Stigmatizing Fear Tactics "From a marketing perspective, it may be necessary to capitalize on the fear of violence to get the law passed." These words, written by D. J. Jaffe in 1993, launched a campaign by what is now the Treatment Advocacy Center (psychlaws.org) in Arlington, Virginia to toughen involuntary outpatient commitment laws throughout the U.S. The items below are examples of how psychlaws.org capitalizes on fear, and were posted on this web site from 1999 to the present. The most recent items are first. Please note that earlier postings contain the acronym "TAC." We no longer use "TAC" to avoid confusion with the Boston-based Technical Assistance Collaborative (tacinc.org).

March 21, 2010 - News of the Week DOES THE TREATMENT ADVOCACY CENTER HELP OR HARM? (See below for A Factoid in the Making) Kendra's Law, New York's controversial statute permitting compulsory medication of psychiatric outpatients, is due to expire at the end of June, 2010.  Already we are seeing efforts to make it permanent by the law's chief proponent, the Treatment Advocacy Center in Arlington, VA. Recent quotes by key spokespeople suggest that a new wave of fearmongering may be in the making. Seventeen years ago, D.J. Jaffe, an advertising executive, advised mental health advocates that "from a marketing perspective it may be necessary to capitalize on violence" to pass laws compelling psychiatric outpatients to take psychotropic medication. Soon Jaffe joined forces with Dr. E. Fuller Torrey, a psychiatrist who shared Jaffe's compulsory medication agenda. Thus was launched an intensive public relations campaign linking mental illness with violence. Since then, factoid-laced, sensationalistic articles, op-eds and television features have appeared with depressing frequency in the national media. For an example, see "Will The Damage Be Doubled?" What's a financially-strapped advocacy movement to do? Advocates' protests requesting fairness fall on deaf ears at "60 MINUTES," "48 HOURS," "The Washington Post," and other national media. For nearly 20 years the Torrey/Jaffe team, unimpeded, has relied on a scare strategy to win public support for compulsory medication. The fact is that there are no violence studies that focus on people with untreated schizophrenia and bipolar disorders, the Torrey/Jaffe team's target population. The Treatment Advocacy Center copes with this problem by lifting phrases out of context from work by others. The result is self-serving misinformation with respectable citations. Does this twisted form of advocacy help or harm those it purports to assist ? Could this be a reason researchers are finding the public to be less tolerant toward people with psychiatric disabilities and decreasingly willing to accept housing and community support programs? See "Study Finds Fear Tactics Win Public Support for Coercion" Below are some examples of *factoids circulated by the Treatment Advocacy Center.  These items have been selected from the archives of the Anti-Stigma Home Page, http://www.stigmanet.org The Torrey/Jaffe team wrongly interpreted conclusions concerning stigma in the Surgeon General's Report on Mental Health (1999). See "Torrey Twists Meaning of Surgeon General's Report" The Torrey/Jaffe team distorted research concerning the effect of the news media on public opinion. See "Selective Reporting of News Skews Views" and "The Most Important Cause of Stigma?" The Torrey/Jaffe team selectively reported violence estimates (in research based on a study investigating medication effectiveness) to inflate the result. See Treatment Advocacy Center Reduces Research on Violence to a Stigmatizing Soundbite The Torrey/Jaffe team added incorrect interpretations to findings of a U.S. Department of Justice report on homicide. See "Just the Facts, Please!" The Torrey/Jaffe team summarized research involving 49 subway pushings and attempted pushings over a 17-year period (1975-1991). The researchers (Martell & Deitz) chose to gather data only on assailants who were psychotic at the time of the offense (20 individuals - 1 of these rejected ). Torrey's 1-sentence summary of this study is nonsensical: "Among 20 individuals who pushed or tried to push another person in front of the subway in New York, all except one was severely mentally ill and offered motives directly related to their untreated psychotic symptoms."  Such rewriting of  research findings is outrageous.  And no reader would guess that such pushings occurred only once or twice a year in a city of (then) 7 million people. The Torrey/Jaffe team mislabeled Andrew Goldstein (of Kendra's Law fame) a "treatment refuser" even after his psychiatric records proved he had repeatedly tried to get treatment from a downsizing mental health system. See "More About Kendra's Law" Four prominent and respected research organizations, The Lewin Group, the U. S. Department of Justice, the National Advisory Mental Health Council (NIMH), and the MacArthur Foundation on Mental Health and the Law have confirmed that their work does not support findings attributed to them by the Torrey team. See "Just the Facts, Please!" and "Ten Top Stories of 2007 Continue Fearmongering"   As the Kendra's Law expiration date draws near (June, 2010), the Torrey/Jaffe team has doubled its earlier 5% estimate of homicides committed by people with "untreated schizophrenia and bipolor disorders" to a frightening 10% of all homicides in the U.S. The doubled (10%) figure, however, misuses research and homicide numbers from data spanning 1990-2002. See Dr. Torrey Doubles Bogus Homicide Estimate *Editor's note: "A factoid is a questionable or spurious - unverified, incorrect, or fabricated - statement formed and asserted as a fact but with no veracity. The word appears in the Oxford English Dictionary as 'something which becomes accepted as fact, although it may not be true.' " Quote is from Wikipedia, the free encyclopedia. MORE INFORMATION A FACTOID IN THE MAKING A quote from Dr. Torrey In an ABC News interview last week, Dr. Torrey stated: "The most recent data would suggest that about 10 percent of the homicides in the United States are committed by people who are bipolar or schizophrenia -- when they are not on medication." Where's the evidence? The Treatment Advocacy Center's most recent briefing paper on violence (updated April 2009) states that Individuals with severe mental illnesses are probably responsible for approximately 10 percent of homicides in the United States. They cite the following study. "In Indiana, researchers examined the records of 518 individuals in prison who had been convicted of homicide between 1990 and 2002. Among the 518, 53 (or 10.2 percent) had been diagnosed with schizophrenia (n=27), bipolar disorder (n=12), or other psychotic disorders not associated with drug abuse (n=14). An additional 42 individuals had been diagnosed with mania or major depressive disorder. It should be emphasized that the study included only those who had been sentenced to prison and did not include those individuals who had committed homicides and were subsequently found to be incompetent to stand trial or not guilty by reason of insanity and therefore sent to a psychiatric facility instead of prison. Thus, the 10.2 percent is an undercount. The authors also noted that 80 percent of the mentally ill individuals who committed homicides had received past psychiatric treatment but that "many of the offenders were not receiving treatment" at the time of the homicide." Matejkowski JC, Cullen SW, Solomon PL. Characteristics of persons with severe mental illness who have been incarcerated for murder. Journal of the American Academy of Psychiatry and the Law 2008;36:74â€"86 Quoting Dr. Torrey: "In 2007, there were 16,929 homicides in the United States. If individuals with severe psychiatric disorders were responsible for only 10 percent of these, that would be approximately 1,690." What's Wrong With This Picture? Torrey is either deceptive or very careless. In fact, the research shows there were 27 people with schizophrenia and 12 people with bipolar (39 people). There's no information on their medications status. Torrey's "preventable tragedies" file (2008) showed that homicides sometimes are committed while the assailant is on meds. Problem #1: Torry has included 14 people with "other psychotic disorders" to bring his total number to 53. He can't do that and then apply the figure to "untreated people with schizophrenia and bipolar." Problem #2: Torrey can't assume that none of the 39 assailants with schizophrenia and bipolar were on meds. The study confirms this. An analysis I did of his preventable tragedies showed 1/3 of homicide assailants were on meds at the time of the crime. (Also, some years ago in a NYTimes article about rampage killers, of 24 assailants who were prescribed meds 10 were taking them at the time of their rampage murders.) If we speculate that 13 of the 39 assailants could have been on meds, then Torrey's estimate is reduced to 4.4%. Problem #3: Torrey uses an outdated figure for total homicides in the U.S, 16,929 (2007). The most recent figure is 14,180 (2008). This lowers his already unsubstantiated estimate (1,690) committed annually by people with untreated schizophrenia and bipolar illness March 12,  2010 - News of the Week ! DR. TORREY DOUBLES HIS BOGUS HOMICIDE ESTIMATE ! Dr. E. Fuller Torrey's obsession with homicide figures dates back to the 1990s when the media were quick to accept his unsubstantiated estimate that "1,000 homicides are committed annually" by an unmedicated group of people with schizophrenia or bipolar illness. Last week, in a startling claim in an ABC News feature, Torrey raised the estimate to 1,690 annually-- that would be 36 per week every week committed by an extremely small group of individuals. Dr. Torrey's new 'discovery' about homicides is clearly as bogus as his previous guesstimates. The new number (10% of all homicides!) doubles his earlier estimate (5%), a figure based on six clippings from the Washington Post and some deceptive tinkering with research done by others. (Note: authors of the studies have confirmed that their work does not support Torrey's conclusions.) Torrey's source of the 10% figure, which he projects to 1,690 homicides annually, seems even more shakey. Oddly, Torrey's website file of "Preventable Tragedies" showed only 179 homicides during the peak year of 2003. It is alarming that the most visible, articulate, and engaging psychiatrist in the business has successfully promoted facts and figures tailored to suit his narrow agenda of coerced medication. Continuous repeated references to violence by the Treatment Advocacy Center can't fail to affect public attitudes. And this is after all the Torrey/Jaffe team's goal December 30, 2007 - News of the Week TAC'S "TOP 10 STORIES OF 2007" CONTINUE A PATTERN OF FEARMONGERING Last week, the Treatment Advocacy Center, the nation's leading proponent of compulsory neuroleptic medication, issued a list of ten "under-reported stories of 2007." Seven of the ten stories involve crime or dangerousness. Clearly, http://www.psychlaws.org intends to continue its pattern of fanning fear to win public support for its controversial agenda. Also troubling are errors of fact. For example, by lifting a phrase out of a research study published by Jeffrey Swanson et.al. (Archives of General Psychiatry, May 2006), TAC created an astounding rate of violence for patients with schizophrenia, 10 times greater than the general public, (or 19.1% vs 2%). Acts considered violent by TAC range from a brief threatening gesture to a physical assault causing injury. TAC fails to mention that the Swanson team found two levels of violence: only 3.6% of research participants were involved in serious violence. This rate is similar to the general population rate of 2% (ECA data circa 1980). For the public, violence means danger. But Swanson's research team uses the word to mean involvment in a fight whether or not the respondent was the aggressor or defending himself. The researchers called such fights assaults by the respondents. The fights involving 15.5% were called "minor violence" (no injury and no use of threat or knife). The remaining 3.6% were called "serious violence" (a weapon was used or there was some injury, at least a bruise.) Quoting from Heathcote W. Wales, Georgetown U., letter to the Washington Post, "Hype Won't Help The Mentally Ill," 6/4/06. The Treatment Advocacy Center also ignored the Swanson team's finding that the odds of violent behavior varied with factors other than psychotic symptoms. Further, the data used for the Swanson study was designed for a different project, the Catie study on medications. This raises questions about the data's findings. MORE INFORMATION Read an interesting online conversation between John Grohol, psychologist, and Jeffrey Swanson, researcher, about pitfalls and variations that plague research on violence. Go to http://psychcentral.com/blog/archives/2007/05/04/crime-consequences-and-mental-illness/ September 10, 2006 - News of the Week CAN PSYCHLAWS.ORG REWRITE HISTORY? Let Andrew Goldstein's Record Speak The background of Kendra's Law, now under intense scrutiny in New Mexico, is well documented. For this reason, attempts by Psychlaws.org to rewrite the psychiatric history of Andrew Goldstein are easy to refute. For those unfamiliar with the case, Goldstein acquired notoriety as a "treatment refuser" after he pushed Kendra Webdale to her death in a New York City subway on January 3, 1999. Posted online are reports by impartial investigators: REPORT #1: "Bedlam on the Streets," by Michael Winerip, New York Times Magazine, May 23, 1999. Magazine cover blurb: "Long Before Andrew Goldstein pushed a woman in front of a train, he pleaded for help. He couldn't get it. The Crisis of the Mentally Ill" . Click http://nytimes.com and enter search for Michael Winerip Bedlam on the Streets. (If you don't have access to the NYTimes archive, we'll send a hard copy. Email stigmanet@webtv.net and give us your postal mailing address.) REPORT #2: "In the Matter of David Dix (pseudonym)," A Report by the New York State Commission on Quality of Care for the Mentally Disabled, November 1999. Click http://www.cqcapd.state.ny.us/publications/dix.htm. In pro/con commentaries in the Albuquerque Tribune, September 7 2006, critics of Kendra's Law contended that if there had been adequate resources, including stable housing, treatment, and case management, the subway tragedy would not have occurred. The reports cited above confirm that view, showing that Andrew Goldstein knew he needed help and committed himself to psychiatric hospitals 13 times, perhaps expecting to be stabilized and discharged to a supervised setting where he had done well for 4 years. In a recent blog, Psychlaws.org ignores these positive signs and instead accuses the Albuquerque advocates of "recycling an old fallacy" about Goldstein's search for supervised treatment. Psychlaws also dismisses the premature hospital discharges, dead-end waiting lists, administrative mixups, and endless broken promises that plagued this former honor student. Three weeks before Kendra Webdale's death, Goldstein was prematurely discharged from a hospital with a one-week supply of medication. Although Psychlaws made Goldstein the poster boy for compulsory treatment, he more fittingly symbolizes the dangerous gaps in an uncoordinated underfunded mental health system. Of the few homicides commited by people diagnosed with psychiatric disabilities, 1 in 8 follows an assailant's premature discharge from or refused entry to a treatment facility (See Psychlaws.org's "Preventable Tragedies, July-Dec 2004). May 12, 2006 - News of the Week KENDRA'S LAW TEETERS ON FALSE PREMISE System Reform Requires High Quality Programs, Not Coercion Laws The guru of forced psychotropic medication for outpatients, Dr. E. Fuller Torrey, recently acknowledged in a National Public Radio interview that although 42 states have court-ordered treatment laws, they are rarely used. Why? Perhaps Torrey's organization, the Treatment Advocacy Center (psychlaws.org), is itself at fault. Psychlaws has linked coercion laws to much-publicized deaths, winning their passage in the glare of highly emotional media coverage. When the full facts emerge, however, they often reveal a trail of negligence by budget-squeezed poorly-coordinated mental health facilities. "Bad case, bad law," is a cliche that may explain states' caution in applying their court-ordered treatment laws. Psychlaws perfected its "public safety" approach to legislation in 1999, after the fatal encounter of Kendra Webdale and Andrew Goldstein in a Manhattan subway station. Under Psychlaws' guidance, a family's overwhelming loss came to symbolize a menace to every New Yorker. To launch "Kendra's Law," the Torrey group first shoehorned Goldstein into the role of a "medication refuser" who lacked insight into his psychosis. Several months of intense publicity overwhelmed the actual facts of Goldstein's record, including findings by the New York Times that he had tried in vain to get the help he knew he needed. As the truth emerged, Goldstein's psychiatric history is an appalling account of mistakes made and opportunities missed by the psychiatric facilities he turned to, often voluntarily, for help. In spite of all this, a vengeful tone at his trials helped put him in prison, and his mislabeling continues to re-surface in the press. Innovative states are proving that high quality programs are successful without a law enforcement approach. The appeal of Psychlaws' coercion campaign will fade further as states shift to treatments developed in consultation with people with first-hand knowlege of psychiatric conditions. These programs are promoted by the Bazelon Center for Mental Health Law, The Presidents' Commission on Mental Health, and SAMHSA. Footnote: Are forced treatment laws redundant? Has the Treatment Advocacy Center's aggressive and fearmongering stance on forced medication hindered system reform? Here are two critics' views on the law's redundancy: 1999 - "The focus of coercion upon the patient is, I submit, a misdirection of energy. Coercion is needed, but to enforce the laws already on the books that are routinely disregarded with impunity, either because of the scarcity of resources or because of conflicting pressures." Source: Clarence J. Sundram, former Chairman (for 20 years), NYS Commission on Quality of Care. "Misdiaagnosis and Non-Solutions," May 20, 1999, a statement in opposition to the then-proposed Kendra's Law. 2006 - " 'Kevin's Law' [Michigan's forced-treatment law] is unnecessary because we judges already had the authority to order medication on an outpatient basis." The quote is from Judge Patrick J. McGraw, Saginaw County Circuit Court Family Division. The article notes that "Mr. McGraw, who handles nearly all mentally ill committments in the county, says he occasionally orders outpatient medication but has yet to use 'Kevin's Law' for any person." Source: "Forced Drugging," by Scott Davis, The Saginaw News, March 1, 2006. A Comment on the Treatment Advocacy Center's (Psychlaws) Inflation of Kendra's Law Outcomes: In March 2005, the New York State Office of Mental Health released an analysis of outcome data on 2,745 recipients of New York's outpatient commitment program, Kendra's Law. Psychlaws, led by E. Fuller Torrey, has selected data out of context and is using it to win support for similar laws in other states. The Torrey group is publicizing high rates of improvement without explaining that only a modest number of the program's 2,745 recipients improved significantly between the time they entered the program and 6 months later. For example, Psychlaws reports that IOC recipients experienced 87% less incarceration after 6 months in the program. What Psychlaws doesn't explain is that prior to entering the program, 23% of recipients experienced incarceration, and after 6 months in the program, 3% experienced incarceration. The state's official report describes this as an 87% improvement for 23% of 2,745 program recipients. (To complicate matters, some data analysts would consider this a 20% improvement.) How does Psychlaws' skewing of outcomes poison the IOC debate? Consider the preposterous claims of a forced treatment proponent in Maine: "In New York, 91% of those who were not taking medications began taking them, just because that law was on the books" and "arrests for petty and violent crimes involving people with mental illness dropped 78% and millions of dollars in hospital costs were freed up for community services." Source: Maine Times Record, March 10, 2005 We welcome readers' comments. Email stigmanet@webtv.net

February 17, 2002 - News of the Week IS TAC CHANGING ITS TUNE? CAN YEARS OF DAMAGE BE UNDONE? For years, the Treatment Advocacy Center (TAC) has used fear tactics to win support for coerced antipsychotic medication. Is TAC toning down its message? Additions and deletions on its website click here suggest this may be the case. For some examples of TAC's fear tactics, read the postings on this web page. Also see "Mindless and Deadly: Media Hype on Mental Illness and Violence," by Phyllis Vine (FAIR-Fairness & Accuracy In Reporting). In a switch, the TAC home page now gives site visitors a few options that are non-proselytizing and unrelated to violence. A TAC briefing paper, "How Many Homicides Per Year Are Commited By Individuals With Severe Psychiatric Disorders?" appears to have been dropped. Sensationalistic statements to the press and article titles are less melodramatic. Some fear-mongering articles have been dropped or buried somewhere. But still, the site continues to be a minefield of misleading statements and half-truths. Looking back, it was in October 1993 that E. Fuller Torrey, at a psychiatrists' meeting in Baltimore, unveiled his now-familiar idea that "the public stereotype that links mental illness to violence is based on reality and not merely on stigma." But the shift to emphasize and exaggerate violence had emerged much earlier. In November 1991, a fear-mongering feature in the Toronto Star stated that "100,000 schizophrenics and manic-depressives roam the urban jungle [New York City]. The article said, "Their presence is not merely harrowing. It is dangerous." It went on to quote D. J. Jaffe, who had recently joined forces with Dr. Torrey. It appears that Patricia Pearson, the Toronto Star's reporter, had relied on Jaffe for her information, since no other source was mentioned. By 1994, the Torrey-Jaffe team was creating the Treatment Advocacy Center and proposing stiff new state commitment laws. A briefing paper circulated by Jaffe in 1994 stated: "According to a just released report by my friend, Dr. E. Fuller Torrey, individuals with neurobiological disorders (NBD, formerly known as 'mental illness') as a group are more violent than the general population. There are more people with these disorders in jails and prisons than their presence in the population would indicate. In other words, public fears of violence by individuals with NBD are not unfounded." Before long, editorials by Jaffe or Torrey (such as one titled "Mental Illness, Public Safety," New York Times, December 1995), began to appear in the news media. We rehash this history because it is unclear whether TAC is moving to reverse its decade-long reliance on bloated and repetitive claims about homicide to win public support for its agenda. Although TAC may be adding some broader information to its website, it continues to tailor the research findings of others to agree with its views. It is nearly impossible for readers to detect the errors that result. Take for example a new briefing paper called "Stigma and Violence." TAC uses a series of New York Times articles concerning 50 years of multiple murders (April 2000) to support its contention that homicide by individuals with severe psychiatic disorders is a root-cause of stigma. TAC cites the Times' finding that nearly half the "rampage killers" had a psychiatric diagnosis (a hindsight decision in half the cases). But TAC neglected to mention the death toll: 17 deaths in a peak year. This is not a big public safety issue; the figure is imperceptible compared to other accidental deaths. Medical mistakes are said to account for 44,000-98,000 deaths each year. There are over 40,000 highway deaths annually, 1,400 accidental gun deaths, 800 fatalities from running red lights, 16,000 fatal falls, 4,000 drownings, 8,000 deaths from accidental poisoning, and on and on. Furthermore, TAC chose to ignore the fact that among the 24 slayers in the Times articles who had been prescribed medication, nearly half (10) were taking it at the time of the murders. This is significant because TAC's fundamental message has been that homicides are commited by unmedicated individuals. When TAC states that stigma stems from violent crimes, it implies that the media report these crimes like any other. Not true! TAC ignores the conclusions of prominent researchers who found that the news media over-report psychiatric crimes, position them more prominently than other crimes, and keep them in the public eye longer. These practices help to explain TAC's success with the media. A TAC briefing paper says that "people with a history of severe mental illness" commit 1,000 homicides annually. But to support this claim, TAC cites a 1994 Department of Justice study whose author has confirmed to us that the study contains nothing about diagnosis, severity of illness, or treatment. TAC also inserts the word "severe" to suit its purpose. (Actually, the 1,000 figure looks like the work of a math contortionist.) Another briefing paper says that "1,000 homicides are commited each year by people with untreated schizophrenia or manic-depression". Again, this is a guesstimate. But if true, it would mean that members of this small segment of the population commit 20 homicides every week, year after year. Where's the hard evidence? Unfortunately, the mental health community lacks concrete information about violence and mental illnesses. TAC has filled in the blanks with self-serving numbers, harped repeatedly on any homicides that occur and, in our view, fueled the prejudice that hampers advocacy efforts. What's your view? E-mail stigmanet@webtv.net.

September 9, 2001 - News of the Week FANNING FEAR IS EASY "It is vastly easier to amplify fear than it is to assuage it." (From an editorial, "The Statistical Shark," NYTimes, September 6, 2001) The Treatment Advocacy Center (TAC) maintains that the public's fear of people with mental illnesses stems from violence, mainly homicide. TAC proposes to eliminate these "stigmatizing" acts with tougher court-ordered-treatment laws. To get such laws passed, TAC focuses attention on rare violent acts, not only at the time they occur but with repeated reminders long afterward. This fear strategy reinforces existing stereotypes. On prime time television drama, for example, "mentally ill" characters are violent in 60 percent of their roles. Such distortion makes people with mental illnesses seem the most dangerous of all demographic groups -- three to four times more violent than other character groups on TV. (Numerous studies show that significantly higher rates of violence are found in abuse of alcohol and other substances, not mental illnesses.) The TAC's tactics are questioned in September's Psychiatric Services in an article analyzing mandated community treatment. The article, by John Monahan, et. al., states that "Advocates of outpatient commitment have explicitly 'sold' the approach largely by playing on public fears of violence." The authors conclude that involuntary outpatient commitment may be won at the cost of increasing prejudice, and with no certainty of reducing community violence. It is time for the National Alliance for the Mentally Ill, the American Psychiatric Association, and the National Mental Health Association to publicly denounce the Treatment Advocacy Center's fear tactics. NOTE: "The Statistical Shark" may be downloaded free until Thursday, September 13. Click http://www.nytimes.com/ , then enter "The Statistical Shark" in Search box.

June 24, 2001 - News of the Week MORE NEBULOUS NUMBERS FROM TAC The Treatment Advocacy Center (TAC) has issued a new Briefing Paper. Its title is, "How Many Homicides Per Year Are Committed By Individuals with Severe Psychiatric Disorders?" Homicide is a prominent theme in TAC's campaign to expand court-ordered psychotropic medication. For years, TAC has plied the public with virtually baseless homicide numbers. The new Briefing Paper continues to promote TAC's convictions and assumptions about homicide using nebulous numbers, quoting selective studies, and misusing information from research done by others. Some material in the paper is new, however. For the first time, TAC admits to using estimates on "violent crime" to arrive at an estimate of "homicides." Using this logic, if an identified group is said to commit 2% of the nation's violent crimes, TAC assumes the same group commits 2% of the nation's homicides. This frees TAC from needing data (currently unavailable) about the actual number of homicides committed by whatever group they say requires court-ordered psychiatric medication. In another oddity, TAC lists European homicide studies despite vastly different homicide patterns in Europe. It is misleading to suggest that European data applies to the U.S. TAC has expanded its focus from "people with untreated schizophrenia and manic-depression" (estimated at 1.4 million people) to a much larger category: "individuals with severe psychiatric disorders." We need to know if this newly-created group includes people with antisocial personality disorders, which are generally ranked higher than other psychiatric conditions in violence-risk studies and are considered unresponsive to medication. The public should know if "psychopathic" personality disorder is part of TAC's new group. Also new, the paper acknowledges that alcohol and other drugs contribute to the majority of homicides committed by people with psychiatric diagnoses. This may mean that TAC will address the nation's dire need for integrated mental health and substance abuse treatment programs. The Briefing Paper says studies "suggest" (!) that in "almost all" homicides attributable to individuals with severe psychiatric disorders, the individuals who committed these homicides were not taking medication for their illness at the time. Readers should note that this is another TAC "guesstimate," and is unsubstantiated. TAC's struggle with math continues (4.3% is not 0.43, but 0.043). A pleasant surprise: the paper drops an earlier TAC statement about "untreated" mental illnesses. TAC had wrongly reported that a 1994 Justice Department analysis of 1988 homicides, "Murder in Families," referred to untreated mental illnesses in their analysis of homicide, when in fact the report made no reference to diagnosis or to treatment status. READ MORE ABOUT THIS TOPIC: CLICK www.psychlaws.org/BriefingPapers/index.htm For the Treatment Advocacy Center's briefing paper, "How Many Homicides Per Year Are Committed By Individuals With Severe Psychiatric Disorders?" CLICK www.fair.org/extra/0105/mental-illness.html For a related article, "Mindless and Deadly: Media Hype on Mental Illness and Violence." CLICK http://community.webtv.net/stigmanet/ARCHIVESInvoluntary/ For National Stigma Clearinghouse Archives on Involuntary Outpatient Commitment For more about TAC's nebulous numbers, ask for "Just The Facts, Please." E-mail your request, with your mailing address, to stigmanet@webtv.net. (This 1-page leaflet has a chart and cannot be posted on Webtv.)

April 1, 2001 - News of the Week TAC TAKES FEAR TACTICS TO MARYLAND The Treatment Advocacy Center (TAC) has written an opinion piece, "Courts Must Be Able to Order Help," which appeared in the Baltimore Sun on March 1st. The article recommends a forced-treatment law for Maryland similar to New York's Kendra's Law. The article opens in capital letters with 'IT IS SHOCKING," followed by six sentences using "dead," "killed," "violent," "shock," tragedies," "bludgeoned," "stabbed," "shot," "tragic," and "violence." The article goes on to perpetuate the lie that Kendra Webale's subway assailant in New York, Andrew Goldstein, was "medication noncompliant" and required court-ordered treatment. In fact, Mr. Goldstein (now in prison) had repeatedly asked for treatment and was repeatedly denied the help he knew he needed. No one condones violence. Neither should we condone fear-mongering. Research at Duke University found that individuals with severe mental illnesses who were not taking medication were no more violent than other individuals in the study, as long as they were not abusing substances. (Am J Psychiatry, 155:2, p.230, February 1998.) When rare acts of violence occur, often (as in the case of Andrew Goldstein) they are the results of program cost-cutting and treatment diversion policies. Maryland would do well to look beyond New York's flawed example for ways to improve the state's mental health system.

Letter to the Editor "Torrey accused of dangerous and fuzzy math" Mental Health Weekly Monday, March 12, 2001 Reprinted with permission of Manisses Communcations Group (1-800-333-7771) More should be said about E. Fuller Torrey, M.D.'s homicide estimates, which were a factor in NAMI California's differences with Dan Weisburd, publisher of The JOURNAL (see MHW, Feb. 19). There is no scientific basis for Torrey to say that a lack of psychotropic medication is responsible for 1,000 homicides annually. Torrey's often-repeated statement that "people who have untreated schizophrenia and manic-depression commit 1,000 homicides each year" has a ring that appeals to the news media. The Wall Street Journal featured it as a blurb in a Torrey opinion piece titled "Why Deinstitutionalization Turned Deadly." Lesley Stahl of "60 Minutes" used a shortened version, "The mentally ill are responsible for as many as 1,000 homicides each year," to introduce a segment on coercive treatment, "A Right That Could Be Wrong." The figure is becoming accepted as fact (much like a now firmly rooted fiction that the man who triggered New York's Kendra's Law expanding court-ordered treatment was a noncompliant patient who refused to take medication.) But there is no scientific study to substantiate Torrey's numbers. He has cited as his sources his personal estimate (!) based on six Washington Post news articles about 13 homicides in the Washington, D.C. area; a report by the U.S. Department of Justice, and a report done for the National Institute of Mental Health (NIMH) by The Lewin Group. None of these sources verifies Torrey's assertion that absence of medication is responsible for 1,000 homicides annually. Torrey himself admits that the six newspaper articles (from 1992, a peak year for homicides) provide only a rough estimate. After extrapolating the 13 "local" homicides to the national population and getting 770, he rounds off the figure to 1,000. Interestingly, although total U.S. homicide figures have dropped sharply since 1992 (from roughly 23,000 to 16,000), Torrey's "1,000 homicides" does not vary. The cited Department of Justice study done in 1994, "Murder in Families," (using data from 1988), does not include psychiatric diagnosis or treatment status. It refers to people with "a history of mental illness," a category that is both broad and vague. When Torrey applies the department's findings to people who have "untreated schizophrenia and manic depression" he cloaks his opinion with a scientific basis that does not exist. The Lewin Group's report, "The Economic Cost of Mental Illness, 1992," cautions that "conclusions about the magnitude of the relationship between mental illness and violent behavior based on studies of psychiatric populations should be avoided or at least interpreted with caution." Despite this caveat, and despite a mismatch between the Torrey statement and the Lewin analysis, Torrey has used the Lewin report to validate his statement. Jean Arnold, Chair National Stigma Clearinghouse

December 3, 2000 - News of the Week ARE FEAR TACTICS ACCEPTABLE? The controversy over involuntary outpatient commitment continues, state by state, as the Treatment Advocacy Center pushes legislatures to change state laws. Florida is a present target. "WHEN WILL FLORIDA LEGISLATORS REALIZE THAT BEING PSYCHOTIC IS MINDLESS AND DEADLY?" (Op-ed Headline, Orlando Sentinel, October 27, 2000)) The above heads an op-ed article by E. Fuller Torrey in the Orlando Sentinel is titled, "Not Treating Mental Illness is Dangerous and Deadly." The piece is an attack on Florida's Baker Act, a hard-won law intended to protect people diagnosed with mental illnesses from institutional abuse. The article uses two violent incidents that occurred this Fall in Melbourne, Florida -- resulting in a homicide, a critical injury, and a suicide -- to advocate for stiffer laws that expand the grounds for court-ordered medication. Torrey, who heads the Treatment Advocacy Center (TAC) in Arlington, Virginia, seeks to frighten the public into supporting his ideas. But scaring the public has far-reaching consequences. In New York we are seeing the fallout from a fear campaign in 1999 for forced-treatment legislation (Kendra's Law). "The Railroading of Andrew Goldstein," by Patricia Warburg Cliff, is an article in the latest issue of The Journal of NAMI California ("Mental Illness and the Law"). Ms. Cliff, a NAMI board member, is dismayed that Kendra Webdale's mentally ill subway assailant, Andrew Goldstein, has been sentenced to state prison. She asks,"Has the 'justice system' reverted to a witch hunt to punish the violent mentally ill whom the public system has dismally failed?" It's a good question. Advocates must carefuly examine what is happening. The bedrock issues in TAC's crusade for more forced treatment are "lack of insight" and "medication noncompliance." But in fact, it is alcohol and substance-abuse disorders that push violence rates above the rates found in the general population. Ironically, substance-abuse and mental-health policymakers feel little pressure from advocates or the public as they argue endlessly over who is to provide the crucial dual-diagnosis programs. Clarence Sundram, who for 20 years chaired the New York State Commision on Quality of Care, points out the futility of passing harsher laws: "The focus of coercion upon the patient is, I submit, a misdirection of energy. Coercion is needed, but to enforce the laws already on the books that are routinely disregarded with impunity, either because of the scarcity of resources or because of conflicting pressures." Advocates should question the wisdom of supporting divisive new laws that have not improved conditions in states where they were tried. ITEM 2: Letter to the Orlando Sentinel from Harold A. Maio, Director, The Mental Health Clearing House, Fort Myers, Florida. E-mail: hkmaio@earthlink.net Dear Letters Editor: E. Fuller Torrey states that "1,000 homicides in the United States are committed each year by people who have untreated mental illness." According to recent statistics for murders in the U.S., about 20,000 people are murdered each year. That would mean that I, a person with severe depression, am 20 times more likely to be murdered by E. Fuller Torrey than he is by me, and that I should fear him 20 times more than he should fear me. I do fear him. I do for several reasons: First, it is his goal to instill fear into the public - with the help of the media - about people like myself. Second, he employs the term "mental illness" as a catch-all for every mental illness. There are many mental illnesses, just as there are many physical illnesses; and I assure you there are physical illnesses we fear, and many we do not. Third, history has continually revealed the abuses that abound in the area of mental health "treatment" and each state has fought ways to interdict this abuse without succes. This pattern has persisted since the "Discovery of the Asylum" in the 1820's (a book by David Rothman which I highly recommend) to the present day. Florida recently contracted its South Florida institution to a private company because it was not able to contain the abuses - by employees - of people supposedly there for treatment. The state is in the process of closing another, coldly isolated institution in a cattle pasture outside a small town in Central Florida for similar reasons. Florida, like many other states, is beginning to step into the 21st century and realize that for the vast majority of mental illnesses, the best treatment is in integrated settings. That does not mean that we, as the rest of the public, will all succeed, or even succeed to the same degree. But we will have a better chance in an integrated setting. For a real-life illustration, I have been married for 28 years. I have 2 children, a girl 21, and son 15. I have taught throughout my life, from university level to public and private school. I have been "treated" in the worst institutions and in the best. I am not the "unusual success," but the general rule. Harold A. Maio, Director, The Mental Health Clearing House, Fort Myers, Florida. E-mail: hkmaio@earthlink.net PLEASE NOTE: Dr. Torrey's estimate of "1,000 homicides" is not substantiated by scientific research. And in another calculation, he equates "violence" with "homicide." These and other distortions of fact are hard to spot and unfortunately even more difficult to undo.

August 13, 2000 - News of the Week JUST THE FACTS, PLEASE! The statement, "There are 1,000 murders each year by people with untreated schizophrenia and manic-depression," has appeared in a number of major publications and national news broadcasts. If true, this would mean that a minuscule segment of the U.S. population (.5 of 1 percent) is committing over 6 percent of the nation's murders. But this statement is not substantiated. A Department of Justice study cited as the source of the statement does not provide data about diagnosis or treatment, according to its author, Dr. Patrick Langan. The statement is part of a national push for court-ordered medication led by E. Fuller Torrey and D. J. Jaffe, founders of the Treatment Advocacy Center. At the 1999 convention of the National Alliance for the Mentally Ill, Mr. Jaffe, an advertising executive, advised forced-treatment advocates to use the argument that stronger commitment laws are necessary to protect the public from "dangerous" mentally ill people. This is a new wrinkle in advocacy. No other disability group has exaggerated the violence of its members in order to pass coercive laws against them. Not advocates for people with diabetes, who may harm themselves or others when insulin shock causes blackout. Not advocates for people with Alzheimers', whose behavior may be threatening. Not the advocates for people with AIDS dementia or Huntington's disease or autism or developmental disabilities. Only advocates for people with mental illness, it seems, frame their arguments in terms of danger to the public. There is some objective data that may help establish the truth about violence. Uniform Crime Reports are issued annually by the Department of Justice in an effort to improve the training and safety programs of law enforcement officers nationwide. According to the DOJ's latest report (1998), murder and assault by "mentally deranged" people are at the bottom of the dangerous-situation list. They rank just above "civil disorders," posing a negligible danger to police officers. Over 10 years (1989-1998), "mentally deranged" individuals accounted for only 1.6 percent of all homicides of police officers, and only 1.5 percent of all assaults. Furthermore, in the period from 1989-1998, there was no escalation in violence by "mentally deranged" individuals against police officers. We welcome your comments. E-mail stigmanet@webtv.net.

August 6, 2000 - News of the Week COURT-ORDERED TREATMENT FACES CREDIBILITY GAP With familiar eloquence, a Washington Post opinion piece by E. Fuller Torrey and Mary T. Zdanowicz capitalizes on a widely-publicized homicide to promote court-ordered psychotropic medication (August 1). Veteran advocates may remember Dr. Torrey's equally impassioned pleas, in 1986, for "passage in each state of a bill of rights that guarantees minimum standards of care." Since then, Torrey's position has swiveled 180 degrees. Now he calls for stiff laws that punish patients for decades of neglect by a dysfunctional system. Involuntary outpatient commitment deserves examination. But research on the issue to date has not found that court-ordered treatment works better than high-quality programs. Yet for the past decade, based on their assumptions and convictions, the forced-treatment advocates have worked hard for policies that are unproven, divisive, and potentially counter-productive. Clarence J. Sundram, who for 20 years chaired the New York State Commission on Quality of Care, a mental health watchdog agency, made this assessment: "The focus of coercion upon the patient is, I submit, a misdirection of energy. Coercion is needed, but to enforce the laws already on the books that are routinely disregarded with impunity, either because of the scarcity of resources or because of conflicting pressures."

January 23, 2000 - News of the Week THE MOST IMPORTANT CAUSE OF STIGMA? An oddly sweeping and emphatic statement by Dr. E. Fuller Torrey about the "single most important" cause of stigma, in a letter to Behavioral Healthcare Tomorrow (December issue), raised our curiosity. Torrey's letter asserts that "studies in Germany and the United States have shown that the single most important cause of public stigma against individuals with mental illness is episodes of violence, including highly publicized homicides, committed by them." We have read the researchers' conclusions; Dr. Torrey misses the point. The research concerns how selective reporting affects public attitudes. It is exactly this selective coverage that Dr. Torrey's Treatment Advocacy Center plays upon to market forced-treatment legislation. The German and American studies Torrey refers to are attempts to understand the cause of the public's fear of people with mental illness. These studies, by Matthias C. Angermeyer and his colleagues at the University of Leipzig, and Jo Phelan, Bruce Link, and colleagues at Columbia University, span more than five years. What the researchers have found is that exaggerated media attention to violence (to the exclusion of other images of mental illness) has a lasting negative effect upon the public. Episodes of violence are rare. It is not the episodes, but the sensational press coverage, that causes the stigma.

December 5, 1999 - News of the Week TAC MEETS STIFF OPPOSITION IN ST. LOUIS TAC'S FEAR TACTICS STIR UP BAD WILL In its nationwide push for stiffer laws to compel psychotropic medication, the Treatment Advocacy Center (TAC) of Arlington, Virginia, has met angry resistance in St. Louis from MadNation, a St. Louis-based cyber-network of psychiatric survivors. TAC's use of inaccurate information and statistics has raised the wrath of Vicki Fox Wieselthier, MadNation's founder, who is leading a David-and-Goliath battle against TAC's forced-treatment campaign in Missouri. TAC first tested its strategy in New York, where it "capitalized on the fear of violence" (their words) to win a forced-treatment law in August. (See News Archive for August). By playing the public-safety card, TAC won a tough law that nearly everyone finds fault with. Still needed are housing, community support services, and medical care for thousands of mentally ill people who are living with elderly parents, and thousands more who are already destitute on the streets of New York. TAC's fear campaign left a poisonous aftermath which has fueled hysterical accusations and acts of violence against "the mentally ill" of New York City. MadNation is determined to prevent such a dismal setback in St. Louis.

November 28, 1999 - News of the Week LET'S STOP THE SPREAD OF INACCURATE, INFLAMMATORY MISINFORMATION TAC's Numbers on Homicide Rates in U.S. Are Misleading and Unsubstantiated On Monday, in St. Louis, Vicki Wieselthier of www.MadNation.org alerted us to a television news promo that blasted KSDK's daytime viewers throughout the day with the bogus statement, "1,000 homicides are committed annually by mentally ill people." Working fast, Vicki alerted St. Louis advocates and the ad was later pulled. Missouri psychiatrists quickly faxed their objections to KSDK (excerpt below, from www.MadNation.org ): I wish to convey our great concern about the portrayal of psychiatric patients in the upcoming report. The promotion I saw this morning spoke about the "1,000 murders committed each year by persons with mental illness." No reputable scientific data supports the assertion about 1,000 murders, and this inflammatory language does a disservice to a vulnerable population who are much more likely to be the victims than the perpetrators of crime and violence. The fear of people with mental illness engendered by this inaccurate portrayal leads to stigma and makes it harder for people in recovery to obtain housing, employment, and develop relationships with their neighbors. Unfortunately, murders by people believed to be mentally ill make news, while murders by people who are not mentally ill often don't make news. Think about a frightening comparison: if every time a murder was committed by a young African American male, would you emphasize the race and gender of the assailant in your reports? If you did, there would be justified cries of public outrage from every civil rights organization in the country. Wilson M, Compton, M.D., President, Eastern Missouri Psychiatric Association. The statement, "1,000 homicides..." was created by the Treatment Advocacy Center (TAC) in Arlington, Virginia, to win support for forced psychotropic medication. TAC postulates that people with untreated schizophrenia and manic-depression (1.4 million people -- less than 1% of the U.S. adult population) commit 5% of the nation's murders. The frequent use of the quote is part of TAC's strategy to "capitalize on fear" to attain stiffer forced-treatment laws. TAC cites the U.S. Department of Justice as the source of its homicide information. This is incorrect. The DOJ, in a 1994 study using 1988 homicide data from 33 urban counties in 20 states, tried to assess histories of individuals who had committed homicide. The data indicated some history of mental illness in 4.3% of those homicides. But contrary to TAC's explicit claims, the study makes no mention of "untreated" mental illness; neither does it mention schizophrenia, manic-depression, or any diagnosis. Furthermore, the data is limited to large urban counties. Also, the DOJ study found that 44% of the homicide victims had criminal records, which seems surprising. Clearly, TAC has invented findings not warranted by the study's data. TAC arbitrarily raised the DOJ's homicide estimate from 4.3% to 5%. Then they arbitrarily attributed these homicides to less than 1% of the U.S. population, the number TAC says have "untreated schizophrenia and manic-depression." In another error: 4.3% of 16,914 (the total homicides in 1998) is 727, not 1,000 as TAC claims. And DOJ's predictions for 1999 will lower the figure still further to 645. We could use TAC's method of mismatching research data to prove an opposite conclusion from theirs. The National Institute of Mental Health estimates that 22% of the U.S. population has a diagnosable mental illness. If we speculate that mentally ill people do commit 4.3% of the nation's homicides, it follows that 22% of the adult population is responsible for 4.3% of homicides, and 78% of the population is responsible for 95.7% of homicides. In other words, "mentally ill" people are much less homicidal than "non-mentally ill" people.

November 14, 1999 - News of the Week IN WAKE OF ANDREW GOLDSTEIN CASE, EXPERTS OUTLINE HARD WORK AHEAD TO RE-SHAPE AND COORDINATE MENTAL HEALTH SYSTEM Appearing in today's New York Times (11/14) is an excellent report by Erica Goode on the dysfunctional mental health system in New York. In "Experts Say State Mental Health System Defies Easy Repair," Goode reports a common concern among experts that "...it will take much more than money and some additional beds to turn a chaotic, vastly overburdened system into a system that works." The article identifies an even more formidable problem -- public opinion -- and states that what is required is "a basic attitudinal shift in a society that has long stigmatized mental illness: to treat patients as real prospects for recovery, and to offer attractive, high quality services that patients actually want and will accept." The story of Andrew Goldstein and thousands like him, exposed by Times staffers Michael Winerip, Erica Goode, Nina Bernstein, and others, may initiate a turning point in public awareness and official negligence. Unfortunately, damage done by forced-treatment advocates, who falsely labeled Goldstein "treatment-resistent" in a fear campaign to win passage of Kendra's Law, leaves a lasting mark. For a copy of "Experts Say State Mental Health System Defies Easy Repair," e-mail your request to the National Stigma Clearinghouse, click stigmanet@webtv.net. Remember to give us your mailing address.

November 7, 1999 - News of the Week Survivor-Activist Joseph A. Rogers sums up a costly, pain-filled Mental Health Failure. Joe Rogers points out misguided expenditures on Kendra's Law in a letter to the New York Times on November 6. (Consider also the Webdale family's $70 million lawsuit against the system's hospitals that withheld mental health care.) Letter: "Re 'Report Faults Care of Man Who Pushed Woman Onto Tracks' " (New York Times news article, Nov. 5): The tragedy of Andrew Goldstein and Kendra Webdale is compounded by the fact that Mr. Goldstein could have lived in a group home in the community for a fraction of the amount that New York State spent on his repeated short stays in the hospital. Mr. Goldstein had done well in such a place, and he had taken his medication. He wanted to go back there, but there was no room. It is unfortunate that Gov. George E. Pataki, who had cut New York's budget for community-based mental health services, has signed Kendra's Law, which will further drain resources that could have been put to better use in the new and innovative mental health initiatives that he is said to be planning. Joseph Rogers is executive director of the National Mental Health Consumers' Self-Help Clearinghouse, Philadelphia, Pennsylvania.

September 5, 1999 - News of the Week DEADLY STEREOTYPING IN NEW YORK: 12 Police Bullets Kill Mentally Ill Man On August 30, a mentally ill man armed only with a hammer was slain in the street by a 12-bullet barrage from six policemen. Outrage at the slaying may signal that New Yorkers will no longer tolerate a makeshift community mental health system. Letters to the New York Times (9/6/99), triggered by an editorial by Bob Herbert (9/2/99), cited as culprits an underfunded and overburdened mental health system and an unprepared police force, creating "dangerously false stereotypes about people with serious mental illness." A recent violence-based campaign conducted by the Treatment Advocacy Center (TAC), which misrepresented a mentally ill man to win forced-treatment legislation, may influence actions of undertrained police.

August 8, 1999 - News of the Week A STIGMATIZING CAMPAIGN WINS The New York State Legislature has passed one of the most extreme involuntary outpatient commitment laws in the nation,"Kendra's Law." The law's main proponent, the Treatment Advocacy Center (TAC), framed forced medication as a public safety issue after a mentally ill man pushed a woman to her death in the New York subway. The fact that the assailant had literally begged for treatment -- but was repeatedly turned away by an underfunded mental health system -- was buried in a flood of public outrage at the tragic death. But as Assemblywoman Deborah Glick pointed out, "We've had too many bills with names that carry an emotionalism that dissuade proper public policy discussion."

August 1, 1999 - News of the Week A MARKETING STRATEGY CREATES STIGMA TAC campaign capitalizes on fear -- and misinformation --to promote court-ordered psychotropic medication The Treatment Advocacy Center (TAC) in Arlington,Virginia has persuaded the New York State Legislature to consider a sweeping law ("Kendra's Law") that puts psychiatric patients in New York at risk of court-ordered commitment and forced medication. The new law would empower a variety of complainants to seek court orders based on their belief of need. The marketing strategy for "Kendra's Law" is based on the premise that a subway assailant with mental illness had refused to accept treatment and required coercion. In fact, the man had tried in vain to get treatment. He voluntarily committed himself to psychiatric care 13 times, only to be dismissed and abandoned by an underfunded mental health system. To support their argument,TAC similarly misrepresents a number of other cases and research findings. To its credit, the New York legislature has withheld its approval of the proposed bill and is exploring non-repressive alternatives that show good treatment outcomes.

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