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Tuesday, 12 December 2017

 

The Great Turning

imccollumBy Iden Campbell Mccollum (Originally posted here)

When I first heard of the proposed “Helping Families in Mental Health Crisis Act of 2013” (H.R. 3717)”, I felt relieved and thought “maybe somebody has finally got it!” However, as I read and processed the words I realized just how much Tim Murphy didn’t get it. Is this mental health system broke? Yes it is. Can it be fixed? Yes it can. But we must do it collectively and with the experience and voices of those with true lived experiences including their families and allies.

People have ended up in jail and on the streets due to sweeping enactments by the government such as H.R. 3717. Do we really want to continue this legacy of big government telling us how to treat the most vulnerable in our communities? Our communities collectively must do this. Communities that have family and neighborly support have better outcomes for those with mental health breaks. We have not yet developed community support such as that in this country. We continually rely on government, hospitals and law enforcement to treat and make better those in need. This is not the way to go. We need community and family to love, nurture and support those that are the most vulnerable.

I personally know how hard it can be for a family that seeks support for their child or loved one who is in need of treatment and how frustrating it can be when that help is not given. I have struggled for years trying to find services that work for my sister. As a person that has been diagnosed with a developmental disability and a mental health issue, no one system wants to support her. It has been a constant battle for 25-plus years to get her housing, benefits and treatment. I myself have battled the system as a self-advocate for fair treatment, culturally competent treatment and housing. I have received treatment and been hospitalized in four states, received public mental health care in six states and housing in none.

In one state I received excellent care but no housing. Thus I was being treated while I continued to live in my truck. Each time I went to my therapist I had experienced a new trauma. All other states were sub par at best. In each state I met individuals who were being forced into treatment. I remember thinking that they seemed like they were the walking dead. No facial expressions, just following orders. Is this what we want our communities to look like? Our fellow brothers and sisters being forced into treatment that we know does not work for everyone?

Medication is not the end all for mental health crisis. Some people respond to medications, some do not. Some go deeper into crisis while others just exist. We must and can do better. Our system can be fixed but not just by one person writing an act and thinking it’s a cure-all because he is a licensed clinician.

I stand with millions of others who have shown through our resiliency that our movement is real, has saved lives and most of all we have people that can give voice to what really needs to be changed within the system. If only people will listen.

Read more: The Great Turning

The Power of Words: What the Wall Street Journal Didn't Tell You

scomstockBy Scott Bryant-Comstock

Note: This blog was published on Mad in America and is adapted from Scott Byant-Comstock's "Morning Zen" blog on the Children's Mental Health Network website.

Two weeks ago there was an editorial in the Wall Street Journal that basically eviscerated the Substance Abuse and Mental Health Services Agency (SAMHSA) while at the same time calling for support of HR 3717 – The Helping Families in Mental Health Crisis Act.

HR 3717 has elements that we agree with as well as elements we don’t. In addition, there are elements that are just plain confusing to us. If you haven’t already, I encourage you to read the Morning Zen post where we went through the bill page by page, identifying areas that raised red flags for us. We will be posting an updated more-detailed review next week.

Since then the introduction of the proposed bill we have read with great interest articles in the press, personal communication, and written testimony from past Energy and Commerce Subcommittee on Health hearings on HR 3717. Much of what has been written is definitely passionate and unfortunately sometimes vitriolic. In this post I want to address three of the most popular sound bites (two of which found their way into the WSJ editorial) that continue to come up again and again. It is interesting to note that these three provocative sound bites seem to have gone unquestioned in the popular press all these months, taken at face value for fact, creating an impression that might not be accurate. The other interesting aspect is that all three sound bites reference the Alternatives Conference. Some day I'm gonna have to go to that conference to see what all the fuss is about.

Note to readers: I have no monetary investment in the Alternatives Conference, nor have I ever participated in the Alternatives Conference.

Here are the three juicy morsels that keep making their way into the press:

  • The 2013 Alternatives Conference included a session titled “Dance Your Way to Wellness and Recovery
  • The 2013 Alternatives Conference included… a presentation from the “Hearing Voices Network,” which believes that hearing voices is a natural part of human experience...
    • From WSJ article - SAMHSA underwrites the Alternatives conference, which in 2013 included a session titled "Dance Your Way to Wellness and Recovery" and a presentation from the "Hearing Voices Network," which "believes that hearing voices is a part of human experience."
  • The 2013 Alternatives Conference included a session titled “Unleash the Beast.”
    • Opening Statement of the Honorable Tim Murphy Subcommittee on Oversight and Investigations Hearing on “Examining SAMHSA’s Role in Delivering Services to the Severely Mentally Ill” May 22, 2013."If SAMHSA were to use an evidence-based approach to identifying how to prioritize its resources – like other federal agencies do – would their record, not to mention their strategic initiatives going forward, look the same as they do now? For example, in 2012, an annual conference that has been funded by SAMHSA for many years – and at which the SAMHSA administrator regularly delivers a keynote – Alternatives, an hour and a half workshop was held, described as follows:Unleash the Beast is a mind/body fitness program that looks to the animals of the jungle for wisdom and skills that can benefit our lives in a myriad of ways. Through animal-inspired movements, behaviors, and expressions, participants are encouraged to shed layers of formal conditioning in order to return to their primal nature.While mental and physical health is important, I question the value of this exercise in advancing the treatment for mental illness in humans. And, I question if there is any scientific merit." 

In the most recent hearing on HR 3717 one of the expert witnesses was asked if he thought SAMHSA offering a workshop titled Dance Your Way to Wellness and Recovery was a good use of federal funds. I remember at the time thinking how I would answer. It would be something like “It depends on the context.” Realizing that I did not know the context I did some digging. Here now is some background on each of them.

Read more: The Power of Words: What the Wall Street Journal Didn't Tell You

The Murphy Bill: A Threat to Justice Everywhere

Gina NikkelBy Gina Nikkel (Originally published here)

HR 3717, authored by Congressman Tim Murphy, has been introduced in response to mounting concerns about the treatment of persons with mental health challenges.   It is universally recognized that improvements are needed in the mental health system.  Unfortunately, HR 3717 will have serious unintended consequences.  It will reverse many key advances made in mental health care in the last 30 years and place federal and state governments at high risk for litigation under the Americans with Disabilities Act and the Supreme Court’s Olmstead decision.   No other population needing care is subject to the civil rights violations that will be implemented by the provisions of this bill.  Furthermore, the criteria proposed for coercing people into treatment, especially mandated medication usage, will bring a new level of government intrusion and control.   Finally, HR 3717 completely ignores emerging scientific research regarding long-term harmful outcomes of medication use and the negative impacts of forced treatment.

Increased discrimination and stigma will be the result of several of the bill’s provisions.  These are based on an erroneous belief that people with mental health challenges are more prone to violence than other populations. This mistaken proposition ignores a great body of evidence showing that they are more often victims of violence, not perpetrators.

  1. There are a number of other major problems with this proposed legislation: It eliminates many initiatives that are already shown to promote recovery from mental health problems through the use of evidence-based, voluntary, peer-run programs and family services and supports.   Dr. Daniel Fisher, PhD, MD states: “These services have a proven track record in helping people stay out of the hospital and live successfully in the community.  Because hospitalization is far more expensive and has far worse outcomes than these effective and cost-efficient, community-based services, this bill would cost more money for worse outcomes.”
  2. The bill’s attack on the Substance and Mental Health Services Administration seems ill-advised given that SAMHSA is the lone federal agency voice of hope with its focus on recovery principles.  This policy direction is supported by an increasing and impressive body of carefully designed research showing that long-term outcomes are far better than has been assumed by the mainline mental health world.  Recent studies supported by the Foundation for Excellence in Mental Health Care and other funders are showing definitively that hope is a reasonable expectation for most people with major mental health challenges, in particular people diagnosed with schizophrenia.   These studies (Harrow, Wunderink, Harding, et al) can be provided at the request of any legislator or committee.
  3. There is no evidence that creating yet another federal bureaucracy with yet another Assistant Secretary and Department will reduce costs to either state or federal governments.  The best way to reduce costs and disability is to promote recovery and wellness, those priorities for which SAMHSA is already providing leadership and inspiring hope.
  4. As noted above, key provisions of this proposed legislation violate Olmstead V. L.C. (1999) which requires treatment services to be delivered in a least restrictive environment.   Many states are already dealing with costly challenges to their current systems of care and this will add to the burden of both state and federal governments.   The US Supreme Court has clearly laid the legal foundation to move away from institutional and coercive care.
  5. It is clear from research and much field experience showing that when people know or believe they are going to be placed on a list and be forced into treatment, they will become even more resistant and try to avoid services as much as possible.  These coercive provisions will backfire and result in the exact opposite of the intentions of the bill.
  6. Finally, this bill would eviscerate the rights and privacy protections enshrined in the federally mandated Protection and Advocacy (P&A) System, which is the largest provider of legal advocacy services to people with disabilities in the United States.  At a time when people with mental health challenges are most likely to be misunderstood so that their American civil rights are violated, HB 3717 puts not only federal and state governments in even more litigious positions but threatens the hope and well-being of people and families struggling to regain their lives.

Read more: The Murphy Bill: A Threat to Justice Everywhere

We are the People

ocohenBy Oryx Cohen (Originally published here)

Mahatma Gandhi said, “First they ignore you, then they laugh at you, then they fight you, then you win.”

With Pennsylvania Republican Representative Tim Murphy currently trying to push his Murphy Bill (HR 3717) through Congress, the battle is clearly on.

The so-called Helping Families in Mental Health Crisis Act, or Murphy Bill HR 3717, is a misguided response to national tragedies; one that would set back proven, positive, recovery-oriented, community-based, peer-initiated mental health innovations by 40 or 50 years.   The bill is in direct conflict with the 2003 President’s New Freedom Commission recommendation to promote recovery and consumer involvement to help transform our broken mental health system.

While the bill purports to support the use of evidence-based practices, in actuality the legislation would effectively eliminate solidly evidence-based, voluntary, peer-run mental health services and family supports that have been successful and popular.

The Murphy Bill could also be in violation of the Supreme Court’s 1999 Olmstead decision, as it advocates returning to an era where people diagnosed with serious mental health conditions were institutionalized, sometimes for life, instead of living in the community. In fact, because Assisted Outpatient Commitment is central to the Murphy Bill, even those of us that currently live in the community could be subjected to forced treatment in our own homes.

Read more: We are the People

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