Pete Earley

(3-23-22) It’s happened again. This time, two are dead and three others wounded. All homeless men. All brutally attacked.

Gerald Brevard III, a 31 year-old Washington D.C. resident, with a long history of mental illness, has been charged with killing Morgan Holmes, 54, who was found shot and stabbed in his tent, which was set on fire, on March 9th in the nation’s capital. Brevard is a suspect in another murder in New York City that happened several hours later and three other shootings of homeless men.

As almost always in killings that involve a suspect with a diagnosed serious mental illness, there were plenty of red flags that were ignored.

“He is a good person and like many across the world, he suffers from mental illness,” Brevard’s father, Gerald Brevard Jr., told local Washington NBC News4 reporter Shomari Stone. “The bigger picture is not that he has mental illness, but the number of times that he’s been within the judicial system and how the system has failed regarding the treatment of so many, including my son.”

The senior Brevard is right. The most recent missed opportunity happened in Fairfax County.

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(3-19-22) The debate about whether the National Institute of Mental Health should spend more of its $2 billion budget on clinical studies (behavior studies) versus pure brain research continues in today’s blog with NIMH critic Dr. E. Fuller Torrey claiming that NIMH Director Dr. Joshua Gordon recently misspoke during an interview with a New York Times reporter.

The New York Times’ story focused on Dr. Thomas Insel, former NIMH Director, and his new book, Healing: Our Path From Mental Illness To Mental Health, but it quoted both Dr. Insel and Dr. Gordon defending the agency’s dramatic shift away from clinical research.

That shift began under Dr. Insel’s leadership (he left NIMH in 2015). In the article, reporter Ellen Barry quotes Dr. Insel defending the move:

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(3-18-22) The National Institute of Mental Health is the largest research organization in the world investigating the causes and potential cures for mental illnesses. Each year, it spends $1.6 billion dollars.

But what is it accomplishing?

Under its current director, Dr. Joshua Gordon, NIMH has focused almost entirely on studying the brain and turned its back on clinical studies – such as the effectiveness tele-psychiatry and studies that could help identify why some Americans with serious mental illnesses are continually entangled in our criminal justice system and how we can help break that cycle.

In this excerpt from a recent paper published in Psychiatric Services, NIMH critic, Dr. E. Fuller Torrey and Treatment Advocacy Center Director, Lisa Dailey, J.D., take Dr. Gordon and NIMH to task for “failing to support research that is likely to help anyone who currently has a serious mental illness.”

The questions they raise deserve to be answered!

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(3-15-22) This is the second part of journalist Michael Judge’s interview with Dr. E. Fuller Torrey, once named as the most influential psychiatrist in America. Part one was posted yesterday. Used with permission from Michael Judge.

The Man Who Helped Millions, Including My Family, ‘Survive Schizophrenia’

A conversation with Dr. E. Fuller Torrey, author of “Surviving Schizophrenia: A Family Manual.” He’s a rare find in today’s medical world—a psychiatrist who refuses to give up on the most severely ill.

Michael Judge

By Michael Judge  (This article first appeared on The First Person With Michael Judge)

Michael Judge: My two brothers were very, very severely ill . . . one of them, John, died at 21, right before his 22nd birthday; and the other died at the age of 54.

Fuller Torrey: It’s a hard life.

It’s a hard life. So then you completed medical school and went on to become a psychiatrist. How soon after that did you publish Surviving Schizophrenia?

I went to medical school, then interned for a year in San Francisco, and then went into the Peace Corps for two years as a Peace Corps doctor in Ethiopia. Then I came back and took my residency in psychiatry at Stanford and started working on Surviving Schizophrenia, I’d say in the mid-1970s. I was in Washington with the National Institute of Mental Health (NIMH). At the same time, I took a job at St. Elizabeth’s Hospital working with the most severely ill, and found that as I was educating the families, I was saying the same things to all the families. I soon realized that I should write it down because all the families needed the information. So it was after I went to work at St. Elizabeth’s in 1976 that I started putting Surviving Schizophrenia together.

So were you doing direct, hands-on clinical work and then taking notes for the book? You came to believe you could help families that way?

Yes. I was just a regular ward doctor at St. Elizabeth’s and I had severely ill patients. And you learn very quickly when you’re taking care of them all, and also the families always wanted to know what was going on and how to help them. So that provided me with all the material. And still, when I go back and look at Surviving Schizophrenia, I remember a lot of my patients that I used as examples.

And back then, the drugs were far less helpful, right? Back then it was just a lot of Lithium and perhaps Haldol or Prolixin?

Yeah, the drugs were not as good. We didn’t have Clozapine. Clozapine came in later. But still, if you used them right, they could help a lot of patients.

Yes, my brother Steve was eventually put on Clozapine, and that was a real lifesaver for him. He went from being basically unresponsive to almost all medications and then, in the early 1990s, he got on one of the first drug trials for Clozapine, and he responded immediately. It was almost as if he had come back from the dead, you know?

Not everyone responds to Clozapine, but if they do, it can be very dramatic as you’re describing. Sadly, it’s underutilized. Even today, it’s not being prescribed nearly as often as it should be.

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(3-15-22) I heard about mental health advocate June Judge before I met her several years ago. She was well known in mental health circles for her tenacity and get-to-work attitude. Her son, Michael Judge, a former editor at The Wall Street Journal, has launched his own subscription newsletter and he recently sent me an interview that he conducted with the legendary and always controversial Dr. E. Fuller Torrey, founder of the Treatment Advocacy Center.  Mr. Judge graciously allowed me to reprint the interview in two parts. 

The Man Who Helped Millions, Including My Family, ‘Survive Schizophrenia’

A conversation with Dr. E. Fuller Torrey, author of “Surviving Schizophrenia: A Family Manual.” He’s a rare find in today’s medical world—a psychiatrist who refuses to give up on the most severely ill.

Michael Judge

By Michael Judge  (This article first appeared on The First Person With Michael Judge)

It’s not often that you can look back on your life and say, with certainty, this person saved my life. But that’s how I feel about Dr. E. Fuller Torrey, the world-renowned psychiatrist and best-selling author known to friends simply as Fuller.

Back in April 1983, when Fuller’s groundbreaking book Surviving Schizophrenia: A Family Manual was first published, I was a 16-year-old kid who had just lost two of his greatest heroes to schizophrenia.

My brother Steve was battling the horrific symptoms of the brain disease—delusions, hallucinations, severe paranoia—after being diagnosed with schizophrenia in 1979 while a third-year cadet at the Air Force Academy. My brother John, a star football player with a full-ride scholarship to the University of Iowa, took his own life just six months before the first printing of Surviving Schizophrenia, after he too was struck down by the disease in a landslide of delusions, shame, and despair.

It was Fuller and my mother, June Judge, a fierce advocate for those suffering from the most severe forms of mental illness, who together saved my life.

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(3-10-22) A federal panel created by Congress to advise it and the Substance Abuse and Mental Health Services Administration (SAMHSA) about serious mental illnesses and serious emotional disturbances is being reinvigorated by Health and Human Services Assistant Secretary Miriam E. Delphin-Rittmon, PhD..

Before it was largely forgotten midway through the Trump Administration, the Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC) was pushing for better cooperation between federal agencies that provide mental health services and was promoting new and best practices.

ISMICC is composed of 14 non-federal members who work with representatives from federal agencies that oversee mental health programs. It was created by the 21st Century Cures Act and signed into law during the final days of the Obama Administration. ISMICC’s 14 non-government members represent specific groups. For example, two members must be peers with lived experiences. I am the lone parent representative. Judge Steven Liefman from Miami-Dade, Florida, is one of two judges on the panel. (I’ve posted a list of all members at the end of this blog.)

Shortly after being confirmed, Assistant Secretary Delphin-Rittmon announced that she wanted the ISMICC advisory panel to become more involved in advising SAMHSA about programs that work and don’t. (President Trump issued an executive order shortly after taking office, ordering agencies to eliminate most advisory panels, charging that many were unnecessary or obsolete.) Assistant Secretary Delphin-Rittmon assigned SAMHSA officials, Dr. Anita Everett and Cynthia Kemp, to bring ISMICC back to life. Both have done a bang up job!

This month, ISMICC members will break into five informal work groups to discuss how the federal government can improve mental health programs. I am serving on the workgroup that is examining criminal justice reform.

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