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In-depth ‘In Crisis’ series examines shortfalls in Idaho’s mental health care system

The Idaho Statesman and Boise State Public Radio are running an extensive, five-part reporting project this week on Idaho’s mental health system, titled, “In Crisis.” Among the revelations so far: Involuntary mental commitment cases in the state rose from 2,337 in 2007 to 4,686 in 2013. The state is short on both treatment facilities and providers, and its suicide rate is 48 percent higher than the national average. More than 22 percent of uninsured adults who don’t qualify for Medicaid now – but would if the state expanded Medicaid under the Affordable Care Act – were in “serious psychological distress.” And prisons and jails are among the state’s top mental health care providers.

The series also reported that Idaho's per-capita spending on mental health was the nation's lowest except for Puerto Rico at $37, but the state Department of Health & Welfare disputes that figure, saying a glitch in how data was examined for a Kaiser Family Foundation report comparing states left out part of Idaho's spending, which H&W says actually came to $143.56 for fiscal year 2010, above the national average of $120.56. You can see the full series, which continues tomorrow, online here and here; it includes audio, video, data and more.

Mental health crisis

We walk the streets of our communities and at any time we see them: persons who have mental illness.

When one of these persons commits a crime – or is it a crime if they have limited awareness? – they are arrested and put in jail. While waiting for appropriate care, psychiatric care at a hospital, many of these people spend months in jail. And their mental health status deteriorates.

“Mental-health advocates are seeking class-action status in a federal lawsuit arguing that holding these patients in jail violates right to due process and constitutes cruel and unusual punishment. Many hope the Legislature will intervene with more funding,” writes Andy Mannix in a Seattle Times story.  

Our society has lost its way in caring for people who cannot find their way.

(S-R archive photo)

Anne Lamott speaks

Anne Lamott writes about faith, recovery from addiction, and the profound presence of God in the ordinariness of life. She is not pious or pretentious – she has lived through too much pain and suffering for that nonsense.

Robin Williams was her neighbor when she was growing up in the Bay area. Anne writes of his life, mental health and our common search for meaning in the raw pain of life.  

(S-R archive photo: Anne Lamott)

CdA had highest score for crisis center, but lost out due to local lawmakers’ opposition

Coeur d’Alene actually had the highest score in the competition for a state mental health crisis center by a slim margin, Coeur d’Alene Press reporter Taryn Thompson reports today, but lost out to Idaho Falls because North Idaho lawmakers didn’t support the project. North Idaho Reps. Kathy Sims, Vito Barbieri, and Ron Mendive and Sen. Bob Nonini all voted against SB 1352, which passed the House 28-6 and the Senate 53-14 and sought to establish three of the centers. JFAC approved funding for just one in the first year, putting three locations – Coeur d’Alene, Idaho Falls and Boise – in competition for it.

Thompson reported that the Department of Health & Welfare scored the competing proposals, then worked with the governor’s office to make the final choice. "The fact that a majority of legislators in eastern Idaho wanted the project helped in the final decision," Otter’s press secretary, Jon Hanian, told the Press; he cited a “proven level of legislative support in eastern Idaho.”

You can read Thompson’s full report here; she obtained the scoring data through a public records request under the Idaho Public Records Act. Over the weekend, Thompson reported on the magnitude of the mental health crisis in North Idaho that had local officials hoping for funding for a 24-hour crisis center; see that report here. Letters in support of the Coeur d’Alene crisis center were signed by the county commissions and sheriffs of all five North Idaho Panhandle counties.

Barbieri told Thompson that law enforcement and others don’t need to “panic or specifically worry.” He said, “If it turns out that there's as dire a need here as opposed to somewhere else in the state, they'll get it. … Of course, with a bureaucrat, they all need it right away."

Boise, Idaho Falls and CdA vie for $1.5M mental health crisis center

Here’s a news item from the Associated Press: IDAHO FALLS, Idaho (AP) — The Idaho Department of Health and Welfare says a decision about where to build a $1.5 million state-funded behavioral-health crisis center will likely be within a week. Spokeswoman Niki Forbing-Orr tells the Post Register (http://www.postregister.com) that a committee is reviewing proposals from three cities. Idaho Falls in eastern Idaho, Boise in southwestern Idaho, and Coeur d'Alene in northern Idaho are vying for the center that would serve as a safety net to treat at-risk mentally ill people whose symptoms often land them in hospitals or jail. Health and Welfare requested from state lawmakers $600,000 in startup money and $4.56 million to operate three crisis centers. Lawmakers earlier this year approved the $600,000 grant, but they reduced operations funding to $1.52 million, enough for only one crisis center.

What does your gut tell you?

We often ask that question when others are baffled about decisions. And there may be more wisdom and influence living in that gut than we realize.

As a college sophomore, Elaine Hsiao learned in microbiology class one’s gut holds almost twice our brain weight in bacteria. For what purpose? As a graduate student Hsiao learned that these bacteria might actually influence our thoughts, moods and behavior.

Now a research fellow, Hsiao explores how those microbes can affect brain function. Perhaps she is on a path of healing; perhaps one day we treat mental health by simply introducing more microbes into one’s system.

My gut tells me such a discovery would bring peace and wholeness to millions.

(S-R archive photo: a scene from “Diary of a Wimpy Kid.” 20th Century Fox)

Idaho prisons see jump in inmate suicide attempts

Here's a news item from the Associated Press: BOISE, Idaho (AP) — Idaho Department of Correction officials say they're seeing an increase in attempted suicides and other mental health problems within the state's prisons and jails. Department Director Brent Reinke told Board of Correction members Thursday that in the last month guards found four inmates "hanging from sheets" at facilities around the state. One of those inmates — a man housed at the Nez Perce County Jail who was about to return to prison — died before guards found him. The remaining three were found and rescued. Reinke says the number of inmates showing signs of suicidal behavior or other mental health problems has also risen. He says that in June, the department tallied 78 reports of inmate problems or unusual behavior, compared to 56 in June of 2012.

Click below for a full report from AP reporter Rebecca Boone.

Rusche: NRA MIA On Mental Health

Rep. John Rusche, D-Lewiston, in Huckleberries comments section (re: Obama on gun vote: 'Shameful day'): But in the Legislature and the Governor's budget this year spending for mental health services was decreased over the year before, and millions under pre-recession levels. Health and Welfare has withdrawn MH workers from all except our urban areas due to budget restrictions, county jails and prisons are now the largest provider of mental health services in the State. We stopped funding for behavioral counselors in our schools. I tend to agree that the amendment would not have done much, but in spite of the loud cries from the NRA and pro-gun advocates that better mental health services are needed, we are making no progress. I would like to see the NRA put some effort behind improving mental health services. More below. (StateImpact file photo)

Question: Do you think the NRA should use its considerable grass-roots clout to lobby for more funding for mental health services?

Ex-Shock player in solitary confinement

Judy Reisner wants her son, Kevin Ellison, to get mental health treatment, but he sits in the Spokane County Jail. (SRPhoto/Dan Pelle)

A former pro football player arrested for arson in June remains in solitary confinement at the Spokane County Jail, and his mother says his mental health issues will worsen without treatment.

Kevin Marcus Ellison, 25, who was a starting linebacker and defensive back for the Spokane Shock arena football team, has twice been denied release from jail for mental health treatment. His lawyer appealed U.S. Magistrate Cynthia Imbrogno’s last decision, but U.S. District Court Judge Lonny Suko rejected the appeal Aug. 1, citing in part an altercation Ellison had with jailers last month.

Ellison’s mother, Judy Reisner, traveled from Los Angeles to Spokane to visit Ellison in jail on Wednesday. He’s not doing well, she said.

Read the rest of my story here.

Past coverage:

June 20: Kevin Ellison to stay in jail without bail

June 14: Shock player says God told him to start fire

Watch me talk about this story with KHQ's Dave Cotton:

Murder suspect’s mental state questioned

A man who told detectives he murdered another methamphetamine addict in a fight over cigarettes will undergo a mental health examination. 

Acquaintances of suspect Shane Caleb Smith, 38, told investigators he is known as “Psycho Shane” and sometimes speaks of imaginary people and vivid hallucinations.

He also often accused people at gunpoint of things they did not do, witnesses told police.

Smith, who is pictured just after his arrest courtesy KHQ-TV, is accused of shooting Warren Scott Flinn on May 12.

Flinn, 44, died at a hospital May 16. 

Smith told detectives he and Flinn (right) had been out “scrapping” for metal near the railroad tracks on Lake Road when they began to argue over cigarettes.

Smith was arraigned on a second-degree murder charge Tuesday in Spokane County Superior Court. He was not given a trial date; rather, he was ordered to appear in court July 27 for an update on whether he's competent to stand trial.

Attack suspect to undergo mental exam

A man accused of a bizarre attack in downtown Spokane earlier this month is to undergo a mental health examination.

 Justin T. Betts, 29, is due back in Spokane County Superior Court next month to determine if he's competent to stand trial. An arraignment scheduled for last Thursday was cancelled.

Police say Betts, who had just been released from jail, was high on methamphetamine when the owner of Thompson's Food Mart at 1208 W. 3rd St., saw him get into a customer's car April 7 about 9:30 a.m.

Betts threatened the owner with a gun when confronted, police say, and also threatened several other people in the area. Betts also walked into the nearby Honda dealership and threatened employees, police say.

He told police his name was "Jimmy Jake Franks," but officers eventually identified him as Betts, whose criminal convictions include third-degree child molestation in 2004.

Betts remains in jail on charges of first-degree robbery, two counts of felony harassment and possession of controlled substance.

DSHS worker had ‘disturbing’ child porn

A state social services employee accused of distributing child pornography must undergo a mental health evaluation before he can leave jail, a judge ruled today.

A federal prosecutor said the material distributed by Darrell J. Rogers, who licenses foster homes for children, is some of the worst he's encountered in his 36 years of practicing law.

"This is not normal child pornography," Assistant U.S. Attorney Earl Hicks said at Rogers' bail hearing in U.S. District Court. "This is child pornography that is very disturbing."

The material includes a video of a 3-month-old girl being raped by an adult male, Hicks said.

"This is not like trading baseball cards," Hicks said. "What kind of person would have an interest in this?…Most people are disgusted by it, and most people would ask 'what's wrong with this person?'"

Rogers, 51, is a married father of two with no criminal history. He's lived in Spokane his entire life and has worked for the state Department of Health and Human Services since 1995. Family, friends and coworkers attended his hearing; some left afterward in tears.

Distributing child pornography carries a mandatory minimum sentence of five years in prison for each image.

U.S Magistrate Cynthia Imbrogno will review Rogers' mental health evaluation. Rogers and his wife must pay $25,000 bond to secure his release from jail. If he is released, Rogers will be confined to his home and must wear an electric monitor. Firearms that FBI agents found in his home during a search on Tuesday must be removed.

Imbrogno called the conditions "perhaps about as stringent as they get for this type of charge," she said.

Hicks cited Rogers’ employment as a person in a position of trust with children as further reason for a mental health evaluation.

"He's leading a double life, in effect," Hicks said.

A DSHS spokesman said Rogers will be reassigned to a position in which he does not have contact with children if he's released from jail pending the resolution of his case. Imbrogno said she'll decide if Rogers can be employed after reading his evaluation.

Rogers has been in the Spokane County Jail since Tuesday, when FBI agents arrested him at his home in the 7100 block of North Westgate Place in the Indian Trail area in north Spokane and seized a computer containing sexually explicit images of children.

The FBI began investigating him in February after an agent in Maryland downloaded child pornography from an Internet Protocol address linked to Rogers' home.

The material features the infant and children up to six years old, Hicks said.

Rogers told the FBI the material was on a computer in the guest bedroom when questioned, Hicks said.

Rogers also told investigators he'd never hurt a child and would contact authorities if he knew of someone who was. He said he wasn't sexually attracted to children but was "trying to figure out" child pornography.

Hicks said Rogers' response was typical "even from people who have been diagnosed as pedophiles."

"I'm not saying Rogers is; I'm saying that's a typical response," Hicks said.

He called the assertion that viewing and distributing child pornography doesn't harm children "bunk."

"Fifty-one-year-olds creating generations of pedophiles. If we look at the facts, that’s what happens in a lot of circumstances," Hicks said.

Public defender Matthew Campbell said a mental health evaluation isn't necessary and said Rogers is not a danger to the community. "He has no criminal history," Campbell said.

Campbell said prosecutors have not opposed pre-trial release in other child pornography cases, but Hicks said the cases didn't involve three month olds being raped by adult males.

Idaho Mental Health Cuts In Top 10

StateImpact Idaho is beginning to look at the effects of the $34 million Medicaid cut that the Idaho Legislature passed last session.  Related to that, a new report from the National Alliance on Mental Illness (NAMI) tallies the state-by-state changes in general fund appropriations for state mental health agencies since 2009.  According to the report, Idaho is among the ten states that have made the greatest cuts, by percentage, since that year. As advocates for people with mental illness will point out, Idaho hasn’t had a great track record of funding services for the state’s mentally ill. “I think the shocking part is we spend $44 per capita on mental health, and the national average is $122. So we’re about a third of the national average,” said Doug McKnight, president of the Idaho chapter of NAMI/Molly Messick, State Impact. More here.

Question: Do you suppose underfunding mental health services is one of the way's the Otter administration provides good governance?

Just wondering

Did it bug anyone else that on numerous TV programs ranging from Bob Newhart's set-in-Chicago show to "Frasier," the titles "psychiatrist" and "psychologist" were often used interchangeably?


Niece found fit for trial in man’s death

ST. MARIES, Idaho (AP) — A psychologist has found a North Idaho woman is fit to stand trial in the shooting death of her uncle in May.

The Coeur d’Alene Press reports Daniel Hayes of Hayden Lake found 28-year-old Melisa R. Bates could both understand the charge against her and help her attorney with her defense.

Bates is charged with first-degree murder in the death of 43-year-old Robert D. Marek at his house eight miles south of St. Maries. Court records say Bates had been staying with Marek.

Benewah County Prosecutor Douglas Payne said Marek was shot with a handgun and beaten with a metal rod and an attempt was made to burn his body.

Bates is scheduled for a preliminary hearing on Aug. 22 in St. Maries before Magistrate Patrick McFadden.

Policing ~ with care

Mental illness plagues many of our homeless neighbors. Their behavior is often interpreted as threatening or at least confusing and bothersome. The Seattle Police Department now has a mental health expert who rides with them, often as the initial contact for a person deemed experiencing a mental health crisis. Perhaps other law enforcement groups will take a look at this model of community policing - and create a compassionate outreach program like it. We all know someone who suffers from mental health challenges; we know that resources are few.

 A trained caregiver out in our community can reduce anxiety - for the person on the street as well as officers who are trained and committed to protect their communities.  

Bayview murder suspect unfit for trial

COEUR d’ALENE, Idaho (AP) — A district judge has suspended the criminal case against a Bayview man accused of attacking four neighbors with a hammer, killing one, because a psychologist has determined he’s unfit to stand trial.  

 The ruling last week is in the case of Larry Cragun, 31, who is charged with first-degree murder and other felonies in the Dec. 19 death of Patricia Heath, 43, and attacks on others.  

Cragun has been ordered into the custody of the Idaho Department of Correction for care and treatment. First District Judge Benjamin Simpson also ordered a progress report on Cragun’s status in 90 days.  

Kootenai County Prosecutors Barry McHugh told The Coeur d’Alene Press the case will no longer go forward until Cragun understands the charges and is better able to assist in his own defense.  

Cragun is accused of bursting into his neighbors’ trailer home and attacking them with a hammer and knife. He has pleaded not guilty.   

The attack at 34552 N. Limekiln Road in Bayview followed weeks of problems between the Heaths and Cragun, including bizarre claims by the suspect that authorities say were unfounded, including an allegation that Heath's son was "placing pubic hair in Cragun's food," according to a police report.

After the attack, customers at JD's Resort told authorities that Cragun had said he needed to call 911 because he'd killed three or four people. He didn't complete the phone call. Instead, he grabbed a customer's beer "drank it, and left a dollar on the bar," according to the police report.

Witnesses told police Cragun posted flyers suggesting there was an umbrella submerged in Lake Pend Oreille that, along with GPS tracking satellites, allowed the government to read peoples’ minds.  

Heath died of massive head trauma the day after the attack, and three others were injured. He also faces two counts of first-degree attempted murder, aggravated battery, aggravated assault and burglary.  
The judge ordered a mental health evaluation for Cragun in March.

The evaluation was conducted by Dr. Chad Sombke, of Boise, who concluded Cragun is unfit mentally to proceed with his case.

Past coverage:

Dec. 20: 1 dead, 3 injured in Bayview hammer attack

Idaho murder suspect to get mental eval

A 26-year-old woman accused of killing her uncle in St. Maries, Idaho, will undergo a mental evaluation.

 Melisa R. Bates could be heard yelling uncontrollably from her holding cell upstairs from the Benewah County courthouse Wednesday, according to KHQ.

Bates was to be arraigned on a murder charge, but that has been postponed 30 days as she completed a mental health evaluation. Bates will be held at a mental health institution in Lewiston, KHQ reports.

Bates was arrested near Bayview Tuesday after deputies found the burned remains of her uncle, Robert Dean Marek, 43, while checking to see why he didn't show up for work.

A motive for the slaying has not been released.

Idaho Last In Mental Health Support

Although money for every state was tight this legislative session, one-third of them actually put more toward mental health. But Idaho was not one of them. And with the latest round of cuts, Idaho is now at the very bottom of the list. "I was about in eighth grade when I got depressed and kind of blew it off," says 22-year-old Lindsey Altorfer.  "When I was a sophomore in high school I would cry myself to sleep and have panic attacks, and I thought something was wrong, and I kept bearing it and saying I'm fine, until I eventually had a breakdown."
For Altorfer, that breakdown included two hospital stays after suicide attempts. Finally, as a high school senior at Capital High School in Boise, Altorfer was diagnosed as bi-polar with attention deficit disorder/Mike Murad, KBOI. More here. (AP file illustration)

Question: Last in number of women holding judge's positions and now last in mental health support. Is there a pattern here?

Steele will undergo mental health exam

The former Aryan Nations lawyer accused of hiring a man to kill his wife will undergo a mental health examination.

Edgar J. Steele, 65, is to be evaluated by a licensed psychologist Friday at the Ada County Jail in Boise.

Psychologist Robert Engle is to submit a report by April 13 detailing Steele's "physical well-being, psychological functioning and mental health condition" currently and at the time police say Steele hired Larry Fairfax to kill his wife, Cyndi Steele, according to an order by U.S. District Judge B. Lynn Winmill.

Prosecutors requested the mental evaluation after Steele's lawyers filed a notice saying they intend to introduce expert evidence regarding a mental disease or defect that has “bearing on (Steele's) guilt or his lack of a knowing or intentional mental state."

Cyndi Steele has said she believes her husband is innocent and that tapes reportedly containing recorded conversations between Steele and Fairfax were manufactured by the federal government.

The Steeles say the case is an attempt to silence Edgar Steele, self described "attorney for the damned," because of his unpopular views.

Steele is to stand trial April 26 in U.S. District Court in Boise.

Read past coverage here.

Dumpster hideout prompts mental exam

A man hid in the back of a garbage truck near East Wenatchee on Tuesday, prompting authorities to take him to receive mental health treatment.

The site manager of the Waste Management Land Fill, 191 S. Webb Ave.,saw the man crawl out of the back of a garbage tuck as employees were dumping it into the land fill.

The man was not injured. He told Douglas County sheriff's deputies he was ridding in the dumpster "to escape people who were chasing him," accoridng to a news release.

A deputy drove the man to a hosptial for a mental health evaluation. He does not face criminal charges.

Mental Health Services Faces Cuts

The economic downturn has left deep scars on Idaho's public services for the mentally ill, including efforts to help some of the state's most-vulnerable children. Gov. C.L. “Butch” Otter's recommended budget for the Department of Health and Welfare's mental health services division for fiscal year 2012 is $32.4 million, down 4.6 percent from 2011 and a full 19 percent less than in 2008. The division has laid off or left unfilled 35 full time positions to assist adults with mental health problems, and another 14 positions to help kids/Associated Press via Betsy Russell/Eye On Boise. More here.

Question: Is this a good time to be cutting mental health services?

Stacy: Mental Health Issue Hits Home

StacyP: I have a 19 year old son who suffers from chronic depression, among other things, and requires medication and regular counseling to keep at bay the demons that urge him to hurt himself. When his doctors told me a year ago that he was responsible for his own treatment from then on I was devastated. Fortunately for me, my son has not decided to deviate from “the plan”, but I recognize that could happen at any time, for any reason. The doctors wished me luck (and a good lawyer) when it does because that's what it takes to get someone hopsitalized for mental illness these days. Sad, sad times.

Question: Are you dealing with a friend or loved one who has a serious mental health problem?

Fisherman: Deal w/Underlying Issue

Old Fisherman (re: weekend thread about attack on Congresswoman Giffords & others): After spending time to read through this long thread, it's refreshing to see a precious few of you are trying to make sense out of this and undersand what happened. Some of you pay respects to all those injured or dead, and their families. A few of you have hit the nail on the head regarding mental health. We as a Nation have failed miserably to provide for our citizens that have mental health issues, and yes, gov't cuts that funding first when the shoe pinches. That has to be corrected. Then our own state puts mental health on the block along with education. If someone were able to look back over the past 5 years at shootings, the numbers would be chilling. The reasons are pretty much the same. I am not saying if the alleged shooter had access to mental health this would not have happened, but it's worth thinking about.

Question: Would better funding for mental health services in this country help defuse murderous assaults like the one over the weekend in Tucson, Ariz.?

Report: Gunman was volatile, explosive

A gunman killed in a shootout with police last week had attempted suicide several times, been hospitalized at Eastern State Hospital and was described as “volatile and explosive” in a state psychiatrist’s report two years ago.

Ethan A. Corporon saw drug-induced images of aliens and spaceships, dreamed of killing himself with a shotgun and described intense mood swings that experts said made him dangerous and likely to commit crimes, according to a June 2008 report by Dr. William Grant, forensic psychiatrist at Eastern State Hospital.

In a 2005 interview with another doctor, Corporon said “what do I have to do to get some attention, kill someone?” and said he had access to a shotgun.

Read my full story here.

Elton to get court-ordered mental evaluation

The mental state of a Spokane County commission candidate is in question.

 A week before filing for office Friday, civic gadfly David H. Elton was ordered by Spokane County Superior Court Judge Maryann Moreno to undergo mental evaluations to determine whether he’s competent to stand trial on harassment charges related to threatening e-mails sent last year to Spokane City Council President Joe Shogan and to Betsy Cowles, chairwoman of the Cowles Co., which owns The Spokesman-Review.

Elton’s trial, previously set to begin June 28, is on hold pending his mandatory mental health evaluation, Deputy Prosecutor Dale Nagy said.

Read the rest of my story here.

Previous coverage:

April 15: Elton avoids jail after violating court orders

April 3: Elton’s wife donated to Stevens’ campaign

Jan. 21: Trial set for Elton on threat charges

Feb. 12, 2009: ‘Murder’ email meant as joke, suspect says

The economy and the mental health of families

A growing number of families have hit a crisis point, according to this recent USA Today story, “As economic fears rise, families on verge of unraveling.”

Parents are suffering from stress and sometimes can’t cope with economic uncertainty, experts say. The worst-case scenario happened in Los Angeles late last month, when Ervin Lupoe became so depressed about losing his job that he killed his wife and five children before taking his own life, according to CNN and other news reports.

In the last few months, more Americans have turned to therapists, according to the USA Today story. Domestic violence and suicide hotlines also have reported increased calls.

It’s not just the parents who have lost their jobs, therapists say. People who are still working also experience anxiety because they don’t know if they’ll be able to hang on to what they have. Inevitably, children begin to share their parents’ worries and burdens.

Around Christmas time, we had a discussion about the need for transparency – how families can benefit when parents can discuss problems with money and talk to kids about the economy and their fears. But even then, some parents have a hard time reassuring their children – simply because they themselves don’t know if things will be OK.

Besides just talking about it and perhaps coming up with a savings plan, what else can families do to keep it together during these tough economic times?