Feuding Continues Over Trump’s Pick For Mental Health Czar, Reports New York Times

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(5-26-17) While it certainly is not unusual for a president’s nominee for a cabinet position to raise a ruckus, most assistant secretary choices sail through.

It appears that will not be the case with President Donald Trump’s nomination for the newly created job of mental health czar. Rep. Tim Murphy (R-Pa.) continues to express his displeasure  with the White House’s choice and has not been shy about saying so.

The bickering caught the attention of The New York Times this week.

Trump’s Pick for Mental Health ‘Czar’ Highlights Rift  -The New York Times

By BENEDICT CAREY and SHERI FINK

Caption: Elinore McCance-Katz has been tapped by President Trump to fill the position of assistant secretary for mental health and substance use. The “czar” position was created to overhaul the mental health care system and bridge more than 100 related federal agencies. Steven Senne/Associated Press

For decades, therapists, patient advocates and countless families have worked to elevate mental health care in the political conversation. Their cause recently received a big boost when a new law created a federal mental health “czar” to help overhaul the system and bridge more than 100 federal agencies concerned with mental health.

But the White House’s choice for the first person to fill that position has already been divisive, exposing longstanding rifts within the field that may be difficult to mend.

President Trump has announced his intention to nominate Elinore F. McCance-Katz for the new position, assistant secretary for mental health and substance use. Dr. McCance-Katz is a psychiatrist whose long career has been focused on treating drug addiction, in particular opioid abuse. She has the support of several prominent groups, including the American Psychiatric Association and the National Alliance on Mental Illness, but others, including the Foundation for Excellence in Mental Health Care, are skeptical.

A central tension in the debate is between the medical model of psychiatry, which emphasizes drug and hospital treatment and which Dr. McCance-Katz has promoted, and the so-called psychosocial, which puts more emphasis on community care and support from family and peers.

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The Daughter Of The Man Who Helped Keep The Cold War From Becoming Hot Talks

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(5-25-17) Ever wonder what it is like to be the daughter of a CIA officer – and not just any ordinary operative but one who actually helped keep the Cold War from turning hot?

Eva Dillon has written an exceptional book called  Spies in the Family: An American Spymaster, His Russian Crown Jewel, And the Friendship That Helped End the Cold War.

Before I started focusing almost exclusively on mental illness and my novels, I published nonfiction books about American traitors. One was CIA turncoat Aldrich Ames, who plays a critical role in Dillon’s book so I was especially eager to read her account.

Dillon’s story focuses on two men. Soviet Major General Dmitri Polyakov was the most important Russian “asset” who worked for us during the Cold War, and Dillon’s father, Paul Leo Dillon, was his CIA handler.

To understand why her new book is both an excellent read and important, you must understand what Gen. Polyakov did for our nation. He was the United States’  highest-ranking, longest-serving Soviet double agent during the Cold War. James Woolsey, Director of CIA under President Clinton, called him the “jewel in the crown”who “kept the Cold War from becoming hot.”

My CIA contacts have told me that Polyakov’s disclosures alone filled an entire room full of file cabinets.

The second thing you must realize is Dillon has written a true insider book describing the mental toll it took on her father handling such a valuable “asset” who was in constant danger.

Dillon interviewed me for her book because Aldrich Ames was responsible for Polyakov’s arrest by the Soviet KGB. While the Kremlin had its suspicions for years, it was Ames who confirmed that the general had spied for us – a fact Ames told them even though Polyakov had retired from the GRU (Soviet military intelligence) and was an older man. Ames knew in disclosing Polyakov’s past, the general would be executed. Yet, Ames offered up Polyakov’s name simply to line his pockets and impress his new Kremlin “friends.” (In case you are wondering, Polyakov betrayed the Soviet empire for philosophical reasons not cash.)

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Stigmatizing Slurs About Mental Illness By Folks On All Sides Should Stop

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(5-22-17) From the White House down, politicians on both sides of the aisle, celebrities, and even mental health therapists need to stop using language inappropriately that increases stigma and marginalizes mental illnesses. 

Unfortunately, there has been a shameful increase of such remarks recently, especially last week. The use of inappropriate language showed up internationally, as well, with Russian President Vladimir Putin misusing the word “schizophrenia” when talking about American politics. 

One way to fight this is for responsible media outlets to explain when these words are used erroneously. Repeating them unchallenged fosters stigma.

I’ve posted an excerpt at the bottom of this post from the Associated Press style-book, which most publications use as their ethics standards.

Examples:

1.  President Donald Trump reportedly told Russian diplomats that ex-FBI Director James Comey is a “nut job…” according to The New York Times… “He was crazy, a real nut job.”

2.  Trump directed the term at “wacky Glenn Beck.” Trump said the nationally syndicated radio host is a “real nut job” because he “always seems to be crying.”

3. Trump said North Korean leader Kim Jong Un “could be a total nut job.” “I mean, you’ve got this madman playing around with the nukes, and it has got to end. He’s certainly — he could be a total nut job, frankly,” Trump said on Fox News’ “On The Record” in January 2016.

4.”You know, I call him crazy Bernie because he’s not very good,” Trump said.

Here’s the flip side.

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Four NAMI Board Candidates Running On SMI Platform

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(5-18-17) Four candidates are seeking election to the National Alliance on Mental Illness national board on what they are calling a “Focus on Serious Mental Illness” platform.

They are:

In their five minute candidate speeches, all four said they want NAMI to focus more of its attention on adults with serious mental illnesses, defined as schizophrenia, bipolar disorder, and severe and persistent depression (known as SMIs).

Virginia has one nominee seeking election. Frankie Berger, Nominated by NAMI Central Virginia (Virginia) is not part of the “Focus on Serious Mental Illness platform.” However, in her speech she cites her concerns about the need for more services for individuals with SMI.  Most of her talk is about her struggles as a youngster single-handedly being responsible for her mentally ill mother – oftentimes using babysitting money that she earned to pay household bills. You should listen to her emotional story here.)

D. J. Jaffe, author of the book Insane Consequences: How the Mental Health Industry Fails the Mentally Ill, and Mary Zdanowicz, who was executive director of the Treatment Advocacy Center for nine years, are perhaps the best known of the four hoping to change NAMI’s sixteen member board.

In their speeches, both mention that NAMI needs to do more to counter anti-psychiatry groups and actions by the Bazelon Center for Mental Health Law. (You can listen to their speeches here – Jaffe  Zdanowicz.)

In an email, Jaffe wrote:

“We want NAMI to return to a focus on the four percent with serious mental illness, versus the eighteen percent of adults with any mental illness. In other words, we believe we should focus on the eleven million who are the most seriously ill versus the forty-three million with a wide range of ‘conditions’ that NAMI now claims to represent even though there are scores of other organizations advocating for them.”

I’ve felt tension before within NAMI’s ranks, but I was surprised recently when I was asked to substitute the term “mental health condition” for “mental illness” at a recent NAMI function and specifically asked to focus on “positive stories of recovery” rather than how individuals with SMIs are ending up in jails and prisons.

I have never been asked before to do this and I was astonished because “mental illness”  is part of NAMI’s name.

Curious, I checked NAMI’s website and saw that the category “Mental Illnesses” had been replaced by “Mental Health Conditions,” which were identified as  “ADHD, Borderline Personality Disorder, Anxiety Disorders, Dissociative Disorders, Eating Disorders, Obsessive Compulsive Disorders, Post Traumatic Stress Disorders,” along with schizophrenia, bipolar disorder, and depression.

NAMI’s website explains:

“A mental health condition isn’t the result of one event. Research suggests multiple, linking causes. Genetics, environment and lifestyle influence whether someone develops a mental health condition. A stressful job or home life makes some people more susceptible, as do traumatic life events like being the victim of a crime. Biochemical processes and circuits and basic brain structure may play a role, too.”

In the midst of all this, I was asked to help publicize a series of rallies being held on May 20th by a group called  Families for the Treatment of Serious Mental Illnesses, whose organizers include NAMI members who said they felt abandoned. I was surprised at how widely that blog spread.

NAMI’s Executive Director Responds

In a telephone call, NAMI’s Executive Director Mary Giliberti, said she could not comment on specific candidates. She said NAMI has always and will always advocate for individuals with serious mental illnesses.

“If you look at NAMI’s work as a whole – our helpline, education programs and advocacy – we are the go-to organization for families and individuals with serious mental illnesses and much of our recent work has been getting our name out there so we can reach more of them as early as possible.”

She explained that NAMI broadened its mission “to reach people early because we now know that you can get better outcomes for people with serious mental illness and reduce the worst consequences if we intervene early.”

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Harvey Rosenthal: The “Worried Well” – A False Narrative Meant To Divide

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(5-15-17) I bumped into Harvey Rosenthal recently at the National Council on Behavioral Health Care convention in Seattle and invited him to write a guest blog. Harvey is Executive Director of the New York Association of Psychiatric Rehabilitation Services and one of the best known advocates for recovery and peer support services. Given what seems to be a constant battle being waged between the “medical model” that focuses on medication adherence and the “recovery model” that focuses on peer support and other social services, I thought it would helpful to hear his point of view, especially because a new Assistant Secretary of Mental Health and Substance Abuse will soon be appointed.)

Re-Balancing Federal Policy Need Not Have To Choose Between Extremes

BY HARVEY ROSENTHAL

For far too long, advocates for court mandated outpatient commitment have promoted the false narrative that recovery, rehabilitation and peer support providers and advocates don’t want to serve Americans with the most serious conditions…..and that our motivation in supporting the redirection of public funds from hospital to community is simply to capture public dollars for our own purposes. In contrast, these groups have outrageously played upon unfounded connections between violence and mental illness to promote a singular one-size-fit-all prescription of “more meds, more beds and more coercion.”

Along the way, these groups have promoted beliefs that a recovery and rehab focus only applies to the ‘worried well’ and excludes the most distressed, that peer support is inevitably against treatment and medication and that rights advocates are only interested in helping people in the greatest need to avoid such treatment?Click to continue…

Dr. McCance-Katz: Profile of White House Nominee For Mental Health Czar Widely Distributed

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(5-12-17) The website STAT posted a story about President Trump’s pick for the newly created position of Assistant Secretary for Mental Health and Substance Abuse inside the federal Department of Health and Human Services that is being widely circulated. Written by Meghana Keshavan, it is one of the more in-depth pieces describing Dr. Elinore McCance-Katz, the former Chief Medical Officer at the SAMHSA (the Substance Abuse And Mental Health Services Administration) who accused that agency (after resigning) of being anti-psychiatry and directed by folks who did not believe mental illness was real.)

Trump’s pick to run mental health is poised to shake things up. Even some liberals can’t wait

By MEGHANA KESHAVAN @megkesh

Dr. Elinore McCance-Katz has been nominated to run the federal agency dealing with mental health and substance abuse.STEVEN SENNE/AP

 President Trump’s pick to run federal mental health services has called for a bold reordering of priorities — shifting money away from education and support services and toward a more aggressive treatment of patients with severe psychiatric disorders.

The proposal has some psychiatrists — a generally liberal bunch — cheering despite their distrust of the Trump administration.

But it’s also sparked concern among other health professionals, who worry that the administration will put too much emphasis on medicating and hospitalizing patients, and remove supports that might help them integrate successfully into society.

If confirmed by the Senate, Dr. Elinore McCance-Katz will take the helm 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.

She will be the first to assume the title of assistant secretary for mental health and substance abuse — a near-cabinet position which reports directly to Health and Human Services Secretary Tom Price. Congress created the post to bring order to a scattered system; this is the first time mental health and substance abuse have received such a weighty emphasis in D.C.