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The Honorable Advocate

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The Honorable Advocate

DJ Jaffe (1954‒2020) August 24, 2020
Health Care
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Don Lyle Jaffe, known to all as DJ, died this past weekend. With his passing, Americans with serious mental illness lost their most devoted advocate. Though our mental-healthcare system remains in many ways a long-standing disgrace, some rays of hope for reform have broken through in recent years. Jaffe’s hand was behind every one of these encouraging developments.

More generally, we’ve lost one of the most honorable advocates of any cause. Advocates’ influence on policymaking is sometimes suspect. Many are too concerned with their funding, or with status. But none of that was the case with DJ Jaffe. He was not a professional advocate. Self-taught, modest to a fault, and only ever interested in improving the lives of the mentally ill in material ways, such by as reducing their rates of incarceration and homelessness, Jaffe set an example of advocacy as a noble calling.

Jaffe didn’t like to be known as a “mental-health advocate.” He’d often say, “I’m not a mental-health advocate, I’m an advocate for the seriously mentally ill,” meaning the 4 percent to 5 percent of the adult population that suffer from often-incapacitating conditions, such as bipolar depression and schizophrenia. This was a provocation, meant to accuse the broader mental-health community of neglecting the hardest cases. Jaffe believed in straight talk. He insisted that authentic reform required acceptance of bitter truths, such as the fact that some people never recover from mental illness, and that the untreated seriously mentally ill are more dangerous than most people.

He also believed that true advocates should work across the political spectrum. A liberal Democrat “to the left of Bernie,” as he liked to put it, Jaffe took pride in his many partnerships with conservatives who shared his vision of a mental-healthcare system that offered “treatment before tragedy.” Last year, he advised some Democratic presidential campaigns on their mental-health agendas. But he was also a strong supporter of Elinore McCance-Katz, the Trump administration’s head of the Substance Abuse and Mental Health Services Administration. DJ Jaffe was a coalition unto himself, his contacts reaching from low-income Harlem to affluent Bay Area suburbs.

Jaffe never flagged, even when the prospects for reform were at their dimmest. He would take meetings with almost anyone, and happily rehash the same points he’d gone over thousands of times before. The late Christopher Hitchens could have been speaking of DJ when he claimed, “Very often the test of one’s allegiance to a cause or to a people is precisely the willingness to stay the course when things are boring, to run the risk of repeating an old argument just one more time, or of going one more round with a hostile or (much worse) indifferent audience.”

Jaffe’s most notable accomplishment was helping to pass New York’s Kendra’s Law, which created the most effective assisted outpatient treatment (AOT) program in the nation. He considered AOT the most promising and underused policy intervention for the untreated seriously mentally ill. DJ embraced the goals of community-based mental-health care. That system could only work, though, if it provided adequate supervision for the sickest cases. Thousands of seriously mentally ill individuals and their families benefited from Jaffe’s enthusiastic promotion of assisted outpatient commitment.

Jaffe played a lead role in passing the Helping Families in Mental Health Crisis Act of 2016, which formed the core of the mental-health policy reforms that President Obama signed into law in the 21st Century Cures Act. There was no more effective critic of California’s Mental Health Services Act and New York City’s Thrive NYC initiative, programs which have demonstrated scant results after billions in spending. Jaffe showed many why shoveling more money into a broken system is not real reform. Several prominent New York politicians, including City Council Speaker Corey Johnson, have of late spoken with urgency about how the seriously mentally ill need policies tailored to their specific needs. That was all because of DJ Jaffe.

His website, mentalillnesspolicy.org, is an outstanding clearinghouse of research and analysis. In his 2017 book, Insane Consequences: How the Mental Health Industry Fails the Mentally Ill, Jaffe condenses a lifetime’s work of researching the mental-health system, its flaws, and its promise. A good summary of his thought may be found in a talk he gave at the 2018 national conference of the National Council for Behavioral Health, of which he was particularly proud.

One more thing. Jaffe taught that no voice is more important to mental-health reform than that of families. That was his background: he became involved in the issue when he and his late wife became responsible for caring for her mentally ill sister. Not everyone understands how much we ask of family caregivers of the mentally ill. But the hard-won lessons that come from navigating our dysfunctional mental-health system give families unique credibility. No one understands like families how best to help the hardest cases who refuse treatment. Jaffe learned much from the many families he worked with, but they also learned from him that they’re not alone, and that real reform won’t happen unless they step up.

DJ Jaffe joined the Manhattan Institute as an adjunct fellow in 2018 and published frequently in City Journal. He was a generous colleague; we didn’t have him for as long as we needed him. But he set a standard that his many friends will long be able to turn to for guidance and strength. “What would DJ have made of this?”—we’ll all be asking that question for years to come.

Photo: Manhattan Institute

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