by Art Levine
“He settled in, took off, and he’s gotten better and better over the years,” Drake says. “I see him now once in a while around town. He has his own apartment, his own car, a pass to the Skyway. He has friends.”
“He doesn’t look like the same guy at all.”
ENDNOTES
Quotes and facts derived from interviews by the author generally won’t be included in the endnotes section. Some documents and websites cited below can be read in full at this book’s companion website, www.mentalhealthinc.net, or at the author’s Scribd account: https://www.scribd.com/user/9995978/Art-Levine-Mental-Health-Inc.
Full URLs for all endnotes in the book can be found here: https://www.scribd.com/document/350654872/Mental-Health-Inc-Web-Endnotes.
In some cases, well-known events or statistics that have been widely publicized or are easily found via Google may be omitted. Full web addresses for news articles available online from the original publications are generally not included because of the changing nature of web URLs; in cases of online-only documents, lengthy URLs will typically be replaced by the website’s homepage.
Introduction
9 anger: “Steve Tompkins” [name changed for privacy], interview with author, April 2015.
10 “not going to do that”: Redacted South Charleston PD police report on April 16, 2014, disturbance, sent by email from W. Michael Moore, counsel for City of South Charleston, on June 12, 2015.
11 vets treated by the Department: Jamie Reno, “Nearly 30% of Vets Treated by VA Have PTSD,” The Daily Beast, October 21, 2012; Department of Veterans Affairs (VA), National Center for PTSD, How Common Is PTSD? as of October 3, 2015, http://www.ptsd.va.gov.
11 vets could get access: American Public Health Association, “Removing Barriers to Mental Health Services for Veterans,” November 18, 2014, https://www.apha.org.
11 increased more than 40 percent: VA, Budget in Brief, 2017, February 18, 2016, http://www.va.gov; Lukas Pleva, “Funding Bill Signed Into Law,” Politifact, April 5, 2010.
11 “often unavailable”: National Alliance on Mental Health (NAMI), “State Mental Health Cuts: A National Crisis,” March 2011, https://www.nami.org.
11 stunning 55 percent: Pamela Hyde, Administrator, “Report to Congress on the Nation’s Substance Abuse and Mental Health Workforce Issues,” Substance Abuse and Mental Health Services Administration (SAMHSA), January 24, 2013, 10, http://store.samhsa.gov.
11 twenty-three million Americans: Congressional Budget Office (CBO), “American Health Care Act (AHCA), Cost Estimate,” May 24, 2017, https://www.cbo.gov.
11 damage to Obamacare’s protections: Casey Quinlan, “Trump Is Already Taking Actions to Sabotage Obamacare,” ThinkProgress, March 9, 2017, https://thinkprogress.org.
12 narrowly passed the House: Sarah Kliff, “The American Health Care Act: The Obamacare Repeal Bill the House Just Passed, Explained,” Vox, May 4, 2017, https://www.vox.com/policy.
12 more than 130 million people: Emily Gee, “Number of Americans With Pre-Existing Conditions by Congressional District,” Center for American Progress (CAP), April 5, 2017, https://www.americanprogress.org.
12 extra $20,000 a year: Sam Berger et al., “Latest ACA Repeal Plan Would Explode Premiums for People With Pre-Existing Conditions,” CAP, April 20, 2017, https://www.americanprogress.org/issues.
12 administration’s backstage regulatory: Families USA, “ACA Threat Tracker,” http://familiesusa.org; Michael Hiltzik, “Trump Didn’t Blow Up Obamacare on Monday, but Left It Hanging by a Thread,” Los Angeles Times, May 22, 2017, http://www.latimes.com/business/hiltzik.
13 leave all the ACA marketplaces: Amy Goldstein, “Aetna Exiting All ACA Insurance Marketplaces in 2018,” Washington Post, May 10, 2017, https://www.washingtonpost.com/national/health.
13 about fourteen million people: Jon Greenberg, “Medicaid Expansion Drove Health Insurance Coverage Under Health Law, Rand Paul Says,” Politifact, January 15, 2017, http://www.politifact.com/truth-o-meter.
13 previously uninsured: Judith Dey et al., “Benefits of Medicaid Expansion for Behavioral Health,” ASPE Issue Brief, Office of the Assistant Secretary for Planning and Evaluation (ASPE), Department of Health and Human Services (DHHS), March 28, 2016, https://aspe.hhs.gov; Richard Frank et al., “Keep Obamacare to Keep Progress on Treating Opioid Disorders and Mental Illnesses,” The Hill, January 11, 2017, http://thehill.com/blogs/.
13 crafted by Sen. Marco Rubio: Robert Pear, “Marco Rubio Quietly Undermines Affordable Care Act,” New York Times, December 9, 2015; Seth Chandler, “Judge’s Ruling on ‘Risk Corridors’ Not Likely to Revitalize ACA,” Forbes, February 13, 2017.
13 drastically reduced their involvement: Reed Abelson, “Humana Plans to Pull Out of Obamacare’s Insurance Exchanges,” New York Times, February 14, 2017.
13 “if the market is destroyed”: Timothy Jost, “What’s Next for Health Policy,” Alliance for Health Reform (AHR), April 4, 2017, http://www.allhealth.org.
13 financially viable: CBO, “American Health Care Act.”
14 $839 billion from Medicaid: Benjy Sarlin, “Deep Medicaid Cuts Drive Backlash to House Health Care Bill,” NBC News, May 5, 2017, http://www.nbcnews.com/politics.
14 gutted protections for consumers: Michael Hiltzik, “All the Horrific Details of the GOP’s New Obamacare Repeal: A Handy Guide,” Los Angeles Times, May 4, 2017, http://www.latimes.com/business/hiltzik.
14 effort to blackmail: Gene B. Sperling et al., “Six Ways to Tell If Trump Is Sabotaging Obamacare,” The Atlantic, March 29, 2017, https://www.theatlantic.com/politics; Robert Pear, “Trump Threatens Health Subsidies to Force Democrats to Bargain,” New York Times, April 13, 2017, https://www.nytimes.com.
14 avoid a government shutdown: Burgess Everett et al., “White House to Continue Obamacare Payments, Removing Shutdown Threat,” Politico, April 26, 2017, http://www.politico.com/story.
14 quadrupled to 960 in 2017: Sarah Kliff et al., “Nearly 1,000 Healthcare.gov Counties Will Have Just One Insurer Next Year,” Vox, October 26, 2016, https://www.vox.com/science-and-health.
15 frontal assaults on the program: M. J. Lee et al., “Trump Budget: $800 Billion in Medicaid Cuts,” CNN, May 22, 2017, http://www.cnn.com.
15 more than Medicare: Kate Zernike et al., “In Health Bill’s Defeat, Medicaid Comes of Age,” New York Times, March 27, 2017, https://www.nytimes.com.
15 leading funder: Judge David L. Bazelon Center for Mental Health Law, “Medicaid: Lifeline for Children and Adults With Serious Mental Illnesses,” http://www.bazelon.org.
15 administration’s “sabotage” efforts: Families USA, “Affordable Care Act Attack Tracker,” April 2017, http://familiesusa.org/; Tony Pugh, “Health Advocates Blast New Trump Proposals to Stabilize Obamacare Marketplace,” McClatchy, February 15, 2017, http://www.mcclatchydc.com; AHR, “Materials List: Medicaid Moving Forward,” April 3, 2017, http://www.allhealth.org.
15 federal waivers: Rachel Gershon, “Waivers Represent a Quieter Way for Republicans to Change Health Care,” STAT, March 29, 2017, https://www.statnews.com.
15 lock out Medicaid recipients: Kaiser Family Foundation, “All About Section 1115 Medicaid Waivers,” http://kff.org/tag/waivers; Lisa Gillespie, “State Official Expects Kentucky Medicaid Waiver to Be Approved by June,” WFPL (Louisville), March 23, 2017, http://wfpl.org/state-official.
15 test them for illegal drugs: Scott Bauer, “Walker Medicaid Director Defends Drug Testing for Medicaid Recipients,” Associated Press, April 6, 2017, http://dailyreporter.com; Grant Smith, “Jeff Sessions Will Double Down on Failed Drug War,” The Hill, February 2, 2017, http://thehill.com.
16 thirteen million: Issie Lapowsky, “Obamacare’s Demise Is a Looming Disaster for Mental Health,” Wired, January 15, 2017; Lindsay Holmes, “Trumpcare Will Be Catastrophic for People With Mental Health Issues,” HuffPost, May 4, 2017, http://www.huffingtonpost.com.
16 “Healthy Indiana”: Jake Harper, “Indiana’s Model for Medicaid Could Spread—But It’
s Not Working for Everyone,” WFYI (Indianapolis), January 10, 2017, http://www.wfyi.org.
16 required monthly payment: Maureen Groppe, “Indiana’s Alternative Medicaid Program Shows Tradeoffs of Charging Recipients for Care,” USA Today, May 8, 2017, https://www.usatoday.com/story.
16 “block grants”: Maura Calsyn et al., “The Republicans’ Plan for Medicaid: A Wolf in Sheep’s Clothing,” CAP, January 12, 2017, https://www.americanprogress.org.
17 cut over 350,000: “2005 TennCare Cuts,” Tennessee Justice Center, https://www.tnjustice.org/2005-cuts/; Kristin M. Hall, “Obit Calls Out TennCare Cuts,” Knoxville News Sentinel, April 12, 2011, online at https://www.scribd.com.
17 theoretically eligible: Ione Farrar, TennCare Reform, One Year Later, Community Research Council, June 2007, 9,16–17, online at Sribd.com, “Tenncare-Cuts,” https://www.scribd.com/
18 even liberal governors: Chad Terhune et al., “Why Blue States Might Ditch Beloved Obamacare Protections,” Kaiser Health News, May 8, 2017, http://khn.org/news.
18 exorbitant out-of-pocket costs: NAMI, “Out-of-Network, Out-of-Pocket, Out-of-Options: The Unfulfilled Promise of Parity,” November 2016, http://www.nami.org.
18 potential deathblow: German Lopez, “The House’s Obamacare Repeal Bill Would Strand Drug Addicts Without Access to Care,” Vox, March 13, 2017, http://www.vox.com; Richard Frank, “Keep Obamacare,” The Hill, January 11, 2017; Kaiser Family Foundation, “Medicaid’s Role in Addressing the Opioid Epidemic,” March 17, 2017, http://kff.org/info-graphic/.
18 worsened by the impact: Deirdre Shesgreen, “Trump Administration Missing Mark On Opioids, Advocates Say,” USA Today, May 15, 2017, https://www.usatoday.com/story; Julia Lurie, “Trump’s Health Secretary Says Addiction Meds Are ‘Substituting One Opioid For Another,’” Mother Jones, May 10, 2017, http://www.motherjones.com/politics/2017/05/tom-price.
19 second-most common: Centers for Disease Control and Prevention (CDC), “Suicide: Facts at a Glance,” 2015, http://www.cdc.gov/.
19 33,000 firearm deaths a year: CDC, National Center for Health Statistics, All Injuries/Mortality/All Firearm Deaths, June 30, 2016, https://www.cdc.gov/nchs/fastats/.
19 over 60 percent: Margot Sanger-Katz, “Gun Deaths Are Mostly Suicides,” New York Times, October 8, 2015, https://www.nytimes.com.
19 over $4 billion: Deanna Pan, “MAP: Which States Have Cut Treatment for the Mentally Ill the Most?” Mother Jones, April 29, 2013, http://www.motherjones.com.
19 budgets still remain below 2009 levels: NAMI, “State Mental Health Legislation 2015: Trends, Themes and Effective Practices,” December 2015, http://www.nami.org.
19 40 percent: Association for Psychological Science, “Stigma as a Barrier to Mental Health Care,” September 4, 2014, https://www.psychologicalscience.org.
19 ten million: NAMI, “Mental Health by the Numbers: Prevalence of Mental Illness,” 2015, http://www.nami.org.
20 senseless mass shooting: Mark Follman et al., “US Mass Shootings, 1982– 2016: Data From Mother Jones’ Investigation,” Mother Jones, September 24, 2016, http://www.motherjones.com.
20 shot or killed in each incident: Gun Violence Archive, “Mass Shootings—2017,” http://www.gunviolencearchive.org.
20 60 percent: Jonathan M. Metzl and Kenneth T. MacLeish, “Mental Illness, Mass Shootings, and the Politics of American Firearms,” American Journal of Public Health 105, no. 2 (February 2015): 240–249, http://ajph.aphapublications.org.
20 “psychopathic shooters”: Peter Langman, School Shooters: Understanding High School, College, and Adult Perpetrators (Lanham, MD: Rowman & Littlefield, 2015), 1–6.
21 “D-” rating: NAMI, “Grading the States: A Report on America’s Health Care System for Serious Mental Illness—2006,” March 1, 2006, https://www.nami.org.
21 another potential loophole: “Congress Moves to Roll Back a Sensible Obama Gun Policy” editorial, New York Times, February 7, 2017, https://www.nytimes.com.
21 eleven times more likely: Linda A. Teplin, PhD. et al., “Crime Victimization in Adults With Severe Mental Illness,” Archives of General Psychiatry 62 (August 2005): 911-–21, http://jamanetwork.com/journals/jamapsychiatry.
21 likely to engage in violence: Seena Fazel et al., “Schizophrenia and Violence: Systematic Review and Meta-Analysis,” PLOS Medicine 6, no. 8 (August 11, 2009), http://journals.plos.org/plosmedicine/.
21 major risk factors: Michael Rezendes et al., “The Desperate and the Dead: Families in Fear,” Spotlight, Boston Globe, June 23, 2016, https://apps.bostonglobe.com/spotlight.
22 research on violence: Seena Fazel et al., “Schizophrenia and Violence”; J. C. Matejkowski et al., “Characteristics of Persons With Severe Mental Illness Who Have Been Incarcerated for Murder,” Journal of the American Academy of Psychiatry and the Law 36, no. 1 (March 2008): 74–86, http://jaapl.org.
22 protest of nearly two hundred: Brian MacQuarrie, “Rally Held to Protest Spotlight Series,” Boston Globe, August 2, 2016, https://www.bostonglobe.com.
22 “They demonized us”: Ruthie Poole, interview and email correspondence with the author, August 2016.
23 reform bill: Tim Murphy, U.S. House of Representatives, “Helping Families in Mental Health Crisis Act of 2016,” July 2016, https://murphy.house.gov.
23 rights-oriented mental health advocates: Susan Rogers et al., “Response to Murphy’s Bill: Mental Health Advocates Blast Rep. Tim Murphy’s Bill…,” Bazelon Center, December 12, 2013, http://www.bazelon.org.
24 risky antipsychotic: Julie Robinson, “Veterans’ Families Question Cause of Deaths: Post-Traumatic Stress Syndrome Treatment Cited,” Charleston Gazette (West Virginia), March 1, 2009, online at http://www.commondreams.org; Department of Justice (DOJ), “Pharmaceutical Giant AstraZeneca to Pay $520 Million for Off-Label Drug Marketing,” April 27, 2010, https://www.justice.gov; Bailey Perrin Bailey et al., “Plaintiffs’ Omnibus Legal Memorandum Responding in Opposition to AstraZeneca’s Summary Judgment Motions…,” Seroquel Litigation Documents, November 24, 2008, http://industrydocuments.library.ucsf.edu.
24 $5 billion a year: Michelle McNickle, “Drugmakers Face Loss of Exclusivity on Several Blockbuster Brands,” Medical Practice Insider, March 29, 2012, http://www.medicalpracticeinsider.com.
24 side effects: Matthew Perrone, “Deaths Raise Questions on Drugs Given to Sleepless Vets,” AP/NBC News, http://www.nbcnews.com; “Highlights of Prescribing Information,” Seroquel, AstraZeneca Medication Guide (approved by the Food and Drug Administration [FDA]), June 2011, http://www.accessdata.fda.gov.
24 four hundred combat veterans and other military: Fred A. Baughman, “Soldiers of the Iraq/Afghanistan Era Dead of What Seem to Be Probable Sudden Cardiac Deaths…,” European Heart Journal, December 29, 2011, http://proximajmone.altervista.org; also see full document online at https://www.scribd.com/document.
24 “drug toxicity”: James Dao et al., “For Some Troops, Powerful Drug Cocktails Have Deadly Results,” New York Times, February 13, 2011, http://www.nytimes.com; Bob Brewin, “Military’s Drug Policy Threatens Troops’ Health, Doctors Say,” Nextgov, January 18, 2011, http://www.nextgov.com.
24 aggressive marketing: Martha Rosenberg, “Are Veterans Being Given Deadly Cocktails to Treat PTSD,” AlterNet, March 5, 2010, http://www.alternet.org.
24 pharmaceutical-subsidized patient advocacy groups: David Dayen, “New Report Exposes ‘Patient Advocacy’ Groups as a Big Pharma Scam,” The Intercept, December 1, 2016, https://theintercept.com.
25 (PIER): W. R. McFarlane, “Portland Identification and Early Referral: A Community-Based System for Identifying and Treating Youths at High Risk of Psychosis,” Psychiatric Services 61, no. 5 (May 2010): 512–515, https://www.ncbi.nlm.nih.gov/.
25 “shambles”: Michael F. Hogan et al., “Achieving the Promise: Transforming Mental Health Care in America,” The President’s New Freedom Commission on Mental Health, DHHS publication no. SMA-03-3832, July 2003, http://govinfo.library.unt.edu.
26 “n
eurodevelopmental”: S. Hossein Fatemi and Timothy D. Folsom, “The Neurodevelopmental Hypothesis of Schizophrenia, Revisited,” Schizophrenia Bulletin 35, no. 3 (2009): 528–548, schizophreniabulletin.oxfordjournals.org.
26 bedlam era: Robert Whitaker, Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill (New York: Basic Books, 2002), 1–38.
26 “snakepit” hospital era: Richard D. Lyons, “How Release of Mental Patients Began,” New York Times, October 30, 1984, http://www.nytimes.com.
27 less than 40,000 such beds: Treatment Advocacy Center, “Going, Going, Gone: Trends and Consequences of Eliminating State Psychiatric Beds, 2016,” http://www.treatmentadvocacycenter.org.
27 make up a third: Treatment Advocacy Center, “Serious Mental Illness and Homelessness,” September 2016, http://www.treatmentadvocacycenter.org.
27 nearly 700,000: David Grabowski, “Mental Illness in Nursing Homes: Variations Across States,” Health Affairs, 28, no. 3 (May 2009): 689– 700, https://www.ncbi.nlm.nih.gov; Angela M. Greene et al., Understanding Unlicensed Care Homes: Final Report, DHHS, ASPE, September 1, 2015, https://aspe.hhs.gov.
27 Nearly once a month: Rob Barry et al., “Neglected to Death, Part 1: Once Pride of Florida, Now Scenes of Neglect,” Miami Herald, April 30, 2011, http://www.miamiherald.com.
27 potentially fatal side effects: Robert Whitaker, “Lure of Riches Fuels Testing,” Boston Globe, November 17, 1998, online at http://psychrights.org/Stories/SusanEndersbe.htm.
27 exaggerated and false claims: Steven Brill, “America’s Most Admired Lawbreaker,” HuffPost, Highline, September 2015, http://highline.huffingtonpost.com; Sammy Almashat et al., “Twenty-Five Years of Pharmaceutical Industry Criminal and Civil Penalties: 1991 Through 2015,” Public Citizen, March 31, 2016, http://www.citizen.org; Steven Sheller et al., Pharmageddon—A Nation Betrayed: A National Trial Lawyer Reveals an Industry Spinning Out of Control (Norfolk, VA: Cape Cedar Media, 2016).