Teens' Mental Disorders Often Untreated in U.S., Study Finds

Posted on 2013-11-22 02:00:28 UTC
-- Robert Preidt

Shortage of child psychiatrists partly to blame

THURSDAY, Nov. 21, 2013 (HealthDay News) -- Less than half of American teens with mental health disorders receive treatment, and those who do get help rarely see a mental health specialist, a new study indicates.

The findings underscore the need for better mental health services for teens, said study author E. Jane Costello, associate director of the Duke Center for Child and Family Policy in Durham, N.C.

"It's still the case in this country that people don't take psychiatric conditions as seriously as they should," Costello said in a Duke news release. This remains so, despite a wave of mass shootings in which mental illness may have played a role, she and her colleagues noted.

The analysis of data from more than 10,000 teens aged 13 to 17 across the United States also showed that treatment rates varied greatly for different types of mental health problems.

For example, teens with attention-deficit/hyperactivity disorder, conduct disorder or oppositional defiant disorder received mental health care more than 70 percent of the time, while those with phobias or anxiety disorders were least likely to be treated.

The researchers also found that blacks were much less likely than whites to be treated for mental disorders, according to the study, published online Nov. 15 in the journal Psychiatric Services.

In many cases, teens received treatment from pediatricians, school counselors or probation officers, rather than mental health specialists. This is because there are not enough qualified child mental health professionals to handle the demand, said Costello, who is also a professor of psychology and epidemiology at Duke University.

"We need to train more child psychiatrists in this country," Costello said in a university news release. "And those individuals need to be used strategically, as consultants to the school counselors and others who do the lion's share of the work."

As many as one in five children living in the United States experiences a mental health disorder in any one year, according to a U.S. Centers for Disease Control and Prevention report.

More information

The American Psychiatric Association has more about teen mental health.

              

Eddy - The Mayor of Montauk Manor

By Beverly Maher

I had just closed my chicken and rib restaurant. I am not a person who enjoys sitting idly. I found an ad in the paper to be your own boss and sell a product that was advertised to be the best product for your skin. The company was Newskin. I liked the idea that I may be able to work from home. I contacted the promoter, he invited my partner Bob, and I to come to his home, meet his wife, and see what the company could offer me to promote the product. They were in West Babylon, not far from my own family. When we pulled up to the house, there was a farm stand just to the left of the house. It was dark, so we were not able to see much. They were a nice couple. Joe was younger than Joanne was. He was promoting Newskin she was supporting his venture. In our conversation, Bob and I learned the farm stand was a mutual venture. We were also informed; Joanne owned and operated five adult homes on Long Island as well. Ambitious and interesting people. I liked the product. I told them I would try it and signed up. I had been doing it for a few weeks when I mentioned I was looking for part time work to supplement my income between sales. Joe mentioned his wife was looking for an administrator for one her homes in Lindenhurst. I called Joanne and she told me to come down the next day to find out the details. We walked around the huge house and she told me what she expected of an administrator. I met the residents they seemed gentle enough. They greeted me with smiles. The cloud of smoke that greeted me was surprising. The main door, which was actually the back door, enters into the smoking room. They had coffee cups and there was not much conversation going on. Most of them looked disheveled, whiskers on their chins. Some could use a shower. Joanne explained how the state regulated the home and everything had to be to the state's standards. The state regularly visited the home to ensure the safety of the residents. The house had a capacity for 29 beds, meaning 29 residents could occupy the home at one time. Joanne had 24 filled and it was very important to fill the rest. That would be the administrator's responsibility. I met the cook, who doubled as the aide, and I met the housekeeper. It was a good feel. I wanted to take on the challenge and asked Joanne when I could start. I had not mentioned to Jim or Joanne that I was leaving Bob. I was considering living in Suffolk County to be near my family already. I was waiting for the School year to be finished for Lauren, my special needs daughter. I started the next Monday. The last state visit was posted on the wall and I took it to my desk. There were 80 violations on it. I knew that would be my priority, both to learn the violations and to fix the violations. I left the door open to be able to listen to goings on outside my door. The smoking room was right outside the door. While I was reading, I heard a faint knock at my door. A man's head peaked in and asked if I had a minute. Sure, come on in. "I'm Eddy." He stated. "I'm Beverly, come in and have a seat, I replied." Eddy went on to tell me how he became a resident of Montauk Manor. His substantive demeanor was impressive. I certainly was curious as to why he was here. He was a man of about 60. Too young to be one of the elderly residents. Montauk Manor was diversely mixed with elderly residents, some Vets that were elderly, but most of the residents were mentally ill. Eddy told his story.

"I was married for 25 years. I got depressed a lot. I kept losing jobs. One day I broke down and did not want to do anything. They put me in a hospital and put me on Lithium. It started to get better, but my wife did not want me back. We had a daughter. She is such a good daughter! She lives in the neighborhood!" His voice had a pitch, one you would hear if someone was from the city. "I go to her house and I get to see my grandkids, we have dinner together, it's great!" "That is nice Eddy." He was clean, he was shaved, his matching outfit seemed out of place at Montauk Manor. I found out the residents called him the mayor. I could understand why.

For the next couple of months I was very busy. I found a book for case management and found out that I would have to write about all the residents and keep up to date any and all issues corresponding to them. I would take some time out of my day to leave the office and talk to the residents. I informed Joe and Joanne that I lost interest in selling Newskin. I was excited about the new venture. Rob was 25 years old. A handsome young man. He was clean and never had to be reminded to take a shower. He wore very nice clothes. As I would learn he would receive a package from Florida, where his parents lived. His mother made sure he had everything he needed to keep up with his appearance. Rob was one of the few residents who did not need to borrow money for cigarettes and coffee right after they received their allowance. That was a common theme. I would see this throughout my adult home experiences with the exception of Merryville. Merryville was an adult home that specialized in Alzheimer's and Parkinson victims. Rob paced; he walked with a tempo. He did not speak. He knew how, he just chose not to. He would answer if spoken to, but only single syllable answers. He would awaken at around 8am, have breakfast and start pacing. He would go to his room walk to the end, turn around and walk to the living room. He would get to the end, turn around, and walk to the smoking room. He would have a cigarette standing and start pacing again. He did this all day long only stopping to eat and nap. His mother would occasionally call to speak to him. He simply answered in one syllable, yes, no. I spoke to his mother on a few occasions before I handed him the phone. She told me the medication he was on now was a miracle med. He used to be uncontrollable, at least now he was calm.

Josephine was a gas. She would walk all over town. All she wanted to do was work and earn money so she could buy coffee and cigarettes. She worked for Joanne. Joanne had a flower stand right next to Montauk Manor. When she needed Josephine at the farm stand next to the house, Josephine would walk the distance and work for the day. She was very small and frail looking. Her work ethics were extraordinary. She had the ability to work long hours even on hot days. Josephine was outgoing, very friendly. My sister came by once with a couple of her daughters and they loved Josephine's banter. She told them how beautiful they were. She shared a few funny stories with everyone. We all chuckled. Josephine was on medication for depression and anxiety. At that time, she was compliant with her medication and she was able to function in her day-to-day life. In private, she would tell me stories of her many mood swings and why her family was not anxious for her to live with them.

We had a few vets in the house. They were sweet, soft spoken and polite. They smoked and drank coffee throughout the day. The aide had to guide them to take showers and change their clothes. She would also shave them when she was not cooking. The housekeeper was good. Montauk Manor was a mansion and she was expected to keep up with all the residents' rooms. I discovered through the violation sheet how important it was to make sure the residents were not doing anything like using extension cords irresponsibly. The cook and I would help Helena, the housekeeper in the afternoons, after lunch. Helena would assist with the lunch. After we changed all the curtains in the living room and had it painted we started tackling the bedrooms. If they needed painting, we had Joanne set up the painter. We would do curtains and drapes, depending on the need. Before we knew it, Montauk Manor was looking like a real home.

That summer I decided to create a garden and grow the vegetables for the residents. Joe came over and roto tilled the grass covered area that would be our garden. I chose the area in the back, outside the smoking room window. I wanted the residents who did not go out to watch the progress of the garden. I worked hard to clean out the grass and get the soil ready. Eddy would be smoking his cigarette and watching me. The vets would be outside watching, smoking, drinking from their dirty Styrofoam cups. Eventually the garden was ready for planting. I planted tomatoes, peppers, eggplant, string beans. I planted anything we could use in the day to day cooking. The garden started to look like a vegetable garden. The plants were growing and we were all able to see nature grow. Eddy was watching me pick the weeds one afternoon and he announced, "We have a real victory garden!" His daughter was picking him up that day and while he was waiting, he said, "I am going to buy you a new pair of sneakers. Those sneakers you are wearing are all worn." I smiled at his thoughtfulness. I always wore white keds in those days. 

A couple of weeks later Helena ran into my office. She told me that Eddy looked sick and to come immediately to his room. After seeing Eddy, I called 911. They rushed him to the hospital. His daughter called and kept us abreast of his progress. He was having thyroid problems because of taking Lithium and would no longer be able to take it. When he returned to Montauk Manor all were very happy to see the mayor home again.

The state came in and inspected our home. I received a few violations and I had fixed all the old violations. One of the violations was that I was not a licensed administrator. I applied for my administrative license. I had all the qualifications except one. I did not have the experience in adult homes. This was my first and only experience. I would need five years to fulfill that goal. I was at Montauk Manor for one and one half years. I counted this towards my license. I had a long way to go.

I worked in a number of adult homes after that. Some hired me to assist with bookkeeping or general assistant to the administrator for helping with correcting violations. One hired me as a coordinator because they would not replace the incompetent administrator they had. Sometimes I worked as an aide, just to get the time in.

Two years after my time at Montauk Manor I was visiting my own daughter in Brunswick Psychiatric Hospital. Lauren had started exhibiting signs of schizophrenia while I was at Montauk Manor. It was difficult to find the right medication to keep her from experiencing the strange world of mental illness. As I walked to the back where the entrance was, I saw a man sitting on the stone bench with the sun beating down on him. He was squinting and I kept staring to see why he looked familiar. As I got closer, a smile started forming on my mouth. He was covering his eyes with his hand to block the sun, but it was unmistakable. As I got closer, I noticed he had at least a week of growth on his face, his clothes were dirty and he looked disheveled. He was wearing a pair of sneakers. They had no shoelaces; they were well worn and dirty. He noticed me. We smiled together, when our eyes met. "Hello Eddy." "Well hello there!" he said with that pitch in his voice. I did not ask why he was here. "Nice sneakers Eddy!" I said. He looked down at the white keds and said, "They're yours, I bought them for you that day I went with my daughter shopping. Do you want them?" "No thank you Eddy, you keep them for me.""Ok" he replied "Take care Eddy." I answered. I walked into the hospital to visit my daughter, my eyes starting to well up. He was gone when I came out. It is a sad world for the mentally ill.

The Community Mental Health Act of 1963

FILE - In this Oct. 31, 1963 file photo, President John F. Kennedy signs a bill authorizing $329 million for mental health programs at the White House in Washington. The Community Mental Health Act, the last legislation that Kennedy signed, aimed to build 1,500 mental health centers so those with mental illnesses could be treated while living at home, rather than being kept in state institutions. It brought positive changes, but was never fully funded. Former U.S. Rep. Patrick Kennedy will host a conference on Oct. 24, 2013 in Boston, to mark the 50th anniversary of the act, and formulate an agenda to continue improving mental health care. (AP Photo/Bill Allen, File)

PROVIDENCE, R.I. (AP) — The last piece of legislation President John F. Kennedy signed turns 50 this month: the Community Mental Health Act, which helped transform the way people with mental illness are treated and cared for in the United States.

Signed on Oct. 31, 1963, weeks before Kennedy was assassinated, the legislation aimed to build mental health centers accessible to all Americans so that those with mental illnesses could be treated while working and living at home, rather than being kept in neglectful and often abusive state institutions, sometimes for years on end.

Kennedy said when he signed the bill that the legislation to build 1,500 centers would mean the population of those living in state mental hospitals — at that time more than 500,000 people — could be cut in half. In a special message to Congress earlier that year, he said the idea was to successfully and quickly treat patients in their own communities and then return them to "a useful place in society."

Recent deadly mass shootings, including at the Washington Navy Yard and a Colorado movie theater, have been perpetrated by men who were apparently not being adequately treated for serious mental illnesses. Those tragedies have focused public attention on the mental health system and made clear that Kennedy's vision was never fully realized.

The legislation did help to usher in positive life-altering changes for people with serious illnesses such as schizophrenia, many of whom now live normal, productive lives with jobs and families. In 1963, the average stay in a state institution for someone with schizophrenia was 11 years. But only half of the proposed centers were ever built, and those were never fully funded.

Meanwhile, about 90 percent of beds have been cut at state hospitals, according to Paul Appelbaum, a Columbia University psychiatry professor and expert in how the law affects the practice of medicine. In many cases, several mental health experts said, that has left nowhere for the sickest people to turn, so they end up homeless, abusing substances or in prison. The three largest mental health providers in the nation today are jails: Cook County in Illinois, Los Angeles County and Rikers Island in New York.

"The rhetoric was very highfalutin. The reality was a little more complicated, and the funds that were provided were not adequate to the task," said Steven Sharfstein, president and CEO of Sheppard Pratt Health System, a nonprofit behavioral health organization in Baltimore.

"The goals of deinstitutionalization were perverted. People who did need institutional care got thrown out, and there weren't the programs in place to keep them supported," said former U.S. Rep. Patrick Kennedy, the president's nephew. "We don't have an alternate policy to address the needs of the severely mentally ill."

He is gathering advocates in Boston this week for the Kennedy Forum, a meeting to mark the 50th anniversary of his uncle's legislation and an attempt to come up with an agenda for improving mental health care.

The 1963 legislation came amid other changes in treatments for the mentally ill and health care policy in general, Appelbaum said. Chlorpromazine or Thorazine, the first effective antipsychotic medicine, was released in the 1950s. That allowed many people who were mentally ill to leave institutions and live at home.

In 1965, with the adoption of Medicaid, deinstitutionalization accelerated, experts said, because states now had an incentive to move patients out of state hospitals, where they shouldered the entire cost of their care, and into communities where the federal government would pick up part of the tab.

Later, a movement grew to guarantee rights to people with mental illness. Laws were changed in every state to limit involuntary hospitalization so people can't be committed without their consent, unless there is a danger of hurting themselves or others.

Kennedy's legislation provided for $329 million to build mental health centers that were supposed to provide services to people who had formerly been in institutions, as well as to reach into communities to try to prevent the occurrence of new mental disorders. Had the act been fully implemented, there would have been a single place in every community for people to go for mental health services.

But one problem with the legislation was that it didn't provide money to operate the centers long-term.

"Having gotten them off the ground, the federal government left it to states and localities to support," Appelbaum said. "That support by and large never came through."

Later, during the Reagan administration, the remaining funding for the act was converted into a mental health block grant for states, allowing them to spend it however they chose. Appelbaum called it a death knell because it left the community health centers that did exist on their own for funding.

Robert Drake, a professor of psychiatry and community and family medicine at Dartmouth College, said some states have tried to provide good community mental health care.

"But it's been very hard for them to sustain that because when state budget crunches come, it's always easiest to defund mental health programs because the state legislature gets relatively little pushback," he said. "Services are at a very low level right now. It's really kind of a disaster situation in most states."

Sharfstein points out that most mentally ill people are at a very low risk of becoming violent. He said it's unthinkable we would go back to the era when people were housed in "nightmare" conditions at overcrowded, understaffed and sometimes dangerous state hospitals.

"The opportunity to recover is much greater now than it was in 1963," he said.

But for those who do not take their medication, don't recover from their first episode of illness and don't seek treatment and support from professionals, they are vulnerable to homelessness, incarceration and death, he said.

Linda Rosenberg, president and CEO of the National Council for Behavioral Health, counts among its 2,100 member organizations many of the original community mental health centers that were built under the 1963 legislation.

"Whenever you pass a piece of legislation, people would like to think that you've solved the problem," she said. "It did some very important things. It laid some ground work. It's up to us now to move forward."

Lauren has a unique personality. She has a way of saying things that make me stop, listen, smile often. Here are just three examples. 

Lauren was on the phone with Kourtney. They were discussing Lauren's jewelry business. Lauren always gets Kourtney to talk about her jewelry business. She has an interesting business acumen. She's a great salesperson.  Lauren is always coming up with ideas for her business, sometimes these ideas don't even pertain to her business or make much sense.  Kourtney is living in US St. John's as an archaeologist.  Lauren says to Kourtney " Kourtney if you could collect shells and send them to me, I can carve them to make jewelry! Don't you think that's a great idea!" I don't know what Kourtney's answer was but after they hung up Lauren came into the living room where I was on the couch. She didn't start talking to me directly at first, it was just a statement in general. "I think this the ticket to my career; Kourtney lives in the tropics!! This is my ticket to a great career don't you think Ma?!" she say's excitedly.

Another time Chyna and I are sitting on the couch,  Lauren is talking to no one in particular again "I'm talented, I'm really talented. I looked at Chyna and she is looking at me seemingly saying " well if you say so." Chyna is our dog, she is an adorable shih tzu.

 Lauren and I were discussing her living with Phillip. I personally do not think it is a good idea. She has more stability at home during the week. She spends the entire weekend with him, they go out to eat, they stay up late, they stay in bed all morning. They have a wonderful time together. I'm not against her freedom, I'm afraid of her forgetting to take her meds and such.  At home she has consistency. Anyway,

I didn't tell her how I felt, instead, i said "we'll see, maybe one day." She seemed to be satisfied with that answer and a few minutes went by and out of the blue she said " If i live with Phillip, I don't want to pay a left hand and foot for my website".  Lauren has a web site, she sells her hand made jewelry on line. I took the statement to mean she didn't want to pay and arm and a  leg. 

Kicked Out Of Friendly's
                          By Kourtney Donohue
                                   

We got a booth in the back of Friendly's Ice Cream restaurant.  The waitress was visibly irritated that she was serving five loud, giggly, pre-teenage girls ice cream sundaes that were bigger than their heads.  As we began to inhale our chocolate fudge smothered sundaes, Kristie, my sister, was reminded of something she recently heard, "Someone told me that chocolate and cocaine come from the same plant."  Lauren, our first cousin, stopped eating her sundae, stared wide eyed across the table at Kristie and demanded to know more, "Kristie am I eating cocaine right now?  Am I Kristie?  I'm eating cocaine?!?!"  Kristie realized what she'd done and began to stutter "uhh well, but it's-- no Lau, it's not the sa--"

Lauren interjected before she could finish, "Kristie tell me the truth, am I eating cocaine?"  Kristie said "No Lau!" but she giggled nervously.  I attempted to answer too, but I also began to giggle nervously.  Lauren continued to panic and she thought we were mocking her because we couldn't stop laughing, "Oh my God I'm on cocaine!  You gave me cocaine!  I'm on cocaaaaaaaaaaine!?!?"  Lauren slammed both hands on the table rocking back and forth screaming at the top of her lungs "OH MY GOD I'M ON COCAINE!!!!!  I CAN'T BELIEVE I'M ON COCAINE!!!!!"  We tried to stop her, "Lauren no you're not! shhhhhh! You are not on coca--". I couldn't say it with a straight face, I couldn't control the nervous giggle.  People were looking at us.  We were worried the waitress was going to come over.  Lauren wouldn't listen to us.  She wouldn't calm down.  She panicked even more.  She would not stop screaming. She finally stood up from the table and she screamed out to the restaurant that -oh my god, she was on cocaine!  I saw the waitress heading over to us.  We jumped up and shuffled Lauren toward the bathroom, dodging the waitress as she stomped over to address the big scene we made.  Lauren ran ahead of me into the bathroom, slammed the door and locked it before I could slip in with her.  She refused to let us in.  We were all banging on the door, "Lauren please let us in."  "Open the door."  "You are NOT on cocaine."  All we could hear was Lauren wailing from the inside, "I CAN'T BELIEVE YOU GAVE ME COCAINE!!!!  I CAN'T BELIEVE I'M ON COCAINE!!!!"    

The waitress came up behind us at the bathroom door and demanded to know what was going on.  I said, "Please give me a chance to talk to her.  You don't understand".  But I didn't know how to make her understand Lauren.  Lauren has a lot of fear.  She often overreacts.  Ok I'm exaggerating, she always overreacts.  She interprets things kind of like Amelia Bedilia, the maid from those children's books - she often takes things literally.  One time she read in a Cosmo magazine that dark eyelashes accentuate the eyes, so she plucked out all her blonde eyelashes, even though most of them were blonde!  And she is very in touch with her how she feels, whether it's good or bad feelings.  She is honest about those feelings, which is unlike most people.  Everyone in the family knows this.  That's why when Aunt Janine was getting ready to go to her 20th high school reunion and didn't believe us that she looked great she said, "I want Lauren's opinion".  Lauren said, "You look hot Aunt Janine!".  Aunt Jan persisted, "But does this outfit make me look fat?".  Lauren looked her up and down and said, "No way! Well hold on, turn this way, ok maybe a little bit from this angle but other than that you look fabulous Aunt Janine! You look fabulous!".  We spent the next hour convincing Aunt Jan to go to the reunion.  Everyone trusts Lauren's opinion.  Everyone loves her honesty (most of the time) and her unique enthusiasm for life.  But when she freaks out - she freaks out.  And not too many people understand it.  But who really understands someone else's perspective?  And how can anyone really explain another's perspective?  That is why we share stories, feelings, thoughts...so that we can get a little glimpse into the perspective of others.  But at the time - there was just no explaining Lauren's perspective to the Friendly's waitress.                

The waitress refused to listen to me, "You all need to leave" she ordered.  I pleaded, "No please, you don't understand, she is not on cocaine".  The waitress said, "Well it sure seems like she is!"  It didn't help that Lauren was screaming from behind the locked door that she was indeed, on cocaine.  I told the waitress that we have to calm her down to get her out.  Finally she let us do this and Lauren agreed to open the door a crack, but wouldn't come out.  I whispered to Lauren through the crack of the door, "Lau, the waitress is kicking us out of here.  Please tell her that you're not on cocaine."  Lauren opened the door a little more, looked at the waitress with tears in her eyes and cried, "YES I AAAAAAAMMMM! I'M ON COCAINE! I CAN'T BELIEVE I'M ON COCAINE! OH MY GOOOOOOD!" 

"That's it you're all out of here!" the waitress said, she was raising her voice and going to get a manager.  This was our opportunity, we pushed our way into the bathroom and drilled it into Lauren that she was not on cocaine, and eventually, she began to calm down.  We said, "Lauren we all ate the chocolate, we've been eating it our whole lives, we are not on cocaine."  She looked at us with softer eyes, "I'm not on cocaine?  You promise Kourtney?!"  "Yes Lau, you're not on cocaine."  She then howled her iconic loud Lauren laugh "AAAAAghgghhhhhahahaaahahahaha.  I can't believe I thought I was on cocaine!  Aaaahahahaahahahahaahah"  Mouth wide open, head thrown back, out of breath rocking laughter.  That's the Lauren we knew was in there.  Always able to laugh at herself.  Always keeping us laughing.  The waitress still didn't believe us, we tried to get her to let us finish our ice cream but she wasn't having it.  We were kicked out of Friendly's. 

 Outside we sat in the parking lot waiting for one of our parents to pick us up. Lauren
knew she wasn't on cocaine. We were all angry. Not at Lauren or the situation, 
but because the waitress didn't even let us finish our ice cream. Worst of all;
how dare she accuse our cousin of being on cocaine!

2006 The Bungled Rendezvous

Lauren met Phillip at one of the day habilitation programs that are part of a number of varied locations that ACLD has created to take special care of handicapped individuals in the community at large. She came home from her program Bridges and immediately picked up the phone to call me at work.  "Mom, your not going to believe this". "I met a guy!". She pronounced each word carefully "I  Met  a  guy". I was picturing the  giant smile that was on her face, it was in that voice.  "I didn't want to give him our phone number, she gushes! because I remembered what you said about strangers and not giving them my phone number, right?" She is losing her breath at this point. " So I took his phone number, right?" She is rambling . "I told him I can't call him until you come home, right?  When you come home I will call him, right?" "Ok, ok" I said. Hold on just a minute. "Is he part of the program?" "No, he lives in his own apartment". " Then what was he doing there?" "He said, he was there to see his therapist.  Mom he's so cute and he was so nice, can I call him please, please…." "Ok, ok, we'll talk when I get home".

She called him that night and they talked about getting together soon. Meanwhile I had given her some questions I wanted answered when she did talk to him.  So when she got off the phone I asked her to join me at the kitchen table.  "How old is he? " "He's 42". "Lauren, don't you think that is a little old for you? Your only 27?  Is he close with his parents?" I asked. "Yes, they talk all the time".  "What does he do for a living? Is he working?" "yes, he has a job at Applebee's" she answered. "What does he do at Applebee's?" " I don't know, I didn't ask, I forgot, no more questions" she said with a stern warning " I am going out with him, whether you like him or not!"

 The next evening he called and I asked to speak to him.  He was nervous so I didn't press him.  He seemed mild enough the few words we spoke.  Lauren took the phone and went into the bedroom to talk in private.

 The next day I went to work.  At the time I was commuting on the Long Island Railroad to Manhattan. I called Lauren from work as usual and she seemed distraught." What's wrong?" I asked.

"I want to meet Phillip, he's coming to meet me". "Where? You can't meet him now, you need to wait until I'm home" I said excitedly. "He wants to meet now, I'm going to meet him" she shouted. The phone went dead. I called my sister Maryjane and told her what was happening  and she hung up and ran out the door calling one of her daughters, Carol to join her because she may need a hand.  Maryjane lived only 5 minutes away in West Babylon.  When she got to my block she spotted Lauren sneaking around the building. She also spotted a man watching her every move.  She stopped the car and yelled at her to get in the car immediately! Lauren did as she was told. She said Phillip never showed up at the seven eleven as planned. After work, I picked  Lauren up at Maryjane's.  On the way home I reminded her she was never supposed to go to the seven eleven unless I was home.  She said Phillip couldn't find the seven eleven.  He told the cab driver all he knew was a seven eleven. Of course, that's all Lauren knew. She said she told him there was a seven eleven on the corner.  Phillip knew all the cab drivers, because that is how he got to work every day.  He had the cabbie driving to seven elevens all over town, just not the right seven eleven.  Lauren and Phillip were so anxious to see each other they never asked anyone for the proper directions.  That is when I knew they would be good for each other.

 Lauren and Phillip have been an item ever since. They broke up for a brief period in 2010, but that story is for another day.

 

From Angel's to Devil's 1991-1993

We were living in New Hyde Park, a suburb of Long Island when Lauren started exhibiting signs that she may be schizophrenic. She came home from school one day when she was 15 and announced she did not have to look both ways when she crossed the street because the angels where watching over her. When I realized she was serious I took her to see a psychiatrist recommended by the school. He spoke to her for a 1/2 hour or so and diagnosed her with Schizophrenia. He got the diagnosis right but the Melleril  he prescribed really didn't help with the voices she kept hearing.  One psychiatrist after another we went through EEG's and psychotropic meds to see what would work.  When Lauren told one doctor she was seeing the angels he put her on a narcotic because he said he thought she had neurological dysfunction. Lauren had to be hospitalized numerous times for getting out of control. When Lauren was 17 we moved out the house we were living in New Hyde Park. We lived with  Bob and Raymond.  I was leaving Bob and Ray my son was attending Queens college and liked the closeness of the house in New Hyde Park to the campus. Everyone was ok with the living arrangements and since the house I was renting only had two bedrooms it made sense. I bought a sofa bed in the den for Raymond whenever he wanted to stay with us. By the time Lauren was nineteen, the angels were looking like devils to her.  I was one of those devils.  One such weekend, we were with friends when she had a psychotic episode.  One of the friends we were staying with was also an administrator in an adult home as I was. We recognized the glazed over eyes, nonsensical speech and I called 911.  She screamed from the ambulance as they were taking her to Stony brook Hospital in Long Island as she pointed at me  "she is the devil!!'   Lauren's life was spinning out of control. She was afraid. She was angry. The medication surely  was not working. 

HALI

HANDS ACROSS LONG ISLAND (HALI) was formed in 1988 as a grassroots, multi-service, organization managed and operated by, and for, psychiatric survivors. Today, they are the largest and most successful peer-run, multi-service agency, mental health organization in NY State, helping over 3,500 consumers each year. HALI operates the FIRST peer-run mental health clinic in the United States.
http://www.hali88.org/

Grandma's Funeral

When we received the phone call from Raymond telling us that Grandma Nawrocki had passed away, Lauren took it pretty well, so I started to think about the outfit she will wear to the funeral. The wake was in two days, with only one viewing night. I was unable to attend, so I dropped Lauren and her fiance off for the funeral at Raymond's and I went to work.  Raymond said the plan was to go to a restaurant after the funeral and he would be dropping Lauren and Philip off at Phillip's apartment  so I wouldn't have to worry about  them.  I felt it better for Lauren to just go to the funeral and not the wake the night before  because as she put it "I don't want to look at dead people."

I called Raymond at around 3:00 to see how the day was going. He seemed very agitated.  "I just dropped them off at the diner by Philips apartment !" he yelled. "What's the matter?" I asked. "What's the matter? What's the matter?" he was yelling. I looked around my office to see if anyone could hear him, but of course they couldn't. I calmly asked "what happened? Why did you drop them off? I thought you were all going to a restaurant?" "Ma, ma" he repeated, " you would not believe what my day was like."  "First, we're in church and I'm looking around and a few people had some tears in their eyes and all of a sudden Lauren starts crying; I mean really crying!! then  the crying turned into wailing! I mean she was wailing mom! I didn't know how to stop her!" he's yelling. The mass finally ended and they drove on to the cemetery.  Raymond explained they didn't stop to eat anything and they had to wait at the cemetery for  quite some time.  Philip did not eat breakfast and  Lauren is always hungry to begin with. Raymond,  is not accustomed to being the one handling her; I am. " Everyone was given the obligatory carnation to place on the casket for their final farewell to Mrs. Nawrocki,"  Raymond explained.  Raymond turned to Lauren and Philip and told them he was taking them to the diner so they could get something to eat. Raymond was saying to me on the phone" Maa, exaggerated,  her and Philip  ran to the casket and threw  the carnations on the casket and started running from the cemetery and yelling at everyone around them "bye"... "bye"... and quickly ran to Raymond's car as he and Tricia stood with their mouths open watching them get into the car." "I am never taking her to another funeral" he promised. I on the other hand, I was laughing so hard I was crying. 

Kendra's Law

Kendra's Law, effective since November 1999, is a New York State law concerning involuntary outpatient commitment. It grants judges the authority to issue orders that require people who meet certain criteria to regularly undergo psychiatric treatment. Failure to comply could result in commitment for up to 72 hours. Kendra's Law does not require that patients are forced to take medication.

It was originally proposed by members of the National Alliance on Mental Illness [2], the Alliance on Mental Illness of New York State, and many local NAMI chapters throughout the state. They were concerned that laws were preventing individuals with serious mental illness from receiving care until after they became "dangerous to self or others". They felt the law should work to prevent violence, not require it. They viewed outpatient commitment as a less expensive, less restrictive more humane alternative to inpatient commitment.

The members of NAMI, working with NYS Assemblywoman Elizabeth Connelly, NYC Department of Mental Health Commissioner, Dr. Luis Marcos, and Dr. Howard Telson were successful in getting a pilot outpatient commitment program started at Bellevue Hospital.

Background

In 1999, there was a series of incidents involving individuals with untreated mental illness becoming violent. In two similar assaults in the New York City subway a man diagnosed with schizophrenia pushed a person into the path of an oncoming train. Andrew Goldstein, age 29, while off medicines, pushed Kendra Webdale to her death in front of an oncoming NYC subway train. The law is named after her. Her family played a significant role in getting it passed. Subsequently Julio Perez, age 43, pushed Edgar Rivera onto the subway tracks. He lost his legs and became a strong supporter of the law. Both men had been dismissed by psychiatric facilities with little or no medication. Kendra's Law, introduced by Governor George E. Pataki, was created as a response to these incidents. In 2005, the law was extended for 5 years.

As a result of these incidents, involuntary outpatient commitment moved from being a program to help the mentally ill to a program that could increase public safety. Public safety advocates joined advocates for the mentally ill in trying to take the successful Bellevue Pilot Program statewide. What was formerly known as involuntary outpatient commitment, was re-christened as assisted outpatient treatment, in an attempt to communicate the positive intent of the law.

Criteria

Kendra's Law basically allows courts to order certain seriously mentally ill individuals to accept treatment as a condition for living in the community. The law is aimed to help a small group who have a history of rehospitalization that is associated with going off medications because they have horrible side effects.

In order to be admitted to Kendra's Law individuals must meet the following criteria established in Section 9.60 of NYS Mental Health Law:

Criteria for assisted outpatient treatment. A patient may be ordered to obtain assisted outpatient treatment if the court finds that:

• the patient is eighteen years of age or older; and
• the patient is suffering from a mental illness; and
• the patient is unlikely to survive safely in the community without supervision, based on a clinical determination; and
• the patient has a history of lack of compliance with treatment for mental illness that has:

1. at least twice within the last thirty-six months been a significant factor in necessitating hospitalization in a hospital, or receipt of services in a forensic or other mental health unit of a correctional facility or a local correctional facility, not including any period during which the person was hospitalized or incarcerated immediately preceding the filing of the petition or;
2. resulted in one or more acts of serious violent behavior toward self or others or threats of, or attempts at, serious physical harm to self or others within the last forty-eight months, not including any period in which the person was hospitalized or incarcerated immediately preceding the filing of the petition; and

• the patient is, as a result of his or her mental illness or hatred of miserable drug side effects, unlikely to voluntarily participate in the recommended treatment pursuant to the treatment plan; and
• in view of the patient's treatment history and current behavior, the patient is in need of assisted outpatient treatment in order to prevent a relapse or deterioration which would be likely to result in serious harm to the patient or others as defined in section 9.01 of this article; and
• it is likely that the patient will benefit from assisted outpatient treatment; and
• if the patient has executed a health care proxy as defined in article 29-C of the public health law, that any directions included in such proxy shall be taken into account by the court in determining the written treatment plan.

According to the Treatment Advocacy Center (treatmentadvocacycenter.org) all the following organizations support the law:

   National

• Treatment Advocacy Center (TAC)
• American Psychiatric Nurses Association
• American Psychiatric Association
• National Alliance for the Mentally Ill (NAMI)
• National Sheriffs Association
• National Crime Prevention Council

   Statewide

• National Alliance on Mental Illness New York State (NAMI NYS)
• NYS Association of Chiefs of Police (NYSCOP)

   Regional/local

• AMI-Friends of NYS Psychiatric Institute, NYC
• NAMI/Familya of Rockland County
• NAMI Schenectady
• NAMI Chataqua County
• NAMI of Buffalo and Erie County
• NAMI of NYC/Staten Island
• NAMI Orange County
• NAMI Champlain Valley
• Harlem Alliance for the Mentally Ill
• NAMI of Montgomery, Fulton, Hamilton Counties
• NAMI/Albany Relatives
• NAMI North Country
• Albany County Forensic Task Force
• Westchester County Chiefs of Police Association
• Orange County Police Chiefs Association
• Town of New Windsor, Police Department
• Town of Chester, NY Police Department
• Town of Mechanicville, Police Department
• West Seneca, NY Police Department
• Broome County District Attorney,

   Selected individual supporters

• Pat Webdale – Mother of Kendra Webdale
• Dr. E. Fuller Torrey – Author, Surviving Schizophrenia
• Dr. Xavier Amador – Author, I am Not Sick, I Don't Need Help!
• Rael Jean Isaac – Co-author Madness in the Streets
• Pete Early – Author, Crazy: A Father's Search Through America’s Mental Health Madness
• Dr. Robert Yolken – Director of Developmental Neurovirology Johns Hopkins Univ.
• Dr. Richard Lamb – Dept. of Psychiatry, USC
• Edgar Rivera – Lost legs in subway pushing

Opposition

Kendra's Law is opposed for different reasons by many groups, most notably the Anti-Psychiatry movement and the New York Civil Liberties Union. Opponents say that the law has harmed the mental health system, because it can scare patients away from seeking treatment.[3] The implementation of the law is also criticized as being racially and socioeconomically biased.[

Studies

As a result of the opposition to Kendra's Law, two studies were conducted on Kendra's Law. One was released in 2005[ and one in 2009.

The 2005 study found:

Specifically, the Office of Mental Health (OMH) study found that for those in the Assisted Outpatient Treatment (AOT) program:

• 74 percent fewer recipients experienced homelessness;
• 77 percent fewer recipients experienced psychiatric hospitalization;
• 83 percent fewer recipients experienced arrest; and
• 87 percent fewer recipients experienced incarceration.

Comparing the experience of AOT recipients over the first six months of AOT to the same period immediately prior to AOT, the OMH study found:

• 55 percent fewer recipients engaged in suicide attempts or physical harm to self;
• 49 percent fewer recipients abused alcohol;
• 48 percent fewer recipients abused drugs;
• 47 percent fewer recipients physically harmed others;
• 46 percent fewer recipients damaged or destroyed property; and
• 43 percent fewer recipients threatened physical harm to others.

As a component of the OMH study, researchers with the New York State Psychiatric Institute and Columbia University conducted face-to-face interviews with 76 AOT recipients to assess their opinions about the program and its impact on their quality of life. The interviews showed that after receiving treatment, AOT recipients overwhelmingly endorsed the program:

• 75 percent reported that AOT helped them gain control over their lives;
• 81 percent said that AOT helped them to get and stay well; and
• 90 percent said AOT made them more likely to keep appointments and take medication.

Additionally, 87 percent said they were confident in their case manager's ability to help them—and 88 percent said that they and their case manager agreed on what is important for them to work on. AOT had a positive effect on the therapeutic alliance.

In 2009, an independent study by Duke University into alleged racism found "no evidence that the AOT Program is disproportionately selecting African Americans for court orders, nor is there evidence of a disproportionate effect on other minority populations. Our interviews with key stakeholders across the state corroborate these findings."

 Current status

Kendra's Law is set to expire in June 2015 unless it is renewed.

Current status[edit]

On January 15, 2013, New York Governor Andrew Cuomo signed into law a new measure that extends Kendra's Law through 2017.

The Treatment Advocacy Center (TAC)

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

 

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 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 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 for research into bipolar disorder and schizophrenia in the United States.[2] 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.

♦ 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

♦ 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.

♦ Education of policymakers and judges regarding the nature of severe mental illnesses, advanced treatments available for those illnesses, and the necessity of court-ordered treatment for those who meet strict legal criteria

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

♦ Support for the development of innovative treatments 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.

 

 

Edwin Fuller Torrey

 

 

Edwin Fuller Torrey, M.D. (born September 6, 1937, Utica, New York), is an American psychiatrist and schizophrenia researcher. He is executive director of the Stanley Medical Research Institute (SMRI) and founder of the Treatment Advocacy Center (TAC), a nonprofit organization with the goals of eliminating legal and clinical obstacles to the treatment of severe mental illness.

 

 

Dr. Torrey has conducted numerous research studies, particularly on possible infectious causes of schizophrenia. He has become well known as an advocate of the idea that severe mental illness is due to biological factors and not social factors. He has appeared on national radio and television outlets and written for many newspapers. He has received two Commendation Medals by the U.S. Public Health Service and numerous other awards and tributes. He has been criticized by a range of people, including federal researchers and others for some of his attacks on de-institutionalization and his support for forced medication as a method of treatment. He has also been described as having a black-and-white view of mental illness and as being iconoclastic, dogmatic, single-minded and a renegade.[4

Torrey is on the board of the Treatment Advocacy Center (TAC), which describes itself as being "a national nonprofit advocacy organization.  TAC supports involuntary treatment when deemed appropriate by a judge (at the urging of the person's psychiatrist and family members). Torrey has written several best-selling books on mental illness, including Surviving Schizophrenia

 

Education and early career

Torrey earned his bachelor's degree, magna cum laude, from Princeton University, and his medical doctor's degree from the McGill University School of Medicine. Torrey also earned a master's degree in anthropology from Stanford University, and was trained in psychiatry at Stanford University School of Medicine. At McGill and later at Stanford, he was exposed to a biological approach and recalls that one of his first-year instructors at McGill was Heinz Lehmann, the first clinician in North America to use the first antipsychotic, chlorpromazine. The medical school was housed next door to the Montreal Neurological Institute, a premier neuroscience center.

Torrey then practiced general medicine in Ethiopia for two years as a Peace Corps physician and in the South Bronx. From 1970 to 1975, he was a special administrative assistant to the NIMH director. He then worked for year in Alaska in the Indian Health Service. He then became a ward physician at St. Elizabeth’s Hospital for the mentally ill in Washington, D.C.[3] for nine years, where he reportedly worked with the most challenging patients and aimed to avoid the use of seclusion or restraints on the acute admission units.  He also volunteered at Washington homeless clinics.

 Stanley Medical Research Institute

Torrey is the founder and Executive Director of the Stanley Medical Research Institute (SMRI), a large, private provider of research on schizophrenia and bipolar disorder in the US. SMRI also maintains a collection of postmortem brain tissue from individuals with schizophrenia, bipolar disorder, and major depression and from unaffected controls, which are made available to researchers without charge.

After reading Torrey's book "Surviving Schizophrenia," Theodore Stanley, a businessman who had made a fortune in direct-mail marketing and whose son had been diagnosed in the late 1980s with bipolar disorder, contacted Torrey and he and his wife provided the funds for the new institute.

As of 2004 the Stanley Institute had 30 employees and funded half of all U.S. research on bipolar disorder and about a quarter of all schizophrenia research. In 2003 the institute's rapidly growing research budget exceeded $40 million, 74 percent of which was given out to other researchers through grants.  It reports that 75% of its expenditure goes towards the development of new treatments.

The Stanley Medical Institute in Bethesda Maryland has collected in excess of 600 brains PDF In ARCH GEN PSYCHIATRY/VOL 61, NOV 2004, in a report called, "Brain Anatomy in Adults With Velocardiofacial Syndrome With and Without Schizophrenia", SMRI published results of a Structural Magnetic Resonance Imaging Study showing difference in brain structure of people with and without schizophrenia.

The SMRI has been sued for allegedly taking brains for use in research without proper consent. One lawsuit was settled out of court.

As of 2008 SMRI was also supporting the Stanley Center for Psychiatric Research at the Broad Institute, which plans to scan the entire genome for variants that predispose to schizophrenia and bipolar disorder, and screen hundreds of thousands of compounds against new molecular targets prior to clinical testing.

SMRI reports that it has a close relationship with and is the supporting organization for the Treatment Advocacy Center (TAC).

 Treatment Advocacy Center

Torrey is a founder of the Treatment Advocacy Center, a national organization that supports outpatient commitment for certain people with mental illness who, in his view of their treatment history and present circumstances, are judged unlikely to survive safely in the community without supervision. TAC has been credited by New York State Attorney General Eliot Spitzer and others with helping pass Kendra's Law in the state. Kendra's Law allows court-ordered involuntary treatment of people diagnosed with schizophrenia or other severe mental illness who have a history of noncompliance with psychiatric advice, i.e., individuals who are, "as a result of his or her mental illness, unlikely to voluntarily participate in the recommended treatment pursuant to the treatment plan."  Previously, only inpatient programs were available to submit a person to involuntary treatment. TAC's efforts to pass Kendra's Law led to similar successful passage of Laura's Law in California, and similar laws in Florida and elsewhere. Torrey has testified numerous times in front of Congress.

National Alliance on Mental Illness

Torrey was for many years an active advisor for the National Alliance on Mental Illness (NAMI). Parents felt that he spoke up for them when much of the medical establishment had previously held that parenting was responsible for schizophrenia. Torrey helped build NAMI into a powerful political force through campaigning and donating the hardcover royalties from the sale of his book "Surviving Schizophrenia".

Although Torrey, TAC, and NAMI remain aligned, NAMI may have tried to distance itself from TAC in 1998. One source The Psychiatric Times, reported that TAC was designed from the start to be "a separate support organization with its own source of funding." According to MindFreedom International, an association of survivors of psychiatric treatment opposed to involuntary treatment, NAMI severed its relationship with TAC because of pressure from groups opposed to Torrey both from within NAMI and outside NAMI. Torrey is, according to MindFreedom, one of 'the most feverishly pro-force psychiatrists in the world'. MindFreedom suggests that the 'links between NAMI and TAC are simply going from overt to covert.'

In 2002, NAMI's Executive Director issued a statement highly critical of 60 Minutes for producing a piece entitled "Dr. Torrey's War." In the statement, NAMI alternately criticized and backed various positions espoused by Torrey while aiming its criticism at 60 Minutes for what NAMI called "sound bite journalism." .

Torrey was also the keynote speaker at the 23rd annual NAMI convention in 2002.

In 2005, NAMI gave Dr. Torrey a tribute on its 25th Anniversary Celebratory Donor Wall, for those who have donated over $25,000. It called him a groundbreaking researcher, a ferociously resolute advocate, a prominent and admired author of dozens of books and a dedicated practicing clinician, and said that he had "touched the lives of countless NAMI members throughout this nation."

NAMI has some continuing links to TAC via their board of directors. One individual, Frederick Frese, is presently on both the NAMI and TAC boards. TAC has two other former NAMI board members on their board and Laurie Flynn, the former NAMI executive director, is part of the TAC Honorary Advisory Committee.

In 2008, Torrey disagreed with a NAMI view on second-generation antipsychotics and accused the medical director and executive director of failing to disclose conflicts of interest, because they are employees of an organization that receives more than half its budget from pharmaceutical companies. He argued they were not representing the views of many members of NAMI including himself.

 Scientific research and views

In the 1950s, it was commonly thought that schizophrenia was caused by 'bad parenting'. Torrey has argued that this theory had a toxic effect on parents. His sister had severe schizophrenia and spent most of five decades in hospitals and nursing homes until her death.

Torrey has been a fierce opponent of the influence of Freud and psychoanalysis. He has also argued that psychiatry should focus only on severe mental illness, conceived as neurological disorders, rather than other mental issues that he viewed as non-medical.

Torrey was principal investigator of a NIMH Schizophrenia/Bipolar Disorder Twin Study conducted at the Neuroscience center of St Elizabeth's Hospital in the late 1980s/early 1990s, and copublished more than a dozen studies on structural brain differences between affected and unaffected siblings. He differed from his collaborators in arguing that the genetic heritability of schizophrenia was lower than typically estimated.  A review of Torrey's data analysis, however, suggested he had erroneously compared different sorts of concordance statistics.

In the early 1970s, Torrey became interested in viral infections as possible causes of schizophrenia or bipolar disorder, particularly a parasite Toxoplasma gondii whose definitive host is the cat, but whose intermediate host can be any mammal, including humans.  Up to one third of the world's human population is estimated to carry a Toxoplasma infection.[12] Since then he has published, often with Robert Yolken, more than 30 articles on seasonal variation and possible infectious causes of schizophrenia, focusing especially on Toxoplasma gondii. He is involved in five or six ongoing studies using anti-Toxoplasmosa gondii agents (e.g. antibiotics such as minocycline and azithromycin[14][15]) as an add-on treatment for schizophrenia. He believes that infectious causes will eventually explain the "vast majority" of schizophrenia cases.  Some of his collaborators have disagreed with the emphasis he has placed on infection as a direct causal factor.  Many of the research studies on links between schizophrenia and Toxoplasma gondii, by different authors in different countries, are funded and supported by the Stanley Medical Research Institute. The hypothesis is not prominent in current mainstream scientific views on the causes of schizophrenia, although infections may be seen as one possible risk factor that could lead to vulnerabilities in early neurodevelopment in some cases.

Torrey has generally been in favor of antipsychotic drugs. He has claimed that taking antipsychotics reduces the risk of violence, homelessness and prison. He has argued that "noncompliance" in about half of cases of schizophrenia and bipolar disorder is due to lack of "insight" into the illness because the part of the brain for self-awareness has been affected; and that in some who are aware it is due to adverse effects ranging from tremors or sedation to sexual dysfunction to substantial weight gain.  He has also reported that at least some antipsychotics cause medical conditions in some people that can be fatal, especially African Americans.  He has also argued that pharmaceutical companies have too much influence over psychiatric organizations and psychiatrists, effectively buying them off.[1

Torrey has advocated in favor of a flexible well-funded range of community mental health services, including Assertive Community Treatment, clubhouses (staffed by professionals with consumers as members), supported housing and supported employment, emphasizing illness and medication compliance throughout.

 Recognition

Dr. Torrey has appeared on national radio and television (outlets like NPR, Oprah, 20/20, 60 Minutes, and Dateline) and has written for many newspapers. He has received a 1984 Special Families Award from NAMI, two Commendation Medals from the U.S. Public Health Service, a 1991 National Caring Award, and a humanitarian award from NARSAD (now known as the Brain & Behavior Research Foundation). In 1999, he received a research award from the International Congress of Schizophrenia. In 2005, a tribute to Torrey was included in NAMI's 25th Anniversary Celebratory Donor Wall.