Friday, May 30, 2014

What Lessons Can Be Learned From The Santa Barbara Mass Murders? A must-read blog post today by Pete Earley

The Elliot Rodger case is especially painful to parents. News reports suggest his parents recognized their son was troubled, got him into treatment and when his writings and statements on social media alarmed them, they called the police to request a “wellness” check. When his statements became even more worrisome, they left immediately to visit him only to be too late.
Armchair quarterbacking is always risky, but here are a few thoughts about this recent shooting.
Lesson one: I strongly endorse Crisis Intervention Team Training for the police, but a psychiatrist should have been sent to evaluate Rodger based on his parents’ call and Rodger’s psychiatric history.
Lesson two: Even if a psychiatrist would have found Rodger’s mental condition troubling, little could have been done because he was not posing an immediate danger to himself or others. I’ve written before about the need to re-examine “danger to self or others” as a criteria. Coercion should always be the last step, but we need to find a better criteria for deciding when to use it simply because no one can predict dangerousness.
Lesson three: The reason the police were called is because we do not have viable alternatives. Most emergency rooms are no better equipped to evaluate an individual in crisis than are the police.  We need more crisis stabilization centers, such as those in San Antonio, Texas, and Philadelphia, Pennsylvania, where someone who is experiencing a mental crisis can be evaluated and offered the help that he/she needs.
Lesson four: communication and coordination are crucial. Did anyone bother to contact Rodger’s therapist?  Did anyone listen to why his parents were so alarmed? Were they asked about their son’s past episodes? Too often, parents are marginalized. Not all parents are good parents. But most care about their adult children’s mental health. I’ve heard too many stories from parents who attempted to talk to law enforcement, doctors and therapists only to be dismissed and told that background information about their adult child’s earlier episodes was insignificant. Would the same be said about a heart condition?
Lesson five: it’s all about money. Elliott Rodger came from an affluent family but being wealthy is no guarantee that you will receive meaningful care and treatment. (See lesson one – sending a psychiatrist with first responders would be wonderful, but in most communities getting an appointment to see a psychiatrist can take days, weeks, even months. See lesson three –we need more crisis stabilization centers, but building them takes money.)

Monday, May 26, 2014

Poor mental health can affect longevity as much or more than heavy smoking, study finds

Treatment before tragedy - Listen to family!

(AP Photo/Jae C. Hong). This photo shows the windshield of a car that was shattered by a bullet at the scene of a shooting on Saturday, May 24, 2014, in Isla Vista, Calif.Doris A. Fuller, executive director of the Virginia-based Treatment Advocacy Center, said California law has provisions that permit emergency psychiatric evaluations of individuals who pose a serious threat, but that was never triggered.
Rodger's family has disclosed their son was under the care of therapists.
"Once again, we are grieving over deaths and devastation caused by a young man who was sending up red flags for danger that failed to produce intervention in time to avert tragedy," Fuller said in a statement.
"In this case, the red flags were so big the killer's parents had called police ... and yet the system failed," she said.
Read here:  Killers family tried to intervene before rampage

Saturday, May 24, 2014

Rep. Murphy Responds to Santa Barbara Mass Shooting

Announces Public Forum For This Thursday on Helping Families in Mental Health Crisis Act to Aid Those In Psychiatric Need

For Immediate Release: Saturday, May 24, 2014
Contact: Brad Grantz202.225.2301

(WASHINGTON, DC) – Congressman Tim Murphy (R-PA) released the following statement regarding the mass shooting in Santa Barbara County, California.
“Our hearts break for the victims and families affected by the tragedy near Santa Barbara. We pray for their souls to find peace. But I am also angered because once again, our mental health system has failed and more families have been destroyed because Washington hasn’t had the courage to fix it. How many more people must lose their lives before we take action on addressing cases of serious mental illness? I put forth a solution with my Helping Families in Mental Health Crisis Act,” he said. “Washington must take action on my bill.”
Murphy, Chairman of the Oversight & Investigations Subcommittee of the House Committee on Energy & Commerce, will hold a briefing on Thursday to highlight the committee’s recent reportwhich was released following a yearlong investigation reviewing the mental health resources and programs across the federal spectrum. The committee’s investigation began in January 2013, following the tragedy in Newtown, Connecticut, and against the backdrop of subsequent mass killings tied to untreated SMI at the Navy Yard in Washington, D.C., and Fort Hood, Texas. The briefing will take place on Thursday, May 29, 2014, at 12:30 p.m in room 2322 of the Rayburn House Office Building and streamed live online here.
Chairman Murphy, a clinical psychologist, along with a handful of experts and families with lived experiences will participate in a discussion on the findings from the committee’s recent report and other developments related to the treatment of serious mental illness. 
The report explains, “The committee’s inquiry has drawn attention to the importance of targeting funds for mental health to areas with the greatest impacts on public health and safety. … The findings of the committee’s investigation underscore the need to improve training for law enforcement and emergency medical services personnel on mental health issues.”
Murphy’s Helping Families in Mental Health Crisis Act has been described as the most comprehensive overhaul of the mental health system since the Kennedy Administration. With a focus on delivering acute psychiatric care to the most challenging cases of serious mental illness, it also includes provisions to expand access to inpatient and outpatient psychiatric treatment, training for law enforcement and first responders to understand how and when to properly intervene when a person is experiencing a mental health crisis. Murphy’s bill also encourages states to adopt a “need for treatment” standard of commitment rather than the imminent danger standard and breaks down convoluted legal barriers preventing family members from helping a loved one with a serious mental illness.
Murphy authored the bipartisan Helping Families in Mental Health Crisis Act following a year-long investigation into the nation’s broken mental health system. Nationwide support for his legislation has come from newspaper editorsphysiciansand parents of children with mental illness.

"Our family has a message for every parent out there: You don't think it will happen to your child until it does," Martinez said. "His death has left our family broken."

AP College Community Shooting_001ISLA VISTA, Calif. — Santa Barbara Police Saturday identified Elliot Rodger, 22, as the man suspected of killing six people during a Friday night drive-by rampage.

The attack ended with Rodger dead in his BMW --hours after a disturbing video titled "Elliot Rodger's retribution" was posted, a manifesto authorities said was a clear sign of "premeditated mass murder." Rodger's father, a Hollywood director and his family say they warned police about disturbing videos weeks before the shooting rampage their son committed near a Santa Barbara university.

Friday, May 16, 2014

Committee Releases Report Following Yearlong Investigation of Federal Programs Addressing Severe Mental Illness

Congressman Tim Murphy: “Our investigative work revealed that those most in need of treatment – patients with serious mental illnesses such as persistent schizophrenia, bipolar disorder, and major depression — are the least likely to get the acute medical help they desperately need.”

For Immediate Release: Thursday, May 15, 2014
Contact: Brad Grantz202.225.2301

(WASHINGTON, DC) – The House Energy and Commerce Committee today released a report regarding its investigation of federal programs that address severe mental illness (SMI). Since January 2013, following the tragedy in Newtown, Connecticut, and against the backdrop of subsequent mass killings tied to untreated SMI at the Navy Yard in Washington, D.C., and Fort Hood, Texas, the committee has reviewed mental health resources and programs across the federal spectrum. Oversight and Investigations Subcommittee Chairman Tim Murphy (R-PA), a practicing psychologist, has also held a number of public forums and hearings on the subject.
To address the shortfalls in treatment of severe mental illness, Murphy introduced H.R. 3717, the Helping Families in Mental Health Crisis Act, in December 2013. Two major portions of this bill have already become law as part of H.R. 4302, the Protecting Access to Medicare Act. NBC 4 Washington will air a special report tonight at 6PM on Dr. Murphy’s mental health reform efforts as part of its “Changing Minds” series.
The report explains, “The Committee’s probe has focused on three areas of critical public policy interest: (1) the scope of society’s problem that is untreated SMI, (2) how privacy laws may interfere with patient care and public safety, including in mental health situations, and (3) how federal resources appropriated for research into and treatment of mental illness are presently being spent.”
A bipartisan Oversight and Investigations Subcommittee public forum in March 2013 highlighted how “neither access to health insurance, nor the financial ability to seek help guarantee success in navigating the mental health system.” The investigation also revealed concerns with existing privacy laws. The report notes that, “Therefore, it may be worthwhile to explore establishing lower barriers for families who, in good faith, seek information about a family member with SMI to protect their health or safety, particularly where that individual is unable to fully understand or lacks judgment to make an informed decision regarding their need for treatment, care, or supervision.”
Upon release of the report Murphy commented, “Our investigative work revealed that those most in need of treatment — patients with serious mental illnesses such as persistent schizophrenia, bipolar disorder, and major depression — are the least likely to get the acute medical help they desperately need. We revealed significant gaps in inpatient and outpatient care, confusing and outdated legal barriers to treatment, and outright failures in the current mental health system. The good news for millions of families confronting a mental health crisis is that our investigative work has charted a legislative path to rebuild the system and to finally take serious mental illness out of the shadows and into the bright light of hope and recovery.”
The report concludes, “The committee’s inquiry has drawn attention to the importance of targeting funds for mental health to areas with the greatest impacts on public health and safety. … The findings of the committee’s investigation underscore the need to improve training for law enforcement and emergency medical services personnel on mental health issues. They also demonstrate the importance of training primary care physicians in mental healthcare… while working toward a better integration of psychiatric and primary care…”
For additional background on the Helping Families in Mental Health Crisis Act, click here.
Read the complete report online here.
To read a letter from the Office and Management and Budget detailing federal spending on mental health, click here.
Congressman Murphy's website click here:

Wednesday, May 14, 2014

USA Today Investigates Mental Illness Neglect

USA Today has launched a series of articles on the “man-made disaster” created by “a mental health system drowning from neglect,” and it’s a don’t-miss.
"The cost of not caring: Nowhere to go” tells the story of “the financial and human toll for neglecting the mentally ill” with personal narrative, video and graphics.
This is a disease, just like cancer," Colorado family member Candie Dalton tells reporter Liz Szabo. "It's just as devastating. But you don't get the support. You don't get people saying, 'Oh, your child is in the hospital. Can I come over with a casserole?'"
Coverage like this in the third most widely circulated newspaper in America will significantly raise awareness of the need to reform mental health policies and remove obstacles to treatment – and provide an easy way for you to familiarize your community and elected leaders with the consequences of non-treatment.
Once you’ve seen the story, be sure to let USA Today know how much you support their coverage of the devastation caused by neglecting serious mental illness. If you have a personal story to tell in a few words, include it in your letter. Letters must be 200 words or less. You can also:
  • SHARE the story with your friends by clicking on a link from the bottom of the article, tweeting it or posting it on your Facebook page.
  • COMMENT on the story using the link at the end of the article.
FORWARD the article to your public officials and tell them you support mental illness treatment policies that will address these problems.

Thursday, May 8, 2014

Treatment Advocacy Center - "Maryland Steps Forward"

(May 7, 2014) Our neighbor Maryland has long been among the very worst states in the union for those who cannot seek or agree to essential treatment for their severe mental illness. Marylanders in this condition (and the families who love them) currently face a tragic triple whammy:
Maryland1. A hospital commitment standard requiring a finding of “danger to life or safety,” which is often interpreted to slam the hospital doors on anyone who doesn’t appear imminently violent or suicidal;
2. The notorious “Kelly Decision” of 2007, in which the Maryland Court of Appeals ruled that a patient committed to a mental hospital who refuses medication cannot be medicated over objection without evidence that the person poses a danger while in the hospital, irrespective of the danger the person would pose in the community if released in his or her current unmedicated state;
3. The lack of an assisted outpatient treatment (AOT) law to help those caught in the revolving doors of the mental health and criminal justice systems to survive safely in the community. (Only four other states share this dubious distinction.)
With the strokes of several pens yesterday morning, Maryland Governor Martin O’Malley gave hope for a brighter day ahead. The governor signed two bills championed in this year’s legislative session by the Treatment Advocacy Center and our indefatigable partners in NAMI-Maryland.
One bill, HB 592/SB 620, nullifies the Kelly decision (effective October 1) by amending the state law interpreted by the court. The new language makes explicit that a committed patient may be medicated over objection if a review panel finds the patient’s mental illness symptoms cause dangerousness in the hospital, caused the dangerousness that led to commitment, or would cause dangerousness if the person were released.
The second bill, HB1267/SB882, represents progress towards addressing the two other glaring flaws in Maryland’s treatment laws. It directs the state’s Department of Health and Mental Hygiene (DHMH) to convene a work group to examine AOT and deliver to the legislature by November 1, 2014 “a proposal for a program that … best serves individuals with mental illness who are at high risk for disruptions in the continuity of care.” It further directs DHMH to “evaluate the dangerousness standard for involuntary admissions and emergency evaluations of individuals with mental disorders, including … how the standard should be clarified[.]” (DHMH is already on record acknowledging the state’s need for both AOT and a consistent, more flexible interpretation of “danger to life or safety.”)
For now, we’ll say “one down, two to go,” with optimism that by this time next year, Maryland will stand proudly among the best states in meeting the needs of those whose anosognosia puts voluntary mental health care out of reach. We offer heartfelt thanks and kudos to the Maryland lawmakers who this year carried the mantle of this too-often-voiceless population: Senator Dolores Kelly and Delegate Dan Morhaim of Baltimore County, and Senator Mac Middleton and Delegate Peter Murphy of Charles County.

Sunday, May 4, 2014

Shooting suspect in custody after day-long standoff in Knoxville, Tennessee yesterday.

Members of the Knoxville Police Department Special Operations Squad escort a man who was holed up in a house at 2328 Wheeler St. in Knoxville, Saturday, May 3, 2014.  (AMY SMOTHERMAN BURGESS)
After a daylong standoff in a house in the Interstate 40-Cherry Street area, a man surrendered to police at 7:17 p.m. Saturday, authorities said.
The standoff had closed the westbound lane of nearby I-40 for most of the day and traffic had been backed up for more than three miles at one time.

“The negotiators kept talking to him. At times he would talk to us and at times he would not. It seemed he had mood swings of some type that prevented him from wanting to talk to us,” he said.