DJ Jaffe will tell you he’s a left-wing liberal, but most of the people who listen to his proscriptions on mental health care tend to be conservatives. Not that this matters to Jaffe, who has spent years in the trenches as a non-partisan advocate for the seriously mentally ill and as a executive director of Mental Illness Policy Org, a group that produces policy analysis for legislators, mental health advocates, and the media.
His 2017 book, Insane Consequences: How the Mental Health Industry Fails the Mentally Ill is about exactly what the title suggests: how those with serious mental illness are lumped into one amorphous group along with those with much milder mental health issues; and how the seriously mentally ill — those with violent tendencies who may never recover — are mixed in with the general population of people who can, and often do, get better.
“My fellow Democrats unfortunately think throwing money at mental health is the same as treating the seriously ill,” says Jaffe, who is an adjunct fellow with The Manhattan Institute and has worked with the American Legislative Exchange Council (ALEC). “And they’re wrong.”
Jaffe says the problem with the “throw money at the issue and hope it fixes it” approach is that 1) it leaves fewer resources for the seriously mentally ill – the 4% of the population so seriously ill that their malady creates a “functional impairment that inhibits their ability to engage in daily life and activities”; and 2) it blurs the focus, leaving legislators unwilling to take initiative on solutions for the seriously mentally ill for fear those solutions may detract from solutions for those less ill.
“May was Mental Health Awareness Month, and everyone is running their public service announcements of high-functioning individuals seeking mental health improvement at best,” Jaffe says. “Well that misleads the public about what’s really needed. They won’t show people who are homeless and psychotic and eating out of a dumpster because they fear it will cause a stigma about the issue and harm their ability to help. I say it stigmatizes the issue to deny that the seriously mentally ill who are left untreated are more violent.”
Following the most recent shooting at a high school in Santa Fe, Texas, Jaffe pointed out that school shooters are among the seriously mentally ill who are lost in the confusion of what constitutes serious mental illness versus what constitutes minor mental health issues. He says there’s a pervasive idea that anything that makes a person happier can be a treatment, and that’s a dangerous line of thinking when deciding what can be done for the seriously mentally ill.
In a recent TED Talk (embedded below) at NATCon18 (the National Council for Behavioral Health Conference), Jaffe laments that the seriously mentally ill — because most policy programs have funneled mental health treatment resources into yoga, and dance, and therapy dogs, etc. — are going from hospitals straight to jails. He notes the number of seriously mentally ill hospitalized today looks smaller because many of those who, 40 years ago, would be hospitalized are now incarcerated.
“We have to start ending this mental illness to jail pipeline,” he says. “And there are several ways we can do it. We should support hospitals, and that means eliminating the federal government’s Institution for Mental Disease (IMD) exclusion (which restricts Medicaid payments for certain institutions, potentially reducing access to low-income individuals with mental illnesses) which is federally sanctioned discrimination against the mentally ill.”
He is also vocally critical of what he calls “radical peer communities,” groups like The Bazelon Center for Mental Health Law, the federal program Protection and Advocacy for Individuals with Mental Illness, the American Civil Liberties Union (ACLU), and The Center for Mental Health Services.
These are groups, Jaffe says, that “believe that being psychotic, delusional, and hallucinating is a ‘right’ to be protected rather than an illness to be treated.”
Watch the full TED Talk below, and learn more about Jaffe’s work via his writing at Huffington Post.