(6-15-20) In an opinion editorial published by the Washington Post today, I call for shifting responsibility for the seriously mentally ill away from the police to community social services and the medical community.

Mental Illness Is A Health Issue, Not A Police Issue

(Reprinted From The Washington Post)

By Pete Earley

Pete Earley is the parent designee on the Interdepartmental Serious Mental Illness Coordinating Committee, which advises the federal government about mental health reform.

Americans with mental illnesses make up nearly a quarter of those killed by police officers, according to The Post’s Fatal Force database. Meanwhile, a cumulative list shows 115 police officers have been killed since the 1970s by individuals with untreated serious mental illnesses.

It doesn’t have to be this way. The movement underway to “defund the police,” is a long-needed moment to shift responsibility for the seriously mentally ill away from police and put it back to where it belongs: on social service agencies and the medical community.

Forty percent of adults with serious mental illnesses will come into contact with the criminal justice system during their lives. Each year, 2 million of them are booked into jails. Most are charged with minor misdemeanor crimes and low-level felonies directly tied to their psychiatric illnesses. Jails and prisons currently hold more people with serious mental illnesses — 365,000 individuals — than hospitals. They remain in jail four to eight times longer than people without mental illnesses charged with the exact same crime, cost seven times more than other inmates in jail, are less likely to make bail and more likely to gain new charges while incarcerated.

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(6-11-20) Millions of Americans have watched bodycam video of a white Fairfax County (Va.) police officer fire a stun gun probe into an unarmed, clearly disoriented black man before pinning him to the pavement, striking him with the stun gun and apparently firing another jolt to subdue him.

Fairfax Police Chief Edwin C. Roessler Jr., and Commonwealth Attorney Steve Descano immediately condemned Officer Tyler Timberlake’s actions. Roessler called the officer’s conduct “horrible” and “disgusting,” adding “What you see here is unacceptable. It does not value the sanctity of human life.”

Timberlake was charged with three misdemeanor counts of assault and battery.

To fully understand the refreshing importance of Roessler’s and Descano’s actions, you must look backward at two earlier deaths at the hands of Fairfax law enforcement.

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Dr. E. Fuller Torrey rips into NIMH, its advisory board and NAMI

(6-8-20) Dr. E. Fuller Torrey is again accusing the National Institutes of Mental Health of virtually abandoning clinical trials that could help Americans with schizophrenia and bipolar disorder in the short term.

Instead, NIMH, the main federal government agency for research into mental illness with a budget of almost $2 billion, has made basic brain research its priority. The results of such research will take three or four decades to show results, if then.

What’s the difference between “clinical trials” and “basic research.”

Elizabeth Sinclair Hancq, the director of research at the Treatment Advocacy Agency, which Dr. Torrey helped found, provided examples for me in an email.

• Basic research: growing cells in petri dishes and testing the effect of a particular drug on cellular mechanisms, like stopping their growth or activity. Basic research also includes animal model studies when trying to understand underlying cellular or system biology.
• Clinical trials: Testing the effect of a particular drug on symptoms and disease processes.

Perhaps the best way to see the marked difference between the two is by looking at clinical trials the NIMH is not funding. TAC listed 16 examples in a press release all of which are listed at the end of this blog.

Here is a sampling:

• Efficacy of generic drugs: Psychiatric patients being switched from brand-name to generic psychiatric medications frequently complain about loss of efficacy. NIMH should support studies of generic drug efficacy for psychiatric illnesses.

• Long-term injectable antipsychotics: In recent years, several new long-term injectable antipsychotics have been introduced. Although each was approved by the FDA for being better than a placebo, almost nothing is known about their comparative efficacy against each other. NIMH funded trials on these medications would help physicians make more informed decisions on medications for their patients.
• Long term effects: Many of the psychotropic drugs commonly administered to millions of patients in the United States were only studied for their acute effects. Very little is known about the long-term effects of treatment with these medications regarding side effects, maintenance dose, and use of blood levels. These should be systematically studied. The results of such studies might enable treatment using doses which are lower than those currently used, reducing side effects and improving medication compliance.
• Duration of treatment: Current guidelines are not clear regarding how long patients should be treated after a first episode of psychosis. In practice, many clinicians recommend stopping after one year, often increasing risk of relapse. (Studies) should be done randomizing patients to continuation of low dose antipsychotic treatment 1, 2 and three years after their first psychotic episode, to see if continued treatment reduces risk of relapse, while monitoring side effects.
• ECT: Electroconvulsive therapy (ECT) is underused in the United States compared to other developed nations. Randomized, sham–controlled studies using modern research designs should be conducted in the United States testing the efficacy and safety of ECT. This might encourage the use of this unpopular, but safe and efficacious evidence-based treatment.

Dr. Torrey wrote that NIMH funding is now skewed with 90 percent going for basic research, versus a fifty-fifty split.

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(6-5-20) From My Files Friday: In 2016, I asked Washington area management consultant Steven Kussmann to suggest ways the mental health community could be more effective in achieving meaningful reforms. Given all that is happening in our nation now, his call for action seems especially appropriate. 

Changing The Mental Health Movement From Within

by Steven Kussmann 

Less than 3% of our population self-identifies as gay or lesbian. Yet, the LGBT community created a movement that changed our nation’s definition of marriage and secured same sex marriage as a constitutional right! Change did not happen organically nor overnight. It was the result of a highly-effective social movement strategy and decades of well-targeted action.

The number of U.S. citizens with a serious emotional and mental health disorder is 10-times greater than the LGBT population. Why then do our social and political successes pale in comparison with those achieved by this community? What can we learn from them to achieve similar results? How can we apply those lessons to transform the mental health movement into a powerful engine for effective change?

The lessons are many, and their application requires a fundamental refocus of movement strategy and structure. To succeed as a force for real social and political change, the mental health community, both its leadership and grassroots network, must rethink and retool its strategy and tactics.

Here are five get-the-ball-rolling ‘lessons learned’ from the success of others the mental health community can act on now:

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(Editor’s note:  Google Analytics noted that my website recorded 200,000 readers a month shortly before the pandemic hit. Advertisers and marketing companies began contacting me. I do not accept advertising nor marketing promotions in the guise of blog posts.) 

(6-2-20) Guest blog by Joseph Meyer.

We Need To Thank the Black Lives Matter Movement

The Black Lives Matter movement is leading the protests about the death of George Floyd in Minneapolis at the hands of police officers.  Obviously, BLM is primarily laser-focused on the experiences of persons in the African American community, as its name indicates.  But, on the BLM website, its leadership asserts “we work vigorously for freedom and justice for Black people and, by extension, all people.”

The site specifically mentions ageism, expresses support for the broad membership of the GLBTQIA community, and in a summary statement acknowledges the problems faced by other groups: “We are guided by the fact that all Black lives matter, regardless of actual or perceived sexual identity, gender identity, gender expression, economic status, ability, disability, religious beliefs or disbeliefs, immigration status, or location.”

There it is—disability—and, although BLM does not specifically mention mental illness, the BLM movement has time and again been outspoken and active in standing up for the rights of persons with mental illnesses when other advocacy organizations have been mostly silent.  So I want to thank the BLM movement because I believe it has done a better job than any of the mental health advocacy organizations at peacefully, yet emphatically, calling attention to deadly threats faced by the seriously mentally ill – especially persons of color – in our communities at the hands of the police. Click to continue…

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(6-1-20) My son, Kevin, is a certified peer specialist – a person with a serious mental illness in recovery who helps others with their mental illnesses. I’m proud of him and his work.

Unfortunately and unnecessarily, peers are sometimes viewed as being adversaries to parents and families. This is counter productive. The same thinking that applies to peers can be said about parents and families. Only a parent or family member can fully understand what that experience involves. Parents handle issues differently. Some better than others. But teamwork is more productive than head butting, especially when each side should have the same goal, which should be helping an individual prosper.

The voices of family members are important. I remember vividly what a brother told me about his sister when I interviewed him in Miami for my book. He told me that his sister had schizophrenia and during the past 30 years she had been seen by two dozen psychiatrists, assigned three times that number of social workers, and had been arrested, and appeared before judges. When all of those doctors, social workers and judges were gone, he was still with her picking up the pieces.

It is important for parents to talk about their experiences. I am delighted that Randye Kaye, an author, public speaker, and mental health activist, invited two other mothers of adult children with serious mental illnesses to participate in a video discussion. Baltimore advocate Laura Pogliano and Miriam Feldman, both have written for this blog.

In addition, Kaye invited Robert Kolker, the New York Times bestselling author of Hidden Valley Road: Inside the Mind of an American Family to join their discussion. Kolker’s book chronicles the experiences of the Galvin family, a midcentury American family in Colorado Springs with twelve children, six of whom have been diagnosed with schizophrenia. Kolker’s book is a selection of the revived Oprah’s Book Club.

Thank you Randye Kaye, Laura Pogliano with SARDAA, and Miriam Feldman for sharing your experiences. Kaye is the author of  Ben Behind His Voices.  Feldman’s book, He Came In With It: A Portrait of Motherhood and Madness, will be available July 21st. Here is an NPR interview with Kolker about Hidden Valley Road.

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