It is back. As the House and Senate both try to tackle reform of the mental health system in very different ways and prepare for the war to follow when they bring their competing bills to the conference table the advocacy for mental illness has come back with a bang with the spring. Mr. Jaffe has a new post out that I haven’t read yet, but from what I understand writes off the Senate bill as a complete and total betrayal of the rights and needs of the severely mentally ill. Hopefully I can read it in the next few days.
The early preview seems to me that Rep. Murphy will greet Sen Alexander with all the scorn he can muster. The early stuff I have read feels eerily like the scorched earth campaign of Murphy 1. We will see I guess but based on what I know of him Sen Alexander does not seem like someone that will be intimidated by Rep. Murphy’s histrionics or name calling from anyone for that matter. Perhaps Rep. Murphy will think again, but to me it looks like a who will blink challenge and if no one blinks perhaps there will be no Bill at all. I am not sure Rep Murphy can blink. I don’t think Sen. Alexander will blink. I don’t know, but it should prove interesting.
The link above is to a blog written by a lady named Natasha Tracy. She is a Facebook superstar and from what I can gather many people believe she is the voice of truth. I don’t know if she has any formal tie to Dr. Torrey and Mr. Jaffe. I do think I have read very positive comments about her by Mr. Jaffe so I think it fair to say that she is at least to some extent of like mind. (If you haven’t yet please read her blog post).
Her title really says it all. Peer support initiatives should no longer be funded. According to her they don’t work and they most importantly take money away from things that do count like services for the severely disturbed.
The first problem I saw with the post was that she didn’t understand what peer support services was. Writing off peer support as something that gave people a warm feeling and improved their social lives is somewhere way to the other side of superficial. I certainly think she is dangerous to straw men everywhere if this post is an example of her work.
I noticed on Facebook , that Jennifer Padron, one of the pioneers in peer support, who does know so what she is talking about challenged Ms. Tracy to a public debate after reading her post. Somehow I think it is a debate not likely to happen.
One of the best debate tactics I know is to tell people they need to do something that no one will listen to or seriously consider. When problems happen then you claim it is proof that if they had just listened to you things would be okay. You can’t lose at it. If this is an example of Ms. Tracy’s skill with that tactic I bet she loses very few arguments. You might call it the “I told you so fallacy”.
Ms. Tracy is several years behind in her argument. Peer support services are increasingly integral to many state systems. She claims they steal money from services for the severely mentally ill. My first response to her is simple. Prove it. Name one state, one anything, in which one dollar designated for “clinical services” has been diverted to peer support. I try to keep track of such things and to my knowledge it has never happened. Not once. Not one penny.
In Tennessee the budget for peer support services is about 3-4% of the total budget. I believe if she is speaking normal mental illness language when she talks about “services for the severely mentally ill” she is talking about psychiatric hospitalization. The notion that peer supports 3-4% of the budget somehow has affecting funding for psychiatric hospitalization is simply silly. No one in Tennessee would even begin to try to make such an argument. The real reason at least in Tennessee that psychiatric hospitalization does not have the sacred position it once had is that over the last few years more and more people believe it is far too little bang for far too many bucks and that the bulk of the people it served can be better served in the community if adequate services are provided.
By the way, most people who seem to like psychiatric hospitalization seem normally in the next sentence to throw in something about “evidence based practices.” I am still waiting for the first person to explain to me how psychiatric hospitalization is an evidence based practice. I don’t think the people who work in hospitals even believe that.
On the other hand I believe that many peer support programs have been designated as evidence based. Recently Tennessee started a peer support program called “peer link.” The data the first year indicated an over 80% decrease in psychiatric hospitalization for those of serves. Thousands of people with diagnoses of severe mental disease are served in Tennessee peer support centers. Ask any professional in the state from the Commissioner on down and they will tell you these centers are integral in keeping people out of the hospital and out of jail.
Another debate strategy. Beware of people who tell you “they got a study.” They always make it sound like their study is the only study. Ain’t so. Just simply Google evidence base for peer support. Go to anyone of many organizations who compile such studies. Everybody always has proof of they just ignore anything that disagrees with them.
Much of Rep Murphys argument is to tell you who to blame, who the villain is. Ms. Tracy does the same. Her basic argument, unless I badly misunderstand her point, is that there needs to be more psychiatric hospitalization for more people and peer support initiatives are keeping this from happening. I haven’t even tried to detail all the mistakes or misrepresentations I think are in her post.
Suffice it to say. The silly season has started again.