(6-14-16) I was in Chicago last week to attend a housing summit hosted by the Corporation for Supportive Housing, a cutting-edge leader in developing housing for persons who are homeless, have mental illnesses and addictions, and those leaving prisons. Much of the talk was about “metrics” — being able to show results with verifiable numbers. If you can’t show that what you are doing is actually producing results, government agencies and philanthropic organizations are reluctant to support you. That being the case, I was surprised yesterday when Dr. E. Fuller Torrey sent me a copy of his latest jab at the Substance Abuse and Mental Health Services Administration (SAMHSA), which he has frequently targeted. According to the article, the federal agency that is supposed to be helping individuals with mental illnesses keeps no metrics about schizophrenia. How can that be?

Washington Funds Ignorance of Mental Illness

By E. Fuller Torrey, published June 13, 2016 in The National Review  

The federal government collects accurate data on the number of pigs in Iowa, on milk cows in New York, and on turkeys in Delaware but none whatsoever on the number of people with schizophrenia. The Centers for Disease Control and Prevention keeps a long list of diseases that must be reported, including cryptosporidiosis, chlamydia, and cancer, but not schizophrenia.

This is remarkable, since schizophrenia is among our most consequential and expensive diseases. In a 2013 study, the annual economic burden of schizophrenia was estimated to be $156 billion. Three studies have reported that individuals with schizophrenia are responsible for 10 percent of all homicides in the United States; other studies suggest that people with schizophrenia — such as Jared Loughner in Tuscon, Aaron Alexis at the Washington Navy Yard, and James Holmes in Aurora, Colo. — are also responsible for up to one-third of mass killings. Even Adam Lanza in Newtown, Conn., had had a diagnosis of schizophrenia, in addition to autism spectrum disorder.

Other developed nations believe that it is important to ascertain the prevalence of schizophrenia and whether it is increasing or decreasing. For example, recent European studies have reported that schizophrenia is twice as common in England and the Netherlands as in Italy or Spain, that it has been steadily increasing in south London over three decades, and that early-onset schizophrenia is increasing in Denmark.

And what do we know about the United States? Nothing.

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Photo by Roll Call

(6-12-16) Politics is the art of compromise. That’s a common saying on Capitol Hill. Politics is about negotiating consensus and cooperation between factions.

This coming Wednesday, June 15, the House Energy and Commerce Committee is scheduled to convene a hearing to consider and vote on the Helping Families in Mental Health Crisis Act (H.R. 2646), introduced by Rep. Tim Murphy (R-PA).

The legislation the committee will be voting on has been so mightily revised by Committee Chairman Fred Upton (R-MI), to appease its detractors and House Democrats that it is hardly resembles its first version.

For those who supported Murphy’s initial efforts that’s a bitter pill. For those who opposed Murphy’s campaign, there’s reason to celebrate because Murphy’s most divisive proposals have been dropped. Advocates for the mental health groups that I polled over the weekend feel the compromise bill is “good legislation.”

The fighting is far from over, however. On Wednesday, there will be attempts by both sides to reword and rework the latest revisions, but I would imagine that Upton is a shrewd enough politician to not bring his revamped bill up for a vote without knowing that he has enough support to  get it passed.

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(6-10-16) The top editorial in today’s Washington Post. Thank you!)

In a Virginia jail, a young man wasted away and died — and no one bothered to notice

By Editorial Board June 10 at 7:37 AM The Washington Post 

A MENTALLY ill black man, just 24 years old, is arrested in April 2015 for shoplifting a Mountain Dew, a Snickers bar and a Zebra Cake — total cost: $5 — from a convenience store in Virginia. He languishes in jail for 14 weeks, refusing medicine, his weight plummeting, his cell smeared with feces. After 101 days, having lost more than 40 pounds — literally wasting away, as a starving man does — he dies.

And no one noticed a thing, until it was too late.

Those are some of the essential facts surrounding the case of Jamycheal Mitchell, whose death last summer triggered at least three official investigations and not one coherent answer to the central question: Why didn’t anyone intervene?

The first and hastiest investigation was done by the facility where Mitchell starved to death, the Hampton Roads Regional Jail. Scarcely a week after his body was discovered, jail officials concluded their probe, pronounced themselves blameless — and released not an iota of information.

The next two investigations, by Virginia’s Office of the State Inspector General and the Department of Behavioral Health and Developmental Services, were no more edifying. The inspector general, citing guidance from the state attorney general, said it lacked jurisdiction to question jail personnel, thereby raising doubts about the utility of its existence. And the DBHDS, in thousands of turgid words, did not bother to address or, so far as can be determined, even ask about the most glaring failure of all: How could no one have noticed that a man was wasting away in plain sight?

This is not an investigation. This is a whitewash.

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(Within hours after posting this blog, I received an email from Community Services Board Executive Director Tisha Deeghan who explained that the CSB board had a member with lived mental health experience serving on it up until April 27th when that appointee retired. She reminded me that it is the Fairfax Board of Supervisors’ responsibility to appoint board members, not the board’s. I also received an email from Board of Supervisor Chair Sharon Bulova’s office assuring me that the board was aware that the CSB currently does not have a self-acknowledged peer serving on its board. I was told that it is actively searching for an appropriate candidate.)

(6-9-16) The Fairfax – Falls Church Community Services Board, which is responsible for delivering mental health services where I live in Northern Virginia, does not have anyone on its 16 member board who is a peer. The board also recently decided to not hire a new Director of Consumer and Family Affairs, a job specifically created to be held by a peer. This means there is no peer in a top leadership position in my county.

In 1968, Virginia decided that mental health services should be administered locally. The state created 39 Community Services or Behavioral Health Boards, commonly called CSBs. While the legislature allowed local jurisdictions to pick board members, it codified the importance of peers and family members. According to Virginia law:

One-third of the appointments to the board shall be individuals who are receiving or who have received services or family members of individuals who are receiving or who have received services, at least one of whom shall be an individual receiving services.

Not having a peer on our local board may or may not violate that statute – I am not a lawyer. But I know that not having a person with lived experience on the board puts it at a disadvantage when it comes to fully understanding how its decisions will be viewed by the Virginia residents most impacted by them.

The CSB also recently decided not to fill the Director of Consumer and Family Affairs position. That post was held by David Mangano, who retired last year.

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(6-6-16) Officials from the National Alliance on Mental Illness, Mental Health America, the NAACP, the ACLU, and the Bazelon Center for Mental Health Law today called on the U.S. Justice Department to investigate the death of Jamycheal Mitchell, a 24 year-old African American with a history of mental illness, who died last August in the Hampton Roads Regional Jail in Virginia.

Mitchell had been arrested for allegedly stealing $5 worth of snacks from a convenience store and was found dead in his feces covered cell 109 days later while waiting for transfer to a state mental hospital for evaluation. A medical examiner said he’d died from a heart attack caused by “wasting syndrome.” He had lost 40 to 50 pounds.

Mira Signer, the executive director of Virginia NAMI chapter, was a driving force behind the letter, which was signed by NAMI National’s CEO Mary Giliberti; Evelyn Steward, president of NAMI Hampton News; Bruce Cruser, executive director of Mental Health America of Virginia; Claire Guthrie Gastanaga, executive director of the ACLU in Virginia; Ira Burnim, legal director of the Judge David L. Bazelon Center for Mental Health Law, and James P. Boyd, president of the Portsmouth branch of the NAACP.

In an Op Ed published in The Washington Post last month, I asked for the Justice Department’s Civil Rights Division to investigate Mitchell’s death. In that editorial, which drew the ire of the Virginia Attorney General’s office, I complained about probes of Mitchell’s death released by the Virginia Department of Behavioral Health and Developmental Disabilities (DBHDS) and the State Office of Inspector General. Both balked at actually investigating what transpired inside the jail, claiming they didn’t have jurisdiction to look there. So far, Hampton jail officials are the only ones who actually know what took place in the jail. Eight days after Mitchell’s body was found, they conducted an internal investigation and announced their employees had done nothing wrong. They have refused to make that report public. Jail officials also taped over video taken outside Mitchell’s cell that would have shown how often employee’s gave him food or entered his cell.

In their letter to the Justice Department, the authors wrote: “the ultimate question remains unknown: how did Mitchell starve to death before the jail staff’s and medical staff’s eyes?” 

Mitchell was supposed to be checked by a nurse once a day and also eyeballed by correctional staff regularly, yet there is no mention in any jail or nursing reports that have been made public about his alarming loss of weight.

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(5-3-16) I am so grateful to Jennifer Marshall for continuing to combat stigma by speaking out about her mental illness and recovery! The co-founder of This Is My Brave was featured yesterday in a major front page story in The Washington Post about individuals with mental disorders who have talked openly about their illnesses and recovery. Bravo to all of them and to The Washington Post for publishing such an important story of hope on its front page.

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