Seriously Ill Mother Declared “Not Restorable” By State Psychiatrist In Horrific Murder Trial. Is That Possible?

(2-20-20)  This story from the Washington Post raises questions about criminal justice and serious mental illness. Is it possible, as a state psychiatrist argues, that someone is so ill that he/she can never meet the court’s standards for restoration?  
Catherine Hoggle, Jacob Hoggle and Sarah Hoggle, before the children went missing in September 2014. (Montgomery County Police)
Catherine Hoggle, Jacob Hoggle and Sarah Hoggle, before the children went missing in September 2014. (Montgomery County Police)

For five years, as a criminal case against his former girlfriend Catherine Hoggle has held fairly steady, Troy Turner’s emotions have swung up and down.

They started with hope: He’d find the couple’s two children, Jacob, 2, and Sarah, 3, who’d gone missing after being under Hoggle’s care. That gave way to deep frustration: Hoggle wouldn’t say what happened to them, even as she was locked in a Maryland jail and then transferred to a state mental hospital. Then Turner came to a terrible conclusion: Hoggle had killed the children and wouldn’t tell anyone where their bodies were.

On Tuesday — while appearing before a judge who over the next few weeks will weigh whether to dismiss murder charges against Hoggle in the case — Turner got a chance to speak in court.

Hoggle sat just 15 feet away.

“I’ve heard people refer to it as a mystery. There is no mystery. Catherine planned, carried out a plan, and killed my children,” Turner said, his voice choking. “Right now, the person who murdered them, I’m looking at her.”

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Attorney General Barr Puts Partisan Politics Above Common Sense In Naming Crime Commission

Photo courtesy of ABC News

(2-17-20) I was surprised late last month by Attorney General William Barr‘s choices for a presidential crime commission created to study how our criminal justice system interacts with Americans who are homelessness and have a mental illness. I only recognized one name on the list. This was BEFORE the recent criticism Barr has faced because of his decision to get involved in the Roger Stone case. I decided to check out the backgrounds of his selections. Here is what I discovered.

President Donald Trump issued an executive order late last month creating the President’s Commission on Law Enforcement and the Administration of Justice after repeatedly calling for a crackdown on homelessness and linking Americans with mental illnesses to violence.

While the President has an opportunity to use the commission to make much needed reforms, none of the 18 officials whom Barr selected work in cities with the largest homeless populations – San Jose, San Diego, Seattle, Los Angeles and New York City. Together those five account for more than 150,000 of the 564,708 homeless Americans. At least forty-five percent are believed to have a mental illness.

Instead, Barr chose police chiefs, sheriffs, and others in law enforcement from smaller jurisdictions with fewer homeless, such as Wichita, Kansas; Pinellas County, Florida; McKinney, Texas; and Shelby County, Alabama. While many of Barr’s choices have impressive law enforcement backgrounds, they come from communities that account for a combined total of less than 23,000 homeless residents. Los Angeles alone has 59,000. South Dakota counted about one thousand homeless residents in the entire state, yet its secretary of public safety was chosen by Barr.

Even more troubling, Barr’s handpicked appointees are overwhelmingly from red states and counties that voted for Trump in 2016, while the snubbed West Coast cities and New York City lean Democratic and have been frequently lambasted as “liberal” by Trump.

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Speaker Was Suicidal But Found Healing, Hope, and Love At A Clubhouse

A two minute testimonial from a recent Hope Clubhouse member (not the woman mentioned in this blog.)

(1-14-20) From My Files Friday: I’m a big fan of clubhouses and when I gave a keynote nine years ago at a fundraiser for Hope House in Fort Myers, Florida,  I heard an inspiring message worth re- retelling. (I will be speaking March 8th at the Key Clubhouse in Miami.)

 How A Clubhouse Changed My Life

First posted 10-24-11

The young woman giving her testimony had excelled in high school and gone to college with high expectations – only to have a mental break.  Diagnosed as having bipolar disorder, she became so ill that she was forced to drop out. At one point, she felt suicidal.

When she called the local police during a manic episode, rather than getting help, she got into an argument and ended up being arrested. She was jailed overnight, as an officer told her, “to be taught a lesson.”

That experience — at the hands of unsympathetic and poorly trained sheriff’s deputies — resulted in her developing PTSD. She was in such anguish that she simply wanted to give up —  until her parents got her to visit the HOPE CLUBHOUSE in Fort Myers, Florida.

“The HOPE CLUBHOUSE,” she said. “Saved my life.”

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Trump’s Budget And Vision For Mental Health Clearly Influenced By Treatment Advocacy Center

(2-11-20) President Donald J. Trump has proposed a record $4.8 trillion budget for the 2021 fiscal year and the Washington Post has published an Op Ed by Joe Grogan, assistant to the president and director of the Domestic Policy Council, outlining the administration’s mental health agenda.

I don’t like writing about politics on this blog because my interest is solely in mental health, not partisanship. But I found this editorial interesting, in part, because it reflects the thinking of D. J. Jaffe, Dr. E. Fuller Torrey, John Snook, executive director of the Treatment Advocacy Center,  and HHS Assistant Secretary for Mental Health and Substance Abuse Dr. Elinore McCance-Katz, as enumerated at a recent White House summit.  You can watch presentations at the summit by Jaffe, Snook, and McCance-Katz by clicking on their name. Once the Democrats choose a final candidate, I will post that individual’s mental health platform.

A community garden grows outside a homeless encampment in Oakland, Calif., last month. (Philip Pacheco/AFP via Getty Images)
President Trump is exceptionally focused on fighting for Americans who can’t fight for themselves and confronting problems other administrations, Democratic and Republican, have ignored. This is particularly true for Americans who suffer from addiction and serious mental disorders. In this year’s budget, President Trump is proposing the boldest reform in decades for the millions of Americans who live with serious mental illness.

This administration has already led the way on combating the drug addiction crisis. President Trump directed the declaration of an opioid public health emergency in 2017 and took action to confront the driving forces behind the crisis. Last week, the National Center for Health Statistics reported a decline in drug overdose deaths for the first time in 28 years. Life expectancy rose for the first time in four years.

Now, we must end the disgraceful way Americans with serious mental illness are treated. They are not receiving the care they desperately need. In 2018, 47 million people experienced some form of mental illness. More than 11 million of these Americans lived with mental illness of such severity that it impaired their ability to carry out normal life functions. And nearly 4 million Americans received no treatment at all. This is unacceptable.

In the 1950s, there were more than 550,000 state psychiatric hospital beds in the United States. By 2016, this number had dropped to 37,679. Instead of receiving care, the sick are locked behind bars, often after encounters with police officers ill equipped to manage these encounters effectively. There are more than 392,000 incarcerated individuals with serious mental illness. That means there are 10 times more individuals with serious mental illnesses in prison beds than in state psychiatric hospital beds.

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HHS Secretary Azar Tells Me He Wants To Make Mental Health Reforms A Priority

(2-7-20) Health and Human Services Secretary Alex M. Azar II told me during a 45-minute meeting that he intends to focus on improving mental health services.

I was invited to share my family’s story with Secretary Azar and Assistant Secretary for Mental Health and Substance Abuse Dr. Elinore McCance Katz and Shannon Royce, Director of the Center for Faith and Opportunity Initiatives at HHS, at the invitation  of Laura C. Trueman, director of HHS Intergovernmental and External Affairs.

I cited my family’s frustrating struggle to get help for my adult son, Kevin,  to illustrate barriers that Americans face.

I recounted how I had rushed Kevin to an emergency room during a psychotic break, only to be told that he was not considered dangerous enough to be hospitalized and treated. After we were turned away, my clearly delusional son broke into an unoccupied stranger’s house to take a bubble bath and was arrested and charged with two felonies.

Azar said he had heard similar stories from other family members and asked how HHS could help break roadblocks to care.

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Two Important Questions For Parents Of Seriously Mentally Ill Adults: What Happens When Meds Harm? What Happens When Parents Age?

Photo credit: The Atlantic Magazine

(2-3-20) An email from a mother raises two important issues. What happens when you need medications to remain stable but those same medications are hurting your overall health? How do aging parents protect the future of an adult child with a serious mental illness and intellectual disabilities?

Dear Pete,

Our son lives with us, and always has. In his early teens, he was finally diagnosed as having Bipolar-1 disorder although we are fairly certain he had been struggling with its onset as early as 2nd grade.

His condition became progressively worse with age. By his late 20’s, after several very traumatic and severe manic episodes, he spent a week in a local hospital’s behavioral health unit in Virginia.  I spent weeks looking for a community support system and searching for a psychiatrist after he was discharged. My search was difficult because of HIPAA. I was told our son was over 18 years old and, therefore, it was up to him, not us.

Desperate, I finally convinced a sweet, compassionate, Office Manager named Chris to plead my case with Dr. James Dee, who was not accepting new patients. I’m sure Pete that you recognize that name because he is the same psychiatrist who treated your son, Kevin. He was the best psych-pharmacologist we’ve encountered and we were devastated when he died recently. Dr. Dee got our son into our local Virginia Psych Rehab Services Day Treatment Program, which he attended for seven years. Dr. Dee helped our son come to terms with his mental illness and learn essential coping skills – especially anger management and the importance of getting therapy and taking meds.

Early on, we met with a lawyer to inquire about legal guardianship to protect our son when he experienced a manic state and was unable to make appropriate treatment decisions.

What happened?

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