
No Country for Old Men with a plot twist ✝️ @p82home • serving families affected by serious mental illness with @GeeslingMatthew • cowboy fast-draw
Phoenix, AZ
Joined December 2020
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A THREAD 🧵 HOW DID WE GET HERE?
The day Decarlos Brown Jr. crossed paths with Iryna Zarutska on a NC light rail train ended in tragedy. Minutes later she was dead.
This was not an isolated event. It was the outcome of decades of broken policy on serious mental illness.
The IMD Exclusion is one of the quietest rules in Medicaid law yet it has fueled homelessness, incarceration & tragedy for decades. This thread traces how we got here & why it must end.
Psalm 37:1-2
Fret not yourself because of evildoers;
be not envious of wrongdoers!
For they will soon fade like the grass
and wither like the green herb.
Deborah Geesling retweeted
In 1992, Congress created the Community Mental Health Block Grant and barred states from using the funds for inpatient care.
That prohibition remains in force today. 42 U.S. Code § 300x-5, Restrictions on use of payments: the state “will not expend the grant to provide inpatient services.”
As a result, states are prohibited from using these federal dollars for the inpatient psychiatric treatment many people with serious mental illness need.
Deborah Geesling retweeted
I don't have time to engage this conversation other than to quote the ever wise Flannery O'Connor:
"I believe that there are many rough beasts now slouching toward Bethlehem to be born and that I have reported the progress of a few of them, and when I see these stories described as horror stories I am always amused because the reviewer always has hold of the wrong horror.”
How should Christians approach Halloween?
Christians tend to fall into four different camps when it comes to participating in Halloween:
- Total abstinence
- Full participation
- Partial participation
- Redemptive participation
Some abstain from Halloween altogether. Others fully participate in the festivities, while some enjoy the family fun without participating in the glorification of evil.
I believe the better alternative is redemptive participation.
My mom has set this example for me for years. She uses Halloween as an opportunity to share the gospel by attaching Bible verses to candy, making Scripture signs for her front lawn, and sharing the love of Jesus with the families who come to her door.
As she says, “What other time of year do you have people coming to your home and asking you for something? This is like the easiest evangelism opportunity possible.”
A night associated with darkness can actually be an opportunity to shine the light of Christ.
Bed capacity at the Arizona State Hospital is not the only issue. In this final episode Dr. Olson explains how even the place of last resort refuses to take the most seriously mentally ill.
Watch part 4 of my interview: youtu.be/vSADt4zj5B0?si=P2nR…
Deborah Geesling retweeted
This is incredibly useful because a constant refrain from many mental health industry advocates, who are constantly pushing their services toward younger and younger kids, is that “half of all mental health conditions develop by the age of 14.” That is totally misleading.
Because (1) it’s not true, (2) the younger-age diagnoses are generally more mild conditions and forms of conditions that don’t necessarily improve with or require treatment—not the serious nor functionally impairing mental illnesses, and (3) its suggests that efforts to prevent mental illness “upstream” work, when they’re really WILDLY limited: we don’t know the causes of mental illnesses so we can’t prevent them.
We’ve been pumping kids full of therapy speak, therapy itself, and pills. None of it is going to prevent mental illnesses from developing among those who will go on to develop one, and for the vast majority who will never go on to develop of a serious mental illness—statistically, between ~94-96% of kids—they’re being exposed unnecessarily to treatments and interventions that could put them at greater risk of harm than potential benefit.
And since so much of youth mental health care is low-quality and doesn’t meet best clinical practices, kids are even more exposed to potential harm than they’d be otherwise.
Mental healthcare is important and can be useful. But youth mental healthcare should be pursued/ delivered judiciously and thoughtfully.
My final interview with Dr. Carol Olson, which in my opinion shows how dire the situation is for the severely mentally ill. Not to be dramatic, but sitting in many stakeholder meetings learning these things, my hair would literally stand on end. We can’t be neutral on this; we have to act.
open.substack.com/pub/debora…
Deborah Geesling retweeted
We now have an in person caregiver support group for families affected by serious mental illness in North Phoenix hosted by Shiloh Community Church. Join them on the first and third Monday of every month!
shilohcommunity.com/caregive…
Deborah Geesling retweeted
Really very interesting article about the reduction of schizophrenic episodes for those who have diabetes and are treated with GLP1s vs other current diabetic medication. Objective evidence and I suspect more to come.
GLP-1s associated with reduced need for acute psychiatric care for people with schizophrenia and type 2 diabetes, study of US data suggests.
Find out more in The Lancet Psychiatry: spkl.io/60197X6Uc

ALT Research in context panel for a paper published in The Lancet Psychiatry, entitled \"GLP-1 receptor agonist initiation and risk of psychiatric hospitalisation and emergency department presentation in adults with schizophrenia and type 2 diabetes in the USA: an observational cohort study using electronic health records data\".
Episode 4 is up. Our final conversation hones in on the IMD Exclusion and the Arizona State Hospital. youtu.be/vSADt4zj5B0?si=gJLd…
This weekend, my husband and I were graciously invited to the Courage Awards event hosted by @InstituteCicero in Austin, where they honor lawmakers making a difference. Impressed by Cicero’s work, I met @dkurtzz, who is passionate about helping the seriously mentally ill. What impresses me most, aside from his intellect, is his willingness to listen and learn, something rare these days. I took few pictures but will remember the many conversations with caring people.
Families need to know that someone they love will be treated with dignity, protected from abuse, and given the care they need. Those are reasonable things to ask.
I appreciated Dr. Carol Olson’s conviction that we can build a humane system with real accountability. There is so much work ahead, but hearing her speak about what is possible encouraged me.
Later today, in Episode 4, I ask her where she would begin. I hope you’ll join us.
If you haven't listend to episodes 1-3 of my conversation with Dr. Olson, Chair at Valleywise Health, catch up here: youtu.be/wipQH-PYvek
I post pictures of myself with my son, but my husband is the one who my son looks up too. Dads have the biggest impact by protecting their wives from doing too much for their SMI kids while offering patient guidance and understanding. It’s not easy, and he would be first to say he’s not perfect. But he’s here, that’s not often the case for families affected by disabilities like this. Thank you @GeeslingMatthew
Deborah Geesling retweeted
Milton Friedman on why politicians love Keynesian economics:
“The theory [of pump priming] was a godsend to politicians who had been grasping at any expedient. Throughout the ages, politicians have been only too willing to spend money.”
“Here along came a scientific theory offered under the most responsible of auspices that justified what they had been wanting to do all along. Is it any wonder that government spending has exploded ever since?”
In this conversation, I asked Dr. Carol Olson a difficult question: What does it actually look like when someone is too ill to be safe outside a hospital?
We need to understand this without losing sight of the person who is sick and frightened. We also need to understand what can happen when appropriate treatment is unavailable and the next intervention comes from the criminal justice system.
Her answer deserves more than a short clip. In Episode 3, we talk about the care some people need and why acknowledging that matters for their dignity and safety.
youtu.be/wipQH-PYvek?si=648_…
Deborah Geesling retweeted
Mao’s style cultural revolution is happening in the west. The historic Limoges town hall has just completely collapsed after far-left rioters set it on fire.
It was built in 1876. It survived World Wars. It did not survive modern France.
Deborah Geesling retweeted
“Our failure to protect such mentally ill people by insuring they receive treatment is a major miscarriage of our mental health care system and a blot on our claims to be civilized.”
— E. Fuller Torrey, American Psychosis
Our nation is failing the seriously mentally and their families, and in this case, the public.
Michelle DeWitt took her son to a mental health hospital after he became violent at home. Doctors had diagnosed him with schizophrenia and prescribed medication, which he refused to take.
The hospital told her they didn’t have enough room to admit him and, because he wasn’t threatening to hurt himself, they couldn’t take him.
“You can’t make a person come,” they said.
She later obtained a court order. He was held for 14 days, then released. He stopped medication, became homeless, and fatally stabbed Iryna Zarutska on a Charlotte light rail train.
The system is broken when it denies the ability to institutionalize someone who is violent and psychotic.
Deborah Geesling retweeted
In 1992, Congress passed the ADAMHA Reorganization Act. President George H.W. Bush signed it into law. It created the Community Mental Health Block Grant, and barred states from using the funds for inpatient care.
That prohibition remains in force today. 42 U.S.C. § 300x-5: the state “will not expend the grant to provide inpatient services.”
As a result, states are prohibited from using these federal dollars for the inpatient psychiatric treatment many people with serious mental illness need.
The program sends states more than $1 billion a year.
“Our failure to protect such mentally ill people by insuring they receive treatment is a major miscarriage of our mental health care system and a blot on our claims to be civilized.”
— E. Fuller Torrey, American Psychosis





















