Martha Roby: Raising mental health awareness during COVID-19
Taking proper care of yourself and others can help manage this anxiety.
Corrections, gambling to be focus of legislative session
The state prison crisis is expected to take center stage in the legislative session.
Judge: Alabama has been ‘indifferent’ to isolated inmates
A federal judge said Monday that Alabama has been “deliberately indifferent” about monitoring the mental health of state inmates placed in the isolation of segregation cells. U.S. District Judge Myron Thompson issued the ruling days after attorneys for inmates said the suicide rate in state prisons has reached a crisis level. “The court finds that the (Alabama prison system’s) failure to provide adequate periodic mental-health assessments of prisoners in segregation creates a substantial risk of serious harm for those prisoners,” Thompson wrote in the 66-page order. Thompson wrote that prison officials have been “deliberately indifferent with regard to their failure to provide adequate periodic evaluations of mental health to prisoners in segregation.” Alabama Department of Corrections spokesman Bob Horton said the department is reviewing the decision. Thompson in 2017 wrote that mental health care in state prisons was “horrendously inadequate” and violated the Eighth Amendment’s prohibition on cruel and unusual punishment. In his Monday order, Thompson said the failure to adequately monitor inmates in segregation contributes to the unconstitutional conditions. Thompson directed the prison system and attorneys for inmates to confer on how to proceed. The Southern Poverty Law Center, which is representing inmates in the ongoing class-action lawsuit over prison mental health care, praised the decision. “It has been evident for years that ADOC has failed to identify, monitor, and properly care for people who have serious mental illnesses and who develop them in ADOC custody. That systematic failure has led to needless suffering, especially for people in segregation,” said Maria Morris, senior supervising attorney at the SPLC. The advocacy organization said Friday that there have been 13 suicides in 14 months. “People are killing themselves in our prisons because conditions are horrendous,” Southern Poverty Law Center President Richard Cohen said at a news conference with the families of inmates. The prison system said in a response Friday that it was working to address the issue, and said the suicide spike “calls into question the long-term effectiveness of the suicide prevention measures proposed by the SPLC” during the litigation. Republished with permission from the Associated Press
Alabama prison system ordered to report mental health segregation data
On Tuesday, U.S. District Judge Myron Thompson issued an order for the Alabama Department of Corrections (ADOC) to report how many inmates with mental illnesses have been placed in segregation units, The Associated Press reports. This comes when attorneys for inmates requested intervention after three suicides occurred in four weeks in state prisons. Thompson previously instructed state prisons not to isolate prisoners without extenuating circumstances after finding in 2017 that care for mentally ill inmates was “horrendously inadequate.” History of mental health issues in Alabama prisons The issue of mental health care in state prisons has been ongoing. In December 2018, Alabama prison officials stated that they were making “substantial progress” in increasing mental health staff and asked not to be held in contempt of court of an order requiring minimum levels of mental health staff. In a December filing, the ADOC wrote that Wexford Health Sources, the contractor hired to provide health care, had not been able to meet staffing targets but said “both are making all efforts to increase staffing as quickly as possible.” The letter continued, “In sum, the state is not contending that it has fulfilled every requirement of the staffing remedial order. But it has made in good faith all reasonable efforts to do so, and those efforts have resulted in substantial progress.” They claimed that a shortage of professionals available, especially in rural areas, has made staffing difficult. Lawyers for the inmates wrote “Defendants’ contempt is placing prisoners with serious mental-health needs at a substantial risk of serious harm every day. Their failures are most evident when looking at staffing levels for mental-health staff with advanced training, specifically psychiatrists, CRNPs, psychologists, and registered nurses.” In September of 2018, the Southern Poverty Law Center asked Judge Thompson to hold the ADOC in contempt. “Adequate staffing is critical to address the mental health needs and secure the safety of the prisoners in ADOC’s care,” said Maria Morris, senior supervising attorney at the SPLC. “Time and time again, ADOC has failed to meet court-ordered deadlines to fill essential staffing positions. We have no confidence that ADOC is doing all it can to hire enough staff to care for prisoners with mental illnesses. We are asking the court to rule ADOC in contempt for continuing to fail to meet these court-ordered deadlines.” This came after a warden testified in February 2018 after a mentally ill prisoner committed suicide.
Prison system: Alabama making progress in mental health
Alabama prison officials contend they are making “substantial progress” in increasing mental health staff and have asked a federal judge to not find the state in contempt of court. U.S. District Judge Myron Thompson has scheduled a Jan. 7 hearing on whether the Alabama Department of Corrections should be found in contempt of a court order to increase mental health staffing numbers to minimum levels. The department wrote in a Friday court filing acknowledged that Wexford Health Sources, the contractor hired to provide health care, had not been able to meet staffing targets but said “both are making all efforts to increase staffing as quickly as possible.”“In sum, the state is not contending that it has fulfilled every requirement of the staffing remedial order. But it has made in good faith all reasonable efforts to do so, and those efforts have resulted in substantial progress,” the filing stated. Attorneys for the inmates have asked the judge to find the prison system in contempt, arguing the prison system is “woefully short” of a requirement to fill 263 full-time mental health positions. “Defendants’ contempt is placing prisoners with serious mental-health needs at a substantial risk of serious harm every day. Their failures are most evident when looking at staffing levels for mental-health staff with advanced training, specifically psychiatrists, CRNPs, psychologists, and registered nurses,” lawyers for inmates wrote earlier this month. Elaine Gedman, chief administrative officer and executive vice president for Wexford Health Sources, disputed that characterization. She wrote in a declaration with the court filing that they had provided 227 full-time equivalent positions. The prison system wrote that there has been difficulty in recruiting staff because of a shortage of health professionals in the state, particularly in rural areas. They also said compliance should be measured by “hours of service” provided, instead of just positions filled. Thompson last year ruled that mental health care was “horrendously inadequate” in state prisons and created unconstitutional conditions. The ruling came after the Southern Poverty Law Center and the Alabama Disabilities Advocacy Program filed a class-action lawsuit over health care in state prisons. The first inmate to testify at the trial killed himself days after describing past suicide attempts and a lack of psychiatric treatment while in state custody. Republished with permission from the Associated Press.
Another chance to talk about mental health
Today’s World Mental Health Day, as if I needed another reason to write or talk about the challenges we face as a society and as a state addressing mental health care. From mental health care funding and destigmatizing the issues, we have got to do better. I encourage you on this day to look around you, and speak up, and talk about your own issues, issues that have affected your friends/family. Go and call and check in on a friend who you know has been struggling. If you have the resources to donate to cause that supports mental illness, do that. If you have children, I urge you to take a minute to check in on them and talk to them about mental illness, depression, anxiety, bullying, happiness and all of the things we sometimes take for granted or ignore. Today is a day like every other day where there are people around us suffering in silence. Suffering themselves. Suffering because they are the primary care givers for a loved one who has untreated mental illness or possibly mental illness that is being treated but still causes them a lot of stress and anxiety. We have a long way to go in our country in the way in which we address issues of the mind and illness we can’t see and don’t understand. We have a long way to go as a state in the way that we fund treatment. I urge you, or remind you, to check out the resources below if you need help. And to take a moment and do your part and help change the way we talk about this issue. National Alliance for Mental Health: NAMI, the National Alliance on Mental Illness, is the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness. Alabama Department of Mental Health: Promoting the health and well-being of Alabamians with mental illnesses, developmental disabilities and substance use disorders Crisis Center of Birmingham: Mission is to serve the unmet needs of people experiencing personal crisis or mental health issues and respond with services that promote coping, emotional health and well-being. Our primary service area is Central Alabama, which is defined as the five county area surrounding Birmingham. This includes Blount County, Jefferson County, St. Clair County, Shelby County and Walker County.
Walt Maddox: State in mental health care crisis
Standing with a probate judge who described how he can sometimes not find treatment beds for people who need to be committed, gubernatorial challenger Walt Maddox said Monday the state is facing a mental health care crisis and must put more resources into treatment. The Democratic nominee opposing Republican Gov. Kay Ivey held a news conference outside a closed psychiatric hospital in Montgomery. Maddox said a shortage of mental health services could be addressed by Medicaid expansion and his lottery and gambling proposals to put more money into treatment. “Alabamians are hurting,” Maddox said. Maddox said the state’s failure to expand Medicaid under Ivey and previous Gov. Robert Bentley is “maybe the worst” health care and economic decision the state has made. “How we treat our fellow man is, I believe, one of the ways we will be judged. Right now, under the Bentley-Ivey administration, those vulnerable to mental illness have been forgotten about. The decisions regarding their lives are budget-driven, in the hopes Alabama will forget about them.” Ivey issued a statement through her campaign that, “I am committed to ensuring we continue to help Alabamians lead healthier, safer and happier lives.” Ivey said she appointed an experienced and dedicated new mental health commissioner, secured additional funding to create new programs and services, and ensured the Department of Mental Health had a voice on a number of commissions and tasks forces. She also said earlier this month that she is not opposed to Medicaid expansion, but questions how the state would pay for it. Maddox argued the economic investment in health care would pay for itself. He has also suggested striking a compact with the Poarch Band of Creek Indians to pay for the state’s share of expansion. The state in 2012 announced the closure of most psychiatric hospitals in an effort to move people to community-based treatment, a step that was supported by patient advocates. However, Maddox contended the state has failed to adequately fund crisis care and other community services. Maddox said his proposal to start a state lottery would provide $25 million for “wraparound” mental health services in public schools. Montgomery County Probate Judge Steven Reed, who is supporting Maddox in the race, said he sometimes cannot process petitions for mental health commitment because there are no treatment beds available. He described families trying to keep tabs on ill family members because there are no treatment options. He said some “had to lock themselves inside of a bedroom because the loved one may be going through a spell or having some hallucinations.” He said there are no adolescent treatment beds in the county. “That is a risk to them. That is a risk to our community … It is a major problem not having enough beds in our community and throughout this state,” Reed said. Republished with permission from the Associated Press.
SPLC asks judge to rule Alabama’s prison system in contempt over mental health staffing
The Southern Poverty Law Center (SPLC) is asking U.S. District Judge Myron Thompson to hold the Alabama Department of Corrections (ADOC) in contempt for failing to meet deadlines for increasing mental health staffing. “Adequate staffing is critical to address the mental health needs and secure the safety of the prisoners in ADOC’s care,” said Maria Morris, senior supervising attorney at the SPLC. “Time and time again, ADOC has failed to meet court-ordered deadlines to fill essential staffing positions. We have no confidence that ADOC is doing all it can to hire enough staff to care for prisoners with mental illnesses. We are asking the court to rule ADOC in contempt for continuing to fail to meet these court-ordered deadlines.” In the summer of 2017, Thompson ruled Alabama’s psychiatric care of state inmates is “horrendously inadequate” and in violation the U.S. Constitution’s ban on cruel and unusual punishment. In February, he set deadlines in May, June and July for increasing mental health staff, which the ADOC has failed to do. On Friday, Thompson issued an order requesting a hearing to begin Tuesday at the federal courthouse in Montgomery, Ala. to give ADOC the opportunity to show they should not be held in contempt. Parties ruled to be in contempt can face fines and, in some cases, jail time. SPLC is asking here that a monitor be appointed to oversee how ADOC is progressing and to keep the Court and the Plaintiffs informed.
Let’s talk about mental health not in whispers, but in shouts
Today authorities confirmed what has widely been speculated since the death of Attorney General Steve Marshall‘s wife Bridgette — that she in fact committed suicide. Often times we only talk about suicide in the case of celebrities… Robin Williams, Kate Spade, Anthony Bourdain, and others. But the fact is suicide affects so many more of us. More importantly, the underlining cause of suicide, untreated mental illness or mental illness not responsive to medications and treatment, affects nearly all of us in some shape or form. I don’t know a single person not touched by mental illness — either persistent and severe conditions that plague them on and off throughout their lives, or acute in response to major life changes. We have to do better as a society. Although I write quite frequently about mental health and the importance of destigmafying it, and properly funding mental health care and community-based programs, and addressing it in our schools, even I feel like I don’t do enough. I talk openly about my generalized anxiety disorder and the co-occurring depression that can come with it in extreme periods of stress. But I feel like nothing is enough. We have to make this an everyday conversation and rather than whisper about it we should shout. We should say out loud that one can no more control mental illness than they can control asthma, diabetes and other health conditions. What we can control however is how we address it. How we treat it. How we talk about it. Treatment shouldn’t be a dirty secret. Seeking treatment shouldn’t be made to seem like a sign of weakness. Please join me and let’s all talk publicly about mental health. Let’s talk what’s happening in one another’s lives and in the lives of our loved ones, our neighbors, our colleagues. In loving, caring, and supportive ways. My heart breaks for Steve Marshall and his daughter Faith (I find myself in tears writing this now) and all I can ask for is in this time we don’t gloss over the opportunity to do better. I hereby call on state and lawmakers to take on this issue now. It shouldn’t take another mass shooting, or another celebrity suicide or God forbid the tragedy that the Marshall family is enduring right now to bring up the conversation. The time is now. Let’s all go out and do better! Here are some state and national resources below about mental health: NAMI Alabama: The mission statement/purpose of NAMI Alabama is to provide support, education, and advocacy for persons with mental illnesses, their families, and others whose lives are affected by these brain disorders. This is accomplished by: Educating the people of Alabama about mental illness thereby reducing stigma Providing support for individuals with mental illness to grow and contribute to their community Developing, nurturing and coordinating a statewide network of local affiliates Promoting public policies which expand services and improve treatment for all persons living with a mental illness and supporting research leading to the control and management of mental illness Alabama Department of Mental Health: The state agency tasked with, “Promoting the health and well-being of Alabamians with mental illnesses, developmental disabilities and substance use disorders.” Substance Abuse and Mental Health Services Administration (SAMHSA): The agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. SAMHSA’s mission is to reduce the impact of substance abuse and mental illness on America’s communities.
Mental Health Awareness Month is ending, but the work continues
For those of you who didn’t know, May is Mental Health Awareness Month. As the month winds down, I’d be remiss not to post about Mental Health Awareness, and how much better we need to do around the nation with education, destigmatization and prioritizing access to affordable mental healthcare. Too often the only time we see people talk about mental health awareness, or mental health in general, is when tragedies such as public violent acts occur (though it’s a misconception that those suffering from mental illness are inevitably going to be violent) or with the suicides of celebrities. Meanwhile, millions all around us are suffering daily. In addition to those who suffer from mental health illness, families are being broken apart and employers are losing productivity, students are failing… there is such a high cost for what has been historically our nation’s inability to recognize and address the mental health crises. The cost of ignoring the problem is so much more significant. Before Mental Health Awareness Month ends, I want to encourage you, the readers of Alabama Today, to get more facts, become more educated and talk about mental health with those around you much more frequently. We don’t need to wait for a crises to strike to address what we can and should be doing. Encourage your lawmakers to adequately fund mental health. Talk to your teachers, educators, school administrators about what they are doing in schools to recognize and possibly intervene with students who may need additional help. People with severe, persistent mental illness can, and do, live active, vibrant lives. They can be, and often are, productive members of our society. Those who often go untreated generally fair far, far worse. We need to do better by acknowledging and educating those around us about the issues. Here are some state and national resources below about mental health: NAMI Alabama: The mission statement/purpose of NAMI Alabama is to provide support, education, and advocacy for persons with mental illnesses, their families, and others whose lives are affected by these brain disorders. This is accomplished by: Educating the people of Alabama about mental illness thereby reducing stigma Providing support for individuals with mental illness to grow and contribute to their community Developing, nurturing and coordinating a statewide network of local affiliates Promoting public policies which expand services and improve treatment for all persons living with a mental illness and supporting research leading to the control and management of mental illness Alabama Department of Mental Health: The state agency tasked with, “Promoting the health and well-being of Alabamians with mental illnesses, developmental disabilities and substance use disorders.” Substance Abuse and Mental Health Services Administration (SAMHSA): The agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. SAMHSA’s mission is to reduce the impact of substance abuse and mental illness on America’s communities.
Walt Maddox announces mental health policy plan
Tuscaloosa Mayor and Democratic gubernatorial candidate Walt Maddox on Monday released his policy plan to address mental health issues in Alabama if elected Governor. Maddox’s plan focuses on improving mental health through Medicaid expansion. “Nationwide, almost one-third of persons who receive health insurance coverage through Medicaid expansion have a mental disorder, a substance abuse disorder, or both,” said Maddox. “People who are uninsured have a higher prevalence of mental health conditions than the overall population, and expansion is key to providing broader access to mental health treatment.” Maddox says Alabama has consistently decreased or level funded mental health “in an era where society is experiencing increasing mental health problems.” “All of Alabama’s 54 rural counties are classified as mental health care shortage areas,” Maddox continued. “Our jails and prisons have become de facto mental hospitals, but without providing effective treatment. There’s no reason we cannot return to the days of providing comprehensive and effective prevention and treatment for mental illness.” As such, Maddox’s plan includes focusing on prisoner mental health. “For too long, politicians in Alabama have focused on meting out harsh punishment through long prison sentences, while ignoring the fact that many prisoners have mental health problems and most of them will return to society one day.” In June 2017, a federal court found Alabama prison system’s mental-health care to be “horrendously inadequate” and thus in violation of the U.S. Constitution’s ban on cruel and unusual punishment. His mental health plan also includes: Providing mental health resources to schools. As part of his Alabama Education Lottery proposal $25 million will be allocated annually for Community Innovation Grants that can be used by local school systems to improve social services to students, including providing mental health resources. Appointing a professional commissioner of mental health who is given free rein to advocate for more funding, more effective treatments, and better facilities. Separating out substance abuse programs from under the Department of Mental Health, so that a cabinet level officer would report to the Governor on the state’s opioid crisis and other substance abuse problems, allowing the Department of Mental health to concentrate on its core mission. “Alabama has betrayed its own legacy of effective and compassionate mental health treatment by continually underfunding mental health services, relying on jails and prisons to house the severely mentally ill, and passing the state’s responsibility down to communities and local governments. Under my administration, mental health will be a priority,” Maddox posted on Facebook announcing his plan.
Mental health commissioner Lynn Beshear calls for action in schools
Alabama’s Department of Mental Health Commissioner Lynn Beshear called for mental health prevention and intervention to ensure school safety in an op-ed Saturday. Beshear said the state must focus on identifying behaviors that trigger school violence and proactively treating mental health. The state’s school-based mental health services put clinicians into schools to counsel students. Only 36 school systems in Alabama have the services and Beshear advocated for expanding it to the other 106. One in five U.S. children experience a mental, emotional or behavioral disorder, the American Institutes for Research reported. Mentally ill children often drop out of school and end up in the juvenile justice system, according to the National Center for Mental Health and Juvenile Justice. Gov. Kay Ivey’s newly created school security council will review mental health. Republished with the permission of the Associated Press.
