9-9-15 Anyone who reads  Virginia Commonwealth Attorney Raymond F. Morrogh’s  51 page report about the death of Natasha McKenna, the 37 year old African American woman with schizophrenia who died after being repeatedly stunned with a taser while in the Fairfax County Detention Center, can’t help but be appalled.

For those of us with a loved one with a mental illness, his report is painful and frustrating to read because it shows how difficult it is for someone who is clearly sick in Fairfax County to get meaningful help. Except for one doctor, Lydia Haile, MD., most others named in this report dealt with McKenna poorly, some might say callously.

Morrogh’s report is the first detailed account by an official about what happened to McKenna from January 7 — when she was transported by ambulance to INOVA Alexandria Hospital and showed signs of being psychotic — until her death on February 7th.

Prosecutor Raymond F. Morrogh Relies on Excited Delirium In His Findings

Moorogh concludes that no one is criminally at fault. In fact, he praises the deputies involved. While there may be no legal culpability, the report reveals countless failed opportunities when McKenna could have and should have received help but didn’t.

The most detailed information in Morrogh’s report is about McKenna’s physical altercations with the police and sheriff’s deputies. He gives blow-by-blow, in some times, second-by-second accounts of how McKenna kicked, attempted to bite, and spit at officers. He quotes officers claiming that McKenna had super human strength.

Sergeant Timothy said, “For me it’s probably the most difficult inmate I’ve ever had to deal with in that capacity, male or female… And I’ve dealt with… men on PCP fighting… it’s like she didn’t feel pain…” Deputy Guevarez said, “.. I remember it was … a struggle. I mean.. .I’m not a weak guy but she, she was wearing me out; she was wearing us all out. Deputy Holmes said, “.. .in my 19 years, that was the worst inmate.. .1 have ever dealt with. I’ll be honest with you… she was the real deal. Seriously, she was the worst… the hardest inmate.. .I’ve dealt with big guys, I’ve dealt with other females, smaller guys, guys in gang[s]. She was the toughest person that… I have ever dealt with to get her in that chair and with a struggle.” Deputy Viola said, “[Ms. McKenna was] probably one of the most aggressive CO inmates I’ve ever had to deal with .. .in my experience.” Deputy Barb recalled that, “.. .She was pushing with the most force I’ve seen in the… six years I’ve worked there.. .1 had never seen anybody push like this.. .”

In another sentence, Morrogh quotes an officer stating:

I hate to describe it like this, like a demonic possession because she was growling the whole time.

Because McKenna is dead, there is no one to speak on her behalf about what happened. The deputies’ statements go unchallenged and dovetail perfectly with the conclusion of Dr. Jocelyn Posthumus, M.D., a forensic pathologist with the Office of the Chief Medical Examiner who performed an autopsy on McKenna two days after she died and found that she was not the victim of foul play but of excited delirium, which Morrogh explains thusly:

Most persons suffering from excited delirium are hyper-aggressive, impervious to pain, and demonstrate unusual, “superhuman,” strength. They engage in a lengthy period of struggle, followed by a period of quiet and sudden death.

His conclusion: no one is legally at fault — no one that is, except Natasha McKenna. She brought this all on herself.

How easy it is to blame someone with mental illness. How easy it is to claim that everyone followed the rules except the person who was mentally ill. How easy to cry crocodile tears.

Let’s take a look at Morrogh’s use of the “excited delirium” conclusion of Dr. Posthumus.

Morrogh quotes liberally from a report issued by  a task force of the American College of Emergency Physicians that states that excited delirium is real. There’s no mention that excited delirium is not a currently recognized medical or psychiatric diagnosis according to either the Diagnostic and Statistical Manual of Mental Disorders (DSM-IVTR) of the American Psychiatric Association or the International Classification of Diseases (ICD-9) of the World Health Organization.

But here is an even more interesting note: if you check the 2012 and 2013 annual statistical reports issued by the Office of the Chief Medical Examiner in Virginia you will not find a single mention of excited delirium as a cause of death in the state. It is not listed as a cause of any death in Virginia during 2013 in the 128 in-custody deaths that were examined by that office. Not  one incident. Nor is it cited in the deaths of 60 persons with mental illnesses who were examined. Not one incident. In the entire 238 page annual report in 2013, there is absolutely no mention of a death in Virginia that was attributed to excited delirium.

As the Washington Post has pointed out repeatedly, nearly all deaths associated to excited delirium happened while the deceased was in police custody, which has caused civil rights activists to claim that it is simply an excuse used to justify excessive force and avoid lawsuits.

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The mystery about my mother’s 70 year-old painting has been solved thanks to Mary Kay Grimaldi, an editor with Shell Point Life magazine in Fort Myers, Florida.

In June, I wrote about how I’d received an email from a stranger, Mary Beth Bower, who had come across an oil painting in a Florida thrift store that she thought might have been painted by my mother, Jean Earley. The canvas was dated 1945, and after seeing it, I was able to confirm that it was one of mother’s earliest paintings even though I’d never seen it before and didn’t know it existed. It was not listed in the portfolio of my mother’s work that she kept. She painted it two years after marrying my father when she was 26 years old.  As newly weds, my parents had moved to Colorado from the East Coast to begin their life together. The painting was a scene that my mother could see from their tiny apartment, I later learned. My mother died at age 94 in December 2013.  My father died fourteen months later, also at age 94. (Read blog about mystery painting.)

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From My Files Friday: Three lessons we could learn from the LGBT Community. 

Mental health advocates can learn how to fight stigma and influence legislation by studying the LGBT Community.  Recently, The Washington Post published an editorial by immigration activist Frank Sharry that  explained how LGBT activists had given underdogs a blueprint for successfully changing public opinion.

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If you think Virginia solved its hospital bed shortage problem after state Senator Creigh Deeds and his son were turned away from a local community mental health center with tragic results, you are wrong.  Deeds’ son, Gus, attacked his father with a knife and then ended his own life in 2013 after being told there were no crisis care beds available locally.

The news story below is yet another black eye for my home state, which has failed to adequately deal with mental health problems despite promises made after the Virginia Tech shootings in 2007 that left 33 dead.

After you read it, you will understand why mental health reform must include discussions about crisis care beds, state hospital beds, and community housing, as well as CIT and  jail diversion.

Death of a young black man in a Virginia prison sparks outrage

Jamycheal Mitchell allegedly stole $5 worth of junk food from a 7-11. Four months later, he was found dead in a jail cell.

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One of the last times I returned to Fowler, Colorado, was when I was working for The Washington Post and my good friend and editor, Walt Harrington, urged me to revisit my teenage home and write about my sister’s death. Alice died in a car accident and is buried there.

Even though my parents moved away from Fowler in 1970, they wanted their ashes taken there for internment — so after my mom died in 2013 and my father passed away earlier this year, it fell upon my brother, George, and me to carry out their wishes.

Not a day goes by when I don’t think of my parents and I am glad they were wise enough to have us make the journey together. In the eyes of my parents, it was a “reunion” and a time to remember when the five of us had lived together as a family. For me, it was time to grieve, to bond with my brother, to honor our parents and to ponder many of the same questions about death that had haunted me nearly thirty years ago when I set out on a trip to understand my sister’s death.

 

MISSING ALICE: The Story of My Sister, Her Death, and My Search for Answers

(First published in the Washington Post in 1986)

Midway across Ohio, the man beside me on the DC-10 asked where I was going.

“Fowler, Colorado. A little town of about a thousand people near Pueblo.”

“Why would anyone go to Foouuller?” he asked, grinning as he exaggerated the name.

“A death. My sister.”

“Sorry,” he mumbled and turned away.

I was relieved. I didn’t have to explain that my sister had been dead 19 years. Alice was killed when I was 14. She was two years older and we had been inseparable as children.

I couldn’t talk about her death at first. My voice would deepen, my eyes would fill with tears. My parents would cry at the mention of her name, and we rarely spoke of her. Then it seemed too late.

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I have been a member of a mental health subcommittee studying ways to improve services in Fairfax County, Virginia where I live. The introduction to our draft report might be useful reading for many of you. I have edited out several local references and added some key points in parenthesis.

You’ll find that much of our report contains information that I have cited in my speeches and previous blogs. You might want to compare what we are suggesting with services in your community.

Mental Health Reform: An Introduction 

“Police officers have increasingly become the first responders when a citizen is in the midst of a psychiatric crisis. According to the National Alliance on Mental Illness (NAMI), up to 40% of adults who experience serious mental illness in their lifetime will come into contact with the police and the criminal justice system at some point in their lives. (1) The vast majority of these individuals will be charged with minor misdemeanor and low-level felony offenses that are a direct result of their psychiatric illnesses – the most common being trespassing or disorderly conduct.

Despite the minor nature of these crimes, encounters between persons with mental illness and the police can escalate, sometimes with tragic consequences. Nearly half of all fatal shootings by law enforcement locally and nationally involve persons with mental illnesses.

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