Miriam, to carry what you say even further this article doesn't address what
happens in the dynamics of the family of the mentally ill person and the
emotional toll that an untreated illness can have on other members of the
family who must live with the person and their untreated illness. The
reality is that the mental illness can change rational thought processes to
such an extreme that when one is in the middle of an episode they may have
no idea what they are doing or that their thought processes have been
altered to the point that they are a danger to themselves or the community
as a whole. Whether we like it or not there are some people that at times in
their lives can't make decisions about their needs by themselves and need
this type of structure. It is possible that the bill may go too far and
while I receive articles telling me that electroshock therapy has improved
due to new techniques I am very skeptical. It is interesting that the
University of Michigan has been using it in their psych hospital for a while
and wants to expand their program because they believe that it works.
Chuck
-----Original Message-----
From: Miriam Vieni
Sent: Wednesday, July 27, 2016 12:24 PM
To: blind-democracy@xxxxxxxxxxxxx
Subject: [blind-democracy] Re: Coercive Mental Health Legislation Threatens
Rights of People With Disabilities
I have no quarrel with the article. However, there are some very serious
issues around people with mental illness that most people tend to ignore or
deny, unless they have a loved one who is mentally ill. I remember watching
one of my best friends in high school, spiral down into a full blown
schizophrenic episode. There were three of us who were very close and two of
us watched in terror as our friend's behavior became more and more bizarre
and out of control. By the time we felt that we had to say something to
someone in authority, her family had had her hospitalized. I remember that
first visit to her in the hospital. She was almost unrecognizeable. We were
seventeen when my friend first became ill. The last time I saw her was in
2003 or 2004 when we were in our sixties. At that time, she was a severely
mentally disabled woman, living at home, having been in and out of mental
hospitals for years. My point is that mental illness is an illness, not a
lifestyle choice. The daughter whom we adopted has an undiagnosed mental
illness. Her interpersonal functioning and ability to fulfill her potential
have been clearly damaged by this illness. One of its many manifestations is
severe, long term depression which prevents her from being proactive in
taking actions that are necessary to normal functioning. She is able to
live on her own and work with emotional support and occasional financial
support and some advice and physical help from her sister and
brother-in-law, and from me. But she lives on the edge. I have, over the
past few years, urged her to ask for a psychiatric referral. The reason I've
given her is that she needs medication to help with her depression. She
could never accept my real reason, that she has an illness which I want
officially diagnosed because when she loses her job, and this will happen
because the corporation for which she works has moved most of its offices to
other states and clearly won't remain here forever, it is unlikely that she
will have the capability of getting another job and she will need social
security disability. Her mental illness needs to be documented. But, as with
other health issues which she has and cannot deal with, she hasn't taken my
advice about psychiatric help. Yes, I, too, believe in self determination
and I know that coercing people into treatment doesn't work. But I also know
that people who are mentally ill, often are unable, because of their
illness, to secure the treatment they need. It doesn't appear by magic or by
wishing for it.
Miriam
-----Original Message-----
From: blind-democracy-bounce@xxxxxxxxxxxxx
[mailto:blind-democracy-bounce@xxxxxxxxxxxxx] On Behalf Of S. Kashdan
Sent: Wednesday, July 27, 2016 11:01 AM
To: Blind Democracy List
Subject: [blind-democracy] Coercive Mental Health Legislation Threatens
Rights of People With Disabilities
Coercive Mental Health Legislation Threatens Rights of People With
Disabilities
By Sadie Ryanne Baker
Truthout, Monday, July 25, 2016
http://www.truth-out.org/opinion/item/36933-coercive-mental-health-legislati
on-threatens-rights-of-people-with-disabilities?tmpl=component&print=1
Republican Congressman Tim Murphy introduced the Helping Families in Mental
Health Crisis Act. The most troubling provision in the bill is the expansion
of involuntary or mandatory outpatient commitment, which consists of
court-ordered medication, therapy, drug testing and case management.
Between headlines of racist police atrocities, on July 6, 2016, the US House
of Representatives quietly passed the Helping Families in Mental Health
Crisis Act by a vote of 422 to 2. If made law, this legislation, also called
the Murphy Bill, would be the most significant reform affecting mental
health care since the Community Mental Health Act of 1963 ushered in the era
of deinstitutionalization.
Hailed as a rare bipartisan victory, the Murphy Bill lets politicians
falsely claim progress against gun violence while stigmatizing people with
mental illness, undermining civil liberties and diverting attention away
from institutionalized racism and structural poverty. Actually, it does
nothing to increase access to vital resources or address the pandemic of
police violence against people with mental illness.
One quarter to a half of people killed by police are experiencing an
emotional crisis--about one every 36 hours, disproportionately people of
color. Just since this legislation cleared the House, police responding to a
911 call about an apparently suicidal person sitting in a Miami street shot
the man's Black caregiver who was attempting to protect him. At the same
time, the media have attempted to attribute the retaliatory attacks on
police in Baton Rouge to the shooter's post-traumatic stress disorder.
The Murphy Bill was introduced by Republican Congressman Tim Murphy
following the mass shooting at Sandy Hook Elementary School. Murphy, a
clinical psychologist with thorough right-wing credentials, believes
patients' civil liberties are a barrier to effective treatment and has made
clear that his goal is to empower not people with disabilities, but our
parents and caregivers. The bill has many powerful supporters, including
dozens of nonprofits, lobbyists and health industry trade groups.
Supporters claim to be remedying the broken system left in the wake of
deinstitutionalization--the widespread closure of state-run psychiatric
hospitals, which was viewed as progressive in its time but, due to lack of
funding for replacement services, in effect moved millions of people with
psychiatric disabilities onto the streets and into prisons. Today, the three
largest psychiatric "treatment" facilities in the United States are jails,
where abuse, squalid conditions and violence are routine.
One of the Murphy Bill's most troubling provisions is the expansion of
Assisted Outpatient Treatment (AOT). AOT, also known as involuntary or
mandatory outpatient commitment, consists of court-ordered medication,
therapy, drug testing and case management. While 46 states already have AOT
laws, they are not widely utilized. Supporters of AOT tout it as an
alternative to the more expensive options of hospitalization and
incarceration, but there may be no benefit at all. One systematic review of
studies found "no significant difference in service use, social functioning
or quality of life compared with standard care."
In the hands of a racist and classist criminal legal system, AOT has become
another tool for enacting violence against marginalized communities. Black
people in New York state are five times more likely to experience
court-ordered treatment than white people.
At its worst, AOT allows abusive family members and biased judges with zero
mental health competence to force treatment on individuals supposedly too
sick to recognize they need help. The Western Massachusetts Recovery
Learning Community, a peer-to-peer mental health support group that
describes itself as largely funded through grants from the Department of
Mental Health, reports on its website that what "treatment" can entail under
AOT rules varies highly from state to state, but in some states has included
the following:
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.
In addition to expanding AOT, the Murphy Bill attacks privacy rights of
people diagnosed with mental illness. According to the Congressional
summary, the bill
requires the caregiver of an individual with a serious mental illness to be
treated as the individual's personal representative with respect to
protected health information, even though the individual has not consented
to disclosure of such information to the caregiver, when the individual's
service provider reasonably believes it is necessary.
This would exempt people diagnosed with mental illnesses from federal
privacy laws, giving sensitive information on patients' diagnoses,
medications and medical appointment dates and locations to families, spouses
or social workers under the guise of "compassionate communication." For
example, this information could "out" transgender people to transphobic
family members, or be exploited by abusers against women with disabilities,
who are 40 percent more likely to experience intimate partner violence than
non-disabled women.
The Murphy Bill also seeks to undermine the Substance Abuse and Mental
Health Services Administration (SAMHSA), creating a new mental health czar
and prohibiting SAMHSA from establishing its own independent programs and
terminating existing programs "not explicitly authorized or required by
statute." One potentially threatened program is the National Center for
Trauma-Informed Care and Alternatives to Seclusion and Restraint (NCTIC),
which "works to eliminate the use of seclusion, restraints, and other
coercive practices and to develop the knowledge base on trauma-informed
care." Other at-risk programs include those serving vulnerable and
marginalized populations, such as LGBT people, Native communities, people
experiencing homelessness and Spanish-speaking communities. Rep. Murphy and
his allies have repeatedly attacked SAMHSA for supposedly wasting taxpayer
money on a recovery model that allows patients to be co-creators of their
own treatment plans.
This is a victory for right-wing organizations like the Heritage Foundation
that have been calling for the abolition of SAMHSA, as well as a loosening
of federal privacy laws, for years. Conservatives have criticized SAMHSA for
its willingness to collaborate with organizations led by mental health
service users and its focus on prevention and coping practices over what
they call "evidence-based practices," which involve strictly medical
responses.
All this is proceeding under the pretense of violence prevention, despite
the fact that, according to the US Department of Health and Human Services,
"only 3% to 5% of violent acts can be attributed to individuals living with
a serious mental illness" and "people with severe mental illnesses are over
10 times more likely to be victims of violent crime than the general
population."
Around 20 percent of Americans have a mental health diagnosis in a given
year. If we count only "severe" mental illnesses, this number is still well
above 5 percent. Legislation, such as the Murphy Bill, claims to reduce
stigma while doing the opposite, perpetuating the false narrative that
people with psychiatric disabilities are dangerous.
It would be convenient to think if Sandy Hook shooter Adam Lanza or Isla
Vista shooter Elliot Rodger had been forced into treatment, their victims
would still be alive. Perhaps in a few cases that's even true. But we should
not scapegoat all people with psychiatric disabilities or punish people for
"thought crimes." Giving more power to hospitals, courts and families holds
too much potential for abuse.
Violence is more closely linked to poverty than to mental health diagnoses,
yet this is not being addressed. The Murphy Bill contains no increase in
funding for housing, food stamps or disability benefits--services that could
improve the health of people with psychiatric disabilities as well as reduce
overall violence. The legislation does not decrease the cost of treatment,
nor does it help people who need intensive care but can't afford to take
time off work.
To be sure, the Murphy Bill contains some positive elements, such as making
it easier for Medicaid to bill for mental health treatment. The law attempts
to address the shortage of psychiatric beds, track data on mental health and
use tele-psychiatry for rural populations. It also makes vague commitments
to fund youth suicide prevention initiatives. However, the efficacy of these
measures remains to be seen.
Finally, the proposed law would also increase crisis intervention training
for police. These trainings could possibly help to reduce violence, but
trainings will never solve the racism and violence inherent in the US
criminal legal system. If we truly care about preventing violence, a good
place to start would be disarming--or disbanding--police, not giving them
more resources.
The bill now moves to the Senate, where a vote is expected by September. The
continued focus on disabled people as perpetrators rather than victims of
violence hides deeper crises facing this country, and is unlikely to end
until people with disabilities and our allies organize for real,
revolutionary change at every level of society. We need our basic needs met,
alternatives to calling police when we are in crisis, and community support
services that allow people with disabilities to live independently--not more
court orders.
Sadie Ryanne Baker is a crazy Appalachian trans woman and radical mental
health activist living in Chicago, where she is a support worker for LGBTQ
youth experiencing homelessness. Read more at queerlymad.com.
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