Pete Earley

(2-1-21) I posted a blog in December by several peer leaders urging the Biden Administration to reverse a slew of actions that Dr. Elinore McCance-Katz implemented while Assistant Secretary for Mental Health and Substance Abuse. Not surprisingly, two of her biggest political backers, Dr. E. Fuller Torrey and Dr. Sally Satel, are urging the new administration to do just the opposite – to continue and build on her policies. Their argument was published today in The National Review and also sent to me.

Don’t Undo The Trump Administration’s Mental Health Reforms

By Dr. E. Fuller Torrey and Dr. Sally Satel

Those with the most severe mental illnesses had a great friend in Trump’s Department of Health and Human Services. President Biden must build on that legacy.

As the executive orders pile up and President Biden seeks to distance his administration from President Trump’s, he should be careful to preserve and learn from the things Trump got right.

One such positive legacy is the work of Dr. Elinore McCance-Katz on improving services for people with serious mental illnesses. McCance-Katz resigned in early January after almost four years as the first assistant secretary for mental health and substance use and the director of the Substance Abuse and Mental Health Services Administration (SAMHSA), which runs point on federal mental-health policy.

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(1-29-21) Should the police be the first responders when someone with a mental illness is in distress? Recently, Crisis Intervention Team programs have come under fire because of incidents such as the killing of Patrick Kenny who had paranoid schizophrenia. The four Springfield, Oregon police officers involved in his death all had CIT training and one was a CIT instructor. Jeff Fladen, executive director of the Tennessee state chapter of the National Alliance on Mental Illness defends CIT programs, and sees them as necessary even if communities develop alternatives to having the police respond.  You can read here about the history and effectiveness of the estimated 400 CIT programs currently in the U.S.. 

CIT is Foundational (and We Need Co-Response Too)

Guest blog by Jeff  Fladen

As a leader of my state’s effort to expand CIT (Crisis Intervention Training) for law enforcement and other first responders, I have been hearing the same story nearly every day.

Instead of CIT, what about Co-Response and Alternative Response models, where mental health professionals assist the police during a mental health crisis either in person such as a social worker ride along or remotely from a control room or crisis center.

The Cahoots (Crisis Assistance Helping Out On The Street) program, launched by the White Bird Clinic in Eugene, Oregon some 30 years ago, is often brought up as an example of a successful co-response, although this program does not include social workers “riding along” with law enforcement. Cahoots features two-person teams consisting of a medic (a nurse, paramedic, or EMT) and a crisis worker who has substantial training and experience in the mental health field.

The program developed as an alternative to law enforcement acting as the mental health crisis first responder and offers an alternative approach to non-emergent issues. Other Co-response models include the Boulder Early Diversion Get Engaged (EDGE) program in Colorado, and the Boston Police Co-Responder Program, in existence since 2011. Additional programs around the country have developed  or have been announced in the past year.

I am deeply concerned that this is sometimes framed as an either/or discussion when it comes to CIT.  It shouldn’t be.

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(1-27-21)  What mental health organizations received a loan from the Small Business Administration through its Paycheck Protection Program to keep its workforce employed during the Covid 19 crisis?

The federal government has made 4.8 million PPP loans, worth a staggering $521,483,817,756. A second round is now in the works.

In the beginning, there were numerous complaints about who received forgivable tax dollars. Tampa Bay Buccaneers Quarterback Tom Brady, who signed a two year $50 million football contract, got nearly a $1 million loan for TB12, a company that hawks his t-shirts and other Brady items.  Evangelist Joel Osteen collected $4.4 million in PPP funds for his megachurch. The Los Angeles Lakers got $4.6 million but were  shamed into returning it.

The SBA moved to tighten rules and Congress took steps to insure that the bulk of funds went to smaller businesses that desperately needed loans to avoid laying off workers. The average amount of a PPP loan is currently $107,000.

If you type the words MENTAL HEALTH into the Washington Post data base that lists loans more than $150,000, you can learn if your local mental health provider is listed.

Here’s what several national mental health organizations received, including two that garnered more than $1 million.

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(1-22-21) Kimberly Kenny wrote a powerful blog last July for me describing how Springfield, Oregon police officers chased and fatally shot her brother during a mental health crisis. Shockingly, the four officers involved had undergone  Crisis Intervention Team training. The Kenny family received a $4.55 million settlement from the city — the largest lawsuit settlement involving police in Oregon’s history. The local prosecutor refused to file criminal charges and the department said its officers did not violate any laws or department policies.

After her blog was posted, the Kenny family told their story to The Washington Post: Fatal police shootings of mentally ill people are 39 percent more likely to take place in small and midsized areas.

And just before the year ended, the paper produced a podcast about the killing: Policing mental health crises: What can go wrong when police are the ones responding to mental health crises…

The disturbing 32-minute podcast narrated by investigative reporter Kimberly Kindy is difficult to hear because it contains recordings of Patrick Kenny pleas with police before his death. His sister told me in an email that she wants her brother’s death to be a wake-up call. A report, published by the Ruderman Family Foundation, found that nearly half of all fatal police shootings involved someone with a mental illness or disability.

We need alternatives to having the police be the first-responders when someone is in crisis.

Here is Kimberly Kenny’s original blog.

Crisis Intervention Training Didn’t Prevent Four Police Officers From Assaulting and Killing My Brother

 by Kimberly Kenny

The entire incident took less than five minutes.

It happened a little before 9 pm on a Sunday, near a hardware store Patrick liked to go to sometimes.

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(1-18-21) How racially diverse are the nation’s two largest, grassroots mental health organizations?

It seems an appropriate question to ask on Martin Luther King Jr. day.

So I decided to do a cursory review of upper management and the boards of directors at the National Alliance on Mental Illness and Mental Health America.

Mental illnesses don’t discriminate and inclusion doesn’t happen by chance. It must be deliberate.

NAMI

The National Alliance on Mental Illness is headed by Daniel H. Gillson Jr. who is its first African American President and CEO. Counting him, there are a total of five males and nine women on NAMI’s Senior Leadership team. Six of those 14 members are from racial minorities.*  Among them is Mónica L. Villalta, who is NAMI’s National Director of Inclusion and Diversity Officer.

NAMI has an elected 16 member board of directors. It includes six members from racial minority groups. The male/female breakdown is 10 women and 6 men.

In a press release issued last May, Gillson wrote that “racism is a public health crisis.”

“As the nation’s largest grassroots mental health organization, it is our responsibility to serve all. While as an organization we are still early in our intentional Diversity, Equity and Inclusion journey and have much to do, we have renewed our commitment to our values. We continue to strive to deliver help and hope to all who need it.

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This blog was updated at 12:45 today with the addition of another candidate.

(1-15-21) Who will replace Dr. Elinore McCance-Katz as the next Assistant Secretary for Mental Health and Substance Use?

Six names are being whispered, but insiders are warning that California Attorney General Xavier Becerra, the Biden Administration’s nomination for Secretary of Health and Human Services, will make the final call after he is confirmed by the U.S. Senate. He isn’t coming from the mental health and substance use community so his choice to head the Substance Abuse and Mental Health Services Administration could be a surprise.

Among the names I’m hearing are: Dr. Jeffrey Lieberman. Andrew Keller. Dr. Anita Everett, Arthur C. Evans, Judge Steve Leifman and Paolo del Vecchio. Click to continue…