NYAPRS Note: While we usually try to avoid dignifying the work of DJ Jaffe, I do want to refer to the article that follows this announcement regarding the next SAMHSA’s Center for Mental Health Services National Advisory Council on February 1.
If you can make it through, Jaffe launches yet another rant spinning his well-worn wildly unsubstantiated claims tying SAMHSA and the recovery movement with every tragic death and encounter with the criminal justice system and homelessness involving a person diagnosed with a serious mental illness. Along the way, he attacks preventive ‘Mental Health First Aid’ programs and peers on teams that enforce outpatient commitment orders and continues his crusade focused solely on more hospitalizations, medication and court mandated care, with never a word about all of the progressive innovations that have been launched over the past few decades.
SAMHSA spends the tiniest amount of its program dollars and education and TA initiatives on bullying initiatives or other preventive measures but you’d never know that from reading Mr. Jaffe. Recovery, rehabilitative and relapse and crisis management programs are apparently anathema to him, or perhaps they’ve escaped his extremely narrow view because they don’t fit his narrative.
It’s too bad that this politicized propaganda gets so much public attention because those approaches have spared millions of what he’d call ‘the sickest’ individuals from disabling chronic disease, death, despair, isolation, suicide, incarceration and homelessness.
Full disclosure, NYAPRS offers technical assistance to state and local groups on peer approaches that engage and serve what he’d call the ‘sickest and most resistant’ individuals via indirect SAMHSA funding to the tune of 3% of our budget, a relatively scant amount I’d give back in a minute to refute Jaffe’s claim that anyone who opposes his miniature world view is motivated via a collusion with the federal agency that has helped save or advance the lives of tens of millions of Americans over the past few decades.
Let’s hope that in 2017 this dark distraction is one of the casualties of draining the swamp of what ails us.
There�I feel better now�.this was just a holiday present to myself. Happy New Year everybody. Harvey Rosenthal
This is a save the date for the next meeting of the SAMHSA/Center for Mental Health Services National Advisory Council on February 1, 2017. More information will be shared closer to the date.
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Substance Abuse and Mental Health Services Administration
Notice of Meeting Center for Mental Health Services
Pursuant to Public Law 92–463, notice is hereby given that the Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Mental Health Services (CMHS) National Advisory Council (NAC) on February 1, 2017, from 9:00 a.m. to 5:15 p.m. E.D.T.
The meeting will include discussion of the Center’s policy issues, and current administrative, legislative, and program developments and a conversation with the SAMHSA Principal Deputy Administrator, and the SAMHSA Chief Medical Officer.
The meeting will be held at the SAMHSA building, 5600 Fishers Lane, 5th Floor, Conference Room 5W07, Rockville, MD 20857. Attendance by the public will be limited to space available. Interested persons may present data, information, or views, orally or in writing, on issues pending before the committee. Written submissions should be forwarded to the contact person (below) on or before January 18, 2017. Oral presentations from the public will be scheduled at the conclusion of the meeting. Individuals interested in making oral presentations are encouraged to notify the contact on or before January 18, 2017. Five minutes will be allotted for each presentation.
The meeting can be accessed via telephone. To attend on site, obtain the call-in number and access code, submit written or brief oral comments, or request special accommodations for persons with disabilities, please register at the SAMHSA’s Advisory Committees Web site at http://nac.samhsa.gov/Registration/meetingsRegistration.aspx or contact Pamela Foote (see contact information below).
Substantive meeting information and a roster of Committee members may be obtained either by accessing the SAMHSA Committees’ Web site http://www.samhsa.gov/about-us/advisory-councils/cmhs-national-advisory-council or by contacting Ms. Foote.
Committee Name: Substance Abuse and Mental Health Services Administration, Center for Mental Health Services National Advisory Council.
Dates/Time/Type: Wednesday, February 1, 2017, 9:00 a.m. to 5:15 p.m. EDT: OPEN.
Place: SAMHSA, 5600 Fishers Lane, 5th Floor, Conference Room 5W07, Rockville, Maryland 20857.
Pamela Foote, Acting Designated Federal Official,
SAMHSA CMHS National Advisory Council,
5600 Fishers Lane, Room 14E53C,
Rockville, Maryland 20857,
(240) 276– 1279,
Mental health malfeasance
Donald Trump should make sure he drains the swamp at the federal mental health agencies
By D.J. Jaffe Pittsburgh Post-Gazette | December 27, 2016
The 21st Century Cures Act signed by President Barack Obama contains smart, well-designed mental-health provisions. But unless President-elect Donald Trump and Tom Price, his nominee for secretary of health andhuman services, “drain the swamp” at the Substance Abuse and Mental Health Services Administration and the Center for Mental Health Services, many of the new law’s useful provisions could be negated or undone by the permanent bureaucracy.
SAMHSA and CMHS are largely responsible for overseeing and implementing federal mental health policy, and will remain so under the Cures Act. Unfortunately, those agencies are failures, as SAMHSA’s former chief medical officer, Elinore McCance-Katz, revealed in an op-ed, after she left the agency in disgust in 2015.
“SAMHSA does not address the treatment needs of the most vulnerable in our society. There is a perceptible hostility toward psychiatric medicine, a resistance to addressing the treatment needs of those with serious mental illness, and a questioning by some at SAMHSA as to whether mental disorders even exist — for example, is psychosis just a ‘different way of thinking for some experiencing stress?’”
SAMHSA and CMHS virtually ignore skyrocketing rates of homelessness, arrest, incarceration, suicide and hospitalization that occur when the seriously mentally ill are allowed to go untreated. Instead, they wrap the provision of social services in a mental health narrative and divert funds to unrelated or ineffective programs.
These agencies encourage states to spend part of the $500 million that they receive in federal mental health block-grant funding on people who don’t even have mental illness and on “prevention,” though serious mental illnesses, such as schizophrenia and bipolar disorder, can’t be prevented.
Nonprofit groups that depend on SAMHSA funding have lobbied states to close psychiatric hospitals, thereby making treatment more difficult. Recently, SAMHSA-funded groups convinced New York City to divert $8 million of city funds to Mental Health First Aid, a SAMHSA-promoted educational program that trains people to “better recognize the signs, symptoms and risk factors of mental illness and addiction and more effectively provide support.” The program does nothing to help the mentally ill because no treatment is made available, even when symptoms are identified.
SAMHSA and CMHS are failed agencies that have almost no support from anyone other than those whom they fund. Thanks to the leadership of U.S. Rep. Tim Murphy, R-Upper St. Clair, the mental health provisions of the Cures Act attempt to refocus SAMHSA and CMHS on the seriously ill — as opposed to the worried well — and to rely on science rather than pop psychology.
The Cures Act replaces the SAMHSA administrator with an assistant secretary for mental health and substance-use disorders. The person who fills this important job will be responsible for both SAMHSA and CMHS, and for coordinating mental health policy with other federal agencies.
Mr. Trump should appoint a top psychiatrist like Dr. McCance-Katz or others who are committed to focusing on the seriously ill and ending the funding of nonsense. Or he could appoint a judge who is committed to reducing incarceration of the seriously mentally ill.
Mr. Murphy, along with powerful Texas Republican Sen. John Cornyn, included in the bill many provisions that are designed to force SAMHSA and CMHS to focus on the seriously ill. In the past, however, these agencies have ignored congressional direction, especially as it relates to assisted outpatient treatment.
Known as “Kendra’s Law” in New York and “Laura’s Law” in California, AOT is court-ordered out patient treatment of the most seriously ill, who may be so sick that they are unaware of their own symptoms. AOT is reserved for a tiny group of patients who have historically failed to comply with treatment. By keeping such patients out of jails and hospitals, and ensuring that they take prescribed violence-preventing medications, AOT has improved outcomes and reduced the costs of care.
The Cures Act extends and modestly expands federal AOT funding through 2022. The last time Congress funded AOT, however, CMHS bureaucrats hijacked the grant-funding process, giving preference to states whose AOT teams employed a “peer-support worker.” In other words, the agency required state mental health agencies to hire people with mental illness. There is no evidence that this improves outcomes, but it clearly increases costs.
SAMHSA-funded groups succeeded in watering down the final bill. Early iterations of the Cures Act contained provisions that would have allowed parents to access medical information about their seriously mentally ill adult children, as well as provisions to increase the number of hospital beds available to the seriously ill and rein in federally funded anti-treatment lawyers.
But the bill is still a major step forward. It provides funding for mental health courts, which can divert nonviolent, seriously mentally ill offenders to mandated treatment instead of jail. It provides funds to train police on how to de-escalate interventions with the seriously ill. It provides for the collection and dissemination of data on the number and types of crimes committed by mentally ill individuals, the involvement of mental illness in deadly incidents involving law-enforcement officers and the costs of imprisoning the seriously ill.
For too long, we have spent too much on trying to improve “mental wellness” — whatever that is — rather than delivering treatments that can reduce homelessness, arrest, incarceration, suicide and hospitalization among the seriously mentally ill. We’ve sent the least ill to the head of the line and the most-seriously ill into the shadow mental health system of jail and prison. Bullying and stress have been treated; schizophrenia and bipolar have been ignored. This bill attempts to end that insanity.
And if the right person is appointed as assistant secretary, it will likely work.
D.J. Jaffe is executive director of Mental Illness Policy Org. and the author of “Insane Consequences: How the Mental Health Industry Fails the Mentally Ill.” This piece originally was published in the Manhattan Institute’s City Journal.