Pete Earley

(4-20-21)

In most American communities today, the behavioral health crisis system isn’t really a system at all, but a combination of services provided by law enforcement and hospital emergency rooms that are typically not designed to meet the needs of individuals in the midst of behavioral health crises,

So begins Roadmap To The Ideal Crisis System, a much-anticipated, recently released report written to provide advocates, local leaders, and your community with a step-by-step blueprint that shows how to create an “ideal system.”

The 208 page report – yep its thorough – leaves no aspect of crisis care uncovered. It was spurred, in part, by Miami Dade Judge Steven Leifman’s request for a practical guide that communities could use that would explain what an ideal system looks like and how to go about implementing one.

That was a daunting challenge.

The timing of the report is important because in 2022, the nation is scheduled to replace its national suicide hotline number with a much broader crisis hotline number – 9-8-8. In anticipation of the 9-8-8 switch, the report’s authors are urging communities to review what services are currently available and begin implementing its recommendations for forging an “ideal” system.

The report explains how 9-8-8 hubs can be used as an entryway into services where callers are triaged by specially trained experts capable of connecting them to crisis care services best suited for their individual needs – whether the caller is experiencing suicidal thoughts or is having a mental health or drug crisis.

Called “groundbreaking” by the National Council for Behavioral Health, the report spells out how “to design and implement a mental health crisis system and demonstrates how a community’s response must be fully integrated with the treatment system.” Read the full report or read the executive summary.” The council, which represents mental health providers and is pushing the report’s recommendations, states:

The comprehensive new report attempts to address every point in the continuum of crisis services. And because it is the first report of its kind, this blueprint will serve a vital role for any community that is planning its crisis system. With 9-8-8 fast approaching, it’s time to begin the work to plan, design and implement that system of care so the resources are in place when people call for help.

To help politicians, advocates, and legislators, the report includes a Report Card for grading your community. A section of the report also lists its recommendations for reducing reliance on police as first responders during mental health and drug crises.

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The arrival of Amazon’s east coast headquarters will give Arlington County a boost. Will county officials make Arlington a mental health showplace as well?

(4-14-21) Long-time Advocate Bob Carolla argues today that Arlington County, Va., could become a state and national showplace in providing community mental health care through a host of innovative programs. Will public- private partnerships help achieve the vision?

Arlington, Va–A New Frontier for Mental Health Care?

By Bob Carolla

Looking east, Arlington, Virginia is a gateway to the nation’s capital. Looking west, it is a gateway to a growing high tech economy.

It’s also home to an eternal flame that burns on a hill at the gravesite of John F. Kennedy in Arlington Cemetery: a symbol of the idealism of a New Frontier and an unfinished presidency. Part of his unfinished vision is available, accessible and excellent community based mental health care. Unfortunately the 1963 Community Mental Health Act remains a largely broken promise. Today, we have an inadequately treacherously fragmented, mental health care system that includes a yield of chronically ill homeless persons.

Arlington, where I live, currently is poised to fulfill President Kennedy’s vision.  Here’s steps that could help it accomplish that goal.

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(4-12-21) Involuntary Commitment is a topic that stirs strong opinions and feelings. I asked Dinah Miller, a Baltimore, Maryland, psychiatrist, and co-author of Committed: The Battle Over Involuntary Psychiatric Care to react to last week’s blog written by Cheryl Nimtz.

What I Discovered When I Investigated Involuntary Care

(4-8-21) From My Files Friday:  It’s been nearly a decade since I posted this blog about one of the first and most inspiring peers I was fortunate enough to meet. His death made me wonder about how we treat peers. We expect them to be models of recovery. What happens if the symptoms of their illnesses surface? Are we there to support them?

Death Of An Advocate

First published September 2011

I first met Glenn Koons when I was invited to speak at a luncheon in Montgomery County, Pa., being hosted by the National Alliance on Mental Illness. It was one of the first speeches that I delivered after publication of CRAZY: A Father’s Search Through America’s Mental Health Madness and before my talk, veteran NAMI Board Member Carol Caruso introduced me to Glenn. I was immediately struck by his easy-going manner. Carol bragged that Glenn was one of the first NAMI trained  Peer-to-Peer specialists in the entire nation. Glenn and I spoke for several minutes and I was impressed by his thoughtfulness and enthusiasm.

Our paths continued to cross during the coming years at various NAMI meetings and conventions. I was always happy to see Glenn and was thrilled when I learned that he had been one of only four NAMI peers who had been invited to the White House by President Obama to celebrate the 20th anniversary of the Americans with Disabilities Act of 1990. 

A few weeks ago, I was asked to write an article for NAMI’s VOICES publication. In my article, I mentioned three “consumers” who have inspired me. They were  Dr. Fred Frese, Diana Kern, and Glenn Koons.

The day after I submitted my article, an email arrived telling me that Glenn was dead.

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(4-6-21) If you met Cheryl Nimtz today, you would never suspect what she has experienced as an individual with lived experience. Rather than hiding her past, she writes poignantly about it in today’s blog and I am deeply grateful. 

I Tell My Story To Foster Wisdom, Understanding And Insight

By Cheryl Nimtz

Growing up, I had success by societies standards. I earned good grades, lettered in sports and graduated with honor society status in high school. I climbed the Grand Tetons, graduated with an associate degree and right out of college became one of Fort Wayne Indiana’s first women combat firefighters. (1980-1982)

At the young age of 21, I wasn’t aware of the storm brewing in my head. At the end of the two years, I started tripping in my dance of success.

I made poor decisions, lost my moral fiber and struggled emotionally. Things went from bad to worse when I resigned from the challenging job I loved. Soon after, I joined an extreme fundamentalist church and floundered as I tried to follow every rule to the letter.

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(4-2-21) An influential Virginia Sheriff lashed out at the state’s behavioral health department and the General Assembly during a press conference this week stating that both needed to “stop passing the buck and step up to develop and implement solutions to address the constant bed shortages and other deficiencies in the state response to mental health crises.”

Flanked by other sheriffs and police chiefs, Montgomery County Sheriff Hank Partin warned: “Folks that are in crisis, that need help – they aren’t receiving help.”

It is not uncommon, the sheriff said, for his officers to spend hours driving across the state searching for an available state hospital bed only to arrive and be told that none is available.

The officers’ complaints about a lack of state hospital beds for Virginians, who are being held under Temporary Detention Orders (TDOs), is hardly new.

A decade ago, then Inspector General G. Douglas Bevelacqua warned that there were not enough crisis care beds available at state psychiatric hospitals or at local hospitals. During a 90-day period, he discovered emergency rooms had turned away 200 individuals who had met involuntary commitment criteria and were judged dangerous. He called it “streeting” – simply kicking ill individuals to the streets.

In November 2013, state Sen. Creigh Deeds took his son, Gus, to a mental health facility but was told no local hospital bed could be found within the necessary time period for a TDO. Deeds and his son were sent home where Gus attacked his father with a knife, slashing his face, before ending his own life.

In 2015, Jamycheal Mitchell, age 24, died from “wasting away” syndrome in a Hampton Roads Regional jail after waiting 101 days for a state hospital bed. He suffered a heart attack after literally starving to death.

Virginia is not the only state that doesn’t have enough crisis care beds. Back in a 2005 study, the Treatment Advocacy Center warned:

“The consequences of the severe shortage of public psychiatric beds include increased homelessness; the incarceration of mentally ill individuals in jails and prisons; emergency rooms being overrun with patients waiting for a psychiatric bed; and an increase in violent behavior, including homicides, in communities across the nation.”

Fifteen experts cited in that report recommended states have “50 (range 40 to 60) public psychiatric beds per 100,000 population for hospitalization for individuals with serious psychiatric disorders.” At that time, Virginia had less than half that recommended number – 22.5 beds.

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