Date: Fri, 16 Feb 2001 00:23:36 -0900
From: derobertsjr@gci.net
Reply-To: derobertsjr@gci.net
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To: Jim Gottstein <jimgotts@touchngo.com>,
          "Donald E. Roberts, Jr." <derobertsjr@gci.net>
Subject: Support Coalition International Campaigns

Mental Health Workers Bring
Psychiatric Drugs To Your HOME
To Assure Compliance: Stop PACT!

(return to Forced Drugging)

(return to NAMI's Slush Fund)

A new proposal to Congress may mean daily psychiatric drug deliveries to your doorstep.

Picture this: Every morning, seven days a week a car pulls up in front of your house, as it has every day for years. Inside that car is a locked box of containers with powerful psychiatric drugs. An eager government-paid mental health worker jumps out of the car rings your doorbell and presents you with your daily prescribed psychiatric drugs. You are asked to swallow the pills in front of the worker, and drink water to show that the pills are down. If you swallow, the worker is running off to the next "dose drop." If you refuse, you face repeated visits, cajoling, pressure and in some states even the threat of immediate detention in a locked psychiatric facility.

Does that sound like science fiction? It's already happening in several areas of the USA and some other countries. This technique is part of a program that may soon sweep the whole USA, unless some of these methods are resisted, now.

It's called "Program of Assertive Community Treatment" (PACT). The money for this massive PACT campaign is coming directly from the PSYCHIATRIC DRUG INDUSTRY. The December '99 issue of Mother Jones (page 22) reveals that the psychiatric drug industry has given millions of dollars specifically to the National Alliance for the Mentally Ill's Campaign to End Discrimination. NAMI acknowledges in the article that most if not all of the funding for their NAMI Campaign to End Discrimination comes from the drug industry. In fact, that campaign is exactly where NAMI funnels much of its drug company money. Now, look at any of the key PACT material such as their manual, their web site, their conferences, and you will see that they brag they are funded by the NAMI Campaign to End Discrimination: You do the math: This drug company slush fund of millions is what is fueling this chemical crusade. Click on the photo to the right to see the psychiatric drug industry's vision of the entire USA by the year 2002. Will that be your doostep?

Also see "Is Your State A Double Whammy?"

CLICK HERE to see the psychiatric drug industry's vision of the perfect "mental health system." (approx. 500k)

The drug industry wants this scene to become the national standard by 2002. A "mental health" worker performs a "dose drop" at the door of a subject's home. This sequence is from a PACT training video "Hospital Without Walls."

PACT Packs a Punch

In October 1998, leaders of the National Alliance for the Mentally Ill (NAMI) met with U.S. Congresspeople to announce one of its major campaigns for the next four years. NAMI's proposal is based on something called the Program of Assertive Community Treatment, or PACT, which NAMI says is now used extensively in six states and is being tried out in 19 others. NAMI wants to have the U.S. Congress pass laws so that this "PACT" model will be used throughout every state in the USA by the year 2002, reaching hundreds of thousands of people in their own homes.

What is PACT?

Why is Support Coalition so concerned about PACT? On the surface, PACT (and a similar program known as just ACT) has elements that sound good to some members:

• The stated purpose is to try to keep people living out in the community instead of going into locked psychiatric facilities.
• PACT tends to have a very low client-to-staff ratio of about 10 to 1.
• Staff is available 24 hours a day to bring personal emotional-support services to people in their own homes, on demand, rather than requiring a person to find and use various programs during limited hours, far from home.
• Some PACT staff build close relationships with clients (for example, regularly washing a woman client's hair).
• PACT is an integrated team approach rather than a bunch of fragmented services. Vocational rehabilitation and other community services are included.

But NAMI, which is led by parents of people using the psychiatric system, has a history most Dendron readers already know: While some NAMI members do support human rights, NAMI has collected millions of dollars of donations from the psychiatric drug industry. More than half of NAMI's major corporate donors, according to NAMI's own annual report, are psychiatric drug manufacturers.

As usual, NAMI is using this program as a Trojan Horse: This "wraparound" service, as it's sometimes called, looks pretty on the outside, but inside you can find a lot of "medication militia" hiding out. While PACT programs vary state to state, in many states PACT is actually wrapped around the centerpiece of "medication compliance," raising concerns about human rights violations.

In Canada, "ACT" is currently being promoted in Ontario, and the Support Coalition sponsoring group in Toronto called "People Against Coercive Treatment" (cleverly, it also has the acronym PACT), has already held a protest on October 30, 1998 outside a conference promoting the model. Don Weitz, who helped organize the protest, told Dendron, "We hope resistance to 'ACT' spreads across Ontario damn soon before the right-wing Ontario government passes a 'community treatment order' forced-drugging law this year or next. We have lots of hard work to do to defeat this new wave of psychiatric and government assault on psych survivors, the homeless, and poor people. We're gonna fight this psychiatric fascism masquerading as 'community treatment' and never, never give up!" UK members report the push for "assertive outreach" is on there, too.

Needles on Wheels

Support Coalition has obtained one of the main videotapes promoting PACT, produced by Duke University and based on the PACT in South Carolina. Revealingly, the video is called Hospital Without Walls. This video shows that making sure people "stay on their meds" is a huge part of the PACT model.

The psychiatric drugs typically being used in PACT are not like recreational street drugs. PACT drugs tend to be the super-powerful neuroleptics, such as Haldol, Prolixin, Clozapine, and many other brand names. While some people choose to take neuroleptics, they can kill. In the long run, neuroleptics can cause persistent brain changes, so the person may end up with worse emotional and mental problems than before they started the drugs. Therefore, it can be difficult to quit neuroleptics. Withdrawal can unmask these underlying neuroleptic-induced brain changes, leading to a vicious cycle of more and more psychiatric drugging, for life.

The PACT video shows a person receiving a long-term neuroleptic injection as the narrator says, "Medication can't always prevent a crisis. But it's the cornerstone of stability in the seriously persistent mentally ill, and a primary target of PACT treatment and supervision." Note that word: cornerstone.

A PACT team member supervises people setting up their own "med boxes" for the week. For many of their clients, PACT goes out to homes and personally makes sure they're "on their meds." As the narrator put it: "All staff share in making daily morning and evening medication deliveries for those who need it."

In the video, the music goes up, like it's some kind of exciting police squad hitting the streets. Staff are driving around doing their medication deliveries, sometimes literally running between house and car in the rain to get the job done.

Says one of the workers, particularly dedicated: "We go all over the place. If we feel like they won't take their medication as directed, then we'll be there every day, morning and night. We open the package and watch them swallow it. Some patients are chronically resistant to this, even after years." Chronically resistant is another way to describe someone trying to say "no!"

For some people who don't want psychiatric drugs, PACT staff are on the doorstep every day, sometimes several times a day, for years. Viewers of the video see clients answer their doors with cups of water in their hands. The worker quickly opens the drug box, the person pops the pills while standing in the doorway, swallows some water then the worker dashes off to the next drug delivery, known as a "dose drop."

As one PACT person puts it, "Medication is the key to controlling their symptoms, and that's what we try to teach them." The video shows a 24-year-old African American. The narrator says, "Diagnosed schizophrenic, she will have to take medications for the rest of her life, a fact she did not easily accept."

In the video, Laurie Flynn, director of NAMI, makes an interesting slip of the tongue: "PACT is a real safety net around their relative." Safety nets are supposed to be under people, not around them!

PACT + IOC = DANGER!

A range of techniques from encouragement to court orders are already being used to gain "med compliance" in PACT.

One of the states that says it has a "high adherence" to the PACT model is Rhode Island, which uses "Mobile Treatment Teams." There are now 14 teams there with more than 600 clients. Dendron interviewed Gloria Mazza, who directs the program.

Does her program actually visit some of the clients at home each day to deliver psychiatric drugs? "Yes, said Gloria, "part of our program here can include a daily drop of medications to the person's home, or even a dose drop several times a day. For those clients who receive depot injectables such as Haldol, most are at home when they receive the injection. We have a nurse who visits them for their injection."

What do PACT staff do if the person doesn't answer the door? Mazza explained, "The team will sit down in a meeting and bring in information from everyone -- family, friends, police -- and will come up with a strategy and a plan. Sometimes it involves standing at the door, talking, asking 'Could I come back at a later time, like tomorrow at 10, and we can go out for a cup of coffee?' We do what's needed. It's a continuous-treatment approach. We build relationships." For a "very few" clients, Mazza said, court orders are used to back up this "relationship."

Jerry Anderson, who supervises the Idaho PACT program, confirms that they use "medication deliveries" there, though he told Dendron, "We're more flexible than the original PACT model." He didn't sound real flexible: Idaho's new Involuntary Outpatient Commitment (IOC) law goes into effect in January 1999. Some 36 U.S. states and the District of Columbia now have IOC, allowing courts to order people to stay on psychiatric drugs. Anderson confirmed his PACT will certainly act as the eyes, ears, and enforcement for this court-ordered forced drugging.

Adding up PACT plus IOC can equal a horrible human rights disaster, impacting thousands of people living in their own homes.

NAMI issued a news release in October 1998 announcing their campaign to have Congress mandate PACT nationally. To boost the effort, NAMI has issued a new book, A Manual for PACT Start-Up. A wide variety of techniques to "prompt and supervise" those with "medication adherence problems" are listed.

A Wisconsin activist familiar with PACT, which began in Madison, said clients have described it as "organized stalking." While many of these methods are based on repetitive convincing and cajoling, PACT is also at times directly involved in outright coercion and force. On page 79 the manual explains, "When clients are ordered by the court to take medications or when medication treatment is a condition of probation or parole, the team accepts responsibility for adherence and for reporting back to the legal authority. In these situations, the team usually directly supervises medication taking."

Taxpayers Fund the Drug Industry

Missing from the PACT video and manual is any in-depth discussion of consumer empowerment, consumer-directed services, peer support, promoting alternatives, or advocacy systems. It's as if these concepts had never been invented.

NAMI says PACT is currently used statewide in Delaware, Idaho, Michigan, Rhode Island, Texas, and Wisconsin. An additional 19 states and the District of Columbia are implementing PACT demonstration projects. So half the U.S. states already have some PACT activity. NAMI has asked Congress to pass laws requiring the federal Mental Health Block Grant and Health Care Financing Administration to mandate and fund PACT throughout the USA, throughout every state. NAMI hopes to gain help from a new Congressional Working Group on Mental Health that it is proposing.

One of the biggest barriers to PACT is cost. Neil Meisler, a promoter of the PACT model, notes in a survey of 11 PACT and ACT programs in 1996 that "the mean expenditure per consumer is $6,914 (range, $5,000 to $18,000)." His study shows about 40 percent of P/ACT expenditures are paid for by federal taxpayers through Medicaid. All of this means more money for the drug manufacturers.

PACT has actually been incubating for more than 20 years. A number of psychiatric survivor activists have developed a love/hate relationship with PACT during this time. When PACT is totally voluntary, advocates admire the people-power approach, which reaches out to people in their own homes. But all advocates we've talked to are chilled by the central role of "medication compliance" in many PACTs. If PACT is based on building close, trusting relationships with clients, then also acting as "med police" is an obvious conflict of interest.

NAMI Feels the Heat

By pushing this PACT program, NAMI leaders are showing everyone that they are not giving up on their campaign to make it easier to commit and forcibly treat people. However, NAMI's "Chemical Crusade" has suffered a major setback in 1998. Support Coalition proudly contributed to that setback!

The last issue of Dendron reported that NAMI had announced in November 1997 that they were joining forces with an extreme organization called "Treatment Advocacy Center" (TAC) to create NAMI-TAC. A primary stated purpose of NAMI-TAC was to promote the use of involuntary psychiatric procedures. This "Treatment Advocacy Center," fueled by hundreds of thousands of dollars in donations from the Stanley Foundation, is led by one of the most feverishly pro-force psychiatrists in the world, E. Fuller Torrey. Torrey has a part-time position in the U.S. National Institute of Mental Health (NIMH), which is now working hand-in-hand with Stanley Foundation research projects.

Diverse advocates for human rights in the "mental health system," including Support Coalition, fought back against NAMI and scored a "win." A wide spectrum of advocates, psychiatric survivors, mental health consumers, parents, and organizations created a grassroots uprising uniting people with usually conflicting views. We "convinced" NAMI leaders to distance NAMI from TAC. The day after an especially-tumultuous national conference in July 1998, NAMI's executive director, Laurie Flynn, announced plans to "sever" the relationship between NAMI and TAC.

It's true this "severing" may mean that links between NAMI and TAC are simply going from overt to covert. After all, 1999 marks the 20th year that NAMI has pursued more forced psychiatry, and it is expected to continue to do so. TAC itself has simply dropped the initials "NAMI" from in front of their name and is pushing ahead with plans to make it far easier to force psychiatric procedures and to commit people by changing laws all over the USA.

The Element of Surprise

However, this severing is still an important victory. Quite a few members and nonmembers of NAMI worked together on the effort to split up NAMI-TAC. Inside NAMI, the "Consumer Council" and state affiliate leaders officially criticized NAMI-TAC. Outside NAMI, groups such as MadNation and Support Coalition mobilized people through publishing, an e-mail campaign to dozens of NAMI leaders, a national protest in Washington, D.C. on May 2, and more.

When the dust cleared, E. Fuller Torrey was furious about the divorce between his pet project, TAC, and NAMI. Without the official support of NAMI's grassroots numbers, TAC is just an eccentric think tank. An incredibly insulting letter from Torrey to NAMI Consumer Council President Wesley Alcorn was by Dendron. In it, Torrey blasted Alcorn and claimed that the cause of this mysterious rebellion was that Alcorn was acting grandiose and needed his medication adjusted!

In other words, NAMI-TAC never knew what hit it: a spirited human rights force that included many Support Coalition members.

Since pro-force crusaders de-value our humanity, we will always have the element of surprise! We will dump this toxic alphabet soup: PACT, IOC, NAMI, TAC, NIMH, and APA!


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