Chattanooga, Austin and Mark Twain

I was speaking to a Virginia state legislator one day about how programs such as Crisis Intervention Teams, jail diversion and mental health courts can save public tax dollars and actually help persons with mental disorders get help rather than sitting untreated in jail cells.

“You aren’t from Virginia are you?” the legislator suddenly asked.  

“I wasn’t born here, but I have lived in Northern Virginia since 1978,” I replied.

He snickered and said, “I thought so. Do you know what Mark Twain said about Virginia,  son?”


“Mark Twain said if the world ever ended, he wanted to live in Virginia because things happened in Virginia seventy-five years after the rest of the country.”

Whenever I travel to other states, as I have been doing recently, I return home feeling sad about the snail’s pace we are taking in Virginia. We are making progress, especially with CIT and jail diversion, but we remain behind when it comes to implementing mental health courts and jail intercept programs that identify prisoners with mental health issues and direct them into treatment programs.  Many of our state treatment facilities are log jammed because there is inadequate housing  in our communities for persons who are ready to return home but have no place to go.

What I find most frustrating is a failure in our state legislature and by our governor to recognize the importance of meaningful community mental health services– even after the Virginia Tech shootings.  When our governor discovered our state was going to have a budget surplus, instead of a predicted huge deficit, there was no mention of making mental health a priority – even though spending for community services is LESS now from what it was BEFORE the Virginia Tech massacre.

When will Virginians understand that providing good mental health services will not only improve the lives of persons with mental disorders but also, over time, save money?


I spoke in Chattanooga recently at the NAMI Tennessee 2010 Annual Convention and I was impressed by the breakfast event that Sita Diehl and her NAMI team arranged to celebrate the first year anniversary of Chattanooga CIT officers. The city’s mayor issued a proclamation about CIT and top officials from the Hamilton County Sheriff and Chattanooga Police Departments were there to hand out the awards. Not only were  the sheriff and police chief in attendance, but retired Major Sam Cochren, one of the founders of the modern CIT movement, attended along with a large contingent of CIT officers who came to support the award winners. Nearly a dozen CIT officers where honored during the breakfast for their service and when it came time to announce the two CIT OFFICERS OF THE YEAR (one from the county and one from the local police), the officer handing out the awards became teary-eyed. 

The breakfast reminded me of the Academy Awards — that’s how dramatic the presentations were. 

I hope every NAMI  group follows Tennessee’s lead by not only recognizing CIT officers but doing it in such an impressive way. It shows both appreciation and respect for how important CIT is in our mental health system!


From Tennessee, I flew to Austin, Texas, to speak to state legislative staff members at the state capitol and later to the public at an open forum. The Hogg Foundation for Mental Health sponsored my two speeches. Founded in 1940 by the children of former Texas Governor James S. Hogg, the foundation has awarded millions of dollars in grants to worthwhile causes that improve mental health services.

A tip-top publicist and former journalist, Merrell  Foote, got me booked on the local FOX NEWS morning show and arranged for The Texas Tribune to interview me. Texas is facing as much as a $21 billion deficient and I spoke about why our jails and prisons have become our new asylums, why this is wrong, and how we can reform our system and get people treatment rather than wasting money on current programs that don’t work.

Everyone realizes there is no new money during a recession and cuts will be made, so it makes sense to spend the money that is appropriated more wisely and efficiently through programs such as CIT, jail diversion, mental health courts, and re-entry programs. As I always do, I stressed the importance of HOUSING in recovery.

I was especially pleased that 60 legislative staff members came to hear me even though  the Texas Speaker of the House was hosting a golf tournament that same day. Most of the staff members were young, energetic and worried about how vulnerable mental health funds were  going to be in Texas once the budget ax begins to chop.

The Hogg Foundation’s Program Director Colleen Horton told me about an innovative idea being tested in Texas that other states might want to try.  It deals with the costs of making psychotic persons “competent” enough to be put on trial after they are arrested. Competency and treatment are not the same. Instead of helping ill persons get treatment, states spend millions simply getting them coherent enough to understand that they are going to be put on trial.

When I did research for my book, competency meant taking psychotic defendants into a room each morning and showing them a mock courtroom that had signs on the chairs that identified where the judge, prosecutor, defense attorney and jurors sat. Once inmates could identify who sat in each chair and pass a few other simple tests, they were deemed competent enough to be put on trial — even though they still were delusional.

Colleen told me that the remaining ten state hospitals in Texas can’t keep up with all of the inmates who are being sent to them to be made competent and that means prisoners with mental disorders have to spend additional weeks in jails waiting for a turn. At last count, there was a waiting list of more than 380 persons awaiting “restoration.”

This backlog wastes taxpayers’ money and causes ill persons to spend inordinate amounts of time in jails.

With help from the Hogg Foundation, four pilot competency programs were launched in Texas, including one in San Antonio which is developing a national reputation for being at the cutting edge of mental health care. Rather than being sent to a state hospital, inmates can be restored to competency through outpatient community-based  mental health services.

Colleen said 350 inmates, charged with lesser crimes, had gone through outpatient competency at a cost of $140 per person per day, compared to $407 per person per day in a state hospital. They were also able to pass through the competency process faster, which meant less time in jails and more savings for the public.

This is an example of how innovative thinking can save much needed tax dollars, which can free up funds for other useful mental health services.

When I was in New York — yep, I’ve been on the road a lot this month — Ohio Justice Evelyn Lundberg Stratton told me about another way states can save money. The Obama Administration is funneling millions of dollars into much needed mental health programs for our returning veterans. Yet, many community mental health centers and state programs never ask clients if they are veterans and might qualify for these services.

As Justice Stratton told me, each time a consumer is able to move to the veterans side of the ledger, it opens up more money and space for a consumer who is not a veteran.

Justice Stratton has suggested that states make it a policy of always asking a person with mental disorders or co-occurring problems if he/she is a veteran. 

It’s a great idea that I hope Virginia doesn’t wait 75 years to adopt!

About the author:

Pete Earley is the bestselling author of such books as The Hot House and Crazy. When he is not spending time with his family, he tours the globe advocating for mental health reform.

Learn more about Pete.


  1. Thanks Pete.

    The CIT awards ceremony in Chattanooga was truly a team effort with active involvement from the Sheriff and Police departments, from Major Sam Cochran (Ret.) and Dr Dupont of the CIT institute, from NAMI Chattanooga and NAMI TN. Your hard-hitting, but factual and fair speech described our national predicament, indicted us as a society and suggested a few of the many solutions that could lead us back to a decent approach to treating mental illness. We are truly grateful to the law enforcement community for embracing the CIT model. While we expect and hope for compassionate policing from every officer, counseling and resource linkage should not be their job. However since our society is far from ideal, NAMI and other advocates need to take every opportunity to support law enforcement officers who do the right thing. NAMI hopes CIT will become common practice, and community by community, our hope is being realized.

    Even more, we want our nation to invest in services that intervene at the first sign of mental illness and promote recovery. We know what works, we can spend our scarce resources much more prudently. We hope this chapter in our history, where people are criminalized for disease, will come to a close soon and we will move on to an effective, compassionate approach to mental illness.

    Thanks for including us in your busy schedule. It was a pleasure and an honor.

    Sita Diehl
    Director of State Policy and Advocacy

  2. Mr. Earley –

    I was signed up for your Austin lecture and had to miss it at the last minute. After reading this blog I am really saddened. I do public policy for children’s mental health in San Antonio, and also a mother a teenager with mental illness. I loved your book and was looking forward to hearing you speak.

    And as if your work and book wouldn’t be enough to compel me to hear you, I had no idea that you were from Virginia. I am one of the founders of the San Antonio Chapter of the Virginia Tech Alumni Association. I keep in contact with folks in VA, and am continuously surprised that an event so tragic and terribly personal to all in the state is not enough to get the appropriate services and resources to those in need.

    Keep doing your amazing work – and maybe our paths will cross someday.

    Chris Bryan