My Wife Undergoes Surgery: A Cautionary Tale


The call from my wife’s doctor came after a routine check-up. A tiny speck of blood in her urine. The doctor sent Patti to a urologist. He suggested a CT scan of her kidneys.

In the past decade, Patti’s two younger sisters have died from cancer. Her mother is currently in stage four. Would you be afraid?

The scan revealed two lesions, one hardly noticeable. Both less than 1 cm. Some of us never learned metrics. It is 0.39 inch.

A biopsy was ordered. Worries before the needle went in. What would it show?

Whew! Relief. High fives! Smiles. It’s benign. No cancer.

Just the same, Patti said, “I want it out.”

Our insurance company asked why? Said it wasn’t necessary. The biopsy showed no cancer. Leave it alone. Live with it.

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CIT & Jail Diversion: Lessons Learned In Bexar County Could Help Your Community


I have been a proponent of the Jail County Diversion Model in Bexar County, Texas, ever since I visited San Antonio five years ago and met Leon Evans and Gilbert Gonzales. That model is now being recognized nationally as the gold standard for diverting persons with mental disorders into appropriate services rather than jails. Not only are persons in crisis getting meaningful help — taxpayers are saving money.

I was thrilled when I learned that Fairfax Sheriff Stacey Kincaid was taking a delegation of Fairfax officials to Bexar County to investigate how our community might implement parts of the Bexar County model. Reporter Julie Carey tagged along and in several three minute reports, she describes both the model and what it accomplishes.

Bexar County has published a step-by-step guide that explains how your community can implement its model. I would urge you to watch the videos and get the guide into the hands of your local leaders.Click to continue…

Washington D.C. Homeless Man: From Harvard Law To The Curb

Alfred Postell graduated from Harvard but now roams D.C. streets. Washington Post photo

Alfred Postell graduated from Harvard but now roams D.C. streets. Washington Post photo

A recent story about a homeless, mentally ill man who roams Washington D.C.’s streets caused quite a sensation when it was published by The Washington Post recently.

Stories such as this put a human face on our broken mental health care system and, hopefully, help promote both public understanding and the need for reforms. This front page article helped refute the stereotypical image of persons on the street being lazy bums. This man was a high achiever until —

I was pleased that Green Door, the D.C. mental health provider that recently honored  my family during its fund raising gala, is attempting to help Alfred Postell move off the streets.

While I don’t like to repost articles on my blog, this one is an exception. Kudos to my old employer for publishing an impactful, non-sensational and thoughtful article about homelessness, mental illnesses and the plight of those who we abandon on the streets.

The Homeless Man Who Went To Harvard
July 13
The Washington Post

The judge settled his gaze on the homeless man accused of sleeping beside an office building in downtown Washington.

It was a Saturday afternoon in early April at D.C. Superior Court, and Alfred Postell, a man diagnosed with schizophrenia, stood before Judge Thomas Motley.

Postell’s hair was medium length and graying. His belly spilled over his pants. A tangled beard hung from his jowls.

“You have the right to remain silent,” a deputy clerk told Postell, according to a transcript of the arraignment. “Anything you say, other than to your attorney, can be used against you.”

“I’m a lawyer,” Postell replied.

Click here to continue reading. The  Post also published a follow up story trying to explain to readers why Postell has not received care. Click here.




Readers React With Skepticism About Officials Promises of ‘Transparency’ In Investigating Woman’s Death In Jail


Fairfax County readers of this blog are angry and distrustful of local officials based on emails that I received this week about the Natasha McKenna police investigation. Many of you do not live in Virginia, but you have been following my posts about the death of the 37 year-old African American with schizophrenia who was shocked with a taser at least four times while in handcuffs and leg restraints inside our local jail.

Her death is yet another example of what can happen when persons with mental disorders become entangled in our criminal justice system instead of being diverted into community treatment. Sadly, Fairfax County has dragged its feet on accepting Crisis Intervention Team Training and implementing such jail diversion tools as a mental health court.

This week, our chief of police announced that his office had completed a five month long investigation of the McKenna case but he didn’t reveal specifics.  Instead, he turned his report over to the local commonwealth’s attorney who will determine if criminal charges will be filed.  That office has not filed criminal charges against anyone in law enforcement involved in a police shooting while on duty since the police department was created more than seventy years ago.  Fairfax County averages about four police shootings per year. About half of those involve persons who have a diagnosed mental illness.

One troubling shooting involved David Masters who attempted to drive away from officers after being ordered to stop. Masters, who had a diagnosed mental illness, was suspected of taking flowers from outside a business. The officer who fatally shot Masters was later quietly discharged from the police force.

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Police Finish Investigation Into Woman’s Death In Fairfax Jail: I’m Disappointed

UPDATE:  After posting this item, I received this email from Chief Ed Roessler Jr.


I fully understand the questions raised and as you mention, the investigation is detailed and I can assure you our detectives have provided a thorough and comprehensive investigation to the Office of the Commonwealth’s Attorney.  Please understand my intent was never to blame Ms. McKenna.  The mission of the investigation was for the detectives to gather all of the facts and evidence related to the entire chain of events.  The goal of all the media release(s) to date is to provide a high level of transparency to our community about the investigative steps/process.  As you understand with an active case under legal review, I cannot be specific at this point. 

I will do my best to answer the investigative questions when appropriate.  The policy issues you raise are directed at the Office of the Fairfax County Sheriff and the Alexandria City law enforcement agencies and they are more appropriate for those agency leaders to answer.  I can assure you I am working with our partners in the region (local/state/non-profits) to build the Fairfax County Police Department’s capacity to compassionately and safely interact with those suffering from mental illness so that we can direct them to resources to help them through episodes and get long-term help.


Ed Roessler


Reporter Jackie Bensen asked me yesterday (July  13) to react to the Fairfax County police announcement that it had finished its investigation into the death of Natasha McKenna. The statement by Police Chief Ed Roessler contained little new information but appeared to me to imply that McKenna was responsible for everything that had happened to her, excusing the actions of the deputies involved in her subsequent death. Everyone involved in this tragedy has said that the public will be told all of the facts, but that certainly hasn’t happened so far. 

Police Complete Investigation Into Death of Fairfax County Inmate
As the investigation into the death of Natasha McKenna continues, a local mental health advocate is questioning whether detention center employees used excessive force. News 4’s Jackie Bensen reports.

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Engagement Is The Secret To Stability, But How Do We Achieve It?


I’ve been asked to post the comments that I made during the 2015 NAMI convention where I appeared on a panel discussing Assisted Outpatient Treatment, one of the most divisive topics in the mental health community. Panel members were asked to briefly comment on San Francisco’s version of Laura’s Law and then talk about a specific subject. In my case, it was what I have learned getting individuals with mental illnesses engaged in treatment based on my experiences with my adult son.

Remarks July 9th, NAMI Convention, panel discussion “Treatment Engagement in San Francisco: Humane or Coercion?”  (Slightly edited.)

I have read San Francisco’s version of Laura’s Law and after hearing Dr. Angelica Alameida’s description of it, I would characterize it as an attempt to make coercion less coercive.

Consider the multiple safeguards in the bill’s language: A judge can only implement an AOT order if: “a referred individual is unlikely to survive safely in the community without supervision.. if a referred individual has a history of lack of compliance within a specified time period…If a referred individual has been offered the opportunity to participate in a treatment plan voluntarily…If a referred individual’s condition is substantially deteriorating.  AOT must be the least restrictive placement necessary to ensure the referred individual’s recovery and stability. The referred individual must benefit from AOT.” The law requires peer specialists and family members to be involved in the process.

According to Dr. Alameida, the law is intended to engage persons who are in critical need of help not force them into treatment.  All of this language is intended to insure that AOT is not used flippantly and not implemented until after every other form of treatment has been attempted and has failed.

Will San Francisco’s law placate opponents of AOT? I decided to find out by asking several of them before I came to San Francisco. All of them said they wouldn’t support this new version. “You can put lipstick on a pig,” one said, “but it still is a pig.” This critic and others said they oppose all forms of coercion. If we simply had patience, met individuals where they were, and provided them with enough community support, acceptance and love, they would recover without being coerced.

I’ve thought a lot about those critics’ argument and I am confused by it.

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