A Rational Approach To Fixing The IMD Exclusion That Limits Beds For The Seriously Mentally Ill

Image by Ben Kerckx from Pixabay

(1-25-23) A critical shortage of hospital beds for individuals with serious mental illnesses has prompted repeated calls for the elimination of the Institutions of Mental Disease or “IMD Rule.”

The National Alliance on Mental Illness supports getting rid of it, while consumer groups and disability advocates oppose changing the law. The last serious attempt in Congress to end the IMD exclusion happened when former Rep. Tim Murphy (R-Pa.) introduced the Helping Families in Mental Health Crisis Act, back in 2015, but Murphy’s efforts were blocked by Democrats and civil rights groups.

Now newly elected Rep. Dan Goldman (NY), is considering reintroducing legislation to repeal the IMD rule,  and the hope is that he will instead introduce a bill to limit its reach, rather than attempting to eliminate the rule.

 The fact that Goldman is a Democrat and the bill is named in honor of a woman who was pushed in front of a New York subway by a man with untreated mental illness may help it get some traction.

But while the debate about the IMD exclusion always focuses on fears that our nation will return to mass re-institutionalization, another stumbling block will be the expense to Medicaid if the IMD is dropped. Supporters of the IMD Rule claim it will cost the federal government billions of dollars if Medicaid starts paying for mental health hospital beds.

Cheryl Roberts recently wrote about Goldman’s efforts in a New York Daily News editorial. Judge Roberts runs the Greenburger Center for Social and Criminal Justice, which I’ve written about on this blog.

Congress must stop blocking mental health clinics from needed money 
An Editorial by Cheryl Roberts. First published in the New York Daily News

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“I pulled the needle out of my arm for the last time and embarked on an arduous journey of recovery.”

(1-5-23) A skilled author can use fiction to tell powerful truths about the reality of serious mental illnesses and those whose lives are touched by it in ways that nonfiction often can’t convey. So I was delighted when I learned that Jordan P. Barnes, already an accomplished author, had written Late Blight in the Koʻolaus: A Novel. 

Because of his own experiences with addiction, he is especially well-suited to pen a novel about the challenges that individuals face after leaving a hospital and returning to a community. I asked him to tell me about his novel since I’ve not had a chance to read it yet.

Dear Pete,

A little over eleven years ago, I pulled the needle out of my arm for the last time and embarked on an arduous journey of recovery that would change and challenge me in ways I could never foresee. Now, with over a decade of clean time behind me, I am fortunate in many ways and owe much of my success in overcoming heroin addiction and homelessness to the endless support of my parents.

My parents never gave up hope on me, despite the fact I’d long given up hope on myself. I was also facing multiple felonies at the time, but with my parent’s support, I entered a two-year inpatient treatment program in 2011 and have been working on bettering myself ever since.

Today I am a husband, homeowner, father of two, and an independent author.

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Losing My Son Broke Me. Telling Our Story Opened The Door To Healing

(1-3-22) I’ve always enjoy promoting books about mental health, including those that I’ve not yet read but pique my interest. This week, I’m posting guest blogs by two authors telling their personal stories.  I’ve asked them to describe why they wrote their books and provide a short excerpt. 

For the Love of Jeremy — A Memoir of a Family Affliction: Mental Illness and Addiction

By Renate LeDuc

Losing my son broke me at the deepest level and something just emanates from your heart and soul when that happens. I was driven to write this book for several reasons.

First and foremost, of course, was my own healing. It is a mother’s instinct to protect her child. If that child dies, it is a mother’s instinct to protect that child’s memory. This book is a part of that process.

For the Love of Jeremy: A Memoir of a Family Affliction: Mental Illness and Addiction is about unspoken truths. It has opened the door to healing my family’s somewhat secretive past of suicide and mental illness. Opening the lines of communication will promote knowledge, awareness, compassion, and progress.

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Lessons About Serious Mental Illnesses That I’ve Learned As A Parent

(1-1-23) I continually get emails from parents who are desperate for help. I am not a psychiatrist, therapist, or a neuroscientist. I am a father. I listen and try to comfort those who I can. Most often, I feel frustrated because helping others successfully navigate our mental health care system is extremely difficult. 

More than a decade ago, I posted a blog about the lessons that I had learned helping my son. I reprint it each year with the hope that it will help others who have discovered that they are on the same rocky road that I have and am traveling.

Happy New Year fellow travelers!

Helping Someone Who Has A Mental Illness: Lessons I’ve Learned

It’s difficult helping someone with a mental illness.

My relationship with my son,  Kevin, has not always been easy. Those of you who have read my book know that I was forced to lie about him threatening me in order to get him taken into a hospital rather than put in jail. During a later break, I called the police and my son was shot twice with a Taser. These events hurt parent-son relationships.

So what have I learned?

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Columnist Writes: “If we’re ever going to stop the suffering … while they’re still breathing, we’re going to have to stop protecting their right to die screaming, scared and usually alone.”

Image by Apollo22 from Pixabay

(12-21-22) While I don’t like to simply reprint articles, my son, Kevin, told me that this recent story in the Sacramento Bee brought him to tears. He believed that he could have ended up like James Mark Rippee if he’d not had strong family support and a fabulous case manager. Of course, Kevin had to accept that he had a serious mental illness before that support system could help him.

While some might cringe reading about this tragedy so near to Christmas, I feel the opposite. What better time to remind ourselves of the sentiments found in Matthew 25:40.

40 And the King shall answer and say unto them, Verily I say unto you, Inasmuch as ye have done it unto one of the least of these my brethren, ye have done it unto me.

(Thrilled to see that advocate Teresa Pasquini is quoted in this article.)

We’ let blind, mentally ill, homeless Mark Rippee die in Vacaville. But let’s name names

BY MELINDA HENNEBERGER

James Mark Rippee, who was blind, severely mentally ill, homeless — and unhelped, despite all the years that his sisters spent trying to change that — died on Tuesday at age 59.

You could say, as doctors at Fairfield North Bay Medical Center did, that he died of multiple organ failure after an untreated urinary tract infection caused sepsis.

Or you could say that the cause was really the 1987 motorcycle accident that took his sight and part of his frontal lobe more than half a lifetime ago, when he was 24.Over the next few years, his brain injury robbed him of his sanity and safety, too.

You could consider some corner of accountability for the entrepreneur who had lately been charging him $600 a month to let him sleep in his backyard, along with other homeless people, though no one knows who left Mark at a Vacaville ER unable to breathe at 2:30 on Saturday morning, long after he should have received medical care.

Or you could say that he died because we just didn’t care enough whether he kept on living.

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Sen. Cassidy Becomes Emotional Explaining Why He Cares Deeply About Mental Health Reforms

Sen. Bill Cassidy advocating for mental health reforms

(12-19-22) I got to know Sen. Bill Cassidy (R. La.) in 2016 when he joined with Sen. Chris Murphy (D. Conn.) in passing the most significant mental health legislation in decades – the Mental Health Reform Act. 

Because of his work on that crucial bill, I knew he cared deeply about improving our  mental health care system. I became more convinced after he invited me to Louisiana to deliver a keynote speech during a one day mental health care summit. We were able to have dinner together that night.

What I didn’t know was that his passion comes from a deeply personal loss. He became emotional during a recent interview with CNN and shared his story when asked about how mental illnesses impact families.

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