DJ Jaffe’s Quote for February 20th, 2021

We particularly like this DJ Jaffe’s quote: Clinical evidence has now indicated that allowing schizophrenia to progress to a psychotic break lowers the possible level of future recovery, and subsequent psychotic breaks lower that level further – in other words, the cost of withholding treatment is permanent damage. Meanwhile, bureaucratic road-blocks, such as time-consuming judicial hearings, are passed off under the cloak of “due process” – as if the illness were a crime with which one is being charged and hospitalization for treatment is punishment. Such cumbersome restraints ignore the existing adequate safeguards – the requirement for two independent assessments and a review panel to check against over-long stays.

Read more at: https://mentalillnesspolicy.org/media/bestmedia/uncivilliberties.html

DJ Jaffe, Mental Illness Policy Organization

DJ Jaffe’s Quote for February 14th, 2021

The anti-treatment advocates say: “If that’s how people want to live (babbling on a street corner, in rags), or if they wish to take their own lives, they should be allowed to exercise their free will. To interfere — with involuntary committal — is to deny them their civil liberties.” Whether or not anti-treatment advocates actually voice such opinions, they seem content to sacrifice a few lives here and there to uphold an abstract doctrine.

Read more at: https://mentalillnesspolicy.org/media/bestmedia/uncivilliberties.html

DJ Jaffe, Mental Illness Policy Organization

DJ Jaffe’s Quote for February 7th, 2021

Anti-treatment advocates insist that involuntary committal should be limited to cases of imminent physical danger — instances where a person is going to do bodily harm to himself or to somebody else. But the establishment of such “dangerousness” usually comes too late — a psychotic break or loss of control, leading to violence, happens suddenly. And all the while, the victim suffers the ravages of the illness itself, the degradation of life, the tragic loss of individual potential.

Read more at: https://mentalillnesspolicy.org/media/bestmedia/uncivilliberties.html

DJ Jaffe, Mental Illness Policy Organization

DJ Jaffe’s Quote for January 31st, 2021

Community services for the most severely ill have been badly shortchanged because the states and the federal government never developed a rational way of sharing costs for running them. Lack of overall planning and fragmented budgets led to attempts at cost-shifting that left the severely ill out in the cold.

 Insane Consequences: How the Mental Health Industry Fails the Mentally Ill

DJ Jaffe, Mental Illness Policy Organization

DJ Jaffe’s Quote for January 24th, 2021

Untreated patients with severe illness are a terrific burden on themselves, their families, and the community. Their psychotic symptoms and inability to care for themselves attract police attention. And because treatment facilities are almost non-existent, cops have no alternative but to bring them to jail, where they are vulnerable to attack, subject to solitary, and likely to de-compensate further. Untreated patients with severe illness are a terrific burden on themselves, their families, and the community. Their psychotic symptoms and inability to care for themselves attract police attention. And because treatment facilities are almost non-existent, cops have no alternative but to bring them to jail, where they are vulnerable to attack, subject to solitary, and likely to de-compensate further.

 Insane Consequences: How the Mental Health Industry Fails the Mentally Ill

DJ Jaffe, Mental Illness Policy Organization

DJ Jaffe’s Quote for January 17th, 2021

His Insane Consequences traces in intricate and fascinating detail how state governments de-institutionalized the severely ill by closing snake pit mental hospitals, only to re-institutionalize them again in completely inappropriate, even more degrading, and more expensive prison dungeons.

 Insane Consequences: How the Mental Health Industry Fails the Mentally Ill

DJ Jaffe, Mental Illness Policy Organization

DJ Jaffe’s Quote for January 10th, 2021

His Insane Consequences traces in intricate and fascinating detail how state governments de-institutionalized the severely ill by closing snake pit mental hospitals, only to re-institutionalize them again in completely inappropriate, even more degrading, and more expensive prison dungeons.

 Insane Consequences: How the Mental Health Industry Fails the Mentally Ill

DJ Jaffe, Mental Illness Policy Organization

DJ Jaffe’s Quote for January 3rd, 2021

The crucial mistake was to discharge severely ill patients without providing anything approaching adequate community treatment and housing. Instead, community investments went to serve less severely ill people who never would have been hospitalized. The same is true today: hospitals are being closed and the most seriously ill are neglected while people with mild problems are often over-treated with medicines, they don’t need that may make them worse.

 Insane Consequences: How the Mental Health Industry Fails the Mentally Ill

DJ Jaffe, Mental Illness Policy Organization

DJ Jaffe’s Quote for December 27th, 2020

US patients are currently prisoners; twice that number have previously been in jail and stand a good chance of rotating back; and about 200,000 are homeless.

Prison conditions for the severely ill in the US are dangerous and disgusting beyond your imagination. And being homeless, always a severe challenge to human ingenuity poses a daily threat of violence to those who are made most vulnerable by mental illness.

 Insane Consequences: How the Mental Health Industry Fails the Mentally Ill

DJ Jaffe, Mental Illness Policy Organization

DJ Jaffe’s Quote for December 20th, 2020

If I suffered from a severe mental illness, Trieste would be my first-choice place to live. Patients in Trieste are regarded as valued citizens of the city who need and deserve adequate services. They are treated in attractive and accessible, club-like community settings; with easy access to both psychosocial and medical care; with respect for their dignity and autonomy; and usually have paid jobs working for a large gardening coop run by the mental health system. There are no homeless and the thought of imprisoning people with mental illness would be shocking.

The United States would be my last choice. We have criminalized mental health problems with a barbaric throwback to the dismal conditions before the Enlightenment. Among peer countries, we have become the very worst place to have a severe mental illness. As D. J. Jaffe has documented in his wonderful new book, Insane Consequences: How the Mental Health Industry Fails the Mentally Ill,

DJ Jaffe, Mental Illness Policy Organization

DJ Jaffe’s Quote for December 13th, 2020

  1. Spend smarter: Spend on mental “illness”, not mental “health.”

  2. Use Assisted Outpatient Treatment (court-ordered outpatient treatment) for those with a history of violence dangerousness or multiple rehospitalizations due to noncompliance.

  3. Reform involuntary commitment laws so they prevent violence, rather than require it.

  4. Reform Medicaid law to preserve psychiatric hospitals (eliminate the IMD Exclusion)

  5. Reform HIPAA so parents of mentally ill can help loved ones.

DJ Jaffe, Mental Illness Policy Organization

https://mentalillnesspolicy.org/#consequences-status-quo

 

DJ Jaffe’s Quote for December 7th, 2020

Excerpts from Insane Consequences: How the Mental Health Industry Fails the Mentally Ill 

People with severe mental illness die, on average, 20 years earlier in large part because they are denied treatment, neglected, and extruded from our society.

The abuse and neglect of the mentally ill is a shameful stain on our nation. How did we get here? And how can we emulate Italy and the Nordic countries that provide humane care at a lower cost?

 

DJ Jaffe’s Quote for December 1st, 2020

Excerpts from Insane Consequences: How the Mental Health Industry Fails the Mentally Ill 

We have criminalized mental health problems- as a barbaric throwback to the dismal conditions before the Enlightenment.

 

DJ Jaffe’s Quote for November 24th, 2020

Excerpts from White Paper on Thrive NYC

https://mentalillnesspolicy.org/wp-content/uploads/thrivenyc_white-paper.pdf

March 26, 2019

The needs of the seriously mentally ill are being ignored while dollars and attention flow to “mental illness lite” and social problems masquerading as mental illnesses. The ability to get care has become inversely related to need. The least seriously ill go to the head of the line and the seriously ill to jails shelters prisons and morgues. Riker’s is New York’s largest facility to treat the mentally ill. We don’t need a ‘new paradigm’ a ‘shift in culture.’  We need a return to the old culture where the primary responsibility of the mental health system was to treat the seriously mentally ill. New York has moved from a hospital-based system which by definition served the seriously ill to a community-based system that refuses to serve those so seriously ill they would otherwise need hospitalization. Under the First Lady’s leadership, community programs are now getting more of what they want: mental health dollars absent an obligation to serve the seriously ill. Former NYPD Police Commissioner Bill Bratton told a forum that to reduce the problems the police face, he needs easier civil commitment standards, city hospitals to take in those they bring in, keep them long enough to be stabilized, give them treatment and housing after release, and enroll in Kendra’s Law if warranted. That is still the best plan for the seriously mentally ill in NY. What the City Council can do. The City Council should cut the 54 initiatives down to a few that help the most seriously mentally ill and require the administration to focus on those. It should exercise its oversight and budget responsibilities and ensure mental health funds are being used where they are most effective. They should hold officials responsible for, and require them to report on rates of homelessness, arrest, incarceration, violence, EDP calls, and needless hospitalization of the seriously mentally ill. The council should ramp up funding for Kendra’s Law.

DJ Jaffe, Executive Director, Mental Illness Policy Org.

 

DJ Jaffe’s Quote for November 17th, 2020

DJ JAFFE ON HOW NATIONAL MENTAL HEALTH ORGANIZATIONS ABANDONED THE SERIOUSLY MENTALLY ILL AND WHY HE STARTED MENTAL HEALTH POLICY ORG

Excerpted from Pete Early,Q & A With Controversial Mental Health Advocate D. J. Jaffe: A Self-Made Influential Player In Washington.”  http://www.peteearley.com/2018/09/13/q-a-with-controversial-mental-health-advocate-d-j-jaffe-a-self-made-influential-player-in-washington/

Pete Early Question:  You have served on the NAMI and TAC boards. Why did you feel it necessary to start your own website and group?

DJ Jaffe Response: The Group I started, Mental Health Policy Org, focuses on the group NAMI National no longer does: the 4% who are the most seriously ill. Disaffected and disaffiliated NAMI are the core of Mental Illness Policy Org’s support.

Here’s the problem, to get more members NAMI felt it had to expand beyond families of the most seriously ill, which used to be their core constituency. Today, the NAMI national office, like MHA, CMHS, and others look at the existence of the seriously mentally ill as a public relations disaster. So they sweep them under the rug. For example, bringing attention to the fact that when the most seriously ill go untreated, they are more violent than others and how to reduce that violence, would make it harder for NAMI to convince the public of the platitude that the mentally ill are no more violent than others.

Bringing attention to the fact that some SMI needs hospitals and not everyone recovers is counter to their goal of convincing the public that everyone recovers and if we had more community services we wouldn’t need hospitals.

Focusing on the fact that the biggest barriers to care for the seriously are the lack of services, doctors, clubhouses, group homes, transportation options, etc., is counter to their goal of convincing the public that the biggest barrier to care is stigma.

Focusing on the fact that anosognosia, being unaware you are ill, is a real problem facing 40% of the seriously ill is counter to their goal of convincing the public that everyone should be empowered to self-direct their own care.

So the seriously ill are shunned, marginalized, and ostracized by NAMI, MHA, and others. They are not the poster children for the recovery they want to associate with. Now having said that some state organizations and the local affiliates still focus on the seriously ill and the Family to Family program offered by locals is excellent.

 

DJ Jaffe’s Quote for November 8th, 2020

D.J. JAFFE ON WHY WE NEED TO PRIORITIZE MENTAL HEALTH SPENDING

Pete Early Question: You have a reputation for being a policy geek. Your book contains numerous recommendations, but what do you think are the two biggest changes that need to be made on the federal level to improve the lives of individuals with mental illnesses?

  1. DJ Jaffe Response: Globally we have to focus on existing mental health funds on those who need help the most, not the least. We have to send the most seriously ill to the head of the line, rather than jails shelters prisons, and morgues. We have to prioritize, not marginalize the seriously ill. We need to support programs, like Clubhouses, that have proven track records of improving the most meaningful metrics which are rates of homelessness, arrest, incarceration, violence, suicide, and needless hospitalization of the seriously ill. Two specific policies on the federal level to help accomplish that are:

  2. Eliminate the IMD Exclusion. It prevents Medicaid from reimbursing states for seriously mentally ill adults who need long-term hospital care. It applies to no other population than the mentally ill. It’s a blatant form of government discrimination and created the hospital bed shortage.   Rep. Eddie Bernice Johnson (D., TX) has been the leader on this and worked with Rep Tim Murphy to chip away at this in the Helping Families in Mental Health Crisis Act but the most important IMD ameliorating provisions were removed from the final bill

  3. Robustly Fund Assisted Outpatient Treatment (AOT). AOT allows judges to order a tiny group of the most seriously ill to comply with treatment if they have a history of multiple arrests, incarcerations, or hospitalizations as a result of not complying. It reduces homelessness, arrest, incarceration in the 70% range, an extraordinary result given that it is only for the most seriously ill. It would be great if the Centers for Medicaid and Medicare Services (CMS) made the $2,000-$5,000 court costs of AOT Medicaid reimbursable. They are essentially case management services. And because you asked for two, I won’t mention housing, which I know you’ve been working on through the Corporation for Supportive Housing.

Excerpted from Pete Early, “Q & A With Controversial Mental Health Advocate D. J. Jaffe: A Self-Made Influential Player In Washington.”  http://www.peteearley.com/2018/09/13/q-a-with-controversial-mental-health-advocate-d-j-jaffe-a-self-made-influential-player-in-washington/

 

DJ Jaffe’s Quote for November 2nd, 2020

PRIORITIZING THE NEEDS AND FUNDING FOR THE SERIOUSLY MENTALLY ILL

100% of the population can have their mental wellness improved, 20% have something in the Diagnostic and Statistical Manual (DSM) often mild illnesses like anxiety, mild depression, and ADHD. But 4% of adults have a serious mental illness meaning they have a functional impairment which substantially interferes with or limits one or more major life activities.

The untreated seriously mentally ill need help the most and are most likely to become homeless, arrested, incarcerated, victimized, violent, suicidal, or hospitalized without treatment. They need hospital beds, medications, case managers, supported housing, clubhouses, civil commitment, Kendra’s Law, and other treatments not needed by the higher functioning. This is the group ThriveNYC and DOHMH fail to prioritize

The needs of the seriously mentally ill are being ignored while dollars and attention flow to “mental illness lite” and social problems masquerading as mental illnesses. The ability to get care has become inversely related to need. The least seriously ill go to the head of the line and the seriously ill to jails shelters prisons and morgues. Riker’s is New York’s largest facility to treat the mentally ill. We don’t need a ‘new paradigm’ a ‘shift in culture.’ We need a return to the old culture where the primary responsibility of the mental health system was to treat the seriously mentally ill. New York has moved from a hospital-based system which by definition served the seriously ill to a community-based system which refuses to serve those so seriously ill they would otherwise need hospitalization. Under the First Lady’s leadership, community programs are now getting more of what they want: mental health dollars absent an obligation to serve the seriously ill.

Excerpts from White Paper on Thrive NYC

DJ Jaffe, Executive Director, Mental Illness Policy Org.

https://mentalillnesspolicy.org/wp-content/uploads/thrivenyc_white-paper.pdf

March 26, 2019

 

DJ Jaffe’s Quote for October 26th, 2020

VIOLENCE AND PEOPLE WITH MENTAL ILLNESS

Violence is almost always associated with going off treatment and becoming delusional or psychotic. There are many reasons people with serious mental illness go off treatment. Some reasons are not unique to mental illness while others are.

The ability to regulate behavior is compromised because the brain is the organ affected.

Anosognosia: Up to 50% of people with schizophrenia and many with bipolar lack insight: they are so sick they don’t know they are sick (anosognosia).

Costs/Side Effects: Some refuse treatment because of costs, side effects, lack of support, etc.

Civil Liberties: A misunderstanding of civil liberties, the nature of mental illness, combined with misinformation leads us to protect the right of the psychotic to ‘die with their rights on’ rather than mandating violence preventing treatments that can restore free will.

Reaction to hallucinations and delusions: When people with serious mental illness act out, they are often doing so as a logical reaction to their delusions, hallucinations, and paranoia. If you think someone is the Devil and trying to kill you, you will try to hurt them first.

Misplaced Funding: Most money spent goes to improving mental ‘health’ not treating mental “illness”. People with serious mental illness are usually sent to the end of the line, rather than the front. The ability to get services is inversely related to need, therefore people with serious mental illness find it difficult to get services. Mental health providers often discriminate against highly symptomatic people with serious mental illnesses

DJ Jaffe, Mental Illness Policy Organization

https://mentalillnesspolicy.org/#consequences-status-quo

 

DJ Jaffe’s Quote for October 17th, 2020

VIOLENCE AND PEOPLE WITH MENTAL ILLNESS

If you are talking about the 40-50% of Americans who may have a “diagnosable mental disorder” during their lifetime (18% annually), then ‘no’, the mentally ill are not more violent than others.

If you are talking about the 4% of Americans with the most serious mental illnesses that affect daily functioning–primarily schizophrenia and treatment-resistant bipolar disorder, then ‘no’, the mentally ill are not more violent than others.

If you are talking about the subset of the 4% group who go off treatment that has previously prevented them from being psychotic, hospitalized, or violent, then ‘yes’ the mentally ill are more violent than others. This higher than normal rate of violence increases, even more, when these groups abuse substances. When people ask, “Are the mentally ill more violent“, they are usually asking about this group, the most seriously mentally ill who are not in treatment.

DJ Jaffe, Mental Illness Policy Organization

https://mentalillnesspolicy.org/#consequences-status-quo

https://mentalillnesspolicy.org/consequences/violence-statistics.html 

 

DJ Jaffe’s Quote for October 12th, 2020

VIOLENCE AND PEOPLE WITH MENTAL ILLNESS

Recent studies have established that being severely mentally ill and not taking medication is one of the major clinical predictors of violent behavior. Two other major clinical predictors of violent behavior are past history of violence and substance abuse (alcohol and/or drug) which are also disproportionately found in people with untreated serious mental illness. People with milder mental illnesses or serious mental illness that is treated are not more violent than others.

 Severely mentally ill individuals who ARE taking their medication are NOT more dangerous than the general population.

DJ Jaffe, Mental Illness Policy Organization

https://mentalillnesspolicy.org/#consequences-status-quo

https://mentalillnesspolicy.org/consequences/violence-statistics.html 

 

DJ Jaffe’s Quote for October 6th, 2020

VIOLENCE AND PEOPLE WITH MENTAL ILLNESS

After every mass tragedy, mental health advocates fire off “mentally ill are no more violent than others” press-releases because 20% of adults with a mental health condition that they represent are no more violent than others. But as an advocate for the 4% who are seriously ill, I highlight that the seriously mentally ill who go untreated are often more violent than others. I do that so we can take steps to reduce the violence. People in the mental health industry know the connection to violence I’m talking about is there, but they want it to be our little secret. They know psychiatric units are locked and cardiac units aren’t. They know nurses in psych units wear panic buttons and those in liver care units don’t. They know we train police to deal with the mentally ill not those with psoriasis. And they know our outreach workers go out in pairs for their own safety. It may be provocative and disruptive to acknowledge the connection to violence but it’s also true and it’s necessary if we want to reduce the violence.

DJ Jaffe, Mental Illness Policy Organization

https://mentalillnesspolicy.org/#consequences-status-quo

 

DJ Jaffe’s Quote for September 26th, 2020

Schizophrenia interferes with a person’s ability to think clearly, manage emotions, make decisions, and relate to others.

The Mindstorm March 19, 2013

https://www.manhattan-institute.org/html/restore-sanity-mental-health-spending

 

DJ Jaffe’s Quote for September 21st, 2020

Meanwhile, the seriously mentally ill are allowed to decompensate on the streets until they are ready for jail. Ten times as many mentally ill people are now incarcerated as hospitalized.

Washington Examiner March 25, 2019

Health PolicyMental Illness

https://www.manhattan-institute.org/html/restore-sanity-mental-health-spending

 

DJ Jaffe’s Quote for September 13th, 2020

The only kinds of fights worth fighting are those that you are going to lose. Because somebody has to fight them and lose and lose and lose until someday someone who believes as you do, wins.

 

DJ Jaffe’s Quote for September 7th, 2020

To improve care for people with serious mental illness money is not missing, leadership is. We have to stop listening to mental health advocates and start listening to mental illness advocates. We need to replace mission creep with mission control. As Police Chief Biasotti, testified to Congress,

We have two mental health systems today, serving two mutually exclusive populations: 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. …(M)ental health officials seem unwilling to recognize or take responsibility for this second more symptomatic group.”

We have to stop ignoring the seriously ill.

DJ Jaffe

Mental Illness Advocate vs Mental Health Advocate

Excerpts from Speech to NAMI/NYS Convention

Exec. Dir. Mental Illness Policy Org.

November 15, 2013

https://www.psychologytoday.com/us/blog/braintalk/201412/mental-illness-advocate-vs-mental-health-advocate

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