Why should hospitals care if a homeless, psychotic patient has a decent place to live after that person is discharged?

Because if they don’t, it’s going to cost them money.

Section 3025 of the Affordable Care Act established the Hospital Readmissions Reduction Program, which penalizes hospitals for “excess readmissions.”

What is an “excess readmission?”

As defined by the act, an excess readmission happens when someone is re-admitted to a hospital for treatment of the same health problem within 30 days after they were discharged.

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Journalist and author Robert Whitaker has been a controversial figure in mental health circles since 2001 when he published his first book, Mad In America: Bad Science, Bad Medicine, and The Enduring Mistreatment of the Mentally Ill. In 2010, Whitaker’s book, Anatomy of An Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America predictably sparked outrage and condemnation in many circles while it was loudly endorsed and applauded in others. An article by Whitaker in the non-peer-reviewed journal Medical Hypotheses, titled The case against antipsychotic drugs: a 50-year record of doing more harm than good should explain to those unfamiliar with his work why he has become such a lightening rod.

In April, Whitaker released a new book entitled: Psychiatry Under The Influence: Institutional Corruption, Social Injury, and Prescriptions for Reform, which he co-authored with Lisa Cosgrove, a fellow critic of the pharmaceutical industry and a professor at the University of Massachusetts in Boston. This book is aimed at more of an academic crowd than a mass audience.

Knowing how controversial Whitaker’s work is, I asked Virgil Stucker, executive director of CooperRiis Healing Community to write a review, which he was kind enough to send me.

Book Review: Psychiatry Under The Influence: Institutional Corruption, Social Injury, and Prescriptions for Reform

By Virgil Stucker

CooperRiis Healing Community

Bob Whitaker and Lisa Cosgrove’s 207 page book Psychiatry Under the Influence is packed full of provocative and thoughtful comments accompanied by detailed analyses of pharmaceutical research, clinical practice, organizational psychology and social philosophy. It reveals very troubling behaviors that have resulted from the confluence of the practice and promise of psychiatry with the profit seeking of pharmaceutical companies. Thought leaders in psychiatry, who have no financial ties to these companies, need to respond to its findings. It is also a book that should be read by everyone who seeks to help some of society’s most psychically vulnerable as well as by those who seek to help restore grit and resilience into daily life.

Thankfully, it is a book that also helps us to begin bridging the divide between the “It’s All-About-the-Medication” versus the “No-Medication” groups, also known as the Psychiatrists versus the Anti-Psychiatrists.   These divided groups are much like the Fundamentalists versus the Atheists. Too often, these divides cause people to lose their heads, to stop listening and to react mindlessly. From my perspective this book is not fuel for the fire but is instead an honest and open expression of Whitaker and Cosgrove’s best efforts to show us compelling evidence of undue influence on psychiatry by pharmaceutical interests while suggesting a unifying path forward.

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6-8-15 During my travels, I’ve discovered that most communities with good jail diversion programs got them because of a strong leader, usually a judge, a sheriff or a mental health advocate. Yesterday (Sunday June 7), the Washington Post published an Op Ed piece that I wrote about the difference between a community where leaders took action and Fairfax County, Virginia, where I live. Where does your community fit? Is it moving forward or are your leaders sitting on their hands?

What Fairfax can do now for the mentally ill

There’s been enough talk about treatment for the mentally ill. It’s time for Fairfax County to act!

The Washington Post Local Opinion Page
By Pete Earley

If Natasha McKenna had lived in Bexar County, Tex., instead of Fairfax County, the 37-year-old would have received treatment for her schizophrenia rather than dying after being stunned by a deputy sheriff four times with 50,000-volt shocks from a Taser while her arms and legs were shackled and her face covered with a hood.

More than a dozen years ago, Fairfax and Bexar County officials decided to investigate jail-diversion programs that would direct people such as McKenna into community treatment for mental disorders instead of into jail.

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114TH CONGRESS 1ST SESSION

IN THE HOUSE OF REPRESENTATIVES Mr. MURPHY of Pennsylvania introduced the following bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis, and for other purposes.

Rep. Tim Murphy (R-Pa.) introduced a new version of his Helping Families In Mental Health Crisis Act on Thursday (June 4^rd ) and it contains compromises aimed at appeasing critics while keeping changes that should please his initial supporters.

I’ve read the 173 page bill twice and have asked for reactions from NAMI’s top lobbyist, Mental Health America, the Treatment Advocacy Center, the Bazelon Center For Mental Health Law, and the National Disabilities Rights Network. I also exchanged emails with D. J. Jaffe at Mental Illness Policy.Org. who testified before Murphy’s subcommittee and has been one of Murphy’s strongest backers. Jaffe was especially helpful in explaining parts of the bill to me. However, any mistakes that follow in this rushed review are my own.

Here’s a quick analysis of what Murphy, along with Rep. Eddie Bernice Johnson (D-Tx) have reintroduced. You can read the bill on your own here.

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Photo is from Treatment Advocacy Center’s announcement of Rep. Tim Murphy’s award. Pictured with Dr. E. Fuller Torrey

(6-1-15) The question being asked on Capitol Hill is whether Rep. Tim Murphy (R-Pa.) will drop a requirement in his mental health legislation that would require states to begin using Assisted Outpatient Treatment as a condition of receiving federal mental health dollars.  Under AOT, as it is known, states can require persons with a diagnosed mental illness to take anti-psychotic medication if that medication has proven to help him/her in the past and he/she has a documented history of violence or repeated hospitalizations.

It is a hot button issue for those who oppose forced treatment but is supported by many parents.  It also is one of the main pillars in Murphy’s Helping Families in Mental Health Crisis Act, which had been steamrolling through the House during its last session until Democrats introduced a poison pill bill that kept Murphy’s bill stuck in a committee.

Murphy certainly gave no hints that he was willing to abandon AOT when he appeared May 20th at a Capitol Hill rally that was sponsored by the Treatment Advocacy Center and attended by more than a hundred family advocates.

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Six minute CODE Trailer from NAMI, TN from Dixie Gamble on Vimeo.

The National Alliance on Mental Illness Tennessee has created a training film specifically aimed at correctional officers. It is called CODE, an acronym for Correctional Officers De-escalation Education. Filmmaker Dixie Gamble gained unprecedented access to the Tennessee state prison system where she interviewed inmates and correctional officers. She also spoke to me and numerous mental health experts including LEAP Institute’s Dr. Xavier Amador, NAMI’s Ron Honberg and Dr. Ken Duckworth, and CIT Expert Sam Cochran. The film is narrated by Steve Lopez, author of the best-selling book that inspired the film The Soloist.

NAMI Tennessee Executive Director K. Jeff Fladen announced that the World Premier for CODE will be held Thursday, June 18th, at the Belcourt Theater in Nashville at 7:30 p.m.. Tickets are $15 and will be used to help defray the cost of the film. CODE also will be shown at this year’s NAMI Convention in San Francisco on July 8th. I will be in the audience for that event.

We know that Crisis Intervention Team training has revolutionized how police departments interact with individuals who are in the midst of a psychotic break. Now, CODE offers us training specifically aimed at Correctional Officers. Given that jails and prisons have become our new mental asylums, this is an important film. Please circulate the trailer, make your local correctional departments aware of CODE and spread the word.

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