Search Results for: that way madness lies

(2-20-18)  What would you do if you won the lottery? Everyone has thought about it. Instant wealth. Travel the world first class? Buy multiple homes? Expensive cars? Indulge yourself with luxuries?

Maxine Clark and Bob Fox are two St. Louis, Mo., based philanthropists who are using their self-made wealth to dramatically help others, especially children. Maxine’s interest in kids should be no surprise. She’s the founder of Build-A-Bear Workshops! (Yes, my granddaughter has three stuffed animals from our local store.)

I was lucky to spend time with Maxine – (Bob was sick with the flu) – when I spoke recently at the Spirit of Provident Annual Gala, a fund raising event and celebration hosted by Provident, a mental health provider  founded in 1860 by James Yeatman to help the sick and the poor in St. Louis. What you read is not a misprint. It was founded in 1860!

Provident was honoring Maxine and Bob at the gala, but the day before that event, the couple arranged for me to speak at the Clark-Fox Policy Institute at Washington University in St. Louis. My keynote was entitled Misguided and Misdiagnosed: Mental Health and the Criminal Justice System. After my speech, one of my favorite advocates, Susan W. McGraugh, a professor at Saint Louis University School of Law, who works with indigent, incarcerated clients, spoke eloquently about what services were available in St. Louis and what needed improvement. Later that night, Maxine hosted a private dinner for me with community leaders to discuss such topics as jail diversion, better police training, and affordable housing.

I explained that the first step is always for a community leader with clout (a judge, sheriff, or local official usually) to step forward and organize (force) all of those who have some connection with mental health/substance abuse (nearly everyone) to sit down at a table and find ways to collaborate. I said that night what I always say – that it is impossible to provide meaningful mental health services in your community unless you want to talk about supportive housing, job opportunities, easy access to mental health community services, transportation, specialized veterans programs, criminal justice reforms (such as jail diversion), helping children and giving people hope.

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(2-9-18) A recent blog by Dr. Dinah Miller, co-author of the book, Committed: The Battle Over Involuntary Psychiatric Care, elicited this response from John Snook, executive director of the Treatment Advocacy Center.  John serves with me on the Interdepartmental Serious Mental Illness and Serious Emotional Disturbance committee, that advises Congress on the state of mental health care in the nation. I consider both John and Dinah friends and fellow advocates. Clearly, they have much different opinions.

Dear Pete,

I must admit I read Dr. Miller’s piece regarding the “worried well” with some amazement. She completely misses the point — a point that doctors like her have willfully ignored for the last twenty years: severe mental illnesses demand immediate and targeted attention.

Across the nation, rates of homelessness, incarceration, substance abuse and suicide that occur when the seriously mentally ill are left untreated are beyond crisis levels. Needed treatment beds are so decimated that mental health officials increasingly provide care only under threat of their own arrest.

Dr. Miller appears to want to sweep these many failures of the mental health system she represents under the rug as ancient history. Her piece is an impressive attempt at gaslighting – in her world, mental health providers have always considered the needs of the most severely ill. Those suffering with untreated severe mental illness and their families who suffer with them know better.

Let’s put this discussion in perspective.

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Photo: Fairfax County Sheriff Stacey A. Kincaid awards highest sheriff’s honor to CIT Lt. Redic Morris for his heroic service to individuals with mental illnesses/addictions.

(1-31-18)  What can be accomplished in two years when law enforcement, court officials, mental health providers, community leaders and mental health advocates work together to stop the inappropriate incarceration of persons with mental illnesses and addictions?

Nothing short of a miracle here in Fairfax County, Virginia, where I live.

The county issued a report this week about its Diversion First program and the results were so impressive that representatives from several national organizations attended a public meeting to learn about the county’s accomplishments.*

For more than a decade, I was critical and frustrated by a lack of interest in Fairfax in jail diversion, but after the tragic death of Natasha McKenna in 2015 in our jail, Fairfax Sheriff Stacey A. Kincaid made diversion a priority, recruited allies and doggedly pushed the county forward. The result: a series of impressive changes.

Let’s begin with Crisis Intervention Team training, a crucial step in the jail diversion/sequential intercept model.

After my book, CRAZY: A Father’s Search Through America’s Mental Health Madness, was published in 2006, Patti and I donated $500 per year to our local NAMI chapter to fund an award to be given to a CIT Officer of the Year. We felt it important to encourage CIT. But we stopped in 2010 after budget cuts in 2008 virtually eliminated what scant CIT training was being done.

No longer.

Thanks to Fairfax Chief of Police Col. Edwin C. Roessler Jr., CIT training for police has become a priority, just as it has inside the jail because of Sheriff Kincaid. Their CIT and Diversion First efforts have been supported politically and financially by Board of Supervisor Chair Sharon Bulova, Supervisor John C. Cook, and Deputy County Executive David Rohrer.

Bravo!

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(6-23-17) Virginia is scheduled to execute William Morva on July 6th, unless Governor Terry McAuliffe commutes his death sentence to life without the possibility of parole.

Morva has a debilitating mental illness called delusional disorder that makes him believe his delusions are real.

He should not be put to death.

In August 2005, Morva was arrested for attempting to rob a convenience store. The clerk testified that armed masked men approached the glass doors of the store but when the doors did not open automatically, the men ran away. Eventually, Morva was arrested and charged with a string of attempted thefts—each as ill-conceived and poorly executed as the next. The other young men with him were released on bail and received short sentences. But Morva’s mother recognized that her son was sick. She left him in a Virginia jail under the mistaken belief he would get treatment. He didn’t.

Even though his family contacted jail officials to express concern about his deteriorating mental health, he was not evaluated or treated by any psychologist or psychiatrist. His symptoms grew worse. He believed that he had been wrongly arrested. As he grew sicker and sicker, he became convinced he was being held in jail by some unknown figure who wanted to kill him.  

A year after he was arrested, he told jail officials that he needed to be taken to a hospital because he was sick. Once there, he overpowered the guard watching him and took his service weapon. While fleeing the hospital grounds, he shot and killed Derrick McFarland, an unarmed hospital security guard. The next day he fatally shot Sheriff’s Deputy Eric Sutphin who’d spotted Morva walking on a local trail. He was captured that afternoon.

Morva murdered both men. I am sorry for the families of both and do not wish to diminish their losses. Death penalty cases always involve horrific crimes.

But as the father of a son with a mental illness, I have seen how delusions can alter an individual’s reality so that they do not understand their actions. This seems to be the case with William Morva who showed signs of mental distress long before he tried to escape from jail.

One of the issues that troubles me about cases such as this is the belief that someone who has a mental illness is incapable of rational thought and actions. Ergo, if Morva could plan and carry out his escape, he knew what he was doing and, therefore, deserves to die.

This idea is nonsense. I can remember having rational conversations with my son at the breakfast table about the daily headlines while, at the same time, he was convinced that God had chosen him for a special, secret mission and he needed to rescue a former high school girlfriend who he’d gotten pregnant. None of it was true.

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(5-11-17) All of Washington is talking about the firing of former FBI Director James Comey, but let’s not forget that Senate Republicans are in the midst of rewriting a health care bill that could have a major impact on mental health care.

Fortunately, one of the 13 Republicans drafting Trumpcare has authored mental health care legislation. Another senator, who is not on the all white male redraft and repeal Obamacare panel, has gained national attention for demanding a higher bar than what can be found in the House’s hastily passed version.

The Senators are: John Cornyn (Tex.), the majority whip in the Senate, and Dr. Bill Cassidy (La.) who is a freshman but is highly regarded for his medical expertise.

Both played pivotal roles in the fading days of the Obama administration in passing mental health bills. Sen. Cornyn authored the Mental Health and Safe Communities Act ,which uses federal funds to encourage jail diversion, support Crisis Intervention Team training, and implement mental health courts. All are important programs designed to shift individuals with serious mental illnesses into community treatment programs instead of abandoning them in the never ending – jail-streets-jail-streets – revolving door.

Sen. Cassidy, along with Democrat Sen. Chris Murphy (Conn.), introduced a much changed version of Pennsylvania Republican Rep. Tim Murphy‘s Helping Families in Mental Health Crisis Act  in the Senate. It was Cassidy and Chris Murphy who convinced Republican  Sen. Lamar Alexander, chair of the powerful HELP committee, to push their Mental Health Reform Act through the Senate during December’s lame duck session which led to a compromised version of the House and Senate bills becoming law. Without their leadership in the Senate, there is a good chance that Rep. Tim Murphy’s bill would have died, just as it had in a previous session.

More recently, Sen. Cassidy has become a favorite of news shows because of his comment about Trumpcare having to meet the “Jimmy Kimmel” test in response to an emotional monologue the late night talk show host gave about his newborn son’s open heart surgery. Cassidy’s compassion appealed to many advocates who have warned that the Republican bill could potentially cut millions of mentally ill Americans from Medicaid roles. Medicaid is the largest payer for mental health care.

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(2-23-17) A tweet by Dr. Jeffrey Lieberman, the chair of the Psychiatry Department at Columbia University, announcing that Miami-Dade Judge Steven Leifman has been appointed as the first Assistant Secretary for Mental Health and Substance Use Disorders is premature. No final decision about the appointment has been made.

“Thrilled with appt. of Judge Steve Leifman as First Asst. Sec. of Mental Health in US History,” Lieberman tweeted.   

While Judge Leifman is a strong candidate for taking charge of the Substance Abuse and Mental Health Services Administration (SAMHSA), which has a $3.5 billion budget, Health and Human Services Secretary Tom Price has not officially announced which candidate he will recommend to the White House. The new Assistant Secretary will then have to be vetted and approved – either by President Trump or his staff – before his appointment is sent to the U.S. Senate for confirmation.

For his part, Judge Leifman is not commenting publicly about the tweet or his possible appointment.

Judge Leifman is considered to be the leading candidate because, in my opinion, he is the most qualified and clearly the best choice for the job, a sentiment widely agreed on in Washington.

But he still faces hurdles. When Vice President Mike Pence was governor of Indiana, he appointed Dr. John Wernert to overhaul Indiana’s state mental health system. That could cause problems if Pence decides to get involved. There are still some who are lobbying for a psychiatrist, not a judge, to be put in charge of  SAMHSA.

Being a psychiatrist or someone with an equivalent medical background was one of the requirements that Rep. Tim Murphy (R.-Pa.) originally put in his Helping Families in Mental Health Crisis Act (HB- 2646), which started the effort in Congress to reform our mental health system after the Newtown shootings. But that requirement was dropped when Murphy’s bill reached the Senate. Senators didn’t want their hands tied when it came to the confirmation process and they also wondered if a psychiatrist would have the management skills needed to run a large bureaucratic organization.

I have always supported Judge Leifman because I have seen first-hand how he has transformed the mental health care system in Miami-Dade County from one of the most horrific in the nation to one that is now  nationally  recognized as a “gold standard” model being copied by other progressive communities.

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