- Alternatives 2009 Health and Wellness Screening Report Available
- Comparative-Effectiveness Advocates Vow Better Outcomes Will Follow
- Mental health: Out of the cuckoo's nest
- National Mental Health Advocates Join
Hogg Foundation's Advisory Council
- Intervoice Letter to Parents of Children who Hear Voices
- Are you Depressed, or Just Human? By Dr. Andrew Weil
- In movie the "Soloist" a Homeless musician and LA
Times reporter show the power of peer support
- Psychiatric peer review touted: Care termed
a low-cost, effective alternative
- Peer-run Respites Free up Beds, Save Money:
Letter to the Editor by Cathy A. Levin
- Listening to Madness
- A talk with Judi Chamberlin
- Dan Fisher and Judi Chamberlin were
guests on MindFreedom Live Free
Web Radio
- Ruby Rogers passed away January 12th at the age of 71
- Jonathan Delman Receives Robert Wood Johnson
Foundation Prize
- Terrific Interview with two of our heroes, Sally Zinman and Jay Mahler
- Kennedy Center staff learns about hallucinations
- Hope and Recovery in Australia, by Dan Fisher
- We are the Light, We are the Change -Somos la luz, somos el cambio
My reflections on Alternatives 2007, by Dan Fisher
- Anne Beales Receives Member of the British Empire for Services to Mental Health
- Mental patients find understanding in therapy led by peers
- Secretary LaWare Announces Leadership Changes at AHS
- The evidence base for consumer-run services
- Hoyer Received Award at the National Council on Disability's 15th Anniversary Observance of the ADA
- State Mental Health Commissioners Say Seclusion and Restraint are Safety Interventions, Not Treatment Interventions
- Judi Chamberlin debates E. Fuller Torrey, MD on Involuntary Treatment
Alternatives 2009 Health and Wellness Screening Report Available
Currently, Americans who have major mental illnesses die an average of
twenty-five 25 years earlier than the general population (NASMHPD, 2006 and
other sources). They experience the largest health disparity in the United
States. Sixty percent of premature deaths are due to medical conditions such as
cardiovascular, pulmonary and infectious diseases which are frequently caused or
worsened by controllable lifestyle factors (physical activity, smoking, access
to adequate healthcare and prevention services, diet and nutrition, and
substance abuse as well as others). In responses to these alarming statistics,
the Substance Abuse and Mental Health Services Administration (SAMHSA), Center
for Mental Health Services which supports the annual Alternatives Conference to
provides a forum for peers from all over the nation to meet, to exchange
information and ideas, and therefore choose to offer effective proactive
strategies through a health and wellness screening service. The screening was
conducted on October 20-30, 2009 and was planned, coordinated and managed by
peer provider staff from the Institute for Wellness and Recovery Initiatives at
Collaborative Support Programs of New Jersey. The event was staffed by peers
with nursing and health care backgrounds. [Click
here to read the full report] (PDF, 56KB, 6 pages)
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Comparative-Effectiveness Advocates Vow Better Outcomes Will Follow
The additional research on treatment options will not be able to meet its
stated aim of improving mental health care treatment outcomes, however, unless
it includes a range of options, maintain some mental health experts. For
psychiatrist Daniel Fisher, M.D., Ph.D., those options should include
patient-centered care and the use of “patient peers” in treatment. [Click
here to read the article]
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Mental health: Out of the cuckoo's nest
 A
radical US advocate for psychiatric patients' rights brings to the UK his
first-hand message that a diagnosis of mental illness is not a life sentence
"Dan Fisher, a prominent psychiatrist who is advising the Obama administration
on mental health issues, has been on a personal mission for two decades to
change the way wider society understands and reacts to mental illness. An
advocate of the "recovery model" – which posits that a diagnosis of mental
illness is not for life, and that people can recover completely – Fisher is an
outspoken and controversial figure in the US, campaigning vigorously for the
rights of people diagnosed with a mental illness." [Click
to read the full article]
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National Mental Health Advocates
Join Hogg Foundation's Advisory Council
AUSTIN, Texas Renowned mental health experts and consumer advocates Dr.
Daniel Fisher and LaVerne Miller, Esq., have been appointed to the National
Advisory Council of the Hogg Foundation for Mental Health.
The 10-member council advises foundation staff on strategic direction and
potential funding initiatives. Council members have Texas-based or national
expertise in mental health, consumer advocacy, philanthropy and other fields
related to the foundation's mission of promoting the mental health of all
Texans.
"We are honored and privileged that these prominent, influential and informed
leaders have agreed to serve as advisers to the foundation," said Executive
Director Dr. Octavio N. Martinez Jr. "Their knowledge and wisdom will help shape
the foundation's initiatives and help to promote consumer, youth and family
engagement in Texas."
 Fisher
is a board-certified practicing psychiatrist and executive director of the
National Empowerment Center. He has recovered from schizophrenia, dispelling the
myth that people do not recover from mental illness. His recovery and work in
the field were recognized by his selection as a member of the White House
Commission on Mental Health.
He co-developed the Empowerment Model of Recovery and the PACE/Recovery
program to shift the system to a recovery orientation. He conducts workshops,
gives keynote addresses, teaches classes, and organizes conferences for
consumers/survivors, families and mental health providers to promote recovery of
people labeled with mental illness by incorporating the principles of
empowerment. He helped organize the National Coalition of Mental Health
Consumer/Survivor Organizations, a national network of mental health consumers,
and through that role has consulted with the Obama administration.
Fisher is a recipient of the Clifford Beers National Mental Health
Association Award and the Bazelon Center for Mental Health Law's Advocacy Award.
He received his M.D. from George Washington University and completed his
residency at Harvard Medical School. He also has a Ph.D. in biochemistry from
the University of Wisconsin and an AB from Princeton University.
 Miller
is an attorney and consultant whose career has centered on mental health and
social justice. Following years of severe depression, Miller realized that
finding meaningful work and peer support were critical for her own recovery as
well as for many other consumers.
She works with Policy Research Associates and the federal Center for Mental
Health Services to increase consumer, youth and family engagement and
involvement in state initiatives and activities supported by federal mental
health transformation grants. From 1996 to 2008 she was director of Howie T.
Harp Peer Advocacy Center in Harlem, which trains consumers with histories of
homelessness, mental illness and incarceration and promotes recruitment, hiring,
retention, integration and advancement of consumers in the workforce.
Miller previously was an assistant district attorney in Manhattan, a
community organizer and housing advocate in Queens, and co-chair of the New York
City Federation for Mental Health, Chemical Dependency, Mental Retardation and
Developmentally Disabled. She is a graduate of the University of Pennsylvania
and Northeastern Law School.
The Hogg Foundation was founded in 1940 by the children of former Texas
Governor James Hogg to promote improved mental health for the people of Texas.
The foundation's grants and programs support mental health consumer services,
research, policy analysis and public education projects in Texas. The foundation
is part of the Division of Diversity and Community Engagement at The University
of Texas at Austin. [View as
Article...]
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| We write this letter primarily for parents and
care givers, in the hope that it will enable them to develop a new and
more empowering way of thinking about their children’s experiences, and
that it will help them to find ways to help those children with their
emotional development and with recovering from being overwhelmed by
hearing voices. Please sign on to this letter to express your support by
emailing your name, location, and organization to
admin@intervoiceonline.org. |
Intervoice Letter to Parents of Children who Hear Voices
Open letter to Oprah Winfrey in response to her program
about “The 7-Year-Old Schizophrenic”
From: Paul Baker -
Coordinator of INTERVOICE, Spain - 10/19/2009
Dear Oprah
We are writing this letter in response to your program about “The 7-Year-Old
Schizophrenic”. This concerned Jani, a child who hears voices, and was broadcast
on the 6th October 2009.
We do so in the hope we can provide a more hopeful and positive alternative
to the generally pessimistic picture offered by the members of the mental health
community featured in the program, and in the accompanying article on your
website.
What upset us most and moved us to write the letter, is that, as a result of
the program, parents of children who have similar experiences to Jani will be
left with the impression that they are powerless and will not be able to do
anything constructive to help their children to come to terms with their
experience of hearing voices.
For it is simply not true that nothing can be done.
We say this because we have been researching and working with adults and
children like Jani and their parents for the last twenty years, and in doing so
have reached very different conclusions from the ones reported on your program.
We write this letter primarily for parents and care givers, in the hope that
it will enable them to develop a new and more empowering way of thinking about
their children's experiences, and that it will help them to find ways to help
those children with their emotional development and with recovering from being
overwhelmed by hearing voices.
Unfortunately, there is very little practical advice available about children
who hear voices which addresses the needs of parents or other members of the
family. This is a shame because they are the most important form of support to
such children. So, we want you to know that there are some simple commonsense
things that parents can do to help children who hear voices - even children in
seemingly hopeless situations, like Jani. [Read
full letter with signatures from 136 people in 16 countries]
top of page
Are you Depressed, or Just Human? By Dr. Andrew Weil
Many cultures find the American insistence on constant cheerfulness and pasted-on smiles disturbing and unnatural. Occasional, situational sadness is not pathology -- it is part and parcel of the human condition, and may offer an impetus to explore a new, more fulfilling path.
[Read more at:
www.huffingtonpost.com/andrew-weil-md/are-you-depressed-or-just_b_307734.html]
top of page
In movie the "Soloist" a Homeless musician and LA
Times reporter show the power of peer support
In their chauffeur-driven limousines the celebrity guests headed back to their
mansions after the premiere of new Oscar favourite The Soloist. But as they
drove off towards the Hollywood hills the real star of the $150m movie set off
in a different direction - back to a homeless shelter on the edge of one of Los
Angeles' most dangerous ghettos. [Click
to view story]
top of page
Psychiatric peer review touted: Care
termed a low-cost, effective alternative
People with psychiatric illness get better care from other people with a
psychiatric history than from traditional doctors and psychologists in a
traditional medical setting, according to Daniel B. Fisher. [Click
to read full article]
Peer-run Respites Free up Beds, Save Money:
Letter to the Editor by Cathy A. Levin
Congratulations on “Psychiatric peer review touted” (Telegram & Gazette, July
20), the comprehensive article on proposed peer-run crisis alternatives for
people experiencing emotional distress, which would help reduce the strain on
emergency departments and inpatient hospitals. David Matteodo, a lobbyist for
private psychiatric hospitals, is quoted as saying alternatives to psychiatric
hospitals should be regulated. [Read
more...]
top of page
Listening to Madness
Why some mentally ill patients are rejecting their medication
and making the case for 'mad pride.'
They Don't Want To Be Normal
Click to view
artworks by the "mad pride" movement
We don't want to be normal," Will Hall tells me. The 43-year-old has been
diagnosed as schizophrenic, and doctors have prescribed antipsychotic medication
for him. But Hall would rather value his mentally extreme states than try to
suppress them, so he doesn't take his meds. Instead, he practices yoga and
avoids coffee and sugar. He is delicate and thin, with dark plum polish on his
fingernails and black fashion sneakers on his feet, his half Native American
ancestry evident in his dark hair and dark eyes. Cultivated and charismatic, he
is also unusually energetic, so much so that he seems to be vibrating even when
sitting still. [Click to view full NEWSWEEK article published May 2, 2009]
top of page
From the Boston Sunday
Globe, 3/22/2009
A talk with Judi Chamberlin
 Facing
death, a plea for the dignity of psychiatric patients
Interview by Carey Goldberg:
"NOTHING ABOUT US WITHOUT US." That is the motto of a grass-roots
movement that has carried various names over the last generation, but has always
revolved around a single principle: self-determination for people diagnosed with
mental illness. Call them psychiatric patients or consumers or survivors, they
are fighting together to gain more control over their treatment, and more say in
the mental health system overall. And they have won some striking successes in
recent years, gaining more input into official policy and creating new jobs for
people who, 12-step-style, have recovered from the worst of their illness and
now want to help others in crisis.
The mother of that movement, many people would say, is Judi Chamberlin of
Arlington. [Click
to view Judi's page] top of page
Dan Fisher and Judi
Chamberlin were guests on
MindFreedom Live Free Web Radio
Every second Saturday,
MindFreedom International executive director David Oaks hosts
MindFreedom Free Live Web
Radio on BlogTalk Radio with
topics that include: Mad Pride, alternatives to traditional mental health care,
and campaigns for human rights in psychiatry. On his March 14, 2009 show, he
interviewed two special guests:
 DAN FISHER, MD psychiatric survivor and psychiatrist, was one of
two
key advisors to Barack Obama's presidential campaign about mental
health issues. Dan will talk about his goals for the mental health
system under the Obama administration, and about his recent
international organizing in Australia/New Zealand.
JUDI CHAMBERLIN is an historic leader in the movement led by
mental
health consumers and psychiatric survivors. Judi has publicly
announced that because of severe health problems she is now in
hospice with a life expectancy that is not very long. Judi will try
to answer your questions on air, but if her health prohibits this we
will play a specially-recorded message from Judi to you.
DAVID W. OAKS has worked for more than three decades as a human
rights activist in the field of mental health. He directs the nonprofit
MindFreedom International.
Dan, Judi and David all met in the "mad movement" in the 1970's
in
Massachusetts. On the show, they also exchanged a few stories about our roots.
To listen to the archived show, go to:
www.blogtalkradio.com/davidwoaks.
top of page
Ruby Rogers passed away January 12th at the age of 71
Ruby was the lead plaintiff in Rogers v. Okin, a 1979 case brought before
the Massachusetts courts. The landmark ruling established key rights for the
mentally ill in Massachusetts who until then could not refuse medical
treatment once they were committed to a State facility.
Judi Chamberlin, co-founder of the Ruby Rogers Mental Health and Advocacy Center in Somerville, MA speaks of Ruby Rogers:
When we decided to name the Center after Ruby we asked her permission, and
she was quite honored. As I recall, she came to the dedication.
Ruby had a very difficult life, but she was quite aware that she played a
pivotal role in establishing rights for patients in Massachusetts mental
hospitals.
She also had a sly sense of humor. When she heard that I had written a book,
she told me "I wrote a book, too," giving me a look that let me know she was
putting me on. Judi
Ruby Rogers; helped win key rights for mentally ill
By Bryan Marquard - Globe Staff / February 20, 2009
In Turners Falls, nearly 100 miles west of where she spent decades confined
in Boston psychiatric facilities, Ruby Rogers died quietly in a nursing home, a
relatively anonymous end for a woman whose name is routinely invoked during
Massachusetts court hearings involving the mentally ill.
"They said she just lay down and went to sleep," said her sister, Claudette
Smith of Dorchester.
Ms. Rogers, who spent her last years at the Farren Care Center, left a sweeping
legacy that established key rights for the mentally ill in the Commonwealth.
Click to read the
full obituary at the Boston Globe
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Jonathan Delman Receives Robert Wood
Johnson Foundation Prize for
Local Innovation in Improving Health and Health Care
The Robert Wood Johnson Foundation recently announced the 2008 recipients of
the Community Health Leaders (CHL) Awards. The CHL Award honors unrecognized
individuals who overcome daunting odds to improve the health and quality of life
for underserved men, women and children in communities across the United States.
 Jonathan Delman, Executive Director, Consumer Quality Initiatives, Roxbury,
Massachusetts and nine others were selected because they "dedicated themselves
to tackling some of the most intractable problems affecting the health of their
communities". They join a distinguished list of 150 previous award recipients.
"Jonathan Delman has struggled with mental illness his entire adult life. Despite
facing everyday stigmas surrounding his mental illness, Delman has chosen to
help others like himself to improve their experiences. He founded Consumer
Quality Initiatives, which partners with consumers and academics to conduct
high-quality research on people’s experiences with mental health services. He
then provides the results to policy makers and service providers to help them
improve services. His work has changed the way the Massachusetts Department of
Mental Health cares for residents with mental health issues."
Click to view Robert Wood Johnson Foundation - Community
Health Leaders Awards article with full list of award recipients
Click to view 11/2/2008 Boston Globe article - Man battles own mental illness,
wins leadership prize
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Terrific Interview with two of our heroes, Sally Zinman and Jay Mahler
Conducted
by the Rev. Barbara F. Meyers the producer of a public access TV show called Mental
Health Matters - Alameda County. The half-hour shows focus on various
aspects of mental health. In June 2008 they focused on the Consumer
Movement. [Click
to view video]top of page
Kennedy Center staff learns about hallucinations
The voices were distracting her. O'Rourke, counseling services coordinator at the Kennedy Center, was one of many center employees who participated in "Hearing Voices," a workshop designed to show the center's staff what life is like for someone with auditory hallucinations. [Click for more on Hearing Voices]
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Hope and Recovery in Australia
By Daniel Fisher, M.D., Ph.D. - May 23, 2008
 I spent three very busy, exciting days in Melbourne, Australia, in connection with a conference on recovery. From May 7 through May 9, 2008, I was immersed in the world of the Australian consumer movement as it is gaining its voice of recovery. The conference was sponsored by a psychosocial provider organization, Vicserv. The energy and creative contributions to the conference came from us -- the consumers. This phenomenon was recognized by a provider who was overheard telling another provider she was glad there were so many consumers attending, but did not come to hear them speak up so often. These providers were used to consumers being seen but not heard. Out of the 800 attendees, perhaps 100 were self-disclosed consumers. In addition there were scores of others who only felt comfortable to disclose privately to myself or other consumer speakers. They were fearful that a public disclosure would have a negative impact on their career. One such consumer/provider suggested a national day of disclosure to reduce the stigma associated with the label.
My involvement began the day leading up to the conference. I wrote a piece for the Vicserv publication, Paradigm, about the importance of the consumer voice in systems transformation. [More on Dan Fisher's trip to Melbourne]
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We are the Light, We are the Change
Somos la luz, somos el cambio
My reflections on Alternatives 2007, by Dan Fisher
 “We are the light, we are the change,” summarized my feelings about this excellent Alternatives. These are the words that our institute ended with. As those of us on the panel spoke the words, “we are the light, we are the change,” we reached out to the audience and one by one they reached back and held our hands. They picked up the chant. They in turn reached out and held the hands of their neighbors, who in turn picked up the chant. Large smiles spread across our faces. Then a Latina consumer led us in the same chant in Spanish. “Somos la luz, somos el cambio.” As we all entered into the Spanish version, the electricity between us intensified. Soon you could see by our expressions we were all feeling a new sense of joy. I could feel words bringing all my senses together, my feelings were welling up, my heart was brimming over, my thoughts were free to flow, and my skin felt the warm glow of spirits meeting spirits. We all ended by hugging and holding the feelings. I truly feel that the spirit of those words reflected the feeling of Alternatives 2007.
The institute “Getting a place at the table and gaining a voice” was presented by Joe Rogers, Sharon Kuehn, Lauren Spiro and myself. We also had two international consumer leaders who joined us by internet: Jenny Speed, Deputy Director of the Australian Mental Health Consumer Network, and Anne Beales, Management committee member of the National Survivor User Network (of England). The institute started with each of us sharing our story of how we came into the movement and the work we do. [More on Alternatives 2007]
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Anne Beales Receives Member of the British Empire for Services to Mental Health
By Dan Fisher - December 10, 2007
 A very effective consumer advocate, Anne Beales, whom I met in Canada in August, 2007 has been awarded the important MBE by Queen Elizabeth. Anne has coordinated the formation of a national network of mental health consumers across England similar to the National Coalition of Mental Health Consumer/Survivors we are forming here. Anne is working with me and leaders from other countries to form an International Coalition of Mental Health Consumer/Survivors.
The following is a news release of the event:
Brighton [UK] -based campaigner Anne Beales has been awarded an MBE for services to mental health. A long-standing campaigner for mental health, Anne has fought tirelessly over many years to improve access to mental health services and the rights of those with mental health needs. (Click for more on Anne Beales)
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Forgotten Suitcases, Emotional Baggage
A history of mental-health treatment, told through
lost souls, at the New York Public Library.
A New York Times Article, December 7, 2007. The Lives They Left Behind -
Suitcases from a State Hospital Attic,
View online exhibit from the Community Consortium.
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Mental patients find understanding in therapy led by peers
By Carey Goldberg, Boston Globe Staff | June 8, 2007
TAUNTON -- Years ago, Jess Zaller came to the Pathways mental health program as a day patient. In and out of institutions, he had fought mental illness since childhood. His life felt like a nightmare of chaos and despair.
Zaller, 45, was back in a Pathways therapy group last week, but this time as a leader, listening carefully as members laid bare the pain of their fears and compulsions. When he delicately pointed the way, it was often in the first person, using his own hard lessons learned:
"Our lives are at stake," he told members. "It takes a lot of courage to walk a path of recovery, and each one of us develops our own path."
Massachusetts is beginning to develop a corps of people like Zaller who have been through the depths of schizophrenia, bipolar disorder, or depression, and recovered enough that they can help others with mental illness.
Such comradely aid has long been exchanged informally, or scattershot at mental health venues. But now the state has launched a new job category -- certified peer specialist -- meant to formalize these relationships and gradually, they hope, get peer counseling reimbursed routinely by insurers and Medicaid.
"There's something about receiving support from someone who's gone through exactly what you're going through now that people find invaluable," said Michael O'Neill, the state's assistant commissioner for mental health services.
A few handfuls of Massachusetts residents, including Zaller, have completed the eight -day training session and exams to be certified as peer specialists. On Monday, they are to be recognized at a State House ceremony.
The new field must work through many possible problems, from the potential for relapse among specialists to the potential for resistance from more traditional mental health staffers. But O'Neill expects the state's corps to grow to hundreds.
Massachusetts is redesigning its mental health system to be more user-friendly, he said, and "peer support is a fundamental element of that redesigned system." In the coming months, Massachusetts will be setting up six regional centers where peer specialists will work with clients and support each other in their fledgling vocation, O'Neill said .
The concept has taken off in 30 states. In half a dozen, Medicaid, the public insurance program for the poor and chronically ill, pays for the services, said Paolo del Vecchio, associate director for consumer affairs at the federal government's Center for Mental Health Services.
"Over the past five years, we've really seen the development of a new mental health profession emerging," he said.
The growth of the peer specialist profession comes against the backdrop of a sweeping national shift toward greater optimism that those in dire condition may improve or recover, and toward giving people with mental illness more control over the help they get. People with mental illness are not passive patients, the thinking goes; they can help themselves and as they get better, they can help others .
In their work, peer specialists are expected to share their stories of recovery when relevant to their clients. They may have learned skills worth sharing, or simply inspire hope by being much better than they once were.
The work goes beyond a typical speaker at a 12-step meeting.
It can include helping a patient in a psychiatric hospital make the shift back to living at home, or supporting an emergency room patient in crisis. A specialist might remind a team of clinicians that their patient is in a kind of hell, or take a lonely client out for pizza.
Early research, which is just beginning to accumulate, suggests that peer specialists may be particularly useful with patients who would normally resist help from the mental health system, said Larry Davidson, a Yale professor who conducts studies on peer specialists.
People with mental illness sometimes feel disliked by the professional staff who treat them, he said; it appears that with peers, "they feel less disliked and more understood."
Studies show that "people in recovery can provide services at least as well as people who don't have that experience," Davidson said. Hard data are being collected now on whether they offer "value added," he said.
Anecdotal reports of successful work by peer specialists abound. In Georgia, which has 340, they have proven particularly useful in helping discharged state hospital patients build new lives at home, said Gwen Skinner, the state's top mental health official.
Though the new field is growing, resistance remains, Davidson and others said. They worry that staff and clinicians without mental illness could feel threatened by the influx of newcomers whose experience with illness is considered an asset. Traditional staff could also worry about being replaced by peer specialists. Certified peer specialists are supposed to earn a typical mental health staff salary of $12 an hour to $15 an hour on an entry level, said Deborah Delman executive director of M-Power, the Massachusetts mental health advocacy group that runs the peer training courses. But some peer workers who are not certified may earn less, she said.
After they are certified, Massachusetts peer specialists will continue to be overseen by The Transformation Center, a statewide training organization that is supposed to ensure they maintain ethical standards and continue their education.
The peer specialists also pose staffing issues. What if, for example, a peer specialist works with patients at a state hospital, then has a relapse and is rehospitalized there, then resumes the job? Boundaries and definitions may get fuzzy; confidentiality may become a concern.
Also, Davidson said, if supervisors view their patients as problems, then adding peer specialists to their staff is asking for more problems. The challenge, he said, is for them to shift to thinking about all people with mental illness as "having assets and strengths to help solve problems."
Judging by responses in Zaller's small therapy group in Taunton, some people with mental illness immediately see the benefits of being helped by a peer.
"He's not looking at us through a book," said one group member, Diane Silvia. "He can relate to us, and we can relate to him."
Carey Goldberg can be reached at goldberg@globe.com - © Copyright 2007 Globe Newspaper Company.
**In accordance with Title 17 U.S.C. section 107, this material is distributed without charge or profit to those who have expressed a prior interest in receiving this type of information for non-profit research and educational purposes only.**
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Meds Alone Couldn’t Bring Robert Back
Experts like to debate the effectiveness of new drugs, but they overlook a key element of recovery. February 6, 2006 issue of Newsweek, by Jay Neugeboren
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Michael Hartman Appointed Commissioner of Mental Health, & Beth Tanzman Named Deputy Commissioner of Mental Health
Waterbury, Vt. – Agency of Human Services (AHS) Secretary Cynthia D. LaWare today announced several new appointments in the Agency. Michael Hartman was appointed Commissioner of the new Department of Mental Health (DMH), Beth Tanzman was named Deputy Commissioner of Mental Health and Brendan Hogan will serve as the new Deputy Commissioner of the Department of Disabilities, Aging and Independent Living (DAIL).
"These new appointments will help make Vermont stronger than ever in the service of individuals with mental illness, individuals with disabilities and our aging population," said Secretary LaWare. "In his role as Deputy Commissioner, Michael Hartman has impressed policy makers, service providers and consumers alike with his wealth of experience and thoughtful, decisive leadership style. I know he will make an outstanding Commissioner of Mental Health. And Michael will be ably assisted by Beth Tanzman, a proven leader whose professional credentials, determination and patience has almost single-handedly kept the Vermont State Hospital Futures Project moving forward. Brendan Hogan's in-depth knowledge of Medicaid and Medicare and his experience at the Office of Vermont Health Access (OVHA) will be a tremendous asset to DAIL and the individuals they serve."
Hartman was appointed Deputy Commissioner for Mental Health, in December, 2006, when Mental Health was under the Vermont Department of Health. Prior to that appointment, he served since June 2000 as Director of Community Rehabilitation and Treatment/Intensive Care Services at Washington County Mental Health Services, Inc. in Montpelier. He was also the Executive Program Director of Collaborative Solutions Corporation. CSC is the new service provider that established Second Spring, an 11 bed Community Recovery Residential facility in Williamstown, Vermont, which opened this spring. Since 1998, he has been an Adjunct Faculty member of the Southern New Hampshire University Program in Community Mental Health, Burlington site. Hartman has over 25-years of experience in the mental health and social work arena in Vermont. Hartman received his BA from Goddard College in 1982 and his Masters in Social Work from the University of Vermont in 1998. He is a resident of Montpelier.
Beth Tanzman has worked and consulted in public mental health systems for 18 years. Since November, 2005 she has directed the Vermont Mental Health Futures Project, a strategic planning process for the continued transformation of Vermont's public mental health system towards a consumer-directed, trauma-informed, and recovery-oriented system of mental health care. In this leadership role, Tanzman works collaboratively with all stakeholders in Vermont's mental health system to replace the existing 54-bed inpatient capacity of the Vermont State Hospital (VSH) with a new array of inpatient, rehabilitation, and residential services for adults. Prior to this, she served as director of Vermont's Adult Community Mental Health Services where she was a key leader in Vermont's mental health system change efforts. Before working for the State of Vermont, Tanzman was a consultant and researcher with the Center for Community Change through Housing and Support. Tanzman served as Chair of the National Association of State Mental Health Program Directors (NASMHPD) Adult Services Division (2000-2002) and is active in the national Evidence-Based Practices research and implementation. Tanzman received her BA from the University of Vermont in 1984 and her Masters in Social Work from State University of New York, Albany in 1988. She resides in Burlington. top of page
The evidence base for consumer-run services
"Grading the Evidence for Consumer-Driven Services." The UIC National Research and Training Center is offering this workshop as part of its National Web-Based Education Program. The speakers, Drs. Judith Cook, Jean Campbell, and Lisa Razzano discuss the evidence base for consumer-operated, delivered, and centered services, where people control the kinds of help they get, from whom, and in what settings. They present the evidence grading pyramid, along with the specific levels of evidence for models such as recovery self-management, drop-in centers, advance directives, and self-directed care. A special focus of this web cast is on the results of the national multi-site research study of consumer-operated service programs or COSP, directed by people in recovery and funded by CMHS. To view the web cast and download transcripts and slides, visit the Center's website at: www.psych.uic.edu/uicnrtc/webcast1.htm. The Center is supported by NIDRR and CMHS. top of page
Hoyer Received Award at the National Council on Disability's 15th Anniversary Observance of the ADA
Congressman Steny H. Hoyer (D-MD) was awarded the George Bush Medal for the Empowerment of People with Disabilities on July 25th, 2005, at the National Council on Disability's 15th Anniversary Observance of the Americans with Disabilities Act (ADA). Former President George H.W. Bush presented him with the award at an evening gala at the Kennedy Center for the Performing Arts in Washington, DC. In recognition of her years of cross disability advocacy, NEC's Judi Chamberlin was an invited guest. On the actual anniversary date, July 26th, NCD sponsored a seminar consisting of a number of workshops addressing various aspects of the ADA, at which a number of government officials spoke, including A. Kathryn Power, Director of the Center for Mental Health Services.
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State Mental Health Commissioners Say Seclusion and Restraint are Safety Interventions, Not Treatment Interventions
On July 13, 1999 the membership of the National Association of State Mental Health Program Directors (NASMHPD) approved a position paper on seclusion and restraint. The first two and a half paragraphs of the position paper read as follows:
NASMHPD Position Statement on Seclusion and Restraint
"The members of the National Association of State Mental Health Program Directors (NASMHPD) believe that seclusion and restraint, including "chemical restraints," are safety interventions of last resort and are not treatment interventions. Seclusion and restraint should never be used for the purposes of discipline, coercion, or staff convenience, or as a replacement for adequate levels of staff or active treatment.
The use of seclusion and restraint creates significant risks for people with psychiatric disabilities. These risks include serious injury or death, retraumatization of people who have a history of trauma, and loss of dignity and other psychological harm. In light of these potential serious consequences, seclusion and restraint should be used only when there exists an imminent risk of danger to the individual or others and no other safe and effective intervention is possible. P> It is NASMHPD's goal to prevent, reduce and ultimately eliminate the use of seclusion and restraint..."
To request a copy of this position paper contact the National Association of State Mental Health Directors' at 703-739-9333 or write them at 66 Canal Center Plaza, suite 302, Alexandria VA 22317 or you can contact them via their website at http://www.nasmhpd.org
State Medical Directors' Council Says Seclusion and Restraint are Security Procedures and are NOT Medical Treatments
During February 18 -19 1999 a meeting was held in Atlanta Georgia. Participants included two state mental health commissioners/directors, five state medical directors, two representatives from state offices of consumer affairs, and representatives from other NASMHPD divisions, affiliates and staff. A report on reducing the use of seclusion and restraint was generated and a final draft was approved by the Medical Directors Council and published in July 1999. The paper is called, "Reducing the Use of Seclusion and Restraint: Findings, Strategies and Recommendations." To request a copy of this position paper contact the National Association of State Mental Health Directors' at 703-739-9333 or write them at 66 Canal Center Plaza, suite 302, Alexandria VA 22317 or you can contact them via their website at http://www.nasmhpd.org
Under the section of the report titled "Problem Statement: Definition of the Issues and Consensus Reached by Participants," the following was written on pages 3 and 4:
"Definition of the Issues
The issues raised by the use of seclusion and restraint in the mental health system go far beyond a narrow focus on the techniques involved in the use of these interventions. The overutilization of seclusion and restraint can be seen as a symptom of a larger problem in the culture of the clinical environment. An effective approach to this issue will, therefore, need to include consideration of clinical and cultural issues."
"Misapplication of the techniques of seclusion and restraint creates safety problems for both the individual and the staff involved. The rate of work-related injuries is higher in mental health than in the construction industry, and more staff injuries occur during the implementation of seclusion and restraint than occur from unexpected assaults. Thus this report will take a broad, inclusive approach to the issue of the use of seclusion and restraint, attempting to convey some of the complexities involved. The report begins with a discussion of prevention and early intervention, and then identifies standards for safe and effective implementation."
"In a fundamental way, this issue is about how mental health systems treat the people they serve. If the goals of the public mental health system are to treat people with dignity, respect and mutuality, to protect people's rights, to provide the best quality care possible, and to assist people in their recovery, any use of seclusion and restraint must be rigorously scrutinized. Many people enter the mental health system for help in coping with the aftermath of traumatic experiences. Others enter the system in hope of learning how to control symptoms that have left them feeling helpless, hopeless, and deeply fearful. Still others enter the system involuntarily. In these cases, the need for treatment has been expressed by the committing authority, not by the recipient. Any intervention that recreates aspects of previous traumatic experiences or that uses power to punish is harmful to the individuals involved. In addition, using power to control people's behavior or to resolve arguments can lead to escalation of conflict and can ultimately result in serious injury or even death."
"Consensus Reached by Participants
Given that seclusion and restraint are virtually always experienced by the individuals involved as traumatic, put both staff and patients at risk, and can seriously jeopardize the treatment milieu, are there ever instances when these interventions are justified? It was a consensus of those present that seclusion and restraint are justified only if they are being used for the clearly defined purpose of maintaining safety and if all other, less intrusive interventions have failed. Clearly, these factors will vary according to setting, with acute care and emergency room settings presenting a different challenge from long-term care settings. For example, substance abuse is more likely to be a complicating factor in emergency room settings than in long-term care facilities. Similarly, the justification for the use of seclusion and restraint may vary over time even within the same setting, depending on what other alternatives have been tried and on other factors affecting the basic safety of the unit."
"Regardless of the context, is critical that seclusion or restraint be used only as a "last resort measure" to maintain safety. Substantial care must be taken to define the situations in which safety concerns are strong enough to justify the use of seclusion and restraint. Seclusion should be used only in situations of imminent risk to self or others or serious disruption to the treatment milieu, restraint only in situations of imminent risk. Neither technique should ever be included as part of an individual's treatment plan, or as part of the day-to-day management of a unit. Finally, these interventions should under no circumstances be used as a threat, either implicitly of explicitly, nor should they ever be used as punishment."
"Seclusion and restraint should be considered a security measure, not a form of medical treatment. However, given the medical risk of serious injury or even death posed to recipients, the use of seclusion and restraint should be medically supervised."
"In addition to seclusion and restraint, it is imperative that other forms of control be closely monitored to ensure that one potentially abusive practice is not substituted for another. In particular, the use of emergency psychotropic medications should be closely monitored. When used properly, psychotropic medications can be helpful in treating agitation due to mental illness, allowing a complete clinical and medical assessment to be done. However, drugs should not be used solely to immobilize or sedate people as a mechanism for control. Over-medication and polypharmacy are of particular concern with children. Similarly, the use of law enforcement and stringent behavioral programs, while appropriate under some circumstances, should always be monitored to prevent misuse."
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Judi Chamberlin debates E. Fuller Torrey, MD on Involuntary Treatment
Should Forced Medication be a Treatment Option in Patients with
Schizophrenia? [more]
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