Which Path Will Biden’s Nominee To Run SAMHSA Choose? Agency Has Swung Between Anti-Psychiatry & Pro Assisted Outpatient Treatment

(4-26-21) President Joe Biden’s nominee to run the federal government’s mental health and substance abuse programs is largely unknown in Washington D.C. among mental health leaders.

Biden announced on Friday (4-23-21) that he’d chosen Dr. Miriam E. Delphin-Rittmon to be the next Assistant Secretary for Mental Health and Substance Abuse. She currently serves as the Commissioner of the Connecticut State Department of Mental Health and Addiction Services. If her nomination is approved by the U.S. Senate, she will take charge of SAMHSA, with a $6 billion budget, much of which is distributed through block grants to states.

As SAMHSA head, she will spell out priorities for that agency during the next four years.

Asked over the weekend for comments, several leaders of major mental health organizations, replied that they had heard “good things” about the nominee from their members and other contacts in Connecticut, but few had dealt personally with Dr. Delphin-Rittmon.

An exception was former Assistant Secretary Dr. Elinore McCance-Katz, who the nominee will replace.  They worked together at SAMHSA during the Obama Administration. Dr. Delphin-Rittmon spent two years there, according to her official resume released by the White House.

“I met Miriam when I came to SAMHSA as the Chief Medical Officer and she was a Senior Adviser. I liked her very much. She is bright, knowledgeable, and a very nice person. I don’t know what direction she will take as the Assistant Secretary, but I am confident that she will be dedicated to working on behalf of Americans with mental and substance use disorders.

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Mentally Ill Americans Not Being Vaccinated, Plus Documentary Questioning If Community Care Is Enough?

Image by torstensimon from Pixabay

(4-23-21)  Three items worth your time.

  1. Two national mental health advocates warn that Americans with serious mental illnesses are not getting vaccinated and a “schizophrenia diagnosis is the second largest predictor of mortality from COVID-19, after age.”
  2. Arlington Va. advocates gain an ally in pushing for Coordinated Specialty Care (CSC) for those with early episode psychosis (or First Episode Psychosis).
  3. “If you tried, you couldn’t create a worst mental health system than what we have today,” claims Dr. Steve Seager in a powerful documentary that shows how our rush to close state hospitals has increased incarceration, homelessness, deaths and the abandoning of 350,000 on our streets. Featured in this film, which I missed when it was first released, are frequent guest bloggers on my page – Laura Pogliano, Teresa Pasquini, Susan Inman and the late D. J. Jaffe.

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“Groundbreaking” Report Shows Steps To Create An Ideal Crisis Care System In YOUR Community

Courtesy of Gary Blau PHD


In most American communities today, the behavioral health crisis system isn’t really a system at all, but a combination of services provided by law enforcement and hospital emergency rooms that are typically not designed to meet the needs of individuals in the midst of behavioral health crises,

So begins Roadmap To The Ideal Crisis System, a much-anticipated, recently released report written to provide advocates, local leaders, and your community with a step-by-step blueprint that shows how to create an “ideal system.”

The 208 page report – yep its thorough – leaves no aspect of crisis care uncovered. It was spurred, in part, by Miami Dade Judge Steven Leifman’s request for a practical guide that communities could use that would explain what an ideal system looks like and how to go about implementing one.

That was a daunting challenge.

The timing of the report is important because in 2022, the nation is scheduled to replace its national suicide hotline number with a much broader crisis hotline number – 9-8-8. In anticipation of the 9-8-8 switch, the report’s authors are urging communities to review what services are currently available and begin implementing its recommendations for forging an “ideal” system.

The report explains how 9-8-8 hubs can be used as an entryway into services where callers are triaged by specially trained experts capable of connecting them to crisis care services best suited for their individual needs – whether the caller is experiencing suicidal thoughts or is having a mental health or drug crisis.

Called “groundbreaking” by the National Council for Behavioral Health, the report spells out how “to design and implement a mental health crisis system and demonstrates how a community’s response must be fully integrated with the treatment system.” Read the full report or read the executive summary.” The council, which represents mental health providers and is pushing the report’s recommendations, states:

The comprehensive new report attempts to address every point in the continuum of crisis services. And because it is the first report of its kind, this blueprint will serve a vital role for any community that is planning its crisis system. With 9-8-8 fast approaching, it’s time to begin the work to plan, design and implement that system of care so the resources are in place when people call for help.

To help politicians, advocates, and legislators, the report includes a Report Card for grading your community. A section of the report also lists its recommendations for reducing reliance on police as first responders during mental health and drug crises.

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Advocate Says Arlington County Va. Could Finally Fulfill John F. Kennedy’s Mental Health Call

The arrival of Amazon’s east coast headquarters will give Arlington County a boost. Will county officials make Arlington a mental health showplace as well?

(4-14-21) Long-time Advocate Bob Carolla argues today that Arlington County, Va., could become a state and national showplace in providing community mental health care through a host of innovative programs. Will public- private partnerships help achieve the vision?

Arlington, Va–A New Frontier for Mental Health Care?

By Bob Carolla

Looking east, Arlington, Virginia is a gateway to the nation’s capital. Looking west, it is a gateway to a growing high tech economy.

It’s also home to an eternal flame that burns on a hill at the gravesite of John F. Kennedy in Arlington Cemetery: a symbol of the idealism of a New Frontier and an unfinished presidency. Part of his unfinished vision is available, accessible and excellent community based mental health care. Unfortunately the 1963 Community Mental Health Act remains a largely broken promise. Today, we have an inadequately treacherously fragmented, mental health care system that includes a yield of chronically ill homeless persons.

Arlington, where I live, currently is poised to fulfill President Kennedy’s vision.  Here’s steps that could help it accomplish that goal.

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Involuntary Commitment Battlefield Diagrammed By Doctor Who Studied All Sides

(4-12-21) Involuntary Commitment is a topic that stirs strong opinions and feelings. I asked Dinah Miller, a Baltimore, Maryland, psychiatrist, and co-author of Committed: The Battle Over Involuntary Psychiatric Care to react to last week’s blog written by Cheryl Nimtz.

What I Discovered When I Investigated Involuntary Care

By Dr. Dinah Miller.

But, if I had not had the good fortune of being involuntarily committed and put on one tiny pill, I would still be homeless begging on the streets, in prison with little or no treatment, caught in human trafficking, swallowed by drug addiction or dead.” ~Cheryl Nimtz on Pete Earley’s Blog

It is nice to have Cheryl Nimtz come forward to share her stories, a story of how psychiatrists have helped her.

For 12 years, I wrote a blog with Drs. Anne Hanson and Steve Daviss called Shrink Rap that we began after publishing our book by the same name.  We would write, and when the topic turned to forced or involuntary treatment, the comments invariably got very heated.

There was so much about the horrors of involuntary care, and it was through blogging that I discovered how psychiatry’s efforts on behalf of people with episodes of severe mental illness can be traumatizing.

We would hear from people like Cheryl too — people whose lives were chaotic, who were in imminent danger, who had been hallucinating, delusional, or remarkably disorganized and who presented a danger to themselves or others, who were then hospitalized and got better.Click to continue…

Pressure On Peers To Be Perfect: Remembering Inspirational Peer

Glenn Koons and Actress Marlee Matlin

(4-8-21) From My Files Friday:  It’s been nearly a decade since I posted this blog about one of the first and most inspiring peers I was fortunate enough to meet. His death made me wonder about how we treat peers. We expect them to be models of recovery. What happens if the symptoms of their illnesses surface? Are we there to support them?

Death Of An Advocate

First published September 2011

I first met Glenn Koons when I was invited to speak at a luncheon in Montgomery County, Pa., being hosted by the National Alliance on Mental Illness. It was one of the first speeches that I delivered after publication of CRAZY: A Father’s Search Through America’s Mental Health Madness and before my talk, veteran NAMI Board Member Carol Caruso introduced me to Glenn. I was immediately struck by his easy-going manner. Carol bragged that Glenn was one of the first NAMI trained  Peer-to-Peer specialists in the entire nation. Glenn and I spoke for several minutes and I was impressed by his thoughtfulness and enthusiasm.

Our paths continued to cross during the coming years at various NAMI meetings and conventions. I was always happy to see Glenn and was thrilled when I learned that he had been one of only four NAMI peers who had been invited to the White House by President Obama to celebrate the 20th anniversary of the Americans with Disabilities Act of 1990. 

A few weeks ago, I was asked to write an article for NAMI’s VOICES publication. In my article, I mentioned three “consumers” who have inspired me. They were  Dr. Fred Frese, Diana Kern, and Glenn Koons.

The day after I submitted my article, an email arrived telling me that Glenn was dead.

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