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{{Short description|U.S. non-profit organization}}
The '''Treatment Advocacy Center''' (TAC) is a ] nonprofit organization dedicated to promoting laws allowing 6 month intensive and court-ordered outpatient treatment for individuals diagnosed with severe ]es who are judged likely to become violent if they don't receive the court-ordered treatment. According to their website, TAC advocates "elimination of legal and clinical barriers to timely and humane treatment for Americans diagnosed with severe ] disorders who refuse care." Founded in ] by ] researcher ] and other family members of people with mental illness and people with mental illness, TAC seeks to expedite involuntary treatment for people with serious mental illness who do not consent to treatment.
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The '''Treatment Advocacy Center''' ('''TAC''') is a U.S. non-profit organization based in Arlington, Virginia, originally announced as the NAMI Treatment Action Centre in 1997.<ref>{{cite web |url=https://www.nami.org/Press-Media/Press-Releases/1997/Legal-Advocacy-Project-Established-to-End-Barriers|title=Legal Advocacy Project Established to End Barriers to Care for Millions &#124; NAMI: National Alliance on Mental Illness}}</ref><ref>{{cite web |title=DJ Jaffe Article |url=http://www.schizophrenia.com/newsletter/1197/1197namitac.htm |website=www.schizophrenia.com }}</ref> The TAC was subsequently directed by psychiatrist ] and identifies its mission as "dedicated to eliminating barriers to the timely and effective treatment of severe mental illness".<ref>{{cite web |title=Treatment Advocacy Center |url=https://www.treatmentadvocacycenter.org/about-us |accessdate=14 April 2019}}</ref> The organization is most well-known for proposed laws, policies, and practices regarding legally compelled outpatient services or ] for people diagnosed with mental illness (also known as assisted outpatient treatment, AOT<ref>{{Cite news|url=https://www.health.harvard.edu/newsletter_article/Involuntary_outpatient_commitment|title=Involuntary outpatient commitment - Harvard Health|last=Publications|first=Harvard Health|work=Harvard Health|access-date=2017-08-13|language=en-US}}</ref>). The organization identifies its other key issues as "anosognosia, consequences of non-treatment, criminalization of mental illness, psychiatric bed shortages, public service costs, violence and mental illness".<ref>{{Cite web|url=https://www.treatmentadvocacycenter.org/key-issues|title = Key Issues}}</ref> Advocates for mental health have criticized TAC for endorsing coercion and forced treatment.
Current federal and state policies, according to TAC, hinder treatment for individuals with mental illness who are most at risk for ]ness, arrest, violence, hospitalization or ]. TAC statistics show 40 percent of the 4.5 million individuals with schizophrenia and manic-depressive illness (bipolar disorder), an estimated 1.8 million people, are not being treated for their illness at any given time.


==History==
==Justifications for involuntary treatment==


Although according to the TAC website, ] founded the Treatment Advocacy Center in 1998 as an offshoot of the ] (NAMI), other sources indicate that the original name was the NAMI Treatment Action Center.<ref>{{cite web |url=https://www.nami.org/Press-Media/Press-Releases/1997/Legal-Advocacy-Project-Established-to-End-Barriers|title=Legal Advocacy Project Established to End Barriers to Care for Millions &#124; NAMI: National Alliance on Mental Illness}}</ref> ], the NAMI director at the time, stated in a press release, "It's a national disgrace that, in this age of remarkable progress in brain research and treatment, so many individuals are left out in the cold".<ref>{{cite web |url=https://www.nami.org/Press-Media/Press-Releases/1997/Legal-Advocacy-Project-Established-to-End-Barriers|title=Legal Advocacy Project Established to End Barriers to Care for Millions &#124; NAMI: National Alliance on Mental Illness}}</ref> TAC received initial financial support from Theodore and Vada Stanley, founders of the Stanley Medical Research Institute; TAC was founded as an affiliate organization with a separate executive director and board. The organization operates with funding from the affiliated Stanley Medical Research Institute, a non-profit organization which provides funding for research into bipolar disorder and schizophrenia in the United States. Torrey is currently a member of the Treatment Advocacy Center's board and is executive director of the Stanley Medical Research Institute. The relationship between Torrey and NAMI seemed to sour according to sources,<ref>{{cite web |url=http://www.peteearley.com/2013/03/18/the-changing-face-of-nami/|title=The Changing Face of NAMI|date=2013-03-18}}</ref> with Torrey being disinvited from NAMI's national convention in 2012 after advocates protested his TAC involvement and promotion of outpatient commitment.
TAC asserts there are three primary reasons assisted treatment is justified:


==Organization==
# ] and ] illness can severely impair an individual’s self-awareness, causing many to believe they are healthy and not in need of medical care (] in medical terminology). TAC's theory is that these patients' conditions impair their brain function, and since they do not think they are sick, many of them do not actively seek treatment and often refuse it.
# ] advocates have changed state laws and practices to such an extent that it is now virtually impossible to treat such individuals unless they first commit a violent act. TAC believes this is a ludicrous and cruel barrier to treatment. Basically the law requires individuals to be well enough to recognize their illness before they can be treated. Otherwise, treatment has to be denied unless patients become violent.
# Public psychiatric services have deteriorated significantly in recent years with the closure of state psychiatric hospitals. While these much needed hospital beds have been eliminated, there has been no increase in outpatient services. In addition, the failure of for-profit managed care companies to provide services to these individuals who need them most has only further exacerbated the situation.


=== Areas of focus ===
==Activism==
The Treatment Advocacy Center activities and projects include:


* Developed a template law for legally mandated outpatient mental health treatment. Released in 2000, the draft text is meant as a legal framework for authorizing court-ordered treatment of individuals diagnosed with mental illness who are determined by the court to meet certain legal criteria around dangerousness to self or others or inability to care for oneself due to a mental illness.
The Treatment Advocacy Center is working on the national, state, and local levels to educate civic, legal, ], and legislative communities on the benefits of assisted treatment in an effort to decrease homelessness, jailings, suicide, violence and other devastating consequences alleged to be caused by lack of treatment.
* Research and study into public policy and other issues related specific to serious mental illness.
* Education of policymakers and judges regarding TAC's viewpoint on serious mental illness; TAC's opinion is that more legally mandated treatment and increases in hospital beds will improve care.


=== Funding ===
Principle areas of activism include:
Donors to the Treatment Advocacy Center include ] and ].<ref>{{Cite web |last1=Dailey |first1=Lisa |last2=Torrey |first2=E. Fuller |last3=Knable |first3=Michael |title=2020 Impact Report |url=https://www.treatmentadvocacycenter.org/storage/documents/annual_report_2020.pdf |url-status=live |archive-url=https://web.archive.org/web/20230405102419/https://www.treatmentadvocacycenter.org/storage/documents/annual_report_2020.pdf |archive-date=2023-04-05 |access-date=2023-09-09 |website=Treatment Advocacy Center}}</ref><ref>{{Cite web |last1=Dailey |first1=Lisa |last2=Knable |first2=Michael |last3=Torrey |first3=E. Fuller |title=2021 Annual Report |url=https://www.treatmentadvocacycenter.org/storage/AnnualReport2021.pdf |url-status=live |archive-url=https://web.archive.org/web/20230405152338/https://www.treatmentadvocacycenter.org/storage/AnnualReport2021.pdf |archive-date=2023-04-05 |access-date=2023-09-09 |website=Treatment Advocacy Center}}</ref>
* Education of policymakers and judges regarding the nature of severe mental illnesses, advanced treatments available for those illnesses, and the option of community ordered treatment in some cases;
* Assisting individuals in states working to promote laws that enable individuals with the most severe mental illnesses to receive assisted treatment;
* Promoting innovative approaches to diverting the psychiatrically ill away from the criminal justice system and into psychiatric treatment; and
* Insisting that individuals receive involuntary psychiatric services and maintain medication compliance upon release from hospitals.


==Beginnings== ==Controversy==
TAC's major focus on legally mandated treatment is opposed by other advocacy groups. The ] in a statement on forced treatment states "not only is forced treatment a serious rights violation, it is counterproductive. Fear of being deprived of autonomy discourages people from seeking care. Coercion undermines therapeutic relationships and long-term treatment."<ref>{{Cite web|url=http://www.bazelon.org/our-work/mental-health-systems/forced-treatment/|title=Forced Treatment|date=2017-07-18|website=Bazelon Center for Mental Health Law|access-date=2019-04-15}}</ref> Daniel Fischer, founder of National Coalition for Mental Health Recovery, described outpatient commitment as "a slippery slope" back to the kind of mass institutionalization seen in the 1940s and '50s".<ref>{{cite web |title=Should Mentally Ill People Be Forced Into Treatment? |url=https://time.com/3716426/mental-illness-treatment-cost/ |website=Time Magazine |date=20 February 2015 |access-date=18 April 2019}}</ref>

For many years, individuals with mental illness and their families advocated for assisted ] for people with severe mental illnesses who disagree with their psychiatric care providers. In these individuals, the organ that provides awareness (the brain) is unable to provide its regulatory function. Instead, it generates hallucinations, delusions, paranoia. Severely mentally ill individuals may not know they are sick or may not want treatment even if they are aware that they are ill. Current policy in some jurisdictions requires these individuals who lack awareness of their illness to become a "danger to self or others" before they can be treated. As a result, in a direct vote by the membership of the National Alliance for Mental Illness (the largest consumer/family organization in the country, backed in large part by the pharmaceutical manufacturing industry), the membership adopted a policy on how laws could better enable psychiatrists to force-treat individuals.

The many experiences of NAMI consumers and their families left them profoundly distressed by the increase in episodes of ] associated with treatment refusal. These advocates concluded that what was needed was a concerted effort to address state treatment laws that prevent the treatment of people with severe mental illnesses, before they commit acts of violence on others or themselves. Mr. and Mrs. Theodore Stanley, generous supporters of research on schizophrenia and bipolar disorder, shared the advocates concerns and agreed to partially support a modest effort to improve the treatment system - which soon emerged as the Treatment Advocacy Center. Originally founded as part of NAMI, it was later spun off as an independent organization with many members of the NAMI board serving on the TAC board.

TAC is now supported by a host of additional individual donors and grants, and does not accept funding from pharmaceutical companies or entities involved in the sale, marketing or distribution of their products.

As Torrey says, "Until we find the causes and definitive treatments for schizophrenia and bipolar disorder, we have an obligation to those who are suffering to try to improve their lives. Except for biological chance, any one of us might today be there, living on the streets or in jail. TAC is the only organization willing to take on this fight, and I am very proud to be part of it."

The Treatment Advocacy Center has support from the ] of the political spectrum, who believe enacting TAC policies will reduce violence, and support from the ], who want to offer better care for individuals with mental illness. For example, the Treatment Advocacy Center sponsored Kendra's Law in New York had support from the right wing New York Post and Daily News, and the left wing New York Times, Newsday, and Albany Times Union. It had support from public safety groups like the Attorney General, and advocates for individuals with mental illness like NAMI, NYS Department of Mental Health, and others.

==The case for involuntary treatment of psychiatric outpatients==

"People care about public safety," TAC publicist D.J. Jaffee told attendees at a ] ] (NAMI) conference. "Once you understand that, it means that you have to take the debate out of the mental health arena and put it in the criminal justice/public safety arena." Jaffe went on to point out that efforts by NAMI to enact assisted treatment laws as a way to provide better care for the mentally ill had failed because the public doesn't care about the seriously ill. He said that when the media does focus on mental illness (e.g., following an act of violence), it provides an opportunity to communicate policies which can simultaneously help individuals with mental illness and protect the public.

"] is a cruel disease. The lives of those affected are often chronicles of constricted experiences, muted emotions, missed opportunities, unfulfilled expectations. It leads to a twilight existence, a twentieth-century underground man... It is in fact the single biggest blemish on the face of contemporary American medicine and social services; when the social history of our era is written, the plight of persons with schizophrenia will be recorded as having been a national scandal." E. Fuller Torrey, ''Surviving Schizophrenia''

At a ] meeting in Baltimore in ], Torrey, expressed his concern that "the public stereotype that links mental illness to violence is based on reality and not merely on stigma."

==Criticism==

The Treatment Advocacy Center has critics due to the profound human rights implications of coerced or forced drugging. Psychiatric drugs, particularly neuroleptics, are disabling and many have long term negative (sometimes fatal) effects and for these reasons, among others, many patients refuse to take them. Advocates for the mentally ill point out it is stigmatizing (and dishonest) to portray the mentally ill as violent. Advocates accuse TAC of falsifying data to paint a picture of the violent lunatic in order to garner support for their draconian involuntary treatment scheme. There is no reliable method to predict violence, nor is there a reliable, objective method of diagnosing mental illness. Some religions disapprove all treatment for mental illness (other than that offered by the religion).

Critics believe that TAC uses fear tactics to win support for assisted outpatient treatment.. When it is reported that someone with a psychiatric label commits or becomes the victim of a violent crime, TAC posts particulars on their website.


==See also== ==See also==


* ] * ]
* ] * ]
* ] * ]
* ] * ]
* ] * ]

==References==
{{Reflist}}


==External links== ==External links==
*
* TACReports.org


{{authority control}}
* - 'The Treatment Advocacy Center is a national nonprofit organization working to eliminate barriers to timely treatment of severe mental illness' (TAC homepage)
:* - 'Criminalization of Americans with Severe Mental Illness', Treatment Advocacy Center
:* - 'Consequences of Non-Treatment', Treatment Advocacy Center
* - 'Treatment Advocacy Center' (TAC's official blog)
* - ']: New Year Brings New Hope for Mentally Ill: Governor Granholm signs legislation improving Michigan’s mental health treatment law'
* - '] Failure to Research Severe Mental Illnesses Both Federal Disgrace and Personal Tragedy', E. Fuller Torrey, M.D., ]
* - 'Treatment Advocacy Center Retraction', ], ] (June 6, 2002)
* - 'A Guide to California's AB 1424: Law became effective Jan. 1, 2002', Carla Jacobs, Randall Hagar, Chuck Sosebee
* - 'Stigmatizing Fear Tactics', ] (February 17, 2002)


] ]
]
] ]
]
]

Latest revision as of 11:49, 17 November 2024

U.S. non-profit organization
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The Treatment Advocacy Center (TAC) is a U.S. non-profit organization based in Arlington, Virginia, originally announced as the NAMI Treatment Action Centre in 1997. The TAC was subsequently directed by psychiatrist E. Fuller Torrey and identifies its mission as "dedicated to eliminating barriers to the timely and effective treatment of severe mental illness". The organization is most well-known for proposed laws, policies, and practices regarding legally compelled outpatient services or outpatient commitment for people diagnosed with mental illness (also known as assisted outpatient treatment, AOT). The organization identifies its other key issues as "anosognosia, consequences of non-treatment, criminalization of mental illness, psychiatric bed shortages, public service costs, violence and mental illness". Advocates for mental health have criticized TAC for endorsing coercion and forced treatment.

History

Although according to the TAC website, E. Fuller Torrey founded the Treatment Advocacy Center in 1998 as an offshoot of the National Alliance on Mental Illness (NAMI), other sources indicate that the original name was the NAMI Treatment Action Center. Laurie Flynn, the NAMI director at the time, stated in a press release, "It's a national disgrace that, in this age of remarkable progress in brain research and treatment, so many individuals are left out in the cold". TAC received initial financial support from Theodore and Vada Stanley, founders of the Stanley Medical Research Institute; TAC was founded as an affiliate organization with a separate executive director and board. The organization operates with funding from the affiliated Stanley Medical Research Institute, a non-profit organization which provides funding for research into bipolar disorder and schizophrenia in the United States. Torrey is currently a member of the Treatment Advocacy Center's board and is executive director of the Stanley Medical Research Institute. The relationship between Torrey and NAMI seemed to sour according to sources, with Torrey being disinvited from NAMI's national convention in 2012 after advocates protested his TAC involvement and promotion of outpatient commitment.

Organization

Areas of focus

The Treatment Advocacy Center activities and projects include:

  • Developed a template law for legally mandated outpatient mental health treatment. Released in 2000, the draft text is meant as a legal framework for authorizing court-ordered treatment of individuals diagnosed with mental illness who are determined by the court to meet certain legal criteria around dangerousness to self or others or inability to care for oneself due to a mental illness.
  • Research and study into public policy and other issues related specific to serious mental illness.
  • Education of policymakers and judges regarding TAC's viewpoint on serious mental illness; TAC's opinion is that more legally mandated treatment and increases in hospital beds will improve care.

Funding

Donors to the Treatment Advocacy Center include David Baszucki and National Life Group.

Controversy

TAC's major focus on legally mandated treatment is opposed by other advocacy groups. The Bazelon Center for Mental Health Law in a statement on forced treatment states "not only is forced treatment a serious rights violation, it is counterproductive. Fear of being deprived of autonomy discourages people from seeking care. Coercion undermines therapeutic relationships and long-term treatment." Daniel Fischer, founder of National Coalition for Mental Health Recovery, described outpatient commitment as "a slippery slope" back to the kind of mass institutionalization seen in the 1940s and '50s".

See also

References

  1. "Legal Advocacy Project Established to End Barriers to Care for Millions | NAMI: National Alliance on Mental Illness".
  2. "DJ Jaffe Article". www.schizophrenia.com.
  3. "Treatment Advocacy Center". Retrieved 14 April 2019.
  4. Publications, Harvard Health. "Involuntary outpatient commitment - Harvard Health". Harvard Health. Retrieved 2017-08-13.
  5. "Key Issues".
  6. "Legal Advocacy Project Established to End Barriers to Care for Millions | NAMI: National Alliance on Mental Illness".
  7. "Legal Advocacy Project Established to End Barriers to Care for Millions | NAMI: National Alliance on Mental Illness".
  8. "The Changing Face of NAMI". 2013-03-18.
  9. Dailey, Lisa; Torrey, E. Fuller; Knable, Michael. "2020 Impact Report" (PDF). Treatment Advocacy Center. Archived (PDF) from the original on 2023-04-05. Retrieved 2023-09-09.
  10. Dailey, Lisa; Knable, Michael; Torrey, E. Fuller. "2021 Annual Report" (PDF). Treatment Advocacy Center. Archived (PDF) from the original on 2023-04-05. Retrieved 2023-09-09.
  11. "Forced Treatment". Bazelon Center for Mental Health Law. 2017-07-18. Retrieved 2019-04-15.
  12. "Should Mentally Ill People Be Forced Into Treatment?". Time Magazine. 20 February 2015. Retrieved 18 April 2019.

External links

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