Mental
Health Association in New York State, Inc. |
Friday Fax from Albany
MHANYS’ CONFERENCE – OCTOBER 20-21 AT THE ALBANY MARRIOTT: Special
film showing: This very personal documentary chronicles the filmmaker’s mother, Millie, and her family through Millie's battle with schizophrenia and her subsequent trials within the public health system. This intimate film illuminates a national plight through one family's struggle and helps dispel the stigmas and misconceptions surrounding this illness. The Wall Street Journal wrote that Out of the Shadow “movingly captures a side of schizophrenia that few of us ever see, revealing the humanity behind the disease.” This film and the follow-up discussion are free of charge and open to the public. Please call to reserve seating. October
20th at 8 p.m. at the Albany Keynote
address: The Spiro sisters have written their firsthand account of identical twin sisters- one who became a psychiatrist and the other who developed schizophrenia. “This harrowing but arresting memoir—written in alternating voices by identical twins, now in their 50s—reveals how devastating schizophrenia is to both the victim and those who love her.” - Publishers Weekly This highly praised, best-selling book has been featured on Good Morning America, The New York Times, People Magazine, and Readers Digest. Pamela Spiro Wagner and Carolyn Spiro will be giving the keynote address at MHANYS’ annual conference October 21st at 12 p.m. at the Albany Marriott on Wolf Road in Colonie. Cost is $50 and includes lunch.
MHANYS Annual Conference Panel Discussions on Friday October 21st include: MEDICARE PART D: HOW IT WILL IMPACT INDIVIDUALS WITH PSYCHIATRIC DISABILITIES. With the implementation of Medicare Part D on January 1, 2006, this panel will provide the most up to date information and advocacy strategies for both recipients and providers about the impact of Medicare Part D on individuals who are dual eligible (have both Medicare and Medicaid) and have a psychiatric disability. Panelists include: Reg Glover, Director of State Operations Finance Group, New York State Office of Mental Health; Dawn Lannon, Director, Bureau of Adult Strategic Direction, New York State Office of Mental Health; Erica Defur-Malik, Senior Director, Health Care Reform, National Mental Health Association, Dayle Berke, Center for Medicare & Medicaid Services. PERSONALIZED RECOVERY ORIENTED SERVICES (PROS): LESSONS LEARNED FROM THE SEVEN START UP COUNTIES AND INFORMATION UPDATE. The impact of PROS implementation will be far reaching in the mental health community. This panel will provide hands on information about the first seven identified PROS counties. As PROS implementation begins in these seven counties, it will be invaluable for MHA’s and other stakeholders to be provided with all relevant information that will help in coordination and system integration in other counties. Panelists include: Robyn Katz, Director of Adult Community Services, New York State Office of Mental Health; Liz Mehnert, LMSW, Division Director, MHA in Orange County, Inc.; Larry Tingley, Director of Community Services in Jefferson County JUVENILE JUSTICE SYSTEM AND IMPACT TO MENTAL HEALTH COMMUNITY. As many as 65% of youths in the juvenile justice system have a diagnosable mental illness. However, many of these youths enter the juvenile justice system without being identified or treated in the community. This panel will discuss agency collaborations, best practices and strategies providers can utilize to work with the juvenile justice population that have mental illness. Panelists include: Michael Bigley, Senior Program Specialist, Division of Children and Family Services, New York State Office of Mental Health; Representative from the New York State Office Of Alcoholism and Substance Abuse Services; Meredith Ray, Director of Juvenile Justice Projects, Division of Children and Family Services, New York State Office of Mental Health For more information, see our Conference Brochure and Registration, or contact Lillian Lasher at (518) 434-0439 ext. 22 or llasher@mhanys.org.
MHANYS TESTIFIES AT ASSEMBLY HEARING ON CIVIL COMMITMENT OF SEXUAL PREDATORS: On Tuesday, September 20th, the NYS Assembly Committees on Codes; Correction; and Mental Health, Mental Retardation and Developmental Disabilities held a very high profile hearing to address “Criminal Penalties and the Civil Commitment of Sex Offenders: Whether Strengthening Our Existing Laws Would Ensure Their Effectiveness in Making Our Communities Safer?” Amongst those who testified were Westchester County Executive Andrew Spano, Westchester District Attorney Jeanine Pirro (who is also running against Hillary Clinton for US Senate), and the relatives of a woman killed by a convicted sex offender in Westchester County. After participating in a roundtable discussion hosted by these same Committees on this issue in July, MHANYS’ Michael Seereiter appeared in conjunction with NAMI-NYS’ Bob Corliss before the panel of Assemblymembers to explain MHANYS position on this issue and to voice concern with some of the existing proposals. First, MHANYS pointed out that people with mental health needs are 12 times more likely to be the victim of a crime than the general population. This gives mental health advocates good reason to have “a heightened concern about sex offenders and other violent criminals, and (we) share the concerns of the District Attorneys and others who want to ensure that these dangerous offenders remain off the streets. Therefore, MHANYS supports the calls for extending the penalties associated with sexual offenses to ensure that those who are likely to offend again remain either in prison or on parole for longer periods of time, depending on the offense. However, we have concerns with the proposals to civilly commit sexual predators who are believed to remain dangerous and a threat, even as their prison sentence expires.”
MHANYS’
testimony closed by pointed to the fact that “there is more that
the state can and must do for people with mental illness to help prevent
them from becoming the victims of such heinous crimes. Continued funding
and greater expansion of community-based public mental health services
must be of the highest priority to reduce the number of people with mental
illness who are so often the victims of violence, helping individuals
who have become victims recover from such trauma, and assist the small
subset of people with mental illness who are at increased risk of violent
behavior. Therefore, as the Legislature and Governor consider legislation
aimed at containing sexual predators, we also urge you to enact Timothy’s
Law to provide appropriate access to the mental health treatments
and services that will help individuals living with mental illness recover,
thereby reducing the number of people most likely to be the victims of
such heinous crimes.”
ISSUES REGARDING CO-OCCURRING DISORDERS: Two weeks ago, Glenn participated in a Substance Abuse and Mental Health Services Administration (SAMHSA) policy academy with representation from the Governor’s Office, OMH, Office of Alcoholism and Substance Abuse, Division of Criminal Justice Services, the Department of Health (DOH), County Directors and Provider groups in Philadelphia, PA. New York was one of ten states that participated in this conference. It served as a true reminder about the significance of integrated treatment (one of the six core evidence based best practices) for people with psychiatric disabilities. According to estimates from the DOH, there are currently 60,000 people on Medicaid who touch both the mental health and substance abuse systems. This does not even take into account the large number of individuals with co-occurring disorders not currently in the public mental health system. At the policy academy we touched on several different strategies as state response to these ongoing issues. There have been several best practices that have been identified nationwide regarding co-occurring disorders. The public policy dilemma becomes, how we can best integrate treatment so that it is person centered, focuses on core outcomes, provides a universal evidence-based assessment tool and has fidelity to the existing models of care that are working. Not to mention the issues of funding of these programs. Our state work group took a look at all these issues and discussed some short and long-term strategies including working with additional stakeholders and priority populations (including individuals about to be released from prisons). Based on what we saw and heard, New York is among the nation’s leader in issues regarding co-occurring disorders. However, there are still public policies changes that can be addressed to improve our existing system. Over the next several months, there will be further discussions about additional strategies. We would appreciate anyone who would like to provide feedback to us. We know that there are several MHA’s across the state that are doing innovative work in this arena.
LOSS OF AVIVA RICE: A few weeks ago, the entire mental health community lost a good friend in the passing of Aviva Rice. While at NAMI, I had the pleasure of working very closely with Aviva and her husband Izzy. She was a wonderful and passionate advocate who had an amazing ability to be incredibly candid and yet be greatly admired and respected by policy makers and stakeholders. She and Izzy were also visionaries. Ten years ago when few people knew that ACT teams would be best practice models, Izzy and Aviva spent every waking moment talking about the significance of ACT teams to the family movement and to the entire mental health community. The true testament to their great work is that today, there are over 70 ACT teams across New York State. Aviva was a terrific advocate and an even better person and she will be greatly missed.
MEDICARE PART D UPDATE: The past few weeks have brought with them some new developments in the effort to implement the new prescription drug benefit under Medicare. While the Bush Administration continues to maintain that the drug benefit will be up and running by January 1, 2006, due to the catastrophes on the Gulf Coast and a large-scale belief that this transition will be less than seamless (especially for dual eligibles), there have been calls from members of Congress to delay the programs start date an entire year, to January 1, 2007. We will share any information on this as it becomes available. Recently, CMS has signed contracts with many of the plans that will be offering coverage under Part D. These will include 20 plans offering stand-alone prescription drug coverage, 5 of which will charge a premium of $20 of less per month. There are 11 ‘benchmark’ or below plans which individuals with Extra Help can enroll in without having to pay any premium.
EVENTS: Bridge Walk 2005 – On October 7th, PEOPLe, Inc. and the MHA in Dutchess County will host the 3rd annual Bridge Walk across the Mid-Hudson/FDR Bridge in Poughkeepsie. This event helps to celebrate wellness and healing, and to remember and honor those of family members and friends who continue to fight mental illness along side their loved ones, and those who have lost loved ones. The walk will take place on October 7, 2005 - gather at 6:00 p.m., walk at 6:30 p.m. Additional information is available by calling (845) 452-2728 Orange
County Wellness Conference - On October 21st, PEOPLe Inc.’s
Steve Miccio will facilitate an event sponsored by many mental health
organizations throughout the Hudson Valley Region that will focus on wellness
management. Presentations will include:
IN THE NEWS: Murder
victim’s family urges civil confinement legislation. By Simon
Yirka-Folsom Assembly Republicans and the family of Concetta Russo-Carriera, who was killed in June by a level-three sex offender, last week held press conferences and hearings urging the Assembly to vote on a civil confinement bill. It has passed overwhelmingly seven times in the Senate, but has not yet been put to a vote in the Assembly. “Stalling in the Assembly reflects an agenda more concerned with criminals’ rights than citizens,” said Assemblyman David McDonough, R,C,I- Merrick. If passed, the law would allow judges to hold an offender after the completion of his prison sentence. The law would also require an intensive review process including a unanimous decision by jury before admitting the offender into the confinement process. Assembly Republicans stressed that there is close to a 100 percent repeat offense rate among sex offenders. Assembly Republicans propose monitoring released offenders by satellite, as well as civil confinement beyond the end of prison sentences. Also included in their bill is a provision preventing convicted sex offenders from living within 1,000 feet of school grounds, requiring local law enforcement to release information to the community on level two and three sex offenders, and expanding available information about sex offenders on the Division of Criminal Justice Services’ Web site. “We have not done enough at the state level,” said Charles H. Nesbitt, R,C,I- Albion. “We don’t need hearings to tell us that.” The family of Russo-Carriera believes that if civil confinement had been enacted, Russo-Carriera’s death could have been prevented. They expressed surprise upon hearing members of the Assembly say that over 100 level-three sex offenders have been released since June. “It’s no favor to the offender to let them into society, because the man that killed Connie will probably be in jail for the rest of his life,” said Vincent Scala, a cousin of Russo-Carriero. “And it’s certainly no favor to the community.” Three Assembly committees held a hearing on criminal penalties and the civil confinement of sex offenders immediately following the press conferences to determine whether civil confinement legislation is warranted. Committees on codes, correction and mental health presided over the hearing. Richard Hamill, president of the Alliance of Sex Offender Service Providers, testified that members of his organization are not supportive of civil confinement because money allocated to the service would be spent on offenders that are least likely to make successful use of resources. Hamill suggested that New York spend its resources on offenders in the mid-range with respect to likelihood of repeat offending, because, according to him, those people are most likely to be rehabilitated. Hamill also encouraged the committees to look into the merits of lifetime parole. Jeanine Pirro, Westchester County district attorney, also testified at the hearing. She likened sex offenders being released into communities to a “cancer,” saying, “You’ve got to cut it out and separate it, get these people out of society.” Joseph R. Lentol, D- Brooklyn, chair of the codes committee, said, “There are none of us that would disagree that these people are a danger, but what we may not agree with is that a longer prison sentence may not be a better idea.” Assemblyman Peter M. Rivera, D- Bronx, chair of the mental health committee, agreed with Lentol. According to Rivera, in Kansas, which has already enacted civil confinement, 16 of 18 prisoners that were released from the program turned out to be repeat offenders. Rivera sponsored a bill that would “triple mandatory sentences” for sexual predators. According to Rivera, this would effectively solve the problem, because it would “take these criminals off our streets for the rest of their lives.” “I believe that civil confinement is a necessity,” said Pirro. “The fact that New York doesn’t have it is an embarrassment.” Mental health professionals protested the belief that a violent sex offender qualifies as being mentally ill. Michael Seereiter, director of public policy at the Mental Health Association, supported the extension of penalties for sex offenders, reporting that the mentally ill are 12 times as likely to be victims of sex crimes. Because of this, he urged lawmakers to keep offenders separate from the mentally ill if they decided to pass civil confinement legislation. Dennis Carroll, assistant supervisor at the Sex Offender Commitment Division, Washington Defender Association in Washington State, spoke to the Assembly members about his state’s experience with civil confinement. “People have looked at our statute as the answer,” Carroll said. “It has been proven over the years that it is not the answer.” Carroll also noted that no significant decline in sex offenses have been attributed to civil confinement. He said that over the 15 years that the law has been in practice, there has only been one unconditional release from the confinement program, but that was on the condition of a debilitating physical condition, not because of rehabilitation. Assembly Republicans proposed extensive measures aimed at protecting citizens from violent sex offenders, including monitoring released offenders by satellite, as well as civil confinement beyond the end of prison sentences. Also included was a provision preventing convicted sex offenders from living within 1,000 feet of school grounds, the requirement of local law enforcement to release information to the community on level two and three sex offenders, and expansion of available information on the DCJS Web site.
Mentally
Ill More Likely to Be Victims of Violence. More than one-fourth of individuals with severe mental illness were victims of violent crime in the past year, almost 12 times general population rates, according to a study in the August issue of Archives of General Psychiatry. Depending on the type of violent crime (rape/sexual assault, robbery and assault), prevalence was 6 to 23 times greater among persons with severe mental illness than among the general population, said lead author Linda A. Teplin, PhD, Owen L. Coon Professor of Psychiatry and Behavioral Sciences at Northwestern University's Feinberg School of Medicine. In addition, the annual incidence of violent crime in persons with severe mental illness who live in the community is more than four times higher than that in the general population, said Dr. Teplin, who is director of the Psycho-Legal Studies Program at the Feinberg School. Dr. Teplin and her colleagues administered the National Crime Victimization Survey (NCVS) to 936 randomly selected patients from 16 outpatient, day, or residential mental health agencies in Chicago and compared results with those of the 32,450 participants in the annual NCVS conducted by the Bureau of the Census for the Bureau of Justice Statistics. Research has shown that individuals with mental disorders who live in the community are a vulnerable population at high risk for becoming victims of crime. Symptoms associated with severe mental illness, such as disorganized thought processes, impulsivity, and poor planning and problem solving may compromise one's ability to perceive risks and protect oneself, Dr. Teplin and colleagues suggested. Other factors correlated with victimization, including substance abuse, conflicted social relationships, poverty, and homelessness, also are common among persons with severe mental illness, the authors said. "People associate mental disorder with violence. We found that crime and mental disorder are linked but not in the way people think. Persons with severe mental disorders are terribly vulnerable to victimization," Dr. Teplin and co-investigators said. "Since deinstitutionalization in the mid-1960s, people with severe mental illness have had no choice but to live in the community. But we have denied them basic needs, such as safe housing, supportive services, and adequate mental health treatment," Dr. Teplin said. Dr. Teplin and colleagues propose that mental health treatment include systematic screening and monitoring persons for victimization, skill-based prevention programs to help these individuals learn to minimize risks, and interventions to reduce re-victimization. At the policy level, they call for building collaborative relationships between the mental health and criminal justice systems and advocacy. "People don't think of crime victimization as a health disparity. But crime victimization disproportionately affects persons with severe mental disorder, especially racial and ethnic minorities. Moreover, many persons with severe mental illness are poor and homeless, adding to their risk," the authors said. Dr. Teplin's co-researchers were Gary M. McClelland, PhD, research assistant professor; Karen M. Abram, PhD, assistant professor; and Dana A. Weiner, PhD, research assistant professor, Department of Psychiatry and Behavioral Sciences at the Feinberg School. This study was supported by MERIT award R37MH47994 from the National Institute of Mental Health. - Chicago
Comparing
Schizophrenia Drugs.
Editorial A government-financed study has provided the strongest evidence yet that the system for approving and promoting drugs is badly out of whack. The study compared five drugs used to treat schizophrenia and found that most of the newest, most heavily prescribed drugs were no better than an older drug that is far cheaper. The nation is wasting billions of dollars on heavily marketed drugs that have never proved themselves in head-to-head competition against cheaper competitors. The whole class of antipsychotic drugs has had undeniable value in blunting the symptoms of schizophrenia, enabling many patients to leave mental hospitals and move into the community. But the first generation of these drugs fell into disfavor because they often caused neurological side effects, like tremors and other involuntary movements. That spurred the development of a new generation of drugs known as atypical antipsychotics, which now dominate the market and rake in some $10 billion in annual sales. The trouble is that these new drugs were approved largely on the basis of short-term clinical trials that compared them primarily with placebos, so there was little if any evidence that they were any better than many of the older drugs. That gap has been filled by an 18-month clinical trial involving more than 1,400 adults around the nation. The study, sponsored by the National Institute of Mental Health, measured how long patients were able to keep taking their assigned drugs before deciding to change, usually because a drug wasn't working or had intolerable side effects. Three-fourths of the patients, a shocking number, stopped taking the drug they had been given, suggesting that there is a clear need for better treatments. The study found that the oldest drug, perphenazine, was as effective and caused no worse side effects than three of the newer drugs. Zyprexa, a new drug made by Eli Lilly, helped patients control symptoms slightly better than the others, but at the cost of serious side effects. Doctors should find a trove of useful data in the study to help them decide which drug might be best for a particular patient. But Congress and the Bush administration ought to pay attention as well. Surely it would make sense to force manufacturers to test their drugs not just against placebos, but against existing drugs that they are seeking to displace. And surely it would be cost-effective for the government to sponsor large studies comparing a slew of expensive drugs with their cheaper alternatives.
Medicare
prescription subscribers have bevy of options.
By James T. Mulder New Yorkers who want to sign up for the new Medicare prescription benefit this fall will face a bewildering array of choices. Twenty insurance plans will offer the coverage to state residents, and five of the plans will have monthly premiums of less than $20, the federal Centers for Medicare & Medicaid Services announced Friday. Beneficiaries also can opt to get their prescription coverage through Medicare managed care plans, which provide all Medicare-covered services "The competition between these organizations to serve all Medicare beneficiaries has resulted in lower costs for people with Medicare," said Dr. Mark B. McClellan, administrator of CMS. Medicare is the federal health insurance program for people 65 and older and the disabled. The optional drug benefit, the largest expansion in Medicare's 40-year history, takes effect Jan. 1. People can begin enrolling in the plans Nov. 15. People with low incomes can apply for subsidies that will reduce or eliminate their monthly premiums. The benefit is available to everyone in Medicare, regardless of income. Beneficiaries who have coverage from a former employer should be getting letters by Nov. 15 explaining whether their coverage is as good as the new Medicare benefit. The drug plans are expected to launch a marketing blitz Oct. 1. Excellus, the Rochester-based health plan that dominates the Syracuse market, is one of the companies approved to sell stand-alone Medicare drug coverage statewide. Details about each plan's prices and coverage will not be available until next month. Some drugs may be covered by one plan and not another. Each plan will have its own list of covered drugs. And some plans will participate with some pharmacies and not others. By mid-October, Medicare will have a program on its Web site (www.cms.gov) that will help people compare drug plans and choose the best one. This information also will be available by calling a toll-free number, (800) 633-4227. McClellan urged beneficiaries and those close to them to begin investigating the new benefit. "America, pull up a chair," McClellan said, "it's time to talk about Medicare prescription drug coverage." |