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The Dorothea Dix Think Tank was created by Dr. Dean Brooks to decriminalize mental illness. It was established as a donor-advised charitable fund with the Foundation for Excellence in Mental Health Care. Dr. Dean Brooks, former superintendent of the Oregon State Hospital, was a veteran and nationally known advocate, best known for his role in the film, One Flew Over The Cuckoo’s Nest, where he played Dr. Spivey as a "weak-willed ward psychiatrist who deferred all power to Big Nurse." Using his extensive contacts, Dr. Brooks assembled a panel of experts in mental health and the law to discuss and recommend solutions for what has become a national scandal in our country.

The Problem
According to the National Institutes of Mental Health, five to seven percent of Americans suffer from what are called Serious Mental Illnesses (SMI), such as schizophrenia and bipolar order. These SMIs often are debilitating, robbing persons of their ability to live normal lives.

In 1955, some 560,000 Americans were being treated for mental problems in state hospitals. Between 1955 and 2000, our nation’s population increased from 166 million to 276 million. If you took the patient-per-capita ratio that existed in 1955 and extrapolated it on the basis of the new population, you’d expect to find 930,000 patients in state mental facilities. But there are fewer than 55,000 in them today.

Where are the others?
More than 360,000 of them are in American jails and prisons. Another half million are on court-ordered probation. The largest public mental health facility in America is not a hospital. It’s the Los Angeles County jail. On any given day, it houses 3,000 mentally disturbed inmates.

Sadly, America’s jails and prisons have become our new mental asylums. The cost to the public is staggering in both wasted tax dollars and in human suffering. Two of the driving forces behind this shift from treatment to incarceration have been an ongoing lack of access to meaningful community based treatment services and civil rights laws that prevent people, who are clearly sick, from being involuntarily committed into treatment programs.

Addressing the issue
Having opened a donor-advised charitable fund at the Foundation for Excellence in Mental Health Care, psychiatrist Dean Brooks has assembled a group of nationally recognized experts as a “think tank” to study the imprisonment of persons with mental disorders. This group is specifically focusing on mental health laws and access to services.

Mental Health Laws
In 1975, the courts issued what is known as the Lessard civil commitment decision, which stopped persons with mental disorders from being involuntarily committed to a state hospital “unless they were a danger to self or others.” The unintended consequences of this law forty years later is that the “dangerousness” criteria often prevents persons from getting help until they break a law. Thirty-five states have recognized this problem by adding language to their statutes that permit involuntarily commitment if a person is “gravely disabled” or “unable to care for self or others.”

Yet, the dangerousness issue continues to be a hot topic. (See December 10, 2011 article by Meg Kissinger in the Milwaukee Journal Sentinel headlined: “Law creates barriers to getting care for mentally ill.” It’s first paragraph describes the dangerous statute as “tragically inadequate.)

The Dorothea Dix Fund and its “think tank” are taking a detailed look at the “dangerousness” criteria and have been given the challenging task of suggesting an alternative that will satisfy civil rights concerns but also get people who are clearly sick into treatment.

Of course, having a better involuntary commitment statute is meaningless without having treatment services available, which is the second issue that the Dorothea Dix Fund is addressing. Once again, the fund’s members are looking for solutions “outside the box” such as whether our U.S. Constitution guarantees persons who are involuntarily committed (and therefore lose their freedom) access to a high standard of medical care and treatment services that must be provided by state and federal governments.

The Think Tank
What makes the Dorothea Dix Fund different from studies, such as the President’s New Freedom Commission on Mental Health? The fund has brought together a panel of recognized experts who have “hands on” experience both in mental health and our justice system. They include: Dr. Dean Brooks, retired superintendent of Oregon State Hospital; Pete Earley, author of Crazy; Dr. Darold Treffert; Dr. Paul Fink; Dr. Richard Lamb; Elyn Saks JD, Director of the Saks Institute at USC; Al Bendich, JD; Dr. Steven Sharfstein; Judge Steven Leifman; Dr. Jerry Dennis; Fred Frese, PhD; Dennie Brooks; Greg Roberts, current superintendent of Oregon State Hospital; Max Williams, JD, Executive Director of the Oregon Community Foundation; Virgil Stucker, President and Chairman of the FEMHC and Gina Nikkel, PhD, Executive Director of the FEMHC.

Dean Brooks has challenged this group to use their expertise and their extensive contacts to effectively alter the impact of the Lessard decision and help divert individuals in need to care and treatment.