Thursday, January 31, 2013

Crowd Source Better Care for Mentally Ill in California

We are going to improve care for persons with serious mental illness in California by crowd-sourcing the hunt for waste and fraud in Prop 63/Mental Health Services Act (MHSA)

MHSA funds meant to help seriously mentally are being diverted

MHSA funds are supposed to help people with serious mental illness. And many do. But funds are also being diverted elsewhere. The media has reported on MHSA funds being used for Wilderness Adventure Tours, Gardens for people of Hmong ancestry, massage chairs and tons of other programs not related to serious mental illness. They have also reported on programs that may be worthy and/or politically correct social services (ex tutoring, ending poverty, etc.)  but don't serve people who have mental illness. We have also reported on diverting, wasting, or giving away MHSA funds to well-connected 'consultants' and insiders

California State Auditor is investigating

Because of the media attention, the California State Auditor is looking closely at how California Counties (And especially Sacramento, LA, San Bernardino and Santa Clara) are not spending the money to provide real services to people with serious mental illness.

The Auditor Needs Our Crowdsourcing To Find the Waste and Fraud

Sunday, January 27, 2013

Are mentally ill more likely to be victims or perpetrators (and does it matter)?

Whenever there is "Psychotic Killer on Rampage" headline, some mental health advocates claim persons with mental illness are more likely to be victims than perpetrators. That statistic surprises me.  I wrote on many of the statistical tricks used to claim persons with mental illness are no more violent than others. Some studies artificially reduce rates of violence by:
  • Defining mental illness so broadly it includes up to 50% of the population
  • Including only the most serious acts of violence (homicide) and excluding knifings etc.
  • Excluding suicide or self-harm
  • Excluding the most seriously ill patients in jails, prisons, shelters, psychiatric hospitals, from the population being studied 
  • Including only patients who are receiving treatment and excluding those who are not.
  • Excluding mentally ill who also abuse substances

By using these tricks one can draw the conclusion that persons with mental illness are no more violent than others.

However, using some of the same tricks--which basically exclude the most seriously ill and only include the highest functioning-- should also show that that group is also no more likely to be victims.

So I looked into it just a little bit. It needs more investigating, but what  I think is happening is that

Wednesday, January 16, 2013

Psychiatrists are Wrong To Not Help Reduce Gun Violence By Mentally Ill

 The New York Times and Wall St. Journal reported on an argument being made by psychiatrists and psychologists that would allow them to escape provisions of the gun control law that would help persons with serious mental illness. Psychiatrists and psychologists are opposing a requirement inserted in NYS Gun Control legislation that requires them to tell county mental health directors when a mentally ill patient is likely to become dangerous. They fear making this report infringes on patient confidentiality and might, sometime in the future dissuade someone with mental illness from coming in or telling the truth, for fear it could result in them losing the ability to own a firearm.

The reporting requirement is exceedingly important in a way that the mental health industry is avoiding mentioning: by providing directors of county mental health programs with the names of people with serious mental illness who may become dangerous, it allows the mental health directors to prioritize their resources. They can ensure these most seriously ill and potentially dangerous individuals--a very small group--go to the front of the line for services, rather than the jails, prisons, shelters, and morgues they are historically sent to.

Monday, January 14, 2013


Following are the major mental illness provisions of the SAFE  NYS GUN LAW (S-2230 A-2388)  passed by NYS Senate and Assembly and expected to be signed by Governor Cuomo today.  
       Much of the credit must go to Senator Catharine Young (R) and Assembly member Aileen Gunther (D) who long ago identified ways to improve Kendra’s Law and proposed the original bill on which today's action is based. We especially thank the NYS Chiefs of Police and it's President, Michael Biasotti for their help in improving care for the most seriously ill. For more info visit

  1. It closes the crack that allowed mentally ill individuals to be released from state prison forensic hospitals without evaluating them for inclusion in Kendra’s Law before they are released. If the person meets the criteria, the prison director must file a petition or notify the director of mental health services in the community the released prisoner is expected to reside.  (See Loopholes not closed)
  2. It closes the crack that allowed court orders to simply expire without determining if they should be renewed. Requires Directors of Community (mental health) Services to establish procedures so that court orders that are expiring get reviewed prior to expiring. Historically, Directors of Community Services just let many orders expire without review.  
  3. It closes the crack that allowed a court order to become unenforceable if a patient moves to a different county. Requires Directors of Community (mental health) Services to notify directors in other counties if a patient in Kendra’s Law moves to the other county. The director in the new county becomes responsible for provisioning services for the patient. 
  4. Allows court orders to extend for up to one year. Research shows when a court order is for one year or more, the beneficial effect of the court order continues, even when the order itself expires. This provision also saves money.
  5. Extends the sunset from June 30, 2015 to June 30, 2017. 

Which persons with mental illness can and can't buy guns

Many are concerned by proposals to create lists of persons with mental illness with the purposes of limiting access to guns. The question has arisen as to who is listed?

The following cites may help: 1968 Omnibus Crime Control Act, 1998 National Instant Criminal Background Check System (NICS)  excluded only people previously 'adjuticated as mentally defective' from owning guns. That phrase means there has previously been "A determination by a “court…or lawful authority that a person…is a danger to himself or others or lacks the mental capacity to contract or handle his own affairs” or "A finding of insanity in a criminal trial" It would include people who have been involuntarily committed, but not those who have been voluntarily hospitalized. Interestingly, it would include those who have previously been involuntarily committed due to substance abuse (some of whom have a higher propensity towards violence than persons with serious mental illness).