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August 8, 2006 CALLS AND E-MAILS TO GOVERNOR PATAKI NEEDED FOR HOUSING WAITING LIST AND TO 'BOOT THE SHU': As has been reported in previous editions of the Update, on August 4th, two bills mental health advocates have been pushing for were delivered to Governor Pataki for his consideration, having passed both the Assembly and Senate earlier in the year. As The Journal News opines in an editorial this week that follows below, “One is about counting and the other common sense.” MENTAL HEALTH HOUSING WAITING LIST - The first bill will establish a waiting list for individuals with psychiatric disabilities seeking housing, which “would help . . . officials, for the first time, put real numbers to the predicament, the hope being that real solutions will emerge,” (The Journal News). As the paper continues, “Anecdotal evidence, including from local-agency reports, makes plain that there is a lack of appropriate housing alternatives for people with psychiatric disabilities … What exactly, though, is the wait time for existing housing? Just who is being unserved? Are less-expensive alternatives being overlooked?” Simply put, this bill is necessary if the state is going to responsibly plan for the future housing needs of New Yorkers with psychiatric disabilities. Unfortunately, significant opposition to this bill persists among state agencies, making the prospects for this bill’s enactment into law questionable. Therefore, everyone must contact the Governor to tell him to sign the mental health housing waiting list bill. ‘BOOT THE SHU’ – The second bill mental health advocates have long been pushing for is the legislation to ban the inhumane use of solitary confinement for prisoners with psychiatric disabilities. Newspapers from throughout the state have weighed in over the past month in support of this legislation with editorials titled, “Sign it, governor - Pataki should do his part to make inmate mental health bill a reality”(Elmira Star-Gazette, August 7), “End the torture - Gov. Pataki should sign legislation banning solitary confinement for mentally ill inmates,” (Albany Times Union, June 30), and “End isolation - State must treat mentally ill inmates” (Long Island Newsday, July 10). These media outlets understand the same thing that both mental health advocates and correctional officers understand in pushing for enactment of this law – “New York would join a handful of other states that recognize the inhumane and harsh nature of solitary punishment. Recidivism rates for prisoners with mental illnesses would plummet. And state prisons would become easier to manage, safer for guards as well as inmates.” (Syracuse Post-Standard, July 31). Unfortunately, this bill also faces stiff opposition from state agencies. Therefore, everyone must also call the Governor to tell him to sign the legislation to 'Boot the SHU'. Contact Governor Pataki by: PHONE: E-MAIL:
MHANYS SEEKS INPUT ABOUT INTEREST IN BECOMING PART OF DISASTER PREPAREDNESS AND MUTUAL AID NETWORK: Helena Davis, MHANYS' Managing Director, has received requests for technical assistance regarding disaster planning and relief due to recent flooding. Helena would like to hear from MHA's across the state as to whether they would be interested in becoming part of a disaster preparedness and mutual aid initiative among all affiliates in NYS to assist each other when disasters strike. Please contact Helena at (518)434-0439 ext 219 or hdavis@mhanys.com. Helena is ready to provide training, technical assistance and resources and would like to know what affiliates have to offer and/or need. In addition, she has prior experience in crisis management, trauma care, plus organizational and program development.
IN THE NEWS: Connecting
Dots. Editorial Two important bills headed to Gov. George Pataki's desk Friday merit his signature. One is about counting and the other common sense. Ultimately, though, both are about compassion for adults with mental illnesses, including those behind bars and on the street. Connect the dots a bit further, and the measures are as easily about murder victim Concetta Russo-Carriero and Phillip Grant, the homeless ex-convict recently convicted in her slaying. The first bill proceeds under the assumption that you can't solve a problem until you know how big it is. Lawmakers and advocates for the mentally ill are pushing a measure that would establish within the state mental-health system a list of mentally ill adults awaiting community housing - this to serve a population that now resides in accommodations ranging from shelters and group homes to private homes and the street. Released sex-offender Grant was homeless - and purported by so many to be mentally unstable, the proverbial ticking time bomb - when he encountered office worker Russo-Carriero in a White Plains parking lot last year. Anecdotal evidence, including from local-agency reports, makes plain that there is a lack of appropriate housing alternatives for people with psychiatric disabilities, whether they be released prisoners, like Grant, or entirely unaffiliated with the criminal justice system, no doubt the larger population. What exactly, though, is the wait time for existing housing? Just who is being unserved? Are less-expensive alternatives being overlooked? The housing waiting list bill's prime sponsor is state Sen. Thomas Morahan, R-New City. It is modeled on a similar state effort a few years ago on behalf of people with developmental disabilities. As with that initiative, the law would help the officials, for the first time, put real numbers to the predicament, the hope being that real solutions will emerge. A second bill recognizes that New York is in the 21st century, not the 17th, and that prisoners with psychiatric conditions belong in treatment - not boxed into solitary confinement where their symptoms can only worsen. Hark back to Grant: He spent 23 of his 44 years in prison, for committing three rapes. What in-prison treatment he received has been described as minimal, all but ensuring that the damaged person behind bars would eventually become a damaged person on the street. We don't know what time he spent in solitary. Mental-health
advocates have dubbed their campaign "Boot the SHU.'' The "Boot the SHU'' measure would require that mentally ill prisoners get adequate treatment and rehabilitation, and that correctional officers receive better training. Prison guard associations also back the measure; they think it will make for safer prisons. Pataki's office has cited technical problems with the bill, but since it wouldn't become law for 18 months after signing, there would be plenty of time for the Legislature to address them through amendments. Left-leaning California bans the practice of putting mentally ill prisoners in "special housing units,'' but so do the tough-on-crime states of Florida and Texas. Surely New York can join them in the 21st century.
They
Can't Help It. Editorial For prisoners with mental illness Gov. George Pataki has a chance to end a thoroughly cruel and barbaric practice in New York's state prison system. On Friday, a bill is due to cross his desk prohibiting prisons from locking away mentally ill inmates in solitary confinement. These prisoners would go, instead, into a secure residential program where they'd be able to get treatment. The governor should sign this legislation. If he does, New York would join a handful of other states that recognize the inhumane and harsh nature of solitary punishment. Recidivism rates for prisoners with mental illnesses would plummet. And state prisons would become easier to manage, safer for guards as well as inmates. About 12 percent of the state's 63,500 inmates have been diagnosed with a serious mental illness. But at least 20 percent of the thousands of prisoners in solitary confinement suffer from depression, bipolar disorder, schizophrenia or some other type of mental illness. That's because inmates with mental problems are more likely to exhibit behavior that would result in disciplinary action. They can't help acting that way; it's part of their sickness. Prison guards, whose main mission is to maintain order, don't discriminate; they punish unruly inmates by throwing them in solitary-lockdown cells called "special housing units." Prisoners have their own term for it: "the box." Inmates stay alone in "the box" for 23 hours a day, often for months at a time. There's little natural light, little to do and little human contact. Because New York places no limit on the time a prisoner can be kept in solitary, inmates with serious mental illness can spend years in social isolation, according to the Correctional Association of New York. That leads to a cycle of mental deterioration, often with deadly consequences. Prisoners in solitary are three times more likely to commit suicide than inmates in the general prison population. Acts of self-mutilation also are common. The bill going to the governor would ban placing inmates with serious mental illness in isolated confinement as punishment or to maintain order. The legislation, sponsored by state Sen. Michael Nozzolio, R-Fayette, also would set up residential mental-health programs where these inmates could get the treatment they need. The programs would be run jointly by the state Office of Mental Health and the Department of Correctional Services. The state Commission on Quality of Care for the Mentally Disabled would monitor the whole operation. Gov. Pataki should do the humane thing by attaching his name to this long-overdue legislation. Mentally ill people should be treated, not punished, for their sicknesses.
Sign it, Governor - Pataki should do his part to make inmate mental
health bill a reality. Editorial New York has a chance to join a growing number of states that have ended the inhumane practice of punishing mentally ill prison inmates by throwing them into solitary confinement. A bill that's before Gov. George E. Pataki would ban the practice of 23-hour-a-day lockdown for prisoners who are mentally disturbed. The measure would require that alternative housing be designated for such prisoners, would provide for special training for an expanded staff of correction officers who deal with them, and would give mental health professionals a bigger role in the treatment of those inmates. We urge the governor to sign it. Ten states already have taken such action, some of them only after years of costly litigation. In New York, Republicans and Democrats, conservatives and liberals alike have gotten behind the measure, which also has the backing of at least some correction officers. Ed Lattin, union steward with the New York State Correctional Officers and Police Benevolent Association at Elmira Correctional Facility, is among its supporters. "The overall view is it would help out the entire system if something was done with these psychological prisoners instead of just sticking them in a cell and forgetting about them," Lattin told the Star-Gazette. Elmiran Al Mothershed, the union's Western Region vice president, is understandably cautious in his assessment of the bill. If Pataki signs the measure, Mothershed wants to be sure the union gets the staffing and training that's been promised. Beyond that, though, he seems to agree with the need to find a better way to deal with mentally ill inmates. It's hard to argue against the bill. It's well documented that inmates with psychological problems who are placed in solitary confinement not only are subject to mistreatment by other prisoners but are likely to either injure themselves or attempt suicide, and perhaps both. Besides, they become a greater risk to correction officers while in lockdown, and those officers now are poorly trained to deal with their special needs. We agree with state Sen. George H. Winner Jr., R-Elmira, who voted for the bill and said he wants Pataki to explain himself if he doesn't sign it. "I'd like to see him sign it," Winner said. "But if in fact he's going to veto it, I'd like him to say what is going on within the (corrections) department to address the situation." Good point. Something needs to be done about this very serious situation. If this bill isn't the answer, as members of both houses of the Legislature seem to think it is, then we'd like to know what is.
Gov. Pataki Must Sign Into Law Measure to Stop Solitary Confinement
of Mentally Ill Inmates. Editorial The legislature has passed, and we hope the governor signs, a measure to treat, rather than browbeat, prison inmates with mental-health problems. The proposal is well overdue. The New York prison population of more than 70,000 inmates includes about 12 percent with mental illness of one kind or another. That totals more than 8,000 inmates. Yet that 12 percent is currently disciplined in ways identical to the mentally healthy population. This clearly is bad for the inmates and equally so for the correction officers who have to administer the discipline. A typical form of discipline is longer periods of solitary confinement, an effective tool against mentally sturdy inmates but a potential disaster for the less stable. Studies reveal that when the mentally ill inmates are put into solitary confinement, they are three times as likely as healthy inmates to commit suicide or intentionally injure themselves. If they survive, their mental conditions typically continue to deteriorate. This is not humane. Yet remedies in the traditional prison setting are limited. The bill would establish residential mental-health treatment programs for inmates and provide for the assessment of all inmates put into solitary for more than 24 hours. It would also set up a state commission on quality care for the mentally disabled and authorize the panel to monitor the quality of care in treatment programs. The goal is to ensure both the best treatment of the mentally ill inmate and the safety of the staff and the prison population. The program would be jointly operated by the Department of Correctional Services and the Office of Mental Health. All correctional staffers will receive 40 hours of training, and the service will begin 18 months after the governor signs the bill into law, which we hope will be this week. To characterize current treatment of mentally ill inmates who are put into solitary confinement as barbaric would probably be going too far. But it certainly isn't in keeping with current understandings of mental illness and best treatment practices. It verges on torment, if not torture. Critics and cynics will insist that these inmates have committed anti-social acts and deserve to be treated in kind — an eye for an eye. But do we have no regard and no compassion for the people with the affliction of mental illness? And, if they are driven deeper into their mental maestrom, aren't the officers assigned to keep order in the prisons put in more serious peril? We have to wonder why such a measure has not been introduced before this. It would confound reason to think the governor would not sign this into law at once.
Stop Isolating the Mentally Ill. Editorial It's time to stop the inhumane and counterproductive practice of confining mentally ill prison inmates in isolation in New York state. Treating mentally ill prisoners, instead of punishing them, for behaviors they can't control is an approach that is long overdue. Gov. George Pataki has the power to make it happen, and should sign a bill into law that would place such inmates in secure residential treatment programs, instead of solitary confinement. Several other states already have taken this step. The programs would be developed within existing facilities. The change is one of several provisions in a bill aimed at improving treatment for seriously mentally ill inmates. It is needed not only for the health and safety of the inmates, but those who work in correction as well. New York state's prisons have become de facto psychiatric centers with the mental health system being deinstitutionalized. As psychiatric facilities were downsized and patients released into the community, many mentally ill went to group homes but many ended up on the streets without treatment. Some took to crime to survive, with little way of fending for themselves. New York is not alone in dealing with this phenomenon. Experts estimate 15-20 percent of inmates across the U.S. have serious mental illnesses. An estimated 8,000 inmates, or 12 percent of the state's prison population, are seriously mentally ill. But they represent 23 percent of inmates in solitary confinement. For years, those suffering from mental illness in the general prison population have been treated like all other inmates. Many are placed in solitary confinement for 23 hours a day, indefinitely, when they are disciplined for acting out. They end up in these special housing units, referred to as "the box," even when their behavior may have been caused by their symptoms.
2003 study cites discrepancy If isolated inmates try to kill or injure themselves, they face even longer stays in the box, which is often the trigger for the actions in the first place, mental health advocates said. The current situation is also unfair to correction officers, who often don't know how to properly deal with those suffering from mental illness. All correctional staff would receive annual training, under the bill, with an emphasis on those working in the residential treatment programs. The union representing corrections officers supports the proposed law. The governor should quickly sign the bill and make clear New York recognizes that those with mental health problems are indeed suffering from an illness that needs to be treated.
Your July 30 editorial asking Gov. George Pataki to sign the bill banning solitary confinement for mentally ill prisoners raises troubling questions. First of all, what alternatives are there to control violent outbursts if solitary confinement is banned? The possibilities are chemical or physical restraints -- straight-jackets, handcuffs and leg irons, or forcibly injected chemical tranquilizers. That doesn't sound more humane to me. Besides, violent outbursts take time to subside, sometimes days. You can't keep prisoners in handcuffs or straight jackets for days. The kindest and most effective method of restraining them, for their safety and the safety of others, is to get them into a stripped room as quickly as possible. The editorial writer probably never stood next to a violent, explosive mentally ill prisoner at the initial outburst. It's scary, to say the least, and demands restraint as quickly and humanely as possible. Once restrained, however, it takes time for the prisoner to calm down. Solitary confinement reduces the opportunities for suicide, although it is possible. On the other hand, many prisoners who were not in solitary confinement have committed suicide in our jails and prisons. The real problem facing corrections is not solitary confinement, per se, but its abuses: failure to properly monitor prisoners in "The Box," confinement for trivial offenses like foul language or throwing food, excessively long periods in The Box -- weeks or months, even -- and finally, infrequent medical and psychological evaluations to determine if the prisoner is improving or deteriorating, or if other remedies, such as transfer to mental health facilities, should be considered. Mental illness is not always crystal clear or easily apparent; at times violent outbursts do not signal suicidal intentions; just as often, suicidal intentions may seem unlikely, when they are actually imminent. Simply banning solitary confinement to abolish any possibility of suicide makes no sense. Until mental health professionals come up with a better solution to violent outbursts from prisoners, particularly those most clearly mentally ill, solitary confinement seems to be the best remedy we have right now. SYLVIA
HONIG
Road to Recovery. By Thom Forbes I am, at the least, a fourth-generation alcoholic. So is my wife, Deirdre. Our 22-year-old- daughter, Carrick, is a recovering heroin addict. Most members of our family have been successful professionally -- Deirdre's father was a lawyer and judge; my side brims with journalists who kept the proverbial pint flask in their desk drawers. My great-grandfather was run over by a trolley car while covering a story in 1904 -- still reporting, probably inebriated, but certainly a broken man who was estranged from his family. Many of his progeny shared his taste not only for booze but also for the illusory camaraderie that goes with it in bars and binges. Most of us got sober, but we've taken different routes to get there. I've learned along the way that there is a difference between not using a drug and being in recovery, which encompasses the way you lead your life, interact with other people and face your mortality. To greater and lesser degrees, we functioned despite our illnesses, as many of you, or your loved ones, do today. More than 22 million of us older than 12 abuse or are dependent on alcohol or illegal drugs, according to 2004 government figures, and that's not counting prescription drug misuse, a rising crisis. Sixty-three percent of Americans say that addiction -- their own or another's -- has had an impact on their lives. Road to Ruin I first swore off booze as a 16-year-old who'd stop off in a saloon on the way home from high school for a few boilermakers -- shots of bourbon chased by a beer. That period of sobriety lasted a few weeks; relapse is part of this disease. I had my last drink two decades ago, when I was 32. My bottom came when I discovered the liquor cabinet was dry one evening. With my toddler tugging on my leg for attention, I felt physically compelled to buy a bottle of vodka, spiritually driven to stop letting alcohol control my life, and intellectually determined to end the cycle of waking up with a hangover, nipping at lunch to feel "normal," imbibing in the evening to get blotto and arising again with a hangover. Few of my friends thought I had a problem; most drank as much as I did. My best buddy from those days, prone to depression and Seagram's 7, blew his brains out 10 years ago, still drinking. I did not seek treatment or help from a 12-Step program like Alcoholic Anonymous because I was not comfortable turning over my life to a "higher power." Whenever someone asks me how to get sober, however, my first recommendation is to head to the nearest 12-Step meeting. Deirdre did, and the fellowship she found "in the rooms" was the cornerstone of her recovery 19 years ago -- and counting. You're always counting, because sobriety is, as the AA slogan goes, "one day at a time." The reality is that I picked up a lot of the 12-Step philosophy by osmosis, and its precepts have helped not only the millions who join but countless others who are "sick and tired of being sick and tired." Every treatment philosophy has its zealots, from 12-Steppers to members of therapeutic communities such as Phoenix House that break you down in order to build you up. Any of them may work for you. Some will tell you that their way is the only way. That's true only to the extent that it's true for them. The bottom line is that many people overcome their addiction and flourish, but less than 10 percent of people who need intensive treatment at a substance abuse facility actually receive it in a given year, according to the federal Substance Abuse & Mental Health Services Administration. Road to Recovery Deirdre and I had our own ideas about what would work for our daughter, Carrick, who first drank at 12, smoked marijuana at 13, dabbled in other recreational drugs by 15, became a heroin addict at 17 and met her bottom while speedballing -- mixing heroin and cocaine -- at 19. By that time, she had been through three emergency rooms, seven detoxes, three short-term residential programs, a four-month wilderness therapy program, several 12-step programs, four special schools and had prematurely quit a long-term treatment community twice. She had talked to dozens of psychiatrists, psychologists, social workers, medical doctors and addiction counselors. The deeper her addiction took hold, the better she got at telling them all what they wanted to hear. After she turned 16, Carrick was often away from home. When she'd visit our suburban New York state home, she recently recalled, "I would come home with a warm greeting, pillage the house and leave with a warm farewell. It was not just stealing money, but time, sleep and sanity." We eventually told Carrick that we would no longer enable her in her addiction -- including providing shelter and food -- while she was using drugs, but we would do anything we humanly could to help her in her recovery. Some people feel that barring our daughter from our home was heartless. We knew her life was at risk every day she was on the streets of New York City, but she proved time and again that she would not face her recovery as long as we protected her from her bottom. Nor was it fair to our son, Duncan, five years younger. Or ourselves. In the end, Carrick decided, on her own, to try methadone maintenance, a controversial treatment that critics contend "substitutes one drug for another." It saved our daughter's life. She is gradually reducing her dosage with the intention of quitting; others may need to stay on methadone all of their lives. Many become productive members of society, no longer scheming for the next fix. "You've got to meet addicted individuals on their own terms rather than confront them on yours," says Dr. Harris B. Stratyner, clinical division director of Addiction/Recovery Services for the Mount Sinai Medical Center in New York. "The goal is to get people to completely stop using, but not to say to them, ‘You're using, therefore I'm not going to engage you in treatment.' That's not the way you motivate someone." Stratyner is a leading proponent of a "carefrontation" model of treatment, which holds that addicted individuals should not be held responsible for having their disease any more than diabetics are, but must take responsibility for their recoveries. So must the family and friends who get caught in the vortex of lies and manipulations that swirl around an addicted person. It's human nature to want to believe a child or spouse who tells you "this is the last time," no matter how often you've been burned already. At times, Deirdre and I enabled Carrick to continue using without facing repercussions -- for example, by making excuses for her behavior to friends and teachers. One day, I found a hypodermic needle and a card that allowed Carrick to exchange it for a clean one. My instinct was to break the needle and rip up the card. But what would that have accomplished? Dirty needles spread hepatitis C, which Carrick has contracted, and HIV. Shuddering, I chose the lesser of two evils, a misunderstood concept known as "harm reduction," and put the paraphernalia back. Some say that it's fruitless to force a person into treatment, particularly a teenager who is still enjoying the dopamine-induced good feelings that drugs undeniably provide. More than 80 percent of teens relapse within a year of treatment, according to one study. Carrick will tell you, however, that she took away one very powerful idea from the programs she attended and prematurely left: When she was ready, she could get better. And once she tried, we again did everything we could to help. "Without trying to sound melodramatic, giving me another chance probably saved my life," Carrick says. "The line between enabling and supporting sometimes requires you to take a risk and hold onto realistic hope." Call it paternalistic -- in my case it literally was -- but addicts frequently don't know what's best for them and interventions may be necessary. When Carrick was living on the streets, we prayed that she would be arrested and mandated to treatment by a judge. When she was finally nabbed for theft, however, she was sentenced to 30 days in jail. She celebrated her release by getting high. Drug courts around the nation are beginning to substitute treatment for incarceration for nonviolent offenders. About 80 percent of the more than 2 million teens in the juvenile justice system have drug and alcohol problems, according to figures compiled by the Robert Wood Johnson Foundation, and a similar percentage have diagnosable mental illnesses. Indeed, addicted individuals of all ages who suffer from illnesses such as bipolar disorder may use mind-altering drugs to self medicate. We once begged the admitting doctor at a psychiatric hospital to treat Carrick's underlying depression. We were devastated when he not only gave us the party line that Carrick would first have to abstain from drugs, but also expressed his doubt, based on her record, that she'd be able to do so. She has, though, and is attending college with the intention of becoming a fifth-generation journalist. An antidepressant stabilizes her mentally; she says she no longer "gets in a crummy mood for no apparent reason." No Easy Street In 1998, more than 10 years after she got sober, my wife Deirdre became so deeply depressed and suicidal that I marked her survival from hour to hour. She eventually signed herself into New York Hospital-Cornell Medical Center, a psychiatric hospital in White Plains, N.Y. Her life was saved by electro-convulsive therapy, antidepressants and talk therapy. She has gone on to become an accomplished substance abuse advocate and professional, working as an intake coordinator for Madison East, a unit within New York's Mt. Sinai Medical Center. She's a happy and productive wife, mother and citizen. Fortunately, we've been able to afford treatment for her and Carrick over the years, but because New York State lacks a parity law for mental health and substance abuse, insurance coverage has been erratic and spotty. We've broken into retirement IRAs and refinanced our mortgage to pay medical bills. What's most unfortunate to many of us on the front line -- addicts and family members -- is that the war on drugs has become a polarized battle between two camps: hardliners whose "zero tolerance" approach relies on interdiction and prisons for illegal drugs and laissez-faire libertarians and reformers who believe that supply, demand and individual choice should allow the market to reach its natural level. The market for mind-altering drugs is a lucrative one, indeed. They are responsible for the livelihoods, legal and illegal, of millions of people worldwide -- from drug lords to rapid detox clinicians, from bartenders to prison guards, from bureaucrats to copywriters. A recent study by researchers at the University of Connecticut confirmed that the more alcohol ads teens see, the more they drink. But the alcohol industry has the economic muscle to protect its interests: The beer industry in the United States alone spends $1.36 billion in measured advertising dollars annually, employs 1.78 million people, pays $54 billion in wages and benefits, and generates $30 billion in taxes. The money for treatment is harder to come by. The Bush administration's $12.7 billion drug control budget request for 2007 earmarks 65 percent for interdiction and law enforcement and barely 36 percent for treatment and prevention. A National Center for Addiction and Substance Abuse report found that of the $277 each American paid in state taxes to deal with substance abuse and addiction in 1998, only $10 went toward treatment and prevention. There is an obvious common ground: People. If we were to focus our efforts on the family members, friends and neighbors whose brain chemistry has been altered by drugs and alcohol, and treat abuse and dependency as the public health scourge that it is, we'll have declared a war on addiction. It's a campaign that can be won, one life at a time. I've seen it happen. Thom Forbes is an author, blogger on addiction and recovery, and former reporter for the New York Daily News. |
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