(10-16-18) Last week’s news that Paolo del Vecchio is being reassigned inside the Substance Abuse and Mental Health Services Administration sparked a flurry of reactions.

Del Vecchio has served as director of SAMHSA’s Center for Mental Health Services (CMHS) for six years and is viewed as a powerful advocate for persons with lived experience. His transfer by Dr. Elinore F. McCance-Katz, Assistant Secretary for Mental Health and Substance Abuse, is being seen by some of del Vecchio’s supporters as a sign that the agency is moving away from supporting peer services and the recovery model of treatment in favor of the traditional medical model and paternalism. 

Dr. McCance-Katz’s supporters insist del Vecchio’s transfer simply reflects her desire to build her own leadership team.

Appointed last August, Dr. McCance-Katz could have fired del Vecchio after her first 120 days in office or demoted him if she wanted to undermine peers and del Vecchio’s recovery work as CMHS director. She kept him as one of her top mental health and substance abuse advisors until last week when she asked him to direct SAMHSA’s Office of Management, Technology, and Operations, a top post at SAMHSA, but one with less direct oversight of mental health and substance abuse policy.

Said one insider: they simply didn’t gel and she has the right to pick her own managers who support her. Said another: she bent over backwards giving him chances but it didn’t work.

A third point of view expressed to me is that speculation about del Vecchio’s reassignment is resulting in both Dr. McCance-Katz and del Vecchio being wrongly branded.  Her as being anti-peer. Him as not carrying about the serious mentally ill.
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(10-12-18) FROM MY FILES FRIDAY:  Mike Wallace of 60 Minutes fame quietly helped my son when Kevin suffered a major psychotic break. Mike understood mental illness because he suffered from depression and had contemplated ending his own life. After Mike died in 2012, I revealed how he had intervened at my request to help Kevin – a fact that Mike had asked me to downplay in my book because he felt CBS might not react favorably to his actions.)

Mike Wallace Helped Me When I Needed Him Most  

Mike Wallace and I didn’t start off as friends.

The great CBS newsman, who died Saturday at age 93, telephoned me when I was writing my first book, Family of Spies: Inside the John Walker Jr. Spy Ring.  It was 1986 and Wallace had learned that I was the only reporter who had gotten John Walker Jr. to talk to me.

At the time, Walker hated the media and didn’t want to talk to anyone about the 18 years that he had spent spying for the Soviets or how he had recruited his son, Michael; his brother, Arthur; and his best friend, Jerry Whitworth, as traitors.

For those of you who haven’t read my book or might not remember the case, John Walker Jr.’s arrest in 1985 was the biggest spy scandal in the U.S. history since Julius and Ethel Rosenberg were convicted and executed in 1953.

Walker’s treachery stunned the nation and Mike Wallace was eager to get the first television interview with him.

I was flattered that someone as important in broadcast journalism as Mike Wallace would call me. I immediately went to work to help him. I got Walker to agree to give Wallace an exclusive for 60 Minutes. At one point when Wallace was interviewing Walker, they took a break in filming and Wallace called me from the federal prison in Marion, Illinois, to check some facts.

Wallace’s interview with John Walker Jr. was mesmerizing. It was Wallace at his best as an interrogator. In one memorable scene, Wallace eviscerated Walker by asking him how he could be so cruel as to groom his only son to be a traitor. It was such an incredible interview that Wallace was rewarded with an Emmy, one of some 20 Emmys that he won.

And what of my book and me?

Wallace never mentioned either. He and 60 Minutes basked in the limelight.

I felt duped and hurt.

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(10-08-18) I recently interviewed Baltimore psychiatrist Dinah Miller about mental health care today from her professional and personal vantage point. Dr. Miller is a  practicing psychiatrist, instructor in psychiatry at Johns Hopkins School of Medicine,  a prolific blogger and nonfiction and fiction author. Her new book, co-authored with Dr. Annette Hanson, is Committed: The Battle over Involuntary Psychiatric Care.

Question:   Much talk lately has been about focusing on “serious mental illnesses” as opposed to the broader range of all mental illnesses. Do you accept this delineation and, if not, why?

Dr. Miller:  Pete, this is a great question, and it’s more of a political question.  Obviously, some people experience psychiatric disorders in more chronic and/or disabling ways, and some people need more than others.  There are two things I don’t like about the designation of “serious mental illness.”  For one, it sets up a bit of an “us” versus “them” dynamic and seems to imply that there are people who are different from the rest of the population, and that this small set of of very ill people somehow stand out in a way that obviously identifies them.  People can be very sick at one point in time and very healthy at another point in time.

That division is based on the presence of specific psychiatric diagnoses: schizophrenia, bipolar disorder, or severe depression.  Our diagnoses are decided by committees, and what we designate as a disorder changes over time, and the same person may be given different diagnoses at different times; this isn’t a precise thing.

The problem is that based on this idea of ‘severe mental illness’ is the political idea that the mental health pot of dollars should be divided so that these individuals get more, at the expense of services to those who don’t have serious mental illness.  And then we get to terms like “worried well,” which serves to demean the suffering of people who do not have debilitating conditions.

But what is serious?

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(10-5-18) When it comes to mental illnesses, we still continue to think of the brain as being separate from the rest of the body. As this New York Times story by science writer Moises Velasquez-Manoff, documents this is foolish thinking. 

He Got Schizophrenia. He Got Cancer. And Then He Got Cured.

Published in The New York Times. Written by Moises Velasquez-Manoff, science writer.

The man was 23 when the delusions came on. He became convinced that his thoughts were leaking out of his head and that other people could hear them. When he watched television, he thought the actors were signaling him, trying to communicate. He became irritable and anxious and couldn’t sleep.

Dr. Tsuyoshi Miyaoka, a psychiatrist treating him at the Shimane University School of Medicine in Japan, eventually diagnosed paranoid schizophrenia. He then prescribed a series of antipsychotic drugs. None helped. The man’s symptoms were, in medical parlance, “treatment resistant.”

A year later, the man’s condition worsened. He developed fatigue, fever and shortness of breath, and it turned out he had a cancer of the blood called acute myeloid leukemia. He’d need a bone-marrow transplant to survive. After the procedure came the miracle. The man’s delusions and paranoia almost completely disappeared. His schizophrenia seemingly vanished.

Years later, “he is completely off all medication and shows no psychiatric symptoms,” Dr. Miyaoka told me in an email. Somehow the transplant cured the man’s schizophrenia.

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((10-1-18) Washington Post Reporter Justin Jouvenal has revealed that Fairfax County has paid $750,000 in a court-sealed wrongful death settlement to the family of Natasha McKenna.

In February 2015, my wife, Patti, read a tiny item in the Post that noted a woman had died while in custody.

“Do you think she had a mental illness?” she asked me.

Several phone calls later, I’d learned that Natasha McKenna, 37, who reportedly had schizophrenia, had suffered a heart attack after being repeatedly stunned with a taser by deputies while being moved from her cell.

I posted a blog about what I had learned and alerted the Post and other local media.

Her death sparked justifiable community outrage.

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