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Harvey Rosenthal: The “Worried Well” – A False Narrative Meant To Divide

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(5-15-17) I bumped into Harvey Rosenthal recently at the National Council on Behavioral Health Care convention in Seattle and invited him to write a guest blog. Harvey is Executive Director of the New York Association of Psychiatric Rehabilitation Services and one of the best known advocates for recovery and peer support services. Given what seems to be a constant battle being waged between the “medical model” that focuses on medication adherence and the “recovery model” that focuses on peer support and other social services, I thought it would helpful to hear his point of view, especially because a new Assistant Secretary of Mental Health and Substance Abuse will soon be appointed.)

Re-Balancing Federal Policy Need Not Have To Choose Between Extremes

BY HARVEY ROSENTHAL

For far too long, advocates for court mandated outpatient commitment have promoted the false narrative that recovery, rehabilitation and peer support providers and advocates don’t want to serve Americans with the most serious conditions…..and that our motivation in supporting the redirection of public funds from hospital to community is simply to capture public dollars for our own purposes. In contrast, these groups have outrageously played upon unfounded connections between violence and mental illness to promote a singular one-size-fit-all prescription of “more meds, more beds and more coercion.”

Along the way, these groups have promoted beliefs that a recovery and rehab focus only applies to the ‘worried well’ and excludes the most distressed, that peer support is inevitably against treatment and medication and that rights advocates are only interested in helping people in the greatest need to avoid such treatment?Click to continue…

Dr. McCance-Katz: Profile of White House Nominee For Mental Health Czar Widely Distributed

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(5-12-17) The website STAT posted a story about President Trump’s pick for the newly created position of Assistant Secretary for Mental Health and Substance Abuse inside the federal Department of Health and Human Services that is being widely circulated. Written by Meghana Keshavan, it is one of the more in-depth pieces describing Dr. Elinore McCance-Katz, the former Chief Medical Officer at the SAMHSA (the Substance Abuse And Mental Health Services Administration) who accused that agency (after resigning) of being anti-psychiatry and directed by folks who did not believe mental illness was real.)

Trump’s pick to run mental health is poised to shake things up. Even some liberals can’t wait

By MEGHANA KESHAVAN @megkesh

Dr. Elinore McCance-Katz has been nominated to run the federal agency dealing with mental health and substance abuse.STEVEN SENNE/AP

 President Trump’s pick to run federal mental health services has called for a bold reordering of priorities — shifting money away from education and support services and toward a more aggressive treatment of patients with severe psychiatric disorders.

The proposal has some psychiatrists — a generally liberal bunch — cheering despite their distrust of the Trump administration.

But it’s also sparked concern among other health professionals, who worry that the administration will put too much emphasis on medicating and hospitalizing patients, and remove supports that might help them integrate successfully into society.

If confirmed by the Senate, Dr. Elinore McCance-Katz will take the helm of the Substance Abuse and Mental Health Services Administration, a federal agency with a budget of about $3.6 billion a year, most of it dispensed in grants to help states pay for mental health and addiction treatment.

She will be the first to assume the title of assistant secretary for mental health and substance abuse — a near-cabinet position which reports directly to Health and Human Services Secretary Tom Price. Congress created the post to bring order to a scattered system; this is the first time mental health and substance abuse have received such a weighty emphasis in D.C.

Two Republican Senators Who Care About Mental Health Are Playing Key Roles In Trumpcare

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(5-11-17) All of Washington is talking about the firing of former FBI Director James Comey, but let’s not forget that Senate Republicans are in the midst of rewriting a health care bill that could have a major impact on mental health care.

Fortunately, one of the 13 Republicans drafting Trumpcare has authored mental health care legislation. Another senator, who is not on the all white male redraft and repeal Obamacare panel, has gained national attention for demanding a higher bar than what can be found in the House’s hastily passed version.

The Senators are: John Cornyn (Tex.), the majority whip in the Senate, and Dr. Bill Cassidy (La.) who is a freshman but is highly regarded for his medical expertise.

Both played pivotal roles in the fading days of the Obama administration in passing mental health bills. Sen. Cornyn authored the Mental Health and Safe Communities Act ,which uses federal funds to encourage jail diversion, support Crisis Intervention Team training, and implement mental health courts. All are important programs designed to shift individuals with serious mental illnesses into community treatment programs instead of abandoning them in the never ending – jail-streets-jail-streets – revolving door.

Sen. Cassidy, along with Democrat Sen. Chris Murphy (Conn.), introduced a much changed version of Pennsylvania Republican Rep. Tim Murphy‘s Helping Families in Mental Health Crisis Act  in the Senate. It was Cassidy and Chris Murphy who convinced Republican  Sen. Lamar Alexander, chair of the powerful HELP committee, to push their Mental Health Reform Act through the Senate during December’s lame duck session which led to a compromised version of the House and Senate bills becoming law. Without their leadership in the Senate, there is a good chance that Rep. Tim Murphy’s bill would have died, just as it had in a previous session.

More recently, Sen. Cassidy has become a favorite of news shows because of his comment about Trumpcare having to meet the “Jimmy Kimmel” test in response to an emotional monologue the late night talk show host gave about his newborn son’s open heart surgery. Cassidy’s compassion appealed to many advocates who have warned that the Republican bill could potentially cut millions of mentally ill Americans from Medicaid roles. Medicaid is the largest payer for mental health care.

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National “Speak Out” Day May 20th Demanding Help for Families Dealing With Serious Mental Illness

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PLEASE WATCH THE VIDEO AT THE END OF THIS BLOG. IT IS POWERFUL. 
(5-8-17) During Mental Health Awareness month, groups like to quote that one-in-five Americans are impacted by a mental illness each year, but that is a wide net thanks to a DSM-5 that includes such diagnoses as obstructive sleep apnea and restless leg syndrome.
About 10 million Americans have SMIs – serious mental illnesses, such as schizophrenia, bipolar disorder, and severe and persistent depression.
An organization representing the SMIs has asked me to help publicize their call for a day of focusing on serious mental illnesses.
Events are planned in Washington D.C., Sacramento, Springfield, Sarasota, Palm Beach and Augusta and — you guessed it, this is a grass roots campaign being led by parents, many of whom, are frustrated with larger mental health organizations who they say are abandoning the sickest of the sick.
Here is a copy of their press release and a video that they’ve made that shows the faces of sons, daughter, brothers, sisters, mothers and fathers, who have died because they did not get treatment. Watch it and you will notice the names of several individuals whose stories have been told on my blog.

For Immediate Release: Let’s Fight for Social Justice To Ensure Treatment Not Tragedy

Families for Treatment of Serious Mental Illness  (TreatSMI), friends and fellow advocates of both those suffering and who care about those suffering from serious mental illnesses will be coming together in our Nation and State Capitals demanding the right to treatment before tragedy, a hospital bed instead of jail or homelessness, housing, and an end to the criminalization of the seriously mentally ill.

Please join us in replacing stigma with honor, silence with voice, despair with hope, shame with respect, and ignorance with science so that we finally get treatment before tragedy.

States and cities where we’re joining together on May 20, 2017 are Washington DC, Sacramento, CA, Springfield, IL, Sarasota, FL, Palm Beach, FL, and Augusta, ME.

Schizophrenia and Related Disorders of America (SARDAA) will also be standing with TreatSMI on May 20th during the last day of their five-day event, “Hearing Voices of Support: An Experiential Event,” in New York, NY.

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Insane Consequences: D J Jaffe’s Attempt To Turn A Spotlight On The Seriously Mentally Ill

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BannerAd(5-1-17) Given the ongoing dispute about who will be the first Assistant Secretary for mental health and substance abuse, it seems a fitting time to discuss D.J. Jaffe’s new book, Insane Consequences: How the Mental Health Industry Fails The Mentally Ill.

For the past thirty years, Jaffe has been deeply involved in advocating for better care for the seriously mentally ill and his book provides a roadmap for what he is convinced needs to be done to rescue and reform our current system.

Jaffe became an advocate because of a family member. In his case, it was his wife’s younger sister, Lynn. What happened to Jaffe, his wife, Rose, and to Lynn has become an all too common story.

She started becoming paranoid, convinced that conversations taking place across the street involved plots to kill her…We took her to the emergency room. She was admitted, diagnosed, medicated, and provided rehabilitative therapy. But to “protect her privacy,” her doctor wouldn’t tell us her diagnosis, what medication she’d given Lynn, or what would happen when her hospitalization ended. Lynn returned home to us and stopped taking the antipsychotic medications we didn’t even know she’d been prescribed…”

Thus, Jaffe was thrust into our baffling mental health care system which he quickly found to be both frustrating and lacking. Determined to help change it, he began by knocking on the door of the National Alliance on Mental Illness, raising money for its New York City chapter and eventually joining its board. From there, he moved to the Treatment Advocacy Center where he became a strong advocate for Assisted Outpatient Treatment and a dedicated admirer of Dr. E. Fuller Torrey, one of TAC’s founders. More recently, he has launched his own organization, Mental Illness Policy. Org, which he describes as “a nonpartisan think tank that creates detailed policy analyses for legislators, the media and advocates.”

It is his untiring work as a self-admitted policy wonk that has made him a favorite of reporters eager to have someone explain or react to the newest unintelligible legislation that is churning its way through either a state or federal legislative body. Most recently, he worked closely with Rep. Tim Murphy (R. Pa.) and his staff in developing the Helping Families In Mental Health Crisis Act, which is designed to shift federal dollars away from what often are called “wellness” programs and focus on “the seriously mentally ill.” But let’s allow him to explain:

“America’s mental health system is insane, expensive, and ineffective. Under the guise of protecting civil rights, it is killing people. Under the guise of increasing freedom, it is increasing incarceration. Under the guise of facilitating recovery, it ensures that fewer recover. In the name of protecting privacy, it causes suicide. America treats the least seriously ill (“the worried well”) and forces the most seriously ill to fend for themselves. The ability to get help has become inversely related to need. We move sick people from hospitals to jails and label it progress. Government funds those who create the problems rather than those with solutions. The more dysfunctional the system becomes, the more money we throw at it. Our mental health system is not based on science and has nothing to do with compassion. As a result, there are ten times more people with mental illness incarcerated as hospitalized. Being mentally ill has essentially become a crime.” 

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You Need To Be Watching What Is Happening In Washington: A Big Shift Maybe Coming

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(5-2-17) First some great budget news.

Texas Senator John Cornyn, the Republican majority whip in the Senate, is putting federal dollars behind his  Mental Health and Safe Communities Act, that was signed into law during the final days of the Obama administration.

Because of the hoopla about Pennsylvania Republican Rep. Tim Murphy’s Helping Families in Mental Health Crisis Act, Cornyn’s legislation didn’t get as much attention as it deserved.

Getting a law passed and funding it can be two separate challenges.

Cornyn just got $2.5 million set-aside for supporting a dozen national Crisis Intervention Team training centers to help better prepare law enforcement officers for dealing with individuals in a mental health crisis.

In addition, he’s pushing for another $76 million in the new administration’s budget that could go to fund critical mental health programs. Including:  $43,000,000 for drug courts, $12,000,000 for mental health courts and adult and juvenile collaboration program grants, $14,000,000 for grants for substance abuse treatment for state prisoners and $7,000,000 for a veterans treatment courts programs

Bravo and a big Thank You to the Texas Senator!

Now the other important news in Washington D.C.

I know many of you are too busy putting out fires to read about the ongoing feuding over who will be named as the first assistant secretary for mental health and substance abuse. But you need to pay attention because whoever gets confirmed is going to be tasked with overhauling the Substance Abuse and Mental Health Services Administration (SAMHSA.) and that could make a huge difference in funding for future programs.

In the past week, I’ve been interviewed for background by reporters from the Wall Street Journal and Politico.  I’m reprinting Brianna Ehley’s latest post about the squabble as first printed in Politico Pro.

Trump’s nominee for mental health chief wants to shake up the agency

By Brianna Ehley, published in Politico Pro

Elinore McCance-Katz quit her job at the federal agency in charge of mental health programs two years ago over staunch disagreements with top officials about what she considered to be a flawed mission that neglected people with serious mental illness.

Two years later, the Trump administration hopes to bring her back to the agency to shake things up.

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