Helpful hints about what to do in a crisis, and a Post editorial

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Happy Fourth of July!

A new Psychiatric Crisis Resource Kit that can help families if someone they love develops a mental disorder is scheduled to be unveiled this week in Chicago at the national convention of the National Alliance on Mental Illness. It’s been developed by the Treatment Advocacy Center.    

Of course, the first thing that comes to mind whenever someone mentions TAC  is its aggressive and relentless campaign to promote Assisted Outpatient Treatment laws. But whether you support AOT laws or oppose them really doesn’t matter. All of us with loved ones who have a mental disorder need to be prepared and from what I have seen so far, TAC has done a real service by putting together a mental health first aid kit.

When my son first became ill, I was completely at a loss about what to do. And based on the emails and letters that I receive weekly, other parents, families and friends find themselves in the same situation.

For instance, the kit recommends that families compile a list of telephone numbers for key people, agencies and organizations that should be contacted if there is an emergency. While that sounds like a no-brainer, how many of us have the telephone number of a mobile crisis team, a psychiatric case manager, or an Assertive Community Treatment (PACT or ACT team) handy? Do you know the emergency numbers for your community mental health provider? How about your local suicide hotline? Do you know if your community has a Crisis Intervention Team and, if so, how to contact it. What’s the number of a public defender who knows mental health laws? Or a private attorney? Is there a mental health court in your jurisdiction and, if  there is, do you know what sort of cases it will hear?

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Why Aren’t Our Elected Leaders Listening?

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Can you imagine what would happen if a newspaper reported that a hospital refused to treat someone suffering a heart attack? What would the public think if a car accident victim was turned away from an emergency room? Yet, according to a recent report by the Virginia Office of Inspector General for Behavioral Health and Developmental Services, at least 200 persons who were having a mental health crisis and met Virginia’s involuntary civil commitment standard because they were dangerous were refused treatment in the Hampton Roads area between April 2010 and March 2011. 

The practice of turning away psychiatric patients in Virginia has become so common that there is a word for it  — “Streeting.”

The IG’s report cited an example of a 66-year-old Virginia woman who needed immediate care but was turned away by 15 private hospitals. She then was driven a hundred miles away to a crisis stablization unit only to be turned away there because she did not make it through the unit’s medical clearance process due to lethargy, a medication side effect.  Forty-eight hours later she was finally admitted to a hospital emergency room.

She was lucky. At least she finally found a bed.

Where is the community outrage? Why are doctors, mental health professionals, community leaders and elected officials not alarmed?Click to continue…

Advocates, Fired Cop, Unnecessary Death and AOT Controversy

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When the 14 year-old old boy came home from school and found his mother on the floor badly beaten and unconscious, he decided to do something. He took a pistol from a drawer, marched into his mother’s bedroom where his drunken step-father had passed out on the bed, and fired point blank into the man’s skull killing him. Arrested and charged as an adult, the youth was taken to an adult  jail to await trial.

The boy had been there only three days when defense attorney Bryan Stevenson met him. He was so traumatized that he could not answer any of the lawyer’s questions. He’d been repeatedly sexually assaulted — so many times in that three day period in jail that he’d lost count of how many men had abused him. All the boy did for two hours was sob as Stevenson held him.  

This tragic story was one of several that Bryan Stevenson described in an impassioned speech that he gave last week during an Advanced Judiciary Academy conference at the University of Illinois in Champaign/Urbana. I’ve written about Bryan before on my blog. He’s an inspirational advocate.

Bryan and I were invited to speak to the Illinois judges about how wealth and poverty influence our criminal justice system. We’d been invited to lecture because of my book, CIRCUMSTANTIAL EVIDENCE: Death, Life and Justice in a Southern Town.  For those of you who might not have read it, CIRCUMSTANTIAL EVIDENCE  is a true story about the murder of a popular, white teenager in the Alabama town that inspired the novel, TO KILL A MOCKINGBIRD.  A poor, uneducated,  black man named Walter “Johnny D.” McMillian was convicted of the killing which happened inside a dry cleaners on a busy Saturday morning. McMillian was sentenced to death after two witnesses testified that they’d seen his truck parked outside the cleaners at the time of the murder and another witness claimed he actually see McMillian standing over the dead girl during a robbery.  It seemed as if McMillian had been caught red handed.

But after Stevenson began investigating the case, a different picture emerged. Both witnesses who’d claimed to have seen the truck recanted their stories. Both had received reward money in return for testifying. The eyewitness who swore that McMillian had murdered the girl was proven to be a liar. Even worse, Stevenson discovered that the prosecution had hidden crucial evidence that proved McMillian was innocent. During the murder, he had been at his home miles away helping host a fish fry. Two law enforcement officers had stopped there that day but had failed to come forward to substantiate his alibi. Put simply, McMillian had been framed.

Although Bryan proved McMillian was innocent, Alabama officials refused to free him. It took a 60 Minutes segment about the case to shame local and state officials into releasing an innocent black man from death row.

I spoke first at last week’s conference and described the murder and investigation. Bryan spoke after me about the case but quickly moved to such broader issues as the number of persons with mental illnesses now being incarcerated and his latest campaign to stop pre-teens and teenagers under age fifteen from being charged as adults when they commit crimes. Many of these children are sentenced to life in prison. His work as the executive director of the Equal Justice Initiative prompted the judges in the audience to do something that Judge Susan Hutchinson, who helped organize the academy, said she’d never witnessed  before.

They gave him a standing ovation.

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Where would you draw the line?

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An investigative report recently released by the Inspector General’s Office in the Virginia Behavioral Health and Developmental Services Department is causing a stir. Each year, the IG is required to make unannounced visits to state facilities that treat  persons with mental disorders and report his findings.   

The section of G. Douglas Bevelacqua’s report that is getting the most attention, especially from the National Alliance on Mental Illness Virginia Chapter  is the IG’s discovery that “streeting” is now a common practice in Virginia. “Streeting” is the term that hospitals use when someone, who should be admitted, is turned out onto the street because there are no beds available. (More on this in a future blog.)

It’s another discovery that Bevelacqua cites that I want to discuss here. 

In his report, Bevelacqua writes that a federal regulation is being so narrowly interpreted by Virginia Attorney General Kenneth T. Cuccinelli  that as many as ten percent of patients in state run facilities are being denied access to treatment that could help them recover. 

Patients are being denied “medically necessary interventions that would allow them to participate in their treatment.”  They are being “denied palliative care” and their rights to helpful treatment are being “restricted,” the IG claims.

Kenneth T. Cuccinelli is well-known in Virginia mental health circles. When he was running for office, he talked about his efforts as a state legislator to improve mental health services. I spoke to him about the need to reform Virginia’s mental health system and he was well versed in the problems that our state faces. He sees himself as a friend of persons with mental illnesses.

So why is the IG suggesting that Cuccinelli’s office and a federal rule – that was written to protect persons with mental illnesses from abuse –are actually causing great harm to patients in Virginia?

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What’s Really Insane? Our System.

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I want to call your attention to two recent events. I’d hoped to write about them sooner but traveling to give speeches, getting my new book  “put to bed” so that it can be published in January and launching a new book project caused me to fall behind.

The first is the ruling by San Diego based Judge Larry Alan Burns that Jared Lee Loughner, the twenty-two year old accused of killing six persons and wounding thirteen, including U.S. Representative Gabrielle Giffords, is so mentally disturbed that he cannot understand what is happening in a courtroom. This means he cannot be put on trial. 

Judge Burns decided to send Loughner, who has been diagnosed with schizophrenia,  to the U.S. Medical Facility for federal prisoners in Springfield, Missouri, where doctors will attempt to restore his competency. 

I’m afraid that many people mistakenly believe that the judge’s decision means that Loughner is going to be treated for his mental disorder. While he certainly may benefit from the medical attention that he will receive, it’s important to note that restoring competency and providing someone meaningful treatment are not the same.

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Another Earley Advocates!

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The featured speaker at the awards dinner at our local chapter of the National Alliance on Mental Illness was listed in the program under the name: EARLEY. But it was not me.

It was my son, the person whom many of you have come to know from my book:  Crazy: A Father’s Search Through America’s Mental Health Madness, by the name MIKE.  The NAMI meeting was the first time that he has ever spoken in public and he got a much  deserved standing ovation after he’d described his journey to recovery.

I am tremendously proud of him. Like so many others, our family has been through a roller coaster of events and emotions since 2001 when my son was first diagnosed with a severe mental illness. He’s been arrested and shot with a taser. There have been court hearings, four major breakdowns, repeated hospital stays, hours of therapy, angry words — so many angry words — even feelings of hopelessness and despair.

But for the past three years, he has been doing fantastic! He has been able to manage the symptoms of his illness. He is in RECOVERY and he is one of my heroes!

There are many reasons for his recovery, but he deserves the most credit. He has worked hard to get better. Fortunately, he had the expert guidance of a tremendous case manager. My son found a medication that helped him. And he had access to other crucial services that he needed!

I am blessed. I am telling you this to give you HOPE for your loved one. People do get better!  But why am I telling his story, when his own words can tell it better than me?

Here are excerpts from his speech. When you read them, you will understand why I am proud and fortunate to have such a wonderful son. I know many of you are struggling. Don’t give up. There were times when I didn’t think we would get where we are today.

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