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

Tuesday, October 11, 2016

This Book Could Help You Change the Mental Health System Forever: Insane Consequences: How the Mental Health Industry Fails the Mentally Ill



Now available  for pre-order.


I am proud to say Insane Consequences: How the Mental Health Industry Fails the Mentally Ill is now available for pre-order on Amazon and Barnes and Noble.  


This critically important book gives people who care about the seriously mentally ill the facts they need to be better advocates and provides specific guidance on how to force the mental health system to deliver better treatment. It documents the failure of the mental health system, tells who is to blame, provides you direct links to policy and treatment research, and describes specific actionable ideas to reform the system. The brilliant foreword by Dr. E. Fuller Torrey (Author, Surviving Schizophrenia) puts these proposals in perspective.

Please pre-order Insane Consequences on Amazon or Barnes and Noble.  For the record, 100% of my proceeds will go to Mental Illness Policy Org. and other organizations working to improve care for the seriously ill. I am not making a nickel on this, I am simply trying to help. It is 340 pages and we have kept the pre-order price low, considering the size of the book: $25 for hard cover and $11.99 for Nook and Kindle. Both Amazon and Barnes and Noble let you read a detailed description of the book and they include reviews of my past work.

(Note: if you buy it via smile.amazon, a portion of the proceeds will go direct from Amazon to the charity of your choice. I would suggest Treatment Advocacy Center or whatever is important to you.)

Thank you for considering pre-ordering Insane Consequences. I don't think you will be disappointed and I know you will be helping improve care for others who have serious mental illness. Thanks for all you do. Please share with others who care.

Monday, June 13, 2016

Pass a strong H.R. 2646 focused on seriously mentally ill

Statement by DJ Jaffe, Exec. Dir (6.14.2016)

 “H.R. 2646 sends the seriously mentally ill to the head of the line for services rather than to jails, shelters, prisons and morgues.”

“The Helping Families in Mental Health Crisis Act (HR2646) being proposed by Representatives Tim Murphy (R., PA) and E.B. Johnson (D., TX) starts to bring sanity to the insane mental health policies that are rampant in government. Historically, government agencies have ignored the seriously ill in order to promote “mental wellness” in all others. This bill starts to bring that practice to an end by focusing government on the elephant in the room: getting evidence-based treatment to adults known to be seriously mentally ill.  It replaces years of federal mission-creep with a dose of mission-control. That will help reduce homelessness, arrest, incarceration, hospitalization, and violence, while saving taxpayers money.” 

“We thank Representatives Tim Murphy, E.B Johnson, Fred Upton and Frank Pallone. We urge the E&C Committee to put a doctor at the head of SAMHSA and CMHS, fund Assisted Outpatient Treatment, increase the number of hospital beds, free parents from HIPAA Handcuffs and start to focus federal efforts on the elephant in the room: getting science based treatment to adults with serious mental illness, rather than on programs based on pop-psychology and pseudo-science.

(End of statement)

Assisted Outpatient Treatment (AOT) (See research summary: http://mentalillnesspolicy.org/national-studies/aotworks.pdf)
  • Cuts homelessness, arrest, incarceration, violence and hospitalization for the most seriously ill by 70%.  
  • Saves taxpayers 50% of the cost of care.
  • Only for the small group of the most seriously ill who refuse or are unable to comply with voluntary treatment and already put themselves or others at-risk.
  • Supported by Int’l Assoc. of Chiefs of Police, National Sheriff’s Assoc., SAMHSA, DOJ, AHRQ, NAMI, and others.

Reform SAMHSA and CMHS (See http://mentalillnesspolicy.org/samhsa.html)
  • According to SAMHSA’s former Chief Medical Officer:
“SAMHSA does not address the treatment needs of the most vulnerable in our society. Rather, the unit within SAMHSA charged with addressing these disorders, the Center for Mental Health Services, chooses to focus on its own definition of “recovery,” which generally ignores the treatment of mental disorders…There is a perceptible hostility toward psychiatric medicine: a resistance to addressing the treatment needs of those with serious mental illness and a questioning by some at SAMHSA as to whether mental disorders even exist—for example, is psychosis just a “different way of thinking for some experiencing stress?” (http://www.psychiatrictimes.com/depression/federal-government-ignores-treatment-needs-americans-serious-mental-illness/page/0/1)
  • SAMHSA and CMHS replaced the “medical model” with an internally invented “recovery model” that requires even the most seriously ill to “self-direct” their own care. (John Hinckley was ‘self-directing’ when he tried to get a date with Jodi Foster by shooting Pres. Reagan)
  • There is virtually no support for SAMHSA or CMHS other than from the organizations they fund that want to continue to receive funds free of an obligation to serve the seriously ill.  
Other ways to improve care for seriously mentally ill
  • Create hospital beds 2) Free parents from HIPAA Handcuffs 3) rein in anti-treatment activities of PAIMI.
We hope legislators will put a doctor at the head of both SAMHSA and CMHS like all other federal medical agencies. We also hope they will define "evidence-based," a term used throughout the bill to mean
“a program or practice that has independent evidence it improves a meaningful outcome in adults with mental illness or children with serious emotional disturbance.”   “Meaningful outcomes" includes reductions in homelessness, hospitalization, arrest, incarceration, violence, and suicide or other outcomes."
SAMHSA and CMHS rarely do any of that. The evidence they use is not independent, the programs are not for mentally ill, and the outcomes they measur are rarely the meaningful ones.

# # #


Mental Illness Policy Org. is a non-partisan, science-based think tank focused exclusively on the 4% of adults who have the most serious mental illnesses. We accept no government, healthcare or pharmaceutical company funding and are supported almost exclusively by families who have seriously mentally ill loved ones who the mental health system refused to treat and experienced heartbreaking tragedies as a result.

Monday, March 7, 2016

Deblasio policies cause NYC mental illness stabbings

Deblasio administration refuses to use Kendra's Law when needed

Our hearts go out to James Patrick Dillon, his family, those who were stabbed by him, and the  police who had to respond. Like almost all these cases, Mr. Dillon was already known to be seriously mentally ill, had a family that tried to help him get treatment, but could not get him treatment because the DeBlasio administration refuses to focus it's mental health efforts on the most seriously ill. 

Specifically, the DeBlasio administration has failed to robustly implement Kendra's Law. Kendra's Law allows judges to order the most seriously ill, who refuse treatment, to accept six months of mandated and monitored treatment as a condition of living in the community. Kendra's Law reduces homelessness, arrest, incarceration in the 70% range. It keeps patients, public and police safer. 

Our Oped in Manhattan Institute’s City Journal on how ThriveNYC ignores the most seriously mentally ill  http://www.city-journal.org/2015/eon1208dj.html

Our oped in NY Post on how NYC mental health officials ignore the most seriously mentally ill  http://nypost.com/2015/11/15/the-citys-dangerous-mental-health-dodge/

Our oped in Manhattan Institute’s City Journal on how NYC data shows it is failing seriously mentally ill   http://www.city-journal.org/2015/eon0805dj.html

Brian Lehrer (NPR) interview with DJ Jaffe on how NYC mental health officials decided to ignore violent mentally ill   https://www.wnyc.org/radio/#/ondemand/571653

Brian Lehrer (NPR) interviews Chirlane McCray and Dr. Gary Belkin about failure to use Kendra’s Law    http://www.wnyc.org/story/first-lady-chirlane-mccray-kendras-law/
Follow us on Twitter: @MentalIllPolicy
Join us on Facebook: Mental Illness Policy Org. 

Wednesday, March 2, 2016

Join Important March 10 Mental Illness Teleconference with Pete Earley


Dial (712) 775-7031 at 7PM EST on Thursday, March 10 and use Access Code 715149.

Mental Illness Policy Org invites you to join our popular evening teleconference interview series. DJ's next special guest will be former Washington Post reporteradvocate and author Pete Earley.

Pete will tell his personal story trying to get care for a loved one, and use his experience as a former reporter to explain how to get the media to do more and better stories about serious mental illness. He'll answer all your questions.


We hope you'll join us for this important call. Bring all your questions. Share this with your friends and social networks.

To join the call, dial (712) 775-7031 at 7PM eastern(!) standard time on Thursday, March 10 and use Access Code 715149.

Thank you for all you do to improve care for people with the most serious mental illnesses.

Monday, February 22, 2016

NYS Needs Kendra's Law & Psychiatric Hospitals. Don't let mental health industry close them

The two trade associations representing NYS mental health providers (NYAPRS and MHA) are having their annual rally in Albany tomorrow (Tue. 2/23). We OPPOSE their attempts to move mental health spending away from the 5% who are the most seriously mentally ill and towards the higher functioning. Their proposals to end Kendra’s Law and close state psychiatric hospitals puts patients, police, and public at needless risk. We will be in Albany on Tuesday to oppose raiding services that treat the seriously mentally ill.

1. Support making Kendra’s Law Permanent and Stronger. (S-04722/A01275).

While NAMI/NYS supports this, the trade associations do not. Kendra’s Law is NY’s most successful program for the most seriously mentally ill. It allows judges to order someone who already accumulated multiple episodes of arrest, violence, incarceration or needless hospitalization to stay in six months of mandated and monitored treatment while they continue to live free in the community. It is only available to those who already refused to accept voluntary treatment that was made available to them. It also allows judges to order community programs to accept these individuals into their programs. Kendra’s Law is proven to reduce arrest, violence, hospitalization and incarceration in 80% range each, cut costs to taxpayers and reduce stigma. 81% of those in it said it helped them get well and stay well.
S04722/A01275 make Kendra’s Law permanent, ensure court orders are reviewed before expiring, requires community directors to take reports from family members about loved ones who might benefit, and lowers cost by allowing patients to voluntarily stipulate to Kendra’s Law orders. The NYS Assoc. of Chiefs of Police support.

2. Oppose Closing more Psychiatric Hospital Beds.

The trade associations are supporting Gov. Cuomo’s budget proposal to close 225 more psychiatric beds that serve the seriously mentally ill. We oppose. The trade associations look at these beds as a bank account and want them closed so the savings can be given to their member organizations. But there are two problems with that. NYS is short at least 4,000 psychiatric hospital beds even if we had perfect community programs. So closing hospitals guarantees the sickest will not receive treatment. Secondly, even when some savings are given to community programs, they refuse to use them to provide actual treatment to the same adults who are being discharged from hospitals. Instead the funds are used on wasteful sideshows like educating the public, fighting ‘stigma’, identifying the asymptomatic, or funding programs with no evidence of efficacy. As a result, NYS has more mentally ill incarcerated than hospitalized. The percentage of prisoners in NYC jails with mental illness shot up 30% between 2010 and 2014.
We do support increasing housing options, but first we must increase those that provide 24/7 onsite support (group homes), versus the independent housing options supported by the trade associations that serve the higher functioning.