Pete Earley

(3-1-17)  There’s promising news to report in Fairfax County, Va., where I live. Two peers have been appointed to important jobs and individuals familiar with mental illnesses have been named to serve on a panel that will review complaints about police actions.

Peer Jobs Filled

The Fairfax-Falls Church Community Services Board, which oversees mental health care, announced it has hired a Director of Consumer and Family Affairs, a management job specifically created to be held by a peer. That position has gone unfilled since the end of 2015 when David Mangano retired.

Facing budget cuts, Tisha Deeghan, the CSB executive director, initially had hoped to save money by dividing Mangano’s responsibilities among her top staff. But that move upset peers because none of those managers had lived experiences with mental illnesses. Peers argued that they needed one of their own in management, in part, because of the unusual nature of their jobs. Peer specialists often receive services from the CSB while working for it. That can put them in an uncomfortable position when they feel obligated to advocate for their clients against CSB decisions.  (The controversy about filling Mangano’s position ruptured feelings in the peer community, as evidenced by a still ongoing personnel dispute between CSB management and long-time peer advocate Gina Hayes.)

Director Deeghan said the CSB had hired Mark Blackwell to fill the county’s top peer job.

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Virginia Attorney General Mark Herring at podium with Governor Terry McAuliffe standing behind him.  

(2-28-17) Republic Delegate Robert B. Bell from Albemarle and Democratic state Senator R. Creigh Deeds from Bath continue to demand better mental health services and protections in Virginia.

In the final hours of the legislative session Saturday night, they were able to get language passed that clarifies who is responsible for investigating suspicious inmate deaths in Virginia jails.

Their dogged, bipartisan determination should bring an end to the cowardly behavior shown by state officials surrounding the death of Jamycheal Mitchell, a 24 year-old African American whose lifeless body was found in the Hampton Roads Regional Jail in August 2015. Mitchell, who had been diagnosed with a serious mental illness, had been jailed for allegedly stealing $5.05 worth of snack food from a convenience store. A judge ordered him sent to a state hospital to be restored to competency, but his paperwork was tossed into a drawer and not found until six days after his death.

By that time, Mitchell had spent 101 days in jail. An autopsy showed he had died from a heart attack brought on by starvation. He lost 46 pounds even though he was supposedly under multiple daily checks by correctional officers and a daily health check by a nurse.

The horror of his death was compounded when state officials claimed they either did not have jurisdiction to fully investigate what happened or dodged doing a credible investigation. Instead, they happily accepted assurances from jail officials who declared themselves innocent of any wrongdoing. Not surprisingly, that internal jail probe has never been made public.

At least three state agencies and Virginia’s Governor Terry McAuliffe contributed to this debacle. They include Virginia Attorney General’s office, the Office of State Inspector General, and the disAbility Law Center of Virginia.

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(2-23-17) A tweet by Dr. Jeffrey Lieberman, the chair of the Psychiatry Department at Columbia University, announcing that Miami-Dade Judge Steven Leifman has been appointed as the first Assistant Secretary for Mental Health and Substance Use Disorders is premature. No final decision about the appointment has been made.

“Thrilled with appt. of Judge Steve Leifman as First Asst. Sec. of Mental Health in US History,” Lieberman tweeted.   

While Judge Leifman is a strong candidate for taking charge of the Substance Abuse and Mental Health Services Administration (SAMHSA), which has a $3.5 billion budget, Health and Human Services Secretary Tom Price has not officially announced which candidate he will recommend to the White House. The new Assistant Secretary will then have to be vetted and approved – either by President Trump or his staff – before his appointment is sent to the U.S. Senate for confirmation.

For his part, Judge Leifman is not commenting publicly about the tweet or his possible appointment.

Judge Leifman is considered to be the leading candidate because, in my opinion, he is the most qualified and clearly the best choice for the job, a sentiment widely agreed on in Washington.

But he still faces hurdles. When Vice President Mike Pence was governor of Indiana, he appointed Dr. John Wernert to overhaul Indiana’s state mental health system. That could cause problems if Pence decides to get involved. There are still some who are lobbying for a psychiatrist, not a judge, to be put in charge of  SAMHSA.

Being a psychiatrist or someone with an equivalent medical background was one of the requirements that Rep. Tim Murphy (R.-Pa.) originally put in his Helping Families in Mental Health Crisis Act (HB- 2646), which started the effort in Congress to reform our mental health system after the Newtown shootings. But that requirement was dropped when Murphy’s bill reached the Senate. Senators didn’t want their hands tied when it came to the confirmation process and they also wondered if a psychiatrist would have the management skills needed to run a large bureaucratic organization.

I have always supported Judge Leifman because I have seen first-hand how he has transformed the mental health care system in Miami-Dade County from one of the most horrific in the nation to one that is now  nationally  recognized as a “gold standard” model being copied by other progressive communities.

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(2-20-17) I often feel as if I am preaching to the converted because many of the speeches that I give are to mental health or law enforcement groups. So I was especially thrilled last week to speak at an event that focused on more than mental health – the Lake Nona Impact Forum outside of Orlando, Florida. Many of the 250 “thought leaders” who attended were not familiar with the mess that our nation’s mental health system is in.

Sanjay Gupta, MD, Chief Medical Correspondent for CNN, moderated the panel that I was on with fellow mental health advocate Margaret Trudeau, the former wife of Pierre Trudeau, 15th Prime Minister of Canada and the mother of Justin Trudeau, 23rd Prime Minister of Canada; and with Dr. Andrew Nierenberg, Director of the Bipolar Clinic and Research Program at Massachusetts General Hospital and Professor of Psychiatry, Harvard Medical School.

Ms. Trudeau’s description of her personal struggles with bipolar disorder was self-effacing, poignant and often funny. Best of all, her recollections came from her heart and deeply touched those fortunate enough to hear her. Of course, Dr. Nierenberg is one of the nation’s leading experts on treatment-resistant bipolar depression and the longitudinal course of mood disorders and he offered easy to understand explanations to difficult medical problems.

All three of us were invited to the event because of Muffy Walker, one of the founders of the International Bipolar Foundation and one of my favorite examples of an individual who decided to put her creative talents to use by helping found and finance a non-profit organization that calls attention to bipolar disorder and funds research.  (Read her inspirational story here.)

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(2-13-17) Officials at Rapid City Regional Hospital in South Dakota need to re-read the Hippocratic Oath and ask themselves if they are proud of how they are treating individuals with mental illnesses in the Black Hills region.

Unless someone in a mental health crisis also has an “acute medical need,” the hospital is turning them over to the police to be held in jail for 24 hours even though they have not committed any crimes.

A hospital spokesman explained that psychotic individuals often are disruptive and frighten other patients so they are not welcomed at the hospital. South Dakota allows law enforcement to temporarily detain individuals in jail up to 24 hours without charging them with a crime.

Rapid City Police Chief Karl Jegeris criticized the hospital, according to Mike Anderson, a reporter with The Rapid City Journal, who disclosed the hospital’s new policy.

“This is the biggest step backward our community has experienced in terms of health care for mental health patients. And though it’s legally permissible by statute to put someone in an incarceration setting, it doesn’t mean that it’s the right thing to do.”

The Rapid City hospital is not the first to turn away pesky psychotic individuals. Consider the angry call that I received in Fairfax County, Virginia, where I live, from an outraged parent who said a local ER here called the police and had her son arrested for trespassing after he showed up seeking psychiatric help.

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