no dignity or humanity to be found by allowing someone to live in florid psychosis: this is cruel and unusual punishment"
At a Penn State public forum on its child sexual abuse crisis on 11/30/11, it was
said, "It is not sufficient to do only what is legal, one must also do what is moral". Our legal attitude and behavior towards
the plight of the most severely mentally ill is not moral.
definition of "Recovery", which was published on SAMHSA's Web site on December 22, 2011 now states that recovery
is a "process of change through which individuals improve their health and wellness, live a self-directed life, and strive
to reach their full potential." This lofty and lovely sounding goal continues to be a hollow rambling when applied to
the realities of those suffering from treatment resistant and/or treatment defiant psychosis. Since most of the
funding comes from SAMHSA, most will follow this nearly delusional thinking. Have we completely lost commonsense and
An example of the recovery model at work:
Mentally ill boy turnes 18, public mental health services abandon
his care, process of criminalization begins, arrest occurs and release occurs at 4 A.M. (normal policy), boy goes missing!
Let's now look at what happens when one applies
recovery model concepts to a criminalized population:
CONCERNING TREATMENT RESISTANT AND TREATMENT DEFIANT PSYCHOSIS:
The only way to reverse
recidivism (re-hospitalization and re-incarceration) is by securing treatment adherence (compliance) and best symptom control.Treatment
adherence cannot occur without maximal symptom control and vise versa. Understanding the interplay and symbiotic relationship
between treatment adherence and maximal symptom control are the fundamental tenets required for creating effective treatment
plans i.e. reversing recidivism.
An entire generation of seriously mentally ill individuals has experienced failed
system interventions which have effectively denied them treatment. The evolution of de-institutionalization which was followed
by the era of criminalization is now followed by the era of the “recovery model”. Each new ineffective system
intervention fails to secure treatment adherence or symptom control. We continue to waste countless lives and exorbitant sums
of money due to: pervasive misunderstanding of how to treat the seriously mentally ill and a lack of courage
to apply the right and moral treatment tenets.
Model” has demonstrated little to no value for stabilization and growth of individuals suffering from severe mental
illness with or without substance abuse. This website will offer an alternative to the existing ineffective policies and practices
mandated by recovery model funding or insurance funding both of whom ignore the most seriously mentally ill.
For an initial analysis on the reasons why the Recovery Model is not suitable
for the treatment needs of treatment resistant and treatment defiant psychosis, please click here and read the following:
do the majority of the mentally ill individuals already confined to incarceration, abandoned to homelessness or living lives
of desperation inside their families’ homes or community group homes NEED in order to change their circumstances and experience
relative wellness? Neither, the Public Health Care System, American Psychiatric Association, nor any Private Provider has
yet to reduce the enormity of the problem or offer an effective model of care. The answer can be found in the following “John
Henry Model”©. This model of care has been applied successfully for more than two decades and offers stabilization
of symptoms, long term adherence to treatment, and growth opportunities consistent with individual skill sets. A short introduction
to the “John Henry Model”© is provided below for your consideration. The detailed programming content and
treatment plan philosophies are beyond the scope of this introduction. However, one important element of success for this
model applies limited and periodic minor restrictions to any right which contributes to illness or endangers the individual
for just cause. These rights restrictions are legal in any contractual relationship established prior to initiation of treatment
and are only applied for best interest objectives: "Individual Treatment Contract" (c). To read more on
the "Individual Treatment Contract" please click here. Any agency or treatment program which follows the party line protecting rights over needs is ineffective, ignores
the suffering of the severely mentally ill, and perpetuates the existing problem. To read an analysis of "The Right to
Treatment vs The Right to Refuse Treatment", please click here.
John Henry Model (c)
Health Comprehensive Integrated Care (Integrated Recovery) is becoming a more frequently used concept for addressing the failed
policies of treatment for the chronic and seriously mentally ill with or without co-occurring substance abuse. This population
which is either untreated by patient defiance, treatment resistance, or failed access to treatment, consumes the lion’s
share of mental health care dollars. Our prisons and state hospitals are full of individual’s dual diagnosed with psychotic
disorders and substance abuse histories and these sad lives can be abundantly found among the homeless.
Any hope of providing effective and sustained treatment will depend on the capacity
of a treatment environment to provide the comprehensive integrated services needed to control symptoms, change dysfunctional
behavior and thinking, and offer growth opportunities consistent with existing skill sets. This comprehensive array of services
or (Applied Integrated Therapies A.I.T.) © are described below and are an integral part of the John Henry Model ©
of care. Critical to the success of Applied Integrated Therapies is the existence of permanent, suitable, and affordable housing.
From this central place of safe and stable housing, these wraparound comprehensive services can be consistently provided and
maintained for as long as is necessary.
John Henry Model (c)
Applied Integrated Therapies (A.I.T.) (c) http://appliedintegratedtherapies.com/ http://www.themassiminocompany.com/
"Applied Integrated Therapies for the Seriously and Chronically
Mentally Ill with or without co-occurring substance abuse." Multifaceted integrated treatment strategies whose
purpose is to provide stabilization of symptoms, maintenance of realized gains and growth ultimately leading to sustained
rehabilitation. Components of the multifaceted strategies must include:
• Aggressive medication utilization
(including Clozapine) with lifelong adherence to treatment
• Individual, Family, and Group Psycho-therapies
including but not limited to insight, cognitive and process oriented strategies.
• Intense behavior modification
(applied behavior analysis with board certified behavior analyst – BCBA)
• Social skills training
• Continuing enhanced educational and recreational opportunities
• Life-skills teachings (money
management, hygiene, time management, prioritization skills, etc.)
• Habit retraining (food, exercise, healthy
personal choices etc.)
• Addiction intervention (overeating, alcohol, tobacco, and drug abuse termination)
and abstinence maintenance.
• Work and structure (discipline) training
• Medical consultants
providing continuous collaborative treatment with the mental health team.
• Societal reintegration training
(maladaptive behavioral extinction coupled with continual reinforcement of socially appropriate conduct, leading to the creation
of independent life-skills and continuous learning and clear thinking mastery.
The John Henry Model (c) "A comprehensive integrated relapse prevention and growth model for outpatient psychiatric
The John Henry Model designates a unique
and comprehensive model of integrated services for outpatient psychiatric care. In much the same way that we have learned
to value a computer's parts, its hardware and software working together for smooth and efficient operation, the John Henry
Model similarly merges the hardware (property, structures, personnel) with the software (programming, concepts, routines,
schedules and implementation) to create an efficient, effective and economical solution for psychiatric rehabilitation and
To implement the John Henry Model is to understand
and believe that all of the elements of care required to treat any chronic disabling mental illness must exist in a cooperative,
constant, affordable, desirable, competent and accessible form. One might ask which of the elements of care are more
important. Is it constant affordable physician psychiatric care? Is it decent, permanent single room occupancy housing,
Is it oversight, guidance and continuous reinforcement for habit change, compliance and growth? Is it access to friendship,
human purpose and relationship? Is it the relapse prevention programming and techniques? The truth is that every
element of required care is equally important. The desired outcome (patient wellness) of any healthcare service devoted
to care for the chronically mentally ill will always be limited by the elements of care that are missing, not by the elements
of care that are present. In other words, to offer someone prescribed medication without housing is a failed effort.
To offer someone housing without the opportunity for social engagement and human purpose is likewise a prescription for failure.
The wheel requires all of its spokes. The building requires all of its support pillars. The John Henry Model does
so with its unique approach to providing comprehensive and integrated services designed to address relapse and encourage patient
growth in a setting of outpatient psychiatric residential care.
full text and description of the John Henry Model expands and defines each essential element of comprehensive care and includes:
• Facilities/physical layout
• Programming content
• Outcome expectations
We hope this
brief introduction to the John Henry Model (c) and Applied Integrated Therapies (A.I.T.) (c) has been useful. Health-care
reform which addresses the needs of the seriously mentally ill will require bold innovation, commitment, and a belief
that effective treatment strategies are possible. We look forward to your thoughts and ideas. Please use the email