Saturday, November 26, 2016

Memo on Section of CURES BIll that focuses on mental illness

The CURE bill is expected to pass House and Senate last week of November or First of December. Following are provisions of Helping Families in Mental Health Crisis Reform Act of 2016  (HR2646) and  MENTAL HEALTH AND SAFE COMMUNITIES ACT (S2002) that are incorporated in that bill.

SUBTITLE A—Leadership


Sec. 6001. Assistant Secretary for Mental Health and Substance Use
Establishes an Assistant Secretary for Mental Health and Substance Use (Assistant Secretary) to head the Substance Abuse and Mental Health Services Administration (SAMHSA). The authorities of the existing SAMHSA Administrator are transferred to the Assistant Secretary.

Sec. 6002. Strengthening the Leadership of the Substance Abuse and Mental Health Services Administration

       Requires the Assistant Secretary to:
o   Maintain a system to disseminate research findings and evidence-based practices to service providers to improve treatment and prevention services and incorporate these findings into SAMHSA programs;
o   Ensure that grants are subject to performance and outcome evaluations and that center directors consistently document the grant process and conduct ongoing oversight of grantees;
o   Consult with stakeholders to improve community-based and other mental health services, including adults with a serious mental illness (SMI), and children with a serious emotional disturbance (SED);
o   Collaborate with other federal departments, including the Departments of Defense (DOD), Veterans Affairs (VA), Housing and Urban Development (HUD), and Labor (DOL) to improve care for veterans and service members, and support programs to address chronic homelessness; and
o   Work with stakeholders to improve the recruitment and retention of mental health and substance use disorder professionals.

Friday, November 25, 2016

Senate agrees to pass lame duck mental health reform bill

(11/25/16) Today, a healthcare reform package, including language from Congressman Tim Murphy’s (PA-18) and Rep. Eddie Bernice Johnsons (D. TX) Helping Families in Mental Health Crisis Act (H.R. 2646) and Chairman Fred Upton’s 21st Century Cures Act (H.R. 6), was finalized. The reform package will be voted on in the Senate when they return after Thanksgiving and will then have to be reconciled with what the House passed, presumably a fait acompli. I believe it also includes language from Sen. John Cornyn's S2002.

A description of bill is here Some of the more interesting stuff starts on page 18 and 29

A copy of the bill is here 

There is AOT funding and reform of the Substance Abuse and Mental Health Services Administration (SAMHSA) in the bill.  Here are the provisions we were most interested in having included. Some were, others were not.


Congressman Murphy  has been the true hero of this process leaving his door open to, and never abandoning those of us who have seriously mentally ill relatives. He released the  following statement:



“This is a landmark moment. The federal government’s course in addressing mental health and illness in America is being fundamentally changed. Congress has finally come together in a bipartisan effort to bring serious mental illness out of the shadows. Now federal agencies will be moving from feel-good programs for behavioral wellness to ones that emphasize evidence-based care for those at highest risk and those with symptoms of serious mental illness. We've achieved long-sought reforms by creating an Assistant Secretary for Mental Health and Substance Use to elevate, integrate and coordinate programs; investing in services for the most difficult to treat cases; expanding the mental health workforce, and so much more.“It couldn't be more fitting that we've reached this bipartisan agreement between the House and Senate at the close of Thanksgiving week. I am tremendously grateful for everyone who joined in the cause because we wouldn't be here if not for the unwavering efforts of the of the families, caregivers, providers and organizations that worked tirelessly to fix our broken mental health systemWe won't solve it all in in one bill and we didn't get everything we needed, but we needed everything we got. It is my pledge to the patients and families in crisis that I will never stop fighting to deliver treatment before tragedy for those most in need.” 

The Helping Families in Mental Health Crisis Act unanimously passed the House Energy and Commerce Committee, 53-0, in June and passed the U.S. House of Representatives, 422-2, in July More information on the bill can be found here.


Mental Illness Policy Org thanks the thousands of families of the seriously ill who  joined with us to educate Congress that the needs of the seriously ill are different than those of the higher functioning, and that those needs have largely been ignored by government. By focusing SAMHSA on the seriously ill, funding Assisted Outpatient Treatment and looking for ways to free families of the seriously ill from HIPAA Handcuffs that prevent them from facilitating treatment, we believe the lives of all Americans--those with serious mental illness and those without--will be better served. - DJ Jaffe, Executive Director, Mental Illness Policy Org.

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Senate agrees to pass lame duck mental health reform bill

(11/25/16) Today, a healthcare reform package, including language from Congressman Tim Murphy’s (PA-18) and Rep. Eddie Bernice Johnsons (D. TX) Helping Families in Mental Health Crisis Act (H.R. 2646) and Chairman Fred Upton’s 21st Century Cures Act (H.R. 6), was finalized. The reform package will be voted on in the Senate when they return after Thanksgiving and will then have to be reconciled with what the House passed, presumably a fait acompli. I believe it also includes language from Sen. John Cornyn's S2002.

A copy of the bill is here 

There is AOT funding and reform of the Substance Abuse and Mental Health Services Administration (SAMHSA) in the bill.  Here are the provisions we were most interested in having included. Some were, others were not.


Congressman Murphy  has been the true hero of this process leaving his door open to, and never abandoning those of us who have seriously mentally ill relatives. He released the  following statement:



“This is a landmark moment. The federal government’s course in addressing mental health and illness in America is being fundamentally changed. Congress has finally come together in a bipartisan effort to bring serious mental illness out of the shadows. Now federal agencies will be moving from feel-good programs for behavioral wellness to ones that emphasize evidence-based care for those at highest risk and those with symptoms of serious mental illness. We've achieved long-sought reforms by creating an Assistant Secretary for Mental Health and Substance Use to elevate, integrate and coordinate programs; investing in services for the most difficult to treat cases; expanding the mental health workforce, and so much more.“It couldn't be more fitting that we've reached this bipartisan agreement between the House and Senate at the close of Thanksgiving week. I am tremendously grateful for everyone who joined in the cause because we wouldn't be here if not for the unwavering efforts of the of the families, caregivers, providers and organizations that worked tirelessly to fix our broken mental health systemWe won't solve it all in in one bill and we didn't get everything we needed, but we needed everything we got. It is my pledge to the patients and families in crisis that I will never stop fighting to deliver treatment before tragedy for those most in need.” 

The Helping Families in Mental Health Crisis Act unanimously passed the House Energy and Commerce Committee, 53-0, in June and passed the U.S. House of Representatives, 422-2, in July More information on the bill can be found here.


Mental Illness Policy Org thanks the thousands of families of the seriously ill who  joined with us to educate Congress that the needs of the seriously ill are different than those of the higher functioning, and that those needs have largely been ignored by government. By focusing SAMHSA on the seriously ill, funding Assisted Outpatient Treatment and looking for ways to free families of the seriously ill from HIPAA Handcuffs that prevent them from facilitating treatment, we believe the lives of all Americans--those with serious mental illness and those without--will be better served. - DJ Jaffe, Executive Director, Mental Illness Policy Org.

Follow us on Facebook and Twitter

Senate agrees to pass lame duck mental health reform bill

(11/25/16) Today, a healthcare reform package, including language from Congressman Tim Murphy’s (PA-18) and Rep. Eddie Bernice Johnsons (D. TX) Helping Families in Mental Health Crisis Act (H.R. 2646) and Chairman Fred Upton’s 21st Century Cures Act (H.R. 6), was finalized. The reform package will be voted on in the Senate when they return after Thanksgiving and will then have to be reconciled with what the House passed, presumably a fait acompli. I believe it also includes language from Sen. John Cornyn's S2002.

A copy of the bill is here 

There is AOT funding and reform of the Substance Abuse and Mental Health Services Administration (SAMHSA) in the bill.  Here are the provisions we were most interested in having included. Some were, others were not.


Congressman Murphy  has been the true hero of this process leaving his door open to, and never abandoning those of us who have seriously mentally ill relatives. He released the  following statement:



“This is a landmark moment. The federal government’s course in addressing mental health and illness in America is being fundamentally changed. Congress has finally come together in a bipartisan effort to bring serious mental illness out of the shadows. Now federal agencies will be moving from feel-good programs for behavioral wellness to ones that emphasize evidence-based care for those at highest risk and those with symptoms of serious mental illness. We've achieved long-sought reforms by creating an Assistant Secretary for Mental Health and Substance Use to elevate, integrate and coordinate programs; investing in services for the most difficult to treat cases; expanding the mental health workforce, and so much more.“It couldn't be more fitting that we've reached this bipartisan agreement between the House and Senate at the close of Thanksgiving week. I am tremendously grateful for everyone who joined in the cause because we wouldn't be here if not for the unwavering efforts of the of the families, caregivers, providers and organizations that worked tirelessly to fix our broken mental health systemWe won't solve it all in in one bill and we didn't get everything we needed, but we needed everything we got. It is my pledge to the patients and families in crisis that I will never stop fighting to deliver treatment before tragedy for those most in need.” 

The Helping Families in Mental Health Crisis Act unanimously passed the House Energy and Commerce Committee, 53-0, in June and passed the U.S. House of Representatives, 422-2, in July More information on the bill can be found here.


Mental Illness Policy Org thanks the thousands of families of the seriously ill who  joined with us to educate Congress that the needs of the seriously ill are different than those of the higher functioning, and that those needs have largely been ignored by government. By focusing SAMHSA on the seriously ill, funding Assisted Outpatient Treatment and looking for ways to free families of the seriously ill from HIPAA Handcuffs that prevent them from facilitating treatment, we believe the lives of all Americans--those with serious mental illness and those without--will be better served. - DJ Jaffe, Executive Director, Mental Illness Policy Org.

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Wednesday, November 9, 2016

Impact of Trump Election on Federal Mental Health Policy


(Full disclosure: I am a left-wing Democrat.) 


Here are two snippets from Trump's policy platform on serious mental illness

From Trump Healthcare page:
"Finally, we need to reform our mental health programs and institutions in this country. Families, without the ability to get the information needed to help those who are ailing, are too often not given the tools to help their loved ones. There are promising reforms being developed in Congress that should receive bi-partisan support. https://assets.donaldjtrump.com/HCReformPaper.pdf

From Trump 2nd Amendment page:
"Fix our broken mental health system. All of the tragic mass murders that occurred in the past several years have something in common – there were red flags that were ignored. We can’t allow that to continue. We must expand treatment programs, and reform the laws to make it easier to take preventive action to save innocent lives. Most people with mental health problems are not violent, but just need help, and these reforms will help everyone. https://www.donaldjtrump.com/policies/constitution-and-second-amendment

Democrats
My experience is that Dems are willing to throw money at improving mental health in the 18% of adults who may have some form of illness (anxiety, ADHD, mild depression, etc.) but they won't admit to the unpleasant truths that need to be recognized to help the 4% of adults with serious mental illness. Dems will not admit that not everyone recovers, that when the most seriously ill go untreated they are more violent than others, that some people do need hospitals, that involuntary treatment is better than incarceration, etc. 

If they won't admit the problems, they will not solve them. They are also unduly influenced by the mental health industry, much of which wants to continue to receive mental health funds, free of any obligation to help the seriously ill. As an example, the mental health industry is cheering the new Obama-appointed federal Mental Health Parity Task Force Report, in spite of the fact that it left out the most seriously ill. I have previously written on Hillary Clinton's failure to focus on the seriously mentally ill. And today, election day, the NY Daily News gave big play to my op-ed on the failure of NYC Mayor Bill de Blasio to focus the $850 million NYC mental health plan on the seriously ill. Again: this is from a Dem.

Republicans
On the other hand, Republicans are concerned about the effect of homelessness and untreated serious mental illness on quality of life, the spiraling cost of funding pop-psychology and politically-correct pablum (MHFA, stigma etc.) and disturbed by the growing jail populations. So while they are tight-fisted and may be less willing to fund the worthy, but tangential social services that often are wrapped in a mental health narrative, I have found they are willing to fund evidence based interventions that really do prevent homelessness, arrest and incarceration of the most seriously ill. Even if one argues Republicans have (what to some are) impure motives for supporting mental illness reform (i.e., to stave off calls for gun control), that still gets them focused on improving mental illness treatment. From our perspective, that is a good thing.


Trump
So from a mental illness policy perspective, if Trump sticks to what has become Republican orthodoxy (a big 'if', i.e, focus on the most seriously ill), then perhaps things will get better. For example, he could start by "Draining the Swamp" at SAMHSA/CMHS, which is funding so much anti-psychiatry and anti-science that passes as "recovery" or "trauma" treatment these days.

One idea for Trump would be to appoint this person as SAMHSA Administrator. She was the former Medical Director of SAMHSA, and wrote this devastating critique on 
SAMHSA/CMHS when she left. Reforming SAMHSA and CMHS is more likely to happen under Republicans, than Dems (assuming again that Trump is a Republican). Of course, he has also promised to dismantle the Affordable Care Act which would hurt persons with mental illness as it hurts all others. And it is hard to pin him down on specifics. 


Effect on Mental Illness Legislation in Senate

The Senate will come back to work for just a few short weeks before the new administration takes over. They do have mental health reform on their calendar, but it is questionable as to whether there is actually enough time in the short session to get around to it, and if they do get around to it, will it be the weak bills they are currently considering or something stronger.  We should try to get the Senate to take up and pass the The Helping Families in Mental Health Crisis Act (HR2646) during this short lame duck session. It passed House in uniquely bipartisan 422-2 vote. It will start to get the federal mental health agencies to focus more on the seriously ill, help create more hospital beds, fund programs like Kendra's Law and focus on programs that have evidence of efficacy.  Mental Illness legislation should not have to wait until a new administration takes office.

Call your two U.S. Senators at (202) 224-3121 and urge him/her to bring the Helping Families in Mental Health Crisis Act (HR2646) to a vote in Senate as soon as Senate returns to work.  Mental Health reform should not be put on hold until the new administration takes over. The call takes two minutes



###

Thanks for all you do. Reminder. My book, Insane Consequences: How the Mental Health Industry Fails the Seriously Ill is a valuable advocacy tool that can be pre-ordered on Barnes & Noble and Amazon. Follow Mental Illness Policy Org on Facebook and Twitter.

Impact of Trump Election on Federal Mental Health Policy


(Full disclosure: I am a left-wing Democrat.) 


Here are two snippets from Trump's policy platform on serious mental illness

From Trump Healthcare page:
"Finally, we need to reform our mental health programs and institutions in this country. Families, without the ability to get the information needed to help those who are ailing, are too often not given the tools to help their loved ones. There are promising reforms being developed in Congress that should receive bi-partisan support. https://assets.donaldjtrump.com/HCReformPaper.pdf

From Trump 2nd Amendment page:
"Fix our broken mental health system. All of the tragic mass murders that occurred in the past several years have something in common – there were red flags that were ignored. We can’t allow that to continue. We must expand treatment programs, and reform the laws to make it easier to take preventive action to save innocent lives. Most people with mental health problems are not violent, but just need help, and these reforms will help everyone. https://www.donaldjtrump.com/policies/constitution-and-second-amendment

Democrats
My experience is that Dems are willing to throw money at improving mental health in the 18% of adults who may have some form of illness (anxiety, ADHD, mild depression, etc.) but they won't admit to the unpleasant truths that need to be recognized to help the 4% of adults with serious mental illness. Dems will not admit that not everyone recovers, that when the most seriously ill go untreated they are more violent than others, that some people do need hospitals, that involuntary treatment is better than incarceration, etc. 

If they won't admit the problems, they will not solve them. They are also unduly influenced by the mental health industry, much of which wants to continue to receive mental health funds, free of any obligation to help the seriously ill. As an example, the mental health industry is cheering the new Obama-appointed federal Mental Health Parity Task Force Report, in spite of the fact that it left out the most seriously ill. I have previously written on Hillary Clinton's failure to focus on the seriously mentally ill. And today, election day, the NY Daily News gave big play to my op-ed on the failure of NYC Mayor Bill de Blasio to focus the $850 million NYC mental health plan on the seriously ill. Again: this is from a Dem.

Republicans
On the other hand, Republicans are concerned about the effect of homelessness and untreated serious mental illness on quality of life, the spiraling cost of funding pop-psychology and politically-correct pablum (MHFA, stigma etc.) and disturbed by the growing jail populations. So while they are tight-fisted and may be less willing to fund the worthy, but tangential social services that often are wrapped in a mental health narrative, I have found they are willing to fund evidence based interventions that really do prevent homelessness, arrest and incarceration of the most seriously ill. Even if one argues Republicans have (what to some are) impure motives for supporting mental illness reform (i.e., to stave off calls for gun control), that still gets them focused on improving mental illness treatment. From our perspective, that is a good thing.


Trump
So from a mental illness policy perspective, if Trump sticks to what has become Republican orthodoxy (a big 'if', i.e, focus on the most seriously ill), then perhaps things will get better. For example, he could start by "Draining the Swamp" at SAMHSA/CMHS, which is funding so much anti-psychiatry and anti-science that passes as "recovery" or "trauma" treatment these days.

One idea for Trump would be to appoint this person as SAMHSA Administrator. She was the former Medical Director of SAMHSA, and wrote this devastating critique on 
SAMHSA/CMHS when she left. Reforming SAMHSA and CMHS is more likely to happen under Republicans, than Dems (assuming again that Trump is a Republican). Of course, he has also promised to dismantle the Affordable Care Act which would hurt persons with mental illness as it hurts all others. And it is hard to pin him down on specifics. 


Effect on Mental Illness Legislation in Senate

The Senate will come back to work for just a few short weeks before the new administration takes over. They do have mental health reform on their calendar, but it is questionable as to whether there is actually enough time in the short session to get around to it, and if they do get around to it, will it be the weak bills they are currently considering or something stronger.  We should try to get the Senate to take up and pass the The Helping Families in Mental Health Crisis Act (HR2646) during this short lame duck session. It passed House in uniquely bipartisan 422-2 vote. It will start to get the federal mental health agencies to focus more on the seriously ill, help create more hospital beds, fund programs like Kendra's Law and focus on programs that have evidence of efficacy.  Mental Illness legislation should not have to wait until a new administration takes office.

Call your two U.S. Senators at (202) 224-3121 and urge him/her to bring the Helping Families in Mental Health Crisis Act (HR2646) to a vote in Senate as soon as Senate returns to work.  Mental Health reform should not be put on hold until the new administration takes over. The call takes two minutes



###

Thanks for all you do. Reminder. My book, Insane Consequences: How the Mental Health Industry Fails the Seriously Ill is a valuable advocacy tool that can be pre-ordered on Barnes & Noble and Amazon. Follow Mental Illness Policy Org on Facebook and Twitter.

Thursday, October 27, 2016

White House Parity Task Force Report Leaves Out Seriously Mentally Ill

Federal Parity Task Force Report Fails to End Federal Discrimination Against the Seriously Mentally Ill that is part of Medicaid.

The Mental Health and Substance Use Disorder Task Force report issued by the White House today shamefully fails to end the federal government's own massive discrimination against people with serious mental illness that is embedded in Medicaid. The Medicaid Institutes for Mental Disease (IMD) provision prevents states from receiving federal reimbursement for seriously mentally ill individuals between 18 and 64 who need long-term psychiatric hospital care. This limitation applies only applies to the mentally ill and parity can not be achieved without eliminating it. If you have a disease in any organ and are Medicaid-eligible, Medicaid pays with a single exception: individuals who have a mental illness in their brain.  

The IMD Exclusion causes states to lock the front door of psychiatric hospitals and kick the mentally ill out the back. The failure to eliminate the IMD Exclusion will cause more individuals with disorders like schizophrenia and bipolar disorder to be offloaded to jails, shelters, prisons and morgues. The Task Force should have called for ending this injustice. 

We do appreciate the recommendation of the Task Force to end the 190-day limit on inpatient care for the seriously ill that is part of Medicare Part A and urge the President to act on it immediately.

Background Info: Op-ed by DJ Jaffe in Washington Post
http://mentalillnesspolicy.org/media/bestmedia/imd-exclusion-washington-post.html

Tuesday, October 25, 2016

NYC Health & Hospitals Corp Kicked Mental Health Advocate (Me) Out of Meeting.

Last night (October 24) I was prevented from attending the 2016 Annual PUBLIC meeting of the Harlem Community Advisory board to NYC Health and Hospitals Corp. It was in the second floor auditorium of Harlem Hospital.

The annual meeting was entitled, “Understanding the Roadmap to Mental Health.” The word “roadmap” refers to ThriveNYC, the $800 million NYC mental health plan. Since I think it is failing because it funds pop-psychology and useless programs and generally ignores serious mental illness, I thought attendees would be a good audience to share my point of view with.
So I made up a package of three handouts: a one-pager on why I believe ThriveNYC is failing, a copy of the critical article on ThriveNYC that Seth Baron wrote for City Journal and a fact sheet containing the research on Kendra’s Law, a useful program that Dr. Gary Belkin, the director of mental health services in NYC refuses to make available to most who could benefit from it.
As I usually do, I showed up early (I knew several people who are members of Harlem NAMI, as am I) and started handing out my fact sheet to those few who were already seated. This all took place before the event started.
A man came over and told me I couldn’t hand out literature. I explained that it was directly related to the purpose of this PUBLIC meeting. He said I couldn’t and asked me to leave. I was pretty sure I was within my rights, and I said that at a public meeting all sides should be allowed to present their point of view. He said, “We are trying to build support for the Roadmap and you want to say it doesn’t work so you have to leave” 
While I was gathering my belongings a woman who identified herself as Detective Fleming came over, and said Mr. Cook said I had to leave. I asked who that was and she said he was (I think) a hospital (Community Affairs?) Director. I said that I was surprised as a police officer that she takes orders from him, versus someone at NYPD, but she said she is a detective, but did not work for NYPD, she works for the hospital and escorted me out. Note that I was very calm and so were they. We had a disagreement, that is all, and they said they had the right to force me to leave, and I didn’t know enough to know if they are right or not.
Guards posted outside Harlem Hospital to make sure no literature questioning efficacy of ThriveNYC was given to participants at public hearing on Thrive NYC (10.24.27)

So I left and started handing out my literature on the street to people who were going into Harlem Hospital. I would ask, “Are you going to the mental health meeting” and if they answered in the affirmative, I handed them literature. At that point Detective Fleming and a big guy who I took to be a boss (Cook?) and a little guard came out and told me I couldn’t hand out literature in front of the hospital. I said, respectfully, that I am ex-hippie who has participated in many protests and I am pretty sure I am allowed to hand out literature on the sidewalk. The big guy tried to mildly intimidate me and said, “Do you want me to ratchet this up.” And at that point I took a big breath and said, “yes, I think I do.” (In my mind, I was thinking, if he wants to escalate this, he will likely call police and if they tell me I can't hand out literature, I would have to take their word for it.) He went inside-I thought to call police-and the other security guards stayed behind to watch me and tell me repeatedly I had to leave. I didn’t. I continued. And they continued to tell me I had to leave. I must have been right, because even though they stayed around watching me, continually saying I could not hand out literature, they did nothing when I did.
I was frankly very surprised. It did get the adrenaline going a little a bit. I had thoughts about a night in jail, something that hasn't happened to me since the Vietnam War Protests in DC. 

I think they were wrong to try to shut down free-speech, especially, as I wasn’t even saying anything, just handing out literature. I don’t think it was part of any cabal, although frankly I don’t understand it, as handing out literature at a public meeting is fairly mom and apple pie. 

I do think it explains one important reason why ThriveNYC is failing to serve the seriously mentally ill. First Lady Chirlane McCray, Deputy Mayor Richard Buery and others are only hearing from mental "health" officials, mental "health" industry reps, and mental "health" advocates. 
In fact, they usually won't even use the term "mental illness" as if it were a pejorative. 
 I don't think McCray or Buery had anything to do with me being kept out. T
he most likely reason officials kept me out was because they wanted to  avoid upsetting them by having it get back to them that someone questioned their program publicly. McCray and Buery are not hearing from those of us who care about the seriously mentally "ill". The mental health industry loves to receive money from the city without any obligation to serve the seriously ill. And McCray and Buery's ThriveNYC largely gives it to them.

Read thoughtful articles about ThriveNYC failing the most seriously ill here or here and here

NYC Health & Hospitals Corp Kicked Mental Health Advocate (Me) Out of Meeting.

Last night (October 24) I got kicked out of the 2016 Annual PUBLIC meeting of the Harlem Community Advisory board to NYC Health and Hospitals Corp. It was in the second floor auditorium of Harlem Hospital.

The annual meeting was entitled, “Understanding the Roadmap to Mental Health.” The word “roadmap” refers to ThriveNYC, the $800 million NYC mental health plan. Since I think it is failing because it funds pop-psychology and useless programs and generally ignores serious mental illness, I thought attendees would be a good audience to share my point of view with.
So I made up a package of three handouts: a one-pager on why I believe ThriveNYC is failing, a copy of the critical article on ThriveNYC that Seth Baron wrote for City Journal and a fact sheet containing the research on Kendra’s Law.  
As I usually do, I showed up early (I knew several people who are members of Harlem NAMI, as am I) and started handing out my fact sheet to those few who were already seated. This all took place before the event started.
A man came over and told me I couldn’t hand out literature. I explained that it was directly related to the purpose of this PUBLIC meeting. He said I couldn’t and asked me to leave. I was pretty sure I was within my rights, and I said that at a public meeting all sides should be allowed to present their point of view. He said, “We are trying to build support for the Roadmap and you want to say it doesn’t work so you have to leave” 
While I was gathering my belongings a woman who identified herself as Detective Fleming came over, and said Mr. Cook said I had to leave. I asked who that was and she said he was (I think) a hospital (Community Affairs?) Director. I said that I was surprised as a police officer that she takes orders from him, versus someone at NYPD, but she said she is a detective, but did not work for NYPD, she works for the hospital and escorted me out. Note that I was very calm and so were they. We had a disagreement, that is all, and they said they had the right to force me to leave, and I didn’t know enough to know if they are right or not.
Guards posted outside Harlem Hospital to make sure no literature questioning efficacy of ThriveNYC was given to participants at public hearing on Thrive NYC (10.24.27)

So I left and started handing out my literature on the street to people who were going into Harlem Hospital. I would ask, “Are you going to the mental health meeting” and if they answered in the affirmative, I handed them literature. At that point Detective Fleming and a big guy who I took to be a boss (Cook?) and a little guard came out and told me I couldn’t hand out literature in front of the hospital. I said, respectfully, that I am ex-hippie who has participated in many protests and I am pretty sure I am allowed to hand out literature on the sidewalk. The big guy tried to mildly intimidate me and said, “Do you want me to ratchet this up.” And at that point I took a big breath and said, “yes, I think I do.” (In my mind, I was thinking, if he wants to escalate this, he will likely call police and if they tell me I can't hand out literature, I would have to take their word for it.) He went inside-I thought to call police-and the other security guards stayed behind to watch me and tell me repeatedly I had to leave. I didn’t. I continued. And they continued to tell me I had to leave. I must have been right, because even though they stayed around watching me, continually saying I could not hand out literature, they did nothing when I did.
I was frankly very surprised. It did get the adrenaline going a little a bit. I had thoughts about a night in jail, something that hasn't happened to me since the Vietnam War Protests in DC. 

I think they were wrong to try to shut down free-speech, especially, as I wasn’t even saying anything, just handing out literature. I don’t think it was part of any cabal, although frankly I don’t understand it, as handing out literature at a public meeting is fairly mom and apple pie. 

I do think it explains one important reason why ThriveNYC is failing to serve the seriously mentally ill. First Lady Chirlane McCray, Deputy Mayor Richard Buery and others are only hearing from mental "health" officials, mental "health" industry reps, and mental "health" advocates. 
In fact, they usually won't even use the term "mental illness" as if it were a pejorative. 
 I don't think McCray or Buery had anything to do with me being kept out. T
he most likely reason officials kept me out was because they wanted to  avoid upsetting them by having it get back to them that someone questioned their program publicly. McCray and Buery are not hearing from those of us who care about the seriously mentally "ill". The mental health industry loves to receive money from the city without any obligation to serve the seriously ill. And McCray and Buery's ThriveNYC largely gives it to them.

Read thoughtful articles about ThriveNYC failing the most seriously ill here or here and here

Monday, October 24, 2016

NYC's New Helpline Not What Seriously Mentally Ill Really Need

On Oct. 24, with great fanfare, NYC First Lady Chirlane McCray announced a new HelpLine for Mentally Ill (Call 1-888-NYC-WELL or text, "WELL" to 65173). When pressed by a reporter, Ms. McCray admitted that it was little more than 1 800 LIFENET with the addition of text capability.

Ms. McCray is widely hailed by the mental health industry for introducing THRIVE/NYC an $800 million mental health plan. But it largely ignores the seriously mentally ill.



WHY THRIVE/NYC IS FAILING

IT THROWS MONEY HERE[1]
THAT SHOULD BE USED HERE

Evidence
Mental Health First Aid (MHFA)
Peer Support
Assisted Outpatient Treatment[2]
Hospitals
Housing
Cuts Homelessness
No

No
Yes
Yes
Yes
Cuts Arrest
No
No
Yes
Yes
Yes
Cuts Incarceration
No
No
Yes
Yes
Yes
Cuts Suicide
No
No
Yes
Yes
Yes
Cuts hospitalization
No
No
Yes
Yes
Yes

THRIVE/NYC shuns the seriously ill and focuses on “improving mental wellness” in all others.
  • ·      Thrive/NYC funds “prevention” but serious mental illness can’t be prevented because we don’t know what causes it.
  • ·      Thrive/NYC funds “early intervention” but we can’t predict who will become seriously ill until after the symptoms first appear.
  • ·      Thrive/NYC funds “trauma,” but trauma is not a mental illness. Everyone loses a loved one, loses a job, experiences accidents, etc. PTSD is mental illness and even that runs from mild to severe.
  • ·      Thrive/NYC diverts mental health funds to programs that do not help seriously mentally ill.


NYC needs an “all hands on deck” approach to reducing homelessness, arrest, incarceration, suicide, and hospitalization of seriously mentally ill. Mental Illness Policy Org promotes ideas to accomplish that. Join us on Facebook and Twitter and subscribe to our email list at http://bit.ly/2eKarUd

Here is an article that appeared in City Journal that got it right. Also read this one in Daily News


De Blasio’s Mental-Health Blindspot

By Seth Barron (City Journal Online 10/20/16)


On Tuesday, an NYPD sergeant shot and killed 66-year-old Deborah Danner, an emotionally disturbed woman who attacked officers, first with a pair of scissors and then with a baseball bat. Mayor Bill de Blasio and police commissioner James O’Neill wasted no time blaming the sergeant for not following correct police protocol for responding to mentally distressed individuals. It may well be the case that the responding officers made serious errors. It may be that the sergeant’s actions were criminal. But the real mistake was the city’s Department of Health and Mental Hygiene’s neglect of Danner’s serious mental illness.
Danner’s case was known to the city. Her sister, with whom she lived, was Danner’s legal guardian, and the NYPD had been called to their house many times. Like many seriously mentally ill individuals, Danner had cycled through the city’s police-medical complex, and was apparently non-compliant with her medical regimen—that is, she didn’t take her anti-psychotic medicine as prescribed. “It’s the classic situation: someone is supposed to take meds and they go off their meds,” de Blasio said at a press conference. “Because of their illness they choose not to take their meds. Once they don’t take their meds it is very hard to get them to engage another kind of treatment.”   
Listening to the mayor, one would think that the paradox he outlined has never been addressed before. But New York, like almost every state, has a robust set of laws known generally as assisted outpatient therapy (AOT). Locally, the statute is known as “Kendra’s Law.” It has proven effective at keeping the mentally ill out of hospitals and shelters and promoting compliance with doctor’s orders. Kendra’s Law covers cases where a non-compliant and seriously mentally ill individual has previously been hospitalized, and is judicially and medically judged to pose a danger to himself or others. The law provides for a six-month period of supervision, during which the subject must comply with treatment or face possible commitment to a hospital. This rarely happens. 
Kendra’s Law is remarkably successful at helping the seriously mentally ill live relatively stable lives. The statistics are stunning: violent or harmful behaviors decrease by 44 percent; hospitalizations decrease by 77 percent; drug and alcohol abuse decrease by half. Patients report high levels of satisfaction with their participation in AOT, and the costs of care decline substantially, because outpatient treatment is so much cheaper—in financial and human terms—than incarceration or hospitalization.
Despite AOT’s track record of success, New York State rarely chooses to apply Kendra’s Law, even in seemingly obvious cases like Deborah Danner’s. Liberal critics of involuntary psychiatric commitment, still shuddering from the 1972 Willowbrook exposé, argue that any hint of coercive intervention is a violation of the civil liberties of the mentally ill. Meanwhile, the mental-health industry prefers to focus on mental illness as a public-health problem, like venereal disease or typhus. Publicity campaigns advise people on how to identify the signs of depression in themselves or their associates, or warn about the problem of stigmatizing mental illness. This epidemiological approach to mental illness fails because untreated schizophrenia is not contagious, nor is it hard to identify.
Thousands of homeless or incarcerated mentally ill New Yorkers aren’t living on the streets or in Rikers Island jail because they fear the stigma of mental illness. Rather, the city’s mental-health establishment has chosen not to deal seriously with their care.  
De Blasio speaks magnanimously about his grand approach to treating mental illness through his ThriveNYC plan, but that plan includes virtually nothing for the seriously mentally ill. Instead, the mayor is spending millions of dollars on feel-good advertising campaigns promoting peer counseling and awareness. His wife, Chirlane McCray, announced a collaboration this week between ThriveNYC and Tumblr, where people will be encouraged to submit quilt patches representing “a creative expression around changing the conversation around mental health and an individual’s relationship with mental illness.” 
Awareness isn’t the most pressing issue regarding the mentally ill in New York City. New Yorkers are already aware of the many suffering people in their midst. By making the police take up the slack for the city’s failed mental-health policy, de Blasio is being cynical and careless. Kendra’s Law is a working solution to the problems of people like Deborah Danner, but the mayor refuses to use it.





[1] MHFA Research at http://mentalillnesspolicy.org/samhsa/mental-health-first-aid-fails.html. Peer support studies showing no benefit beyond ordinary care: Cochrane Collaborative, “Consumer-Providers of Care for Adult Clients of Statutory Mental Health Services." American Psychiatric Association “Guideline Watch: Practice Guideline for the Treatment of Patients with Schizophrenia.” "BMC Psychiatry, A Systematic Review and Meta-Analysis of Randomised Controlled Trials of Peer Support for People with Severe Mental Illness.”  
[2] Assisted Outpatient Research at http://mentalillnesspolicy.org/national-studies/aotworks.pdf