Mental Illness and Violence: The Advocate's Dilemma

With the recent prominence of gun violence in the media due to the mass shooting at Sandy Hook Elementary School last December, we as mental health advocates are in a very precarious situation. The discussions resulting from this atrocity have centered around two topics: gun control and expansion of mental health services. While we may vary in our stances on gun control, increasing the public discussion about mental illness is every mental health advocate’s dream—unless the backdrop of that conversation is violent crime.

The uneducated public and the story-hungry media are quick to jump to conclusions about the mental health status of people such as Adam Lanza and others who commit these horrible crimes. They are quick to label these troubled young men as “mentally ill.” And perhaps they are. According to the National Institute of Mental Health, for a very small percentage of people—those with “episode[s] of psychosis, especially psychosis associated with paranoia and so-called ‘command hallucinations,’ the risk of violence is increased.” Co-occurring substance abuse or childhood antisocial behavior may increase the risk of violence. But the majority of people with mental illness are not violent.

Thus, when we use the risk of violence as a rationale for better and more available services for people with mental illness, we also put at risk all the good works we have done over the years to reduce the stigma surrounding mental illness. When we conflate mental illness and violence we do ourselves and our community a disservice.

For decades, Fountain House and other mental health organizations have fought to educate the public as well as the government about the causes and effects of mental illness - to challenge the myth that people with mental illness are violent, unintelligent, worthless, lazy, incompetent, and dependent. While we certainly know that some people with mental illness are prone to violence, we also know that some members of the general population are prone to violence for some of the same reasons. When factors such as substance abuse, being a victim of violence (physical or sexual), and poor school performance as a youth are present, the likelihood of a person committing a violent crime increases. These factors play a role whether or not a mental illness is present.

As advocates, it is our role to take advantage of every opportunity to engage the public in productive dialogue and agitate for more and better mental health services. But we must also weigh the cost of increasing our visibility in the gun control and violent crime debate. We must be cautious, like any social movement, that we do not let an extreme example represent our entire population and movement to the general public.

My diagnosis of depression does not make me a violent person. Most people with mental illness are not perpetrators of violent crime. As a movement, we must be sure to take hold of this opportunity to raise awareness of mental illness and push for improved funding and delivery of services. But we must be clear that we stand by our statement that people with mental illness can be and are productive members of society - that our communities are not put at risk by including people with mental illness in our schools, homes, and businesses, but rather enhanced and improved by the depth and breadth of the knowledge, skills, abilities, and talents we bring to the table.

Summer Berman
Michael Walther Executive Fellow, Fountain House
 


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Delivering "Unconditional Love" to US Veterans

sites/default/files/table-layout_0.jpgFrom February 1st to February 15th, the United War Veterans Council (UWVC) embarked upon their 5th Annual Goodwill Valentine’s Caravan series – their effort to mobilize the public to send messages of love and gratitude for our veterans, military service members, and their families. I joined them on their visit to Walter Reed National Military Medical Center in Bethesda, MD.

What can I say about my trip?

“AMAZING” does not do it justice! To see the gratitude, the joy, the smiles on the wounded veterans at Walter Reed - to see grace at its peak - conjured emotions I’d not yet experienced!

At times it was hard to hold composure. I wanted to hug the vets. I wanted to scream and say, “Why did this have to happen to such a young population that has such a long road ahead, a long life to live? WHY?” Then to hear a wounded soldier say, “At least I’ve been given the chance to live; my buddies never came home,” shook me to my core and brought me back to the present moment. The gratitude of this wounded soldier - his zest for life, his acknowledgment that, though he lost limbs, he was a better person for it, because at least he had his life and now valued life in a different way - reminded me of how lucky we are to live in a country in which we feel free to do as we please. Yet freedom is not free! This was a WOW moment, and I reflected upon it for a long time. I’m grateful for this experience and the emotions it conjured, even though, as a soldier, I’d been trained to “suck it up!”

We also visited Ft. Belvoir in Fairfax County, Virginia, the base I once knew as my home base. It truly brought up sentiments I had long forgotten. It has become a place of tranquility for wounded soldiers, a place that made me proud of having served, a place that seemed like home. It was a true joy to see the faces of the veterans when they received the Valentine’s Day cards made by staff and members of the Fountain House Clerical Unit, and vets particularly loved and remarked upon our hand-made bookmarks. I was delighted and honored to introduce Fountain House to the veteran community

As a nation, we grapple with how to provide the best mental healthcare for our veterans, but it makes so much sense for Fountain House-model programs to be part of the transition phase for veterans. It was clear to me how the Fountain House working community could be vital to suicide prevention for veterans.

Everyone from the United War Veterans Council exhibited a solidarity that flowed naturally. I was reminded of “one for all and all for one!” I am sincerely thankful to have joined the group that was traveling to DC to deliver “Unconditional Love.” To give without conditions, to give without expecting to receive anything in return - that is the true meaning of “giving of oneself.” I am forever grateful for this experience!

Although I separated from the Service in 2006, it felt like I never left; the camaraderie was automatic. I’m flattered and honored to have represented Fountain House to the community that has sworn under oath to serve and protect the United States of America. I am a proud American; I am a proud Fountain House staff!

Jennifer Rivera
Director of Human Resources, Fountain House
 

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Lobbying for Mental Health

sites/default/files/lobbyday.jpgSince 2009, I’ve been going to Legislative Day, sponsored by the New York Association of Psychiatric Rehabilitation Services (NYAPRS), an advocacy organization that Fountain House has supported for over twenty years.

I get all revved up about this day, because it gives my peers and me a chance to go to Albany to see all the political leaders and let them know about the issues that the mental health community at large faces and how important accredited clubhouses are throughout the metropolitan area and across the country. It seems that when the general public hears about clubhouses, they think only of social clubs. Fountain House and all the other clubhouse programs that follow Fountain House’s model are so important for the mental health community. They give people with mental illness hope, a chance to re-enter society and live productive lives.
This year I was fortunate enough to be a team leader, not only for my group from Fountain House, but also for Metro Club PROS (MCP), where I work as a Recovery Specialist. I’m very proud to say that the Fountain House group I led up to Albany consisted of members and staff, working side by side as usual – a crucial part of the clubhouse model formula. Each person shared their personal stories of how clubhouses have imporoved their lives with the legislators and their staffers.
We also discussed relevant issues of the day, specifically the violence erupting across our nation that has been linked to mental illness. We expressed our concern about how the media portrays it and the stigma it’s creating against our community, even though, in reality, occurrences of violence are miniscule relative to the overall mental health community. Members of our group also discussed other issues, such as reinvesting savings from state hospital downsizing to boost community-based housing and also employment and peer services.
Let me backtrack a little so you can get an idea of how the day was. I arose at 4:30 in the morning, was out of the house by 5 AM, and by 5:30 I was at the bus departure area at Union Square. The first person I saw was Carla Rabinowitz, the NYAPRS point person who coordinates the Legislative Day trip. We went over the lists of who was coming from Fountain House and MCP, and we made sure they were all on the bus. We departed at approximately 6:30 AM and arrived in Albany between 9:30 and 10 AM.
When we arrived, Harvey Rosenthal, President and Director of NYAPRS, greeted us heartily and directed us to an auditorium in the New York Capital District’s iconic Egg Builiding, where we would be until lunch time. On the program schedule, Harvey gave us an overview of the New York State budget. NYAPRS Co-Presidents Maura Kelly and Steve Coe and Public Policy Co-Chairs Carla Rabinowitz and Raymond Schwartz then collectively made presentations on this year’s priorities:
  • Protecting the community mental health safety net
  • Reinvesting savings from state hospital downsizing
  • Enhancing Medicaid community recovery supports
  • Protecting Medicaid beneficiary rights and medication access.
  • Serving New Yorkers with psychiatric disabilities in the most integrated settings
  • Creating a detailed Olmstead Plan
  • Enhancing strategies to help distressed individuals
  • Opposing psychiatric profiling
Four people who have worked above and beyond in the field of mental health recovery were recognized for their efforts: Wendy Brennan, Senator David Carlucci, Assemblywoman Aileen Günther, and Kristin Woodlock.
Around noon we had lunch and reviewed our strategy before we went to rally at the steps of the State Capitol building. Following the rally, we kept appointments with our respective assembly people; my group saw Mark Gjonaj, Assemblyman 80th District and Linda B. Rosenthal, member of Assembly 67th District. By four in the afternoon we were back on the buses and on our way home after a very productive and satisfying day!

Alan Miller
Clerical Unit and Advocacy Committee, Fountain House


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Breathe Free Supports FH Smokers to Kick the Habit

sites/default/files/Smoking_Cessation_dallas_0.jpgEarlier this week, the Centers for Disease Control and Prevention and the Substance Abuse and Mental Health Services Administration released new data that show one of every three adults with mental illness smokes, compared with one in five adults without mental illness. Although we suspect this number is slightly lower among the Fountain House membership (and plan to gather data to evaluate that claim), there’s no question that smoking represents a major health risk to our community.  

In order to support members in their efforts to quit smoking or to help them cut back on smoking, we created the Fountain House Breathe Free program. We hold a meeting each week (Tuesdays at 5 pm) where members come together to discuss their efforts, learn about possible approaches to aid in smoking cessation, and hear updates from their peers, all while cultivating an atmosphere of trust and mutual support. The meetings are structured such that there is time at the beginning of each meeting for any relevant announcements and members are encouraged to bring up any issues that are currently significant (e.g. Mayor Bloomberg’s recent ban on smoking in parks and beaches, President Obama’s struggles to kick his smoking habit, efforts to curtail smoking within Fountain House, etc.). Often times this involves reading through a magazine or newspaper article. Periodically, the group will watch a film on the topic or invite a guest speaker - usually a member or staff that has successfully quit smoking - to talk about their experience and answer any questions group members pose. Each meeting features a discussion aspect on topics including:
 
·         Stress reduction techniques
·         Triggers
·         Stages of change
·         Behavioral adaptation
·         Resources in New York City
 
At the end of each meeting each member has an opportunity for a personal check-in. During this time they share with the group what their specific short-term goal was for the week and how it went. They may bring up what went well, in which areas they could use more support, or ask questions of the group.
The weekly group typically consists of 5 to 15 people. In 2012, 40 members received support with smoking cessation through these groups. Given that Fountain House has about a thousand active members, we can reasonably estimate that about 300 of them are smokers. We clearly have much work to do in terms of recruiting and engaging more members in smoking cessation efforts.
 
However, the member success stories are the heart of the inspiration and mutual support that provide the foundation for the Breathe Free Program. Just this week, a member who has been part of the group on and off for the past six years announced that he had been without a cigarette for two and a half weeks. Another long-time group member is going on four months smoke-free. The group meeting provides the forum for continued support, shared struggles, frustrations, encouragement, and hope.
 
Several group members have written about their experiences for the weekly Fountain House Newspaper and/or attended trainings on tobacco cessation in mental health programs and specifically within the clubhouse environment. Group leaders are also available to meet with people individually for additional support. The goal of the program is to continue to expand and to incorporate different methods of support to attract more members to the group.

Joseph Shaffer
Wellness Unit Leader, Fountain House
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Third Annual Spring Breakfast

This event is sold out. Please contact Robyn Marks for more information.

EVENT DETAILS

DESCRIPTION

The Associates Host Committee presents:

Between the Sheets
Sex and Mental Health
A Woman's Perspective...

A breakfast discussion featuring C. Neill Epperson, MD and Shari Lusskin, MD

Sponsored by Le Cirque

DATE

March 12, 2013
9:00 - 10:30 AM

Tuesday, March 12, 2013

Le Cirque

Kate Allen

Donya Bommer

Kathleen Kocatas

Jennifer Oken

Katie Tozer

Katie Zorn

 

Jennifer Carlston

Nicole Cunningham

Chiara Edmands

Linda Garnett

Heather Georges

Sarah Simmons Goldstein

Shoshanna Gruss

Kamie Lightburn

Katherine Lipton

Laura McVey

Dara O'Hara

Sarah Von Maltzahn

 

Learning on the Job

I’m finishing up a supported job in the mailroom at Morgan Stanley. Even though the job wasn’t perfect, I still gained a lot from the experience. I learned things both big and small - about myself and about life in general.

The first hurdle was the dress code: modified corporate, which means slacks or skirt, long-sleeved shirt or jacket, and closed toe shoes (no sneakers). I stocked up at the Fountain House Thrift Shop and, for a few dollars, got all that I needed. Although at first I was resentful of the dress code, I now find that dressing to look good by these standards has a positive effect on how other respond to me, and thus, makes me feel better about myself. It engenders a feeling of pride that has gone far beyond the job.
 
I find that you need to pay special attention to your shoes. New Yorkers spend an extraordinary amount of time examining each other’s shoes…in the subway, in elevators, on the bus, waiting in line - you don’t want to be moving around feeling bad about your shoes. Check the thrift store often until something in your size turns up.
 
At Morgan Stanley I see myself a lot in the chrome elevator doors. It reminds me to stand up straight and take the frown off my face. The frown is an old habit that I don’t need right now. There, that looks better. I don’t look half bad. Hey, I think I look pretty good! These are new thoughts for me.
 
I was reminded that I can’t be in control of everything. On the job you run into situations that you don’t like and all kinds of people who have the right to tell you what to do. Don’t foster bad feelings over these problems. I have come to understand that I am only one little piece in a very large puzzle, and my biggest job is just to fit in. On some jobs showing initiative can fail to have the desired effect.
 
At home, under the stress of the holidays, I crashed and burned and had a mental health crisis that could have escalated into something very serious. The healthy part of me that has been nurtured through Fountain House helped me through. I also thought about the promise I had made to show up at my job every day for six months, ready to work. Working gives me what I need right now: discipline, structure, commitment, and healthy social contact. I’m getting back on-track without having had to miss any days at work. The pay is so-so, but I’ve learned that the benefits are great.

Susan Baus
Wellness Unit, Fountain House
 
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Social Co-ops Support Entrepreneurship

A jewelry design venture that gives new life to antique watch fobs; an environmentally-friendly exterminating business that specializes in beagle-assisted bedbug detection; a greeting card company that features nuanced sk

Winter at High Point Farm

sites/default/files/moving-wood.jpgI recently spent some time at High Point Farm, Fountain House’s beautiful 477-acre farm in Montague, NJ. When winter is in all its glory, life at the farm slows down a little, but there’s still a constant stream of members and staff from the city going to do the necessary work. When I was at High Point, two groups were staying over - one for the whole week and one for just a couple of days.
A number of chores must be done every day, year-round – feeding the chickens and cooping them at night, taking care of our two barn cats, and, of course, feeding and watering the alpacas. But the wintertime brings its own work: constantly stoking the wood burning furnace to reduce our dependence on oil and, to do so, cutting and splitting wood throughout the season. Groups go into the forest to cut up the trees that have fallen during the last year. Our farm staff does the most difficult work, but members and staff help drag the logs in and use the log splitter.
Last Tuesday was special; we hired a portable saw mill and created our own lumber from the trees on our property. While we were cutting the trees a pair of bald eagles was flying over our lake, having a great time. The day ended with the staff and members sitting down to dinner, cooked and prepared by all, while a fire burned in the chalet’s fireplace.
At Fountain House we are truly a working community, and these moments are the best expression of that ethic. Without the collective effort of many different people, we would never be able to sustain this jewel of a farm that everyone can enjoy.

Check out more wintry pictures of High Point on Facebook.

Kenneth J. Dudek
President, Fountain House

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The Cost of Mental Healthcare

Across the country, there’s been a lot of talk about violence and mental health and how the two intersect.   New York has been no different, with the tragic Sandy Hook shooting happening not far to the east; two fatal subway shovings, one in Manhattan and one in Queens; and the shooting of firemen in Webster, New York. All of the perpetrators in these incidents have been labeled mentally ill, and all have been used to illustrate the need for comprehensive care for people who live with mental health issues.
 
Alongside regular reporting on the violent shootings and new information on the alleged perpetrators in the subway assaults in December, The New York Times highlighted the recent stress on New York City’s mental health system in the wake of Hurricane Sandy. The tragedy in Connecticut prompted Mother Jones to update an older article about how the majority of mass shooters in this country’s history showed signs of mental illness before their attacks.
 
I suppose it’s not surprising that as a society we speak more of how to deal with or support or help those with mental illness in the wake of dramatic, violent events, but the truth of the matter is that our mental health system has been receiving cuts for years now - certainly since the recession began in 2009 - and aside from that, budgeting for mental health care is not a priority in our society.
 
For four and a half years I worked on Fountain House’s Mobile Outreach Team. It was a group of members and staff that drove around the five boroughs of New York in a van, visiting 142 adults with mental illness who lived independently in their own apartments. Usually the work was relatively routine: conducting safety inspections, checking in to make sure people weren’t isolating themselves, giving support to homebound people who couldn’t get out to see a social worker, or simply being a few friendly faces that helped people feel connected to something larger than themselves.
 
Other times we did have to intervene in crises, bringing people in to see their psychiatrists or taking people to psychiatric emergency rooms. Sometimes we had to call 911 when someone had stopped taking their medications and we were seriously concerned about their safety or the safety of others around them. Hospital staff, police officers, and first responders we worked with ran the gamut from professional and helpful to rude and unhelpful and everywhere in between. I was struck time and again by how much work needs to be done to get services to those with the most serious mental health needs quickly, competently, and compassionately. There were too many times that we had to try to persuade police not to send a troop of officers in to speak to one scared, paranoid person in a room or that we received a phone call after taking a seriously ill person to a psych ER, only to find out they’d been discharged mere hours later because they weren’t “sick enough.”
 
All this came to a head for me when, in July of 2011, we were told that our contract to provide outreach to our community had been cut due to budgetary reasons. For years, during audits, we were told that our team did good and necessary work, but that didn’t spare us from the cuts. Our members and staff were devastated, and now these 142 people are not receiving the same support they once did.

Similar cuts have been made to other agencies in New York. While I can’t say for certain if these cuts directly led to any tragedies, I can say that our society is neglecting some of its most vulnerable people. It’s imperative that we strive to improve our day-to-day mental health services and don’t make them the first cuts when times get tough. We’re doing a disservice not only to those with mental health needs, but to each and every one of us. As a community, we can’t afford to think of mental health only when a tragedy occurs; we must realize that it’s a day-to-day reality for one in five of us.
 
Ian Campbell
Active Reachout, Fountain House

 
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