Pete Earley

(2-5-18) Want to reduce the suffering of individuals with serious mental illnesses held in Virginia jails and prisons?

Send an email or call state Senator Ryan T. McDougle  (R) – Senate District 4), at district04@senate.virginia.gov  (804) 698-7504 and urge him to support Senate Bill No. 801 currently in his Rules Committee.

Introduced by Virginia state Senator Barbara Favola, the legislation would require the Virginia Department of Corrections and the Department of Behavioral Health and Developmental Services to study and devise plans to reduce the use of solitary confinement for prisoners who suffer from serious mental illnesses.

The two state agencies would also be tasked to develop strategies ensuring “that prisoners with serious mental illness (SMIs) receive necessary and appropriate treatment delivered with a focus on the patient.”

Inmates are typically held in 80-square-foot cells for 23 hours a day, seven days a week. They are supposed to receive one hour a day of recreation five times a week, but those exercises are done inside a 96-square-foot, fenced area – basically a large cage. Inmates eat alone in their cells and, by design, have little, if any, interaction with others.

You can imagine how those conditions compound problems for someone with a serious mental illness. (Please share your personal stories on my Facebook page if you or a loved one has been held in such conditions.)

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(1-31-18) Baltimore psychiatrist Dinah Miller, M.D., co-author of COMMITTED:  The Battle Over Involuntary Psychiatric Care, has reacted to my blog about HHS Assistant Secretary Dr. McCance-Katz’s decision to put a hold on a government operated website that identifies “evidence based practices.” COMMITTED, written with her co-author Annette Hanson, M.D., recently won the Carol Davis Ethics Award  given by the American Psychiatric Association each year for the best book published about ethics by psychiatrists.

Please Stop Using the term: ‘Worried Well’

Dear Pete,

Let me start by saying that after 25+ years as a psychiatrist, I’ve never heard of the NREPP website, which identifies “evidence based practices,” so I’m not certain whether closing it is a good thing or a bad thing. Instead, I’d like to respond to some of the things that were said in the course of your blog post.

You used the term “worried well.”  Please don’t use that term, ever.

It implies there are people with legitimate suffering because they have “real” mental illnesses, and those whose suffering is trivial because they don’t have “serious” mental illness.

Suffering is suffering– it all hurts, and sometimes those with no obvious signs of mental illness surprise us all when something suddenly goes horribly wrong.

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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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Shaylon homeless on the street. Photo taken by a friend who later lost track of Shaylon.

(1-22-18) Dear Pete: We are a family with not a lot of means. We have tried in many ways to help my grandson. Please publicize his case. His mother (my daughter) Laural Fawcett recently wrote this account.*

Thank you. Janet Capella. 

Here We Go Again On The Merry-Go-Round Of Horrors, written by Laural Fawcett

Shaylon, my son, has had a number of psychotic episodes which led him to harm himself and others.

Severe visual and auditory hallucinations caused him to leave home and end up on the street. He recently spent a year-and-a-half in jail (he was released in June 2017) because he thought a pedestrian passerby was attacking him and trying to set his feet on fire. This occurred in San Francisco where he often ends up when he is hallucinating. For some reason he, and many others like him, are drawn to San Francisco.

I just finished my training as an Emergency Medical Technician (EMT). In the last couple of weeks, I showed up at Shaylon’s two court hearings. (He was picked up for failing a probation check-in.) What a total, farcical, miscarriage of justice and waste of my time except for the precious opportunity to get a glimpse my son. He was medicated but obviously in psychosis and not well.

The judge repeatedly said, “We don’t want you here. You don’t belong here and you need to stay away from San Francisco.”

He didn’t speak to other criminal defendants, prior to my son, in such a condescending manner. In fact, other defendants were offered programs and assistance.

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(1-25-18) Five U.S. Senators have sent a letter to HHS Assistant Secretary Dr. Elinore McCance-Katz asking her to explain why she has put the National Registry of Evidence-Based Programs and Practices (NREPP) on ice and terminated the contractor who oversaw it.

Chances are, you have never heard of NREPP, but it’s a big deal – a really big deal.

That’s because NREPP essentially determines which mental health and substance abuse programs are “evidence based practices” , opening the door for them to claim a piece of $2.2 billion in HHS block grant funding being doled out each year.

NREPP was created in 1997 to maintain a computer registry that rates practices according to available evidence about their effectiveness. Theoretically, it provides those who access it with helpful information about what they should be doing in their communities.

The five Democrat senators questioned why Dr. McCance-Katz chose to hit the hold button on NREPP, leaving in limbo at least 90 programs seeking “evidence based practice” ratings.

The Washington Post described her decision as a “Trump administration” effort to, “suspend a program that helps thousands of professionals and community groups across the country find effective interventions for preventing and treating mental illness and substance-use disorders.”

Hold on, that’s not what I see happening.

What Dr. McCance-Katz is doing is exactly what Congress told her to do when it passed the Helping Families in Mental Health Crisis Act as part of the 21st Century Cures Act.

The reason why Dr. McCance-Katz has closed the NREPP website is because it has been listing programs as being evidence based practices whose usefulness is questionable. It appears as if NREPP often rubber stamped any practice that popped into the heads of someone with a treatment program that they wanted to sell.

Seriously.

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(1-22-18)  The writer of this letter is a veteran police officer in a major city who emailed me after reading my book, CRAZY:  A Father’s Search Through America’s Mental Health Madness. 

Dear Pete,

I have a mentally ill older brother named Tom.*

He’s been sick since he was 18, and while reading your book, I immediately felt a bond with you and your son, Kevin. My brother’s story is not much different from your son’s.

Tom is/was a very bright individual, probably smarter than me, but at age 18, he was with his girlfriend and another individual smoking pot when he had a traumatic episode. He was rushed to the hospital and doctors didn’t know what was wrong with him. Over the course of the next several months, he became worse and worse and my parents didn’t know what to do. His brain was failing him and he began hearing voices. He told us God was speaking to him, as well as Jim Morrison from the Doors.

I was still very young when this was occurring, I would guess 1984/1985? I was just 12 or 13 and my older brother was diagnosed as having schizophrenia. My parents, as well as my younger sister and I didn’t know how deal with this.

Tom was completely out of his mind!

 I remember my brother being sent to a state hospital.

My parents and I visited him there and I recall the dismal conditions. I was absolutely horrified seeing the other individuals my brother was being housed with. One Flew Over the Cuckoo’s Nest would be the best comparison.

When you wrote in your book about the 9th floor of the Miami Dade jail, I kept having flashbacks of how ill the people in my brother’s hospital were – catatonic, drooling on themselves, others talking to the walls. As a young teenager, I began to cry, wondering why my brother was in this place. He couldn’t be this bad, could he?

Eventually, my brother was released and allowed to come home. The years that followed were absolutely brutal for my family. Doctors didn’t know what medicines to give my brother, essentially, he became a guinea pig, throwing everything they could at him to try and stabilize his brain.

My brother was bounced around from halfway house to halfway house, always running into trouble.

Trouble just seemed to find him.

People would ask him to buy them booze, drugs, etc. and he would always be taken advantage of. Ultimately, he ended up back at home and still lives with my parents to this day. His medicine seems to be stable now and he’s able to function day-to-day, however, every couple of years I will get a call from my police department stating that they have my brother and want to know what they should do with him.

Each time, I explain that he is sick and request that they wait for me to come get him. The officers have been pretty good at letting me take him back home.  When he’s on his meds, he’s pretty good, some people don’t even know he’s ill. When he’s off his meds he’s “bark at the moon batshit crazy”. Thankfully, my parents watch over him very closely and get him back on track.

Unfortunately, my parents are getting up there in age and won’t always be around to take care of him. I’ve assured them that I will always make sure he has a safe place to live and I won’t let him live on the streets. Your book terrified me with the stories of the subjects living on the streets and being beaten, taken advantage of, and wandering around like lost souls.

I can’t have that happening to my brother. 

I think every law enforcement officer in the country should be required to read your book. When I was a young patrol officer I almost shot a mentally ill subject who was wielding a knife. It happened about 15 years ago when my partner and I were called to a disturbance at an apartment complex. As we arrived, a young male and female came running down the stairs exclaiming, “He’s up there, he has a knife!”

They told us their friend was suicidal and was acting irrational. We asked if anyone else was in the apartment and the two replied they were not sure. This kind of perplexed us because the apartment was rather small. At this point in my career, I had only six years on the department and was still fearless.

Generally, officers won’t enter a residence unless they can determine that other lives are in jeopardy.

If you have a single individual making threats, our procedure now is lock down the area, call it a barricade situation and call in our Special Assignments Unit. But when my partner and I rushed up to the 2nd floor apartment, we found the door open. As soon as we crossed the threshold, we were confronted by a young, white male, in his early 20’s, holding a large kitchen knife. We immediately drew our guns, which we pointed at the male, commanding him to “drop the knife.”

He said  ‘No” and told us that he wanted to die.

My partner and I were stuck.

Here we were, guns drawn, in a tiny apartment, facing a distraught young man who was telling us he wanted to die.

“Suicide by cop.”  I did not want to shoot this guy.

We warned him that if he took one step forward, we would be forced to fire but that was not how we wanted this emergency to play out.  He was well within the lawful 21 foot ‘danger zone’ that we’d learned about at the academy. At that distance,  a potential attacker could reach and stab you before you could draw your weapon and fire. We already had our guns drawn, but he was within 8 to 10 feet of us. We knew damn well that we could just shoot him and be justified.

My department had recently obtained tasers but only two or three officers, who were working on our shift, had them and neither was with us. We were still in a stand-off when our supervisor arrived. He remained  outside the doorway, calling for a taser while we kept our guns aimed at this clearly unstable and suicidal suspect.

In these situations you are so focused that time often seems to slow down. We must have waited for 15 or 20 minutes for an officer with a taser to arrive.

Holding a person at gunpoint for that long, trying to negotiate with them, begging them to not take one step forward, can be very tiresome, both physically and mentally.

The taser equipped officer finally arrived and I could hear our team standing behind us outside the open door formulating a plan. In a purposeful move, the officer with the taser entered, stepped between us and fired.

It was a polyester dogpile after that. I remember trying to pull the knife away from him and when he was given another jolt, I was shocked by the electricity flowing through his body. I screamed in a high pitched  squeal and my former supervisor still laughs to this day when he talks about me being shocked.

Thankfully, we were able to successfully subdue the subject and get him handcuffed. My partner and I put him in our patrol car and advised him that we were taking him to a mental facility. During the ride, he became calm and thanked us for not shooting him.

That’s right. He thanked us and acknowledged that he needed help and was very upset about something that I don’t even remember now. What I do remember is that I didn’t have to take his life.

I don’t know what happened to this individual, but what I do know is he was very lucky that my partner and I arrived that night.  We didn’t join the police force to take lives. We joined to protect and serve them. Another officer might have simply shot the individual.

I would have been 100% justified in the shooting, but looking back, I would have felt absolutely terrible about it. He could have been my brother, your son Kevin, or some other mentally ill person who just needed proper medication and guidance.

*Tom is a pseudonym.