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June 5, 2006 WHY WE STRONGLY SUPPORT A HOUSING WAITING LIST BILL (A.2895-A (Rivera) / S.3653-A (Morahan)), by Glenn Liebman: Along with many of our colleagues in the community, MHANYS supports a housing waiting list bill that will establish a waiting list for adults within the office of mental health service system. In my years both as an advocate and inside government—the greatest need I saw was that of the fundamental right of housing. Whether working with aging family members who had children with mental illness, AOT recipients, individuals coming out of the corrections system or adult home residents who wanted to move to more independent settings, the common denominator for all those groups I worked with was the desperate need for housing. A stable place to live provides one of the greatest foundations for recovery. The state has provided some innovative housing over the last several years including reaching an agreement with New York City on a New York/New York III partnership. This provides funding for 5,400 new beds for individuals with psychiatric disabilities at risk of homelessness. While efforts like that one are laudable, there have to be additional planning mechanisms in place to quantify the housing need. A housing waiting list will help to quantify on both a regional and statewide level the exact housing needs of individuals with psychiatric disabilities. There is currently almost no way that one can actually ascertain the housing needs of individuals with psychiatric disabilities in a given area of the state. With a housing waiting list bill in place, there would be a planful way for the state, the county and housing providers to identify the need and develop strategies that would work to create housing for those vulnerable individuals with psychiatric disabilities. All of us who have worked in the mental health community for a long time know that there are many roadblocks to housing. Some are financial, some are stigmatizing (citing issues) and some are related to the assessed needs of individuals living in the community. However, if there was a waiting list in place than there would be a stronger rationalization to overcome these obstacles and create greater coordinated care efforts among state agencies, providers and county government. In addition, the housing waiting list could better quantify numbers of those of who we are unsure of regarding their needs for independent housing. Those individuals include the number of adult children with psychiatric disabilities living at home with aging parents. When I was at NAMI, we surveyed our members and found that over 30% rated safe housing for their children as their top priority. Another number that has been difficult to quantify is those individuals with psychiatric disabilities aging out of the juvenile justice system and foster care systems. It is very difficult to estimate how many of those individuals have the need for housing. Back in 1998 when Governor Pataki introduced the New York CARES Project in response to the waiting list in the OMRDD system, he said, “New York has a long tradition of providing compassionate care for its citizens especially for the most vulnerable of our population…That demonstrates our belief that those who live here need access to services to help them live a healthier, happier and more productive life.” The same is true for individuals with psychiatric disabilities---a housing waiting list would help provide that compassionate care for a vulnerable population of New Yorkers. Is it too late to do anything this year? The answer to this is a resounding “No.” Despite the fact that there are less than three weeks left of legislative session, there is still time to spread the word about this bill. There are always last minute deals based on how much pressure can be put to bear on an issue. Action Steps: Please take five minutes out of your day to call your Assembly member and state Senator. Urge your Assemblymember to pass A. 2895-A and urge your Senator to pass S. 3653. It is only through the pressure that we put forth over the next few weeks that this bill will pass both houses of the legislature.
The
Mental Health Association in New York State (MHANYS) strongly supports
A.2895 A, an act to amend the mental hygiene law, in relation to
the establishment of community housing waiting lists for adults
within the office of mental health services system. There have been several housing initiatives developed in recent years that are laudable, including the New York/New York III agreement providing for over 5500 additional housing units in New York City for individuals with mental illness who are also at risk of homelessness. However, there is still an unmet need in New York City and the rest of the state. Individual recipients, family members, housing providers and counties all feel strongly that there is a statewide need for more housing. Though there are individual efforts from both not-for-profits and governmental units to assess housing needs, there is no universal tool that quantifies on both a regional and statewide level the exact housing needs of individuals with psychiatric disabilities. A housing waiting list bill would provide that tool and create better planning in the different regions of the state. A true needs assessment would create stronger partnerships between housing providers, counties and state government. For example if the general housing need for individuals with psychiatric disabilities in Onondaga County was known, housing agencies, state government and local government could work to design and modify efforts to meet those needs. Currently, there is little way to actually ascertain what the housing needs are for individuals with psychiatric disabilities in a given area of the state. There are certainly obstacles to creating housing in New York for people with psychiatric disabilities. There are funding issues, citing issues, stigma issues and individual assessment concerns. However, housing is the foundation upon which recovery from mental illness is built. Recovery from mental illness means people with psychiatric disabilities require less assistance from public service and may even return to work. Meeting the demand for housing will ultimately save the state money. A housing waiting list in place will create an opportunity for partners to identify planful strategies that would work to create housing for those vulnerable individuals with psychiatric disabilities that are in desperate need of a place to live. This model has been successfully used within the state’s system of care for individuals with developmental disabilities and mental retardation. In 1998, Governor Pataki signed into law the New York State Creating Alternatives in Residential Environments & Services (NYS-CARES) program, designed to eliminate the housing need identified by the Office of Mental Retardation and Developmental Disabilities’ housing waiting list. As he stated when he announced the creation of the program, “New York has a long tradition of providing compassionate care for its citizens, especially for the most vulnerable of our population…That demonstrates our belief that those who live here need access to services to help them live a healthier, happier and more productive life.” The same is true for individuals with psychiatric disabilities – a housing waiting list would help provide that compassionate care for a vulnerable population of New Yorkers. IN THE NEWS: Father
Turns Grief to Action. By Norah
Machia Timothy O’Clair’s family struggled for five years to get the proper treatment for his depression, yet they were continually faced with mental health coverage limits on their insurance policy. Although his parents, Thomas P. and Donna S. O’Clair of Schenectady, spent most of their money on care for their son, they were eventually forced to give up custody of Timothy to the state temporarily so his treatment would be covered by the Medicaid system. By that time, they had already “lost” several years when Timothy should have been receiving full treatment for his depression, his father said. In March 2001, Timothy hanged himself in his bedroom closet. He was just weeks away from his 13th birthday. Mr. O’Clair spoke about his son’s tragic death at a rally Wednesday morning in front of the Watertown Municipal Building that was held to raise awareness of mental health issues. “Timothy would have been graduating from high school next month,” said Mr. O’Clair, who displayed large color photographs of his son on a bicycle and the engraving on his tombstone. “His mental health issues led him to take his own life.” Mr. O’Clair is traveling throughout the state to generate support for proposed legislation named after his son. Timothy’s Law, which the Assembly approved in March 2004, would require health insurance companies to provide mental health and substance abuse coverage that is equal to what they provide for medical care. The proposed law, however, has not yet been brought for a vote in the Senate. “We have to remain hopeful that it will get approved,” Mr. O’Clair said. “It’s difficult when it fails to get voted on by the Senate. It’s like losing him all over again.” Timothy’s Law “would allow people with mental health issues to get the care they deserve,” he said. Insurance companies are not obliged under New York state law to provide the same coverage for mental health treatment as for physical care. For example, a policy could cover 80 percent of the cost for treatment of a sore throat, but could cover only 50 percent for a mental health visit. “All we want is a level playing field for mental health disabilities, which are very treatable,” Mr. O’Clair said. “It’s a basic human right.” It’s also a right that is recognized by 35 other states, which have laws that require equal insurance coverage for physical and mental health treatment, said Michael Seereiter, director of public policy, Mental Health Association in New York State, Albany. “There are nine million federal employees and retirees who also have equal coverage,” said Mr. Seereiter, who attended the rally. Those who support the law, including the National Association of Social Workers, claim passage of the bill in New York would result in insurance rates increasing only $1.26 per month per person to provide parity for mental health and substance abuse coverage. The bill is being opposed by some businesses and insurance companies, however, which have claimed the law would drive rates much higher. But Mr. Seereiter said that the parity in coverage would result in a cost savings for businesses in the long run, because if people could get the needed treatment, there would be better productivity and fewer sick days at the workplace. The event, which also included a walk to Thompson Park following the rally, was organized by a group of north country mental health advocates and clients. The organizers hoped to raise awareness of mental health issues and the services available in the community to help people, said Jennifer Hodge, Samaritan Medical Center community education manager. Note: This Editorial has been re-published in the Staten Island Advance, Troy Record, Schenectady Daily Gazette and Legislative Gazette. Senate
Must Act on Mental Health Mental health care is disparate throughout New York, and state Senate action is needed to fix the problem. Currently, coverage of mental illnesses can be limited, regardless of needs and diagnosis. For the past four years, the Assembly has approved Timothy's Law, a bill that insists mental illnesses be treated the same way as any other physical illness. The law is named for 12-year-old Timothy O'Clair of Schenectady, who hanged himself after four years of a heart-wrenching search for care for mental illnesses. Insurance limitations led to lapse in care, efforts to pay privately couldn't be sustained. At one point, his distressed parents made him a ward of the state in order for him to receive the attention his illness demanded. It's an act of desperation, yet 3,500 other families have also named their children wards of the state. The Senate has not actively supported the full parity issue even though it affects not only those who need mental-health services, but almost all of society. People suffering from mental illnesses who do not receive treatment are more apt to become drug addicts or criminals than those without these challenges. QUICK
ACTION NEEDED History should not be repeated this year. Senate supporters insist the exemption for small businesses is needed, while advocates in the Assembly believe all residents deserve to have access to fair mental-health coverage, regardless of the size of the company they work for. Swift passage of this bill in the Senate would at least allow the two versions to go to a conference committee where, hopefully, a compromise could be reached. Mandates are rarely good for businesses, but ignoring New Yorkers who struggle with mental illness is not a solution. A study by PricewaterhouseCoopers says parity, or having insurance coverage that treats mental illnesses the same as physical illnesses, will cost an additional 1.6 percent, or $15 a year, per person. Insurance industry experts say it could increase premiums 3.5 percent, although 25 other states with full parity, and 10 additional states that exempt small companies from the mandate, have discovered no discernible impact on business. The two houses disagree on what should be included in the bill, but the only way to resolve the differences is for the Senate to act now and let the conference committee work on the differences. New Yorkers deserve to have their mental illnesses treated with the same concern as other illnesses. Youth
Fight Enemy Within. By Lindsey
Tanner Chicago – Nearly 1 in 5 students at two Ivy League schools say they have purposely injured themselves by cutting, burning or other methods, a disturbing phenomenon that psychologists say they are hearing about more often. For some young people, self-injury is an extreme coping mechanism that seems to help relieve stress; for others, it’s a way to make deep emotional wounds more visible. The results of the survey at Cornell and Princeton are similar to other estimates on this frightening behavior. Counselors say it’s happening at colleges, high schools and middle schools across the country. Separate research found more than 400 Web sites devoted to the subject, including many that glorify self-injury. Some worry that many sites serve as an online subculture that fuels the behavior – although whether there has been an increase in the practice or just more awareness is unclear. Sarah Rodey, 20, a University of Illinois student who stated cutting herself at age 16, said some online sites help socially isolated kids feel like they belong. One of her favorites includes graphic photographs that the site warns might be “triggering.” “I saw myself in some of those pictures, in the poems. And because I saw myself there, I wanted to connect to it better” by self-injuring, Rodey said. The Web sites, recent books and media coverage are pulling back the curtain on the secretive practice and helping researchers better understand why some as young as grade-schoolers do it. “You’re trying to get people to know that you’re hurting, and at the same time, it pushes them away” because the behavior is so distressing, said Rodey, who has been diagnosed with bipolar disorder. The latest prevalence estimate comes from an analysis of responses from 2,875 randomly selected male and female undergraduates and graduate students at Cornell and Princeton who completed an Internet-based mental health survey. Seventeen percent said they had purposely injured themselves; among those, 70 percent had done so multiple times. The estimate is comparable to previous reports on U.S. adolescents and young adults, but slightly higher than studies of high school students in Australia and the United Kingdom. The study appears in this month’s issue of Pediatrics, released today. Cornell psychologist Janis Whitlock, the study’s main author, also led the Web site research, published in April in Developmental Psychology. Among the Ivy League students who harmed themselves, about half said they’d experienced sexual, emotional or physical abuse that researchers think can trigger self-abuse. Repeat self-injurers were more likely than non-injurers to be female and to have had eating disorders or suicidal tendencies, although self-injuring is usually not considered a suicide attempt. Greg Eels, director of counseling and psychological services at Cornell, said the study’s findings are not surprising. “We see it frequently and it seems to be an increasing phenomenon.” Dr. Daniel Silverman, a study c-author and Princeton’s director of health services, said the study has raised consciousness among his staff, who are now encouraged to routinely ask about self-injury when faced with students “in acute distress.” “Unless we start talking about it and making it more acceptable for people to come forward, it will remain hidden,” Silverman said. Some self-injurers have no diagnosable illness but have not learned effective ways to cope with life stresses, said Victoria White Kress, an associate profession at Youngstown State University in Ohio. She consults with high schools, and says demand for her services has risen in recent years. Psychologists who work with middle and high schools “are overwhelmed with referrals for these kids,” said psychologist Richard Lieberman, who coordinates a suicide prevention program for Los Angeles public schools. Rodey, a college sophomore, said cutting became part of her daily high school routine. “It was part of waking up, getting dress, the last look in the mirror and then the cut on the wrist. It got to be where I couldn’t have a perfect day without it,” Rodey said. “It I was apprehensive about going to school, or I wasn’t feeling great, I did that and I’d get a little rush,” she said. Whitlock is among researchers who believe that “rush” is feel-good hormones called endorphins produced in response to pain. But it is often followed by deep shame and the injuries sometimes require medical treatment. Rodey said she stopped several months ago with the help of S.A.F.E (Self-Abuse Finally Ends) Alternatives treatment programs at a suburban Chicago hospital. Treatment includes behavior therapy and keeping a written log to track what triggers the behavior. Rodey said she feels “healed” but not cured “because it’s something I will struggle with the rest of my life. Whenever I get really stressed out, that’s the first thing I think about. Psychiatrists,
Criminal Justice Experts At Odds Over Handling of Pedophiles.
By Joan Arehart-Treichel Are there better ways to protect America's children from convicted pedophiles? It used to be that Americans convicted of pedophilia would get sentenced from one day to life in prison, and it was then up to the prison warden to decide whether and when they were safe enough to be released, Howard Zonana, M.D., explained in an interview. Zonana, a professor of psychiatry at Yale University, is a past chair of APA's Task Force on Sexual Offenders. But today, Zonana continued, there is fixed prison sentencing for convicted pedophiles, and once pedophiles have served their sentences, they have to be released. Moreover, once they are released, they do not have to receive any treatment for their pedophilia unless they have a period of probation. "So you can see why there is public concern," he said. So how might the American criminal justice system be altered so that convicted pedophiles pose less of a danger to children? Here are several possibilities, along with their pros and cons: • Psychiatric commitment: Under increasing public pressure on elected officials to get tough with sexual predators, 16 states and the District of Columbia have enacted laws allowing the commitment of sexual predators to public psychiatric hospitals after their prison terms are up. The governor of New York has issued an executive order permitting the same. While such laws and orders are undoubtedly protecting children better than before, they do present other concerns, psychiatrists and mental health advocates recently told Psychiatric News (Psychiatric News, November 18, 2005). A primary concern is that psychiatric commitment laws may misuse psychiatry to detain people for whom confinement rather than treatment is the goal. Another concern, Richard Rosner, M.D., chair of the New York State Psychiatric Association's Committee on Psychiatry and the Law, pointed out, is that placing pedophiles in public mental health facilities would overwhelm already tight state mental health system budgets. "To the extent that the mental hospital beds are filled by people for whom they were not intended, there are fewer of them available for people for whom they were intended," he said. Psychiatrists' opposition to civil commitment of pedophiles who have completed prison terms, in fact, is swaying elected officials on the issue. For instance, the Vermont legislature recently rejected a measure to establish a civil commitment program for convicted sex offenders at psychiatrists' urging (Psychiatric News, March 17). • Life imprisonment: Another approach that might better protect children without burdening the public mental health system is to imprison all convicted pedophiles for life. Yet "vast sums of public money are [already] being targeted toward the containment of sexual predators," Richard Krueger, M.D., medical director of the sexual behavior clinic at New York State Psychiatric Institute, pointed out. So imprisoning even more would undoubtedly be colossally expensive. Also, blanket imprisonment, Zonana asserted, would mean "incarcerating a lot of people for whom there wouldn't be trouble." The long-term recidivism rate for convicted pedophiles is not known. But in a five-year follow-up study of 400 convicted pedophiles treated in the community, less than 8 percent were accused of subsequent offense. "That is a far cry from the common public misperception that most of these people will be back into trouble," declared lead study investigator Fred Berlin, M.D. Berlin is an associate professor of psychiatry at Johns Hopkins University and director of the National Institute for the Study, Prevention, and Treatment of Sexual Trauma. • Chemical castration: Still another possibility for better protecting children that would entail neither lifetime imprisonment nor commitment to a psychiatric facility would be to mandate that all convicted pedophiles, prior to their release from prison, receive a mandatory evaluation to determine as nearly as possible the underlying cause of their behavior. For those who are symptomatic (that is, present with pedophilic symptoms), there is robust evidence that medications that lower sex hormone production can be helpful by decreasing pedophilic symptoms and thus sexual recidivism, Fabian Saleh, M.D., told Psychiatric News. And such agents, he added, which are given by monthly injection, are just as effective as surgical castration in reducing pedophiles' re-offending. Saleh, an assistant professor of psychiatry at the University of Massachusetts, is also director of research at the National Institute for the Study, Prevention, and Treatment of Sexual Trauma. But a drawback of chemical treatment, Saleh pointed out, is that it is not always effective in reducing recidivism rates among child molesters. Medications only treat those offenders whose behavior is motivated by an underlying paraphilic disorder, such as pedophilia. Note: Assemblymember Connelly was a long-time advocate for people living with mental health needs and was the Chair of the Assembly Mental Health, Mental Retardation and Developmental Disabilities Committee for a number of years. She will be greatly missed. Elizabeth
A. Connelly, 77, Longtime Assemblywoman, Is Dead.
By Dennis Hevesi Elizabeth A. Connelly, a New York State assemblywoman from Staten Island for 27 years who was a leader in the fight against drunken driving, died yesterday at her home in the Westerleigh section of the borough. She was 77. The cause was cancer, her husband, Robert, said. Mrs. Connelly, who retired in 2000, was the Assembly's chief sponsor of the 1982 law that raised the state's legal drinking age from 18 to 19; it has since been raised to 21. She was also a co-author of the law requiring judges to suspend the driver's license of anyone convicted of drunken driving. When she retired, she was the speaker pro tempore of the Assembly, the highest rank a woman had ever reached there, and regularly presided over contentious debates. Sometimes describing herself as a conservative Democrat, Mrs. Connelly sponsored legislation in the 1980's that would have ended state Medicaid financing for abortions. The measure failed. Born Elizabeth Ann Keresey on June 19, 1928, Mrs. Connelly was a Brooklyn native whose family moved to the Bronx when she was 2. She did not attend college. In the mid-1940's, she worked as a secretary at the New York Life Insurance Company. Then, from 1946 to 1954, she worked in telephone sales for cargo at Pan American World Airways, with her future husband as her boss. Besides her husband, Mrs. Connelly is survived by a son, Robert Jr. of Las Vegas; three daughters, Alice Lanzi of Staten Island, Margaret Nicholson of Katonah, N.Y., and Therese Shannon of Goshen, N.Y., and seven grandchildren. The Connellys moved to Staten Island in 1954, and Mrs. Connelly became active in local politics, joining the North Shore Democratic Club of Richmond County. She was first elected to the Assembly in 1973 and was re-elected 13 times. In 1977, Mrs. Connelly was appointed chairwoman of the Assembly Committee on Mental Health, Mental Retardation, Developmental Disabilities, Alcoholism and Substance Abuse. "A family member suffered from mental illness," her husband said yesterday, "and that's why she dedicated herself to that cause." Mrs. Connelly was also a co-sponsor of a 1994 bill calling for the secession of Staten Island from New York City. The effort stalled after the Assembly's Democratic leadership said they believed the State Constitution required that such a measure be requested by the city, not one of its boroughs. |
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