IOC ain't fo' me!!!
Coalition on Homelessness, SF (coh@sfo.com)
Mon, 15 Nov 1999 19:04:42 -0800
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HOMELESS PEOPLE'S VIEWS, News, Alerts, Actions & Research
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Promoting Stigma
After decades of neglect, our state legislature is being aggressively
lobbied to restore California's mental health system. All of the
proposed treatment enhancements and services are desperately needed
and would be welcome, with one exception - an attack on the civil
rights of mentally disabled people called involuntary outpatient
commitment.
Involuntary outpatient commitment is court-mandated medication
compliance. It can mean a person is court-ordered to keep regular
clinic appointments to receive long-lasting injections of powerful
psychiatric drugs. The consequences of non-compliance are hospital
commitment and forced drugging. These proposed legal provisions are
termed "assisted treatment."
In practice, its primary victims are poor and homeless people,
particularly African-American men. In some urban areas, homelessness
itself is interpreted as proof of "grave disability", creating the
justification to drug homeless people against their will. In states
where this policy is law, forced medication coupled with a lack of
medical supervision has led to deaths due to toxic levels of
psychiatric medication.
At New York City's Bellevue hospital, a pilot study testing the
viability of involuntary outpatient commitment failed to support its
advocates' claims. A three year study of its relative effectiveness
found no statistically significant differences between the
experimental group, a control group, and those who discontinued
treatment in the areas of re-hospitalization, arrests, violence,
symptomatology, or quality of life. It concluded: "there is no
indication that, overall, the court order for outpatient commitment
produces better outcomes for clients or the community than enhanced
services alone."
Alarmingly, it also noted that the court procedures themselves became
perfunctory, and accountability was so lacking that renewal orders
frequently occurred without a formal hearing, despite the fact that
"the court order itself had no discernible added value in producing
better outcomes."
The betrayal of the de-institutionalization movement in California
only became apparent when the state-funded community-based mental
health services to replace the snake pits were themselves facing
extinction. Now we are faced with a proposal to criminalize an entire
community of people based on disability. Disability isn't a choice;
it's something each of us learns to accommodate as best we can. We
need to ask ourselves: how many violent acts committed by untreated
mentally ill people, however sensationalized, might have been
prevented if a comprehensive range of voluntary, culturally
appropriate community mental health services had been available?
A look at twentieth century history gives the best illustration of
how far stigmatization, scapegoating and hate can go when
misrepresented as scientific authority.
Eugenics originated as a sub-discipline of psychiatry here in the
United States. The first compulsory sterilization laws in Germany
were modeled on American sterilization laws enacted a decade before.
In the three years from 1941-1943, over 42,000 Americans were
sterilized under the Model Eugenical Sterilization Law.
California led the nation with over 10,000 forced sterilizations
(mostly persons of color). The "mental diseases" targeted by this law
were "insane", "feeble-minded", "epileptics", and "idiots".
The Holocaust's first victims were "mentally ill" people. The first
extermination facilities were operated by psychiatrists, who then
trained the SS how to use them. In a society where ruling authority
was maintained in the name of a higher "biological" principle,
psychiatrists weren't ordered to murder people, they were simply
empowered to do so by their government, so they did. In 1941, 90,000
German psychiatric inmates were murdered, 71,000 in gas chambers at
psychiatric institutions.
If our generation remembers no other lesson, we must remember that no
supposed biological marker - no stigma - is reason enough to deny
anyone's liberty. We must support fully funded, community-based,
VOLUNTARY mental health treatment before we consider discarding
another person's self-determination.
If it isn't voluntary, it isn't treatment.
630 words
Chance Martin is editor of the STREET SHEET, published by the
Coalition on Homelessness, San Francisco. He has also directly
experienced homelessness and forced treatment due to severe
psychiatric disability.
********************************************************************
Public Testimony for Mental Health Forum 11/16/99
Good afternoon, my name is chance martin, and I am a psychiatrically
disabled adult. I live in the Tenderloin and work for the Coalition
on Homelessness, where I edit the STREET SHEET and participate as a
consumer on our Substance (Ab)use / Mental Health work group.
I've been asked to say a few words about the prospect of changing our
California Welfare and Institutions Code to provide the legal basis
to compel consumers living in the community to participate in
treatment, willing or not. For the sake of brevity, I won't speak to
the obvious and utterly reproachable attack on the most basic civil
and human rights of mentally ill people that these proposals
represent.
Instead, I'm just going to outline the social context in which these
unnecessary and morally reprehensible proposals are being made.
The December issue of MOTHER JONES magazine has a fascinating article
about NAMI, one of the principle organizations campaigning to erode
the safeguards to the civil rights of persons suffering psychiatric
illnesses as outlined in the California Welfare & Institutions Code's
Lantermann, Petris, Short Act. While NAMI portrays itself as a
"grassroots" organization representing the interests of mentally ill
people and their families, they have accepted almost 12 million
dollars from pharmaceutical companies from 1996 to 1999 alone. When
we "follow the money" we find solid and valid reasoning for the
growing concern among many consumers nationally that NAMI's primary
advocacy agenda is to further the interests and influence of
corporate pharmaceutical giants.
The revelations outlined in the article range from the alarming to
the absurd, the most ironic being that while NAMI budgets 4 million
dollars annually to combat discrimination against people with mental
illnesses, while they maintain the speculative assertion that mental
illnesses are biological in nature. They portray mental illness as
"biologically-based brain disorders," despite the fact that no
empirical scientific research exists to support such claims, thus
sowing the seeds of stigma for those who suffer mental illness. They
then spend an obscene amount of cash to combat the fruits of the
stigma they have sown. Sounds like a closed-feedback loop ensuring
job security for NAMI's staff. It also sounds like NAMI's
organizational cognitive disorder can truly be characterized as "a
danger to itself and others."
Then we have the "Treatment Advocacy Center," and it's champion of
forced treatment, Dr. E. Fuller Torrey. While this man waxes eloquent
about the prospects of social control through chemistry, what is
missing from the dialogue is his own morbid obsessions, best
evidenced by the fact that this man keeps the largest collection of
human brains since the infamous Dr. Mengele.
With all the brains this guy's got, and all of his corporate backing,
one might expect that he would have produced hard evidence that the
brains of persons with psychiatric disabilities are actually
different than those of "normal" people, but he hasn't. All he has is
his morbid little slide collection of brains that have been scarred
and disfigured by years of psychiatric medications which he often
uses as a backdrop for his presentations in pursuit of legitimacy.
Again, this charade is financed largely by our corporate
pharmaceutical oppressors.
At the Coalition on Homelessness, we have a different understanding
of what "grassroots advocacy" really means. We recently undertook the
task of recruiting and training volunteer mental health consumers to
survey 282 homeless people who self-identified as suffering from
mental illnesses. What we were seeking was the input of homeless
mentally ill people to guide our advocacy efforts, and to instruct us
in what kinds of services they want. We imagine organizations like
NAMI might find our methods radical by their standards, but
fortunately we don't labor beneath the handicap of plush offices in
which to devote our time determining how to spend a
multi-million-dollar budget.
We found that among the respondents to our survey, 152 homeless
people had tried to voluntarily access mental health services, and of
those seeking voluntary treatment, 31% or 47 people could not access
the services they needed. Let me restate that figure for emphasis:
31% of homeless people so tormented by mental illness that they would
voluntarily seek treatment couldn't get any. This lack of
accessibility to community-based voluntary mental health services for
poor and homeless people is why San Francisco has the highest rate of
involuntary commitment in the state.
Simply put, hundreds of homeless people aren't be able to access
services until they are legally determined to be a danger to
themselves or others. By not making enough voluntary services
available at a community level, San Francisco allows homeless
mentally ill people to suffer to the extent that they qualify only
for the most expensive, most restrictive treatment we can offer them.
This, in turn, creates so much demand on our psychiatric emergency
services that those who are detained for the 72 hour period
prescribed by law rarely spend more than 24 hours actually receiving
inpatient services.
These facts go a long way in explaining why 51% of our respondents
reported a negative experience with San Francisco's mental health
system. Yet the desire for recovery burned so brightly in the hearts
of these human beings - who are supposedly biologically incapable of
making informed treatment decisions - that 224 of them, or 92%, told
us that if programs and services were available that would meet their
needs, they would willingly, even gladly, enter them.
Armed with a valid basis to guide our grassroots advocacy for
mentally ill homeless people, we went to Community Mental Health
Services, San Francisco's Health Commission, and finally the Board of
Supervisors and the Mayor to wrestle enough money from the City's
budget to begin to address this critical gap in mental health
services. We managed to wring $2.3 million dollars from the city of
San Francisco - an amount equal to what NAMI probably squanders on
office supplies and self-congratulatory propaganda each year.
And these funds are only enough to make a decent beginning at making
these vital services available to all who need them.
At the Coalition on Homelessness, we support voluntary treatment on
demand for everyone seeking mental health services; NOT we demand you
get treatment, or else. It has long been documented that around half
of those who have experienced involuntary treatment will go to any
length to avoid further treatment, while a three-year pilot study of
the effectiveness of court-mandated treatment can point to no
significant improvements to the community, or to consumers, over
voluntary services.
Perhaps when we have made voluntary, culturally-appropriate,
community-based, consumer-guided mental health treatment available to
everyone in San Francisco who wants it - when we can say we truly
have quality mental health treatment on demand - then we may again
examine why there are those people who aren't being helped by it. But
until that day comes, we regard the efforts of these so-called
"advocates" and "reformers" as nothing more than a fearful mob
re-enacting the ritualized scapegoating and sacrifice of those they
perceive as "different." And for that they deserve not only our
scorn, but also our pity.
If it isn't voluntary, it isn't treatment.
END FORWARD
**In accordance with Title 17 U.S.C. section 107, this material
is distributed without charge or profit to those who have
expressed a prior interest in receiving this type of information
for non-profit research and educational purposes only.**
*******************************************************
HOMELESS PEOPLE'S NETWORK <http://aspin.asu.edu/hpn>
6,000+ POSTS by or via homeless & ex-homeless people
Nothing About Us Without Us - Democratize Public Policy
*******************************************************
chance martin
Coalition on Homelessness, San Francisco
468 Turk St.
San Francisco, CA 94102
vox: (415) 346.3740
Fax: (415) 775.5639
coh@sfo.com
http://www.sfo.com/~coh
--============_-1269400999==_ma============
Content-Type: text/enriched; charset="us-ascii"
***********************************************************
HOMELESS PEOPLE'S VIEWS, News, Alerts, Actions & Research
6,000+ ONLINE POSTS by or via homeless & ex-homeless people
HOMELESS PEOPLE'S NETWORK http://aspin.asu.edu/hpn
***********************************************************
<bold>Promoting Stigma
</bold>After decades of neglect, our state legislature is being
aggressively lobbied to restore California's mental health system. All
of the proposed treatment enhancements and services are desperately
needed and would be welcome, with one exception - an attack on the
civil rights of mentally disabled people called involuntary outpatient
commitment.
Involuntary outpatient commitment is court-mandated medication
compliance. It can mean a person is court-ordered to keep regular
clinic appointments to receive long-lasting injections of powerful
psychiatric drugs. The consequences of non-compliance are hospital
commitment and forced drugging. These proposed legal provisions are
termed "assisted treatment."
In practice, its primary victims are poor and homeless people,
particularly African-American men. In some urban areas, homelessness
itself is interpreted as proof of "grave disability", creating the
justification to drug homeless people against their will. In states
where this policy is law, forced medication coupled with a lack of
medical supervision has led to deaths due to toxic levels of
psychiatric medication.
At New York City's Bellevue hospital, a pilot study testing the
viability of involuntary outpatient commitment failed to support its
advocates' claims. A three year study of its relative effectiveness
found no statistically significant differences between the experimental
group, a control group, and those who discontinued treatment in the
areas of re-hospitalization, arrests, violence, symptomatology, or
quality of life. It concluded: "there is no indication that, overall,
the court order for outpatient commitment produces better outcomes for
clients or the community than enhanced services alone."
Alarmingly, it also noted that the court procedures themselves became
perfunctory, and accountability was so lacking that renewal orders
frequently occurred without a formal hearing, despite the fact that
"the court order itself had no discernible added value in producing
better outcomes."
The betrayal of the de-institutionalization movement in California only
became apparent when the state-funded community-based mental health
services to replace the snake pits were themselves facing extinction.
Now we are faced with a proposal to criminalize an entire community of
people based on disability. Disability isn't a choice; it's something
each of us learns to accommodate as best we can. We need to ask
ourselves: how many violent acts committed by untreated mentally ill
people, however sensationalized, might have been prevented if a
comprehensive range of voluntary, culturally appropriate community
mental health services had been available?
A look at twentieth century history gives the best illustration of how
far stigmatization, scapegoating and hate can go when misrepresented as
scientific authority.
Eugenics originated as a sub-discipline of psychiatry here in the
United States. The first compulsory sterilization laws in Germany were
modeled on American sterilization laws enacted a decade before. In the
three years from 1941-1943, over 42,000 Americans were sterilized under
the Model Eugenical Sterilization Law.
California led the nation with over 10,000 forced sterilizations
(mostly persons of color). The "mental diseases" targeted by this law
were "insane", "feeble-minded", "epileptics", and "idiots".
The Holocaust's first victims were "mentally ill" people. The first
extermination facilities were operated by psychiatrists, who then
trained the SS how to use them. In a society where ruling authority was
maintained in the name of a higher "biological" principle,
psychiatrists weren't ordered to murder people, they were simply
empowered to do so by their government, so they did. In 1941, 90,000
German psychiatric inmates were murdered, 71,000 in gas chambers at
psychiatric institutions.
If our generation remembers no other lesson, we must remember that no
supposed biological marker - no stigma - is reason enough to deny
anyone's liberty. We must support fully funded, community-based,
VOLUNTARY mental health treatment before we consider discarding another
person's self-determination.
If it isn't voluntary, it isn't treatment.
630 words
<italic>Chance Martin is editor of the <bold>STREET SHEET</bold>,
published by the Coalition on Homelessness, San Francisco. He has also
directly experienced homelessness and forced treatment due to severe
psychiatric disability.
</italic>********************************************************************
Public Testimony for Mental Health Forum 11/16/99
Good afternoon, my name is chance martin, and I am a psychiatrically
disabled adult. I live in the Tenderloin and work for the Coalition on
Homelessness, where I edit the <bold><italic>STREET
SHEET</italic></bold> and participate as a consumer on our Substance
(Ab)use / Mental Health work group.
I've been asked to say a few words about the prospect of changing our
California Welfare and Institutions Code to provide the legal basis to
compel consumers living in the community to participate in treatment,
willing or not. For the sake of brevity, I won't speak to the obvious
and utterly reproachable attack on the most basic civil and human
rights of mentally ill people that these proposals represent.
Instead, I'm just going to outline the social context in which these
unnecessary and morally reprehensible proposals are being made.
The December issue of <bold><italic>MOTHER JONES</italic></bold>
magazine has a fascinating article about NAMI, one of the principle
organizations campaigning to erode the safeguards to the civil rights
of persons suffering psychiatric illnesses as outlined in the
California Welfare & Institutions Code's Lantermann, Petris, Short Act.
While NAMI portrays itself as a "grassroots" organization representing
the interests of mentally ill people and their families, they have
accepted almost 12 million dollars from pharmaceutical companies from
1996 to 1999 alone. When we "follow the money" we find solid and valid
reasoning for the growing concern among many consumers nationally that
NAMI's primary advocacy agenda is to further the interests and
influence of corporate pharmaceutical giants.
The revelations outlined in the article range from the alarming to the
absurd, the most ironic being that while NAMI budgets 4 million dollars
annually to combat discrimination against people with mental illnesses,
while they maintain the speculative assertion that mental illnesses are
biological in nature. They portray mental illness as
"biologically-based brain disorders," despite the fact that no
empirical scientific research exists to support such claims, thus
sowing the seeds of stigma for those who suffer mental illness. They
then spend an obscene amount of cash to combat the fruits of the stigma
they have sown. Sounds like a closed-feedback loop ensuring job
security for NAMI's staff. It also sounds like NAMI's organizational
cognitive disorder can truly be characterized as "a danger to itself
and others."
Then we have the "Treatment Advocacy Center," and it's champion of
forced treatment, Dr. E. Fuller Torrey. While this man waxes eloquent
about the prospects of social control through chemistry, what is
missing from the dialogue is his own morbid obsessions, best evidenced
by the fact that this man keeps the largest collection of human brains
since the infamous Dr. Mengele.
With all the brains this guy's got, and all of his corporate backing,
one might expect that he would have produced hard evidence that the
brains of persons with psychiatric disabilities are actually different
than those of "normal" people, but he hasn't. All he has is his morbid
little slide collection of brains that have been scarred and disfigured
by years of psychiatric medications which he often uses as a backdrop
for his presentations in pursuit of legitimacy. Again, this charade is
financed largely by our corporate pharmaceutical oppressors.
At the Coalition on Homelessness, we have a different understanding of
what "grassroots advocacy" really means. We recently undertook the task
of recruiting and training volunteer mental health consumers to survey
282 homeless people who self-identified as suffering from mental
illnesses. What we were seeking was the input of homeless mentally ill
people to guide our advocacy efforts, and to instruct us in what kinds
of services they want. We imagine organizations like NAMI might find
our methods radical by their standards, but fortunately we don't labor
beneath the handicap of plush offices in which to devote our time
determining how to spend a multi-million-dollar budget.
We found that among the respondents to our survey, 152 homeless people
had tried to voluntarily access mental health services, and of those
seeking voluntary treatment, 31% or 47 people could not access the
services they needed. Let me restate that figure for emphasis: 31% of
homeless people so tormented by mental illness that they would
voluntarily seek treatment couldn't get any. This lack of accessibility
to community-based voluntary mental health services for poor and
homeless people is why San Francisco has the highest rate of
involuntary commitment in the state.
Simply put, hundreds of homeless people aren't be able to access
services until they are legally determined to be a danger to themselves
or others. By not making enough voluntary services available at a
community level, San Francisco allows homeless mentally ill people to
suffer to the extent that they qualify only for the most expensive,
most restrictive treatment we can offer them. This, in turn, creates so
much demand on our psychiatric emergency services that those who are
detained for the 72 hour period prescribed by law rarely spend more
than 24 hours actually receiving inpatient services.
These facts go a long way in explaining why 51% of our respondents
reported a negative experience with San Francisco's mental health
system. Yet the desire for recovery burned so brightly in the hearts of
these human beings - who are supposedly biologically incapable of
making informed treatment decisions - that 224 of them, or 92%, told us
that if programs and services were available that would meet their
needs, they would willingly, even gladly, enter them.
Armed with a valid basis to guide our grassroots advocacy for mentally
ill homeless people, we went to Community Mental Health Services, San
Francisco's Health Commission, and finally the Board of Supervisors and
the Mayor to wrestle enough money from the City's budget to begin to
address this critical gap in mental health services. We managed to
wring $2.3 million dollars from the city of San Francisco - an amount
equal to what NAMI probably squanders on office supplies and
self-congratulatory propaganda each year.
And these funds are only enough to make a decent beginning at making
these vital services available to all who need them.
At the Coalition on Homelessness, we support voluntary treatment on
demand for everyone seeking mental health services; NOT we demand you
get treatment, or else. It has long been documented that around half of
those who have experienced involuntary treatment will go to any length
to avoid further treatment, while a three-year pilot study of the
effectiveness of court-mandated treatment can point to no significant
improvements to the community, or to consumers, over voluntary
services.
Perhaps when we have made voluntary, culturally-appropriate,
community-based, consumer-guided mental health treatment available to
everyone in San Francisco who wants it - when we can say we truly have
quality mental health treatment on demand - then we may again examine
why there are those people who aren't being helped by it. But until
that day comes, we regard the efforts of these so-called "advocates"
and "reformers" as nothing more than a fearful mob re-enacting the
ritualized scapegoating and sacrifice of those they perceive as
"different." And for that they deserve not only our scorn, but also our
pity.
If it isn't voluntary, it isn't treatment.
END FORWARD
**In accordance with Title 17 U.S.C. section 107, this material
is distributed without charge or profit to those who have
expressed a prior interest in receiving this type of information
for non-profit research and educational purposes only.**
*******************************************************
HOMELESS PEOPLE'S NETWORK <<http://aspin.asu.edu/hpn>
6,000+ POSTS by or via homeless & ex-homeless people
Nothing About Us Without Us - Democratize Public Policy
*******************************************************
chance martin
Coalition on Homelessness, San Francisco
468 Turk St.
San Francisco, CA 94102
vox: (415) 346.3740
Fax: (415) 775.5639
coh@sfo.com
http://www.sfo.com/~coh
--============_-1269400999==_ma============--