(5-11-21) The American Psychiatric Association awarded its 2021 Distinguished Service Award to the Treatment Advocacy Center, founded by Dr. E. Fuller Torrey.

What’s interesting about the APA award is that it shows that Dr. Torrey’s 1998 creation is no longer, as one advocate put it, “a scrappy underdog”  hoping for a seat at the table.

The award and TAC’s recent actions cement its role as a power player. This is especially true when it comes to calling for criminal justice reform. More than mainline organizations such as Mental Health America and the National Alliance on Mental Illness, TAC has arguably been the most aggressive critic of the inappropriate incarceration of Americans with mental illnesses.

Calling TAC a “David to the Goliath” of a mental health care system that fails to meet the needs of individuals with serious mental illnesses, Dr. Jeffrey Geller, president of the APA, said in announcing the award:

“Not afraid to go out front with issues that could fundamentally improve the lives of persons with SMI but were not initially seen favorably, Treatment Advocacy Center has led the way to the availability of Assisted Outpatient Treatment (AOT) in almost every state.

“It has and is doing so by nurturing the concept, educating all stakeholders, developing model legislation, lobbying for statutory changes, and assisting in implementation. Treatment Advocacy Center continues in these efforts, focused on expanding the utilization of AOT statutes nationwide.”

The APA Distinguish Service Award honors “exceptional meritorious service to the field of psychiatry.” APA describes itself as the “leading psychiatric organization in the world” with some 40,000 members in a hundred different countries, all engaged in psychiatry.

TAC’s agenda has not made it universally loved. Mental Health America, the Bazelon Center For Mental Health Law, and groups such as Mad In America, strongly oppose AOT. Critics also have accused TAC of releasing reports that bend facts to push its platform.

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(5-7-21) From My Files Friday: Summer days cause me to remember Sam Ormes, one of the most creative, goofy, and caring individuals I’ve ever met inside a jail. It was a hot day in 2004 and I was doing research inside the Miami Dade Detention Center for my book, CRAZY: A Father’s Search Through America’s Mental Health Madness, when I heard about a cantankerous employee who had created a television station inside the old jail that was giving inmates hope and purpose. Sadly, jail officials eventually shut down Sam and his station but not before his creation made national news and helped dozens of inmates, including those with mental illnesses. Sam died nearly five years ago without much fanfare, but he was a light in a dark place.  

 A  Story of Zany Antics, Creativity, and Redemption Inside A Dismal Jail

I found him in a tiny cubicle crammed with electronic gizmos inside the Miami Dade jail.  Sam Ormes looked like a hoarder. Nearly every inch of the space was filled with television equipment, cameras, video tapes and stage props, including a rubber chicken hanging on a rope from the ceiling near his desk chair.

Sporting a bow tie, a 1960s style beatnik goatee and reading glasses perched on the tip of his nose, Sam explained that he was the originator and driving force behind Inmate Corrections Television, better known as ICTV.

An inmate televisions station in a jail? How did that happen? I asked. He told me to sit down and listen.

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(5-3-21) How do you help someone who is addicted, seriously mentally ill and living on the streets in Los Angeles’ Skid Row?

Today’s guest blog comes from Dr. Susan Partovi, MD, who has been helping those on skid row streets in Los Angeles for more than 17 years and is the Medical Director for Homeless Health Care LA.

I would argue that she is more familiar with the problems and what needs to be done than most us, including directors of mental health organizations, civil rights lawyers in Washington D.C., and politicians drafting legislation. As of a 2019 count, the population of the Skid Row district was 4,757. Skid Row contains one of the largest stable populations (about 4,200–8,000) of homeless people in the United States 

She needs to be heard. 

Meet Skid Row’s Josephine

By Dr.  Susan Partovi

Josephine is a drug user on skid row in her early 40’s with bipolar disorder. This means that she often has episodes of psychosis.  She often trades sex for her drugs which has left her open to the savages of that lifestyle.

Since I first met her, she has become blind because she once was hit so hard that her retinas detached. She has acquired HIV. She often sees me for STD symptoms. Last week, I saw her with a huge bruise on her face. Her jaw looked broken. Sometimes I see her completely psychotic speaking in an unintelligible language. She sometimes comes in irate yelling at whomever and we calm her down. She has been hospitalized frequently for danger to self or danger to others and in and out of jail.

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(4-28-21) In a 2018 newspaper interview, President Joe Biden’s nominee to become the new Assistant Secretary for Mental Health and Substance Abuse opposed Assisted Outpatient Treatment.

I wrote on Monday that Dr. Miriam E. Delphin-Rittmon will have to navigate between opposing views in charting SAMHSA future, including AOT. Her predecessor pushed for greater use of it but AOT often is strongly opposed by those with lived experience and peer organizations.

A reader sent me a 2018 newspaper interview with Dr. Delphin-Rittmon that was conducted after the Treatment Advocacy Center, which lobbies for more use of AOT, gave her home state of Connecticut a ‘failing grade.’ It is one of three states that don’t authorize use AOT.

It’s likely Dr. Delphin-Rittmon will be questioned about AOT when the Senate Health, Education, Labor and Pensions Committee conducts her confirmation hearing. (You can check its membership and schedule here.)

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(4-26-21) President Joe Biden’s nominee to run the federal government’s mental health and substance abuse programs is largely unknown in Washington D.C. among mental health leaders.

Biden announced on Friday (4-23-21) that he’d chosen Dr. Miriam E. Delphin-Rittmon to be the next Assistant Secretary for Mental Health and Substance Abuse. She currently serves as the Commissioner of the Connecticut State Department of Mental Health and Addiction Services. If her nomination is approved by the U.S. Senate, she will take charge of SAMHSA, with a $6 billion budget, much of which is distributed through block grants to states.

As SAMHSA head, she will spell out priorities for that agency during the next four years.

Asked over the weekend for comments, several leaders of major mental health organizations, replied that they had heard “good things” about the nominee from their members and other contacts in Connecticut, but few had dealt personally with Dr. Delphin-Rittmon.

An exception was former Assistant Secretary Dr. Elinore McCance-Katz, who the nominee will replace.  They worked together at SAMHSA during the Obama Administration. Dr. Delphin-Rittmon spent two years there, according to her official resume released by the White House.

“I met Miriam when I came to SAMHSA as the Chief Medical Officer and she was a Senior Adviser. I liked her very much. She is bright, knowledgeable, and a very nice person. I don’t know what direction she will take as the Assistant Secretary, but I am confident that she will be dedicated to working on behalf of Americans with mental and substance use disorders.

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(4-23-21)  Three items worth your time.

1. Two national mental health advocates warn that Americans with serious mental illnesses are not getting vaccinated and a “schizophrenia diagnosis is the second largest predictor of mortality from COVID-19, after age.”
2. Arlington Va. advocates gain an ally in pushing for Coordinated Specialty Care (CSC) for those with early episode psychosis (or First Episode Psychosis).
3. “If you tried, you couldn’t create a worst mental health system than what we have today,” claims Dr. Steve Seager in a powerful documentary that shows how our rush to close state hospitals has increased incarceration, homelessness, deaths and the abandoning of 350,000 on our streets. Featured in this film, which I missed when it was first released, are frequent guest bloggers on my page – Laura Pogliano, Teresa Pasquini, Susan Inman and the late D. J. Jaffe.

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