Public fears of violence on the street by discharged (mental) patients who are strangers to them is misdirected. The people at the highest risk are family members and friends who are in their homes or in the patient’s home.

(6-23-16) In a study released this week, the Treatment Advocacy Center investigates a subject few like to discuss: family violence, specifically homicides committed by persons with mental illnesses. 

Because of stigma, we always begin every conversation about violence by explaining that individuals with mental illnesses are no more violent than the general public and, in fact, are more likely to become victims than perpetuators.

And that is exactly how the authors of RAISING CAIN: The Role of Serious Mental Illness In Homicide begin their 48 page study.

But they quickly explain their rational in writing about murders committed by persons with mental disorders:

It is…politically incorrect to study the relationship of family homicides to serious mental illness, especially in the United States, where the concept of “recovery” is the dominant theme in writing about individuals with mental illness. (But) …it is not discourse about family violence and homicides that is a major cause of stigma against all people with mental illness; rather, it is the family violence and homicides themselves. Until we confront the causes of family violence and homicides directly,  the stigmatization of persons with serious mental illness will continue to be an enormous problem. Yet, to ignore that a small percentage of persons with mental illness can be violent seems disingenuous.

This reasoning should not surprise anyone who is familiar with TAC, which is one of a few advocacy groups that speaks openly about violence. What did the authors of the report find:

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(6-24-16)  A local peer advocate asked if he could respond to a recent blog that I posted about our mental health board’s decision to defund the top peer job in our community. Yesterday afternoon, three Fairfax groups asked residents to sign a petition calling on the Community Services Board to restore funding for the Director of the Office of Consumer and Family Affairs. )

By Michael Pendrak

The Fairfax/Falls Church Community Services Board’s recent decision to save money by not filling the position of Director of Consumer and Family Affairs (DCFA) has devastated the peer/consumer community.  It has caused a chill in relations and mistrust between those who deliver and receive mental health services. Instead, of recognizing and appreciating the voices of peers/consumers, we feel the CSB board is practicing tokenism.

Eight years ago, Fairfax County undertook a detailed examination of its mental health services and issued a list of recommends in what is known as the Beeman Report. One of its highest priorities was to “Establish an Office of Consumer and Family Affairs with well-defined responsibilities and a leader who reports directly to the CSB Executive Director.”  (At the time, persons with mental health experience were more commonly known as consumers as in, ‘consumers of mental health services.’)

The Beeman Commission urged and the Board of County Supervisors agreed that there should be an office dedicated specifically and exclusively to representing the interests of consumers and their family members in Fairfax-Falls Church.  That office was to be free from interference from anyone below the level of the CSB Executive Director.  The Beeman Commission noted it was vital that there be peer leadership at the highest and all levels of the CSB.

At present, there are leaders among peers, but there are no peers among the leaders in the CSB.

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(6-20-16) Here’s a quiz.

Choose what you would expect an agency — created to protect persons living with disabilities — to do when a Virginian with schizophrenia gets arrested for taking $5 of snack foods without paying, is jailed for 101 days, and found dead in a feces covered cell from a heart attack caused by starvation?

(A.) Investigate the death and conditions in the jail to determine why that inmate lost 40 -50 pounds while supposedly being checked daily by a nurse.

(B.) Join the ACLU, Bazelon Center for Mental Health Law, NAACP, the National Alliance on Mental Illness, Virginia Chapter of Mental Health America, and the Washington Post in asking for a federal investigation.

(C.) Hold a press conference to denounce the death and file a lawsuit under the Civil Rights of Institutionalized Persons Act against the jail and state.

(D.) Write a letter of complaint to the governor.  

If you answered (D.), you have correctly answered what the Richmond-based disAbility Law Center of Virginia, an organization that contracts with the federal government to act as legal advocates for Virginians with disabilities, has done in the tragic case of Jamycheal Mitchell, the 24 year-old, African American inmate who was found dead last August in the Hampton Roads Regional Jail in Portsmouth.

A letter.

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(6-17-16) The Richmond Times-Dispatch has learned that a prisoner died at Central State Hospital, a mental facility in Virginia, after being sent there from the Hampton Roads Regional Jail in Portsmouth. This happened between May 25th and June 8th.

This is the same jail where Jamycheal Mitchell, who had schizophrenia, was found dead last year from a heart attack caused by starvation. The National Alliance on Mental Illness, Virginia chapter of Mental Health America, the NAACP, the Judge David L. Bazelon Center for Mental Health Law, and the ACLU have asked the U.S. Justice Department to investigate Mitchell’s death pursuant to the Civil Rights of Institutionalized Persons Act. In a strongly worded editorial, The Washington Post also has called for a federal probe.

The Justice Department has been reluctant to investigate individual deaths unless those fatalities reflected a pattern of civil rights abuses. If this new death resulted from how the inmate was treated while being detained at the Portsmouth jail, advocates could argue that there is a pattern of abuse of prisoners with mental illnesses inside the jail.

Unfortunately, Virginia mental health officials, the jail, and state bureaucrats all declined to answer basic questions about this second death when asked by investigative reporters Sarah Kleiner and K. Burnell Evans. Instead they claimed the federal Health Insurance Portability and Accountability Act (HIPAA) prohibited them from talking about the death.  A HIPAA legal expert in Virginia was quoted in the article saying, “People take a more aggressive approach to restriction (under HIPAA) than they really ought to.”

The failure of state officials to answer questions should not shock anyone who has been following Virginia’s shameful actions in the Mitchell case.

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(6-15-16) The Fairfax-Falls Church Community Services Board, which provides mental health services in my Virginia county, plans to hire at least one addition peer specialist in fiscal year 2017 and another in 2018, in addition to continuing to fund ten Diversion First peer spots through outside contracts, CSB Executive Director  Tisha Deeghan told me in an email.

She was responding to a blog that I published that questioned why there was no self-acknowledged peer on the 16 member CSB board and why the CSB recently decided not to fund its top peer management job after the retirement of Dave Mangano. In her email, Director Deeghan reiterated that the CSB and its management consider peer support essential. 

She explained that Mangano was specifically hired to introduce peer programs into the county. Those programs are now so well-established that the board does not believe it can justify paying a Director of Consumer and Family Affairs manager at a cost of $147,815 annually (pay and benefits) to oversee them when it has other pressing program needs that require funding. Mangano’s responsibilities have been divided among other senior managers, but none of them is a self-acknowledged person with lived experience. 

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D. J. Jaffe who strongly backed Rep. Murphy’s mental health bill joins others in the hearing giving Murphy a standing ovation. 

(6-15-16) As expected, the House Energy and Commerce Committee, chaired by Rep. Fred Upton (R-MI), passed bipartisan mental health legislation by a unanimous vote of 53-0 today. The bill – House Resolution 2646, the Helping Families in Mental Health Crisis Act, was introduced by Oversight and Investigations Subcommittee Chairman Tim Murphy (R-PA) in the wake of the tragedy in Newtown, Connecticut.

What the committee passed is known as an amendment in the nature of a substitute (AINS) which in laymen’s terms means legislation that has been greatly revised after months of everyone arguing about it.

While the compromise bill negotiated by Chairman Upton doesn’t contain several of Murphy’s most controversial proposals, Murphy said he never wavered from his original objectives. (see video.)  You can read my earlier blog about what was cut from his original bill here.

Murphy has been relentless and tireless in pushing for mental health reform since 2013, saying he wanted the legislation to be one of his legacies. He is widely credited with getting Congress to undertake its first serious effort in decades to reform our broken mental health system.

The Murphy bill now mirrors a Senate bill that originally was a spin off of his legislation. It was introduced by Sen. Chris Murphy (D-Conn.) and Sen. Bill Cassidy (R-La.). Once both pass their respective chambers, the two bills will be meshed into one for a vote before being sent to the president for his signature, making it a law.

I received several celebratory emails from readers who lobbied for  the bill’s passage. I also received a telephone call from a person with mental illness who was distraught because she felt the bill will strip her of non-medical services, a common concern raised by opponents.

“We need more than medical solutions. People need recovery oriented programs that help someone with something as simple as finding a friend who can go to a movie with them,” she said. “Murphy’s bill will end all of that because those services will not be judged evidence based but are still necessary for us to feel connections and be human.”

Murphy has said his bill will not cut treatment services that help people recover but it will stop frivolous  SAMHSA spending. During a series of hearings, Murphy cited examples of SAMHSA funded projects that he described as being anti- psychiatry and wasteful.

One example was a workshop called “Unleash the Beast” that promised to help attendees learn about mental illness by studying animal movements. SAMHSA’s former Chief Medical Officer recently published a scathing article that said top agency managers at SAMHSA were openly hostile toward the use of psychiatric medicine, refused to focus on helping the seriously mentally ill, and questioned whether bipolar disorder and schizophrenia were even real, arguing that psychosis is just a “different way of thinking for someone experiencing stress.”

Much of Murphy’s efforts were aimed at redirecting the agency.

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