National Stigma Clearinghouse
NEWS ARCHIVE 2010
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January 4, 2010 - News of the Week
ARE SHOCK TREATMENT MACHINES SAFE? WILL THE FDA RULE OUT AN EVALUATION?
The following article comes from a nationwide coalition of mental health consumer/survivor organizations. This Washington-based coalition represents a large population with incomparable experience of electroconvulsive therapy.
This Friday, January 8, the FDA will decide whether or not to evalaute ECT as required. The advocates urge us to ask the FDA to meet its obligation to review medical devices.
Source: National Coaliton of Mental Health Consumer/Survivor Organizations (NCMHCSO)
E-mail, January 4, 2010
The FDA Wants to Declare Electroshock Machines Safe Without a Safety Investigation.
TELL THEM NO!
The Food and Drug Administration is in charge of regulating medical devices just as it does drugs, including the machines used to give Electroshock.
But it's not doing its job. It has allowed these machines to be used on millions of patients over the past generation without requiring any evidence whatsoever that shock treatment is safe or effective. This is so even though shock machines are Class III -- high risk -- devices, which by law are required to be subjected to thorough clinical trials as thoroughly as new drugs and devices just coming onto the market.
But because of intense lobbying by the American Psychiatric Association -- which claims the devices are safe but opposes an investigation -- the FDA has disregarded its own law. (For the full story of how shock survivors and other advocates have fought for a scientific safety investigation of Electroshock for the past 25 years, see Linda Andre's new book, Doctors of Deception: What They Don't Want You to Know About Shock Treatment.)
In April 2009 -- 30 years after it first ruled the devices high-risk and named brain damage and memory loss as risks of the treatment -- the FDA belatedly announced it would call on the manufacturers of the devices to provide evidence of safety and efficacy.
The deadline for submissions has passed, but the manufacturers have not conducted any clinical trials, claiming they cannot afford them. They simply point to the opinions of shock doctors (including those who have financial interests in companies making Electroshock machines) as evidence that shock is safe.
[To submit your electronic comment to the FDA, click here.]
For more information and sample letters, please visit our website: http://www.ncmhcso.org/ect.htm
National Coalition of Mental Health Consumer/Survivor Organizations
1101 15th Street, NW #1212, Washington, DC 20005
The purpose of the NCMHCSO is to share information that is consistent with our mission and values and that is significant for our constituency. The information above does not constitute an endorsement of any particular organization.
END OF ARTICLE
OTHER CONTACT INFORMATION
Record a comment by phone:
U.S. Dept. of Health & Human Services (oversees FDA)
January 17, 2010- News of the Week
GOVERNOR PATERSON, NEW YORK LEGISLATORS: PLEASE RESTORE HIJACKED MENTAL HEALTH FUNDS
Unfortunately, New York never found the funds to build a promised community support system for people with psychiatric disabilities. Now more than ever, the missing community programs are needed.
Advocates' hopes soared in 1994 when the hard-won Community Mental Health Reinvestment Act (CMHRA) was signed by Governor Mario Cuomo. The CMHRA promised that savings from a massive shutdown of inpatient psychiatric beds would be used to finance community support programs.
As reported in 2002, this downsizing of the state's psychiatric beds saved $242 million dollars annually. But most of those savings did not reach the community mental health system as promised.
The 2002 report states that Governor George E. Pataki, who became Governor in 1995, transferred a large percentage of the psych center savings to the state's general fund. The governor reportedly also found other ways to move mental health funds to his higher priorities. In another blow to hoped-for progress, the governor let the Community Reinvestment Act expire in September 2001 and stonewalled attempts to revive it.
The severely hobbled system reached meltdown in 1999 when a fatal encounter between a prematurely-discharged hospital patient and an aspiring young writer in a Manhattan subway station sent shockwaves across the state. Albany's leaders responded by quickly passing a new state law permitting coerced community treatment of 'treatment refusers' (Kendra's Law).
But the essential community programs were rare in 1999 and are still rare today.
As for the subway assailant, his futile search for psychiatric treatment was revealed in a meticulously-documented cover story in the New York Times Magazine by Michael Winerip (May 23, 1999). Despite this revelation, his 'treatment refuser' label lives on in the press.
A scathing report of shortchanged funding and system failure was released on October 31, 2002 by Assemlyman Martin A. Luster, who was then the chairman of the State Assembly's mental health committee. It seems that copies of the report, titled Broken Promises, Broken Lives: A Report on the Status of the Mental Health Delivery System New York State, are in no official archive.
For a single xeroxed copy of the 49-page Luster report, email firstname.lastname@example.org Please include a postal mailing address.
We urge Governor Paterson, the Legislature, the media, and the public to review this still-relevant report.
RESEARCHERS FIND LITTLE DATA CONCERNING ATTITUDES OF PROFESSIONALS
Researchers Otto Wahl and Eli Aroesty-Cohen, University of Hartford, after searching for literature concerning the attitudes of mental health professionals toward those they treat, report a serious lack of scientific data on this important topic. Their findings appear in the Journal of Community Psychiatry, Vol. 38 No. 1 (2010), Attitudes of Mental Health Professionals About Mental Illness: A Review of the Recent Literature. View Online at http://www3.interscience.wiley.com/cgi-bin/fulltext/123215869/PDFSTART
For decades, social scientists have sought to understand the general public's attitudes toward mental illnesses. The result is a significant body of research concerning the public's views of psychiatric disorders; most has been negative. Little scientific data is available, however, about the attitudes of mental health professionals. Yet the attitudes of mental health practitioners are important for good treatment outcomes and good quality of life for their patients. Further, in their roles as educators and members of their communities, professionals' views shape the opinions of future practitioners and other influential community members. Not least, the growing emphasis on recovery-oriented psychiatric programs calls for mental health professionals to understand and adapt if need be to those programs.
Researchers Wahl and Cohen focused their study on how psychiatrists, psychologists, and psychiatric nurses view and respond to the people they treat. After a comprehensive worldwide search, the researchers found 19 articles published since 2003 that met all their criteria for review. These 19 studies, though few in number, show that professionals' attitudes are a topic of concern around the globe. Coming from Scandinavia, Australia, Japan, Brazil, the U.S., Switzerland, the U.K., Austria, Turkey, Italy, and Singapore, the studies reflect unique cultures and conditions within each country. The researchers note,
Conclusions about prevailing attitudes in any one country will need a greater number of studies from each country than currently exist. For example, the three studies that employed U.S. samples are hardly sufficient to draw firm conclusions about the attitudes of U.S. Practitioners.
Overall, Wahl and Cohen's review of the existing literature suggests that while psychiatrists, psychologists, and psychiatric nurses are generally more positive in their attitudes toward people with psychiatric diagnoses than the general public, the researchers found negative attitudes present even in studies with overall positive results.
The failure to find consistent positive results for the attitudes of mental health professionals and the substantial number of mental health professionals expressing negative views is troubling... It is easy to see how the negative views expressed by many professionals may perpetuate stigma and interfere with practitioners' ability to respond helpfully to their patients' needs or to establish successful therapeutic relationships. It is easy to see how those negative attitudes may provide models for continued public negativity related to mental illness. … At the very least, we may need to include more discussion of attitudes about mental illnesses within our training programs
Worth special attention: Wahl and Cohen provide a useful guide to the challenges that confront future researchers in a section titled “Implications and Directions for Future Study.” They chart the pitfalls as well as the fruitful directions needed to advance this fledgling field of study. Hopefully, the article will inspire researchers and advocates alike to give the topic its due attention.
Correspondence to: Otto Wahl, Department of Psychology, University of Hartford, 200 Bloomfield Ave., West Hartford, CT 06117. E-mail:email@example.com
IS "SHUTTER ISLAND" A SOURCE OF TOXIC STIGMA?
For thirty years I've watched the horror-entertainment industry exploit and distort mental illnesses to titillate their audiences. Shutter Island, filmmaker Martin Scorsese's murky new whodunnit, appears to fit this pattern with Leonardo DiCaprio starring as a delusional murderer whose therapy is to investigate the crime he committed.Shutter Island is the latest product of a popular trend launched in 1960 by Alfred Hitchcock's "Psycho." This lucrative genre of films, also known as the Hollywood psycho-trough, features slasher movies catering to a huge audience of horror fans and teens. Mental health advocates contend that these pseudo-psychiatric characters fuel the public's misunderstanding of clinical terms such as psychosis and schizophrenia, over-emphasize violence and dangerousness, and erase the distinction between psychotic and psychopathic disorders.
More than ever, millions of Americans are plagued by the stigma of a psychiatric diagnosis. Studies have found that the public's fear of mental illnesses has intensified since 1950. Suggested causes include Hollywood's exploitation, the emptying of psychiatric hospitals without providing community supports, and a violence-focused public relations campaign initiated in 1993 by proponents of forced psychotropic medication.
For more than thirty years, mental health advocates have worked hard to reduce the toxic stigma and discrimination that plague millions who have psychiatric labels. Unfortunately, the end is nowhere in sight.
But all is not doom and gloom. See the research results of a middle-school education project described below in the newsletter of a progressive NAMI chapter.
New York Times review of "Shutter Island" by A. O. Scott, February 19, 2010.
"Shutter Island" plot and information posted by Wikipedia
Pathways, a NAMI Queens/Nassau Newsletter with five excellent stigma-related articles
March 9, 2010 - News of the Week
"SCHIZOPHRENIA" AND THE UPCOMING DSM-5
Now is an ideal time, while the DSM-5 authors are open to public comment on their new version of the APA's diagnostic manual, to recommend change to the much-misused diagnostic term “schizophrenia.” An excellent place to start is Phyllis Vine's “Should the Term Schizophrenia Be Changed?” Phyllis tells of a lively discussion on the topic last summer among 75 psychiatrists and psychologists from 25 countries. Of special interest is work being done outside the United States to find alternatives to a term that all seemed to agree is deeply stigmatizing. Her article's links and video clips add useful information.
There is no evidence in the APA's Proposed Revisions that “schizophrenia” might be replaced. Quite the contrary, a list of 16 non-specific labels (e.g. “mood disorders”) includes a odd 17th , “schizophrenia and other psychotic disorders.” Why not just “psychotic disorders?” Why include a term that is universally confusing? Why give it special billing over every other psychiatric condition?
Schizophrenia is a popular choice of people, sometimes even psychiatrists, who rush to judge an assailant on hearing a news report of violence. Schizophrenia is a term lawyers sometimes drop when they are concerned about a future criminal trial. Beyond hope of correction at this point is the popular misuse of schizophrenia to suggest “self-contradiction.”
Let us hope the confusion surrounding schizophrenia will be given serious attention before the DSM-5 goes to press.
“Should the Term Schizophrenia Be Changed?”
Proposed Revisions to the APA Diagnostic Manual (DSM-5)
"The Term 'Schizophrenia' Misused as a Label for Harm-Causing Conditions"
"Is Psychlaws.org Co-opting the Virginia Tech Tragedy?"
! DR. TORREY DOUBLES HIS BOGUS HOMICIDE ESTIMATE !
Dr. E. Fuller Torrey's obsession with homicide figures dates back to the 1990s when the media were quick to accept his unsubstantiated estimate that "1,000 homicides are committed annually" by an unmedicated group of people with schizophrenia or bipolar illness. Last week, in a startling claim in an ABC News feature, Torrey raised the estimate to 1,690 annually-- that would be 36 per week every week committed by an extremely small group of individuals.
Dr. Torrey's new 'discovery' about homicides is clearly as bogus as his previous guesstimates. The new number (10% of all homicides!) doubles his earlier estimate (5%), a figure based on six clippings from the Washington Post and some deceptive tinkering with research done by others. (Note: authors of the studies have confirmed that their work does not support Torrey's conclusions.)
Torrey's source of the 10% figure, which he projects to 1,690 homicides annually, seems even more shakey. Oddly, Torrey's website file of "Preventable Tragedies" showed only 179 homicides during the peak year of 2003.
It is alarming that the most visible, articulate, and engaging psychiatrist in the business has successfully promoted facts and figures tailored to suit his narrow agenda of coerced medication. Continuous repeated references to violence by the Treatment Advocacy Center can't fail to affect public attitudes. And this is after all the Torrey/Jaffe team's goal
March 21, 2010 - News of the Week
DOES THE 'TREATMENT ADVOCACY CENTER' HELP OR HARM?
Kendra's Law, New York's controversial statute permitting compulsory medication of psychiatric outpatients, is due to expire at the end of June, 2010. Already we are seeing efforts to make it permanent by the law's chief proponent, the Treatment Advocacy Center in Arlington, VA. Recent quotes by key spokespeople suggest that a new wave of fearmongering may be in the making.
Seventeen years ago, D.J. Jaffe, an advertising executive, advised mental health advocates that "from a marketing perspective it may be necessary to capitalize on violence" to pass laws compelling psychiatric outpatients to take psychotropic medication. Soon Jaffe joined forces with Dr. E. Fuller Torrey, a psychiatrist who shared Jaffe's compulsory medication agenda. Thus was launched an intensive public relations campaign linking mental illness with violence. Since then, factoid-laced, sensationalistic articles, op-eds and television features have appeared with depressing frequency in the national media. For an example, see "Will The Damage Be Doubled?" , a repeat of "Breaking Point," an infomercial for involuntary outpatient commitment on CBS's 48 Hours.
What's a financially-strapped advocacy movement to do? Advocates' protests requesting fairness fall on deaf ears at "60 MINUTES," "48 HOURS," "The Washington Post," and other national media. For nearly 20 years the Torrey/Jaffe team, unimpeded, has relied on a scare strategy to win public support for compulsory medication.
The fact is that there are no violence studies that focus on people with untreated schizophrenia and bipolar disorders, the Torrey/Jaffe team's target population. The Treatment Advocacy Center copes with this problem by lifting phrases out of context from work by others. The result is self-serving misinformation with respectable citations.
Does this twisted form of advocacy help or harm those it purports to assist ? Could this be a reason researchers are finding the public to be less tolerant toward people with psychiatric disabilities and decreasingly willing to accept housing and community support programs? See "Study Finds Fear Tactics Win Public Support for Coercion"
Below are some examples of *factoids circulated by the Treatment Advocacy Center. These items have been selected from the archives of the Anti-Stigma Home Page, http://www.stigmanet.org
The Torrey/Jaffe team wrongly interpreted conclusions concerning stigma in the Surgeon General's Report on Mental Health (1999). See "Torrey Twists Meaning of Surgeon General's Report"
The Torrey/Jaffe team distorted research concerning the effect of the news media on public opinion. See "Selective Reporting of News Skews Views" and "The Most Important Cause of Stigma?"
The Torrey/Jaffe team selectively reported violence estimates (in research based on a study investigating medication effectiveness) to inflate the result. See Treatment Advocacy Center Reduces Research on Violence to a Stigmatizing Soundbite
The Torrey/Jaffe team added incorrect interpretations to findings of a U.S. Department of Justice report on homicide. See "Just the Facts, Please!"
The Torrey/Jaffe team summarized research involving 49 subway pushings and attempted pushings over a 17-year period (1975-1991). The researchers (Martell & Deitz) chose to gather data only on assailants who were psychotic at the time of the offense (20 individuals - 1 of these rejected ). Torrey's 1-sentence summary of this study is nonsensical: "Among 20 individuals who pushed or tried to push another person in front of the subway in New York, all except one was severely mentally ill and offered motives directly related to their untreated psychotic symptoms." Such rewriting of research findings is outrageous. And no reader would guess that such pushings occurred only once or twice a year in a city of (then) 7 million people.
The Torrey/Jaffe team mislabeled Andrew Goldstein (of Kendra's Law fame) a "treatment refuser" even after his psychiatric records proved he had repeatedly tried to get treatment from a downsizing mental health system. See "More About Kendra's Law"
Four prominent and respected research organizations, The Lewin Group, the U. S. Department of Justice, the National Advisory Mental Health Council (NIMH), and the MacArthur Foundation on Mental Health and the Law have confirmed that their work does not support findings attributed to them by the Torrey team. See "Just the Facts, Please!" and "Ten Top Stories of 2007 Continue Fearmongering"
As the Kendra's Law expiration date draws near (June, 2010), the Torrey/Jaffe team has doubled its earlier 5% estimate of homicides committed by people with "untreated schizophrenia and bipolor disorders" to a frightening 10% of all homicides in the U.S. The doubled (10%) figure, however, misuses research and homicide numbers from data spanning 1990-2002.
See Dr. Torrey Doubles Bogus Homicide Estimate
*Editor's note: "A factoid is a questionable or spurious - unverified, incorrect, or fabricated - statement formed and asserted as a fact but with no veracity. The word appears in the Oxford English Dictionary as 'something which becomes accepted as fact, although it may not be true.' "
Quote is from Wikipedia, the free encyclopedia.
A FACTOID IN THE MAKING
A quote from Dr. Torrey
In an ABC News interview last week, Dr. Torrey stated: "The most recent data would suggest that about 10 percent of the homicides in the United States are committed by people who are bipolar or schizophrenia -- when they are not on medication."
Where's the evidence?
The Treatment Advocacy Center's most recent briefing paper on violence (updated April 2009) states that Individuals with severe mental illnesses are probably responsible for approximately 10 percent of homicides in the United States. They cite the following study.
"In Indiana, researchers examined the records of 518 individuals in prison who had been convicted of homicide between 1990 and 2002. Among the 518, 53 (or 10.2 percent) had been diagnosed with schizophrenia (n=27), bipolar disorder (n=12), or other psychotic disorders not associated with drug abuse (n=14). An additional 42 individuals had been diagnosed with mania or major depressive disorder. It should be emphasized that the study included only those who had been sentenced to prison and did not include those individuals who had committed homicides and were subsequently found to be incompetent to stand trial or not guilty by reason of insanity and therefore sent to a psychiatric facility instead of prison. Thus, the 10.2 percent is an undercount. The authors also noted that 80 percent of the mentally ill individuals who committed homicides had received past psychiatric treatment but that "many of the offenders were not receiving treatment" at the time of the homicide." Matejkowski JC, Cullen SW, Solomon PL. Characteristics of persons with severe mental illness who have been incarcerated for murder. Journal of the American Academy of Psychiatry and the Law 2008;36:74â€"86
Quoting Dr. Torrey: "In 2007, there were 16,929 homicides in the United States. If individuals with severe psychiatric disorders were responsible for only 10 percent of these, that would be approximately 1,690."
What's Wrong With This Picture? Torrey is either deceptive or very careless.
In fact, the research shows there were 27 people with schizophrenia and 12 people with bipolar (39 people). There's no information on their medications status. Torrey's "preventable tragedies" file confirms that homicides sometimes are committed while the assailant is on meds.
Torry has included 14 people with "other psychotic disorders" to bring his total number to 53. He can't do that and then apply the figure to "untreated people with schizophrenia and bipolar."
Torrey can't assume that none of the 39 assailants with schizophrenia and bipolar were on meds. The research study confirms this. A sample from Dr. Torrey's "preventable tragedies" showed 1/3 of homicide assailants were on meds at the time of the crime. (Also, some years ago in a NYTimes article about rampage killers, of 24 assailants who were prescribed meds 10 were taking them at the time of their rampage murders.) If we speculate that 13 of the 39 assailants could have been on meds, then Torrey's estimate is reduced to 4.4%.
Torrey uses an outdated figure for total homicides in the U.S, 16,929 (2007). The most recent figure is 14,180 (2008). This lowers his already unsubstantiated estimate (1,690) committed annually by people with untreated schizophrenia and bipolar illness
April 11, 2010 - News of the Week
IT CAN BE DONE! TORONTO LAUNCHES A MODEL HOUSING PLAN
ARTICLE: Toronto Hospital's 'Urban Village' Integrates Mentally Ill Patients, The Canadian Press, April 5, 2010
By Sheryl Ubelacker
April 5, 2010
TORONTO — Originally erected in 1850 as the Ontario Lunatic Asylum and enclosed on all sides by a solid brick wall, Canada's largest hospital for treating mental illness is undergoing a radical transformation that could make it a model for the rest of the country.
The Centre for Addiction and Mental Health is tearing down walls both literally and figuratively, revamping its 10.9-hectare site in Toronto to create an urban village that will integrate its buildings and the people it cares for into the surrounding neighbourhood.
"It reflects changes in the understanding of what's necessary for people who have mental illnesses and addictions to live their best life, to fulfil their potential in life, which in some cases can be limited by their illness," says Dr. Catherine Zahn, president and CEO of CAMH.
That means helping a person struggling with a mental illness and-or addiction to reintegrate into society - to return to their home, hold down a job, to be a good family member and friend, says Zahn.
"And the best way to do that is when and if an individual who has mental illness is capable of it, to start right away, to have them in an environment that most closely resembles the real world."
The multi-phase process of overhauling the nine-square-block CAMH site in the city's vibrant Queen Street West neighbourhood began two years ago with the building of four "alternative milieu" units that provide transitional housing for in-patients prior to discharge.
On Tuesday, the hospital breaks ground for three buildings that comprise the next phase of its rebuild, among them a 60-bed Intergenerational Wellness Centre for youth and geriatric patients that includes Canada's first in-patient facilities for teens with both mental illness and addictions.
But the revamp isn't just about new buildings.
New streets wend their way through the site, connecting and blending CAMH with the neighbourhood's local cafes, businesses and residences.
"The idea is that there is very little value in closing people with mental illness off from the community and vice versa," says Zahn.
"The opening up to the community from the perspective of our patients just carries that metaphor forward that to fully recover they have to be rehabilitated, that the community has to be part of their healing process."
Zahn says the integrated CAMH campus, dotted with plenty of green space, trees and gardens, is meant to help erase the stigma that isolates people suffering from such illnesses as schizophrenia, bipolar disorder or severe depression.
"It includes transforming attitudes about people with mental illness, so reducing stigma but also reducing prejudice," she says. "The unknown is always a stimulus for prejudice. So getting to know the organization better, opening it up, is an important stimulus to reducing prejudice and subsequently reducing discrimination."
Angela Foot has already felt the power of that inclusiveness.
In early 2006, she was referred to CAMH because she had hit her "own personal rock bottom" and was suicidal. Her diagnosis of bipolar disorder finally explained the many years she had struggled with violent mood swings - alternating between long periods of mania when she couldn't sleep and then weeks to months plunged in the depths of depression - that destroyed relationships and finally left her unable to work.
As an out-patient, Foot was prescribed a number of treatments, including various group therapy sessions that took place in one of CAMH's institutional buildings. But recovery was slow, she says.
In December 2008, she was admitted to one of the new alternative milieu units, a street-front apartment-like building that provides a home-like, stepping-stone residence for patients before discharge back into the community.
"It was so different than what my experience was in the day-treatment program, which is in one of the older buildings," says Foot, 36. "Because those four new buildings are on the street, with sidewalks and trees and benches and so on, it feels like you're a part of the community and a part of the outside world."
Designed to be airy and light-filled, each floor includes a shared kitchen, dining area and TV lounge, with individual rooms for residents fitted out with private bathrooms and showers.
The living quarters are a long way from the outdated notion of a huge room lined up with beds, says Foot. "You have this sense of dignity, I guess, over taking control of your illness but not feeling like you're a complete freak show."
"If you create an environment that is not so isolating, it may in fact speed up your recovery or enable you to take better advantage of all of the treatments that are available to you," says Foot, who lived in the unit for a month before being discharged back home as an out-patient.
"Had I at that point been in the new building ... my experience could have been very different."
Alice Liang of Montgomery Sisam Architects Inc., part of a consortium of architectural firms hired to refine the master plan and erect the first phases of the rebuild, says brick, residential-type windows and other materials were used to make the new buildings harmonize with existing structures in the neighbourhood.
The designs also incorporate energy-saving elements such as green roofs and are meant to be sustainable, she says. "Thirty years from now, if the hospital no longer needs those buildings they can easily be converted into private residences or apartments."
"The important aspect to really stress from our architectural perspective is that we took this on not to create a monumental building (like) the ROM museum or the (Ontario) Art Gallery," Liang says of the recently redesigned iconic Toronto landmarks. "We really see these buildings as good solid designs that are good neighbours that really work with the community and support the whole notion of integration."
But CAMH didn't rely only on professionals when deciding how to make its buildings more patient-friendly. It went right to the source.
Alex Bustos, a 20-year-old out-patient who's been receiving therapy for depression and substance abuse since early 2009, says he and other young people at CAMH were consulted about what would make "kids of our age feel most comfortable, to feel like they're at home ... not like an institution, which is kind of scary and cold."
That included everything from room design and paint colour to the type of flooring and furniture style, says Bustos, who has been free of his marijuana habit and alcohol addiction for three months.
Bustos, who will soon get his high school diploma and is considering going into social work, calls his treatment and recovery at
"There's more hope in my life, more purpose to live. Before I was struggling, so I felt hopeless. Life is good."
Of course, notes Zahn, CAMH is a hospital and will still provide long-term care, as it has all along.
"We have patients here who are very, very ill and they do require secure environments ... And there's no intention to diminish the care of people who require that type of an environment."
It will take another five to 10 years before the entire campus has been completely transformed to conform to the urban village vision, she says.
But as antiquated structures are demolished to make way for the new, the blurring of lines between those being treated for mental illness and the rest of the world has already begun, says Zahn, quoting one patient's reaction.
"Finally we can see out - and they can see us."
Reprinted Using Fair Use Standard
April 18, 2010 - News of the Week
Graying in a Home, Not an Institution
by Michael Winerip
New York Times, April 18, 2010
GRAYING IN A HOME, NOT AN INSTITUTION
By Michael Winerip
SVETLANA GOMELSKY, 61, who has schizophrenia, is the beneficiary of one of the quietest, least-heralded social revolutions of her generation.
Starting at about 18, she began hearing voices. "The first time, I thought it was an accident," she said. "They went away." She married, had two children, lived in the Long Island suburb of Lawrence and worked as a secretary at a Hebrew school. But eventually the voices returned, growing more intrusive. "I got scared," she said. "Not only was I hearing voices, I could talk to them. I started to feel God gave me these powers because he had a special plan for me."
Her husband divorced her; her children, by then young adults, moved out of the house into an apartment. In 1992, she wound up in a psychiatric hospital for six months. "I couldn't function, I lost my house, all these bad things happened to me," she said.
But her timing was lucky. By then, New York State had taken notice of all the mentally ill being discharged from hospitals and winding up homeless on the streets, and was paying for the first supervised community residences and apartment programs. Ms. Gomelsky got a place on a quiet suburban street, in a new group home of 10 residents that had 24-hour supervision, oversaw her medications, provided therapy and job training.
In the 18 years since, there have been setbacks, but many more gains. She has moved to a subsidized apartment where a caseworker visits just once a month. She works 20 hours a week as an office clerk. Sweetest of all, three days a week, she's able to baby-sit her three grandchildren, ages 10, 9 and 2, so her daughter can work.
There is no miracle here. Ms. Gomelsky's schizophrenia has not gone away, nor have the voices stopped, even with meds. "I do find if I'm busy, I hear them less," she said. "If they become a problem I speak to my therapist and psychiatrist and they adjust my meds, so I can manage."
Ms. Gomelsky's is the first generation with serious mental illness to largely escape the state hospitals. In the 1950s, there were 93,000 long-term patients in New York mental hospitals, some who had lived there for decades. Today there are 4,000.
By 1978, New York had financed just 308 group-home and apartment beds for the mentally ill in the entire state; today, there are about 30,000.
When Marjorie Vezer, 57, executive director of South Shore Association for Independent Living — the nonprofit agency that houses Ms. Gomelsky — opened her first group home in the late 1980s, she said, "we were looking for young people, in the 18 to 35
She found them. They've largely stayed and now, as they gray, they dominate state-financed community housing. In 1999, 56 percent of the state's group-home and apartment population was in the 41 to 70 age range; today, 72 percent is.
The 18- to 30-year-olds now make up just 11 percent of the state total.
Twenty-five years ago, Ms. Vezer's group-home counselors kept an eye out for sexual promiscuity issues, drug and alcohol abuse, fighting. Now the added worry is residents' health: hypertension, heart issues, diabetes, obesity. Ms. Vezer recently hired her agency's first two nurses.
Between the psychiatric disorders — 70 percent of the 308 people Ms. Vezer houses have schizophrenia — and middle-age problems like high cholesterol, some residents can take 20 pills a day.
One reason more young adults are not entering the housing system is that state funds have failed to keep pace with the need.
The state has not done as well for the mentally ill as it has for the developmentally disabled. Though community beds paid for by the State Office of Mental Retardation and Developmental Disabilities cost two to three times as much as beds for the mentally ill — because of higher supervision levels — New York has financed 7,000 more beds for that population.
We have very different attitudes about the two groups. In the late 1990s, when 26 developmentally disabled adults were found living in homeless shelters in Westchester, there was outrage. Indeed, Gov. George E. Pataki was so embarrassed by the press reports, he created an extra housing program for the developmentally disabled.
There is no similar outrage about homeless shelters being full of people with schizophrenia. Patrick Markee of the Coalition for the Homeless said surveys indicate about half the 7,900 people in New York City's single-adult shelter system have serious mental illness.
That, of course, is the story we know too well: the ragged people on the corner talking to themselves.
The story we hardly know at all, because it's hidden from view, is the 30,000 seriously mentally ill New Yorkers like Dennis and Pat Siegel (shown in the photo) who live in quality state-financed housing. Both have schizophrenia, both have been hospitalized for long stretches and both have been homeless.
In the years before the couple met, Mrs. Siegel, 62, worked as a secretary. When her illness flared, she left her parents' home and lived in her car on Long Island. "I stayed in a parking lot in East Meadow," she said. "I'd walk to a soup kitchen in Hempstead for lunch — they'd let you take extra rolls, so that was my dinner." After selling the car, she said, she slept outside. "In Garden City, by the fancy stores, I stayed in a bush." Asked how long, Mrs. Siegel said, "I didn't have a calendar, I was day by day."
The schizophrenia first hit Mr. Siegel, who's now 60, when he was in his 20s and working as a salesman. After that, he said, he couldn't hold a job. "I tried, please put that in the article," he said. "King Kullen, Petland, a Shell station, cleaning."
He was hospitalized repeatedly and tried killing himself twice. Mostly he lived in illegal rentals. "I stayed in a little house in Elmont," he said. "There was a different family on each floor, and I was in the basement."
In 1997, he moved into an apartment run by Ms. Vezer's agency. He saw a caseworker regularly, and his hospitalizations went way down. "I haven't been hospitalized in five years," he said.
That's a big savings for taxpayers. It costs $250,000 for a year at a state hospital; $30,000 for a month on the psychiatric unit of a community hospital; and $14,500 for a year in the cheery apartment where Mr. Siegel now lives.
He met his future wife at a social club paid for by a mental health agency.
"Dennis said, 'Here's my number, give me a call,' " Mrs. Siegel said.
"I played it cool," Mr. Siegel said.
Once a month they went out to dinner. "One day Dennis said to me, 'Oh my God, do you want to marry me?' "
"That's what I did," Mr. Siegel said.
She borrowed $200 to buy a dress along with five pizzas, chips and sodas for 20 friends at the boardinghouse where she lived. They were married Dec. 6, 1999, at Long Beach City Hall.
Within a month, the agency found another place for Mr. Siegel's male roommate, and Mrs. Siegel moved in.
Their apartment is a sunny one-bedroom with lots of windows, on the second floor of a house, along a quiet side street in Valley Stream.
"You can walk to the railroad station," Mr. Siegel said. "The bus stop's a block away."
"Pat keeps it spotless," he added. "She scrubs the toilets with bleach, the floors. Cooks meals for me."
"Look at this belly," Mrs. Siegel said. "He's gained weight."
"I don't really know what else to say, except thanks," Mr. Siegel said. "What do you like about the place, Pat?"
"Exactly what you said, honey," Mrs. Siegel said.
End of Article
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June 12, 2010 - News of the Week
NEW JERSEY ADOPTS "HOUSING FIRST" PROGRAM AS COST-SAVING WAY TO HELP MENTALLY ILL HOMELESS INDIVIDUALSARTICLE: Community mental health saves lives and tax dollars
Source: The Times
Â©2010 Times of Trenton
Â© 2010 NJ.com All Rights Reserved
(from Google Alerts Email)
State budget planners have a daunting task. How do they save tax dollars without throwing to the wolves society's most vulnerable?
One strategy is to invest in more programs like community mental health, which not only pays for itself and returns to the taxpayer $1 billion each year in savings, but also each year improves the quality of life for 500,000 New Jersey residents.
Thirty years ago, the state began investing in community mental health's statewide network of community prevention and treatment programs. These programs replaced high-cost inpatient care as the treatment of choice for those with disabling mental health conditions.
By investing in community mental health programs, the state has reduced the number of public psychiatric beds from 15,000 in 1970 to roughly 2,000 in 2010. Thanks to this 87 percent reduction, the taxpayer avoided a $2 billion price tag in FY 2010 for public psychiatric beds.
Instead, investing in community mental health has allowed the state to finance the entire community treatment system and remaining public psychiatric beds at a combined cost of $1 billion.
In FY 2010 alone, this provided the taxpayer a net savings of $1 billion. Now, multiply that by 20 or 30 years and we get a sense of how much has been saved over the past few decades. So, what will be the impact of the proposed cutbacks in the FY 2011 budget?
Whenever there are community mental health cutbacks, there is always the risk of increased high-cost emergency care, hospitalizations, community incidents, incarcerations, etc. Any cutback to these services is always a high-cost gamble for short-term budget savings (emphasis added).
Instead of cutbacks, the state should focus on applying community mental health's cost-saving strategy to other problems. For example, we should focus on reducing the high cost of homelessness by implementing community mental health's Housing First model throughout New Jersey, as numerous other cities and states have done.
Housing First is a triumph of common sense. It looks first to correct the homeless person's housing problem and then address the other problems that have contributed to homelessness.
Housing First programs provide housing, treatment and 24/7 support to ensure that the formerly chronically homeless stay healthy enough to be good tenants and good neighbors.
Housing First studies have shown that by providing an apartment and community treatment to the chronically homeless with mental illness, we can reduce their use of high-cost services (e.g., emergency room visits, hospitalizations, incarcerations, etc), and thereby reduce the taxpayer's burden.
Greater Trenton Behavioral HealthCare operates the state's first Housing First program. A consortium of government agencies, the Greater Mercer United Way and the Mercer Alliance to End Homelessness jointly funds this pilot project. Researchers from Tufts University provide program evaluation.
Of the 55 chronically homeless adults and families served by the Greater Trenton program since it began 30 months ago, none has been evicted or hospitalized. Although one was incarcerated briefly, he is back in the program and doing well.
These results are better than expected. Most studies found success rates of 70 percent to 90 percent. These studies also found that Housing First not only paid for itself but also produced net savings during the study period of $4,745 per person in Denver, $9,400 per person in Massachusetts, and $8,839 per person in Rhode Island. It is too early to count the savings from the Greater Trenton program, but we are clearly headed in the right direction.
The human cost savings, however, may be even more important. For example, Anthony, age 35, who was homeless for six years, has been in his own apartment for two years for the first time in his life. He has also been in recovery for 18 months from substance use, actively engaged in mental health treatment and working part-time.
After being homeless for 10 years, Marie, age 47, has been a Housing First tenant for 14 months. Although she still uses alcohol, it is much less frequent. She is working with her psychiatrist and housing counselor to find an alternative to drinking to reduce her distress. Also with help from her counselor, she is addressing for the first time post-traumatic stress from early childhood sexual abuse. Marie has returned to photography and has had several shows at local galleries. She says this is the first time she has felt happy and has hope for her future.
Investing in community mental health helps people like Anthony and Marie recover lost hope and get a second chance. Such investments save tax dollars and solve community problems by saving lives.
Cutbacks and over-regulation of community providers weaken their cost-saving capacity and ultimately lead to hospitalization, incarceration and other higher cost outcomes.
Rather than whittle away at community mental health's capacity to reduce the taxpayer's burden, let's continue to invest in what works and focus budget reductions on what does not.
End of Article
July 18, 2010 - News of the Week
5 Communities Re-examine Use of Police to Intervene in Mental Health CrisesSource: Bazelon Center for Mental Health Law
Press release: July 6, 2010
More frequently, news outlets across the country, like the ones below, are reporting shocking stories about tragic outcomes stemming from police involvement in mental health emergencies.
· “Camden County Man Dies After Struggle with Police,” Philadelphia Inquirer 4 May 2010
· “Autopsy Links Taser to Cardall’s Death,” Salt Lake City Tribune 19 November 2009
Recognizing the devastating impact of cyclic arrest, incarceration and hospitalization on people with serious mental illnesses and their communities, the Bazelon Center for Mental Health Law has launched an initiative designed to reduce reliance on local law enforcement to intervene in psychiatric emergencies. The goal of the initiative, called the Performance Improvement Project (PIP), is to enable community mental health systems to take a more active role in preventing the scenarios whereby people with serious mental illnesses are subject to police intervention.
Five sites were selected to participate in the Performance Improvement Project--Travis County (Austin), TX, Wayne County (Detroit), MI, Allegheny County (Pittsburgh), PA, Multnomah County (Portland), OR, and Westchester County (White Plains), NY. The Bazelon Center, with support from the Open Society Institute and others, is the lead organization. The Bazelon Center will coordinate the initiative and provide partial funding to each project site.
The project relies on local expertise and a systematic process of observation and analysis to track down the “root causes” that leave people with mental illnesses vulnerable to police involvement. From this information, project sites will be able to uncover service shortcomings, assess social and fiscal costs, and identify any needed systems improvements. A compilation of findings across sites will reveal structural obstacles faced by public sector providers as they attempt to meet the needs of the most vulnerable people with serious mental illnesses.
“For too long, we have viewed people with serious mental illnesses cycling through jails and emergency rooms as routine, when this is, in fact, a clear signal of failing public systems,” said Robert Bernstein, executive director of the Bazelon Center for Mental Health Law.
“Although the results of the Performance Improvement Project will lead to better performance by community mental health providers, the greater goal of this initiative is to illuminate barriers to improvement that stem directly from regulations and policy made at various levels,” Bernstein said.
“Establishing an engaged, coherent and fully-resourced community mental health system improves outcomes for people with serious mental illnesses, reduces costs, and reduces the burden on law enforcement to serve as the social service safety net,” he added.
“This project could represent a giant step forward for community mental health” said Linda Rosenberg, President and CEO of the National Council for Community Behavioral Healthcare. “Applying a performance improvement model to quantify how policies and practices are actually affecting services makes a lot of sense. Data from this project can fuel long-needed change,” added Rosenberg.
The five sites selected by the Bazelon Center have a history of making efforts to provide coordinated community services and supports designed to help avert mental health crises that lead to contact with law enforcement. Each has also demonstrated interest in pursuing policy reforms that support better outcomes for individuals and improved accountability for government investment in mental health and other human services.
# # #
The Bazelon Center for Mental Health Law is the leading national legal-advocacy organization representing people with mental disabilities. It promotes laws and policies that can enable people with psychiatric or developmental disabilities to exercise their life choices and access the resources they need to participate fully in their communities.
August 1, 2010 - News of the Week
A BRITISH CLINICAL PSYCHOLOGIST MAKES STRONG CASE FOR SHIFT IN PSYCHIATRIC TREATMENT
"Arguing passionately for a future of mental health treatment that focuses as much on patients
as individuals as on the brain itself, this is a book set to redefine our understanding of the treatment
of madness in the twenty-first century." (Quote from book jacket)
Doctoring the Mind: Why Psychiatric Treatments Fail
by Richard P. Bentall
Book Review by Lesley McDowell
Published June 13, 2010 The Independent
The end of the 20th century saw powerful indictments of the way we treat people with mental-health problems, not from those in the psychiatric profession but from those on the receiving end. Psychiatry's increasing reliance on pharmaceuticals was coming under attack, and a more caring, less drug-dependent way was being advocated by the newer strand of mental-health specialists: clinical psychologists.
One of the many fascinating things that Richard P. Bentall's excellent book flags up is the lack of progress we seem to have made in the past 200 years. Ironically, knowing far more about how the brain works than, say, the 18th-century's William Cullen, or even Freud, seems barely to have improved our ability to treat mental problems. If anything, neuroscience, in emphasising the brain's failures, has advocated a more simplistic approach: a chemical imbalance in the brain? Here, pop a pill. We may no longer chain "mad" people to walls or apply leeches to their skin, but the moment in the early 19th century when more holistic methods were advocated was quickly eclipsed when the emerging study of psychiatry sought to establish itself as a science, and did so by becoming as authoritative as possible.
Many of us may not know about the opposition between psychiatry and clinical psychology, but, given that mental illness is apparently on the increase - "the lifetime risk of suffering from any kind of psychotic disorder may be as high as 3 per cent, [which] means as many as 1.8 million British citizens" we had perhaps better start becoming educated about them. Bentall, a professor of clinical psychology himself, can hardly be the most disinterested commentator on these arguments, but he has produced a lucid and accessible account of a tricky but endlessly absorbing subject.
- End of book review: Doctoring the Mind: Is Our Current Treatment of Mental Illness Really Any Good? -
- Reprinted using Fair Use Standard -
August 8, 2010 - News of the Week
PEER COUNSELORS CAN SOFTEN AN EMERGENCY ROOM EXPERIENCE
For more information see
Peer Counselors Support Consumers in Emergency Rooms by Phyllis Vine
For people who have psychiatric vulnerabilities, an emergency room visit can be prohibitively traumatic. An extreme example is the death-by-neglect of Esmin Green, a woman who collapsed and died unnoticed on the floor of a psychiatric waiting room after a 24-hour wait for help. June 18, 2008, at the Kings County Hospital Center in Brooklyn, New York City.
Psychiatric peer counselors have become a fast-growing source of valuable assistance in programs that provide psychiatric services. They can also contribute valuable help in emergency rooms.
Phyllis Vine (www.miwatch.org) explores this innovative services model, now expanding nationally, in Peer Counselors Support Consumers in Emergency Rooms
Update on Kings County Hospital Psychiatric Center
Source: NYAPRS Enews, August 10, 2010
Following Esmin Green's tragic death in the Kings County Hospital psychiatric emergency room in 2008, a legal settlement prompted New York City's Health and Hospitals Corporation to increasingly hire peer staff in their inpatient and outpatient programs at Kings County and other HHC public hospitals. Here is a promising account of this welcome new direction: Peers Bring Hope To The Mentally Ill by Erin Durkin, New York Daily News, August 9th, 2010.
August 20, 2010 - News of the Week
CAN THERE BE RECOVERY WITHOUT A SAFE PLACE TO LIVE? (2 articles)
A sharp rise in brutality against homeless individuals, many of them mentally ill, adds new urgency to the longstanding need for safe housing. KUDOS to Clint Zweifel, Missouri's state Treasurer, who this week presented state officials with a plan to prioritize mental health housing.
ARTICLE 1: KILLINGS OF HOMELESS RISE TO HIGHEST LEVEL IN A DECADE
To read this article without registering, go to New York Times website. Enter search for eric lichtblau > click Times Topics recent and archived news by Eric Lichtblau > scroll to "Killing of Homeless..." (August 19, 2010)
ARTICLE 2: A PLACE TO CALL HOME -- FOR CLINT ZWEIFEL MENTAL HEALTH HOUSING IS A PRIORITY
By Bob Watson
For the Fulton Sun
August 20, 2010
When the Missouri Housing Development Commission meets this morning, state
Treasurer Clint Zweifel wants its members to approve his plan to direct a third
of the state's annual low-income housing aid to mentally ill Missourians.
"The $127 million investment that I am proposing provides a place to call
home for sons, daughters, moms and dads and military veterans who suffer from
mental illness and are homeless -- or at a very high risk of suffering from
homelessness," Zweifel told reporters in his Capitol office.
"My proposal would provide an estimated 400 homes that would provide safe,
stable housing to help our friends and neighbors get back on their feet, and
fight chronic homelessness right here in Missouri."
The treasurer would couple the new housing with "critical, supportive services that are so important ... that these individuals ultimately need to be healthy and well and thrive," including on-site care, crisis help and case management.
Zweifel said his plan would not require any new spending nor does it mandate
a specific model for developers to follow.
"It's not a one-size-fits-all-approach government mandate," he explained. "It's instead a way to use the best of what Missouri has to offer -- community-based organizations, local governments, state government and businesses really coming together to provide real solutions that deal with the issue of homelessness."
He said several housing commission members already support his idea.
But Housing Commission Chairman Jeffrey Bay told The Associated Press Wednesday that he didn't have enough information about Zweifel's proposal to decide whether to support it -- and he didn't expect Zweifel's idea to be resolved at today's meeting.
"I am not aware that the staff has investigated it adequately and fully to know all of the ramifications of it," Bay said.
NAMI of Missouri supports Zweifel's plan.
"We've seen increases in homelessness in Missouri in the last few years and, with resources being more and more strapped, we just expect that trend to continue," said Cynthia Keele, the group's director. "It's also real important that people with mental illness have stable housing, because how can you recover?
"We know, today, what it takes for people to recover from mental illness and how to help people get back and get back into society. But how can anyone start that process, if they don't have a place to live?"
Keele said some developers already have said they'd be interested in such a project, using tax credits the MHDC already has the authority to give to developers.
Though he promoted his plan at a Wednesday morning news conference, Zweifel sent Bay a letter on July 2 of his request for the commission's vote on his idea.
"This is consistent with the MHDC's commitment to fighting homelessness in Missouri," the treasurer wrote. "Focusing on mental illness and homelessness should be a critical strategic function of the MHDC."
The commission's members include Zweifel, Gov. Jay Nixon, Lt. Gov. Peter Kinder, Attorney General Chris Koster and six Missourians appointed by the governor.
The meeting is set to begin at 9 a.m. today at the Capitol Plaza Hotel.
- End of Article 2 -
Reprinted using Fair Use standard
September 5, 2010 - News of the Week
IN VIOLENT CRIMES, WHY IS SCHIZOPHRENIA A FAVORITE CALL? (YOU CAN THANK ALFRED HITCHCOCK)
Isn't it amazing that psychiatrists are able to diagnose the perpetrator of a violent crime based only on news reports? Say again? On Wednesday last week, gunman James J. Lee was killed by police after taking three men hostage at the Discovery Channel headquarters. On Thursday, ABC News quoted several prominent psychiatrists who speculated that the assailant must be suffering from paranoid schizophrenia.
Can even the most experienced psychiatrists diagnose a person they've never seen? It seems unlikely. Many psychiatric patients receive different diagnoses from different psychiatrists despite intensive reviews of their conditions. If psychosis is a symptom, there are many possible causes.
A just-published study makes a strong case for re-examining the efficacy of current diagnostic practice, particularly as it concerns schizophrenia. This study is accessible (but not permanently) at www.miwatch.org In the miwatch Headlines box, scroll to JOURNALS where you will find "Are psychiatric diagnoses of psychosis scientific and useful? The case of scizophrenia" by Jim Van Os.
Why would the media circulate a diagnosis based on a rush to judgment? Are such diagnoses ethical? What about the media who circulate them? Is the potential jury pool the target of such premature speculation?
Many experts have said that schizophrenia is a last-ditch choice when other diagnoses seem not to fit. To be sure, schizophrenia is a term fraught with misunderstanding and misuse. For decades, the public (which includes jurors, judges, and lawyers) has been confused about what "schizophrenia" actually means.
Largely to blame for the confusion is the word "psycho," a movie title coined in 1960 by Alfred Hitchcock. It's been forgotten that for Hitchcock, "PSYCHO" had no link to psychosis or schizophrenia. Yet 70 years later this false and stigmatizing notion thrives in the public's imagination. Schizophrenia seems permanently associated with violence, causing untold damage to millions of gentle law-abiding individuals.
Likely to prolong the confusion and stigma that plague schizophrenia is a proposed category in the new upcoming edition of the psychiatric diagnostic manual. The DSM-5 proposes a category titled "Schizophrenia and other psychotic disorders," while other category titles are very broad. A typical category is titled "Mood Disorders," (which includes disorders that may have psychotic symptoms.)
September 12, 2010 - News of the Week
CREATOR OF "PEOPLE SAY I'M CRAZY" REACHES OUT WITH WEBSITE
At age 21, John Cadigan's life was painfully interrupted by paranoid ideas so severe that his world became a threatening prison. Thus began a seemingly hopeless struggle for survival that lasted more than a decade.
Fast forward ten years. With encouragement from his filmmaker sister, Katie, John created "People Say I'm Crazy," an extraordinary documentary that traces his journey toward recovery. John did most of the arranging, directing and photography, while Katie oversaw production details. "People Say I'm Crazy" won acclaim from critics when it was first released in 2003, and soon awards began to pile up.
John sees his website as a way to share his experiences, and to hear from and exchange views with others whose lives have been interrupted with what are commonly called mental illnesses.
A NEW STUDY UNDERSCORES THE NEED TO RETHINK STIGMA REDUCTION EFFORTS
SOURCE: Press Release, September 15, 2010
Study: Mental illness stigma entrenched in American culture; new strategies needed
BLOOMINGTON, Ind. -- A joint study by Indiana University and Columbia University researchers found no change in prejudice and discrimination toward people with serious mental illness or substance abuse problems despite a greater embrace by the public of neurobiological explanations for these illnesses.
The study, published online September 15 in the American Journal of Psychiatry, raises vexing questions about the effectiveness of campaigns designed to improve health literacy. This "disease like anyother" approach, supported by medicine and mental health advocates, had been seen as the primary way to reduce widespread stigma in the United States.
"Prejudice and discrimination in the U.S. aren't moving," said IU sociologist Bernice Pescosolido, a leading researcher in this area. "In fact, in some cases,it may be increasing. It's time to stand back and rethink our approach."
Stigma, the well-documented reluctance by many to socialize or work with people who have a mental or substance abuse disorder, is considered a major obstacle to effective treatment for manyAmericans who experience these devastating illnesses. It can produce discrimination in employment, housing, medical care and social relationships, and negatively impact the quality of life for these individuals, their families and friends.
Funded by the National Institute of Mental Health, the study examined whether American attitudes concerning mental illness have changed during a 10-year period when efforts on many levels and by many groups focused on making Americans aware of the genetic and medical explanations for depression, schizophrenia and substance abuse. While Americans reported more acceptance of these explanations, this did nothing to change prejudice and discrimination, and in some cases, made it worse.
The study involved questions posed to a nationally representative sample of adults as part of the General Social Survey (GSS), a biennial survey that involves face-to-face interviews. Around 1,956 adults in the 1996 and 2006 GSS first listened to a vignette involving a person who had major depression, schizophrenia or alcohol dependency, and then they answered a series of questions.
Some key findings include:In 2006, 67 percent of the public attributed major depression to neurobiological causes, compared with 54 percent in 1996.
High proportions of respondents supported treatment with overall increases in the proportion endorsing treatment from a doctor, and more specifically from psychiatrists, for treatment of alcohol dependence (79 percent in 2006 compared to 61 percent in 1996) and major depression (85 percent in 2006 compared to 75 percent in 1996).
Holding a belief in neurobiological causes for these disorders increased the likelihood of support for treatment but was generally unrelated to stigma. Where associated, the effect was to increase, not decrease, community rejection of the person described in the vignettes.
Pescosolido said the team's comparative study provides real data for the first time on whether the "landscape for prejudice for people with mental illness" is changing. It reinforces conversations begun by influential institutions, such as the Carter Center, about the need for a new approach toward combating stigma.
"Often mental health advocates end up singing to the choir," Pescosolido said. "We need to involve groups in each community to talk about these issues which affect nearly every family in America in some way. This is in everyone's interest."
The research article suggests that stigma reduction efforts focus on the person rather than on the disease, and emphasize the abilities and competencies of people with mental health problems. Pescosolido says well-established civic groups -- groups normally not involved with mental health issues -- could be very effective in making people aware of the need for inclusion and the importance of increasing the dignity and rights of citizenship for persons with mental illnesses.
For a copy of the study, please contact Alex Capshew at firstname.lastname@example.org
Co-authors include Jack K. Martin, Schuessler Institute for Social Research
at IU; J. Scott Long and Tait R. Medina, Department of Sociology in IU's College
of Arts and Sciences; and Jo C. Phelan and Bruce G. Link, Columbia University
Mailman School of Public Health.
End of Press Release
EDITOR'S NOTE: A look at what is possible
In January of 2009, three British consumer-led organizations joined forces to launch a massive, well-funded anti-discrimination program called Time to Change. Having survived harrowing symptoms and social isolation, the oganizers were determined to tell the public the real story about mental illnesses. Endorsements of their campaign came from the Prime Minister, members of Parliament, and favorites from the entertainment world, among other bold-type names. Six months into the campaign, the British Department of Health issued a report on the preliminary results. An ongoing evaluation will not only increase the project's effectiveness but will help others plan stigma reduction programs. ja
October 15, 2010 - News of the Week
MARK VONNEGUT RECOUNTS HIS UNEVEN PATH TOWARD RECOVERY IN NEW MEMOIR
Thirty-four years ago, Mark Vonnegut M.D. wrote a groundbreaking best-seller, The Eden Express, A Memoir of Insanity. The mature Vonnegut now shares his experiences of psychosis, the recovery process, disturbing practices and trends in healthcare, and much MUCH more, in a new memoir, Just Like Someone Without Mental Illness Only More So. An apt description of this absorbing book is on its bright blue jacket: "Wise, unsentimental, and inspiring." Below is an insightful review.
BOOK REVIEW: Doctor wryly recounts his recurring dance with mental illness
by Jim Higgins
Milwaukee Journal Sentinal
October 13, 2010.
Just Like Someone Without Mental Illness Only More So" by Mark Vonnegut;
Delacorte Press (224 pages, $24)
In his second memoir, Mark Vonnegut neither minimizes nor attributes special
meaning to his struggles with mental illness. He treats his four psychotic
breaks, and the reconstructions that followed, with sardonic acceptance - the
same way he appears to treat his relationship with his father, the late writer
In his first book, "The Eden Express" (1975), Vonnegut wrote about the
breakdowns he experienced while living at a British Columbia commune and his
efforts to regain his health. Remarkably, he recovered enough to be accepted
into Harvard Medical School, which he says most likely couldn't happen today for
someone with a history like his. "Harvard took some flack for admitting me,
which probably had something to do with why I shut up and didn't write much for
Fortunately for us, Vonnegut did write again. He also became an unusual thing
for a Harvard Med School grad: a practicing pediatrician in Massachusetts. He
wanted nothing more than to keep treating kids. But ...
"When the voices came back, it was like they'd never gone. Fourteen and a
half years, and it was like we picked up in the middle of a conversation just a
few minutes earlier," he writes in "Just Like Someone Without Mental Illness Only More So."
The problem, Vonnegut writes, isn't hearing voices. "The problems come when
you try to do something about the voices or mention them to others."
After trying, unsuccessfully, to jump through a closed third-floor window,
Vonnegut finds himself on a gurney in restraints in a hospital where he trained
and still works. "It's probably possible to gain humility by means other than
repeated humiliation, but repeated humiliation works very well."
He recovers, gives up alcohol and returns to family practice. "I've had the
bad luck to get sick four times and the remarkable good luck to get better again
each time," he writes. "None of us are entirely well, and none of us are
irrecoverably sick. At my best I have islands of being sick. At my worst I have
islands of being well."
Vonnegut shares with his late father a knack for throwing down sentences -
many sentences - of such naked wit and intelligence they make a reader stop for
an extra beat:
"Without writers fooling themselves about what their books might accomplish
there would be no books at all."
"A human without a disease is like a ship without a rudder."
"If I'd been raised by wolves, I would have known a little less, but not much
less, about how normal people did things."
He also offers a devastating critique of what the American health care system
has become: not as a patient, but as a longtime family doctor. "A dispassionate
look at all the many innovations of the insurance industry, from HMOs and
managed care to co-pays and prior authorizations, would show that each
innovation was a way for insurers to make money at the expense of the family
good. If these innovations were studied like a new drug or medical device, they
would be taken off the market."
Despite everything, and as jaundiced as he may now be, Vonnegut hangs on to a
nourishing kernel of idealism inside:
"Of course I'm trying to save the world. What else would a bipolar
manic-depressive hippie with a BA in religion practicing primary-care pediatrics
be up to? If the saving-the-world stuff doesn't work out, I have steady work and
a decent income.
End of review: Just Like Someone Without Mental Illness Only More So
October 21, 2010 - News of the Week
SURVIVORS OF PSYCHIATRIC TRAUMA ARE HEARD AT LAST
For as long as most of us can remember, psychiatric survivors have said that peer-run respite programs can often head off a psychiatric crisis and traumatizing trips to an emergency room or jail. A growing body of data now prove beyond question that respite programs are extremely effective. And thanks to the tireless work of Daniel Fisher M.D., Ph.D., a founder of the National Empowerment Center, and fellow activists coast-to-coast, peer-run respite programs are at last headed for serious expansion.
For an excellent explanation of peer-run respite programs , visit
Special Report: Psych Respite Run By Staff Who've "Been There"
December 3, 2010 - News of the Week
A STUDY OF CONSUMER-RUN PROGRAMS YIELDS WEALTH OF INNOVATIVE IDEAS
A national survey of more than three dozen consumer-run programs has just been published by the Temple University Collaborative on Community Inclusion (formerly the UPenn Collaborative). This useful compendium of examples, titled Into the Thick of Things, proves that people with psychiatric disabilities are discovering many paths for reconnecting to community life.
Excerpt from Introduction:
"Many consumers may be living in community settings but nevertheless still remain isolated from the real richness of community life. This study, therefore, has sought to gather examples of consumer-operated programs that have focused, at least in part, on promoting community inclusion."
Click here to download Into the Thick of Things
HELP PLAN THE 2nd INTERNATIONAL COMMUNITY INCLUSION CONFERENCE
CALL FOR PAPERS
Temple University Collaborative on Community Inclusion has issued a Call for Papers for its upcoming Second International Research Conference on Community Inclusion to be held in Philadelphia (PA) September 19-21, 2011.
Click here for full information concerning the TUC's Call For Papers
WORKSHOP AND PRESENTATION PROPOSALS
Proposals for workshop and institute presentations are due January 31, 2011. Proposals from consumers are especially welcome.
The conference focuses on new research and innovative programs and policies that promote community inclusion. Go to Temple University Collaborative on Community Inclusion website for more information.
December 18, 2010 - News of the Week
THOUGHTS ON A HUFFINGTON POST BLOG AUTHOR
From a marketing perspective, it may be necessary
to capitalize on violence to get the law passed
Memo from D.J. Jaffe to NAMI advocates, 1993
D.J. Jaffe, an advertising executive, worked for seventeen years to secure state laws permitting the forced psychotropic medication of psychiatric outpatients. Eventually, Jaffe's fearmongering strategy delivered New York's Kendra's Law after a young woman's tragic death and a six-month siege of intense publicity.
Jaffe told a national NAMI audience in July of 1999 that "laws change for a single reason, in reaction to highly publicized incidents of violence." He urged his audience to focus their advocacy on law enforcement agencies. Looking for help from their state's mental health systems, he said, was a waste of time.
That fearmongering leaves lasting effects on public attitudes was clearly not Jaffe's concern. Jaffe first took his coercive medication law to the law enforcement sector and won its support. Then on January 3, 1999, a fatal encounter between Andrew Goldstein and Kendra Webdale gave Jaffe the highly publicized violent incident he needed. The anguish of a shocked and grieving family was transformed into a threat to every New Yorker. Andrew Goldstein was *railroaded into the role of "treatment refuser." (*term used by a former NAMI board member)
Jaffe's strategy worked. As he described it, he approached the Webdale family a few days after Kendra's death and told them that "her killer was mentally ill, and that her death happened because he wasn't getting treatment, and we've been working to get treatment, and why don't you come and join us... And what happens is the media goes and interviews these people and because we've seen them first, they are telling our story."
But has the end justified the means?
During its first three years of operation Kendra's Law drained vital resources from new York's scarce community programs. The public-safety selling point that won Kendra's Law seemed hollow when a participant committed a brutal murder, and even more hollow when statistics showed that only 15% of program participants had committed a violent act before entering the program.
The upside is that many families have been able to negotiate alternatives to court orders, putting their family members first in line for scarce enriched programs. For others, Kendra's Law is a way to obtain a beneficial discharge plan (a prior law exists but is often broken for lack of community services).
Three evaluations of the law are available online.
Despite a strong push by supporters of Kendra's Law to make it permanent, New York's lawmakers voted in June 2010 to extend the law for five years and further test its effectiveness. The most recent evaluations (see list below) of the controversial law found that the key issue of voluntary vs. involunary psychiatric medication was far from resolved due to insufficient data. Researchers also found troubling disparities in the law's implementation across the state.
1st evaluation of Kendra's Law:
Final Report on the Status of Assisted Outpatient Treatment
Issued March 2005 by the New York State Office of Mental Health. The findings of this internal report did not justify making the law permanent.
2nd evaluation of Kendra's Law:
New York State Assisted Outpatient Treatment Program Evaluation
An independent evaluation issued June 30, 2009 by the New York State Office of Mental Health.
This independent evaluation, led by Marvin S. Swartz et. al, was required by the New York State Legislature when it extended the law in 2005.
3rd evaluation by Jo C. Phelan et. al, published in Psychiatric Services:
Effectiveness and Outcomes of Assisted Outpatient Treatment in New York State This independent evaluation was published in February 2010 after its initial presentation at the annual conference of the Internationals Association for Forensic Mental Health Services, Vienna, Austria, July 14-16, 2009. The article abstract is free. The full article might be free for a first-time request (it was for me-j.arnold).