Yes: I did.
I cited this barbaric penalty in my previous blog post, which was a plea for Ashley Biden to join her father’s Administration and co-ordinate federal policy regarding mental healthcare reform. Solitary confinement in our jails is one of the scourges that most needs reforming–obliterating, actually–if we are to call ourselves civilized. Solitary works horrors on the human brain. It drives mentally ill prisoners deeper into madness, and can afflict the sanity of those who have not shown symptoms of brain disease. And it does no good whatsoever–corrective, societal, or moral. That is the widespread theory. Here is the latest glimpse of the widespread practice.
Will you step up as the standard-bearer for the mentally ill?
Full disclosure: I have struggled with this blog post for days: post it or throw it away? Revise it one more time so that it reads as Beltway-savvy, or put on my Mister Smith hat and hope it will ignite a 1939 Hollywood moment? Decide to not intrude into the life-choices of an honorable private woman who made it clear recently that she wants to remain private, or say the hell with it and make the intrusion anyway?
Hell with it. Here goes:
On August 23rd of last year, America lost one of the two or three greatest champions of mental healthcare reform since Dorothea Dix. The vast sub-nation of the afflicted, their families, and their ardent yet scattered and over-burdened advocates is seeking a replacement: someone who can help unify this nationwide archipelago of sufferers into a single movement with a coherent voice.
I believe that Ashley Biden, the new President’s daughter, is the person most graced by fate to advance our mission. And I will tell you why: in addition to her experience and expertise in mental health issues, Ms. Biden would embody an influential link to policymakers that the afflicted and their caretakers have yearned for roughly since the founding of the Bedlam Asylum in 1377.
I can already hear the screams of “nepotism!” from the President’s political foes. (At the same time, I’m mindful that some of the most stalwart friends of the mentally ill have been Republicans.)
As Elizabeth Warren used to say, I have a plan for that: make Ms. Biden an unpaid White House staff advisor specializing in the interests of the mentally ill.
(Ashley, is there anything else I can do to enhance your life before I sign off??)
Let me give a thumbnail sketch of the man whose death has created such a vacuum:
Dj Jaffe was 65 when cancer took him from us. Most Americans had never heard of him. Yet within the archipelago, he was a superhero. He’d walked away from a cushy career in advertising to take up the cause when his sister-in-law developed schizophrenia. He understood and worked with Congress, the courts, community health centers, and the county jail, having mastered the complexities of schizophrenia and its related chronic predators upon the human brain. In 2011 he founded the indispensable Mental Illness Policy Org., a colossus of links to data, information, helpful sources, and policymakers. He was a co-founder of the Treatment Advocacy Center along with his own personal hero, the pioneering E. Fuller Torrey. His nonprofit book, Insane Consequences: How the Mental Health Industry Fails the Mentally Ill, is the single most comprehensive manual on the subject in our time.
Dj Jaffe’s passing has left an unacceptable void of wisdom, energy, and passion at the center of our efforts to reclaim the grievously broken systems of mental healthcare in America. There are dozens of men and women who would do credit to my late friend’s legacy. And then there is Ashley Biden.
As I say, Ms. Biden has made it clear that she dislikes “the spotlight,” and bravo for that. Yet her role as an advisor to her father, or perhaps as director of a new foundation, need not entail being in the spotlight so much as seizing the spotlight. And turning it around upon a shadow-enshrouded system that to this day abuses insane people with barbaric neglect and cruelty reminiscent of the Middle Ages.
With scattered exceptions, the mental-illness archipelago historically has been starved of government access. And when any level of government intervenes, it usually leaves things worse than they were. (I write this as a believer in active government.)
Think of “deinstitutionalization,” the sixty-year-old policy disaster that set off the national homeless calamity that expands to this day. Think of county jails as our new, dysfunctional mental hospitals. Think of mind-destroying solitary confinement, a useless torture practice that too often serves as a convenient storage-box for possibly prodromal juveniles. Think of un-convicted juveniles, untreated afflicted kids among them, waiting behind bars, often for weeks and months, for their trials. Think of untrained or uncaring police killing psychotic victims on the streets.
The crises and atrocities cited above are known to most people with a passing interest in the squalid fate of “crazy people” in America. The wish-list below will seem arcane to lay readers; yet it is packed with urgent, unaddressed problems that stunt and shorten the lives of the chronically mental ill, spread a widening cone of misery through their families and communities, and diminish the financial—and moral—health of the nation.
I’m indebted for this list to Leslie Carpenter of Iowa City, who with her husband Scott forms a tireless advocacy duo in America. Here it is:
–End the outdated, discriminatory federal rule known as the IMD Exclusion. This will increase the number of acute-care and long-term beds.
–Increase reimbursement rates for mental health professionals, direct care staff and facilities. This will help with recruitment, retention and quality of staff caring for people with serious mental illness (SMI).
–Modify the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to allow for more reasonable communication with families who are all too often the unpaid caregivers for loved ones with SMI.
–Increase funds for continued research for schizophrenia and related brain disorders.
–Fund and expand Assisted Outpatient Treatment Programs, along with Civil and Criminal Mental Health Courts.
–Expand funding for Certified Community Behavioral Health Centers in every state in the country.
–Stop wasting money on unproductive anti-stigma campaigns and. Use those funds to pay for the treatment of the most seriously ill, and the stigma will go away.
–Stop funding just more housing. Allow HUD subsidized funding for residential care facilities, group homes and facilities all along the continuum of care for people living with SMI and substance use disorders. Funded housing, tied with assisted outpatient treatment (AOT) programs, will allow the housing of people who don’t know they are sick, and keep them in treatment via outpatient civil commitments for treatment.
–Stop shutting down Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) if someone has to be hospitalized for 30 days or more. Shutting down the ability to pay rent is a major cause of homelessness among the chronic mentally ill.
–Create loan forgiveness incentives for mental health professionals practicing in rural locations.
–Fund medical schools to increase enrollment for psychiatrists and other mental health professional programs including nurse practitioners, physician assistants and psychologists.
Every one of these proposals requires intense, coordinated governmental action. As of today, there is no governmental coordinator. Not even Dj Jaffe had such power. This thin and secretly failing hero drew upon his extraordinary passion, his vast self-education in this complex cluster of subjects, and his gift for eloquence in the media, in testimony, and in his book.
The dispossessed mentally ill people among us cry out for a figure to replace Jaffe, and perhaps even surpass his legacy. Given Ashley Biden’s training, intelligence, commitment to the cause of mental health, and principled access to the (recently besmirched) corridors of congressional power, I believe that she could be this figure—a catalyst for reclamation.
We live in a fragile national moment, a moment saturated with promise and with menace. On the hopeful side, I marvel at the brisk accomplishments of President Biden’s first weeks in office, and I hear an old trumpet sounding, and I can almost envision a second New Frontier. On the dark side linger the shock-images and aural bedlam of the Capitol insurrection and the miasma of the impeachment trial, with portents of worse to come. And I wonder whether collective psychosis—madness—is our new pandemic.
It will take every person of good will to steer our future toward the light. Mental illness is just one item in a crushing agenda; yet it looms over us all, a scourge of mostly unfathomed proportions. (How far have some of us drifted into collective psychosis? Is there momentum in this direction?) A voice of informed influence near the apex of our government would be a godsend. The archipelago needs you, Ashley Biden.
. . . again. And now the real work of his loved ones, the work of keeping him alive on the Vacaville streets through the Covid-thick winter, commences. Again. Because no city or county or stage agency cares. Still.
Mark Rippee of Vacaville, California, has entered what may be the final struggle for his catastrophic life. His survival prospects are not good.
Most readers of this blog know about Mark’s grotesque misfortunes that span thirty-three years. And about the shocking indifference to them among the social services and the members of the Solano County Board of Supervisors. To refresh your memory, click on this blog link to read my previous posts.
Mark was released from a Vacaville hospital on October 26. He had spent two hundred fifty-eight days there, the longest respite of his tortured life since June 1987, when a motorcycle crash left him blinded, his body shattered, parts of his brain exposed, and his mind vulnerable to the schizophrenia that soon struck him. He’d been hospitalized after being struck by a car for a second time while wandering sightlessly around the town.
No agency in the city, the county, or the state of California cares about Mark Rippee. The attached links detail how his sisters Linda Privatte and Catherine Hanson, both women in their 60s with major illnesses themselves, have tried in vain to obtain conservatorship over him and to find a secure place for him to live. The care agencies and political bodies enfold themselves in narrow interpretations of law and policy. The sisters believe that in fact some laws meant to protect people such as Mark have been violated, with no one inclined to enforce them.
The family has been helped, materially and spiritually, by a growing army of concerned friends and Vacaville citizens. The sisters have posted a call for blankets, food, medium-sized long-johns and lined sweatpants, beanies, deodorant, lotion, hand sanitizer, baby wipes, a coat, gloves, socks. And water. Always water.
To simply read this sad list is to recoil at the scale of difference between Mark Rippee’s plight and the stony disdain—the contempt—of the agencies and the political structure designed to help him.
The charity now arriving is a godsend, and a tribute to the humanity of Vacaville’s private citizens. Yet it is not enough to assure this broken man’s survival. Mark, now 57, remains vulnerable to winter’s ravages, to further collisions with cars and trucks, and—most threateningly—to his environment’s rising Coronavirus rate. Solano County has entered tier 2, the “red” tier, which signals a “substantial” level of infection.
No one tells Mark’s story with more passion and clarity than Linda and Catherine, who have told it to deaf ears for three decades. Their stories and updated reports are linked below.
Today is a dark day. Mark was discharged from the Acute Care hospital after 258 days of healing from his injuries after being struck by a car for the second time in the last year. He was taken by the facility’s van back to the streets of Vacaville. He left with only a cane, duffle bag, boots, and 2 sets of clothes. They gave him 1-2 months worth of medications but would not confirm what they were. I don’t know how he will know what he is taking or when it is time. He has been on increased Anti-psychotic meds recently and I do not know if he will be on the streets. His new Social Worker is with Solano APS and is the same one who did the “Snapshot Assessment” of Mark and declared him “Not Conservable.” He was planning to meet Mark on the streets of Vacaville to “Receive” him back to town. When we called the facility this morning to check on when he was to be released and how… he was already gone. The nurse claimed, “Oh he is not going back to the streets, but is going to the Vacaville county building!” I started explaining that he is going back to the streets! That is where he has lived on the streets for years! I have 2 people trying to help with getting him a new ID. The facility could not confirm if he even had a blanket. He was supposed to get a flu shot before leaving – he didn’t. We have already put together many things he will need, but with a bad leg and a shoulder that doesn’t work, it will be even more difficult to carry much. He is supposed to still be using a walker – but chose a cane. He will have difficulty social distancing and not touching everything he comes in contact with. They said they gave him a few masks. His discharge was scheduled for 11 am this morning. I tried calling all morning and couldn’t reach him or the Social Worker. It turns out they released him earlier than 11 am, so he was already gone before I could even talk to him. I did not even go to bed last night thinking that tonight Mark will be sleeping on the streets. CJ has been up for two nights bracing herself for his release. His drastic improvement over the last 8 months was not enough proof for the county to comprehend that housing, treatment, and care was exactly what was needed in his case. I am back to taking it day by day to keep him alive. How long before another traffic accident or injury? We know it won’t be long… and we will go back to jumping every time the phone rings.I just received verification from one of our members that he arrived at the Carroll Building in Vacaville and the APS Social Worker was not there! He is now alone and darkness comes.Linda Rippee
The Road Ahead… by Linda (Rippee) Privatte Updated June 1.
“No matter the circumstances, what happened on Friday night is a tragedy, and I expect this investigation to be handled swiftly and transparently for the sake of everyone involved.” –Salt Lake City Mayor Erin Mendenhall last Sunday, two days after the autistic 13-Linden Cameron was shot several times by a city police officer. Linden remains in serious condition.
It has been a week. We are waiting, Madame Mayor.
On Tuesday I posted a blog about Linden Cameron, the 13-year-old Salt Lake City boy who was shot repeatedly by a police officer, whom his mother had called to help him through a psychotic episode.
This blog will be brief: Linden is in serious condition—he somehow survived—in a Salt Lake City hospital. Two private citizens have started fundraisers for the medical bills that would otherwise overwhelm his mother. Their links are here https://www.gofundme.com/f/24rhnm8shc and here https://www.gofundme.com/f/linden039s-medical-bills.
Linden’s story has been picked up by newspaper, broadcast, and online outlets around the world. Below is the New York Times account. I will have more to say on this.
But we care, Diane Keaton. Join our cause to make America care about “crazy people.”
I can visualize the scene: a book-tour venue; a synagogue in Washington. (I can visualize it thanks to the subtly bravura piece by the Washington Post reporter Ellen McCarthy, linked below.) Every seat is taken, because today this is a celebrity book-tour venue. The celebrity author, an iconic movie star, walks onstage. The audience leaps up in a standing ovation. They are mostly middle-aged women who had paid forty dollars each to come and see the movie star in person. In person!
The folks squirm back into their seats and the iconic movie star–Diane Keaton–begins to speak. Diane Keaton has just published her third memoir. It is a departure from the usual books from Hollywood stars. Its subject is her younger brother. Her mentally ill younger brother, whose name is Randy. Its title is Brother & Sister.
Diane Keaton speaks ruefully about the book’s rueful theme, which is her regret over abandoning Randy during the decades when she was driving herself to Hollywood stardom and the adulation of the millions. As children, the two had been close. But Ms. Keaton’s growing fame had come at the expense of this bond. Randy sank into the morass of “alcoholism, joblessness, divorce, isolation, fantasies about violence against women and a suicide attempt,” in reporter McCarthy’s retelling.
(Brother and sister reconciled some ten years ago, and Keaton now visits Randy in his assisted-living quarters.)
“’There are so many people who live through the pain of having a family member who doesn’t quite fit in,’” she remarked, as McCarthy reports. “She said she wanted to open up a dialogue about mental health and to offer herself up as a cautionary tale that could inspire people to ‘be better’ to their loved ones sooner than she had.”
And then Diane Keaton consented to answering some questions written in advance by audience members.
McCarthy: “The questions . . . had nothing to do with Randy’s [life]. They had to do with [the Keaton movies] Something’s Gotta Give, The First Wives Club and Father of the Bride. With whether Keaton has a favorite co-star.”
And there you more or less have it: No one in the room cared about crazy people. Or if they did care, they kept it to themselves. Diane Keaton’s cautionary tale was smothered–banished, rendered nonexistent–beneath an avalanche of forty-dollar-a-seat celebrity worship.
And my guess is, that’s the way it will go as long as Diane Keaton continues her tour for Brother & Sister. Lots of jam-packed venues with expensive seating. Lots of standing ovations. Lots of iterations by Diane Keaton about the travails of her mentally ill brother Randy, her lamented separation from him, and the late-life restoration of their loving bond.
Followed by lots of “Do you have a favorite co-star?” “How did you like working on The First Wives’ Club“?
Ms. Keaton, I have an invitation for you. It is for when you grow weary of fielding fangirl and fanboy questions during your tour for the book about reclaiming the union between your brother and you. Or even if you don’t grow weary.
Come and make common cause with us. Give your support to the growing nationwide movement to reform mental healthcare. You will have caught us at the floodtide: our activists have presented proposals to all of the Democratic candidates for the 2020 presidential election. And they have listened, and shown that they care.
This would not require much in the way of your personal time and commitment. Your imprimatur . . . your endorsement of our goals . . . perhaps a shout-out to one of our several organizations or causes, or brief remarks at one of our national gatherings . . . any or all of these things could supercharge our efforts. The moral dimensions of your journey with (and without, and with again) Randy; your insights as a denizen of the pressurized and volatile Hollywood community, where psychic balance often lives at the border of madness; your message to a nation still largely clueless about mental illness . . . and, yes, the weight of your hard-fought and well deserved celebrity hood.
A partial list of leaders in the movement follows. There are many others. Please join us and support us.
Sooner Than Tomorrow (a blog)
No One Cares About Crazy People (a blog)
In the aftermath of two traumatic mass shootings, the president re-invokes a horrid, distorted falsehood about the mentally ill.
And there it is: history’s defining damnation of sufferers of incurable damage to the brain, distilled into a three-word phrase of transcendent ugliness and stunted understanding.
The phrase was uttered on Monday. It was uttered to identify the provenance of the weekend’s massacres by shooters using legally purchased high-capacity semi-automatic weapons toward their collective harvest of 31 people dead and some 50 wounded.
The phrase was uttered by the President of the United States. It left stains, stains which, in moral and intellectual terms, replicated the stains of blood shed by the shooters’ victims.
Blaming “mentally ill monsters” (or “nut jobs,” or “wackos,” or “lunatics”) for such carnage is a morally repugnant, if time-tested device for shifting the public’s passion for safety away from gun control and toward the presumed demons in our midst. The president could not have been more transparent in exploiting the device. “Mental illness and hatred pulls [sic] the trigger, not the gun,” he instructed us, going on to label one of the shooters as “another twisted monster.”
In fact, it is a settled truth in psychiatric research that victims of brain afflictions are no more prone to violence than the general population. The prominent advocate Dj Jaffe makes an important stipulation: that the untreated mentally ill—those not stabilized by antipsychotic medications—can be more likely to cause harm to themselves or others. Still, implying that mental illness itself equates to degenerate aggression serves only to further isolate and punish the most helpless members of our society; to herd them back toward the dark corners and confinements of “insane asylum” days.
And herein lies the “intellectual” stain that President Trump’s words help spread: most people—like the president himself—do not understand mental illness: what it means, how it occurs, how it differentiates, why its victims behave as they do, and how even its most abject sufferers can be aided, often stabilized, by medications and therapy. In this vacuum of understanding, people tend to substitute prejudice, false science, myth, and hostility toward “crazy people.”
“Serious” mental illness—the kind in question here—is rare and unique. And incurable. Unlike alcoholism or anger or depression, serious mental illness is rooted in genetic flaws of the brain. Its various names include schizophrenia, schizoaffective disorder, bipolar disorder—similar yet not interchangeable conditions. It results in a loss of reason and rational control; hallucinations and the hearing of voices; alienation from family and friends; and, yes, sometimes—rarely—violence.
My wife and I have educated ourselves about serious mental illness because we’ve had to. It invaded our family several years ago, causing the suicide of a beloved son. Unfortunately, this is the painful route to understanding for most people: a loved one is stricken.
The costs of this cluelessness describe a cone of destruction that widens from the stricken individual through society.
The cone draws in and ravages parents and siblings of the stricken. It can cripple the finances of families without adequate insurance to cover treatment and medications. It drains human capital from the workforce, and thus economic revenue. It reduces the budgets of hospitals that can’t get reimbursement for their mentally ill patients. It overburdens police, whose lack of training and, sometimes, self-restraint, can result in death by gunshot of unarmed people in psychosis. It coarsens our criminal-justice system: think of schizophrenic adolescents hustled into jail by untrained or uncaring judges, where they await trial—often for weeks and months—while their unmedicated psychosis deepens. Think of solitary confinement. Think of a brain-afflicted child, perhaps your own (as countless parents must) ensorcelled in a cell, abused by fellow inmates and guards, with no end in sight, no comprehension. No hope.
Now think about “mentally ill monsters.”
Mentally ill monsters are not the source of our current crisis of public massacres. The monster is the gun: too many guns, with too little restraint and oversight regarding purchase. To his credit, President Trump gave lip service to keeping guns away from those “who pose a grave risk to public safety,” and to strengthening gun laws generally.
But leave the gun issue aside. Part of any president’s duty—a foundation of his “bully pulpit”—is to educate his fellow citizens on matters of complexity and urgent public import. The nature of serious mental illness, and the reclamation of its victims, comprise one such matter. The president could make a great, galvanizing contribution to ending the centuries-old oppression of “crazy people.” He could lead us in that direction. He could educate us. But first he must educate himself.