Pete Earley

(1-11-21) I asked Dr. Elinore McCance-Katz to review her four years as the first-ever Assistant Secretary For Mental Health and Substance Use now that she has resigned. Her response follows:

Dear Pete,

I can’t imagine that anyone was more surprised than me when I was nominated to the political appointment of the first Assistant Secretary for Mental Health and Substance Use.

I have never been active in any political party although I have worked in government for many years—for both Republicans and Democrats.

I have done this because I believe it is imperative that healthcare practitioners have a real ‘place at the table’ and provide subject matter expertise and experience working with those who suffer from illnesses to the government which regulates the delivery of healthcare services in this nation. I have three major tenets that influence my approach and decisions in behavioral health.

Health Care Is  A Right, It’s Cruel To Not Help SMI, And Families Matter

The first is that healthcare is a right—that people have a right to treatment of mental and substance use disorders. The second is that it is not honoring a person’s civil rights to allow them to suffer from brain diseases such as schizophrenia, schizoaffective disorder, bipolar disorder, and drug and alcohol addiction because they are too ill to realize they need medical care—rather it is cruel. That approach condemns affected people too often to live unsheltered, without adequate food, isolated and alone, at risk for violence, abuse, injury and sometimes death. For far too many it results in imprisonment for minor infractions of the law further stigmatizing and isolating them. I believe that a society is judged by how it treats its most vulnerable and, from my perspective, there are none more vulnerable than those who are terribly impaired by severe mental and substance use disorders. I believe families are the real backbone of the safety net system for those living with these serious mental illnesses and that they should be communicated with by healthcare providers when someone too ill to know to contact family members is admitted to a hospital—to not do so is callous. For the great majority of those with serious mental illness family members are the consistent caregivers and as such, should be included in care plans developed by clinicians unless there is evidence for mistreatment or abuse. In my experience, that is rarely the situation.

These principles have guided me through these last four years in federal service.

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(1-7-21) Dr. Elinore McCance-Katz resigned tonight as the first Assistant Secretary of Mental Health and Substance Abuse at the Department of Health and Human Services Administration because of the violent attack by Trump supporters yesterday at the U.S. Capitol.

McCance-Katz’s term was due to end January 20, when President-Elect Joe Biden is scheduled to be sworn in. But in a statement released this evening, she wrote that yesterday’s “behavior was totally unacceptable and, in my own heart, I simply am not able to continue. I believe that we are given certain life situations where we must make the difficult decisions and we get one chance to do it the right way… I cannot support language that results in incitement of violence and risks our very existence.”

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(1-4-21)  John Snook is resigning as executive director at the Treatment Advocacy Center after six years. In this Q. and A. departing interview, he discusses the role of TAC.

Question: Why do we need TAC? What makes TAC unique besides the fact that it doesn’t accept Big Pharma money?

TAC plays a role that no other mental health organization does – it’s the only organization focused exclusively on the care of those with severe mental illness. Those with severe mental illness unfortunately don’t have a lot of champions; it’s TAC’s job to ensure that their needs aren’t ignored by policymakers or the mental health community.

The sad fact is that it’s much easier to make the case for mental health than it is for mental illness reform. People don’t want to be reminded of the homeless woman on the street corner or the psychotic man trapped in solitary confinement. And so we often see the conversation drift to talk about everyone’s mental health and away from tough issues like the role of untreated mental illness in fatal encounters with law enforcement.

TAC is there to remind us that unless we have those difficult conversations, nothing is going to get better and those most in need will continue to be left behind. 

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(1-1-21)  John Snook is resigning as executive director at the Treatment Advocacy Center after six years overseeing its operations, the non-profit announced today. He has accepted a job as Director of Government Relations and Strategic Initiatives at the National Association for Behavioral Healthcare, a Washington DC-based association that represents America’s largest psychiatric hospital chains.

His departure creates openings at the helms of two major mental health non-profits. Mental Health America’s President and CEO Paul Gionfriddo announced earlier this month that he is retiring in the new year. MHA is the oldest  mental health advocacy group founded by former mental patients.

TAC was founded in 1988 by Dr. E. Fuller Torrey to advocate “for the elimination of barriers to effective treatment for individuals with severe mental illness.” Its focus has always been on serious mental illnesses. One of its core missions is to advocate for greater use of Assisted Outpatient Treatment. It also has pushed for more inpatient crisis care beds. TAC’s current Director of Advocacy, Lisa Dailey, will serve as TAC’s acting director until its board selects a successor.

I was told that John is leaving on good terms for career advancement. NABH is about twice the size of TAC in gross revenues. NABH members include more than 800 specialty psychiatric hospitals, general hospital psychiatric and addiction treatment units, residential treatment centers, youth services organizations, and other providers of care.

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During a two minute clip, one of my favorite humanitarians explains why he washed the feet of homeless Bostonians. 

(12-24-20)  For Dr. James J. O’Connell, it began during his residency by washing the feet of a homeless man.

One homeless client wondered aloud how skilled of a doctor O’Connell was if he had been assigned such a humbling task.

But it was that simple act of kindness which opened his eyes to the importance of treating individuals who are homeless as people of worth and launched his career as a street doctor to Boston’s homeless.

I was delighted when CBS’s Sunday Morning show featured Dr. O’Connell recently during a segment called Promoting the Power of Kindness.The eight minute segment raises questions about whether kindness can be taught or is a born trait for some.

I met him when he joined the board of directors of the Corporation For Supportive Housing, a national leader in building housing and developing programs that help individuals in need live independently. (If you want to be impressed read Dr. O’Connell’s bio at the end of his blog.) 

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(12-21-20) I asked Luna Greenstein, who works at NAMI national as a senior manager, to tell me how the nation’s largest, grassroots mental health advocacy organization responded to the challenges of 2020.

The Growth of NAMI’s Mission in 2020

By Luna Greenstein

This year has been filled with adversity on many levels, but it is in times of adversity that we are forced to grow, to evolve. It is also in times of adversity that we tend to bond with our fellow humans who are facing the same challenges.

The National Alliance on Mental Illness (NAMI)’s evolution during 2020 is a perfect example of this.

We started this year like any of our last 40 years —  focused on our mission to better the lives of Americans with mental illness and their families. We were updating our programs to keep with the times, bringing people into our community through our awareness campaigns, and bringing our State Organizations and Affiliates throughout the country together to ensure we held a united front.

We also had a new CEO start in January, Dan H. Gillison Jr., the first Black American to lead the organization since its founding in 1979. As it turns out, he was exactly the right person at the right time.

When the pandemic hit in March, our mission expanded to face the challenge ahead. While we were still focused on our grassroots mission, we found ourselves with an increased need to help  all Americans, not just those with mental illness, cope with this crisis that was now impacting everyone’s mental health.

A Huge Undertaking : Becoming “everything to everyone.”

As you can imagine, this was a huge undertaking.

But no one was better suited to do this than NAMI. We are truly the only mental health organization that wants to “be everything to everyone.” While this isn’t always possible, we certainly try.

We are an Alliance made up of thousands of people who, simply put, care about other people and their mental health and want to help them have access to the resources, tools and care people need to cope with the challenges of mental health issues. Lastly, we are a group of people who are extremely familiar with discomfort — all of us have a reason why we are so dedicated to this mission — and, to put it mildly, this pandemic has been uncomfortable for everyone.

How did we change?

One of our goals at NAMI is to “meet people where they are.”  Well, now they were all at home. NAMI had to find ways to be there with everyone, too. The Alliance banded together to help our Affiliates and State Organizations transition their education classes and peer support groups to an online format.

The NAMI HelpLine switched to being remote for the first time in our history, and we increased our capacity significantly to handle the huge influx of calls from the new wave of Americans experiencing mental health issues for the first time.

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