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

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

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.

MENTAL HEALTH PROVISIONS OF NYS SAFE GUN LAW (S-2230 A-2388)

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 http://kendras-law.org/

KENDRA’S LAW LOOPHOLES THAT WERE CLOSED

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. 

KENDRA’S LAW LOOPHOLES NOT CLOSED:

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).

Why the public won't listen to mental health advocates

While virtually the entire nation unites around the reasonable proposition that people with serious mental illnesses should not own assault weapons, one group takes umbrage: mental-health experts. In the wake of incidents such as the one at Newtown, the experts immediately issue press releases claiming that people with mental illness are no more violent than others, leading to the conclusion that people with serious mental illness should not be the target of gun-control efforts.

How can the chasm be so wide? Who is right? The public that believes mental illness is associated with violence, or the experts who claim it is not? The science of violence becomes clear when you look at the totality of mental illness violence studies versus any single study. The definitive answer is: It depends on who is mentally ill.

Are mentally ill more violent? Here's the definitive answer.

The stats on violence are clear when you look at the totality of violence studies, versus any single study. Studies are also often intentionally skewed and misrepresented. Here is the truth:

Five Point Action Plan for President Obama to Reduce Violence by Mentally Ill

President Obama said the federal government has to do something meaningful to prevent future shootings like the twenty-six in Newtown, Connecticut.  Here is what the federal and state governments can do to prevent violence related to mental illness.

What Washington can do

Cuomo Olmstead Commission may do more harm than good for mentally ill in New York

I have a sister in law with a serious mental illness and want to thank and congratulate Governor Cuomo for issuing Executive Order 84on Friday creating a cabinet level committee to help move persons with mental illness out of segregated institutional care and back into the community. (Olmstead v. LC.,)  But I fear the way the committee is currently constituted, it lacks the expertise to do the job correctly and may do more harm than good.

 Too many members have expertise in mental health and none have it in criminal justice.

NYS Office of Mental Health: The wrong response to Hurricane Sandy

Whenever a tragedy like Hurricane Sandy strikes, the New York State Office of Mental Health (OMH) calls up mental health workers en masse and assigns them to do counseling for those affected by the tragedy. The problem is, they’re not needed, rarely do any good, are expensive, and take resources away from where they are truly needed: helping the most seriously mentally ill.

Will California’s next proposed tax increase work any better than the last?

Before deciding whether to support or oppose Proposition 30, California voters should take a close look at what happened with the last tax on millionaires they approved. In 2004, Californians altruistically passed Proposition 63, the Mental Health Services Act (MHSA), a 1% tax on millionaires to improve services for people with serious mental illness Yet in spite of the $8 billion raised many are still homeless, psychotic, eating out of dumpsters and screaming at voices only they can hear. Programs that can help, like Laura’s Law, remain unimplemented. The number of homeless mentally ill increased.
What happened?
Mental health officials accepted the voter’s mental health money, but not their requirement to spend it on the most seriously ill.

NYS OMH Commissioner Leaving: Good News for NYS

Last week we wrote on a NYS Inspector General Report proving the NYS Office of Mental Health (OMH) falsifies discharge plans of people with mental illness in order to kick them out of the hospital.

This week we are happy to report that in an article posted online NYS OMH Commissioner Michael Hogan made it clear he is leaving.

This is good news. NY needs a commissioner who will focus the department on serving the sickest people, rather than the largest number of people. It is the key change needed at OMH: Send those with the most serious mental illnesses to the front of the line, rather than the back, like Hogan did.

We previously wrote Huffington Post why Michael Hogan should be fired and in Albany Times Union on how eliminating OMH could improve services for the most seriously ill. We calculated how his refusal to support one program (Kendra's Law) was costing NYS $73 million. Huffington Post writer and medical director of the New York State Office of Mental Health estimated that inefficiency in OMH was costing up to $665 million. While OMH stopped focusing on the most seriously ill and started focusing on the least, the tragedies mounted as more persons with mental illness shot others, were shot by police, or killed themselves in an effort to escape the Hell that lack of care placed them in.

Hopefully, Governor Andrew Cuomo is replacing Mr. Hogan with a commissioner who will reverse his practices and return the focus to people with serious mental illness. It won't be easy. OMH is the biggest state agency giving out billions of dollars. That tends to gain you a lot of friends interested in preserving the status quo.

New Report: NYS Office of Mental Health Falsifies Discharge Plans for Mentally Ill

An investigation by acting New York State Inspector General Catherine Leahy Scott found officials at Kingsboro Psychiatric Center allowed the release of mentally ill patients without a required discharge plan and then directed staff to cover it up. In this particular case, Kingsboro discharged a mentally ill woman to a street corner near a shelter. (Read Full Report or Summary)
The Inspector General expanded her investigation and found the failure to see that discharged patients get appropriate care is systemic.

CA Mental Health Services Act (MHSA/Prop 63) Insider Dealing

Over $16 million in Prop 63/MHSA funds is being diverted to organizations
associated with Oversight Commissioners

"Insider Dealing in MHSA Funds"

September 10, 2012

Summary
California's Mental Health Services Act is a good and important program that funds services for people with serious mental illness. But Mental Illness Policy Org (MIPO) found that over $16 million in Mental Health Services Act (MHSA) funds are going to organizations currently or formerly run by those responsible for oversight of the expenditures. This is likely a violation of California’s conflict-of-interest laws and raises serious questions about whether MHSA funds are being spent appropriately. The Associated Press in “California Mental Health Spending Often Bypasses Mentally Ill” and numerous op-eds have previously reported on the diversion of other MHSA funds to projects that do not serve people “with serious mental illness"..Rose King filed a whistleblower complaint. This is the first report on insider dealing.

Numerous setbacks in care for seriously mentally ill

Sorry for not sending summer Mental Illness News. Here are recent developments in serious mental illness (not mental “health”).

 

Announcement: VIDEO FOOTAGE WANTED

We would like video of people with serious mental illness who are off medications and psychotic. If you have, please send. Try to get permission to use, but if you can't, we can blank out faces if needed. We want to educate the public about what serious untreated mental illness looks like. Footage may come from police interrogations, home video, trials, whatever. Most advocacy groups won’t allow public to see untreated serious mental illness. We want to change that because we believe a better understanding will lead to better laws and treatment.

 

LIBERTARIAN Thomas Szasz, progenitor of the ‘mental illness is a myth’ myth died. Szasz’s ideology that mental illness is a myth has permeated parts of government and prevented millions from receiving treatment. The NY Times obit revealed his prior connection to Scientology. Relatedly, we prepared a fact sheet comparing and contrasting Scientology (CCHR) and Mindfreedom. To their credit, the Libertarian Cato Institute ran our piece on How involuntary commitment & Treatment can increase civil liberties of mentally ill. Dr. Ronald Pies highlighted the pathology of schizophrenia and Rael Jean Issac, author of the most brilliant book on subject, Madness in the Streets took on Szasz directly.

 

CONSUMER NEWS

 

• In MICHIGAN, video emerged of Milton Hall, a man known to have mental illness and going untreated being shot and killed by police who felt threatened.
• FLORIDA police felt threatened by and killed mentally ill Ghulam Yahya Mujtaba.
• IN TEXAS, Thomas Cafall, a man with mental illness killed two at TEXAS A&M before being shot by police.
• IN COLORADO Mentally ill Kyle Miller, was shot by police after pointing a gun at officers.
• In ARIZONA Jared Loughner shot Gabrielle Giffords he is being given the involuntary treatment he needed, but could not receive before the shootings.

 

 

In light of the above, advocates argue for more police training. We believe if the mental health system were trained not to abandon people with serious mental illness and hide behind civil commitment laws the police would not need to be called.

 

It is nice to see consumer leaders emerging willing to stand up to the anti-treatment Szasian wing of the movement:

• Consumer blogger Natasha Tracy wrote on antipsychiatry consumers attacking those who disagree.
• Linda Saslow wrote a beautiful op-ed on being involuntarily committed.
• Erin Hawkes wrote “Forced Medication Saved My Life”.

 

 

FAMILY NEWS

 

Families are between a rock and a hard place: if they call the mental health system, they won’t help unless their child is well enough to accept help. When they deteriorate and the family is forced to call police, police can feel threatened and shoot. as two cases in CALIFORNIA demonstrated.

• Julian Kurita in NY received the minimum sentence, after his mom pleaded for the court for leniency when he was convicted of killing her husband, his father due to his schizophrenia.
• Jeneen Interlandi wrote a moving and highly visible piece in Sunday NY Times Magazine about civil commitment laws creating an inability to get her father treatment for his mental illness and the needless pain and suffering that caused. Hundreds of families commented.

 

POLITICS OF SERIOUS MENTAL ILLNESS:

 

• New stats show state psych bed shortage is getting even worse.
• New Pew Center report shows states are making it harder for people with mental illness to get meds.
• The Supreme Court upheld the Affordable Care Act (ACA), but as we wrote it really doesn’t help seriously mentally ill who need hospital care.
• Sadly, Paolo del Vecchio, a non-MD, and a leader of the anti-treatment movement was made Director of SAMHSA. (On the plus side legislators discussed cutting SAMHSA’s budget as we have suggested).
• Marvin Ross wrote on transplant committees denying organ transplants to people with schizophrenia.
• When James Holmes killied 12 in a COLORADO movie theater we wrote on the inadequacy of legal system to handle persons with mental illness for National Review as did Dr. E. Fuller Torrey. Like most, James Holmes was known to the mental health system but was exercising his right to not accept treatment. Perhaps Pete Early said it best, in USA Today:

 

“The suspect's parents will be blamed, though our civil rights laws make it extremely difficult for family members to force anyone to see a doctor or seek medical treatment if he or she has a mental disorder and is acting oddly. By law, we protect the right of an individual to be "crazy." Yet, we become outraged when a Cho or a Loughner kill and maim.” Huffington Post blogger made a full-throated case for better assisted treatment laws.

 

 

CIVIL COMMITMENT NEWS:

 

• Thanks to our efforts the Department of Justice certified Assisted Outpatient Treatment as an “effective crime prevention strategy.”

• GEORGIA Legislators are looking into reforming their civil commitment laws.
• WEST VIRGINIA is contemplating reform of civil commitment laws and MIPO’s testimony was covered by the Charleston Gazette.
• TEXAS is starting to see the benefits of implementing Assisted Outpatient Treatment (a court order to stay in treatment while in the community).
• Thanks to advocates in TENNESSEE, Knoxville started a pilot AOT program in Knoxville.
• OHIO is giving discharged prisoners more medicines.
• The DELAWARE legislature started a group to evaluate civil commitment laws (although it is dominated by ‘mental health’ interests rather than those who have experience with people with serious mental illness (ex. corrections).
• In Arizona, Deborah Fabos started a FB group for and blog for AOT reform. Mary Lou Brncik criticized AZ’s policy of incarcerating mentally ill.

 

BAD STATE NEWS:

 

• ILLINOIS received a court go-ahead to close Tinley Park Mental Health Center which (gasp!) provides inpatient psychiatric services to severely mentally ill.
• Pierce County WASHINGTON jail saw OT costs soar because of incarcerating mentally ill.

 

MEDICAL BRIEFS:

 

New fact sheet shows ANOSOGNOSIA (lack of awareness that you are ill) prevents many seriously mentally ill from getting treatment. There was a tempest in a teapot when pop-media reporting spanking is associated with mental illness. Not true.

 

BEST QUOTES

 

”A mentally ill person in US can get a gun easier than healthcare for their illness.”

 

"With respect to severe mental illness, our county has a “can't do, can’t change, cant fund and can’t help attitude”

said Jim Bassler, who’s son Aron killed two and was hunted down by police and killed after the mental health system used civil commitment laws to deny him care.

PSYCHIATRISTS:

 

• Dr. George Dawson (a/k/a “Real Psychiatry”) and James Coyne (a/k/a “Skeptical Sleuth”) regularly tackle the internet memes, myths, pop-psychology and nonsense surrounding serious mental illness. Coyne wrote how the race towards early identification of ‘at-risk’ individuals (as opposed to treating those who are already ill) may be leading to oncologists being bribed by pharma to find 'mental illness' in Psychology Today.
• Dr. Sally Satel, Dr. Steve Sharfstein, and Dr. E. Fuller Torrey did a brilliant serious mental illness roundtable discussion that focused on Dr. Torrey’s succinct analysis of the failure of federal mental ‘health’ system. The roundtable focused on SAMHSA encouraging states to move away from medical treatment; the failure to use Assisted Outpatient Treatment; the lack of psychiatric hospital beds and many of the other issues important to Mental Illness Policy Org but ignored by mental ‘health’ community (NAMI, MHA, consumertocracy, etc.)

 

JUDGES, POLICE & CORRECTIONS

 

• Judge Leifman says, ““We never deinstitutionalized; we just transferred responsibility from a hospital system to the prison system,”
• GEORGIA prison chief wrote on why we should “Decriminalize Mental Illness”
• Michael Biasotti, President of NYS Association of Chiefs of Police encouraged NY legislators to close the cracks in Kendra’s Law.

 

NEW YORK

 

Mental Illness Policy Org was very active in NYS this summer and started a NY Specific site. We wrote too many op-eds and testimonies to present them all here.

 

NY FAILURE TO CLOSE CRACKS IN KENDRAS LAW:

 

In spite of our efforts the legislature did not close the cracks in Kendra’s Law as proposed by NYS Senator Catherine Young and Assembly Member Ailleen Gunther. Mentally ill individuals discharged from prisons, jails, and involuntary commitment will continue to go to the community without first determining if they could benefit from enrollment in Kendra’s Law. This was a victory for NY’s mental ‘health’ community and a defeat for those who care about people with serious mental illness. See numerous editorials and op-eds in NY Daily News, and op-eds in NY Post. We thank them for their support (although don’t agree with periodic use of juvenile and offensive language). Highlights include our own op-ed blaming NYS OMH Commissioner Michael Hogan and this by Michael Benjamin. The Daily News blamed NYS Assembly MH Committee Chair Felix Ortiz for acknowledging the dangers and Felix Ortiz for doing nothing, and Felix Ortiz for promising hearings he never even held. Other papers around the state (that no longer make the articles available online) also supported reform. Thanks to our efforts the Department of Justice certified Assisted Outpatient Treatment as an “effective crime prevention strategy.”

 

PATIENT’S RIGHTS IN NY

 

NYS is holding hearings on how to comply with Olmstead v. L.C. which held that services for persons with mental illness be provided in the “most integrated setting ". We testified greater use of Kendra’s Law can prevent people from going to incarceration. The commission did not hold any hearings in jails or prisons where those who live in the least integrated setting are.

 

NY MENTALLY ORDERED OUT OF GROUP HOMES

 

NYS OMH Commissioner Michael Hogan also issued instructions to kick seriously mentally ill people out of adult homes.

 

REPORT ON NYS MENTAL HEALTH COURTS issued

 

LYNN SHUSTER one of the best advocates for improved care for seriously mentally ill in NYS stepped down as leader of NAMI Buffalo. Her parting words,

 

“Never trust a bureaucrat. It's THEIR money (and power and prestige, it's just our loved one's lives. And we know which comes out on top. "Making nice" makes you feel good, but doesn't result in success. News reporters are our friends. Tell the truth, the REAL truth.... Maintain a sense of humor even in dark days--we all need to laugh. Persevere. Persevere some more.... “

 

 

CALIFORNIA

 

Mental Illness Policy Org was very active in California and started a site on Laura’s Law and a site on Problems with Proposition 63/Mental Health Services Act. We had numerous op-eds and letters published including this by Mary Ann Bernard

 

INSIDER DEALING IN CALIFORNIA MHSA/PROP 63:

 

Mental Ilness Policy Org researched and issued a report finding over $16 million of Prop 63 funds going to oversight committee commissioners own organizations and a salary of $681,758 for Rusty Selix.

 

CA MHSA FUNDS NOT REACHING MENTALLY ILL

 

Due to voters altruistically passing Prop 63, a 1% tax on millionaires to fund services (Mental Health Services Act) for people with “serious mental illness”, California is the only state with plenty of money to provide care for people with serious mental illness. But it is being diverted elsewhere. Taking off on the work of Carla Jacobs, Rose King, Teresa Pasquini, and many others in CA, Hannah Dreier at AP reported Calif mental health dollars bypassing mentally ill . This led to editorials, calls for an investigation, the consideration of an investigation, our criticism, and a coverup by those who approved the spending. (They failed to disclose that the programs do not serve people with mental illness as the legislation requires.)

 

How can you help in California?

 

Be a Whistle Blower. The auditor wants to hear about problems with MHSA. She needs your help. If you know MHSA Programs that do not serve people with serious mental illness, especially in Los Angeles, please send them to the auditor. Make them as specific as possible and include links, details that will allow verification. You know the California mental illness system better than the auditor, so send Ms. Howle the tips she needs:

Elaine M. Howle

California State Auditor

555 Capitol Mall

Suite 300

Sacramento, California 95814

Phone Number: (916) 445-0255

General Fax: (916) 327-0019

Executive Office Fax: (916) 323-0913

 

Email a copy of your information about programs that do not focus on serious mental illness to those trying to stop the diversion of MHSA funds.

 

 

LAURA’S LAW

 

CalMHSA gave (and MHSAOC approved) a $2,917,092 grant to Disability Rights California and $1,539,225 to California Network of Mental Health Clients which will be used to prevent counties from providing Laura’s Law to patients who could benefit from it. This supplements SAMHSA money flowing into CA also being used to prevent those who don’t know they are ill from receiving treatment.

 

• SACRAMENTO County Mental Health Board subcommittee supports implementing Laura's Law, but the full committee found an excuse not to pass this on to board of supervisors.
• MENDOCINO health director made false claims about Laura’s Law which led the Board of Supervisors to punt, which we answered.
• SAN FRANCISCO’s health director tried to position a voluntary program as a substitute for Laura’s Law. We answered. As did SF Chronicle which has done a tremendous job covering Laura’s Law. Also the Examiner.

 

Thank you for your financial support which makes our work possible. Together we will get more mental ‘health’ money going to people with ‘serious mental illness’.