Consumers Seek Unified Voice at Mental Health Conference

From the Oregonian, August 29, 1999

Janelle Anderson hopes to leave the summit knowing she has affected this movement — and her own healing. Feeling suicidal, she committed herself to the Eastern Oregon Psychiatric Center in Pendleton in May.

When she became upset and alarmed a nurse, she offered to swallow some calming medication. But she said the nurse refused. Anderson looked up and saw the nurse with the syringe. Angry, she bit one of the workers who was holding her down. She was placed in restraints for three hours.

Now she has her first criminal charge as an adult — fourth-degree assault.

She hopes she can interrupt what can become a relentless dance with the system. She says what she needs is love — not forced injections and restraints.

“For a long time, consumers and survivors have worked with other organizations,” said Joseph A. Rogers, executive director of the National Mental Health Consumers’ Self-Help Clearinghouse in Philadelphia, lead sponsor of the summit.

“But many of us think the time has now come for us to stand alone,” said Rogers, who has bipolar disorder. “Quite simply, no one can represent us as well as we can represent ourselves.”

The summit is happening amid discussions from kitchens to Congress about when a person with a mental illness and a propensity for violence should be forced into treatment or locked up in a psychiatric hospital.

Some at this weekend’s summit want to broaden the discussion to ask “whether.”

Forced medication or hospitalization is only one of the issues summit participants talked about. But it is a key rallying point for this emerging movement. And it may be the most difficult fight.

Fueled by a few high-profile cases of people with mental illnesses who have become violent — such as the man who killed two police officers in the U.S. Capitol last year and another who opened fire at a Jewish community center in Los Angeles this month — an “assertive treatment” model is gaining momentum. The Clinton administration in June endorsed Medicaid coverage for the model, which is used or being tried in 25 states. Discussions about adopting the model in Multnomah County took place this month.

The model includes reaching out to people who aren’t getting treatment and providing long-term, fully integrated and individualized services. The National Alliance for the Mentally Ill says such programs “keep people from falling between the cracks.”

Much about the model is widely praised. But some activists are wary of what they consider a heavy-handed approach, including home visits to deliver and watch people take their medication.

“Even those of us who are pretty pro-treatment are worried about the push toward involuntary treatment,” Rogers said.

Among people with mental illnesses, opinions vary about the acceptability of outside influence over treatment.

Some support forced treatment the moment a person is a danger to himself or others. Others reject forced treatment, ever. But underlying those perspectives is a belief that people should get to choose how they deal with their illnesses, just as diabetics or heart patients do.

“I think that when we use force (to get someone into treatment), it is representative of a breakdown of something we should have been doing upfront to meet that person’s needs,” said Kevin Fitts.

Fitts is director of Oregon’s Office of Consumer Technical Assistance, a Portland-based advocacy organization run by and for people with mental illnesses and a co-sponsor of this weekend’s summit.

At 34, Fitts also has bipolar disorder. When he was 19, his parents committed him to Dammasch State Hospital. A few years later, struggling with drug and alcohol abuse and feeling suicidal, he returned on his own.

Now Fitts manages his illness without medication. He runs to channel his energy. He talks with friends or a therapist when he needs to.

Many in the mental health community understand the need for choice.

“A person ought to be in control of what happens to their body,” said Dr. Lawrence Hipshman. Hipshman is director of medical services and clinical standards for Unity Inc., the merger of three community mental health programs in Multnomah County.

“Again and again, people will adhere to their treatment regimen better when they feel they’re doing something they want to do,” Hipshman said.

Participants in this weekend’s summit hope to close the conference today with a unified statement about forced treatment. They also hope to reach consensus in such areas as culturally appropriate treatment for ethnic or racial minorities; ways to combat stigma; health insurance coverage; and political organizing.

Portland was chosen for the conference for logistical reasons, such as getting the focus away from the East Coast. It was also in recognition of Oregon’s history of grass-roots activism on mental health issues.

In the 1970s, a group of Oregonians formed the Insane Liberation Front. A man called Howie the Harp was a key figure in the Oregon movement.

In 1988, The Mind Empowered Inc. became the first publicly funded advocacy group run by people with mental illnesses in Oregon. Now the state Office of Mental Health Services has an advisory council, and half of the members are people who are mentally ill, their advocates or relatives. The state authorized funding to start the Office of Consumer Technical Assistance, Fitts’ organization, last year.

People came from across the country to attend this weekend’s summit.

Yolanda McCall came from Philadelphia “to be empowered and to learn more about different people’s struggles and their survival.”

McCall, 44, lives with a form of schizophrenia and works for a program for people who are homeless, involved in substance abuse and mentally ill.

Nancy Yazzie came from the Ft. Apache Indian Reservation in Arizona to learn more about support services for mental illness. “We don’t get much help from the community,” said Yazzie, 58.

Janelle Anderson hopes to leave the summit knowing she has affected this movement — and her own healing. Feeling suicidal, she committed herself to the Eastern Oregon Psychiatric Center in Pendleton in May.

When she became upset and alarmed a nurse, she offered to swallow some calming medication. But she said the nurse refused. Anderson looked up and saw the nurse with the syringe. Angry, she bit one of the workers who was holding her down. She was placed in restraints for three hours.

Now she has her first criminal charge as an adult — fourth-degree assault.

She hopes she can interrupt what can become a relentless dance with the system. She says what she needs is love — not forced injections and restraints.