BONUS: Ann Corcoran: Psychosis Is Not a Choice

Welcome to Why Not Me? Embracing Autism and Mental Health Worldwide?
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TI.
Hi, I'm Tony Mantour. Welcome to Why Not Me? Embracing
Autism and Mental Health Worldwide. We're taking a brief pause
for the Thanksgiving holiday, and during this time I'd love
to share one of my favorite episodes from the last
few months. I also want to wish you a very
happy Thanksgiving. So joining us today is Anne Cochrane. She
is the executive director of the National Shattering Silence Coalition NSSC,
a powerful voice for those affected by serious mental illness,
including the eight million children and fourteen point two million
adults living with or lost to these conditions. Since twenty seventeen,
the NSSC, a non partisan alliance of family members, individuals
with SMI, professionals, and compassionate advocates, has been driving change
and raising awareness to reform health and criminal justice systems
for those with SMI. We're honored to have her share
her expertise with us today, So before we dive into
our episode, we'll be back with an uninterrupted show right
after a word from our sponsors.
Thanks for coming on.
Thanks for having me, Tony, and it's been great to
collaborate with you and families and mental health advocates.
Chance to have the voices be heard.
Well, it's my pleasure. So if you could tell me
how you got involved in this charity.
So the National Shadow Silence Coalition that it was founded
in twenty seventeen by a woman the name of Jean Gore,
and unfortunately she lost her battle to cancer about two
years ago. I stepped up as executive director and had
been involved with the organization for about two years at
that point in time, and you know, we've just really
continued to grow from there. We're an organization made up
of caregivers, peers, and professionals all looking to advocate to
improve outcomes for those with serious mental illness in their families.
So, how have you seen your organization grow since you've
can it over What are some of the differences that
you've seen over the last few years.
Well, I think that word is just getting out there
and we're doing a lot of educational awareness.
We do peer and protos quarterly.
We've developed several guides, one as a psychosis guide, the
other as a caregiver guide. We've also done collaborations with
people like Yourself and Humanities over Handcuffs, but also with
Aware now that's a digital platform magazine for social causes.
We have done the Beyond Stigma campaign, which features a
story every month in their column showing that the reason
that individuals svin mental illness aren't getting the help they
need goes well beyond stigma. And so we're really just
trying to get our stories out there so that people
can understand that it's discrimination and neglect that these individuals
are facing. Because if you think about any other marginalized group,
where would we let someone become homeless, not treat them
in are out of a hospital? There really isn't another
group that I can think of that we treat this way.
What are some of the things that you fight for
for change? I mean, I know stigma is a big thing.
I know, the perception is a big thing. Those are
just things that people see. What are you trying to
change for people that's actually living in.
Yeah, so that's a great question.
It really isn't stigma that when we talk about savere
mental illness and people with in psychosis, which means they
have lost touch with reality, they can't choose to have
treatment because they don't know and I know that you
know the word innstagnosia. They have no awareness and to
the illness. Therefore, they are not going to seek treatment.
And that is the number one difficulty that families face
and trying to get their loved ones help. Perfect example
that I can tell you a woman that I'm dealing
with in Massachusetts. She has a son twenty nine years old,
an office medications for over a year, completely psychotic, threatening
to kill and rate people. Most recently, he was going
to take dumb bells outside and beat them because he
was a creator.
And this woman cannot get him help.
So I've been working with her I've called out Department
of Mental Health. I called a corresponse team to go
out and evaluate him, you know, spoken with the treatment
team that was taking care of him every possible person,
And two months later.
He was still out in the community.
He was recently arrested for getting an altercation with a
group of people, and he's now sitting in jail, in isolation,
completely psychotic, and the lawyer, the public defender for her son,
will not talk to this woman because he hasn't done
anything really that bad. We're going to try and get
him out. So it's really like, what are we going
to wait for a tragedy?
Did it happen? And then we're going on to turn
around and say, well, how did that happen? Well, this
is how it had happened.
Of course, because this mother has been fighting to try
and get her son help for over a year.
Now and can't.
Okay, so we brought us up several times through the month.
I think for people that might be listening, they still
need to know the differences. You bring up anisygnosia, Can
you explain the differences between that and someone that's in
like full blown psychosis and psychotic.
So well, anastagnosia is usually you know, can be a
pot of psychosis, and they really don't understand that they
have an illness. And that really is the number one
reason that people stop taking medication.
So even when somebody you know, might have gotten out.
Of the hospital, have been stabilized and on the medications, well,
they usually stop taking their medications. And it's because they
feel okay and they think there's nothing wrong with me.
And it's not very different than denial. It's not that
they're denying they have an illness. They truly don't think
that they're ill. And it's similar to somebody with Alzheimer's,
like they don't recognize that they have Alzheimers.
It right, and.
It's sort of, you know, the same way the brain works.
These individuals do not think they're ill, and it's a
very real condition. And so what happens when they're off
the medication, Eventually they do go back into psychosis, which
means they have lost touch with reality. What they are
seeing and hearing they one hundred percent believed to be true.
And we know that most people with service mental illness
are dangerous. That's true, But we also know that leaving
psychosis untreated is a recipe for disaster because we don't
know what someone is thinking.
And we've had Matt Stick and his dad, Michael.
On one of our doing one of our pair talks,
and Matt took the life of his mother. And when
you listen to him talk about it, and he's very open,
he said, I loved my mother. He was not a
violent person, he would never want to hurt her, but
he truly believed that he had to take her life
because she was possessed with demons. So why are we
leaving You know, people in the community untreated in psychosis,
when we know that they have lost touch with reality,
you cannot predict at what point those delusions or hallucinations
are going to become dangerous.
Some people have and hallucinations.
We have another mom who her daughter was you know,
hearing voices telling her to kill her mother, who she
thought was an impostor and had raped her.
So these are very you know, it's very real.
To the person experiencing them, and you can't tell them
that it's not true.
It's not happening.
So we really need to treat psychosis as a medical emergency.
It is, and unfortunately, so many of the laws don't
allow us to do that. We have to wait until
a person becomes dangerous before we can get them help.
Another situation, we had a family that reached out. One
person reached out thirty five times, and that didn't include
other family members thirty five times plus, so say let's say.
Fifty times combined.
They reached out trying to get their loved one help
was a psychosis and no one would help them, and unfortunately, that,
you know, led to lives being lost. So we're really
is the blame when people are begging for help and
you have the system, you know, folding them around and say, well,
we can't do anything.
They're not dangerous.
So how do you get the legislators and the people
that form these laws to change them if they don't
understand it really is.
Through education, and we're seeing that in Massachusetts. Massachusetts is
one of the last two states in the entire country
without an assistant outpatient treatment law. And what that would
do it would allow someone.
To be treated in the community before they deteriorated to
the point that they needed in patient hospitalization. So what
we're doing now here in Massachusetts is we have to
wait until somebody gets so set and then they're hospitalized
and we just have to hope and pray that a
tragedy doesn't occur. And so with an assistant outpatient treatment law,
there's usually a very strict criterion and vary some state
to state on what that criteria may be. It's usually
that they have to have a certain number of hospitalizations
or have involved in the criminal justice system, have a
diagnosis of severe mental illness and a history of non compliance,
so that they now you know, in our likelihood, if
this person doesn't get help, then they are going to
end up in the hospital. So in Massachusetts, really what
it is because we had organizations, like large mental health
organizations that were actually against this because they were feeding
the legislator's false information. So what we have done is
educate all of our legislators on what is happening and
how many families are actually suffering and trying to get
help when there is none, and they truly.
Didn't understand this information before.
There was a recent retrial where a police officer's life
had been taken and during that retrial, I had the
mom reach out to me and she said, well, you're
not hearing in this trial and on the news is
that my son had a long history of schizophrenia. Two
weeks before this incident happened, I was begging the hospital
to keep him and was told that no we asked him,
he doesn't want to hurt himself or anybody else. So again,
I just think we're really is fault, you know, in that.
And I know that the family of this officer, they
had no idea that this happened. And I just think
as people in the community, we should be outraged that
US state is allowing this to happen because we have
made it, you know, a public safety issue. When you
have no means to treat people with serious mental illness
and get them the help they need early on, we
are putting everybody in the community at risk.
It could be a neighbor.
Yeah, So you say, get more understanding, more information to
these people. Unfortunately, we're a society that until it affects
our family, it is not a problem. So we can't
wait for it to affect some legislator or some judges
or lawyer's family to get them to say, oh, we
got to change this. So how do we get to
those people that are in charge now? But they don't
understand and because they don't understand. They're almost pleading ignorance
to it and just moving forward like it's non existence.
Yeah, so why I've done in Massachue. So we have
Daryl Harmon, which I know you're having on your show.
He is a peer who has lived with schizophrenia successfully
for over forty years. He developed a wonderful guide to
psychosis and psychotic illans is a peer perspective, so he
explains exactly what psychosis is and.
What Annasug knows you is.
I have used at pamphlet, walked into DA's offices, explained
to them, you know, gave him my elevated pitch of
what's in that handbook and giving them a few stories
of the tragedies we've had in Massachusetts.
And I can see it in their face.
It's like a light bulb goes off and they suddenly
understand why our state is failing terribly and we're seeing
all these tragedies happen in Massachusetts.
And I walk out with their support for this legislation.
So what really is, you know, building those relationships and
having these conversations with important you know people and our
legislators as well, so that they understand where you know,
why our.
Law isn't walking in Massa chooses and what needs to change.
Why do you think that some of the legislators are
kind of afraid to take this on because it does
appear one of those things like I don't know if
I want to touch that subject or not.
Yes, well, you know, we're very fortunate that we do
have some champion legislators in Massachusetts for mental health and
that have filed, you know, these bills and supported them.
A lot of it goes back to the disability rights,
you know, folks, because.
They will say, well, you know, somebody should have.
The autonomy to choose, but when we're allowing preventable suffering,
that is not autonomy.
That's neglect.
Another example is a lot of individuals that end up
getting put in a state hospital for competency restoration. They'll
go in in their in psychosis and they have the
CPCUS lawyers fighting there for their right to choose whether
or not they want to be treated. So they will
keep going against the medical team's advice, filing for extensions
to postponly civil commitments and leaving the individual inside coosis
much longer than they ever should be. That really is
the most inhumane thing you can do. And so you're
talking about autonomy, but is that really autonomy when somebody
is left in psychosis and is.
Not competent in immenity situations.
Someone that might have gone in for a misdemeanor ends
up committing a felony while in jail or in the
state hospital while psychotic, because they are really not in
control of what they're doing.
Okay, so there's a couple of things I want to
go over.
But the first thing is I've heard that the biggest
hospital in the country for mental health is the LA
prison system. How do we change that. We're putting these
people in prison with no medical people that don't understand it,
and they're in there going through all the things they're
going through.
The guards think that.
Being defined when they're really just going through the process
of the mental illness they have.
How can we get that changed?
Yeah, and that is true.
Our jails and prison have become the defect on mental
health institutions. And I know that because I've been speaking
to a lot of the sheriffs of Massachusetts and when
I ask them, well, how many people in your jail
have a mental illness? They're different numbers, varying seventy to
ninety percent is a number on getting that people have
either serious mental illness and or substance use disorder that
is extremely high. So while Massachusetts will pat themselves on
the back for decreasing the number of people that unconcerrated,
are asked at webinars. You know, you're saying that you're
closing jails, but can you tell me how many people
in the jails now have mental illness? And they don't
have an answer, then yeah, I don't know that they're
necessarily keeping track of it, but the shoffer's.
Run in the prisons, they know that.
Really it's really about early intervention and treating these individuals
early on. And which is why we're advocating so hard
for an AOT law in Massachusetts because that is going
to be the thing that's going to catch people upstream
before they even enter.
The criminal justice system. There's just no need for that
to happen.
And then we also talk about the need for more beds, Well,
if we treated people earlier on, we are not going
to be taking up those beds. We're waiting till people
get so set that then they need to be hospitalized.
And you know, of course that is then taking up beds.
My feeling is we're not going to need all those
extra beds if we're treating people earlier on, and those
beds can be left for the sickest people that need
them for the longest time.
Yeah, because at least in the legal system, if a
person goes in front of a judge with some serious
mental illness and then somehow they get diverted out by
a miracle, the chances of them non treated of showing
back in front of that same judge again is like
almost like ninety five percent that'll.
Kind of happen.
How do we get it across to these legislators and
judges and the adas and das that by working together
and putting these people in a situation where they can
have an opportunity to get better, that it's not I'm
only going to save a person's life, but it's going
to save the taxpayers millions of dollars.
Yes, absolutely, And that's been a challenge here is I've
been trying to figure out, and I've had conversations with
some judges, how do I get in there to have
these you know, conversations. And I know so in Massachusetts
we're different than a lot of other parts of the country.
Our judges are not elected by the people.
They're appointed by our governor.
Okay, so you.
Know, I think that's very different there, and they're not
able to advocate for any legislation. So I still haven't
figured out how to have these conversations with our judges,
but I am working on having conversations and meetings with
das prosecutors defense attorneys, because there really needs to be
some education there, I think, so that they understand. I've
sat in on a lot of trials because everything is
virtual as well as in person, and I'll be amazed
when I'm watching somebody's child go in front of the
judge and that I know has mental illness and has
you know, been in psychosis, and there is not Oftentimes
there is not one mention of the fact that by
the defense or the prosecution that this individual has a
serious mental illness. So what I try to do is
empower people families and teach them how to navigate the system,
and to encourage them to write letters and you.
Know, really outside of the box thinking.
And I've discussed this with judges as well, told them
at one point, well, I have people white letters even
when they're not a victim in these cases, write a
letter and give it.
To the prosecution.
And the judge looked at me and he said, well,
that's kleba and he said most of the time they
will read that. And that really has been improving outcomes
for the families that we have been working with.
Now, what about the actual legal system. I'm assuming it's
very similar because like with autism, if you get an
autistic person in front of a judge, the judge doesn't
understand it, doesn't understand it, and lots of times the
defense attorney doesn't understand it, and then they're at the
mercy of whoever that wants to hand down the decision.
Is it that same way with the legal system?
With this, sometimes yes and sometimes no, it falls on
the families to educate the defense attorney.
The prosecutor, and the judge.
It really does in a lot of these cases because
they're not going to have that background information and unless
families get involved, and oftentimes families don't know that they're
able to do that.
No one tells you that you can do it.
It's not written anywhere, and that's why we develop do
ki I give his guide to put these little tips
in there because it is really outside of the box
thinking and things that you can do. One of the things,
you know, families will often feel like, well, there's nothing
I can do, and I'll always say there's always something
you can do.
It might not be something that people often.
Do, but we really need to be creative in the
way we're dealing with the criminal justice system when your
family members are involved, because oftentimes it can mean the
difference between them being incarcerated and serving time versus them
being on probation and having you know, mental health treatment.
Now, lots of times the cycle happens like I just described,
They'll go in front of the judge, they'll get diverted
out for some little thing, and then they wind up
back in front of him again. Then the second time,
the judge has that mindset of Okay, I might as
well throw the book at this guy because he doesn't
get it, when he really doesn't get the fact that
the guy or the person in front of him has
a serious mental illness. So when they wind up incarcerated,
then that creates that cycle that is just detrimental to
everybody involved.
So we've got to.
Get past that so that people can understand and that's
still at the judicial level.
I would think it is, and I have to say
we're doing you know, I forget. I'm not really sure
how many mental health courts we have in Massachusetts, but
those seem to you know, we do have them in
some areas.
So if you.
Commit a crime in a study that has a mental
health court, you're pretty lucky. If you don't, then you know,
you might not be so lucky, because you're right. The judges,
the prosecutors, defense attorneys, they most of the time, they
don't understand it. And that's again where families need to
be proactive and be involved because it's really odd job
to educate them because they're.
Not mental health professionals.
Why would they necessarily know if no one tells them.
Right, So we've gone from the incarcerated to the judges,
to the das to the defense attorneys.
Now the big issue.
As I see it, is a larger one that people
don't understand, and that's the homeless situation. When you walk
down the streets and you see people living on the streets,
you think, oh, their bombs or this or that, and
really a lot of them nine out of ten, I
don't know if it's that high, but I've heard it's
high have mental illness of some degree, and they're there
because they have no other place to go. So if
we don't get that treated and that under control, then
the rest of it from that point to the judicial system,
is it going to be what it is?
Yeah, and Tony, it's not all.
It's not necessarily because they have no place to go.
It's because they are in psychosis.
And don't want to be at home.
I had another family that I was involved with NSC
and their son was in complete psychosis after going off
his meds, left their house.
I believe it was like you know, in the middle
of the winter in the spring.
He was found in downtown Boston, unable to walk, really
in pretty bad shape. And the family thought, we found him,
this is great, We'll get him in the hospital, get
him back on his medications, and.
Hopefully things will improve from there.
That he went to the hospital, was there, and I
got a call from the dad two weeks later their
son had died in the hospital an infection. So he
had a loving home who was college educated. So it's
not that these individuals have no place to live. It's
an untreated psychosis that leads them to the streets, and
that's pretty sad. And when we have solutions and where
again we're allowing this preventable suffering.
Yeah, so we've got to get where it starts. Ultimately,
we always think about the legal system as being the
bad guys and all that, and sometimes they can be.
But the situation is we don't get.
It treated at a local level and get it under control,
nine chance out of ten, it's going to wind up
in some legal system and then depends upon what happens
on where they wind up in the final end. How
do we get that entry level, so to speak, situation
under control.
Well, I think that there really needs to be more
of a focus on assisted outpatient treatment. Again, there's two states,
Massachusetts and Connecticut that don't have the laws.
That doesn't mean that.
All the other states have great AOT laws utilize.
Them the way they should be.
But my hope is is that we're going to strengthen
these AOT laws.
You know, it is very state by state, but and if.
We could see them expand not only in one county
but throughout the entire state. So that's going to be
really a odd thing to do. It's going to take
some time, but it can be done. It's not impossible.
And with community behavioral health centers, I think that we're
really in a good position to be able to do that.
I know in Massachusetts we have.
Twenty six community behavioral health centers, and so I see
that as an ideal situation to pass an AOT law
because they have basically these types of programs already set
up within the community behavioral health centers for people that
can voluntarily walk in and ask for these services. But
we just need the mandate to provide them to those
that are too sick to know that they need help.
Okay, so now can you use other states'.
Legal statuses to maybe take to your LEGAC to show
them that things need to be changed.
Well, I mean we do that, but it's finding a
Massachusetts people will say they don't want to know what
other states are doing, like that's insulting to them.
But yes, I mean we do look at the cost savings.
You know, it was at Human Adgacy Center AOT symposium
last month and there was someone from Alabama talking about
the cost savings and two of their counties, one county
they saved and one year over fifteen million dollars. Can
you imagine how many people we can treat and how
many services with fifteen million dollars? Because think about it.
You know, people cycling in and out of the hospital,
people being arrested, the number of times someone appears before judge,
how long these cases go on.
The individuals that are incarcerated, I.
Mean, those have high cost associated with them, and it
makes no sense.
The point I was going to make is the end
result and the perfect example of that is tomorrow, which
will be the last episode of this month. I have
Cindy Murphy on and that's the Tristan Murphy case to
where he ultimately committed suicide in a jail. So can
you use that because ultimately they're working on a bill
that will stop that. So can you use that and
take that to these legislators say hey, look here's a
perfect example of the worst case scenario. Why wouldn't you
use this so that we don't ever see that?
And again, you know, I think that we do some
of that, and we have.
Some pretty horrific stories where somebody killed their mother and
lit them on fire on their lawn. Another one the
elderly individuals, their lives would take in you know, so
we have those horror stories. But in Cindy's case, and
by the way, the Tristan Murphy did pass by the
House and it's now being on the desk of the governor,
which is great.
I hope that.
The rest of the country can take a look at
that and emulate what has been done there, because that
really is something so tragic and never should have happened.
But Cindy was a great advocate and ultimately had this
law pass.
It's going to be life changing for Florida in terms
of mental illness.
All right, So in closing, what would you like to
let the listeners know that you think is really important
that they know about what you're doing, what needs to
be done.
I would say that let listeners know that there's always
something you can do to reach out and connect with us.
We can always help you navigate a system that you
might not be familiar with. It's Nsscoalition dot org, and
our stories are powerful and it's family stories that are
going to help change these policies so that this neglect
and discrimination ends. And I think that these stories are
what are going to touch the hots of legislators and
once again, you know, make that change.
That's needed.
Well, it's been good. I appreciate you coming on.
Oh, and thank you for having me Tony.
I think you're starting a movement people, you know, families
want to tell us stories and you're giving them a
platform to do that.
So thank you very much.
Oh, it's been my pleasure. Thanks again.
Thanks for taking time out of your busy schedule to
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