SMI Spotlight

TAC
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  • MENTAL HEALTH
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SMI Spotlight shares stories, research, and helpful information relating to severe mental illnesses such as schizophrenia, schizoaffective disorder, and bipolar disorder. SMI Spotlight is hosted by TAC's Scientific Officer, the renowned clinical psychologist Dr. Xavier Amador, author of "I Am Not Sick, I Don't Need Help!"

Episodes

  1. JAN 21

    Effective Talk Therapy for Schizophrenia and Psychosis

    In this SMI Spotlight episode, Dr. Xavier Amador - clinical psychologist and author of I Am Not Sick, I Don’t Need Help! - sits down with Dr. Aaron Brinen, author of Living Well With Psychosis and a leading expert in Recovery‑Oriented Cognitive Therapy (CT-R).Together, they explore how CT-R helps people living with severe mental illness (SMI) build hope, strengthen personal agency, and move toward meaningful, self‑directed recovery.Dr. Brinen shares insights from his clinical work, the science behind CT-R, and the powerful role that goals and adaptive motivation play in helping individuals with psychosis move forward. He also offers practical guidance for clinicians, ACT teams, families, and anyone seeking effective recovery‑focused strategies.If you’re a family member seeking tools to support a loved one, a clinician wanting to learn more about CT-R, or someone with lived experience looking for hope-oriented approaches you’ll find this conversation invaluable.Video chapters: (00:00) - Intro (02:23) - Dr Brinen's background (04:17) - The connections between treatment of psychosis and anxiety disorders (05:07) - Recovery oriented cognitive therapy - meaningful recovery (07:59) - Tapping into personal, motivating dreams and goals to serve recovery. (09:02) - What's a typical opening question in this type of therapy? (10:44) - How does recovery oriented CBT help with symptoms of SMI? (14:49) - What's the time investment by a clinician to get this intervention to work? (15:50) - Training ACT teams in CT-R and how widespread is CT-R? (19:28) - CT-R with Anosognosia - lack of insight(21:23) - How CT-R bypasses the "need" to have insight into one's diagnosis (24:45) - Hope, identity, and personal agency (28:02) - Activating the adaptive mode in CT-R (30:33) - How to find a CT-R therapist (31:16) - 3 actionable steps for families to help a loved one with SMI (35:14) - A key priority for policymakers to help people with SMI

    41 min

  2. 2025-11-19

    The nurses leading mental illness outreach in NYC subways

    In this episode of SMI Spotlight, Dr Xavier Amador sits down with three nurses from New York City’s SCOUT (Subway Co-Response Outreach Team) program — a unique initiative that brings mental health expertise directly into the NYC subway system. These clinicians meet people with severe mental illness (SMI) where they are, building trust underground, offering compassionate care, and helping individuals access treatment when they need it.The SCOUT nurses share what drew them to this work, how they build relationships in unpredictable environments, and how they know when it’s time to bring someone to the hospital. They break down the mental status exam, discuss person-centered assessment tools, and talk about maintaining dignity, safety, and humanity — even when police are present. Through powerful stories, they show what successful outreach really looks like: connection, compassion, and meeting people with severe mental illness without judgment.We also explore how SCOUT measures success, what program evaluation looks like in the field, and how a humanizing approach can change lives at an individual level. Whether you’re a clinician, advocate, policymaker, or someone who wants to better understand SMI, this conversation offers a grounded, hopeful look at compassionate street-level mental health care in NYC.Video Sections: (00:00) - Intro(01:41) - What is the SCOUT program? (03:08) - What attracted them to the program? (07:02) - How do you build relationships and know when it's time to take someone to the hospital? (10:18) - Mental Status Exam Overview (13:11) - Clinical assessment tools with a humanizing approach (16:51) - Maintaining the dignity of the person (18:19) - Helping individuals feel safe even with police presence (19:38) - Tactics for helping people feel safe (23:20) - Program success stories (28:21) - Measuring success in connection and care (29:01) - Program Evaluation (30:15) - Seeing the humanity of unhoused and mentally ill people (35:46) - People-first thinking and language (39:40) - Treating everyone like family (41:49) - Effectuating change at an individual level

    47 min

  3. 2025-10-14

    A sister's story: actor Michele Hicks on her brother's schizophrenia

    In this episode of SMI Spotlight, host Dr. Xavier Amador talks with actor and advocate Michele Hicks about her brother’s journey with schizophrenia and what it means to be a family caregiver.Michele shares her deeply personal story — from recognizing her brother’s first symptoms and navigating interactions with police and providers, to understanding anosognosia (lack of insight), the limits of HIPAA, and the emotional toll of caregiver burnout and guilt.She also discusses how her experience inspired her advocacy work with Treatment Advocacy Center, the importance of including families in treatment, and how the media industry can help portray serious mental illness with honesty and compassion.Hosted by Dr. Xavier Amador, SMI Spotlight explores real stories and expert perspectives on severe mental illness (SMI) — bringing awareness to conditions with psychosis like schizophrenia and bipolar disorder while highlighting the people and policies shaping better care.Video Sections: (00:00) - Intro(01:31) - Michele Hicks (01:47) - Intro to Michele's advocacy work with TAC(02:20) - How is Michele's brother now (02:56) - Interactions with police (03:42) - The start of Michael's symptoms (04:39) - Intellectual disability with schizophrenia and anosognosia (05:56) - Being a parentified child caregiving for siblings with challenges (08:04) - Interactions with medical providers (09:57) - HIPAA (10:28) - Michele's advocacy work (10:58) - Navigating HIPAA as a family member (12:57) - Navigating burnout as a family caregiver (14:19) - Navigating feelings of guilt (15:59) - Michele's relationship with her brother (17:39) - Media industry and depictions of SMI (18:58) - Mental Health vs Mental Illness (19:32) - How Michele got involved with TAC (22:03) - Importance of self care (22:46) - Involving families in treatment as much as possible (24:05) - Ways of processing - not calling (26:40) - The weight of responsibility as a caregiver (28:14) - The role of creatives spreading stories

    30 min

  4. 2025-09-18

    When full recovery from schizophrenia isn't possible

    In this episode of SMI Spotlight, Dr. Xavier Amador speaks with Leslie Carpenter, TAC's legislative advocacy manager. Leslie is a passionate mental health advocate whose lived experience supporting a family member with a severe mental illness has shaped her perspective on treatment and recovery. She is an accomplished advocate who led efforts in Iowa to pass legislation for Assisted Outpatient Treatment (AOT) programs. Together with Dr. Amador, Leslie discusses anosognosia and the challenges of creating a continuum of care for people living with SMI.Video Sections: (00:00) - Intro (01:28) - SMI Spotlight (01:52) - How Leslie became a mental health advocate (03:06) - Anosognosia (05:15) - Most discouraging/hopeful moments (07:47) - High level of functioning vs. low level of functioning (10:07) - Treatment System Process and Problems (12:40) - Additional supports needed (13:55) - Biggest misconceptions about AOT (15:53) - What advice for other families in her situation? (17:38) - Advice to policymakers and insurance companies (19:54) - Is the best place to treat people in their communities? (23:38) - Advice for clinicians treating first episode psychosis (26:21) - Creating robust multi-disciplinary continuum of lifelong care for people with SMI (28:53) - Challenges addressing physical health for people with SMI (31:25) - Higher pain threshold for people with schizophrenia (32:14) - TAC Advocacy Bootcamp as a source of hope (33:52) - Substance use with severe mental illness (35:41) - CCBHC's (37:05) - Using AI to find treatment resources

    39 min

  5. 2025-08-12

    Ask Dr. Amador: Severe Mental Illness, Substances, and HIPAA

    In this SMI Spotlight Q&A episode, Dr. Xavier Amador—founder of the LEAP approach and renowned clinical psychologist—answers real questions from our viewers about living with, supporting, and advocating for people with severe mental illness (SMI) such as schizophrenia and bipolar disorder.From managing stress-induced symptom spikes to navigating HIPAA, helping loved ones accept medication, and addressing substance use, Dr. Amador offers practical advice and compassionate insight backed by decades of experience.Video Sections: (00:00) - Intro (00:57) - Welcome! (01:06) - Q1 - Managing spikes in symptoms from stress(03:34) - Q2- Asking others to use LEAP methods (06:39) - Q3 - In relationships, avoiding triggering each other's SMI symptoms (08:14) - Q4 - Managing hallucinations when medicated and otherwise stable (11:38) - Q5 - What support resources for early days of recovery? (14:39) - Q6 - How to use LEAP when delusions/paranoia have estranged someone from you (17:44) - Q7 - Encouraging taking meds and accepting outcomes if meds aren't taken (20:24) - Q8 - Using LEAP with a teenager (21:36) - Q9 - Encouraging someone with SMI to stop using substances (24:33) - Q10a - Navigating HIPAA (28:25) - Q10b - How can HIPAA be fixed? (34:37) - Contact us!

    35 min

  6. 2025-07-15

    Ask Dr. Amador: Top Anosognosia Questions Answered

    In this episode of SMI Spotlight, renowned clinical psychologist and author Dr. Xavier Amador answers your most pressing questions about anosognosia—a common and often misunderstood symptom of severe mental illness like schizophrenia and bipolar disorder. Dr. Amador, founder of the LEAP method and author of I Am Not Sick, I Don’t Need Help!, shares expert insights on: • Whether withholding financial support can motivate treatment • If showing someone a video of themselves during psychosis can increase insight • What people remember after a psychotic episode • The different types of insight impacted by anosognosia • Where to begin when a loved one refuses help • Whether insight improves with age • How to manage medication-related weight gain SMI Spotlight is a podcast series from TAC, focused on evidence-based care and real-life strategies for supporting people with severe mental illness. 00:00) - Intro(00:56) - Q1 - Withholding Money for Medication Adherence(04:10) Q2 - Anosognosia and Video Playback(07:35) - Letting go of convincing(08:56) - Q3 - Anosognosia and Memory(10:42) - Q4 - Permanence of Anosognosia(12:34) - Different types of insight(13:54) - Q5 - Where to start when someone has anosognosia(15:15) - Q6 - How to get providers to use LEAP Methods(17:55) - Q7 - Does Insight Increase With Age?(20:26) - Q8 - Weight Gain from Medications (25:51) - Contact us!

    27 min

  7. 2025-06-03

    CEO of the APA on Decriminalizing Mental Illness

    In today's episode of SMI Spotlight, Dr. Xavier Amador is joined by Dr. Marketa Wills, CEO and Medical Director of the American Psychiatric Association (APA). Dr. Wills discusses her career journey, leading her to enter the field of psychiatry and administration. She covers her vision for the upcoming advocacy from the APA, emphasizing the need to decriminalize mental illness. To achieve this decriminalization, she discusses the need for more tools and legal mechanisms to provide treatment for individuals with severe mental illness who may be unable to see their own need for medical intervention. She also speaks to how the APA advocates to address the shortage of psychiatrists nationwide. #smi #apa #xavieramador Video Sections: (00:00) - Intro(01:54) - What got Dr Wills interested in psychiatry?(05:12) - Personal Connection(06:49) - First Woman BIPOC head of APA(08:11) - Dr. Wills' vision for the APA(09:56) - Policy changes Dr. Wills is focused on at the APA (12:14) - Clozaril REMS(16:05) - Encouraging new doctors to focus on psychiatry and SMI(18:58) - Addressing Burnout(21:27) - Peer support for psychiatrists(23:36) - Thoughts for families frustrated with psychiatrists(25:29) - AI and psychiatry(26:52) - How will APA reach people with anosognosia?(29:32) - Anosognosia in the DSM

    32 min

  8. 2025-05-13

    A Mother's Story of Love and Loss to Schizophrenia

    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

    42 min

  9. 2025-04-15

    How Collaborative Care Improves Mental Health Treatment

    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

    33 min

  10. 2025-03-11

    Ask Dr. Amador - Navigating Severe Mental Illness

    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 PER@tac.org🔔 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

    36 min

  11. 2025-02-11

    Anosognosia: What TV Gets Wrong About Schizophrenia

    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

    58 min
  12. What People Get Wrong About Anosognosia - Dr. Xavier Amador

    2024-11-12

    What People Get Wrong About Anosognosia - Dr. Xavier Amador

    Anosognosia, also called lack of insight, is a biological condition that prevents some people with severe mental illness (SMI) from knowing that they are experiencing symptoms of a brain disorder. Anosognosia is thought to be the most common reason for not seeking or maintaining treatment for people with severe mental illness. In the first episode of SMI Spotlight, TAC's executive director Lisa Dailey discusses anosognosia with Dr. Xavier Amador. The interview covers Dr. Amador's journey supporting his brother with schizophrenia, studying anosognosia as a clinical psychologist, and developing the LEAP method to help connect with people and encourage them to seek treatment even if they don't believe they have a mental illness. 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. Video Chapters: 00:00-Introduction 01:07-Dr Amador's Connection to Severe Mental Illness 04:28-Connecting Anosognosia with SMI 06:22-Difficulty with Mental Health Professionals' Acceptance of Anosognosia 08:30-The Impact of Thinking of Anosognosia as Denial 11:32-Don't try to talk someone out of a delusion 12:24-Is Anosognosia like a light switch? 13:20-Why Dr Amador's Brother Took Medications Despite Having Anosognosia 14:08-The Importance of Listening (The L in LEAP) 16:08-What is LEAP? 19:10-Respectfully Disagreeing with Delusions 21:13-How Dr Amador met Dr E. Fuller Torrey (Founder of TAC) 23:57-How a focus on Anosognosia aligns with TAC's Mission 25:19-The Value of Focusing on the Relationship 26:20-What Advice can be hard to find? 28:20-Recent Developments in SMI Treatment 29:57-Why Focus on Helping People with Anosognosia? 32:36-What Topics does Dr Amador want to Cover? 35:18-The gaps in Available SMI Information 36:44-The Importance of Understanding the Science Behind SMI 38:31-Voluntary Treatment vs Waiting for rock Bottom 41:36-The need for Connection 43:28-The Difference that Families make 45:50-Contact us!

    48 min
  • 12 Episodes

About

SMI Spotlight shares stories, research, and helpful information relating to severe mental illnesses such as schizophrenia, schizoaffective disorder, and bipolar disorder. SMI Spotlight is hosted by TAC's Scientific Officer, the renowned clinical psychologist Dr. Xavier Amador, author of "I Am Not Sick, I Don't Need Help!"

Information

  • Creator
    TAC
  • Years Active
    2024 - 2026
  • Episodes
    12
  • Rating
    Clean
  • Copyright
    © TAC
  • Show Website
    SMI Spotlight

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