Prepared by:
National Stigma Clearinghouse

NEWS ARCHIVE 2008-2009

Please scroll down for earliest items

November 1, 2009 - News of the Week

Link: Archived radio program produced and hosted by Anne Barbano with guests Marj Berthold, Nora Jacobson, and Laura Ziegler

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 Barbano (, a Burlington mother who excels at empathetic listening.

Earlier programs on "The Next Frontier" are archived at "Living the Autism Maze."

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: For more links to Morgan's work, GOOGLE 'Morgan Brown Norsehorse'

October 25, 2009 - News of the Week


Bring Change 2 Mind offers encouragement and help: "This is where the misconceptions stop"

Take a 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 2 Mind.

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 psychiatric disabilites.

October 18, 2009 - News of the Week
Two Interviews (source: NYAPRS E-NEWS)
A Talk With Judi Chamberlin;
Facing Death, A Plea For The Dignity Of Psychiatric Patients

By Carey Goldberg
Boston Globe
March 22, 2009

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 in crisis.
The mother of that movement, many people would say, is Judi Chamberlin of Arlington.
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 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 coercion?
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 you going?
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 wrong here."
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 not.
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 Globe interview

Reprinted using Fair Use doctrine

________________________INTERVIEW with Judi Chamberlin

Off Our Backs
by Leah Harris

BNET Health Publications
July/August 2003
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 years ago?
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 movement?
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 our culture.
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 Empowerment Center?
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 help?"
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.;col1

End of Interview by Leah Harris

September 20, 2009 - News of the Week

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

  • Click here for the conference program, the presenters, and the list of workshops. Use this link TO REGISTER, and to download a printable brochure.

  • 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 for change.

    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.

    Don't miss this unique opportunity to learn about treatment alternatives from the field's top experts.

  • Click here for the conference program, the presenters, and the list of workshops. Use this link TO REGISTER, and to download a printable brochure.

  • September 6, 2009 - News of the Week
    Story from BBC NEWS:

    Not funny peculiar
    by Patrick Jackson
    BBC News

    These 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 through laughter.

    David Granirer, who takes medication for depression himself, has been teaching them a course called Stand Up For Mental Health since 2004.

    He now runs classes in Vancouver, Toronto and Ottawa, as well as performing himself.

    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 material

    "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 wearing stripes*."

    Succeed in stand-up "and you feel like you can do anything", says the teacher.

    Shedding shame

    Alex's Favourite Joke

    "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 time".

    "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 adds.

    "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," he says.

    Comedy plus medication

    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 believes.

    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

    Reprinted using Fair Use doctrine

    September 2, 2009 - News of the Week


    ARTICLE forwarded by NYAPRS E-News:

    Peer Wellness Coach - A New Role for Peers
    by Peggy 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 infrequent exercise.
    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 wellness.
    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.
    What is coaching?

    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.
    Why Peers?

    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….

    End of Article

    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, NY.

    August 24, 2009 - News of the Week


    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 us all."

    Sarah Triano
    Executive Director
    Silicon Valley Independent Living Center
    2306 Zanker Road
    San Jose, CA 95131
    408-894-9041 (v)
    408-894-9012 (tty)
    408-894-9050 (fax)

    Article Source: Mercury News, San Jose CA


    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 cell. 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 in fun
    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 good faith
    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?

    End of Mercury News article

    Reprinted using Fair Use Doctrine

    July 26, 2009 - News of the Week


    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 21, 2009
    San Jose Mercury News, Campbell's Psycho Donuts Owner To Take On Head of Mental Health Organization..." July 21, 2009

  • News Release - July 23, 2009
    United 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 24, 2009
    CNS News, Political Correctness Watch: Mental Health Advocates Blast 'Psycho Donuts' Shop, July 24, 2009

  • June 11, 2009 - News of the Week


    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 business.

    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 DeAnza College.

    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 illustration.


  • Read Kim 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.

    -Kim Hing
    Film Student

    End of statement


  • Visit 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 resources.

  • Website 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.

  • Blog with info concerning F.U.S.E.

  • April 26, 2009 - News of the Week

    Dr. 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 treatment?

    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.  


    Link: Mental Health Needs are Stressing Out Veterans Administration by Lou Michel, Buffalo News, November 7, 2008

    Link: To Fight Stigmas, Start With Treatment by Sally Satel, M.D., New York Times, April 21, 2009

    April 19, 2009 - News of the Week

    A few 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 and dignity.

    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 Trauma."

    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.
    Hardy Stone
    US Army Airborne Infantry
    USMA 1980
    Frederick, Maryland

    Reprinted with permission

    April 15, 2009 - News of the Week


    Two 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 jam.

    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 of the Week

    Source: Santa Cruz Sentinel, "Severe mental illness is a tiring challenge, every waking moment, every waking day. Do not dismiss this essay..."
    Biggest challenge of mental illness is the stigmatization

    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, etc.

    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 human beings.

    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 insane. World and local events are dominated by acts that are profoundly inappropriate — that is, inhumane — from genocide to child 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 the rights of others. To "fit in" — somewhere — is the more and 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.

    Mael Anne Dinnell is a Santa Cruz resident.

    Reprinted using Fair Use Doctrine

    March 22, 2009 - News of the Week


    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 illnesses, often 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 at

    "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 Minot.

    Mental 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


    Deadline: Friday, May 1st

    We Invite Your Participation

    Contact Us Today !!

    (570) 629-5960



    Here Are A Few Suggested Article Topics Related to Our Theme:
  • Personal Stories: How My Recovery Has Helped Me Move On With Dignity & Pride

  • The Recovery Community: How My Peers Have Made A Difference in My Life

  • Peer Specialists: I Am Now Helping My Fellow Consumers in Their Recovery

  • Advocates: The Most Important Issues On Our Advocacy Agenda

  • Service Providers: How Our Programs Are Making A Difference

  • Service Providers: Helping Consumers Keep Their Family Ties Intact

  • Treatment Professionals: Recovery Oriented Treatment Principles

    Call Us With Your Idea for An Article !!
    Ira 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:

    Autism Spectrum News:

    - End of Mental Health News announcement -

    Reprinted with permission

  • March 1, 2009 - News of the Week


    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 mounting.

    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 to order)

    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, 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."


  • A Review of "Another Kind of Valor," by Phyllis Vine, Ph.D.

  • VALOR website

  • To hear the VALOR Prologue and meet the cast, go to

  • Ordering information for "Another Kind of Valor"

  • February 1, 2009 - News of the Week


    Don't miss the inviting website!

    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: 

  • Hard-hitting TV ad

  • Celebrity press ads featuring Stephen Fry, Ruby Wax and Alastair Campbell

  • Bold, uncompromising stunts to grab public attention

  • A string of high-profile supporters, from celebs to politicians

  • Press events

  • 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 can't 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 difference.

    '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 website, offers a wide range of excellent resources.

    January 18, 2009 - News of the Week


    '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 ward.

    (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 article...)

  • Readers looking for Wonderland background information will find eight postings in the NSC Archives. Scroll to February 27, 2000, the earliest Wonderland entry.

  • For a list of Wonderland reviews and articles, most with web links, email a request to (j arnold)

  • December 7, 2008 - News of the Week


    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


    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 secret weapon.

    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

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  • 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.


  • LINK to "In the Matter of David Dix" : a report by the New York State 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 he needed.

  • LINK 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.

  • LINK to a collection of articles and reports concerning Kendra's Law. Provides a LINK to Kendra's Law Updates.

  • ARTICLE: The Railroading of Andrew Goldstein 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 this tragedy.

    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.

    End of article

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    November 21, 2008 - News of the Week


    An Audience Discussion Guide is Included to Promote Public Awareness

    For details and order information, click

    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
    Returning 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.
    While 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.

  • The article below typifies a growing trend. It underscores the urgent need for public action on behalf of men and women returning from Mideast battlefields.

    War Veterans Seeking Help In Record Numbers

    By Lou Michel
    Buffalo News
    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 veterans.

    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, Romberg said.

    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 Article


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  • November 9, 2008 - News of the Week

    IT CAN BE DONE! Peer Counselors Become Agents of Recovery
    Note on language: readers may prefer to substitute the terms "people with psychiatric disabilities and substance use disorders" instead of "the mentally ill and drug addicts."

    Philadelphia Agency Is Rolling Out A Model For Clients, Including Addicts, With Emphasis On Recovery

    By Don Sapatkin  Philadelphia Inquirer  October 9, 2008

    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 Services.
    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 approach.
    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 1970s.
    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 of life."
    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. Lehigh Ave.
    The site is the first of several planned centers that will offer a range of support groups, counseling, education and social events in communities.
    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.

    End of Article

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    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 psychiatric hospitals.

    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

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    October 26, 2008 - News of the Week


    Neighbors and 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.

    In sharp contrast...

    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 appproximately 550.

    An article from 2006 describes how community cooperation turned a seemingly doomed project into a success.
    ARTICLE source:


    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 Community Board.

    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 years.

    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 the Year.
    -End of Article-

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    September 30, 2008 - News of the Week


    Former Adult Home Undergoes Transformation in NY

    New Psychiatric Rehabilitation Center Opens In Riverhead
    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 people.
    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 field.
    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 condition.
    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 apartments.
    "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 assessment.
    "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 health."

    End of Article


    Source: NYAPRS ENews

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    September 10, 2008 - News of the Week


    ARTICLE: Community Voices: Healthcare for the Underserved, 9/10/2008 (forwarded by NYAPRS Enews)
    Studies 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 addressed."

    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 stressors."

    Moreover, the paper notes that:

    -- Racism can affect mental health by reducing socioeconomic status, diminishing access to desirable resources and contributing to poor living conditions.

    -- 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 communities.

    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 youths.

    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

    End of Article

    Copyright 2008 PR Newswire

    Reprinted using Fair Use standard

    August 31, 2008 - News of the Week


    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 ( 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, 2008:

    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 deinstitutionalization.

    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


    August 10, 2008 - News of the Week



    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 criminal.

    "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 proposals.

    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 illness.

    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 dignity."

    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."

    End of Article

    Reprinted using Fair Use standard

    KENDRA'S LAW UPDATES, 2006-Current

    August 4, 2008 - News of the Week

    Homeless No More: The Pathways To Housing Story

    By Jay Neugeboren
    Huffington Post
    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 diagnosis.")
    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 homelessness."
    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 Article -

    Reprinted using Fair Use standard

    July 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 ( 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 for a Book Review by Sue E. Estroff of Dr. Torrey's latest book
    The Insanity Offense: How America Fails the Seriously Mentally Ill and Endangers Its Citizens, and What We Must Do to Stop It
    Go to for an announcement of Dr. Torrey's book. Top of home page, click Read More

    June 29, 2008 - News of the Week




    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.


    Visitors to the Directory can search by name, locality, or program type to find up-to-date information on consumer-driven programs around the country.


    Any and all consumer/survivor initiative programs in the United States are invited to apply for inclusion in the Consumer-Driven Services Directory.


    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:

  • One study 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.

  • Another study showed that CSIs saved more than $12 million in reduced hospital stays for three hospitals over the course of one year.

  • People with 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 next step."

    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

    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

    June 22, 2008 - News of the Week


    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 conditions.

    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 events.

    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.

    MORE INFORMATION Advocacy Center
    Preventable Tragedies

    Book Excerpt by E.F. Torrey
    Wall Street Journal, June 13, 2008

    Charlottesville Prejudice and Civil Rights Watch

    June 4, 2008 - News of the Week



    Lights! Camera! Advocacy!
    CIAD Takes Media to Heart

    New York NonProfit Press    June 3, 2008
    (Links to 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 media 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 areas. 
    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 would 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 ten 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 Team 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. "When I was young I did a lot of work organizing against the war.  But, we couldn't use media.  You couldn't touch it. You needed a trust 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 $55,000 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 Team's productions have been a valuable component of the organization's overall, multi-faceted advocacy strategy. 
    Shoes Blues, 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 Stigliano 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 another. "They are all turned over, I can hardly walk."
    "It is a brilliant and beautiful piece," says CIAD Executive Director Geoff Lieberman.
    Dying for Air was filmed at a community meeting held by CIAD in August of 2005.  "It was just a series of people 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 one 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 Guy?

    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 there 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 video."
    "It sparked a lively give and take between inspectors and residents," says Stearns.
    "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.
    Residents' Rights

    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 admission agreement.
    "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 your check."
    The video uses a variety of techniques to tell its story and make its points.
    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 Adult 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 new puppet on the block before sitting down to meet the adult home administrator.
    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 have a right to look it over," she advises the viewer.  "You have a lot 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 bring 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 materials.  
    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.  By the time you have spoken on mike about air conditioning or some other issue three or four times, you have become very articulate.  And, 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 is why it is a really good organizing tool.  Even if you never finish 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 of 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 talking, to share experiences and talk about their own ideas.   One way to do that is peer-to-peer interviews."  The Media Team will create opportunities for one resident council leader to interview another on camera – How do you run your resident council?  What works for you?  Then, they switch roles. 
    An Act of Courage

    For the adult home residents of CIAD, participating in the Media Team has been exciting and empowering.  It has also been dangerous. "We operate in a very hostile environment," says Stearns. "These homes are privately owned.  For us to videotape on the premises is not only 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 resident's 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, call 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, the filming of resident's feet alone – without faces – in Shoes 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.

    End of Article

    Forwarded from: NYAPRS E-News

    May 11, 2008 - News of the Week



    Article: NEW YORK TIMES - May 11, 2008
    Fashion & Style Section
    "Mad Pride" Fights a Stigma


    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 dog.

    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 and socially."

    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 patients.

    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 them with.

    "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. DuBrul said.

    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 Spikol (

    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 the couch."

    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
    End of Article

    Reprinted using Fair Use standard

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    April 20, 2008 - News of the Week



    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'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 

    For complete 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 webinar, Pat Deegan will discuss shared decision making as applied to the psychopharmacology consultation.

    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.
    Register Online at or
    Learning Objectives:

    1.     Explain why supporting people through decisional conflict is a superior approach to insistence on treatment compliance. 

    2.     Explain the concept of personal medicine and how it interacts with psychiatric medicine in the recovery process.

    3.     List three ways a power statement engages clients and clinicians in shared decision making.
    Pat Deegan, PhD
    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 “voices curriculum� has received international acclaim and is used to train psychiatrists, mental health workers, family members and police officers to work more compassionately with people diagnosed with mental illness.

    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 Kansas.
    601 Global Way Suite 106 * Linthicum, MD 21090 * 410-789-7054 (ph) * 410-789-7675 (fax) * *

    April 13, 2008 -- News of the Week


    View video clips at Search "Experts debate mental illness and violence." (clips posted on YouTube)

    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 ( 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

    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.

    COMMENT 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 revealed in 2006.

    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


    Is Psychlaws Widening Its Net? (See Footnotes)

    LINK: "Sane policy needed to help the mentally ill," by D.J. Jaffe, Albany Times Union, March 11, 2008


    For over a decade, D. J. Jaffe and his colleagues at the Treatment Advocacy Center in Arlington, VA ( 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 illness."

    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:

  • Psychiatric hospitals are overcrowded with people waiting for discharge with nowhere to go.

  • Community support programs have room for just 22% of eligible New Yorkers.

  • State-assisted housing has room for just 6.5% of eligible applicants.

  • The current over-reliance on medication, the most problem-prone aspect of treating a mental illness, does little to turn patients' lives around.

  • Community programs' staff turnover rates due to meager salaries block patient progress.

  • Calls to 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 priorities.

  • Needed 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.

  • 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.

    Jean Arnold, Co-founder and Chair
    National Stigma Clearinghouse


    (1) Jaffe 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.




    February 23, 2008 - News of the Week


    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 2/20/2008).

    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'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.

    February 19, 2008 - News of the Week


    The following FDA Press Release was received from advocate Laura Van Tosh with a request to circulate it.


    FDA Issues Public Health Advisory on Chantix
    Agency requests that manufactureres add new safety warnings for smoking cessation drug

    February 1, 2008
    Media Inquiries:
    Susan Cruzan, 301-827-6242
    Rita Chappelle, 301-827-6242

    Consumer Inquiries:

    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 ]

    Patients should 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 varenicline therapy.

    Patients should immediately report changes in mood and behavior to their doctor. 
    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 behavior.

    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 warrant. 

    For more information:

    End of FDA Press Release

    January 31, 2008 - News of the Week


    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 quickly to 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?

    The Treatment 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 a 6-month 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 respond?

    The "Preventable Tragedies" database in 2006 contained 1,387 newspaper descriptions of homicides by "people with severe mental illness" from 1989 - April 2005. We examined the 66 descriptions covering the period July-December, 2004.

    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 database were committed by people taking medication. This affirms the possible role of medication in acts of violence.

    Our 6-month sample of homicides in  database showed the following:

  • 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.

  • 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 mental illnesses.
    We welcome comment: E-mail

    January 27, 2008 - News of the Week


    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 supports?

    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


    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.

    ARTICLE: Source, New Hampshire Business Review

    We Can't Wait to Fix the Mental Health System

    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 real action.

    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 December 2009.

    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 Concord-based Disability
    Rights Center.

    January 10, 2008 - News of the Week


    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 gun violence.

    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 potentially dangerous.

    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.


    STIGMATIZING EDITORIAL: "Progress on Guns," New York Times, January 8,2008 (emphasis added)

    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 — addresses 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 are needlessly lost.

    Copyright NYTimes
    Reprinted using Fair Use Standard

    January 6, 2008 - News of the Week


    The Treatment Advocacy Center ( 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 below.)

    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, 2002.)

    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 agenda.



    "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."


    Statements by the researchers are cautious. Click for the full report


  • "To what extent is violence associated with developmental and life-historical variables that precede the onset of schizophrenia? Definitive answers to these questions remain elusive.

  • "Violence 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]

  • "The 6-month prevalence of any violence was 19.1%, with 3.6% of participants reporting serious violent behavior."

  • Other 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






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