(12-20-16) WUSA Reporter Peggy Fox set out yesterday to discover why a man in apparent mental stress was fatally shot on the hospital grounds where he had been taken by police for evaluation. Unfortunately, she wasn’t able to learn anything more than I was when I raised questions in my blog about the death. The hospital said it couldn’t comment because of HIPAA laws while Commonwealth Attorney Raymond F. Morrogh said there was little anyone could do because persons with mental illnesses have “rights” and can’t be held for treatment in a hospital without posing an “imminent danger” to themselves or others.

For the record, there was no indication in a report that Morrogh released last Friday that Yovani Amaya Gomez ever refused treatment, a rejection that surely would have been noted in his medical file. After the mass shooting on the Virginia Tech campus in 2007, the words “imminent danger” were dropped from Virginia’s criteria for involuntary treatment. The current criteria is that an individual can be temporarily held if there is a:

“Substantial likelihood that (a) person will in the near future • Cause serious physical harm to self or others as evidenced by recent behavior causing, attempting, or threatening harm and other relevant information, if any; or • Suffer serious harm due to lack of capacity to protect himself from harm or to provide for his basic human needs § 37.2-808(A)

I served on an advisory panel that helped draft that language and it was loosened specifically to give medical personnel more leeway.

The point of my blog was not to challenge Morrogh’s conclusion that Deputy Sheriff P. McPartlin was justified in fatally wounding Gomez. Rather, I asked why detectives had not delved deeper into what happened shortly before the shooting when Gomez was in the emergency room at Fairfax Inova Hospital. Answers to a list of questions that I posed might have been helpful in preventing future shootings.  You can watch Peggy Fox’s report here.  Or continue reading her transcript.

Here is a transcript of her report.

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Noe Sanchez Amaya, 27, an uncle of Giovanny Martinez, holds a flier Fairfax County police circulated as they tried to identify Martinez after he was fatally shot. (Matt McClain/The Washington Post)

(12-19-16) Shortly after 2 p.m. on a hot August day earlier this year, a 29 year-old Hispanic man approached a police officer seeking help. Yovani Amaya Gomez appeared to be in some sort of mental crisis. A little more than eight hours later, Gomez would be fatally shot on the hospital grounds where he had been taken for help.

Details about the shooting were made public Friday (12-16) by Virginia Commonwealth Attorney Raymond F. Morrogh who concluded that Deputy Sheriff P. McPartlin was justified in fatally wounding Gomez.

Unfortunately, the investigative report that Morrogh released lacks critical information about what happened inside the Fairfax Inova Hospital where Gomez was taken before the shooting —  information that might have been helpful in preventing future fatal encounters.

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(12-16-16) Fairfax County officials this week announced they are implementing recommendations to restore public confidence in our police department at a much faster pace than previously reported.

In an Op Ed published in The Washington Post earlier this month, John Lovaas and I criticized the Board of Supervisors, which governs the county, for not implementing 202 recommendations suggested last year by an Ad Hoc Police Review Commission after the fatal shooting of an unarmed man by police during a 2013 domestic disturbance. The police officer was later fired and pleaded guilty to manslaughter but only after 17 months of stonewalling by the police and county.

John and I served on that 35 member Ad Hoc commission and we felt the board was dragging its feet based on its own published progress reports. In our Post opinion column, we reported the county had acknowledged approving only 20 recommendations, according to its own website. We further noted it had rejected 4 and had listed the remaining 178 either as being “under review” or “in progress.”

To us that was unacceptable.

Our criticism drew an instant response from Chairman Sharon Bulova, who appointed the commission, and Supervisor John Cook, who is overseeing implementation of the recommendations, along with others on the ten person board who said our critique was both inaccurate and unfair.

After our article was published, Deputy County Executive David M. Rohrer and Chief of Police Edwin C. Roessler announced during a public meeting on Tuesday (12-13) that 119 of the 202 recommendations — more than half — already have been implemented, or fully implemented with modifications by the Supervisors, in the past twelve months.

That’s significantly more than the 20 we cited.

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(12-13-16) Shortly before 3 p.m. today, President Barack Obama will sign the 21st Century Cures Act, which includes two important mental health bills, including the Helping Families in Mental Health Crisis Act that Rep. Tim Murphy (R-Pa.)  tenaciously pushed for nearly four years.

Two years ago, I began a year-end tradition of naming individuals or groups who I believe had the most impact in mental health during the year. Rep. Murphy was my primary pick  in 2014 even though Democrats successfully blocked his initial efforts to get his bill passed. As I’ve written before, he was relentless and should be proud and much credited today at the White House signing.

But he didn’t get his bill to the president’s desk today alone and I am selecting three other key players this year as my choices for the most impactful mental health warriors of 2016.  They are Senators John Cornyn, (R.-Tx.) Chris Murphy (D-Conn.) and Bill Cassidy (R.-La.).

It was Chris Murphy and Dr. Bill Cassidy who initially introduced a companion bill to Tim Murphy’s in the Senate. They held a Senate Mental Health Summit to educate their colleagues and worked on compromise language that won their bill widespread support. Bipartisan support is not enough, however, in Congress to get a bill moving through the political system.  Because both Murphy, who was elected in 2013, and Cassidy, who moved from the House to the Senate in the 2014 elections, lacked seniority, it would have been difficult for them to get their legislation out of committee. Undaunted, they were able to persuade Sen. Lamar Alexander (R. Tenn.), the powerful chair of the Senate Health, Education, Labor and Pensions Committee (HELP), to back them.

Even with Alexander’s help, the Murphy/Cassidy bill would have had difficulty if Sen. Cornyn, the Senate Majority Whip, had not made mental health reform one of his chief priorities. He had simultaneously introduced his own mental health bill, the Mental Health Safe Communities Act, in the Senate Judiciary Committee.

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(12-12-16) Breaking news! The U.S. Department of Justice today announced it will investigate the Hampton Roads Regional Jail in Portsmouth, Va., after repeated requests from mental health advocates following the death of Jamycheal Mitchell, a 24 year-old African American with schizophrenia who suffered a fatal heart attack prompted by starvation after spending 101 days in jail last year.

Seven advocacy groups initially requested an investigation of the jail, including:

• The National Alliance on Mental Illness of Virginia, the state office of NAMI;
• NAMI (National Alliance on Mental Illness), the national organization of NAMI;
• NAMI Hampton-Newport News, a local affiliate of NAMI;
• The ACLU of Virginia;
• NAACP Portsmouth;
• Bazelon Center for Mental Health Law and
• The Mental Health America of Virginia, a statewide organization.
• The Treatment Advocacy Center signed a second version of a letter to the Justice Department sent by the original 7 agencies.

I also called for an investigation, and was joined by The Washington Post, after state agencies failed to publicly explain how Mitchell, who was accused of stealing $5.05 worth of snack foods, died in the jail while reportedly under the daily medical care of a nurse and regular checks by correctional officers. Two investigative reporters for The Richmond Times Dispatch, Sarah Kleiner and K. Burnell Evans, were relentless in investigating Mitchell’s death, and deserve credit for keeping this story alive, as does Gary Harki, with the Virginian Pilot.  Another key player in publicly demanding an investigation was Douglas Bevelacqua, a former Virginia inspector general responsible for mental health probes.

All of us who care about the inappropriate incarceration of persons with mental disorders owe a huge thank you to the eight groups and the investigative reporters who focused on this horrific case. It is important to note that the Justice Department did not state that it would specifically investigate Mitchell’s death. This is unfortunate. But it will look at practices in the jail and hopefully its probe will improve services there that will spread across the state. This is a major victory for Virginia NAMI’s Mira Signer, who spearheaded the effort, and it should be further embarrassment for state officials and Virginia agencies charged with protecting persons with mental illnesses who should have investigated this when it first happened but chose instead to simply allow jail officials to investigate and absolve themselves. I will be writing more about this later.

Email message to me from Justice Department official:

Pete,

Because you had previously provided information to our office as we did preliminary work on this matter, I wanted to let you know that our office and the U.S. Attorney’s Office for the Eastern District of Virginia have just formally opened an investigation into the Hampton Roads Regional Jail.  Thanks again for your help during our preliminary inquiry.  I will be continuing to work on this case going forward, so please do not hesitate to contact me should you have any questions or have any information you believe would aid us in our investigation.

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(12-12-16) Every year during the holidays, all of us are asked to donate to groups that we believe are making our lives and society better. I am hesitant to mention my favorites because, in doing so, I will be slighting equally important and worthwhile mental health groups. Still, here are some that I would urge you to consider.

INTERNATIONAL

• Sometimes in life, you meet someone who strikes you as a living saint, someone who is so good that you feel humbled. That happened to me earlier this year when I met Vandana Gopikumar, a co-founder of The Banyan. Vandana and her partner, Vaishnavi Jayakumar, are the equivalent in mental health in India to Mother Teresa. They have rescued hundreds of homeless, seriously mentally ill women from the streets of Chennai, India. If you want to know that the money you give will literally save someone who has a mental illness and is destitute from starving on the streets, then The Banyan is the group to support.

NATIONAL

•  I’m a lifetime member of the National Alliance on Mental Illness because I believe in its mission, leadership, and, most of all, the good acts of its members in hundreds of local and state chapters. The first question I ask panicked parents who contact me is: Do you know about NAMI? Its variety of programs, Washington policy work, and growing NAMI Walks continue to make it our nation’s premier grassroots mental health organization. That’s why I contribute to it monthly.
• It might seem odd to include the Corporation For Supportive Housing on a mental health list, but CSH is one of the nation’s leaders in providing supportive affordable housing to individuals with mental illnesses and addiction problems, as well as, prisoners re-entering our communities. If you read its short history, you will understand why I am honored to serve on its Board of Directors and support it with a monthly donation.  

Over twenty years ago, a homeless advocate named Julie Sandorf was approached by two Franciscan priests who were successfully saving their mentally ill parishioners from homelessness. She travelled to their St. Francis Residence, founded for mentally ill parishioners on the brink of eviction from a single room occupancy hotel. With a safe place to live and psychiatrists and social workers on site, the tenants stayed housed and healthy. Julie spent the next year studying this new housing approach. With support from the Pew Charitable Trusts, she found hundreds of similar stories around U.S.: troubled people who had bounced between shelters, hospitals, jails and the streets were suddenly living productive lives thanks to this combination of quality housing and support services.

In 1991, Julie founded the Corporation for Supportive Housing (CSH)  and …twenty years later, we’re still inspired to bring supportive housing to those who need it most… people coping with homelessness and extreme poverty, as well as chronic health conditions such as mental illness, addiction or HIV/AIDS.

• Some readers will be outraged by me recommending donations to the Treatment Advocacy Center because it was primarily created to push Assisted Outpatient Treatment laws. But it regularly sounds alarms about emergency room psychiatric boarding, a lack of crisis care beds, violence, poorly funded community based treatment, the effectiveness of assertive community treatment and the inappropriate incarceration of individuals who have mental illnesses. Whether your love or hate TAC, it has become the “go-to” source for mainstream reporters who write about mental health and one of the most effective at influencing the national dialogue and Congress. TAC has become an important voice for families and consumers who believe changes in HIPAA regulations, the dangerous criteria and bed shortages need to be addressed.

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