The 2024 Law & Mental Health Conference on psychosis was June 10, 11 2024.
What is psychosis exactly – from a medical or clinical perspective, from a legal or criminal perspective, and from the perspective of those who have experienced psychosis? What are our best practices with psychosis for treatment, for housing, for families and friends, for courts, jails, and hospitals? How can those who have psychosis practice self-care and find mutual aid?
KEYNOTERS
Norman J. Ornstein – American Enterprise Institute
Norm Ornstein is a senior fellow emeritus at the American Enterprise Institute (AEI), where he has been studying politics, elections, and the US Congress for more than four decades. He often appears on C-SPAN, CBS, CNN, Fox News Channel, MSNBC, NPR, and “PBS NewsHour,” among other outlets. He served as an election analyst for CBS News for thirty years, and also was an on-air election analyst for BBC News. Through his family foundation named in honor of his late son Matthew, he helped spearhead the documentary “The Definition of Insanity,” about criminal justice and mental illness, which premiered at the Miami Film Festival in March 2020 and aired nationally on PBS on April 14, 2020.
Dr. Ornstein’s books include the New York Times and Washington Post bestsellers “One Nation After Trump: A Guide for the Perplexed, the Disillusioned, the Desperate, and the Not-Yet Deported” (St. Martin’s Press, 2017) with E. J. Dionne and Thomas E. Mann and “It’s Even Worse Than It Looks: How the American Constitutional System Collided with the New Politics of Extremism” (Basic Books, 2012) with Thomas E. Mann. His other books include, “The Broken Branch: How Congress Is Failing America and How to Get It Back on Track” (Oxford University Press, 2006) with Thomas E. Mann; and “The Permanent Campaign and Its Future” (AEI Press, 2000) edited with Thomas E. Mann.
Dr. Ornstein has a PhD and a master’s in political science from the University of Michigan and a BA from the University of Minnesota.
How to Help Save the Mentally Ill From Themselves – New York Times op ed, 2015
Locking People Up Is No Way to Treat Mental Illness – The Atlantic, 2022
The Definition of Insanity – film website
Matthew Harris Ornstein Memorial Foundation – website
Patricia E. Deegan PhD – Pat Deegan & Associates
“Why Don’t They Just Take Their Meds?”
For over 30 years Pat has been a thought leader and disruptive innovator in the field behavioral health recovery. Pat founded a company run by and for people in recovery. The mission: To safeguard human dignity by bringing individual voice and choice to the center of the clinical care team. Toward this end she developed Pat Deegan’s Recovery Approach that includes the award winning CommonGround software, Medication Empowerment, Certified Personal Medicine Coaching, the online Recovery Library, the CommonGround Academy for peers and practitioners, and the Hearing Distressing Voices Simulation. Since 2009 Pat has worked as a consultant helping to develop and evolve the OnTrackNY model for coordinated specialty care teams for young folks experiencing early psychosis. Pat is an activist in the disability rights movement and has lived her own journey of recovery after being diagnosed with schizophrenia as a teenager. She has held a number of academic appointments, has numerous publications, and has carried a message of hope for recovery to audiences around the world. She received her doctorate in clinical psychology from Duquesne University.
Voices of Recovery: Pat Deegan – video interview
OPENING REMARKS
Paul Appelbaum, MD – Columbia University
Paul S. Appelbaum, MD, the Elizabeth K. Dollard Professor of Psychiatry, Medicine and Law, and Director, Division of Law, Ethics and Psychiatry at Columbia, was previously A.F. Zeleznik Distinguished Professor and Chairman, Department of Psychiatry; and Director, Law and Psychiatry Program, University of Massachusetts Medical School.
Dr. Appelbaum is the author of many articles and books on law and ethics in clinical practice. Dr. Appelbaum is Past President of the American Psychiatric Association, the American Academy of Psychiatry and the Law, and the Massachusetts Psychiatric Society, and has twice served as Chair of the Council on Psychiatry and Law and of the Committee on Judicial Action for the American Psychiatric Association.
Novel ethical and policy issues in psychiatric uses of psychedelic substances – Sept 2022
Malpractice claims in psychiatry: approaches to reducing risk – Oct. 2021
Ethical Challenges in the Primary Prevention of Schizophrenia – April 2022
Understanding Civil Commitment: An Historical Approach – June 2023
MORE – about Dr. Appelbaum
SESSION PRESENTERS
Nev Jones, PhD – University of Pittsburgh
“Harms of a Single Story: Moving Beyond Medication-Centered Treatment”
Nev Jones is a community-engaged mental health services researcher, with an interdisciplinary academic background in social and political philosophy, community psychology and medical anthropology. Prior to moving to Pitt, she was a tenure stream faculty member at the University of South Florida, and prior to that worked in policy, direct service, quality improvement and evaluation roles in the public mental health system in California. She brings a strong disability justice and lived experience advocacy orientation to her work and was a 2017 NIDILLR Switzer Fellow, 2021 recipient of the Pioneer Award from the National Association of Peer Supporters and 2022 recipient of the Judi Chamberlin Joy in Advocacy award from the National Coalition on Mental Health Recovery.
Publications: https://www.researchgate.net/profile/Nev-Jones-2
Advancing service user/survivor leadership in research: http://www.transformmhresearch.org/
Rethink psychosis project: https://rethinkpsychosis.weebly.com/
Susan Hatters-Friedman, MD, DFAPA – Case Western University
“Postpartum Psychosis: Understanding the Diagnosis and its Intersection with the Justice System”
Susan Hatters Friedman, MD, DFAPA, is a forensic and reproductive psychiatrist. Dr. Friedman is past president of the American Academy of Psychiatry and the Law, and has served as Chair of the Law and Psychiatry committee at the Group for Advancement of Psychiatry. She has received the Seymour Pollack Award for her contributions to teaching and educational functions of forensic psychiatry, the AAPL award for the Best Teacher in a Forensic Psychiatry Fellowship, the Red AAPL award for outstanding service to organized forensic psychiatry, the Manfred Guttmacher Award for editing the book Family Murder: Pathologies of Love and Hate with GAP, and the Association of Women Psychiatrists’ Marian Butterfield award for her contributions to women’s mental health. Susan currently serves as the inaugural Phillip J. Resnick Professor of Forensic Psychiatry at Case Western Reserve University, where she also has appointments in the departments of Pediatrics, Reproductive Biology (Obstetrics/ Gynecology), and Law. Dr. Friedman also continues to serve as honorary faculty at the University of Auckland (New Zealand), having worked in New Zealand for seven years previously.
Mother, doctor raise awareness about postpartum psychosis, April 2023
Postpartum Psychosis: A Life-Threatening Emergency, February 2023
I Study Parents Who Kill Their Kids. There’s One Thing People Don’t Understand About These Cases. February 2023
Postpartum Psychosis, November 2022
Realities of Pregnancy and Mothering While Incarcerated, May 2020
Protecting mother and infant, April 2019
Treated mental illness child abuse Psychiatric Services, November 2017
Violence by Parents Against Their Children, 2016
Rob Wipond – author of “Your Consent is Not Required”
“How the Flexible Meaning of “Psychosis” Drives Rising Rates of Involuntary Commitment”
Rob Wipond is a freelance investigative journalist who writes frequently about the interfaces between psychiatry, civil rights, community issues, policing, surveillance and privacy, and social change. His articles have been nominated for seventeen magazine and journalism awards in science, law, business, and community issues. He’s the author of the book Your Consent is Not Required: The Rise in Psychiatric Detentions, Forced Treatment, and Abusive Guardianships, an investigation of people’s experiences of involuntary psychiatric interventions and review of the science, laws, financial interests, and cultural politics behind the expanding uses of mental health law powers in the U.S. and Canada today.
RESOURCES – Rob Wipond website
MAD IN AMERICA – articles by Rob Wipond
PURCHASE – Your Consent is Not Required
Jenae Aesha Richardson, PsyD – Stanford
“Cognitive Behavioral Therapy for Psychosis, Barriers to Implementation, and Proposed Solutions”
Dr. Jenae Richardson is a Clinical Assistant Professor and a CA Licensed Clinical Psychologist in the INSPIRE Clinic at Stanford University School of Medicine. She specializes in utilizing evidence-based treatments (EBTs) to treat individuals with psychosis and has worked with this population across inpatient and outpatient settings. She is passionate about improving the dissemination and implementation of Cognitive Behavioral Therapy for psychosis (CBTp), and at the INSPIRE Clinic, she leads CBTp trainings for mental health professionals and provides CBTp to individuals with psychosis. Dr. Richardson completed her pre-doctoral internship at the University of Arizona’s Early Psychosis Intervention Center and her postdoctoral fellowship at Veterans Affairs Palo Alto Health Care System. She obtained her doctorate in clinical psychology from Long Island University Post and conducted research exploring barriers to implementing CBTp in the United States.
Do cognitive deficits predict negative emotionality and aggression in schizophrenia? Jan 2018
Eleasa Sokolski, MD – Oregon Health and Science University
“Methamphetamine and Psychosis”
Eleasa Sokolski is an addiction medicine specialist and psychiatrist at Oregon Health and Science University. She works as part of the inpatient addiction medicine consult service and also sees outpatients for general psychiatry in the OHSU internal medicine clinic.
Dr. Sokolski is an active member of OHSU’s Improving Addiction Care Team.
She previously completed a combined internal medicine and psychiatry residency at University of California at Davis, followed by an addiction medicine fellowship at OHSU. Her professional interests include medical education and treatment of co-occurring disorders.
Civil Commitment for Substance Use Disorders: Coercion or Compassion? Cynthia M.A. Geppert, MD, PhD, MA, MPH, MSBE, DPS, MSJ, June 2022
It’s Time to Train Residents in Addiction Medicine – December 2023
Rapid Low-dose Buprenorphine Initiation for Hospitalized Patients With Opioid Use Disorder – August 2023
Neil Gong, PhD — UC San Diego Sociology
“Social Prognosis: How Inequality Shapes Recovery From Mental Illness”
Neil Gong is assistant professor of sociology at the University of California, San Diego. He uses field research and historical methods to study psychiatric services, homelessness, and how communities seek to maintain social order. He is author of Sons, Daughters, and Sidewalk Psychotics: Mental Illness and Homelessness in Los Angeles, which compares outpatient treatment in public safety net and elite private settings. In addition to his academic work, Neil has written for popular venues such as the Los Angeles Times, the Washington Post, and the Atlantic.
Californians narrowly passed Proposition 1. But will it work? – LA Times 2024
Forcing homeless people into treatment can backfire. What about a firm nudge? – Washington Post 2024
Link to purchase Sons, Daughters, and Sidewalk Psychotics: Mental Illness and Homelessness in Los Angeles
Will Hall, MA, DipPW – survivor, therapist, and PhD candidate
“Psychosis and Disability Justice: Why We Need To Abolish Forced Psychiatry”
I am a schizophrenia diagnosis survivor and longtime organizer in the psychiatric survivor movement. Trained in Open Dialogue and Jungian psychology, I am author of the Harm Reduction Guide to Coming Off Psychiatric Drugs, and Outside Mental Health: Voices and Visions of Madness, and host of Madness Radio. I have taught and consulted on mental health, trauma, psychosis, medications, domestic violence, conflict resolution, and organizational development in more than 30 countries, including in 2023 at Stanford Medical School Master Clinician Series and Louisiana State University Grand Rounds, and my work has been widely featured in the media for my advocacy efforts around mental health care, including the documentaries Crazywise and Healing Voices and co-founding the organizations Hearing Voices Network USA, Portland Hearing Voices, Freedom Center, and Mad Camp, and working with The Icarus Project collective. My learning arose from my own experiences of reclaiming my life from madness and a diagnosis of schizophrenia, including facilitating patient mutual aid support groups, and joining with other survivors for advocacy and activism. I am passionate about new visions of mind and what it means to be human, and today work as a therapist, trainer, and community development worker, and am a PhD Candidate at Maastricht University School for Mental Health and Neuroscience, where I am principal investigator on the Maastricht World Survey on Antipsychotic Drug Withdrawal.
RESOURCES – to review after Will Hall’s talk
Joanna Naples-Mitchell, JD – Physicians for Human Rights
“Why “Excited Delirium” is a Fraud”
Joanna Naples-Mitchell is a human rights lawyer in New York City and the U.S. Research Advisor at Physicians for Human Rights, where she supports PHR’s research and advocacy related to the intersection of law enforcement, racism, and medicine. As PHR’s U.S. Researcher from 2019-2022, she coauthored three reports, including the March 2022 report “Excited Delirium” and Deaths in Police Custody: The Deadly Impact of a Baseless Diagnosis. Joanna also directs the Redress Program at the nonprofit Zomia Center, where she advocates on behalf of civilians harmed in U.S. military operations in Iraq, Syria, and Afghanistan. Joanna has previously worked at Human Rights Watch and the Human Rights and Special Prosecutions Section of the U.S. Department of Justice Criminal Division. She holds a law degree from New York University School of Law and a bachelor’s degree from Harvard University. She is admitted to practice law in the state of New York.
End Excited Delirium – Campaign Zero
White Paper Report on Excited Delirium Syndrome – American College of Emergency Physicians, 2009
Sofia Jeppsson, PhD – Umeå University
“Coercion – Premises, Reasons, and the Bigger Picture”
Sofia Jeppsson defended her dissertation Practical Perspective Compatibilism in 2012. For the next few years, she continued to publish on abstract questions relating to free will and moral responsibility, while holding fixed-term positions at Stockholm University and the University of Gothenburg. In 2018, she landed a permanent job with good job security at Umeå University, a position she still holds. She then felt safe enough to fully come out as Mad. Now, she openly draws on her lived experience in her philosophical writings – both specific psychotic phenomena, and how drastically her mental health have changed through being a care assistant, an academic on a precarious job market, and finally an academic with job security and an ordered life.
Much of Jeppsson’s work still concerns agency and responsibility; she argues against the view that we can draw sharp lines between those who are responsible for their actions and those who are not, and for more nuanced judgments made on a case-by-case basis. She has further published on epistemological implications of madness, arguing that no anti-sceptical arguments may be relevant for the madperson themself. On the topic of the so-called “self-illness ambiguity” in psychiatric treatment, she argues that there is no border between “self” and “mental illness” which exists independently of the subject’s self-view and self-interpretation. She also publishes on criminal justice ethics and other issues within applied ethics.
Yvonne Yang, MD, PhD – UCLA Psychiatry Residency Research Training Program
“The Chemistry of Psychosis”
Dr. Yvonne Yang received her MD and PhD from the Yale School of Medicine and Yale Interdepartmental Neuroscience Program. She received her psychiatry training at the UCLA David Geffen School of Medicine and Semel Institute for Neuroscience and Human Behavior, taking on the role of chief resident her final year. She then completed a fellowship on psychotic disorders at the Greater Los Angeles Veterans Affairs Healthcare Center Mental Illness Research, Education and Clinical Center. She currently directs the UCLA Semel Institute Psychiatry Residency Research Training Program, the West Los Angeles VA Thoughts and Perceptions Clinic, is Chief of the Psychosis Section at the Greater Los Angeles VA Healthcare System, and is an Assistant Clinical Professor at UCLA. She is the recipient of a Career Development Award from the VA to study the relationships among neuroinflammation and oxidative stress in Veterans with schizophrenia, and the recipient of the Cousins Center Seed Grant initiative on the Impact of Discrimination on the Human Immune System.
Antipsychotic discontinuation and recovery: chicken or egg?, 2021
Pharmacological management of treatment-resistant schizophrenia: fundamentals of clozapine, 2018
Beyond dopamine: Novel strategies for
schizophrenia treatment, Dudzik 2024
Psychedelics and Neural Plasticity: Therapeutic Implications, Grieco 2022
Advancements in Non-Dopaminergic Treatments for Schizophrenia: A Systematic Review of Pipeline DevelopmentsKomatsu, 2024
Antipsychotic Drug Development: From Historical Evidence to Fresh Perspectives, Weston-Green-2022
Dr. Yang’s conference slides – NEW ADDITION.
Presiding Judge Maria D. Hernandez – Orange County Superior Court
“Creating Justice through Collaboration and Early Intervention through CARE (Community Assistance, Recovery and Empowerment Act)”
Judge Maria Hernandez was appointed to the bench as a commissioner in 2006 and appointed by Governor Arnold Schwarzenegger as a judge in 2009. She was elected as assistant presiding judge of the Superior Court of Orange County in 2021 and then elected as presiding judge in January 2023. Prior to serving on the bench, she worked as a senior deputy public defender in Orange County. Judge Hernandez received her bachelor’s degree from the University of California, Irvine, and her juris doctor degree from Western State College of Law.
Judge Hernandez spent nine years with the juvenile court, serving as the presiding judge of the juvenile court from 2014 to 2018, where she created and presided over the dedicated court addressing commercially sexually exploited children and cochaired the Orange County Committee relating to boys in the child welfare system. She recently launched a Young Adult Court, which addresses the special needs of emerging adults charged with felonies in the criminal justice system.
Judge Hernandez is the California CARE Court judge for Orange County.
Fact Sheet on CARE Court – State of California
Lisa B. Dixon, MD, MPH – Columbia University
“Improving Outcomes and Providing Care: The Importance and Challenges of Reducing the Duration of Untreated Psychosis in Early Psychosis Care”
Lisa Dixon, MD, MPH is a Professor of Psychiatry at the Columbia University Medical Center and the director of the Division of Behavioral Health Services and Policy Research within the Department of Psychiatry. She also directs the Center for Practice Innovations (CPI) at the New York State Psychiatric Institute.
Dr. Dixon is an internationally recognized health services researcher with over 25 years of continuous funding from the National Institute of Mental Health and the VA. As CPI director, she oversees activities for the New York State Office of Mental Health in implementing evidenced based practices for persons diagnosed with serious mental illness. She is leading the innovative program, OnTrackNY, a statewide initiative designed to improve outcomes and reduce disability for the population of individuals experiencing their first episode of psychosis.
Pathways Through Early Psychosis Care for U.S. Youths From Ethnically and Racially Minoritized Groups: A Systematic Review – August 2023
Apryl Alexander, PsyD, ATSA-F, University of North Carolina at Charlotte
“Challenges and Opportunities in Addressing the Competency Crisis”
Dr. Apryl Alexander is the Metrolina Distinguished Scholar in Health and Public Policy and Associate Professor in the Department of Public Health Sciences at UNC Charlotte. She received her doctorate in clinical psychology from the Florida Institute of Technology with concentrations in forensic psychology and child and family therapy.
Dr. Alexander’s research and clinical work focuses on violence, trauma/victimization, human sexuality, sexual offending, and trauma-informed and culturally informed practice. She is an award-winning researcher, and her work has been published in several leading journals, including the Journal of Forensic Psychology Practice, Child Maltreatment, Journal of Child Sexual Abuse, and Sexual Abuse. Alexander has been interviewed by numerous media outlets, including The Washington Post, The New York Times, USA Today, and NBC Nightly News, about her research and advocacy work.
READ – The association between specific competence-related abilities and competence restoration treatment (2019)
READ – Competency restoration for adult defendants in different treatment environments (2019)
WATCH – Sexual Violence is preventable – here’s how, TED Talk with Apryl Alexander
Clare Cortright, JD – Cal Voices
“The Politics of California’s CARE Act (Community Assistance, Recovery and Empowerment Act)”
Clare Cortright, Esq. is a California licensed attorney and mental health consumer with lived experience of serious mental illness. She has extensive experience defending clients on civil commitment holds and involuntary medication petitions under California’s Lanterman-Petris-Short Act. She also has served as a mental health provider in residential mental health programs.
She is the Policy Director for Cal Voices, California’s oldest peer-run organization. She works on state-level mental health legislation and policy. Her interests include the civil rights of persons with mental health disabilities and the incorporation of abolitionist principles in the mental health peer movement.
MORE – about Cal Voices
SPECIAL SCREENING
The Definition of Insanity is a documentary film about the Miami-Dade Community Mental Health Project — a novel approach to solving the mental health crisis that could be a model for America. Shocked by how people with mental illness were treated in Miami-Dade’s jails, Judge Steve Leifman works with a team of dedicated public servants, as well as former adversaries in the criminal justice system, to help people with mental illness navigate from lives of tragedy to possibility. The film reveals a humane criminal justice approach to mental illness that is orchestrated from the court outwards into the community through its novel Jail Diversion Program.
From court dates to group therapy, the film follows Miami’s community-based experiment to solving the mental health crisis, where incarceration becomes the last resort and everyone from the police to prosecutors works together to support the notion that “recovery is possible.” Below are expanded scenes that are not in the film as well as interviews with the filmmakers and key stakeholders in the Miami Model. 54 minutes
Justin Volpe, who appears in the documentary film “The Definition of Insanity” is joined by Jason Renaud of the Law & Mental Health Conference to discuss the film, the state of court-mandated care for people in Florida, and the impact of the film.