Pete Earley

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Haunting video called The Voices of 10 Million posted at Change.org by group petitioning NAMI to “stop shunning our families and our loved ones.”

(1-19-17) Several long-time mental health activists have written an open letter to National Alliance on Mental Illness CEO Mary Gilberti and NAMI’s board of directors complaining about what they describe as the organization’s “lack of focus” on serious mental illnesses and “mission creep.” NAMI bills itself as the largest grassroots mental health organization in the nation with chapters in every state and several hundred thousand members.

Many of the letter writers are well-known NAMI members who are parents of adult children, some of whom are currently incarcerated or have died while in custody or during fatal encounters with law enforcement. Other signers represent loved ones who are stuck in a revolving door of streets and jail because they “lack the capacity to voluntarily engage in their treatment due to the fact they simply do not believe they are ill,” according to an email sent to me by one signer. (Full disclosure: I am a lifetime member of NAMI.” 

Chief among their complaints is that NAMI national’s leadership has abandoned the seriously mentally ill — who they call the 4% — who refuse treatment and, therefore, are often ignored by mental health providers and mental health organizations in favor of individuals who are not as ill, comply with treatment or are already in recovery.

In an email, G.G. Burns, a well-known Kentucky advocate wrote: “While many of the local and state NAMI affiliates work very hard to support families in the trenches, they, often do not receive the support and training they need from the national organization to address individuals and their families who are seriously ill and lack the ability to advocate for themselves.”

NAMI issued a response last night which I will post Friday morning. Meanwhile, here  is a link to the letter writers’ petition that further explains what they hope to accomplish.)

“Silence becomes cowardice when occasion demands speaking out the whole truth and acting

accordingly.”

― Mahatma Gandhi

Dear Ms. Gilberti and NAMI Board of Directors,

As local, state and national family leaders and advocates of mental illness system reforms, we write to urge that NAMI promotes needed steps to fully support and implement the mental health provisions included in the 21st Century Cures Act.

First, we thank NAMI for its support of HR 2646, The Helping Families in Mental Health Crisis Act. As families and advocates of the 4% of the most seriously mentally ill people, we came out of the shadows and told our shared tragedies on the Capitol Hill. As evidenced in our stories, videos, hearings, testimonies* and letters we urged Congress to listen to our cries for help and hope, and we are grateful that we were finally heard.

Will NAMI also hear our cries? NAMI’s motto is “you are not alone.” Yet, many of us feel that we are alone and that our loved ones have been abandoned to the streets, jails, prisons and morgues or left to linger, often untreated or inadequately treated, in the back bedrooms of our homes.

We are forever grateful for the founding mothers of NAMI who were tired of their sons and daughters being blamed for their serious mental illness. They started a movement to win improved access to treatment and supports. We joined them and fought with them for years. Many of us are still loyal members. But, we are also still waiting for public and private systems of care to provide our loved ones a right to treatment before tragedy.

Many of NAMI’s policies and signature programs are valuable, key pieces of a strong mental health system. However, we believe that there is a lack of focus on specific programs needed for our loved ones,many who lack capacity to keep themselves safe and are therefore unable to assimilate into voluntary-based community mental health systems. Sadly, NAMI has allowed mission creep to put our families at risk. We simply cannot accept the status quo or waiting another 50 years for what our families need now.

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Officers help evacuate airport passengers during mass shooting at Fort Lauderdale airport that killed five. (Photo courtesy of Daily News) 

(1-8-17) Not everyone agreed with my grim Monday blog about mass murders and my blaming of the dangerous criteria that often is used in deciding who can buy and possess a firearm or be involuntarily admitted into a hospital. Among those with a different point of view was Dr. Annette Hanson, co-author of the book, COMMITTED, The Battle Over Involuntary Psychiatric Care.  Dr. Hanson is an assistant professor of psychiatry at the University of Maryland School of Medicine and Johns Hopkins University School of Medicine. She also is a coauthor of Shrink Rap: Three Psychiatrist Discuss Their Work, and she contributes to a blog by that same name.)

Mass Shootings, Mental Illness, and Public Safety

By Dr. Annette Hanson

Would changing the legal definition of dangerousness for involuntary treatment prevent mass shootings?

In a word, no.

A mass shooting, which is commonly defined as the killing of four victims in a public place, is a relatively rare event.

In 2012, the year with the highest number of mass shootings, there were only seven incidents. Our ability to predict such rare events is tenuous at best. Prediction could be improved if the pool of all potential shooters could be narrowed down a bit, but to date no useful “profile” or typical characteristics of a mass shooter have ever been identified. While some mass shooters have had contact with mental health care prior to their crimes, as many as thirty percent have had no mental health history whatsoever. The strongest consistent characteristic of a mass shooter is male gender, but public gun policy based on gender is obviously impractical.

Even for perpetrators with a history of mental health treatment, changing the legal definition of dangerousness for civil commitment does not help clinicians decide who should or should not be admitted against their will.

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(1-16-17) Twenty four days after President Barack Obama signed into law what was billed as the most major mental health reform bill in decades, a gunman pulled a semi-automatic pistol from his checked luggage in the Fort Lauderdale-Hollywood International Airport and began shooting, murdering five and injuring six others.

It is fair to ask if any of the reforms in the mental health bills that were merged into the 21st Century Cures Act would have stopped Esteban Santiago-Ruiz from committing murder.

Sadly, I believe the answer is no.

Yes, the Helping Families in Mental Health Crisis Act, the Mental Health and Safe Communities Act, and the Mental Health Reform Act, included promising initiatives. The bills call for better law enforcement training, more support for early identification and intervention programs, greater use of Assertive Community Treatment, more peer provided services, additional funds for community mental health programs and for continued funding for Assisted Outpatient Treatment.

Having police officers who have been Crisis Intervention Team trained can intercede and stop violence, having peers available to help persons with mental illnesses who encounter the police can help stop violence, access to better services can stop violence, and outpatient treatment can stop violence.

But none of these programs can make a difference if the person who is sick either doesn’t believe he/she is ill or rejects help. Whether by persuasion or coercion, there is no legal way in America today to stop a mentally distributed individual from buying or owning a gun unless they are or have been ruled a danger to themselves or others, or previously hospitalized.

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(1-13-16) FROM MY FILES FRIDAY – Next week, I will be posting a blog about the recent shooting inside the Fort Lauderdale airport, but today I am reposting an Op Ed of mine published by The Washington Post on September 27, 2013 after a similar rampage at the Washington Navy Yard here in D.C. These shootings continue to spark frustration and anger but little preventive action. This editorial garnered about 100 comments, many agreeing but others strongly challenging my views.)

Getting the mentally ill the help they need

By Pete Earley, published in The Washington Post

When should society intervene if a person shows signs of mental illness?

As with the shooters at Virginia Tech, in Tucson and in Aurora, Colo., there were ample warnings that Aaron Alexis was experiencing mental distress before he killed 12 people at Washington’s Navy Yard.

Police in Newport, R.I., did nothing to help Alexis when he complained about hearing voices and being zapped by skin-vibrating microwaves.

In 1975, the Supreme Court ruled in O’Connor v. Donaldson that the state “cannot constitutionally confine. . . a non-dangerous individual who is capable of surviving safely in freedom by himself or with the help of willing and responsible family members or friends.”

That decision established our legal threshold of posing a danger to one’s self or others.

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(1-10-17) Who will president-elect Donald Trump nominate as the new Assistant Secretary for Mental Health and Substance Abuse?

Hearings begin today for the controversial big name cabinet posts so it will be a while before the Senate gets around to the White House’s choice for this new job in the Department of Health and Human Services, but four names already are being circulated on Capitol Hill.

Even before the $6.3 billion 21st Century Cures Act  was signed into law last month (that’s the omnibus bill that contained mental health reforms), I began lobbying for Miami-Dade County Judge Steve Leifman.

The others being mentioned are Dr. John Wernert, who runs Indiana’s mental health system; Dr. Robert Heinssen, a program director at the National Institute of Mental Health; and Dr. Ellie McCance-Katz, the chief medical director in Rhode Island.  Of course, other candidates might surface in the coming days and it’s also possible that Trump could pull a name out of hat that surprises everyone.

But I hope not.

It will take a strong, knowledgeable and accomplished leader to implement the hard-fought reforms that became law primarily because of Rep. Tim Murphy (R-Pa.) and Sens. John Cornyn (R-Tx.), Chris Murphy (D-Conn.) and Bill Cassidy (R-La.)

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