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Views on assisted outpatient treatment: Fuller Torrey, M.D.

April 24, 2014
by Alison Knopf
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Fuller Torrey, M.D, shares his experiences and views on AOT.
Fuller Torrey, M.D.

AOT is essential because of anosognosia, Fuller Torrey, M.D., founder of the Arlington, Va.-based Treatment Advocacy Center, told Behavioral Healthcare and central to the legislative work Rep. Tim Murphy (R-Penn.) is trying to accomplish. “The whole issue of involuntary treatment is one that’s difficult to resolve,” he said. “Either you believe that nobody should ever be treated involuntarily and there’s no such thing as anosognosia, that people really can make decision – or you come down on the other side and say there’s a subset of people who have anosognosia, who cannot understand that they are sick,” he said. (Anosognosia is a condition in which the individual doesn’t realize that he or she is mentally ill.)

Torrey used AOT on patients in the District of Columbia when he worked at St. Elizabeth’s hospital, on a “fairly regular basis,” he said. “It was almost always a male,” he said, adding that women are less likely to refuse medication. “Typically, it was someone who had been in the hospital 15 times, had no awareness of his illness, and who would throw his medicine in the garbage on the way out.”

Torrey says he would go to court and say he knew he had to discharge the patient, but also knew the patient wouldn’t take his medication. “I would tell the court,” he said, ‘I would like to discharge him on the condition that he has to come back every two or three weeks to get his injection, and if he doesn’t come back, I have the legal right to send police out to get him.’That patient would come back and say, ‘The only reason I’m here is because you’re making me come here.’ And I would say, ‘Roll up your sleeve -- and how are you?’ And it worked.”

Torrey’s sister is a good example, he said. She was hospitalized for 25 years, after which she would always take her medicine. “She would take it because she learned that she would be right back in the hospital if she didn’t,” he said. “She liked life in the community.”

Read the pros and cons of AOT in the two-part series starting with part one by clicking here.

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Another possible school of thought exists if you can see past your own selfish absolutes. In more than fifty years the only great discovery that psychiatry has made has been renaming disorders and finding new ones to fit new medications. I've been listening to doctors describe my character as though phrenology is now affiliated with my current range of prescriptions and diagnosis instead of the shape of my head, and the simple truth is psychiatry is no closer to even explaining the cause (or even satisfactorily defining my disorder (which, notably, was first described in second century AD and has not changed)than they are in predicting the way I view my mental state. Anosognosia is nothing more than a tool to add to a profit margin. If psychiatry has established a telepathic link to the mentally ill, I would have to wonder why they can't predict behaviors before they occur.
Psychiatry has been trying the same failed methods of treatment every ten years for quite some time, and it destroys lives.

I would greatly like to speak with Dr. Torrey. I have been homeless or in shelters for nearly two years now in California. For the past 8 years, I’ve been the subject of a great deal of harassment that has been referred to as “behavior modification.” During that time, I was told twice that my “whole life is an experiment.” The ordeal of the past 8 years started with a very threatening experience with a mental health professional who used deceptive and confusing tactics during our encounter. The experiment that is my life is a behavior-control/mind-control/brainwashing experiment related to loneliness studies and is connected to my time as a student at Ohio State University and The University of Toledo. I figured it out when I read this article: https://newrepublic.com/article/113176/science-loneliness-how-isolation-can-kill-you. They are trying to keep me buried and it is critical to them to portray me as insane. By the way, I’ve seen how many homeless people in San Francisco and Sacramento have overtly manifested mental illnesses and I’ve seen the wretched conditions they live in, namely, being homeless which is extremely difficult. I would greatly like to speak with Dr. Torrey about my situation. I was told once, “You’re an experiment,” and, on another occasion, “Your whole life is an experiment.”

— John Paul Zoccali zoccali.jpaul1@gmail.com USPS: General Delivery, 660 J Street, Sacramento, CA 95812