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Author advocates for mental health reform
SCOTT PIEPHO
Book Review
Published: May 6, 2013
Nationally acclaimed author and activist Peter Earley kicked off a Summit County symposium with stirring call to continue reform of our treatment of the mentally ill. Speaking before an audience of attorneys, court personnel and mental health professionals, Earley gave a rousing keynote address at the Summit County Alcohol, Drug Addiction and Mental Health (ADM) Board’s first conference regarding mental illness and criminal law.
Over the course of a 45 minute speech, Earley wove his own family’s experience, the stories of mentally ill people caught in the criminal justice system and our country’s history of the intersection of mental health and criminal law.
The program as a whole, he said, was designed to combat what later speakers would call “the criminalization of mental illness” – the growing tendency of mentally ill people ending up in jail after crises related to their illnesses.
Earley said his story began during a psychotic break experienced by his son. At that time his son had been diagnosed as bipolar and was stable with medication, but would stop taking his medicine and relapse into psychosis.
In the course of seeking treatment, Earley was told that he could not put his son in treatment involuntarily unless he tried to kill himself or someone else. As he struggled to get his son help, the former Washington Post reporter said he became interested in the mental health system and began investigating it.
The resulting book, Crazy, Crazy: A Father's Search Through America's Mental Health Madness was a finalist for the Pulitzer Prize in 2007. He has since become an advocate for mental health reform.
In his telling of the history of our society’s treatment of the severely mentally ill he makes the case that we have come full circle. In colonial times a mentally ill person was generally either cared for at home or ended up in jail in the “lunatic” ward, Earley said. Today, he added, that is also becoming the most frequent outcome.
In between then and now, Earley explained that the nation has seen a series of incomplete reforms. In the 19th century, Dorothea Dix took up the cause and successfully advocated for setting up state-run hospitals for the mentally ill. But ultimately those hospitals were underfunded that they became wretched places unfit for caring for any human beings, much less sick ones.
More recently, Earley noted that states have deinstitutionalized the mentally ill, but have not approved community-based services either. As part of that reform, Earley said the law set the standard for involuntary commitment – danger to one’s self or others – so high that it does not allow help for sick people whose lives could be improved with intervention.
Looking at today’s system, Earley reported on group homes that are again underfunded, understaffed and often don’t meet basic building code requirements. He noted that he spends $4 more a day boarding his dog than the state of Virginia spends housing the mentally ill. “We haven’t improved these people’s lives by getting them out of those hospitals, we just hide them better,” he said.
Increasingly, the alternative to the care system Early said is the criminal justice system. In Ohio the chances are 1 in 4 that if a person has a psychotic break he will end up in jail, said Earley. The largest mental health provider in the United States is the Los Angeles County Jail.
“We are responding by turning mental illness from a health issue into a criminal justice issue,” he said.
Not surprisingly, the criminal justice system is inadequate to address the problem, Earley said.
“The criminal justice system did not create the problem and you can’t count on it to solve the problem.”
Ohio, and especially Summit County, have been recognized as national leaders in diverting mentally ill suspects out of the criminal justice system, Earley said, but he warned that the programs used here – including special training for police and mental health courts – will be of limited usefulness without adequate treatment resources to help such people get back on their feet.
Truly addressing the problem requires community-wide collaboration to provide a variety of services including housing, jobs and substance abuse treatment, he said.
“Not everyone can recover, but you have to believe that everyone can recover or no one will,” said Earley.
Throughout the rest of the day, presenters from Summit County agencies described programs that put this area on the leading edge of work in the field. Dr. Mark Munetz, a professor at NEOMed and chief clinical officer for the ADM board, gave a session regarding the sequential intercept model which he helped pioneer.
The model encourages actors within the criminal justice system to evaluate criminal defendants and divert them from the criminal justice system at various points along the process.
Munetz said Summit County is also one of the first in the nation to offer Crisis Intervention Team training to patrol officers. The training teaches officers how to “deescalate” a mentally ill person having an episode.
Summit County is also the first in the state to create a mental health court, Munetz said. Such courts now sit in all three municipal courts -- Akron, Stow and most recently Barberton.
According to ADM Board Executive Director Gerald Craig, the symposium was held in part to spotlight the innovative and collaborative work being done in the county.
“We are doing a good job here, but we haven’t done a good job of publicizing it,” said Craig.
The symposium was underwritten by the Margaret Clark Morgan Foundation.