Ann Corcoran: Psychosis Isn't a Choice

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Hi, I'm Tony Mantor. Welcome to Why Not Me the World?
Humanity over Handcuffs the Silent Crisis special event. Joining us
today is Anne Cochrane. She is the executive director of
the National Shattering Silence Coalition n SSC, 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.
Thanks for coming on.
Thanks for having me, Tony, and it's been great to
collaborate with you on humanities over handcuffs, giving 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 on Silence Coalition that it was
founded in.
Twenty seventeen by one the name of Jene Gore and
unfortunately she lost a battle to cancer about two years ago.
I stepped up as executive director and.
Have 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
the families.
So, how have you seen your organization grow since you've
taken 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 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
an 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 severe
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 innsagnosia. They have no awarenessent 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 tirty nine years old, an office
medications for over a year, completely psychotic, threatening to kill
and wade people. Most recently, he was going to take
dumbbells outside and beat them because he was a creator.
And this woman cannot get him help. So I have
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 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 stable 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 Alzheimer's 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 pirtalk 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 commund to 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 him 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
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 fus 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 led to lives being lost. So where
really is the blame When people are begging for help
and you have the system, you know, folding them rounds
and saying, well, we can't do anything.
They're not dangerous.
So how do you get the legislators and the people
that formed 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 deterarerated 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
very strict criteria 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 the 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 our 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 your neighbor.
Yeah, so say, get more understanding, more information to these people. Unfortunately,
we're a society that until it affects our family, it's
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 what I've done in Massachusetts. So we have
Darrel Harmer, which I know you're having on your show.
He is a peer who is little with schizophrenia. Successfully
for over forty years, he developed a wonderful guide to
psychosis and psychotic galans is a peer perspective, so he
explains exactly what psychosis is and what Anna sugnos 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 is aren't walking in
Massachusetts 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 cheat.
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 in psychosis 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 imeny of these 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 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 they're
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 prisons 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 mental illness? The 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 path themselves on the back for
decreasing number of people that unconcerrated, are they 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 general smart 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 failing 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 ada's 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 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 are 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 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 clever,
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 walking 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, the DA 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 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 a criminal justice system when
your family members are involved, because oftentimes it can mean
the difference between them being incocerated 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 them 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 think 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, they're 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 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 NSSC 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 from
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 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't be.
But the situation is, if we don't get it treated
at a local level and get it under control, nineteen
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
or 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 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 legislators to show them that
things need to be changed.
Well, I mean we do that, but it's funny and
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 Adcacy Center aot Sympolsium
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, oh, 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 costs 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 I think that we do
some of that, and we have some pretty horrific stories
where somebody killed their mother and let 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 at 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 teut 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 We're going to touch the hearts of legislators.
And once again you'll make that change that's needed.
Well, it's been good. I appreciate you coming on.
Oh, and thank you for having me Tony. It's again.
It's been a wonderful collaboration and I hope we can
continue because I really 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 the time out of your
busy schedule to listen to our show today. We hope
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