(6-30-17) I subscribe to The Atlantic and admire its often courageous and always thoughtful journalism. It recently published a profile of Tom Insel, former head of the National Institute of Mental Health, whom I first met in 2006 after my book was published when he asked me to speak at NIMH.  A favorite at mental health conventions, Insel is one of the kindest and most thoughtful advocates whom I’ve had the pleasure of knowing. Here’s an excerpt.)

The Smartphone Psychiatrist

Frustrated by the failures in his field, Tom Insel, a former director of the National Institute of Mental Health, is now trying to reduce the world’s anguish through the devices in people’s pockets.

Published in the Atlantic. Written by:DAVID DOBBS

Sometime around 2010, about two-thirds of the way through his 13 years at the helm of the National Institute of Mental Health (NIMH)—the world’s largest mental-health research institution—Tom Insel started speaking with unusual frankness about how both psychiatry and his own institute were failing to help the mentally ill. Insel, runner-trim, quietly alert, and constitutionally diplomatic, did not rant about this. It’s not in him. You won’t hear him trash-talk colleagues or critics.

 Yet within the bounds of his unbroken civility, Insel began voicing something between a regret and an indictment. In writings and public talks, he lamented the pharmaceutical industry’s failure to develop effective new drugs for depression, bipolar disorder, or schizophrenia; academic psychiatry’s overly cozy relationship with Big Pharma; and the paucity of treatments produced by the billions of dollars the NIMH had spent during his tenure. He blogged about the failure of psychiatry’s Diagnostic and Statistical Manual of Mental Disorders to provide a productive theoretical basis for research, then had the NIMH ditch the DSM altogether—a decision that roiled the psychiatric establishment. Perhaps most startling, he began opening public talks by showing charts that revealed psychiatry as an underachieving laggard: While medical advances in the previous half century had reduced mortality rates from childhood leukemia, heart disease, and aids by 50 percent or more, they had failed to reduce suicide or disability from depression or schizophrenia.

“You’ll think that I probably ought to be fired,” he would tell audiences, “and I can certainly understand that.”It was unsettling—as if the kindly captain of the world’s biggest ocean liner had sat down with his guests at dinner one evening and told them that their ship was unexpectedly lost and, if the crew could not soon correct course, they might well run aground, founder, and die.

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(7-10-17) I recently asked Paul Gionfriddo, the President and CEO of Mental Health America, if he would answer a series of questions for me. Thankfully, he agreed.)

Question 1: People sense a new vitality at Mental Health America. Tell us what made you agree to take charge of MHA?

Mental Health America is an amazing place to work, with incredibly gifted and energetic staff people and affiliates across the nation who are making a real difference. Four years ago, I was happily working from home, writing my policy memoir (Losing Tim) and taking occasional consulting jobs to help pay the bills. My wife, Pam, who was and still is the CEO of MHA of Palm Beach County, came home each night, and listened to my stories about how I’d fix the mental health system that had failed Tim so badly. When the MHA position came along, she said, “you’d be perfect for this.” David Shern (former MHA CEO) also strongly encouraged me to apply. When I talked to the search committee and Board, I told them that there were other organizations working in the deep-end space, but that we needed a national advocacy organization to do more upstream – early identification, early intervention, and health/behavioral health/education/workplace integration. My story – and I’m sticking to it – is that they had 100 qualified candidates for the position, and only got to me after first considering the other 99. But ultimately this approach made sense for them and for me, and so here we are.

Question 2. You describe your family’s struggles with your son, Tim, in your article, How I Helped Create A Flawed Mental Health System That’s Failed Millions (which I will post Tuesday.) What can you tell us today about your relationship with your son?

Like so many others, Tim went through a lot – in school and afterwards – as someone living with a serious mental illness that emerged during early childhood. I love Tim deeply, as I love all my children. I am constantly amazed by his resilience in the face of schizophrenia. I am in awe of his patience in dealing with the challenges and roadblocks to independence and recovery that have been put in his way during this past quarter century and trapped him in the revolving door of occasional hospitalization, frequent incarceration, and chronic homelessness. He and I share a sense of humor, and have always had a good relationship during our most troubling times. Of course, he calls far too infrequently, and worries me far too frequently. When I tell him this, he just laughs, and says “I’m fine, Dad.” Typical 32-year-old.

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(7-7-17) When I closed my eyes during James Hayes speech at the NAMI convention, I was whisked back to the days when I was a child and my family used to attend church revivals in Oklahoma. His speech, the last in this week-long series, was delivered with the enthusiasm of a evangelical preacher. I was not surprised when he was re-elected to another term on the board because his passion for NAMI came through loud and clear.  

Dr. JAMES HAYES – NAMI Is Filled With Everyday Heroes

It is hard for a boy from South Carolina to do a 5 minute speech in less than 12 minutes but I’ll try. 

We know about mental illness as we have 4 adult children, 3 of whom live with serious mental illness and 2 wonderful grandchildren who live with autism.

We know mental illness across the ages! NAMI has been a life saver for us.

We know about serious mental illness because we live with it every day!

I am a retired Pediatric Oncologist and when I started in 1972, 30% of children with cancer survived. Now in 2017, 92% survive.

We can do that in mental illness!

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(7-6-17) Virginia Governor Terry McAuliffe should be embarrassed to show his face at a State of Mental Health Care: Challenges and Solutions forum being held by the Hill newspaper Tuesday, July 18, at The Newseum.

It is disingenuous to have McAuliffe on the same platform with mental health advocates after his decision this afternoon to not intervene in the planned execution of a 35 year-old man with a severe mental illness – despite pleas by the National Alliance on Mental Illness, the daughter of one of the murder victims, numerous elected leaders and The Washington Post. 

Morva is scheduled to be put to death by lethal injection tonight at 9 p.m. even though an independent, court appointed psychiatrist said Morva has a severe delusional disorder that impaired his thinking when he fatally shot Montgomery County Deputy Sheriff Corporal Eric Sutphin and hospital security guard Derrick McFarland while escaping from jail in 2006.

McAuliffe’s decision really should not surprise anyone who has paid attention to how his administration has treated individuals with mental illnesses.

Both he and Attorney General Mark Herring cried crocodile tears when the body of Jamycheal Mitchell, who died of a heart attack caused by starvation, was found in his Hampton Road Regional Jail Cell where he had been waiting for 101 days for admission into a state hospital for treatment of his schizophrenia.

Although he claimed concern, Gov. McAuliffe cleared one of his political appointees of mishandling an investigation into Mitchell’s death without ever bothering to speak to an employee who filed a whistleblower complaint about the state Inspector General’s investigation. Later, he found another plum state government job for that Inspector General after the state legislature refused to reappoint her. Meanwhile, it was Herring’s office that reportedly sat on an investigative report about Mitchell’s death until the state legislature adjourned and then, according to a Richmond Times Dispatch story, “intervened” when investigators attempted to find out what had happened to Mitchell while he was being held in jail after stealing $5.05 worth of snacks.  The handling of the Mitchell case was so badly handled that the U.S. Department of Justice decided to launch its own probe of the jail.

In refusing to grant clemency, McAuliffe and Herring both showed their same stripes. The governor announced:

“I personally oppose the death penalty; however, I took an oath to uphold the laws of this Commonwealth regardless of my personal views of those laws, as long as they are being fairly and justly applied. Thus, after extensive review and deliberation consistent with the process I have applied to previous requests for commutation, I have declined Mr. Morva’s petition. I have and will continue to pray for the families of the victims of these terrible crimes and for all of the people whose lives have been impacted.”

McAuliffe ignored the findings of a report by an independent psychiatrist appointed by a federal court after Morva’s trial and the only expert to have interviewed Morva and considered his complete psychiatric history. Attorney General Mark Herring (who represents Virginia on appeals) could have had Morva evaluated by another expert of the state’s own choosing, but Herring never bothered to go back to the federal court and ask for that evaluation. It was just a man’s life in the balance.

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(7-6-17) I first became friends with Mary Zdanowicz when we were appointed to serve on a Virginia task force rewriting the state’s involuntary commitment standards. Several members of that committee, who had mental illnesses, were adamant about not changing the “imminent danger” language that had stopped me from getting my son help when he clearly was psychotic. Sadly, the meetings turned contentious. Through it all, Mary took the high ground. She ignored unnecessary bickering and insults, and never disclosed that she had a mental illness even though one of our antagonists considered us the enemy and felt that her diagnosis gave her more insights than Mary or any of the rest of us could possibly have. I came to greatly admire Mary’s dedication and determination – especially under fire. I was not surprised when I learned she was running for the NAMI board on a “Focus on Serious Mental Illness” ticket because, in her own life and professionally, Mary always has advocated for the sickest of the sick. Here’s her speech from the convention. She was not elected.

MARY ZDANOWICZ – FOR SOME: HOPE IS NOT ENOUGH

Why Focus on Serious Mental Illness?

Because NAMI is the only organization for people with serious mental illnesses and their families. 

To be clear, serious mental illness is not based upon diagnosis alone. It is not just schizophrenia and bipolar disorder.

It depends on the duration and severity of functional impairment of any diagnosable mental illness. It includes anxiety disorders, PTSD and others.

In recent years though, NAMI elected officials have broadened the organization’s focus.

This would be fine except it seems that the focus on mental illness is diminishing and “mental health disorders” are gaining prominence.

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