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Friday, 15 December 2017

 

A Declaration of Interdependence for the Era of the Murphy Bill

rbassmanBy Ron Bassman (Originally published here)

How we think about health, happiness, and self-fulfillment, and a myriad of issues including suicide, inexplicable violent acts, and the influence of technology/information glut, ecology, the impact of war, poverty, the inequitable distribution of wealth and power and how they are linked with flawed systems of government has been assigned to the domain of social scientists.  The most influential of those are the psychiatrists who have been given the government-mandated power to diagnose, incarcerate and forcibly drug those who are perceived to have a form of mental illness. I believe that such power is arbitrary, unjust and frequently harmful.

Madness defies explanations that prize uniformity.  It is a dynamic chaos without boundaries that is unique to the individual.  Yet madness contains enough common features to seduce our thought leaders to create all-encompassing theories.  At its simplest, madness may be a reaction to pain, suffering and confusion in which the individual attempts to use all of his or her resources to find a way out of ever-shifting mazes. Too many of others'  attempts at help, where force is used without regard to the person's wishes, needs, and timing that is so important to the individual, often serve to make the maze' s walls more confining and impenetrable.  . 

I have been trying to generate outrage about the new iteration of the Murphy Bill.  Unfortunately the response has been more of mild agreement - that it is not good - rather than what I hoped would be enough outrage to mobilize actions.  NAMI, if it has not already, will be calling on its huge network to generate a response that would make the Bill look like it is mandated by a public majority.

Today I got a surprise call from a dear friend, Tom Olin, whom many consider the premier visual documentarian of the disability rights movement.  He said he had just come from Tennessee and had visited the Highlander school where we had first met.  While talking to people there, they asked him if he could get a copy of the statement we created there in 2000, so that they could display it next to a photograph of his that was already hanging there.  Tom asked me if I still had the statement and if I did to send it to him.  I dug it up and read it over.  It brought up great memories of the comraderie of that meeting, and how thrilling it was to be part of that historic site of civil rights activism.  But too soon I felt sad, realizing that what we had fought to change back then had not changed much.  And now, more disturbing, is the potential damage to our rights, dignity and ultimately our freedom if the Murphy bill is passed.

Read more: A Declaration of Interdependence for the Era of the Murphy Bill

Eugenics & the 2014 Murphy Bill

BonniebelleBy Bonnie Schell (Originally posted here)

Sterilization of the “unfit” and proposals to help families with a mental health crisis may seem to be disparate topics, certainly one historically more repugnant than the other. Yet, the two “solutions” have several things in common:

  • The absence of choice by the individual affected
  • The paternalistic assumption that those with power know what is needed
  • Both serve the interests of families, caretakers, guardians, and conservators
  • Both proceed out of good intentions.

Both the Murphy Bill (H.R. 3117 of 2014) and the eugenics movement were unfortunate solutions to real problems. What are the problems of the family with a diagnosed mentally ill “loved one”?  Relatives of a family member in emotional and/or cognitive distress can’t get a crisis response for a relative who is currently or likely to be violent toward self or others or likely to deteriorate until the family member can no longer care for himself. They can’t get the family member to admit she is ill or to take recommended psychiatric medications. They are unable to find out the whereabouts of the family member in the “system;” they don’t know if their family member has been mugged on the street or is “safe” in a hospital bed. They can’t get civil and human rights organizations to acknowledge the rights of the family. They can’t get timely professional services (due to personnel shortages and Utilization Management Departments of Managed Care Organizations) and instead are offered peer services by persons they believe to be under educated and once “crazy” themselves who mislead their family member to hope for recovery.

Read more: Eugenics & the 2014 Murphy Bill

Mental Health Advocates Blast Rep. Tim Murphy’s Bill as a Costly Step Backward, to the Days When a Mental Illness Diagnosis Was a Life Sentence

Originally posted at the Bazelon Center for Mental Health Law

Washington — December 12, 2013 — Today, Congressman Tim Murphy introduced legislation that, if passed, would reverse some of the advances of the last 30 years in mental health services and supports. It would exchange low-cost services that have good outcomes for higher-cost yet ineffective interventions, according to the National Coalition for Mental Health Recovery (NCMHR), a coalition of 32 statewide organizations and others representing individuals with mental illnesses; the National Disability Rights Network (NDRN), the non-profit membership organization for the federally mandated Protection and Advocacy (P&A) Systems and Client Assistance Programs (CAP) for individuals with disabilities; and theBazelon Center for Mental Health Law, a national non-profit legal advocacy organization.

“This legislation would eliminate initiatives that promote recovery from serious mental illnesses through the use of evidence-based, voluntary, peer-run services and family supports,” said Daniel Fisher, M.D., Ph.D., a founder of the NCMHR. “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.

“Even worse,” Dr. Fisher added, “the bill greatly promotes stigma and discrimination by its unfounded and damaging connection between mental illness and violence.”

NDRN, NCMHR and the Bazelon Center note that the bill does not represent the mainstream of national thought, practice and research. 

“This proposal targets the rights of individuals with mental illnesses and restructures federal funding to heavily encourage the use of force and coercion. It also would reduce privacy protections and rights advocacy,” said NDRN executive director Curt Decker.

“Most troubling, this legislation threatens to essentially dismantle the efforts of the Substance Abuse and Mental Health Services Administration (SAMHSA) to promote recovery and community inclusion for the broad variety of people in our community – and to do so at a time when SAMHSA’s efforts to ensure that effective behavioral health approaches are fully integrated into public health are essential,” said Harvey Rosenthal, a Bazelon Center trustee.

Read more: Mental Health Advocates Blast Rep. Tim Murphy’s Bill as a Costly Step Backward, to the Days When...

The Media Missed the Story: Civil Rights and the Helping Families in Mental Health Crisis Act

ChristianBy Christina Exoo (Originally published here)

There’s a fierce debate brewing on Capitol Hill over two competing bills that seek to overhaul our nation’s mental health system. Rep. Ron Barber (D-AZ), a survivor of Jared Loughner’s 2011 mass shooting, has proposed the Strengthening Mental Health in Our Communities Act of 2014, a bill that would provide additional funding for the Substance Abuse and Mental Health Administration (SAMHSA). Barber’s legislation specifically targets at-risk populations who may be underserved − young people, seniors, veterans, and Native American communities − and seeks to provide patient-driven treatment before the illness becomes unmanageable.

Rep. Tim Murphy (R-PA) has offered the Helping Families in Mental Health Crisis Act, the final result of a yearlong investigation that began after Adam Lanza’s 2012 attack on the Sandy Hook Elementary School left 28 dead, including Lanza. The Helping Families in Mental Health Crisis Act seeks to reallocate the $460 million in block grants currently distributed to community mental-health centers by SAMHSA, and replace that with a top-down system of federal control. It’s already garnered impressive bipartisan support − a full one-third of its co-sponsors are Democrats − by seeking to disperse $60 million in federal funds to states willing to collect data on key outcomes (such as emergency room visits and mortality rates of persons with serious mental illness) and institute evidence-based programs of medical-model practices.

However, buried under Title VII, Section 704 of the 134-page bill, there’s a catch − to be eligible to receive federal grant money, states must change their standards for involuntary treatment of the mentally ill from posing an imminent danger to oneself or others, to the far more vague “disabled and in need of treatment.”

Disabled is defined in this way: “[T]his impairment causes the individual to be incapable of understanding the advantages and disadvantages of accepting treatment and understanding and expressing an understanding of the alternatives to the particular treatment offered after the advantages, disadvantages, and alternatives are explained to the individual.” In other words, refusing treatment would become sufficient grounds to legally compel treatment.

This is the standard that currently exists in most states. A person may have the right to refuse treatment, as long as he or she is competent, but the very refusal to accept treatment is regularly seen as evidence of incompetence. In essence, it becomes very difficult, if not impossible, for a person seen to be mentally ill to refuse treatment. Diagnosis leads to an almost automatic claim by the state that it can now force treatment.

The Helping Families in Mental Health Crisis Act would expand outpatient commitment laws, curbing the civil rights of millions of Americans. That expansion is predicated on the assumptions that the mentally ill are more likely to engage in violence than the general population, and that forced medication will reduce this violence. Yet, looking at the clinical research may question these assumptions.

Are Persons with Mental Illness More Likely to be Violent?

Are persons with mental illness more likely to be violent than the general population? The New York Times offered a roundtable discussion entitled “Can Therapists Prevent Violence?” where two of the six pieces explicitly endorsed Rep. Murphy’s Helping Families in Mental Health Crisis Act, and none of the six questioned the premise of the discussion. American Enterprise Institute scholar Sally Satel wrote a piece entitled “Loosen Restrictions for Therapists to Report Danger.” However, 2012 study of violent risk assessment by psychiatric residents found that the young doctors were “no better than chance” at predicting violence in patients.

Read more: The Media Missed the Story: Civil Rights and the Helping Families in Mental Health Crisis Act

More On the “Civil War” Between Mental Health Advocates

justinbrownBy Justin Brown (Originally posted here)

In a recent Huffington Post blog — republished at Mad In America — prominent psychiatrist Allen Frances declared: “Psychiatric coercion has become largely a paper tiger: rare, short-term, and usually a well- meaning attempt to help the person avoid the real modern-day coercive threat of imprisonment.” With Representative Tim Murphy’s bill — advocating for court-ordered “outpatient” psychiatric compliance —  locked in committee, it is tempting to believe that Frances might be right. Does Murphy’s bill look scary to us, but actually lack any real teeth? After all, why should we focus on this divisive legislation when we have so many other important issues to address? Allen Frances warned: “We simply can't afford a civil war among the various advocates of the mentally ill at a time when strong and united advocacy is so desperately needed.”

It is possible that Rep Murphy’s attempt to force psychiatric compliance onto millions of American has no teeth and yet the Murphy Bill may still be successful in hardening the ideological lines between advocates for mental health, pushing us further and further apart until we are ready for battle.

Recall the great paper tiger of the American Civil War: John Brown. How was it that an extreme abolitionist — who some would say was mad — with an entirely impractical plan for freeing the slaves had such a profound impact on American history? This paper tiger should not have frightened anyone. Brown began an entirely unrealistic rebellion that was squelched with ease, and yet somehow Union soldiers marched into battle singing: “John Brown’s body lies a moldering in the grave but his truth goes marching on.”

The key to Brown’s influence was the fact that the South took him seriously, even when the North did not. While most in the North viewed him as too extreme, those in the South believed Brown was just the first of many Northerners prepared to go to war against slavery. It was out of this false belief in the teeth of the paper tiger that Southerners chose to secede from the Union and the bloodiest war in American history ensued. Without any real followers — either among Northern whites or Southern blacks — John Brown was able to frighten the South into beginning the Civil War. Even without teeth, the paper tiger started the war that abolished slavery.

What could be achieved today by creating a “civil war” between mental health advocates? In an earlier MIA blog, I suggested that the goal of the Murphy Bill is to divert our attention away from a much-needed national conversation about somewhere between 270 and 310 million guns held in 37% of American households, but there may be a more basic economic objective here. On September 15, 2014, Republican Senator Mike Lee of Utah announced that the bill he is co-sponsoring with Assistant Senate Majority Leader Dick Durban, a Democrat from Illinois, would save $4.36 billion over the next ten years according to the nonpartisan Congressional Budget Office. The more partisan Justice Department estimates the amount at $7.4 billion for ten years and $24 billion for twenty years.

Read more: More On the “Civil War” Between Mental Health Advocates

Defeating Goliath: Mental Health is a Social Justice Issue, and People with Lived Experience and Their Allies are Rising Up

lharrisBy Leah Harris (Originally published here)

The political status quo cannot be trusted to fix a problem that they themselves created. Many politicians address the symptoms of our deeper problems, but it's time to address the disease itself: the system of legalized corruption that now threatens to replace the will of the people – intended by our Founders to be the true governing force in America -- with the will of a moneyed few. -- Marianne Williamson,
Marianne Williamson for Congress

Like many Americans, I have long been cynical about the political process in my country. I am well aware of the reasons that so many of us eschew engagement with government: the undue influence of moneyed interests in the dealings of Washington, the lying, the corruption, the stealing, the cover-ups, the bad behavior, the squabbling, the same tired old rhetoric, what seems to be an inability and unwillingness to address the root causes of the most serious social, economic, environmental, and political problems in our nation.

How could we not be cynical in that face of all that?

While I have lived just a few miles away from the Capitol for the last fifteen years, I have been unsure about getting involved in legislative advocacy. I’ve been intimidated by the complexity of the legislative process, and more inclined to leave it up to others who I perceive as having more experience than me. And honestly, I haven’t felt very hopeful about effecting change. My cynicism had turned to “learned helplessness,” a phenomenon which is discussed by Bruce Levine in his book Get Up, Stand Up: Uniting the Populists, Energizing the Defeated, and Battling the Corporate Elite.

And then along came a mental health bill so destructive, so regressive, that I had to step out of my "uncomfortable comfort zone." As Bruce Levine points out in Get Up, Stand Up: “sometimes outrageous laws radicalize people.” This bill is the “Helping Families in Mental Health Crisis Act of 2013,” H.R. 3717, which I have written about in depth here, legislation introduced Representative Tim Murphy of Pennsylvania’s 18th Congressional District.

For the first time in my life, I took a step beyond making a call or sending an email in response to an action alert – though those are great and important things to do in and of themselves. I made an appointment to visit with my Representative’s staff to educate them about the dangerous provisions in the bill, and joined with several allies from the disability rights and civil rights communities in my area. It wasn’t as intimidating as I feared; it was a conversation, and I felt empowered by contributing to it. So now I am asking everyone to consider taking their advocacy to the next level.

I feel that it’s vitally important that we engage with this process now, as a way to make significant social change and create social justice. According to Douglas J. Amy, professor of Politics at Mount Holyoke College:

The problem with being too cynical about our public institutions is that it becomes a self-fulfilling prophecy. If you insist on believing that government is irredeemably terrible – it will be. Cynicism can all too easily lead to apathy and an unwillingness to participate in politics and government. Why bother to take part in a process you know is basically screwed up? Also, if you believe that all politicians are corrupt, you won’t work to elect those good candidates who are truly dedicated to public service – which only makes it easier for the bad candidates to win office. If you don’t work to make government more democratic and responsive to the public, it will remain in the hands of moneyed interests.

Bruce Levine offers a historical perspective in Get Up, Stand Up:

While a government that is truly of the people and by the people seems childishly naïve for millions of Americans, real-deal populists once believed it was not naïve. The people in the Populist Movement not only believed it, they seized government institutions for their use…This real-deal populism – the sense of ownership of government – has been replaced with a bastardized populism that makes government the enemy without recognition that it is control of the government by large corporations that is the underlying problem. If we are not controlling government, then the corporations will control government; and if there us no government at all, then corporations will directly control us.

Read more: Defeating Goliath: Mental Health is a Social Justice Issue, and People with Lived Experience and...

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