The report from Treatment Advocacy Center has reported a two to three times higher prevalence of schizophrenia than previously reported. That’s indeed a significant update. It’s important to understand that schizophrenia spectrum disorders, which include schizophrenia, schizoaffective disorder, and schizophreniform disorder, are complex mental health conditions that can significantly impact a person’s thoughts, feelings, and behaviors. These disorders often emerge in early adulthood, and their symptoms can include hallucinations, delusions, thought disorders, and movement disorders, among others.

While alarming, this increase in reported cases may actually reflect improved diagnostic procedures, better awareness, and a decrease in stigma around mental health issues rather than an actual increase in the prevalence of the disease. As mental health issues become less stigmatized, more people might seek help and receive an appropriate diagnosis.

It’s also crucial to point out that a more accurate estimation of prevalence can lead to a more effective allocation of resources for treatment, support, research, and interventions. Understanding the true scale of a problem is the first step toward addressing it more effectively. Hopefully, this groundbreaking data can help steer the conversation toward more inclusive and comprehensive mental health services.

However, this data also highlights the urgent need for continued research into these disorders, as we still have a lot to learn about the exact causes, risk factors, and most effective treatments. Support from families, communities, and healthcare providers is crucial for those affected by these conditions. Furthermore, as societies, we must continue to work towards eradicating the stigma associated with mental health conditions and ensure access to necessary care and support.

Laurie Goldstein

RESEARCH WEEKLY: More people with schizophrenia in the U.S. than previously reported – Treatment Advocacy Center

By Elizabeth Sinclair Hancq

(June 28, 2023) Groundbreaking new data  released this week suggests there are 3.7 million adults living with schizophrenia spectrum disorders, including schizophrenia, schizoaffective disorder, and schizophreniform disorder. These results suggest that the number of individuals with schizophrenia spectrum disorders is two to three times higher than previously reported.  

The new data is from the Mental and Substance Use Disorders Prevalence Study , a national epidemiological survey that was conducted by RTI International and created and funded in 2019 by the Substance Abuse and Mental Health Services Administration. MDPS is unique, because trained clinicians conducted interviews with not only people living in households, but also individuals housed in prisons, state psychiatric hospitals, and homeless shelters, who had not been taken into account in previous estimates. The broader scope of those interviewed reflects much more accurate estimates of the prevalence of severe mental illness in the United States. Additionally, the incorporation of clinical interviews in the study design allows for more precise counts of people living with severe mental illnesses. 

The study was created by SAMHSA’s Assistant Secretary for Mental Health and Substance Use from 2017-2021 Dr. Elinore McCance-Katz to address major knowledge gaps in our understanding of the number of people living with serious mental illness in the United States. This was in response to a report published  by Dr. E. Fuller Torrey and me in “Psychiatric Times” calling attention to the major shortcomings of current prevalence estimates and the National Institute of Mental Health changing their prevalence estimate of schizophrenia, despite no new data being published. The attention that Treatment Advocacy Center’s report received provided the support needed to get the notice of policymakers to address the miscounting of severe mental illness in the U.S. and directly resulted in the creation of the MDPS project. 

MDPS is a cooperative agreement between RTI International and SAMHSA in collaboration with Columbia University/New York State Psychiatric Institute, Duke Health, University of Washington, Harvard University, University of Chicago, and Treatment Advocacy Center. 

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A deeper dive into the schizophrenia results 

MDPS found that 1.8% of adults aged 18-65 in the United States have a lifetime diagnosis of a schizophrenia spectrum disorder. Approximately two-thirds of those individuals, or 1.2% of the adult population, have a past-year diagnosis of schizophrenia spectrum disorder, meaning they experienced psychosis symptoms in the 12 months prior to being interviewed for the study.  

This translates to 3.7 million individuals with schizophrenia spectrum disorders living in the United States, 2.4 million of whom had active symptoms in the past year. This means there are two million more individuals living with a schizophrenia spectrum disorder in the United States than what is currently listed on the NIMH website .  

MDPS also asked participants about their treatment history in the past year. Of those with schizophrenia spectrum disorder, 73% received some type of treatment in the previous 12 months, according to the results. For those with schizophrenia spectrum disorder:

·    66% received some outpatient treatment. 
·    12% received some psychiatric inpatient treatment.  
·    69% received some type of psychotropic medication.

However, it is important to note that these treatment rates do not represent adequate treatment. In order to be categorized as receiving any treatment, an individual needs to have received some type of mental health treatment with at least one outpatient or inpatient visit and any type of psychotropic medication, not necessarily treatment specific for schizophrenia or psychosis. Therefore, the prevalence of having received meaningful treatment for their disorder is likely much lower than this.  

Policy implications

The results from this study have several important policy implications. First, the results indicate that sensitive, ethical, and rigorous research methods can be implemented to ensure that people with serious mental illness are more accurately measured in epidemiological research, including those living in non-household settings. Second, the results show there are significantly more treatment and other social services needed for the almost two million more people living with schizophrenia in the United States than previously measured. Severe mental illnesses like schizophrenia often require intensive treatment that depends on local, state, and federal resources to fund and provide the services. Policy leaders should utilize this new data to understand their community needs and allocate resources appropriately.  

The implications of the mistakes of the past are profound – underestimating the number of people with severe mental illness almost certainly contributes to the lack of adequate treatment and other services for these individuals with the most severe of psychiatric disorders. While the MDPS results are a major step in the right direction for the prioritization of people with severe mental illness, it took the attention garnered by Treatment Advocacy Center’s spotlight on the miscounting to get us there. We will continue to work to ensure there are continued efforts to accurately measure how severe mental illness impacts people, families, and society.  

Each year, we honor our founder, Dr. E. Fuller Torrey, through the Torrey Action Fund. The Torrey Action Fund is an annual fundraising campaign that supports everything we do, including critical research into severe mental illness and the publication of ResearchWeekly. Please consider donating to the Torrey Action Fund and help us continue our important work. TreatmentAdvocacyCenter.org/Donate

Elizabeth Sinclair Hancq is the director of research at Treatment Advocacy Center.

The first Tuesday of each month from 4-6 pm Arizona time, except for holiday weekends, ACMI will have a featured guest to discuss a relevant Behavioral Health topic; after the speaker, we will discuss current issues with the Behavioral Health System attendees. This month, come hear about Population Health- interventions for Familiar Faces (high utilizers) that work. We have Dr. Michael Franczak discussing population health and the latest innovations which lead to better outcomes. Learn about the use of AI to deliver information to clinicians which assists them with developing better treatment plans.

Dr. Michael Franczak currently serves as the Director of Population Health Services for Copa Health, Mesa, Arizona.  Dr. Franczak has been involved in Mental Health, Substance Abuse, and Intellectual Disability services in Pennsylvania, North Carolina, and Arizona for the past 40 years.  Dr. Franczak has served as an expert witness in many landmark cases concerning Mental Health and Intellectual Disabilities and is currently an expert to the US Department of Justice, Civil Rights Division.  Dr. Franczak has been the primary investigator on numerous grants from the Substance Abuse Mental Health Service Administration, including Housing Approaches for Persons with a Serious Mental Illness, Jail Diversion for Persons with a Serious Mental Illness, Integrated Substance Abuse Mental Health Treatment Models, System of Care Practices for Children and Adolescents and Substance Abuse Services for Adolescents. His current work focuses on using and analyzing data to create actional information to improve individual outcomes.  Dr. Franczak was awarded the Mental Health America of Arizona Hall of Fame Award in 2018.

Topic: ACMI Stakeholder’s Meeting

Time: July 11th, 2023 04:00 PM Arizona

Every month on the First Tuesday until December 25th, 2025,

August 1st, 2023, 04:00 PM Dental- Brighter Way, Kris Volcheck

Sept 12th, 2023,  04:00 PM Hom Inc

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The first Tuesday of each month from 4-6 pm Arizona time, except for holiday weekends, ACMI will have a featured guest to discuss a relevant Behavioral Health topic; after the speaker, we will discuss current issues with the Behavioral Health System attendees. This month, come hear about Assertive Community Teams (ACT). We have Mercy Care discussing ACT teams and checkbox items and measurements. We have both Valleywise and CopaHealth describing their ACT team services.

Dr. Darling is the current medical director and psychiatrist for the Valleywise Health Assertive Community Treatment program. She has been in this role since graduating from her psychiatry residency in 2017. She is core faculty with the Creighton University Arizona Health Education Alliance Psychiatry Residency Program and faculty with the departments of psychiatry at The University of Arizona College of Medicine Phoenix, Mayo Clinic College of Medicine and Science Phoenix, and Creighton University College of Medicine. Dr. Darling completed her undergraduate education in psychology at Arizona State University in 2004. She then worked in case management for the outpatient SMI system in Maricopa County before attending medical school at Midwestern University Arizona College of Osteopathic Medicine. She completed her psychiatry residency training at Maricopa Integrated Health System in 2017. During her residency, she served as the chief resident for two years and was the Arizona Psychiatric Society resident of the year in 2017. Dr. Darling is board certified by the American Board of Psychiatry and Neurology, with a primary focus on treating refractory serious mental illness. In addition to her clinical work, Dr. Darling trains Creighton Alliance PGY3 psychiatry residents, hosts Creighton Alliance family medicine residents during their psychiatry rotation, and supervises 4th-year medical students on psychiatry rotations. She teaches two didactic courses for the Creighton Alliance residents, covering community resources for PGY1 residents and advanced psychopharmacology for PGY3 and PGY4 residents. Dr. Darling is involved in mentoring current residents and received the Howard E Wulsin Excellence in Teaching Award from the Arizona Psychiatric Society in 2022.

Dr Winona Z Belmonte, MD, is a board-certified psychiatrist.  She is the Asst Medical Director for ACT Services and Chief Psychiatrist for Metro Clinic of Copa Health. She is a product of the University of Virginia   Health Systems at Charlottesville, Virginia, where she graduated in psychiatric medicine with subspecialty/fellowship training in geriatric psychiatry.   She accepted a position to serve the full spectrum of psychiatric practice in the rural underserved areas of Virginia for three years. Challenging as it was, the experience galvanized her knowledge and acumen in clinical work and deepened her passion to provide the best service to those struggling with mental illness.  This passion took her to Phoenix, where she saw an opportunity to provide services in an environment where a team-based approach to care is alive.  She has served under multiple RBHA in Maricopa County since 2005 in various capacities but mostly as chief psychiatrist of clinics and Assertive Community Treatment psychiatrist. She was the first Medical Director of People of Color Network.  She is a dedicated psychiatrist with extensive experience in complex psychopharmacology and complicated social determinants of health issues.  

Blythe FitzHarris, P.h.D., LCSW is the Chief Clinical Officer at MercyCare and is responsible for clinical program development, including Adult and Children’s Systems of Care and the Central Region Behavioral Health Crisis System. Blythe oversees multiple Mercy Care service delivery systems, including integrated care, the Office of Individual and Family Affairs (OIFA), grant services, cultural diversity, and tribal affairs. She directs initiatives, strategies, and programs to address social determinants of health (such as housing and employment) and system performance. Blythe also oversees coordination of care with system stakeholders such as the Arizona Department of Economic Security and the Arizona Department of Justice and works closely with system advocates. She works across the organization to address member, family, provider, and/or contractor concerns to ensure positive clinical outcomes, care coordination, and quality service delivery. Previously, Blythe served as the Adult Systems of Care Administrator for Mercy Care. In this position, Blythe oversaw the Adult SMI System of Care, which included outpatient behavioral health services, Assertive Community Treatment, housing, rehabilitation, and employment services for members in Maricopa County and parts of Pinal County. She also served as Mercy Care’s lead for the Arnold v. Sarn settlement agreement. Blythe has more than 30 years of experience working in public behavioral health in a variety of clinical and operational positions and has taught social work at the university level.   Blythe is a licensed clinical social worker and has a master’s in social work and a Ph.D. in social welfare with a focus on mental health and recovery from Arizona State University.

Topic: ACMI Stakeholder’s Meeting

Time: June 6th, 2023 04:00 PM Arizona

Every month on the First Tuesday until December 25th, 2023,

July 11th, 2023, 04:00 PM – Population Health- interventions for high Utilizers, Dr. Mike Franczak

August 1st, 2023, 04:00 PM Dental- Brighter Way, Kris Volcheck

Sept 12th, 2023,  04:00 PM Hom Inc

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Secure residential
Secure residential

Introduction:

Serious mental illnesses can be highly debilitating, affecting individuals’ ability to function in society and diminishing their quality of life. It is imperative to recognize the significance of secure facilities as essential tools for providing comprehensive care to those suffering from such conditions. By establishing secure facilities that prioritize treatment, insight, and rehabilitation, we can empower individuals with serious mental illness to gain invaluable insight into their conditions and facilitate their successful reintegration into the community. In this essay, we will explore the compelling arguments supporting the need for secure facilities as vital components of mental healthcare.

Safe and Controlled Environment:

Secure facilities offer a structured and controlled environment, ensuring the safety and well-being of individuals with serious mental illness. These environments provide a supportive framework to prevent self-harm, protect patients from external harm, and maintain a stable routine conducive to healing. By removing external stressors and triggers, secure facilities allow individuals to focus solely on their recovery journey, ultimately enhancing their chances of gaining insight into their illness.

Comprehensive Treatment and Rehabilitation:

Secure facilities are uniquely equipped to provide comprehensive treatment and rehabilitation programs tailored to the specific needs of individuals with serious mental illness. These facilities often employ a multidisciplinary approach involving psychiatrists, psychologists, therapists, and other mental health professionals. Through evidence-based therapies, medication management, counseling, and skill-building workshops, individuals can develop coping mechanisms, increase self-awareness, and acquire essential life skills. This comprehensive treatment approach empowers individuals to manage their conditions effectively and take steps towards reintegrating into the community.

Insight into Illness:

Secure facilities create an environment that encourages self-reflection, insight, and understanding of one’s mental illness. Through therapy sessions, group discussions, and educational programs, individuals can gain a deeper understanding of the causes, symptoms, and impact of their condition. This insight is a crucial stepping stone towards accepting their illness, embracing treatment, and making informed decisions about their recovery journey. By fostering self-awareness and providing psychoeducation, secure facilities empower individuals to actively participate in their own healing process.

Stigma Reduction and Community Reintegration:

Secure facilities play a pivotal role in combating the stigma surrounding mental illness and fostering community reintegration. By providing individuals with the tools to manage their conditions, secure facilities empower them to challenge societal misconceptions and stereotypes. The supportive environment within these facilities allows patients to practice and develop social skills, rebuild relationships, and establish a support network. As individuals gain insight into their illness and demonstrate progress, they are better equipped to reintegrate into the community, fostering understanding, empathy, and acceptance among society at large.

Long-term Benefits and Cost-effectiveness:

Investing in secure facilities for serious mental illness yields long-term benefits and is a cost-effective strategy for society as a whole. By providing intensive treatment and support, these facilities can reduce the frequency and severity of relapses, emergency room visits, and hospitalizations. As individuals gain insight, acquire coping skills, and reintegrate into the community, they are more likely to become productive members of society, contributing to the workforce, and reducing reliance on disability benefits. Furthermore, the overall economic burden of untreated mental illness, including lost productivity and increased healthcare costs, can be mitigated through early intervention and comprehensive treatment within secure facilities.

Conclusion:

The establishment of secure facilities for individuals with serious mental illness is an essential aspect of a compassionate and effective mental healthcare system. By providing a safe and structured environment, comprehensive treatment, insight into illness, and opportunities for community reintegration, secure facilities empower individuals to reclaim their lives and realize their full potential. Investing in these facilities not only benefits the individuals themselves but also society as a whole, promoting well-being, reducing stigma, and fostering a more inclusive and understanding community.

Thank you to those who could attend our May 2nd Stakeholder’s meeting.

Rachel Streiff, Dr. Robert Laitman, and Dr. Ann Mandel presented.

Below are the links to the webinar and slides:

Webinars – Association for the Chronically Mentally Ill (ACMI) (acmionline.com)

Downloads – Association for the Chronically Mentally Ill (ACMI) (acmionline.com)

Please join us for our next informational event on June 6th, 2023, at 4 PM AZ time. Experts will be discussing Assertive Community Treatment teams. (ACT)

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The first Tuesday of each month from 4-6 pm Arizona time, except for holiday weekends, ACMI will have a featured guest to discuss a relevant Behavioral Health topic; after the speaker, we will discuss current issues with attendees with the Behavioral Health System.

This month, come hear about Innovations in Clozapine Therapy with SMI advocate Rachel Streiff and special guests Dr. Robert Laitman and Dr. Ann Mandel.

Dr. Robert Laitman practices internal psychiatric medicine in New York City alongside his wife, Dr. Ann Mandel Laitman, and is a co-author of “Meaningful Recovery From Schizophrenia and Serious Mental Illness with Clozapine: Hope and Help.”

Rachel Streiff is a chemical and biomedical engineer who became an advocate for families struggling with Serious Mental Illness after a member of her own family achieved recovery.

…………………………………………………………………………….

Topic: ACMI Stakeholder’s Meeting

Time: May 2nd,, 2023 04:00 PM Arizona

Every month on the First Tuesday until December 25th, 2023,

June 6th, 2023, 04:00 PM

July 11th, 2023, 04:00 PM

August 1st, 2023, 04:00 PM

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The first Tuesday of each month from 4-6 pm Arizona time, except for holiday weekends, ACMI will have a featured guest to discuss a relevant Behavioral Health topic; after the speaker, we will discuss current issues with attendees with the Behavioral Health System.

This month hear from Dr. Shar Najafi-Piper (CEO) and Michaela Statt (VP of Outpatient Services) Copa Health to discuss (a) Copa’s array of services, (b) its corporate culture, and (c) your questions.

Dr. Shar Najai-Piper

Dr. Najafi-Piper has distinguished herself as a licensed psychologist and clinical executive over the past 17 years. Throughout her career, she has served as a behavioral health technician, outpatient counselor, team lead clinician, program/executive director of outpatient clinics, vice president of outpatient services, and president of quality care centers and behavioral services.

…………………………………………………………………………….

Michaela Statt

Michaela has a Bachelor’s Degree in Psychology and a Master’s Degree in Social Work from ASU. Throughout her career, she found her niche in healthcare administration and operations. She has worked at Copa Health for over nine years in a variety of roles, including Clinical Coordinator (East Valley Campus), Clinical Director (West Valley/Wickenburg), Site Administrator (Arrowhead Campus), and most recently, Director of Health Information Management (Brookstone).

Topic: ACMI Stakeholder’s Meeting

Time: April 4th, 2023 04:00 PM Arizona

Every month on the First Tuesday until December 25th, 2023,

May 6th, 2023 04:00 PM

June 6th, 2023 04:00 PM

July 11th, 04:00 PM

August 1st, 04:00 PM

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Sign up in support of SB1710 Arizona State Hospital (ASH), governing board, and governance, which is being heard on Monday, March 13th, 2023, at 2:00 pm in House Room HHR 4.

To request to speak, follow the process indicated in this manual RTS (azleg.gov)

Note: you must sign up for an account initially in person at the Capitol using the kiosk. After you sign up initially in person, you can subsequently submit comments and request to speak online.