Tuesday, 12 December 2017

RLC Articles

The RLC produces a newsletter each and every month that offers monthly calendars, announcements and articles. Although old newsletters are archived on the website, the articles - often on important advocacy-related issues - run the risk of being buried and difficult to find. In an attempt to make that information more accessible, we still also list RLC-published articles from the newsletter (and other relevant sources) here for your ease and perusal.


Outpatient Commitment Laws & Massachusetts

 Originally published in the RLC Newsletter, March 2013


44 states in the US currently have outpatient commitment laws in place. They are often referred to as ‘Assisted Outpatient Treatment’ or AOT, though they also go by other names (e.g., Kendra’s

Top 5 Biggest Concerns with AOT laws:

1.It will lead to many human rights violations

2.Depending on how the law is written, it’s not  

   even limited to people with a history of  

   violence, but to anyone who is perceived to be

     at risk for hospitalization

3.It uses FORCE as the primary approach

4.It ignores the fact that people being treated in

   the mental health system are dying 25 years

     younger than others in the community

   5. It ignores or devalues people’s preferences,

     culture and personal belief systems

Law, etc.). Connecticut, Massachusetts, Maryland, Nevada, New Mexico, and Tennessee are the only states that do not have current outpatient commitment laws.

What is AOT?: Laws can look somewhat different from state to state. For example, the New York Office of Mental Health says that AOT was enacted in their state in 1999 to “ensure that individuals with mental illness and a history of hospitalizations or violence participate in community-based services appropriate to their needs.” Essentially, requirements under AOT can include

1. Medication
2. Drug testing to measure whether or not someone has been taking
prescribed medication
3. Therapy (individual and/or group)
4. Day or partial day programs
5. Vocational training

Read more: Outpatient Commitment Laws & Massachusetts

Are We 'Anti'?

Originally published in the RLC Newsletter, March, 2013

Questions about who is ‘anti’ come up fairly frequently in our community. That is, who is anti-psychiatry, anti-medication, anti-medical model and so on. Which group, which person, which community is just flatly against another perspective or approach? The questions get no questionsasked, and often the accusations fly.

 Given the nature of its work, the Western Mass RLC is one of the communities that now and then finds itself accused of being ‘anti’ one or all of these things and so we wanted to tackle this question head on and try to articulate what we’re ‘for’ and ‘against’ as best we can.

 Overall, we see ourselves as less ‘anti’ and more ‘pro.’ As in pro-information, pro-sharing of resources, pro-informed choice, pro-control over your own story and path, pro-change, pro-empowerment, pro-community, pro-human rights, pro-questioning everything.  

 In turn, we are not anti-medication or anti-pscyhiatry or anti-medical model if for no other reason then because being ‘anti-medication’ would mean that we don’t believe in your right to make an informed choice about what you put into your body and what does or might help you. Similarly, we are not ‘anti-medical model’ because that would mean we are disregarding a way that some of us choose to define our own stories. And we are not ‘anti-psychiatry’ in that we believe in everyone’s right to choose who will be a part of their circles of support, including psychiatrists, therapists and other clinical supporters!

Read more: Are We 'Anti'?

Forced Outpatient Treatment



The public hearing on forced outpatient commitment

has been scheduled as follows:


Tuesday, October 22nd at 9am


@ the State House in Boston, room A-1




About Forced Outpatient Commitment: Forced outpatient commitment can be referred to by many different names. Some people call it ‘Assisted Outpatient Treatment’ (AOT) or ‘Involuntary Outpatient Commitment.’ In some states where it exists, it has been named after a person (e.g, ‘Kendra’s Law’ in New York State). In the United Kingdom, they are referred to as Community Treatment Orders (CTOs). Regardless of what it is called, Massachusetts is one of only six states remaining that do not have any outpatient commitment laws currently on the books. (Connecticut, Maryland, Nevada, New Mexico and Tennessee make up the other five.)

Representative Kay Khan of Newton, Massachusetts has filed a petition to have a bill passed to bring outpatient commitment to our state. You can view the full bill here: malegislature.gov/Bills/188/House/H1792.

Based on established legislative process, a public hearing must be held in order for a bill to be evaluated and have the potential to pass. This is our one and only opportunity to be heard in a public forum by the legislature on whether or not we believe that outpatient commitment should become legal in Massachusetts. If this is something you disagree with, please remember that it is much harder to get rid of a law than it is to stop something from becoming a law in the first place.

What Forced Outpatient Commitment Could Mean for People with Psychiatric Diagnoses in Massachusetts: Outpatient commitment laws vary from state-to-state in terms of what they allow and how they are enforced. However, essentially, an outpatient commitment law would mean the following: If you are found to be at risk for not following treatment recommendations and if (by not following those recommendations) you are believed to be a likely risk for hurting yourself, hurting other people, or going in and out of the hospital, then a petition for an outpatient commitment order could be made. If successful and you are placed on an outpatient commitment order, you could be required to do any number of things related to recommended treatment. At least in some states, these have included (not a complete list!): Taking your prescribed medication; Electroshock Therapy (ECT); Attending all therapy and psychiatry appointments; Attending day programs, vocational programs and/or drug and alcohol treatment programs or groups; Submitting to regular drug testing; Living in a residential program.


If you fail to comply with treatment requirements on your outpatient commitment order, you can be immediately picked up and taken to the hospital whether or not you appear to be doing well overall.


Read more: Forced Outpatient Treatment

Advocates, Inc.: Limiting the Influence of the Pharmaceutical Industry

Advocates, Inc. was founded in 1975 on the grounds of Westborough State Hospital. At that time, they were made up of a group of volunteers who were providing rehabilitative services.

As of 2013, Advocates has become one of the largest human services organizations in the state.  They employ over 1000 staff members and serve over 20,000 people across Eastern and Central Massachusetts (including Community Based Flexible Supports, Emergency Services,Therapy and Medication clinics, and so on).

samplesSo, when Advocates decided that they were going to take a hard look at their practices around accepting gifts and free samples from pharmaceutical representatives, the path that lay ahead of them was neither easy nor smooth.
Potentially, they could have taken a very top down approach and had one or two people in a leadership role proclaim a new policy and expect everyone to follow it. Certainly, that would have been easier in some respects, given their size and diversity of responsibilities. But, this was not their way and not likely to lead to the most ‘buy-in’ of any change that would ultimately be proposed.

Instead, they developed a much more inclusive process that involved the following distribution of the following reading material for discussion:

It also included group review of the following websites:

  • Pharmed Out (www.pharmedout.org): A Georgetown University Medical Center project that “advances evidence-based prescribing and educations healthcare professionals about pharmaceutical marketing practices.”
  • NoFreeLunch.org (www.nofreelunch.org): An alliance of health care providers who “believe that pharmaceutical promotion should not guide clinical practice,” and who hold the mission to “encourage health care providers to practice medicine on the basis of scientific evidence rather than on the basis of pharmaceutical promotion.”

to read the rest of this article, please click below

Read more: Advocates, Inc.: Limiting the Influence of the Pharmaceutical Industry

What Makes a Peer Role 'Peer'?

Originally published in the RLC Newsletter, January, 2013


In a recent Newsletter, we printed an article that talked a bit about the meaning of the word ‘peer'  (original article available here); the definition of ‘peer’ seems to be shifting away from one that is based on relationships with others, and toward a replacement for ‘consumer’ or ‘client’ within the mental health system.  There's also a great deal of debate and misunderstanding about what ‘peer’ means when it becomes a job title.

In our state, there are a growing number of paid peer roles, titled everything from Peer Specialist and Peer Bridger, to Peer Advocate and beyond.  And yet, there remains a tremendous amount of confusion about what makes a peer role a 'peer role'.  The biggest point of confusion seems to be understanding the difference between a traditional role filled by someone who discloses that they have experience being given a psychiatric diagnosis, receiving mental health services, and so on; and a peer role

Read more: What Makes a Peer Role 'Peer'?

Did You Know?: Cell Phones, Computers & Other Electronic Devices in the Hospital

Originally published in the RLC Newsletter, April, 2013


People who are hospitalized in any DMH-operated or contracted adult inpatient unit are now entitled to keep their electronic devices with them. Electronic devices can include:

  • Cell phones (including smart phones)cell phone
  • iPods and MP3 players
  • iPads or other tablet devices
  • Laptops or personal computers
  • Any other device (whether or not it is Wi-Fi compatible)

This is true even if these devices contain built-in cameras, audio or video recording devices; and it also applies to visitors.

Former Commissioner Leadholm issued this policy (the Electronic Device Use policy #12-01) on January 4th 2012 and it became effective on January 30th of the same year. Massachusetts is currently the only state in the country that has a policy of this type in place.

The overall purpose of the change, as stated in the policy document, is as follows:

Electronic Devices are often people’s primary link to the community and may be the main way that people stay in touch with friends, family, and employers, keep calendars, pay bills and collect and access other important information. For an individual hospitalized, maintaining connection to natural supports in the community facilitates their own recovery and successful re-integration into the community.”

Read more: Did You Know?: Cell Phones, Computers & Other Electronic Devices in the Hospital


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