​Police, EMS, firefighters and other first responders have rewarding and important jobs. However, first responders are often exposed to traumatic scenes that can affect their ability to cope. In the first responder community, there have been countless lives lost to suicide. In 2017, more firefighters lost their lives to suicide than in the line of duty. These suicides are often caused by an underlying mental health issue resulting from traumatic stress. 
 
There is evidence that first responders resist seeking mental health care because of the stigmatization and the fear of looking weak in their community. There is a fear of being the subject of ridicule and putting your job at risk by admitting that you need help. These issues are often perpetuated by those who lack a clear understanding of mental illness. It is important for the agencies where these officers work to support their employees and help them access the care they need. 
 
SAMHSA Resources
 
The Substance Abuse and Mental Health Services Administration (SAMHSA) has put together an online training coursethat addresses the occupational stressors faced by first responders. The course also addresses mental health and substance abuse issues including depression and post-traumatic stress disorder. In addition, it teaches healthy coping mechanisms. This online course should be utilized by police and fire departments in assisting their employees in recognizing mental health issues and encouraging them to find help. SAMHSA's websiteincludes a number of different trainings and resources. 
 
Employee Assistance Programs
 
The departments that hire and train first responders should also actively promote mental health awareness and work toward eliminating the stigma of receiving mental health care. Providing employee assistance programs can help change a department’s attitude towards mental health and give employees access to the care they need. 
 
Safe Call Now
 
Safe Call Nowat (206) 459-3020 is a 24/7 hotline specifically for first responders and their families. Callers to the hotline can speak confidentially to other first responders trained in mental health crisis counseling. These counselors can help with exploring treatment options for responders in a crisis. 
 
National Suicide Prevention Lifeline
 
The National Suicide Prevention Lifelineat 800-273-8255 is available 24/7. Calls to the Lifeline are confidential and trained crisis counselors can help you and provide you with information regarding mental health care providers in your area. 
 
If you or a loved one has a mental disability and has been arrested or convicted of a crime, you need an experienced criminal defense attorney on your side. Elizabeth Kelley specializes in representing individuals with mental illnesses. To schedule a consultation call (509) 991-7058.

​The Virginia State Senate approved a bill a few years ago that would ban capital punishment for defendants suffering from severe mental illness. The Republican-controlled Senate passed the bill by a vote of 23-17. The bill now moves on to the House of Delegates which is comprised of 51 Republicans and 49 Democrats.
 
The Bill
 
The bill defines “severe mental illness” as “active psychotic symptoms that substantially impair a person’s capacity to (i) appreciate the nature, consequences, or wrongfulness of the person’s conduct; (ii) exercise rational judgment in relation to the person’s conduct; or (iii) conform the person’s conduct to the requirements of the law.” The bill specifically excludes disorders that manifest primarily in repeated criminal conduct or are "attributable to the acute effects of voluntary use of alcohol or any drug."  The "severe mental illness" determination would be made during the sentencing phase of a defendant's trial. The jury or the judge would be tasked with deciding, by a preponderance of the evidence, whether the defendant suffered from a severe mental illness at the time of the offense. If found to have a severe mental illness, a defendant would be sentenced to life in prison without parole in lieu of the death penalty. The bill would not prevent people with severe mental illness from being convicted of crimes.  
 
Virginia’s History of Executions
 
Virginia does have a history of executing individuals who may have had a severe mental illness. In July of 2017, Virginia executed William Morva, a man with a delusional disorder. Morva had been sentenced to death in 2008 for the 2006 murder of a security guard during an escape from custody. He asked for a commutation of his sentence based on a psychiatrist’s finding that he suffered from a severe mental illness. Morva’s attorney argued that he believed he was acting in self-defense at the time of the murder. Virginia governor Terry McAuliffe refused to commute the sentence.   
 
Virginia is second only to Texas in the number of executions it has completed since 1976. There has, however, been a sharp decline in recent years. There are currently only two men on death row, and no defendant has been sentenced to death since 2011. 
 
If you or a loved one has a mental disability and has been arrested or convicted of a crime, you need an experienced criminal defense attorney on your side. Elizabeth Kelley specializes in representing individuals with mental illnesses. To schedule a consultation call (509) 991-7058.

​According to a study published in the New England Journal of Medicine, babies born in certain months have a higher rate of attention deficit and hyperactivity disorder (ADHD). The study found that children born in August are more likely to be diagnosed with ADHD than children born in other months.
 
Reasons for the Link
 
The study focused on children living in states where children must turn 5 before September 1st before being allowed to begin kindergarten. There are 21 states in the nation with this cutoff date. This means that children born in August in these states are usually the youngest children in their classroom. Some researchers believe this may be part of the problem. The study may actually demonstrate that there are developmental components to an ADHD diagnosis and that the immaturity of a child’s brain can cause them to demonstrate symptoms that may be linked to ADHD. 
 
A study in Taiwan found that youngest children are significantly more likely to be diagnosed with ADHD than older children in the same class. The study also found that the prevalence of ADHD diagnoses decreased month by month from the youngest children to the oldest children in the class. Could this mean that a significant number of children are being misdiagnosed?
 
Ensuring a Correct Diagnosis
 
Many ADHD diagnoses result from a failure of the child to meet the behavior and performance expectations at school. By a certain age, most children have developed the skills necessary to pay attention, stay on task, and wait their turn in school. But classroom ages can span an entire year which means that some of the children in a given classroom have not yet reached these developmental milestones. The differences between the oldest and the youngest child in a class can be substantial. If children are being evaluated for ADHD, it is crucial that their behavior be compared to that of other children their age and not of other children in their classroom.  
 
If you or a loved one has a mental disability and has been arrested or convicted of a crime, you need an experienced criminal defense attorney on your side. Elizabeth Kelley specializes in representing individuals with mental illnesses. To schedule a consultation call (509) 991-7058.

​Increasingly, law enforcement has become the first line of contact for people with serious mental illness and up to 10% of police calls involve someone with mental illness. A recent report found that people with mental illness were 16 times more likely than others to be killed in a police encounter. According to the report, about one in four fatal police encounters involve someone with a mental illness. 
 
In April of 2018, New York City police officers shot and killed a man in Brooklyn who was known to be mentally ill after he pointed a metal pipe at officers. That same month, a 36 year old woman with mental illness in Georgia was shot by police after her family called 911 for help with her delusions. In 2016, Boston police officers shot and killed a mentally ill man who attacked emergency medical technicians who were called by his mother.  These events happen on a regular basis but are not always reported in the media. 
 
Lack of Police Training
 
Despite the fact that law enforcement officers are on the front lines of dealing with mental illness, many of them lack sufficient training on how to deal with people with mental disabilities. There is a severe lack of training in how to cope with and safely interact with an individual suffering from a mental health crisis. Training that assists officers in identifying individuals with a mental disability and how to handle them could go a long way toward reducing violent police encounters. 
 
In many cases police officers receive the opposite of the type of training they should be receiving. The tactics used by police can sometimes escalate a situation when an individual is in the midst of a mental health crisis. Someone in a crisis may react more violently and officers should be trained on how to safely approach an individual and bring down the situation. People with mental illness don’t always exhibit obvious symptoms so police officers should be trained to recognize the signs of a crisis that are not always easy to detect. 
 
Lack of Treatment
 
The lack of mental health treatment in many communities has turned the mental health crisis into a police matter rather than a public health situation. An increase in quality mental health care would clearly lead to a decrease in the number of police encounters in the first place. 
 
If you or a loved one has a mental disability and has been arrested or convicted of a crime, you need an experienced criminal defense attorney on your side. Elizabeth Kelley specializes in representing individuals with mental illnesses. To schedule a consultation call (509) 991-7058.

​In 2018, California’s chief prison psychiatrist released a scathing 161-page report on mental health care in the state’s prisons. The report indicates that state officials are misrepresenting the care received by inmates with mental disabilities and are putting the health of these inmates at risk. In the report, Dr. Michael Golden states that inmates are not receiving the psychiatric care they need. 
 
Central Problem
 
One of the central problems the report focuses on is the lack of physicians in the prison system. Inmates may receive treatment from psychologists and other non-physicians rather than psychiatrists who are medical doctors. This means that medications are being managed and other crucial decisions about mental health care are being made by individuals without medical degrees. Shockingly, in some cases medical decisions by doctors are being overridden.
 
There is also a problem with accurate reporting of information to the courts and the public. For instance, the report alleges that the prisons mischaracterize the rate at which inmates are seen by psychiatrists and that fewer than 50% of inmates are seen in a timely manner. Some inmates are not receiving regular psychiatric treatment due to prison transfers. Other inmates are not receiving their treatment or doctor visits in a confidential environment, which can be a key factor in appropriate treatment. Without proper reporting of important information, the problem can’t be fixed.
 
Inmate Treatment
 
The report makes serious allegations about how mentally ill inmates are treated. The report refers to a specific incident involving an inmate with psychosis who was not given her medication and ripped out her own eyeball and ate it. The inmate had been placed on suicide watch and had been screaming for hours prior to the event. The psychiatrist on call was not contacted and the inmate did not receive her medications for four hours prior to the incident.
 
The California Department of Corrections and Rehabilitation (CDCR) denies the allegations in the report and made a statement indicating that they’ve made strides to improve the treatment of inmates with mental illness in their facilities. 
 
If you or a loved one has a mental disability and has been arrested or convicted of a crime, you need an experienced criminal defense attorney on your side. Elizabeth Kelley specializes in representing individuals with mental illnesses. To schedule a consultation call (509) 991-7058.

​Studieshave found that women are more likely to be diagnosed with a mental illness than men. This is particularly true in the case of common mental illnesses such as depression and anxiety. Depression is twice as common in women and is the number one mental health problem suffered by women. Women are also twice as likely to be diagnosed with post-traumatic stress disorder. But what are the reasons for the higher rate of diagnosis?
 
Gender Bias in Treatment
 
While women are more likely to get a diagnosis of mental illness, they are also less likely to have their symptoms taken seriously. Women are often discredited by health care providers and their symptoms thought to be exaggerated. While labels such as “hysterical” are no longer used to refer to women with mental health issues, there is still a bias in treatment. In addition, some women are diagnosed with mental illness even when their symptoms are physical. Serious health conditions such as autoimmune disorders are sometimes diagnosed by biased health care providers as anxiety or depression. 
 
Women More Likely to Suffer Trauma and Discrimination
 
Trauma is more common among women. One in four women has faced a completed or attempted sexual assault and one in three report being abused by a domestic partner. Trauma is a risk factor for a number of mental health issues including depression and post-traumatic stress disorder. The challenges of facing gender discrimination and mistreatment of women can also be factors in undermining a woman’s mental health. In addition the expectations placed on women to do more than their fair share of housework and childcare can lead to stress which is another risk factor for mental illness. 
 
Women More Likely to Report Symptoms and Seek Help
 
Unfortunately, men are socialized not to share their emotions and to view mental health challenges as a form of weakness. Men are less likely to seek help for their mental health issues and this can result in a lower rate of mental illness diagnosis. Women are more likely to seek help when they are suffering.
 
If you or a loved one has a mental disability and has been arrested or convicted of a crime, you need an experienced criminal defense attorney on your side. Elizabeth Kelley specializes in representing individuals with mental illnesses. To schedule a consultation call (509) 991-7058.

​A new survey of parents estimates that 1 in 40 children in the United States has autism spectrum disorder. The study was published in the December 2018 issue of the Journal Pediatrics. This number means that the condition was reported in 2.5% of children which amounts to approximately 1.5 million children between the ages of 3 and 17. A previous report estimated the prevalence at 1 in 59 children based on 2014 data, meaning there has been an increase in cases.
 
The more recent study collected data from the National Survey of Children’s Health which surveyed the parents of more than 50,000 children between the ages of 3 and 17. Only children who received a diagnosis of autism spectrum disorder were included in the estimate. The numbers are based on parent reporting and not on health or scientific data. Because there is no biological test for autism spectrum disorder, it can be difficult to track.
 
Access to Care
 
In addition to a higher prevalence of autism spectrum disorder, parents in the survey were also asked various questions regarding the health of their children. Parents who reported that their child was diagnosed with autism spectrum disorder were 44% more likely to report problems obtaining treatment for their child and were 24% less likely to receive help with care coordination than those families dealing with comparable such as ADHD and Down Syndrome. The parents of children with autism spectrum disorder were also 23% more likely to report that they didn’t have a designated team of caregivers for their children. 
 
While there has been some improvement over other surveys, it is clear that there are delays in getting a diagnostic evaluation even after signs of autism have been recognized. There is an urgent need for early diagnosis of the condition and follow up treatment, especially in lower income areas. Developmental and behavioral interventions can be helpful for children with autism spectrum disorder, parents need training and support to help their children succeed. 
 
If you or a loved one has a mental disability and has been arrested or convicted of a crime, you need an experienced criminal defense attorney on your side. Elizabeth Kelley specializes in representing individuals with mental illnesses. To schedule a consultation call (509) 991-7058.

​In a past case involving a death row prisoner named Bobby Moore, the U.S. Supreme Court found that Texas’s framework for determining whether a prisoner had an intellectual disability, and was therefore not subject to execution, violated the Eighth Amendment. The Texas courts had relied on non-clinical criteria when determining whether Mr. Moore was intellectually disabled and the Supreme Court ruled that medical standards should be used. The Supreme Court’s majority decision noted that Mr. Moore had serious mental and social difficulties beginning in childhood that were not taken into account by the lower court.
 
If things had gone as they should, the Texas courts should have then applied the standard set out by the Supreme Court and found that Mr. Moore was intellectually disabled and not subject to execution. However, that’s not how things are working out in Texas.
 
Texas Pursues the Case
 
After the Supreme Court decision, the Harris County prosecutors changed their tune and asked for a life sentence, agreeing that Bobby Moore was intellectually disabled and should not be executed. The Texas Court of Criminal Appeals, supposedly applying a new standard, still determined that Mr. Moore was not intellectually disabled and could still be executed. Mr. Moore, who was convicted in 1980 for his part in the killing of a man during a botched robbery attempt, has been appealing his death sentence for decades. In October, Mr. Moore’s legal team once again appealed to the Supreme Court. After the prosecutors made the rare step of siding with the defense, the Texas Attorney General’s Office asked to take over, stating the prosecutors don’t represent the entire state of Texas.
 
A group of conservatives, prominent lawyers, and former deputy attorney generals have jumped into the case and filed a 24-page amicus brief criticizing the Texas Court of Criminal Appeals for disregarding the Supreme Court and noting that Mr. Moore is clearly intellectually disabled. It is unclear whether the Supreme Court will take up the case and reverse Texas's ruling.
 
If you or a loved one has a mental disability and has been arrested or convicted of a crime, you need an experienced criminal defense attorney on your side. Elizabeth Kelley specializes in representing individuals with mental illnesses. To schedule a consultation call (509) 991-7058.

​According to the Oregon Attorney General, the number of people deemed “criminally insane” and who then went on to commit new crimes was too high. Oregon law places those deemed “criminally insane” into the hands of the state Psychiatric Security Review Board for a set time not to exceed the maximum sentence for the crime. The board is required to release people who are no longer considered dangerous because of a mental disorder or no longer have a mental disorder. Only about a quarter of those released are found to no longer be dangerous by a medical professional. 
 
High Recidivism Rates
 
A Malheur Enterprise-ProPublica analysiscalculated recidivism rates based on outcomes found in the Psychiatric Security Review Board records. The analysis found that 35% of people who were released from psychiatric supervision were charged with a crime again within three years. Most often they were back in a court in less than a year. Many were found to be homeless after leaving state supervision, despite the fact that securing housing is supposed to be a priority. The analysis determined that Oregon released people found not guilty by reason of insanity quicker than nearly every other state in the nation. The state board and not a team of mental health care professionals make the determination that someone is fit to be released. 
 
Solutions
 
Oregon officials are looking to extend the time that people are kept under the supervision of the Psychiatric Security Review Board to allow more time for people to receive the correct treatment. However, there may be other solutions that could mitigate the problem. The state should ensure that the treatment given to those under state supervision is of high quality and effective. Increased funding of mental health treatment programs and other assistance, once people are released from supervision, could go a long way toward improving outcomes. In addition, looking at the criminal justice system as a whole, increasing funding for housing and community mental health programs could help prevent the problem before it even begins. Involving mental health professionals in the decision-making process when it comes to releasing someone from supervision is also important. 
 
If you or a loved one has a mental disability and has been arrested or convicted of a crime, you need an experienced criminal defense attorney on your side. Elizabeth Kelley specializes in representing individuals with mental illnesses. To schedule a consultation call (509) 991-7058.

​A federal judge made a finding that the Illinois Department of Corrections (IDOC) has failed to meet the needs of its mentally ill prison population. Close to a third of the state's inmates is thought to have a mental illness, so it is critical that they receive the necessary care and attention while they are incarcerated.
 
2016 Settlement
 
After a lawsuit was filed in 2007 by former IDOC inmates, the state entered into a settlement agreement in 2016. As part of the settlement, the state was required to meet 25 requirements with regard to its treatment of inmates with mental illness. According to a monitor, the state failed to meet 18 of these 25 requirements. While there has been some important progress, the state is clearly not holding up its end of the bargain when it comes to improving care for inmates. 
 
One of the important issues that were brought to light was the need for adequate staffing. As part of the settlement, IDOC was required to hire a significant number of mental health personnel to provide better services to the inmates. IDOC failed to do so meaning that many inmates with mental illness were not receiving the proper oversight and care. IDOC has faced challenges in hiring adequate staff to work in the prison system. The state is currently short on the 65 psychiatrists it was required to hire and cites challenges in recruitment and retention as a source of the problem. 
 
IDOC has also faced problems with medication management, ensuring timely evaluations and treatment plans, and putting plans in place to deal with inmates in crisis. The judge found that a lack of proper monitoring of psychotropic medication created a dangerous situation for the inmates. He also found that mentally ill inmates in segregation fare worse than those in the general population. While IDOC has taken some steps, it is clear that further improvements are essential. 
 
Treatment of Inmates with Mental Illness
 
This ruling by a federal judge comes months after an incident involving an IDOC inmate named Larry Earvin. Mr. Earvin, who had schizophrenia and bipolar disorder, died weeks after an altercation with prison guards. Mr. Earvin died from blunt abdominal trauma, and an investigation into the incident is ongoing. IDOC had a responsibility to ensure, not only that their employees acted appropriately, but that Mr. Earvin received all necessary treatment for his mental health conditions.  
 
If you or a loved one has a mental disability and has been arrested or convicted of a crime, you need an experienced criminal defense attorney on your side. Elizabeth Kelley specializes in representing individuals with mental illnesses. To schedule a consultation call (509) 991-7058.