Pete Earley

Is it possible for supporters of Mind Freedom,  the Bazelon Center for Mental Health Law, Mental Health America, the National Alliance on Mental Illness,  Mental Illness Policy and the Treatment Advocacy Center to have a civil discussion and reach a consensus about how everyone can work together to improve mental health care in America?

The Scattergood Foundation hopes so.

How would you design a mental health system?

Last year, Scattergood brought together several prominent mental health advocates for a conference and challenged them to identify the issues that cause dissent  and find ways to formulate solutions that would enable all of us to improve the delivery of mental health services to those who need them. Scattergood has now released two position papers and is seeking comments about both.

The subjects: liberty and privacy.

Dr. Lloyd Sederer and Dr. Michael Hogan will officially present the papers on May 5th to some four thousand attendees at the National Council on Behavioral Health conference in Washington D.C. and I have been asked to participate in a panel discussion about the paper’s findings and recommendations. Joining me will be consumer advocate Harvey Rosenthal, Dr. Harold Schwartz, Scattergood President Joe Pyle and the national council’s president and CEO, Linda Rosenberg , along with Dr. Sederer and Dr. Hogan.

If you visit the Scattergood’s website, you can read both papers and offer your comments. You can also fill out a poll that gives you a chance to state whether or not you strongly disagree or agree with the findings of the two papers.

While both are thought-provoking and well done, I suspect the paper on liberty — Liberty and Recovery: Resolving a Mental Health Dilemma — will most stir the pot. That’s because its authors endorse the use of Assisted Outpatient Treatment BUT ONLY after explaining that AOT should be used only as a last resort and would not be needed as frequently if decent community mental health services were put into place. The authors’ state:

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My friend, Dr. Dinah Miller, a Baltimore psychiatrist and one of the co-authors of the popular blog, Shrink Rap, has written about Steve Lopez’s follow up (that I posted Wednesday) to the ongoing Soloist story. Here is her take on Nathaniel Ayers.

NO EASY ANSWERS

Today’s post is brought to you by Steve Lopez of the LA Times and is located over on Pete Earley’s blog.  You can click HERE to read the touching story of Nathaniel Ayers, a talented musician who suffers from schizophrenia and does not want to take medication for his condition.  On his third court appearance, a judge appointed a relative as conservator for Mr. Ayers so that medications can be given.  It sounds, from the article, like Mr. Ayers had intolerable side effects to an older anti-psychotic medication and has never been willing to try the newer, atypical anti-psychotics which have more favorable side effect profiles –unless, of course, you’re the person having the side effects, in which case the “profile” may not matter.  Please read the article over on Mr. Earley’s blog, then come back here to read about my thoughts.

So I’m hoping that the story has a good outcome, and here are a number of things that may happen here.  I go from best possible outcome to worse possible outcome, and feel free to shuffle the order on the shades of gray:

• Best:  Mr. Ayers takes the medication, it works, his symptoms resolve, he feels better emotionally, and he is able to function better, and he has no side effects and decides he wants to continue it.  This would be the happy ending we all want to hear.
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What became of Nathaniel Ayers, the talented musician who was diagnosed with a severe mental illness and ended up homeless on the streets of Los Angeles? You will recall that he was the subject of Steve Lopez’s best selling book, The Soloist as well as the powerful movie based on that book.

Steve tells us in a thought-provoking column printed last night that explores the difficult choices that many of us with loved ones face.

A tough call on medication 

* Nathaniel Ayers has won victories in his battle to function despite schizophrenia. But he lands in a courtroom, and hard decisions await.

By STEVE LOPEZ,

Howard Askins grew up in New York, the son of blue-collar transit authority employees who expected him to go far, and he did. His first stop was Brown University, and then he was off to Harvard, where he earned both medical and law degrees before moving on to psychiatric residency at UCLA.

Nathaniel Ayers, like Askins, grew up working class — in his case, Cleveland was home. His dream was music, not medicine, and his hard work landed him at the prestigious Juilliard School for the Performing Arts in New York City, where he played for a time in the same orchestra as Yo-Yo Ma.

On Monday, the two African American men sat across from each other in a former pickle factory on San Fernando Road that serves as the mental health division of Los Angeles County Superior Court. The two have a deep mutual respect for one another, but a great difference of opinion.

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My parents believed that the Lord worked in mysterious ways and while I have struggled with my own religious doubts and beliefs, there are stories that sometimes cause me to wonder.

My good friend, Evelyn Stratton, shares one about her life in the YouTube video above. She describes how an anonymous couple played an important role in helping her parents become missionaries and how she unknowingly crossed paths with that family decades later as a Supreme Court justice. Her personal story begins 50 seconds into the video and lasts until 2:36. She then finishes the story at the 12:41 mark. You have to hear it to believe it! Sandwiched between this personal account,  she discusses her mental health advocacy.Click to continue…

The editorial board of  The Washington Post has endorsed the Helping Families in Mental Health Crisis Act introduced by Rep. Tim Murphy (R-PA) the only psychologist serving in the U.S. Congress.  In doing so, the newspaper takes a stand in a controversy that has split the mental health community in predictable ways.

The Post editorial writers noted:

 The Helping Families in Mental Health Crisis Act is more comprehensive than other recent efforts to reform the system and perhaps has the brightest prospects in a divided Congress. The bill would reorganize the billions the federal government pours into mental health services, prioritizing initiatives backed by solid evidence and tracking their success . It would change the way Medicaid pays — or, in this case, underpays — for certain mental health treatments. It would fund mental health clinics that meet certain medical standards. And it would push states to adopt policies that allow judges to order some severely mentally ill people to undergo treatment.

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