(8-3-22) Summer is prime reading time and although books about mental illnesses are not usually on a beach read list, I have asked the authors of books that have crossed my desk recently to tell us why they wrote their book and give us a sample chapter. 

 Against All Odds: A Practical Guide to Successfully Navigate Psychosis and Behavioral Health Systems 

By Gary Tsai, M.D.  (Book website: click here.)

For nearly three decades, my family struggled to get help for my mom. She was a loving mother and brilliant scientist, and happened to have schizophrenia and anosognosia, a condition whereby the area of the brain responsible for self-reflection is damaged, causing someone to lack awareness of their condition.

Unsurprisingly, it was extraordinarily difficult to get her to agree to accept treatment for a condition she fundamentally did not believe she had.

More surprisingly, since this is a rather common phenomenon that affects 40 – 50% of people with serious mental illness, the system responsible for providing care for her was not designed to do so and seemed nearly impossible to access. While in most areas of healthcare, the quicker and easier it is to access services the more severe the condition is, we quickly found out that the opposite was true in mental health systems.Click to continue…

Sandra, Judaea, and Eugene Jones.

(07-19-2022) “Your son is in our jail.”

It’s been a year since Sandra Jones received that alarming phone call last July, and the Chesapeake, Virginia mother is still seeking answers about why her son, Judaea, then 18-years-old, ended up being arrested and jailed.

“This whole thing still bothers me,” Jones told me during a telephone interview.

What happened to Judaea is an example of how easily someone who is mentally impaired can become entangled in our mental health and criminal justice systems, and the trauma it causes families.

Sandra and her husband, Eugene, adopted Judaea shortly after they both retired from civil service jobs. The child was her husband’s great nephew and Judaea arrived with an assortment of diagnoses including Autism, Intellectual Disability-Moderate, ADHD, Anxiety Disorder, Conduct Disorder (impulse control), Shaken Baby Syndrome and Tardive Dyskinesia.

His new parents loved him and nurtured him, but by the time Judaea turned 18, he was becoming more than the couple could handle. “We wanted him to live independently, to have friends, and have a life outside our home,” Sandra Jones said. “We weren’t getting any younger and needed help.”

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(7-14-22) The National Council for Mental Wellbeing (formerly the National Council for Behavioral Health) said criticism of its Mental Health First Aid training program is “flawed.”

MHFA was recently lambasted in a report issued by the Manhattan Institute, a conservative New York think tank that frequently criticizes government spending. The National Council represents the nation’s mental health care industry and promotes/sells MHFA training programs.

MHFA courses are extremely popular and have been taken by more than two million Americans. Congress recently included $120 million for MHFA training in the Safer Communities Act, along with another $64 million in next year’s budget.

In a formal statement, the Council said Carolyn D. Gorman, the author of Mental Health First Aid: Assessing the Evidence for a Public Health Approach to Mental Illness, did not understand the purpose of MHFA training. Gorman wrote that there was scant evidence that MHFA benefited Americans with serious mental illnesses.

The National Council’s response:

We agree that more needs to be done to ensure that people with mental health challenges, especially those with serious mental illness, have access to treatment. With that in mind, we wish the author had come to us while developing this report. We would have welcomed the opportunity to reconcile the inaccuracy of the report’s fundamental premise – what Mental Health First Aid (MHFA) is and what it seeks to accomplish.

Unfortunately, the flaw in the basic premise impacts the validity of the report’s overall conclusions. The report faults MHFA for not solving the crisis of untreated mental illness in the United States. This represents a fundamental misunderstanding about MHFA – what it is and what it seeks to accomplish.

MHFA was never designed to reduce the prevalence of mental illness or improve access to high-quality treatment and services. So it is wrong to measure the effectiveness of the program against those objectives, as the report does.

MHFA has one clear and simple goal: to give individuals the skills they need to recognize and respond to signs and symptoms that indicate someone might be experiencing a mental health or substance use challenge and guide them to appropriate care. That is the only valid objective to measure the program’s effectiveness, and the results of peer-reviewed studies have demonstrated the program is effective by that measure.

The mental health system in this country has significant challenges, and we all must work together to address them. The National Council for Mental Wellbeing works tirelessly toward this goal. While important strides have been made in the last decade, much work remains to ensure that everyone who needs treatment for mental illness can access the care they need.

(Carolyn Gorman responds: The Council suggests the point of the MHFA program is to give people the skills to recognize mental illness. I directly acknowledge and address this objective in my report in multiple places. While some studies do in fact find a *statistically* significant increase in recognizing some specific symptoms of specific illnesses, those findings are much less *practically* significant—baseline rates of recognition for mental illness are incredibly high even before MHFA training.  To make a comparison, this is like going from getting a B+ grade on a school final exam to an A- or an A. We’d still consider a B+ student competent and proficient, and wouldn’t make the student re-take the whole class. I am grateful for the National Council’s openness to dialogue in the future as they do important work, and I’m sure there is much we could agree on elsewhere and dually champion.”

(7-13-22) Mental Health First Aid,  a widely popular national training program, is being called “ineffective” in a scathing report issued by the Manhattan Institute, a New York City based conservative think tank.

A newly released study, Mental Health First Aid: Assessing the Evidence for a Public Health Approach to Mental Illness, concludes that the training program fails to “connect mentally ill individuals…with an appropriate level of treatment before a crisis leads to tragedy.”

The goal of the training program is “to teach everyday citizens how to identify, understand, and respond to signs of mental illnesses and substance abuse disorders,” the report’s author, Carolyn D. Gorman, writes. She notes that more than two million Americans have completed MHFA training. Some police departments have elected to use MHFA’s three-day training program rather than the more comprehensive 40 hour Crisis Intervention Team training program.

But Gorman writes there is scant evidence that the program actually benefits or impacts the lives of individuals with symptoms of serious mental illnesses.

In an email exchange, she explained: “Just to be clear, there was no evidence the program helped even non-mentally ill individuals. Mental health was not improved among recipients of MHFA, for those with no baseline need for mental health care, nor for those with a baseline need for mental health care. I make the point only because I often hear arguments that those who take MHFA training ‘feel good that they took the training’ but even for the average person, it is no better than having no training.”

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(7-6-22) After five years, I’ve resigned from the federal panel that advises the U.S. Congress about serious mental illnesses.

I was appointed to be the parent designee on the Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC) when it was formed and held its first meeting on August 31, 2017.

I am resigning because I believe ISMICC could benefit from a younger, fresh voice.  In my letter, I urge Assistant Secretary for Mental Health and Substance Abuse Miriam E. Delphin-Rittmon, PhD., to appoint a mother, preferably from the BIPOC community, as my replacement, although I have no say in her decision.

Because of the structure of ISMICC, I was appointed to two terms by the previous head of SAMHSA. I want Dr. Delphin-Rittmon to be able to appoint an ISMICC board member of her choosing, especially since she has revitalized ISMICC after it was pushed to a back burner during the final years of the Trump Administration.

Being on ISMICC enabled me to push for reforms. But I also leave with disappointments.

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