David Covington, from Arizona, described the "No Force First" approach to working with people in mental health crisis that eschews the use of restraints and seclusion.
David Covington, from Arizona, described the "No Force First" approach to working with people in mental health crisis that eschews the use of restraints and seclusion. Photo courtesy David Covington, Flickr Creative Commons

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<p>As the “Helping Families in Mental Health Crisis Act” advances in the U.S. House of Representatives, members of the recovery-oriented care community expressed opposition at a statewide conference.

By Taylor Sisk

Advocates for people living with mental health and substance use issues gathered Nov. 11-13 in Clemmons for the seventh annual “One Community in Recovery” conference, with a number of speakers reaffirming their opposition to the federal “Helping Families in Mental Health Crisis Act.”

Logo from the annual N.C. Recovery Conference

The legislation is more commonly known as the “Murphy bill” for its sponsor, Rep. Tim Murphy (R-PA), a psychologist.

“This movement will be set back decades if the Murphy bill passes,” Sharon Young, co-founder of Full Circle Counseling and Wellness in Hendersonville and a member of the conference’s planning committee, told those assembled, expressing a commonly held sentiment among recovery-oriented care advocates.

The bill, HR 2646, passed the U.S. House Energy and Commerce subcommittee earlier this month along largely party lines: Republicans in favor, Democrats against. It now goes to the full committee for a vote.

Opponents object to provisions in the bill they believe would restrict the privacy of people with mental health issues and their freedom to determine their own future. They also believe the bill would deprive people of care that advances recovery.

The recovery-oriented care movement has been gaining momentum in North Carolina and across the country. The theory behind it is that those with behavioral health issues should be helped to find their own paths back to good health, happiness and productivity beyond simply being asymptomatic.

Several state psychiatric hospitals have begun using recovery-based treatment and are finding positive results.

A primary point of contention in the Murphy bill is the funding of incentives for states to implement assisted outpatient treatment initiatives, which allow a court official to order outpatient services as an alternative to institutionalization.

While many advocates believe AOTs provide a level of safety at a critical time, the view of those in the recovery-oriented care movement is that they are coercive and a violation of rights. They contend the money would be better spent on community-based supports and services.

North Carolina is one of 45 states that have AOT laws in effect.

‘Creatively maladjusted’

The recovery conference, held at the Village Inn Event Center near Winston-Salem, brought together behavioral health advocates and providers from throughout the state and beyond.

Oryx Cohen. Photo courtesy National Empowerment Center

Oryx Cohen, acting executive director of the National Empowerment Center in Lawrence, Mass. and co-producer of the documentary Healing Voices, delivered the day-three keynote address.

Cohen has written that he believes the Murphy bill “threatens the recovery and community integration practices that current consumers of mental health services and survivors of coercive psychiatric interventions have worked so hard for over the last 40-plus years to create.”

He takes issue with the bill’s proposal to dismantle the federal Substance Abuse and Mental Health Administration. SAMHSA funds community-based services such as peer-run respite centers and suicide-prevention initiatives.

Cohen also objects to the proposed reduction in funding for, and a ban on lobbying by, Protection and Advocacy for Individuals with Mental Illness programs, which advocate for the rights of individuals with psychiatric diagnoses. Disability Rights North Carolina is the PAIMI for this state and has been active in pushing for better community-based treatment and housing for people with mental health disabilities, among other issues.

Cohen drew a rousing response from his audience, quoting Martin Luther King Jr.: “The salvation of the world lies in the hands of the creatively maladjusted,” adding, “Let us all be creatively maladjusted.”

Mental health is an integral part of the human experience, Cohen said, “and there’s a continuum of mental health” that we’re all situated along “at different points, and even at different points at different times in our lives.”

A movement united

During a Q&A session after Cohen’s address, Sharon Young stressed the urgency of the advocacy community working as one.

She said that, for example, people have taken issue with positions the National Alliance on Mental Illness has taken, saying it’s too “biologically based” in its assessment of the sources of mental health issues, but that there’s a great deal on which most all self- and family advocates agree.

(The national NAMI office supports the Murphy bill. Ann Akland, executive director of NAMI’s Wake County chapter and mother of a child who lives with a serious mental illness, said that while the bill “probably isn’t perfect … it’s a step in the right direction.”)

Young also pointed to friction that sometimes arises even within the recovery movement between mental health and substance-use care advocates.

Mental health advocates sometimes express frustration that their paths to recovery go unacknowledged because the benchmarks along those paths are less discernible than, for example, a given number of days being sober.

“I’m impassioned about this being a civil rights movement,” Young said, “and I’m worried about our movement.”

Civil rights movements are launched, she said, with “righteous anger because civil rights are violated,” but that those movements that survive “transcend the anger.”

“This civil rights movement is too important for us to be fighting over differences,” Young said, “when 90 percent of it is common ground.”

“So I’m challenging us to look within our own community to embrace each other and carry each other’s messages and be change agents together,” she said. “Or else we will not succeed.”

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