Pete Earley

(12-13-16) Shortly before 3 p.m. today, President Barack Obama will sign the 21st Century Cures Act, which includes two important mental health bills, including the Helping Families in Mental Health Crisis Act that Rep. Tim Murphy (R-Pa.)  tenaciously pushed for nearly four years.

Two years ago, I began a year-end tradition of naming individuals or groups who I believe had the most impact in mental health during the year. Rep. Murphy was my primary pick  in 2014 even though Democrats successfully blocked his initial efforts to get his bill passed. As I’ve written before, he was relentless and should be proud and much credited today at the White House signing.

But he didn’t get his bill to the president’s desk today alone and I am selecting three other key players this year as my choices for the most impactful mental health warriors of 2016.  They are Senators John Cornyn, (R.-Tx.) Chris Murphy (D-Conn.) and Bill Cassidy (R.-La.).

It was Chris Murphy and Dr. Bill Cassidy who initially introduced a companion bill to Tim Murphy’s in the Senate. They held a Senate Mental Health Summit to educate their colleagues and worked on compromise language that won their bill widespread support. Bipartisan support is not enough, however, in Congress to get a bill moving through the political system.  Because both Murphy, who was elected in 2013, and Cassidy, who moved from the House to the Senate in the 2014 elections, lacked seniority, it would have been difficult for them to get their legislation out of committee. Undaunted, they were able to persuade Sen. Lamar Alexander (R. Tenn.), the powerful chair of the Senate Health, Education, Labor and Pensions Committee (HELP), to back them.

Even with Alexander’s help, the Murphy/Cassidy bill would have had difficulty if Sen. Cornyn, the Senate Majority Whip, had not made mental health reform one of his chief priorities. He had simultaneously introduced his own mental health bill, the Mental Health Safe Communities Act, in the Senate Judiciary Committee.

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(12-12-16) Breaking news! The U.S. Department of Justice today announced it will investigate the Hampton Roads Regional Jail in Portsmouth, Va., after repeated requests from mental health advocates following the death of Jamycheal Mitchell, a 24 year-old African American with schizophrenia who suffered a fatal heart attack prompted by starvation after spending 101 days in jail last year.

Seven advocacy groups initially requested an investigation of the jail, including:

• The National Alliance on Mental Illness of Virginia, the state office of NAMI;
• NAMI (National Alliance on Mental Illness), the national organization of NAMI;
• NAMI Hampton-Newport News, a local affiliate of NAMI;
• The ACLU of Virginia;
• NAACP Portsmouth;
• Bazelon Center for Mental Health Law and
• The Mental Health America of Virginia, a statewide organization.
• The Treatment Advocacy Center signed a second version of a letter to the Justice Department sent by the original 7 agencies.

I also called for an investigation, and was joined by The Washington Post, after state agencies failed to publicly explain how Mitchell, who was accused of stealing $5.05 worth of snack foods, died in the jail while reportedly under the daily medical care of a nurse and regular checks by correctional officers. Two investigative reporters for The Richmond Times Dispatch, Sarah Kleiner and K. Burnell Evans, were relentless in investigating Mitchell’s death, and deserve credit for keeping this story alive, as does Gary Harki, with the Virginian Pilot.  Another key player in publicly demanding an investigation was Douglas Bevelacqua, a former Virginia inspector general responsible for mental health probes.

All of us who care about the inappropriate incarceration of persons with mental disorders owe a huge thank you to the eight groups and the investigative reporters who focused on this horrific case. It is important to note that the Justice Department did not state that it would specifically investigate Mitchell’s death. This is unfortunate. But it will look at practices in the jail and hopefully its probe will improve services there that will spread across the state. This is a major victory for Virginia NAMI’s Mira Signer, who spearheaded the effort, and it should be further embarrassment for state officials and Virginia agencies charged with protecting persons with mental illnesses who should have investigated this when it first happened but chose instead to simply allow jail officials to investigate and absolve themselves. I will be writing more about this later.

Email message to me from Justice Department official:

Pete,

Because you had previously provided information to our office as we did preliminary work on this matter, I wanted to let you know that our office and the U.S. Attorney’s Office for the Eastern District of Virginia have just formally opened an investigation into the Hampton Roads Regional Jail.  Thanks again for your help during our preliminary inquiry.  I will be continuing to work on this case going forward, so please do not hesitate to contact me should you have any questions or have any information you believe would aid us in our investigation.

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(12-12-16) Every year during the holidays, all of us are asked to donate to groups that we believe are making our lives and society better. I am hesitant to mention my favorites because, in doing so, I will be slighting equally important and worthwhile mental health groups. Still, here are some that I would urge you to consider.

INTERNATIONAL

• Sometimes in life, you meet someone who strikes you as a living saint, someone who is so good that you feel humbled. That happened to me earlier this year when I met Vandana Gopikumar, a co-founder of The Banyan. Vandana and her partner, Vaishnavi Jayakumar, are the equivalent in mental health in India to Mother Teresa. They have rescued hundreds of homeless, seriously mentally ill women from the streets of Chennai, India. If you want to know that the money you give will literally save someone who has a mental illness and is destitute from starving on the streets, then The Banyan is the group to support.

NATIONAL

•  I’m a lifetime member of the National Alliance on Mental Illness because I believe in its mission, leadership, and, most of all, the good acts of its members in hundreds of local and state chapters. The first question I ask panicked parents who contact me is: Do you know about NAMI? Its variety of programs, Washington policy work, and growing NAMI Walks continue to make it our nation’s premier grassroots mental health organization. That’s why I contribute to it monthly.
• It might seem odd to include the Corporation For Supportive Housing on a mental health list, but CSH is one of the nation’s leaders in providing supportive affordable housing to individuals with mental illnesses and addiction problems, as well as, prisoners re-entering our communities. If you read its short history, you will understand why I am honored to serve on its Board of Directors and support it with a monthly donation.  

Over twenty years ago, a homeless advocate named Julie Sandorf was approached by two Franciscan priests who were successfully saving their mentally ill parishioners from homelessness. She travelled to their St. Francis Residence, founded for mentally ill parishioners on the brink of eviction from a single room occupancy hotel. With a safe place to live and psychiatrists and social workers on site, the tenants stayed housed and healthy. Julie spent the next year studying this new housing approach. With support from the Pew Charitable Trusts, she found hundreds of similar stories around U.S.: troubled people who had bounced between shelters, hospitals, jails and the streets were suddenly living productive lives thanks to this combination of quality housing and support services.

In 1991, Julie founded the Corporation for Supportive Housing (CSH)  and …twenty years later, we’re still inspired to bring supportive housing to those who need it most… people coping with homelessness and extreme poverty, as well as chronic health conditions such as mental illness, addiction or HIV/AIDS.

• Some readers will be outraged by me recommending donations to the Treatment Advocacy Center because it was primarily created to push Assisted Outpatient Treatment laws. But it regularly sounds alarms about emergency room psychiatric boarding, a lack of crisis care beds, violence, poorly funded community based treatment, the effectiveness of assertive community treatment and the inappropriate incarceration of individuals who have mental illnesses. Whether your love or hate TAC, it has become the “go-to” source for mainstream reporters who write about mental health and one of the most effective at influencing the national dialogue and Congress. TAC has become an important voice for families and consumers who believe changes in HIPAA regulations, the dangerous criteria and bed shortages need to be addressed.

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(12-7-16) Rep. Tim Murphy’s Helping Families in Mental Health Crisis Act passed 94-5 this afternoon in the U.S. Senate clearing the way for it to be signed into law by President Obama before he leaves office.

Murphy’s mental health reforms, along with Sen. John Cornyn’s (R.Tx.)  Mental Health and Safe Communities Act,  were tucked into the 21st Century Cures Act, a $6.3 billion health care bill that critics called a boondoggle for the pharmaceutical industry, which spent millions lobbying for its passage, but supporters insist will cut bureaucratic red tape that prevents life-saving medicines from reaching markets quickly. Because the Act contains two pet projects of both Obama and Vice President Joe Biden, the Cures Act is expected to be signed quickly.

Murphy, a Pennsylvania Republican who is the only practicing psychologist in Congress, was relentless in pursuing passage of his bill — a process that started nearly four years ago and often turned bitter at congressional hearings. In a release he wrote:

This historic vote is one of the rare moments in Congress where members can say with confidence their vote to pass these reforms will indeed save lives. We are ending the era of stigma surrounding mental illness and focusing on delivering treatment before tragedy. By bringing research, treatments and cures into the 21st Century, we are finally breaking down the wall between physical health and mental health. (Full text of his release can be found at bottom of this blog.)

From the start, Murphy focused on concerns raised by parents and family members about barriers they face trying to help loved ones get help, including what they consider overly restrictive civil rights protections.  Cornyn’s bill was primarily aimed at funding successful criminal justice programs, such as Crisis Intervention Team training for law enforcement, mental health courts, and jail re-entry programs. Both Murphy and Cornyn are strong advocates of increased use of Assisted Outpatient Treatment, which has been strongly opposed by many groups that represent individuals with mental illnesses and disabilities.

 One of the organizations that Murphy depended on for advice and support from the start was the Treatment Advocacy Center, founded by Dr. E. Fuller Torrey. It’s executive director, John Snook, said in an email:

“This is one of the most important moments for mental health in more than fifty years. Mental Health Reform offers real hope to families and their loved ones who have been locked out of care. It focuses squarely on treatment of severe mental illness, providing people access to a bed instead.”

Murphy’s bill met strong opposition from the start from Democrats and eventually underwent numerous revisions to make it more palatable. When the House passed Murphy’s bill last week,  I published a blog that compared some of Murphy’s initial language with what now is in the Cures Act.

In addition to posting Murphy’s release here, I am adding a review of the bill that is being circulated by a consumer group whose members  opposed Murphy’s bill. I felt it would be helpful to see how critics of the bill now see it and the revisions that they helped add to make it more acceptable to them.

Obviously I will be writing more about this bill in later blogs, but I wanted to get news of its passage out ASAP.

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(12-2-16) A 62 year-old Virginia woman arrested for trespassing, who had schizophrenia, diabetes and was incontinent, was released three weeks after she was jailed thanks to cooperation between jail officials, a judge and local mental health officials.

Her release was cited by officials at the Hampton Roads Regional jail as an example of how the jail is taking steps to improve the way it treats inmates with mental illnesses, according to a story by Virginia Pilot Reporter Gary A. Harki. Last year, Jamycheal Mitchell  suffered a fatal heart attack in that same jail after literally starving for 101 days while reportedly under constant watch by correctional officers and a nurse. He’d been arrested for stealing $5.05 worth of snack food.

Had jail officials not cooperated with a judge and mental health workers, the 62 year-old woman would have spent four months waiting for trial, Linda Bryant, the jail’s assistant superintendent, was quoted telling Harki.

Okay, now read the first paragraph of this story again, 

The jail is citing this as an example of success because it was able to get a 62 year-old incontinent, mentally ill woman charged with misdemeanor trespassing released after spending ONLY THREE WEEKS in jail!

While I applaud the jail administration’s new attitude and spirit of collaboration, this is not a case that anyone should be celebrating and using as an example of exemplary service.

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