UPDATE: On Friday afternoon (8-4), a spokesperson for Rep. Tim Murphy (R.-Pa.) issued the following statement about Dr. McCance-Katz’s confirmation.

Congressman Murphy looks forward to working with the new Assistant Secretary to fulfill the promises made in the Helping Families in Mental Health Crisis Act. Likewise, now more than ever, it’s crucial to work together to turn the tide on our nation’s opioid and addiction crisis, the worst drug crisis in United States history.

(8-3-17) Dr. Elinore F. McCance-Katz was confirmed by a voice vote this afternoon in the U.S. Senate as the Department of Health and Human Services Assistant Secretary for Mental Health and Substance Abuse.

Rep. Tim Murphy (R-Pa.), who drafted the Helping Families in Mental Health Crisis Act that created the new position, had objected to Dr. McCance-Katz’s nomination when the White House and HHS Sec. Tom Price announced it.

His amended legislation was merged into the 21st Century Cures Act, which was signed into law during the final days of the Obama Administration.

By creating an Assistant Secretary for Mental Health and Substance Abuse, Rep. Murphy said he hoped to give mental health and addiction services a higher prominence in the federal bureaucracy. Murphy, the only practicing psychologist in Congress, began pushing for major federal mental health reforms after the Newtown shootings.  He’d backed a different candidate for the post but could not vote since the new job required Senate approval and not confirmation by House members.

As the first ever assistant secretary, Dr. McCance-Katz will be the Trump administration’s defacto mental health and substance abuse czar, whose duties will include overseeing the Substance Abuse and Mental Health Services Administration.

Before being confirmed today, Dr. McCance-Katz was the chief medical officer for the state Department of Behavioral Healthcare, Developmental Disabilities and Hospitals in Rhode Island.

In 2013, she worked as SAMHSA’s first chief medical officer but left the federal government for the Rhode Island position after only two years.  In a critical essay published in the Psychiatric Times, Dr. McCance-Katz wrote that SAMHSA’s Center for Mental Health Services, which administers federal mental health programs, ignored serious mental illnesses and evidenced based practices in favor of feel-good recovery programs that were politically popular but did little to help persons diagnosed with debilitating disorders.

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(8-1-17) Dr. Elinore F. McCance-Katz, the Trump Administration’s nominee to become the Department of Health and Human Service‘s first Assistant Secretary for Mental Health and Substance Abuse breezed through her confirmation hearing this afternoon.

She appeared before the Senate Committee on Health, Education, Labor and Pensions (HELP), one of the final hurdles before she can assume oversight of the 8 federal agencies and 112 federal programs that deal with mental health and substance abuse.

Dr. McCance-Katz said her top priorities would be dealing with the opioid crisis and focusing on serious mental illnesses.

As expected, most of the questions from the HELP committee centered on the opioid crisis, but Sens. Bill Cassidy (R.-La.) and Chris Murphy (D.-Conn.) zeroed in on mental illness. This was not surprising because they were responsible for introducing the Senate version of Pennsylvania Republican Rep. Tim Murphy’s Helping Families in Mental Health Crisis Act, which created the Assistant Secretary position. A much altered version of the original House bill became law in December during the waning days of the Obama administration.

Both senators told Dr. McCance-Katz that they expected her to use the “tools” and “powers” that the new law gives her to break down silos and force federal agencies to begin cooperating and coordinating their efforts.

Sen. Cassidy, who also is a medical doctor, specifically criticized SAMHSA (the Substance Abuse and Mental Health Services Administration) calling it “dysfunctional.”

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First of its kind program in nation scheduled to open next year. 

(7-31-17) Morgan first began acting out when he was two years old. His behavior only got worse as he aged. His parents were given a number of conflicting diagnoses. None good.

At one point, his parents hired a live-in young counselor, who Morgan liked, to help them deal with their son’s outbursts. Next came a Connecticut boarding school for students with a wide range of disruptive issues from anxiety to Asperger’s to bipolar disorder. Despite that school’s stellar reputation, Morgan stole a car at age fourteen and went on a joy ride. By the time he was sixteen, he had been kicked out of four schools. Desperate, his parents sent him to a residential treatment center in Utah for “troubled teens.”

That helped, but not for long.

Pressured by a friend at age sixteen, he attempted to rob a taxi driver in Manhattan. A year later, paranoid and delusional, he called the police and reported that he was being followed. When they ignored him, he gathered all of the trash where he was living, put it on his stove and started a fire, believing firefighters would come and rescue him.

He was arrested for arson. A judge sentenced Morgan to five years in a New York prison.

Morgan’s father, Francis J. Greenburger, pleaded with a prosecutor. With Morgan’s ten inch thick medical file in hand, Greenburger persuaded the prosecutor to give Morgan a break. He would be sent to a mental health treatment facility instead of Riker’s Island if his father could find a locked, treatment facility where he could serve his sentence.

Morgan’s father wasn’t some ordinary Joe. A high school drop out at age fifteen, Francis Greenburger was a self-made, multi-millionaire who oversaw more than 25-million-square-feet of prime real estate in Manhattan, nationally and internationally. He also owned one of New York’s most respected literary agencies. (An agent associated with his firm represented my first three books.) With his wealth, his social influence, his grit and his loving determination to help his son, Greenburger began his search.

Greenburger later told me, the prosecutor had “sent me on a fool’s errand. None existed.”

Despite Morgan’s well documented history of mental illness, Greenburger watched his son taken away in handcuffs and leg shackles bound for Riker’s Island, a notorious facility where few with mental illnesses emerge in better condition from when they entered.

For a loving dad such as Greenburger that was unacceptable. If he couldn’t help his son, he would help others. If there was no alternative to prison, he would build one.

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Virginia State Senator Creigh Deeds

(7-28-17) At a time when it’s easy for all of us to feel disappointment in our political system, we have an example of the best in our democracy here in Virginia.

I’m talking about the cooperation and determination of state Sen. Creigh Deeds (D.) and representative Rob Bell (R.) in working together to improve mental health and substance abuse care in the state.

An example of Deeds’ statesmanship came late yesterday when his attorney announced the state senator had chosen to drop the Virginia Department of Behavior Health and Developmental Services from a $6 million wrongful death lawsuit that he had filed last year in response to the preventible death of Gus, his 24 year-old son.

In return, the department has pledged to partner with him in helping overhaul Virginia’s fractured mental health and substance abuse system.  The exact details about what the state actually will do haven’t been formalized. However, according to a Richmond Times Dispatch story by K. Burnell Evans, the department has agreed to hold an annual symposium “that will provide a forum for discussion of mental health topics and issues of significance in Virginia and of interest across the country.”

In announcing Deeds’ decision to let the department off-the-hook, his attorney said, “It has always been Senator Deeds’ goal to reach a point of constructive change that can serve to prevent any other family from experiencing the tragedy his family experienced.”

Simply put, it never has been about the money. It has been about forcing the state to improve services – something it has historically failed to do.

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(7-26-17) A grinning Virginia Governor Terry McAuliffe was able to bluff his way through a recent appearance held in Washington D.C. when questioned about his decision to execute an inmate with a serious mental illness. While claiming, once again, that he personally opposed the death penalty, he rationalized the execution by assuming the role of a modern day Pontius Pilate and repeating damaging testimony offered by a psychiatrist at William Morva’s first trial while dismissing testimony later by an independent psychiatrist and new evidence about Morva’s mental health history. I’m thrilled that a former prosecutor and defense attorney rebuffed McAuliffe in this Washington Post opinion piece posted Sunday, July 23rd.)  

William Charles Morva was put to death because our legal system failed him. When Virginia Gov. Terry McAuliffe (D) denied Morva clemency on July 6, he apparently misunderstood the facts about Morva’s mental illness and squandered an opportunity for compassion.

When the governor refused to intervene, he missed a chance to exercise a solemn constitutional duty to save Morva’s life. In a case that cried out for mercy, McAuliffe disregarded that the sentencing jurors never heard the compelling evidence of Morva’s long-standing, debilitating mental illness. Although Morva’s death is an irreversible mistake, he should not die in vain.

Death should be an extraordinary, rare punishment. U.S. and Virginia laws reflect the centuries-old bedrock principles that a death sentence is exceptional and that mercy alone is always reason enough to avoid the death penalty.

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