The current debate about bringing back mental asylums made me wonder what Virgil Stucker, the founding executive director and president of the CooperRiis Healing Community in North Carolina might think. He was kind enough to offer his thoughts. 

Think of the Modern Asylum as a ‘Recovery College’

By Virgil Stucker

The notion of ‘bringing back the asylum’ for individuals with overwhelming mental health challenges has been stirring debate. There are multiple points of contention, some of which lead us down unproductive and confused paths. We rightly bristle when we think of the abuse that the asylums of old caused. Let’s hit the pause button and acknowledge that none of us seeks to bring back those abusive systems.

We also bristle at the notion of Dr. Ezekiel Emanuel who seems to think that as many as 500,000 in the US are mentally broken and simply need humane, permanent containment. What I hear him saying is that no matter what we do, some of society’s most vulnerable appear unable to conduct their lives successfully on their own. This may be true for ‘some’ but not for 500,000. Nor should we assume that permanent containment and separation from society should be the starting point for anyone.

All of us also agree that we should do better than simply containing our most vulnerable in prison and jails (about 600,000 with mental health diagnoses). Also none of us thinks that it is OK simply to allow them to roam the streets or simply to chemically contain them via the overuse of medications. We continue to hope that we can develop and improve systems that will help our most vulnerable to recover their capacities for independent and successful living.

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It’s hard to describe mania to someone who has never experienced it. One minute I’m so high that my mind and body enter a nirvana-like state with feelings of ultimate power and supreme authority. And then in the next minute I feel so paranoid and scared that I think my heart will thump out of my chest.  

In 2005, my mania escalated to the level that I believed a police officer was trying to pull me over to murder me. I took the police on a high-speed chase and was arrested for the first time in my life. A couple of days later, I believed I was waging nuclear war with China and President Bush was obeying my signals from my jail cell. I thought a microchip was implanted in my lung and the evil forces of the government were trying to control my actions. I was eventually placed in a mental health hospital and remained there for nearly a month.

This is how Paton Blough begins his personal story about his encounter with law enforcement. Paton’s narrative is the first in an ambitious series called 31 Stories in 31 Days being launched this month by the National Alliance on Mental Illness.

Each day during May a different story will be told, including one later this month by my son, Kevin Earley.

NAMI’s 31 Stories in 31 Days will put human faces on a shameful, national scandal — the inappropriate incarceration of persons with mental illnesses in our jails and prisons. (An estimated 500,000 persons!) The program was created to augment a new national effort called Stepping Up that is being launched on Tuesday (May 5th) by NAMI,  the Council of State Governments, the National Association of Counties, the American Psychiatric Foundation and numerous law enforcement associations, mental health organizations, and substance abuse organizations.

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(5-1-15) My friend, Dr. Dinah Miller, a Baltimore psychiatrist and one of the authors of the popular blog, Shrink Rap, took issue with a blog post that I published April 20th about an emergency room nurse who’d been bitten by a psychotic patient and decided to press criminal charges. That blog hit a nerve with many of you. As a follow up, I checked on the court hearing in this case and learned it had been postponed until June.)

Some thoughts on Authority and Victimization

This is our blog, and it’s my place to vent some, and on this beautiful morning in Baltimore with all the trees in bloom in pink and white, I could really use some space to vent.  While none of us were in the middle of the unrest, it is awful to watch our beloved city on CNN — this isn’t how it should be.
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(4-28-15) A woman with schizophrenia, who was repeatedly shot with a 50,000 volt Taser while in jail restrained with handcuffs and leg shackles, died from “excited delirium,” according to the Virginia Medical Examiner’s Office.

In an editorial in today’s Washington Post, the newspaper described that ruling as being “troubling for several reasons.” My former colleagues at The Post have been aggressively reporting on the death of Natasha McKenna ever since I revealed nearly three months ago the violent circumstances surrounding the 37 year-old black woman’s death while in custody. Here is a snippet from the Post editorial.

Medical examiners around the country have cited ‘excited delirium’ as a cause of death with increasing frequency for the past decade or so, almost exclusively in cases involving civilians — arrested and prison or jail inmates — who die in struggles with law enforcement officers. Not infrequently, those deaths have involved the use of stun guns, usually Tasers, by police…

The American Civil Liberties Union, among others, has cast doubt on ‘excited delirium’ as a cause of death, suggesting it is used mainly to give cover to excessive use of force by law enforcement…That point is reinforced by the fact that neither the American Medical Association nor the American Psychiatric Association appears to recognize ‘excited delirium’ as a medical or mental health condition…Outside of the medical examiner’s profession, the term does not seem to occur in medical textbooks.

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4-27-2015   Yesterday I published a blog about the controversy surrounding Dr. Ezekiel Emanuel and his colleagues’ JAMA article calling for states to begin constructing modern day asylums. I mentioned two points of view — Emanuel’s and Dr. Lloyd Sederer’s. Today I am posting the friendly debate that the two men had during last week’s National Council For Behavioral Health’s conference. This video is 30 minutes long and courtesy of the council.