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November 21, 2008 - News of the Week'ANOTHER KIND OF VALOR' CAPTURES TORMENT OF STRESS DISORDERS IN VIDEO VIGNETTES
An Audience Discussion Guide is Included to Promote Public Awareness
For details and order information, click http://www.cimh.org/Learning/Publications-DVD/Another-Kind-Of-Valor.aspx
Will the grateful American public provide our returning war veterans with the help they need to cope with combat-related stress disorders and brain injuries? The public first needs a basic understanding of these challenging conditions. To bridge the gap in public understanding of wounds that are disabling but invisible, the California Institute for Mental Health (CIMH) has released 'Another Kind of Valor', an outstanding set of videos that is both deeply moving and a powerful stimulus for discussion of problems that affect families and communities nationwide.
The CIMH video kit consists of 3 DVDs with nine powerful half-hour vignettes based on actual stories of battle trauma, plus a learning CD that serves both as a learner's guide and a facilitator's handbook useful for self-study or group discussions.
Returning to civilian life from combat is almost always a hard road to run. Studies have shown that a third of G.I.'s returning from the combat zones of Iraq and Afghanistan - more than 300,000 men and women - have endured mental health difficulties.
While most Americans can empathsize with the challenges faced by veterans suffering from physical injuries and disabilities, it is often more difficult for civilians to comprehend the complex emotional and psychological problems confronting veterans suffering from post-deployment mental health issues - or the invisible injuries of war - such as post-traumatic stress disorder, depression, and traumatic brain injury. By bringing these stories to life through the docu-drama format, Another Kind of Valor helps to foster awareness, discussion, and understanding of the struggles our disabled veterans and their family caregivers face, and contributes to the development of a more supportive encironment in which they can begin to heal and recover from the wounds of war.
MENTAL HEALTH NEEDS ARE STRESSING OUT VETERANS' ADMINISTRATION
War Veterans Seeking Help In Record Numbers
By Lou Michel
Buffalo News
November 7, 2008
Dana Cushing is a disabled veteran who is supposed to receive an hour of counseling each week through the Buffalo VA. But she shares that hour of a psychologist's time with 15 others in group therapy. "So you have 60 minutes divided by 15 people. That's four minutes apiece, and that's not going to help," Cushing said.
She is not alone.
Returning war veterans are seeking help for depression, anger and other mental health problems in record numbers in Buffalo Veterans Affairs Medical Center and similar hospitals around the country.
The most common treatment is medication. In fact, the number of prescriptions given to local [Buffalo] veterans to help them with mental problems has increased from about 1,700 seven years ago to almost 8,000 in the 2007-08 fiscal year.
The problem is that medicine, on its own, does not teach the veterans how to cope. That is why a campaign is under way to enlist psychologists and other mental health providers to work with war veterans.
There's just one catch. There's no pay. It's volunteered time. Not a lot. Just one hour a week. "We're appealing to the social and moral conscience of behavioral providers in the community to reach out and offer one hour per week," said Thomas P. McNulty, president of Mental Health Services of Erie County. "Soldiers and their families deserve nothing but the very best from our community."
The need is pressing and will continue to grow, according to Barbara Van Dahlen Romberg, national founder and president of Give an Hour. "I hear from some veterans that it is difficult to get immediate appointments and frequent appointments," she said.
The effort here and in other states comes at a time when more federal money is pouring into the Department of Veterans Affairs to treat psychologically injured veterans. Critics say there is too much emphasis on medication and not enough on counseling. Antidepressants top the list of medicines prescribed to returning Iraq and Afghanistan veterans at the Buffalo VA, which has spent more than $2 million on psychiatric medications since 2001.
E-mails to Romberg from the loved ones of veterans across the country often express concern that the vets are "primarily receiving medications and not enough counseling," she said. A volunteer force of psychologists is "nimble and fluid" and can fill in the gaps as needed, Romberg said.
The demand for counseling is expected to continue to increase as more veterans return home, McNulty said. To date, an estimated 1.6 million service members have spent time in Iraq or Afghanistan. "What we're hearing is that the wave of veterans returning will put undue stress on the current system, and new resources must be identified to meet that need," he said, adding that he is working with VA employees who cannot be faulted for the growing demands.
And, McNulty says, it's not only veterans who need the care. Their family members, children especially, need counseling to cope with extended absences caused by multiple deployments. "Let's say the mom is the one in the service, and mom's not home two years. The kids feel bad. They've lost two years. Then mommy, or daddy, returns from the war into a home that is already stressed by their absence," McNulty said. "In addition, there's the issues the soldier brings home."
There are others, as well, who could benefit from the planned local chapter of Give an Hour. Consider Army veteran Christopher Simmance. Over the last two years, the City of Tonawanda man says he has seen four or five psychiatrists and is awaiting assignment of a new one. "My old psychiatrist quit in May. He told me he couldn't stand how the VA was treating vets. He gave me a bunch of refills," said Simmance, who developed post-traumatic stress disorder several years after serving in a Middle East international peacekeeping force.
Medication alone, the vets say, doesn*t heal. Yet it is a big part of their treatment. And while the VA's mental health staff might appear sufficient in number to treat the more than 2,000 new war veterans [from Buffalo] of the last several years, these men and women are not the only ones who rely on the VA. Each year, the Buffalo VA treats more than 40,000 veterans, who are all entitled to care from its 11 full-time psychiatrists and 70-plus psychologists, social workers, addiction therapists and part-time mental health workers.
Working with McNulty to launch the local volunteer effort a few weeks from now is Christopher M. Kreiger, a disabled Army veteran, who suffered traumatic brain injuries serving in Iraq and post-traumatic stress. "I've been out trying to push to see if psychiatrists would be willing to donate an hour a week to a veteran in need who cannot get it at the VA," Kreiger said. "Even the staff that works at the VA says there's a shortage."
Rather than sit at home and complain, Kreiger, of the Town of Tonawanda, says working to help fellow veterans has helped him. "The more I get into it, the more my problems don't seem so big," he said, explaining that idle time is a big problem for psychologically wounded veterans. "I just sit at home. I just watch TV," Simmance said. At one point, he said the VA wanted to assign him to a foreign-born psychiatrist. He refused, claiming his overseas military experiences would make it difficult for him to open up to that particular doctor.
Simmance said he consumes up to four prescription drugs a day for his post-traumatic stress. Bret Mandell, an Army veteran who has seen action in Iraq and Afghanistan, described similar experiences in dealing with the VA, adding that he has taken up to seven different medications for post traumatic stress. "Every time I went up there, they kept switching me around to different people, and I couldn't get a good relationship with anyone to where it benefited me," Mandell said of the VA.
Tracy Kinn, a New York State veterans counselor, says vets need to be proactive if they want to secure VA services. "They work for us, but they are very overworked," said Kinn, a former Marine. Veterans who don't take a proactive approach, she said, may wind up only with medications and "without the care."
Jeremy Lepsch, a psychologically disabled Marine from North Tonawanda, said he has noticed progress in the level of VA care. "It seems they've talked to the staff because everyone seems a lot more friendly and caring," Lepsch said. The VA also has enhanced its day treatment facility on Main Street at Hertel Avenue, describing it as a "psycho-social rehabilitation recovery center," according to Buffalo VA spokeswoman Evangeline Conley. "We're learning and modifying the programs based on current needs and what seems to be best for veterans," Conley said.
Source:
http://www.printthis.clickability.com/pt/cpt?action=cpt&title=Mental+health+needs+are+stressing+out+VA&expire=&urlID=32281567&fb=Y&url=http%3A%2F%2Fwww.buffalonews.com%2Fhome%2Fstory%2F486523.html&partnerID=173606
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November 9, 2008 - News of the Week
IT CAN BE DONE! Peer Counselors Become Agents of Recovery
ARTICLE:
Note on language: readers may prefer to substitute the terms "people with psychiatric disabilities and substance use disorders" instead of "the mentally ill and drug addicts."
Philadelphia Agency Is Rolling Out A Model For Clients, Including Addicts, With Emphasis On Recovery
By Don Sapatkin Philadelphia Inquirer October 9, 2008
Recalling Philadelphia's roots as a medical innovator dating to colonial times, city officials outlined yesterday what they described as sweeping changes - some completed, others envisioned - in the treatment of drug addicts and the mentally ill.
Over the last several decades, scientific advances have dramatically improved the lives of the mentally ill, many of whom are also addicted to drugs and sometimes homeless. But those discoveries have not always guided government programs across the nation that are intended to help.
"The question is how do we reorganize our system to deal with the realization that people get better?" said Arthur C. Evans, director of the Philadelphia Department of Behavioral Health and Mental Retardation Services.
At a news conference yesterday at a community mental-health center, Evans said some recovering addicts were being trained as peer counselors, allowing them to use their experiences to help others in similar straits. By paying the peer counselors, the program serves another need - getting people back on their feet and staying connected, as opposed to what has been described as the treat-them-and-drop-them approach.
Evans described the new longer-term model as the most sweeping change in the field since hundreds of thousands of mentally ill people were released from institutions during the deinstitutionalization wave of the 1970s.
The changes, which will be phased in over the next two or three years, will be accommodated in his department's $1.4 billion budget, Evans said, noting that peer counselors are not paid like doctors.
The speakers made a point yesterday of describing their new approach as "recovery" rather than "treatment."
Among them was Robert D. Martin, 42, who said he had bipolar disorder and was addicted to crack and living on the streets of Center City in the late 1980s and early '90s. Early in this decade, he said in an interview, his treatment in "partial programs" - "you sat for eight hours a day, then were sent back on the street" - gave him "a glimmer of life."
In mid-2007, just as some of the rethinking was being implemented at Evans' agency, two weeks of intensive training taught Martin how to support recovering addicts, how to run groups, and how to teach people the skills that most Americans take for granted, such as applying for Social Security cards and preparing to go back to school.
He got a job as a peer counselor and has since been promoted. He moved from the street to a shelter to the three-bedroom house he now rents with his wife of two years in Logan. And he just traded in an old clunker for a 2006 Nissan Maxima.
"I'm living life again," Martin said, sitting outside the news conference at the Philadelphia Recovery Community Center at 1701 W. Lehigh Ave.
The site is the first of several planned centers that will offer a range of support groups, counseling, education and social events in communities.
In general, Evans said, the changes that he calls "recovery transformation" - but that may be known to professionals elsewhere as "recovery-oriented systems of care" - are supported by research.
When he was a deputy commissioner of mental health and addiction services in Connecticut, Evans implemented what was described as the first such comprehensive effort, and when he arrived several years ago in Philadelphia, he set about doing the same thing.
"Over the years, it has become clear that people with addiction problems also have other mental-health issues," said Joe Troncale, medical director of the Caron Foundation near Reading, a leading addiction treatment center.
Troncale had no direct knowledge of the changes in Philadelphia but said the integrative or holistic model that was described to him appeared to be the direction in which behavioral health was heading.
Philadelphia, he said, had been known as a leader in humane mental health services going back to the beginning of the nation, when Dr. Benjamin Rush sought to classify forms of mental illness and wrote the first American textbook on psychiatry.
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Source: NYAPRS Enews
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EDITORIAL
New York Times
November 7, 2008
New York City pioneered the strategy of providing homeless people not just with housing but with drug treatment, psychiatric care and other services they need to live successfully on their own. Even with all the add-ons, supportive housing apartment buildings cost substantially less than shelters and are many times less expensive than jails or beds in psychiatric hospitals.
This strategy is taking root all over the country and proving beyond a doubt that people who were once homeless can be good neighbors and good citizens. Unfortunately, many neighborhoods are continuing to fight the developments, believing that they bring down property values. A long-awaited study from New York University's Furman Center for Real Estate and Urban Policy should put an end to that misperception.
The study examined the sale prices of apartment buildings, condominiums and individual homes in New York City neighborhoods where 123 supportive housing developments were opened between 1985 and 2003.
Fear seems to have suppressed property values somewhat while the new developments, which often replaced vacant lots or eyesores, were being built. But that evaporated once people saw the buildings and how well they were run.
In the five years after the developments were opened, the study finds, the prices of buildings nearest the supportive housing development experienced "strong and steady growth," and appreciated more than comparable properties that were slightly farther away. In other words, the closer property owners lived to these often handsome developments, the better they fared.
The Furman study confirms what advocates have been saying for years: well run supportive housing can help both formerly homeless citizens and the neighborhoods in which they are built. Politicians and business leaders across the country should pay attention.
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October 26, 2008 - News of the Week
IT CAN BE DONE!
Neighbors and Civic Organizations Join With Advocates to Develop Housing Opportunities
Massive institutions on Long Island in NewYork once warehoused tens of thousands of people with psychiatric vulnerabilties. When deinstitutionalization began to sweep the nation in the 1970s, wave after wave of patients were dispersed from Long Island's institutions to fend for themselves. Many sought refuge with families who searched in vain for needed services. Many others ended up on the streets of local communities with no housing or supportive services -- impoverished, homeless, with deteriorating health.
By 1990, community care had become a bitter broken promise. As a result, throngs of destitute patients across the nation are now in jails and prisons for illness-related offenses. The U.S. Dept. of Justice reported in 2006 that more than half of all jail and prison inmates had symptoms of a mental health disorder.
In sharp contrast...
As early as 1972, a Long Island group called Concerned Friends and Parents of Central Islip State Hospital began to meet in Suffolk County. The group grew, evolved, and was renamed Concern for Independent Living. This active, creative group has just celebrated the opening of its latest outstanding housing project (see News item for Sept. 30 below), increasing their creation of apartments to appproximately 550.
An article from 2006 describes how community cooperation turned a seemingly doomed project into a success.ARTICLE source: http://www.concernhousing.org/pollackgardens/Journal-Page9.pdf
ARTICLE
NEIGHBOR OF THE YEAR:
Town of Islip and the West Sayville Civic Association, Neighbors of Pollack Gardens, a project of Concern for Independent Living.
In many areas, local civic associations and community boards provide the primary opposition to developing new affordable housing (emphasis added by by NSC).
But in the case of Concern for Independent Living's Pollack Gardens, an outstanding new supportive residence in West Sayville, Long Island, the project would not have moved forward without the help and support of the West Sayville Civic Association (WSCA) and the Town of Islip Community Board.
After hearing about the proposal to build Pollack Gardens, Brendan McCurdy, President of WSCA, didn't object; instead he called Concern to learn more about both the agency and the program. He brought the information back to WSCA and convinced its members to support the project, a ground up, gut rehabilitation conversion of a run-down adult home. His wife Maura updated neighbors about the progress of the project through the WSCA newsletter, expressing the view that supportive housing would be a positive addition to the community.
Equally important, the Town of Islip Community Board played a critical role in cutting through red tape to save the project's tax credit funding. Three months before the funding deadline, it was discovered that part of the property needed to be rezoned to get site plan approval. This process normally takes more than nine months.
Everyone said it was impossible to secure the necessary approvals in only three months and the project appeared doomed - everyone except Eugene Murphy, Planning Commissioner, and Hope Larson, who was then the Director of the Building Department.
The Town of Islip scheduled an emergency Town Board meeting one day before the deadline, something that had not been done in at least 25 years.
Ten minutes after they unanimously passed the resolution, Hope Larson — who happened to be dressed as Wonder Woman for Halloween — issued the building permit. The very next day, Concern for Independent Living closed on the tax credit financing five minutes before the deadline.
The building opened a little over a year later, where it now provides a wonderful home to fifty individuals with psychiatric disabilities, thanks to the community leaders of West Sayville and Islip. The Network is pleased to honor Mr. McCurdy, Mr. Murphy and Ms. Larson as the Network's 2007 Neighbors of the Year.
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September 30, 2008 - News of the Week
IT CAN BE DONE!
Former Adult Home Undergoes Transformation in NYARTICLE: http://www.27east.com/story_detail.cfm?id=170539
New Psychiatric Rehabilitation Center Opens In Riverhead
By Jessica DiNapoli Southhampton Press September 30, 2008
The building at 260 West Main Street features beautiful artwork, crown molding, high ceilings and a well-equipped gym. These luxurious amenities would suggest that the building is an apartment complex or a hotel found in New York City.
But the newly renovated facility is actually located in downtown Riverhead and owned by Concern for Independent Living Inc., a not-for-profit housing agency that offers permanent shelter for those who are recovering from psychiatric disabilities. The facility, called Concern Riverhead, has been in operation since June and offers its 50 residents apartment-style living as each single-occupancy room comes with its own bathroom and kitchenette.
The residents of Concern Riverhead range in age from 18 to 60, and either have low-income jobs or are homeless, explained Elizabeth Lunde, the associate director of Concern for Independent Living. The Medford-based organization runs similar facilities across Suffolk County and, at the present time, provides housing for approximately 550 people.
The Riverhead facility celebrated its official grand opening with a ribbon-cutting ceremony last Thursday, September 25, that was attended by local government officials and representatives of the mental health field.
Concern for Independent Living purchased the building, which was constructed in 1929 and formerly known as the Henry Perkins Hotel, four years ago. From the 1970s until 2004, the building housed the Henry Perkins Adult Home, a facility mostly known for its dilapidated condition.
For the past three years, Concern for Independent Living has invested close to $15 million in renovating the building, with construction commencing in August 2007. Work was completed on the facility in June.
The money for the extensive renovation came from three sources, explained Steve Piasecki, the upstate coordinator for the Supportive Housing Network of New York, a housing advocacy organization. Mr. Piasecki said the New York State Office of Mental Health, the Federal Home Loan Bank and the Community Preservation Corporation all contributed to the project.
"We absolutely improved the facility," Ms. Lunde said. "We want our places to look like apartment buildings or hotels because the folks rise to the level of their surroundings." She noted that there are staffers at the facility 24 hours a day, seven days a week.
As part of the renovations, Concern for Independent Housing restored the historical architecture of the first floor of the building, including the pediments, and added office space. The agency gutted the second, third and fourth floors of the building, which now house 50 apartments.
"It was a warren of old rooms from the old hotel," Ms. Lunde said. "The Henry Perkins Adult Home ... kept almost everything from the old hotel."
Ms. Lunde noted that there might have been some renovations completed in the adult home in 1920s, shortly after the structure was built.
When Concern for Independent Housing acquired the building in 2004, there were still 120 people living there as residents of the Henry Perkins Adult Home, explained Ms. Lunde. The not-for-profit helped relocate those residents to other mental health facilities in the area before embarking on their renovation plan, she said.
Riverhead Town Supervisor Phil Cardinale, who attended last week's ceremony, said the Henry Perkins Adult Home was "not a positive for the Town of Riverhead." He emphasized during the event that the home, which had been cited by the state for a variety of violations, was poorly managed prior to its closure.
As Ms. Lunde explained, the pristine interior of the Concern Riverhead facility is designed to help improve the mental health of its residents.
"It's nice, it's clean," said Sharon Francis, one of the 50 residents of the facility. "The staff is nice and helpful." Before moving to her new home in downtown Riverhead, Ms. Francis said she received treatment at the Buckman Center at Pilgrim Psychiatric Center in Brentwood.
The Main Street location is also convenient for residents as they are within walking distance of many small shops and a bus stop, according to Ms. Lunde. Ms. Francis noted that she takes the bus by herself when she has to run errands.
Christopher Betts, the vice president of the Albany-based Community Preservation Corporation, said the former adult home that once occupied the building had been a blight on the community for years. He said the former facility provided substandard housing to its residents.
Mr. Betts added that the recent renovations to 260 West Main Street are not only an investment in the building but in the surrounding community. "Supporting projects like this has a positive impact on property values," he said.
Town officials agreed that the new facility, one of the first buildings that greets drivers who are traveling east on Route 25 in Riverhead, improves their overall impression of the downtown area, which has seen a number or retail stores close shop in recent years following the shuttering of Swezey's Department Store.
"It's a great building to greet everyone," said Riverhead Town Councilman John Dunleavy.
"The restoration of the site is wonderful," Mr. Cardinale added.
And elected officials were not the only ones to agree with that assessment.
"Once upon a time this was a rundown adult home," said William Polchinski, a therapist at the Peconic Center on East Main Street in Riverhead, an outpatient clinic of the Pilgrim Psychiatric Center. "But Concern made it beautiful and it absolutely affects people's mental health."
http://www.27east.com/story_detail.cfm?id=170539
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Source: NYAPRS ENews
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September 10, 2008 - News of the Week
STUDIES FIND SHOCKING RISE IN DEATHS OF FORGOTTEN TEENAGERSARTICLE: Community Voices: Healthcare for the Underserved, 9/10/2008 (forwarded by NYAPRS Enews)
Studies Find Dramatic Increase In Suicides Among Adolescent African-American Males
Experts Call For New Treatment Strategies and Better Access to Care
A significant increase in mental illness and behavioral problems among adolescent African-American males demonstrates the need for new approaches to treatment and better understanding of the complex challenges facing these youths, according to a policy paper issued by Community Voices: Healthcare for the Underserved, an advocacy group based at Morehouse School of Medicine.
The paper, titled "The Secret Epidemic: Exploring the Mental Health Crisis Affecting Adolescent African-American Males," outlines data indicating that mental health problems are rising among members of this at-risk group, their access to treatment facilities is relatively low and treatment strategies must be revamped to address the socioeconomic issues that confront them.
"Our research found that many young black males are treatable, but they are going undiagnosed because of failures in America's health-care system," said Dr. Henrie M. Treadwell, Director of Community Voices, a nonprofit seeking to improve health services and access to health care. "Our entire society feels the impact of this failure. Suicides and homicides have increased for this group, and the residual effect is impacting communities across the country. This problem must be addressed."
Dr. Claire Xanthos, a health services research specialist, wrote the paper, which cites studies showing that black males ages 15-19 die from homicide at 46 times the rate of their white counterparts and that from 1980 to 1995, the suicide rate for black adolescents rose from 5.6 to 13 per 100,000 of the population.
Xanthos writes that "these figures should not be surprising since adolescent African-American males in contemporary American society face major challenges to their psychological development and well-being. In addition to dealing with the physical, mental and emotional issues typically experienced during adolescence, adolescent African-American males are confronted with unique social and environmental stressors. They must frequently cope with racism and its associated stressors, including family stressors, educational stressors, and urban stressors."
Moreover, the paper notes that:
-- Racism can affect mental health by reducing socioeconomic status, diminishing access to desirable resources and contributing to poor living conditions.
-- When positive adult male role models are absent, many black youths turn to their peers for help in forming a male identity, an adaptation that often means absorbing negative influences.
-- Urban stress is an important factor in the psychological development of young black males because many live in deprived and dangerous neighborhoods where they are exposed to violence.
-- Significant problems are also encountered by black males who grow up in predominantly white, middle-class communities where they feel distanced from the white youths and also from blacks from poorer communities.
Citing these problems, the paper makes a plea for better access to mental health treatment for young black males, noting that they currently often confront a "confusing maze" when trying to get help.
The paper notes that when young black youths do find treatment, depression is often overlooked because their symptoms often differ from white youths'. For cultural and social reasons, black youths often express suicidal feelings through somatic complaints rather than sadness or depression.
Moreover, the paper calls for more "bicultural" training for young black males. Such training would better prepare them to follow proper behavior in school and the workplace, while also working with young black males to get them ready to deal with the discrimination they are likely to face. Also cited is the need for a significant increase in the number of black therapists available to work with African-American youths.
Dr. Treadwell said it is essential that new policies be implemented to address the social and environmental factors that create poor mental health outcomes for young black males.
"We must increase the capacity of America's mental health system to help resolve the problems faced by young black males," she said. "There must be more research in this area, and more people of color must be trained and hired to help this at-risk group."
Contact: Alicia Ingram, 404.493.1724
http://www.marketwatch.com/news/story/young-african-american-males-face-mental/story.aspx?guid=%7B670BE33D-39C9-4FA8-BF60-BCFEC5363A56%7D&dist=hppr
Copyright 2008 PR Newswire
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August 31, 2008 - News of the Week
A NEW BOGUS STATISTIC ON HOMICIDE ?
The number of homicides committed by people with unmedicated schizophrenia, severe depression, and bipolar disorders is not known. Unfortunately, this lack of data hasn't stopped the Treatment Advocacy Center in Arlington VA (Psychlaws.org) from creating its own version of the non-existing information.
If a quote from a recent interview with Dr. E. Fuller Torrey in World Magazine is accurate, Psychlaws' annual estimate for homicide by mentally ill persons has unaccountably doubled from 5% to 10% of the nation's total. Rational estimates, meanwhile, place the rate close to that for homicide by the general population.
In the past, the Torrey team has re-interpreted research done by others to support its crusade for compulsory psychotropic medication. Their most reliable source of data concerning homicide is a Department of Justice (DOJ) report, Murder in Families, done in 1994 using data from 1988 (twenty years ago!). The report was based on prosecutors' reports from 33 large urban counties during a decade of crack cocaine-related violence and high homicide rates. The DOJ found that 64.4 percent of homicides were committed by people using alcohol at the time of the murder, 35.5 percent were committed by people who were unemployed, 1.6 percent by people who were homeless, and 4.3 percent by people with histories of mental illnesses. The mental illnesses were not described -- that is, the diagnoses were unknown, severity was unknown, and treatment status was unknown.
In the early 1990's, more than a decade after the Justice Department report, Dr. Torrey applied the DOJ's 4.3 percent homicide rate to a very different group of individuals. Although the Justice Department had studied urban dwellers with unspecified histories of mental illnesses, Torrey applied the DOJ rate (after rounding 4.3 to 5 percent) to people with schizophrenia, severe depression, and bipolar disorders whom he labeled unmedicated. Such statistical manipulation is unethical at best.
A more recent analysis of violence (CATIE project, NIMH 2006) found serious violence among people with schizophrenia to be only slightly higher than the general population without psychiatric disorder (3.6 percent compared with 2 percent). Since only 1 percent of the population has schizophrenia, their homicide numbers, if scientifically analyzed, would be a tiny blip on the charts.
If Dr. Torrey has bumped the 4.3 percent to 10 percent, when can we expect 20 percent?
Excerpts from a letter to World Magazine from Jean Arnold, August 25, 2008:
RE: "OUR INSANE MENTAL HEALTH SYSTEM," World Magazine, August 23, 2008
Your recent column in World Magazine captured very well Dr. E. Fuller Torrey's strong views on the mental health system. I suggest, however, that the article needed input from people who have lived behind the system's locked doors.
I too have followed for over two decades Torrey's criticism of America's non-system of mental health treatment. I first met Dr. Torrey in New York in the early 1980's. He was criss-crossing the country urging families of mentally ill individuals to fight for the community services that were promised, but never delivered, by the proponents of deinstitutionalization. Dr. Torrey admonished the families to "Make it happen!" because no one else would. In 1986, he exhorted a NAMI conference audience to fight for community services, research funds, and regular inspections at state hospitals and psychiatric outpatient clinics. He urged them to learn about state budgets and about who is served and who is not. In closing, he told them to advocate for passage in every state for a bill of rights that guaranteed minimum standards of care. But despite Dr. Torrey's vigorous efforts, he could not bring about the miracle needed to reverse the failure of deinstitutionalization.
By the early 1990's, Torrey was disappointed if not embittered by the snail-like pace of change. Joined by D.J. Jaffe, an advertising executive, Torrey reached beyond the family movement to create with Jaffe the Treatment Advocacy Center in Arlington, VA. Their strategy to bring about change, described by Mr. Jaffe in a candid speech to NAMI in 1999, was to fan the public's fear of violence and enlist support from the law enforcement sector. This decision to "capitalize on fear" (Jaffe's words) produced the swift enactment of a compulsory treatment law in New York in 1999 (Kendra's Law). Ironically, the mentally ill assailant who triggered the law's passage was sentenced to prison despite a state investigation's findings that he had tried, repeatedly, to obtain the psychiatric treatment he knew he needed.
Since 1999, the Treatment Advocacy Center's fear-based crusade to further extend compulsory medication has met a number of setbacks. The quick and easy passage of Kendra's Law surprised even its proponents, but this success has not been repeated. Although 47 states have laws allowing psychiatric outpatient commitment, the severe shortage of community resources and programs, both voluntary and involuntary, renders the laws unworkable. Medication alone is a false solution, experts say, considering the problems it can cause. Dosage must be closely monitored and the patient needs a safe place to live with access to pre-crisis help and other supportive programs to meet special needs such as substance abuse problems.
Although Dr. Torrey has railed for decades against civil rights activists as the source of the system's problems, he surely knows that the national economy, political priorities, and prejudice, are the real roadblocks to mental health reform. He seems unaware that his relentless emphasis on violence contributes to the public's reticence to fund resources, a finding confirmed by researchers Corrigan et al (Psychiatric Services, May 2004).
Judging from the responses your article received on the Free Republic website, there is little compassionate caring among its readers. But I wonder, if you had interviewed someone less committed to fear mongering, might these same responders have reacted differently?
Sincerely,
Jean Arnold, Co-founder and Chair
National Stigma Clearinghouse
FOOTNOTE:
It is not unusual for the Treatment Advocacy Center's statistics to be inaccurate or misleading.
Its website posts a large number of summarized studies on violence. All are intended to support a contention that people with psychiatric disabilities constitute a public safety hazard. But their summaries of research done by others may or may not be accurate. For example, one summary claims the researchers found 19 out of 20 subway pushers in New York to be psychotic. In fact, the researchers (Martell and Deitz, Arch Gen Psych June 1992) studied only the psychotic assailants. Say again? The researchers found 49 pushing incidents spanning 17 years, but studied only those cases that involved a psychotic assailant.
The World Magazine interview quotes Torrey's use of a new unsubstantiated homicide statistic. This is not surprising since Torrey's earlier estimate (5%) was also unsubstantiated. Whether he inadvertently mis-spoke or thinks 10% sounds better than 5%, neither figure is supported by fact
August 10, 2008 - News of the Week
NEW MEXICO COURT RULES OUTPATIENT COMPULSORY MEDICATION LAW UNENFORCEABLE
ARTICLE:
City Will Keep Fighting for Mental Health Law
By Scott Sandlin And Dan McKay Albuquerque Journal August 7, 2008
Albuquerque officials reacted quickly this week after a second court struck down the city's Kendra's Law clone, which would have required forced medication of some people with mental illnesses.
Mayor Martin Chavez said he would pursue remedies in both the state Supreme Court and the Legislature after the New Mexico Court of Appeals ruled that the city's Assisted Outpatient Treatment ordinance was preempted by a raft of state mental health laws, both civil and criminal.
"We'll keep fighting," Chavez said Wednesday.
Mental health and civil rights advocates, meanwhile, said the focus should be on fixing a broken and wholly inadequate mental health service system. They, too, will be back at the Legislature with proposals.
Mental health advocates said existing law has mechanisms for getting a substitute decision-maker appointed when a person is incapacitated.
Despite "fearmongering" by its backers, the city ordinance would not have prevented tragic circumstances in which people have died, said Nancy Koenigsberg, a staff attorney at Protection and Advocacy. The organization was created to protect the rights of people with mental illness.
In both New York, where Kendra's Law was enacted, and in New Mexico, people with mental illness were trying to access care in the system and couldn't get it, she said.
"Even the ordinance that was struck (down) acknowledged that for any kind of treatment to achieve its goal, it must be linked to a system of comprehensive care in which state and local authorities work together to ensure outpatients receive case management or special services. That's great. We agree with that. And it doesn't exist," she said.
The state Medicaid program has cut back case management services, and other providers of outpatient mental health services have cut them back or eliminated them altogether, Koenigsberg said.
"You're talking about a person with a chronic illness who needs help to get to appointments or address barriers to work getting to an aid program — and they are few and far between," she said.
Chavez argues the city ordinance is necessary to keep from putting "innocents at risk." In 2005, a mentally ill man was accused in the killing of two police officers and three other people.
Asked about criticism that not enough mental-health services are available, Chavez said opponents can "say that to the widows of the police officers" and their families.
The ordinance was crafted carefully and applies to "just a narrow slice of people," Chavez said.
He described opponents as merely a small, vocal group.
Andrew Penn, a senior staff attorney at the Bazelon Center for Mental Health Law in Washington, D.C., praised the appeals court decision by Chief Judge Jonathan Sutin for "confirm(ing) the right of an individual to make his or her own mental health treatment decisions. That is something we find so important in terms of individual rights and dignity."
He said studies have shown that forced treatment doesn't work.
"I don't think the solution in keeping people safe lies in forced commitment. It lies in more effective community services," he said.
Peter Simonson, director of the ACLU of New Mexico, said the city ordinance was "overreaching," targeting an overly broad group.
"The city wants to be able to medicate people who refused to consent to psychotropic drugs, while the Legislature carefully preserved the right of a person to refuse (treatment). We're talking about drugs that can have a long-term, permanent effect on your neurological system and can be very damaging," he said.
Had the law withstood the challenge, there conceivably could have been a situation where someone forced to accept medication couldn't have paid for it — and had to be incarcerated, Simonson said.
"The backdrop for this whole thing is a broken system. Not only did the city law ignore that, but it also penalized a person for being at its mercy," he said.
Koenigsberg said a newly formed network of mental health advocacy groups worked to create proactive legislation, including two companion bills introduced in the last legislative session by Rep. Nathan Cote, D-Las Cruces. One would have created safe houses for people who need behavioral health support but not hospitalization. Another would have recruited and trained quick-response teams statewide for people experiencing urgent behavioral health needs.
They'll be back with the proposals again.
"I know there will be other things brought forward before the Legislature again — and that's where it belongs. It is a statewide issue. ... It shouldn't be in the courts," Koenigsberg said.
Chavez had pushed for a statewide version of the law before Albuquerque enacted its own. He said the city will continue lobbying for such a law while pursuing its options for appeal.
Chavez, a lawyer himself, said the city's legal team believes there's a good chance of success if the city continues litigation.
"I really expected to do better in the Court of Appeals," he said.
Most states already have a version of Kendra's law, Chavez said, calling the recent court decision "troubling."
Reprinted using Fair Use standard
FOR BACKGROUND
KENDRA'S LAW UPDATES, 2006-Current
August 4, 2008 - News of the WeekA NEW YORK CREATION MAKES NATIONAL NEWS
ARTICLE:
Homeless No More: The Pathways To Housing Story
By Jay Neugeboren
Huffington Post
August 3, 2008
This past week, the Bush administration reported a most welcome 30 percent drop in the number of chronically homeless people living in the nation's streets and shelters. According to a front page article in The New York Times, it attributed "much of the decline to the 'housing first' strategy that has been promoted by the Bush administration and Congress, and increasingly adopted across the country."
What neither the Times nor the Bush administration reported is that the "housing first" strategy being adopted was originated, informed, and guided by a New York City based organization, Pathways to Housing, which pioneered this approach 15 years ago, and has been successfully implementing it ever since. The Bush administration has relied heavily on Pathways, whose program, until 4 years ago, was the only "housing first" program in the nation.
By taking those homeless people that cities traditionally do not deem "housing ready"--they are still using drugs, they are not taking their meds, et cetera--and by giving them their own apartments, and then wrapping social, psychological, and medical services around them, Pathways has proven more successful at stably housing these people than the city has at housing those it deems "housing ready."
88 percent of Pathways' clients have remained stably housed for two or more years, while the city's housing retention rate for similar periods is below 50 percent. Add to this the fact that all the people Pathways finds housing for have, or have had, along with homelessness, co-occuring conditions of mental illness, and one can only marvel at, and be humble before, the program's mission, and its successes.
And one reason for its success, according to its director, Sam Tsemberis, is that the program is "client driven"--i.e., Pathways takes its cues from the expressed needs and desires of the homeless people it serves. (Cf. William Osler's advice to his fellow physicians at Johns Hopkins: "If you listen to the patient, the patient will give you the diagnosis.")
When, during its first dozen years, communities inquired about the Pathways "housing first" program, resistance was widespread. How can you let those people into housing if they've been drug users, or are still using drugs--or if they're schizophrenic? What if they stop taking their meds? The answer, according to Dr. Tsemberis, is that Pathways serves clients because they fall off the wagon.
"That's what addiction means. We anticipate that people will relapse--it's part of the recovery process, and the advantage of this harm-reduction approach is that people are not evicted and homeless again simply because they've relapsed. They remain housed, and so can continue to work on curing their addiction or improving their mental health. What we do, that is, is to separate housing from treatment--thus, if you relapse, you're still housed. There's treatment for addiction and for mental illness--and there's housing for homelessness."
That the Pathways "housing first" model is also less costly than shelters or traditional supportive housing models has now made it attractive to the Bush administration, and to many communities.
The Pathways model, however, is based not on economics, or on ridding the streets of "undesireables," but on the belief that housing is not something that must be "earned" by "good behavior," but is a fundamental right. For how can anyone have a decent life without first having a home?
http://www.huffingtonpost.com/jay-neugeboren/homeless-no-more-the-path_b_116399.html
Reprinted using Fair Use standard
July 21, 2008 - News of the Week
DR. TORREY'S SHORT MEMORY
E. Fuller Torrey is no ordinary psychiatrist. His success at attracting publicity is legendary. His questionable statistics are accepted by the media. His made-up statistic concerning 1,000 annual homicides commited by people with untreated mental illnesses made the Congressional Record. The National Stigma Clearinghouse file is thick with Torreyisms that have appeared in the national media and elsewhere.
Most recently, a muddled Torrey statement charged that "as our readers are well aware, changes in state commitment laws have made it impossible to treat nearly half of discharged patients after they have left the hospital." (see Link below) Torrey's seeming amnesia about his activities over the past 15 years is disconcerting. In 1993, his newly-created Treatment Advocacy Center (Psychlaws.org) launched a fearmongering crusade to make outpatient commitment easier nationwide. Now, nearly every state has a law that permits involuntary outpatient commitment to psychiatric treatment. The catch: There are far too few resources to treat involuntary or voluntary patients.
Psychlaws' strategic use of fear to gain public support may have backfired. Their dire warnings and an obsessive focus on violence may have had an unintended consequence. A study by Corrigan et al (Psychiatric Services, May, 2004) found that such tactics produce a negative effect on public attitudes and less willingness to provide resources. The system backup we now see -- hospitals overcrowded with patients ready for discharge with nowhere to go, and long waiting lists for community housing and programs -- could be fallout from Torrey's successful campaign to change the laws.
Torrey has spent fifteen years crusading for an untested concept that over-relies on medication alone. Meanwhile his charismatic domination of the mental health scene has slowed progress toward more viable solutions. The good news: Although Torrey denigrates all who disagree with him -- actually denying the citizenship of consumers/survivors/ex-patients in the subtitle of his latest book -- his dismissive behavior may have fueled the burgeoning consumer/survivor movement. The first-hand experience of this group has become a boon to the mental health community.
Go to www.miwatch.org for a Book Review by Sue E. Estroff of Dr. Torrey's latest book
The Insanity Offense: How America Fails the Seriously Mentally Ill and Endangers Its Citizens, and What We Must Do to Stop It
Go to www.psychlaws.org for an announcement of Dr. Torrey's book. Top of home page, click Read More
June 29, 2008 - News of the Week
CHECK OUT THIS VALUABLE INTERNET RESOURCE !
A NATIONAL DIRECTORY OF CONSUMER-DRIVEN SERVICES IS ON THE WEB
ALL PEER PROGRAMS ARE INVITED TO JOIN THE LIST
A big boost for consumer/survivor initiatives is an online national directory of programs and services run by and for people with psychiatric vulnerabilities. The directory not only guides users to hard-to-find resources; it is a unique, growing body of information useful to the mental health community.
These programs, sometimes called peer support programs, not only reduce hospital stays and emergency visits but improve people's health outcomes and support their recovery, according to a Canadian study released in 2005 (see below).
The Directory is an ongoing project created by the National Mental Health Consumers' Self-Help Clearinghouse, a national consumer technical assistance center funded by the federal Substance Abuse and Mental Health Services Administration (SAMHSA).
The Directory's creators have assembled an impressive catalog of peer support programs from pioneers in the field. This valuable catalog will inspire more programs and help groups to choose among a wide array of tested models. As a unique body of information, the Directory offers limitless opportunities for networking, problem-solving, and research.
Consumer-driven programs (CDS) vary greatly in size and design but share a vision of consumer participation in all aspects of life, including meaningful employment, education, and relationships with friends and family. They may be found in a range of settings from large mental health service agencies to grassroots volunteer efforts.
The purpose of the Directory is to provide consumers, social scientists and service-providers with essential resources, including background materials, contact information, pertinent research findings and discussion by leaders in the field.
CLICK HERE TO VISIT THE WEBSITE
Visitors to the Directory can search by name, locality, or program type to find up-to-date information on consumer-driven programs around the country.
TO JOIN THE DIRECTORY, CHOOSE CONTACT/APPLY
Any and all consumer/survivor initiative programs in the United States are invited to apply for inclusion in the Consumer-Driven Services Directory.
Article: Canadian study finds supports for and by people with mental illnesses are key to recovery
Source: Joint press release, July 28, 2005
Candian Agencies for Mental Health and Addiction Programs
TORONTO, July 28 /CNW/
A report released today shows that consumer/survivor initiatives (CSIs) play a critical role in promoting recovery for people with mental illness, but have been historically undervalued.
"Consumer/Survivor Initiatives: Impact, Outcomes and Effectiveness," has gathered research which demonstrates CSIs are vital to the mental health care system; they improve people's health outcomes and support recovery, as well reducing the use of hospital, emergency and other expensive services. The evidence the report offers is clear:
"The provincial government has identified that people need to be involved in their health care," said David Kelly, Executive Director of the Ontario Federation of Community Mental Health and Addiction Programs (OFCMHAP), one of the organizations which developed the report. "CSIs have been at the forefront of this area for many years."
Shawn Lauzon of the Ontario Peer Development Initiative (OPDI), a provincial association of CSIs and a partner in the report's development, said "This report is the first to make the case so clearly; CSIs are good for people with mental illness, and they're good for the health care system as a whole."
"Despite the money they save the health care system, CSIs have received no new investments for many years," noted Karen McGrath, CEO of the Canadian Mental Health Association (CMHA), Ontario, another of the report's partners. "The provincial government's goal of moving care into the community means that increasing support to CSIs is a logical next step."
Paul Garfinkel, CEO of the Centre for Addiction and Mental Health, adds "We know from our own experience here at CAMH that consumer-run businesses, training programs, peer support groups are enormously valuable in developing skills, building social relationships, and promoting independence. They are making a tremendous difference here at CAMH. The trouble is there aren't enough of them."
CSIs are run for and by people with mental health problems, or who have received mental health services. CSIs take many forms, including employment and training programs, peer support, advocacy, and Patient Councils at both general and psychiatric hospitals. They support people in transition from hospital to community and help people with mental illness take control of their lives and recovery.
The report was developed in partnership with the Centre for Addiction and Mental Health, the OPDI, CMHA, Ontario and OFCMHAP. The full report can be found at each organization's web site, including http://www.ofcmhap.on.ca.
For further information: contact: David Kelly, OFCMHAP, (416) 490-8900 ext. 22, (416) 822-0712; Shawn Lauzon, OPDI, (416) 484-8785 ext. 238; Liz Scanlon, CMHA, Ontario, (416) 977-5580 ext. 4131; Media Relations, CAMH, (416) 595-6015
Ontario Federation of Mental Health and Addiction Programs
June 22, 2008 - News of the Week
TORREY SCORES VICTORY FOR FEARMONGERING IN WALL STREET JOURNAL
Has E. Fuller Torrey's reputation as a maverick psychiatrist dimmed his appeal as a newsworthy author? Apparently not. Last week, the Wall Street Journal (6/13/2008) plugged Dr. Torrey's upcoming book by publishing its preface. Judging from the inflammatory title, "The Insanity Offense: How America's Failure to Treat the Seriously Mentally Ill Endangers Its Citizens" and the WSJ excerpt, the book is calculated to fan the public's fear of people diagnosed with psychiatric conditions.
Torrey laces his preface with homicides, a fear-mongering strategy that has been the trademark of his crusade for more psychiatric hospital beds and stronger civil commitment laws. For nearly twenty years, Torrey has played the violence card to frighten the public into supporting his coerced medication and increased hospitalization agenda.
Torrey's strategic use of fear has been explained by D. J. Jaffe, who co-founded the Treatment Advocacy Center with Torrey in 1993. That year, in a policy statement widely-circulated by Jaffe, he wrote, "From a marketing perspective, it may be necessary to capitalize on the fear of violence to get the [involuntary outpatient commitment] law passed."
Even Jaffe's clear statement of intent, however, did not prepare advocates for Torrey's near-obsessive focus on homicide. Those of us who have worked for years for balanced and accurate representation of mental illnesses are incensed that Torrey uses his considerable media access to dwell only on homicide stories (some of them 30 years old), violence, and his proposed coercive laws. Further, he has closed his mind against successful violence prevention alternatives such as "Housing First" and denigrates anyone who disagrees.
The WSJ excerpt shows, once again, how Torrey fixates on homicide in his messages to the public. When he refers to his 10-years-and-growing database of "preventable tragedies," he unfortunately gives the false impression that the 3,000 tragedies in the file are all homicides. In fact, the database of "preventable tragedies" sorts Torrey's 10-year collection of summarized news clippings into 11 categories of violent events.
Overall, Torrey's data on preventable tragedies holds some surprises. For example, although the American public commits over 16,000 homicides annually, only 184 per year (averaged over 10 years) are recorded for Americans diagnosed with mental illnesses.
We can expect Torrey's new book to call for more coercion and commitment. Ironically, the "preventable tragedies" show that a broad set of variables lead to tragedy -- among them are a lack of essential programs, the little recognized pitfalls of medication, and dysfunctional social conditions that are unrelated to psychosis and unresponsive to antipsychotic medication.
A trip through the tragedies is bound to make readers question the simplistic solutions Torrey has adamantly promoted since 1990.
MORE INFORMATION
Psychlaws.org/Treatment Advocacy Center
Preventable Tragedies
Book Excerpt by E.F. Torrey
Wall Street Journal, June 13, 2008
http://online.wsj.com/article/SB121319870711964571.html?mod=googlenews_wsj
Charlottesville Prejudice and Civil Rights Watch
http://hymes.wordpress.com
June 4, 2008 - News of the WeekADULT HOME RESIDENTS MAKE HOMEGROWN VIDEOS SPEAK VOLUMES
ARTICLE:
Lights! Camera! Advocacy!
CIAD Takes Media to Heart
New York NonProfit Press June 3, 2008 (Links to article & tech tips below)
Media is no sideshow for the Coalition of Institutionalized Aged and Disabled (CIAD), a consumer-led advocacy organization of adult home and nursing home residents. Unlike some groups where media projects and video productions seem somehow disconnected from their day-to-day work, CIAD has incorporated its Media Team into each of its core activities.
Advocacy! Organizing! Empowerment! CIAD now uses media to strategically enhance and extend its efforts in each of these areas.
In some cases, the payoff is easy to see. Dying for Air, a nine-minute video in which adult home residents spoke about their suffering without air conditioning during that summer's heat wave was a component in CIAD's advocacy campaign – a campaign which would ultimately win back-to-back State budget allocations of $2 million each in FY 2007 and FY 2008.
In other instances, the value of media can be found in new and improved ways of reaching out to adult home residents themselves and in the empowerment which resident organizers find through the production of advocacy and training videos.
The Media Team
The CIAD Media Team was launched back in 2004 when Jennifer Stearns, a former video editor with NBC began working with the organization as part of her Masters' Thesis in Health Policy. Its first production – Adult Home Residents Speak Out – was a ten minute video filmed at that year's "Speak Out", CIAD's annual rally and lobby day in Albany NY. The video captured the excitement and passion of adult home residents at the Speak Out and is now used by CIAD organizers to encourage residents to attend the annual events.
In the years since, the Media Team has evolved into an integral part of CIAD's Policy Committee, a dozen-or-so adult home resident leaders who work alongside CIAD staff organizers to determine policy priorities and organizing strategies. The Policy Committee guides the Media Team project by deciding what to videotape, participates in production and handles all on-camera roles, including on-site or in-studio reporting, narrating and conducing of interviews.
"Using media has tremendous value for all groups doing advocacy and organizing," says Stearns, who joined CIAD's staff on a part time basis in 2005 and is now Director of the Media Team. Technological changes have now made this advocacy tool accessible and affordable for groups of almost any size. "This is so exciting," she says. "When I was young I did a lot of work organizing against the war. But, we couldn't use media. You couldn't touch it. You needed a trust fund to do a documentary."
CIAD has received support for its media activities from two primary sources. Manhattan Neighborhood Network's Community Media Department provided an initial $10,250 Training Grant in 2007 and a Community Media Grant in 2008. New York Community Trust awarded a $55,000 grant for the Media Team in 2007.
Advocacy
Advocacy is probably the first thing people think of when contemplating the role of media for nonprofits. And, at CIAD, the Media Team's productions have been a valuable component of the organization's overall, multi-faceted advocacy strategy.
Shoes Blues, the team's second production was a short two-minute video about residents' need for a clothing allowance. Media Team members Alex Kulakis and Robin Stigliano filmed the feet of residents at three adult homes as they described problems with their shoes – the only shoes they could afford given the lack of a clothing allowance. "My shoes are used shoes," says one resident. "A girl sold them to me for one dollar. The bottom is ripped." "I have a big hole in my shoe," says another. "They are all turned over, I can hardly walk."
"It is a brilliant and beautiful piece," says CIAD Executive Director Geoff Lieberman.
Dying for Air was filmed at a community meeting held by CIAD in August of 2005. "It was just a series of people standing at a podium talking about how they were suffering, how they couldn't sleep, how it was 100 degrees in their room and they were afraid their friends were going to die during the night," says Stearns. "Then it showed an adult home where there was only one window air conditioner in the whole building and that was the administrator's office. It was pretty powerful." In addition to conveying the pain of adult home residents, it also captured the reactions of several State legislators who were at the community meeting to hear them speak.
In September 2005, CIAD staff organizer Noor Alam showed Dying for Air video at an Albany meeting that included Kelly Hansen, Director of the Adult Home Quality Initiative, David Wolner of the Governor's office, and other state government officials. "Alam reported that the video clearly made an impression on those present," says Stearns.
Who Was That Guy?
CIAD also used video in its efforts to collaborate with the NYS Department of Health which sends inspectors into individual adult homes. "Using residents to help train DOH inspectors was something we had done with our nursing home constituency years ago," says Lieberman. In 2006, when DOH invited CIAD to lead a sensitivity training workshop at its annual statewide conference, CIAD produced Who Was That Guy?, a 15-minute video capturing adult home residents' misconceptions about the DOH adult home inspection process. Residents rarely knew who the inspectors were or why they were there. Some even thought the DOH officials were there to inspect them, rather than the safety and quality of the adult home itself. "Typically, we would have just gone to the conference with some residents and given a traditional panel discussion," says Lieberman. "Instead, we were able to show this ten-minute video."
"It sparked a lively give and take between inspectors and residents," says Stearns.
"It was a little bit provocative and it lead to some good things," agrees Lieberman. In 2007, DOH responded to the concerns expressed in the video by collaborating with CIAD on an informational pamphlet, When Your Home is Inspected, which all adult homes are now required to hand out to residents.
Residents' Rights
However, CIAD has looked beyond the obvious power of media as an advocacy tool and tapped into its significant value for organizing and educating adult home residents themselves.
"One of our jobs as organizers is to go into the homes and educate people about their rights," says Stearns. "We are doing a series of residents' rights videos." One covers the pressures which resident's feel when they first move into an adult home and sign an admission agreement.
"When you move into an adult home you have to sign a lot of papers," says Gary Levin, a former adult home resident and now an organizer with CIAD. "They don't go into a lot of detail. The one thing they drum into your head over and over again is that you need to give us control over your check."
The video uses a variety of techniques to tell its story and make its points.
There are brief interviews with adult home residents. "When I moved in it was really a rush, rush job," Dorothea Harle tells the interviewer on camera. Harle is a resident of Madison York Adult Home in Queens and a current member of the CIAD Media Team.
There is a recreation of an admissions interview played out using puppets. "Welcome to Paradise Manor," one puppet resident tells another. "It doesn't look like paradise to me," responds the new puppet on the block before sitting down to meet the adult home administrator.
And, there is advice from a staff attorney with MFY Legal Services which provides legal representation for adult home residents throughout New York City. "Before you sign an admission agreement you have a right to look it over," she advises the viewer. "You have a lot of rights when you first move in."
In addition to admissions agreements, the Residents' Rights series of videos cover such topics as the personal needs allowance, how to get control of your own money, and the rights of residents to make their own choices regarding treatment programs.
CIAD uses the Residents' Rights videos at Speak Outs and to get information out to residents at individual adult homes. "We bring the tapes and show them at Residents' Council meetings," says Stearns, who uses a light weight carrier to transport a portable projector.
"Some residents have taken the DVDs into the home and played them on the TV set in the lobby or a resident may have a TV with a DVD player and will invite people into their room to watch it," says Levin.
The value of video as an organizing and education tool is further enhanced by the fact that many adult home residents, a significant portion of whom may have disabilities of various types, often are more attuned to learning visually rather than through written materials.
For 2008/2009, the Media Team is planning three more videos for the series -- Your Resident Council, Your Right to Tenancy and Your Right to Privacy, Dignity and Respect.
Empowerment
"For organizations like ours -- empowerment groups -- looking to give people voice, the Media Team does that in as concrete a fashion as you possibly can," says Lieberman. "The process is as important – in some ways more important –than the product."
"It is all leadership development," says Stearns. "We used the power of having a microphone to empower our resident council leaders. By the time you have spoken on mike about air conditioning or some other issue three or four times, you have become very articulate. And, you are much more likely to stand up at a meeting and say the same things. Plus, you have been exposed to the ideas of 10 other residents talking about air conditioning in their home. That is why it is a really good organizing tool. Even if you never finish a video, just the process of doing it is very effective."
"I get a heck of a lot of fun out of doing it -- as well as learning a lot," says Harle.
The production and sharing of videos has also been a way to build and strengthen CIAD's network of resident council leaders. "One of the problems of adult homes is that they are very isolated," says Stearns. "They often are located in fringe neighborhoods and most residents don't even have phones. We wanted to get them talking, to share experiences and talk about their own ideas. One way to do that is peer-to-peer interviews." The Media Team will create opportunities for one resident council leader to interview another on camera – How do you run your resident council? What works for you? Then, they switch roles.
An Act of Courage
For the adult home residents of CIAD, participating in the Media Team has been exciting and empowering. It has also been dangerous. "We operate in a very hostile environment," says Stearns. "These homes are privately owned. For us to videotape on the premises is not only trespassing, it is invasion of privacy. You have no idea how vulnerable they are and what kind of pressure they are under." Adult home operators typically control a resident's living space, money and the programs they attend. "Many adult home residents have mental health diagnoses," says Stearns, "which means anyone can say they were acting out, being aggressive and need to be hospitalized. Adult home operators can pick up the phone, call an ambulance or the police, and have them carted off."
The Team's use of puppets was one way to capture the experience of life in adult homes without actually shooting there. Similarly, the filming of resident's feet alone – without faces – in Shoes Blues was a way to collect resident comments without placing them at risk. Nevertheless, Media Team members voluntarily step up to conduct interviews, participate in panel discussions and tell the world about life in adult homes.
"These videos are a tribute to the courage of the residents you see on camera," says Stearns.
http://www.nynp.biz/papereditions/June%2008/Lights!%20Camera!%20Advocacy!%20CIAD%20Takes%20Media%20to%20Heart.html
Forwarded from: NYAPRS E-News
May 11, 2008 - News of the Week
"MAD PRIDE" ADVOCATES BRING FIRST-HAND EXPERIENCE TO MENTAL HEALTH DISCUSSION
ENLIGHTENING TREND REPORTED BY NEW YORK TIMES
Article: NEW YORK TIMES - May 11, 2008
Fashion & Style Section
"Mad Pride" Fights a Stigma
http://www.nytimes.com/2008/05/11/fashion/11madpride.html
By GABRIELLE GLASER
In the YouTube video, Liz Spikol is smiling and animated, the light glinting off her large hoop earrings. Deadpan, she holds up a diaper. It is not, she explains, a hygienic item for a giantess, but rather a prop to illustrate how much control people lose when they undergo electroconvulsive therapy, or ECT, as she did 12 years ago.
In other videos and blog postings, Ms. Spikol, a 39-year-old writer in Philadelphia who has bipolar disorder, describes a period of psychosis so severe she jumped out of her mother's car and ran away like a scared dog.
In lectures across the country, Elyn Saks, a law professor and associate dean at the University of Southern California, recounts the florid visions she has experienced during her lifelong battle with schizophrenia -- dancing ashtrays, houses that spoke to her -- and hospitalizations where she was strapped down with leather restraints and force-fed medications.
Like many Americans who have severe forms of mental illness such as schizophrenia and bipolar disorder, Ms. Saks and Ms. Spikol are speaking candidly and publicly about their demons. Their frank talk is part of a conversation about mental illness (or as some prefer to put it, "extreme mental states") that stretches from college campuses to community health centers, from YouTube to online forums.
"Until now, the acceptance of mental illness has pretty much stopped at depression," said Charles Barber, a lecturer in psychiatry at the Yale School of Medicine. "But a newer generation, fueled by the Internet and other sophisticated delivery systems, is saying, 'We deserve to be heard, too.' "
About 5.7 million Americans over 18 have bipolar disorder, which is classified as a mood disorder, according to the National Institute of Mental Health. Another 2.4 million have schizophrenia, which is considered a thought disorder. The small slice of this disparate population who have chosen to share their experiences with the public liken their efforts to those of the gay-rights and similar movements of a generation ago.
Just as gay-rights activists reclaimed the word queer as a badge of honor rather than a slur, these advocates proudly call themselves mad; they say their conditions do not preclude them from productive lives.
Mad pride events, organized by loosely connected groups in at least seven countries including Australia, South Africa and the United States, draw thousands of participants, said David W. Oaks, the director of MindFreedom International, a nonprofit group in Eugene, Ore., that tracks the events and says it has 10,000 members.
Recent mad pride activities include a Mad Pride Cabaret in Vancouver, British Columbia; a Mad Pride March in Accra, Ghana; and a Bonkersfest in London that drew 3,000 participants. (A follow-up Bonkersfest is planned next month at the site of the original Bedlam asylum.)
Members of the mad pride movement do not always agree on their aims and intentions. For some, the objective is to continue the destigmatization of mental illness. A vocal, controversial wing rejects the need to treat mental afflictions with psychotropic drugs and seeks alternatives to the shifting, often inconsistent care offered by the medical establishment. Many members of the movement say they are publicly discussing their own struggles to help those with similar conditions and to inform the general public.
"It used to be you were labeled with your diagnosis and that was it; you were marginalized," said Molly Sprengelmeyer, an organizer for the Asheville Radical Mental Health Collective, a mad pride group in North Carolina. "If people found out, it was a death sentence, professionally and socially."
She added, "We are hoping to change all that by talking."
The confessional mood encouraged by memoirs and blogs, as well as the self-help advocacy movement in mental health, have deepened the understanding of bipolar disorder and schizophrenia. Books such as Kay Redfield Jamison's autobiography, "An Unquiet Mind: A Memoir of Moods and Madness," have raised awareness of bipolar disorder, and movies like "Shine" and "A Beautiful Mind" have opened discussion on schizophrenia and related illnesses. In recent years, groups have started antistigma campaigns, and even the federal government embraces the message, with an ad campaign aimed at young adults to encourage them to support friends with mental illness.
Members of MindFreedom International, which Mr. Oaks founded in the 1980s, have protested drug companies and participated in hunger strikes to demand proof that drugs can manage chemical imbalances in the brain. Mr. Oaks, who was found to be schizophrenic and manic- depressive while an undergraduate at Harvard, says he maintains his mental health with exercise, diet, peer counseling and wilderness trips -- strategies that are well outside the mainstream thinking of psychiatrists and many patients.
Other support groups include the Mad Tea Party in Chicago and the Freedom Center in Northampton, Mass., which provides education, acupuncture, yoga and peer discussions to about 100 participants.
The Icarus Project, a New York-based online forum and support network, says it attracts 5,000 unique visitors a month to its Web site, and it has inspired autonomous local chapters in Portland, Ore., St. Louis and Richmond, Va. Participants write and distribute publications, stage community talks, trade strategies for staying well and often share duties like cooking or shopping. The Icarus Project says its participants are "navigating the space between brilliance and madness." It began six years ago, after one of its founders, Sascha Altman DuBrul, now 33, wrote about his bipolar disorder in The San Francisco Bay Guardian, a weekly newspaper. Mr. DuBrul, who is known as Sascha Scatter, received an overwhelming response from readers who had experienced similar ordeals, but who felt they had no one to discuss them with.
"We wanted to create a new language that resonated with our actual experiences," Mr. DuBrul said in a telephone interview.
Some Icarus Project members argue that their conditions are not illnesses, but rather, "dangerous gifts" that require attention, care and vigilance to contain. "I take drugs to control my superpowers," Mr. DuBrul said.
While psychiatrists generally support the mad pride movement's desire to speak openly, some have cautioned that a "pro choice" attitude toward medicine can have dire consequences.
"Would you be pro-choice with someone who has another brain disease, Alzheimer's, who wants to walk outside in the snow without their shoes and socks?" said Dr. E. Fuller Torrey, executive director of the Stanley Medical Research Institute in Chevy Chase, Md.
Dr. Torrey, a research psychiatrist who specializes in schizophrenia and manic depression, said he understood the roots of the movement. "I suspect that not an insignificant number of people involved have had very lousy care and are still reacting to having been involuntarily treated," he said.
Many psychiatrists now recognize that patients' candid discussions of their experiences can help their recoveries. "Problems are created when people don't talk to each other," said Dr. Robert W. Buchanan, the chief of the Outpatient Research Program at the Maryland Psychiatric Research Center. "It's critical to have an open conversation."
Ms. Spikol writes about her experiences with bipolar disorder in The Philadelphia Weekly, and posts videos on her blog, the Trouble With Spikol (http://trouble.philadelphiaweekly.com/).
Thousands have watched her joke about her weight gain and loss of libido, and her giggle-punctuated portrayal of ECT. But another video shows her face pale and her eyes red-rimmed as she reflects on the dark period in which she couldn't care for herself, or even shower. "I knew I was crazy but also sane enough to know that I couldn't make myself sane," she says in the video.
In a telephone interview, she described one medication that made her salivate so profusely she needed towels to mop it up. "Of course it's heartbreaking if you let it be," she said. "But it's also inherently funny. I'd sit there watching TV and drool so much, it would drip on the couch."
Ms. Spikol said she has a kind doctor who treats her with respect, and she takes her pharmaceutical drugs to stabilize her mood. "I have asthma, and I use medications to maintain it, too," she said.
Ms. Saks, the U.S.C. professor, who recently published a memoir, "The Center Cannot Hold: My Journey Through Madness," has come to accept her illness. She manages her symptoms with a regimen that includes psychoanalysis and medication. But stigma, she said, is never far away.
She said she waited until she had tenure at U.S.C. before going public with her experience. When she was hospitalized for cancer some years ago, she was lavished with flowers. During periods of mental illness, though, only good friends have reached out to her.
Ms. Saks said she hopes to help others in her position, find tolerance, especially those with fewer resources. "I have the kind of life that anybody, mentally ill or not, would want: a good place to live, nice friends, loved ones," she said.
"For an unlucky person," Ms. Saks said, "I'm very lucky."
Copyright 2008 The New York Times Company
Reprinted using Fair Use standard
To submit a letter to the editor of the NY Times e-mail to: letters@nytimes.com
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Contact MindFreedom International:
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Web site: http://www.mindfreedom.org
E-mail: office(at)mindfreedom(dot)org
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February 23, 2008 - News of the Week
DR. TORREY BLAMES "EVERY NEW YORKER" FOR KENDRA'S LAW FAILURE
Last week in Manhattan, Kendra's Law was unable to prevent a brutal murder. The assailant's father has told the New York Times that even court-ordered treatment under Kendra's Law had failed to end a long ordeal that began in 1991, when Leonard Tarloff repeatedly found himself working to get his son treatment for mental illness. (NYTimes 2/20/2008).
Yesterday Dr. E. Fuller Torrey, chief proponent of the law, skipped lightly over the law's failure in an Op-Ed for the New York Post ("Deadly Madmen," 2/22/08). Dr. Torrey began the Op-Ed by recalling murders committed in the 1980s and 90s. His manipulation of facts is familiar. First he created a violent backdrop by recalling 7 highly publicized assaults commited decades ago. He ignored news reports which at the time showed at least 5 of the 7 assailants were under psychiatric treatment (Michael Vernon), had been refused help (Andrew Goldstein), were discharged prematurely (Juan Gonzalez and Andrew Goldstein), were told to find help somewhere else (Kevin McKiever), or had no prior signs of distress (Colin Ferguson). Implying that violence has reached epidemic proportions, Torrey called violent acts an "endless list" of virtually identical cases all requiring forced medication.
Torrey cites his website's "Preventable Tragedies" database as proof that medication is the solution. That seems simplistic after one views the data. In 2006, I looked at the data in psychlaws.org's "Preventable Tragedies" database (unfortunately many entries are now deleted). This impressive resource contains clues to the mental health system's weaknesses. Focusing on 66 homicide cases nationwide in a 6-month period, I found that a significant number of assailants were reportedly taking medication or showed meds in their toxicology reports. Many case summaries showed the homicide assailants had been prematurely discharged from or refused entry to treatment facilities. Histories of violence and problems with alcohol and substance use had plagued many of the assailants. While the data show that many assailants did indeed go off medication, this does not mean the medication was effective. Antipsychotic meds are said to be ineffective for people who have non-psychotic personality disorders. It is puzzling that Torrey has closed his mind against successful violence prevention alternatives such as "Housing First" and castigates anyone who disagrees.
Dr. Torrey not only shuns the fact that Kendra's Law was unable to prevent David Tarloff's murder of Kathryn Faughey. He shows no interest in what may have gone wrong. He does not acknowledge the dire scarcity of housing, special services, and high quality programs promised under Kendra's Law. He shows no concern for people who are forced to take medication that may cause them problems. He faults protectors of civil rights when he surely knows that commitment laws are interpreted flexibly and reflect society's economic and political priorities.
Torrey never questions Kendra's Law --- a 7-year experiment that has consumed an inordinate amount of time, energy and resources -- and blames the Faughey murder on everyone else including "every New Yorker for not demanding a system that works."
The Treatment Advocacy Center's inability to face reality seems obvious in the following examples: New York's official evaluation of Kendra's Law (2005) reported improvement rates of program participants who had caused "harm to others." Before entering the program, just 15% of the participants had previously harmed others. After six months in the program, 8% had harmed others. The Treatment Advocacy Center cites these figures as proof that Kendra's Law reduced "harm to others" by one-half. Example 2: Totally ignored is the program's disappointing rates of success in reducing alcohol and substance use among people who have combination diagnoses. Considering that such problems reportedly affect 50% of Kendra's Law participants and puts them at high risk for violent behavior, this lack of candor is troubling. Example 3: The state's report of 2005 (the latest available) indicates a shortage of case management services. Case management was to be a keystone of the Kendra's Law program. An apparent over-reliance on meds alone and the shortchanging of other community supports boosts critics' claims that access to appropriate high quality programs, not forced meds, turns lives around best.
January 31, 2008 - News of the Week
HOW PSYCHLAWS.ORG'S "PREVENTABLE TRAGEDIES" REVEAL SYSTEM'S WEAKNESSES
The year 1999 in New York City began with a senseless murder in the subway. Andrew Goldstein, a man diagnosed with schizophrenia, pushed Kendra Webdale, an aspiring writer, to her death as a train approached.
Goldstein had been discharged from a psychiatric hospital 3 weeks earlier. Perhaps the most tragic aspect of Kendra's death is how nearly it never happened.
The what-ifs are agonizing. What if North General Hospital had not discharged Goldstein too soon? What if they had discharged him to a supervised residence and escorted him there? What if they had given him a month's supply of medication, rather than a 1-week supply? What if they had assigned a mental health worker to accompany him to clinic appointments? What if the pleas for supervision from both Goldstein and his mother had been heeded?
Kendra's Law passsed easily in New York, with its proponents using Andrew Goldstein as the impetus to act quickly to protect public safety. Yet Goldstein had asked repeatedly for treatment he did not receive. It now appears that Seung Hui Cho has been assigned a Goldstein role in Virginia. He showed up for his court-ordered treatment but fell through the cracks in the system.
Just how often does this happen?
The Treatment Advocacy Center (psychlaws.org) has assembled an impressive database called "Preventable Tragedies." Hoping to find some clues, in 2006 we searched the Psychlaws database.
It showed that cases like Goldstein's are not uncommon. Over a 6-month period, the data showed that at least 1 in 8 homicides followed premature hospital discharge or refused entry to a psychiatric treatment center. In Goldstein's case, a New York State investigation found that a clinic had sent him a letter saying his case would be closed if he did not respond. Did he get the letter? Was he too sick to respond?
The Psychlaws database in 2006 contained 1,387 newspaper descriptions of homicides by "people with severe mental illness" from 1989 - April 2005. We examined the 66 descriptions covering the period July-December, 2004.
Unexpectedly, 12% of the descriptions showed that the assailants had been discharged prematurely from a psychiatric facility or were turned away when they asked for help. This figure is surely an undercount, since the news clippings summarized in the database vary widely in the amount of information furnished.
Another big surprise was the number of assailants using medication. Only 25 of the 66 summaries mention whether or not the assailant was taking medication at the time of the homicide. Surprisingly, 9 were taking medication; 16 were not. If this is a representative sample, 36% of homicides in the psychlaws.org database were committed by people taking medication. This affirms the possible role of medication in acts of violence.
Our 6-month sample of homicides in the Psychlaws database showed the following:
These numbers show a pattern of program needs that could guide policymakers. Instead, the Treatment Advocacy Center promotes above all else, medication, the most complex and problem-prone aspect of treating mental illnesses.
We welcome comment: E-mail stigmanet@webtv.net
January 6, 2008 - News of the Week
TREATMENT ADVOCACY CENTER REDUCES RESEARCH ON VIOLENCE TO A STIGMATIZING SOUND BITE
The Treatment Advocacy Center (www.psychlaws.org) has never been shy about tailoring research results to suit its politicial agenda. Most recently, a Psychlaws press release announced that a research team led by Jeffrey Swanson Ph.D, of Duke University, had discovered a high rate of violence among people with schizophrenia. By cherry-picking the research for words most likely to serve their ends, Psychlaws has caused great harm. (See MORE INFORMATION below.)
Other research led by Dr. Swanson has found that a combination of childhood victimization, a high-crime neighborhood, and substance abuse, raise the likelihood of violence above the general population rate. "Without any of these factors, those with severe mental illness were no more likely to engage in violent behaviors than people in the general population without a psychiatric disorder." (Quote from Duke University Medical Center press release, "Three Risk Factors Cited in Violent Behavior Among People With Severe Mental Illness," August 30, 2002.)
The Treatment Advocacy Center's mission is to medicate people who have psychiatric problems. They proudly disclose their political strategy, which is to convince opinion-shapers, law-makers, and the public that medication is a public safety issue. Fixated on violence as a means of gaining support, the Torrey group has largely succeeded in focusing public discussion of mental health on this issue. Equally damaging, critics say, is the group's misleading claim that medication, the most problem-prone aspect of treatment, is the solution.
Medication is not a panacea. "If we're worried about violence among people with serious mental illness, we need to pay far more attention to finding safe housing in decent neighborhoods, mitigating the effects of physical and sexual victimization, and aggressively treating substance-abusers," said Marvin Swartz, M.D., professor of psychiatry at Duke University.
It is unfortunate that psychiatric research findings are often boring and unpenetrable. Further, the field suffers from a lack sufficient scientific data. Despite researchers' best intentions and improved research tools, results must be viewed with caution. If study findings reach the public, which is rare, they are fair game for interpretation by anyone with an axe to grind. It is the large gap between researchers and the general public that has allowed Psychlaws to advance its agenda.
QUOTE FROM TREATMENT ADVOCACY CENTER PRESS RELEASE, Dec 18, 2007
"Data from the CATIE study of antipsychotic drugs demonstrated patients with schizophrenia were 10 times more likely to engage in violent behavior than the general public (19.1% vs. 2% in the general population). Most major mental health organizations continue to deny the increased risk of violence that accompanies symptoms of untreated mental illness."
QUOTE FROM RESEARCH REPORT, BY JEFFREY SWANSON ET AL.:
Statements by the researchers are cautious. Click for the full report
Example:
THE FEDERAL CENTER FOR MENTAL HEALTH SERVICES OFFERS A FREE EDUCATIONAL RESOURCE: CHALLENGING STEREOTYPES: AN ACTION GUIDE - a 32-page booklet with directories. For a free copy call 1-800-789-2647. Available ONLINE at http://www.mentalhealth.org/stigma/pubs.asp, publication SMA-01-3513
The mass media wield a powerful influence over public opinion. It is essential that the news media are challenged to be fair and accurate, and that the mass entertainment media meet standards of fairness when using the public's communication channels.
At stake is the public's understanding of what are known as "mental illnesses." A 1990 survey of public attitudes sponsored by the Robert Wood Johnson Foundation concluded that "Mass media is, far and away, the public's primary source of information about mental illness."
There is an inexpensive and direct way to combat stereotyping. It is not the only way (perhaps not even the best way), but it is effective and often leads to further dialogue with members of the community and key representatives of the media. The method is a "smoking gun" approach; it addresses misrepresentation head on, explains the damage done, and offers alternative ways of portraying mental illnesses to the people in charge. When the media get it right, praise and honors should reward the extra effort.
Like members of the public, many media professionals have limited knowledge about mental illnesses. Stereotypes become self-perpetuating unless they are replaced by clear, credible alternatives. If mental health activists fail to speak out, we resign ourselves to the status quo.
Most people, and particularly media people, have a natural curiosity about what they don't understand. Seek to build good relationships with journalists and other media professionals by being informative and reliable. Let members of the media know you respect their intention to be fair and accurate.
For a copy of CHALLENGING STEREOTYPES: AN ACTION GUIDE (32-page booklet), call 1-800-789-2647 and ask for publication #SMA 01-3513.
When you call, ask for a list of other excellent educational resources offered by the federal Center for Mental Health Services, a division of the Substance Abuse and Mental Health Services Administration.
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