New Assistant Secretary for Mental Health and Substance Abuse is sworn in by Secretary Tom Price while her husband holds bible.

9-14-17) Dr. Elinore McCance-Katz, who was sworn in earlier this week as our nation’s first Assistant Secretary for Mental Health and Substance Abuse, is going to need a tremendous amount of support from families and mental health advocates if she is to change the course of the Substance Abuse and Mental Health Services Administration, a federal agency with a budget of about $3.6 billion a year, most of it dispensed in grants to help states pay for mental health and addiction treatment.

Reforming SAMHSA is the mandate that both Congress and the White House have given her, but the road to accomplishing that is filled with minefields.

She is taking charge at a time when SAMHSA has been under intense fire voiced during congressional hearings held by Rep. Tim Murphy’s (R.-Pa.) leading up to passage of the law during the Obama administration that created Dr. McCance-Katz’s new job.

But Rep. Murphy’s harsh critique was hardly the only voice clamoring for change.

For years, Dr. E. Fuller Torrey has lashed out against SAMHSA. Among his criticism: that SAMHSA failed to employe a single psychiatrist, funded groups that were outspokenly anti-psychiatry and anti-medication, and issued a three year planning document that was 41,804 words in length but didn’t include a single mention of schizophrenia, schizoaffective disorder, bipolar disorder, autism or obsessive disorder. Instead, he said, SAMHSA frittered away millions on feel good programs for the worried well. As an example, Rep. Murphy and Dr. Torrey cited SAMHSA’s funding of an “Unleash the Beast” program that promised to help attendees learn about mental illness by studying animal movements.

Even SAMHSA’s own employees were unhappy. A 2015 study by a non-partisan watchdog group ranked SAMHSA at 317 out of 320 federal agencies when it came to employee job satisfaction.

Among the SAMHSA’s harshest critics was Dr. McCance-Katz herself.

In an earlier incarnation, Dr. McCance-Katz served as SAMHSA’s first chief medical officer but left after only two years. Once out the door, she blew the whistle on SAMSHA, writing in an April 2016 Psychiatric Times article that at SAMHSA:

 “There is a perceptible hostility toward psychiatric medicine: a resistance to addressing the treatment needs of those with serious mental illness and a questioning by some at SAMHSA as to whether mental disorders even exist—for example, is psychosis just a “different way of thinking for some experiencing stress?”

All of which, now begs a question that needs to be answered.

Changing the top leader at a federal agency doesn’t change the career employees who have been sailing the ship for the past decade.

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(9-12-17) My good friend, Steve Weiss, recently asked if I would help publicize A BIT TOO MUCH ABOUT ME, a performance by Zac Sandler. The show is being performed this coming Friday, September 15th, beginning at 7 p.m. at The Triad Theater,  158 W 72nd Street, New York City. (It also will be live streamed, details below.) If you live in the New York area or happen to find yourself in Manhattan, please check it out.
What’s the show about?

“Welcome to what’s inside Zak’s head.  From the piano, Zak narrates his experience with a serious mental condition as it progresses from out-of-control to chaotic, to in-control and harmonious, while he strives to navigate his relationships and his writing career.  Joining Zak is a group of actors who play younger Zak, his exes, and the parts of his brain that come out during his mental episodes.”

I am especially pleased to be plugging this performance.

My friend, Steve Weiss, whose recommending the show, has been someone who has unselfishly helped my family numerous times during crises.

HOW STEVE WEISS HELPED MY SON WHEN THE POLICE WERE CALLED

After my book was published, Kevin stopped taking his medication. I called a mobile crisis response team and explained that I was concerned because I could see Kevin was beginning to slip into psychosis.

Is he dangerous?” the dispatcher asked me.

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It’s disturbing to see individuals with mental illness handcuffed and led away. Thankfully, they were taken to a crisis stabilization unit and not jail. 

(9-9-17) My good friend Miami Dade Judge Steven Leifman and his family have evacuated from Miami but not before he spoke to community leaders about the city’s seriously mentally ill, homeless population. 

 In an email, the mental health advocate told me: “These individuals were transferred to Jackson Memorial Hospital’s Crisis Stabilization Unit – they were not sent to an inappropriate shelter. We also coordinated with Jackson so they were prepared to handle the increased volume.”

Douglas Bevelacqua, a former IG for mental health in Virginia, noted in an email to me, “Hurricane Katrina raised everyone’s consciousness about the plight of companion animals during, and after, a major storm. There are many organizations and programs to help save and reunite dogs and cats with their owners. I wonder if Houston’s mentally ill street population is getting a fraction of the attention directed to its companion animals.” Bevelacqua wonders if  the National Alliance on Mental Illness, Mental Health America, or some other mental health group will sponsor or participate in a national disaster relief fundraiser. Good question.

During emergencies, everyone realizes many homeless individuals are so impaired by their brain disorders they cannot make rational decisions to protect themselves. But when the sky is clear, society is fine leaving them to fend for themselves on the streets.)

Miami shelters homeless against their will as Irma closes in

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(9-4-17) Health and Human Services Secretary Thomas Price called serious mental illness a “silent epidemic” that touches nearly all Americans. Housing and Urban Development Secretary Ben Carson agreed. But where were their peers when the Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC), created by Congress, held its first meeting last week?

The 21st Century Cures Act stated that these top federal officials would be members of the committee.

Attorney General Jeff Sessions.

Secretary of Veterans Affairs David J. Shulkin.

Secretary of Defense James Mattis.

Secretary of Education Betsy DeVos.

Secretary of Labor R. Alexander Acosta.

Commissioner of Social Security Nancy A. Berryhill.

I know I am nitpicking. All of these leaders work grueling hours and simply can’t be everywhere the public would like them to be. Plus, they sent senior officials from their agencies to represent them, many of them mental health experts.

But the Trump Administration missed a opportunity by not having its elite leadership team appear at the inaugural meeting, even if it were only long enough for a photo. (See photo at end of this blog showing those who did attend.) Each agency also should have issued a press release on the day of the meeting issued by its top executive addressing how their agency is working on improving mental health services and is reducing stigma within its own ranks.

Consider the powerful, positive message their appearances would have sent to the public and to the federal employees who work in their agencies.

Last week, I posted Secretary Price’s impressive opening statement and in this blog, I will share Dr. Elinore McCance-Katz’s important remarks to the committee.

But first a personal observation. When Secretary Price arrived at the meeting, he spoke to everyone in the room, asked their names, and shook their hands. Unfortunately, Secretary Ben Carson arrived at the last minute and left immediately after he spoke so he was unable to greet everyone.

When I worked at The Washington Post, I spent several weeks traveling with Archbishop Desmond Tutu. He made a point of introducing himself to every doorman, every food server, and the housekeeping staff when we traveled, at times, he did this before greeting dignitaries. I never forgot the visual statement it made: you are important regardless of whether you are the head of a great university or a janitor. You matter.

You might not agree with Secretary Price’s politics, but he showed tremendous class when he arrived at the meeting and took time to introduce himself and shake hands.

As for the others, they missed an important moment when they could have done tremendous good simply by showing up for a picture.

Remarks by Assistant Secretary Dr. Eleanor McCance-Katz

Thank you Secretary Price.

• In my role as Assistant Secretary for Mental Health and Substance Use, I am pleased to pledge the support of SAMHSA to the Secretary’s priority issue related to Serious Mental Illness. As many of you know, SAMHSA is the agency within HHS that is charged with leading the efforts to address behavioral health issues, such as SMI and SED in our country and I look forward to the work of this committee in helping SAMHSA to address this mission.

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