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In Response to the WSJ Op-Ed: Mentally Ill, Drink a Smoothie

By Debbie Plotnick, MSS MLSP

Dear E. Fuller Torrey and Doris Fuller:

Early Saturday morning, I saw the op-ed that you both authored which ran in the Wall Street Journal. 

It pretty much was all I could think of over the weekend. At first I was very, very angry. This was because it hurt me personally, as a family member, as a mental health advocate, and as a social worker.

The subtitle and implications about those who are “high functioning” demeans people like my daughter and others whose now-present full lives include a painful history of suicide attempts, manic and psychotic episodes. It also demeans others who deal with the management of an ongoing mental health condition. There are so many individuals like this in and out of the mental health field. I work with many people who had all of the above; sometimes you'll know it, sometimes you won't. This term (high functioning), as well the tone of your op-ed comes across as downright dismissive and insulting to those that have dealt with a mental illness (all of which are serious) and to anyone who has ever beaten, or who lives with, a potentially life ending or altering condition.

It is also not helpful to personally attack administrators at SAMHSA and the Center for Mental Health Services (CMS) for not being psychiatrists. The American Psychiatric Association (APA) believes that the limited number of psychiatrists is best used as part of a team that includes primary care providers, social workers, and peers (people who’ve lived with a mental health condition). It is SAMHSA we have to thank for developing the evidence base for peers, who will play an increasingly important role in providing integrated, whole health care. 

It is also not helpful to fuel the false belief that it is common for people with mental illness to be violent by repeating extrapolated, patently false, exaggerated murder statistics. This drives people away from seeking treatment, while perpetuating the public’s fear of people who are mentally ill.

As you, I have worked in this field for many years, and have worked with a variety of mental health professionals, as well as advocates and families throughout the country. While you didn’t list him by name, your piece references and criticizes the work of Paolo del Vecchio—who, like me, is a master’s level social worker with years of experience doing direct service for people with SMI. I know the programs he ran including outreach to some of the sickest folks in Philadelphia. And he, like me, has designed and run community support programs, and now works to bring that knowledge to scale. It is shared knowledge of these types of programs, and getting help to people early as well as late, where we have sometimes worked so hard to find found common ground. I would like to believe we are all in this field because we care about making the system—and the people that use it—better.

Rather than attacking each other, we need to do more to come together to really help people at every level of need to get services and supports that will help, especially when their illness is just starting. And of course, we need to be there for them when their needs are extreme. We can’t do either of those things if we are expending our energy trying to score political points or get editorials in newspapers.  I invite you to join me in working with professionals of all types, and consumers and families to help the people we all care about.

Comments

AMEN

They compare to most TV Church Programs in their presentations.

Those who get money from SAMHSA tend to support SAMHSA. You can learn about their failures at http://mentalillnesspolicy.org/samhsa.html Whether SAMHSA is failing because the head is not a psychiatrist or doesn't care about the most seriously ill is largely irrelevant. What is important is that they are failing. I wish the author was concerned about that.
DJ Jaffe
Exec. Dir.
Mental Illness Policy Org.
http://mentalillnesspolicy.org

The only thing you should be angry about after reading that article is the magnitude of the problems outlined. NOT whether it bruised your own ego as someone under-educated in the diagnosis and management of serious mental illness (compared to a psychiatrist). Unfortunately your failure to realize the significance of not having a psychiatrist in such a position suggests you are likely to misunderstand other aspects of mental illness.

People in the mental health field who do not hold MD degrees are constantly on the defensive, insecure about their lack of training, as if that should even be discussed. If you truly care about improving things for the mentally ill you should put your own ego aside, do your job, don't overstep your boundaries, instead help to prop up the psychiatric profession, as that will only make your job easier and help the field as a whole. It starts at the top, more good psychiatrists can have the broadest impact, not more degrees for those looking for a loophole into a career (not suggesting you are one of those).

“All human failures are the result of a lack of love.” Alfred Adler

Thank you Debbie Plotnick for this thoughtful and well written piece that comes from the heart and from a lived experience.

Sadly, the likes of E Fuller Torrey, DJ Jaffee, Congressman Murphy and others use FEAR to drive their agenda of hate...and let us not fool ourselves to think that where they are coming from is anything less then hatred and FEAR of others. Why do they drive this agenda that is based upon histrionics, false claims and distorted truths??? What is their agenda...why do they have to dehumanize others? I wish I could answer that, but I don't know. I know bullies prey upon others....are we dealing with some bullies here who have not resolved their own traumas in life, that they have to lash out and hurt other people?

The Nazis used fear and hatred to drive their agenda that dehumanized others, so have racists throughout all of time...we need but look at what was done to the Native Americans in this country that was driven by fear and hatred.

Why do E Fuller Torrey, DJ Jaffee, Congressman Murphy not ask the question, "What Happened To You?" instead of "What's Wrong With You?" Why do they ignore the significant trauma and abuse in the lives of those they deem "mentally ill"? Why do they not look at the studies that show that 50 - 60% of people do not get a benefit from psychiatric drugs. And why do they ignore the toxicity in many of these drugs? Why do they not look at the majority of people they want to dehumanize as less than, and make people afraid of us, as having experienced horrible abuse in our lives? And so much of that traumatic abuse goes back to childhood. Why don't they take the time to listen and read what Dr. Bessel Van Der Kolk, Dr. Gabor Matte, Dr. Peter Breggin and others have to say about the "mentally ill" and the trauma and abuse in people's lives?

“If we could somehow end child abuse and neglect, the eight hundred pages of DSM [and the need for the easier explanations such as DSM-IV Made Easy: The Clinician's Guide to Diagnosis] would be shrunk to a pamphlet in two generations.” John Briere, Ph.D. is Associate Professor of Psychiatry and Psychology at the Keck School of Medicine, University of Southern California, Director of the Psychological Trauma Program at LAC-USC Medical Center, and Co-Director of the MCAVIC-USC Child and Adolescent Trauma Program, National Child Traumatic Stress Network.

He is a past president of the International Society for Traumatic Stress Studies [ISTSS], and recipient of the Robert S. Laufer Memorial Award for Scientific Achievement from ISTSS and the Outstanding Professional Award from the American Professional Society on the Abuse of Children [APSAC].

I have many questions, but I know they will not be answered as to why these men and others do what they do to spread fear...

Sincerely, Michael Skinner www.mskinnermusic.com Hope, Healing & Help for Trauma, Abuse & Mental Health

As a consumer and provider of mental health services, I have to agree with Ms. Plotnick. Just because someone is "high-functioning" doesn't mean they don't have real troubles and need real help. I carried a diagnosis of schizoaffective disorder while holding down 3 jobs. I have attempted suicide several times and was in and out of the hospital. It was because of initiatives like those of SAMHSA, such as supported employment and supported housing, that I am able to continue living in the community and provide positive contributions to society despite my on-going struggles with depression and psychosis.

The reality is that SAMHSA is not perfect, but neither are psychiatrists, or peers, or anyone else in the field. There is no 100% successful treatment for "mental illness" or any illness for that matter. Medication simply doesn't solve everything and to pretend or assume that it does is a ghastly detrimental mistake. In my experience I have found that IF the medications do help, they only address part of the problem, take long periods of time to be effective and often cause intolerable side-effects. That is all in addition to the difficulty of even affording them.

I do not believe that Ms. Plotnick's response was ego-based. Some may feel that she took the article personally. Well, if she did, I say rightfully so. After all, the reality is that living with a "mental illness" and/or supporting someone with a "mental illness" is very personal. Thank you, Debbie Plotnick, for your dedication to your daughter and to people like me. We are PEOPLE too, and must be treated as such; respected and loved, not feared. We should ALL be in this together. It affects all of us.

i have yet to find evidence of hate in fuller, jaffe or murphy. the statistics they quote are based on openly available data. i see no one here with other stats, just attacks on theirs. thats not science, not how rational policy is made.

nor do i see any defense of the particular programs SAMHSA has funded bu so many of us roll eyes over. art classes open to everyone... smi, in crisis, in therapy or treatment...or none of the above. carnival rides to explain the brain and somrhow also cut stigma for children. the coloring books are a better bang for the buck! but where in these is a hint of evidence to base the funding?
show us ! dont just say were haters and fearmongers. we too are paremts,famoly...or were, as the cases might be...
nor among the lists where jaffe contrinutes do i see haters or fear mongering. i see parents like in your group who seem to keep clearing a line and reinforcing it. i dont think asking SAMHSA to follow its charge to put SMI first is off base. We do believe it promotes good programs, but merely protest that it ignores advocating for most ill. we too regret the lack of early interventions, we too are sad that drugs are often the whole tx, that people are thrown out of treatments when the behaviors (symptoms) being treated dont pass the facilities nice behavior code. well, why are they there, but those less than nice nice behavior? yes, theres plemty in common as far as "issues." and as for leadership from SAMHSA, it wasnt Murphy alone runnimg the hearings that have all peer support in a frenzy. clean your own house, dont go directly to demial.

we all know the system is underfunded, not performing well. whats so frightening about asking for evidence of outcomes before continuing to cut checks? there is no sudden cut off in murphys legislation, just a 5 (FIVE) YEAR window to get their acts together. thats pretty liberal imho.

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