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Trump’s Pick for Mental Health ‘Czar’ Highlights Rift

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For decades, therapists, patient advocates and countless families have worked to elevate mental health care in the political conversation. Their cause recently received a big boost when a new law created a federal mental health “czar” to help overhaul the system and bridge more than 100 federal agencies concerned with mental health.

But the White House’s choice for the first person to fill that position has already been divisive, exposing longstanding rifts within the field that may be difficult to mend.

President Trump has announced his intention to nominate Elinore F. McCance-Katz for the new position, assistant secretary for mental health and substance use. Dr. McCance-Katz is a psychiatrist whose long career has been focused on treating drug addiction, in particular opioid abuse. She has the support of several prominent groups, including the American Psychiatric Association and the National Alliance on Mental Illness, but others, including the Foundation for Excellence in Mental Health Care, are skeptical.

A central tension in the debate is between the medical model of psychiatry, which emphasizes drug and hospital treatment and which Dr. McCance-Katz has promoted, and the so-called psychosocial, which puts more emphasis on community care and support from family and peers.

“I feel like I died and went to heaven,” a prominent backer of the medical approach, Dr. E. Fuller Torrey, associate director of the Stanley Research Institute, said of the new position and Dr. McCance-Katz as its nominee. “I honestly didn’t think I’d see something like this happen in my lifetime.” Dr. Torrey and an organization he co-founded, the Treatment Advocacy Center, has been pushing to expand medical psychiatric services for more than 20 years.

But Harvey Rosenthal, executive director of the New York Association of Psychiatric Rehabilitation Services, which is funded in small part by Samhsa, said he was concerned about the potential direction the appointment of Dr. McCance-Katz could signal. “I fear that in this political environment it could denigrate and unravel some of the great progress we’ve made in person-centered recovery and rehabilitation services and peer support.”

Dr. McCance-Katz declined to comment, citing the continuing confirmation process.

For partisans, this rift is tribal: Those on the medical side are appalled at the lack of hospital beds and aggressive court-ordered — i.e. involuntary — drug treatment for people most in need, particularly those with schizophrenia, many of whom do not believe they need treatment and end up in prison.

On the other side, advocates, former patients, and some doctors argue that medical treatment by itself — beds and meds, as they call it — is often not sufficient and, when forced, can alienate the people it is meant to help.

In practice, the two sides argue more over emphasis in care and agree on many points; in public, it is all black and white. The creation of the new mental health czar position, and the nominee, are seen broadly as a victory for the medical side. Dr. McCance-Katz, if she is confirmed, is expected to steer more funding toward assertive drug treatment of the seriously mentally ill, and less toward social supports.

Dr. McCance-Katz began her career at Yale, later moving to the Albert Einstein College of Medicine and the University of California, San Francisco, building an expertise in treating drug addiction with medications. She was medical director of California’s Department of Alcohol and Drug Programs, before becoming the first chief medical officer at the Substance Abuse and Mental Health Services Administration, or Samhsa, the primary federal agency overseeing substance abuse and mental health services, in 2013. The medical officer serves under the agency’s director.

The person most responsible for creating the czar position, Representative Tim Murphy, Republican of Pennsylvania, a practicing psychologist, also objects to Dr. McCance-Katz’s nomination, but for another reason. Mr. Murphy, as chairman of a congressional subcommittee, investigated federal mental health programs after a 20-year-old man with severe mental illness shot and killed 26 elementary school students and teachers at Sandy Hook school in Newtown, Conn., in 2012. He found fault with Samhsa for not sufficiently addressing the hardest-to-treat forms of mental illness, and for using some of its funds to support organizations and conferences where participants encouraged patients to go off their physician-prescribed psychiatric medicines.

Mr. Murphy said he was disturbed that Dr. McCance-Katz publicly defended the agency as efficient and effective during her two-year tenure as the leading physician at Samhsa. “She does not have my confidence,” Mr. Murphy said in an interview. “When she was there, she knew there was a problem, and she didn’t speak up,” he said. “We never heard from her.”

Samhsa, where Dr. McCance-Katz served as chief medical officer from 2013 to 2015, has itself become a lightning rod in the debate. In fact, Dr. McCance-Katz has sent mixed signals about her preferences. She defended the agency while there, but after leaving she wrote a sharp critique in Psychiatric Times concluding that its approach “includes a focus on activities that don’t directly assist those who have serious mental illness.”

Mr. Murphy and members of his staff said he had raised his concerns about the nominee directly with the secretary of health and human services, Dr. Tom Price, and Vice President Mike Pence.

Representative Murphy has also attacked the choice publicly, on Twitter and in interviews. Many people following the drama, both inside and outside Washington, believe that he is upset that the White House passed over his favored candidate. According to Mr. Murphy’s staff, that was Dr. Michael Welner, a prominent and controversial New York forensic psychiatrist who helped develop the legislation that created the position.

In an email, Dr. Welner confirmed that Mr. Murphy had approached him about recommending him to the Trump administration for the position. He said he initially declined, because of the sacrifices involved, but later accepted because of the prospect of saving lives. He said he believed that federal mental health funding should be refocused on the most costly mental health challenges and on evidence-based treatments.

The agency devotes a small portion of its $3.7 billion annual budget to psychosocial supports, like guidance from so-called peers, the former patients who help those in need navigate the system. While proponents of a more medical approach have criticized this support, other mental health professionals believe there is not enough emphasis on this and other non-pharmacological programs. “Peers are not serving as mental health professionals, but peers are providing much needed support, because they have an understanding of what it’s like to struggle with mental health problems,” said Ellen Garrison, senior policy adviser at the American Psychological Association.

Whichever direction the new mental health czar chooses, most agree that the new position at least concentrates accountability for change in one place.

Senator Christopher Murphy of Connecticut, who co-sponsored the new mental health law, said he hoped that Dr. McCance-Katz would advocate full adoption of its most important provisions, which he said were “those pushing insurance companies to cover more mental health treatment.”

“There’s no choice to be made in treating mental illness through a purely medical model or through a more social and contextual program of support,” Senator Murphy said, adding: “Lots of people with mental illness have a disease of the brain that can be treated with medication, but also have major traumas in their life that need other kinds of therapies as well.”

Others agree.

“The federal agencies most responsible for the welfare of people with severe mental illness and substance problems have all failed them miserably,” said Dr. Allen Frances, a professor emeritus of psychiatry at Duke. “We should turn prisoners into patients, provide easy access to treatment in the community and ensure they have a decent place to live.”

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.

One in 6 American Adults Say They Have Taken Psychiatric Drugs, Report Says

About one in six American adults reported taking at least one psychiatric drug, usually an antidepressant or an anti-anxiety medication, and most had been doing so for a year or more, according to a new analysis. The report is based on 2013 government survey data on some 37,421 adults and provides the finest-grained snapshot of prescription drug use for psychological and sleep problems to date.

“I follow this area, so I knew the numbers would be high,” said Thomas J. Moore, a researcher at the Institute for Safe Medication Practices, a nonprofit in Alexandria, Va., and the lead author of the analysis, which was published Monday in JAMA Internal Medicine. “But in some populations, the rates are extraordinary.”

Mr. Moore and his co-author, Donald R. Mattison of Risk Sciences International in Ottawa, combed household survey and insurance data compiled by the federal Agency for Healthcare Research and Quality. They found that one in five women had reported filling at least one prescription that year — about two times the number of men who had — and that whites were about twice as likely to have done so than blacks or Hispanics.

Nearly 85 percent of those who had gotten at least one drug had filled multiple prescriptions for that drug over the course of the year studied, which the authors considered long-term use. “To discover that eight in 10 adults who have taken psychiatric drugs are using them long term raises safety concerns, given that there’s reason to believe some of this continued use is due to dependence and withdrawal symptoms,” Mr. Moore said.

Dr. Mark Olfson, a professor of psychiatry at Columbia University, who was not involved in the study, said the new analysis provided a clear, detailed picture of current usage: “It reflects a growing acceptance of and reliance on prescription medications” to manage common emotional problems, he said.

The most commonly used type of drug was an antidepressant like Zoloft and Celexa, followed by an anti-anxiety or sleeping pill like Xanax and Ambien. All of these drugs can have withdrawal effects, including panic attacks and sleep problems, for many people on them long term. The prescribing of most anti-anxiety pills is strongly regulated in this and other countries because the drugs can be habit forming.

Usage rates were also higher with increased age, with one in four people of retirement age reporting at least one prescription. This is a growing concern among some doctors, as the incidence of diagnosable mental problems, with the exception of insomnia, tends to be much lower in elderly people than in young adults.

The increased rates in this group are most likely due in part to the fact that most elderly people get psychiatric drugs from their primary care doctor, who often prescribe for episodic conditions like mild depression and insomnia. “Particularly for this group, we need to be mindful of the trade-offs in prescribing,” Dr. Olfson said. “These are not benign drugs.”

The Mental Health Crisis in Trump’s America

A few days after Donald J. Trump was elected president, I started getting anxious phone calls from some of my patients. They were not just worried about the direction President-elect Trump might take the nation, but about how they were going to fare, given their longstanding and serious mental illnesses.

“Will I still have insurance and have my medications covered?” one depressed patient asked me.

As a psychiatrist, I wish that I could be more reassuring to my patients during a highly stressful political transition, but in truth, they have reason to worry.

Mr. Trump campaigned on a promise to “repeal and replace” the Affordable Care Act, and his pick for secretary of health and human services, Tom Price, is a staunch opponent of Obamacare. The 2010 law provides medical coverage to an estimated 20 million Americans and specifically included mental health and substance abuse treatment as one of 10 “essential benefits” that all private insurers and Medicaid have to cover.

For the 43.6 million American adults living with a psychiatric illness and the 16.3 million who have an alcohol use disorder, it is hard to exaggerate the importance of this. Until this law was passed, people with mental illness and substance abuse problems were subject to capricious annual or lifetime limits on coverage, higher deductibles or no coverage at all.

Obamacare changed all that and mandated that psychiatric disorders be treated on a par with non-psychiatric medical illnesses like cancer and heart disease.

It also prohibited the exclusion of people with pre-existing illness from medical coverage, which was an enormous boon for the mentally ill. Three-quarters of all serious mental disorders in adults — like major depression, schizophrenia and anxiety disorders — are present by age 25. So mental disorders are largely chronic illnesses that, while very treatable, are still characterized by relapses and recurrences.

Obamacare isn’t perfect. No legislative action can erase the stigma surrounding mental illness, which is a major barrier to getting good treatment. Nor can it solve the serious shortage of mental health specialists or the limited access to psychiatric treatment, especially in rural areas.

Still, if President-elect Trump makes good on his promise to repeal the law, he will effectively strip millions of Americans with mental illness overnight of the most medically rational and humane benefits they have ever had — without giving them any indication of what, if anything, will replace them.

The consequences would be quick and devastating. Psychiatrically ill Americans who lost their coverage would be forced to seek treatment in emergency rooms, causing a meteoric rise in health care costs. And untreated mental disorders like depression, bipolar illness and schizophrenia would almost certainly lead to higher suicide rates.

The current annual cost to society of treating depression alone is $210 billion — 60 percent of which represents reduced efficiency at work and costs related to suicide. With a reduction in mental health care, this bill will balloon. In other words, untreated mental illness is not just a source of individual morbidity, mortality and immense suffering; it is also a largely preventable drain on our economy.

There is at least one more reason to worry about mental health in the age of Trump. Mr. Trump has said that Congress should give each state a lump sum of federal money for Medicaid, the health insurance program for lower-income people. This would effectively roll back the expansion of Medicaid under Obamacare, which provided coverage to an additional 12 million people in 31 states. Since people with mental illness are far more likely to receive public insurance like Medicaid than private insurance, this will hurt them disproportionately.

America can’t be great if millions of our citizens with medical and psychiatric illnesses lose their insurance coverage. An anxious nation is rooting for Mr. Trump not to let that happen.

Mental health group plans fundraising campaign

Copy of article from Juneau Empire

October 27th, 2016

The Mental Health Consumer Action Network, a new nonprofit devoted to lobbying on behalf of the mentally ill, will begin a door-to-door drive Friday.

Executive director Gregory Evan Fitch said he plans to “try to knock on every door in Juneau” in order to gain 2,000 members who support the organization. Dues are $24 a year or $2 per month. Donations also will be accepted.

The campaign comes as the Alaska Mental Health Trust undergoes significant changes. The Trust’s executive director for the past 21 years abruptly resigned Wednesday following conflicts with the Trust’s board of directors.

Consumers’ mental health nonprofit begins membership drive in Juneau

Copy of Article from KTOO Public Media

October 29th, 2016

By Jeremy Hsieh, KTOO

A fledgling Juneau nonprofit formed to advocate for mental health consumers began a membership drive and door-knocking campaign this weekend.

Mental Health Consumer Action Network founder Greg Fitch said this follows the organization’s first official board meeting earlier this month, and getting MCAN’s charitable tax status and other organizational business in order.

MCAN’s new board president Wade Rathke has decades of experience with the once-infamous organization ACORN International, which he founded in 1970. The progressive group has had its scandals, some real, some bogus, but that’s old news now. Rathke still works with many nonprofits and lives in New Orleans — he’d worked with Fitch at ACORN there in the ‘90s — but was recently in Juneau for the first board meeting and discussed his role and aspirations for the new organization.

Rathke said he hasn’t had mental health issues himself, but, “I think it’s important that people build an organization to give them voice and to allow them to empower themselves around their own grievances and issues to be able (to) act. Mental health consumers over the last, you know, 50 years … are people who’ve been marginalized without a voice in many cases.”

He said organizing the marginalized is exactly what he’s spent his life doing.

“Part of what’s so true about mental health issues, people see it as personal, their own private concern,” he said. “And don’t realize there are other people who are struggling in some cases with the same thing who they could unite with and not only find support but collective cause.”

For a long time, he said society has treated people with mental health issues like a “crazy aunt in the closet.”

“And that’s not appropriate,” he said. “And to have people increasingly willing to talk about issues they’ve faced, how they’ve met those challenges, and how they could have met those challenges in a better way both for themselves and our whole society is a radical new thing, and that’s why I think it’s so exciting to see what MCAN is going to be.”

Rathke said he expects challenges recruiting potential members, who may perceive risk in outing themselves as mental health consumers. But, he’s optimistic.

In a year’s time, Rathke said he’d like to see MCAN with a stable membership in Juneau and possibly start expanding to Fairbanks and Anchorage.

How the former head of ACORN became president of a Juneau mental health organization

Copy of article from Juneau Empire

August 4th, 2016

At age 20, Wade Rathke was a community organizer fighting for the welfare rights of single mothers in Massachusetts. The following year, in 1970, he founded the Association of Community Organizations for Reform Now, better known as ACORN.

ACORN went on to become one of the biggest community-organizing groups in the U.S. that advocated for low- to moderate-income families on issues like voter registration, health care and affordable housing.

Now, at age 67, Rathke has taken on the task of leading the Juneau-based Mental Health Consumer Action Network, or MCAN, in its infancy and helping it get off the ground.

People experiencing mental health issues are “exactly the kind of group that needs to come together to look at how it interacts with programs designed for them,” Rathke said in a recent phone interview. “This is not a group that often has a voice, and it’s a voice that needs to be heard.”

So, how exactly did Rathke — a well-known figure on the national stage — get connected with a hyperlocal Juneau organization? Through Juneau resident Greg Fitch, founder and executive director of MCAN.

In the early 1990s, Fitch worked as a community organizer for ACORN in New Orleans. Rathke’s partner, Beth Butler, who also worked at ACORN, was Fitch’s mentor and the office Fitch worked in was next door to Rathke’s. The two became friends.

Fitch is also a mental health consumer. In the mid 2000s, he was diagnosed with bipolar disorder and PTSD. He wants MCAN to be the voice of people experiencing mental health issues and to have a say when mental health policy is made.

“When I came up with MCAN, the idea of MCAN was organizing the mental health consumer for social justice and change. So I basically took the ACORN concept and turned it into MCAN,” he said.

Fitch reached out to Rathke a few months ago, 25 years after the two worked together, and they started emailing and talking on the phone about MCAN.

“This is getting to the point where we can make a difference in people’s lives and I said, ‘Why don’t you just take over the board and become president?’ and he agreed,” Fitch said.

Rathke said Fitch was a good community organizer in New Orleans and he believes in his current efforts.

“He obviously knows what he’s doing, but I think what he’s trying to do is very rare. I only know of only two or three other efforts in the whole United States where people have tried to organize something similar. I think it’s a project with real promise and desperately meets a need,” Rathke said.

He added that it’s important for mental health consumers to speak for themselves and “be able to participate fully as citizens with a vested interest in their own lives and well-being. How can that not be anything other than good? Yet we don’t necessarily have people standing up and applauding this kind of effort.”

Rathke will initially serve as MCAN board president from afar. Once the group gets more established with resources, he plans to attend board meetings in person. He said the first orders of business will include forming bylaws and formally incorporating as a 501(c)3.

It’s not like Rathke isn’t already busy. After a series of controversies, Rathke left ACORN in 2008, a couple years before the organization ended in 2010, but he’s still the chief organizer of ACORN International and travels to countries like Honduras, Kenya and Peru. Based in New Orleans, Rathke also manages a couple of noncommercial radio stations and a local union; is putting the finishing touches on his third book, which has been in the works for 12 years; and runs a fair trade coffee shop. Not to mention all the other nonprofits and projects he has his hands in.

“I try to help out and keep as many balls in the air as I can before they drop and smash,” he said.

With Rathke as president, Fitch is in the process of filling in the other board positions, which will include a mental health consumer. MCAN is also working on funding. Beyond that, “our first goal is awareness,” Fitch said. “We cannot change things unless we educate people about what we go through. Awareness is our huge first key.”

Fitch wants MCAN to be a statewide organization and eventually go national. Until then, Fitch and others involved in MCAN have already been meeting with state lawmakers. The group hopes to get a state-sanctioned mental health awareness week in Alaska.

• Contact reporter Lisa Phu at 523-2246 or lisa.phu@juneauempire.com.

New nonprofit seeks awareness and housing for mentally ill

Copy of article from KTOO Public Media

August 7th, 2016

By Quinton Chandler, KTOO

No one knows the challenges of living with a mental disorder better than someone who has been diagnosed with one. That’s the argument the founder of a new nonprofit made to explain why his organization will be effective helping improve life for the mentally ill, starting with housing in Juneau.

“I suffer from a mental illness and have for about 25 years,” said Gregory Fitch, the founder of the Mental Health Consumer Action Network, or MCAN. He has schizoaffective disorder, “Which is minor schizophrenia, I also have bipolar and I have what’s called borderline personality disorder.”

“I got together and started to realize that maybe we need to come together as a people to have our voices heard. That’s what MCAN is about. MCAN is about reaching the top level of policymaking, have our voices and concerns heard, so we can get better benefits from policies that affect us,” Fitch said.

He calls people who, like himself, suffer from mental illness “consumers.” He said the word is already widely used in mental health care and it reduces the stigma attached to the words “mentally ill.”

He first thought of starting MCAN eight years ago while working for another community organizer. He said his battle with mental illness slowed the process for getting MCAN off the ground, but recently he found himself in the right place and decided it was time.

“I got better on the right medications. It’s working and I said, ‘You know what? It’s time to do this.’ So we did it. We incorporated in April.” Fitch said. “Since then we have built a massive organization. We have a major president onboard who (was) the president of ACORN International, his name is Wade Rathke. He supports us. We have a local board of representatives here in Juneau.”

ACORN International is the organization Fitch worked for when he first imagined MCAN. A funding shortage and public embarrassment from an embezzlement scandal forced ACORN to disband in 2010 after 40 years of activism.

Gregory Fitch, founder of MCAN on Friday, August 5, 2016. (Photo by Quinton Chandler/KTOO)

MCAN founder Gregory Fitch on Friday at KTOO. (Photo by Quinton Chandler/KTOO)

Fitch is not a registered lobbyist yet. Under State law, he doesn’t have to register until he gets paid. His first goals on MCAN’s list are to educate people on the issues the mentally ill face and to offer a solution to one of their biggest problems – housing.

Dominic Smith is helping Fitch launch MCAN. He’s also a consumer. He said he has a slew of diagnoses starting with clinical depression and attention deficit disorder.

“I have generalized anxiety disorder. I have panic attacks, sometimes they can be minor and it’s just, you’re irritated, agitated and people think you’re just a jerk. They think you’re angry and violent, but I’m not a violent person,” Smith said.

Also on his list are post-traumatic stress disorder, seasonal affective disorder and insomnia.

“The big thing is when I have anxiety or a panic attack, I cannot function. Sometimes I cannot even breathe,” he said, his voice starting to shake. “Sorry if I get emotional but it’s even been so bad that I have flashbacks to my childhood.”

Smith said he came from Wisconsin after years of saving and planning his move to Juneau. He said he came to town with a place to live, but he was accused of stealing a laptop and had to leave.

“And it turns out that next evening they found their computer,” Smith said.

He lived in hotels for a while, then he started camping in the woods and he said he’s not the only one.

“I have many friends that live in boats, people that live in cars and people that just live in the woods like I do,” Smith said.

Recently he found a place to live but he was camping out long enough to get acquainted with the challenges of homelessness. He said multiple items were stolen from him and he was barred from entering businesses because he looked homeless.

Fitch believes MCAN will be able to help other consumers like Smith so, even if they hit a rough patch, they won’t have to sleep in the woods.

“Possibly a shelter situation for the consumer, by the consumer. We’d like to see the mental health community involved in this definitely. This is a long-term goal of ours,” Fitch said. “We’d like to possibly break ground on this within a year.”

Fitch said MCAN will find a headquarters in a few more weeks and then they’ll start making headway. He said they’re serious, that in four months they went from an idea to a social welfare nonprofit, securing support from community members, state legislators and Gov. Bill Walker.

Long-term, Fitch hopes to take MCAN national.