The 5th letter: what would you do

July 29, 2014 by

People With Mental Illness Need a Stonewall Inn

July 29, 2014 by

People With Mental Illness Need a Stonewall Inn | Psychology Today
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On the mental health system of poor people

July 28, 2014 by


This post was written a couple of years ago about the closing of the state hospital in Knoxville. Many of the points are still relevant to current issues.

Originally posted on Hopeworks Community:

Everything affects everything else which affects everything else. The
post below was written about the mental health system in Tennessee for poor people and how much being placed in a state hospital is as much a function of poverty as it is a function of mental health. It is a double edged sword. Mental health issues do play a role in poverty, but poverty plays a major role in mental health issue. What the post does not say that it would say if I wrote it know is that a major reason that we do so little about the mental health issues of the poor is that we do so little about them being poor. The gap between rich and poor is greater and all we do is dismiss them for “being lazy.”

We too have our “poor houses”. They are called hospitals, jails, homeless shelters and the streets. The…

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On the fraud of Murphy

July 27, 2014 by

The Murphy Bill has gotten a free pass on one issue, both by those who have issue with it and those who support it.  He paints the crisis in the mental health system in the broadest strokes with incredible numbers…. 300000 “mentally ill” in jail etc.  Then he offers his solutions.  Some of his ideas are other peoples.  He has tried to “buy” support by including ideas that have a lot of support like the Garrett Smith legislation.  The ideas that are his are the core of the problem:  Nationalization of AOT, increased psychiatric hospitalization, destruction of SAMSHA, and destruction of protection and advocacy programs.  The fair question (putting aside questions of the ethics of his bill) is does what he recommend have any likelihood of really affecting a problem the magnitude of what he describes.  The answer I think is a clear and resounding no.  His bill is a fraud, at best a pseudo solution that is likely to make real solutions even harder.

AOT in New York serves 2000 of the 685000 people in the system.  If you do the math that turns out to be 1/3 of 1%.  That would seem to indicate a couple of things to me:

1.  The biggest problem is not people refusing treatment.  That doesnt even begin to account for the amount of “mentally ill” in jail.  It is simply a distortion of the truth to claim otherwise.  If it shows anything it would seem to indicate that the treatment many have received is not always very effective.
2.  It would also seem fair to ask if criminal behavior is something more than a symptom of “mental illness”.  If it is for people without mental health issues is it not also true of people with mental health issues.  Doesnt it seem remarkably simple minded to ignore issues like poverty, unemployment, racism, gang involvement,  and many others and insist it can all be taken care of by the right medication.
3.  It costs 32000000 dollars a year to serve 2000.  What would it cost to serve many times that amount and in the end would that money not have to be taken from already existing programs.  And how then can the issue of developing more effective services even begin to be addressed?
4.  There is no indication in any of the 44 states that have AOT that it can ever be anything than a minimal part of the mental health system or that there is a need for it to be more than a minimal part of the system.
5.  Rep. Murphy has gotten a free ride with his dubious use of statistics.  He claims that 50% of those with serious mental illness  have anosognosia.  You look at New York and do the math with Murphy figures there should be 380000 with anosognosia.  There are 2000 in AOT.  Where are the other 378000?  People who spout nonsense with a phd behind there name are still full of nonsense.
6.  It matters what you commit people to.  There is nothing in the Murphy bill that recognizes that.  Committing someone to ride in a car with no gas will not get them anywhere they want to go.

Psychiatric hospitalization is an equally questionable answer.  It is way too little bang for way too little buck.  It costs way too much and does way too little for way too few.  The Tennessee experience is that it leaves the community system in poverty and stripped of resources.  Even the people who work in state hospitals would quarrel with the idea that more beds are the answer to what ails.  The psychiatric hospitalization ship sailed a long time ago.

Murphy is a lie for Tennessee.  If it passed tomorrow nothing would  be better.  You see Rep Murphy has no idea what is wrong.

Gun Violence? Blame the “Frustrated Entitled” | Trauma Informed Systems

July 27, 2014 by

Gun Violence? Blame the “Frustrated Entitled” | Trauma Informed Systems
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July 27, 2014 by


From the archives

Originally posted on Hopeworks Community:

Hafrada is a Hebrew word. It is a word for seperation and withdrawal. It refers to the Israeli policy of seperating the Israeli population from the Palestinian population by means of a big wall. We also have our walls. If actions speak louder than words then our actions say we believe in Hafrada. We believe in it every day.

Some of our walls are obvious. We use them to keep people in their place. Every black person in this country knows about hafrada. Every poor person does too. Some groups are perhaps slowly coming out from behind the walls. For some the walls have been there so long that people cant even see them anymore.

The mental health policy of this country was historically built on hafrada and in many ways it still remains.

The psychiatric hospitals of the past were tools of segregation. People went there to live and…

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Both/And: Dbsa President Allen Doderlain visits Tennessee

July 27, 2014 by

Over the last 3 days DBSA president Allen Doerderlain has visited Tennessee. Linda and I have had the pleasure to be his traveling companions over the much of that time.

More than anything it has been a conversation about community. So much about the conversation is either/or. It is about protecting the rights and ensuring a chance for better life for “consumers” or addressing the concerns of family members who feel hopeless to deal with the suffering of their loved ones and themselves. So much of the debate has been about how to help one at the expense of the other. There is a national debate right now about the Murphy Bill which makes me wonder if any solution that is either/or will really ever solve anything.

Allen met with people in Chattanooga, Maryville, and Nashville. Today he goes on to Jackson and Memphis. Everywhere there have been both family members and “consumers.” What has been most impressive to me has been nothing that he said to anyone although what he has had to say has been very important. It has been his commitment to speaking with people and his clear message that his trip is not about his importance but theirs.

He talked about information, empowerment, and inspiration. His message was about more than the fragility of survival. He spoke of the reality of thriving. It is, he said, possible for life to be easier, but that even when it was hard it could be better.

He talked about the power of information– that everything began with what you knew. That doesnt mean much without empowerment, the certain knowledge that you can and do have the right to make decisions about how to use that information to build the life you want. And finally inspiration: the faith we give each other and ourselves that choice makes a difference.

There was a lot of discussion about the reality of injustice as a fact of daily life for those with psychiatric labels. But, particularly, in Maryville, their was a lot of discussion about the pain of not knowing how to help the suffering of people you loved.

I saw a clear recognition, from many people I would have thought would never see, that a real solution had to be both/and. The real enemy was not “consumers” talking about their “rights” or family members talking about their pain. It was a society, a system that that sometimes does more harm than good, a system that often seems so inept and counter productive, and sometimes blind and uncaring. It was about a journey that we must all take together…. a journey today and tomorrow and the days after that. It is a journey about much more than Tennessee. It is a journey about you and me…. a journey everyday. It is a journey of hope…. a journey of realism…a journey for better life.

It has been a good few days. I have enjoyed the traveling. I look forward to the journey ahead.

On what we need to survive and even more important things

July 23, 2014 by

Originally posted on Hopeworks Community:

Sometimes we get so wound up in survival that we never realize that coping and living are not quite the same thing. We try so hard to control the negative things in our life that we forget or never even realize that the absence of negative things is not the presence of positive things.

It is the difference between coping and thriving. If you cant cope with the stress of everyday living, if it seems astronomical to get from the beginning of the day to the end without catastrophe then not much else happens. It is hard to make or maintain meaningful relationships and impossible to live the life you want or become the person you want to be. But coping is important because of what it allows us to more easily do. There is a difference between life defined by what is hard and life defined by what is…

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When you cant even find the tunnel let alone the light at the end: coping with trauma

July 22, 2014 by

Originally posted on Hopeworks Community:

What do you do when something bad happens and it simply isnt going to go away…..EVER.

What do you do when the impact of something negative, very negative is there and realistically is probably not going to ever go away?

Millions of people face that question everyday.  Tragedies are many, widespread and often unexplainable and if you can explain them you cant do anything about them.  What do you do?

It is more than an academic question for me.  Within the last 3 months tragedy has struck my life.  It has produced a change that I dont want that will probably always be there.  It has disrupted every level of my personal life.  It has affected my view of me, my view of life…everything.  It has made me question many fundamental assumptions of life that I hold dear.

It has been a war…. a war of the mind, the body…

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The diagnostic fallacy: on justice and dignity

July 21, 2014 by


From the archives

Originally posted on Hopeworks Community:

In regard to the DSM the biggest fallacy that I see is not the proposal for a better diagnostic system but the fallacy that any diagnostic system is going to make things better.  There is a difference in believing  that a diagnosis might tell you something useful about someone and believing that it can tell you something fundamentally true about him.  In the first instance the diagnosis is a map about a portion of someone’s experience which like all maps serves to guide you and inform you about how to make  decisions about what to do.  In the second the diagnosis is not a map to the truth, but the truth itself.  It leads you to the ultimately destructive conclusion that a person is what you have decided to call him.  The results in every form of human endeavor throughout history have proved time after time the tragedy of this.   The history of…

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Dear Rep Murphy: On the meaning of reprehensible

July 20, 2014 by

You say that it is morally reprehensible for anyone to help a patient question the medical advice a professional gives him.

Let me tell you about reprehensible.

Where I live bipolar disorder is as much a function of the doctor you go to as the symptoms you display. One doctor basically believes everyone is bipolar. He says that the fact he consults and does “education” for a pharmaceutical company has nothing to do with it. Another talks about people “feeling bipolar” to him. They never seem to have the right symptoms for the right period of time but still…. The psychiatrist at the psychiatric unit basically doesnt believe anyone is bipolar. He thinks it is way over diagnosed and way over-dramatized. He normally cures people from bipolar really fast. He just tells them they dont have it. Considering they deal in “medical science” that seems reprehensible to me. How do people know which expert not to question since the 3 of them sometimes tell the same people diametrically opposite things?

My sister in law was according to your terms “severely mentally ill.” She took her life 14 years ago but the illness didnt kill her. The treatment did. She was taking so many meds she had meds for her meds. She couldnt think a clear thought. She told me she was lost. Then she told me there was nothing left to find. Then she died. That was reprehensible.

I met a young lady who told me she had diabetes. She was 22. No family history. No risk factors. She told me she took risperodol for bipolar disorder. Strangely enough about a year later she stopped taking the meds. 4 years later she is doing fine. Was she troubled? Without question yes. Did she have serious issues? Probably. But did she have bipolar or pick doctors poorly? I dont know. She didnt pick diabetes. It was given to her. That is reprehensible.

I live in state that has over 80000 people with mental health issues without insurance because they have chosen not to expand medicaid. That is reprehensible. And it is totally reprehensible that you have voted over 50 times against the ACA while claiming to be an advocate for the very people you would deny medical coverage for.

People with “mental illness” die years earlier than those without. They by and large get lousy medical care. They get “cured” by medicines that for some have life altering consequences. That is reprehensible.

Over 60% of the people with a mental health diagnosis in my state are unemployed. In some states it goes over 90%. It is a result of systematic discrimination against labeled people. That is reprehensible. Never, not once, have I ever heard you address that. Without a job you dont tend to have insurance. You are more likely to become homeless. Your family is more likely to suffer.

You preach about the plight of the “mentally ill” in the jail but you never talk about the factors like poverty, drug addiction, trauma, gang involvement, racism and others that lead to criminal behavior. Largely your party is against any legislation that would affect any of those factors. That is reprehensible.

People are traumatized and hurt everyday in the penal system. Never, not once have I heard you address the abysmal track record of the treatment of the “mentally ill” in our jails. That is reprehensible.

To explain all this as “mental illness” and ignore the widespread injustice faced by so many is blaming the victim and so very Republican. And that is reprehensible.

You would raise the alarm about “crazy people with guns” and ignore the fact this country has a real and pervasive problem with gun violence. You ignore the deaths of thousands of people and seem to write it off as the price of us protecting our constitutional rights and that is so very, very reprehensible.

You ignore the fact that the “mentally ill” are much more likely to be the victim of violence than the perpetrator and in maintaining that prejudice make them more likely to be victimized and that is reprehensible.

You preach against the mental health system and paint SAMSHA as the source of all things bad. You ignore the fact that mental health systems are state creations. But while in one breath you slam the mental health system as being ineffective and almost criminal in the next breath you advocate for a bill that would force people to receive services from the same system you say is useless. You cant have it both ways. To try to smacks of political opportunism and outright fraud. And all of this is way past reprehensible..

You talk about psychiatric hospitalization like criminal behavior is the result of a defiency of hospitalization. The boat sailed a long time ago on hospitalization. They may indeed remain but they will never be the cornerstone of the system again. Other than perhaps crisis stabilization there is no proof they work and many people with lived experience will tell you they do much more harm than good. To even imply that people are against hospitalization because of maintaining their own financial interests in community programs is dishonest, libelous, and, you guessed it, reprehensible.

The budgets of mental health systems have been cut to the bone by state legislature after state legislature. It befuddles me that you dont even seem to recognise that in your prescription of problems. You seem to only see what is in your political interests to see. And that is reprehensible.

AOT is old news. Except New York which pours millions of dollars into, it basically lies fallow. It costs too much and does too little for too few. In New York it serves 1/3 of 1%. To pass it off as the essential piece of reform in a system needing widespread is at best a distortion and at worst a lie. And it is reprehensible.

And a final word (believe me much more could be said) in this country it is not reprehensible that someone would try to help someone else to protect their rights. It is reprehensible not to.


July 18, 2014 by

Living is sometimes so hard it makes it hard to write about it.  This blog is really important to me and it is really frustrating to feel like I am doing such a poor job with it.  Distance and perspective is really hard to find right now. 

My nephews death is really hard.  The police are saying it looks like he laid down in front of the train.  No one may ever know truly, but I think he slipped away and none of us knew he was slipping.  My brothers health is poor to begin with.  I fear Bennie will not be the only casualty.

The wear on Linda and I of our situation is real.  Finding a place for her to live is not the same as finding a way to live together.

We are being flooded with Tenn Care stories.  Their grief is real and many have never had anyone listen.  The suffering is horrific.  And I wonder more and more what world the governor lives in.

Another bad seizure night.  I cant sleep.

Dreams are not my friend tonight.

Tomorrow will be a new day.  My prayer is to find the newness in it.  I am so ready for new days.

4 Ways Mentally Ill Become “Athletes of the Mind” | Trauma Informed Systems

July 16, 2014 by

4 Ways Mentally Ill Become “Athletes of the Mind” | Trauma Informed Systems
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The problem with the Murphy Bill is not that it asks too much. It settles for too little

July 14, 2014 by

The problem with the Murphy Bill is not that it asks for too much, but that it settles for too little. It is a sterile view, narrow view of a catastrophic problem. It would have us rely on AOT as a major solution to the problem and ignore the fact that New York, the most friendly AOT state in the country, with all the pressure for it and all the money spent and all the machinery in place only serve 1/3 of 1% in their program. New York has the criteria for commitment Torrey and Murphy preach. They spend mega bucks. 1/3 of 1%. Even if you ignore all the issues and questions about it it is still trying to save the Titanic with a bailing bucket.

It would have us depend on psychiatric hospitalization. Again ignoring the questions about it as a practice, the idea that it is a possible solution is a cruel hoax by people who know better. The financial ship on psychiatric hospitalization sailed a long time ago.

Murphy ignores a central experience of countless people: being called mentally ill has drastic life consequences. Injustice is a major life experience for people with psychiatric labels. You are far less likely to have a job, far more likely to be without insurance, far more likely to get lousy medical care or none at all, far more likely to be homeless, far more likely to be a victim of violence, far more likely to be treated as a broken person, just far more likely.

A mental health reform bill that does not address justice is like a song without melody. Much ado about nothing.

Murphy is like a person with a microscope who forgets there is a larger world. He doesn’t propose a difference that makes a difference.

‘Bleak picture’ for mentally ill: 80% are jobless
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RIP Diagnostic Psychiaty

July 12, 2014 by

RIP Diagnostic Psychiaty: My Take on an Edge Question – Talking about Bipolar Disorder – Bipolar
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