Murphy stuck????

April 23, 2014 by

GOP Newtown bill hits impasse | TheHill
【from Next Browser】

It sounds based on reports like these that the Murphy Bill is not going to pass as written.  Things change I know, but it looks that way.  There is I understand a democratic bill being written by Rep.  Barber.  Things dont seem to look really great.  The really interesting thing is that it might not matter rather or not the Torrey crowd thinks they have made a great case.  It may only matter whether or not they find common ground with people up to now they have shown no interest in finding common ground with.  Rhettoric that they are so good with may not be their friend.  Winning the battle may cause them to lose the war.

The next few weeks, next few months may be interesting.  Common ground…. what a weird approach to American politics.

The “skinny” on Murphy

April 23, 2014 by

Congressman Tim Murphy introduces controversial Helping Families in Mental Health Crisis Act of 2013 – Children’s Mental Health Network
【from Next Browser】

On what you cherish and how you live

April 23, 2014 by

I know people that life is not going to change for.  An accident of birth, a victim of circumstances, bad luck….a hundred thousand million different reasons.  Everyday is weight. 

People can not always choose what they live with.  Perhaps the answer is in what we live for.  Perhaps we can in some way choose what we cherish.  Maybe when we cant make things different we can still find a difference.

Do hard things, even very hard things, have to matter as much as good things.  Do loud things make it impossible to hear other things?  Do you sometimes even wonder if there are other things?

Perhaps that is where the journey starts- in knowing there are other things.  In knowing that the loss of something loved need not be the end of loving.  Perhaps that is where the seeds of hope can be found.

I had a great and good friend named Cecil Cook who died in a plane crash several years ago (see “The living of Cecil Cook”).   He was the most helpful person with hurting people I have ever known.  He knew a truth very few people ever knew: that kindness was the greatest strength.  It was like breath to him.  I remember once at a funeral he preached he said, “Lets talk about how she lived…”  And for 30 minutes we told stories and laughed and then cried and then told more stories.

Sometimes we have the wrong conversation with ourselves.  I know I do.  This is a brutal period of my life and sometimes at night sitting on my porch I wonder about kinder spaces and better times.  We all suffer small deaths every day but perhaps the conversation should be about how we have lived.

The deepest injury is not in pain or hard times.  Perhaps it is not even in loss or sorrow, not even in the loss of what we cherished, but in the awful soul killing fear that it doesnt matter what we cherish, what we love, what we care about.  Perhaps that is the injury unto death.

Remember Cecil’s words.  “Lets talk about how she lived…”  Give yourself the same gift.

Sara….and the tomorrow news

April 22, 2014 by

About 2 to 3 weeks ago I wrote about my friend Sara who had a massive heart attack and was in a coma.  It is the saddest of sad stories.  Her husband has waited…Waited for a miracle… waited for hope….waited because that is what people who love each other do.  Tomorrow he may know.

Doctors will remove Sara from the machines tomorrow.  If she survives he has been told that she will not survive 4-7 days.

If you are looking for something important to do tonight pray for Sara and Johnie.  It would be a great kindness.

Bless you.

Larry Read the rest of this entry »

Waiting on the stone

April 22, 2014 by

I have a friend who is close to giving up.  And almost no one knows how close.

He is in a horrible situation, mostly not of his making, that has caused him to lose some of the most important things in his life. He has tried many well thought out strategies to deal with it but I think maybe he is just walking through them now. He has always been a hopeful person and that seems so shattered.

His losses are permanent.  Life will never be the same for him.  I think maybe he searches for the life he had and believes without it there is no life.  I struggle with how to tell him the life he had is not the only life he can have.  There can be life after….. I wonder if he wants there to be life after.  I just dont know.

I dont know where to go from here.  I think the hardest thing is letting people hurt and trusting they will come out the other end.  And letting them know that their pain doesnt make your relationship any less welcome.  He told me once he was “tired of being bad news.”  All I could think of to say was to thank him for honoring me.  We can share our good news with anyone but how many people can we share bad days with?

My friend is a person of faith.  Easter was a good day for him.  “Sometimes,” he said, “even the biggest stones can be rolled away….Even when you dont know how or when.”

He told me that maybe he just needed to wait.  I told him I would wait with him….

I have a friend who…..

April 22, 2014 by

I have a friend (in the online sense of the word) who best I can tell thinks most of what I write is nonsense.  He is honest about what he believes.  He likes the Murphy bill a lot and defends it with intelligience and passion.

And despite everything he keeps talking to me.  That impresses me more than I can ever put into words.  If everything is simply a matter of talking only to people we agree with what hope do we have in the end?  What happens when we get to the point when we can no longer talk to people who disagree with us?  It seems like that has come to define so much of what we have become.

Walt has told me when he thinks I am being foolish and overstating my case.  Perhaps on more than one occasion there has been a measure of truth in what he has had to say.  He has been helpful to me in more ways than he probably knows.

Our differences are real.  Our commonality is that we both believe we have a mental health system that is often not there for people who most need help.  And I truly hope that is good enough.

Some recent posts have been very negative about AOT, TAC, and the Murphy Bill.  I hope our conversations survive.  If not I will be grateful for my short exposure to him.

Does “mental illness” cause crime?

April 22, 2014 by

Does “mental illness” cause crime.  The evidence, according to the study linked below is a clear cut no.  This is direct contradiction to much of the AOT gospel.  Read the article.  It is an eye-opener.  It made me realize again the absolute genius of the TAC marketing machine.  Saying there is a lot of people in jails and prisons with “mental illness” is not the same as saying that “mental illness” causes criminal behavior.    That is really an important point to realize.    Let me say it again.  Saying that a lot of people in jail have “mental illness” is not the same thing as saying that “mental illness” causes criminal behavior.    One of the things the study points out is that things like poverty and so many other variables have as much if not more influence on whether or not someone acts in a criminal manner.  One of the biggest variables they discovered was substance abuse.  People with substance abuse issues are much more likely to be inclined to act in a criminal matter.

Does it mean that “mental illness” never leads to criminal behavior?  Absolutely not.  Sometimes it does.  The biggest point I took from the article is that someone can be “mentally ill” and engage in criminal behavior and that behavior not be a symptom of that “mental illness.”

But none of that means that putting people with “mental illness” in jail is a good thing.  Rather or not “mental illness” caused them to be there it seems really clear that being there causes that “mental illness” to be much worse.  Fragile people dont do well with traumatizing, victimizing conditions.    The crime is not what puts people in jail but what jail does to the people in it.  And that is something long, too long ignored talked over, talked around.  It is as I have said before one of the primary civil rights issues of our times.


Crime And Mental Illness, Are They Linked? – Health News – redOrbit
【from Next Browser】

The Future of Mental Health Care

April 22, 2014 by

The Future of Mental Health Care –

More on AOT mythology: the cure for criminal behavior

April 21, 2014 by

One of the most frequent justifications for AOT is that it will effectively deal with “the mentally ill” in jails.  And we are told that it has been proven that it works.  Again the famous New York study.

The problem is that there is, despite what is claimed, no proof it does.  To the best of my knowledge AOT has never been done in a jail setting.  No person coming out of a jail with a mental health diagnosis has ever been told he better take his meds and see his counselor or else he may be found in contempt of court and put in a psychiatric hospital to be assessed for commitability as part of the jail program or in order to leave that jail.  If you can point out to me specifically where this has happened I will be glad to admit my mistake.

I find it hard to believe that someone not intimidated by the prospect of jail will be intimidated by the prospect of a psychiatric examination.  Assessing someone who may have a criminal record who has been placed on AOT as part of a discharge plan at a hospital is not the same as assessing someone coming from a jail, particularly someone who has been in jail for awhile.

It might work.  But the statement that it has been proven to work with prison or jail inmates is factually incorrect.

The problem with being against coercion

April 21, 2014 by

The TAC crew is simply the king of marketing.  The ways they turn arguments against themselves into proof of their positions are masterful.

When advocates criticize AOT as a coercive act what the TAC does would make you believe in magic:

1.  Being against AOT is an act of selfishness by people who only care what happens to them and not to people less fortunate than them.
2.  Instead of being for a change that those who are in severe shape need the people against AOT would have us do nothing.
3.  In fact these people drastically distort our positions to serve their own agendas.
4.  And as long as they are listened to or have influence untold numbers of hurting people will never get the help they need.

The “recovery” movement is not very good at social policy.  TAC is much better at marketing.  If the value of what we believe is to get the hearing it deserves it is a skill we need to develop.

AOT Math

April 21, 2014 by

I dont know what the future brings but at least for right now AOT in Tennessee looks like it might be on its last legs.  A pilot program was started last year amidst a lot of hoopla.  At the end of the year it had served one person.  A bill to extend the project didnt pass.  A simple case of too many bucks for too little bang.

This is what advocacy in Tennessee has been about.  Coercion is everyones biggest complaint, but it has not been our biggest weapon.

Our message has been fairly simple:
1.  What you commit people to counts.
2.  There is not going to be a big investment in new services in Tennessee.
3.  There is no reason to believe that commitment to limited services that didnt help when they were voluntary would work any better.
4.  The machinery of coercion costs a lot of money.
5.  Thus with limited financial resources it can not serve as many people as could be served by other services that are much more cost effective.
6.  Tennessee can not afford AOT.
7.  If the primary proof offered is that it reduces medicaid expenditures by reducing hospitalization a lot of things that Tennessee is already doing does that.  One study in New York even says that simply finding someone a job reduces medicaid expenses 27%.  AOT is not the only ball game in town.

Right now it looks like we have every chance of winning and keeping Tennessee AOT free.  The reason I go into all this is that with all the debate about AOT nationwide one of the things that is almost never disputed is the AOT math nationwide.

Much of the claim to the idea that AOT saves money is a New York study which says that because of AOT expenses for individuals went down from $100,000 to $50000 a year.  Basically people did less inpatient and more outpatient.  But there is another number out there not normally talked about– $31,000,000.  That is how much money New York state spends to bankroll AOT.  It is what the state has to pay to save the money it “saves.”  My math could be really haywire and there is a possibility I misunderstand the reality of New York, but this doesnt sound like saving money.   I talked to a friend tonight who works in New York government.  He told me TAC is really the only one who thought AOT saves the state money.  The gospel according to TAC is not so gospel.  If 50% of what I am saying is 50% true they are not telling the truth.

Perhaps this might be a point of emphasis with legislators.  If the message of TAC is that AOT does something no one else does and saves money in the process and that message is left unchallenged then they will in the end win.  The advocacy to me seems really a 3 part message:

1.  The coercive approach is wrong.  It hurts people and doesnt work.
2.  There are other ways to do the same thing that work just as well if not better.
3.  It does not save money, but is prohibitively expensive and in the end will subtract from our ability to supply other services.

Just some thoughts.

The problem with Murphy

April 21, 2014 by

The Washington Post
【from Next Browser】

Quality Data on Inpatient Psychiatric Facilities Now Available to Seniors on Hospital Compare

April 21, 2014 by

Quality Data on Inpatient Psychiatric Facilities Now Available to Seniors on Hospital Compare
【from Next Browser】

Mental illness in Tennessee prisons and jails: a proposal

April 17, 2014 by

Dear Governor Haslam.

The plight of the mentally ill in Tennessee prisons and jails is, I believe, a human tragedy of unbelievable magnitude.  Throughout the country each day you hear more and more horrible stories of abuse, violence, and of mentally ill being further traumatized.  The story in the video above, the story of Jason Toll, is a Tennessee tragedy.  It is one that should ever have to happen to anyone in this state again.

Local jails are being flooded with the mentally ill.  Our jails have become our largest mental health centers.  It is a job they dont have the financial resources nor the people resources to deal with.  The ultimate victims are the mentally ill, their families and the communities they live in.  It is in a very real way a public health emergency.

I am asking that you appoint a committee to study exactly what we as a state are doing about this crisis and come up with a set of policy recommendations that could improve what we are doing and help us to move forward in the effective and humane treatment of the mentally ill.  That committee should include representatives from the departments of mental health and corrections, as well as sitting sheriffs, mental health professionals, family members of mentally ill in jail, advocacy organizations like Disability Law and Advocacy Center, and mental health groups like NAMI and the Tennessee Mental Health Consumers Association.

Among issues that might be addressed are:
1.  What are we doing right now that is working??  What can we build on?
2.  Diversion.  The use of things like mental health courts to keep the mentally ill out of jail.
3.  Solitiary confinement. The frequency, length and situations under which solitiary confinement can and should be used.
4.  The availibility of mental health treatment within correctional facilities.
5.  Staff training.  Are there techniques and skills staff need to be systematically trained in??
6.  Community transition.  What is being done to make sure that mentally ill inmates are being tied to the community resources they need to be successful in their communities?

I am sure there are additional areas of concern.  These are just some that come to mind.

There is every opportunity to deal with this horrible issue in a proactive manner.  I hope you will respond positively to my suggestion.  It would be a big step forward for all Tennesseans.

Yours truly,

Larry Drain.


April 16, 2014 by

This is the 3301 post on this blog.  It has went far longer than I ever planned it to go or ever thought possible.  It is impossible to thank all the people who have played a part without missing someone.  So thanks to everyone.

Bless each of you.


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