Alzheimer's, who wants to walk outside in the snow without their shoes
and socks?" said Dr. E. Fuller Torrey, executive director of the
Stanley Medical Research Institute in Chevy Chase, Md.
Dr. Torrey, a research psychiatrist who specializes in schizophrenia
and manic depression, said he understood the roots of the movement. "I
suspect that not an insignificant number of people involved have had
very lousy care and are still reacting to having been involuntarily
treated," he said.
Many psychiatrists now recognize that patients' candid discussions of
their experiences can help their recoveries. "Problems are created when
people don't talk to each other," said Dr. Robert W. Buchanan, the
chief of the Outpatient Research Program at the Maryland Psychiatric
Research Center. "It's critical to have an open conversation."
Ms. Spikol writes about her experiences with bipolar disorder in The
Philadelphia Weekly, and posts videos on her blog, the Trouble With
Thousands have watched her joke about her weight gain and loss of
libido, and her giggle-punctuated portrayal of ECT. But another video
shows her face pale and her eyes red-rimmed as she reflects on the dark
period in which she couldn't care for herself, or even shower. "I knew
I was crazy but also sane enough to know that I couldn't make myself
sane," she says in the video.
In a telephone interview, she described one medication that made her
salivate so profusely she needed towels to mop it up. "Of course it's
heartbreaking if you let it be," she said. "But it's also inherently
funny. I'd sit there watching TV and drool so much, it would drip on
Ms. Spikol said she has a kind doctor who treats her with respect, and
she takes her pharmaceutical drugs to stabilize her mood. "I have
asthma, and I use medications to maintain it, too," she said.
Ms. Saks, the U.S.C. professor, who recently published a memoir, "The
Center Cannot Hold: My Journey Through Madness," has come to accept her
illness. She manages her symptoms with a regimen that includes
psychoanalysis and medication. But stigma, she said, is never far away.
She said she waited until she had tenure at U.S.C. before going public
with her experience. When she was hospitalized for cancer some years
ago, she was lavished with flowers. During periods of mental illness,
though, only good friends have reached out to her.
Ms. Saks said she hopes to help others in her position, find tolerance,
especially those with fewer resources. "I have the kind of life that
anybody, mentally ill or not, would want: a good place to live, nice
friends, loved ones," she said.
"For an unlucky person," Ms. Saks said, "I'm very lucky."
Copyright 2008 The New York Times Company
using Fair Use standard
To submit a letter to the editor of the NY Times e-mail to: firstname.lastname@example.org
Contact MindFreedom International:
454 Willamette, Suite 216 - POB 11284
Eugene, OR 97440-3484 USA
Web site: http://www.mindfreedom.org
20, 2008 -
of the Week
PAT DEEGAN TO
DISCUSS RECOVERY-BASED USE OF MEDICATIONS
REGISTER TODAY FOR PAT DEEGAN TRAINING PROGRAM on Wednesday, April
Hear psychologist/advocate/survivor Pat Deegan discuss the
recovery-based, shared decision-making use of psychiatric medications.
To receive handouts prior to webinar, REGISTER NOW.
Webinar Sponsor: USPRA (US Psychiatric Rehabilitation Association,
Price: $129 for USPRA member organizations (colleagues & staff
participate with one registration); $189 regular price.
USPRA PRESS RELEASE
USPRA's April 30th webinar: Shared Decision Making and the Use of
Psychiatric Medication in the Recovery Process is ideal for service
providers who want to work collaboratively with people in recovery
while they decide their own psychotropic treatment.
Join world renowned trainer, advocate and lecturer, Pat Deegan, PhD in
the exploration of shared decision making!
Wednesday, April 30th 3:00- 4:30 pm EDT
details go to
Shared decision making is a person centered clinical method that
empowers clinicians and people in recovery to work collaboratively
while deciding on the next steps in treatment. In this
Pat Deegan will discuss shared decision making as applied to the
She will introduce the concepts of decisional conflict and decision
support, and will explain why decision aids and electronic decision
support systems will become a standard part of recovery-oriented
psychiatric practice in the future.
Finally, Pat will briefly review a peer-run Decision Support Center and
software program that she has created and that is being used in
psychiatric medication clinics in the U.S.
1. Explain why supporting
decisional conflict is a superior approach to insistence on treatment
2. Explain the concept of
personal medicine and
how it interacts with psychiatric medicine in the recovery process.
3. List three ways a power
clients and clinicians in shared decision making.
Pat is a
psychiatric survivor, having first been
diagnosed with schizophrenia as a teenager. She received her doctorate
in clinical psychology from Duquesne University in 1984.
Pat is an activist in the consumer/survivor/ex-patient movement and a
co-founder of the National Empowerment Center Inc. Between 1992 and
September of 2001 she held the position of Director of Training at the
National Empowerment Center, Inc. In this capacity she developed many
self-help tools and resources to support people in their recovery,
including a booklet on coping with distressing voices and a training on
working with people who appear unmotivated. She also developed
innovative trainings and curricula including an audio taped simulation
of hearing voices. The â€œvoices
curriculumâ€� has received international acclaim and
to train psychiatrists, mental health workers, family members and
police officers to work more compassionately with people diagnosed with
Pat has given keynote addresses, lectures, and workshops across the
United States, Canada, Europe, Scandinavia, Australia, New Zealand and
Israel. She has 27 published papers on topics related to recovery,
empowerment and systems transformation.
One of Pat's current projects is researching a recovery-based approach
to using psychiatric medications, in conjunction with the University of
601 Global Way Suite 106 * Linthicum, MD 21090 * 410-789-7054
(ph) * 410-789-7675 (fax) * www.uspra.org *
End of USPRA
13, 2008 -- News
of the Week
DISCUSSION ON VIOLENCE AND MENTAL ILLNESSES
OFFERS HOPE THAT DIALOGUE CAN BE PRODUCTIVE
View video clips
Search "Experts debate mental illness and violence." (clips posted on
Three panelists sought to explain their often differing views about a
controversial topic -- violence and mental illnesses -- at a recent
gathering of journalists. The event, a meeting of the Association of
Healthcare Journalists, took place in Washington on March 27-29, 2008.
Researcher Jeffrey Swanson, psychiatrist E. Fuller Torrey, and NYAPRS
director Harvey Rosenthal made their presentations as Phyllis vine,
editor of MIWatch (www.miwatch.org)
captured their remarks with a hand-held video recorder. Their main
point of agreement was that serious violence is uncommon among people
with mental illnesses.
We recommend the filmed excerpts, although they may leave viewers
wishing for clarification. For example, Jeff Swanson stated that
"multiple variables" may converge to heighten the risk of violent acts.
While Swanson may have explained this intriguing theory to the
assembled audience, video viewers will need to refer to his writings
(see American Journal of Public Health Sept 2002, "The
Social-Environmental Context of Violent Behavior in Persons Treated for
Severe Mental Illness," by Swanson et.al).
E. Fuller Torrey stressed a distinction between "treated" vs.
"untreated" individuals. In the video clips, however, he failed to
inform the audience that he and his organization, the Treatment
Advocacy Center in Arlington, VA, equate "treatment" with
"antipsychotic medication." Torrey's writings make clear that he
considers treatment beyond medication to be frosting on the cake, nice
but not essential. This view differs sharply from that of critics who
insist that recovery-oriented opportunities are essential.
Harvey Rosenthal pointed out that violence by mentally ill individuals
is a rare occurrence that draws a disproportionate amount of
sensationalized publicity. Successful programs don't make news, nor
does the existence of a vast population of non-violent people in need
of safe housing and high quality programs that work.
by Jean Arnold:
For over a decade the mental health community has seen media coverage
dominated by a deliberate fear strategy to promote compulsory
antipsychotic medication. The Treatment Advocacy Center has capitalized
on rare violent tragedies to seek support for its mission. The prime
example is the case of Andrew Goldstein, the assailant behind New
York's present compulsory medication law now serving a prison sentence.
Surely there are ways to provide help to individuals like Andrew
Goldstein without letting this issue dominate the nation's mental
health agenda. For months prior to the attack on Kendra Webdale,
Goldstein had asked repeatedly for help for a worsening assaultive
condition. Goldstein's failure to get help is not unusual, as a search
of the "Preventable Tragedies" file at www.psychlaws.org
Why does the media so rarely report rejected requests for help from
desperate patients and families? And what happened to "patients' right
to treatment" ?
March 17, 2008 - News
of the Week
JAFFE CALLS FOR
SANE POLICY BUT REPEATS FAMILIAR LINE
Is Psychlaws Widening Its Net? (See Footnotes)
"Sane policy needed to help the mentally ill," by D.J. Jaffe, Albany
Times Union, March 11, 2008
We have seen a bandaid solution fail. Why not now turn to the people
who know the system best -- the patients and ex-patients? Encouraging
signs of such a partnership have already begun to emerge under the new
Commissioner of the Office of Mental Health, Michael F. Hogan. A doable
beginning may be to save - and expand - the state's most successful
voluntary programs. At this moment, some excellent programs are headed
for shutdown because they fall outside a traditional funding stream.
For over a decade, D. J. Jaffe and his colleagues at the Treatment
Advocacy Center in Arlington, VA (www.psychlaws.org)
have called for new laws to advance their forced psychiatric medication
agenda. Psychlaws' strategy has been to capitalize on rare but highly
publicized incidents of violence by mentally ill individuals. Their
deliberate fear campaign began in 1993 when Jaffe, an advertising
executive, told advocates, "from a marketing perspective, it may be
necessary to capitalize on the fear of violence to get the law passed."
Over many years this fearmongering crusade has forged a false and
damaging link between mental illnesses and serious violence. Media
acceptance of the Psychlaws line has helped spread their message.
This month, leading researchers John Monahan and Henry Steadman of the
MacArthur Violence Risk Assessment Study reconfirmed what they found in
1998: That serious violence by people with mental illnesses is equal to
[or less than] violence by their neighbors; alcohol and substance abuse
raise the risk for both groups. Another study, by researcher Linda
Teplin of Northwestern University, found violence against
mentally ill individuals to be 11 times greater than against members of
the general public (2005). And Jeffrey Swanson of Duke University, a
widely-respected researcher on violence, wrote this about his findings
(2002): "A great deal of the violence in our mentally ill [research]
participants appears to be attributable to factors outside of their
Jaffe's fear strategy paid off in August 1999 when Kendra's Law, an
outpatient commitment law promising to protect public safety, passed
quickly in New York after a summer of fearmongering publicity. Oddly,
most of the examples cited to prove the need for coercion had been
turned away from overcrowded treatment facilities, put on waiting
lists, or discharged early. Critics at the time called the law an
unacceptable substitute for needed system reform, and their criticism
has proved to be right.
At the outset of the Kendra's Law program aka AOT (assisted outpatient
treatment), only 15% of the participants had any history of harm to
others. Where was the violent population it was meant to serve? Six
years later, the 15% figure dropped to 8% of the participants (OMH
Final Report 2005). Although Jaffe says Kendra's Law has achieved a 58%
reduction in harmful behavior, he forgets that the huge majority of the
program's participants (85%) had never harmed anyone. Furthermore,
Kendra's Law failed to protect either Kathryn Faughey who was killed
last month or her assailant David Tarloff, a Kendra's Law participant
who eluded court-ordered treatment according to his father's statement
to the New York Times.
Everyone agrees that our mental health system is in dire need of
reform. Decades-old promises of essential community supports, housing,
and high quality treatment have proved near-worthless. To make matters
worse, successful programs are often axed while failing ones consume
scarce mental health funds. Thirty years of broken promises make a
turn-around doubly difficult for the lost population roaming the
streets and shelters.
Jaffe's rosy report of patient satisfaction under Kendra's Law is
inconclusive. (This self-reported data was gathered in 2003.)
Currently, many upstate program participants are using the law's
enriched programs without court orders. Their satisfaction would in
fact support critics' contention that New York State needs more housing
and high quality programs, not forced treatment.
The situation today:
hospitals are overcrowded with people
waiting for discharge with nowhere to go.
support programs have room for just 22%
of eligible New Yorkers.
housing has room for just 6.5% of
over-reliance on medication, the most
problem-prone aspect of treating a mental illness, does little to turn
patients' lives around.
programs' staff turnover rates due to
meager salaries block patient progress.
make commitment easier by changing laws
ignore the fact that commitment laws are flexibly interpreted.
Appropriate change is held back by economics, politics, and social
change has been hobbled by a 2-decade
controversy over compulsory medication and treatment. New York's
experiment (Kendra's Law or AOT) is showing its weaknesses. Only the
luckiest patients get the high quality support programs all
participants were promised.
Jean Arnold, Co-founder and Chair
National Stigma Clearinghouse
widens Psychlaws' net.
Mr. Jaffe's article in the Albany Times Union (3/11/08) implied that
people taking anti-anxiety medications are candidates for forced
medication (an example he uses is Steven Kazmierczak who reportedly was
taking Xanax and Prozac). Another Jaffe candidate for coercion is
Leatrice Brewer, a mother whose difficulties and psychiatric history
were well-known but did not signal the severity of her condition.
(2)Psychlaws habitually spins
the work of others to exaggerate
violence. See the LINKS below for two recent examples.
REDUCES RESEARCH TO STIGMATIZING SOUND BITE. DISTORTS
SAYS LACK OF INSIGHT CAUSES VIOLENCE. CONTRADICTS
23, 2008 -
News of the Week
DR. TORREY BLAMES
"EVERY NEW YORKER" FOR KENDRA'S LAW
Last week in Manhattan, Kendra's Law was unable to prevent a brutal
murder. The assailant's father has told the New York Times that even
court-ordered treatment under Kendra's Law had failed to end a long
ordeal that began in 1991, when Leonard Tarloff repeatedly found
himself working to get his son treatment for mental illness. (NYTimes
Yesterday Dr. E. Fuller Torrey, chief proponent of the law, skipped
lightly over the law's failure in an Op-Ed for the New York Post
("Deadly Madmen," 2/22/08). Dr. Torrey began the Op-Ed by recalling
murders committed in the 1980s and 90s. His manipulation of facts is
familiar. First he created a violent backdrop by recalling 7 highly
publicized assaults commited decades ago. He ignored news reports which
at the time showed at least 5 of the 7 assailants were victims of
system negligence. Michael Vernon was under psychiatric
treatment; Andrew Goldstein had committed himself for help repeatedly
and was discharged prematurely; Juan
Gonzalez was discharged prematurely; Kevin
McKiever was told by a facility to find help somewhere else; Colin
Ferguson had shown few signs of distress prior to his attack. Dr/
Torrey's opinion, unsupported by evidence, is that an "endless list" of
violent cases all require coerced medication under Kendra's Law.
Torrey cites his website's "Preventable Tragedies" database as proof
that medication is the solution. That seems simplistic after one views
the data. In 2006, I looked at the data in psychlaws.org's "Preventable
Tragedies" database (unfortunately many entries are now deleted). This
impressive resource, consisting of summarized news clippings, contains
clues to the mental health system's
weaknesses. My data search focused on the 66 homicide cases reported
during the most recent 6-month
period. I found that a significant number of assailants were reportedly
taking medication or showed meds in their toxicology reports. Many case
summaries showed the homicide assailants had been prematurely
discharged from or refused entry to treatment facilities. Histories of
violence and problems with alcohol and substance use had plagued many
of the assailants. While the data show that many assailants did indeed
go off medication, this does not mean the medication was effective.
Antipsychotic meds are said to be ineffective for people who have
non-psychotic personality disorders. It is puzzling that Torrey has
closed his mind against successful violence prevention alternatives
such as "Housing First" and castigates anyone who disagrees.
Dr. Torrey not only shuns the fact that Kendra's Law was unable to
prevent David Tarloff's murder of Kathryn Faughey. He shows no interest
in what may have gone wrong. He does not acknowledge the dire scarcity
of housing, special services, and high quality programs promised under
Kendra's Law. He shows no concern for people who are forced to take
medication that may cause them problems. He faults protectors of civil
rights when he surely knows that commitment laws are interpreted
flexibly and reflect society's economic and political priorities.
Torrey never questions Kendra's Law --- a 7-year experiment that has
consumed an inordinate amount of time, energy and resources -- and
blames the Faughey murder on everyone else including "every New Yorker
for not demanding a system that works."
The Treatment Advocacy Center's inability to face reality seems obvious
in the following examples: New York's official evaluation of Kendra's
Law (2005) reported improvement rates of program participants who had
caused "harm to others." Before entering the program, just 15% of the
participants had previously harmed others. After six months in the
program, 8% had harmed others. The Treatment Advocacy Center cites
these figures as proof that Kendra's Law reduced "harm to others" by
one-half. Example 2: Totally ignored is the program's disappointing
rates of success in reducing alcohol and substance use among people who
have combination diagnoses. Considering that such problems reportedly
affect 50% of Kendra's Law participants and puts them at high risk for
violent behavior, this lack of candor is troubling. Example 3: The
state's report of 2005 (the latest available) indicates a shortage of
case management services. Case management was to be a keystone of the
Kendra's Law program. An apparent over-reliance on meds alone and the
shortchanging of other community supports boosts critics' claims that
access to appropriate high quality programs, not forced meds, turns
lives around best.
19, 2008 - News
of the Week
(CHANTIX) MAY WORSEN PSYCHIATRIC
SYMPTOMS, FDA WARNS
The following FDA
Press Release was received from
advocate Laura Van Tosh with a request to circulate it.
FDA: FOR IMMEDIATE RELEASE
FDA Issues Public
Health Advisory on Chantix
Agency requests that manufactureres add new safety warnings for smoking
February 1, 2008
Susan Cruzan, 301-827-6242
Rita Chappelle, 301-827-6242
The U.S. Food and Drug Administration (FDA) today issued a Public
Health Advisory to alert health care providers, patients, and
caregivers to new safety warnings concerning Chantix (varenicline), a
prescription medication used to help patients stop smoking.
In the Public Health Advisory and a Health Care Professional Sheet that
was also issued today, FDA emphasized the following safety information
for patients, caregivers, and health care professionals:
[bold added and paragraphs
moved forward for emphasis. ja ]
tell their health care provider
about any history of psychiatric illness prior to starting Chantix.
Chantix may cause worsening of current psychiatric illness even if it
is currently under control. It may also cause an old psychiatric
illness to reoccur.
FDA notes that patients with these illnesses were not included in the
studies conducted for the drug's approval.
Health care professionals, patients, patients' families, and caregivers
should be alert to and monitor for changes in mood and behavior in
patients treated with Chantix.
Symptoms may include anxiety, nervousness, tension, depressed mood,
unusual behaviors and thinking about or attempting suicide.
In most cases, neuropsychiatric symptoms developed during Chantix
treatment, but in others, symptoms developed following withdrawal of
Patients should immediately report changes in mood and behavior to
Vivid, unusual, or strange dreams may occur while taking Chantix.
Patients taking Chantix may experience impairment of the ability to
drive or operate heavy machinery.
On Nov. 20, 2007, FDA issued an Early Communication to the public and
health care providers that the agency was evaluating postmarketing
adverse event reports on Chantix related to changes in behavior,
agitation, depressed mood, suicidal ideation, and actual suicidal
As the agency's review of the adverse event reports proceeds, it
appears increasingly likely that there may be an association between
Chantix and serious neuropsychiatric symptoms. As a result, FDA has
requested that Pfizer, the manufacturer of Chantix, elevate the
prominence of this safety information to the warnings and precautions
section of the
Chantix prescribing information, or labeling.
In addition, FDA is working with Pfizer to finalize a Medication Guide
for patients. This is an example of FDA working with drug manufacturers
throughout products' lifecycles to keep health care professionals and
patients informed of new and emerging safety data.
"Chantix has proven to be effective in smokers motivated to quit, but
patients and health care professionals need the latest safety
information to make an informed decision regarding whether or not to
use this product," said Bob Rappaport, M.D., director of the
FDA's Division of Anesthesia, Analgesia and Rheumatology Products.
"While Chantix has demonstrated clear evidence of efficacy, it is
important to consider these safety concerns and alert the public about
these risks. Patients should talk with their doctors about this new
information and whether Chantix is the right drug for them, and health
care professionals should closely monitor patients for behavior and
mood changes if they are taking this drug."
Chantix was approved by FDA in May 2006 as a smoking cessation drug.
Chantix acts at sites in the brain affected by nicotine and may help
those who wish to stop smoking by providing some nicotine effects to
ease the withdrawal symptoms and by blocking the effects of nicotine
from cigarettes if users resume smoking.
FDA will continue to update health care professionals with new
information from FDA's continuing review or if new information is
received on Chantix and serious neuropsychiatric symptoms. FDA may
consider requesting further revisions to the labeling or taking other
regulatory action as the agency's continuing reviews and conclusions
For more information:
End of FDA
31, 2008 - News
of the Week
PSYCHLAWS.ORG'S "PREVENTABLE TRAGEDIES" REVEAL
The year 1999 in New York City began with a senseless murder in the
subway. Andrew Goldstein, a man diagnosed with schizophrenia, pushed
Kendra Webdale, an 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?
Kendra's Law passsed easily in New York, with its
proponents using Andrew Goldstein as the impetus to act
protect public safety. Yet Goldstein had asked repeatedly for treatment
he did not receive. It now appears that Seung Hui Cho has been assigned
a Goldstein role in Virginia. He showed up for his court-ordered
treatment but fell through the cracks in the system.
Just how often does this happen?
Advocacy Center has assembled an
impressive database called "Preventable Tragedies." Hoping to find some
clues, in 2006 Jean Arnold searched the published database.
At that time, the number of homicide summaries averaged roughly
70 per year over a 16 year period (1989 - April 2005).
The summaries showed that cases like Goldstein's are not uncommon. Over
period, the data showed that at least 1 in 8 homicides followed
premature hospital discharge or refused entry to a psychiatric
treatment center. In Goldstein's case, a New York State investigation
found that a clinic had 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
The "Preventable Tragedies" database in 2006 contained 1,387 newspaper
of homicides by "people with severe mental illness" from 1989 - April
2005. We examined the 66 descriptions covering the period
Unexpectedly, 12% of the descriptions showed that the assailants had
been discharged prematurely from a psychiatric facility or were turned
away when they asked for help. This figure is surely an undercount,
since the news clippings summarized in the database vary widely in the
amount of information furnished.
Another big surprise was the number of assailants using medication.
Only 25 of the 66 summaries 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 psychlaws.org database were committed by people
taking medication. This affirms the possible role of medication in acts
6-month sample of homicides in database showed the following:
These numbers show a pattern of program needs that could guide
policymakers. Instead, the Treatment Advocacy Center promotes above all
else, medication, the most complex and problem-prone aspect of treating
At least 8 of
the 66 tragedies we examined (Jul-Dec
2004) involved an assailant who had been discharged prematurely from a
psychiatric facility or was turned away when he asked for help. (Oddly,
the current database shows 9 clippings summaries for that time period,
not the 66 we found in 2006.)
25 of the 66
news article summaries give medication
status. According to these 25 reports, 9 assailants were taking
medication, 16 were not.
27 of the 66
assailants had histories that included
one or more red-flag behaviors: brutal assaults, drug and alcohol
disorders, child abuse, and restraining orders.
We welcome comment: E-mail email@example.com
27, 2008 - News
of the Week
BUILDS FOR SYSTEM REFORM
Does real progress lie ahead?
Or will a rare tragedy mask the longstanding need for mental health
system coordination and voluntary high-quality community services and
Last year, the Virginia Tech rampage took the lives of 32 innocent
people and gunman Seung Hui Cho. The tragedy left the nation in
mourning and searching for what went wrong. Will the intense publicity,
and an over-reliance on pills by supporters of compulsory medication,
undermine the state's needed re-design of its mental health system?
Concerning media coverage: Few people know that Cho kept his
appointment to receive court-ordered outpatient treatment in December,
2005, but due to a series of system glitches, he never received it. (See
Virginia Tech Review Panel report, Chapter IV, page 49.)
An important source for information is Alison Hymes. She is a mental
health survivor/activist who sat on a task force of the Virginia
Commission on Mental Health Reform. Alison reports almost daily on her
state's progress. View her blog at http://www.hymes.wordpress.com
In the article below, a disability rights leader in New Hampshire could
be speaking for the nation. Richard Cohen deplores his state's lack of
will and leadership to repair its mental health system.
New Hampshire Business Review
We Can't Wait to Fix the Mental Health System
BY RICHARD COHEN
Friday, January 4, 2008
What will it take for New Hampshire to wake up to the urgent need to
improve the quality, breadth and choice of mental health services?
Recent events have drawn attention to the need for improved mental
health services, but it appears the will to meet the critical needs of
children and adults with mental illness has been in a virtual free fall
for 10 or more years.
New Hampshire's performance has plummeted according to the National
Alliance for the Mentally Ill (NAMI). NAMI rated the state as a
national leader in 1990. NAMI now scores the state at an overall rating
of "D," and an appalling "F" in having the basic foundation supports in
place to deliver quality services and supports needed for recovery.
Funding for community mental health services continues to be
inadequate, and has actually declined when inflation and an increased
number of eligible citizens are taken into account. Funding is also
disproportionately directed toward institutions and service models
which artificially control rather then enable individuals to recover
and lead independent, fulfilling and safer lives.
Additionally, New Hampshire's mental health insurance parity law has
holes big enough to drive a truck through -- and health insurance
companies regularly do so.
On the national level, the president's New Freedom Commission on Mental
Health issued comprehensive recommendations for action in June 2003.
As we approach the five-year mark, the recommendations have not been
implemented in New Hampshire. Lack of will and commitment, know-how and
vested interests in maintaining the status quo, combined with these
funding issues have created an absolute obstacle to change.
New Hampshire's leaders continue to substitute commission studies for
The first study committee appointed after the president's call for
action met a few times in the fall of 2003, issued a few one-note
recommendations, then dissolved.
The second commission was convened in 2005 and was to issue a final
report in December 2006 and is now requesting an extension until
The former commissioner of the New Hampshire Department of Health and
Human Services sat on an enlightned 2004 report prepared by his staff
for 18 months.
That study concluded that more than half the residents in the state
psychiatric hospital in Concord could be living in the commuity if more
housing and/or clinical supports were available in the commnity,
options which are far less expensive than the nearly $700 per day costs
at the state hospital.
Nothing has been done to implement any of the recommendations.
The tragedies in Whitefield, N.H, and Virginia Tech last spring and
Dover, N.H., and in states around the country more recently, again
dramatically demonstrate the consequences that can follow in the wake
of a failure to provide comprehensive services to evaluate and treat
children and adults with mental illness. Far, far more typically,
persons with mental illness and their families become victims of the
crisis in mental health.
The toll includes extreme emotional suffering, suicide, family discord,
unemployment, homelessness, physical illness, financial ruin and
unnecessary incarceration. Taxpayers also pay the price through
increased health costs created by the over utilization of regular and
specialized hospital inpatient acute care.
Funding directed toward high-quality and true community-based,
recovery-oriented supports and services and true mental health
insurance parity are needed, but it will never happen unless our
Legislature, governor and Department of Health and Human Services find
the will and commitment to act. The time is now, not in 2009.
Richard Cohen is
executive director of the
January 10, 2008 - News of the Week
NEW YORK TIMES
EDITORIAL PROMOTES A DAMAGING STEREOTYPE
Gun law hype
leaves its mark
As gun law proponents attempt to justify tighter gun control under the
National Instant Criminal-background Check System (NICS), they are
putting undue emphasis on mental illnesses as a cause of gun violence.
In fact, mental illness accounts for a minuscule amount of America's
A recent victory for expanding gun control, applauded in a NYTimes
editorial on January 8 (see below), was won at huge cost to law-abiding
people with psychiatric conditions. NICS proponents played the mental
illness card at every media opportunity. Who would ever guess that NICS
is missing 38 million criminal records, 14 million missing drug abuse
records, and 2 million restraining order records? (Estimate from 2003)
Considering that some 54 million NICS records are missing for criminals
and other lawbreakers, it seems absurd to focus on an estimated 2.7
million missing records of law-abiding people who were involuntarily
hospitalized at some time in their lives. Very few of these are
It is true that in 2005, Peter Troy, who shot a priest and a
parishioner in Long Island NY, was both mentally ill and dangerous. But
Troy had been issued a court restraining order for domestic violence,
establishing his legal status as dangerous. Under the new NICS law,
Troy's restraining order would have prevented his gun purchase.
Very few people have legally-established histories of dangerous mental
illness. People under civil commitment to hospitals as "dangerous to
self or others" will be put on the NICS list even though few of them
have ever harmed anyone. If society is looking for dangerous people,
drunk drivers caused 13,990 deaths in one year (NYTimes, May 26, 2007).
The hazards of putting the names of law-abiding mental health patients
and ex-patients alongside convicted criminals have been called a
"privacy nightmare" by experts on mental health law.
It is unfortunate that the Schumer/McCarthy team chose to publicize
their NICS campaign with the most damaging stereotype faced by the
mental health community: a presumption of dangerousness. If violent
crime reduction is truly the nation's goal, the crime fighters' first
concern should be people with histories of criminal violence. It makes
little sense to focus on people who are predominantly law-abiding.
EDITORIAL: "Progress on Guns," New York
Times, January 8,2008 (emphasis
It took too many years and too many deaths to persuade Congress to act,
but President Bush is expected to sign into law today a measure that
will make it harder for people with a history
of dangerous mental
illness to purchase firearms.
That is good news, but there is more
work to be done.
The new law — the product of a rare partnership between gun
control advocates and the National Rifle Association —
a glaring problem. Millions of criminal and mental health records are
missing from the National Instant Criminal Background Check System used
to screen gun purchasers and block sales to people who are disqualified
by law from buying guns. The bill provides new financial incentives for
states and localities to improve their spotty record-keeping and to
share all pertinent information with the federal data system.
This important step forward owes much to the efforts of two New York
Democrats: Senator Charles Schumer and Representative Carolyn McCarthy.
They first tried to pass the measure in 2002, after a gunman, whose
mental history should have blocked his purchase of a .22-caliber
semiautomatic rifle, walked into a Long Island church and gunned down a
priest and a parishioner.
That tragic crime was not enough to prod Congress to act, but last
year's massacre at Virginia Tech was. The fact that the Virginia Tech
shooter was allowed to buy semiautomatic pistols and high-capacity
ammunition magazines, even though a court had found him to be
dangerously mentally ill, sparked public outrage. It also put pressure
on the N.R.A. to work with gun control proponents on legislation to
plug the big gap in the background check system that helped pave the
way for the deadly attack.
Having taken this much-needed step, the gun lobby should now join with
gun control advocates to close another dangerous loophole: the one that
permits nonlicensed dealers to sell firearms at gun shows without
conducting any background check whatsoever. There is no principled
reason gun show sales should be exempt, and the loophole poses a
serious threat to public safety.
The N.R.A has so far successfully beaten back legislation to end the
gun show loophole. It should not take another horrific attack by a mad
gunman to change anyone's mind. This time the N.R.A., Congress and
President Bush should do the right thing — before more lives
Reprinted using Fair Use Standard
6, 2008 - News
of the Week
ADVOCACY CENTER REDUCES RESEARCH
ON VIOLENCE TO A STIGMATIZING SOUND BITE
The Treatment Advocacy Center (www.psychlaws.org)
has never been shy about tailoring research results to suit its
politicial agenda. Most recently, a Psychlaws press release announced
that a research team led by Jeffrey Swanson Ph.D, of Duke University,
had discovered a high rate of violence among people with schizophrenia.
By cherry-picking the research for words most likely to serve their
ends, the Torrey group has caused great harm. (See MORE INFORMATION
Other research led by Dr. Swanson has found that a combination of
childhood victimization, a high-crime neighborhood, and substance
abuse, raise the likelihood of violence above the general population
rate. "Without any of these factors, those with severe mental illness
were no more likely to engage in violent behaviors than people in the
general population without a psychiatric disorder." (Quote from Duke
University Medical Center press release, "Three Risk Factors Cited in
Violent Behavior Among People With Severe Mental Illness," August 30,
The Treatment Advocacy Center's mission is to medicate people who have
psychiatric problems. They proudly disclose their political strategy,
which is to convince opinion-shapers, law-makers, and the public that
medication is a public safety issue. Fixated on violence as a means of
gaining support, Psychlaw has largely succeeded in focusing public
discussion of mental health on this issue. Equally damaging, critics
say, is Psychlaws' misleading claim that medication, the most
problem-prone aspect of treatment, is the solution.
Medication is not a panacea. "If we're worried about violence among
people with serious mental illness, we need to pay far more attention
to finding safe housing in decent neighborhoods, mitigating the effects
of physical and sexual victimization, and aggressively treating
substance-abusers," said Marvin Swartz, M.D., professor of psychiatry
at Duke University.
It is unfortunate that psychiatric research findings are often boring
and unpenetrable. Further, the field suffers from a lack sufficient
scientific data. Despite researchers' best intentions and improved
research tools, results must be viewed with caution. If study findings
reach the public, which is rare, they are fair game for interpretation
by anyone with an axe to grind. It is the large gap between researchers
and the general public that has allowed the Torrey group to advance its
FROM TREATMENT ADVOCACY CENTER PRESS
RELEASE, Dec 18, 2007
"Data from the
CATIE study of antipsychotic drugs
demonstrated patients with schizophrenia were 10 times more likely to
engage in violent behavior than the general public (19.1% vs. 2% in the
general population). Most major mental health organizations continue to
deny the increased risk of violence that accompanies symptoms of
untreated mental illness."
RESEARCH REPORT, BY JEFFREY SWANSON ET AL.:
Statements by the researchers are cautious. Click
for the full report
what extent is violence associated with
developmental and life-historical variables that precede the onset of
schizophrenia? Definitive answers to these questions remain elusive.
was classified at 2 severity levels:
minor violence [15.1%], corresponding to simple assault without injury
or weapon use; and serious violence [3.6%], corresponding to assault
resulting in injury or involving use of a lethal weapon, threat with a
lethal weapon in hand, or sexual assault." [Note: Concerning minor
violence, the term "assault" is used to mean a minor incident or fight
where the person with schizophrenia may or may not have been the
aggressor. J Arnold]
6-month prevalence of any violence was
19.1%, with 3.6% of participants reporting serious violent behavior."
research led by Dr. Swanson has found the
following: "Among people with severe mental illness, a combination of
three risk factors -- having been a victim of violence during
childhood, living in a neighborhood where violence is common, and
having a substance abuse problem -- can increase the likelihood of
violent behavior more than tenfold. Without any of these risk factors,
those with severe mental illness were no more likely to engage in
violent behaviors than people in the general population without a
psychiatric disorder." (Duke
News - Top Story - August 30, 2002)
Read comments by John
Grohol, psychologist, about pitfalls
and variations that plague research on violence. Go to http://psychcentral.com/blog/archives/2007/05/04/crime-consequences-and-mental-illness