From: "Mental Illness Policy Org" <office@mentalillnesspolicy.org>
Subject: Mental Illness Policy Org Message
Date: December 26th 2011

December Update

2011-2012: Care for people with severe mental illness continues to get worse.  

Money is not the issue. The lack of smart policy is

Thank you for your support of Mental Illness Policy Org. (Secure Donation)Here's a summary of the past year in mental illness and predictions for the next.

 The five most important reforms to improve care for people with severe mental illness and reduce homelessness, arrest, incarceration, and violence continue to be:  

1.    Require the mental health system to send the most severely ill to the front of the line for services, rather than the back.

2.    Use Assisted Outpatient Treatment to help those with a history of violence, dangerousness or multiple rehospitalizations.

3.    Reform involuntary commitment laws so they prevent violence, rather than require it.

4.    Preserve psychiatric hospital beds so those who need inpatient treatment can receive it.

5. Reduce incarceration by getting treatment instead of punishment to people found Not Guilty By Reason of Insanity, Guilty Because of Mental Ilness or unfit to stand trial.

BIG STORY #1.

The big story is that in all these areas 2011 saw major steps backwards as people with severe mental  illness continued to be abandoned by politicians, advocates, and professional consumers all of whom have decided to advocate for services for high functioning individuals with mental 'health' issues and ignore issues important to people with severe mental "illness". The mental health establishment continues to encourage politicians to define social issues (poverty, bad grades, bullying, unemployment, overcrowded housing, etc.) as 'causes' of mental illness and to divert funds meant to provide treatment for people with severe mental illness towards those issues.

BIG STORY #2.

As a result of this diversion, the second big story this past year is that police, jails, prisons, shelters and morgues are providing the lion's share of treatment for people with severe mental illness. The criminal justice system is starting to recognize this, resist, and are organizing to try to send care of people with severe mental illness back to the mental health departments. I believe this will be a big story in 2012.

BIG STORY #3.

The last big story of 2011, and one we will see more of in 2012 is on the efficacy of medications for mental illness. There are several reasons for this. 1) As a result of groups like MHA, APA, NAMI and consumers supporting publicly funded campaigns designed to convince people they have a previously undiagnosed mental illness, many people who don't have mental illness are getting medications. 2) Pharmaceutical marketing practices continue to over promise on results and minimize side-effects. 3) Mental health directors are requiring patients to "fail first" on cheaper medications before they can access more expensive and potentially efficacious ones. 4) Budget cuts are coercing front-line mental health workers to use medications rather than interactions to temper problematic behaviors. I don't know how the story will play out in 2012. Reform is needed, but beware of baby-bathwater syndrome (Soon to be in DSM?).

During 2011, we used our Twitter Feed and Facebook Page to highlight real-time breaking news about these issues; our Huffington Post column and op-eds in newspapers to create our own original reporting; and http://mentalillnesspolicy.org to make the best studies easily accessible to media and policymakers.

Most of our efforts in 2011 involved providing information and research to policymakers and media who request it and our research was widely reported. We also did some original reporting. For example, the shooting of Gabrielle Giffords gave us a chance to lay out all five reforms above in an op-ed in the NY Post and another one in National Review.  

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1. Send seriously Ill to front of line for services  

As states continued to cut mental 'health' budgets, the need to focus the remaining resources on those who are most seriously ill, became even more critical, but was still ignored by most advocates, politicians, and media.

The Substance Abuse and Mental Health Services Administration (SAMHSA) continues to work to prevent treatment of people with severe mental illness. We called for eliminating SAMHSA in Washington Times, and on Huffington Post, as did Dr. E. Fuller Torrey in National Review. We discussed the idea with Congressman Charlie Rangel. SAMHSA gave money to organizations that lobby congress to preserve SAMHSA funding. They were successful.  

In order to get people who are severely ill to the front of the line in NYS, we wrote Time to Close New York's Office of Mental Health in City Journal and "Mentally Ill Deserve Better" in the Albany Times Union. In Huffington Post we urged Cuomo to fire NYS Office of Mental Health Commissioner Michael Hogan and replace him with someone who will end mission-creep and return the agency to it's original purpose of providing treatment to people with serious mental illness. We again called to replace Commissioner Hogan in the New York Post after someone needlessly died.

In California we wrote an article in Capital Journal documenting how Prop 63/Mental Health Services Act (MHSA) funding is being wasted on irrelevant programs while people with severe mental illness can't get care. Rose King and others have written how MHSA funding is creating a two-tier system in California. Services for the seriously ill in the 'old' system continue to be ignored, while task-forces, consultants, and other intiatives not intended to provide direct services to the seriously ill get massive funding. The Mental Health Services Oversight Committee used MHSA funds to hire a public relations firm to convince the public there is no problem.

2. Use Assisted Outpatient Treatment

In 2011, SAMHSA did a poll on what strategic initiatives its constituents want it to focus on. Mental Illness Policy Org helped publicize their poll and suggested Asissted Outpatient Treatment. AOT was the number one vote-getter among issues proposed (other than those proposed by organizations SAMHSA itself funds). It was number three overall. SAMHSA ignored the results of that poll. Likewise we helped SAMHSA publicize a poll of what constitutes "recovery". "Fewer days experiencing hallucinations" was our suggestion and the number one vote-getter among non-SAMHSA funded groups. SAMHSA ignored the results.

In 2011, we worked to educate the New Yorkers about ways Kendra's Law could be improved and the Kendra's Law research that led us to those conclusions. Our research was included in a NY Post op-ed by Pat Scimone (who's mentally ill brother was shot by police on Long Island) and an op-ed by Vanessa Bellucci (who's mentally ill brother killed both their parents on Staten Island). We wrote several op-eds and have started to collect all Kendras Law information in a new site: http://kendras-law.org

California

In 2011, we greatly expanded our California efforts and set up a new web-site, http://lauras-law.org to support the efforts of California Treatment Advocacy Coalition director Carla Jacobs, Dr. Gary Tsai, Dr. Cam Quanbeck and others. In 2011, there were numerous incidents of violence in California by and to people with mental illness who were previously refused treatment by their mental health authorities. This made Laura's Law a hot issue. Since all the info at http://lauras-law.org was new in 2011, we won't present it here.

The big picture is that California seems different than in other states in that the opposition is actually led by the county mental heath directors (who will lose their ability to refuse treatment to people with severe mental illness if Laura's Law is implemented). To answer these concerns, we created an analysis of Laura's Law in Orange County, analysis of Laura's Law in San Mateo county ; a Laura's Law op-ed for the San Francisco Chronicle; and an update on the Laura's Law pilot in Los Angeles. In addition, we created a Laura's Law fact sheet, exposition of Laura's Law myths, a guide to funding Laura's Law.

Other important documents include a letter from Nevada County Judge Tom Anderson and Laura's Law research by Nevada County Mental Health Director Michael Heggarty. Mr. Anderson and Mr. Heggarty were 'involuntarily committed' to implement Laura's Law in Nevada County as a result of a lawsuit, and have now become its biggest supporters and are the custodians of some of the best research in California. SAMHSA-funded Disability Advocates in California is reported to threaten to sue any California County that implements Laura's Law.

The Treatment Advocacy Center and its former Executive Director Mary Zdanowicz were successful in implementing Asssisted Outpatient Treatment in NJ.

Reforms to Washington States Assisted Treatment Laws scheduled to go into effect Jan 1, have been "delayed". For the last several years, all reform of laws has gone in the pro-treatment direction. This is the first that hasn't.

3. Reform Involuntary Treatment Laws

The requirement for mentally ill people to become dangerous before treatment can be given over objection has caused more people with mental illness to become violent. These 'psychotic killer on rampage' stories continue to grab the attention of the public and denial from advocates for "mental health". We addressed the six dead in the Seal Beach Salon Shooting, the three national guardsmen dead in the Carson City Shooting, the death of mentally ill Kelly Thomas while in police custody, and the Ft. Bragg shooting of an ex-mayor and subsequent shooting of mentally ill Aaron Bassler. We were heartwarmed by the fact that the families of both Kelly Thomas and Aaron Bassler have become major influential advocates for reform (See below).

Michael C. Biasotti, VP, NYS Chiefs of Police, conducted a nationwide survey of 2,406 senior law enforcement officials (75% who were officers longer than 20 years) that documents police and sheriffs are being overwhelmed "dealing with the unintended consequences of a policy change that in effect removed the daily care of our nation's severely mentally ill population from the medical community and placed it with the criminal justice system." This major report calls for reform of involuntary treatment laws and is receiving attention in the law enforcement community. We wrote a story for Law Enforcement Today highlighting it.

Mental Illness Policy Org associate Mary Ann Bernard wrote a terrific piece in National Review on how California can deal with Brown v. Plata a Supreme Court Order that could lead to incarcerated mentally ill being released into the community.

4. Preserve Psychiatric Hospitals

In 2011, as a result of the Medicaid IMD exclusion and state budget cuts, psychiatric hospitals continued to close and continued to receive press attention from the media, largely driven by the front line mental health workers who work in them, and police who will have to bear the consequences of closure. Budget cuts will likely continue this trend. What has not been reported, and I predict will be an issue in 2012, is that majority of beds that are left are being reserved for forensic patients and sexually violent predators, leaving even fewer available for non-criminal mentally ill. The best statistical report is, "Shortage of Psychiatric Beds" by Dr. E. Fuller Torrey of the Treatment Advocacy Center (Disclosure: I am a co-author).

5. Not Guilty Be Reason of Insanity

An Arizona court ruled that mentally ill Eric Clark has to be freed or retried in the shooting death of officer Jeffrey Moritz. We wrote an op-ed for Law Enforcement Today on the need to reform NGRI so if Eric Clark is found guilty, NGRI, or guilty because of mental illness he receives treatment. This argument was similar to one we wrote in the Wall St. Journal about not guilty by reason of insanity.

Heros of 2011 and In Memorium

We thank the following individuals for becoming powerful advocates for change following death in their families. We also remember their mentally ill loved ones and will continue our work so other families don't have to go through what they did.

Ron Thomas (father of Kelly who had untreated severe mental illness and died at the hands of Fullerton, CA police.)

Jim Bassler (father of Aaron who had untreated mental illness shot two and was in turn shot by police and died in Mendocino, California.)

Pat Scimone (brother of Thomas who had severe untreated mental illness and was shot by police and died on Long Island.)

Venessa Bellucci (brother of Eric who had untreated severe mental illness and shot and killed both their parents in Staten Island.)

Each of these individuals has turned their personal tragedy into a mission to reform laws so people with mental illness don't have to become dangerous before they get care.

To get more news from us, in a more timely way, follow our Twitter Feed and Facebook Page.

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Best wishes to you and your families in the new year. -- To remove yourself use this link: http://mentalillnesspolicy.org/Dadamail1/mail.cgi/u/mipo/example/example.com/ Privacy Policy: We don't share your info with anyone. DJ Jaffe Mental Illness Policy Org 50 East 129 St., PH 7 New York, NY 10035 office@mentalillnesspolicy.org http://mentalillnesspolicy.org Follow us: Twitter: @mentalillPolicy Huffington Post: http://huffingtonpost.com/dj-jaffe

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