New Orleans' Mental Health Crisis - Let's Talk About It

02/28/2025

It’s illegal to hold people against their will if they do not meet legal criteria for commitment. That’s why it’s of paramount importance that evaluations be conducted by skilled, board-certified, psychiatrists who have been through years of education and training to spot symptoms that others might miss or, understand symptoms occurring as a result not of severe mental illness, but something else.

But this is beyond Criminal. There is a special place in hell for doctors, nurse practitioners, and others who would use their power to hospitalize people simply for profit. That is why oversight and accountability in psychiatry is critical.

If you or a loved one has been hospitalized without justification, or not hospitalized with justification, let me know. Stopping this practice is on my to do list.

“In addition to numerous other charges, the suit accuses PIW of involuntarily hospitalizing patients without cause and fabricating diagnoses that allowed PIW to both keep patients longer and bill at a higher rate. The suit, filed by an anonymous alleged victim, is both for herself and others in a class action who suffered abuse and false imprisonment by PIW.”

A woman's nightmarish experience after being involuntarily committed has resulted in a lawsuit against Universal Health Services. Learn more at FindLaw.

02/21/2025

Happy dance! is becoming a reality in New York. Anyone who knows me knows that my focus for a long time has been on the need for transitional psychiatric **living facilities, not hospitals, for people who are no longer in acute psychiatric crisis, but too subacute for discharge directly to outpatient community services.

For the first time in years, I have real hope that we are moving in the right direction to help people living with severe mental illnesses. Much new and improved continuity of care infrastructure building has begun in earnest. 🙏🙏

“New York City is launching a new program called Bridge to Home that aims to provide extended services and supervision to homeless New Yorkers being discharged from psychiatric stays at the city’s public hospitals, the Adams administration announced on Wednesday.

The program, which Mayor Eric Adams and other officials unveiled at Bellevue Hospital, will start with a single, 100-bed facility where residents can stay for up to a year while receiving ongoing care and help finding permanent housing. Officials said they are still looking for a location and operator for the facility, which is slated to become fully operational sometime between mid-2026 and mid-2027.

Adams said the new facility will “provide a safe space for New Yorkers with mental illness to live, to heal, and be cared for so they get the life-changing help they need.” He added that it will also help people avoid returning to the emergency room, the streets, or jail shortly after being discharged. The facility's staff will include a range of professionals, including nurses, social workers and creative arts therapists.”

To start, the initiative calls for a 100-bed facility at an as yet undecided location.

02/08/2025

Excellent article by Efraim J. Keisari, MD, in PressReader.

The watering down of Psychiatry borders on civil rights violations for many reasons.

Nurse practitioners, psychologists and other mental health certifications cannot ever replace the expertise, training and education of a psychiatrist.

While our AOT law in Louisiana allows psychiatric nurse practitioners, psychologists and medical psychologists to perform evaluations that determine whether or not a person‘s freedoms should be taken away, as much as possible, I rely on forensic psychiatric evaluations.

There should be a law, like the coroner’s law that requires the same level of education - an MD - to assess people for inpatient commitments. Once a person has been hospitalized for suspected untreated mental illness/addiction Coroner‘s assistants (psychiatrists) assess patients to determine if civil commitment is warranted. If so, it’s called a Coroner’s Emergency Certificate (CEC).

Nurse practitioners, psychologist, social workers, etc., do not have board certifications that qualify them to recognize complex symptoms.

It’s only a matter of time before there’s a lawsuit somewhere for either a person being committed when they shouldn’t have, or not committed when they should have, by someone not qualified to make that decision.

Some people are worried about the shortage of psychiatrists, especially in rural areas, however telehealth has solved that problem.

“The proposals to authorize nurse practitioners, social workers and psychologists to
complete Assisted Outpatient Treatment evaluations, submit affidavits supporting
said petitions and testify in court about their evaluations are concerning. These
petitions involve complex medical, clinical (medication management and treatment
planning) and legal determinations that profoundly impact individuals’ lives and
liberty.

Physicians, such as forensic psychiatrists, bring years of specialized training in diagnosing severe mental illness and navigating psychiatry’s intersection with the law. Allowing non-physicians to take on this critical role raises concerns regarding the credibility of these evaluations in court. The New York State Psychiatric Association opposes an expansion of the types of practitioners who would be
authorized to certify the need for involuntary outpatient treatment.”

01/26/2025

Yes!

“Ignore the professional “advocates” who pretend that the best place for lost souls is on the streets.”

Public fury over dangerous mentally ill people plaguing the streets and subways has Gov. Hochul, Mayor Adams and mayoral wannabes calling for change — but tweaks to current laws and institutions wo…

11/02/2024

Great article on the need for clubhouses, BUT, clubhouses are post crisis stabilization, not a replacement for psychiatric/medical care when a person is actively symptomatic. Clubhouses like Fountain House are one component of what should be a full continuum of coordinated, psychiatric treatment, and care. Once a person is stable, there is no doubt that clubhouses are critical in reducing the need for institutionalized settings.

Clubhouses fill a huge gap in helping people rebuild community and find purpose in recovery. When I sit in AOT court hearings, my biggest wish is that we had clubhouses in our area. While assertive community treatment teams also provide vital services, vocational specialists do not do what clubhouses do for all of the reasons mentioned in this article.

I agree that for those too sick to live independently in community, they do need a more structured living situation, but I don’t think that has to be institutional in nature. Just as many nursing homes and assisted living facilities are now modern condominium like complexes, there is no reason why we can’t have the same for loved ones with mental illness disabilities.

The need for well run, humane, institutions will never go away as a place for the criminally insane but hopefully, the earlier and earlier we can help people who are genetically and/or environmentally predisposed to severe mental illness, the less reliant society will be on institutions.

"Our system does not prioritize the seriously mentally ill," Carolyn DeLaney Gorman, a policy analyst at the public policy think tank Manhattan Institute, told ABC News. "Almost always, the individuals who are involved in these tragedies have a known mental illness, have been cycling through homelessness, through incarceration through the health care system. They're known to authorities, and they haven't fallen through the cracks. They've actually just been ignored by all of these systems."

New York City's clubhouses -- member-run facilities that offer support to those with serious mental health conditions -- are proving that recovery and rehabilitation are possible, with some lawmakers like Rep. Ritchie Torres, D-N.Y., hoping to expand the availability and access to these institutions for more residents.”

https://abcnews.go.com/US/clubhouses-offer-potential-solutions-severe-mental-illness/story?id=114861546

ABC News

As Daniel Penny heads to trial in Jordan Neely's death, ABC News takes a look at New York city's clubhouse system and its successes.

11/02/2024

Meta for Business Meta Quest Meta AI Meta Verified Onboarding Support has clearly fallen for a scam. Someone reported the following post in comments, sighting cyber security concerns. Dear Meta, there was no fishing for information going on in this post. What you need to know is that there are questionably sane people out there who oppose treatment for people with severe mental illnesses, who will go to no lengths to have information removed citing credentialed and board-certified psychiatrists because they just don’t like the information. Would appreciate it if you would not take down these sorts of posts in the future, based on bogus feedback from disgruntled users. thx

10/21/2024

Funny not funny. Unfortunately, politicians who are unskilled in serious mental illness policy will be duped into thinking that the best states for mental healthcare are also the best states for a serious mental illness.

Connecticut and Massachusetts are rated two of the top 10 states for mental healthcare yet neither have laws that allow someone who has no insight that they’re sick to be placed in court supervised treatment to help them maintain stability in the community and avoid jail, death, homelessness, and repeat hospitalizations.

In my advocacy, when I speak with state and congressional leaders about the mental health system, they immediately tell me all about NAMI and MHA. Cringe…. 😖

For politicians who are serious about helping those we see in our communities who are clearly too sick to help themselves, please get educated. A great place to begin is with the Treatment Advocacy Center.

To be clear, nobody is opposed to better mental healthcare and all of the great programs/resources available in states that shine on that front. The frustration is with the lack of programs/resources for those suffering with chronic untreated or under-treated serious mental illness. Mental health and serious mental illness are not the same thing. Everyone’s mental health can be approved, but about 4% of Americans suffer with diagnosable serious mental illnesses that are also medical in nature. No one can benefit from better mental health services unless they have the capacity to participate. Like dementia and Alzheimer’s disease, serious mental illness often takes capacity away through rendering the person unable to know they are sick. Unlike dementia and Alzheimer’s disease, serious mental illnesses are highly treatable and manageable with medication and when a person is able to access treatment and care.

Learn more about the difference between mental illness and mental health at the Healing Minds NOLA archived videos page: https://healingmindsnola.org/video-archives/