Category Archives: Mental illness and substance abuse

Bhattacharya Case Dismissed

by James A. Bacon

A federal judge has dismissed a case against the University of Virginia by a medical student who charged that university officials had retaliated against him for disputing the speaker’s logic in a panel discussion about microaggressions.

The plaintiff, Kieren Bhattacharya, “has nothing more than speculation to support his claim,” wrote Judge Norman K. Moon with the U.S. District Court in Charlottesville. “He has not unearthed even a scintilla of evidence that would demonstrate that Defendants took any adverse action against him because of his protected speech.”

Bhattacharya’s case generated a flurry of attention among conservative media, including Bacon’s Rebellion, when it was filed more than a year ago. The med school student described an event at which he critiqued the logic of a faculty member opining on the subject of microaggressions. He expressed the view that “a microaggression is entirely dependent on how the person who’s receiving it is reacting” rather than how the statement was intended. The incident prompted a colleague to file a “professionalism concern card,” after which ensued a train of administrative hearings, Bhattacharya’s involuntary commitment to a mental health facility, the issuance of a no-trespass order banning him from the university Grounds, and his subsequent expulsion from med school. Continue reading

Marcus Alerts in Virginia and Risks to Unarmed Responders

by James C. Sherlock

The Marcus Alert is named after Marcus-David Peters, a teacher killed by Richmond police in 2018 amid a mental health crisis.

The Marcus Alert system requires coordination between 911 and regional crisis call centers and establishes a specialized behavioral health response from a combination of behavioral health professionals and law enforcement when responding to a behavioral health situation.

It sounds right, but is dangerous to unarmed responders. We will have to work through that to see if the program is sustainable over time. And where. Continue reading

The Mental Mismatches of Modern Society

by James A. Bacon

In his book, The Story of the Human Body, Daniel E. Lieberman, chair of the department of human evolutionary biology at Harvard, recounts how the human body evolved over six million years from its rain forest-dwelling ancestors in adaptation to changing evolutionary pressures like climate change, and then explores how human bodies are maladapted for contemporary life. Modern man has seen the rise of numerous chronic diseases that once were thought to be the inevitable result of aging but increasingly are regarded as the product of post-industrial lifestyles from insufficient exercise and excess consumption of carbohydrates (heart disease and diabetes) to the wearing of socks and shoes (fungal infections and plantar fasciitis) and squinting for endless hours at books and computer screens (myopia).

In the few hunter-gatherer societies remaining on the planet, Lieberman contends, once people have made it through the gauntlet of early childhood, they routinely reach their 70s, and do so without the scourges of obesity, hypertension, diabetes, and other afflictions of modern society. Our medical establishment, he suggests, treats symptoms. We must turn our attention to underlying causes.

I find Lieberman’s case highly persuasive. But, then, I’ve always been fascinated by human evolution, and I’ve always believed that the emotional substrate of human behavior has been heavily influenced by our Stone Age, hunter-gatherer ancestry. If I could wish one thing of Lieberman, it would be for him to entitle his next book The Story of the Human Mind, and devote it to showing how contemporary lifestyles are maladapted to our psyches, which evolved to maximize evolutionary fitness in bands of hunter-gatherers. Continue reading

Thinking About Gun Control

by Bill O’Keefe

After each mass shooting there is an outcry for Congress to do something. In 2021, there were almost 21,000 murders involving guns and almost 700 mass shootings (those involving four or more victims).

There has been no responsible action at the Federal level because Congress seems more interested in political food fights then in taking action that can make a difference. Henry Clay once observed that politics is not about ideology; it’s about governing, and if you can’t compromise you can’t govern. Congress in the existing political environment can only compromise by accident.

The fact that Congress is paralyzed is no reason for states to avoid taking action.  In the last few years, the Virginia General Assembly has passed several gun laws.  These laws, which created a backlash in a number of counties, imposed universal background checks on gun sales, created extreme risk protective orders that allow authorities to temporarily seize guns from people deemed dangerous, required gun owners to report lost or stolen firearms, restored the former one-handgun-a-month law and boosted penalties for leaving guns accessible to children. Continue reading

Medicaid, Public Health and Chronic Disease Management

UVa Hospital

by James C. Sherlock

From the CDC:

Chronic diseases have significant health and economic costs in the United States. Preventing chronic diseases, or managing symptoms when prevention is not possible, can reduce these costs.

Virginia pays a great deal of money every year to contractors who manage the care of its Medicaid population.

It is a hard job, but even though the challenges are tough, it has appeared to me for a long time that we are not getting our money’s worth from $18 billion annually in Medicaid payments for the populations managed by these contractors.

A white paper, “Prevent Costly Chronic Disease Through Member Engagement” caught my eye as the basis for a follow up to my earlier report on public health and Medicaid managed care in Petersburg.

This is that update. Continue reading

A Lot of Unanswered Questions

The Chambers family. Photo credit: Richmond Times Dispatch

by Dick Hall-Sizemore

Painting racial slurs on the face of an unconscious Black teenage boy is wrong.

That being said, a recent incident in the Richmond area leads to a lot of questions, including concerning the quality of reporting done by the Richmond Times-Dispatch.

According to an RTD on-line story Friday by reporter Mark Bowes, a Powhatan special prosecutor was looking into a 2020 incident in which a 16-year-old Black youth passed out intoxicated at a party in Powhatan County. While he was unconscious,”… the N-word, the letters KKK, a drawing of a penis, the phrase “F— BLM” and ‘White Lives Matter’ [were] scrawled on his head.” Also, he was draped with a Confederate flag and a sex toy was placed next to his head. As teenagers will do, others at the party took pictures of him and posted them on social media. Reportedly, this type of thing had been done before, as a “party joke.” Continue reading

The Mental Anguish Veto

by James A. Bacon

As the debate over de-platforming former Vice President Mike Pence plays out in the pages of the University of Virginia student newspaper, a recent column illuminates, albeit unwitting, the complex interplay between mental illness, sexual orientation, fragility, and intolerance toward views people find uncomfortable.

Mental illness is rampant in American society today, especially in the so-called Generation Z. An increasing prevalence of anxiety and depression has emerged as a major challenge facing colleges and universities in Virginia, and across the United States. A month ago, students at James Madison University staged an occupation of Alumni Hall. Their demands: more resources and special allowances for students suffering from mental illness. UVa is no exception to this trend.

The anxiety and depression experienced by young people are very real, and those who suffer deserve our sympathy and support. But their anguish does not give them the right to cancel the rights of others.

Within that context, a young woman wrote a letter to The Cavalier Daily expressing her reasons for wanting to ban Pence from the Grounds. I do not use her name because I do not want to expose her to ridicule or otherwise add to the burdens she bears. Her story, though, is telling. Continue reading

When COVID Hysteria Meets Safetyism

by James A. Bacon

The percentage of Northern Virginia’s adult population grappling with anxiety and depression more than tripled during the COVID-19 epidemic — from 8% to 28% — according to data published by the Community Foundation for Northern Virginia. The percentage peaked at 39% in February 2020, affecting 755,000 individuals, but abated to 545,000 individuals by October.

Including other types of mental illness, the Community Foundation estimates that, all told, 750,000 Northern Virginia adults, or 39% of the adult population, have mental health needs. An estimated 370,000 want therapy or counseling but the region’s 5,100 mental health professionals can’t come close to meeting the demand. And they charge so much — around $215 per 45-minute session for self-pay — that many people can’t afford them anyway.

Wow!

Let those numbers sink in. Northern Virginia is one of the most affluent metropolitan regions in the country, yet nearly two out of five residents suffer from mental illness. Anxiety and depression are endemic. There’s a lot to unpack here. Continue reading

The State Budget: The House Reductions to Cover Tax Cuts

Del. Barry Knight (R-Virginia Beach, chairman, House Appropriations Committee

Budget is policy. A budget reflects what an organization chooses to spend its money on.

The differences between the versions of the 2022-2024 biennial budget passed by the House and Senate this year are starker than they have been in recent memory. There are major philosophical and policy differences that the conferees will need to work out.

However, before they even get to those differences, there is another obstacle they will need to confront: they differ significantly on how much money the state will bring in. They have to agree on ow much money they have to spend before they can seriously discuss how to spend it.

The Senate budget is based on total general fund revenue that is about $3.4 billion higher than projected by the House. (Unless otherwise specified, all funding amounts in this article refer to the general fund.) The reason for the wide gap, of course, is the House adopting greater tax cuts than the Senate. Steve Haner has very ably compared the different approaches to tax cuts on this blog here, here, and here. Continue reading

Nineteen Millionth Nervous Breakdown



by James A. Bacon

Two dozen students occupied the central lobby of James Madison University’s Alumnae Hall for 90 minutes last week. The group issued a list of demands, the most notable of which was increased funding and staff for the Counseling Center. Protest leaders read from some 50 testimonies submitted by students, reports the student newspaper The Breeze.

“I’ve been struggling with depression and suicide thoughts on and off since I was 14 years old,” one testimony read. “All that changed at the beginning of last semester. My suicidal thoughts got really bad. I would go days without sleeping, and I had no idea how to handle classes when all I could think about was taking my own life.”

Another letter expressed the difficulty the writer and others have felt at JMU. “Our mental state,” it said, “is on the fritz.”

A graduate student urged faculty to disregard class-attendance guidelines and restrictions on test makeups. “That’s detrimental to student’s health and completely ignores the nuance of existence…. These sorts of things are barriers to students that are extraordinarily harmful.” Continue reading

Littel Pick as Health Secretary Signals Youngkin’s Approach to Healthcare Reform

John Littel

by James A. Bacon

Governor-elect Glenn Youngkin has appointed a new Secretary of Health & Human Resources to lead the fight against the COVID-19 epidemic and also to pursue long-term  reforms in mental health and healthcare.

Youngkin’s pick, John Littel, is a Virginia Beach resident and recent president of Magellan of Virginia and chief external affairs officer for parent company Magellan Health. Magellan of Virginia provides behavioral health services to Virginia Medicaid and FAMIS enrollees.

“The COVID-19 pandemic has had devastating impacts on Virginians across the Commonwealth, and John will play a pivotal role in overseeing our efforts in protecting Virginians’ lives and livelihoods,” said Youngkin in a press release.

“Starting on Day One, John’s experience will be an asset as we fix our broken mental and behavioral health system, ensure Virginians have access to affordable, free-market healthcare options, and reform our healthcare safety net to save taxpayer dollars and improve healthcare outcomes,” he added. Continue reading

Chronic Complainers Notch Big Win Against Landlords

by James A. Bacon

Whether you agree or disagree with Attorney General Mark Herring’s position on the case, a dispute between an unnamed individual with mental health issues and her Manassas landlords, Gia and Ernest Hairston, makes a fascinating case study. In a press release, Herring touts the outcome — the landlords paying the tenant $60,000 in compensation — as a victory for the disabled. Based upon upon the facts provided in the press release, it looks more like a victory for chronic complainers.

Here are the facts as contained in a Herring press release issued today. The tenant rented a condominium unit from the Hairstons in the summer of 2018. She told Mr. Hairston that she lived with a mental health condition that was currently under control. After moving in, she complained about the air conditioning system on very hot days and made requests for other repairs.

Mr. Hairston became frustrated by the maintenance requests, telling her that “any adult” would know better and that she was being “difficult” and “a problem.” He said the maintenance concerns were “all in her head.” To document the necessity for the repair requests, the tenant asked that any time the Hairstons came to the unit that her therapist or caseworker be present. After agreeing initially, Mr. Hairston then terminated her lease, giving her 90 days to move. Continue reading

To Get Respect, Show Respect

Khalah Sabbakhan, after her encounter with Richmond police. Photo credit: Daniel Sangjib Min, Richmond Times-Dispatch

by Dick Hall-Sizemore

There are frequent posts on this blog citing the low morale of police officers and officers quitting or retiring as a result. (For one example, see the post from earlier today.) However, for some reason, those posts often fail to report on the continued bad behavior of police.

Early last month, a 45-year old Black woman encountered two white police officers questioning a woman who appeared to be homeless near the Sauer Center in Richmond. (In order to keep the people involved in this incident straight in my narrative, I will refer to the woman being questioned as homeless, although it is not certain that was her status.) The subsequent actions were recorded by the Black woman involved and another eyewitness who started recording after she heard the first woman pleading for help. Continue reading

State Mental Health Plan Too large, Complex to Succeed?

by James C. Sherlock

I really want Virginia’s mental health program to work. It looks like a major struggle, however.

I will recommend a major change: state control of the Community Services Boards (CSB)s.  I think that will be necessary for the plan to have any chance of succeeding.

I have just finished reading a draft 409-page report to the federal government that describes planned efforts to expand and improve the state’s mental health care system. It has been developed by the Virginia Department of Behavioral Health and Developmental Services (DBHDS) for the signature of the Secretary of Health and Human resources.

Three things jump off the pages — all of the hard things are to happen going forward, the complexity of the program will be enormous and the state will not have enough control to make it happen.

Continue reading

Can’t Anybody Here Play This Game? Virginia’s 211 – Service or Crapshoot?

by James C. Sherlock

Sometimes the government of Virginia just makes you want to scream, cry, stay under the covers, whatever.

Navigating government and private social services agencies when you need help is hard, even more so a crisis. But it is way harder in Virginia than it needs to be.

To streamline the navigation process, the Federal Communications Commission in 2000 created 211, a number reserved for helplines that offer information or referrals to health and social support programs.

Given a layup, Virginia has clanged the ball off the bottom of the rim. Continue reading