(April 10, 2014) The Treatment Advocacy Center reported on Tuesday that our jails and prisons have become the de facto mental institutions for people with mental illness, many of whom are kept in solitary confinement once they arrive there.

"Zookeepers are not allowed to keep zoo animals in the kind of housing that we put human beings in," said Dr. James Gilligan, clinical professor of psychiatry in the School of Medicine at New York University, about the use of solitary confinement as punishment for mentally ill inmates (“Are we torturing the mentally ill?,” The Huffington Post, April 4).

Solitary confinement is often used as a punishment of behaviors that are symptomatic of severe mental illness.

In fact, an estimated one-third to one-half of inmates in isolation “have some form of mental illness” and the isolation makes it exceedingly difficult for mental health practitioners in the jails to treat patients. Most often, the care they receive is minimal- medication and a brief check-in through the door with a clinician.

But “solitary is a crucial tool that helps guards maintain order and provide a safe environment in often overcrowded facilities,” corrections officers argue.

Placing someone who is mentally ill in solitary confinement perpetuates the problem- the more time someone with mental illness spends in solitary, the less time they spend receiving appropriate psychiatric treatment.  The more time someone remains in solitary confinement without appropriate treatment, the more likely they are to behave in a way that reinforces the decision to leave them there.

In our study on the treatment of inmates with mental illness in jails and prisons, we found there are now 10 times more individuals with serious mental illness in jails and prisons than in the nation’s remaining state hospitals. This makes the issue of how they receive treatment even more dire.

Read “The Treatment of Persons with Mental Illness in Prisons and Jails: A State Survey.”

To comment, visit our Facebook page. 
Visit our blog archive to read all our recent posts.

(April 9, 2014) In 1972, Marc Abramson, a young psychiatrist in San Mateo County, California, sounded the initial alarm for what he viewed as the “criminalization of mentally disordered behavior.” As California was emptying the state mental hospitals, Abramson was noting a rapid increase in the number of mentally ill inmates in the San Mateo County Jail. Reports from the California state prisons were describing a similar increase.

Forty-two years have elapsed since Abramson published his observations. The Treatment Advocacy Center’s newest report on the plight of individuals with untreated severe mental illness surveyed each state to ascertain what has happened to this trend during the intervening years.

“The Treatment of Persons with Mental Illness in Prisons and Jails: A State Survey” found we have placed more than 300,000 severely mentally ill individuals in prisons and jails that are neither equipped nor staffed to handle such problems. We subsequently have made it very difficult to treat the mentally ill inmates by putting restrictions on other options for controlling their behavior and then blamed the prison and jail administrators when the limited options fail. It is a situation that is grossly unfair to both the inmates and the corrections officials and should be the subject of public outrage and official action.

The survey thus demonstrates that the transinstitutionalization of seriously mentally ill individuals from state psychiatric hospitals to state prisons and county jails is almost complete. From the 1830s to the 1960s, we confined such individuals in hospitals, in large part because there were no effective treatments available. Now that we have effective treatments, we continue to confine these individuals but in prisons and jails where the treatments are largely not available. We characterize seriously mentally ill individuals as having a thinking disorder, but surely it is no worse than our own.

Excerpted from “The Treatment of Persons with Mental Illness in Prisons and Jails.” Read or download the complete report from our TACReports.org website.

To comment, visit our Facebook page. 
Visit our blog archive to read all our recent posts.

(April 7, 2014) If you missed it on C-Span, testimony from a recent House subcommittee hearing examining the disappearance of psychiatric hospital beds is available on YouTube.

“Individuals with serious mental illness who are unable to obtain treatment through ordinary means are now homeless or entangled in the criminal justice system,” Rep. Tim Murphy said in his opening statement to the House subcommittee on energy and commerce oversight and investigations, which he chairs. Watch Rep. Murphy’s opening statement.

“Community programs serve those who seek and accept treatment. Those who refuse, or are too sick to seek treatment voluntarily, become a law enforcement responsibility,” said Chief of Police Michael Biasotti, Treatment Advocacy Center board member and immediate past president of the New York State Association of Chiefs of Police. Watch Chief Biasotti’s testimony.

“Since becoming Sheriff in 2006, I have seen an explosion in the percentage of seriously mentally ill individuals housed in the jail. I have seen first-hand the devastating impact cuts to mental health programs and services has had on the mentally ill in Illinois,” testified Sheriff Thomas Dart, who oversees Cook County Jail in Illinois, the largest jail in the country. Watch Sheriff Dart’s testimony.

A week later, founding Treatment Advocacy Center executive director Mary Zdanowicz was among four witnesses at a House subcommittee hearing on Murphy’s “Helping Families in Mental Health Crisis Act.”

Watch the full hearing here.

Earlier last week, a major component of Murphy’s bill, an assisted outpatient treatment (AOT) demonstration project, was adopted by the House of Representatives and signed into law.

To comment, visit our Facebook page.

Mentally Ill Inmates Often Leave Jail Sicker Than When They Entered

(April 7, 2014) Ten times more individuals with serious mental illness are residing in state prisons and county jails today than in the nation’s remaining state mental hospitals, according to a new study from the Treatment Advocacy Center and the National Sheriffs' Association.

“The Treatment of Persons with Mental Illness in Prisons and Jails: A State Survey” found that, in 44 states, the largest institution housing people with severe psychiatric disease is a prison or jail. Nationwide, the study reports an estimated 356,000 mentally ill inmates compared with 35,000 public hospital patients.

The survey provides state-by-state illustrations of how protocols for treating mentally ill inmates who are deteriorating or acutely ill create obstacles that leave inmates without treatment for extended periods or indefinitely, especially in county jails.

The consequences of failing to treat mentally ill inmates are “usually harmful and sometimes tragic,” according to the report, which represents the first compilation of state laws and practices governing such treatment. Without intervention, symptoms worsen, leading inmates to behave in disruptive and bizarre ways and become vulnerable to being beaten, raped or otherwise victimized, mutilating themselves or committing suicide, the study found. Inmates whose symptoms are uncontrolled also are more likely to be confined in isolation or placed in restraints and, as a group, contribute to the overcrowding of prisons and jails and the increased cost of corrections for both states and counties.

“The lack of treatment for seriously ill inmates is inhumane and should not be allowed in a civilized society,” said Dr. E. Fuller Torrey, founder of the Treatment Advocacy Center and lead author of the study. “This is especially true for individuals who – because of their mental illness – are not aware they are sick and therefore refuse medication.” 

Read the executive summary of “The Treatment of Persons with Mental Illness in Prisons and Jails: A State Survey" and the full report on the TACReports.org website.

(April 4, 2014) It's civilized, not criminalized. It gives me my right to live, participate and recover in the community. Some people — who have never been in jail, homeless, or state hospital — say they do not want “forced” treatment. They say it is an abuse of our civil rights. They have no idea what force means.

I do.

Force means being ripped away from your family and all those you loved, dumped alone in a distant state hospital, when you were only 5 years old and the delusional hallucinations and voices of your illness first join you.

Force means out of the hospital you are sent to the streets and sleep in dumpsters to avoid being raped because you are too ill to ask for help.

Force means being handcuffed and shackled on the cold, wet cement of a tiny cell with only a tin can for a bathroom.  Force means when the voices became so loud, the hallucinations, so visible, that even the beat cops hear and see them.

Force means being treated like than an animal because no one is willing to help you when you are too ill to help yourself.

Force only stopped for me in 2004 when I was 35-years old and a criminal — not civil — court stepped in to say I needed treatment and the community system should give it to me.

In the community with assisted outpatient treatment, I received my right to participate in my treatment plan. I received my right to explain what my medical history was and what medication had previously worked and what had not. I received my right sleep on a bed, go to school, make friends, love my family, and to get well and stay well with the help of people who really cared about me.

I know the difference between force and assistance. There is nothing civil or right about force. Please protect me from those who want to force their beliefs on me and say it shouldn’t be my right to receive assisted outpatient treatment (AOT). I do not want to go to jail again. I do not want to live in a dumpster. I do not want to die.

Should I ever become so sick again, please give me Laura’s Law.

JOY TORRES
CONSUMER AND ADVOCATE

To comment, visit our Facebook page. 
Visit our blog archive to read all our recent posts.

(April 3, 2014) I am my mother’s daughter. I never knew anything other than a life surrounded by serious mental illness. My mother was seriously mentally ill from as far back as I can remember.

Growing up in our family was like living in a combat zone. It never felt safe because you didn’t know when the other boot was going to drop. The drastic mood changes, intense paranoia, grandiose ideas, impulsivity, delusions, depression and anger created a frightening environment for a child who depended on her. This led to emotion and physical neglect, as well as emotional, verbal and at times, physical abuse. And yet I loved my mother. I watched as my father, and later my siblings and I, were powerless to help her.

My mother had zero insight into her illness. She did not believe she was ill. We call that anosognosia. It affects up to 40% of those with schizophrenia and bipolar disorder. Because she didn’t believe she was ill, she would not stay in treatment and as a result could not take care of herself, let alone, me.

She had suicidal ideation, delusions I was possessed, multiple hospitalizations and would disappear for spells at a time…sometimes hours, sometimes weeks and we were powerless to do anything but watch her deteriorate.

I believe in self-determination for those who are capable but we must recognize that there is a small group of people, like my mother, who are too ill to self-direct their own care. We can’t pretend these people don’t exist because by doing so, we marginalize them. They are our loved ones. They cower in their rooms believing an FBI planted a transmitter in their heads. They refuse to eat for fear of being poisoned.

The mental health system won’t help them because they are not well enough to volunteer for treatment.

SYLVIA THOMPSON
PRESIDENT OF NAMI WEST SIDE LOS ANGELES
Read Sylvia Thomson’s full testimony to Congress on H.R. 3717

Lawmakers, patient advocates and family members and people living with psychiatric diseases heard testimony today on Representative Tim Murphy’s Helping Families in Mental Health Crisis Act. Read all testimonies from today’s hearing. With more than a dozen democratic co-sponsors in the house, the bill has broad bipartisan support.

To comment, visit our Facebook page. 
Visit our blog archive to read all our recent posts.

(April 2, 2014) Patients with schizophrenia and bipolar disorder have common biological markers with stress and immune reactions, suggests new research from Australia.

With data from tissue samples taken from the Stanley Medical Research Institute, the Schizophrenia Research Institute compared 35 mentally health individuals, 35 patients with schizophrenia and 34 bipolar patients (“Genes signaling inflammatory stress reactions shared between schizophrenia, bipolar disorder,” Healio Psychiatry, Mar. 21).

The study found that individuals diagnosed with schizophrenia showed the highest levels of an inflammatory-related gene compared to their counterparts diagnosed with bipolar disorder and to those with no diagnosis of mental illness. Individuals with severe mental illness also showed significantly higher levels of stress compared to their healthy counterparts.

"Our data suggest an interrelationship between stress signaling and immune function in the frontal cortex of a portion of individuals, primarily those with bipolar disorder and schizophrenia,” said Stu G. Fillman, the study’s lead author

“Although data on cortisol levels of individuals in this cohort are not currently available," Fillman continued,“it is plausible that elevated cortisol levels in individuals with schizophrenia and bipolar disorder may drive the observed changes in both stress and inflammatory gene messenger RNAs.”

The study also found changes in other areas: immunity factors, cell growth, inhibitory signaling and cell death. The mechanism through which these associations occur will require further study, the researchers said.

The Stanley Medical Research Institute is a supporting organization of the Treatment Advocacy Center.

To comment, visit our Facebook page. 
Visit our blog archive to read all our recent posts.

(April 1, 2014) A national assisted oupatient treatment (AOT) demonstration project is a step closer to reality today, thanks to Rep. Tim Murphy (R-Pennsylvania) and Senator Debbie Stabenow (D-Michigan).

Last December, Murphy introduced the Helping Families in Mental Health Crisis Act (HR 3717), the most significant federal attempt to reform mental health care in the US since the Kennedy era.

Among the bill’s many groundbreaking provisions is a federal assisted outpatient treatment grant program to help local mental health systems launch their own AOT programs. First proposed by the Treatment Advocacy Center in January 2013 as a recommendation to Vice President Biden’s task force on gun violence, the federal grant program would be a godsend to the many local officials who tell us they believe in AOT but are challenged to raise the start-up costs, however modest, in a time of slashed public mental health budgets.

While work goes on to build support for HR 3717 itself – including a hearing this Thursday in the House Subcommittee on Health – Murphy and Stabenow last week added the AOT demonstration project to an unrelated bill to delay a scheduled cut in doctor reimbursements under Medicare (the “Doc Fix”). When President Obama signs the legislation, as expected, the Department of Health and Human Services will have authority to award $60 million for up to 200 AOT start-up grants over the next four years. (Individual grants could award up to $1 million.)

“Authority” represents only half the battle here. For the program to take shape, Congress must next appropriate the necessary funds. To keep up to date on this potentially enormous breakthrough (and help us support the programmatic request at the appropriate time), please make sure you are signed up for our email updates.

In the meantime, we commend and congratulate Rep. Murphy and Senator Stabenow for their great work in bringing the dream of an AOT grant program to life.

To comment, visit our Facebook page. 
Visit our blog archive to read all our recent posts.

(March 27, 2014) Sen. Creigh Deeds, a Virginia Democrat advocating for better access to mental health care, will speak at the National Press Club Monday March 31. Deeds became an advocate after his son was denied a bed when in a psychiatric crisis and subsequently wounded his father before committing suicide.

“The system failed my son,” Deeds has said. “For too long we've been shoving ... problems with respect to the mentally ill under the table . . . We need to take a good long look at fundamental changes in our system of care."

Following the tragedy, Deeds introduced several bills that might have helped his son, including one that would create a real-time psych bed registry and another that would increase the duration of emergency psychiatric holds from four hours – currently the shortest in the nation – to 24.  

The speech on March 31 will be the first time Deeds addresses the topic in Washington.

Sen. Deeds is a former county prosecutor who authored a law allowing public access to the Virginia sex offender registry. He was elected to the Virginia House of Delegates in 1991 and left the House in 2001 to join the state Senate. He was the Democratic nominee for governor in 2009.

Lunch will be served at 12:30 p.m., with remarks beginning at 1 p.m., followed by a question-and-answer session ending at 2 p.m. Tickets cost $36 for non-Press Club members (click here to purchase tickets). For questions about the event, please email This e-mail address is being protected from spambots. You need JavaScript enabled to view it or call (202) 662 – 7501.

To submit a question for the speaker in advance, put DEEDS the subject line and email to This e-mail address is being protected from spambots. You need JavaScript enabled to view it before 10 a.m. on the day of the luncheon.

To comment, visit our Facebook page. 
Visit our blog archive to read all our recent posts.

(March 26, 2014) “What would have happened if Aaron Alexis was not just given sleeping pills at the VA? Or if there was an available hospital bed or outpatient treatment available for others who later became violent, involved in a crime, unable to pay bills, or tossed out on the street?”

These were the questions posed by Rep. Tim Murphy  as he opened at this morning’s House subcommittee hearing on the shortage of psychiatric beds, the latest in a  series of hearings he has chaired on the nation’s broken mental health system.

For more than three hours, a panel of experts and family members described the devastating impact the psychiatric bed shortage has on patients and communities.

“Community programs serve those who seek and accept treatment. Those who refuse or are too sick to seek treatment voluntarily become a law enforcement responsibility,” said Chief of Police Michael Biasotti, Treatment Advocacy Center board member and immediate past president of the New York State Association of Chiefs of Police. “Hospitals are so overcrowded they often can’t admit new patients and discharge many before they are stable. They become what we call ‘frequent flyers.’” Read Biasotti’s testimony.

“My son was admitted on Friday morning and was in the ED that whole day, all day Saturday, all day Sunday and until late Monday afternoon because they could not find an open psych bed anywhere,” Lisa Ashley, the mother of a man with paranoid schizophrenia, told the committee. “He stayed in a room, tied to his bed for those four days and was heavily medicated. . . . I wondered ‘does it take that long to find a psych bed?’” Read Ashley’s testimony.

 “This is a crisis we must all care about – regardless of political affiliation – because it affects us all,” testified Sheriff Dart, who oversees Cook County Jail in Illinois, the largest jail in the country. “While some mentally ill individuals are charged with violent offenses, the majority are charged with crimes seemingly committed to survive, including retail theft, trespassing, prostitution and drug possession. . . . We have criminalized mental illness in this country and prisons and jails are where the majority of mental health care is administered.” Read Sheriff Dart’s testimony.

“Homelessness and mental illness are inextricably intertwined,” said Gunther Stern, executive director of Georgetown Ministry Center, which provides support to chronically homeless men and women in Washington DC. “Greg is someone I first met sitting on a bench in a nearby park. He was shabbily dressed and smelled bad. He would drink, I assume to tame the voices in his head. All of this belied the fact that Greg was once a gifted constitutional lawyer who delighted his children with his dry wit.” Read Stern’s testimony.

“It is an unplanned, albeit entirely unacceptable consequence of deinstitutionalization that the state psychiatric asylums, dismantled out of concern for the humane treatment and care of individuals with serious mental illness, have now effectively been replaced by confinement in prisons and homeless shelters,” Murphy said.

Read about Murphy’s plan to fix the nation’s broken mental illness treatment system.

To comment, visit our Facebook page.