Treatment Advocacy Center

The Treatment Advocacy Center is a national nonprofit organization dedicated to eliminating barriers to the timely and effective treatment of severe mental illness.

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$2.1M

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72%

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9%

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Policy Legislation

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Research

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About the Treatment Advocacy Center

The Treatment Advocacy Center (TAC) was founded by Dr. Torrey, a research psychiatrist who specializes in schizophrenia and bipolar disorder. He is the author of Out of the Shadows: Confronting America’s Mental Illness Crisis, a book which chronicles the criminalization of mental illness. In addition to authoring numerous books and research papers, Dr. Torrey worked at a clinic for homeless people who had severe mental illness. After conferring with other mental health and legal experts, he decided to start an organization that would help individuals with severe mental illness get treatment before they ended up homeless, incarcerated, or worse.

The main issues that TAC focuses on are the criminalization of mental illness, shortages of psychiatric beds, consequences of non-treatment, violence, public service costs, and anosognosia (lack of insight) and its relation to why some individuals who have a mental illness do not take medication. They address these issues by conducting and promoting research and advocating on behalf of policies that improve and increase psychiatric care and research for severe mental illness.


Why We Chose to Feature This Organization

It’s no secret that the American health system is complex, inefficient, and insufficient. Millions of Americans struggle to get the care that they need at a price that they can afford. The mental health system is no different. For over 50 years, access to treatment for mental illnesses such as schizophrenia and bipolar disorder has continuously diminished, leaving countless individuals and their families with nowhere to turn when they need help. Half of the counties across the United States do not have a single mental health professional in them, nor do they have a community mental health center. Outdated laws make it so that individuals cannot get treatment until they are a danger to themselves or others. Additionally, the treatment of mental illness has been separated from general healthcare, making it difficult for those with mental illnesses to get access to the care that they need. The system must be fixed.

The Treatment Advocacy Center helps to make treatment a reality for individuals with severe mental illness. They work to remove the barriers keeping individuals from accessing timely and effective treatment for mental illness. They fight tirelessly to educate our elected officials on the severity of the problem as well as presenting possible solutions and assisting local advocates in making their case. They promote approaches that keep individuals with mental illness out of the criminal justice system and instead guide them into treatment. Their work is incredibly important, and we are proud to feature them in our portfolio and provide them with additional funding to increase their impact.

Policy & Legislature

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Research

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Management

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TAC has advocated on behalf of several state and federal policies that address their key issues, including the criminalization of mental illness, shortages of psychiatric beds, consequences of non-treatment, violence, public service costs, and anosognosia (lack of insight). They have seen success in the passage of many bills, including the following:

Federal S 2002 – The Mental Health and Safe Communities Act

The overall goal of this act is to decriminalize mental illness. While the bill doesn’t seem groundbreaking –,it is still a huge step forward in fixing how our criminal justice systems treat people with mental illness. There are more people with mental illness in jail than there are in treatment. In order to reverse this figure, our police officers and judges must rethink how they approach people with a mental illness.

The bill authorized federal funding for mental health services such as treatment centers, assisted outpatient treatment programs, mental health courts, mental health training for uniformed services (e.g. police officers), crisis intervention teams, and incarceration alternative programs. It also gives families the power to intervene and help prevent mental health crises in their loved ones by providing judicially-administered alternative treatment programs.  

As with most legislative bills, there were some negative provisions added in order to get it passed. In this case, it was the National Instant Criminal Background Check System provision that seemingly makes it easier for people with a history of severe mental illness and involuntary commitment to a psychiatric institution to obtain a gun. While incredibly problematic, TAC believes that the good that will come from the passage of this bill outweighs the bad, and considers its passage a victory. As time goes on, we will monitor the effects of this bill and TAC’s response.

Overlooked in the Undercounted

This report analyzes the role of mental illness in fatal law enforcement encounters. The statistics are dire: when looking at both official and unofficial statistics, a minimum of 1 in 4 fatal police encounters occur against an individual with severe mental illness. This translates to individuals with an untreated mental illness being 16 times more likely than the general population to be killed during an encounter with police. Individuals with untreated serious mental illness account for 20% of all jail and prison inmates and 10% of all law enforcement responses. Out of the estimated 7.9 million adults living with a severe mental illness, up to half are not taking medication or receiving care on any given day. We need policies that keep these people out of the criminal justice system and get them the proper treatment and care that they need. In order to do so, TAC recommends creating and amending policies that would:

  • Treat the untreated: The availability of state psychiatric beds has dropped nearly 97% since its peak in 1955, and no community-based facilities have come in to fill the gap. This has left hundreds of thousands of people living with a severe mental illness finding themselves in the streets, emergency rooms, and the criminal justice system. In order to reverse this trend, treatment beds for individuals suffering from acute or chronic psychiatric conditions need to be increased. Treatment laws that create barriers to treatment, such as requiring courts to wait until individuals become violent, suicidal, or gravely ill before intervening need to be reformed. Laws that are already in place to provide access to treatment for individuals who are too ill to seek treatment for themselves need to be fully made use of. Court-ordered outpatient treatments and assertive community treatments need to be expanded. Lastly, cost-saving evaluations must be considered for both the cost of treatment itself and the taxpayer savings. Increased access and use of proper treatments reduces criminal justice involvement, homelessness, and emergency medical visits, all of which come at a great cost to the taxpayer.
  • Accurately count and report the number of fatal police encounters: Shockingly, the United States government does not have a comprehensive nor accurate database of fatal police encounters. In the absence of this official data, several news organizations, nonprofits, and individual bloggers are operating independent databases. While this data is better than nothing, it is inevitable that their results will be lower than the actual number given that they are based on published anecdotes and/or crowdsourcing. Police fatality is a major issue in the United States, and the government must accurately track the statistics surrounding it.
  • Accurately count and report all incidents involving use of deadly force by law enforcement: Given that less than half of police shootings result in a death, counting only fatal shootings results in an incomplete picture of the use of deadly force by police.
  • Systemically identify the role of mental illness in fatal police shootings: Despite the fact that severe mental illness is an identifiable factor in 25-50% of all fatal law enforcement encounters, questions regarding psychiatric factors are not included in official surveys that gather data regarding fatal and nonfatal police shootings.

Research Weekly Roundup

Each month, TAC’s Office of Research and Public Affairs publishes a collection of new research reports and developments relating to serious mental illness. We will review their October 2017 Research Roundup below. This edition focused on emergency services and psychiatric crisis care.

Datapoint of the Month: 29 out of 46 (56%) responding states report boarding psychiatric patients in emergency departments because of lack of hospital beds.

Research of the Month:

“Characteristics of homeless individuals using emergency department services in 2014”, Healthcare Cost and Utilization Project

This government report analyzed emergency department visits by homeless individuals in 2014. One important finding was that for homeless individuals with a mental or substance abuse disorder, nearly half of emergency department visits that resulted in a hospital admission were for schizophrenia. For many homeless individuals, emergency departments are their only source of healthcare, as emergency departments cannot turn people away due to lack of insurance. This helps to explain why homeless individuals are three times more likely than the general population to visit an emergency department.  

“Persistent frequent emergency department use: Core group exhibits extreme levels of use for more than a decade”, Health Affairs

This report studied visits to California emergency departments by all payers between 2005-2015. The authors found that frequent emergency department users represent between 4-8% of patients and account for between 21-28% of all visits. Users who were considered persistent and frequent were more likely to have a mental illness than those who were considered frequent but non-persistent. This group is also more likely to have a public insurance (such as Medicare or Medicaid) than private insurance.

“Modeling the cost-effectiveness of interventions to reduce suicide risk among hospital emergency department patients”, Psychiatric Services

This report from the National Institute of Mental Health analyzed three outpatient emergency department-initiated suicide prevention interventions and the cost-effectiveness of implementing such programs. The authors found that outpatient interventions are an effective means of reducing suicide risk in emergency department patients. An intervention includes follow-up care letters, telephone calls, and suicide-focused cognitive-behavioral therapy (CBT). The authors recommend that these three programs be implemented on a large scale thanks to their effectiveness in reducing suicide risk in emergency department patients and their relatively low cost.  

Management

Treatment Advocacy Center

John Snook

Executive Director

Experience and Education
  • Director of State and Local Relations at Habitat for Humanity
  • George Mason University – Antonin Scalia Law School
  • Washington & Jefferson College
Compensation
$168,000

Treatment Advocacy Center

Doris Fuller

Chief of Research and Public Affairs

Experience and Education
  • Communications Director at the Treatment Advocacy Center /li>
  • Master of Fine Arts in Creative Writing from Vermont College
  • Bachelor of Arts in English Literature from California State University – Long Beach
Compensation
$138,000

Treatment Advocacy Center

Brian Stettin

Policy Director

Experience and Education
  • Assistant New York State Attorney General
  • University of Texas School of Law
  • City College of New York
Compensation
$120,000

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