Mental Health Association in New York State, Inc.
(Publication Archives)

Friday Fax from Albany

UPDATE ON TIMOTHY’S LAW: Shortly, we will be sending all MHA affiliates an update on Timothy’s Law Campaign’s plan of action and how MHAs can help in moving Timothy’s Law closer to enactment.

A brief synopsis of the plan includes:

• Information regarding the rally on November 18th (flyer follows)
• Disseminating materials related to the rally with interested parties
• Working with local representatives and county Chairs to garner support
• Working with your board of directors and others in the community to find small businesses that support Timothy’s Law.

UPDATE ON $7.7 MILLION CUT: We are appreciative of the MHA’s that have sent us material about the impact of the mental health budget cuts included in the Governor’s vetoes in August. Driven by the data we have received, these cuts will greatly impact programming for many of our members and the consumers they serve. According to several MHAs that have responded, there are potentially thousands of people that will be impacted by these cuts.

We will be meeting with members of the legislature, but we urge you to press your case at the local level as well. We urge you to meet with your local Senator and ask that they restore the $7.7 million dollar cut to mental health that was vetoed by the Governor. Point out the programs in your area that will be hurt by the cut with an estimate of the number of people who will be impacted. Any specific examples would be very helpful to bring to their attention. With all the state Senators up for re-election, now would be a very effective time to meet with them and get commitments to override the vetoes.

Next week, we will be providing you with additional details regarding our statewide strategy.

UPDATE ON SPEAK: As many of you are probably familiar with, OMH has put out a very impressive tool kit about Suicide Prevention entitled SPEAK (Suicide Prevention Education Awareness Kit). Information is available at the OMH website.

The specific sections listed in the website are:

Suicide: Questions and Answers
Men and Depression
Older Adults: Depression and Suicide
Teens: Depression and Suicide
Women and Depression

Many of the affiliates that I have met or spoken to already have suicide prevention programs in place or run programs related to these issue areas including depression among older adults. Please note that Michael Friedman, Director for the Center for Policy and Advocacy of the MHAs of NYC, Westchester and Nassau, recently wrote a paper on depression among geriatrics that was published in Mental Health News. A copy of that article follows.

MHA’s throughout the state have led the way in this area and we will provide any help we can to assist in sharing and dissemination of this vital information. To that end, we have requested copies of the tool kits and will be sending one to each affiliate as soon as they are available from OMH.

We are very appreciative of the wonderful work of Commissioner Carpinello and her staff in developing and sharing this material with the general public.

UPDATE ON MENTAL HEALTH VOTER EMPOWERMENT: Any individual interested in voting must be registered by October 8th. Last week, we were set up at the NYAPRS conference and had hundreds of people ask for information. Close to 100 individuals with psychiatric disabilities took the time to register to vote at the conference. We would like to thank Harvey Rosenthal, Executive Director of NYAPRS, for providing MHANYS with a Mental Health Voter Empowerment table at the NYAPRS conference.

CONCLUSION: After having visited several MHA’s in the past few weeks, I have witnessed a great combination of terrific programs run by very talented staff. However, what has most impressed me is the MHA vision of recovery for recipients that is evident in all the programs I’ve had the opportunity to observe so far.

At the state level, we will continue to advocate for these programs do whatever we can to promote and highlight the variety of quality programs provided by the MHA’s.

Please contact me at gliebman@mha.org with any questions or concerns.

RALLY FOR TIMOTHY’S LAW

NOVEMBER 18, 2004
1:00 Gathering at NYS Museum
1:30 Rally at NYS Capitol

Additional information at:1-888-326-8644 and
http://www.mhanys.org/timothyslaw/index.htm

OR

Join Timothy’s Team for email updates –
http://mail.kilakwa.net/mailman/listinfo/timothysteam_kilakwa.net

PREPARING FOR THE ELDER BOOM. By Michael B. Friedman, CSW

The mental health system, which currently does not serve most older adults with mental illnesses at all let alone serve them well, is in no way ready for the elder boom, which will hit in force beginning in 2011. Perhaps it’s not surprising that there has been so little preparation despite more than a decade of warnings. The big hit will come outside the ordinary five-year planning horizon. But the boom will be so large and will require such extensive restructuring, as well as growth, that preparation cannot responsibly be put off longer.

Here are the facts.

• From 2000 to 2030 the population 65 or over in the United States will grow from 35 million to 70 million and from roughly 13% of Americans to 20%.
• From 2010 to 2020 the growth will be 35%, from approximately 40 million to 54 million.
• Based on current prevalence estimates, from 2000 to 2030 the number of older adults with mental illnesses will grow from approximately 7 million to approximately 14 million.
• Between 2010 and 2020 alone the number of older adults with mental illnesses will grow from approximately 8 million to approximately 11 million.
• During these same periods there will also be a significant increase in the proportion of minority older adults in the United States, rising from 16.5% of the elderly population in 2000 to 25.6% in 2030.

Of course, older adults with mental illnesses are a diverse population. Anxiety and mood disorders are the most prevalent mental illnesses. Dementia becomes increasingly common as people age. Schizophrenia may occur less frequently among older adults than younger adults. In addition, older adults with mental illnesses exhibit a wide range of abilities and disabilities. Some work, have significant personal relationships, and participate in community activities. Some are unable to manage without substantial supports and/or are extremely isolated.

Despite the heterogeneity of the population, there are a number of common issues affecting virtually all older adults with mental illnesses.

• There is a vast shortage of mental health professionals with expertise serving older adults.
• Funding for mental health services is inadequate and discriminatory. For example Medicare reimburses less for mental illnesses than physical illnesses, does not cover prescription drugs, pays for very limited home-based services, and does not cover the kinds of outreach and “wraparound” services that are vital to many people with severe psychiatric disabilities.
• The current service system is, for the most part, structured and financed in ways which assume that people are able to leave home to go for services in specialized settings despite the fact that virtually all providers and researchers report a widespread need for mobile services.
• Most older adults with mental illnesses also have chronic physical illnesses. In part this reflects the fact that older adults are more likely to have chronic illnesses, but in part it reflects an apparent correlation between mental and physical illness. An adequate system must, therefore, address issues of co-morbidity.
• For all older adults activity and social involvement appear to be essential to maintaining and/or improving mental health. It is, therefore, critical to promote access to the social mainstream and to integrate mental health services with services provided through the “aging” system.
• Families increasingly regard institutions for older adults as an undesirable last resort. Therefore, in addition to improving services in institutions, it is essential to conceptualize and create community-based support systems for older adults who need them.
• Because families provide most of the supports which older, disabled adults need, it is critical to address the needs of family caregivers as well as the needs of those for whom they provide care.
• The rise in the numbers of minority older adults makes it more and more important to develop culturally competent services.
• Research has not yet produced ultimate insights or cures for mental illnesses among older adults. More research is critical.

These are not easy issues to address, and they cannot be addressed without substantial shifts in the way in which we think about the provision of mental health services. It is not just a matter of doing more; it requires doing things differently. It requires understanding that the needs of older adults are as different from those of adults as adult needs are from children’s needs.

So it is not as simple as training a large number of geriatric mental health professionals, pressing for more funding to expand services, and expanding research. Finance, research, and the development of a well-trained, highly skilled workforce are all essential of course, but it will also be essential:

• to craft a new vision of service and support, a vision which weaves together the clinical, the rehabilitative, the medical, the social, and the familial,
• to address the fissures in the current structure of serving older adults and to bring together mental health, health, and aging systems

Given the magnitude of other issues confronting the mental health system, it is easy to understand why little work has been done to begin to shape a system of care of older adults with mental health problems. But the march of demography is ineluctable. We must act now or face a vast crisis in the not too distant future.

(Michael B. Friedman is the Director of the Center for Policy and Advocacy of The Mental Health Associations of NYC and of Westchester. The Center has recently begun a project to advocate for improved geriatric mental health policy. For further information e-mail Mr. Friedman at center@mhaofnyc.org.)

In the News:

MHANYS names Liebman executive director. By Matt Peppe
Legislative Gazette, September 27, 2004

Glenn Liebman, who has experience advocating for mental health and working in state government, took over as CEO and executive director of Mental Health Association in New York State in August.

For 18 months prior to his arrival at MHANYS, Liebman was director of adult home initiatives at the New York State Department of Health.

The mission for MHANYS is advocating for issues important to recipients of mental health services as well as educating the public about mental health and the many stigmas attached to it.

“There is the stereotype of someone who is mentally ill as a knife-wielding crazy person, when it reality it is not like that,” Liebman said.

MHANYS hopes to create a public awareness campaign to counter popular stigmas. They hope to add an income tax “check off” for contributions to a mental health awareness campaign. A “check off” is already possible for contributions to other government programs.

Another main issue for MHANYS is the passage of Timothy’s Law. This law would put insurance coverage for mental health illnesses and chemical dependency on par with those received for other illnesses like diabetes or high blood pressure.

The Assembly has passed Timothy’s Law, and MHANYS remains committed to working with the Senate to pass the law.

Michael Seereiter, director of public policy for MHANYS, says the version of the parity bill now in place is not sufficient. “It is a step in the right direction,” Seereiter said, “but the law does not go far enough to bear Timothy’s name.”

Timothy O’Clair, the boy the law is named after, was 12 years old when he committed suicide in 2001, after battling mental illness his whole life.

MHANYS is working in coalition with the Timothy’s Law campaign to promote passage of the Timothy’s Law bill.

Liebman has also worked as program director for Kendra’s Law at the Office of Mental Health. Kendra’s Law, passed in 1999, provides outpatient treatment for certain people with mental illnesses who need supervision while living in communities.

In 1994, Liebman’s first year working in advocacy, the Reinvestment Bill was passed in the New York State Legislature. The Reinvestment Act facilitated the movement of people with mental illnesses from institutionalized settings to communities.

The bill changed the whole structure of mental health services. The Reinvestment Act provided that when a mental health patient left a psychiatric hospital, the money from the empty bed would go towards assimilating a patient into a community. This could be spent in the form of case management, day treatment, or community residence programs for the recipients of services.

The Reinvestment Act also allowed families of people with mental illnesses to participate in deciding how these programs worked.

In 1950 the number of people in New York State institutionalized for mental illness was 95,000. Today that number is just over 4,000.

Liebman says his experience working to advocate an issue, as well as working for the state to form policy, has been very important for him. “It showed me how coalitions could work together toward accomplishing a single goal,” Liebman said. “I also understand some of the institutional obstacles people in the state system face that are nobody’s fault.”

MHANYS is a statewide, voluntary non-profit association with 33 local affiliates. They work with health service recipients, families, professionals, and advocates to address all aspects of mental health and mental illness.

Liebman says that Pataki’s vetoes of $4.5 million in Medicaid aid to localities will hurt many of MHANYS’ member agencies.

“The cuts will seriously impact the services that our affiliates will be able to provide,” Liebman said. He said MHANYS will work hard with the Legislature and other mental health agencies to get an override of Pataki’s cuts.

A Long Island native, Liebman has bachelors and masters degrees in Political Science from SUNY at Albany, and has lived in the area for more than 20 years.

Child mental health unit to reopen. By Ryan Deuel
Binghamton Press & Sun Bulletin, September 28, 2004

14-bed center planned for late 2005

BINGHAMTON - It was seven years ago that Casey Truillo of Port Dickinson first took her 7-year-old son, Lawrence, to the hospital for mental health treatment. Because no facility in the Southern Tier offered in-patient mental health for children and adolescents, Truillo had to drive 90 minutes to Syracuse.

A month later she had to drive to Buffalo, and later to Schenectady.

"I can't even describe the trauma of having a 7-year-old child being hospitalized in a psychiatric facility," said Truillo, a mother of four. "We were lucky. We were able to stay at the Ronald McDonald House in Buffalo. But most of the time we haven't been able to stay anywhere, and we'd have to drive back to Binghamton at 3 o'clock in the morning."

But that will finally change.

A $2.75 million, 14-bed child and adolescent in-patient unit will be created at the Greater Binghamton Health Center, state officials announced Monday. The facility is on Robinson Street on Binghamton's eastern edge.

"In 1991, many of us got the bad news the state decided to close the child and adolescent center at the Binghamton Psychiatric Center" because of consolidation throughout the state, said state Sen Thomas W. Libous, chairman of the Senate Mental Health Committee. "I had the opportunity to speak with parents throughout the state and community. And I became more aware that the fact the in-patient unit had closed was a mistake and we needed to changed that."

Libous, R-Binghamton, was joined at a press conference announcing the project by New York Mental Health Commissioner Sharon E. Carpinello, Broome County Executive Jeffrey P. Kraham and Binghamton Mayor Richard A. Bucci.

Using state money secured by Libous and Carpinello, the 14-bed unit will be in Hecox Hall, which will be renovated. The unit is scheduled for completion in December 2005. A spokesperson for Libous' office said a staffing plan had not yet been completed; it is unknown how many jobs will be created.

The state also plans to create a hospitality house for families visiting the area, Carpinello said.

"It's best when families are full participants in all aspects of service planning and delivery," Carpinello said. "The hospitality house will enable parents who live out of the immediate Binghamton area to become full partners in their child's treatment."

The cost of the hospitality house is undetermined.

Jacqueline and Richard Sands said they approached Libous about the need for improved mental-health treatment facilities for children after an emergency four years ago involving an adolescent in their family. The child was wrongly diagnosed with bipolar disorder and was so highly medicated he nearly overdosed on medication.

"He became suicidal," Jackie Sands said. "We feared for his life."

The Sands took the child to Hutchings Psychiatric Center in Syracuse, where he was treated at the in-patient children's unit for three months. They traveled to and from Syracuse three or four times a week.

"We could take the time from work and drive to Syracuse," she said. "Other parents couldn't make it there all the time. And during visiting hours, children would just cry because no one was there for them."

Statistics show an increasing need for mental health treatment in the community.

During a crisis, youths may be taken to the Comprehensive Psychiatric Emergency Program (CPEP) at Binghamton General Hospital. Last year, CPEP saw 1,076 youths under 18 years old, said Linda Daly, nurse manager for CPEP. That's up from 772 in 1998.

But if a child needs in-patient care, CPEP must send them elsewhere. Last year, the hospital admitted 273 youths to other facilities statewide, Daly said. That's up from 140 in 1998 and 247 in 2002.

"We don't have any facilities here," she said of the hospital. "What determines where they go depends on a number of variables, including their condition, bed availability and what insurance dictates. We're hopeful a facility reopens here soon. But it's too early to tell how the process of referral will work."

For Truillo, the combination of the new unit and the hospitality house will ease her concerns of having to travel around the state. But she also hopes the unit will help increase mental health treatment for area youths.

"We have such a shortage in this area of child psychiatrists," she said, "I'm hoping this unit will attract more doctors and it will help increase capacity to help treat children with mental health needs as outpatients as well."

Until next time, we remain,
Working to ensure available and accessible
mental health services for all New Yorkers