Personally Speaking: Farewell but not Goodbye
By Brian Stettin
This week I will be leaving my position as policy director for Treatment Advocacy Center. After nearly 13 years in the best job I’ve ever had, the moment calls for reflection on the remarkable path we have taken together and the unfinished business that lies ahead.
My connection to Treatment Advocacy Center goes back the organization’s earliest days. I have written previously about the critical assistance I received from the staff in 1999, as a young assistant attorney general tasked with drafting and marshaling of support for New York’s Kendra’s Law. In the decade that followed those extraordinary eight months, I held three positions in New York state government, addressing a variety of important matters, but it mostly felt anticlimactic. My collaboration with Treatment Advocacy Center and exposure to the writings of its founder Dr. E. Fuller Torrey had awakened me to the mental health system’s cruel abandonment of the most severely ill. The moral imperative to be part of the solution had lodged itself under my skin, and I needed to find my way back to it.
As this realization set in, there was never a question that Treatment Advocacy Center would have to be my vehicle. No other organization had the clarity of vision and willingness to speak uncomfortable truths that the challenge demanded. (Which is to say that Treatment Advocacy Center was forged in the image of Dr. Torrey himself.) And in 2009, we made it happen. My family and I relocated to Washington, and I stepped into the role that has afforded me the greatest privilege any job can provide: the sense of doing with one’s life the very thing one should be doing.
It took time to find my footing. There was much to learn: a slate of policy priorities beyond the need for universal AOT; the unique political dynamics of each state we targeted for reform; and the quirks and commonalities among the civil commitment laws of 54 states and U.S. territories.
My first advocacy trip for Treatment Advocacy Center was to New Mexico, a state that had long resisted efforts to pass AOT. It did not go well. A legislator interrupted my committee testimony to rebuke me, and the worst part was that her criticism wasn’t entirely unfair. I licked my wounds and learned from it, and a few years later managed to push through AOT in New Mexico, working closely with a state senator who had been among the skeptics at that first hearing.
I wish I could say that all my advocacy efforts turned out as well in the end, but this work requires a fairly high tolerance for frustration. The question lingering in the back of the mind of any advocate is always: Am I making a difference? When the wrong to be righted is deep-seated, complex and decades in the making, there will inevitably be grist for discouragement. But we must never discount the many dents we make by improving state treatment laws and helping communities make use of them. Each small victory rescues some number of human beings from the ravages of untreated SMI. And each sets the stage for the next, bringing us a little closer to the day when systemic dysfunction will be a bad memory.
I am proudest of the role I have played in moving Treatment Advocacy Center into the arena of fostering AOT implementation on the local level, through direct engagement with practitioners. In one sense, this work has made us a very different organization than the one I joined in 2009, when we focused entirely on pursuing changes in law and state policy. But it has been a shift only in tactics, not in mission. As ever, we are working to make AOT a routine tool in the toolbox of every public mental health system in America. And the progress on that front has been dramatic and undeniable. In 2009 we were aware of only a few scattered pioneering AOT programs outside of New York (where Kendra’s Law mandated universal implementation). Today our schedules are packed with Zoom meetings with AOT programs sprouting up everywhere – 124 of them in our latest count!
It would triple the length of this piece to give due credit to all the incredible colleagues I’ve had the honor of working with over my tenure, but I must single out my two partners in the creation of our AOT Implementation Unit, Amy Lukes and Betsy Johnson. We have truly been a “dream team,” not only because of the distinct areas of expertise each of us offers the AOT practitioners we work with, but also because Amy and Betsy’s attention to detail and organizational acumen have papered over my own deficiencies in those areas. They have big plans to take what we have been doing these last few years to the next level, and it will be fun to watch them pull it off.
Indeed, it has never been clearer to me that Treatment Advocacy Center’s best days are ahead of it. Much of my basis for that view rests in the leadership of my good friend and longtime colleague, Executive Director Lisa Dailey. Lisa’s inspiring vision for what Treatment Advocacy Center can be has helped us to punch even higher above our weight class. Another source of the organization’s strength is its Board of Directors. I am eternally grateful to the Board for its devotion to improving conditions for people with SMI, and its rare commitment to getting to know the staff and engaging with us personally.
I must also extend my heartfelt thanks to those who constitute the backbone of Treatment Advocacy Center: the families of individuals with severe mental illness across the United States who steadfastly refuse to accept a grim fate for their loved ones. You sustain us -- not only through your financial support, but just as importantly by contributing your stories to our advocacy and reminding us every day of the life-and-death stakes of the work we do.
While the time has come for me to step away from Treatment Advocacy Center, rest assured I am not stepping one inch away from its cause. I am not yet at liberty to announce what I will be doing next, but Treatment Advocacy Center will be able to share some news on that in the very near future.
Our shared quest continues. See you in San Antonio!
Brian Stettin is the former policy director for Treatment Advocacy Center.