Sunday, December 11, 2005

 

TAC Newsletter 12/09/05

ENEWS - TREATMENT ADVOCACY CENTER

TREATMENT ADVOCACY CENTER
Visit our web site www.psychlaws.org
December 8, 2005

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1. EXPERTS: MENTALLY ILL FACE CRIMINAL STIGMA - Stockton Record, Nov 24, 2005

2. PSYCHIATRIST QUITS OVER SEX OFFENDER CONTROVERSY - Associated Press, December
2, 2005

3. OHIO SHOULD LIBERALIZE LAWS ON MENTAL HEALTH TREATMENT - Canton Repository,
December 7, 2005
4. A VERY PERSONAL COMMITMENT - The Star-Ledger, December 01, 2005

5. A TRIBUTE TO DR. MORTON BIRNBAUM - Catalyst, Winter 2001

6. DONATE TO THE TREATMENT ADVOCACY CENTER WHILE YOU SHOP

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1. STOCKTON RECORD (CA), Nov 24, 2005

[Editor’s Note: Thomas Testa, a Deputy District Attorney for California’s San
Joaquin County, knows all too well of untreated mental illness – it’s his job to
prosecute those charged with crimes because of actions resulting from symptoms
rather than intent. The murder cases mentioned below involve, of course, only
an infinitesimally small proportion of Stockton’s population with a severe
psychiatric disorder – yet they are only the most egregious consequences of
allowing psychosis to go unchecked. They are also horrific symbols of thousands
of other lives harmed, allowed to waste, or that are otherwise diminished
because of an absence of treatment.

We are surprised that Mr. Testa, a lawyer, did not identify one of the most
formidable obstacles to consistent treatment in his county – state laws that
prize the right of those incapable of making rational medical decisions to
“chose” to be free from undeniably needed psychiatric care.]


EXPERTS: MENTALLY ILL FACE CRIMINAL STIGMA

Local, National Cases Shine Harsh Spotlight On Group

By Scott Smith, Record Staff Writer


STOCKTON -- San Joaquin County Deputy District Attorney Thomas Testa said in
recent years he has prosecuted too many murderers with previously diagnosed
mental health problems and is tired of it.

In each case, Testa said, a person died under heinous circumstances while the
killer goes to state prison or a mental hospital. Countless relatives grieve
because the defendant failed to stay on prescribed psychological drugs, he said.

Testa wonders if a local agency could have stepped in. He said he holds family
members responsible for failing to make their mentally ill relatives take
prescribed medicine.

"I suggest they even go so far as to count the pills," he said.

But the situation is not that simple, said attorneys and psychologists who work
with San Joaquin County residents struggling with mental illnesses. The
percentage of mentally ill people committing violent crimes is low but usually
gains public notoriety.

"Like any minority group, people suffering from mental illnesses are painted
with a broad brush as criminals," said Ellen Schwarzenberg, a San Joaquin County
deputy public defender assigned to the mental health court.

Mental illness, which results from a chemical imbalance in a person's brain,
should be treated as a disease and not criminal behavior, she said. Police don't
understand the problem and frequently take a person to jail rather than to
mental health treatment facilities, she said.

Testa said crimes committed by mentally ill people make national headlines,
punctuating those local cases he prosecutes. He cited four Stockton cases in the
past couple of years:

# Wayne Osborg Jr., 32, was convicted and sentenced to two consecutive life
sentences in August for bludgeoning two men when he didn't show up at a
treatment home for his mental illness.
# Khanh Duy Phan, then 34, was convicted in March 2004 for decapitating his
18-month-old daughter and sentenced to state prison for 26 years to life.
# Peter Nhim, then 18, was convicted in October 2004 of second-degree murder in
the stabbing death of a 9-year-old family friend.
# Robin Rials, then 17, pleaded guilty to first-degree murder in March 2004 but
avoided prison after a judge ruled she was insane when she set fire to an
abandoned trailer where a man slept.

Linda Collins, a court liaison for San Joaquin County Behavior Health Services,
bemoaned a stigma that mentally ill people are criminals rather than fighting a
chronic illness. She urges better education, especially for law enforcement and
court officials.

Collins managed a program focused on treating mentally ill inmates in the County
Jail. The program was successful at reducing recidivism but funding dried up
with budget cuts in recent years, she said.

Proposition 63, passed by voters last year, promises to turn the tide for
mentally ill people caught in the legal system, she said. It taxes Californians
earning more than $1 million annually to fund programs for mentally ill people.

"I work with those people who have done heinous things," she said. "But I've
also seen people return and recover to a full and productive life."

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2. ASSOCIATED PRESS, December 2, 2005

[Editor’s Note: Whether or not sex offenders should be retained after the
expiration of their prison sentences is a morass of moral conundrums. It is
also an issue outside our area of focus, and expertise. We can easily, however,
insist that those adjudged to be sexual predators should not be placed in the
general population of a general psychiatric hospital, and admire the
self-sacrificing gesture of Dr. Brandon Krupp.]


PSYCHIATRIST QUITS OVER SEX OFFENDER CONTROVERSY

By M.L. Johnson, Associated Press Writer


PROVIDENCE, R.I. (AP) -- With a repeat sex offender about to be released from
prison after serving 16 years for raping a young boy, Gov. Don Carcieri directed
state officials put him in a different institution: the state mental hospital.

Dr. Brandon Krupp, who ran the hospital's psychiatric services, opposed the
plan, saying it would not protect the public and could put other patients at
risk. When his protest went unheeded, he quit.

"Doctors aren't jailers," Krupp said in an interview shortly after leaving the
job. "Hospitals aren't prisons."

Krupp's resignation is an extreme reaction to a growing problem: no one knows
what do with sex offenders who seem likely to commit more crimes. Seventeen
states have laws that allow them to hold sex offenders who have completed their
prison terms. More recently, governors in other states have tried to use mental
health laws to keep sex offenders in psychiatric hospitals once their prison
terms end.

New York Gov. George Pataki used his state's mental health law to order a dozen
sex offenders held when their sentences ended. Doctors released one after a
psychiatric review last month, but the others remain hospitalized while an
appeals court reviews their case. In Rhode Island, Carcieri directed state
officials to commit Todd McElroy to the Eleanor Slater Hospital in October,
shortly before he was due for parole on a 42-year sentence for kidnapping and
raping a 10-year-old boy.

McElroy, who is schizophrenic, had been held for more than a year in the
hospital's forensic unit, which has prison-like security. But Krupp says
McElroy's schizophrenia is now under control, and he no longer belongs in a
hospital. As his parole date neared, McElroy moved voluntarily to a regular unit
at the hospital while he awaits a court hearing to determine whether he will be
freed. He shares a 16-bed, coed ward with patients who have done nothing wrong.
He has access to a day room, nurses' station and the outside. Krupp and other
doctors say McElroy's confinement is a gross misuse of medical facilities.

The Rhode Island Psychiatric Society took the unusual step of calling a news
conference to oppose the state's plan to commit McElroy. The American
Psychiatric Association has opposed similar plans, saying government officials
seem more intent on punishing sex offenders than treating them. Medical
guidelines require that a person be mentally ill, dangerous because of the
illness and capable of being treated before they are committed to a hospital.

Most sex offenders don't meet that criteria, said Roxanne Lieb, director of the
Washington State Institute for Public Policy, a state-funded think tank.
Washington passed the first sex offender commitment law in 1990 and holds them
in a secure, separate facility.

"Typically, they are not mentally ill by a traditional definition of the word,"
Lieb said. "They don't have a mental disorder, they don't have a thinking
disorder, they are not psychotic."

Howard Zonana, who teaches forensic psychiatry and law at Yale University, said
the problem is really "how you separate the mad from the bad." Studies show a
significant percentage of prisoners have anti-social personalities, but not all
of them belong in psychiatric hospitals, he said.

"Why not put in every murderer in a hospital after they've served time for
manslaughter?" he asked. But H. Reed Cosper, Rhode Island's mental health
advocate and McElroy's former lawyer, said it's silly to split hairs over why
sex offenders commit their crimes. If they are mentally ill and dangerous, they
should be confined, he said.

Another problem with hospitalization is cost. The 17 states with sex offender
commitment laws spend $224 million per year to keep them in separate, secure
buildings, according to a study by the Washington State Institute for Public
Policy. Holding them in a psychiatric hospital like Slater would cost even more
because of the additional medical care, Zonana said.

That's one reason why members of the National Association of State Mental Health
Program Directors do not want sex offenders in the hospitals they run. Sex
offenders draw limited resources from other patients, the group's spokesman Roy
Praschil said. And, many doctors disagree about whether people can even be
treated for pedophilia and other violent behavior.

From the 1930s to about 1970, 26 states had laws letting sex offenders opt for
psychiatric treatment rather than prison, Zonana said. But those programs died
after graduates raped, or even killed, again. Jeff Neal, Carcieri's spokesman,
declined to discuss McElroy, but acknowledged that mental health laws are not an
ideal way to handle sex offenders. He said the governor plans to introduce a
bill to increase prison terms and set up electronic monitoring for people who
assault children. McElroy and his attorney declined to discuss his case.

Krupp said he hopes his resignation will stir public debate and lead to a better
solution. "This isn't about me wanting this or any other sex offender
unfettered, free on the streets," he said, but "to think that the quick fix for
this is to shove them in the hospital is absolutely wrong. It's neither
appropriate nor will it actually get you the safety you want, because we're not
a prison."

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3. CANTON REPOSITORY (OH), December 7, 2005

[Editor’s Note: It couldn’t have taken Frank McKnight long to write the 97
words in the letter below, but those few minutes spent made the message of
treatment law reform ring in papers throughout his community.]


OHIO SHOULD LIBERALIZE LAWS ON MENTAL HEALTH TREATMENT

Letter to the Editor

On Nov. 28, you ran the story, “Schizophrenic who killed parents strives for
normal life.” What a sad story. Even more so because of the laws in our state
that limit treatment to those with severe mental illnesses.

These people are unable to access treatment voluntarily because of the symptoms
of their illnesses — they simply don’t realize how sick they are.

Several states, including Michigan, Florida and West Virginia, have enacted
assisted outpatient treatment laws that make court-ordered outpatient treatment
possible.

These laws have literally saved lives. It’s time that Ohio does the same.

Frank McKnight, Jackson Township

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4. THE STAR-LEDGER (Newark, NJ), December 01, 2005

[Editor’s Note: We’ve seen the reactions of many governors to the issues
affecting severe mental illness – disinterest, encouragement, action,
stonewalling, and ignorance among them. We’ve never seen this.]


A VERY PERSONAL COMMITMENT

Codey Spends A Night Walking In The Shoes Of Greystone Psychiatric Patients

By Lawrence Ragonese, Star-Ledger Staff


He booked himself into Greystone on Tuesday. There was no court order, no police
involvement. It was a voluntary overnight commitment to the state psychiatric
hospital for one Richard J. Codey. Yes, the state's acting governor.

Trying to keep the spotlight on mental-health issues, Codey checked in at the
nearly 600-patient hospital in Parsippany for a 14-hour, firsthand look at how
patients live and the care they receive.

The 58-year-old celebrity patient asked for no special privileges -- though he
could not shed his own security detail. He ate dinner and breakfast with other
patients, watched TV with them in a day room, sang Christmas carols with them
and then trudged off to room 2-15B for sleep.

Codey did not come to Greystone empty-handed. He bought pizza and soda for his
fellow patients in Ward 73 and arranged a musical show through the First
Presbyterian Church Choir of Caldwell. He gave out specially designed T-shirts
featuring a basketball logo and the words "Giving Recovery A Shot" on the front
and "Gov. Codey #1" on the back.

He even gave one patient, Robert Romash, his governor's watch.

In return, Codey got hugs, high fives, big handshakes and plenty of thanks.

"There were a couple things I wanted to do," Codey said in a pre-bedtime
interview late Tuesday night. "One, bring a little joy into their lives and make
it something that otherwise would not have been. They wouldn't have had a
concert, wouldn't have had pizza, wouldn't have gotten shirts. It adds a little
holiday cheer for them, something they normally would not get."

Second, he wanted to continue calling attention to the needs of the state's
mentally ill and to try to eliminate the stigma residents face.

Codey arrived at Greystone at 5:14 p.m. Tuesday. He was greeted by patient Dave
Lambert outside the Abell complex as a host of hospital officials and employees
looked on. The acting governor was led to his room, unpacked his bags and asked,
"So when's dinner?"

Late for dinner, Codey sat alone but was quickly joined by eight patients who
peppered him with comments and questions.

"We are so proud of the things you have done for this state," said Philip, a
patient wearing headphones and a backward blue baseball cap.

"Are you related to Buffalo Bill Codey?" asked patient Robert.

"Why don't you run for president?" asked another patient, as Codey laughed and
several patients chanted for him to be president.

Later, he joined patients in the Abell auditorium for entertainment he arranged.
Corinne Tracy led a flute trio, Heather Jones played handbells, Barbara Piercy
played piano and the Retromen chorus from James Caldwell High School sang
holiday songs. Two enthusiastic patients, one named Peggy and another named
Codey, joined them onstage for the finale, "Santa Claus is Coming to Town."

Then it was off to Ward 73 for a pizza party financed by the acting governor's
political action committee. For his bedroom, the governor used a vacant program
room at no cost to taxpayers.

Codey has long been an advocate of better mental-health care in New Jersey. In
the 1980s, he went undercover as an employee at now-defunct Marlboro State
Psychiatric Hospital to shine a light on problems there. Since replacing James
E. McGreevey as governor last year, Codey and his wife, Mary Jo, have made
mental-health care in New Jersey a priority issue.

"People like Peggy, that's what this effort is all about," Codey said, referring
to his singing partner. "She is so funny and smart. Helping her, providing good
care for people like her is important. She deserves it."

The acting governor formed a state Mental Health Task Force and has worked to
enact its recommendations, including eliminating liens against patients who
cannot afford state hospital care, setting up a trust fund to create more
housing for the mentally ill, forgiving student loans for people who take
hard-to-fill social services jobs and providing free mental-health screenings
for pregnant women without health insurance.

"It's a quality-of-life issue," he said at breakfast yesterday. "Statistics show
us one in every five New Jersey families today have someone with some kind of a
mental illness. It crosses all barriers -- rich, poor, black, white, male,
female. It's hitting all segments of society."

Patients gave Codey an earful about their situations. Most complained about the
quality of food. Codey agreed, calling his dinner of broccoli and cheese with
some bread crumbs "absolutely terrible."

Some patients wanted a better outdoor smoking area. One asked for the
installation of a change machine to make it easier for patients to use pay
phones.

Others spoke to him of their personal situations.

William, 41, of Rockaway Township, lamented the recent death of his mother. He
said he hopes to overcome a bipolar disorder and eventually get back into the
work force.

Robert, 39, of Jefferson, said he has been at Greystone six times in 17 years.
He has overdosed three times, including after the deaths of his grandmother and
a best friend. He said he first began to sense psychiatric problems in his late
teens when he got an overwhelming urge to put his hand under a running
lawnmower.

He wanted Codey to grant him one wish.

"I know there is no magic pill. But that's what I want," Robert said. "I want
the governor to give me a magic pill to make this all go away."

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5. CATALYST (Vol 3, No. 6), Winter 2001

[Editor’s Note: Morton Birnbaum, a pioneering crusader for the care of people
with severe mental illnesses who is inextricably intertwined with the effort to
create “a right to treatment,” passed away on November 26 in Brooklyn from the
effects of a stroke.

Holding degrees in both medicine and law, he supported himself through his
gerontology practice in Bedford-Stuyvesant while working nights and weekends on
pro bono legal cases targeted at securing wholesale increases in the quality and
quantity of care for individuals with acute psychiatric disorders. As he
described, "I make my living as a doctor, and throw it away as a lawyer."

We can make no better tribute to Dr. Birnbaum than the one below by Rael Jean
Isaac, author of Madness in the Streets, which commemorated his receipt of our
Torrey Advocacy Commendation.]


A TRIBUTE TO DR. MORTON BIRNBAUM

By Rael Jean Isaac


When we think of the giants of mental health reform in the United States, the
names of Dorothea Dix (the woman who through her single-minded devotion
persuaded state legislatures to create the system of asylums for the mentally
ill), Clifford Beers (father of the National Association for Mental Health and
the child guidance clinic), and Albert Deutsch (whose Shame of the States
exposed the extent to which asylums had been allowed to deteriorate, with
patients left untended and untreated) come to mind. But there is another
individual, his contribution today generally overlooked , who belongs in the
class with these pioneering figures: Morton Birnbaum, father of the concept of a
"right to treatment."

Today this is such a familiar principle that it is hard to believe that in 1960
it was considered an outlandish notion. The first two sentences in Birnbaum's
seminal article of that year, The Right to Treatment, sum up its thesis: "The
purpose of this article is to advocate the recognition and enforcement of the
legal right of a mentally ill inmate of a public mental institution to adequate
medical treatment for his mental illness. For convenience, this right will be
referred to as the right to treatment." Birnbaum argued that, "incarceration by
the state in a mental hospital without proper treatment is a deprivation of
liberty without due process [i.e., unconstitutional]."

The article accumulated rejection slips. Birnbaum remembers his disappointment.
"I sent the article off. It seemed to me absurdly simple. I couldn't understand
that no one would accept it. I could show you maybe fifty rejections. I sent it
off to the New England Journal of Medicine - it came back. I sent it to the
Journal of the American Medical Association. It came back. American Journal of
Psychiatry; it came back. I sent it to Harvard Law Review, Yale Law Review. They
didn't even send it out for peer review lots of times. One journal sent it back
with a note saying, 'This is preposterous.' I sent it out for a couple of
years."

Finally, in 1960, the American Bar Association Journal not only published the
article, but accompanied it with an editorial endorsing the idea. And, in its
Sunday edition, the New York Times published an article about this novel idea of
a "right to treatment."

Birnbaum's background made him a surprising advocate for mental patients. He
received his law degree from Columbia in 1951 and subsequently went to medical
school, in 1957 receiving his M.D. in general medicine, not psychiatry. His
interest was in catastrophic illness, the kind of illness which the average
person or family could not cope with financially. He came to focus on severe
mental illness as the chief catastrophic illness where improvement in care was
most needed, developing the ideas for his ground-breaking article as a
post-doctoral fellow at the Harvard University Training Program for Social
Scientists in Medicine in 1958-59.

But even the favorable editorials did not have the effect Birnbaum expected.
Says Birnbaum: "I thought once it got published, the doors would break down and
everyone would say, 'What a wonderful idea, you discovered a new penicillin.'
But nobody broke down the doors. What amazed me was that the only real comments
I got on it were from two patients in state hospitals. One was Donaldson in
Florida and the other was a guy, Stevens, in New York." Birnbaum took on both
cases at his own cost. Fifteen years later, O'Connor v. Donaldson became a
landmark Supreme Court ruling. (Birnbaum pursued the "right to treatment"
Stevens case with equal tenacity, but Stevens was finally freed by an
administrative decision, not through victory in the courts.)

Well before his triumph in freeing Donaldson, who had been held in Florida State
Hospital for fourteen years, the "right to treatment" had a major impact on
mental health law. (Ironically, much to Birnbaum's disappointment, the Supreme
Court used other grounds, not the "right to treatment," to release Donaldson.)
Birnbaum's testimony in 1961 before a Senate subcommittee looking into mental
health law led to the drafting of a model bill with a provision recognizing and
enforcing the right to treatment. But the language did not survive. Enacted in
1964, the final model bill had only a phrase referring to the right.

While Birnbaum was, of course, deeply disappointed, only two years later the
U.S. Court of Appeals for the District of Columbia recognized the right to
treatment on the basis of that hesitant reference in the 1964 bill.

Birnbaum has been a consistent advocate both for mental hospitals and for
treatment. He harbored no hidden agendas, as would so many in the emerging
mental health bar, who invoked the "right to treatment" in order to achieve the
opposite: massive deinstitutionalization coupled with the right to refuse
treatment. In his 1960 article, Birnbaum wrote that he did not expect any major
decrease in the number of hospitalized patients since the new neuroleptic drugs
had produced only a slow, irregular drop in the patient population, patients
continued to relapse despite the drugs, and no radically new methods of
treatment were on the horizon.

Birnbaum harbored a simple, humanitarian conception that would, alas, turn out
to be naive. He conceived of the right to treatment as a pragmatic solution to
the hitherto intractable problem of maintaining decent conditions in state
hospitals. Periodically there would be exposes of dreadful conditions and public
wrath would force improvements, but then the situation would revert to its
previous condition. Birnbaum saw the right to treatment as an enforcement
device. As he explained in a 1971 article in The Alabama Law Review, he proposed
giving the patient the right to obtain his discharge from a hospital, regardless
of the severity of his illness, if the hospital was unable to prove that it
lived up to objective, institution-wide standards (like a set ratio of patients
and physicians) for providing adequate treatment.

Birnbaum was convinced that if the public discovered courts were discharging
severely ill patients because hospitals were not providing treatment, it would
(as he wrote in The Right to Treatment) "force the legislatures to increase
appropriations sufficient to make it possible to provide adequate care and
treatment so that the mentally ill will be treated in mental hospitals."
Birnbaum even wanted to limit the right of hospitals to discharge sick patients
into the community. In his 1971 article he wrote: "If no family is available,
and if no publicly supported halfway house, or similar facility is available,
the patient may not be discharged."

Birnbaum's first clear victory in achieving court recognition (and enforcement)
of the right to treatment was in Wyatt v. Stickney, the famous Alabama case in
which Birnbaum served as co-counsel. (The lead attorney was Alabama lawyer
George Dean.) It was a Pyrrhic victory because he had inadvertently teamed up
with lawyers who were intent on subverting his concept. Bruce Ennis, and the
other lawyers who cut their teeth on Wyatt v. Stickney (and would form the
Mental Health Law Project) had no interest in promoting treatment. Ennis said
frankly that he initially refused to touch right to treatment cases and only
decided to become involved in Wyatt v. Stickney because there was advance
information that the judge would not only endorse the existence of a "right to
treatment" but would set standards so high Alabama could not meet them, and
would be forced to embark on radical deinstitutionalization.

When it turned out that Alabama indeed could not meet the standards imposed by
Judge Frank Johnson, Birnbaum looked to the federal government. He decided to
challenge the constitutionality of the 1965 Medicaid legislation that excluded
state mental hospital patients under age sixty-five from Medicaid benefits.
Because of Medicaid's matching provisions, he calculated that if Medicaid
included state mental hospital patients, Alabama would be able to quadruple its
expenditures on these patients without increasing state appropriations. It was
at this point Birnbaum ran aground on the insistence of Dean, Ennis and the
other like-minded lawyers involved in the case, that state mental hospitals
should be done away with in favor of alternative community facilities. Says
Birnbaum: "My arguments that a sufficient number of alternative facilities were
not available were of no avail." Disillusioned, Birnbaum dropped out of Wyatt v.
Stickney and turned to his opponents in the case. "I said maybe you're
interested. They're going to give a judgment against you, you'll need the money.
For $100 of Alabama funds, you'd get $300 of federal funds. Without it you're
going to get nothing."

In fact, Birnbaum had much more in common with his ostensible chief opponent in
the case, Alabama Health Commissioner Stonewall Beauregard Stickney, than he did
with the members of his own legal team: both of them genuinely wanted to improve
treatment of the mentally ill. At the outset, Stickney had conceded Birnbaum's
case: patients had a right to treatment. Stickney approached then Governor
George Wallace, who agreed to bring the state of Alabama into a suit challenging
the Medicaid exclusion.

Perhaps nothing in his career proved his single-minded dedication to the welfare
of the mentally ill so much as Birnbaum's willingness to forge an alliance with
George Wallace, then a presidential candidate and a symbol of the populist far
right, whom Birnbaum, as a political liberal, regarded with horror. The
incipient alliance ended abruptly when Governor Wallace was shot and paralyzed.

Birnbaum brought his suit, Legion v. Richardson, in 1972, asking that the
Medicaid exclusion be declared unconstitutional. In the end, he would lose the
suit. But on crucial issues, Birnbaum never gives up. During the Clinton
administration, he brought suit again in federal court (Doe v. Shalala) to end
the Medicaid exclusion. The importance of this issue, long neglected by
advocates for the mentally ill, has now been recognized by the Treatment
Advocacy Center.

One of the most striking aspects of Birnbaum's writings is his ability to
recognize key problems long before they come to general attention. Birnbaum
touched on many of the issues that TAC president E. Fuller Torrey, through his
books and articles, has brought to public awareness. In 1970 Birnbaum was
writing about the dwindling number of psychiatrists addressing the needs of the
seriously mentally ill; the failure of the new community mental centers to treat
them (Birnbaum pointed out that in 1969, for all the publicity about their role
as an alternative to state hospitals, the centers accounted for only 4% of
inpatient care episodes for those under 65 and only 2% of those over that age);
the failure to provide "support and rehabilitative services needed by the
severely ill"; the growing number of homeless people roaming the streets in
various states of undress.

Dr. Birnbaum, who maintains a modest geriatric practice in the run-down Bedford
Stuyvesant section of Brooklyn, has said wryly: "I make my living as a doctor
and throw it away as a lawyer." Evening and weekends over the last decades he
has persevered on the lawsuits he has brought to improve conditions for mental
patients - e.g., against the two-tier system of care in psychiatric units of
general hospitals and in state hospitals (1982), against the egregious
overcrowding in Kingsboro Psychiatric Center (1986). His litigation and other
activities, as Birnbaum has written, "are essentially both a one-man activity
and personally financed, as I receive no fee or subsidy."

Dr. Birnbaum has always followed his own star and this is probably the reason
his enormous contribution has been overlooked. If he had been willing to swim
with the tide, and join forces with the Mental Health Law Project in its battle
to "free" involuntary mental patients from both institutions and treatment, he
would doubtless have been celebrated as a "father" of what passes today as legal
reform.

To Birnbaum it would have been unthinkable to betray his vision for the sake of
fame and recognition. He has never become an organizational leader, although he
tirelessly mobilized support of organizations as amicus curiae in the early
lawsuits he brought. Now in his mid-seventies, Dr. Birnbaum perseveres in his
driven, selfless quest to improve the lot of the mentally ill. We humbly salute
him.

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6. DONATE TO THE TREATMENT ADVOCACY CENTER WHILE YOU SHOP
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Thinking About Holiday Gifts?

Order copies for the people you love (including yourself!) and TAC gets a
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Amazon know you are a TAC supporter).

Beasts of the Earth: Animals, Humans, and Disease

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Surviving Manic Depression: A Manual on Bipolar Disorder for Patients, Families,
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by E. Fuller Torrey, M.D. - 416 pages (January 8, 2002) Basic Books; ISBN:
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asked questions. This is a valuable resource for anyone touched by the illness."
- Publishers Weekly

The Invisible Plague: The Rise of Mental Illness from 1750 to the Present


by E. Fuller Torrey, M.D. - 400 pages (January 2002) Rutgers University Press;
ISBN: 0813530032

"Important and provocative." - Dr. Gerald Grob, psychiatric historian

"In their refreshing, thoroughly documented, cogent reply to the current
generally accepted interpretation of the incidence and even the existence of
insanity, Torrey and Miller point out many holes in the arguments of other
recent historians of the subject and don't push any single approach to
schizophrenia and manic depression." - William Beatty, American Library
Association

Surviving Schizophrenia : A Manual for Families, Consumers and Providers


by E. Fuller Torrey, M.D. - 480 pages 4th edition (May 8, 2001) Quill; ISBN:
0060959193

"A comprehensive, realistic, and compassionate approach... Should be of
tremendous value to anyone who must confront these questions." - Psychology
Times

"E. Fuller Torrey is a brilliant writer. There is no one writing on psychology
today whom I would rather read." - Los Angeles Times

Street Crazy, The Tragedy of the Homeless Mentally Ill


by Stephen B. Seager, M.D. - 216 pages (November 30, 2000) Westcom Press; ISBN:
0966582772

"Mental illness profoundly affects most of us, often through the sad story of a
sick relative or friend, and if you've ever wondered what was happening, this
book will answer your questions simply and clearly. I can't recommend STREET
CRAZY highly enough." Carla Jacobs, former member, Board of Directors for NAMI

******************************

Treatment Advocacy Center E-NEWS is a publication of the Treatment Advocacy
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