Do you see why we urgently need sweeping mental healthcare reform?


I’ve all but given up on any hope of gun-law reform. My wife Honoree was shot and killed three weeks ago by a stranger almost surely in psychosis.


Maine Gunman Disclosed He Had Mental Health Issues, Gun Shop Owner Says – The New York Times (nytimes.com)

JAMES MARK RIPPEE (APRIL 17, 1963-NOVEMBER 29, 2022)

Catherine J. Rippee-Hanson recently completed this breathtaking digital pen drawing of her brother, the late James Mark Rippee, taken from a photograph.

mark rippee
Digital artwork by Catherine Rippee-Hanson

You know Mark Rippee’s story if you have followed this blog or read any of the media stories about him. For years, this mentally ill, blind, and homeless man clung to a brutal existence on the streets of Vacaville, California. County and state services, not bound by any hard and fast rules, left him to die there, and he did.

Catherine Rippee-Hanson’s brilliant, damning creation deserves to be enshrined as the prevailing image of American society’s degree of concern for its “crazy people.”

If you retain only one image of those dispossessed by our systems of care for our most helpless citizens, let it be this one.

A STATUE FOR JAMES MARK RIPPEE 

Undulating above the 9,386 military graves at the American Cemetery and Memorial near Colleville-sur-Mer, Normandy, France, its head thrust back and its arms supplicating the heavens, is a bronze figure of terrifying benevolence. It was cast by the American sculptor Donald Harcourt De Lue and placed in 1951 above the cliffs at Omaha Beach, the most brutal of the five landing sites invaded by U.S. forces on June 6, 1944—D Day in World War II. The sculpture is titled “The Spirit of American Youth Rising from the Waves”.

The Spirit of American Youth Rising from the Waves. Photo Credit: Nico 88

I believe that a statue of similar significance should be struck and placed somewhere in America, preferably on a street in Vacaville, California, if the Solano County officials would tolerate such a thing. Call it “The Spirit of American Madness Rising from Our Streets and Jails and Graves.” The statue’s eyeless face would replicate the smashed and scarred features of the late James Mark Rippee, an appalling symbol of the atrocities that can befall a victim of brain-damaging mental illness in a nation that prefers to look the other way. The statue would represent all the oppressed and neglected mad people left to rot in society’s shadows in our time and throughout time.

I know: the very idea of this will strike many as grandiose. Grandiosity might be the only thing that “crazy” people and their overwhelmed protectors have left.

Mark Rippee died at age 59 from many complications in a Vacaville hospital on Tuesday, November 29. Some unidentified Samaritan had brought him there after noticing that he was on the ground, struggling to breathe. (Doctors found evidence of sepsis and pneumonia, among other symptoms.) For years following a horrific motorcycle accident in 1987, when he was 24, Mark had stumbled around the small city’s streets like a maimed animal from the Vaca mountains—hit twice by cars, at the mercy of vicious thugs who beat and robbed him, sleeping under newspapers in frigid winter nights, frequently arrested (unlawful camping was a common charge, for irony fans), suicide-prone, truculent and resistant to care because his derangement made him that way. 

He was kept alive through the Sisyphean efforts of his twin sisters Linda Privette and Catherine Rippee Hansen, and the dozens of compassionate souls in the town who tracked him down and kept him supplied with water, food, and the blankets and canes and small change that were routinely stolen from him. Mark accepted their gifts and concern. He would not accept their strategies for guiding him to professional care. His affliction, steeped in paranoia, would not allow it.

And so, yes, Mark Rippee and his sub-nation of mad people deserve a statue. They are, have been, mass-casualties of war, just as were the eighty-nine million victims of World War II 1https://en.wikipedia.org/wiki/World_War_II_casualties, the forty million in World War I 2https://en.wikipedia.org/wiki/World_War_I_casualties, and all the casualties of all the wars fought since the beginning of time. It is a surreal war, this one, fought mostly by the losers: the “crazy” (chronically insane and brain-damaged) people themselves; their protectors and advocates; neurosurgeons and psychiatrists; some—not nearly enough—lawmakers and enlightened sheriffs of metropolitan jails. No statistics exist to tally the number of mad people who have lived, suffered, and died through history.

The mad people have always been losing this war. Their enemy, merciless, intractable, apparently invincible, is: Nothing. Nothingness. Silence. Indifference. Contempt. 

And mute primal fear. The seriously mentally ill are unique among the world’s dispossessed in that their mere presence repels and terrifies. They reawaken ancient superstitions of demonic transformation. Myths of the vampire and the werewolf, the tale of Jekyll and Hyde—these fantasies merge seamlessly with medieval notions of insane people as monsters, their heads roiling with evil spirits that can be released only by boring a hole through the skull. And the most nightmarish notion of them all: What if I am one of them and don’t know it?

Best to keep away. And keep “them” away. 

Particles of hope are coalescing. Print and broadcast journalism now cover mental-health issues with clarity and urgency hardly seen a decade ago. This surge could flow from the wave of grass-roots advocacy that sprang up at about the same time—the networking of infuriated victims’ mothers, internet-linked coalitions, advocacy groups in cities and towns, enlightened free-lance activists. 

Two important examples come to mind. Both were published in medium-sized California newspapers (an endangered yet essential species in today’s communications world). The first was written by Joceyln Weiner of Cal Matters, a Salinas paper, and appeared in February 2020. Weiner has covered the Mark Rippee story for years and understands the web of vexed policy issues such as of forced treatment, which would enable the involuntary hospitalization of victims who need supervision but don’t want it and are entitled to reject it—people such as Mark Rippee.

Weiner also laid out the excruciating barriers to conservatorship, a court order that eluded the frequent desperate pleadings and petitions of Mark’s sisters. Conservatorship can let a court officer appoint someone to oversee the safety and interests of a person whose mental capacities are deformed. Cathy and Linda Rippee appealed with obsessive ardor, over years, to the Solano County Board of Supervisors for conservatorship of Mark. Every appeal has been denied on arcane policy grounds—hence their constant searches for their brother on Vacaville’s streets and alleys and strip malls. A fundamental reason for the rejections was that Mark Rippee was not (wait for it) “gravely disabled” and thus not eligible. He could do some things for himself, you see. Like crawl under a newspaper on a frigid night.

Another Alice-in-Wonderland rationale of the Board, as Weiner pointed out, was that Mark could not be conserved because each time he was placed on an involuntary hold, he stabilized to the point that he legally had to be released. Stable, and not disabled. Got it.

The second exemplary essay was published the day after Mark died, under the byline of the acclaimed Melinda Henneberger, writing in the Sacramento Bee. After a ten-year career at the New York Times, Henneberger won a Pulitzer Prize at the Kansas City Star in 2022, then moved to The Bee as a columnist. Her piece is at once empathetic toward Mark and lacerating toward those who did nothing as he wandered, weakened, and perished: 

“I say ‘we’ let him die, let’s call the roll: Gov. Gavin Newsom vetoed state Sen. Henry Stern’s ‘Housing that Heals’ bill, which would have guaranteed the right to treatment for severely mentally ill and unhoused Californians like Mark . . . Mark thought the voices he heard were being broadcast by extraterrestrials from a military submarine using ‘mind warfare’ to turn ‘almost every single person in my life against me’ . . . Anyone who doubts that Mark was not capable of freely choosing or rejecting treatment can clear up his confusion by spending five minutes with one of the many untreated severely mentally ill homeless people screaming nonsense at no one on the streets of Sacramento and every other city.”

And as for the Rippees’ failed crusade to obtain conservatorship over Mark, Henneberger writes:

“Another bill that might have kept Mark alive was state Sen. Susan Eggman’s legislation, which would expand California’s definition of ‘gravely disabled’ to make it easier for people like Mark to get help. Though his initial diagnosis was a traumatic brain injury, he supposedly still didn’t qualify for a conservatorship on a medical basis. And in Solano County, he didn’t qualify for a conservatorship based on his mental illness, either. Every county interprets ‘gravely disabled’ differently.”

I personally have written many times about James Mark Rippee on my blog noonecaresaboutcrazypeople.com. The blog’s name is taken from my 2017 book, No One Cares About Crazy People, which I wrote following the suicide of my younger son Kevin, who had battled schizoaffective disorder for years. My friend and colleague Gail Freedman is directing a video expansion of the book.

James Mark Rippee is receiving, in death, a parcel of the attention and analysis that he was denied for most of his life. His sister Catherine predicted in her fury and grief that the attention will last for about a minute.

We—the all-inclusive and thus almost meaningless “we” that Melinda Henneberger sardonically referenced—must see that it lasts longer than that.

To assert this necessity is not to imply my belief that it will come about. The heartbreaking, blind wreckage of a man who for years shambled the streets of Vacaville may well vanish into “our” collective memory faster than a mass shooting. Yet “we,” and we, must try. To paraphrase Beckett, we can’t go on. We’ll go on. As Linda and Catherine Rippee vowed that they would do, “we”—the “we” who care about crazy people—will keep pushing for jail, prison, hospital, and public policy reform in the sub-nation of mental health care. We will keep pushing to free the crazy people from puerile and outdated restrictions such as the HIPAA laws. We will keep trying to educate our fellow citizens; to cleanse their “normal” minds of destructive superstitions. We will. . . well, we will. 

A statue would help shore up our morale. It will not be an imposing statue, with its eyeless face and its smashed and scarred features. Yet those same qualities will invest it with beauty, and consecrate the cause.

MSNBC TAKES A SHALLOW DIVE INTO MENTAL ILLNESS

The road to Hell is paved with good intentions. Sadly, the road to mental-illness coverage is fashioned from similar material.

nicolle wallace
Nicolle Wallace credit: Abovfold, CC BY-SA 4.0 via Wikimedia Commons

Nicolle Wallace is an elite and excellent television journalist. She hosts a Monday-Friday marathon of two-hour news interviews, MSNBC’s Deadline: White House, in which she and her guests dissect the flood of political stories pouring out of the nation’s capital. Riding the crest of this flood for the last several years, of course, has been the Captain Bligh of American conversation, Donald Trump. Trump’s inevitable dominance of the daily news cycle guarantees that much of the expert talk will recapitulate what has been reported on previous days. This is hardly Wallace’s fault, and she brings heroic preparation, intensity, and palpable human passion to her daily goal of making it all fresh and compelling yet again. My wife Honoree and I are grateful viewers of her program.

Aware of her thematic constrictions, Wallace and her producers made an enterprising decision not long ago: they would embark on an occasional series of mini-documentaries exploring topics rarely or glancingly noticed on regular newscasts. Under the rubric Deadline: Special Report, these segments are being streamed on NBC’s affiliate cable channel, Peacock, and occasionally on Wallace’s MSNBC show.  

As Wallace explained to Variety, “The idea is to do multiple series and deep dives into single topics without overlapping too much with what we do on the broadcast.”

This is a rare and noble impulse, yet it comes with a caveat: when you promise to do deep dives, you need to dive deep.

The debut Special Report is streaming now on Peacock: the four-part America’s Mental Health Emergency. Three of the four interview guests offer a tipoff that the Report’s aims are no more than snorkel-level. 

Lindsey Vonn credit Duncan Rawlinson CC BY 2.0 via Wikimedia Commons

These three are celebrities. Granted, they are celebrities who have “gone through a lot,” as the saying has it. Yet their presence as guests only reinforces the weary television trope that no issue will engage an audience unless a super-star shows up to validate it. The travails of Olympic skier Lindsey Vonn and the actors Rosie Perez and Taraji P. Henson, while clearly real and devastating to them, do not begin to embrace the totality of what “mental illness” means at the depths of its menace to human reason. 

The fourth-segment guest nudges the Report toward this level, yet it’s a faint nudge. Wallace interviews the estimable Shilpa Taufique, Ph.D., director of the Division of Psychology at Mount Sinai Health System in New York. Dr. Taufique is also the founder of the small Comprehensive Adolescent Rehabilitation Education center (CARES), which consults with distressed children.

I mean no disrespect for Dr. Taufique’s good work when I point out that her segment has the whiff of “obligatory,” and serves to extend the great “sin” of the Report’s first three episodes: the sin of omission. 

Omitted is any mention of the emperor of all mental maladies. 1.  It goes by several names: serious (or chronic) mental illness. Brain disease. The psychotic family of schizophrenia, schizoaffective disorder, bipolar disorder. No journalistic project that calls itself a “special” “deep dive” into “America’s mental-health emergency” has a right to ignore it. Yet they do, routinely.

The ultimate origins of this abhorrent disease are not yet fully understood by neuroscience. It is known to be partly inherited, a (relatively) rare cocktail of flawed genes that usually forms in mid-adolescence, when the brain is subject to a massive “pruning,” a replacement of outworn genes with new ones that will control the brain until the end of life. The chaotic power of these genes, their obliteration of reason and self-awareness, can be touched off by severe stress of various kinds. 

One would not know that by watching the four installments of America’s Mental-Health Emergency. One would be part of the vast majority of Americans. It’s possible that Nicolle Wallace and her producers are in the dark—out of their depth—as well. Serious Mental Illness is an awful calamity that calls up primal fear. It repels people who still buy into the medieval superstition that “crazy people,” “whack jobs” and “psychos” can shape-shift into murderous monsters. (Think upon the myths of Dracula, the Wolf Man, Dr. Jekyll and Mister Hyde.)

This superstition, this bigotry, this denial have taken an obscene toll on society. Half measures and misspent funds drain our wealth. (Think of the homeless crisis and of the mentally damaged people in that population.) Political leaders remain benighted and callous. County jails, urban and small-town, are filled with suffering souls who belong in mental care centers, watched by doctors who can keep the victim stabilized with medication. (The brutal jail version of special care is solitary confinement, which increases psychosis.) General hospitals toss uninsured patients into the streets. Mindless policies such as the HIPAA code, which prohibits family members from learning the condition of a hospitalized loved one, remain on the books. Lobotomies remain legal. The manifold horror stories of psychotic victims barely out of childhood yet brutalized as criminal adults continue apace, as they have since the Bedlam Asylum was opened in 1329. Mothers’ frantic pleas for help, for simple understanding, continue to haunt my in-box and my dreams five years after No One Cares About Crazy People was published. I recall a long evening of emailing back and forth with a mother in Florida, trapped inside her house as her deracinated son pounded on the door, threatening to kill her.

And how has MSNBC/Peacock’s “deep dive” enlightened us?

It pains me to write what I am about to write, Nicolle Wallace. I admire you and know your intentions are good. But I am writing it out of mourning, and in adrenaline and blood.

Of Lindsay Vonn, who suffers from depression, you tell us that she “was the world’s greatest skier and could fly down a sheet of ice at 80 miles an hour.” You tell a panel of Today Show staffers that “Vonn was so beautiful, so vulnerable, so open” in the interview.

Tyler West credit: Kimmy West

I could get you an introduction to Tyler West, a non-celebrity who is also beautiful, vulnerable, and open. Or was. Tyler, who suffers from bipolar disorder and autism, languishes in a federal prison on an unsubstantiated charge of statutory rape, and for crossing the lawn to a neighbor’s house one night in a psychotic state, opening the unlocked screen door, and falling asleep on a sofa. He has been beaten by inmates to the point of brain injury; thrown into solitary; denied medication. I have called Tyler “a symptom of America’s broken mental health care system.” I have contacted lawyers, advocates, even a Senator, asking for intervention. No one cares. Damndest thing.

Taraji P. Henson via Wikimedia Commons

Of Taraji P. Henson, you report that “Taraji’s character in Empire was a magical, you know, iconic kind of woman. She was tough, she was strong . . . I talked to her for almost an hour.”  You continue, “They [the celebrities] don’t say anything about fame. Fame doesn’t protect them from any of this. And what they all said and what Taraji said most powerfully was I get up every day and try to get through the day. Rosie Perez made the same point.”

I could introduce you to many people who are incapable of getting up.

Rosie Perez credit: Joella Marano from Manhattan, NYC, CC BY-SA 2.0 via Wikimedia Commons

You drew Rosie Perez out on her traumatic childhood. Yet the closest you or she come to a clinical diagnosis was to report that she suffered from “PTSD.” PTSD might or might not have led her into serious mental illness. We never learn.

I could go on—oh, could I go on—but I really do not want to berate you, Ms. Wallace, or to belabor the point. I think I have made the point clear. Serious mental illness, like a certain former president whom you mention daily, seems to be above the law. Or beside it. Or ignored by it. And ignored by most state and national leaders and journalists who might hold the malefactors and policy laggards and brutal jail wardens accountable; increase local mental healthcare centers instead of building new jails; develop guidelines for public/family education along several fronts—and ultimately mobilize opinion for the creation of a cabinet-level Department of Mental Health, which would oversee these and other dire, overdue needs.

Now, there would be a deep dive.  

https://noonecaresfilm.com/

THE FILM WEBSITE FOR “NO ONE CARES ABOUT CRAZY PEOPLE”

As many of you might know, my 2017 book No One Cares About Crazy People is in development as an independent documentary film.

Gail Freedman

The director, Gail Freedman, is expanding the book’s theme to include not only the story of my schizophrenia-afflicted family, but stories of similar families across the United States, with interviews by Gail and footage by her crews in various cities and towns.

This work-in-progress has great potential in expanding the story of serious mental illness, and in educating both political leaders and citizens about SMI: its unsuspected prevalence in the population and its untold costs in public safety, human misery and to our national wealth. Combating SMI is a feasible task, yet it remains crippled by the appalling lack of societal information about its causes, dangers, and treatment. The damage is compounded by the unconscionable negligence among policymakers, law enforcement, prison systems, educators, and even some psychiatrists.

Gail is forging ahead on this project—traveling the country to gather portraits of ravaged families and struggling victims—even as she continues to seek funding for the film’s completion.

You can help. Gail has created a powerful website, filled with information and links to glimpses of the families and experts she has interviewed. You can access it at  https://noonecaresfilm.com.

Please review this shocking yet hopeful documentary, and help Gail complete it and present it to the world.

CHRIST! WHAT ARE PATTERNS FOR? –Amy Lowell, 1916

I am wearily–yes, wearily–posting links to two recent pieces by the peerless mental-healthcare blogger Pete Earley. Below them I’m linking to an archive within the blog you are reading now.


Their common denominator: they are about young brain-damaged men enduring Hell-on-earth lives on the streets of America as those who love them–mothers, sisters–trudge on through the years, and decades, trying vainly to awaken the conscience of the–the what? The whom? The withered, laughably misnamed “mental health” systems in their states that are restricted by outdated boneheaded rules and by the soul-deadened payrollers who run them. By the distracted politicians who appoint those payrollers and promptly forget them. By the oblivious electorate that will never form a constituency to keep the politicians on the case.


It’s all part of a . . . pattern.


http://www.peteearley.com/2022/02/11/mother-fights-relentless-battle-to-help-mentally-ill-son-why-arent-austin-officials-helping-her/


http://www.peteearley.com/2022/01/24/warrior-mom-describes-pitfalls-successes-navigating-californias-mental-health-system/


https://noonecaresaboutcrazypeople.com/tag/mark-rippee/

Godspeed you, “Killer Mike”

An gesture of compassion, forgiveness, and hope at the dawning of 2022!

KILLER MIKE OFFERS TO ASSIST ‘MENTALLY DISTURBED WHITE MAN’ WHO VANDALIZED HIS ATLANTA BARBERSHOP

After his barbershop was vandalized by a mentally disturbed white man in Atlanta, Run The Jewels group member Killer Mike offered to help the man if anyone could identify him.

Killer Mike, a recording artist who is very vocal about supporting and enhancing Black entrepreneurship, posted a message on his Instagram account. He described his place of business being vandalized but used the moment to encourage others to “check on your mentally ill loved ones.”

Read the full story here: https://www.blackenterprise.com/killer-mike-calls-out-mentally-disturbed-white-man-for-vandalizing-his-atlanta-barbershop/

The Crumbleys, Part II

The school shooting in Michigan last week has opened up new avenues for thought and action, and re-opened old ones. We must not let this awful opportunity evaporate.

More than a week after the Oxford High School shootings in Michigan, the episode still bristles with implications that drain the will and resources of mental-health advocates. Granted, we are not (yet) nearly as overwhelmed as, say, hospital staffers in the resurgent Covid plague, though there is some psychic overlap.

School shootings have haunted our collective consciousness for decades—a hoary specter that still grips us with dread—but this case brings new horrors to consider. It was not just any old spree of classroom murders carried out by a mid-adolescent with a semiautomatic handgun bought for him as a Christmas present by his Dad on Black Friday. This one dropped some new elements on us—and managed to bypass an element of omission. Advocates and all people of conscience must grapple with them, no matter the tedium and the elusiveness of solutions. Our sanity as a nation is at stake.

So, what must we grapple with?

First, a recap: the 15-year-old shooter, Ethan Crumbley, faces 24 felony charges for slaughtering four classmates and wounding seven other people with that semiautomatic handgun lying around in his parents’ bedroom. The charges include first-degree murder and terrorism. Ethan was captured before he could turn his Christmas present on himself. This is relatively rare, as is the high count of charges. The terrorism count may be unprecedented, and might set a legal precedent. Or it might set a legal obfuscation: The Oakland County Prosecutor Karen McDonald told CNN, last week:

“There is no playbook about how to prosecute a school shooting and candidly, I wish . . . it didn’t occur so I wouldn’t have to consider it, but when we sat down, I wanted to make sure all of the victims were represented in the charges that we filed against this individual . . . If that’s not terrorism, I don’t know what is.”

Well, with all respect, Ms. McDonald, it might be mental illness. More on that in a moment.

The most striking new element is that the boy’s father and mother, James and Jennifer Crumbley, have been charged with four counts of involuntary manslaughter. This fact turns the spotlight on the criminal culpability of parents who leave lethal weapons unconcealed and unlocked in the household. Its implications could be seminal. The Crumbleys, as media accounts have made clear, are appalling and stupefyingly negligent parents. There’s a lot of that going around.  

James and Jennifer Crumbley 

Here the “element of omission” takes center stage. Are the Crumbleys psychotic? Is Ethan psychotic? What is “psychotic”? How do we identify psychosis, and what do we do about it when we think we’ve seen it at work? Is this case an example of “shared psychosis,” in which some of the victims do not show clinical symptoms? What are the responsibilities—and the risks—of intervening in the actions of one who might be in a psychotic state?

These are old, wearying questions. They have been charged with fresh urgency by the bloody Oxford affair. Or should have been. After days of online searching, I have not been able to find an indication that any of the Crumbleys has received psychiatric diagnosis. I’ve found nothing but the most glancing speculation that serious mental illness—genetically inherited brain disease—was present in any of these people. And I certainly have found no serious, informed discussion about this possibility. And so the Crumbley story remains a missed opportunity at least as a “teachable moment,” a broad, ongoing national discussion on the nature of this beast. And on the policies—judicial/legal, educational, budgetary, and ethical—that scream out for rapid and thoroughgoing reform.

I am going to offer an example of policy dysfunction that I published in my previous blog. It was articulated by D.J. Jaffee, a disciple of the pioneering E. Fuller Torrey, who founded the invaluable Treatment Advocacy Center. Shortly before his death last year, Jaffe restated an observation he’d made many times in his talks and writings. It bears strongly on the Crumbley case:

“The law says we can’t do anything until after the psychotic victim becomes dangerous to self or others. As ludicrous as it sounds, the law requires dangerous behavior rather than prevents it.”

Credit: Database Center for Life CC BY-SA 2.1 JP via Wikimedia Commons

I cannot say whether Ethan Crumbley or his parents are mentally ill. A competent psychiatrist should and must make that call. I will say that telltale signs are blinking red.

There are Ethan’s notebook jottings, noticed by teachers: “The thoughts won’t stop. Help me,” and “Blood everywhere,” and “my life is useless,” and “the world is dead.” There are his sketches depicting a bullet and a bullet-riddled body.

There is the now-infamous message texted by Jennifer Crumbley to her son the day before he shot up Oxford High School, after a teacher told her that Ethan was searching for ammunition online in class: “LOL I’m not mad at you. You have to learn not to get caught.” And of course there is the fact of James buying that hideous weapon for his young son in the first place.

And there is the widely accepted thesis that if the rare onset of schizophrenia is going to occur, it typically occurs in mid-adolescence, Ethan’s period of life. This is the stage in which the prefrontal cortex is pruning itself of outworn synapses and generating new ones. If a genetic disorder produces over-pruning, an oversupply of normally essential chemicals such as dopamine can rush in and produce an imbalance that permanently damages the brain. (No thesis is yet seen as conclusive in the study of this affliction.)

Jurgitta, CC BY-SA 4.0 https://creativecommons.org/licenses/by-sa/4.0, via Wikimedia Commons

The social effects of serious mental illness spread out in a widening cone from the victim through the family, the community, our schools, our political life, and the health of the nation. Mass shootings continue to be rare, but the debilitating dread of mass shootings is nearly pandemic. The cumulative costs are as under-appreciated by the populace as the nature of the disease itself. Ignorance, apathy, and fear continue to rule.

I have called in the past for creation of a federal cabinet-level department that would unify, critique, and extend policymaking in all these problem areas as well as others. Foundational reform of our disgraceful jails and prison systems, de facto catch-basins for the insane, for instance. Solitary confinement, that turns sane prisoners into madpeople and the mad into vegetables, must be abolished.

D.J. Jaffe disagreed with me about this. He felt that such a department would only add another layer of bureaucracy.

All right. Let’s add another layer of bureaucracy.

Mental-health reform is borne on the backs, overwhelmingly, of women: mothers of victims, mostly. Their advocacy work in the past twenty years alone has been heroic and sporadically effective. But these “secular nuns”—the phrase just came to me—are largely worn out and disillusioned. They carry on, but we must not depend on them to keep doing the trench-work that the problem demands. Our advocates need reinforcement—collective national reinforcement. Society must be made safe from our Ethan Crumbleys. Yet we must not let things rest at primitive blame and punishment. Humanity and moral justice call us to protect the mentally ill and to reclaim them if we can. This would be the most honorable means of protecting ourselves, and reclaiming our own souls.

State Senator Cindy Friedman Gets It!

Among the most infuriating barriers to mental healthcare reform is the indifference of policymakers. The mentally ill don’t form a significant constituency, in voting or in contributions. Thus, you know, nobody cares.

State Senator Cindy Friedman, a Massachusetts Democrat, has burst through this complacency. Working with some colleagues mentioned below, Senator Friedman has crafted an important new bill and shepherded it through the Senate. It is on its way to the state’s House of Representatives for enactment into law.

Massachusetts State Senator Cindy F. Friedman (D-Arlington). Massachusetts General Court, Public domain, via Wikimedia Commons


The ABC Act, as it is called, should be a model for every state in the nation. And it signals to reform advocates that they have a new champion. Kudos to Senator Friedman. And thanks to my fellow advocate Donna Erickson for the heads-up!

“The poison of knowledge”–and beyond that, to hope

Leslie Carpenter

Here is a glimpse inside the soul of an activist. Leslie Carpenter of Iowa City, Iowa, is among the very best we have. She has connected, and deeply, with people at all levels of public  service to implant her passionate agenda of mental healthcare reform.


She also immerses herself in the lives, the despair, the desperate pleas for reclamation, from ordinary people who see their loved ones in agony. She embraces their anguished stories and does what she can to aid and comfort them. Often, her efforts fall short, as most of such efforts must. And when fatigue and frustration overtake her, she confesses it, eloquently, as in this Facebook post. Read it, please, and absorb a hero’s account of how god damned hard it is for all of us.

Leslie Carpenter

Sometimes in the life of being a very public serious brain illness advocate, I have people reach out to me for suggestions for loved ones, resources, etc. I try to respond to all of them and at least make an effort to reach them, give them all of my contact information, and let them get back into contact with me. Not all do, but when they do, I try to listen with a caring heart and share information that might be helpful.


Recently, I was asked to meet with someone who has worked within the system who wanted to share information with me of several cases and system failures they felt I needed to know since I work at the local, state and federal level to improve mental health care.I just left that 2.5 hour meeting feeling filled up with the poison of knowledge of so many cases with adverse outcomes, due to not just gaps in the system, but active choices of key people in the system.I have known there were problems, gaps, and challenges. I now know some of the people who specifically have caused harm, and my soul is feeling overwhelmed with sadness and disappointment.I need to move forward with solving some of this mess, and I will. But for now, I am sitting in a random parking lot crying and processing and figuring out the best next steps.For now, let me say this:We need more people to go public with this humanitarian crisis of not treating people with serious brain illnesses and not paying for them to be housed in the best level of care where they can be the healthiest and most stable.We need to care. We need to act, no matter how terrifying it might be to bring this information forward.#WeCanDoSoMuchBetterThanThis

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