Pete Earley

(5-1-17) Given the ongoing dispute about who will be the first Assistant Secretary for mental health and substance abuse, it seems a fitting time to discuss D.J. Jaffe’s new book, Insane Consequences: How the Mental Health Industry Fails The Mentally Ill.

For the past thirty years, Jaffe has been deeply involved in advocating for better care for the seriously mentally ill and his book provides a roadmap for what he is convinced needs to be done to rescue and reform our current system.

Jaffe became an advocate because of a family member. In his case, it was his wife’s younger sister, Lynn. What happened to Jaffe, his wife, Rose, and to Lynn has become an all too common story.

She started becoming paranoid, convinced that conversations taking place across the street involved plots to kill her…We took her to the emergency room. She was admitted, diagnosed, medicated, and provided rehabilitative therapy. But to “protect her privacy,” her doctor wouldn’t tell us her diagnosis, what medication she’d given Lynn, or what would happen when her hospitalization ended. Lynn returned home to us and stopped taking the antipsychotic medications we didn’t even know she’d been prescribed…”

Thus, Jaffe was thrust into our baffling mental health care system which he quickly found to be both frustrating and lacking. Determined to help change it, he began by knocking on the door of the National Alliance on Mental Illness, raising money for its New York City chapter and eventually joining its board. From there, he moved to the Treatment Advocacy Center where he became a strong advocate for Assisted Outpatient Treatment and a dedicated admirer of Dr. E. Fuller Torrey, one of TAC’s founders. More recently, he has launched his own organization, Mental Illness Policy. Org, which he describes as “a nonpartisan think tank that creates detailed policy analyses for legislators, the media and advocates.”

It is his untiring work as a self-admitted policy wonk that has made him a favorite of reporters eager to have someone explain or react to the newest unintelligible legislation that is churning its way through either a state or federal legislative body. Most recently, he worked closely with Rep. Tim Murphy (R. Pa.) and his staff in developing the Helping Families In Mental Health Crisis Act, which is designed to shift federal dollars away from what often are called “wellness” programs and focus on “the seriously mentally ill.” But let’s allow him to explain:

“America’s mental health system is insane, expensive, and ineffective. Under the guise of protecting civil rights, it is killing people. Under the guise of increasing freedom, it is increasing incarceration. Under the guise of facilitating recovery, it ensures that fewer recover. In the name of protecting privacy, it causes suicide. America treats the least seriously ill (“the worried well”) and forces the most seriously ill to fend for themselves. The ability to get help has become inversely related to need. We move sick people from hospitals to jails and label it progress. Government funds those who create the problems rather than those with solutions. The more dysfunctional the system becomes, the more money we throw at it. Our mental health system is not based on science and has nothing to do with compassion. As a result, there are ten times more people with mental illness incarcerated as hospitalized. Being mentally ill has essentially become a crime.” 

Click to continue…

(5-2-17) First some great budget news.

Texas Senator John Cornyn, the Republican majority whip in the Senate, is putting federal dollars behind his  Mental Health and Safe Communities Act, that was signed into law during the final days of the Obama administration.

Because of the hoopla about Pennsylvania Republican Rep. Tim Murphy’s Helping Families in Mental Health Crisis Act, Cornyn’s legislation didn’t get as much attention as it deserved.

Getting a law passed and funding it can be two separate challenges.

Cornyn just got $2.5 million set-aside for supporting a dozen national Crisis Intervention Team training centers to help better prepare law enforcement officers for dealing with individuals in a mental health crisis.

In addition, he’s pushing for another $76 million in the new administration’s budget that could go to fund critical mental health programs. Including:  $43,000,000 for drug courts, $12,000,000 for mental health courts and adult and juvenile collaboration program grants, $14,000,000 for grants for substance abuse treatment for state prisoners and $7,000,000 for a veterans treatment courts programs

Bravo and a big Thank You to the Texas Senator!

Now the other important news in Washington D.C.

I know many of you are too busy putting out fires to read about the ongoing feuding over who will be named as the first assistant secretary for mental health and substance abuse. But you need to pay attention because whoever gets confirmed is going to be tasked with overhauling the Substance Abuse and Mental Health Services Administration (SAMHSA.) and that could make a huge difference in funding for future programs.

In the past week, I’ve been interviewed for background by reporters from the Wall Street Journal and Politico.  I’m reprinting Brianna Ehley’s latest post about the squabble as first printed in Politico Pro.

Trump’s nominee for mental health chief wants to shake up the agency

By Brianna Ehley, published in Politico Pro

Elinore McCance-Katz quit her job at the federal agency in charge of mental health programs two years ago over staunch disagreements with top officials about what she considered to be a flawed mission that neglected people with serious mental illness.

Two years later, the Trump administration hopes to bring her back to the agency to shake things up.

Click to continue…

(5-1-17) My friend and fellow advocate, Jennifer Marshall, posted a blog on her website last week that I wish to share with you.)

I Landed in the ER after watching ’13 Reasons Why’

Click to continue…

(4-24-17) Pennsylvania Republican Representative Tim Murphy said in a press released late today that he was “stunned” by President Trump’s decision to nominate Dr. Ellie McCance-Katz,  to be the first Assistant Secretary for Mental Health and Substance Use in the Department of Health and Human Services.

Murphy, who was the driving force behind the Helping Families in Mental Health Crisis Act that created the new mental health and drug czar position, criticized Dr. McCance-Katz in his release because she worked for two years at the Substance Abuse and Mental Health Services Administration (SAMHSA) during the Obama administration as the agency’s chief medical officer.

The old regime at SAMHSA was incapable and unwilling to work with me and my colleagues in Congress to deliver the transformative changes needed at the agency and throughout the federal government to serve families in crisis. Therefore I am stunned the President put forth a nominee who served in a key post at SAMHSA under the previous Administration when the agency was actively opposing the transformative changes in  H.R. 3717, the original version of my Helping Families in Mental Health Crisis Act. In fact, the previous Administration and SAMHSA actively opposed the creation of an Assistant Secretary, as well as opposing my changes to HIPAA, expanding access to inpatient crisis psychiatric hospital beds, strengthening commitment standards and a host of other reforms. 

“Dr. McCance-Katz served as Chief Medical Officer at the very time SAMHSA was under investigation for multiple failed practices and wasteful spending. She was the key medical leader when the agency actively lobbied against any change or accountability, including when the Energy & Commerce Committee, indeed the entire Congress, was aiming to fix our nation’s broken mental health system by passing the most transformational mental health reforms in a half century. And while she was serving at SAMHSA, there were questionable hiring practices, no accountability for federal grants, an anti-medical approach to serious mental illness and substance abuse treatment and most importantly, the continued upward rise of suicide and substance abuse deaths.

The White House announced Dr. McCance-Katz’s selection late Friday after seriously considering two other finalists for the job. They included Miami Dade Judge Steve Leifman, who Murphy reportedly strongly opposed because he was not a psychiatrist, and Dr. Michael Welner, a forensic psychiatrist who reportedly was Murphy’s favored choice for the position but was passed over without explanation. Last week, the Wall Street Journal confirmed a blog  that I posted last month that named Dr. Welner as Murphy’s first choice.

Rep. Murphy’s criticism of Dr. McCance-Katz ignored criticism that she levied against SAMHSA after she resigned. In a blistering essay published in the Psychiatric Times, Dr. McCance-Katz wrote that SAMHSA’s Center for Mental Health Services, which administers federal mental health programs, ignored serious mental illnesses and evidenced based practices in favor of feel-good recovery programs that were politically popular but did little to help persons diagnosed with debilitating disorders. She claimed that SAMHSA was openly hostile toward the use of psychiatric medicine, didn’t focus on helping the seriously mentally ill, and questioned whether bipolar disorder and schizophrenia were even real, arguing that psychosis is just a “different way of thinking for someone experiencing stress.”

In his press release criticizing her, Rep. Murphy didn’t mention Dr. McCance-Katz’s complaints about the agency, even though his release echoed much the same criticism that she had made in her article. He wrote:

“We must end the era of silly, feel-good, anti-scientific, redundant and wasteful actions at the Substance Abuse and Mental Health Services Administration (SAMHSA) and across all federal programs. The anti-medical approach to mental illness and addiction over the past decade has too often made the care for those with serious mental illness considerably worse.

“Having not been scrutinized by Congress for more than a decade, SAMHSA lacked mission-focus, deviated from congressional intent and spent taxpayer dollars on programs that at best are of dubious quality and effectiveness, and at worst, prevented care from being delivered to the most vulnerable patient population.

Supporters of Dr. McCance-Katz said they were caught completely off-guard by the severity of Murphy’s criticism given that Dr. McCance-Katz shared many of his views.

Click to continue…