“Mental Illness Awareness Week”

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Our “friends” at NAMI Ohio took the occasion of so-called “Mental Illness Awareness Week” to try and drum up support for their efforts to loosen criteria for involuntary outpatient commitment (IOC) laws in Ohio.

I would encourage those interested to do so, particularly those in Ohio, to contact Ohio legislators as NAMI suggest, but encourage them to vote DOWN any changes to the current law.  Remind them that anosognosia is deliberately being mis-applied by NAMI Ohio and their Treatment Advocacy Center puppeteers.

Below is the exact letter sent by NAMI Ohio to thousands of families, policy makers, legislators, individuals, etc.

NAMI OhioPhone: 614-224-2700   / 800-686-2646   Email: [email protected]Website: http://www.namiohio.org
October 9, 2012Dear Mental Health Advocate,In recognition of Mental Illness Awareness Week (Oct. 7 – 13), NAMI Ohio would like to offer a suggestion on how you can make a difference in the lives of many individuals with untreated serious and persistent mental illness.  Please consider sending a letter to your State Senator urging him or her to support S.B. 350 to clarify Ohio’s court ordered outpatient treatment statute.  Below is a sample letter.  To locate the name, address and e-mail for your state senator, simply click here and enter your zip code.  http://www.ohiosenate.gov/map.html.  For additional information on S.B. 350, go to www.namiohio.org (2nd entry on home page).Thank you for your help in getting this important piece of legislation passed in Ohio.Your Friends at NAMI Ohio

SAMPLE LETTER

Date

The Honorable   _________________

Ohio Senate

Statehouse

Columbus, Ohio   43215

Dear Senator   ____________:

I am writing to urge you to support S.B. 350, a bill to clarify Ohio’s court ordered outpatient treatment law, thus eliminating any question about whether a probate court judge has the authority to order certain individuals with serious and persistent mental illness into outpatient treatment.

This bill would give judges clear authority to step in before someone with a serious mental illness who is unaware of his or her need for treatment becomes so ill that hospitalization or incarceration are the only options remaining.  Lack of awareness of illness – a neurological syndrome called anosognosia – is believed to be the single largest reason why individuals with schizophrenia and bipolar disorder do not follow through with treatment.   In many cases, such individuals can be persuaded with a court order to follow their treatment plan. This is commonly referred to as the “black robe effect.”

Court ordered outpatient treatment is not the answer for everyone who meets the criteria, but for some it could mean the difference between life and death.  This bill simply removes any question on the part of judges that they have a tool available to use when there is clear and convincing evidence that without treatment, the individual will likely become an imminent threat to themselves or others and end up in the hospital, jail, or worse… dead.

This issue is very important to me and my family because…  [Please include a SHORT summary about how you and your family have been   impacted by mental illness.]

Thank you for taking the time to read my letter.  I look forward to hearing your position on S.B. 350.

Sincerely,

Signature

Name

Address

City, State, Zip

Telephone Number and E-mail address

***

Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

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David Ross, MEd, LPCC
David Ross, MEd, LPCC
Getting From Here to There: David Ross writes about the efforts in Ashland, County Ohio to move its mental health and drug/alcohol system towards a recovery-oriented system of care, one that puts into practice the core principles of recovery, medication optimization and trauma-informed care.

16 COMMENTS

  1. Amazing! Talk about deliberately creating a “fantasy effect?”

    Google the term “black robe effect” & only two links come up?

    The first is from, guess where?
    http://www.treatmentadvocacycenter.org/about-us/our-blog/69-no-state/1599-they-call-it-the-black-robe-effect and what do we read?

    “While many Texas jurisdictions don’t make much use of a state law that allows civil courts to order outpatient treatment for the seriously mentally ill, in Bexar County it is part of the system,” Eiserer reported. She quoted the Treatment Advocacy Center’s Brian Stettin saying,”What we find is that the actual cases where someone under these orders goes off their treatment are exceedingly rare. We call it the black-robe effect. It matters to people that the court ordered them.”

    So it seems that a fantasy, they call it the “black robe effect” has now morphed into, “This is commonly referred to as the “black robe effect.”

    In the 1960’s the CIA had a saying “deception is the of plausibility,” understanding that psychologically people are not really concerned with truth or reality, but in immediately soothing their internal state, or maintaining homeostasis.

    I guess if I’m an average citizen reading terms like “anosognosia” or what apparently is a commonly understood term “black robe effect.” I would feel a sense of plausibility and perhaps that I’d learned something new, to later share with my friends, “have you heard about the black robe effect,” when the topic of mental illness comes up?

    Then again, have you heard about “the fantasy effect,” and the self-deluding powers of our minds sense of cognition?

    I wonder if Treatment Advocacy Center’s Brian Stettin has read much about the art of deception and the effect of plausibility, on the needs of our self-soothing mind?

    Commonly referred to as, “the fantasy effect.”

    Great post David, although it really made my blood boil.

    Best wishes,

    David B.

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  2. How about posting a sample letter like NAMI does but opposing this outpatient forced drugging ?

    I almost got a “Risperdal rape” with this Risperdal Consta injection against my will. I know when I was suffering withdrawal reactions and sought treatment the hospital tagged them as bipolar symptoms (speech is rapid) and “anosognosia” . They made threats of forced injection and called it help but here I am drug free and recovered despite there threats of chemical rape and horrible mistreatment in general.

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    • Thanks Jack. I will take you up on your offer to excerpt some sections of your fine piece.
      Also, related to an earlier post, New York is one of the earlier adopter of “Health Homes”
      Ohio just started this in October. I always like reading what you’ve heard/seen about this latest effort at “best practices”

      D

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  4. I read this NAMI letter and I want to respond. I want to say something clever or witty. But instead I sit here dumbstruck.

    How on earth can an organization be this castigatingly cruel and condemning without any societal reproach?

    I would not know how to approach someone with a view of the severe and persistently mentally ill as people who have three options in life while roaming about “untreated”: hospitalization, incarceration, or immimient death by their own hand.

    In the twelve years that I roamed this land of the free and home of the brave heavily overmedicated on polypharmacy for my “bipolar” I did not attend a single NAMI event. I don’t know if statistically this is aberrant or not. I just had an inkling that this organization was not advocating for me.

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    • Emily, I can understand your outrage. I wanted to paste the letter directly as it came from NAMI Ohio to help MIA readers understand what we’re up against. I’ve had several in-person face to face meetings with these people and they really do believe the three options you mention. The additional option they espouse and tell families all the time, is a lifetime of psychiatric medications, in an apartment, no ability to work, dependent on the “system” And, get this, they think they’re being compassionate and caring and I’m the one putting lives at risk by blocking efforts to increase Involuntary Outpatient Commitment. It’s mindboggling and I’m often dumbstruck myself after these meetings. That’s one of the many reasons MIA is important to me. A river in a time of dryness, A harbour in the tempest . Wait a minute those are U2 lyrics! Thanks for your comment.

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      • Ahhh, David, it’s way more sorrow than outrage, but yeah, there’s definitely outrage. That could have been me. It just about was.

        I had offers to join NAMI. I had offers to get on SSRI. I had offers to get ECT. It was all within my reach. And I was a complete wreck on those drugs, desperate for others to tell me what to do…

        I see my escape as pretty miraculous.

        I actually gave my only copy of ‘Anatomy’ to a NAMI family. You know what, I never even got a thank you! I won’t give up hope on those I know are in the “system” because I know that if I did not deserve to be there, no one does. It may spell security to some but it is also a mis-spent life.

        Of course, I needed an excuse anyways to go buy more copies of my beloved ‘Anatomy’, or as I like to subtitle it, “The Story of Emily”. Whitaker is the only guy out there writing my experience of the mental health system. I was so unbelievably ordinary before I got swept away by polypharmacy.

        MIA is definitely an oasis. Thanks for your work here. I remember a comment you made a few months ago about not needing doctors to give drugs. You said something about just needing a flow chart. If pleasantus doesn’t work, direct the person to wundermood… I paraphrase but I found it brilliant. I’ve thought on it more than a few times since and I always have a good chuckle. It’s not all doom and gloom if even I can see the humor of it all.

        I wish you much courage with the NAMI “friends”,
        Emily

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        • Thanks for your kind words Emily and getting my sense of humor (definitely an acquired taste I’m told).

          Your words, “mis-spent life” resonated with me. I can’t think of anything more violent than crushing someone’s dreams. I see this happening all too frequently when professionals artificially impose their own prejudices and limitations on those they’re supposed to be helping. “Oh, you can’t work.” or “You can’t go to college,” “You can’t start your own business” “You can’t get married and have children” “You can’t own a home” On and on it goes. Thankfully, some, like Anonymous, have the “fill in blank here” to ignore/refute the limitations others seek to apply to them, to keep their dreams alive and realize them. Unfortunately, not everyone can/does overcome these dispiriting comments.

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    • “NAMI funding pharmaceutical companies” The just refuse to bite the hand that feeds them or more like they would be biting there own hand, whatever.

      I called NAMI to report and seek help with my abusive hospital treatment. What a joke , they said “we are for families… call legal aid ” Thats it. They have nothing in place to address abuse or rights violations this so called “alliance for mentally ill”.

      Mabey I should call every one of there offices with my complaint about that hospitals dirty mistreatment, record there comments and put it on youtube ?

      This got alot of views:

      Indiana NAMI Rep pushing mental illness screening, which will result in even more kids on drugs. http://www.youtube.com/watch?v=Z6TapDyT-mI

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  6. What are they asking to clarify with this bill exactly? I thought that AOT was only for convicted violent offenders (a form of plea bargain to get out of doing jail time). Is this letter requesting that judges should be allowed to order ANYONE diagnosed with mental illness into AOT?

    I’m not opposed to AOT as a form of plea bargain (as it is giving those who may have been in an altered state of mind at the time of the crime an option not to go into the criminal justice system)but there is absolutely no justification of using AOT as a means to ‘prevent’ someone from committing some hypothetical crime. NAMI is really crossing a constitutional line with this one.

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    • Alexa,
      It’s the latter. They’re misapplying the term “anosognosia” to give them cover to force treatment including medications, or else face incarceration. The current law does allow for IOC but it’s pretty restrictive. A so-called “high bar” has to be met in order for a judge to order it. Their clarification would significantly lower that bar to further deprive people of their civil liberties. We simply can’t incarcerate people because we feel uncomfortable around them.

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      • David,

        Perhaps you can try to mobilize some expert testimony to challenge the concept of anosognosia in mental illness. Did you see Sandra Steingard’s article on this site: ‘Anosognosia: how conjecture becomes medical “fact”’? She explains how it cannot be confirmed on MRI the way it is for neurological patients.

        There are several studies that investigate what insight is as well. They found that patients who denied having mental illness and refused treatment in actuality had concerns about side effects, doubted the honesty of the physician or their family members etc. which is why they make those statements declining treatment.

        There is a lot of evidence out there to discredit the anosognosia theory. It is really important that the legislators understand that.

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        • You’re absolutely right Alexa. And I’m planning to “lift” a bit of Dr. Steingard’s blog on anosognosia to do just as you suggest. Thanks for your thoughts, I’ll keep everyone posted. Legislators in Ohio are similar to around the country in that everyone seems to be waiting for the results of the November elections. Then, lame duck sessions start all over the place and that can be a dangerous time. Those senators/rep’s who are on the way out can sometimes be swayed to support issues they wouldn’t have if re-elected or if their party was still in power. What was that quote, “May you live in interesting times.”

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