Friday, October 11, 2013

A story of “Involuntary” Psychiatric Drugging in Alameda County

(aka “Assisted Outpatient Treatment”)

Source
Amy Coulter
San Leandro, CA  94578*

California Assembly Bill 1421, “Mental health: Involuntary treatment” is moving forward to be voted on by the Alameda County Board of Supervisors. The Board of Supervisor’s Health Committee will discuss the AB1421 recommendations on Monday, October 28, 2013 at 9:30 a.m. The meeting will be held in the Board Chambers, located on the 5th Floor at 1221 Oak Street in Oakland.   There are three documents: an AB1421 memo, with detailed program descriptions; an AB1421 program summary and a visual of the new program design.  The revised AB1421 (also known as Laura’s Law) Program recommendations were available for review and public comment via email to Comm@acbhcs.org by September 30, 2013.

Following are my public comments concerning the implementation of AB1421 in Alameda County or anywhere else; which I understand is to be implemented in some form in all counties within California.  I strongly urge everyone concerned about mental health and social stability to read about my family’s experience and other personal stories and info I have linked to below about the pros and cons of involuntary treatment, the proven but rarely discussed dangers of taking or withdrawing from psychiatric medications, and alternatives to psychiatric medications.  Then, please contact your county and state representatives to let your voice be heard on this heart-wrenching and very costly social issue.  By educating ourselves, we not only protect our health, we protect our freedom.

I am against AB1421 because of my family’s experience of caring for and supporting loved ones who are prescribed psych drugs for cognitive and/or behavioral symptoms without receiving adequate evaluations of underlying health conditions, environmental exposures, food sensitivities and relationship dynamics in order to better provide individualized in-home and community therapeutic support services.  Instead, there is a “one-size-fits-all” approach, primarily using psych medication “treatments” for “mental illness” diagnosis with little to no support for individuals or families to recognize, understand or counter the many adverse effects of these medications. Legislation already exists to deal with people deemed a threat to themselves or others, and that is Sections 5150, 5250, 5750 (involuntary psychiatric hold) of the California Welfare and Institutions Code. Legislation or lack thereof, is not the problem.  The real problems are the American Psychiatric Association, pharmaceutical industry, Food & Drug Administration and state-sanctioned, insurance-driven, for-profit medical treatments.

I view our mental health system that mainly pushes pharmaceutical “treatments” to be extremely dangerous to individual and public health.  In a 2010 online interview, Investigative Journalist Robert Whitaker discussed the dramatic increase in mental illness disability rates linked to the overuse of psychiatric drugs in the article Are Prozac and Other Psychiatric Drugs Causing the Astonishing Rise of Mental Illness in America?    In his book, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, Mr. Whitaker explores why “…the number of disabled mentally ill in the United States tripled over the past two decades. Every day, 1,100 adults and children are added to the government disability rolls because they have become newly disabled by mental illness, with this epidemic spreading most rapidly among our nation’s children.”

My son was labeled with a serious mental illness diagnosis at the age of 20 and has been in the mental health”scare” system for ten years in Alameda County.  He has been in a revolving door of county and state mental health hospitals, community or locked facility treatment programs, “clean-and-sober” adult residential facilities, county jail, homeless shelters, homeless or living at home, often unsuccessfully.

I have taken him to holistic psychiatrists for medical tests showing he has food allergies, heavy metals toxicities and other metabolic issues that are known to cause mental and physical illness, and that are worsened by his cruel and unusual punishment while incarcerated at Santa Rita Jail since May 2011 for being seriously mentally ill. He was moved to solitary confinement on February 25, 2013, because he could no longer function in a social setting. This was seven weeks after being returned to SRJ from spending eleven months in a "court-mandated" state hospital for "competency treatment."  In the first six weeks after being admitted to Metropolitan State Hospital on Feb. 15, 2012, his jaw was broken by another inmate patient.  The "treatment" he has been receiving is so far removed from a healing environment, that I am convinced he is being deprived of an opportunity to heal and denied his civil liberties and due process to a timely release into a suitable community setting that considers his unique physiology and trauma that he continues to experience.

His last court hearing was August 2, 2013, where he was referred to the Conditional Release Program to send him to another state hospital that has a 4-month waiting list. His next progress report court date is October 31, 2013, to see if he is still in solitary confinement at SRJ. What an appropriate date that is--the Day of the Dead!  His voice is being silenced; I am his only voice advocating for compassionate and effective therapies that actually support people like him who are experiencing a debilitating mental illness.

The available county-funded, court-mandated community “treatment programs” have always been in what I would deem “impoverished housing in impoverished communities” that provides zero to minimal staffing oversight and structured therapeutic activities.  Over the years during my visits, I have watched him deteriorate and be traumatized by the medications or the withdrawal from medications, and the inadequate/hostile housing environments, poor quality/junk food and “counseling” that the county behavioral health department and/or the jail systems provide to people whose health is already compromised.

It’s clear to me we live in an unhealthy, unbalanced society, and seeing people coming unhinged can be expected.  We know numerous toxins are in the environment and our food system, as well as a corrupt political/corporate state that promotes high anxiety, competition and division within society.  It is also apparent by the recurring battle over deficit ceilings and the unprecedented government shutdown, those in legislative leadership are out of touch and unconcerned about how their decisions affect the lives of average citizens, our local communities and the environment.

A grand experiment of drugging, poisoning and mis-educating the public is happening.  Government and corporate partnerships create public health policies and laws that threaten communities, such as the unfettered promotion of FDA- and non-FDA-approved medications.  For example, the 2013 revised Monograph for Risperdal Consta (a common neuroleptic and one my son has been forced to take) notes that psychosis and suicidal thoughts may be side effects both of taking and withdrawing from the drug.  In Oakland, California, Pacific Research Partners, pays people to participate in clinical trials of more than 200 new non-approved drugs.  Often people are prescribed these drugs without being fully informed that "prescription drugs are sometimes the cause of violent thoughts, acts, and behaviors.” 

Many ill-informed patients and their families struggle with the original symptoms along with the medication side effects and withdrawal psychosis when people stop these medications suddenly, often due to the way the drugs make them feel.  The danger lies not just in the particular circumstances that people with mental illness face but in a system of clinical research that has been thoroughly co-opted by market forces, so that many studies have become little more than covert instruments for promoting drugs.

Neuroleptic drugs used to treat people diagnosed with “serious mental illness” are linked to increased risk of violence, including many documented incidents of people acting upon suicidal, homicidal and multi-cidal ideations.   If we look carefully at those who have committed the epidemic of killings, they are mostly people who have, in fact, been in treatment.  The Attorney General of Connecticut is resisting the release of Sandy Hook shooter Adam Lanza’s records, for fear that they might “cause a lot of people to stop taking their medications.” Congressman Jeff Miller is calling for an investigation into whether the psychiatric medications Aaron Alexis, the Navy Yard shooter was taking were connected to his behavior.  National Institute of Mental Health Director Thomas Insel has acknowledged that the Diagnostic and Statistical Manual of Mental Disorders, the book on which all current psychiatric diagnoses are premised “lacks validity,” and that antipsychotics worsen long-term outcomes.  Only a fraction of those deemed to be at risk of psychosis actually progress to psychosis. And, most importantly, research indicates that forced treatment does not work.   Eleven percent of the population is taking psychiatry’s so-called antidepressants, and at least 20% are taking one or more psychoactive drug.  Psychiatry is tied to pharma, and as long as pharma’s revenues continue to rise, there’s no reason to stop or even slow down.

Mental illness affects whole families and communities!   Many mental health consumers, peer organizations, and psychiatric survivors emphasize, “nothing about us without us.”  Mental health treatments must include daily therapeutic oversight of and interaction with the people who are prescribed or required to take neuroleptic and other psychiatric medications by caring and well-trained community support staff, peers, and family members.  The county and state mental health departments should use the money currently spent on medication compliance efforts to fund living wage jobs in the community to provide safe, stable, healthy, affordable housing and therapies for people recovering from a mental / emotional breakdown.

Outspoken proponents of “medication compliance” are often corporate-funded bureaucrats and politicians; non-profit, family or peer mental health support organizations; or family advocates in desperate need of effective and ongoing community support services.

Vermont State's Mental Health Department highlights the DANGERS IN OUR CURRENT APPROACH TO PSYCHIATRIC TREATMENT while implementing a new community-oriented mental healthcare delivery system.

Many psychiatric survivors like Pat Risser would say We don't have a "mental HEALTH" system; we have a "mental ILLNESS" system, and it’s a "Lack of Voluntary Services to Meet Needs of Mental Health Clients" (This is not a fancy website, but the author provides some history and his perspective about systemic problems in the mental health care treatments available.) 
                                                                    
Please share the online material referenced in the attached document I created about “Assisted Outpatient Treatment” legislation for people living with serious mental illness.  I’ve tried to represent both sides of the issue. **

I dream of the day when it is recognized that we all have limitations but that we are more than those limitations. We are multi-faceted individuals and we all possess many strengths and talents and should focus on those instead of any limitations or dis-abilities.   I hope you find these references helpful.  Please take care of yourself and each other.

Amy Coulter
San Leandro, CA  94578
peacevizion@yahoo.com
p.s. I have also emailed this to the county health officials and legislators in a separate email.


When considering the merits of forced treatment using neuroleptics, several competing viewpoints can be identified. In this debate, there are two polar-opposite answers: (1) that being schizophrenic is reason enough to necessitate neuroleptic pharmacotherapy, regardless of patient wishes, and (2) that neuroleptic treatment should never be provided for schizophrenic patients unless they request it. There are also a range of conditional ‘in-between’ answers (i.e. neuroleptics should only be involuntarily administered under certain conditions).”

ASSISTED OUTPATIENT TREATMENT USING ALTERNATIVE THERAPIES
·       Integrative Psychiatry
·       Good news is reported in mental health care in Vermont
·       When Hurricane Irene washed away Vermont’s state mental hospital, Vermont’s government chose to replace it with a network of smaller, community-based and alternative approaches to mental health care. Citizens of Vermont are legally entitled to alternatives to psychiatric medication; Soteria Vermont will be the second replication in the United States (after Alaska’s) of Loren Mosher’s Soteria project which demonstrated in the 1970s the efficacy of housing people experiencing first psychotic breaks with sympathetic non-professionals as housemates…The original Soteria was dedicated to using little or no psychiatric medication, and to using that only in the short term to stabilize a crisis. Repeated analyses of its records show extremely robust and long-lasting recovery from even the most extreme psychotic states.  Steven Morgan, the project’s director, gives a short history of the project’s origins. Beginning this fall, Steven will be seeking a site for the house and creating a training program for the staff with the goal of opening the house’s doors in the fall of 2013. Vermont has dedicated $1 million per year to the project.” Soteria presentation by Steven Morgan
·       Vermont Mental Health Reform Act 2012 excerpt:   (3) Contract for a voluntary five-bed residence for individuals seeking to avoid or reduce reliance on medication or having an initial episode of psychosis. The residence shall be peer supported and noncoercive, and…..”
·        Short-stay “Second Story Respite House in Santa Cruz, California
·       “Twenty-Nine Medical Causes of Schizophrenia" excerpted from Nutrition and Mental Illness by the late Carl C. Pfeiffer, Ph.D., M.D.
·       Rethinking Schizophrenia” by Dr. Thomas Insel, Director of National Institute of Mental Health: “Treatments, especially pharmacological treatments, have been in wide use for nearly half a century, yet there is little evidence that these treatments have substantially improved outcomes for most people with schizophrenia.”  Sustained recovery occurs in less than 14% within the first five years following a psychotic episode.
·       Recovery From Schizophrenia: “Medications are of course what can often make the biggest difference the quickest, and they are heavily promoted by an industry that makes billions of dollars of profits off them, so it is easy to be seduced into  believing that they should be the cornerstone of treatment.  However, they also come with heavy costs in terms of both subjective and objective negative side effects, and some of these effects can even be fatal. A better approach is to first try alternatives wherever possible, so that at least at times medication use can be avoided altogether. And then, if alternatives fail to succeed and medication does seem necessary, use as little as possible and continue to search for other ways to improve coping over time so that medications can perhaps be eventually reduced or discontinued.”   
·       NY Times “Sunday Dialogue Treating the Mentally Ill“Mandated treatment is a blunt instrument that may drive more people away from seeking care than it compels into care.”  Coercion is sometimes necessary, but we should be clear about its cost: trust and collaboration are largely incompatible with force. Genuine partnership can be a balm for many hurts, and open the way for some people to real and lasting growth.”
·       World's largest site on non-drug approaches for mental health.
·       International Society for Ethical Psychology and Psychiatry (ISEPP) is an organization of people who find, study, use and promote safe, humane and life-enhancing approaches to helping people who are experiencing emotional distress, life crises, difficult dilemmas, spiritual emergencies and other forms of overwhelm and who, due to those experiences, are diagnosed with mental disorders.
·       Changing how we talk about mental illness  I’m afraid that no substantive change will occur because we are discussing mental health in the abstract sphere of politics rather that in the intimate communities where we live day to day — places like our homes, jobs, schools, faith communities and social gatherings.  As a society, we don’t talk about these issues, at least not in the personal ways that raise awareness, foster advocacy and lead to meaningful change. We talk about the dangers of mental health in a way that causes those who are actually living with mental-health challenges to gather in hushed circles and share their struggles, wisdom and perspective with only a select few.”

QUOTES AND REVIEWS IN FAVOR OF ASSISTED OUTPATIENT TREATMENT

·       Stopping the Revolving Door - A Civil Approach to Treating Severe Mental Illness from Treatment Advocacy Center

·       Mental Illness Policy
·       Parents’ perspectives on involuntary treatment after son’s medication ‘non-compliance’: 
·       A reporter’s perspective on the NAMI, Robert Whitaker, and medication “non-compliance” controversy

QUOTES AND REVIEWS AGAINST ASSISTED OUTPATIENT TREATMENT
·       On the relationship between NAMI, the Treatment Advocacy Center, and the Neo-Eugenics Movement
·       When Consent is Misinformed:  Addressing Conflicts of Interest and the Therapeutic Misconception
·       E. Fuller Torrey’s Review of ‘Anatomy of an Epidemic’:  What does it reveal about the rational for forced treatment?
·       Misused research by D.J. Jaffe and Dr. E.F. Torrey
·       Seven dirty secrets that counselors and mental health pros will never reveal
·       Family Advocate at August 12, 2013 MHB Meeting:  “We reserve the right to disagree and not be isolated or attacked for it.  We want discussion and reform of mental health treatments and to stop the use of incarceration as a means of dealing with traumatized and economically disadvantage people.  I believe that any law that contains provisions for forced drugging is an endorsement of torture, as has been made clear by the resolution adopted by the United Nations.  In that light, it is clear from the history of selective enforcement of the laws regarding ‘treatment of the mentally ill’, that the authorities are free to pick and choose what provisions of the law they wish to enforce, while ignoring others or outright refusing to enforce them (a la California Penal Code 2968).  Therefore, any provision of any law that legalizes the forced drugging of any individual is the legalization of torture…The effort to push this law through at this time should come as no surprise to any of us, given the widespread dissemination of the U.S. government's policies of torture, rendition, and assassination.  I would also like to point out that persons who are labeled paranoid schizophrenics because they believe the government is watching them are actually more in touch with reality than those who believe the U.S. government is a democracy. Therefore, this law targets the wrong group of people as delusional.”
·       A parent advocate said in a recent discussion about mental health treatments and AB1421: “…It has been my contention all along, without having done the research that you are performing, that AB1421 is all about money.  Also, it increases the police powers of the state, which is a political reaction to the growing instability of the economy…My perspective, after 13 years of organizing in this field, is that the forces which benefit from the status quo (the pharmaceutical corporations, the psychiatric profession, the mental health bureaucrats, and the insurance companies) have decided to anoint NAMI and TAC as the organizations that speak for the persons who want and need help with their mental problems.  Both NAMI and TAC get their money from big wealthy donors.  These are the organizations from within the community that supposedly speak for us, but in reality they push for the plans that benefit the big money and make our problems worse.  In this way, most of us are left with our little fragmented organizations, no money, and no way to influence public opinion.  The public remains in the dark and educated only to the extent that big $ wants them to be.  Thus, the general public still buys into the "just make them take their meds" philosophy, when there is so much more to the picture that needs to be questioned and addressed.  The media, which could effectively change this consciousness, is a willing collaborator in the mis-education of the public through their financial ties to big pharma and the insurance companies.  The financial crisis of the entire system is pushing this trend to simply drug more and more people, without even hospitalizing them.”
·       A MH consumer and peer advocate said in the same discussion:  “I was fortunately able to attend the MHSOAC conference that was held on July 25, 2013 concerning the state's position concerning the adoption of AB1421…the state's position was this: All the counties are expected to adopt AB1421 or at least some portion of the bill. The bill will still maintain its non-mandatory status, and would not be tied to money. The minutes are now currently available. If you read between the lines this bill is about money; specifically, addressing those consumers that are receiving financial assistance from SSI, SSDI, Medi-care, and Medicaid. The cost-to-benefit ratio of the current system that is in place has been deemed unsustainable and AB1421 addresses this issue. This is not so much about health and wellness as it is about stopping the "bleed" from the social security system.
·       Psychiatrist Dr. Peter Breggin points out the conflict of interest between the psychiatric and pharmaceutical industries.
·       Laws that legalize involuntary drugging were deemed torture by U.N. Special Rapporteur Juane E. Mendez in his March 2013 statement on “Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment.”
·       Protect yourself by educating yourself. It is the only way. Educate yourself about the mind and how it works. Learn how to have healthy relationships. Were you aware that depression follows unhealthy relationships?  Learn about self-sabotage. Learn why you often do the opposite of what is healthy and why you do it. When you understand these things, your burden will be much lighter. Healthy choices will become clear and possible.  This vital education, I am afraid, is the only line of defense against the escalating power and ignorance of the system that - without a doubt - would see your brain on drugs for life.


* Amy Coulter is a friend and neighbor.  I have witnessed the incredible stress she has had to go through to care for the welfare of her son as he has been shuffled through the system. That a single parent has to go through this, as well as keep a job and a roof over their heads is a reflection of the madness of the capitalist system.  RM

** If you want the document Amy cites here send this blog an e mail or we will try to connect you with her.

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