An Educated Consumer
Broadcast starting week of January 30, 2008

Right now in the United States, tens of millions of Americans live as part of a minority group that is routinely denied jobs, housing and basic human rights. This group has no widely recognized leaders, no Martin Luther King, Susan B. Anthony or Cesar Chavez. For the 44 million Americans living with mental illness, change is coming through the efforts of unsung heroes and revolutionary, grass-roots approaches to transformation. Dr. Peter Kramer's guests include Moe Armstrong, who has schizophrenia and who talks about his experiences with the mental health system in the 1960s. We’ll speak with Larry Fricks, who has bipolar disorder and who started a movement of people in recovery from mental illness. He now directs consumer relations and recovery for the state of Georgia. And we visit an innovative peer specialist program in Georgia, where people who’ve experienced mental illness are employed to help others in their recovery. We’ll talk with Duke University researcher, Dr. Eric Elbogen, who studies psychiatric advance directives that allow people to give doctors instructions and plan for their own treatment. And we’ll hear an excerpt from Charles Barber’s memoir, Songs from the Black Chair, in which he struggles as a social worker about whether to divulge his own experience with obsessive compulsive disorder. We also speak with Cynthia Folcarelli, executive vice president of the National Mental Health Association and Charles Konigsberg, director of the Campaign for Mental Health Reform. Plus commentary from John Hockenberry.

Dr. Peter Kramer begins with an essay tracing the roots of the mental health movement from the psychiatric hospitals of the 1950s to today’s innovative peer counseling and mutual support programs.

We then travel to Georgia, where reporter Susanna Capelouto gives us a glimpse of the Georgia Certified Peer Specialist Program in action. It is a federally-funded program in which people with a history of mental illness are employed helping others in their recovery, and functions as an integrated part of the state’s mental health system.

For an in-depth discussion about how successful more compassionate mental health care and peer support are from a medical perspective, Dr. Peter Kramer interviews Larry Fricks and Dr. Larry Davidson. Larry Fricks is Director of the Consumer Relations and Recovery Section of the Georgia Division of Mental Health, Developmental Disabilities and Addictive Diseases. He is a founder of the Georgia Mental Health Consumer Network, Inc. which now has some 3,000 members, and a founder of Georgia’s Peer Specialist Training and Certification.

Fricks explains how the support of peers helped him learn to live with bipolar illness, and describes how a trained workforce of people with mental illness can improve the outcome for the entire mental health care system.

Dr. Larry Davidson is an associate professor and director of the Yale Program for Recovery and Community Health and Senior Clinical Officer and Mental Health Policy Director Connecticut Department of Mental Health and Addiction Services.

His research about the impact of peer support programs, and other programs that encourage self-determination, indicates the strategies result in people seeking out ongoing mental health care treatment who usually drift out of the system.

Next the Infinite Mind’s Jennifer Ehrlich interviews writer and social worker, Charles Barber. His memoir, Songs from the Black Chair, details his own experiences living with obsessive compulsive disorder and how it affects his work counseling homeless people in New York City. Barber is an associate of the Yale Program on Recovery and Community Health.

We then hear from Moe Armstrong, who shares his story of becoming one of the first people with schizophrenia to work as a mental health professional. He is now Director of Consumer Affairs of the Cambridge, MA-based Vinfen Corporation’s Division of Psychiatric Rehabilitation. We hear his powerful first person account of his psychiatric break during the Vietnam War, followed by homelessness, alcoholism, drug addiction and institutionalization. We hear of how he learned to live with mental illness, earned two master’s degrees and now makes his living training others in becoming peer specialists. Click here to learn more about Moe Armstrong’s peer educators training programs and history.

Dr. Peter Kramer then explores whether the voices of people with mental illness are also being heard in the halls of government. And how much farther is there to go? We hear from two strong advocates for mental health services. Charles Konigsberg is director of the Campaign for Mental Health Reform, a coalition of 16 organizations lobbying in Washington for adequate funding of mental health services. Cynthia Folcarelli is Executive Vice President of the National Mental Health Association. She’s a longtime advocate of improving federal and state policies and service systems as well as a mental health consumer herself.

This segment explores the discrimination and stigma about mental illness that continues to marginalize people with mental illness and thwart making the best medical practices actual policy. They describe people with mental illness as a minority group that has yet to achieve its rights, comparing the struggle to the civil and human rights movements. Konigsberg and Folcarelli describe the greatest legislative challenge as securing funding to implement necessary programs in an atmosphere where the Congress is considering cutting $10 billion of dollars federal Medicaid, the largest source of funding for mental health care.

Next, we report about Psychiatric Advance Directives, legal documents that enable people with mental illness instruct doctors about their medical care in the event of a psychotic episode. Although 21 states have approved the directives, the laws governing them are still in flux. Some doctors worry they mean more paperwork for an overburdened system, or that patients will give instructions that conflict with the assessment of doctors in an emergency setting.

Dr. Peter Kramer interviews Dr. Eric Elbogen who is part of a research team at Duke University studying the impact of Psychiatric Advance Directives. He’s a forensic psychologist and assistant professor at Duke University’s Department of Psychiatry and Behavioral Sciences. His team’s research indicates that people with mental illness include critical information in psychiatric directives, such as prior medical history and crisis symptoms, that would aid doctors in administering the best emergency care. Dr. Elbogen also surveyed doctors, and found a general support of the directives, in principle, but a widespread (and unfounded- according to the Duke study) fear that patients would use the documents to refuse all psychiatric medication.

Click here for a do-it-yourself Psychiatric Advance Directive kit.

And commentator John Hockenberry, who describes the perils of passivity when making health care decisions.

 

Heard this week on The Infinite Mind:

Back to the LCMedia home page.