INVOLUNTARY COMMITMENT DATA

 

FACTS

Pharmaceutical firm Eli Lilly and Co. posted fourth quarter net income of $567.3 million. In the fourth quarter, 84 percent of Lilly's total sales growth came from newer products, including schizophrenia drug Zyprexa. Zyprexa sales made the biggest gain in the year, nearly doubling to $1.44 billion.

January 28 INDIANAPOLIS (Reuters) Studies consistently confirm a 50-80% prevalence rate of sexual and physical abuse among persons who later acquire diagnoses of mental illness. (NASMHPD Trauma)

Schizophrenia is a term used to describe a complex, extremely puzzling condition. Because of the disorder's complexity, few generalizations hold true for all people who are diagnosed as schizophrenic. (NIMH Schizophrenia)

No specific gene has yet been found; no biochemical defect has been proven responsible; and no specific stressful event seems sufficient, by itself, to produce schizophrenia. (NIMH Schizophrenia)

Jail inmates have more legal rights and process safeguards than patients in psychiatric hospitals.

Outpatient commitment and programs for assertive community treatment transport the social control and biomedical functions of the hospital or the institution to the community. (PACT)

The existing research literature provides no empirical evidence that involuntary outpatient commitment provides an effective means to address treatment compliance problems associated with severe and persistent mental illness. (Maloy, K, 1992. "Analysis: Critiquing the Empirical Evidence: Does Involuntary Outpatient Commitment Work?", Mental Health Policy Resource Center, Washington, DC.)

The prevalence of violence among people who have been discharged from a hospital and who do not have symptoms of substance abuse is about the same as the prevalence of violence among other people living in their communities who do not have symptoms of substance abuse. (Violence Myth)

 

POINTS OF VIEW

The meaning of parity health legislation is distorted when what is called "parity" reimburses coercion only for the class of people with psychiatric disabilities. That's not parity. That's discrimination.

The public mental health system itself criminalizes and teaches violence. It uses police to gather in, handcuff and transport patients; restraints, chemicals and electricity to subdue these patients; secrecy to withhold records and legal authority to rename this medical care.

The cross-disability world prefers respectful "person-first" language. But some organizations turn people with psychiatric disabilities into objects and make it easy to distance from us by calling us "the untreated mentally ill."

Mental health clients endorse the motto "Nothing About Me Without Me" and support the majority participation of the primary voice in all determinations of policy, planning, research and evaluation.

 

FIVE ALTERNATIVES

Focus attention and legislation on the social violence and emotional and physical family battering that leads people to psychiatric disability.

Focus on reducing substance abuse by raising state taxes on alcohol and dealing harshly with heroin.

Eliminate the not-guilty-by-reason-of-insanity (NGI) defense.

Help to create Advance Directives, Durable Powers of Attorney for Health, which explain the person's own wishes, in case of incompetence, for health care for all people who use health care services. Attach a requirement for an Advance Directive as a requirement for public services.

Listen to the primary voice. Client directed services, drop-ins, peer counseling have an anecdotal track record of success and are currently being researched by the Center for Mental Health Services (CMHS). California sites are part of that project. (CMHS Client Services) The California Network for Mental Health Clients has a grant, also from CMHS, to develop Peer Counseling training. Clients are moving forward with the alternatives that our experience has shown works. The legislature could set up a Peer Counselor Certification, increase the funding for the State Networks of Mental Health Clients, appoint a client Officer of Consumer Affairs in the Department of Mental Health, encourage each county to hire an Officer of Consumer Affairs, and enroll these officers in the National Association of Consumer/Survivor Mental Health Administrators.