Congress Hears About SAMHSA’s Failings: Pushing an Anti-Psychiatry Agenda, Wasting $$$

Rep. Tim Murphy Challenges SAMHSA

Rep. Tim Murphy Challenges SAMHSA

 

Rep. Tim Murphy (R. Pa.) came out swinging hard Wednesday at SAMHSA, during a House Oversight and Investigations subcommittee of the Energy and Commerce Committee.  It was the third session Rep. Murphy’s subcommittee has held about mental illnesses and it was a good one. (You can watch it here.)
 
SAMHSA has long been criticized by Dr. Fuller E. Torrey for wasting money on “feel good” programs that are not evidence based, for not paying adequate attention to severe mental illnesses, and for funding organizations that advocate anti-psychiatry and anti-medical model views.
 
Chairman Murphy relied heavily on Dr. Torrey’s past and current criticisms in his opening statement. Among his – Rep. Murphy’s — specific criticisms were that SAMHSA doesn’t focus enough of its funding and programs on helping persons diagnosed with bipolar disorder, schizophrenia and other severe illnesses, as evidence by the fact that it has only one psychiatrist on its staff and his expertise is substance abuse, not mental illness. SAMHSA was created to be the federal government’s main mental health agency.
 
How can the government’s number one mental health agency only have one psychiatrist on its staff of 574 employees? Murphy asked.
 
Murphy also chastised SAMHSA for its funding priorities. He specifically attacked a yearly “alternatives conference” that SAMHSA funds, which included a workshop called “Unleash the Beast” that promised to help attendees learn about mental illness by studying animal movements.
 
Rep. Murphy’s co-chair, Rep. Diana DeGette, quickly circled the wagons around SAMHSA, arguing that Congress was responsible for setting SAMHSA’s priorities and that many of its programs are worthwhile.
 
When it came to actually refuting Murphy’s (aka Dr. Torrey’s) specific criticisms,  DeGette and her Democratic colleagues seemed to struggle, even when throwing softball questions to SAMHSA Administrator Pamela Hyde.  She didn’t hit a single one into the outfield.
 
During her testimony, Hyde frequently demurred, answering that she didn’t have specific figures — such as how much SAMHSA spent funding its alternative’s conference. She refused to get specific, explaining that SAMHSA simply doles out block grants and really isn’t responsible for how states use federal dollars.
 
That’s nonsense.
The hearings quickly became a partisan show with Republicans chiding SAMHSA for waste and inefficiency — such as the using of taxpayer funds to buy an expensive oil painting for SAMHSA headquarters  – and Democrats trying to turn the spotlight off SAMHSA and onto how sequestration is cutting federal funds for mental health programs.
 
I watched the entire hearing online, because I had a conflict yesterday and couldn’t attend in person. I would strongly urge all of you to watch it.
 
Personally, I found Administrator Hyde’s answers frustrating and evasive. Why didn’t she simply acknowledge that SAMHSA is funding groups that are viewed as being anti-psychiatry? If she believes that the National Empowerment Center and an alternatives conference are  worth tax payer support, then she should have explained why both deserve federal funds.  She knew Republicans on the subcommittee were going to attack those two entities. Instead of coming to their defense, she left them hanging in the wind, hiding behind the rubric that SAMHSA supports lots of conferences and programs that provide lots of different points of view.
 
Is that the best she could come up with? If I were involved in either of those groups, I would have been furious at her answers.
 
Rep. Murphy ended his questioning of Administrator Hyde by personally asking her to stick around to hear Joseph Bruce’s testimony about how a SAMHSA-funded Protection and Advocacy group played a key role in causing his wife’s murder. 
 
In 2006, Joe’s son, William, was committed to a state hospital in Maine where he was coached by an employee of the Disability Rights Center of Maine organization (that state’s federally funded P & A program) about how to avoid taking medication and what to tell hospital officials to get discharged. William took that advice, went home and used a hatchet to kill his mother, Amy. (The Wall Street Journal documented the case.)
 
I know Joe and he is a wonderful advocate. I was happy to hear at the end of testimony that William now is doing well. Said Bruce, “Ironically and horribly, my son was only able to get treatment by killing his mother.” What I wasn’t happy to hear was that little in Maine has changed because of Amy’s death. The same folks who were whispering in William’s ears are still whispering unchecked in other’s.
 
P and A groups were created to make certain that persons in institutions are not abused, neglected or mistreated. I believe that oversight is crucial. However, Joe and other witnesses testified that many P and A groups have turned their focus away from protecting persons in institutions to doing everything possible to get them out of hospitals regardless of how sick they are. In Joe’s son’s case, that logic proved disastrous.
 
After Bruce testified, it was Dr. Torrey’s turn, and while  Administrator Hyde said she didn’t know how much alternatives conferences cost, he did. He said alternative conferences cost $500,000. Torrey added that Hyde recently approved funding for a new alternatives conference despite deep cuts to SAMHSA because of  sequestration. He ended his testimony by playing a video of SAMHSA employees dancing around an employee playing the role of a drunk — a play that cost taxpayer’s $80,000.
 
Dr. Sally Satel, with the American Enterprise Institute, delivered some of the harshest criticism of SAMHSA, accusing it of “actively sabotaging” efforts to pass Assisted Outpatient Treatment programs. She testified that SAMHSA funded anti-psychiatry groups that routinely urge patients to stop taking their medications, saying what SAMHSA is promoting would be akin to having the federal government pay groups to advise persons with HIV not to take AIDS medication. Dr. Satel said that consumers who are well and are managing their illnesses successfully have an upper hand at SAMHSA when it comes to setting SAMHSA priorities — they are a much more listened to voice than families or persons with severe mental illnesses who are too sick to speak for themselves. She was especially critical of the “recovery” movement that, she said, often is anti-medication.
Dr. Joseph Parks III, Missouri Institute of Mental Health, testified that persons with severe mental illnesses die decades earlier than their peers and called for more support for mental health courts and jail diversion programs.
 
When it came time for questions from members, Dr. Torrey promoted AOT, which should have not surprised anyone. Joe Bruce told members that if his son had been forced to take his medication – instead of being counseled about how to avoid medication – he would not have killed his mother.
 
For those of us who have been advocating for several years, yesterday’s hearing did not expose anything new. But that’s not the point. What makes Rep. Murphy’s hearings so important is that they are educating members of Congress and the public about cases such as Joe Bruce’s, issues such as AOT, and how SAMHSA is spending our money.
 
Rep. Murphy’s subcommittee is the same congressional panel that I testified before a few weeks ago.  I continue to be  impressed by several of its members, especially Reps. Bill Cassidy (R-La.) and Morgan Griffith (R-Va.)  Cassidy is a medical doctor and he pushed Administrator Hyde to the point where she became physically uncomfortable when answering his questions. I was especially thrilled when Griffith told members that a judge in his district (home of Virginia Tech) had started a “therapeutic court” on his own since Virginia continues to drag its feet when it comes to launching mental health courts.
 
Dr. Torrey’s influence on yesterday’s  hearing was undeniable. Whether you like or despise him, he has been relentless in attacking SAMHSA and demanding that more attention be paid to persons with severe mental disorders.  SAMHSA has not taken the lead in studying and releasing reports about the alarming rate of persons with mental disorders who are ending up in our jails and prisons. Dr. Torrey has. SAMHSA has not called attention to the national shortage of emergency care beds that we have in our country. (A problem that I hear about repeatedly as I travel.)  Dr. Torrey has.
 
Rep. Murphy should be encouraged to keep investigating  our badly broken system. Whether changes will happen is difficult to tell, but nothing will happen unless he and other concerned members of Congress continue looking at our failing system.
 
Kudos to Rep. Murphy!  
About the author:

Pete Earley is the bestselling author of such books as The Hot House and Crazy. When he is not spending time with his family, he tours the globe advocating for mental health reform.

Learn more about Pete.

  • http://www.themindstorm.net/ Chrisa Hickey

    It’s great that this is finally getting attention. SAMSHA is a waste of time and money, I agree.

    But yet again, Rep. Murphy sponsored a hearing about a disease where not one person who has the disease was asked to testify.

    Why? There are thousands of persons with serious mental illnesses like Schizophrenia and Bipolar Disorder who would make a compelling case for what SAMSHA should be focusing on.

    What other illness would we consider it ok to hear from NO ONE who is an actual patient living with the disease?

    • Guest

      My son, who suffers
      from schizophrenia, was recently living in an IMD step-down facility. It became
      clear to me that many, if not most, of the clients were there because of alcohol/drug
      addictions, not SMI. When I was parked in my car on the street, I would often
      observe clients out on the sidewalk sneaking drinks from mini bottles or
      smoking joints when they thought no one was watching.

      At that time, my son was still extremely psychotic and not
      nearly well enough to focus during group meetings or to have a conversation. He
      would pace constantly, he was agitated, he would laugh, talk and sing to
      himself, and often wander off-site to panhandle or bum cigs, or look for cig
      butts, etc. Often when I went to visit my son, the staff had absolutely no idea
      where he was. If my son wandered off-site, the staff would tell me that they
      were not responsible for him, and that they could not monitor him if he left
      the property. The program director also told me that my son did not fit the
      criterion to be placed into a locked facility because he was not a danger to
      himself or others.

      As I arrived at the
      facility one day, I saw a sweet, middle aged lady client, who I knew also
      suffered from psychosis, as she was being arrested and taken away in a police
      car. It seems that she had wandered down to the corner liquor store and gotten
      herself into some kind of trouble. I never saw this client again. The IMD
      step-down program/staff had obviously failed to protect this vulnerable client
      from wandering off-site and getting into trouble/arrested.

      I feared very greatly for my son’s safety, so I began
      sitting in my car out on the street in front of the facility for many, many
      hours each evening/night, to make sure that my son did not wander away and get
      into any trouble. My son was not sleeping very much at that time, so he would
      often get up several times during the night and wander a lot, and the staff
      never even noticed, unless I told them. This went on for many months; I was
      practically living in my car so that I could try to protect my son.

      At a team treatment meeting, the staff actually told me that
      perhaps “…your son has not hit bottom yet, change has to come from
      within him…” I was completely shocked that they would say such a thing!
      That is something that you might say about an alcoholic or a drug abuser, but
      it absolutely does not apply to mental illness!! It seemed to me that the staff
      was completely uneducated about mental illness!! They didn’t seem to understand
      that my son’s illness was a physiological brain disorder. They were waiting for
      my son to “hit bottom”?!?!
      They said that perhaps I should take my son out of their program and put
      him into a group home. However, at a group home, my son would have received
      even LESS supervision!

      After my son had been living at this IMD step-down facility
      for 10 months, a new psychiatrist began working there. I met with this new
      doctor and he took a great interest in my son and spent time with me going over
      my son’s history/meds/etc., much to the chagrin of the staff, I might add. The
      staff did everything in their power to limit the amount of time I was able to
      spend with the doctor! The staff therapist informed me that my son had “…been
      on program.” and “This is not an intake evaluation.” etc., etc.
      However, fortunately, the doctor was not satisfied with the status quo and he
      believed that my son could, and should, be doing much better than he currently
      was.

      This new doctor changed my son’s meds and my son began
      making obvious improvements right away. My son began sleeping all through the
      night, he became calm, he became able to focus and have conversations and
      socialize, he stopped pacing, he stopped wandering, and he was now able to
      participate in doing simple chores. Under this doctor’s care, my son kept
      improving as his meds were adjusted over time. The facility staff was truly
      shocked to see how much my son was improving. This is the same staff who had
      earlier told me that my son “…had not hit bottom yet.” The staff
      had been willing to just let my son fend for himself, without even trying to
      protect him from dangers off-site.

      My son is now living at home and he is a completely
      different person. My son is polite, considerate, helpful, never wanders, he is
      no longer chain smoking (he is down to one cig every 3 hours), and most
      important of all, he is happy. He still requires prompting for his ADL
      (shaving, shower, changing clothes, brush teeth, clean room, etc., and he still
      lacks in motivation; however, he willingly attends a pilot study program at
      UCLA, 3 days a week, for an hour each day for cognitive training, he goes with
      me on all of my errands and he lends a hand whenever I ask him.

      I am SO thankful for a doctor who was willing to try
      something different and NOT give up on my son! I can tell you that this is the
      very best that my son has been in over 10 years!! He is now able to interact
      and participate in activities with family members and friends in a meaningful
      way. I can tell you that we almost “have our son back” and it is
      finding the right MEDICATIONS that made ALL the difference in the world. Our
      son has come a long, long way in the past 9 months and I have no reason to
      doubt that he will continue to improve. After the horrors that our son has
      suffered over the past 10 years, this is truly a wonderful blessing to finally
      find the right meds that work for him.

      I only wish that ALL of the homeless, mentally ill lost
      souls that I often see languishing in misery on the streets, parks, etc. could
      receive the correct medications that could also give them back their lives!
      THAT should be the one true goal of SAMSHA!!! To help ALL of these most
      vulnerable people who truly cannot help themselves, BEFORE they end up sick,
      starving, frozen, in jail, or beaten, Tasered, or shot to death by the police
      or gangs. They cannot get well, UNLESS
      they have the proper medications.

  • Okjean

    What I got out of watching the hearing: SAMSHA Is run by a lawyer and congress. No wonder our system is in shambles. Not that I have anything against lawyers or the hard working representatives we elect, I just wouldnt go to them for help with my brain.

  • Okjean

    I hope congress does invite a “consumer to testify.” I hope they invite Fred Frese or Eyln Saks. Those are power people, they know what is possible, they have clinical and personal perspective and a proven track record.

  • Gloria Hill

    Undercovering how SAMSHA has wasted tax payers money is a long time coming. I appreciate the excellent effort that is being made by Rep. Tim Murphy who is also a knowledgeable mental health professional. He seems committed to try to help the federal mental health funding be used for the sickest and most needy mentally ill people. I have a son who has had schizophrenia for 22 years who suffers with symptoms everyday that the medications help but don’t totally control. Not everyone “recovers” but medications make it possible for him to live in the community. He needs more than his family’s support but it isn’t available in the Orlando area where we live. I believe he has a neurologic brain disease and much more funding such be spent on research. Many people like my son who have schizophrenia are not able to speak for themselves in such a public hearing. He is ashamed to go public that he has that illness because of the stigma associated with it. I think the Rep. Murphy understands that and resoects, Many families also don’t speak out because they are also ashamed because of stigma. I hope thiese hearing result in some serious changes in our tax payers money is spent and a new agency is formed to do careful oversight with unannounced visits to agencies that are receiving funding.

  • lpogliano

    i am wondering how you can be the head of an organization that is completely funded by tax dollars, with over 500 employees, like SAMHSA, and pretend not to know where your own funding goes, what a conference costs, or how the vast sums of money authorized and doled out in block grants is being spent, or the programs it funds, even on a high level; a grant has goals; if she doesn’t know or can’t account for what grants are selected to be funded, she should not be in charge of such a huge budget. she’s not throwing buckets of candy out in a parade, letting it land willy-nilly for anyone to grab. she’s sponsoring and funding mental health programs that have structure, offices, goals, programs, lots of specifics…pam hyde is either incompetent, or a very poor liar. no other choices. the oversight committee should press for her removal. (oh wait, she is receiving an award soon for all her good works from Mental Health America…)
    as far as tim murphy not inviting consumers to testify: he did. JOE BRUCE. i cannot imagine the pain mr. bruce experiences every time he has to tell the story of his floridly psychotic son killing his own mother, joe’s wife, and his now ruined family. people discount parents and caregivers as consumers, but we are. parents and caregivers ARE consumers. joe’s son could have testified, but as we heard, he’s locked up indefinitely. and he is lucid now, but no thanks to anything SAMHSA funded.

    • KristenKringle

      He also needed to invite the patients to speak, patients who understand what it feels like to be psychotic and to ask what helped them.

    • Sandy Goodwick

      Joe Bruce is NOT… *IS NOT* a ‘consumer’. He did not testify as one.

      What percentage of individuals with mental ‘illness’ are abused/murdered by others? (I am reminded of at least three people who were murdered by police – a young man with Down syndrome who didn’t want to leave the movie theater, a man in his own home in Texas, and a homeless man in Fullerton, CA) Bruce’s testimony (vs. that of a true ‘consumer’) infers (1) people who are ‘consumers’ have nothing to say on their behalf, (2) they (‘consumers’) are too different from the ‘responsible’ people who work in Congress (like Re. Murphy) (3) the “medical model” of disability is the only relevant one (that people with mental illness, by default, are to only be seen as needing fixing in order to join ‘humanity’ vs. actually having critical insight into who ‘they’ are)

      Why is the gun lobby so quick with a hair trigger response that the “blame” for mass shootings = ‘mental illness’ (an easy target due to historical stigma) vs. availability of guns (something the entire rest of the ‘western world’ solemnly notes), age, sex, availability of violent video games? WHY? It is much easier to keep an old fire burning rather than clean house.

      The LACK of credible ‘consumers’ – people with histories that include “severe mental illness” – to provide relevant testimony – says (1) We need to skew the information we gather here, and so we can’t use you. We DON’T WANT to know what works from someone with first-hand experience. (2) We believe that we know what works best – and we don’t want to know from you whether our ideas actually work. WE are in charge of YOU.

  • Okjean

    Good morning, we have a agency called SAMHSA for a reason. We don’t have a pancreas agency, or a broken leg agency. No other illness has so much stigma. Substance abuse and SMI come with a special set of issues that bump up against civil liberties and illness left unchecked can result in criminal behavior. So one way or the other the judicial system is involved. Then there is the issue of who pays for treating the SMI. quite often this population does not have the resources to pay–I’m still not sure when to go when you have insurance or money. (Maybe thinking Canada) The rest of the world is watch US. We are a nation that prides it self on justice and liberty for all. Please SAMHSA drop everything that does not specifically advance getting real help to the people with SMI. Those with a MI that is not serious will benefit too if we can get our act together. SAMHSA should be showing leadership and being the watch dog. Help us improve implementation of the laws we do have. Get insurance to pay. Get programs in place to put people with SMI to work. Turn them into tax payers. Keep them out of jail without cause. Has it occurred that it looks cheaper to jail someone than to treat them? This is America! How can we treat people with an illness with such disregard?

  • Virgil Stucker

    Pete, thank you for your observations. I was not able to view the proceedings myself. What concerns me is that our community dialogue seems to be devolving into arguments between fundamentalists, with imagined anti-psychiatry camps on one side and anti-recovery camps on the other. In the middle is the victim of mental health challenges, who seeks to be in collaboration and wishes not to succumb to the dogma of either camp.

    Sometimes, emotions are so uncontrolled that coercion can be life saving. This is the exception. The norm should be to develop community dialogues and services that support the view that each person can indeed recover an ability for functioning and fulfillment. Although the use of optimized medication helps most individuals with serious mental health challenges in their recovery process, it falls short of helping with the full process of recovery. Optimized Medication may effectively suppress some of the symptoms of one’s diagnosis, but it does little to activate or empower the dreams that one needs in order to engage with successful community living.

    Neither camp serves well the needs of the individual. Human suffering is complex and requires comprehensive approaches. We should avoid the simplicity of the purveyors of dogma.

    Virgil Stucker
    CooperRiis, Executive Director
    Foundation for Excellence in Mental Health Care, Chairman

    • Okjean

      Well said. I think we need lots of different options. But until we have some leadership that can sort out when court ordered treatment is necessary, we will be chasing our tails. The revolving door is real. You probably know as well as anyone what works. Now how do we make that available to more people?

      • Virgil Stucker

        Thank you, Okjean,

        I think that our national leadership should acknowledge the complexity of mental health challanges and avoid dogmatic one-size-fits-all solutions. Ultimately, since community re-integration of individuals with mental health challeges is the goal, we need to focus on the creation of compassionate, comprehensive, community based solutions. Some liminal spaces like CooperRiis, which is like a nonprofit recovery college, are needed. We also need to restore state hospitals. Private philanthropy can also fuel local community dialogues focused on improving the quality and quantity of local mental health care, which should happen in programs, in our congregations, and on the streets where we will no longer walk by the homeless person with mental illness and avoid helping them. Our national community foundation for mental health care, the Foundation for Excellence in Mental Health Care, is facilitating the emerging philanthropic process. Indeed, we are entering a golden age of philanthropy for mental health care. We are indeed entering a time during which we will change our pathogenic society into a salugenic one.
        I see no other choices to make… the time has arrived for rising above the bickering and for moving our civilization forward into a time during which our most vulnerable citizens will be cared for by us.
        Virgil Stucker

    • KristenKringle

      If only the Virgil stuckers of the world were called to speak before congress and interviewed by the media. Patients with serious mental illness who take medication voluntarily, but reluctantly, desperately need to hear the calm, rational voices speaking. Extremist views put patients at risk.

      My psychiatrist thinks like you, Mr Stucker, which is why I see him. I pray that threats and force and reinforcement of fear never become the main way we treat people who are psychotic.

    • Sandy Goodwick

      “… Although the use of optimized medication helps most individuals with serious mental health challenges in their recovery process, it falls short of helping with the full process of recovery….”

      Speaking purely as one person who faithfully took medications for 25+++ years… you are 100% wrong.

      Medications impacted my sense of ‘feelings’ – they were nothing better than emotional Novacaine. If one didn’t work, another was added. If two didn’t work, three must be better.

      Individuals who present (either voluntarily or involuntarily) with mental health ‘challenges’ DESERVE to have options – starting with research conducted by professionals with no direct/indirect ties to pharmaceuticals, research representative of real diversity (not clinical trials that create artificial scenarios such as people who never took any medications, or people who engage in CBT vs medication, etc.).

      I found much more credibility in learning the philosophy behind ‘traditional Chinese medicine’ than I saw in over 25 years accessing western mental health care ‘treatment’; where information only flows in one direction (doctor tells patient, who complies).

      When western medicine is able to step back from having its cognitive nose to the glass that only this (medications) is relevant to ‘care’ … when western medicine begins to take a more holistic look at the absolute interplay between one’s body and one’s history … THEN ‘both sides’ will intuitively become one force for change.

      “… TCM practitioners are practitioners of the “vitalist doctrine”, which states that “man assists, but nature heals”; as opposed to the “doctrine of specific cause”, which postulates that a single micro-organism could produce specific symptoms in healthy organisms…”

      Yes, you’re right – there ARE many human conditions that western medicine has gotten right.

      But mental health ‘care’ is yet not one of them.

      • Virgil Stucker

        Thank
        you, Ms. Goodwick, for sharing your story. I deeply respect your journey and am saddened to read about the early inflexibility you apparently experienced in your relationships with your mental health practitioners. I am happy to read that you have found a path that has maximized your recovery.

        Being a Qi Gong practitioner, I also recognize the value of thinking broadly, of being aware of the whole person and of reaching out to non-Western methods.
        Professional research has found Qi Gong to be especially beneficial for mood stabilization and improvement. I experience this firsthand as well.

        In regards to psychiatric medication, my experience is that most individuals I have worked with personally, who are experiencing extreme states, are indeed helped by the judicious use of medication. From my perspective, ‘medication optimization’ is an approach that first of all honors the individual and seeks collaborative dialogue. Three outcomes occur: generally a lowering of the number and dosages of medications, sometimes an intention to use medications only in episodic response to extreme states, and sometimes the very gradual cessation of psychiatric medications.

        Since treatment optimization is really the objective, the work with medication is only one intervention that is in the ‘recovery formulary’. The key is to help the individual to personalize a comprehensive approach and use and combine all of the interventions that are useful for their recovery.

        Again, Ms. Goodwick, one of my main concerns in this thread of conversation is to avoid dogma. I am hoping to find a plane that rises above the dogma of the anti-psychiatric thinking and of the anti-recovery thinking. Earlier this week, I saw a friend Elyn Sacks again. You may know her heroic recovery story. Ultimately, she chose to use a psychiatric medication as one of the myriad interventions that she found useful for her recovery. I also recently spoke with a leader in the peer recovery movement, who said that he would not have
        survived if he had not been medicated and hospitalized against his will at an earlier point in his life. He now needs no medication. And, now, I have met you and heard your story. I am very glad that you have found a path to recovery that does not require medication.

        I want to say “Yes” to all of these stories. I want say “No” to dogmatic positions that, like religious fundamentalists, claim to know that only path to recovery. We are just too complex for such simple thinking.

        Virgil Stucker
        CooperRiis Healing Community
        Foundation for Excellence in Mental Health Care

        • Sandy Goodwick

          re: “In regards to psychiatric medication, my experience is that most individuals I have worked with personally, who are experiencing extreme states, are indeed helped by the judicious use of medication.”

          The challenge for anyone who is given medications is that ‘judicious use’, more likely than not, becomes chronic use. I have never NEVER – in 25+++ years with psychiatrists – NEVER had even one suggest in any way anything remotely implying they would like to taper me off medications. Never. Ever. In fact, I never even asked the question, because as the compliant patient I *assumed* they would suggest something like that.

          No one EVER reduced the dosage. It just doesn’t happen.

          I wonder … if knowledgeable clinicians were to examine psychiatrists records and compare notes re: patients’ current mental state and medication over time, would research demonstrate that any significant percentage of psychiatrists actively worked to reduce medications ‘judiciously’?

          The argument for medications needs to also weigh the evidence against them – how they are NOT ‘judiciously’ monitored.

          I fully expected to take medications for the rest of my life. I believed what I was told. Now, 2 years later … I am 75 pounds thinner, eating far better, exercising and far more in touch with feelings and finding my own ways to address any mood imbalances.

          I have found ‘Alternatives’ – supplements, exercise, eating healthy, a deeper spiritual connection, speaking out … The ‘recoverING’ isn’t painless … yet I am far more alive without medication than I ever was while on it.

          More than likely, had I remained on medication, I would have discounted claims that one can live effectively without medication – only because I thought I had to use it and I had no other knowledge. Now? I fully, 1,000,000% support those who want to find ‘alternatives’ to medication.

          • Virgil Stucker

            My hope, Ms. Goodwick, is that you would support a friend who might seek your advice about alternatives but also consider one of his or her alternatives to be the use of medication. We all need to avoid dogma, both those who consider medication to be the only answer and those who consider medication never to be the answer.

            Just today I have been approached by a young man who valiantly tried to manage his psychosis without medication for about six months. His peers gave him strong encouragement to stay the course without medication. He now wants to return to limited usage of medication. I honor his choice, as I also honor yours.

            Yes, there are some practitioners who are less able to listen and to work collaboratively. Going forward, we need to change that, led by research, by personal stories, and by the resolve to assure that mutual respect n.

          • Virgil Stucker

            will inform our relationships, not dogma.

            Virgil Stucker

    • Martha Brock

      Very well said. I am glad someone in NC is paying attention, and that you have a cogent, reasoned response.

  • Pegasus

    Like all governments that have grown too big, too self-important, agencys like SAMSHA and hundreds of others exist to provide ‘jobs’ and squander public money. Maybe someday the American people will wake up and stop allowing their money to be wasted. A few good think tanks funded by our tax dollars, and approved by the public, is all we need.

    Programs? Ask anyone who’s living successfully with a M.I. and they’ll tell you it wasn’t due to any program. A good doctor, some therapy, maybe some meds, community/family support, and a whole lot of personal work – thats what cures. Millions of dollare are wasted on programs that keep the mental health workers busy. Great hospital inpatient care complete with thorough follow up – thats where dollars need to go. Re-do the hellholes called prisons – make them rehabs where inmates get well.

    Get rid of Hippa – once sanity is gone, there’s no sense holding on the secrecy and shame. For those who suffer with severe illnesses from which neither God nor man can relieve them, lets provide intelligent family support and peaceful residences of beauty with 24/7 loving care.

    As stigma goes, may we remember that it is fear that causes it, and our fear of it that grows it. Worst of all, it is because of it, that many mentally ill do not recover.
    Only a foolish government would not want to interview the people it spends tons of money on.

    • Sandy Goodwick

      re: “… A good doctor, some therapy, maybe some meds, community/family support, and a whole lot of personal work – thats what cures…” Baloney.

      ONLY works for ‘band aid’ M.I. “Personal work” ..who decides the ‘work’? A doctor who has no clue as to history of prior abuse? A therapist who has no clue as to interplay between mind/body? There are COUNTLESS veterans who sustained PTSD in wartime (WW I, WW II, Korea, VietNam, Gulf, Irag, Afghanistan… ), COUNTLESS adults who cope with after-effects of ‘adverse childhood experiences’ (incest, physical abuse, domestic violence, poverty, neglect, bullying, medical procedures… ) and today live with medical conditions directly related to them – obesity, diabetes, osteoarthritis, substance abuse, workaholism… Your answer is a flippant one that reeks of ignorance.

      • Pegasus

        Hi Sandy –
        I stand by my concise abbreviated consensus- I will elaborate a bit for you, and you may see that you agree.
        A good doctor – one who is skilled in treating the mind-body as a whole. Therapy – a broad term that covers just about any activiity that engages the undesirable symptoms in a transformative way that brings out positive relults. Medication – could literally be anything, prescribed,
        self used, over the counter, avuredic, natural substances.
        Community /family support speaks for itself .

        • Pegasus

          And personal work is that which the mentally ill, in his/her quest to become well, performs every second of every day. It is a very private healing process, often spiritual, but basically originating from the self. As people w/ M.I. learn to love their
          supposed illness, as they do themselves, a real healing begins. A lot of hard personal work that no one else can do, is getting to know oneself and ones’ illness as one entity. Once complete acceptance sets in, and the desire to rid one’s self of the mental illness that is ‘here for a lifetime’, disappears, then health returns. Sadly, many with mental illness treat the illness as an enemy, instead of a part of themselves they must learn to love; then master and control.
          Peace to you.

        • Sandy Goodwick

          The challenge by those ‘in’ the system is that people don’t have a clear-cut way to determine which doctor/therapist is good, vs. which doctor/therapist needs to find a different job. One doesn’t know, when taking pills, whether they ‘work’ in the same way that a patient would ‘know’ that an appendectomy worked, etc. Western medicine assumes that the doctor-patient relationship is primarily that of compliance. Much of the mental ‘illness’ experience defies verbal description. I have asked a question re: a pharmaceutical only to have an MD (pad in hand) ASK me if I want to take the medication (seriously!) I was truly offended – my God, if a patient is suggesting medications to a physician willing to write a prescription – why have him as a middle man?

          Medication ‘side effects’ congeal into a ‘mess’ and patients begin taking it for granted that they’re just always hungry, they’re just not morning people at all, they just don’t have feelings, they just have no interest in exercising, etc, – because they lose the perspective of where they ‘were’ pre-medications from now (5, 10, 15, 20, 25 years later).

          People who’ve not gone through ‘mental illness’ over time don’t “get” this … that medications become a trap for some (not all!). Health insurance in CA is (1) medication management and (2) ‘therapy’. Unless a patient somehow ‘breaks through’ and questions the system, he/she may just keep on blindly accessing the system rather than learn the increasingly vast array of ‘alternatives’.

          When I told my MD that I had stopped all the medications, I actually thought she would be interested in continuing to see me as I went off. She told me she couldn’t see me any more … that it was either medications or fish oil (seriously). That set me to thinking …

          WHY, then, do psychiatrists go to medical school when all they need is a rudimentary knowledge of ‘this pill for that condition’? I seriously (naively!) thought a Blue Cross provider, a trained MD … knew at a profoundly deeper level than me, the many options for treatment. And this one said it was either medications or fish oil.

          Take it or leave it.

          So when she said that to me (that she couldn’t see me any more…. ) I said “GOOD!”

          Think about this … I have been employed, professionally, for 40 years while also dealing with “severe mental illness” albeit without the features that send people to involuntary hospitalizations, jail, etc. I HAVE LOOKED FOR BETTER OPTIONS!!!!!

          And ONLY when I started doing my own research – self-diagnosing myself (correctly!) with a DIFFERENT diagnosis than the one I have had for years … then finding treatment appropriate for the CORRECT diagnosis – reading, learning … I found healing and greater wellness.

          WHAT DOES THIS SAY FOR ANYONE WITH LESS EXPERTISE? If the mental health care system doesn’t work for an educated person with health insurance, does anyone think the same system works effectively for those with less self-advocacy skills, less health insurance, less…? This is PRECISELY why a conference like Alternatives makes sense – if ever there was anyone with a vested interest in getting better, it is the people themselves!

        • Sandy Goodwick

          I have consulted with a whole host of doctors – all of whom were licensed professionals, specialists. I am not illiterate nor psychotic. I have had and used mainstream health insurance in a major American city. A psychiatrist will prescribe medications. Period. End of discussion. Medications “is” the entirety of their ‘treatment’. Mind-body? *I* figured that one out when I self-diagnosed (accurately!) a diagnosis that required different treatment than the standard CBT.

          Pegasus, you’re pipe-dreaming, because the reality is that, unless a patient *specifically is linked to a doctor via referral* s/he will get, over and over and OVER and over … medications.

          Physicians ‘do’ what insurance companies “expect”. Ob/gyn = deliver baby. Psychiatrist – prescribe pills.

          While I have no inside knowledge re: the rest of SAMHSA, I am convinced that “Alternatives” is absolutely, without a doubt one thing SAMHSA (and the people who’ve planned it) got abundantly, completely right.

  • Darby Penney

    It’s hard to take seriously the accusation that SAMHSA is “anti-psychiatry,” when it spends millions of dollars supporting public mental health systems through its state block grants and additional psychiatric programs through its grants and contracts. Dr. Torrey, who believes that schizophrenia is caused by cat feces, is hardly in any position to define “evidence-based.” These hearings are just more politically motivated right-wing attacks against the current administration, and have little relevance to the real world.

  • Emma Goldman

    Clearly Torrey and Satel have no idea what “anti-psychiatry” means. I’m anti-psychiatry, and let me tell you, I put SAMHSA and Torrey & Co in the same category!

  • Darby Penney

    Why did you delete my completely civil comment that expressed a different perspective?

  • Valerie

    I agree completely that SAMSHA puts FAR too much focus on
    drug and alcohol addictions rather than on SMI.
    I realize that many clients have dual diagnoses; however, it seems to me that they focus on the people with addictions MUCH more than the SMI population.

    My son, who suffers from schizophrenia, was recently living in an IMD step-down facility. It became clear to me that many, if not most, of the clients were there because of alcohol/drug addictions, not SMI. When I was parked in my car on the street, I would often observe clients out on the sidewalk sneaking drinks from mini bottles or smoking joints or crystal meth, when they thought no one was watching.

    At that time, my son was still extremely psychotic and not
    nearly well enough to focus during group meetings or to have a conversation. He would pace constantly, he was agitated, he would laugh, talk and sing to himself, and often wander off-site to panhandle or bum cigs, or look for cig butts, etc. Often when I went to visit my son, the staff had absolutely no idea where he was. If my son wandered off-site, the staff would tell me that they were not responsible for him, and that they could not monitor him if he left
    the property. The program director also told me that my son did not fit the criterion to be placed into a locked facility because he was not a danger to himself or others.

    As I arrived at the facility one day, I saw a sweet, middle aged lady client, who I knew also suffered from psychosis, as she was being arrested and taken away in a police car. It seems that she had wandered down to the corner liquor store and gotten herself into some kind of trouble. I never saw this client again. The IMD step-down program/staff had obviously failed to protect this vulnerable SMI client
    from wandering off-site and getting into trouble/arrested. They didn’t seem to feel that it was their responsibility.

    I feared very greatly for my son’s safety, so I began sitting in my car out on the street in front of the facility for many, many hours each evening/night, to make sure that my son did not wander away and get
    into any trouble. My son was not sleeping very much at that time, so he would often get up several times during the night and wander a lot, and the staff never even noticed, unless I told them. This went on for many months; I was practically living in my car so that I could try to protect my son.

    At a team treatment meeting, the staff actually told me that
    perhaps “…your son has not hit bottom yet, change has to come from
    within him…” I was completely shocked that they would say such a thing! That is something that you might say about an alcoholic or a drug abuser, but it absolutely does not apply to mental illness!! It seemed to me that the staff was completely uneducated about mental illness!! They didn’t seem to understand that my son’s illness was a physiological brain disorder. They were waiting for my son to “hit bottom”?!?!

    The staff said that perhaps I should take my son out of their program and put him into a group home. However, at a group home, my son would have received even LESS supervision!

    After my son had been living at this IMD step-down facility
    for 10 months, a new psychiatrist began working there. I met with this new doctor and he took a great interest in my son and spent time with me going over my son’s history/meds/etc., much to the chagrin of the staff, I might add. The staff did everything in their power to limit the amount of time I was able to spend with the doctor! The staff therapist informed me that my son had “…been on program.” and “This is not an intake evaluation.” etc., etc.
    However, fortunately, the doctor was not satisfied with the status quo and he believed that my son could, and should, be doing much better than he currently was. The doctor stated to me that my son had not been moving forward, nor backwards. My son had been “going in circles, and it was now time for him to begin moving forward.” This good doctor told me that “there is always a key, and we just needed to find the right key!”

    This new doctor changed my son’s meds and my son began
    making obvious improvements right away. My son began sleeping all through the night, he became calm, he became able to focus and have conversations and socialize. My son stopped pacing, he stopped wandering, and he was now able to participate in doing simple chores. Under this doctor’s care, my son kept improving as his meds were adjusted over time. The facility staff was truly shocked to see how much my son was improving. This is the same staff who had
    earlier told me that my son “…had not hit bottom yet.” The staff
    had been willing to just let my son fend for himself, without even trying to protect him from dangers off-site.

    My son is now living at home and he is a completely different person. My son is polite, considerate, helpful, never wanders, he is no longer chain smoking (he is down to one cig every 3 hours), and most
    important of all, he is happy. He still requires prompting for his ADL
    (shaving, shower, changing clothes, brush teeth, clean room, etc., and he still lacks in motivation; however, he willingly attends a pilot study program at UCLA, 3 days a week, for an hour each day for cognitive training, he goes with me on all of my errands and he lends a hand whenever I ask him. He now enjoys playing with our new chihuahua puppy.

    I am SO thankful for a doctor who was willing to try something different and NOT give up on my son! I can tell you that this is the very best that my son has been in over 10 years!! He is now able to interact and participate in activities with family members and friends in a meaningful way. I can tell you that we almost “have our son back” and it is finding the RIGHT MEDICATIONS that made ALL the difference in the world. Our son has come a long, long way in the past 9 months and I have no reason to doubt that he will continue to improve. After the horrors that our son has suffered over the past 10 years, this is truly a wonderful blessing to finally find the right meds that work for him.

    I only wish that ALL of the homeless, mentally ill lost souls that I often see languishing in misery on the streets, parks, etc. could receive the correct medications that could also give them back their lives!
    THAT should be the one true goal of SAMSHA!!! To help ALL of these most vulnerable people who truly cannot help themselves, BEFORE they end up sick, starving, frozen, in jail, or beaten, Tasered, or shot to death by the police or gangs. They cannot get well, UNLESS
    they have the proper medications.
    It is not humane to let people suffer so needlessly. If people who suffer from SMI were in their right minds, they would NEVER willingly choose to be hungry, cold, sick and miserable. PLEASE help those who cannot help themselves, to get the medication and care they so desperately need. PLEASE use the money to SAVE their lives and get them the medicine they need to unlock their psychosis.

  • Sandy Goodwick

    I am guessing your disdain for SAMHSA is only matched by your own self-contempt in fearing, or not knowing how to face deeply troubling feelings from within as a parent – to someone whose disability is so different from your own, and also very low on the totem pole of acceptable disabilities. I speak as someone who shares your child’s ‘horizontal identity’ (read Andrew Solomon’s book ‘Far from the Tree’ – he describes in poignant detail what it is like parenting a child so different from one’s self).

    Having a visceral dislike for what was shared needs to be explored … to say the information presented is ‘wrong’ denies you the deeper challenge to figure out what credible evidence supports these positions.

    I just reviewed your link, and for me as a longtime educator with disabilities, the material is highly relevant and profoundly appropriate – it sets the ‘tone’ for living successfully with deeply challenging experiences that absolutely defy use of language to ‘explain’.

  • Ronald Lewis

    I am a consumer and the psychiatry of over medicating those of us diagnosed with mental health disorders is causing more symptoms and leaving our population dying an average of 25 years younger than the average life span of the human population. I dont take medication. I dont see A psychiatrist. I experience hearing voices BUt that does nor mean I need to be medicated or institutionalized. F u Murphy. I am going to make the math simple for you.. I go to a peer run drop in center. we receive a grant for around $130.000 a year. The year before I attended the center I went to Jail 12 times and the hospital 6 times. costing the tax payer around $26000. the drop in center serves 130 to 260 people per month..Do the math.. SAMSHA may be spending allot of money on people diagnosed with mental health disorders advocating for themselves. Do the math do the math consumers are living happier healthier lives at just a fraction of what it cost to keep them institutionalized. F u Murphy

    • advocate4treatment

      Since you and many other consumers are doing so well, you could help those not as fortunate who have severe mental illnesses by not requesting or using SAMHSA’s limited funds. I am truly happy for all of you who are able to move forward in your recovery and hope you can empathize with those who require more intensive and expensive treatment.

      • Ronald Lewis

        I will continue to advocate for samsha’s limited funds. this alternatives conference has been happening for 25 years and I do not see it stopping now.. sure cut the funding and I will advocate we will hold the next one 10,000 strong on the capitol Lawn..

      • Ronald Lewis

        Thats just it I am one of those less fortunate individuals or I was until I stumbled upon this feel good approach to wellness. I get to help those who suffer from severe mental illness and I am willing to bet the tools I have learned and get to teach are more successful that some of the psychiatrists approaches in my area.. I think the drugs companies are just afraid we have found a solution ..So now that we have figured out aiming money toward the solution is producing results lets not back-peddle and direct money toward the problem. Psychiatrist and drug companies just want to keep individuals patients. We patients just want to heal and live productive lives.

  • JAS

    As a sibling and caretaker of a 57 yr. old brother who’s had paranoid schizophrenia for the last 20 years, I only ask one question: Why would the human brain be the only organ exempt from having disease or be “immune” from malfunctioning? Brains malfunction. Hearts malfunction. Livers become diseased. Lungs don’t function sometimes. Brains malfunction just like every other body part for various reasons. I don’t understand why anyone would question in this day and age, if diseases like schizophrenia are biologically based? Why wouldn’t they be biologically based?

  • Martha Brock

    W’hy does it have to be black/white or all/nothing in what SAMHSA funds? Why can’t there be an array of research and funding for groups? I support NEC and others, and I do not consider them “anti-psychiatry.” But, even if they are, it’s way past time when the only voice on mental illness is NAMI and Torrey and his group, who have only harmed clients with perpetual images of dangerousness. Recovery happens–every day. Why can’t Torrey keep up with the times?