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The Treatment Advocacy Center is an American nonprofit organization dedicated to eliminating legal and other barriers to the timely and effective treatment of severe mental illness. The organization promotes laws, policies and practices for the delivery of psychiatric care and supports the development of innovative treatments for and research into the causes of severe and persistent psychiatric illnesses, such as schizophrenia and bipolar disorder.

Among the organization’s principal activities are promoting the passage and implementation of assisted outpatient treatment (AOT) laws and progressive civil commitment laws and standards in individual states.

History

Research psychiatrist E. Fuller Torrey founded the Treatment Advocacy Center in 1998 as a function of the National Association on Mental Illness (NAMI). For nearly 10 years in the decade after the widespread elimination of psychiatric hospital beds in the United States, Torrey had been a psychiatrist at St. Elizabeth's Hospital for the treatment of serious and persistent mental illness in Washington, D.C. There, he frequently treated patients, against their will, who did not consider themselves to be ill but who were nonetheless determined to be displaying symptoms of mental illness by mental health professionals.

He stated that individuals who would have been hospitalized prior to the closing of state psychiatric hospitals (a trend known as “deinstitutionalization”) were increasingly being migrated into jails and prisons because of behaviors that resulted from their non-treatment. With the backing of entrepreneur Theodore Stanley and his wife Vada, the Treatment Advocacy Center separated from NAMI, most likely because of the ties between NAMI and large pharmaceutical companies, shortly after its founding to focus entirely on removing legal barriers to involuntary treatment for those with the most severe mental illnesses.

The Treatment Advocacy Center is a leading proponent for legal revision of laws safeguarding citizens from involuntary commitment and standards and posits itself as a source of authoritative research on issues arising from untreated severe mental illness. The organization operates independently via the support of the Stanley Medical Research Institute, the largest non-government source of funding, mostly into drug research/pharmaceutical company startups, for research into bipolar disorder and schizophrenia in the United States. Torrey continues to serve as a member of the Treatment Advocacy Center’s board and is executive director of the Stanley Medical Research Institute.

Activities

The Treatment Advocacy Center engages in a wide range of activities and projects aimed at increasing treatment for people with severe mental illness. Areas of focus have or continue to include:

♦ Development of a Model Law for Assisted Treatment, released in 2000, the Model Law suggests a legal framework for authorizing court-ordered treatment of individuals with untreated severe mental illness who meet strict legal criteria. Used by lawmakers intent on reforming mental illness treatment laws and standards in their states, the Model Law incorporates multiple overlapping protections to safeguard those under court-ordered treatment and to ensure that only those for whom it is appropriate are placed or remain in assisted treatment. Of course, all of these "safeguards" rely solely on the psychiatrist's opinion and, therefore, are easily subrogated.

♦ Advocacy for civil commitment laws and policies that reduce the consequences of non-treatment for mental illness, which include arrest, incarceration, homelessness, hospitalization violence toward self and others. Not to mention the large amount of money that is made from all involved. Given a conservative daily cost of $940 for both hospitalization and treatment—less than half of the congressional estimate—each involuntary commitment costs around $16,700. Newspaper reports cite the expense as high as $35,000 per commitment. With up to 1.5 million people committed yearly, and using a conservative individual figure of $16,700, the annual health care drain is almost $25 billion! And this is paying for a service that most would refuse if given the chance.

♦ Data-based research and study into public policy and other issues related specific to severe mental illness. An example is More Mentally Ill Persons Are in Jails and Prisons Than Hospitals: A Survey of the States published in 2010.. The Treatment Advocacy Center has a database of thousands of violent events and claims that all could have been prevented.

♦ Education of policymakers and judges regarding the nature of severe mental illnesses, advanced treatments available (Electroconvulsive therapy) for those illnesses, and the necessity of court-ordered treatment for those who meet strict legal criteria (which usually comes down to the psychiatrist's opinion)

♦ Assistance to grassroots advocates working in the states to promote legal reform

♦ Support for the development of innovative treatments (stronger pharmaceuticals) for and research into the causes of severe and persistent psychiatric illnesses

The Treatment Advocacy Center has been credited with the passage Kendra's Law in New York, Laura's Law in California, and similar assisted outpatient treatment laws in Florida and other states. Since the organization’s foundation, 22 states have reformed their civil commitment laws or standards at least in part as a result of the organization’s advocacy.

Model Law

The following are excerpts from Model Law advocated by Treatment Advocacy Center.

§ 2.9 Gravely disabled: may be shown by establishing that a person is incapable of making an informed medical decision and has behaved in such a manner as to indicate that he or she is unlikely, without supervision and the assistance of others, to satisfy his or her need for either nourishment, personal or medical care, shelter, or self-protection and safety so that it is probable that substantial bodily harm, significant psychiatric deterioration or debilitation, or serious illness will result unless adequate treatment is afforded.

§ 2.10 Incapable of making an informed medical decision: means that a person is unaware of the effects of his or her psychiatric disorder or that the person lacks the capacity to make a well-reasoned, willful, and knowing decision concerning his or her medical or psychiatric treatment. Any history of the person’s non-compliance with treatment or of criminal acts related to his or her mental illness shall, if available, be considered.

§ 4.1 Emergency treatment initiated by law enforcement officers. Any law enforcement officer with the power of arrest or any person generally designated to do so by the state, county or department of mental health may bring to a designated facility for evaluation any person the officer has reasonable cause to believe has a severe psychiatric disorder and, because of the disorder, is a danger to himself, herself or to others or is gravely disabled.

§ 4.2 Emergency treatment initiated by others. Any psychiatrist, other physician, psychologist, or person who has been generally designated to do so by the state, county or department of mental health may initiate emergency treatment/observation based on a good faith belief that because of a severe psychiatric disorder a person is either a danger to himself or herself, a danger to others or gravely disabled. Any such person who determines the need for emergency treatment/observation but who is not authorized to transport such individuals to a psychiatric facility may direct any person enumerated in § 4.3 to do so.

§ 7.4 Assisted treatment order. An order for assisted treatment, for its duration, subordinates the individual’s right to refuse the administration of medication or other minor medical treatment (Electroconvulsive therapy) to the department of mental health, its designee, or any other medical provider obligated to care for the person by the Psychiatric Treatment Board in its order. The treatment setting shall be the least restrictive possible appropriate alternative. An initial assisted treatment order requiring inpatient placement may be for up to 30 calendar days. An order for assisted treatment on an outpatient basis may be for up to 180 calendar days.

Censorship of Controversies

The Treatment Advocacy Center invites visitors from their website to comment on their Facebook page. However, anything that is not supporting of their views is summarily removed. There is a lot of evidence that psychoactive drugs are no more effective than a placebo and that the side effects make them harmful. The political philosopher John Stuart Mill and others have argued that society has no right to use coercion to subdue an individual as long as he or she does not harm others. Mentally ill people are essentially no more prone to violence than sane individuals, despite Hollywood and other media portrayals to the contrary. Psychiatrists around the world have been involved in the suppression of individual rights by states wherein the definitions of mental disease had been expanded to include political disobedience. Nowadays, in many countries, political prisoners are sometimes confined to mental institutions and abused therein. Psychiatry possesses a built-in capacity for abuse which is greater than in other areas of medicine. The diagnosis of mental disease can serve as proxy for the designation of social dissidents, allowing the state to hold persons against their will and to insist upon therapies that work in favour of ideological conformity and in the broader interests of society. In a monolithic state, psychiatry can be used to bypass standard legal procedures for establishing guilt or innocence and allow political incarceration without the ordinary odium attaching to such political trials.

Criticism

The Treatment Advocacy Center has critics due to the profound human rights implications of coerced treatment, usually by means of what critics describe as 'forced drugging', who also point out that psychiatric drugs can be very dangerous and disabling. Because of these drawbacks, many reasonable patients refuse to comply with prescribed psychotropic drug treament. Some advocates for the mentally ill believe it is stigmatizing to portray the mentally ill as violent, because they contend such a conclusion is not supported by scientific research. Even if it were found that the mentally ill had a higher rate of violence, involuntary treatment would still be an outrageous infringement of civil liberties of the much larger population of patients, the vast majority of whom will never become violent. Some religions disapprove all treatment for mental illness (other than that offered by the religion). The Church of Scientology has been particularly outspoken in its opposition to involuntary treatment. Critics also dispute the use of the term anosognosia in mental illness. Anosognosia was previously only used in specific stroke patients that lost the ability to recognize their disability. Critics, including some psychiatrists contend that while medical illness has objective signs that can be used to identify the reality of the disease, in psychiatric illness these objective parameters do not exist, therefore the term anosognosia is inappropriate and misleading and can be used to justify treatment for anyone who disagrees with the diagnosis. Critics believe that TAC uses fear tactics to win support for assisted outpatient treatment.. When it is reported that someone diagnosed with a mental illness commits or becomes the victim of a violent crime, TAC posts particulars on their website. In the alternative, where perpetrators are on their medications (e.g., the Columbine massacre), TAC tends to ignore crimes that may be triggered by psychoactive drugs.

Robert Whitaker is on the record saying "However, if the history of science presented in Anatomy of an Epidemic is correct, antipsychotic medications, over the long term, worsen long-term outcomes in the aggregate, and thus a person refusing to take antipsychotic medications may, in fact, have good medical reason for doing so. And if that is so, the logic for forced treatment collapses."

See also

• Outpatient commitment
• Psychiatric hospital
• Anti-Psychiatry
• Against Therapy
• Antipsychology
• Biopsychiatry controversy
• Flexner Report
• History of mental disorders
• Icarus Project
• Interpretation of Schizophrenia
• Liberation by Oppression: A Comparative Study of Slavery and Psychiatry
• Mind Freedom
• Political abuse of psychiatry
• Positive Disintegration
• Psychiatric survivors movement
• Psychoanalytic theory
• Radical Psychology Network
• Rosenhan experiment
• Self-help groups for mental health
• Scientology and psychiatry
• World Network of Users and Survivors of Psychiatry
• Loren Mosher

References

1. E. Fuller Torrey, M.D.
2. Stanley Medical Research Institute
3. "Involuntary Psychiatric Commitment A Crack In The Door Of Constitutional Freedoms" (PDF). CITIZENS COMMISSION ON HUMAN RIGHTS. Retrieved 2 June 2013.
4. "Model Law". Treatment Advocacy Center.
5. Lennard Davis, "Newtown Shootings: A Caution About Violence and SSRIs", Psycology Today, 12/20/2012
6. UNC Health Care
7. Science News
8. Semple, David; Smyth, Roger; Burns, Jonathan (2005). Oxford handbook of psychiatry. Oxford: Oxford University Press. p. 6. ISBN 0-19-852783-7.
9. Noll, Richard (2007). The encyclopedia of schizophrenia and other psychotic disorders. Infobase Publishing. p. 3. ISBN 0-8160-6405-9.
10. ^ Medicine betrayed: the participation of doctors in human rights abuses. Zed Books. 1992. p. 65. ISBN 1-85649-104-8.
11. http://jhp.sagepub.com/cgi/reprint/45/3/403
12. http://community-2.webtv.net/stigmanet/ARCHIVESInvoluntary/
13. "E. Fuller Torrey's Review of Anatomy of an Epidemic: What Does It Reveal About the Rationale for Forced Treatment?". Mad in America. Retrieved 2 June 2013.

External links

• Treatment Advocacy Center Online
• Involuntary Civil/Commitment Destroys Lives

• Misplaced Pages neutral point of view disputes from May 2013
• Medical activism
• Organizations established in 1998
• Political advocacy groups in the United States
• Deinstitutionalisation in the United States
• Mental health law in the United States
• Treatment of bipolar disorder