(10-15-20) This is the second in a three part series about Fairfax County’s mental health docket. Yesterday, I posted Washington Post Columnist Petula Dvorak’s profile of one of the first graduates from the docket program. Today, I look at the history behind the docket and statistics about those it helps.

More than a third of individuals with mental illnesses who participate in the Fairfax County’s mental health docket have been diagnosed with schizophrenia. More than half have drug and substance addictions and nearly half are homeless. The court helps link them with services so they can address those problems – as well as their criminal conduct.

I’ve been advocating for a mental health docket in my local county since 2008. Fairfax County finally submitted an application to the Virginia Supreme Court in January 2019 and launched its docket in July 2019, It held its first graduation ceremony earlier this month.  Fairfax General Court Judge Tina Snee issued completion certificates to three graduates with diagnosed mental illnesses who volunteered to participate in a rigorous treatment program instead of being punished through the traditional criminal justice system.

More than 350 mental health courts/dockets operate nationally. About two-thirds have been supervising cases since 2000. Studies have found that those who complete a court’s requirements tend to have lower rates of criminal activity and increased linkages to treatment services than defendants with mental illnesses who do not.

Judge Snee currently has eighteen participants under her supervision on her docket. Fairfax is one of eleven Virginia jurisdictions with a mental health docket, including one in Fairfax’s neighbor, Loudon County. The state also has approved a behavioral docket in Arlington. There are 95 counties in Virginia, so these dockets remain in a minority in our state.

Fairfax County also operates a Veteran’s Treatment Docket and a drug court. It was Judge Penney S. Azcarate who got support and approval in 2014 for a Veteran’s Treatment Docket. (Judge Azcarate served four years in the U.S. Marine Corps.) Judge Azcarate also oversees the Fairfax County Drug Court.  Judge Azcarate’s actions are what opened the door in the county’s judiciary for a mental health docket.

Sadly, the death of Natasha McKenna, an African American woman with a serious mental illness, who died in 2015 after being repeatedly stunned with a Taser at the Fairfax County’s Adult Detention Center, is what caused the county’s elected officials to get serious about diverting individuals with mental illnesses from jail into treatment. Sheriff Stacey A. Kincaid championed the effort to create a Diversion First program. Former Board of Supervisors Chairwoman Sharon Bulova and former Supervisor John Cook immediately jumped on board. Retired Air Force General Gary Ambrose, who lost his son to mental illness, was put in charge of bringing stakeholders together to develop the country’s Diversion First program. It was launched with great excitement the same year as McKenna’s death with tremendous support from a slew of groups, including fire fighters, local police departments, the Fairfax Falls Church Community Service Board (CSB), The Office of the Public Defender, The Office of the Commonwealth’s Attorney, Court Services/Probation, General District Court (GDC) Judges, GDC Clerk’s Office, Victims’ Services Section – Fairfax County Police Department, and the Fairfax County Sheriff’s Office. The county’s Diversion First program has been operating for five years and is the umbrella over which the mental health docket rests.

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(10-14-20) This is the first of three posts about the Fairfax County Mental Health docket, which recently held its first graduation ceremony. One of my favorite columnists, Petula Dvorak, attended the graduation and wrote about it for The Washington Post.

In one Virginia courtroom, a judge tries to stop a revolving door

By Petula Dvorak, The Washington Post

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(10-12-20) Ernie & Joe: Crisis Cops, a powerful documentary created for HBO, is now being made available for group screenings. If you belong to a chapter of the National Alliance on Mental Health, Mental Health America, or other mental health organizations or you are involved in police/judicial training and have not yet seen this film, you need too!

This superb documentary follows Ernie Stevens and Joe Smarro, two officers in the San Antonio, Texas, police department’s mental health unit, as they defuse potentially violent encounters with individuals in the midst of a mental health crisis and direct them into treatment instead of jail.

At a time when police violence, especially against individuals with mental illnesses, is making national headlines, it’s important to show that compassionate officers are working on our streets and effective diversion programs can be implemented.

Crisis Intervention Team training (the Memphis Model) is the most common de-escalation tool used in law enforcement. San Antonio trains all of its officers in its own crisis de-escalation training program, which differs slightly from the Memphis Model. All 2,191 officers on the force go through its CIT style training. At the time the film was made, there were 10 officers assigned to the department’s mental health team. Now, there are 20. The unit acts as in house experts in training officers and community first responders as well as being on-call to their fellow officers.

In an email, the film’s director, Jenifer McShane, told me: “An interesting by-product of making mental health training a priority within the department is that officer wellness is now a stronger focus and more officers are willing to approach the mental health officers with their own mental health struggles and seek treatment.” This is important because nationally in 2019, 228 current or former officers died by suicide, compared with 172 in 2018, setting a new high record.

As of last year, the University of Memphis Crisis Intervention Team Center reported 2,700 CIT programs were being offered in the United States. By comparison, there are 17,000 local and state law enforcement agencies.  Hopefully this powerful documentary will encourage those departments without de-escalation training to begin such training. As the film points out most police departments spend 60 hours in their academies on teaching officers how to use a gun but only 8 hours on mental health training. Yet, ninety-five percent of police officers go through their career without firing their weapon. Everyone of them who works on the streets deals with an individual in a mental health crisis.

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Dr. Dean Brooks allowed me to sit in his Hollywood chair from the set of One Flew Over The Cuckoo’s Nest during visit

(10-9-20) FROM MY FILES FRIDAY. I’ve been blessed in my life to work with many inspirational advocates. In May 2011, I wrote about Dr. Dean Brooks and his daughters. He died two years later. I think of him often and always with a smile.

The Cuckoo’s Nest Dr. Continues Speaking Out!

Dr. Dean Brooks has spent his adult life advocating for persons with mental illnesses. And he has not slowed down even though he now is 94 years-old and is living in an assistant living facility not far from the Oregon State Hospital in Salem that he used to oversee.

He first burst on the national stage when he appeared in the 1975  movie,  One Flew Over The Cuckoo’s Nest, as the hospital’s  chief psychiatrist, Dr. John Spivey, M.D.  It was a clever irony because Dr. Brooks was actually in charge of the hospital at the time of filming. In the movie, he can be seen interviewing Jack Nicholson to determine if he has an actual mental disorder or is faking it.

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Juan and Blanca Briceno created a shrine for their son Eric Briceno, who was killed by deputies in March during what they said was a mental health call.

(Myung J. Chun / Los Angeles Times)

As Communities Shift Responsibility For Responding To Emergencies Away From Police, Is CIT Training For Law Enforcement At Risk?

(10-6-20) The Greater Los Angeles chapter of the National Alliance on Mental Illness has written a letter demanding answers about the death of a seriously mentally ill man at the hands of sheriff’s deputies. The letter also warns of what I fear is an alarming problem across our nation – the scaling back of robust Crisis Intervention Team training for law enforcement as localities shift responsibility away from police/deputies to other first responders.

Eric Briceno died in March after his mother Blanco Briceno, called sheriff’s deputies about her 39 year old son who was asleep in his bedroom when they arrived.

“We called them to come and help us, to get some help,” Briceno told the Los Angeles Times during an interview. “And instead, they came and killed him, brutally killed him.”

“Deputies ignored the parents’ plea to allow them to bring their son out of his room safely,” the NAMI letter notes. “Instead, (they) entered his bedroom…Mr. Briceno was pepper sprayed and shot with a Taser seven or eight times, according to the autopsy report.”

That autopsy wasn’t made public until late September, prompting NAMI’s Oct. 3rd  letter. The coroner’s office concluded that Briceno died of cardiopulmonary arrest, resulting from neck compression and restraint with a Taser. The death was ruled a homicide…”

“The only information available publicly at this time is the story in the Times,” the NAMI letter notes. “But if the truth is close to the depiction of the facts as portrayed in the article, deputies abandoned good practices and de-escalation protocols in favor of physical intervention and the use of force. NAMI Greater Los Angeles County will not ignore fatal use of force upon individuals living with serious mental illness by any law enforcement agency especially the level of force appears great.”

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(10-4-20) Dr. Lloyd I. Sederer has had an incredible career.

He’s been the Medical Director of a Harvard teaching hospital (McLean Hospital), spent five years as Mental Health Commissioner in New York City, another twelve years as Chief Medical Officer of New York State’s mental health agency and seven years as Medical Editor for Mental Health with the HuffPost.

He’s also been busy as an author, writing nearly a dozen books, including The Family Guide To Mental Health Care, and more than 350 professional articles.

His newest offering, Ink-Stained For Life: Coming of Age in the 1950s, A Bronx Tale, has Sederer looking inward through a series of essays at his younger years and lessons that he’s learned.

“I had no plan to write a memoir, though the itch to write has been in me since my adolescence,” Dr. Sederer noted. The seeds for his new book were planted after the New York Times published an OP Ed in 2010 that Dr. Sederer had written about his chore of putting editions of Sunday newspapers out for sale at his father’s stationary shop when he was a child. “The Times had retitled it (bless them), Ink-Stained for Life, a far better title than I had provided…On the Saturday it was published, I went out early and bought a lot of copies of the paper. So, I had one memoir story and decided to write some more. Thirteen to be specific, twelve new ones and one adapted from a piece I had published in the HuffPost.” (Read original Times essay here.)

I’ve learned much from Dr. Sederer, enjoyed when we have spoken, and appreciate his years of helping individuals with mental illnesses and their families – so I asked him to write about his new book, which I have not yet read, for my blog. I was especially interested in lessons he learned as a psychiatrist. He replied that his career choice was improbable because he was “as neurotic as could be…” as a child.Click to continue…