Marie’s wrist strapped to hospital bed after suicide attempt

(1-9-20)  In Part One of The Shape of Loss: Teen Suicide and the Failure of Mental Health In Public Schools posted yesterday, the mother of a teenager described the attempts that she made to help her adopted daughter, Marie, before she attempted suicide in December 2019. Both mother and daughter agreed to share their story but pseudonyms are being used to protect the family’s privacy. 

The Shape of Loss: Teen Suicide and the Failure of Mental Health in Public Schools: Part Two

Just before starting high school, Marie spent the summer living with her father, my ex-husband, holed up in a dark room, easily weakened from a walk in the woods or around the track. She complained of depression, isolation, a vulnerability that spoke of clipped wings, and I saw a new gauntness around her eyes when she returned home.

During a trip to the Oregon shore, which she loved, I noticed when she pushed up the bottoms of her pants to wade into the ocean, her calves were marked with razor thin white scars that turned shades of pink and purple in the cold water.

A Fresh Start

I spoke of high school all summer, building up the advantage of having a fresh start in a new school, and allowed myself a certain ruthlessness in my optimism. As if I found a twenty-dollar bill in an old wallet, I began to hope that high school might be the ticket. Perhaps, I thought, a new school with greater flexibility, a place where she would finally find her tribe.

It didn’t matter if she was still cruel to me, using words like a golf club that hit the heads off of dandelions, precise and swift, regarding my failures as a parent. She could be pleasant to others.

In September, Marie announced to me that she was going to “Go to school and stay all day. Screw you all. I’m going to get my diploma and get the hell out of this weak-ass town and head to art school!” And, to high school she went.

During the second week an incident happened. She had been befriended by an older teen male who didn’t have many friends. I would later discover he  had “anger problems.” I was told the young man was on a “safety plan” at the school, which prohibited him from being in certain areas of the school or alone with females. Because Marie was naïve, she didn’t see the red flags until it was too late. At lunchtime, they walked to a local store which served sandwiches and drinks to students.  Marie said he assaulted her in the men’s room there. 

Marie no longer was able to feel safe at school after the attack.

The school did not have anyone trained to provide the sort of help Marie needed to deal with trauma. 

My daughter slipped into periods of dissociation, wild mood swings, irritability, and high-risk behavior she’d never displayed previously. I immediately began searching for a therapist. This was in September 2019. I first contacted a trauma center for children and was told there was a ten-week wait list. I pushed, cajoled, and pleaded with the only therapist at our local mental health center and he finally agreed to let Marie take a tour of the facility to see if she would warm to the idea of an 18-week course of therapy to manage her traumatic experience. 

When he met with us, he told her that they were hiring another therapist with a therapy dog and that perhaps the waitlist might open up faster for this new hire. After the tour, I felt we had a foot in the door.  I was mistaken. The social worker, who guided us on the tour, had mentioned that I, myself, was a trained therapist. Therefore, Marie had enough “protective factors” available to her in her home without taking the 18-week course. The social worker also reported that Marie didn’t seem interested in therapy because during the tour, she commented that she would like to “move away and become an artist.” I was informed later that if Marie wanted to be seen at the center, she would have to make the request herself – I couldn’t do it for her – at which point she would be added to the waitlist. There would be a minimum ten-week wait.

I was feeling desperate. My daughter needed help. Now! Marie was stating with more frequency that she was depressed, and her rage continued to build with periods of hypomania and impulsivity.

By this time it was October, I began making more calls and was able to get an appointment with a psychiatric resident who asked if she could film Marie during their interview.  She told us that she would be periodically stepping out of session to “talk with my supervisor.” This young woman clearly became uncomfortable when Marie began talking about the bathroom assault. While well-intentioned, she appeared to wince when Marie would swear, and then smile at her as if she was apologizing for doing so. She also had a propensity for wringing her hands and taking long pauses.

As we were leaving, Marie informed me that she felt badly for the woman and that she had in fact “chosen the wrong profession.” Marie said she didn’t want to traumatize her and had no intention of returning.

Art Reveals Fractured Images

Marie had been drawing for the past two years, Anime girls with pigtails and freckles. Her drawing took on a different depth, entirely outside of anything she had drawn before. Her mind and spirit were fracturing and scrubbed clean of any hope that “things would get better. 

I called every resource in my county that I could, and no one had anything but waitlists or declined our insurance; the therapists with the best potential fit I would email, beg, cajole, and offer to pay out of pocket, not that I could.

Marie was asking for therapy, wanting to try medication again, and there was a desperation I had not seen before: her speech was pressured, she wasn’t sleeping, her irritability and rage made it unsafe for me to be around her.  I called my state senator and complained: complained nothing had been done about the assault, complained about no county services or EASA team [EASA teams include counselors, case managers, occupational and supported employment/education specialists, medical staff, and family education and mentorship] – all I heard was there were waitlists.

Our state senator apologized, and agreed, the system was broken.

I spoke in front of a county committee. They gave me five minutes to describe my plight.

“It is interesting that when a child is mentally ill in this community, it isn’t until they commit suicide that resources show up at the school. There is no crisis team for children,” I told them.

The director of the mental health department for our county was present and she did not approach me, did not follow up, or attempt to call, but remained sitting tight-lipped and indifferent.

I continued to make calls demanding action, quoting the civil rights for individuals with mental illness. To strangers I must have appeared strident, my voice like a woman who plants her fists on her hips, wide stanced and angry: and I was.

I could not understand how nothing was being done. A young woman with a mental illness and developmental delay has been assaulted in a men’s bathroom and she couldn’t receive any services?

I described Marie’s response of long periods of staring off in space, restricting food, insomnia, avoiding where it happened, and suddenly high risk behavior all indicative of a trauma response: I explained how teenage girls process assault by a peer differently, and how her depression and processing delay would take time – that this was normal, and that she warranted help and was in no position to “call up disabilities rights of Oregon and the ABC House [ABC House is the child abuse intervention center serving Benton and Linn Counties in Oregon] to request services, “ which was what I was told she had to do.

At three in the afternoon on Friday December 13^th, 2019, I received a telephone call at work that Marie was found non-responsive and it appeared she may have had a seizure.

I raced out of work, and from my car spoke to the emergency room doctor, I assured her that Marie did not use drugs, but that she had been struggling for several months with depression. While driving and speaking to the nurse on the phone, I could hear the hospital team call a code as Marie went into another seizure.

When I reached the emergency room, I was told that Marie had overdosed on Benadryl. I alerted her father who found an empty container in his garbage: she had swallowed 98 pills, a total of 2,450 mg. of Benadryl. The lethal dose for a girl of her size is 500 mg. The time it would take to die from a lethal dose is two hours; Marie was already seizing with a heart rate of 179/160 (with a normal heart rate being on average 123/65) in the ER.

When I finally got to see her, Marie was hallucinating, moving her arms and legs involuntarily, unable to speak, and instead making gurgling sounds in her throat and struggling to swallow. I stood to her side and held her arms down, using my forearm to push her head flat on the pillow as she would strain to sit up, eyes glassy and unfocused. She was unresponsive, and I was informed that there were no interventions aside from giving her an anti seizure medication and something to lower her blood pressure; I was told she may not make it, that she was critical.

An ICU ambulance was sent for from 80 miles away, and it arrived within an hour, after Marie was intubated and provided a breathing tube; she was on life support and unconscious when they placed her on a Stryker stretcher and loaded her in the ambulance.

As I drove away from the emergency room, I could hear a woman with my voice screaming, and speaking unintelligibly to God in what sounded like a chant, over and over again, “please don’t let my baby die.”

Marie was in the pediatric intensive care unit on life support for the next four days. On day five, they removed the breathing tube, lifted the sedation, but she remained very ill. She spiked a fever almost immediately, could not speak, continued to hallucinate. I would bend down next to her lips to hear her barely whisper, and at first it was nonsensical, still in that world where she had been held hostage. When she finally became lucid, she had aspiration pneumonia, short term memory damage, and was weighing in with a BMI of 16.6.

When Marie was able to speak again, she recounted her suicide attempt, stating she was “never afraid,” and that she had told us she wanted to see a therapist or take medication to feel better, “and you didn’t do anything.” Oh, darling, I wanted to tell her, “I tried.” She had moments when she would say, “I still want to die,” and others in which she would stare into space, weightless and untethered, one foot in each world, it would seem.

Marie discharged home from the hospital after six days, with an offer for her to stay at the children’s hospital while waiting for an inpatient bed, where she would remain and be assessed over ten days.

As a psychiatric social worker with five years of working on an inpatient unit, I felt I could provide the safety and supervision at home that she would find there, without the additional trauma of potential seclusions and involuntary medication administration.

I blame myself, as if I should have held it off, should have known in advance, that she wanted to die. The biggest wager was thinking that she could wait for help, that a waitlist would open, and if I just looked at the locks on the box like Houdini, I’d find a way out. Instead, she found her own.

The post Part Two: Daughter Wanted Help But There Was A Ten Week Wait. The Grim Harm Of Not Helping A Teen appeared first on Pete Earley.

(1-13-20) The death of a 56 year-old homeless man, who was crushed to death, has outraged Brandan Thomas, director of a rescue mission in Winchester, Virginia. I recently posted a blog about a 12 day motorcycle ride that Thomas made to call attention to the plight of homeless Americans. Thomas is director of The Winchester Rescue Mission, which has beds for 32 men and recently opened a second location with beds for 15 women. Some 300 individuals in the Winchester are homeless. Thomas recently said it can take six months for someone who walks into his shelter with a mental health issue to get an appointment with a doctor.

The death of Michael Kenneth Martin was especially troubling to Thomas because he had arranged for Martin to receive Rescue Mission services once he was released from jail, but Martin was freed without the Mission being notified.  The rescue mission is an outgrowth of Canvas Church, which Thomas started in 2013 in a Winchester garage. It has since grown to 200-plus in attendance. He is an example of the power of single individual to foster change in a community.

Homeless man’s death prompts call for change

Reprinted from The Winchester Star newspaper.

“This man is dead because he was mentally ill and was seeking out the best form of housing he could because we did not help him,” an emotional Thomas said at the end of the three-and-a-half-minute video.

Michael Kenneth Martin
Photo provided by family

The post “We have a mental illness crisis!” Pastor Outraged After Homeless Man Is Crushed Sleeping Under Truck appeared first on Pete Earley.

(1-15-2020) Long-time mental health worker and advocate Virgil Stucker recently interviewed me for his Mental Horizons Podcast.  Virgil is best-known as the former founding executive director of the CooperRiis Healing Community, “retiring” after a forty-year career working in therapeutic communities. He now runs Virgil Stucker Associates, a private firm that “empowers mental health decision making for families and individuals… advocating for integrative, holistic solutions to the challenges of mental illnesses.”

In this episode, I talk about my book, CRAZY: A Father’s Search Through America’s Mental Health Madness, what helped my son, and the challenges and successes we face as parents and advocates.

From his website:

After a 14-year career in journalism, including six years at The Washington Post, Pete became a full-time author.

When Pete’s life was turned upside down by the events recounted in his book Crazy, he joined the National Alliance on Mental Illness to advocate for strong mental health reform on the public stage and now rallies against the troubled mental health systems and for the mentally ill.

His blog at peteearley.com attracts thousands of readers every week and is a vast resource for parents supporting a child with a mental illness.

From an earlier blog that Pete wrote.

Lessons I’ve Learned About Helping Someone With A Mental Disorder

The post Lessons I’ve Learned As A Parent: Virgil Stucker Interviews Me On His Podcast About Hope, Healing, & Trends appeared first on Pete Earley.

Photo courtesy of Slate. 

(1-20-20) “I know he’s innocent,” Bryan Stevenson, the author of Just Mercy and real life star behind the movie by the same name, assured me when we first talked in 1991.

This was before Stevenson was famous – when he was in the midst of trying to prove that Walter “Johnny D.” McMillian, an African American death row inmate in Alabama was innocent of murdering a white teenager in Monroeville, the town that Harper Lee used as her inspiration for the classic, To Kill A Mockingbird.

My good friend, Walt Harrington, had urged me to call Stevenson after I mentioned my interest in writing a book about the death penalty. Harrington was among the first journalists to “discover” Stevenson, years before he began receiving international attention (appearing on Oprah and Ellen) for his tireless efforts to save children and adults sentenced to death. [Read Harrington’s story about Stevenson here.]

I warned Stevenson that if I investigated Johnny D.’s case and felt he was guilty, I’d write that. Without hesitation, Stevenson invited me to Alabama.

During the next three years, I interviewed eye-witnesses, followed Stevenson’s legal fight and did my best to discover the truth about who had murdered Ronda Morrison, a white teen found dead in a main street laundry on a busy Saturday morning.

My account, Circumstantial Evidence: Death, Life, and Justice in a Southern Town, published in 1995, won a Robert F. Kennedy Book Award  and an Edgar for Best Fact Crime Book. 

So let me share my thoughts about Just Mercy, the movie, and additional information you might find interesting after watching it.

The movie follows events closely except for a few minor Hollywood embellishments. One oversight is no mention of Mike O’Connor, a white attorney who worked closely with Stevenson investigating Ronda’s death. He played a vital role in finding evidence but the scriptwriters ignored him in favor of featuring the working relationship between Eva Ansley, the Equal Justice Initiative office manager, and Stevenson.

While Michael B. Jordan and Jamie Foxx did excellent jobs playing Stevenson and Johnny D. respectively, Tim Blake Nelson’s portrayal of Ralph Myers was so dead on that when I closed my eyes, I thought I was sitting across from him. As detained in my book, Myers had been badly burned on his face as a child which caused him to speak out of one side of his mouth, which Nelson captured perfectly. I remember standing in front of a vending machine in prison with Myers and realizing that he could not read when he pointed at items to tell me what he wanted.

The movie mentions that Monroeville investigators offered to help Myers get a lighter sentence in a prior murder in return for his false testimony. That murder was the killing of Vickie Lynn Pittman in nearby Brewton, Alabama. Myers and Karen Kelly, a white woman from Monroeville who was having an affair with Johnny D., were accused of committing that killing.

Sadly, in real life, Vickie Pittman’s murder was largely ignored because investigators were more concerned about solving Ronda’s death. As my book documents, this is because she was considered “white trash” while Ronda’s family was well-liked and admired in Monroeville. A sign that the justice system treated poor whites much differently from whites who were prominent.

Just Mercy ends by noting that a white man was later identified as a suspect in Ronda Morrison’s death.  That’s true. Alabama Bureau of Investigation Agents Thomas Taylor and Thomas Greg Cole reopened the murder probe after 60 Minutes raised questions about it.

Taylor and Cole quickly determined that Ronda’s murder was a sex crime, not a robbery. (She’d been found with her blouse open and bra pushed off her breasts.)  Monroeville investigators had claimed Ronda was shot during a robbery and drug deal and her blouse had been torn open during a struggle. This theory fit perfectly with their false case against Johnny D. who they claimed was a local marijuana dealer laundering money through the cleaners.

Ronda’s blouse had been unbuttoned, not ripped open, and her pants unzipped.

Once they established her death was a sex crime, the two ABI agents quickly identified a suspect who I identified in my book with a pseudonym, Howard Demar, because he was never charged.

Demar had shown an unusual obsession with Ronda’s murder having gleefully offered suggestions about possible killers to the local police and also Stevenson. He’d also contacted Ronda’s parents offering his advice – an especially cruel act if he were the killer. As I note in my book:

“It seemed that every time someone new got interested in the case, Denmar showed up at his doorstep…”

At first, Demar was eager to meet with the two ABI agents but began backing away when he realized that he’d become their suspect. Having heard that I was writing a book, he contacted me. I invited him to my hotel room for an interview – he didn’t want me coming to his trailer – and when I asked him to tell me what he thought had happened the morning Ronda was murdered, he eagerly began explaining that the killer probably had been making phone calls to the cleaners when Ronda was at work. The caller didn’t identify himself but flirted with her.

“Okay,” Denmar said, having set the stage, ‘Here is my theory.’ On the morning of the murder, the caller had been more direct when he telephone Ronda. “He comes on to Ronda,’ Denmar explained. “Maybe this call is obscene.” She gets upset and is trying to figure out who has been telephoning her…”Let’s just say maybe, the caller walked into that place of business on that Saturday morning and Ronda…suddenly put a voice to he face. She suddenly knows who has been calling her…”

“At that moment Ronda would have become angry…She would have verbally confronted her caller. Maybe she had even threatened to call the police or tell her father. An argument had started. Maybe she had reached for the telephone.

“‘I’m saying it wasn’t premeditated…’ The caller had not intended to pull out his pistol, but suddenly he did exactly that. Lots of men in southern Alabama carry pocket pistols. The killer had then ordered Ronda into the back of the store. Maybe the gunman had gotten angry and lost control.. Maybe he thought Ronda would enjoy having sex. Maybe ‘it just happened,’ Demar said. “Someone panicked.’

The ABI asked me later what Denmar had said and since he’d agreed to let me quote him in my book, I shared our conversation with them. The two agents brought him in for questioning and he repeated much the same story. They later discovered Denmar had harassed a former girlfriend who had rejected him. Other women stepped forward.

The agents recommended charging Denmar with Ronda’s murder when they completed their investigation but local officials refused and Denmar fled town. He was from a prominent family.

Just Mercy does an excellent job showing how race, ignorance and prejudice led to the wrongful conviction of Johnny D. Incredibly, there are some in Monroeville who continue to believe that this innocent man was the killer. The movie showcases Stevenson’s admirable lifelong efforts to save death row inmates.

What may be easily forgotten by movie goers is that our criminal justice system not only failed in convicting an innocent man but failed to find the guilty one.

I spent time with Charles and Bertha Morrison and saw how their only daughter’s death and local bungling of the investigation haunted them as only a parent who has lost a child to murder can imagine.

Ronda’s killer remains free. The false accusations against Johnny D. were unjust. And those who loved Ronda are still waiting for justice to be served in her death.

(You can read more about fact vs fiction in Just Mercy, an article published on Slate, here.)

The post I Watched The Actual Just Mercy Story Unfold – At Bryan Stevenson’s Invitation appeared first on Pete Earley.

(1-23-20) FROM MY FILES FRIDAY:  Mike Wallace of 60 Minutes  fame quietly helped my son, Kevin, when he suffered a major psychotic break. Wallace understood mental illness because he suffered from depression and had contemplated ending his own life. After Wallace died in 2012, I revealed how he had intervened at my request to help my family – a fact that Wallace had asked me to downplay in my book because he felt CBS might not react favorably to his action.)

Mike Wallace Helped Me When I Needed Him Most  

Mike Wallace and I didn’t start off as friends.

The great CBS newsman, who died Saturday at age 93, telephoned me when I was writing my first book, Family of Spies: Inside the John Walker Jr. Spy Ring.  It was 1986 and Wallace had learned that I was the only reporter who had gotten John Walker Jr. to talk to me.

At the time, Walker hated the media and didn’t want to talk to anyone about the 18 years that he had spent spying for the Soviets or how he had recruited his son, Michael; his brother, Arthur; and his best friend, Jerry Whitworth, as traitors.

For those of you who haven’t read my book or might not remember the case, John Walker Jr.’s arrest in 1985 was the biggest spy scandal in the U.S. history since Julius and Ethel Rosenberg were convicted and executed in 1953.

Walker’s treachery stunned the nation and Mike Wallace was eager to get the first television interview with him.

I was flattered that someone as important in broadcast journalism as Mike Wallace would call me. I immediately went to work to help him. I got Walker to agree to give Wallace an exclusive for 60 Minutes. At one point when Wallace was interviewing Walker, they took a break in filming and Wallace called me from the federal prison in Marion, Illinois, to check some facts.

Wallace’s interview with John Walker Jr. was mesmerizing. It was Wallace at his best as an interrogator. In one memorable scene, Wallace eviscerated Walker by asking him how he could be so cruel as to groom his only son to be a traitor. It was such an incredible interview that Wallace was rewarded with an Emmy, one of some 20 Emmys that he won.

And what of my book and me?

Wallace never mentioned either. He and 60 Minutes basked in the limelight.

I felt duped and hurt.

As fate would have it, Wallace called me again two years later. He had read my second book, The Hot House: Life Inside Leavenworth Prison, and was fascinated with the case of  Thomas Silverstein. At that point, Silverstein had been locked in “no human contact” isolation by the federal government longer than any other inmate.

Mike Wallace asked if I would help him get an interview with Silverstein.

I told him that I was disappointed that he had never given my book or me any credit in the Walker case.  What happened next shocked me.  Mike Wallace apologized.  He told me that he had been going through an extremely tough period in 1986 and that he had done some things that he regretted.

The interview with Silverstein never came about. Wallace’s producers didn’t believe the American public would feel empathy for a convict held in isolation who had killed a correctional officer and also had been convicted of three other murders, although one conviction was later overturned.

Our paths did not cross again until 1996 when my book, Circumstantial Evidence:  Death, Life and Justice in a Southern Town, won an award from the Robert F. Kennedy Center for Justice and Human Rights. The center happened to be honoring Mike Wallace for the many contributions that he had made to social justice during his career.

Mike and I spent time chatting during the award ceremony. He was incredibly smart, quick on his feet, worldly, personable, and not vain or pretentious despite his fame and accomplishments.

When my son, Kevin, was arrested several years later after he broke into a stranger’s house to take a bubble bath during a delusional mental breakdown, I sent a  fax to Mike Wallace’s office. I was desperate, terrified, and I asked for his help.

I explained that my son had been hospitalized, but his doctor had telephoned and said the hospital was going to discharge him even though he wasn’t ready. Our insurance company didn’t want to pay for any more of his care.

Fifteen minutes after I sent that fax, Mike Wallace called me and we spent an hour on the phone.  I knew that he had suffered from clinical depression, but I hadn’t known how sick he really was. He told me about how he’d become exhausted by the pressures that he was under, especially because of the legal problems that had been brought on by the infamous Westmoreland lawsuit against CBS.  He mentioned how he had talked openly on 60 Minutes about how he’d considered suicide in 1986 — the very year when we’d first met.

He told me to “have hope” and then he did something truly incredible.

In my book, CRAZY: A Father’s Search Through America’s Mental Health Madness, I write that I called the hospital and told them that I was friends with Mike Wallace. I explain in my book that threat was enough to make hospital officials reconsider their decision to discharge my son.

But that wasn’t the entire story.

I wrote it that way because Mike Wallace asked me to write it that way. He didn’t think CBS would appreciate what he actually did for me. Now that he has died, I can tell the rest of the story.

Mike Wallace called the hospital too. He telephoned and said he was curious why the hospital was discharging my son when his own doctor didn’t think he was ready.

The result. My son wasn’t discharged. He got the help that he needed.

Although he was busy, Mike Wallace telephoned me several times after that to ask about my son. We became friends and in one of those calls, he mentioned the Walker story and how I had helped him and he had not given my book or me any credit.

He told me that he had repaid his debt.

I told him that what I had done for him paled in comparison for what he’d done for my family and me.

Mike Wallace was a hero of mine in journalism long before I ever met him. His journalistic contributions are legendary and the rest of the world will remember him as a crusading, bare knuckles journalist.

But to those of us with mental disorders or with loved ones who have mental disorders, Mike Wallace will be remembered for his bravery in speaking out about his own personal struggles with depression and suicidal thoughts — and by doing so, fighting stigma and prejudice.

He was a champion for our cause and he was a true friend to me.

I will miss him.

(Originally posted April 9, 2012)

The post Suffering From Depression, CBS Newsman Mike Wallace Extended A Helping Hand appeared first on Pete Earley.

By Pete Earley 

If Virginia Gov. Ralph Northam (D) and the General Assembly are serious about criminal-justice reform, they need to do something this session about the continued imprisonment of Christopher Sharikas.

Sharikas was 15 years old and living in Northern Virginia when he began exhibiting signs of having a serious mental illness. He began hearing voices, became disruptive at school and armed himself with a baseball bat. He was ultimately diagnosed with untreated paranoid schizophrenia.

In April 1997, about a year after he was diagnosed, he flashed a knife at a woman who had refused to give him money, before he ran away. The police interviewed him the following day but declined to arrest him. Later that afternoon, Sharikas approached a woman and demanded her car keys. Voices were telling him that he needed to drive to New York. She surrendered her keys and purse, but Sharikas stabbed her from behind, puncturing her liver.

The post Given Two Life Terms Because Judge Didn’t Believe Child Could Be “Cured” appeared first on Pete Earley.

(1-31-20) Among the several dozen emails I received this week, there are two I wish to share. One is from Dennie Brooks, who shared a personal story about CBS reporter Mike Wallace after I posted a blog describing how Wallace had helped my son. The second email comes from long-time advocate Dr. Gary Mihelish, president of the National Alliance on Mental Illness chapter in Helena, Montana, and a former NAMI board member, who wrote about our nation’s conflicting handling of individuals with serious mental illnesses who are accused of crimes.

Dear Pete,

A fellow I met recently told me that when he was a teenager,  his mother found him just about to put a noose around his neck.  The mother was terribly upset and had no idea what to do.  Mike Wallace had just gone public with his struggles with depression so this mother sent a letter to Mike Wallace’s mother seeking advice.  Mike Wallace’s mother send a note of encouragement back and also told her son. Mike Wallace then wrote a wonderful letter to the mother’s son.

Now an adult, the man told me that he still has that letter. He said Mike’s kindness helped save him.  Mike Wallace was one very special guy.

Best, Dennie.

(Dennie Brooks is the daughter of the late Dr. Dean Brooks, a nationally recognized psychiatrist/advocate featured in the movie, One Flew Over The Cuckoo’s Nest.)

Dear Pete,

Please tell me how this makes sense?

Ted Kaczynski, Rusty Weston and Lloyd Barrus have all, at some time, been residents of Montana.  They have all been diagnosed with a delusional disorder, possibly schizophrenia.  None of them accepted treatment and have denied treatments for their illnesses and refused medication to control their delusions and hallucinations.

They could not be forced to take medications because they had not been proven to be a “danger to themselves or others.”  Only after they had taken someone else’s lives were they considered dangerous.

After they all killed someone, they were forced to take medications so they could be made competent to stand trial and possibly be executed.  Will someone please explain to me how this makes sense to their own families and the surviving family members of their victims.

Dr. Gary Mihelish, President

NAMI Helena

The post Mother Asks Famous TV Reporter’s Mother For Advice; Questions Raised About Our Conflicting Treatment Of Individuals With Mental Illness appeared first on Pete Earley.

Photo credit: The Atlantic Magazine

(2-3-20) An email from a mother raises two important issues. What happens when you need medications to remain stable but those same medications are hurting your overall health? How do aging parents protect the future of an adult child with a serious mental illness and intellectual disabilities?

Dear Pete,

Our son lives with us, and always has. In his early teens, he was finally diagnosed as having Bipolar-1 disorder although we are fairly certain he had been struggling with its onset as early as 2nd grade.

His condition became progressively worse with age. By his late 20’s, after several very traumatic and severe manic episodes, he spent a week in a local hospital’s behavioral health unit in Virginia.  I spent weeks looking for a community support system and searching for a psychiatrist after he was discharged. My search was difficult because of HIPAA. I was told our son was over 18 years old and, therefore, it was up to him, not us.

Desperate, I finally convinced a sweet, compassionate, Office Manager named Chris to plead my case with Dr. James Dee, who was not accepting new patients. I’m sure Pete that you recognize that name because he is the same psychiatrist who treated your son, Kevin. He was the best psych-pharmacologist we’ve encountered and we were devastated when he died recently. Dr. Dee got our son into our local Virginia Psych Rehab Services Day Treatment Program, which he attended for seven years. Dr. Dee helped our son come to terms with his mental illness and learn essential coping skills – especially anger management and the importance of getting therapy and taking meds.

Early on, we met with a lawyer to inquire about legal guardianship to protect our son when he experienced a manic state and was unable to make appropriate treatment decisions.

What happened?

What we were told is that you can pay a lawyer a lot of money and get guardianship but a judge can assign guardian ad litem (a total stranger) to make decisions and that stranger could totally take you “out of the equation.” The lawyer asked: How does that help your son and you? We didn’t pursue it further.

Fortunately, the mood medications that Dr. Dee prescribed helped our son remain stable. We are lucky that medications along with therapy help control his symptoms. For him, stopping the mood meds is not an option. We’ve tried it with always tragic results. Unfortunately, we discovered there can be negative health ramifications from long-term use of mood meds. His regular doctor noticed and couldn’t explain seriously high Cholesterol and Triglyceride levels.

We wondered if his mood meds were responsible but there was no evidence to support this. Thankfully, his doctor brought his cholesterol and triglycerides under control with other medications.

Health problems didn’t end there.

Shortly after that, a sudden spike in his Bun and Creatine levels on his routine bloodwork indicated that he only had 50% kidney function. That prompted three nephrologists to question the possible health ramifications of long-term use of some of the mood meds that he was taking. They never could definitively agree (with each other) whether the loss of kidney function was caused by genetics or the long-term use of his Lithium mood meds. But, to err on the side of caution, it was mutually decided that he should change meds and reduce, and eventually eliminate, the Lithium.

This began a new rollercoaster of manic and rapid-cycling episodes. There were days where he could flash between serious fits of manic anger and ten minutes later, he would break out into heart-wrenching episodes of sobbing where he openly questioned why he was born.

In 2014, my husband and I retired and we moved with our son to a small town in Western, Pennsylvania. Now in a new state, we literally had to start all over again in many ways. In addition to finding new doctors and a psychiatrist, Social Security cancelled our son’s disability and Medicaid coverage without explanation and we had to reapply twice before his coverage was reinstated. We had discovered that the rules in Pennsylvania could be different from those in Virginia.

Back to Square One

Fast forward to today.  The most recent of our son’s severe manic episodes happened as we were in the midst of modifying his mood meds because of ongoing health problems. These major manic episodes resulted in familiar scenarios: calling Crisis Care for Assistance, the Police, and EMTs and ended with several stays in a behavioral health unit.

In addition to his chronic kidney disease, he had multiple and frequent kidney/urinary tract infections (UTIs) which the Urologist eventually determined was caused, he said, because of a not well recognized side-effect of one of his other long-term mood meds – Tegretol. He told us the bladder becomes lazy and does not fully empty – causing the development of the kidney/UTIs. The recurring UTIs required him to wear a Foley catheter for several months straight and after that (to) having to frequently self-catheterize.

Twice last year, as a result of the chronic UTIs, he developed Sepsis (which can very quickly become life threatening if not recognized immediately). These infections resulted in three separate admissions to our local behavioral health unit because he became manic (which each time was exacerbated by the ongoing Kidney/UTIs and the Sepsis). Is there a connection?

Unfortunately, he can go from a normal temp to 104.5 degrees so quickly it is frightening and he does not seem to recognize (on his own) when these health issues are beginning.

What happens when we are gone?

Our son needs medications. He needs someone – us – to help monitor his health.  What happens to your “adult child” when the parents “age” and they can no longer take care of them?

This is a serious question for all aging parents. We recognize that our son needs (and will always need) additional healthcare support with med monitoring, ordering and administration (filling pill container) and general medical health care guidance.  We do not believe this would happen if he was living independently or in a regular group home setting.

It has been a long journey for our oldest son and for us – about 40 years to be exact (beginning when he was about 8).  But we are proud of him and happy to have taken that journey together. And while that journey has been a long and difficult one, planning for his future “without us” is now proving to be our most difficult challenge.

I turned 70 and my husband turned 74 last year.  We are desperately trying to “work the system” in Pennsylvania to understand what our options are and how to prepare for and plan for our son’s future (a future when we won’t be around to take care of him).

We didn’t want to wait until there is a family emergency situation when we would have to address such things under duress.  And as you know, no one will look after our “children/family” as well as we do….AND the system is broken. So, while dealing with a family member’s mental health issues is challenging in itself, we found planning for their future without us to be our biggest challenge yet.

One step forward: An Advance Psychiatric Directive

Last year, we accomplished one very positive step. Pennsylvania has a “Mental Health Advance Directive for PA (MHAD-PA).” Our son signed the MHAD-PA and it gives us authority to help him make necessary mental health care decisions. I believe it would be good if all States had a similar document available. If anyone is interested this directive, you can read more here.

But the verdict is still out, (with us,) as to how effectively this Advanced Directive is used by hospitals (or can be used).

We have learned that if the patient is over age 18 and has checked themselves into a hospital’s behavioral health unit, even with a signed MHAD, it is still like pulling teeth to get the hospital staff to share information with the parents about the patient’s care because of HIPAA. This creates a huge gap in the process – especially when a patient is released and expected to order and take their meds and make it to the necessary follow-up therapy appointments etc.

Without a strong advocate to guide them, this may not happen. And if the advocate is not part of the discharge process, ask yourself how many patients will get the follow-up care that they need?  Heavens, this begs me to shudder at the thought about what someone like our son might do without advocates like us on his side?  It is also scary for him because he knows that he would be left without an advocate. You can’t believe how many times we have been going into or toward the hospital to visit our son and saw a lost soul walking out of the hospital with all of their possessions in the brown paper bag that are used for clothes in the BHU. So, heart wrenching.

What happened when we sought advice?

We contacted local County agencies for advice about our son’s future without us. First, it took me going through three levels of personnel until I reached someone (finally, a Supervisor) who understood what I was requesting. She agreed to meet with us to explore what possibilities “might be available.” After our first meeting, it became clear there is no straight answer. Housing options are severely limited in our area. However, we were told if our son had an Intellectual Disability (ID) or fell into the Autism Spectrum, he’d have a better chance of being accepted.

We were told that our son needed to qualify for a State Funding Waiver (of which there are 3 different levels or increments of funding) to obtain housing. None of the waiver levels is easy to get and those available are very limited in numbers. We found out that the highest level of waiver funding is absolutely “required” for the kind of housing and additional assistance our son would require.  In order to have our son “possibly” qualify for housing in the future, we were told he would need to be retested to document the severity of his illness. Our son will be 48 years old this Spring and it has been years since he has been tested for learning disabilities and other problems that would help him qualify.

Our son agreed to be tested and in addition to the Bipolar-1 diagnosis, our son met the ID criteria and was found to be on the Autism Spectrum. These conditions were not even in our vocabulary back when our son was young in school. Back then our son tried to finish his junior year of high school twice and quit. He was in the throes of his Bipolar-1 disorder and terribly manic at that time. Unfortunately, he tried Adult Ed, GED and the American School Correspondence Course without success. In spite of our encouragement, he has never driven a car and has been unable to maintain a job for more than very short periods of time.

Our son is a good guy. He knows and understands his mental health condition (in as much as anyone can understand it, and wondering why it happened to them?) and he knows he has to take his meds. His experiences at the Day Treatment Center helped with that. But he will not order the mood (or other necessary) meds or fill his pill container. Honestly, I am pretty sure he could not manage his meds on his own. If we have not filled his container, he will say….” Hey, Dad/Mom, I need my meds.”

We are now going through all the motions needed to apply for the “highest level” of State Waiver required to allow him to be eligible for the assisted housing he would need if there are any units open.  Suffice it to say, he could not have undertaken this complicated, application process on his own.

Lack of services: Someone has to die before there is an opening!

I don’t think the problems we encountered are isolated to Pennsylvania.  There does NOT seem to be an easily understandable track for getting a person on a waiting list for housing for the Severely Mentally Ill (and that housing is extremely limited if you do get it.) For someone such as our son, if he qualifies, we were told the waiting list is long to get an ID waiver and there is about a two year plus wait “to get on the waiting list” for an Autism waiver. Sadly, someone has to die before another person makes it onto one of the waiting lists or gets a waiver. We asked officials what would happen to our son if something happened to us before an opening appeared. We were told that, unfortunately, our son might have to become HOMELESS for a while.

Sadly Pete, not much appears to have changed since you wrote your book. Our jails have become our new mental hospitals (only you don’t get the care you need in there). It is so disheartening and scary. Our society has seemingly taken more care in recent years to try to help those individuals with intellectual disabilities and/or Autism and forgotten about the needs of the severely mentally ill. They should all be treated the same and on the same level as any other medical problems. Since our son now has applied for the additional ID and Autism designations, we pray that the Bipolar-1 diagnosis will not impede our son from finding adequate housing under the ID or Autism authority.

We will continue working to protect our son. Meantime I pray a lot, ask for Divine guidance, and we try to help others and try to give back and pay it forward; hoping that someday someone might do the same for our son if something goes haywire and we are not around to help him. We live each day as normal as we can and we try to help others by volunteering at local missions and homeless shelters. We return from those trips always fearful how easily our son could become one of the men or women who we serve.

The post Two Important Questions For Parents Of Seriously Mentally Ill Adults: What Happens When Meds Harm? What Happens When Parents Age? appeared first on Pete Earley.

(2-7-20) Health and Human Services Secretary Alex M. Azar II told me during a 45-minute meeting that he intends to focus on improving mental health services.

I was invited to share my family’s story with Secretary Azar and Assistant Secretary for Mental Health and Substance Abuse Dr. Elinore McCance Katz and Shannon Royce, Director of the Center for Faith and Opportunity Initiatives at HHS, at the invitation  of Laura C. Trueman, director of HHS Intergovernmental and External Affairs.

I cited my family’s frustrating struggle to get help for my adult son, Kevin,  to illustrate barriers that Americans face.

I recounted how I had rushed Kevin to an emergency room during a psychotic break, only to be told that he was not considered dangerous enough to be hospitalized and treated. After we were turned away, my clearly delusional son broke into an unoccupied stranger’s house to take a bubble bath and was arrested and charged with two felonies.

Azar said he had heard similar stories from other family members and asked how HHS could help break roadblocks to care.

I recommended more funding for community services, adding more inpatient crisis care beds, supporting peer services and clubhouses, and helping develop better state laws that would protect individual rights but not insist that someone become dangerous before a loved one can intervene. We need programs that encourage “zero intercept” [less involvement] with police, I said, so we can shift individuals in crisis away from law enforcement and the criminal justice system into treatment.

I noted that the creation of a national hotline number for suicide – 988 – could be broadened by communities into a mental health hotline where professionals could triage callers and direct them to appropriate services.

I said parents often complain about how HIPAA is misused and, even though housing is under the Department of Housing and Urban Development, I explained that Housing First and Assertive Community Treatment teams have been among the most successful recovery programs I’ve seen when traveling to every state except Hawaii. (Some at HUD do not support Housing First because they believe it is not cost effective and rewards bad behavior.)

Finally, I spoke about the 45 recommendations that the Interdepartmental Serious Mental Illness Coordinating Committee has made to better coordinate mental health services delivered by federal agencies.

The secretary asked pointed questions, listened carefully, and showed specific interest in clubhouses, as well as, reviewing the dangerous criteria.

I left the meeting feeling grateful that Sec. Azar had met with me and hopeful that he will follow through with much needed improvements in our badly fractured system.

It’s a daunting task.

The post HHS Secretary Azar Tells Me He Wants To Make Mental Health Reforms A Priority appeared first on Pete Earley.

(2-11-20) President Donald J. Trump has proposed a record $4.8 trillion budget for the 2021 fiscal year and the Washington Post has published an Op Ed by Joe Grogan, assistant to the president and director of the Domestic Policy Council, outlining the administration’s mental health agenda.

I don’t like writing about politics on this blog because my interest is solely in mental health, not partisanship. But I found this editorial interesting, in part, because it reflects the thinking of D. J. Jaffe, Dr. E. Fuller Torrey, John Snook, executive director of the Treatment Advocacy Center,  and HHS Assistant Secretary for Mental Health and Substance Abuse Dr. Elinore McCance-Katz, as enumerated at a recent White House summit.  You can watch presentations at the summit by Jaffe, Snook, and McCance-Katz by clicking on their name. Once the Democrats choose a final candidate, I will post that individual’s mental health platform.

Americans have failed people with mental illness. Trump’s new budget will change that.

The post Trump’s Budget And Vision For Mental Health Clearly Influenced By Treatment Advocacy Center appeared first on Pete Earley.

A two minute testimonial from a recent Hope Clubhouse member (not the woman mentioned in this blog.)

(1-14-20) From My Files Friday: I’m a big fan of clubhouses and when I gave a keynote nine years ago at a fundraiser for Hope House in Fort Myers, Florida,  I heard an inspiring message worth re- retelling. (I will be speaking March 8th at the Key Clubhouse in Miami.)

 How A Clubhouse Changed My Life

First posted 10-24-11

The young woman giving her testimony had excelled in high school and gone to college with high expectations – only to have a mental break.  Diagnosed as having bipolar disorder, she became so ill that she was forced to drop out. At one point, she felt suicidal.

When she called the local police during a manic episode, rather than getting help, she got into an argument and ended up being arrested. She was jailed overnight, as an officer told her, “to be taught a lesson.”

That experience — at the hands of unsympathetic and poorly trained sheriff’s deputies — resulted in her developing PTSD. She was in such anguish that she simply wanted to give up —  until her parents got her to visit the HOPE CLUBHOUSE in Fort Myers, Florida.

“The HOPE CLUBHOUSE,” she said. “Saved my life.”

The clubhouse was launched in Fort Myers by a handful of concerned parents, who wanted someplace for their sons and daughters to go for fellowship and help.  It is modeled after the successful FOUNTAIN HOUSE program in New York that has been helping persons with mental disorders for more than sixty years. Fountain House has been copied across our country and in many foreign countries. Its roots date back to 1944 when a group of persons with mental disorders organized into a group that named WANA  — an acronym  that meant —  We Are Not Alone.

Clubhouses are run entirely by their members. A major emphasis is helping members find meaningful work, even if it is only for a few hours. The sickest might be given a simple task at the clubhouse such as wiping down a table or sweeping up.  But most clubhouses offer members transitional work that can help them later obtain paying jobs.

Jobs Give Members Confidence and Self-Worth

Here’s how a typical clubhouse program works.  The Square Peg Company needs a mail room employee so it contacts the clubhouse. The clubhouse might send one member to the mailroom to work for two hours at the job. That member will then be replaced by another member who works for three hours and finally by a different clubhouse member who finishes the shift. The mailroom job gets done each day, which makes the company happy, and three clubhouse members get work experience.

This model helps members whose illnesses might limit how long they can work at a task. It also helps members pump-up their resumes. Most importantly, it provides members with the opportunity to work, which gives them a purpose. It helps restore confidence and pride.

Having members run a clubhouse enables people who are sick to have a voice in their own recovery. Oftentimes, they are told by doctors, their parents,  other relatives or by mental health workers what they can and can’t do. They are told to lower their expectations.  Letting them be in charge and make decisions is important because it enables members to set their own goals and then strive to achieve them. Clubhouses also build a sense of community. If someone begins to have problems, the other members recognize it and intervene.

I have toured Fountain House and other successful clubhouse programs, such as The Carriage House, in Ft. Wayne, Indiana, and have seen how  the clubhouse model helps people recover.

As clubhouses expand, they often offer their members other services in addition to job training and fellowship. Many clubhouses help with housing.  Having a safe place to live is essential to recovery.

The young woman in Fort Myers met and fell in love with another clubhouse member. They plan to marry.  More important, she said she was  moving on with her life. She was no longer depressed. She was not alone. She became confident about her future.

One reason why I was so happy to speak at the HOPE CLUBHOUSE is because in my talks, I talk about the need for HOPE.

Hope Is At The Hub Of The Wheel

To me, recovery is much like an old fashioned wagon wheel.  Each spoke is a different recovery tool. Jobs are a spoke in this wheel, so is housing, so is medication, so is transportation, so is social acceptance — the spokes go on and on – because the needs of each person are different and require different services.

But the hub that pulls all of these recovery spokes together is HOPE. Without HOPE, there can be no recovery.

I am not naive. I do not believe everyone who is sick will eventually get better. Like cancer, severe mental illnesses are ruthless.  But most can and do, and even in the most severe cases, I believe that we must offer people HOPE.

I’ve seen cases where patients were described as being “un-restorable” and “treatment resistant.” Yet, they have recovered despite such hopeless tags. We don’t know who will get better and who will not. That is why we must offer everyone hope.

Actor Hal Lindsey is credited with saying:

Man can live about forty days without food, about three days without water, about eight minutes without air, but only for a second without hope.

(Happy Valentine’s Day: Remember To Tell Someone They Are Special Today!)

The post Speaker Was Suicidal But Found Healing, Hope, and Love At A Clubhouse appeared first on Pete Earley.

Photo courtesy of ABC News

(2-17-20) I was surprised late last month by Attorney General William Barr‘s choices for a presidential crime commission created to study how our criminal justice system interacts with Americans who are homelessness and have a mental illness. I only recognized one name on the list. This was BEFORE the recent criticism Barr has faced because of his decision to get involved in the Roger Stone case. I decided to check out the backgrounds of his selections. Here is what I discovered.

President Donald Trump issued an executive order late last month creating the President’s Commission on Law Enforcement and the Administration of Justice after repeatedly calling for a crackdown on homelessness and linking Americans with mental illnesses to violence.

While the President has an opportunity to use the commission to make much needed reforms, none of the 18 officials whom Barr selected work in cities with the largest homeless populations – San Jose, San Diego, Seattle, Los Angeles and New York City. Together those five account for more than 150,000 of the 564,708 homeless Americans. At least forty-five percent are believed to have a mental illness.

Instead, Barr chose police chiefs, sheriffs, and others in law enforcement from smaller jurisdictions with fewer homeless, such as Wichita, Kansas; Pinellas County, Florida; McKinney, Texas; and Shelby County, Alabama. While many of Barr’s choices have impressive law enforcement backgrounds, they come from communities that account for a combined total of less than 23,000 homeless residents. Los Angeles alone has 59,000. South Dakota counted about one thousand homeless residents in the entire state, yet its secretary of public safety was chosen by Barr.

Even more troubling, Barr’s handpicked appointees are overwhelmingly from red states and counties that voted for Trump in 2016, while the snubbed West Coast cities and New York City lean Democratic and have been frequently lambasted as “liberal” by Trump.

The presidential commission was created to investigate “challenges to law enforcement associated with mental illness, homelessness, substance abuse, and other social factors that influence crime and strain criminal justice resources,” yet only law enforcement officers are on the panel.

In 1967, President Lyndon Johnson used his executive powers to appoint an identical presidential commission. Its report led to important reforms in policing but its commissioners drew from outside law enforcement, including the president of Yale University, state legislators, law professors and representatives from the media, League of Women Voters, and National Urban League.

If the purpose of President Trump’s commission is to force the homeless, mentally ill and addicted from the streets by criminalizing them, then limiting participation to only law enforcement might make sense. But if the President is serious about his commitment to investing in solutions and community-based services then others with experience working across systems with at risk populations should be heard.

Even within law enforcement, Barr passed over three national experts. Miami-Dade Judge Steven Leifman created a national model that reduced arrests of the mentally ill for minor crimes clearly related to their illnesses. Jail bookings dropped, and the average daily inmate population in Miami-Dade declined by one-third, from 6,373 to 4,225. The change was so dramatic that officials closed one of their three jails, saving taxpayers about $12 million a year. The number of people homeless on the streets has declined.

For decades, Sam Cochran, a former Memphis police major, has been the face of Crisis Intervention Team training, which helps officers avoid deadly encounters with mentally disturbed individuals. People with serious mental illnesses are 16 times more likely to be fatally shot by police during an encounter and one count found 115 police officers were murdered by individuals with mental illnesses between 2011 and 2017. The federal Bureau of Justice estimates that today more than 400 police and sheriff’s departments in the U.S. and 1,000 overseas have implemented CIT programs, saving the lives of police and the mentally ill. Barr also ignored Ron Bruno,vice president of CIT International, a police officer, and a White House appointee to the federal ISMICC panel that advises HHS and Congress about mental health matters.

The commission will hold hearings where “subject matter experts,” such of Leifman, Cochran and Bruno can be heard.

That sounds reasonable, but how eager will the commission’s chairman, a Trump appointee in the Justice Department, be to seek testimony from officials in West Coast cities and New York City who were ignored by his boss and have been blamed by the president for mismanaging homelessness? Will a panel composed exclusively of law enforcement officers invite testimony from families such as Ron and Cathy Thomas, whose homeless son with schizophrenia, Kelly, was beaten to death by six Fullerton, California police officers?

If it does, then we will know its members are serious about exploring real reforms and their appointments were not simply pandering by Barr during an election year.

Commissioners on the Presidential Commission on Law Enforcement and the Administration of Justice include:

• Chair: Phil Keith, Director, Community Oriented Policing Services
• Vice-Chair: Katharine Sullivan, Principal Deputy Assistant Attorney General, Office of Justice Programs
• David Bowdich, Deputy Director, Federal Bureau of Investigation
• Donald Washington, Director, United States Marshals Services
• Regina Lombardo, Acting Director, Bureau of Alcohol, Tobacco, Firearms & Explosives
• Erica Macdonald, United States Attorney, District Of Minnesota
• D. Christopher Evans, Chief of Operations, Drug Enforcement Administration
• James Clemmons, Sheriff, Richmond County, North Carolina
• Frederick Frazier, City Council, McKinney, Texas/ Police Officer, Dallas Police Department
• Robert Gualtieri, Sheriff, Pinellas County, Florida
• Gina Hawkins, Chief of Police, Fayetteville, North Carolina
• Ashley Moody, Florida Attorney General
• Nancy Parr, Commonwealth’s Attorney, Chesapeake, Virginia
• Craig Price, South Dakota Secretary of Public Safety
• Gordon Ramsay, Chief of Police, Wichita, Kansas
• David B. Rausch, Director, Tennessee Bureau of Investigation
• John Samaniego, Sheriff, Shelby County, Alabama
• James Smallwood, Police Officer, Nashville Metropolitan Police Department

The Commission will meet monthly for the next year and then report its findings to the Attorney General, who will submit a final report to the President.

The post Attorney General Barr Puts Partisan Politics Above Common Sense In Naming Crime Commission appeared first on Pete Earley.

(2-20-20)  This story from the Washington Post raises questions about criminal justice and serious mental illness. Is it possible, as a state psychiatrist argues, that someone is so ill that he/she can never meet the court’s standards for restoration?  

For five years, as a criminal case against his former girlfriend Catherine Hoggle has held fairly steady, Troy Turner’s emotions have swung up and down.

They started with hope: He’d find the couple’s two children, Jacob, 2, and Sarah, 3, who’d gone missing after being under Hoggle’s care. That gave way to deep frustration: Hoggle wouldn’t say what happened to them, even as she was locked in a Maryland jail and then transferred to a state mental hospital. Then Turner came to a terrible conclusion: Hoggle had killed the children and wouldn’t tell anyone where their bodies were.

On Tuesday — while appearing before a judge who over the next few weeks will weigh whether to dismiss murder charges against Hoggle in the case — Turner got a chance to speak in court.

Hoggle sat just 15 feet away.

“I’ve heard people refer to it as a mystery. There is no mystery. Catherine planned, carried out a plan, and killed my children,” Turner said, his voice choking. “Right now, the person who murdered them, I’m looking at her.”

 

At issue Tuesday was a complicated legal question on how long a criminal defendant like Hoggle can be held in Maryland while she has been ruled mentally unfit for trial of her children. Under current Maryland law, a person charged with a felony can be held in a mentally incompetent posture for no more than five years, at which point charges must be dismissed.

Hoggle’s defense attorney David Felsen argued the deadline passed on Jan. 10, five years from the time Hoggle was determined to be mentally incompetent after her initial arrest on misdemeanor neglect and hindering charges.

“In this country, we don’t try people who can’t defend themselves,” Felsen said.

Montgomery County’s top prosecutor, John McCarthy, said the duration will not be up until Dec. 1, 2022, the five-year anniversary of Hoggle being ruled incompetent after her charges were elevated to two felony counts of murder.

Over the past five years, Maryland state psychiatrists have repeatedly concluded that Hoggle — who has a history of paranoid schizophrenia — is mentally incompetent to stand trial because she can’t understand her surroundings well enough. But they also viewed her as “restorable.” In a new opinion reached Friday, according to Tuesday’s proceedings, a state psychiatrist opined that Hoggle is no longer restorable. That is the first such opinion in the case, according to McCarthy and Felsen.

Earlier coverage: Family begs Hoggle to tell them what happened to children

No matter how Montgomery County Circuit Court Judge Robert Greenberg rules, Hoggle is hardly expected to be released any time soon from Clifton T. Perkins Hospital Center in Jessup. She instead would probably be ordered held there on a civil commitment.

That would be a shift, though, that Turner and McCarthy fear would ultimately make it easier for her to be released. Under a civil commitment, the hospital would have authority to keep her as long as they deemed her a danger to herself or others, according to Felsen and McCarthy.

“She’s possibly going to walk free one day,” Turner said in court, adding, “These are my babies. And Catherine killed them.”

Greenberg heard arguments from Felsen and McCarthy for an hour on Tuesday.

“These are weighty issues,” the judge said, indicating he’d issue a written opinion soon. Assessments that Hoggle is no longer “restorable” related to her mental competency could play a factor in whether Greenberg directs Hoggle to be civilly committed, according to questions he asked the attorneys on Tuesday.

Turner has spoken about his fears that if Hoggle is released, she would target the third child they had together. It is a concern he shared with the Maryland legislature in a bid last year to change state laws to extend the time someone in Hoggle’s position could be held without a trial.

“I have a 10-year-old, who was 5 when his brother and sister went missing, who is scared to death that his mother is going to come find him one day,” Turner told a committee last year in an effort that ultimately fell short.

The surviving boy “still has nightmares about her showing up with the bodies of his dead brother and sister,” Turner added in court on Tuesday. “He can’t defend himself if she’s out there.”

The crossroads in the Hoggle case play out all the time around the country, according to Christopher Slobogin, a Vanderbilt Law School professor and expert in the field. Courts hold that the government gets a reasonable amount of time to treat a defendant to the point of mental competency, he said, but as a medical matter that should take no more than a year.

At some point, a person who cannot be made competent is afforded the basic constitutional right to either be released or civilly committed to a mental hospital, according to Slobogin.

In cases like Hoggle’s — she is not only accused of killing her young children, but she is also accused of refusing to tell detectives where their bodies are — legal reality doesn’t inherently make sense, Slobogin said.

“I understand where Joe Public is coming from. They’re thinking she probably did this horrible thing, she’s probably dangerous,” he said.

Slobogin stressed, though, that shifting someone like Hoggle to a civil commitment will effectively keep her situation unchanged.

“If she remains dangerous, she could stay committed forever,” Slobogin said.

As for the hospital having the authority to release someone like Hoggle, Slobogin notes, that’s the way it should be. Research consistently shows those who commit violence that stems from mental illness are less likely — under proper treatment — to repeat their crimes than others, he said.

Earlier coverage: Hoggle keeps trying to escape from Perkins

In the case of Hoggle — a former waitress with an IQ once tested at 135 — Turner and other family members have alleged over the years that she has been faking the depths of her mental illness to stay out of state prison.

McCarthy said the shift to a civil commitment could change the control prosecutors and the court have in the case. He cited three reasons: It’s not a judge who decides whether she should be released, it’s Perkins; McCarthy would have no legal standing to make recommendations; and he would no longer have access to Hoggle’s psychiatric evaluations.

“If she is civilly committed, I have no control over her, nor do I have any access to information,” McCarthy said. “If they determine she is no longer a danger, they have to let her loose.”

Perkins had 281 patients as of last week, according to a hospital spokeswoman. Most had been ordered there by a judge in a pending criminal case. Only eight were being held based on civil commitments. Those eight have been at Perkins anywhere from one to eight years, according to the spokeswoman.

To McCarthy, that indicates that those who get civilly committed to Perkins are not necessarily there for lengthy stays. “I find those numbers frightening,” he said.

Dan Morse

Dan Morse covers courts and crime in Montgomery County. He arrived at the paper in 2005, after reporting stops at the Wall Street Journal, Baltimore Sun and Montgomery (Ala.) Advertiser, where he was a Pulitzer Prize finalist. He is the author of “The Yoga Store Murder.”Follow

The post Seriously Ill Mother Declared “Not Restorable” By State Psychiatrist In Horrific Murder Trial. Is That Possible? appeared first on Pete Earley.

My Reasons I want CRSP to remain open:

It helps me regulate my emotions.

It’s structural and continuance.

Its grouping and socialization structure

improves my mental health.

Its classes help my physical health.

— written appeal from client to Fairfax Officials

Dear Pete,

For the third time in less than four years,  an excellent service here in Fairfax County called the CRSP, Community Readiness and Support Program, is being threatened with “REALIGNMENT” from public health provider, the CSB, to an outside mental health contractor.

CRSP is a day support program that offers psycho-educational, pre-vocational and group treatment methods for adults with serious mental illness and/or co-occurring disorders. The program “focuses upon assisting the consumer to improve living skills needed for successful community living.”

The Fairfax County Falls Church Community Services Board  (CSB) is considering transferring the services that CRSP provides clients to an outside mental health service provider – PRS (Psychiatric Rehabilitation Services.) 

In the past CRSP clients and their families succeeded in stopping such a move. In 2015, CRSP Clients and parents convinced the CSB to maintain CRSP, but two years later, CSB executives tried again.

CSB would not answer any questions asked by clients and family members, but stated it was a budget issue.  Upon research, the advocates for CRSP, which included the Northern Va Chapter of  NAMI, found that the program would cost more with less services at PRS.

CRSP clients and advocates were able to present this evidence when they spoke during a public hearing before the Fairfax County Supervisors.  The Supervisors reworked the county budget to keep CRSP in the CSB.  They understood the value of CRSP in the lives it affects.  The Fairfax County Board of Supervisors also fully understood that CSB was transferring a program under the title of saving County funds, when the PRS program would cost taxpayers more.

In 2018, CRSP’s offices were moved from the Springfield location to the CSB Merrifield Building.  The move was done in a transparent manner with input by clients and their families.  We applauded the process of the move.  CRSP clients are  now in a spacious location with views of the surrounding areas.  Other than losing their immediate McDonalds in Springfield, VA, CRSP clients are thriving in the Merrifield location.

That should have been an end to the turmoil, but it wasn’t. We’ve discovered CRSP is being “realigned” and this may again mean moving CRSP to PRS.  Daryl Washington, the executive director of our Community Service Board, acknowledged that  a realignment is being considered but would not answer further questions.  Mr. Washington stated CSB is in the midst of the procurement process, so they legally can’t answer the CRSP advocates questions.

On February 2020, a CRSP parent wrote to her County Supervisor and to Chairman Jeff McKay:

           “There are many rumors that the CRSP program is closing, and its services are being rolled into PRS (Psychiatric Rehabilitation Services), ending its many years of successful launching of many Fairfax County citizens to more productive and healthier lives –truly the mission of the CSB. 

This is puzzling, because my son has not been informed of any closing and there has not been, to my knowledge, any outreach to those most impacted by a possible closing. It is a small program with only 4 staff members, and yet, because of each of the staff members’ devotion to the CRSP population, CRSP clients have thrived.

CRSP serves an interesting population, and if you visit the third floor at the Merrifield CSB, you will see Fairfax County Citizens who share a need for community, a support for each other and a diversity of needs, all with exceptional abilities.

My son, for example, has been diagnosed with Autism, Developmental Delay, Bipolar, Schizoaffective Disorder and other mental health issues. He does not fit easily in any category, which is the uniquely wonderful thing about CRSP. It has been a support service with flexibility to meet the needs of its clients where they are. 

I am concerned that the CSB will lose this valuable resource –CRSP– and the wonderful people who staff it. It probably saved my son’s life. I ask that you please look into why CRSP is closing, if it is. And if it is closing, why has there been no time provided for those impacted to comment or question this move?”

My husband and I are calling attention to the plight of CRSP because our beloved son told us that CRSP gave him “hope.” Our son, Thomas Michael Jaeger, age 47, died of a heart attack on Memorial Day, 2019.

In Memory of our son, we are asking for support that CRSP remain in the able hands of the experienced and competent counselors of the Fairfax Falls Church CSB.   Please support CRSP, not only for current clients and those on the waiting list, but also for future sons and daughters in need of the CRSP program’s “hope.”

If you live in Fairfax County, VA, please call or send an email to your Fairfax County Board of Supervisor and to Chairperson McKay,  703-324-2321, and ask the Board of Supervisors to support CRSP remaining in the CSB.

Thank you,

Helen and Tom Jaeger

Here is a copy of the email that we sent to Daryl Washington:

To:  Daryl Washington

From:  Friends of CRSP

Ref:  Possible Transfer of CRSP to PRS

1. What is the reason for reassessing CRSP, CSB’s Shining Star program to PRS?This is the 3rd time in less than 4 years CSB is reassessing to move CRSP.  We feel the clients and their families need to know why.
2. What will the level of services be at PRS compared to the level at CRSP?  Ex.  CRSP staff to clients 1:4. Will the staff at PRS have the same level of experience as the CRSP staff; education, experience with SMI clients and dual diagnosis clients?  

3. What will the cost and level of services be at PRS compared to CRSP?  Plus what will the startup cost be to move CRSP?  In other words what are the budget/contract details of the possible plan of moving CRSP to PRS?  What will be in the contract with PRS?   
4. What will happen to the clients who can’t be serviced by PRS? 

Respectfully,

CRSP Friends

    Gordon Dean

    Helen Jaeger

    Reed Scarce

    Jane Thatcher

Here is how Daryl Washington responded when I emailed him an advance copy of this blog and asked him about the writers’ concerns:

Dear Pete,

We are in the procurement process, so can’t get into too many details.  This is the executive summary:

• The level of care currently provided by this program will continue.
• There will be no reduction in services or capacity.
• The staff to client supervision ratio won’t change significantly.
• The CSB will be able to serve more individuals at no increased cost or reduction in quality by making this move.
• The provider is licensed by DBHDS and has CARF Accreditation. 

I am happy to provide a greater degree of detail to everyone as soon as it is appropriate.

Regards,

Daryl

The post Fairfax Va. Families Worried About Fate Of Small But Important Recovery Program appeared first on Pete Earley.

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(2-26-20) THIS IS NOT ABOUT MENTAL ILLNESS.

Before I wrote, CRAZY: A Father’s Search Through America’s Mental Health Madness, I authored three books about spies. The History channel recently released a podcast about the CIA traitor Aldrich Ames based, in part, on a long interview with me.

My account about Ames is unique because I was able to interview him without any government censors being present – thanks to a misstep by federal prosecutors.

Early on, prosecutors declared that no journalists would be allowed to speak to Ames without prior FBI and CIA clearance. They informed the judge hearing his case, the FBI, the CIA, and defense attorneys for Ames. But they failed to tell the jailers where he was being held. When I showed up, I was allowed inside and spent 11 days interviewing him before prosecutors discovered it.

From the jail, I traveled to Moscow where I spoke to his KGB “handlers” and then back to the states where the CIA mole hunting team, that had captured him, spoke with me. The result: Confessions of a Spy: The Real Story of Aldrich Ames, published in 1997, is considered the definitive account of the case.

A funny story about the History channel podcast.

When its producers called the CIA to verify information, the agency used my book to “fact check” the broadcast – including the accuracy of my comments!

About the same time the podcast appeared, two friends of mine, published a new book entitled, Spy Sites Of New York, which is part of a series they’ve written.

This book is not some quickly done Map of the Stars offering. Robert Wallace and H. Keith Melton, along with Henry R. Schlesinger, packed their book with fascinating details about spies in the Big Apple.  On Thursday, March 5th, at 6 pm ET, they will be talking about their finding – where else but the KGB Espionage Museum at 245 W 14th St New York, NY 10011. Gerald Goodwin, the head of the New York Chapter of the Association of Foreign Intelligence Officers, will moderate the talk. The $30 ticket price will include a copy of the book, plus an exclusive tour of the museum.

If you live in the New York area and want to learn from two experts, get your ticket!

More spies from more countries are operating today in New York than in any other city. Why New York? The answer is revealed in the newly released Spy Sites of New York City by intelligence historian H. Keith Melton and former CIA senior officer Robert Wallace. From the intrigue of Revolutionary War espionage by the Culper spy ring through Alger Hiss’ clandestine meeting in a mid-town movie theater with his Soviet case officer to 21st century Russian spy Anna Chapman’s using covert internet communications in a Manhattan Starbucks, Spy Sites views New York through a spy’s eye. 230 entries and associated images chronicle and depict secret encounters, drop-sites, street corners, bars, hotels, and parks where shadowy history is made. Spy Sites is the old, yet fresh, story of tradecraft and deception in a city that grew from a small settlement on the tip of Manhattan Island in the 1700s to an international metropolis. Lesser known episodes about the secret intelligence work of author Ernest Hemingway and designer Bill Blass during World War Two share pages with cloak-and-dagger operations emanating from iconic locations like the Empire State Building, Central Park and and Rockefeller Center. Readers may be left with an eerie sense that in New York any waiter, cabbie, or woman playing Candy Crunch on the subway might be much different than they appear to be. In the city where espionage never sleeps, spies know no boundaries.

Spy Sites of New York City is available on amazon.com or a local book store. Autographed copies ($30 including shipping and handling) may be ordered by sending an email to bobwq@yahoo.com.

Sites of New York City

Book review by  William D. Rubinstein

     Spy Sites of New York City is a rather unusual, intelligently written and well-produced guide to buildings and other the other places in New York City and its suburbs associated in the broadest sense with spies and espionage, from the period of the American Revolution to the present age of terrorism. The realities of contemporary Great Power politics also mean that there is an entry for the Permanent Mission of the Russian Federation to the United Nations (on East 67th Street), which is apparently ‘[known as a base for espionage operations’.

     This richly illustrated book is arranged by time period, with, among others, 22 pages devoted to spies of the American Revolution, and 63 pages to espionage under the heading ‘Fascism, Communism, and World War II’. Each chapter is arranged in the form of entries for each relevant place, with, for instance, 52 separate entries in the ‘Fascism, Communism and World War II’ chapter, and some 233 entries in all. The individual entries are unusually well researched and written, and are notably free of tabloid sensationalism.

Continue reading here.

The post History Channel Podcast About CIA Spy Aldrich Ames Features My Work; New Spy Book By Friends Worth Reading appeared first on Pete Earley.

Illustration courtesy of Psychology Today.

(3-2-20) I published an inspiring blog last June about parental guilt written by Faith Tibbetts McDonald, an author and fellow parent of an adult son with a serious mental illness. I met Faith after giving a speech and am thrilled that she has continued to write about her journey in a new book, offering thoughtful advice based on her own experiences.

Am I a helicopter parent? Or healthy in my fierce efforts to ensure my son’s mental health?

By Faith Tibbetts McDonald, author of  On The Loving End Of Crazy.

One gray day last winter, I noticed that my adult son who suffers bouts of major depression and usually stops by our house for coffee on his way to work had not stopped by for two days in a row.

I called his phone. The call went straight to voice mail.

The symptoms of depression ticked through my mind: fatigue, excessive sleeping, feelings of worthlessness, hopelessness. Sometimes, thoughts of suicide.

I drove to his apartment. The mile and a half seemed longer than usual.

His car was in the driveway. He hadn’t gone to work.

To calm my anxious thoughts, I inhaled slowly and let myself in to his house.

I barged to his bedroom where the blinds were pulled shut. He was in bed with the covers drawn up over his head. “I can’t get up,” he murmured.

Not the worst scenario my runaway worries had conjured.

I sat down on the edge of his bed.

“I’m going to sit here until you do get up. And then we will call a doctor.” 

“No, I don’t need a doctor. It’s just the winter blues,” he said as he rolled over, secured the covers around his shoulders, and burrowed deeper into his bed.

“Your medication needs to be adjusted.”

“No, I just have the winter blues.”

I knew better and shifted my efforts to promote my son’s health into high gear.

I made a list: doctor’s appointment, counseling appointment, some kind of exercise, joy-seeking excursion.

With one click on Amazon, I ordered an alarm clock that gradually fills a room with light to mimic the rising sun. It’s supposed to help individuals wake up feeling energetic and happy. Spoiler alert: it didn’t help. Turns out, a person has to set the clock religiously.

My son is an adult.  I can’t visit his apartment and set his alarm clock every night. Or make doctor’s appointments for him. Or force him to the appointments.

Convincing an adult to seek mental health help takes an enormous amount of fortitude and negotiating finesse.

And that’s not the hard part.

Every time I set out to help my son, accusations that are prompted by ideas that circulate in our culture, blare in my thoughts: “Helicopter parent!” “Enabler!” “He has to hit rock bottom and then he’ll seek help.” “You’re over-parenting.” “He has to learn to be his own advocate.”

So, while determining when and how to step in to help, and when and how to step back and let him adult on his own is challenging, negotiating my complicated feelings about that struggle takes intentional thought. I’ve learned to give myself a lot of grace.

What I really want is for my son to develop healthy practices that maintain his own health.

However, sometimes his illness paralyzes and hinders his ability to care for himself.

Walking the fine line between urging him to independence and stepping in when his illness cripples him requires discernment, courage, tenacity and grace.

I need to step in when help is needed.

And step back when he’s healthy enough to function on his own.

Because signs of his illness are not obvious like a bleeding gash or protruding, broken bone, it’s easy to forget, as one health professional told me, “Right now, his brain his broken. That means the part of him that makes good decisions isn’t working.”

To complicate things, when he is ill, he doesn’t ask for help. His illness causes him to drift into himself.

If you love someone who struggles with mental illness, you may find yourself facing a similar struggle. As I determine when and how to step in, here are some practices that work for me:

1. I watch my son’s behavior for signals about the state of his health. I try not to be invasive like a paparazzi photographer. I watch from a discrete distance. When I notice physical signs that he’s struggling, say he misses work, or comes by to visit and doesn’t smile when the dog greets him, or he stops over and lays on the couch for hours, I know it’s time to step in.
2. I ask questions. Examples: You don’t seem very happy to see the dog, what’s going on? What can I do to help you maintain your health this week?
3. I talk to him about how his behavior affects me. I like it when you stop by for coffee in the mornings. I worry when you don’t stop in. If you decide not to come by, could you text me? Or do you mind if I text you? You and your health are important to me. Let’s maintain it with a proactive approach that works for both of us.
4. Once during a dark time, at a counselor’s suggestion, we selected a code word that our son could use if he felt he was spiraling to suicidal thoughts. Now, I can’t remember the word we chose. At the time, having a code word as a tool reminded us that talking about difficult aspects of illness is necessary and possible.
5. Seeking counseling together is an option. We are all doing the best we can in the throes of this illness. When things get tense, I suggest that we get counseling together. Finding a good counselor is a challenge, and my son has never agreed to our getting counseling together, but pointing to it as an option has helped us talk through some difficult matters.
6. When I insist that my son get help, I find ways to offer options. When my son goes through a stint of depression, he is so stymied by the heaviness that cloaks him that he can’t identify areas in which he needs support, so I offer choices: I can make you a healthy meal. I can ask you repeatedly to go on a walk with me. I can drive you to your appointments. What will be helpful?  When I insist that we are going to get medical help, I say here are some options you can choose from: emergency room? Family doctor? Psychiatrist?
7. I provide room in our relationship for him to get better. When he’s healthy, I step back but still work hard to build our relationship.
8. I am compassionate with myself regarding my complicated feelings. Once in a while, I give myself permission to do silly things prompted by worry if doing so helps me feel better. However, I allow my son as much independence and control of his own life as he is able to handle. I don’t want to interfere, but I will when his well-being demands it. The only way I have found to live with the emotional tension I feel is to acknowledge that it exists and that I am doing my best to navigate it.

Maybe there’s a scenario in which the popular advice to wait for someone to hit rock bottom is good advice. But that’s someone else’s story. When it comes to mental illness, people need to step in for their loved ones.

And then there’s the stepping back.

As much as I wish I could, I can’t get better for another person. On the sidelines of another person’s life, I can educate and encourage, but I can’t do the healthy practices that may lead to more vibrant health for him.

I’ve learned that loving someone who struggles with mental illness requires surrender, versatility and lots of communication.

After a stint in the hospital during a mental health crisis, our son lived with us for a few years. He began to talk about moving out which prompted worry for me. How would I keep an eye on his health?

I explained to him: I am never going to say, “Yes, this is a good idea… but you know what’s a good idea for you. Do it!”

We can’t win the struggle for our loved one’s health but we can support them in healthy ways.

We can allow them the space in which they can grow.

And we can be healthy ourselves. It’s not healthy for me to accept labels like “helicopter parent” that indicate I’m parenting inadequately. More accurately, I’m a mother who loves her son. I will sacrifice my comfort for his. I am fierce in my effort to seek my son’s health.

That’s who you are, too. Own it.

About the author: Faith Tibbetts McDonald is an assistant professor of teaching in the English Department at the Pennsylvania State University. Her book On the Loving End of Crazy—One Mom’s Story of Hope is a mother’s true story about parental coping when a loved son becomes crippled by anxiety and depression and after a series of lawless, self-destructive acts, attempts suicide. The book was written to bring hope and help to people who love someone whose life is unraveling due to mental illness. As one reader says, “After reading Faith’s work, we’ll all be better at the hard stuff.”

The post “Am I a helicopter parent? Or healthy in my fierce efforts to ensure my son’s mental health?” Author asks. appeared first on Pete Earley.

(3-6-20) I’m a big fan of Clubhouses, especially Fountain House in New York City, which is the granddaddy of them all. So I am thrilled to be speaking in Miami this weekend at a fundraiser for The Key Clubhouse of South Florida.

It was founded in 2008 by a grassroots group of family members and a young person with lived experience who wanted to provide a warm and safe place for individuals with mental illnesses where they could get help reintegrating into the community. This is what I like best about Clubhouses – nearly all are created by local advocates who are determined to help others and they are run by persons with lived experience!

It took two years to raise enough money to open the doors to its first Clubhouse in downtown Miami for 10 members. Word quickly spread and by 2013, the Clubhouse had moved into a larger building that included a culinary unit and dining room. The goal of Sunday’s event is to raise funds for an even larger facility to serve more members.

The folks at Key Clubhouse have done a fabulous job in designing useful programs. They offer an accredited “recovery through work” program that helps those who are able improve their lives through meaningful employment. They offer pre-employment skills building, a wellness program, social activities, assistance accessing medical services and housing and daily, personal counseling.

If your community doesn’t have a Clubhouse, it should!

Christine Dimattei, a reporter for WLRN radio in Miami, the local NPR affiliate, did a four minute interview with me, during which I quickly described how Miami has transformed itself from the hellhole that I describe in my book, CRAZY: A Father’s Search Through America’s Mental Health Madness, into a model system that is being emulated across the country.

Mental Health ‘Clubhouses’ Emerging As Safe Havens For People With Serious Mental Illnesses

Right now, concerns over the spread of the coronavirus are dominating the news. But in recent years, lawmakers in Florida — and nationwide — have increasingly focused on mental health and its impact on overall health.

According to federal health officials, one in four American adults suffer from a diagnosable mental disorder in a given year. And it’s not uncommon for a person with a serious mental illness who acts out in public to get a jail sentence instead of treatment.

That’s what happened to former Washington Post reporter Pete Earley’s son Kevin, who suffered a manic episode during his senior year of college.

“My son was arrested because he broke into a stranger’s house. Luckily, no one was there. He broke in to take a bubble bath,” says Earley.

After Kevin’s arrest, Earley researched how the criminal justice system deals with mentally ill people — a story told in his 2007 book “Crazy: A Father’s Search Through America’s Mental Health Madness.”

His journey took him from his home in Fairfax County, Virginia to Miami-Dade County’s main jail, after attempts to visit other cities’ jail systems fell flat.

“I had tried L.A. and lasted two days before they threw me out of the jail, claiming I was violating HIPAA,” says Earley “I tried Chicago. They said ‘No.’ Rikers Island said ‘No.’ Baltimore said ‘No.’ And Washington — they said, ‘Hell, no’.”

Earley went to Miami at the invitation of Miami-Dade County Judge Steven Leifman, who would go on to create the county’s Criminal Mental Health Project, a program designed to divert people with serious mental illnesses away from jail and into community-based treatment and support services.

Pete Earley is coming back to South Florida this weekend for a fundraiser to benefit the Key Clubhouse of South Florida. The ‘clubhouse’ model has been steadily gaining popularity worldwide as an alternative to conventional treatments for severely mentally ill people; it offers a path to recovery called “psychosocial rehabilitation.”

“It offers people who feel alone — who feel that no one understands them — a social connection,” says Earley. “It helps them get jobs. It helps them learn skills. It can provide all the services that someone needs to get that step up to help them become productive members of society.”

If you have a Clubhouse in your community, please share its story on my Facebook page, especially how you were able to launch it and keep it funded. Your story might help those without Clubhouses.

The post Working Together, Families And Young Advocate With Mental Illness Opened A Clubhouse That Is Rebuilding Lives appeared first on Pete Earley.

by Elizabeth Chou | Los Angeles Daily News

With little access to hand-washing stations, shelter, sanitary restrooms and medical care, Los Angeles County’s homeless population may be hit especially hard during a novel coronavirus outbreak, public health officials said this week.

“Many of the strategies that we ask people to take — for people who are unsheltered, are actually impossible,” Dr. Barbara Ferrer, director of the Los Angeles County Public Health Department, told the LA County Board of Supervisors.

On the heels of the county’s declaration of a health emergency, Ferrer said extra measures have been launched to help the nearly 59,000 people experiencing homelessness countywide, with more than 44,000 unsheltered, overcome those obstacles.

Health officials have begun visiting the county’s 300-plus homeless and short-term shelters to ensure adequate measures are in place, and that there is access to medical providers, she said.

The public health department also issued a five-page guidance for homeless shelters that calls for ensuring a well-stocked hand-washing stations to be available all through the facility.

“They cannot stay home when they’re sick,” she said. “They cannot wash their hands, (or) often infrequently. And a lot of the times they do not have a medical provider that they are in contact with.”

She added that many people who are homeless tend to be “sicker than the general public and already have heightened mortality rates.”

“So we are very concerned that a novel coronavirus can disproportionately devastate people who are experiencing homelessness,” she said.

County officials on Wednesday declared a local and public health emergency in an effort to ensure resources are available if the illness spreads. On Thursday, health officials confirmed four additional cases of the illness, also known as COVID-19.

Ferrer is also meeting with the other departments and agencies, including the Los Angeles Homeless Services Authority and the county’s emergency management department, to discuss the best ways to quarantine and “house people who have mild illness, and don’t require hospitalization,” in the event there are cases among those who are homeless.

“We need to make sure that these are full service facilities where we can be prepared to allow people to heal and get better and allow their quarantine period in a safe and secure environment,” she said.

Another possibility is also to keep winter shelters open longer, she said.

“What we don’t want is a lot of people now going back to the streets when we could be facing a possible outbreak situation,” said Ferrer.

She said the county is also consulting with the state health department on the matter.

“This is a unique situation only to L.A. County, to be honest, in terms of the magnitude, but it’s something that we absolutely are going to need to be prepared to address and address very quickly.”

Los Angeles Council members Monica Rodriguez and Mitch O’Farrell on Wednesday introduced a motion requesting that emergency funding be used to install hygiene facilities at homeless encampments citywide.

It was unclear how many hygiene stations may be deployed, and how much they would cost. Mobile stations had been under discussions in recent years, particularly after a Hepatitis A outbreak in Los Angeles in 2017, with more than a dozen deployed across the city over the next two years.

Hygiene stations were recently also incorporated into the Los Angeles Sanitation Department’s encampment cleanup program last fall, and as of December, three mobile hygiene stations were deployed with the clean-ups, out of seven total that are expected to up and running by this year.

Rodriguez’s office has coordinated with the sanitation department, and homeless services agencies, and the state to address public health and housing needs faced by residents of an encampment in Pacoima, along Bradley Avenue. The encampment is visited by one of the sanitation department’s mobile hygiene stations.

The post For homeless, coronavirus guidelines can be ‘impossible’ Are your local officials prepared? appeared first on Pete Earley.

Seriously mentally ill prisoners held by the federal Bureau of Prisons are no longer supposed to be housed in isolation cells such as this example.

(3-09-20) Government advisory committees do exactly that. They advise. There’s no guarantee anyone will listen. Agencies have their own experts and priorities, and so do the political appointees appointed by the president to run them.

I understood this when I was appointed to serve on the newly created Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC), which was created by Congress to foster collaboration and communication between the nine federal departments and agencies that deal with more than a hundred mental health/substance abuse programs.

With support from my fellow non-federal board members, I have focused on the federal Bureau of Prisons (BOP) and our panel’s recommendation that it find ways to reduce long term isolation and restraints when dealing with seriously mentally ill patients.

While the Justice Department was required to participate in ISMICC, Congress didn’t mention the BOP. This was unfortunate because the federal prison system houses 175,315 prisoners, including several who have serious mental illnesses (most notably Ted Kaczynski, the Unabomber.)

Sadly, the BOP has a dismal record when it comes to its treatment of seriously mentally ill inmates. In July 2017, the Justice Department’s Office of Inspector General found that on average, BOP prisoners with serious mental illnesses were confined about 896 consecutive days, or about 29 months, in so-called “special management units (isolation)” between 2008 and 2015.  Incredibly, 13% of these inmates were released directly into the community after spending an average of 29 consecutive months in seclusion cells with minimal treatment.  A study by the Marshall Project a year later questioned claims by the BOP that it was enacting changes to improve mental health care and took issue with the BOP’s claim that only three percent of its prisoners had a mental illness. The general accepted statistic is that 16 percent of incarcerated individuals have a diagnosed mental illness.

Twelve of my fellow non-federal ISMICC members joined me (only one didn’t sign on) in asking the BOP Director to begin participating in ISMICC meetings. The then-director agreed but he ended up being replaced last year and the BOP delegate missed our last two meetings.

Undaunted, thirteen of us sent a second letter requesting BOP participation to its new director, Kathleen Hawk Sawyer. 

I was optimistic because I had encountered Hawk Sawyer in the 1980s when I was doing research for my book, The Hot House: Life Inside Leavenworth Prison, having been given unlimited access to spend a year as a reporter inside a federal penitentiary. A trained psychologist, Hawk Sawyer served as the Chief of the BOP’s Psychological Services in the 1980s and eventually became the first woman to head the male dominated agency when she was named its director in 1992. She served as director until 2003 when she retired only to be brought back in August 2019 because the bureau needed a veteran’s steady hand. (Director Mark Inch abruptly resigned after tangling with the White House.)

On February 24, 2020, Director Hawk Sawyer sent me a letter addressing the concerns that 13 of us had raised about the BOP’s lack of ISMICC participation.

“As the Director and as a psychologist, I am aware of the challenges individuals with mental illness can face in prison and the positive difference treatment can make in their lives,” she wrote.

Continuing, she wrote:

“The BOP is committed to reducing the use of restrictive housing, especially for inmates with serious mental illness…We have made significant strides in this area. For example,:

All inmates with serious mental illness are screened by a psychologist within 24 hours of entering a restrictive housing setting to ensure their safety and identify alternatives, if appropriate.

All inmates referred to (higher level isolation units) are screened by psychologists in the Central Office (Washington) and those with serious mental illness are precluded from placement in these settings. 

BOP has implemented effective strategies to monitor inmates for emerging mental illness in restrictive housing and to remove them promptly, if necessary.

BOP added three secure mental health programs over the last seven years to divert inmates with serious mental illness from restrictive housing and provide intensive treatment.

In November, 2019, I approved three additional secure mental health programs that will activate over the next two years, providing intensive treatment opportunities to inmates with serious mental illness outside of restrictive housing.

In December, 2019, I approved 10 reintegration unites to hold inmates in protective custody status, including those with mental illness, in safe, open unites with work, program, and treatment opportunities.

In December, 2019, I approved the BOP’s second Female Integration Treatment Program to provide residential treatment, including mental health treatment, to female inmates.

Director Hawk Sawyer concluded: “the BOP is working diligently to reduce the use of restrictive housing for individuals with serious mental illness.”  She also assured us the BOP would actively participate in future ISMICC meetings.

Those of us who have had a family member in a jail or prison know how easily it is for them to be put in isolation and restraints. We also know how damaging that can be – exasperating their illnesses.

All of us appreciated Director Sawyer’s response and her update.

The day after she wrote her letter to me, Attorney General William S. Barr appointed a new director to replace her.

Michael Carvajal first joined the BOP in 1992 as a correctional officer. He has no psychological training. He is now in charge.

Time will tell whether he will follow through on Hawk Sawyer’s efforts and pledge to reduce long term isolation and restraints.

Let’s hope so.

The post BOP Director Promises Better Treatment For Mentally Ill Prisoners – A Day Before She Is Replaced appeared first on Pete Earley.

(3-13-20) From My Files Friday – In late 2016, I posted a blog about retired Air Force Brigadier General Gary Ambrose who’d received an award for leadership and advocacy in my home state of Virginia.  During his acceptance speech, the general spoke eloquently about his son, Brad. The general continued to advocate after receiving the award, overseeing the jail diversion program in Fairfax.  

“Our full time mission became keeping him safe and alive.”

by Gary Ambrose:

Like many others, our family became mental health advocates by necessity.

We were advocates for Brad, who, for 17 years, lived with paranoid schizophrenia and the voices that urged him to take his own life.

Brad was intelligent, articulate, well-read, and charismatic. We shared a sense of humor. Of course, we loved him. But more than that– we liked him. He was our son, but he was also a friend. During “good times,” when he was medication compliant, he was a pleasant companion. 

He was a peer mentor in the NAMI Peer To Peer program and the first chairman of the Mental Health Subcommittee of the Fairfax County Re-entry Council. In the spring of 2014, he was the first person with mental illness to be highlighted on Channel 4’s “Changing Minds” segment. He was passionate about improving life for people with mental illness.

He had potential.

But, he had also spent many of the 17 years of his illness cycling through the healthcare and legal systems, and was, much of the time, a danger to himself.

Brad’s illness took him from us in 2014.

In retrospect, he first manifested his illness when he was 18 years old.

At the time, we concluded that his “aberrant” behavior was the result of recreational drug use. A psychiatrist to whom we referred Brad asserted that his was the rebellious behavior of a normal, young male, and that “you’ll all laugh about this in 10 years.”

As time passed, Brad’s situation deteriorated, and we were ill-equipped to help him.

Eventually, his illness was diagnosed.

In the beginning, my wife, Marcia and I did the best that we could with no knowledge of mental illness and little available guidance We engaged emergency room staffs; various reps of human services organizations we didn’t understand; Fire and Rescue; law enforcement; prosecutors; public defenders; psychiatrists, both private and public; private attorneys; and so on.

Over the years, whenever Brad lived in our home, we carefully managed his medications to hopefully ensure that he was medication compliant. We worked hard to keep him compliant. He outsmarted us a lot.

Our full time mission became keeping him safe and alive.

In one year alone, Brad was hospitalized 20-plus times for psychiatric issues and overdoses.

We had him temporarily detained for hospitalization five times to protect him from himself.

There was no roadmap to the help we needed. We engaged with elements of the Community Services Board (CSB)–such as the Mobile Crisis Unit–without understanding their role in the big picture of mental healthcare treatment in Fairfax County.

We were always in crisis mode.

Brad’s illness also led to legal problems. Over the years, when he was non-compliant or when his medications lost their effectiveness, his behavior would deteriorate and result in encounters with law enforcement. We estimate (when Brad wasn’t living with us, we sometimes had no idea of his whereabouts) that he served multiple years in jail or in the forensics units of State hospitals.

On one hand, his incarcerations caused us much distress. On the other, they offered some sense of relief because we hoped that jail offered relative safety. At least we knew where he was and that he was in a controlled environment. Of course we were naive in that respect, but that’s a separate topic.

Fifteen years into Brad’s illness, we discovered that there is help.

First, we participated in NAMI’s Family To Family classes—which I considered a life-changing experience. The classes helped us to understand that we were not alone, that our situation was not unique, and that there were options available to us to help us advocate for our son–and ourselves.

NAMI made us aware of Concerned Fairfax, a grassroots mental health advocacy group focused on addressing real-time challenges for people like us—issues like transparency of services and housing options. Our participation with Concerned Fairfax afforded us an opportunity to achieve some influence over our own situation through advocacy.

Through our participation in NAMI and Concerned Fairfax, we learned about the Fairfax Falls Church Community Service Board (which oversees mental health programs) and the role that it plays in delivering the services our son required. Jeanne Comeau, President and CEO of NAMI Northern Virginia, suggested I volunteer to fill a vacant CSB board position, adding “if you really want to get involved.”

I submitted my resume and was appointed to the Fairfax-Falls Church CSB board in 2013. Meanwhile, Marcia joined the NAMI Northern Virginia board, and our daughter became a Resource Advisor for NAMI’s Family To Family program.

Whenever Brad lived in our home, we often transported him to appointments with his case managers and his psychiatrists. He ensured that we knew them, and in the final two years of his life he’d often invite us into their offices for the last 15 minutes or so of an appointment.

Following Brad’s death, it was a struggle for us to visit some of the facilities where he/we had participated in meetings or where he had received treatment. In the days immediately following Brad’s death, we reevaluated our advocacy involvement, as continuing to participate on the CSB board, in NAMI, and in Concerned Fairfax was painful.

Brad had seemed to be doing so well as a peer and had achieved so much in a short time.

Why, then, did this happen to him?

We have no answers. Maybe they’ll come, in time.

We have wrestled with guilt. What should we have done that would have saved our son’s life?

In our struggle for answers, our family came to believe that it’s important for us to continue to be advocates on behalf of people living with mental illness, so that other families might benefit from our experience. I believe that we’ve all found that remaining involved in something that Brad considered important is a potent kind of therapy.

Lessons We Learned

Through our 17 year odyssey with mental illness, we’ve learned a lot and the lessons are clear:

First, the caregivers who included our family as part of the treatment team were the most successful in helping our son.

At the end of the day, we were Brad’s caregivers for the long haul. Ours was the task of keeping him alive. For caregivers who kept us away, or when Brad revoked permission to divulge information, we remained in the “transmit’ mode, telling the caregivers what we thought they needed to know to help our son.

Second, it’s important to include peers in the process as they can relate in ways we simply could not. We had tried without success for several years to encourage Brad to explore peer engagement with NAMI. A NAMI peer mentor, whom we and Brad met via our Family to Family class, finally influenced him to explore that option. I speculate that Brad’s Peer To Peer involvement might have had the potential to save his life.

Third, people with mental illness should not be in jail. Those with mental illness who are incarcerated require mental health services. And those being released require medication, a warm handoff to services, and housing options beyond shelters.

And finally, community mental health organizations should, to the extent possible, be the safety net—beyond emergency services–for everyone.

Although we can no longer advocate for our son, we believe that our advocacy can benefit other parents with family members living with mental illness.

We believe, given our experience, that we can still make a difference.

(Edited remarks delivered by Gary Ambrose on October 6, 2016 on the occasion of receiving the 2016 Virginia Association Of Community Services Boards (VACSB) Gartlan Award for Leadership and Advocacy.) Named for Virginia State Senator Joseph V. Gartlan, the award annually recognizes one individual in the Commonwealth who has distinguished him/herself in leadership and advocacy for citizens with mental illness, intellectual disability and/or substance use disorders.

 

 

 

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