Anosognosia

Call to Action: HR 2646 Markup This Week

realmhchange Anosognosia, Assisted Outpatient Treatment, civil liberties, Criminal Justice, Disability, health privacy, IMD Exclusion, Institutionalization, Involuntary Outpatient Commitment, Legislation, mental health, policy, Senate, Tim Murphy

TIME SENSITIVE! Call or write before 5:00 pm on Tuesday, June 14, 2016.

The most current draft of the Murphy Bill, HB 2646, will be addressed by the House Energy and Commerce (E&C) Committee next Wednesday, June 15, 2016.

If your House representative is on the E&C Committee CALL THEIR HOME OFFICE by the end of Tuesday, June 14. (Instructions on how to find your Rep and who to call are at the end of the announcement.)

WHETHER YOU HAVE A REP ON THE COMMITTEE OR NOT, please call the Washington offices of Chairman Fred Upton and Ranking Member Frank Pallone. Here is their contact information:

Fred Upton (R, MI), Chairman
TEL:

Frank Pallone, Jr. (D, NJ), Ranking Member
TEL:
https://palloneforms.house.gov/contact/email

LEAVE A MESSAGE stating you are strongly opposed to Murphy Bill HB 2646 and you want them to vote against it on June 15, 2016.

Below are the key points for opposing the bill. More details are at our website.

Press release from NCMHR on this proposed legislation.

The National Coalition for Mental Health Recovery is strongly opposed to HR 2646, the Helping Families in Mental Health Crisis Act of 2016, for the following reasons:

Continues to weaken the Substance Abuse and Mental Health Services Administration by creation of unnecessary oversight by an Assistant Secretary for Mental Health. SAMHSA has been indispensable in supporting the recovery of individuals with mental health conditions.

Would violate civil rights by authorizing new funding for assisted outpatient treatment, despite the lack of evidence that mandated outpatient treatment is effective.

Would expand Medicaid funding for institutions, rather than putting the money into evidence-based services in the community, as has been mandated by the Supreme Court’s Olmstead decision.

OVERALL REACTION
The crisis in mental health care has been painted as a problem of “undeserved” rights. It is, in fact, a problem of grossly inadequate resources that are poorly allocated. Consumer-driven services in the community complement traditional mental health programs with highly effective outcomes that are significantly less expensive than other forms of community care. We recommend language and funding for peer support specialist grant programs and other consumer-driven supports.

More than 50 years after deinstitutionalization, mental health systems across the country are still unable to provide the appropriate care in the community that was promised long ago. Time and again, research has proven that the public perception of the relative “dangerousness” of people with mental health conditions is unfounded. Sensationalized, distorted media coverage and the sustained influence of some stakeholders have fueled arguments for forced treatment and an overly medicalized system of care. The march toward re-institutionalization and coercive care is abhorrent. Having a mental health condition does not constitute a life sentence to poverty, marginalization, aberrant behavior or an inability to become a fully functioning citizen who can contribute meaningfully to his/her community. We know that recovery is possible because we are the evidence.
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Who needs to be called? Members of the House Energy and Commerce Committee should be called by their constituents:

Not sure who your representative is? Go to this link and type in your zip code:
http://www.house.gov/representatives/find/

An icon for your representative will appear, and you should be able to locate their contact information. If you prefer email, use the address provided on your representative’s page.

However, THE BEST IMPACT will come from calls to the home district offices. The staff at the home offices will communicate with the DC staff accordingly.

Don’t see your representative on the Energy and Commerce Committee? That’s okay, you can still help by calling the Washington, DC offices of the Chairman and Ranking Member and sharing your views:

Chairman Fred Upton (R, MI)
TEL:

Ranking Member Frank Pallone, Jr. (D, NJ)
TEL:
https://palloneforms.house.gov/contact/email

TIME SENSITIVE! Call or write before 5:00 pm on Tuesday, June 14, 2016.

Fear Tactics in Advocacy: “Anosognosia”

realmhchange Anosognosia, Assisted Outpatient Treatment, civil liberties, mental health, policy

Screen Shot 2016-01-05 at 11.58.07 AM

By Jean Arnold, National Stigma Clearinghouse

(Original post can be found here.)

Has  “anosognosia” tripled in ten years?

The diagnostic term “anosognosia,” was created in 1914  by Joseph Babinski, a French-Polish neurologist.  The diagnosis is primarily given to stroke patients who have lost awareness of a body part, a condition attributed to brain lesions.

In 2000, intense lobbying by Dr. E. Fuller Torrey and  Dr. Xavier Amador convinced psychiatrists to add anosogosia to the psychiatrists’ diagnostic bible, the DSM-IV.  Anosognosia can be used to justify coercive treatment; this and the uncertainty of its relevance to mental illnesses raises moral and ethical concerns among its critics.

Prior to the brain lesions diagnosis, a “lack of insight” concept had allowed patients at least some voice concerning their treatment and medications.  Now, supporters of involuntary outpatient commitment have reportedly conflated the older term with anosognosia.

It’s worth noting that in 2004, Anthony S. David and Dr. Amador estimated that 15% of people with schizophrenia were affected by anosognosia (source: Wikipedia)  That estimate has increased alarmingly. The 15% has grown to 50% for people diagnosed with schizophrenia, 40% of those with bipolar disorder.  Coercion supporters also consider potential violence to be a hallmark of anosognosia.

An even further escalation of anosogosia has come from promoters of Congressional bill HR 2646, the Helping Families in Mental Health Crisis Act.  When asked by a radio host if mentally ill people are more likely to be violent, Rep. Tim Murphy, co-author of HR 2646, prefaced his circuitous answer by noting that “we’re dealing with 60 million folks…”  (10 million is the typical estimate of people diagosed with schizophrenia and bipolar disorder.)  The Murphy statement suggests a flexible approach to diagnosing anosognosia.   

How times have changed since 2000.  In Dr. Amador’s book. I’m Not Sick, I Don’t Need Help, he considered coercive treatment to be counter-productive. The book makes a convincing case that a treatment partnership is more effective than coercion and its results are more lasting.

For more information:

  • “Anosognosia: How Conjecture Becomes Medical Fact” by Sandra Steingard, MD, concerning the rise of the term “anosognosia” in psychiatry
  • Read more about insightul awareness in “The Issue of Insight” by Larry Davidson, Yale University Medical School
  • Here’s a brief description of the source of the word “anosognosia:”
    June 11, 1914: In a brief communication presented to the Neurological Society of Paris, Joseph Babinski (1857-1932), a prominent French-Polish neurologist, former student of Charcot and contemporary of Freud, described two patients with “left severe hemiplegia” – a complete paralysis of the left side of the body – left side of the face, left side of the trunk, left leg, left foot. Plus, an extraordinary detail. These patients didn’t know they were paralyzed. To describe their condition, Babinski coined the term anosognosia – taken from the Greek agnosia, lack of knowledge, and nosos, disease.
  • Is an Ominous New Era of Diagnosing Psychosis by Biotype on the Horizon? By Michael Cornwall, PhD, MadInAmerica.com
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