(2-8-16) I believe in the power of a single individual to cause change.  I believe in the power of one because of what I have personally witnessed visiting all but two states during the past ten years and what I continue to see each day.

Consider Vontasha Simms.

She is the 47 year-old mother of Romechia Simms, who was charged with manslaughter and child abuse after her 3-year-old son, Ji’Aire Lee, was found dead on a Maryland playground sitting in a swing. Romechia, who has schizophrenia and depression, had been pushing him for forty continuous hours and was still pushing him when the police arrived. An autopsy showed he died of hypothermia and dehydration.

Last week, Vontasha borrowed a car and drove 45 minutes from her home in Waldorf, Maryland to the state capitol in Annapolis, to talk to  lawmakers about the need for mental health reform, according to a story  by Fenit Nirappil in the Washington Post.

Vontasha had never been to the State House before and didn’t recognize any of the key players there but she went anyway to urge them to make it easier for parents or close relatives to take charge over adults who had mental disorders.

At the time of her grandson’s horrific death, Vontasha was living in a motel on public assistance. She is not someone who is a polished lobbyist but since Ji’Aire’s death and her daughter’s arrest, she has testified before her county commissioners and used the public outrage about the playground tragedy to talk about how she repeatedly tried to get her daughter help for her mental illness but couldn’t.

That takes courage.

Click to continue…

On Friday, 1-29-16, I posted a blog by  journalist/author Robert Whitaker questioning the value of anti-psychotic medications. Whitaker felt compelled to explain his position about medications because of statements challenging him made by Dr. Allen J. Frances, Professor Emeritus of Psychiatry and Behavioral Sciences at Duke University Medical School in an email.  Here is Dr. Frances’ response to Whitaker’s response.

Do Antipsychotics Help Or Harm Psychotic Symptoms?

By Dr. Allen J. Frances

This is the latest, and perhaps last, of several debates with Bob Whitaker on the role of antipsychotics in treating psychotic symptoms. It was triggered by a recent email exchange that clarified our areas of agreement and disagreement. 

Bob and I agree strongly on the following:

1) Antipsychotic medicines are used far too often in people who don’t need them.

2) Even when necessary, doses are often too high and polypharmacy too common.

3) Antipsychotics are neither all good, nor all bad. Used selectively, they are necessary and helpful. They are harmful when used carelessly and excessively.

4) The treatment of people with psychosis relies far too much on medication alone, far too little on social engagement, psychotherapy, vocational rehabilitation, and providing adequate housing. We both like the normalizing, recovery models offered  by Trieste, Open Dialogue, and Hearing Voices. (click here to read more on this subject.)

5) The care provided for the mentally ill in the US is a disaster that shames our country. (click here to read my thoughts about this.) 

Bob and I disagree strongly on the following:

1) Bob believes that long term use of antipsychotics makes psychotic symptoms worse. He therefore recommends that patients try to avoid antipsychotic medicine altogether or taper off them, whenever possible. 

Click to continue…

Two internal memos, not previously made public, show that state mental health officials in Virginia were warned earlier than has been widely reported about “streeting” – the practice of turning people away from hospitals because of a lack of psychiatric beds.

The two in-house warnings were written by then Inspector General G. Douglas Bevelacqua and sent to James A. Stewart, who was serving as Commissioner of the Virginia Department of Behavioral Health and Developmental Services (DBHDS) at the time, and his upper management.  The memos are dated April 14, 2011 and May 12, 2011.

The public first learned about “streeting” from media reports when Bevelacqua issued an IG report on February 28, 2012, specifically about the practice.

These earlier two memos establish a timeline that shows DBHDS officials were aware of “streeting” some 31 months before State Senator Creigh Deeds and his son, Austin “Gus” Deeds were “streeted” with tragic results.

Click to continue…

I recently asked Washington area management consultant Steven Kussmann to suggest ways the mental health community could be more effective in achieving meaningful reforms. Here is the thoughtful and creative blueprint that he sent me.

Changing The Mental Health Movement From Within

by Steven Kussmann 

Less than 3% of our population self-identifies as gay or lesbian. Yet, the LGBT community created a movement that changed our nation’s definition of marriage and secured same sex marriage as a constitutional right! Change did not happen organically nor overnight. It was the result of a highly-effective social movement strategy and decades of well-targeted action.

The number of U.S. citizens with a serious emotional and mental health disorder is 10-times greater than the LGBT population. Why then do our social and political successes pale in comparison with those achieved by this community? What can we learn from them to achieve similar results? How can we apply those lessons to transform the mental health movement into a powerful engine for effective change?

The lessons are many, and their application requires a fundamental refocus of movement strategy and structure. To succeed as a force for real social and political change, the mental health community, both its leadership and grassroots network, must rethink and retool its strategy and tactics.

Here are five get-the-ball-rolling ‘lessons learned’ from the success of others the mental health community can act on now:

Click to continue…

In the past two decades, Robert Whitaker has published books and articles that challenge the conventional wisdom about the widespread use of medications in treating mental illnesses.  A research paper entitled: The case against antipsychotic drugs: a 50-year record of doing more harm than good, that the journalist/author published in 2004 is representative of the skeptical eye that Whitaker casts.

By chance, I was included in an email exchange where Whitaker objected to being labeled as someone who is unilaterally “against” medications.  Dr. Allen J. Frances, Professor Emeritus of Psychiatry and Behavioral Sciences at Duke University Medical School, suggested that Whitaker clarify his views. In this guest blog, Whitaker explains what his research has shown him.

Click to continue…

This photo was taken by my son, Evan Luzi, near his apartment. It is untouched – the work of the wind – as the snow around it was clean with no tracks.

Patti and I were in the Virgin Islands taking a rare and long anticipated five day vacation when we heard that a blizzard would be hitting the Washington D.C. area, starting at 4 p.m. on Friday (1-22-16). Patti suggested we catch an earlier flight home on Thursday.

“No way!” I said stubbornly. “I’m not giving up two days of vacation. Besides, weather forecasters are always exaggerating. It makes for better ratings.”

A call to American Airlines set off alarm bells on Friday morning. If we didn’t leave the island immediately, we would be stuck in St. Thomas until late Tuesday night. Stuck?

Ordinarily, the threat of being forced to stay in a tropical paradise while the entire upper East Coast was under three feet of snow would be a no-brainer. Bring me another Pina Colada while I watch a perfect Caribbean sunset, please.

But I was scheduled to testify before the U.S. Senate Judiciary Committee on Tuesday (1-26-15) about the importance of Crisis Intervention Team training and jail diversion. I didn’t want to miss that hearing.

Patti and I scrambled to the airport and took off for Miami, the first link of our trip home.

And that is as far as we got on American Airlines, which promptly cancelled the next leg of our flight. We were stranded in Miami on Friday during a downpour of rain. A kind but frazzled flight agent told us that we had been re-booked on a flight that would leave late Tuesday night for Dulles Airport.

“But I have to get back to testify before a Senate committee on Tuesday morning,” I said, hoping that statement would make it sound as if the safety of the entire free world depended on me giving testimony.  (I would later learn that Vice President Joe Biden’s flight had been redirected to Miami and that he couldn’t get home to Washington either.)

My plea didn’t work. Worse, American Airlines refused to give us our bags.

Click to continue…