Pete Earley

(1-8-18) Kudos to Alexandria Virginia Commonwealth Attorney Bryan Porter for assigning a senior supervisory prosecutor to screen cases for persons whose arrest stemmed from some obvious mental illness and not criminogenicity.

Prosecutor Porter has put Molly Sullivan, a chief deputy prosecutor, in charge of reviewing arrestees for possible participation in a diversion program that will offer them treatment instead of languishing in jail. The goal is to address the underlying cause of crimes committed by people with severe mental illness, decrease the length of any incarceration, and to avoid it entirely in those cases where the safety of the community can be served by pre-trial services and mental health treatment and/or probation, according to reporter Denise Dunbar, writing in the Alexandria Times.

“As a society, we simply must do a better job in addressing mental illness. Far too often, police, the sheriff and prosecutors are asked to be the primary treatment providers for the mentally ill, and it should be obvious that we have neither the expertise nor the resources to adequately address the myriad of issues raised by mentally ill citizens,” Porter told the newspaper.

Bravo!

However, more than thirteen years ago when I was doing research for my book, CRAZY: A Father’s Search Through America’s Mental Health Madness, the prosecutor’s office in Miami Dade Florida had one of its chief prosecutors doing exactly what Sullivan has been assigned.

Yes, that was more than a decade ago!

Virginia residents should be asking if their jurisdiction has a Molly Sullivan. (The state’s constitution requires that every county and every city be served by a commonwealth’s attorney.)

The diversion step that Commonwealth Attorney Porter is taking is part of a sequential intercept model concept designed to identify those who are being incarcerated primarily because of their illnesses – typically on charges such as trespassing and loitering – and divert them into treatment.

Such programs have proven to save tax dollars and help persons recover who are sick.

Porter’s actions are another step in several that are happening across the state, primarily because of the efforts of state Senator Creigh Deeds (D.) and Delegate Rob Bell (R.), Sadly, our state remains behind others.

One glaring example of footdragging is the state’s refusal to launch mental health courts as part of diversion efforts. In Virginia, you can’t even utter that term. You have to refer to them as mental health “dockets” or “behavioral dockets” because state legislators and many prosecutors are afraid they will be accused of giving special treatment to defendants.

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(1-5-18) According to the National Health Care for the Homeless Council:

Seven hundred people experiencing or at risk of homelessness are killed from hypothermia annually in the United States – subnormal temperature in the body – remains a leading, critical and preventable cause of injury and death among those experiencing homelessness.

Whenever there is a deadly drop in temperatures, most cities try to persuade homeless individuals to enter shelters, but there are reasons why they refuse. In D.C., many shelters are not safe and most have a two bag limit, meaning you can’t take anything inside with you except two garbage bags of belongings. That means all of your worldly possessions are abandoned outside for others to pick through.

But there is another reason that many officials refuse to acknowledge: the homeless person sleeping on the street has an untreated serious mental illness and co-occurring abuse problem. They are not thinking rationally.

In the richest country in the world, there should be no homelessness. The answer is Housing First.

Stories about homeless persons with serious mental illnesses dying from hypothermia always upset and anger me, but none did as much as a story that I first posted in 2010. Has your community taken steps to stop these senseless deaths?

WHO IS TO BLAME FOR THIS DEATH? 

From My Files: The residents of Morrisville, Pa., got an intimate look this holiday season at our troubled mental health care system. Paulette Wilkie, a homeless woman with a long history of schizophrenia, was found dead from exposure. The 56 year-old woman’s  body was discovered last week behind Ben’s Deli, a sandwich shop that she frequented.

Temperatures the night before had dropped into the mid 20s. But that was not cold enough to trigger the county’s emergency homeless plan. Temperatures must sink to 20 degrees or below for two consecutive days before teams can be dispatched to try to persuade homeless persons to come indoors.

Reporter Ben Finley, writing in the Bucks County Courier Times, noted that people who knew Wilkie said she likely would not have gone into a shelter anyway. The owner of Ben’s Deli said Wilkie refused help from people concerned about her safety and health.Click to continue…

(1-1-18) My blog yesterday prompted a flurry of comments and private emails sent to me. Among the most thoughtful was this letter from Teresa Pasquini, which I am sharing with her permission.)

Happy New Year!

I read your blog yesterday and feel compelled to outreach and clarify a few things.  First, I assume good intentions of you and believe that you were trying to communicate your feelings fairly. I don’t dispute your selections of who you believe to have had the most impact in 2017.  I was an early supporter of Dr. McCance-Katz and recently outreached to Mary Giliberti on her powerful comments at the recent ISMICC press conference. I found great hope in the leadership she displayed and thanked her publicly on Twitter. I hope to have additional conversations with all local, state and national leaders about how we can build bridges, not walls.

However, in spite of your good intentions and my respect for you and your position, there was a judgmental tone used in your blog that truly mischaracterized the intentions of the petition and the many good people who supported it.  Although the petition was signed and co-signed by a number of advocates, I respectfully ask that you consider a follow up to clarify your intent which I saw posted to the comments of this blog on your Facebook page.

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(12-31-17) Who were the most impactful mental health players during 2017? While many come to mind, my choices are Dr. Elinore F. McCance-Katz and Mary Giliberti.

Both faced considerable challenges and overcame them.

The White House named Dr. McCance-Katz the first-ever Assistant Secretary of Health and Human Services for Mental Health and Substance Abuse in August even though she found herself being publicly opposed by then-Pennsylvania Rep. Tim Murphy, the Republican congressman most responsible for creating that job.

(Ironically, before the end of the year both HHS Secretary Tom Price, who swore her in, and Rep. Murphy, each had become entangled in separate highly publicized scandals that led to them departing Washington.)

Since taking charge Dr. McCance-Katz has overseen publication of the first Congressionally mandated annual report about federal mental health and substance abuse recovery programs and quietly started steering the Substance Abuse and Mental Health Services Administration in a different direction.  Before taking office, Dr. McCance-Katz had sharply criticized SAMHSA in a Psychiatric Times commentary , writing:

“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?”

From what I’m hearing, Dr. McCance-Katz has been building bridges with those deeply entrenched bureaucrats in SAMHSA who were the targets of her comments while working on improving morale at a federal agency that its own employees once had rated near the bottom ranks when it came to being a good place to work.

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(12-24-17)  Patti and I wish you a Merry Christmas, Happy Holidays and a Joyous New Year from our house to wherever you are, both old friends and new ones!