Podcast Summary

Podcast: Tony Mantor: Why Not Me?
Episode: Rachel Streiff: Mad Moms Rising for Mental Health Reform
Date: January 7, 2026
Host: Tony Mantor
Guest: Rachel Streiff, co-founder of Arizona Mad Moms

Overview:

This episode features Rachel Streiff, a chemical engineer turned mental health advocate and co-founder of Arizona Mad Moms. Rachel shares her personal journey into advocacy for serious mental illness (SMI) reform in the United States, focusing on systemic failures, community action, and the urgent need for policy, educational, and funding reform. The conversation tackles critical misconceptions around SMI, storytelling as activism, and building effective, patient-centered support systems.

Key Discussion Points & Insights

Rachel’s Introduction to Serious Mental Illness

• Personal Story (02:05): Rachel describes how a family member struggling with SMI and eventual recovery (thanks to a hard-to-access medication, clozapine) transformed her awareness and initiated her path to advocacy.

  • “At the time...I just didn’t have any experience with anything like that. If serious mental illness is not on your radar, you really have no idea.” — Rachel Streiff, 02:24

• Seeing the Invisible Crisis (03:03): Her world changed as she recognized the suffering of those with SMI, eventually becoming an advocate and legal guardian for others.

  • “It’s really a genocide happening right now. People are dying behind bars, dying in the streets, dying prematurely from untreated illness...” — Rachel Streiff, 03:30

Systemic Failures & The Role of The State

• Hospital Closures and New Asylums (04:17): Rachel notes the closure of psychiatric hospitals without bolstering community services, making jails the new asylums.
• The IMD Exclusion Problem (04:24): Policy barriers like the IMD (Institutions for Mental Diseases) exclusion prevent adequate treatment for SMI, leaving families to “pick up the slack.”

Flawed Public Perception & The Role of Education

• Conflation of Mental Health & SMI (06:01): Rachel identifies the confusion caused by blurring mild mental health issues with severe neurobiological illnesses.
  • “That has detracted and funneled funding away from true mental illnesses, true serious mental illnesses. Everyone is confused.” — Rachel Streiff, 06:13
• Cultural Understanding Lost (07:45): Using ‘Psycho’ as an example, Rachel laments a time when society appreciated the complexity of mental illness and its implications for criminal justice.
• “We’ve also somehow lumped these serious brain...disorders...with general mental health, and we are confused.” — Rachel Streiff, 07:56

Advocacy and Organizational Growth

• Mad Moms and Angry Moms (09:34): Rachel co-founded Arizona Mad Moms and previously Angry Moms, groups born from caregivers’ frustration, especially over access to critical medications like clozapine.

  • “She got upset. They called her ‘angry’...But she and a lot of mothers...succeeded in getting FDA regulations removed surrounding access to that important antipsychotic.” — Rachel Streiff, 10:38

• Real Legislative Change (11:50): Following a tragic local suicide, Mad Moms were instrumental in catalyzing legislative change, including the passing of “John’s Law.”

  • “By showing up, by our testimony, we succeeded in passing several laws. Among them was John’s Law...” — Rachel Streiff, 12:06

• Expansion Reflects Failure (13:00): Mad Moms grew from a dozen families to 550+ in two years—tragic proof of widespread system failure.

Geographic & Structural Disparities

• State-by-State Issues (13:24): Rachel explains the diversity of challenges across states: some (like California) have funding but poor laws, while Arizona has reasonable laws but inadequate funding and housing.
• Assisted Outpatient Treatment (AOT)/COT in Arizona (14:15): Arizona’s court-ordered treatment has solid legal structure but suffers from funding gaps and variable provider quality.

Funding, Policy, and Structural Inefficiency

• Funding Misallocation (15:29): Medicaid restrictions (IMD exclusion) result in expensive, short-term hospital stays versus effective long-term care.

  • “There is a revolving door of individuals that are discharging from one facility after two weeks and going right into another...States look the other way because Medicaid dollars are funding this.” — Rachel Streiff, 16:04

• Solution: Redirecting Resources (17:49): Rachel advocates for reallocating money wasted on short-term hospitalization toward supervised housing and long-term programs—models already in place for other disabilities.

  • “If we took that money and we applied it to supervised housing and long term care and assisted living, you would get so much more for your money.” — Rachel Streiff, 17:49
  • “It’s wasteful, neglect and inhumanity.” — Rachel Streiff, 18:52

The Role of Lawmakers, Psychiatry, and Society

• Systemic Accountability (19:41): Rachel highlights lawmakers and medical schools (psychiatry) as pivotal change agents, emphasizing the need to abandon rose-tinted narratives of universal recovery.

  • “This sugar coating that mentally ill people aren’t dangerous...These are truly disabling, devastating, and dangerous sometimes.” — Rachel Streiff, 20:28

• Moving Beyond ‘Stigma’ (21:40): Rachel rejects stigma as a red herring in advocacy, reframing the challenge as medical access, perception, and education.

  • “I don’t allow that word in Arizona Mad Mom circles. That has been a giant red herring. That is not the problem.” — Rachel Streiff, 21:40

Calls to Action & Societal Understanding

• Education, Not Stigma (22:50): Rachel underscores the need for accurate SMI education beginning in schools and in the criminal justice system.

  • “We need to bring back true science into our discussions and our understanding.” — Rachel Streiff, 22:49

• The Reality of Untreated SMI (23:03): Rachel explains, via harrowing real cases, the tragic consequences of untreated SMI and system indifference:

  • “There was a story...a young man...did not get his medication in jail...he plucked out his eye...That is complication that is not uncommon from someone experiencing severe visual hallucinations...no understanding that these are serious medical conditions.” — Rachel Streiff, 23:33
  • “Wish I could turn that anger and that heartache for the real problem. That was a lack of treatment and a lack of access to care and a system that has failed this family.” — Rachel Streiff, 25:05

• Final Reflections (26:25): Both host and guest agree that while many are out of touch, dedicated professionals still work to drive change from within—but that education and legislative action are paramount.

Notable Quotes & Memorable Moments

• On the Public’s Lack of Experience:
  “If a person doesn’t have any lived experience on this, they don’t know what the heck is happening...I still don’t know what’s going on. No one ever does unless they’re living it.” — Tony Mantor, 04:48

• On Outdated Perceptions:
  “We have forgotten that as a society, and there’s a lot of reasons for that.” — Rachel Streiff, 07:46

• On the Reality Facing Families:
  “That’s not a success statement, that’s a tragedy because what we are finding is families and these very sick individuals are being failed by the system.” — Rachel Streiff, 13:03

• On Moving Past ‘Stigma’:
  “I don’t allow that word in Arizona mad mom circles. That has been a giant red herring. That is not the problem.” — Rachel Streiff, 21:41

• On Solutions:
  “We need to bring back the truth, not a watered-down version that everybody has a mental illness because I had a bad day at work today.” — Rachel Streiff, 22:43

Important Timestamps

• 02:05 – Rachel’s personal family story and introduction to SMI.
• 03:30 – The hidden crisis and failures of the system.
• 06:01 – Misconceptions and problems with public perception of mental illness.
• 09:34 – Origin of “Mad Moms” and “Angry Moms” advocacy groups.
• 12:06 – Legislative victories, including “John’s Law.”
• 13:00 – The rapid and tragic expansion of Mad Moms.
• 15:29 – How funding mechanisms perpetuate a broken system.
• 17:49 – Proposed alternatives to current care models.
• 19:41 – Who should be held accountable and the importance of expertise.
• 21:40 – Stigma as a non-issue and the true priority: access and competence.
• 23:03 – Real cases illustrating the consequences of system failure.
• 25:05 – Human costs and the urgent need for change.

Conclusion:

This episode provides a raw and detailed examination of the failures and potential solutions in the SMI care system in the U.S. Rachel Streiff highlights the lived reality faced by families, the inefficacy and inhumanity of current structures, and the path forward: legislative reform, true education, and a relentless focus on access and humanity for the most vulnerable. It’s a compelling call to action for listeners, families, advocates, and policymakers alike.