Mental
Health Association in New York State, Inc. |
Friday Fax from Albany
KATRINA: We are all deeply moved by the images and stories coming from the Gulf Coast in the aftermath of Hurricane Katrina. In this time of need, we are keeping those affected by the hurricane and subsequent flooding in our thoughts and minds and want to provide those who wish to do more with information on how they may do so. MHANYS has been in touch with NMHA regarding the specific impact to the MHAs in the states that have been directly affected by the hurricane and flooding. The MHA in Louisiana is operational, however, the MHA of Metropolitan New Orleans has been destroyed. The MHA of Mississippi, which is located in Biloxi, is non-operational though NMHA has been in contact with their director. The MHA in Alabama is operational. The MHA of NYC has had 2 people at the scene since Saturday, the Director of the 9/11 Mental Health and Substance Abuse Program and an individual from MHA of NYC’s National Suicide Hotline, and 1-800-LIFENET (MHA of NYC’s 24/7 hotline) workers will also be heading to the Gulf Coast. We understand that the United Way is in need of volunteers to answer phones in the 211 centers of Houston and Austin, TX and Monroe, LA. Interested volunteers can contact trisha.ferrell@uwa.unitedway.org. NMHA has dedicated a portion of their website - www.nmha.org/katrina - exclusively to respond to the needs of impacted communities and address the tremendous psychological implications of this disaster. Included in NMHA’s actions is the resurrection of the Mental Health Crisis Response Fund, initially established in 2001 to provide immediate and long-term mental health support in the wake of September 11. Additional information is available on the website or by calling 1-800-969-NMHA (6642). In addition, NMHA also recommends that individuals interested in providing hands-on and/or financial assistance utilize the U.S. Department of Health and Human Services’ website - http://www.os.dhhs.gov/katrina/index.html.
TOP TEN REASONS WHY NOT TO MISS THE MHANYS AWARDS DINNER AND CONFERENCE ON OCTOBER 20th and 21st AT THE MARRIOTT IN ALBANY: 1) Lunch keynote speakers on October 21 are the Spiro sisters, best selling authors of Divided Minds—the compelling story of two twin sisters—one a psychiatrist and the other an individual with schizophrenia. Their story has been featured in Good Morning America, People Magazine, Readers Digest, and other major media outlets throughout the country. 2) After the awards dinner on the evening of October 20th we will be showing the award winning documentary Out of the Shadow. On hand to talk about the documentary and the impact to the mental health system will be documentarian Susan Smiley. There is no cost to attend the film (8 P.M. on October 20th). 3) There will be national and state speakers providing the most up to date information on the impact of Medicare Part D to individuals who are dual eligible and have a mental illness ( 9 A.M. on October 21st). 4) Experts in the field of Juvenile Justice will be discussing the impact of the high percentage of mental illness among the juvenile justice population and innovation strategies to work with this population (2 P.M. on October 21st). 5) A state, county and provider panel will discuss the information learned from the seven counties identified in the first stage of PROS implementation. Get a progress report on those counties and a statewide update on the program. (10:30 on October 21st). 6) Come to the MHANYS Awards Dinner and celebrate the wonderful accomplishments of our membership (6 p.m. on October 20th). 7) Great opportunity to network with MHAs, other mental health advocacy groups, state officials, county leaders and other major stakeholders in the mental health community. 8) Cost of the conference is very affordable. Prices will be posted next week but we have kept cost down to insure a strong turnout. 9) Catch the beauty of upstate New York in late October—prime leaf viewing season. 10) Great opportunity to learn about important mental health issues in a warm and friendly atmosphere. We hope this helps convince you to attend! For more information, contact Lillian Lasher at (518) 434—0439, ext. 22 or at llasher@mhanys.org.
AND THEN THERE WERE 14…: Late last month, Oregon became the 36th state in the U.S. to enact legislation requiring health insurers to provide the same level of coverage for treatment of mental health and addiction needs as they offer for physical health services. Declaring that, “Today marks the day when we officially end discrimination in health benefits between mental and physical problems," Oregon Governor Ted Kulongoski signed the long awaited measure into law on August 21st. Along with Oregon, Washington, Iowa, and South Carolina also added their names to the list of states that have decided to end the discrimination faced by those with mental health and addiction needs in insurance coverage. Unfortunately, because Timothy’s Law was not enacted this year, this leaves New York as one of the dwindling minority of states that continue to condone such discrimination at the hands of insurers. New York shares this less-than-flattering spotlight with states like Alaska, Idaho, Wyoming, and with the hurricane ravaged states of Alabama and Mississippi. In the case of the last two states, one must wonder how people having difficulty dealing with the impact of a disaster like this will fare should they exhaust their limited benefits. Perhaps, as part of the recovery effort, Alabama and Mississippi will consider passing parity legislation to help those struggling with the effects of the hurricane treat any mental health need they may have so that they can then turn their attention to rebuilding. Or, perhaps Congress and the President will finally pass and sign the Senator Paul Wellstone Mental Health Equitable Treatment Act as part of their hurricane relief package to help all Americans struggling with mental health needs, especially those left in Katrina’s path, achieve recovery. Either way, New York must still enact Timothy’s Law.
NAMI HOLDS 23RD ANNUAL EDUCATIONAL CONFERENCE: NAMI's 23rd Annual Educational Conference, "Navigating in Rough Seas: Finding the Way to Recovery from Mental Illness" will be held at the Desmond Hotel and Conference Center in Albany, NY from Friday, October 28th through Sunday, October 30th, 2005. Friday's session will focus on creating a way to recovery through the criminal justice system, highlighting the use of solitary confinement, the insanity defense and services for the dually diagnosed. Saturday will feature a wide range of workshops and informational sessions that will be of great "navigational" help for persons with serious mental illness and their families. Other workshops will include information on Assisted Outpatient Treatment, specific illnesses and medications, legal issues, education and advocacy. Our Saturday night reception will include an outstanding keynote speaker, Dr. Jeffrey Lieberman, who serves as director of the New York State Psychiatric Institute, chairman of the Department of Psychiatry in the College of Physicians and Surgeons at Columbia University Medical Center, head of the Lieber Center for schizophrenia Research housed on the Columbia campus and psychiatrist-in-chief at New York Presbyterian Hospital. Dr. Sharon Carpinello, our New York State Commissioner of Mental Health, Senator Thomas Morahan and Assemblyman Peter Rivera, along with Dr. Robin Siegal, the director of the Albany County Department of Mental Health will be among those speaking on Sunday. This will be a chance to discuss the issues with "Albany" in Albany. For further information, please visit www.naminys.org or contact the NAMI NYS office at (518) 462-2000.
READY, SET, VOTE – CONFERENCE ON THE IMPLEMENTATION OF THE HELP AMERICA VOTE ACT: There are three conferences coming up on the implementation of the Help America Vote Act (HAVA). The
1st will be held in Potsdam, NY on September 27-28 at Clarkson University. Ready, Set, Vote will discuss the current status of the implementation of HAVA and include topics such as: the history of election reform, voter registration, voter rights, voter discrimination complaints, electoral/voting process, polling sites and accessibility status, conducting onsite assessments of polling sites, and an update on HAVA in NYS. Registrations can be made online at www.ccfi.us. Additional information is available by calling 1-888-NYSHAVA and asking for Helen or Cheryl. Or inquiries can be e-mailed to nyshava@ccfi.us.
PROS UPDATE: On August 26th, OMH held a meeting with the 7 county PROS providers and various advocacy groups and trade associations which focused largely on registration and billing issues. Among the highlights of the meeting were: 1) OMH continues their commitment to PROS and they estimate that they will have a few of the seven counties up and running by early November, with all seven counties up and running by January; 2) 11 PAR applications have been received and are currently being reviewed; 3) while draft regulations are also being reviewed, there was no official commitment on when the final regs will be issued (likely to be sometime this month or next); 4) OMH intends on reviewing the work of the 7 PROS counties before moving forward (estimates of six months to a year), and; 5) OMH will be working closely with NYC in the next wave of counties that will be in the PROS program. Additional information on registration/billing specifics were discusses as well, including: 1) for billing purposes, Medicaid will only pay once for the same PROS services, preventing 2 PROS providers from billing for the same service; 2) as soon as a PROS client begins attending a PROS program, the provider will be expected to submit a registration to OMH; 3) for each registration submitted, providers will need to retain in the recipients record, a copy of an attestation signed by the recipient agreeing to the registration; 4) providers will be notified if an individual is successfully registered into their program; 5) the OMH CAIRS (Children and Adult Information Reporting System) will be the primary information exchange vehicle for PROS registration (CAIRS is currently used for AOT, ACT and Case Management), and; 6) OMH is constructing an internal registration support system which will prioritize registration applications We were greatly appreciative of OMH’s providing public forums on this issue and we look forward to future presentations. With
OMH’s commitment to have PROS programs up and running by November,
the PROS component of the MHANYS Annual Conference on October 21st, which
features OMH and several of the counties in the first wave of PROS, will
be even more relevant.
Katrina's
Mental Toll To Be Huge. By Matthew Herper NEW YORK - Victims who are rescued from the horrors of the flood-ravaged city of New Orleans may have frequent and intense psychological problems similar to those that plague troops returning from Iraq, Afghanistan or Vietnam--problems that could spread to the rescuers as well. Up to a third of the victims of the Gulf Coast catastrophe might be affected." This may be the most severe natural disaster that we've faced in this country," says Carol North, a psychiatrist at Washington University School of Medicine. "You can probably expect that mental health consequences are going to be substantial." So far, many public estimates have said that perhaps a tenth of the tens of thousands of people who are trapped in the city might suffer from post-traumatic stress disorder, a disease that raises the risk of suicide sixfold. But experts warn that even for that disease, which is only one way in which a natural disaster can damage the mind, the rates could be far higher, based on other cases in which patients had to face a terrifying calamity. Other diseases, such as serious depression, are also likely to increase substantially, creating a major public health problem. Some 34% of the survivors who were trapped inside the Murrah building in Oklahoma City when it was blown up came down with post-traumatic stress disorder, a disease in which patients can suffer from flashbacks, heightened anxiety and social withdrawal, according to surveys done by North. Even rescue workers can be affected. A group called Disaster Psychiatry Outreach in New York studied firefighters and others who came to the city's aid on Sept. 11, 2001. They found that 20% of these workers developed post-traumatic stress disorder. Rescue workers would traditionally have been expected to be at lower risk for the illness than victims themselves. The people who are most at risk are those who already suffer from mental illness. "People who already are affected with anxiety, depression or certain types of phobias are especially prone to PTSD," says Henry Nasrallah of the University of Cincinnati. That problem could be intensified, North says, as people are separated from necessary medicines such as antipsychotics or antidepressants. The floodwaters can force patients to leave their pills behind, or make them contaminated and unusable. To make matters worse, poor and sick patients are more likely to suffer from mental illnesses. Exactly those who are most likely to be harmed are those who are left behind. "It's people who have no resources who will be in the medical term 'screwed,' " says Michael Vanrooyen of the Harvard School of Public Health. Another population that can be at serious risk: kids. "If we're looking at the long term, the concern will be how this event will shape children's view of the world around them and of their future," says Robin Gurwitch, a psychologist at Oklahoma University. For them, the key is making sure they get basic needs such as food and water and some kind of return to a routine. But doctors emphasize that all of the illnesses are treatable if they can reach those who are most affected. Rebecca Smith, a psychiatrist at Disaster Psychiatry Outreach, says, "The main reason to focus on psychiatric disaster is we can fix it." For some patients, psychotherapy can be a big help. Smith says that cognitive behavioral tricks can almost eliminate symptoms such as panic attacks. But for others, drugs are necessary. It appears that patients who withdraw are those most in danger of having severe post-traumatic stress disorder. They can be the hardest to treat and the most likely to require medicin Right now, Paxil and Zoloft are both approved for PTSD. Other similar drugs, such as Prozac, also work. Smith says there have been some preliminary results with antipsychotics, such as Zyprexa, Risperdal and Seroquel. She has had particular luck with Seroquel in low doses, which has often been used for its sedating effects (see: Antipsychotic Prescribed As Sleeping Pill). About 70% of those treated for post-traumatic stress disorder can be helped, Smith says, but even drugs can't help some patients. In clinical trials, Cincinnati's Nasrallah notes, Vietnam veterans did not respond to Zoloft and Paxil. "Many people recover completely," she says, "but some are plagued for the rest of their lives
Elderly
mental ill to benefit from New York state law.
By Cara Matthews
ALBANY - As the ranks of senior citizens swell, a new state law aims to focus attention and money on a mental-health care system that has failed to meet their special needs. The number of adults 65 and older is expected to increase from 2.4 million to 3.7 million in the next 25 years, and double from 35 million to 70 million across the United States. In any given year, 20 percent of older adults have a diagnosable mental illness, said Michael Friedman, chairman of the Geriatric Mental Health Alliance in the state. "One of the things that's different about older adults is that they're much more likely to have chronic physical conditions as well as mental-health conditions," he said. Many can't get to where services are provided, another difficulty they and the agencies that serve them face, he said. The Geriatric Mental Health Act, recently signed by Gov. George Pataki, will set up a grant program to fund innovative, community-based programs for the mentally ill elderly and set up an interagency geriatric mental- health planning council. Money for the grants would be included in next year's state budget. The law will take effect April 1. Sen. Nicholas Spano, R-Yonkers, the bill's chief Senate sponsor, said the law was "enormously important, given the demographics that show us to have an aging population with many people, as they get older, who are suffering from some form of mental illness that very often is ignored or goes untreated." The target amount of funding to start is $3 million. But it is too soon to speculate on what may or may not be in the 2006-07 executive budget, said Scott Reif, a state Budget Division spokesman. The rate of suicide is higher in the elderly population - particularly men older than 75 - than in any other age group, said Dr. Yeates Conwell, a professor of psychiatry at the University of Rochester School of Medicine. "These are treatable illnesses. Often people assume that getting depressed or confused is a normal consequence of aging," he said. In Westchester County, there about 43,000 people older than 55 who suffer from mental disorders, according to the Department of Health and Human Services' Mental Health Report of the U.S. Surgeon General in 1999, said Mae Carpenter, the county's commissioner of senior programs and services. By 2030, that number is expected to rise to about 55,000. "Right now, the system is so fragmented, that there needs to be interagency planning, joint planning and cooperation," she said. "We need to remove duplication in the system." Carpenter and Jennifer D. Schaffer, Westchester County's commissioner of community mental health, said they hoped to see an expansion of programs such as the ones that send mental-health professionals into people's homes. Westchester has a few such programs, but they are small and have waiting lists, Schaffer said. "The need and the demand is much greater than we have the ability to serve," she said. Of the Geriatric Mental Health Act, she said: "The real hope is that money comes along with it to expand services." Carolyn Hedlund, the executive director the Mental Health Association of Westchester, said that without the new law, shortfalls in services for older adults would have risen to critical proportions in the years to come. The action by the governor and the Legislature laid the "groundwork for a long-term plan that could no longer be delayed," Hedlund said in a written statement. Another challenge in serving mentally ill seniors is stigma, said Assemblywoman Donna Lupardo, D-Broome County. Many senior citizens consider mental illness a character flaw, she said. "These are hidden illnesses. A lot of people will make excuses for mental-health issues in the elderly," said Lupardo, an Assembly co-sponsor and former education director for the Mental Health Association of the Southern Tier. Lupardo described the legislation as a first step toward improving care and services. The state could use much more than $3 million to successfully meet the mental-health needs of seniors, she said. The grants will be available to organizations that provide mental- health, health and aging services. The interagency council the act creates is greatly needed because agencies often don't share successes or failures, or coordinate activities, Lupardo said. "You've got 15 different state agencies out there, all basically with a piece of the pie," she said. Conwell said there were not enough venues where psychiatric services are well integrated with primary care. The legislation encourages innovation through partnering mental and physical health care, which could in turn reduce institutionalization and other costly care and improve quality of life, he said. Groups and agencies that provide services to seniors with mental illness are well meaning, said Martha L. Bruce, professor of sociology in psychiatry in Weill Medical College of Cornell University, Westchester division. But, she said, "right now, the structure has not made it easy for service providers to think together creatively on how to improve care." |