Search Results for: that way madness lies

(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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(5-10-16) How many more horror stories need to be told?

It’s time for us to stop the inappropriate jailing and imprisonment of persons with mental illnesses.

On April 17, CBS 60 Minutes broadcast a segment that showed how prisoners with mental illnesses were being neglected and abused at Rikers Island in New York.

On May 2, The New Yorker published MADNESS by Eyal Press, which tells how mentally ill prisoners in Florida have been tortured, driven to suicide and killed by correctional officers.

The nurses said that Rainey had been locked in a stall whose water supply was delivered through a hose controlled by the guards. The water was a hundred and eighty degrees, hot enough to brew a cup of tea—or, as it soon occurred to Krzykowski, to cook a bowl of ramen noodles. (Someone had apparently tampered with the T.C.U.’s water heater.) It was later revealed that Rainey had burns on more than ninety per cent of his body, and that his skin fell off at the touch.

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