(7-8-20) Discussions about how to shift responsibility for persons with serious mental illnesses away from the police and back on social services and the medical community continue to be debated. I’ve received emails from those who support my views and those who don’t. 

Long-time mental health advocate, Harvey Rosenthal, chief executive of the New York Association of Psychiatric Rehabilitation Services – one of the most influential organizations that represents the rights of individuals diagnosed with mental illnesses – used the Fourth of July weekend to write about freedom for those with mental illnesses.

Promoting Liberty and Freedom: The Pathway to Dignity and True Mental Health System Reform

By Harvey Rosenthal, guest post from a different point of view.

I have always viewed the service and support that we offer to each other as ultimately about promoting and protecting freedom and liberty, or better yet liberation. Liberation from the restrictions and limitations that told and still tell us that recovery ‘happens’ for just some people instead of being expected for everyone and that have been imposed at times on us by our field, our academic institutions, our families, friends, neighbors….and ourselves.

There are a number of freedoms to aspire and commit to and, in some instances, to celebrate today.

Freedom from discrimination, devaluation and ridicule from others and from the fear, shame and self-condemnation we impose on ourselves.

Freedom from attacks by some on choice, rights and privacy protections, especially around the right to choose or refuse treatment and where it’s delivered…and the freedom to have access to meaningful legal assistance and psychiatric advance directives.

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Theatrical release poster by Drew Struzan taken from Wikipedia

(7-6-20) I received a slew of emails about last week’s blog that called for shifting responsibility of the seriously mentally ill from the police to social service agencies and the medical community.

One long-time reader chastised me for unintentionally spreading a “cheap stereotype” of American soldiers when I wrote:

“No one wants RAMBO answering a mental health call.”

In a separate email, Virgil Stucker, who became president emeritus of the CooperRiis Healing Community in 2017 after serving as founding Executive Director from 2003, took issue with this statement:

“We have never shut down longer term treatment facilities. We simply have made them only available to individuals who can afford the high costs of such excellent facilities as McLean Hospital or such healing communities as Gould Farm or CooperRiis.”

Here’s what both had to say:

Dear Mr. Earley,

I’ve been an avid follow of your blog for quite some time now.  Today I read your post: Defunding the Police and Serious Mental Illness: Opportunities, Hard Questions, Dangers.  In the section entitled “Training Will Not Fix The Problem,” I read a line that bothered me quite a bit.  You wrote “No one wants RAMBO answering a mental health call.”  This single sentence has several problems.

To begin, I think you need to go watch First Blood, the movie that introduced cinema-goers to the character of John Rambo.  In this film Rambo is a homeless veteran, depicted as suffering from what seems to be PTSD-like symptoms.  He is walking across the country seeking out friends that he served with.  The movie does end up becoming an 80’s action-fest, but only after Rambo is harassed, arrested, and brutalized by the local sheriff’s department.  Rambo is not my enemy, he is me.  Like me, he is a tortured soul suffering from mental illness.  When his liberty is abused by local law enforcement he snaps and falls back on his special forces training.  I am not trained as such, but I absolutely dread the idea of having an encounter with hostile law enforcement officers.

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(7-5-20) A Fourth of July weekend surprise!

A keen-eyed viewer noticed a copy of my book, CRAZY: A Father’s Search Through America’s Mental Health Madness, behind Washington D.C. news anchor Doreen Gentzler, who is working remotely from her home because of the Covid 19 virus. (Fourth book from top.)

I was delighted and honored, but not surprised because the popular newscaster has been a champion in reporting stories about mental health in the Washington D.C. area. She is the station’s health reporter and played a pivotal role in developing NBC Channel 4’s long-running educational news series about mental illness called Changing Minds. In 2015, NBC reporter Mark Segraves interviewed my son, Kevin, and me about the importance of Crisis Intervention Team training as part of that series.

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(Editor’s note: this is the second in a series about restructuring mental health services.)

(7-3-20) The defund the police movement has sparked conversations about shifting responsibility for the seriously mentally ill away from law enforcement back where it belongs – on social services and the medical community.

This is a great opportunity for improving mental health care, but we must be realistic and answer some tough questions.

We cannot fully end all interactions between the police and courts with the seriously mentally ill. Americans with untreated serious mental illnesses can be dangerous. Involuntary commitment hearings are legal matters. I find talk about arming social workers or completely dismantling police departments counter productive. Our goal should be to create a mental health system that doesn’t rely on the police as first responders and minimizes court involvement.

Step One: If money is to be shifted from the police department budgets to mental health services, those funds should be spent directly on programs that will help reduce arrests, shootings and incarceration. While admirable, it is difficult to see how early education programs in schools about mental illnesses and community youth programs will reduce police engagement. Greater access to integrated health care, peer support, housing, Assertive Community Treatment teams, mobile crisis response teams, crisis care beds, adequately staffed drop off centers that are warm and welcoming – these are where siphoned funds should be spent.

Training Will Not Fix The Problem: I’ve always been a strong and vocal supporter of Crisis Intervention Team Training. CIT trained officers are heroic and what all police officers should aspire to be –compassionate problem solvers. No one wants RAMBO answering a mental health call. But we cannot train our way out of our mental health crisis and we can’t depend on the police to fix our patchwork system.Click to continue…

Chart courtesy of Oklahoma Watch

(Editor’s note: this is the first in a series about restructuring mental health services.)

(6-29-20) The idea that our jails and prisons are filling up with the seriously mentally ill at alarming rates because we have closed state hospitals is simplistic, according to a paper first published by Psychiatric Services and is part of the Think Bigger Do Good policy paper series which funds behavioral health research by Peg’s Foundation, the Thomas Scattergood Foundation, the Peter & Elizabeth Tower Foundation and the Patrick P. Lee Foundation.

Dr. Mark R. Munetz, the co-creator of the Sequential Intercept Model, and two of his colleagues, Natalie Bonfine and Amy Blank Wilson, write that we must consider other factors in addition to serious mental illnesses if we want to address the fact that 2.2 million Americans with mental illness are booked into jail each year and 365,000 currently are incarcerated.

Natalie Bonfine, an assistant professor in psychiatry at Northeast Ohio Medical University, is the primary author of “Meeting the Needs of Justice-Involved People With Serious Mental Illness Within Community Behavioral Health Systems.” For those unfamiliar, the Sequential Intercept Model is recognized nationally as the leading tool in identifying people with serious mental illnesses in the criminal justice system and finding appropriate places to intervene and get them into treatment.

The three researchers state that closing of public mental hospitals lead to “first-generation interventions” to reduce criminalization, such as pre-and post-booking diversion programs, mental health courts, specialized probation, forensic assertive community treatment teams and re-entry programs. But while these programs have shown promise, the authors write that “none has been able to achieve a sustained impact on criminal recidivism.”

Why? Because treating an individual’s mental illness is not enough.

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(6-25-20) Nineteen thousand viewers watched a special Father’s Day program last week hosted by One Mind President Brandon Staglin on Facebook. It was a wonderful opportunity for us to discuss how Kevin’s mental illness impacted our relationship. If you missed it, here’s the program. You can watch more of Brandon’s Brain Waves interview series at One Mind.