HOW DOES YOUR STATE RANK? 

(9-21-20) A report released today by the Treatment Advocacy Center entitled Grading the States: An Analysis of U.S. Psychiatric Treatment Laws has reached the same conclusion that most of us have experienced in person.

There is no national, standardized mental health care system.

Involuntary commitment laws differ wildly, as does available treatment. From the report:

“The U.S. mental health system is not one single broken system, but many…We are effectively running 50 different experiments, with no two states taking the same approach. As a result, whether a person receives timely, appropriate treatment for an acute psychiatric crisis or chronic psychiatric disease is almost entirely dependent on what state that person is in when the crisis arises.”

I would take this a step further. Not only do different states use different commitment standards, different counties and cities do too.

Fairfax County, Va. where I live, historically has been much more reluctant to involuntarily commit an individual who is in crisis than its adjacent counties. The state law is the same but the administrative law judges in charge in Fairfax are more hesitant.

The 160 page report lists each state’s criteria for involuntary commitment and describes how that state accesses dangerous.  It contains useful information about inpatient commitment, who can petition for emergency evaluations, and outpatient commitment along with how long a state can “hold” someone.

TAC used a 100 point grading scale, according to Lisa Dailey, the report’s primary author.  TAC was initially founded to push for adoption of Assisted Outpatient Treatment laws but has expanded its mission to “eliminate barriers” to all treatment. Recently, it has been lobbying for more crisis care beds.

“The report specifically focuses on laws rather than implementation. Some states have notable gaps between strong laws on the books and poor implementation and access,” according to the TAC press release issued with its report.

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Daniel Prude, 41, apparently stopped breathing as police in Rochester, N.Y. were restraining him in March 2020 and died when he was taken off life support a week later. Photo provided by Roth and Roth LLP.

(9-18-20)  Most of the media attention about Daniel Prude’s death in Rochester has been focused on the police response. What hasn’t been answered is why did a treatment center discharge him hours earlier? Cheryl Roberts, a former judge and executive director of the Greenburger Center for Social and Criminal Justice, asks that question and suggests in a recent editorial that America’s health-care system may be ” just as racist” as the criminal justice system. I look forward to reading your thoughts on my Facebook page.

Hard lessons from Daniel Prude’s death: The Rochester tragedy didn’t need to happen

By CHERYL ROBERTS

This editorial first appeared in the NEW YORK DAILY NEWS

Daniel Prude represents the most at-risk group of Americans to be killed in an encounter with police: a Black male living with a serious mental illness.

When police are summoned to so-called Emotionally Disturbed Person (EDP) calls, the results are often deadly. Nationwide, at least a quarter and maybe as high as half of those killed by police had mental illness. But the police alone do not own this statistic. The mental health system can be ineffective and racist too when it comes to African-Americans in mental health crisis.

Like Darrien Walker, killed by police only hours after release from a short-term stabilization center, Prude was seen by medical personnel shortly before his fatal encounter with police. While the hospital has promised a thorough review of the procedures and personnel involved, there will likely never be a complete public accounting should it be found that medical professionals were also at fault or that implicit bias was at the heart of why Prude was released that day without receiving help.

In many ways, America’s health-care system is just as racist as its criminal justice system, but there are no body-worn cameras to document how many times Blacks are dismissed or ignored by the health-care system or its professionals. A 2018 Commonwealth Fund study documented disparities in treatment and outcomes between Black and white patients; poorer disease outcomes, instances of physicians not taking time to explain diagnoses and options, disrespectful front-desk staff, and general lack of support in dealing with complications involving Black patients.

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(9-16-20)  Dr. Elinore McCance-Katz, Assistant Secretary of Health and Human Services for Mental Health and Substance Use, has been accused in an article posted on a popular health news website of repeating President Donald J. Trump’s pandemic statements for political reasons and politicizing the Substance Abuse and Mental Health Services Administration.

Writing in STAT, an American health-oriented news site read by medical professionals, journalist Alison Insinger reports that current and former SAMHSA officials have complained that Dr. McCance-Katz is “politicizing the office and reinforcing administration arguments about Covid-19 that aren’t supported by sound scientific evidence.”

The STAT article, entitled, “Top health official echoes Trump’s Covid-19 views, drawing accusations of politicizing mental health agency,” was written after Dr. McCance-Katz spoke during an hour long podcast posted Friday on the HHS website.

STAT noted that Dr. McCance-Katz did not respond to an emailed request for comment, nor did spokespersons for SAMHSA and HHS.

In that podcast interview, Dr. McCance-Katz can be heard describing Covid 19 as “a very contagious infectious disease which in most people, by the way, is a mild and asymptomatic disease if you are below age 45 and younger…” She adds that Covid is not a life threatening illness for a majority of children, saying at one point, “What is this nonsense that it is unsafe for children to be in school?”

The interview was conducted by Michael Caputo and when he states, “I don’t think the U.S. media gives a damn about public health information,” Dr. McCance-Katz replies: “I don’t either.” She adds that “it appears to me that they (the media) make things up.”

A psychiatrist with a Ph.D. in infectious disease epidemiology from Yale, McCance-Katz argues that the harsh steps taken to contain the pandemic in the spring were excessive and have caused an increase in suicides, drug and alcohol abuse, and mental illnesses.”We used a sledgehammer when I think we needed a scalpel.”

Dr. McCance-Katz’s statements mirror those of the president’s. He appointed her to serve as the head of SAMHSA and as the first assistant secretary at HHS for mental health and substance abuse in September 2017.

“She drank the Kool-Aid,” an anonymous source is quoted stating in the article.

I would strongly suggest that you form your own opinion by listening to the podcast.

During the first 20 minutes of the interview, Dr. McCance-Katz talks about her priorities at SAMHSA and promising steps that she has taken to reduce deaths caused by opioid abuse. 27 minutes into the interview, the subject turns to COVID.

“The people who make these decisions – the people who say it’s safer at home, stay at home, they tend to be people who are fairly affluent,” she states about isolation and the lockdown. “Yeah, it probably is safer at home for them because they go to some nice house, some big house with all the amenities…to get additional isolation and protection but for the majority of Americans, they can’t do that.”

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Healing Minds NOLA – August 28, 2020 – U.S. Senator Bill Cassidy, M.D., Timothy Noonan from Spyboy Media, LLC. on Vimeo.

(9-14-20) A mother rushes her son with mental illness to a local hospital. He’s admitted because he is psychotic and considered a threat to himself or others. But when the mother calls later to check on her son, hospital officials refuse to acknowledge that he is a patient because of their interpretation of HIPAA – the  Health Insurance Portability and Accountability Act.

None of us should be surprised by this mother’s plight. What makes her story different is who shared it.

U.S. Sen. Bill Cassidy, (R.-La.) cited the mother, who he described as a friend of his family’s, during an interview with advocate Janet Hays for her Healing Minds NOLA series. More about HIPAA in a moment, but first let me write more about Hays’ work.

I participated in a discussion hosted by Hays and Eric Smith with Leslie Carpenter last month about civil commitment laws. Prior to that program, Miami Dade Judge Steven Leifman and Treatment Advocacy Center’s Executive Director John Snook spoke about alternatives to incarceration. Streamlining inpatient and outpatient care was the topic of a Sept. 4th program with psychiatrists Robert Laitman and Marvin Swartz. You can find all of these programs here.

This coming Friday, Sept. 18th, at 2 p.n. EST, the topic will be the “IMD Exclusion: The 1965 Federal Rule That Crushed Psychiatric Bed Capacity,” with guests former Representative Tim Murphy (R. Pa.), the primary author of the Helping Families in Mental Health Crisis Act, and parent advocate Teresa Pasquini, who has written for my blog. 

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Three minutes into the above video, Bayless says he has no sympathy for Prescott.

(9-12-20) Sports commentator Skip Bayless is continuing to come under fire for his ignorant and hurtful statement that Dallas Cowboy’s quarterback Dak Prescott is “weak” because he revealed that he struggles with depression.

Bayless’s comment on Thursday’s  show “Undisputed” was immediately criticized.

As Nancy Armour noted in USA TODAY: “That Bayless made his comments on World Suicide Prevention Day, after Prescott said his brother Jace’s suicide contributed to his depression, was all the more cruel.”

Fox Sports immediately distanced itself from Bayless’s comments. Bayless reacted by claiming his comments had been “misconstrued” and opined that there is a difference between clinical depression  and being depressed during the pandemic. He didn’t apologize.

His comments were a hurtful reminder of why people who are struggling with depression are afraid to speak openly.

Athletes, especially NFL football players, can influence public opinion. Prescott should be commended for his openness, not condemned, just as former First Lady Michelle Obama should be praised for  recently disclosing that she has struggled with depression.

Bayless criticized the quarterback after he became emotional during an interview with Graham Bensinger on InDepth during which Prescott spoke about his brother’s suicide. (Interview below.)

It takes courage to speak out about depression. Those who criticize that honesty should apologize.

Here is the interview with Prescott.

(9-9-20) This is not specifically about mental illness but I think it does apply to individuals who want to be a leaders in mental heath.

While I generally don’t like simply posting articles or stories that I’ve read or watched, this seven-minute interview on Face the Nation with David Rubenstein about the qualities of leadership is worth your time.

I’m NOT posting it for political comment. It is not meant to endorse or defame either presidential candidate. Rather, I believe the lessons that Rubenstein proposes can be well used by all of us.

Here is the transcript if you’d rather read the interview.

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