​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.