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June 9, 2006 ASSEMBLY PASSES HOUSING WAITING LIST LEGISLATION – ADVOCATES WORKING TO ENSURE SENATE DOES THE SAME: On Wednesday, the NYS Assembly unanimously passed the Housing Waiting List legislation, A.2895-a, sponsored by Assembly Mental Health Committee Chair, Peter Rivera. As was articulated in Monday’s Mental Health Update, MHANYS is a strong supporter of this legislation that would establish a waiting list for adults within the office of mental health service system. This legislation would allow us to get a handle on the number of individuals in need, which would then allow us to take steps to address those housing needs. Advocates are very pleased to be working with Senate Mental Health Committee Chair, Thomas Morahan, who is a strong advocate for this legislation (S.3653-a) and moving it through the Senate to passage there as well. Currently, it awaits consideration on the Senate floor, having already been reported from the Senate Mental Hygiene Committee. Next week, MHANYS and the Schuyler Center for Analysis and Advocacy (SCAA) will be joined by other advocates to hold a press conference designed to turn public attention to the need to enact this legislation. We are very excited that both of the sponsors, Assemblymember Rivera and Senator Morahan, plan to join us at this press conference. In the meantime, we urge everyone to contact their own Senator to urge for passage of the Housing Waiting List legislation, S.3653-a. You can find out your Senator’s phone number by going to http://www.senate.state.ny.us/senatehomepage.nsf/senators?OpenForm.
ASSEMBLY
CALLS UPON NYS SENATE TO PARTICIPATE IN CONFERENCE COMMITTEE PROCESS
TO REACH AN AGREEMENT ON TIMOTHY’S LAW: Following
is the Assembly’s press release. Silver,
Tonko Urge Senate to Pass Bill Assembly Speaker Sheldon Silver and Assemblyman Paul Tonko today called on the Senate to pass Timothy's Law, a mental-health parity bill (A.2912-A) approved by the Assembly with bipartisan support earlier this year so a joint conference committee can work out a compromise between each house's legislation. In strongly urging immediate Senate action, Silver and Tonko stressed the need to enact a law this year that would end discrimination against mental health and addiction treatment by insurance companies in New York State. They were joined by Assembly Insurance Committee Chair Alexander "Pete" Grannis and Assemblyman Peter Rivera, chair of the Mental Health, Mental Retardation and Developmental Disabilities Committee, in urging the Senate to meet the Assembly in a conference committee to resolve differences between the respective bills once the Senate had passed its legislation. The bill is known as Timothy's Law, for Timothy O'Clair of Rotterdam, New York, who took his own life before his 13th birthday. Tom O'Clair, Timothy's father, and other members of the O'Clair family have participated in many news conferences at the Capitol to explain their painful loss and the suffering they continue to experience because they lacked adequate health-insurance coverage required to provide Timothy with the treatment he desperately needed. "Timothy's Law has been a top priority of the Assembly for several years now. Too many people are suffering because they don't have the health insurance they need. This bill establishes the rights of those who need mental-health care or addiction treatment so that these individuals will no longer be second-class citizens in our health-insurance system," said Silver. "We urge the Senate to recognize the severity of this health-care crisis and quickly pass this critical piece of legislation so we can meet in conference committee and agree on a bill that can become law this year." "Each year, health plans continue to cut back on coverage for mental-health care and addiction treatment. Our parents, children, friends and families cannot continue to stand by and watch insurance coverage for these treatments erode from year to year. Most families can't afford to pay out-of-pocket for expensive care, whether it be outpatient counseling, rehabilitation or inpatient care," said Tonko, the bill's sponsor. Timothy's Law is supported by more than 320 state organizations united under the Timothy's Law Campaign, including Alcohol and Substance Abuse Providers of New York State; Coalition for the Homeless; Coalition of Voluntary Mental Health Agencies; Families Together in New York State; Mental Health Association in New York State; National Alliance on Mental Illness in New York State; New York Association of Psychiatric Rehabilitation Services; New York State Coalition for Children's Mental Health Services; New York State Council for Community Behavioral Healthcare; New York State Psychiatric Association; New York State Psychological Association; New York State Rehabilitation Association; and Schuyler Center for Analysis and Advocacy.
SHU: On Monday, we urge everyone to make calls to push for passage of legislation to ‘Ban the Box’ for inmate with psychiatric disabilities. As NAMI-NYS’ Bob Corliss appropriately stated at a press conference on this issue on Wednesday, "Science tells us that sensory deprivation and isolation is very injurious to people, is very toxic, so people with serious mental illness going into a 23-hour (a day) lock-down facility for months, sometimes years, they become much sicker." In addition, by providing for appropriate mental health treatment for prisoners in needs, this would also help create a safer work environment for correctional officers. We ask everyone to call Senate Majority Leader Joseph Bruno and Senate Finance Committee Chair Owen Johnson to push for passage of S.2207-c before the Senate leaves Albany in two weeks. Both Senators can be reached by calling the Senate switchboard at 518-455-2800 and asking to be connected with their offices. Tell them, "Time is running out to stop the suffering! I'm a registered voter from (your locality) calling to urge you to pass S.2207-C to Increase Safety and Security for both Correctional Officers and Inmates with Severe Psychiatric Disabilities!"
Please call your Senator in their district office to tell them, “Timothy’s Law (S.6735-a) must be enacted NOW. As a registered voter in your district, I am deeply concerned that New Yorkers are still without necessary mental health and substance abuse treatment. I respectfully request that you do whatever it takes to make Timothy’s Law a reality in 2006. We can’t wait another year” You can find out your Senator’s phone number by going to the Timothy’s Law website, www.timothyslaw.org, or by going to http://www.senate.state.ny.us/senatehomepage.nsf/senators?OpenForm. IN THE NEWS: Timothy's
Law Activist Visits Rensselaer County - Tom O'Clair, whose
son inspired the name of mental health law, will talk with Legislature
Republicans. By Kate Perry TROY -- The Rensselaer County Legislature will get a visit from Tom O'Clair, a Timothy's Law activist, today. Timothy's Law, which requires treatment for mental illness and addictions to be covered by insurance companies, was named after O'Clair's son, Timothy. The law, if approved, would require New York state, where such coverage is limited, to provide financial relief for the families that cannot afford treatment. In May, the Republican majority of the Legislature defeated a resolution urging state passage of Timothy's Law. The state Assembly passed the bill four years in a row, including in 2006, but it's never made it to a Senate vote. County Democrats refiled the resolution for consideration this month, and O'Clair's coming to the Legislature's rule committee meeting this afternoon at 4:30 to urge that it move out of committee. Richard Crist, spokesperson for the Republican majority, said GOP legislators took offense to a phrase in the resolution that said Republicans cater to insurance companies. ``The Democrats inserted deliberately insulting language that would have been counterproductive to getting this bill passed,'' Crist said. Steele said the phrase was removed from the new version of the bill.
ALBANY -- Advocates with stories about the devastating effects of solitary confinement on mentally ill prisoners, with some taking their own lives, made a last-ditch effort Wednesday to persuade lawmakers to ban the practice before the Legislature leaves for the summer. People with a serious mental illness have a hard time navigating the rules and regulations in prison and often end up in solitary confinement as punishment, said Bob Corliss of the National Alliance on Mental Illness. "Science tells us that sensory deprivation and isolation is very injurious to people, is very toxic, so people with serious mental illness going into a 23-hour (a day) lock-down facility for months, sometimes years, they become much sicker," he said. "They become a much greater risk to harm themselves or somebody else." Mentally ill inmates often end up in solitary confinement as a result of behaviors caused by their symptoms, which include hallucinations, confusion, depression and paranoia. Their conditions and behavior can deteriorate while being confined to a barren concrete cell, known as the box, advocates said. The bill to ban the box for mentally ill prisoners passed the Assembly 135-27 March 27, but it hit a bottleneck in the Senate. The legislation is under review in the Senate Finance Committee, said Kathleen O'Neill, a spokeswoman for Sen. Owen Johnson, R-Suffolk County, committee chairman. Members of Mental Health Alternatives to Solitary Confinement, a statewide coalition, met with senators and legislative staff Wednesday on the issue. They gave lawmakers samples of the loaf, a bread made of flour, yeast, potatoes and carrots and fed to the worst prisoners in the box. Attached by a ribbon to the cellophane-wrapped loaves was a pamphlet describing the lives of four mentally ill prisoners who took their own lives while in the box. •Jessica Lee Roger, 21, of Poughkeepsie, hanged herself with a sheet on Aug. 17, 2002, at the Bedford Hills Correctional Facility in Westchester County. She had been sentenced to 3 1/2 to seven years in prison for biting her sister's arm, then kicking a guard and setting fire to a mattress while in custody. •James Butler, 36, of Poughkeepsie, hanged himself June 3, 2000, after spending 200 days in solitary confinement. He had been arrested after an altercation with a woman he knew and sent to Fishkill Correctional Facility in Dutchess County. •Jesse McCann, 17, of Kingston, Ulster County, hanged himself with a sheet March 16, 2001. He had been arrested after stealing items from a trailer and taking a wallet from a pizza-delivery truck. •Felix Jorge, 24, of New York City, suffocated himself July 28, 1994, by stuffing his mouth full of wet toilet paper while in the mental health observation room of Clinton Correctional Facility in Dannemora, Clinton County. He had used a toy gun to hold up a woman and had been sentenced to three to six years in prison. If the bill passed, the state would have to establish residential-treatment programs specifically for inmates with serious mental illness. About 11 percent of the prison population, some 7,500 people, have serious mental illness. Twenty-three percent of prisoners in solitary confinement, also known as the box, are in that category, Department of Correctional Services statistics show. The legislation would require hiring more treatment staff, additional training for department staff and renovating existing prison facilities. Advocates said they have heard that the potential cost of the special housing and treatment for that population is an issue in the holdup. State agencies have not provided any hard numbers, and figures of $20 million to $30 million that have been circulating unofficially are too high, they said. Ray Ortiz of the Urban Justice Center in Manhattan, who was briefly in the box while an inmate nearly 18 years ago, said treating mentally ill prisoners that way doesn't help them or society. They are much sicker when they leave than when they arrived, he said. "When you treat people as animals in a cage, they come out as caged animals," said Ortiz, who advocates on behalf of New York City inmates.
It’s been a little over five years since 12-year-old Timothy O’Clair took his own life on March 16, 2001, hanging himself in his bedroom closet just shy of his 13th birthday. Timothy suffered from mental health ailments and his death has been “attributed to the discrimination that he faced at the hands of his parent’s insurance company,” according to the Timothy’s Law Web site. Now, advocates of Timothy’s Law, a mental health parity bill which strives to bring equal insurance coverage for mental health to all insured people in New York state, are pushing for the New York state Senate to pass Timothy’s Law, which the state Assembly has already done. But the Senate still has concerns about the law’s effects on employers. State Sen. Stephen Saland said Thursday that there has been a Timothy’s Law bill in the Senate for a number of sessions, but that it has not been passed yet. “It has been at a standstill for quite some time,” the senator said, touching on the reasons why it is cause for worry. “Primarily it (the Senate) is concerned with the impact on small businesses. There is considerable concern in many quarters that as you expand insurance requirements or mandates, employers who are providing insurance coverage to employees may opt to discontinue providing insurance.” Saland said there is data to back up his concern. “There is some data out there, studies, that validate that position,” he said. “What the Senate bill does is provide an exemption for small businesses with 50 or fewer employees or provides for an exemption where the resulting increase in premiums wouldn’t exceed 2 percent.” He said the Assembly bill did not contain those exemptions. “There is probably about 15 to 18 states that have either a combination of those two or one or the other of them,” he said of the exemptions. “The 2 percent number arrived at in the case of the Senate bill represented a number which was in large part viewed as a response to the disparity in the numbers between what the advocates claim would be the premium increase and what the insurance companies claim would be the increase.” According to Saland, advocates of Timothy’s Law, who base their information on a Price Waterhouse study, claim that the premiums would increase by something like eight tenths on one percent. County Mental Health Department Director Dr. Michael O’Leary, in a speech he gave during a rally in support of Timothy’s Law held in Hudson recently, equated the increase to “$1.26 per insured person per month.” Saland pointed out that the Senate bill’s 2 percent is “more than double” what the advocates say the increase would be. “Clearly everybody agrees on the critical importance of providing mental health parity and the Senate bill certainly would accomplish that, but I think the small business issue is most offensive to the advocates. It is certainly an effort to recognize that small businesses have a difficult enough challenge of surviving in a very competitive business world.” He reiterated the need to deter small businesses from discontinuing health care coverage for their employees and how the Senate’s version of the bill would hopefully make that less likely. Still, O’Leary and many others are stalwart supporters of getting a bill in place and he pointed out a different perspective for the business world to take into consideration. “It’s ironic that a state which prides itself in being business friendly remains inactive in creating legislation that would bring relief to businesses in terms of loss of productivity that results from absenteeism and inefficiency on the job when the employee suffers from treatable disorders such as depression or alcoholism or when an employee’s family member suffers from those disorders,” O’Leary said at the rally. “The facts indicate that U.S. businesses lose $79 billion annually in productivity as a result of mental illness. Treatment works and can mitigate against this loss.” He also urged people to remember there is no difference between mental health and just plain health. “Health insurance should include treatment for mental illness and substance abuse using the same criteria as applies to other health related problems,” he stated. “The standard of medical necessity. Mental illness and chemical dependency are also health problems!” Saland added that the Senate bill also provides a component which required an analysis to determine what the mental health coverage impact would be on insurance premiums. The use of potent antipsychotic drugs to treat children and adolescents for problems like aggression and mood swings increased more than fivefold from 1993 to 2002, researchers reported yesterday. The researchers, who analyzed data from a national survey of doctors' office visits, found that antipsychotic medications were prescribed to 1,438 per 100,000 children and adolescents in 2002, up from 275 per 100,000 in the two-year period from 1993 to 1995. The findings augment earlier studies that have documented a sharp rise over the last decade in the prescription of psychiatric drugs for children, including antipsychotics, stimulants like Ritalin and antidepressants, whose sales have slipped only recently. But the new study is the most comprehensive to examine the increase in prescriptions for antipsychotics. The explosion in the use of drugs, some experts said, can be traced in part to the growing number of children and adolescents whose problems are given psychiatric labels once reserved for adults and to doctors' increasing comfort with a newer generation of drugs for psychosis. Shrinking access to long-term psychotherapy and hospital care may also play a role, the experts said. The findings, published yesterday in Archives of General Psychiatry, are likely to inflame a continuing debate about the risks of using psychiatric medication in children. In recent years, antidepressants have been linked to an increase in suicidal thinking or behavior in some minors, and reports have suggested that stimulant drugs like Ritalin may exacerbate underlying heart problems. Antipsychotic drugs also carry risks: Researchers have found that many of the drugs can cause rapid weight gain and blood lipid changes that increase the risk of diabetes. None of the most commonly prescribed antipsychotics is approved for use in children, although doctors can prescribe any medication that has been approved for use. Experts said that little was known about the use of antipsychotics in minors: only a handful of small studies have been done in children and adolescents. "We are using these medications and don't know how they work, if they work, or at what cost," said Dr. John March, a professor of child and adolescent psychiatry at Duke University. "It amounts to a huge experiment with the lives of American kids, and what it tells us is that we've got to do something other than we're doing now" to assess the drugs' overall impact. But many child psychiatrists say that antipsychotic medication is the best therapy available for children in urgent need of help who do not respond well to other treatments. Without them, they say, many unpredictable, emotionally unstable children would end up institutionalized. Dr. Mark Olfson, a professor of clinical psychiatry at Columbia University and the lead author of the study, financed in part by the National Institute of Mental Health, said the popularity of antipsychotic drugs might result in part from "the fact that psychiatrists have few other pharmacological options in certain patients." The study, which looked at visits to pediatricians and other doctors, found that psychiatrists were the most likely to prescribe antipsychotic drugs. In light of how little these drugs have been studied in children, Dr. Olfson said, "to me the most striking thing was that nearly one in five psychiatric visits for young people included a prescription for antipsychotics." The Columbia investigators analyzed data from the National Center for Health Statistics survey of office visits, which focuses on doctors in private or group practices. They calculated the number of visits in which an antipsychotic drug was prescribed to people under the age of 21 and collected information on patients' medical histories. The total number of visits that resulted in prescriptions for the drugs increased to 1,224,000 in 2002 from 201,000 1993 to 1995. The researchers attributed some of the increase to the availability of a new class of drugs for psychosis, called atypical antipsychotics, that were introduced in the early and mid-1990's. The newer drugs, heavily marketed by their makers, were attractive in part because they appeared less likely than older types of antipsychotics to cause side effects like tardive dyskinesia, a neurological movement disorder similar to Parkinson's disease. From 2000 to 2002, the new study found, more than 90 percent of the prescriptions analyzed were for the newer medications, and most of the patients were boys, predominantly Caucasian children, who were significantly more likely to see psychiatrists than other ethnic groups. Some experts also pointed to an increase in the diagnosis of bipolar disorder in children as a contributing factor. In recent years, psychiatrists have begun to diagnose the disorder in extremely agitated, often aggressive children with mood swings short surges of grandiosity or irritation that alternate with periods of despair. These symptoms in children are thought to be related to the classic euphoria and depressions of adult bipolar disorder. At the same time, several of the atypical antipsychotics, including Risperdal from Janssen and Zyprexa from Eli Lilly, won approval for the treatment of mania in adults. Some psychiatrists now routinely prescribe atypical antipsychotics "off label" for young people thought to have bipolar disorder, and researchers have begun to study the drugs in children as young as preschool age. In the new study, about a third of the children who received antipsychotics had behavior disorders, which included attention deficit problems; a third had psychotic symptoms or developmental problems; and another third were suffering from mood disorders. Over all, more than 40 percent of the children were also taking at least one other psychiatric medication. "We feel the medications are effective in children with bipolar and have some data to show that," said Dr. Melissa DelBello, an associate professor of psychiatry at the University of Cincinnati, who has done several studies of the drugs. Dr. DelBello said that the field "desperately needs more research" to clarify the effects of the antipsychotic drugs but that many children struggling with bipolar disorder got more symptom relief on these drugs than on others, allowing psychiatrists to cut down on the overall number of medications a child is taking. Lisa Pedersen of Dallas, the mother of a 17-year-old boy being treated for bipolar disorder, said he was unpredictable, hostile and suicidal before psychiatrists found an effective cocktail of drugs, which includes a daily dose of antipsychotic medication. "Believe me, I would never choose having him on these meds," Ms. Pedersen said in a telephone interview. "It's not fun watching a child deal with the side effects. But finding the right combination of medicine has made his life worth living." Yet this process is one of trial and error for many children. Ms. Pedersen said her son had responded badly to the first two antipsychotic drugs he received. And some experts think the way that psychiatric drugs are prescribed is obscuring any understanding of underlying disorders and the optimal treatments. "If you're going to put children on three or four different drugs, now you've got a potpourri of target symptoms and side effects," said Dr. Julie Magno Zito, an associate professor of pharmacy and medicine at the University of Maryland. Dr. Zito added, "How do you even know who the kid is anymore?" |
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