Growing Talk About Modern Day ‘Asylums’ Being Heard: Good Or Bad Idea?

 

(7-6-18) In today’s New York  Daily News, Cheryl Roberts, the executive director of the Greenburger Center for Social and Criminal Justice, writes about the need for mental health “asylums.”

During my travels and recently in Washington, I’m hearing more and more discussions about the need for longer-term residential facilities for the sickest of the sick. Americans always react with horror whenever  anyone talks about rebuilding “state hospitals.” That is a real fear based on the atrocious abuses that happened when state hospitals were dumping grounds in our nation.

Two factors are rarely mentioned in such discussions. The first is the widely accepted Rule of Thirds, which states there is a percentage of individuals with schizophrenia who we simply don’t know how to help and have little chance of ever recovering. Can everyone be helped through Housing First and ACT team programs in our communities? Can everyone live independently in supportive housing – an important question given the U.S. Justice Department’s drive to close group homes in favor of everyone having the right under the American Disabilities Act to their own apartment.

The second factor: while dumping individuals in shoddy institutions is unforgivable and unacceptable, no one faults long term residential facilities that currently exist in our nation that are generally so expensive that only the very rich can afford them. These are often farms or hospital connected residential facilities that appear more like college campuses than the locked wards of the past. Are institutions – by their very nature – destructive to the human spirit or did state hospitals become despicable monuments to man’s inhumanity because they were never adequately funded and dreadfully understaffed by an uncaring public? If the latter is true, is it realistic to believe that any public funded residential facility could ever operate on the same par as their private and prohibitively expensive rivals? 

In her OP Ed, Roberts joins an mounting chorus of advocates demanding an end to inappropriate incarceration. The question that lingers is how best can we help those who often are so ill they become entangled in our criminal justice system? Now that is a loaded question! I’ll be interested in hearing your thoughts on my Facebook page.

The Greenburger Center was created by New York philanthropist Francis Greenburger, whom I met decades ago when my first book agent operated out of Greenburger’s literary agency. I’ve written before about how Greenburger’s son, Morgan, was arrested during a mental health crisis and jailed at Rikers Island, which is what led to his politically influential and loving father to found the Greenburger Center.

Out of jail cells & into havens: Rikers must give way to humane alternatives for the seriously mentally ill

By Cheryl Roberts,

OP Editorial published in the New York Daily News

“Bring back the asylum” is a buzzphrase popularized by President Donald Trump, who reaches back in time for a simplistic solution to mass shootings.

For more than 10 million Americans with serious mental illness, asylum — defined as “an inviolable place of refuge and protection” by Merriam-Webster — is a concept that urgently needs to be reclaimed and realized, without recreating the inhumane asylums of the past.

When government began closing asylums 50 years ago, few new institutions emerged to absorb this population. That’s how jails, prisons and homeless shelters became the default housing options for those struggling with mental illness. But some people with serious mental illness still need asylum.

Places that provide asylum can be psychiatric hospitals, psychiatric units in general hospitals, Department of Defense or Veterans Affairs medical centers, private psychiatric hospitals, or treatment centers that provide 24-hour care but are not licensed as hospitals. What they can’t be are prisons or jails.

Click to continue…

My Friend Dr. James J. O’Connell Featured In Reader’s Digest: Street Doctor To The Homeless.

(6-29-18) I’ve written before about Dr. James J. O’Connell who has spent more than thirty years caring for homeless persons through the Boston Healthcare for the Homeless Program. I am fortunate to serve with him on the Corporation for Supportive Housing Board of Directors. This week, Reader’s Digest posted a well deserved profile of Dr. O’Connell written by Jim Axelrod in its “inspiring stories” series.  Compassionate caregivers such as Dr. O’Connell give me hope and truly make our world a better place.

Reader’s Digest: This Doctor Turned Down A High-Paying Career To Help The Homeless

by Jim Axelrod

When his homeless patients can’t get to a physician, he goes to them!

It’s a Friday morning in Boston, which means Dr. Jim O’Connell is making his rounds. He might be more comfortable inside an exam room, but that’s not where his 
patients are. O’Connell is one of a handful of physicians making house calls to the homeless in the city.

More than 550,000 Americans 
are homeless, and many have 
health problems but no access to care. O’Connell and his team, made up of psychiatrists, internists, a nurse practitioner, a case manager, and a recovery coach, are doing something about it. They spend their days walking around where the homeless live—in parks, under bridges, and 
on the outskirts of town. They treat about 700 regular patients. During these rounds, O’Connell himself usually sees about 20 patients. He knows where most of them sleep and whom to ask if they are missing. “I feel like I’m a country doctor in the middle 
of the city, you know?” he said.

O’Connell went to Harvard 
Medical School and was on his way to a prestigious oncology fellowship when his chief suggested he take what was supposed to be a one-year position as the founding physician 
of a new health-care program for Boston’s homeless. That turned into a 33-year career at the Boston Health Care for the Homeless Program, one of the country’s largest of its kind.

“You realize, ‘You know what, I’m just a doctor. And what I can do is 
I can get to know you and ease your suffering, just as I would as an oncologist,’” O’Connell said. “You could not find a more grateful population.”

And his patients are grateful. “This man is unbelievable!” one remarked. “He’s like Jesus,” another added.

Click to continue…

“You S.O.B. How Could You Let Me Live Like That?” A Question We All Should Answer

(6-25-18) Dr. James J. O’Connell has been a street doctor to Boston’s homeless for more than 30 years and is one of the most dedicated and compassionate caregivers whom I’ve been fortunate enough to meet. Over a recent dinner, he shared this story with me about his work at Boston Healthcare for the Homeless Program.

A homeless woman, who was clearly mentally ill, rebuffed all attempts by Dr. O’Connell and his team to help her.  She would put spoiled milk, garbage or other offensive items around where she camped on the concrete to ward off people.

“We spent years on the overnight van trying to earn her trust despite the putrid and rancid barrier she built  around herself.  We were astonished and quite proud of ourselves when, after more than five years, she finally began to smile at us and accept our offers of sandwiches, soup and a blanket.”

One night she became threatening to passers-by, so much so, that the Boston police took her against her will to a hospital.

A year after she was removed from the street, Dr. O’Connell happened to be at an event where he spotted her.

Click to continue…

Pressed by Advocate, CIGNA Responds To Not Including A Peer On Panel. Washington Post Doesn’t

(6-23-18) I recently took my former employer, The Washington Post, to task for not including someone who’d recovered from a mental illness on a recent blue ribbon panel discussion about the status of mental health care in America. AJ French had asked the Post and its co-sponsor, Cigna  to include a representative so all sides could be heard. The Post hasn’t responded, but Cigna did. 

A conversation is a start. By AJ French. 

Sometimes I wrestle with how to go about effectively communicating in a way that will bring about necessary change when every reason exists to become morally outraged by injustice.

This happened again when I learned The Washington Post discriminated against featuring subject matter experts who are leaders in the mental health recovery movement.

Readers who faithfully follow Pete Earley, know that the Washington Post Live staff ignored my communication about inclusion. I am pleased to report that Cigna did not. A representative from their organization called and apologized to me within twenty-four hours.

Click to continue…

NAMI Objects To My Criticism About It Not Doing More In New Hampshire To End Incarceration Of Individuals Imprisoned Simply Because They Are Mentally Ill

(6-22-18) In a recent blog (Time To End New Hampshire’s Shameful Practice of Putting Individuals With Mental Illnesses Into A  Maximum Security Prison To Save Money), I complained because the NAMI New Hampshire chapter had not joined the Treatment Advocacy Center in asking the U.S. Department of Justice to stop the state from imprisoning individuals with mental illnesses in a state prison even though they had not been charged with a crime. (The state doesn’t want to pay for a secure unit at its state hospital. Link to copy of TAC letter below.)

Both NAMI’s national office and Kenneth Norton, NAMI New Hampshire’s Executive Director, told me that my criticism was misinformed and unfair. Here is an edited version of the first email Ken sent me and the official letter that he drafted as a response to my blog. I have not edited nor altered their letter.

Hi Pete, 

I am deeply disappointed that you chose to include statements about NAMI NH in your blog about NH’s Secure Psychiatric Unit without checking facts first. ..NAMI NH has had a long standing position opposing the transfer of patients from New Hampshire Hospital to the Secure Psychiatric Unit.  We have provided oral and written testimony in opposition to this practice at numerous legislative bill hearings, study commissions and in other forums.  Our most recent testimony on this issue was March 27, 2018.

Ken

Here is NAMI’s official response to my criticism:

In mental health advocacy circles, we have a long, unfortunate history of turning on each other and distracting from efforts to achieve broader advocacy objectives.

This is what has just occurred with recent national blogs and posts regarding New Hampshire’s practice of transferring a small group of individuals, who have been civilly committed but not charged with crimes, from our state hospital to our Secure Psychiatric Unit (SPU) where they come under the jurisdiction of the New Hampshire (NH) Dept of Corrections and are co-mingled with people serving criminal sentences.  This process occurs through an administrative transfer that is initiated when an individual engages in such a high level of self-harm or assaultiveness that they are deemed no longer able to be safely maintained at New Hampshire Hospital.

NAMI NH has a well-documented and long-standing opposition to this inappropriate practice and has been actively opposing it for many years – long before it first made national headlines. 

Click to continue…

Frustrated Mother Writes Mental Health Laws Put Parents In “Catch 22” – Waiting Until Crisis To Seek Help

(6-18-18) Guest Blog: A frustrated mother writes an impassioned letter to her elected officials in Washington State about waiting until someone becomes dangerous before helping them.

The Catch-22 in our medical/legal system that criminalizes mental illness

By Jerri Clark, mother of a young adult son with bipolar/schizoaffective disorder

I’m an active participant in NAMI programs and therefore have met many family members who are struggling to find intelligent help in the medical and legal systems of Washington State.  

Most of the stories I hear come from other mothers.

We are struggling to rescue our children from medical and legal systems that don’t make any sense.

Our systems institute punishment when help is desperately needed. They deny access to services and then blame individuals who are severely impaired for not solving their own crises. They push people to a precarious edge and then kick.

Click to continue…