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Dr. Morton Birnbaum Inside This Issue Dedicating this issue of Catalyst to a True Advocate — Dr. Morton Birnbaum By Mary Zdanowicz Congratulations to Dr. Morton Birnbaum, first recipient of the new Torrey Advocacy Commendation Award for outstanding advocacy for treatment of the most severe mental illnesses. This issue of Catalyst is dedicated to Dr. Birnbaum. About the award The Treatment Advocacy Center (TAC) has taken on a monumental task — ensuring the right to treatment for individuals who are so disabled by severe mental illnesses that they do not recognize that they need treatment. TAC works to reduce the consequences of non-treatment including: homelessness, suicide, incarceration, victimization and episodes of violence. This means advocating, when necessary, that treatment be provided Dr. Morton Birnbaum is the recipient of the Treatment Advocacy against a person's expressed wishes based Center's inaugural Torrey Advocacy Commendation Award on their need for treatment rather than waiting until they become dangerous. It also means requiring a person to stay on lone voice advocating a position around ago on the very issue that is the foundation medication and in treatment long enough which there is no consensus in the mental of TAC's work today. The sad fact that his that they are able to recognize the health community. We are inspired by our message still rings true today amplifies difference between being psychotic and advocates in the field — those selfless how much our dedicated TAC advocates being without symptoms so that they may individuals who are not deterred by are needed. develop sufficient insight into their criticism and opposition — whose primary The TAC Board of Directors illnesses to stay in treatment without a concern is securing humane and timely overwhelmingly agreed to award the court-ordered mandate. treatment for individuals who are suffering inaugural Torrey Advocacy Com- These are not always popular from the most severe mental illnesses. mendation Award to Dr. Morton positions. But, we are continually The Board of Directors of TAC Birnbaum. Dr. Birnbaum was nominated reassured when we find that we are not the decided to formally recognize the vital role by Rael Jean Isaac, who co-authored of these selfless advocates by instituting Madness in the Streets — How Psychiatry the Torrey Advocacy Commendation and the Law Abandoned the Mentally Ill. Inside this issue... Award. Board member Fred Frese Ms. Isaac wrote a wonderful tribute to Dr. Tribute to Dr. Birnbaum Page 2 suggested the title which most fittingly Birnbaum for this issue of the Catalyst Refusing to take your meds Page 4 honors the man who inspired the [see page 2] that clearly illustrates why Dr. New study Page 6 Treatment Advocacy Center — the most Birnbaum's dedicated advocacy A personal story Page 7 fearless and dedicated advocate for the overwhelmingly exemplifies the ideals of Advisory committee Page 8 most severely ill — Dr. E. Fuller Torrey. the Torrey Advocacy Commendation Victims of laws Page 8 Your voice Page 9 Included in this issue of Catalyst is an Award. We are proud to dedicate this issue Memorials/Honorariums Page 10 article Dr. Torrey wrote more than 20 years of the Catalyst to Dr. Morton Birnbaum. Catalyst Winter 2001 Journal of the American Medical Association. It came back. American Journal of Psychiatry; it came back. I sent Catalyst it to Harvard Law Review, Yale Law Catalyst is published four times a year by Review. They didn't even send it out for the Treatment Advocacy Center. peer review lots of times. One journal sent it back with a note saying, 'This is preposterous.' I sent it out for a couple of ___________________ years." TREATMENT ADVOCACY CENTER Finally, in 1960, the American Bar 3300 NORTH FAIRFAX DRIVE A Tribute to Dr. Morton Association Journal not only published SUITE 220 the article, but accompanied it with an ARLINGTON, VA 22201 Birnbaum editorial endorsing the idea. And, in its PHONE: 703-294-6001 By Rael Jean Isaac Sunday edition, the New York Times FAX: 703-294-6010 When we think of the giants of mental published an article about this novel idea WEB SITE: WWW.PSYCHLAWS.ORG health reform in the United States, the of a "right to treatment." E-MAIL: [email protected] names of Dorothea Dix (the woman who Birnbaum's background made him a through her single-minded devotion surprising advocate for mental patients. BOARD OF DIRECTORS persuaded state legislatures to create the He received his law degree from E. FULLER TORREY, M.D., PRESIDENT system of asylums for the mentally ill), Columbia in 1951 and subsequently went FRED FRESE, PH.D., SECRETARY Clifford Beers (father of the National to medical school, in 1957 receiving his JAMES COPPLE, TREASURER Association for Mental Health and the M.D. in general medicine, not psychiatry. JUDGE JAMES D. CAYCE RAY COLEMAN child guidance clinic), and Albert Deutsch His interest was in catastrophic illness, the THOMAS N. FAUST (whose Shame of the States exposed the kind of illness which the average person CARLA JACOBS extent to which asylums had been allowed or family could not cope with financially. D.J. JAFFE to deteriorate, with patients left untended He came to focus on severe mental illness KENNETH KRESS, J.D., PH.D. and untreated) come to mind. But there is as the chief catastrophic illness where GERALD TARUTIS, ESQ. another individual, his contribution today improvement in care was most needed, generally overlooked , who belongs in the developing the ideas for his ground- EXECUTIVE DIRECTOR class with these pioneering figures: breaking article as a post-doctoral fellow MARY T. ZDANOWICZ, J.D. Morton Birnbaum, father of the concept at the Harvard University Training of a "right to treatment." Program for Social Scientists in Medicine EDITOR/DESKTOP PUBLISHER Today this is such a familiar principle in 1958-59. LORRAINE GAULKE that it is hard to believe that in 1960 it was But even the favorable editorials did considered an outlandish notion. The first not have the effect Birnbaum expected. two sentences in Birnbaum's seminal Says Birnbaum: "I thought once it got FUNDING SOURCES article of that year, The Right to published, the doors would break down STANLEY FOUNDATION INDIVIDUAL DONORS Treatment, sum up its thesis: "The and everyone would say, 'What a ___________________ purpose of this article is to advocate the wonderful idea, you discovered a new recognition and enforcement of the legal penicillin.' But nobody broke down the The Center is a nonprofit organization right of a mentally ill inmate of a public doors. What amazed me was that the only dedicated to eliminating legal and clinical mental institution to adequate medical real comments I got on it were from two barriers to timely and humane treatment for the millions of Americans with severe treatment for his mental illness. For patients in state hospitals. One was brain diseases who are not receiving convenience, this right will be referred to Donaldson in Florida and the other was a appropriate medical care. as the right to treatment." Birnbaum guy, Stevens, in New York." Birnbaum argued that, "incarceration by the state in took on both cases at his own cost. Fifteen Current federal and state policies hinder a mental hospital without proper years later, O'Connor v. Donaldson treatment for psychiatrically ill treatment is a deprivation of liberty became a landmark Supreme Court ruling. individuals who are most at risk for without due process [i.e., unconsti- (Birnbaum pursued the "right to homelessness, arrest, or suicide. As a result an estimated 1.8 million individuals tutional]." treatment" Stevens case with equal with schizophrenia and manic-depressive The article accumulated rejection tenacity, but Stevens was finally freed by illness (bipolar disorder) are not being slips. Birnbaum remembers his an administrative decision, not through treated for their illness at any given time. disappointment. "I sent the article off. It victory in the courts.) seemed to me absurdly simple. I couldn't Well before his triumph in freeing The Center serves as a catalyst to achieve understand that no one would accept it. I Donaldson, who had been held in Florida proper balance in judicial, legislative and could show you maybe fifty rejections. I State Hospital for fourteen years, the policy decisions that affect the lives of persons with serious mental illnesses. sent it off to the New England Journal of "right to treatment" had a major impact on Medicine — it came back. I sent it to the mental health law. (Ironically, much to 2 Catalyst Winter 2001 Birnbaum's disappointment, the Supreme were not providing treatment, it would (as that a sufficient number of alternative Court used other grounds, not the "right to he wrote in The Right to Treatment) "force facilities were not available were of no treatment," to release Donaldson.) the legislatures to increase appropriations avail." Disillusioned, Birnbaum dropped Birnbaum's testimony in 1961 before a sufficient to make it possible to provide out of Wyatt v. Stickney and turned to his Senate subcommittee looking into mental adequate care and treatment so that the opponents in the case. "I said maybe health law led to the drafting of a model mentally ill will be treated in mental you're interested. They're going to give a bill with a provision recognizing and hospitals." Birnbaum even wanted to limit judgment against you, you'll need the enforcing the right to treatment. But the the right of hospitals to discharge sick money. For $100 of Alabama funds, you'd language did not survive. Enacted in 1964, patients into the community. In his 1971 get $300 of federal funds. Without it the final model bill had only a phrase article he wrote: "If no family is available, you're going to get nothing." referring to the right.
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