(6-17-16) The Richmond Times-Dispatch has learned that a prisoner died at Central State Hospital, a mental facility in Virginia, after being sent there from the Hampton Roads Regional Jail in Portsmouth. This happened between May 25th and June 8th.

This is the same jail where Jamycheal Mitchell, who had schizophrenia, was found dead last year from a heart attack caused by starvation. The National Alliance on Mental Illness, Virginia chapter of Mental Health America, the NAACP, the Judge David L. Bazelon Center for Mental Health Law, and the ACLU have asked the U.S. Justice Department to investigate Mitchell’s death pursuant to the Civil Rights of Institutionalized Persons Act. In a strongly worded editorial, The Washington Post also has called for a federal probe.

The Justice Department has been reluctant to investigate individual deaths unless those fatalities reflected a pattern of civil rights abuses. If this new death resulted from how the inmate was treated while being detained at the Portsmouth jail, advocates could argue that there is a pattern of abuse of prisoners with mental illnesses inside the jail.

Unfortunately, Virginia mental health officials, the jail, and state bureaucrats all declined to answer basic questions about this second death when asked by investigative reporters Sarah Kleiner and K. Burnell Evans. Instead they claimed the federal Health Insurance Portability and Accountability Act (HIPAA) prohibited them from talking about the death.  A HIPAA legal expert in Virginia was quoted in the article saying, “People take a more aggressive approach to restriction (under HIPAA) than they really ought to.”

The failure of state officials to answer questions should not shock anyone who has been following Virginia’s shameful actions in the Mitchell case.

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(6-15-16) The Fairfax-Falls Church Community Services Board, which provides mental health services in my Virginia county, plans to hire at least one addition peer specialist in fiscal year 2017 and another in 2018, in addition to continuing to fund ten Diversion First peer spots through outside contracts, CSB Executive Director  Tisha Deeghan told me in an email.

She was responding to a blog that I published that questioned why there was no self-acknowledged peer on the 16 member CSB board and why the CSB recently decided not to fund its top peer management job after the retirement of Dave Mangano. In her email, Director Deeghan reiterated that the CSB and its management consider peer support essential. 

She explained that Mangano was specifically hired to introduce peer programs into the county. Those programs are now so well-established that the board does not believe it can justify paying a Director of Consumer and Family Affairs manager at a cost of $147,815 annually (pay and benefits) to oversee them when it has other pressing program needs that require funding. Mangano’s responsibilities have been divided among other senior managers, but none of them is a self-acknowledged person with lived experience. 

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D. J. Jaffe who strongly backed Rep. Murphy’s mental health bill joins others in the hearing giving Murphy a standing ovation. 

(6-15-16) As expected, the House Energy and Commerce Committee, chaired by Rep. Fred Upton (R-MI), passed bipartisan mental health legislation by a unanimous vote of 53-0 today. The bill – House Resolution 2646, the Helping Families in Mental Health Crisis Act, was introduced by Oversight and Investigations Subcommittee Chairman Tim Murphy (R-PA) in the wake of the tragedy in Newtown, Connecticut.

What the committee passed is known as an amendment in the nature of a substitute (AINS) which in laymen’s terms means legislation that has been greatly revised after months of everyone arguing about it.

While the compromise bill negotiated by Chairman Upton doesn’t contain several of Murphy’s most controversial proposals, Murphy said he never wavered from his original objectives. (see video.)  You can read my earlier blog about what was cut from his original bill here.

Murphy has been relentless and tireless in pushing for mental health reform since 2013, saying he wanted the legislation to be one of his legacies. He is widely credited with getting Congress to undertake its first serious effort in decades to reform our broken mental health system.

The Murphy bill now mirrors a Senate bill that originally was a spin off of his legislation. It was introduced by Sen. Chris Murphy (D-Conn.) and Sen. Bill Cassidy (R-La.). Once both pass their respective chambers, the two bills will be meshed into one for a vote before being sent to the president for his signature, making it a law.

I received several celebratory emails from readers who lobbied for  the bill’s passage. I also received a telephone call from a person with mental illness who was distraught because she felt the bill will strip her of non-medical services, a common concern raised by opponents.

“We need more than medical solutions. People need recovery oriented programs that help someone with something as simple as finding a friend who can go to a movie with them,” she said. “Murphy’s bill will end all of that because those services will not be judged evidence based but are still necessary for us to feel connections and be human.”

Murphy has said his bill will not cut treatment services that help people recover but it will stop frivolous  SAMHSA spending. During a series of hearings, Murphy cited examples of SAMHSA funded projects that he described as being anti- psychiatry and wasteful.

One example was a workshop called “Unleash the Beast” that promised to help attendees learn about mental illness by studying animal movements. SAMHSA’s former Chief Medical Officer recently published a scathing article that said top agency managers at SAMHSA were openly hostile toward the use of psychiatric medicine, refused to focus on helping the seriously mentally ill, and questioned whether bipolar disorder and schizophrenia were even real, arguing that psychosis is just a “different way of thinking for someone experiencing stress.”

Much of Murphy’s efforts were aimed at redirecting the agency.

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https://youtu.be/oGHWghMfbEU
(6-15-16) In this short snippet from her national television show, Samantha Bee tells how my friend Judge Steven Leifman is transforming mental health care in Florida. That’s wonderful. If you want to understand why reforms are necessary, you should pay special attention to minute 2:46 on her  Youtube sketch.

At minute 2:46, Bee shows how Florida State Hospital “helped” persons be restored to competency so they could be put on trial. They showed them a video of a game show.

No, I am not making this up. To me, the game show demonstrates a lack of respect and seriousness. It trivializes men and women who need help because of their mental illness, not punishment, and it was produced by hospital staff and mental health professionals.

Please remember that being restored to competency is not the same as actually being treated. Treatment means a person receives help. Restoration means a person understands the legal process well enough to be returned to court and put on trial. How do you determine if someone understands the process well enough to aid in his or her own defense?

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(6-14-16) I was in Chicago last week to attend a housing summit hosted by the Corporation for Supportive Housing, a cutting-edge leader in developing housing for persons who are homeless, have mental illnesses and addictions, and those leaving prisons. Much of the talk was about “metrics” — being able to show results with verifiable numbers. If you can’t show that what you are doing is actually producing results, government agencies and philanthropic organizations are reluctant to support you. That being the case, I was surprised yesterday when Dr. E. Fuller Torrey sent me a copy of his latest jab at the Substance Abuse and Mental Health Services Administration (SAMHSA), which he has frequently targeted. According to the article, the federal agency that is supposed to be helping individuals with mental illnesses keeps no metrics about schizophrenia. How can that be?

Washington Funds Ignorance of Mental Illness

By E. Fuller Torrey, published June 13, 2016 in The National Review  

The federal government collects accurate data on the number of pigs in Iowa, on milk cows in New York, and on turkeys in Delaware but none whatsoever on the number of people with schizophrenia. The Centers for Disease Control and Prevention keeps a long list of diseases that must be reported, including cryptosporidiosis, chlamydia, and cancer, but not schizophrenia.

This is remarkable, since schizophrenia is among our most consequential and expensive diseases. In a 2013 study, the annual economic burden of schizophrenia was estimated to be $156 billion. Three studies have reported that individuals with schizophrenia are responsible for 10 percent of all homicides in the United States; other studies suggest that people with schizophrenia — such as Jared Loughner in Tuscon, Aaron Alexis at the Washington Navy Yard, and James Holmes in Aurora, Colo. — are also responsible for up to one-third of mass killings. Even Adam Lanza in Newtown, Conn., had had a diagnosis of schizophrenia, in addition to autism spectrum disorder.

Other developed nations believe that it is important to ascertain the prevalence of schizophrenia and whether it is increasing or decreasing. For example, recent European studies have reported that schizophrenia is twice as common in England and the Netherlands as in Italy or Spain, that it has been steadily increasing in south London over three decades, and that early-onset schizophrenia is increasing in Denmark.

And what do we know about the United States? Nothing.

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(6-12-16) Politics is the art of compromise. That’s a common saying on Capitol Hill. Politics is about negotiating consensus and cooperation between factions.

This coming Wednesday, June 15, the House Energy and Commerce Committee is scheduled to convene a hearing to consider and vote on the Helping Families in Mental Health Crisis Act (H.R. 2646), introduced by Rep. Tim Murphy (R-PA).

The legislation the committee will be voting on has been so mightily revised by Committee Chairman Fred Upton (R-MI), to appease its detractors and House Democrats that it is hardly resembles its first version.

For those who supported Murphy’s initial efforts that’s a bitter pill. For those who opposed Murphy’s campaign, there’s reason to celebrate because Murphy’s most divisive proposals have been dropped. Advocates for the mental health groups that I polled over the weekend feel the compromise bill is “good legislation.”

The fighting is far from over, however. On Wednesday, there will be attempts by both sides to reword and rework the latest revisions, but I would imagine that Upton is a shrewd enough politician to not bring his revamped bill up for a vote without knowing that he has enough support to  get it passed.

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