Healthy Minds Draws Thousands

Thousands of people turned out across the U.S. and in Canada on September 14, 2008, for an unprecedented series of free public forums on how neuropsychiatric research has helped turn the tide on the devastating effects of mental health disorders.

Sponsored by NARSAD, the world’s leading philanthropic organization for research on mental illnesses, the historic day of events served to launch an international public awareness campaign called “Healthy Minds Across America.” Forty-seven unique forums took place at prominent universities and medical centers across the continent, where scientists who are conducting leading-edge research provided some of the latest findings on such conditions as schizophrenia, depression, bipolar disorder, anxiety disorders, including as post-traumatic stress disorder (PTSD), and childhood mental disorders.

The day of events saw nearly 4,000 attendees, including Colorado First Lady Jeannie Ritter, who opened the Healthy Minds Across America forum at the University of Colorado Denver. Among other notable guests at the forums were David Hamburg, M.D., former longtime president of the Carnegie Corporation of New York and an early pioneer of biological psychiatry; Oliver Sacks, M.D., famed neurologist and author; Andrew Solomon, award-winning author of “The Noonday Demon: An Atlas of Depression;” and Barbara Leadholm, commissioner of the Massachusetts Department of Mental Health.

However, most in attendance were patients seeking to learn about potential new treatments for their disorders, parents concerned about their children’s chances of recovery, mental health professionals interested in understanding the causes and mechanisms of mental illnesses and how to better help their clients, special education teachers who wanted to find out how to work more effectively with their students with brain and behavior disorders, and students of psychiatry and neuroscience.

Hopefully, as the result of new research spurred by this event, future Healthy Minds Across America will be able to provide news of new treatments and more answers for consumers and family members.

Sacramento Bee Gets it Half Right

In a Sept. 28, 2008 editorial, the well respected Sacrament Bee urges the county and the state to fully fund programs for people with mental illness, especially the homeless.  The editorial comes in the wake of a tragedy in which Frank Perez was shot by a homeless woman with an untreated mental illness. 

“She is an extreme example of what can happen when mentally ill homeless people are left untreated,” writes the Bee.  “Most aren't packing guns. In fact, they are more likely to be victims than perpetrators. Still, there is a huge public cost to ignoring them.”

The Bee continues to hit the bull’s eye of the problem.

“Too many end up begging on streets and sleeping in doorways. They turn up at hospital emergency rooms, in jails and in prison. In the end, treating mental illness is far less costly for the public, for the homeless and for rare victims like Frank Perez.”

The paper starts down the road for a solution.  In 2004, California voters passed Proposition 63 calling for a tax on the wealthy to ensure programs for people with mental illness didn’t face budget cuts.  Unfortunately, it has been ignored and the Bee is 100 percent correct in pointing out this failure. 

That’s, however, only half of the problem.  Sacramento County as well as the state’s other counties need to enact Laura’s Law.  This law, left up to each county to put in place, would provide assisted outpatient treatment for people with mental illness.  Laura’s Law will increase the cost effectiveness of treatment that the Bee so rightly identifies and—most importantly—it will save lives.

Lawsuit Dropped, Now Put in Place Laura's Law

El Dorado County, Calif. inched a little closer to justice as two sheriff’s deputies dropped an outrageous lawsuit against 67-year-old Karen Mies whose son with a severe mental illness killed his father and then lost his own life in a gun battle with the deputies.

The deputies’ $19.2 million lawsuit was the ultimate insult to injury to the Mies family.  The family had struggled to get their son Eddie the help he needed to battle schizophrenia.  Unfortunately, the law wasn’t on the family’s side.  Laura’s Law hasn’t been put in place in El Dorado County.  That law would have made assisted outpatient treatment available to the Mies family.  It might have prevented the tragedy. 

The lawsuit drew the ire of many, including this blog on two occasions.  The deputies were wrong for filing the suit in the first place.  It only inflicted further pain and suffering on the Mies family.  However, dropping the suit isn’t enough.

The best way for El Dorado County to improve the situation, and help other families from experiencing the same type of tragedy facing the Mies family, is to put in place Laura’s Law.  Now is the time.

 

Another Virginia Warning Call

What minimal mental health treatment reforms made in the wake of the Virginia Tech tragedy are at risk of being undone, the latest result of tight budget cuts.

Advocates are issuing a warning call in hopes that Virginia Governor Timothy Kaine will hault the looming cutbacks from putting more people at risk.

“It will be a real setback, both locally and statewide,” said Tom Spurock, the father of a son with a severe mental illness and a tireless advocate for better treatment.

As a result of the 2007 shootings of 32 Virginia Tech students by Seung-Hui Cho, the state clarified the criteria before a person can be involuntarily committed to treatment and established minimal procedures for assisted outpatient treatment.  Cho had been ordered outpatient treatment but disappeared after making only one appointment at a clinic and never showed up again before he opened fire on the campus. 

Spurlock and other advocates wanted to see the reforms go much further, and brought closer inline with laws in New York, Louisiana, Idaho, and other states that have made major treatment reforms.  Governor Kaine signed the legislation, but he too would have liked to have seen more reforms.

The pending cuts would place a state mental health system already near exhaustion over the edge.  With a serious shortage of psychiatric hospital beds, overcrowded emergency rooms unable to provide psychiatric treatment, jails struggling to care for inmates who have no other place to go, and too many loopholes still left in treatment laws, now is not the time to make cuts.

Indeed, Virginia and other states are facing tough budget times.  Cutting vital mental health services, however, will prove penny wise and pound foolish.  There is a better prescription for Virginia’s mental health woes.  Governor Kaine should place a protective shield around mental health issues so to help ensure there is no sequel to the 2007 tragedy and he should ask the state assembly to take a closer look at making Virginia’s treatment laws a model for the rest of the nation.  Doing so would build a living memorial to those who lost their lives that fateful April day.

Protection and Advocacy for Lawyers

Imagine lawyers as a protected class who need public support and help.  It now seems that’s exactly what’s happening as so called “Protection and Advocacy” attorneys are circling the wagons to aid and abet the misdeeds of one of their own in Maine.

The lawyer posse was formed after an Aug. 16, 2008, front-page Wall Street Journal story detailed the handy work of the Maine Disability Rights Center and their lead attorney Helen Bailey in making sure that in 2006, William Bruce, a 24-year old man with schizophrenia was released from hospital care and his family was prevented from making sure he received treatment.  Despite that the doctors described Bruce as, “Very dangerous indeed for release to the community,” Bailey insisted she knew best.

As it turned out, Bruce was released because of Bailey’s legal handiwork and later killed his mother. 

The National Disability Rights Network has been busy trying to cover the tracks left in the carnage of Bailey’s legal tricks.  No wonder, there is no good that has come out of Bailey’s work.  The larger question remains:  Why keep defending what is clearly indefensible?

Bailey expressed her true sentiments of how she views her job to The Wall Street Journal.  “My job is to get the patient’s voice into the mix of where decisions are made,” she told the reporters.  “No matter how psychotic, that voice is still worthy of being heard.” 

Neither Bailey nor her legal posse has shown any remorse for what happened in the Bruce case.  “There is nothing in the William Bruce case that is contrary to the way we do business,” she says.

Hardly comforting words for a family in grief.  Here is how highly Bailey views the opinion of family members compared to her own sound legal judgment, “There are some God damn nasty families out there.”

Bailey considers this as business as usual, using taxpayer dollars.  As it turns out, they used those funds—in part given to them by the Bruce family and other law abiding citizens who pay their taxes and play by the rules—to offer protection from doctors trying to treat the sick.  Beyond that, Bailey’s group lobbied the Maine legislature to make sure she would get to keep her business as usual scheme going.  Did Bailey use federal dollars to lobby?  Did the Maine legislature believe her?

The answer to the first question is unknown and one would suspect Bailey has another Cracker Jack team of accountants carefully covering her tracks.  As for the second, the Maine legislature didn’t buy her phony argument that not providing medical care to someone with a severe mental illness was in that person’s best interest.  Has that fully stopped Bailey?  No.  She is now trying to use the courts, and likely public funds, to override the will of the people of Maine.

Putting Families and Doctors at the Center of Treatment

In the wake of recent preventable tragedies in Washington State, the venerable Seattle Post-Intelligencer has done an outstanding job of restoring reason to the debate on mental illness.  In both reporting and editorials, the paper has examined what the state can do, instead of dwelling on the tragic events.

Here is what the paper’s editorial board concludes:

“For all the strengths of our system here, including mental health courts and the early adoption of parity for mental illnesses in health insurance, we can do better.

“The Skagit killings highlighted the near impossibility of committing dangerously mentally ill individuals to treatment. P-I reporter Carol Smith found Washington is one of the few states where families and doctors cannot directly petition to have a mentally sick person treated against his or her will. Families and physicians should be put in the center of treatment efforts.

“We’re also a state where involuntary treatment is almost never performed in the community instead of a hospital. The community practice in other states makes enormous sense: By requiring treatment when someone is still well enough to be in the community, there would seem to be a good chance of staving off worsening illness.

“Smith and reporter Daniel Lathrop also discovered the state spends $1.8 billion yearly on mental illness or its aftermath, but only about $530 million on direct treatment. One result: Not enough hospital beds for the mentally ill. Overall, the spending pattern is a warning signal that we need to refocus.

“It’s still possible we need to spend more. But money must be spent effectively and not be tainted by politics, as when King County government last year structured some funding from a new mental health tax to fit a powerful union's organizing efforts.”

At the core of this sound reasoning is putting families and physicians at the center of treatment efforts.  If more states take this message to heart, much can and will be accomplished.

Hospital Beds Continue to Dwindle as Budgets Get Cut

It looks as if two Ohio mental health hospitals will soon close as the result of state budget woes.  On Sept. 11, 2008, Gov. Ted Strickland proposed $540 million in budget cuts; on top of previous cuts it will reduce the state’s budget by a total of $1.27 billion.  The economy is taking its toll and there are probably few good choices when that much of a budget gets slashed.

Considering Ohio has a critical shortage of hospital beds for people with mental illness, the state should look elsewhere to make up the shortfall.  In the larger scope of over a billion dollars in cuts, saving the beds amounts to little more than knick.  When one considers the risk of a preventable tragedy, it’s not worth the risk.

 

Dying With Your Rights On

The following is an excerpt from a World magazine interview with Dr. E. Fuller Torrey.

WORLD:  What is “dying with one’s rights on”?

TORREY:  Dr. Darold Treffert, a psychiatrist in Wisconsin, originally used the term.  He kept track of the increasing number of deaths of individuals with serious mental illnesses who died from accidents, suicides, starvation, etc., because of the new laws making it difficult to treat them.  Dr. Treffert wanted to emphasize the fact that the new slaw were effective in protecting the person’s civil liberties and their right to refuse treatment, but in doing so the laws put the person in danger.  Dr. Treffert is one of only a few American psychiatrists who have spoken out forcefully regarding the abysmal job we are doing in providing appropriate care for individuals with severe mental illnesses.

Today, someone, somewhere with a mental illness died with their rights on.

 

Washington State: Change or No Change

“I Kill for God. I Listen to God,” 28-year old Isaac Zamora told a judge at his court hearing on Sept. 5, 2008, after being arrested for shooting and killing 6 people, and wounding 4 others in Skagit County, Wash. Zamora, suffering from severe mental illness, was kept from the treatment his family had sought, treatment that likely would have prevented this devastating event. Washington law stood in the way of the Zamora family’s ability to get Isaac the treatment he so clearly needed, and the consequences are disastrous.

The Zamoras are far from being the only Washingtonians affected by treatment laws surrounding mental illness. Liz Browning, mother of a young man suffering from schizophrenia, knows all too well the barriers in getting help for a loved one with a mental illness. Liz and her mentally ill son, Marcus, visited several mental hospitals to find help. However, Marcus and Liz were repeatedly turned away during their hospital visits, being told that Marcus was not ill enough to warrant treatment. “You almost hope they are really, really bad,” Browning told the Seattle Post-Intelligencer. “And that's just so wrong.”

Dr. Peter Roy-Byrne is the chief of psychiatry at Harborview: one of the hospitals the Brownings visited on their quest for Marcus’ treatment. Dr. Roy-Byrne feels that the hospitalization of a mentally ill person has made a transformation, turning from a medically based judgment into a legal decision. "It's like if someone came into the ER with chest pain or cardiac arrhythmia, and we had to tell them, until they have a heart attack or need a heart transplant, we can't do anything," the doctor said of the state’s restrictive mental illness treatment standards.

Hopefully, the obstacles to accessing treatment that plagued the Brownings and the Zamoras are not set in stone. Due to the magnitude of the situation, Washington Gov. Chris Gregoire ordered a review of Zamora’s case overseen by the head of the Washington Association of Sheriffs and Police Chiefs, as well as a prosecutor from the Washington Association of Prosecuting Attorneys. The anxiously awaited report is due next week. Hopefully, it will include the changes needed that will save lives.

How Many More Names Will it Take?

New York has Kendra’s Law, California has Laura’s Law, Michigan has Kevin’s Law, and Louisiana has Nicola’s Law.  Those are just a handful of state that have passed assisted outpatient treatment laws to help people with severe mental illnesses after a tragedy sparked lawmakers into action.  A number of other states, New Jersey, Nevada, Pennsylvania, and others have witnessed preventable tragedies and have pending legislation to reform their mental health treatment laws.

The question is:  How more names have to be added before a state acts?

This question was recently posed by New Hampshire’s Concord Monitor.

“Will some unfortunate New Hampshire resident,” writes the paper, “have a similar law named for her? If the state's mental health system continues to be starved for resources and the state's laws governing involuntary commitment aren't revised to better balance civil liberties with public safety, it's a distinct possibility.”

Thinking before another tragedy occurs is the right course of action. 

As the Concord Monitor added, “The state's prisons and its county jails are packed with people whose crimes might have been averted had they received good mental health care. Most of those inmates will return to society, and some, given the state of the law and New Hampshire's mental health system, will pose a serious danger to the public. The Legislature shouldn't wait for a victim who can give a name to the new law before acting.”

There is no time to act like the present.

Tragedy Strikes on New Jersey Train Platform

Michael Fuccile was waiting for his train to work on Sept. 4, 2008, at the Liberty State Park light rail station when 26-year old Elgin Louis Taylor, Jr., who had been diagnosed with schizophrenia since age 16, stabbed and killed him.

The murder was a surprise.  Taylor’s illness and lack of treatment were not.

“I've been fighting the system for years to get the power of attorney to make him go to the hospital and make them keep him until he’s well,” said his distraught father.

This tragedy could have very likely been prevented.  In 2006, the New Jersey Senate unanimously passed a version of “Gregory’s Law” that would have brought assisted outpatient treatment in the Garden State.  Unfortunately, the bill didn’t move out of the Assembly and onto the Governor’s desk. 

The bill was named after 11-year old Gregory Katsnelson who, like Fuccile, was killed by someone with a severe mental illness who refused treatment.  Gregory would have turned 17 next month. 

New Jersey has strong leaders, including Senate President Richard J. Codey, who pushed for the measure.  Now is the time to make the final push so New Jersey is no longer one of a small handful of states that has no assisted outpatient treatment law.

 

Washington State Tragedy Draws Reactions

The shooting tragedy that left six dead in Skagit County, Wash., has sparked strong reactions from average citizens all the way up to Governor Chris Gregoire, who has ordered a 10-day review of what happened. 

Below is an expert from one of the many blog comments received in response to a story in the Seattle Post-Intelligencer.  The Governor’s review panel should take note.

“Most people don't understand mental illness, nor do they care about the mentally ill until something like this horrible tragedy happens. Then everybody gets upset...and talks about how horrible it is and then...nothing happens.

“Unless you have experience with it, you can’t imagine how hellishly frustrating it is to try to get an extremely ill family member into treatment who is convinced that they are not ill. It is simply impossible to scale that wall of delusion without professional help and long term care.

“But the laws leave the people who could help with their hands tied behind their backs. Even if they were allowed to, there is now no place for people who have fallen off their meds to get back on them in a safe and controlled environment, because all but a few of the mental hospitals were shut down years ago, victims of more spending cuts.

“The mental health system here is BROKEN and is being held together with Band-Aids and glue, and thank God by some incredibly caring but overworked, underpaid and understaffed social workers and mental health professionals whose caseloads have gone from maybe 10 in the 70's to up to as many as 75 now. How can anyone be expected to truly track and care for that many ill people?

“It is our mental health system that is really insane.

“My heart goes out the victims’ families, but also... to the family of the shooter...he should have been in treatment, not on the street.”

 

The Washington State Roadblock Tragedy

The headlines are as chilling as they are too familiar.  “Six dead in Skagit County shooting rampage,” reads the September 3, 2008 Seattle Times headline.

The shooter, 28-year-old Isaac Zamora has a history of mental illness and was living alone in the woods, despite attempts by his family to get him the help he needs.  The help that might have saved the lives of six innocent people who were left dead along Interstate 5 north of Seattle.

One of the victims, Anne Jackson a Skagit County sheriff’s deputy, was aware of Zamora’s history of mental illness and had told his family to call her anytime for help.

This raises many, many questions.

Why put a law enforcement officer in this type of situation?

Why wasn’t Zamora in treatment?

Why didn’t county officials do more to help the Zamora family get their son treatment?

In the days to come, some of these questions will be answered and many others will be raised. 

Earlier this year, another tragedy in Washington State raised some of the same questions.  Anthony Williams refused to take medication for his paranoid schizophrenia.  His family tried to get help.  He had numerous contacts with law enforcement over violent threats.  Finally, on New Year’s Eve, he fatally stabbed 31-year old Shannon Harps outside her house.

Prior to the tragedy, county officials said Williams did not pose an “imminent” threat, even though Washington’s law does not insist that someone be “imminently” dangerous to receive treatment.  Washington State does, however, require a county designated mental health professional to act as a middle man when a family tries to get someone help.  This was a roadblock to treatment then, and remains a roadblock today after six more people have lost their lives on the side of an Interstate. 

Washington State needs to remove the roadblock to care before another tragedy strikes.

People Recognize When Something is Wrong

In a previous post, this blog covered a case of Misguided Justice where a California mother of a mentally ill son who was killed under police fire was being sued by the very same police officers who opened fire.  The legal action has caught the ire of many others, and rightly so. 

“Despicable,” was the word used by El Dorado County Supervisor Ron Briggs to describe the law suite against 66-year widow Karen Mies.

“The citizens are appalled, and they are right to be appalled,” Briggs told the Sacrament Bee. “I do not believe that public servants should be suing the people they serve. It's a fundamental problem that breaks the trust.”

Briggs is not the only one who is upset.  Hundreds of letters to the editor, blog comments, and other public statements share the outrage. 

The boss of the two officers suing Mies was among those expressing his outrage. 

“As sheriff, I am embarrassed at the filing of the civil tort against the Mies family by two law enforcement officers,” Jeff Neves said. “I recognize that there are situations and circumstances which, in my opinion could warrant the filing of a civil lawsuit; this is absolutely not one of those cases.”

With any good fortune, the suit will be dropped and Mies left alone.

The next, and larger step, will be for El Dorado County to implement Laura’s Law.  Providing assisted outpatient treatment will help give both parents and police a greater change that tragedies like the one impacting Mies family can be avoided.  It only makes common sense and provides what is just.