MCAN speaks up about downtown land sale

Copy of Article on Juneau Empire

Posted: January 16, 2017 – 12:00am

By JAMES BROOKS

JUNEAU EMPIRE

An organization devoted to supporting mental health is raising concerns about the pending sale of Mental Health Trust-owned land in downtown Juneau.

The Mental Health Consumers Action Network has issued a letter protesting the Trust’s sale of land to Develop Juneau Now LLC, which plans to build a heating plant, apartments and shops near Coast Guard Station Juneau on Egan Drive.

“We respectfully ask that this pending sale … be reconsidered,” the letter states.

Greg Fitch, director of MCAN, said he’s personally concerned that the sale won’t result in a better deal for the mentally ill, who are supposed to benefit from Trust actions.

The letter suggests the Trust should include sale conditions, such as affordable housing dedicated to “mental health consumers and trust beneficiaries” or employing “mental health consumers” in the construction that will follow the sale.

Fitch said MCAN isn’t opposed to Develop Juneau Now — whose backers are the same as those of the Sweetheart Lake hydroelectric plant — but MCAN wants to hold the Trust accountable to its core mission.

“That is exactly where we’re at with this,” he said.

The Trust was established after a scandal revealed improper treatment of the mentally ill at Morningside hospital in Oregon, where Alaskans were sent.

A land grant and financial grant were supposed to allow the Trust to provide services that meet Alaska’s needs, but a 2016 study by the Kaiser Family Foundation ranked Alaska’s mental health care 47th of 51 states and D.C.

“If we’re 47th in the country, my God, there’s no excuse for that,” Fitch said.

He pointed to the recent shooting by an Alaska man who was released from mental health treatment after four days, then flew to Florida and killed several people in Fort Lauderdale’s airport.

Fitch said MCAN intends to speak up for patients and press for the Trust to improve care.

“We’re a mental health consumer group,” he said. “We’re about better care for ourselves.”

Southeast Land exchange bill reintroduced in Congress

Copy of article on KTOO.org

By Leila Kheiry, KRBD January 14, 2017 KTOO.org

With a new U.S. Congress convening, Alaska’s Congressional Delegation has reintroduced a bill that would trade federal land for land owned by Alaska Mental Health Trust – including Ketchikan’s Deer Mountain.

A joint statement Thursday from Sens. Lisa Murkowski and Dan Sullivan, and Rep. Don Young announced that companion bills to accelerate the exchange have been filed.

The House and Senate bills are pretty much identical, according to Matt Shuckerow of Rep. Young’s office. He said Sen. Murkowski, as the chair of the Senate Energy and Natural Resources Committee, is the main force behind the effort, which Rep. Young fully supports.

“This is something that’s been ongoing for a number of years and the Congressman has certainly been supportive of this effort,” Shuckerow said. “As has been detailed by others and the Congressman, this is an effort by all the stakeholders involved to come to some sort of resolution.”

The legislation would put Mental Health Trust land on Deer Mountain and above homes in Petersburg under U.S. Forest Service control. In exchange, the Trust would receive federal land on Prince of Wales Island and in Ketchikan’s Shelter Cove area for logging.

Last summer, the Alaska Mental Health Trust Land Office announced that it planned to move forward with logging Deer Mountain and the Petersburg site if the land exchange wasn’t approved by early this month. After public outcry and questions about the TLO’s decision-making process, a final decision on that plan was delayed.

Shuckerow said the legislation is the same bill that had been introduced in the previous Congress. He said the delegation hopes it will be approved fairly quickly.

“It is a model for governance where there is local support. It’s not a top-down approach; it’s really a bottom-up approach from the communities involved and the stakeholders involved,” he said. “That’s certainly a positive note in that regard, that it’s supported locally. That’s something we can relay to different members of Congress, that this is something that’s supported locally. Oftentimes that’s very helpful in moving legislation.”

Local governments in Ketchikan and Petersburg have approved resolutions in support of the land exchange, and there has been an effort to encourage individual residents to send letters of support.

In Thursday’s announcement, Murkowski states that the exchange will protect land that is valued by the communities while providing other land for timber harvest. She says logging the sites on POW and in Shelter Cove will assist the timber industry, and make money for mental health services in Alaska.

The U.S. Forest Service and the Trust already have agreed to the land exchange. The legislation would speed up the process.

The bill has just been introduced, which is the first step.

A Rampage in Florida Shines a Light on Alaska

Copy of Article Printed 1-13-2017

Kirk Johnson

ANCHORAGE — A deadly shooting rampage at Fort Lauderdale-Hollywood International Airport this month has focused attention on the interconnection of public safety and mental illness and raised questions, especially here in Alaska, about one of the thorniest questions of psychology: how to tell if someone is delusional and dangerous, or merely delusional.

There is no dispute, law enforcement officials said, that the suspect in the Florida case, Esteban Santiago, was disturbed. When he walked into the F.B.I. offices here in Alaska’s largest city in early November, he said his mind was being controlled by the government. After a voluntary four-day evaluation in a psychiatric hospital, he was released, and soon reclaimed the handgun that the police confiscated when he was admitted. He is now charged with killing five people and injuring six more at the airport on Jan. 6.

In many ways, Mr. Santiago’s path through the mental health treatment system was unremarkable, similar to the one faced by people across the nation, the overwhelming majority of whom will never perform violent acts. Improved insurance coverage is now in place for many people — including an expansion of Medicaid for lower-income adults in Alaska — but a stigma about treatment, combined with a shortage of hospital beds and mental health professionals, keeps many people from getting or accepting care.

In Alaska, health care professionals and legal experts said the distinctive demographic, geographic and cultural stamp of the state also colors the often nuanced judgments that doctors, law enforcement officers and judges must make in deciding whether to hold a disturbed person against his or her will.

Alaska, they said, is ingrained with a deep tradition of tolerance — fueled by libertarian instincts holding that people should be able to believe what they want, however eccentric or irrational. And even when people are involuntarily committed for treatment, the median length of stay, at only five days, is shorter than in almost any other state. Only Wisconsin has a shorter median commitment time, at four days, according to the Treatment Advocacy Center, a national group that works to improve mental health laws and care. The national average is 75 days, with some states, like California, having a median of more than four months.

“Getting a commitment here is really hard,” said Merijeanne Moore, a psychiatrist in private practice in Anchorage.

The mental health needs are great here, too. Alaska has the nation’s second-highest suicide rate, after Wyoming, and some rural areas are by far the worst in America in rates of self-harm, federal figures say. Alaska also has among the highest rates of adult binge drinking, according to federal figures.

A study by the Kaiser Family Foundation ranked it 47th among states and territories in terms of the percentage of mental health care needs being met.

At the same time, the number of beds at the Alaska Psychiatric Institute in Anchorage, the state’s only long-term psychiatric hospital, is now half of what it was in the early 1990s, though many other states also cut their mental health treatment systems during the Great Recession.

“There’s a huge street problem, a huge drug problem and a lot of mentally ill people who don’t even have a finger grip on the lowest rungs of the ladder,” said Paul L. Craig, a neuropsychologist in private practice in Anchorage.

The state does have some mental health treatment strengths. The care system for Native Alaskans, paid for by the federal Indian Health Service, has an extensive mental health program for adolescents. The Department of Veterans Affairs and branches of the military treat tens of thousands of active-duty and retired military personnel.

Dr. Craig and other providers said, though, that those systems of care often function like autonomous empires, without coordination. “People fall through the cracks between them,” he said.

In part, the distinctively Alaskan way of thinking about mental illness may reach back to the era before statehood, which came in 1959. For decades up to that point, residents were committed and sent to a psychiatric hospital in Portland, Ore., from which some never returned. The grounds for commitment — effectively a kind of deportation — sound shocking by today’s standards, including a refusal to speak and excessive masturbation.

Partly in response to complaints about those past practices, Congress in the mid-1950s created the Alaska Mental Health Trust Authority, a unique land trust of one million acres, almost the size of Delaware, to produce income dedicated specifically to mental health. The Alaska Mental Health Trust Authority is still active, and has leverage through the millions of dollars it contributes to the state budget through its investments. The trust lobbied hard, in particular, for the expansion of Medicaid in the state.

Guns are also part of the fabric of Alaskan life. Ownership is widespread, and no permit is required for concealed carry. Until 2014, state officials were not required to report data on mental-illness diagnoses to the F.B.I.’s background check system, and Alaska is one of 17 states with no restrictions beyond federal law for keeping guns away from the mentally ill, said the Law Center to Prevent Gun Violence, a national legal research group in San Francisco.

Under federal law, a person who has been involuntarily committed is never again allowed to have firearms.

Mr. Santiago, who entered a no-contest plea last year on a misdemeanor domestic violence charge but has no record of being committed, told the F.B.I. and the Anchorage police in November that he did not want to harm anyone, F.B.I. officials said. He admitted himself to the hospital, so the federal law did not apply. It also meant, law enforcement officials said, that the gun he had in his car when he came into the F.B.I. offices had to be returned to him.

What this case illustrates, said John Snook, the executive director of the Treatment Advocacy Center, is that behavior somewhere short of dangerous may not count. “We use this outdated concept,” he said in a telephone interview. “Most people aren’t dangerous, so they don’t get care.”

And sometimes, establishing dangerousness is difficult.

Just before Christmas, a middle-aged woman who had been living in a 16-bed assisted-living home for the mentally ill in Anchorage began screaming and threatened other residents and the staff, said the home’s manager, Erin Terry. She called 911.

But when the police came, the patient refused to repeat her threats, so despite Ms. Terry’s pleas, the officers deemed the woman no danger and left. Several days later, Ms. Terry convinced a judge otherwise, and the woman was involuntarily committed and removed from the home.

“She was beyond our level of care,” Ms. Terry said. “We were terrified.”

Dr. Moore, the psychiatrist, said that in the last few years she has had two patients who, like Mr. Santiago, walked into F.B.I. offices to complain that the government was exerting control over them. Both were examined and released. One patient has since twice been involuntarily committed in other states, Dr. Moore said.

A version of this article appears in print on January 14, 2017, on Page A9 of the New York edition with the headline: Florida Airport Rampage Casts Stark Light on Alaska.