SMI Spotlight

In today's episode of SMI Spotlight, Maria Sutherland joins Dr. Xavier Amador to discuss the systemic failures that led to the loss of her son Michael, following complications of his schizophrenia diagnosis. Their discussion touches on the need for supportive housing, dedicated behavioral health crisis response teams, extended family guardianship, increased access to long-acting injectables, and widespread understanding of anosognosia - the lack of insight preventing many with SMI from engaging in treatment. Sections:

• (00:00) - Intro
• (01:32) - Maria Sutherland
• (02:25) - Michael and his diagnosis
• (05:46) - First episode of psychosis
• (06:58) - Vulnerable brains
• (07:44) - Seeking and denying treatment
• (08:51) - Learning not to take things personally
• (10:44) - Stabilization through incarceration
• (12:35) Michael's decline post-incarceration
• (14:56) - The need for supportive housing
• (18:22) - Thoughts on intervention teams
• (21:28) - Thoughts on wellness checks
• (23:11) - Building trust through relationships
• (24:08) - Limitations of wellness checks
• (25:23) - Lengthening guardianship rights
• (26:33) - Anosognosia in depth
• (29:29) - Empathy and SMI
• (31:31) - Injections as treatment
• (33:47) - Brain scans aren't for diagnosis
• (34:36) - Efficacy of long-acting injectables
• (36:30) - Nutrition and gut-brain connection
• (38:02) - Supporting people with SMI, like other disabilities
• (39:34) - Self-care#schizophrenia #smi #xavieramador #anosognosia

In this episode of SMI Spotlight, Dr. Xavier Amador sits down with Dr. Roshni Koli, Chief Medical Officer at the Meadows Mental Health Policy Institute, to explore the Collaborative Care Model — an evidence-based approach integrating mental health care into primary care settings.Dr. Koli explains how this model:-Increases access to early mental health intervention-Supports primary care doctors with psychiatric consultation-Reduces stigma and improves follow-through on care-Addresses the urgent workforce shortage in mental healthThey also discuss how collaborative care impacts those with serious mental illness (SMI) and what it means for improving equity in rural and underserved communities.⏱ With evidence from over 90 clinical trials, collaborative care is proven to be more effective than standard care — and it’s the only integrated healthcare model with its own billing codes for care coordination.Whether you're a clinician, policymaker, caregiver, or someone seeking better access to care, this conversation offers a blueprint for a better, more integrated system.Video Sections:

• (00:00) - Intro
• (01:01) - Welcome!
• (03:22) - What is the Collaborative Care Model (CoCM)?
• (04:52) - Why CoCM?
• (05:56) - How CoCM works in practice
• (06:46) - CoCM and stigma
• (07:50) - Engaging caregivers in CoCM
• (09:44) - CoCM for people with anosognosia
• (11:25) - Financial benefits of CoCM
• (13:28) - CoCM for children and adolescent populations
• (13:48) - Results from studies of the CoCM
• (14:29) - How CoCM applies to children
• (15:40) - Measurement-informed care
• (16:54) - Back to pediatric CoCM
• (19:14) - Finding a CoCM physician
• (19:45) - Process for CoCM Implementation
• (20:39) - Cost effectiveness of CoCM
• (21:54) - Behavioral Care Manager training
• (24:39) - Behavioral Care Manager role
• (26:59) - Asking for CoCM
• (28:43) - MMHPI Resources
• (29:07) - CoCM and mental healthcare reform #xavieramador #collaborativecare #carecoordination #smi

In today's SMI Spotlight episode, Dr. Xavier Amador, clinical psychologist, author of I Am Not Sick, I Don’t Need Help!, and creator of the LEAP (Listen, Empathize, Agree, Partner) method, answers listener questions about severe mental illness (SMI), including schizophrenia, anosognosia, family communication, and advocacy.🔹 Topics Covered in This Episode:✔️ How to respond to delusions and paranoid thinking in loved ones✔️ Tips for families dealing with anosognosia (lack of insight)✔️ Using LEAP communication techniques to build trust and encourage treatment✔️ Supporting a loved one in jail or the legal system while maintaining boundaries✔️ Finding and maintaining hope despite societal challenges✔️ How to plan for long-term care as aging caregivers✔️ Breaking the cycle of hospitalization, incarceration, and homelessness📢 About Dr. Xavier Amador:Dr. Amador is a world-renowned psychologist, mental health advocate, and founder of the LEAP Institute. His work has been featured in major media outlets, and his expertise helps families, clinicians, and law enforcement better understand how to communicate with individuals who struggle with insight into their illness.Episode Sections:

• (00:00) - Intro
• (00:59) - Welcome!
• (01:58) - Question 1 - How to respond to different content of delusions
• (04:35) - Minimizing the emotional pain from delusional accusations
• (05:51) - Different types of delusional content
• (06:30) - Ask questions to determine potential risk
• (07:44) - Question 2 - How to stop the revolving door of hospitalization, incarceration, and homelessness
• (09:21) - How for a loved one specifically
• (11:46) - Recognizing small victories
• (13:32) - Question 3 - How to maintain hope in a broken system
• (13:48) - Seeking out success stories
• (15:31) - Lisa's sister's success
• (16:59) - A marathon not a sprint
• (17:46) - Question 4 - How can aging care partners prepare for when they will no longer be able to provide full support?
• (18:17) - Talk to an estate attorney, engage other family
• (20:44) - Living independently with supports
• (22:29) - Question 5 - How to use LEAP in difficult situations
• (24:22) - Example where Dr. Amador used LEAP
• (26:52) - How to handle the repetition of the same topics over and over
• (29:32) - Navigating conflict when people aren't ready to listen
• (30:41) - Managing emotions as a family member
• (33:29) - Dr. Amador and his son
• (34:40) - How to contact us!🎙️ Have a question for Dr. Amador? Submit your questions in the comments, call and leave a message at 703-294-6005, or contact us via email at [email protected]🔔 Subscribe and turn on notifications to never miss an episode of SMI Spotlight and Ask Dr. Amador!#XavierAmador #LEAPMethod #SevereMentalIllness #MentalHealth #Schizophrenia #Anosognosia #Psychology #MentalHealthAdvocate #FamilySupport #MentalHealthAwareness #AskDrAmador #SMISpotlight

Sections:

00:00 Anosognosia: key schizophrenia symptom often overlooked

00:56 Introducing Lindsay and Dr. Xavier Amador

04:12 Myth of the Schizophrenogenic mother

05:44 Med compliance

06:40 "Died by" vs. "committed" suicide

07:21 What helped her brothers stay in treatment?

09:18 Why in treatment even with anosognosia?

10:19 Conflict over taking medication

11:21 Telling someone to stop hallucinating

12:02 Getting help herself

12:27 Sexual abuse and SMI

14:58 Distancing family from psychosis

16:24 Not knowing about anosognosia

18:15 Why even professionals may not have heard of anosognosia

19:49 The difference anosognosia makes in schizophrenia outcomes

20:56 How understanding anosognosia would have made a difference in Lindsay's family

23:18 Anger at the individual with SMI

24:01 Anosognosia in SMI vs. in Alzheimer's

24:54 The wide variety of schizophrenia symptoms

27:07 Clozapine

28:50 Average time from onset of SMI to treatment

29:49 Viewing anosognosia as one possible symptom

30:33 Peter's death from long-term high-dosage of medication for SMI

34:37 Is med treatment enough? Importance of therapy36:23 Wave of support from families who have experienced SMI

37:02 Reflecting on the documentary series

38:44 Separating SMI from other mental health and substance use diagnoses

40:16 Housing for people with SMI

41:28 The difficulty in accessing appropriate care - Clozapine example

42:32 Peter's experience with criminalization

45:14 For profit prisons and the defunding of psych hospitals

46:21 The current lack of enforcement of parity laws

47:56 Arizona Mad Moms

48:49 More compassion for people with SMI

50:50 How awareness of anosognosia changes people's view of SMI

53:04 Lindsay's website54:18 Involving family in the care of people with SMI

55:32 How Lindsay's advocacy for her brother's care was crucial for his heart treatment

56:37 Getting around HIPAA with power of attorney

57:18 Contact us!Lindsay’s website! https://lindsaymarygalvinrauch.com/Schizophrenia is one of the most misunderstood mental illnesses, but few people know about one of its most devastating symptoms—anosognosia. This neurological condition prevents individuals from recognizing that they have an illness, leading to treatment refusal, medication noncompliance, and a cycle of hospitalization, homelessness, and incarceration.In this powerful conversation, we hear firsthand how anosognosia shaped one family’s experience, affecting six siblings diagnosed with schizophrenia and schizoaffective disorder. Their story sheds light on the mental health crisis, the failures of the psychiatric system, and the urgent need for better education, treatment, and compassion.Every year, millions of people struggle with untreated schizophrenia due to anosognosia. Families are left feeling helpless as their loved ones cycle through hospitals, jails, and homelessness. We must educate the public, improve psychiatric training, and advocate for better policies to ensure people with serious mental illness receive compassionate, effective care.

Important Topics Discussed:🔹 Why anosognosia is NOT denial—it's a brain disorder.🔹 How the criminal justice system fails people with schizophrenia.🔹 The urgent need for housing, medical care, and psychiatric support.🔹 Why blaming parents for schizophrenia is outdated and harmful.🔹 How mental health parity laws need better enforcement.🔹 The need to separate serious mental illness from general mental health discussions.🚨 Serious mental illness is a public health crisis. It's time to change the conversation. #Anosognosia #Schizophrenia #MentalHealth #SeriousMentalIllness #SchizoaffectiveDisorder #BipolarDisorder #Clozapine #MentalHealthAwareness #Psychiatry #BrainDisorder #SchizophreniaAwareness #LEAPMethod #DrXavierAmador #EndTheStigma #MentalHealthMatters #SeriousMentalIllnessAwareness #Clozaril #MentalHealthAdvocacy #Psychosis #PsychiatricCare #HIPAA #MentalHealthCrisis

Dr. Xavier Amador is an internationally renowned clinical psychologist and leading expert on anosognosia. As TAC’s Scientific Officer, Amador brings decades of clinical research, worldwide speaking tours, and extensive work in schizophrenia, bipolar, and other disorders to audiences through written blog posts, podcasts, and social media. Amador is the founder of the LEAP Institute, CEO of the Henry Amador Center on Anosognosia, author of many popular books on topics related to SMI, and has previously served as faculty at Columbia University and other institutions. Dr. Amador is passionate about making information about SMI easier to understand and widely available.

As TAC's Executive Director, Lisa Dailey leads an energetic team dedicated to improving the lives of families affected by severe mental illness with a focus on only this population through the lenses of advocacy, research, public education, and movement-building. Dailey brings many years of nonprofit policy and advocacy experience as well as a diverse background as an attorney that includes trial work, representation of asylum-seekers, and legal scholarship in the area of human rights and civil liberties. Dailey read for a master’s degree in international human rights from the University of Oxford after earning a juris doctor from Hamline Mitchell School of Law and bachelor’s degrees in psychology and English from Macalester College.