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September
26, 2006 October
26th at 8:00 p.m.
October 27th, 12:15 – 2:00 p.m.
“Lincoln’s
Melancholy is an extraordinary story, for the depth Information and registration at www.mhanys.org. IN THE NEWS: Send
Governor a Face He'll Remember Ever tried a chocolate-covered insect? Me neither. That'll be our secret. I was supposed to eat one as part of my job as a judge for the "Men Who Cook" fundraiser held recently in Binghamton, an event that supports the Mental Health Association of the Southern Tier. It was a jovial and delicious evening, during which I and the other judges were required (poor us) to sample dishes made by more than 20 local male chefs. My excuse for avoiding the insectoid bonbons was that I could tell by SIMPLY LOOKING that they were delicious. There were beaucoup other wonderful dishes to eat -- but there was also a wonderful moment that took place at the event. That was when Tom O'Clair, a burly, bearded man in coveralls, approached the microphone. He told the story of his son, Timothy, whose face is tattooed on his beefy bicep. Timothy loved to fish, camp, bowl and build things. And he committed suicide just before his 13th birthday. Look at his face, posted on the Web site www.timothys law.org and you may have the same reaction I did: What a waste. What a beautiful boy. What a tragedy. Timothy O'Clair didn't have to die. His family knew he had a serious problem but their medical insurance, obtained through Tom's job for the New York State Thruway Authority, did not cover sufficient mental health care, particularly in-hospital treatment. On Sept. 15, one day after Tom O'Clair told his story and served up his barbecue (yes, he also was one of the "men who cook"), the New York Senate passed Timothy's Law, which eliminates discriminatory and unequal insurance coverage for mental health and substance abuse services. "This is a huge victory," said Susan A. Wheeler, president of the board of directors for the Mental Health Association of the Southern Tier. The law, she points out, will save everyone money, including small businesses, as the $1.26 cost per insured person per month is far less than the cost to the employer of one employee missing one day of work. But the battle isn't over -- Gov. George E. Pataki is expected to veto Timothy's Law. My feeling is if he just opens the Web page and looks at that face, he just might change his mind. So I had this idea: If everyone who reads this column e-mails Gov. Pataki a link to that Web page -- the one showing Timothy's face -- maybe he, too, could see the importance of Timothy's Law, a ray of hope in the darkness of mental health coverage. Maybe our governor will make that connection -- that this could have been his child, anyone's child. That mental health problems do not discriminate, although the laws that concern their insurance coverage do. Governors have to please a lot of people. They have to please big corporations, too. One would hope that every now and then they make a decision without worrying about who they please but because it is the right thing to do. E-mail Gov. Pataki through http://161.11.121.121/govemail, or by mail to Gov. George E. Pataki, State Capitol, Albany, N.Y. 12224. Send him Timothy's face. And tell everyone you know to do the same. Timothy's story should not repeat. Nobody should be refused mental health treatment because insurance companies say no.
Getting New Yorkers the care they need, regardless of whether they're suffering mentally or physically, is the aim of a bill awaiting approval by the state Legislature. Lawmakers need to quickly approve it and the governor should sign it into law. The legislation, known as Timothy's Law, requires parity in insurance coverage between mental illness and other health problems. Private insurance policies in the state currently limit coverage provided for mental health and substance abuse services or require additional co-payments from the insured. The bill is named for Timothy O'Clair, of Schenectady, who hanged himself at age 12 after suffering for years from mental illness. His parents struggled to find the proper treatment and services for the boy. They even relinquished custody of their son to get him treatment paid for by Medicaid, unable to afford the costly care on their own. The two houses of the Legislature reached an agreement on the bill at the end of the regular legislative session in June, but didn't have time to vote on it. The Senate approved the bill at a special session Friday. The Assembly has not yet committed to returning this year to vote on the bill, but has passed similar measures for several years. The legislation is long overdue and will bring New York in line with many other states. For years, much of the opposition arose from concerns of the costs to small-business owners. The compromise included protections for companies with fewer than 50 employees by having the state absorb any increases in premiums. Many supporters of the plan expect the cost of providing the additional insurance coverage will be more than offset by savings from lost productivity and expensive crisis care. The state needs to act soon to make this necessary change. Coping with and treating mental illness is difficult enough. Problems should not be compounded by having to struggle to get adequate insurance coverage.
The speaker of the New York state Assembly says his chamber will stick by its agreement with the state Senate to pass the health-care policy mandate known as "Timothy's Law." Sheldon Silver (D-N.Y.) said passage of the bill may have to wait until after the first of the year. The state Senate last week approved the bill, which requires coverage of mental health conditions for employers and their dependents. The Senate had promised to do so under a deal it reached with the Assembly on the last day of the regular legislative session in June. Silver said he will follow through on the deal. "The next time we are in session we will effectuate that agreement, whether it's the end of the year or the beginning of next year," he said. The Senate dropped its opposition to the mandate bill after the Assembly agreed to remove mandated coverage for drug and alcohol treatment. The Assembly also agreed to make the new coverage requirement a temporary program that will be revisited in two years to see how effective it has been. The bill also requires the state to make about $60 million available annually to offset insurance cost increases for businesses employing fewer than 50 employees. Gov. George Pataki threw supporters of the bill for a loop last week when he contradicted Senate Majority Leader Joseph Bruno (R-Brunswick), who said Pataki had pledged to him to sign "Timothy's Law" if the bill reached his desk. "I do not recall that conversation," Pataki said. The governor promised only to "take a look" at the legislation if it is approved by both chambers of the Legislature. If the Assembly waits until after the New Year to pass the bill, it would go to a different governor. Democrat Eliot Spitzer, the frontrunner in the race for governor against Republican John Faso, is thought to support the health care coverage mandate. The bill is named for Timothy O'Clair, a Schenectady boy who committed suicide at age 12 in 2001. His family struggled for years to get treatment for him paid for through private medical insurance.
Last month, Gov. George Pataki vetoed a bill that would have prevented mentally ill prisoners from being placed in solitary confinement. More than a decade ago, as a judge, I would have been concerned with the legal implications of the treatment of prisoners diagnosed as mentally ill, but my concern is more personal now. You see, in 1993, I pleaded guilty to harassment, was found to be suffering from bipolar disorder and was sentenced to serve 15 months in a mental health unit of a federal prison. While incarcerated, I was stabbed by another inmate. For my protection I was locked down in what the state calls a “special housing unit” — and what prisoners call “the box,” “the hole,” or simply “solitary confinement” — which is used to manage the approximately 8,000 mentally ill inmates in the New York prison system. I spent 40 days in the box while prison guards tried to determine who my assailant was. They failed, and because of my physical and mental deterioration, I was shackled from head to foot and taken to another prison where I was again placed in a special housing unit — this time for 10 days of observation. The special housing unit is a seemingly endless row of small claustrophobic cells — mine was about seven feet by eight feet — each with its own steel sink and toilet. Against one wall there is a metal rack covered by a thin oil-cloth-covered pad. This is the bed. The door is solid steel with a vertical slot that allows for a guard to peer in. A small, knee-high horizontal slot is used to deliver and return food trays. The walls are made of concrete cement blocks. Light comes in from a very small barred window and a large fluorescent light that is on all day and part of the night. When you are in the box, you are confined for 23 hours a day, and although you are allowed one hour in the daylight, that hour is spent in an outdoor zoo-like cage where you are often taunted by other prisoners. I, like most of the inmates in the box, opted to stay inside for the full 24-hour period, hoping to sleep — because sleep at night is next to impossible. That’s when the noises begin. I heard them all night long. One of my neighbors, called “dogman” by the guards, howled until dawn like a wounded canine; another kept shouting “shut up”; still another sang a tuneless melody with words that spoke of “silver threads and golden needles”; and some engaged in loud conversations with voices that only they could hear. After several weeks, of not being able to separate night from day, I too began to hallucinate. The mind-bending conditions of these units in New York that house the mentally ill has been documented by the Correctional Association of New York, which has interviewed men “who were weeping in their cells, who mutilated their own flesh, who hadn’t left their cell in months, who smeared feces on themselves or repeatedly attempted suicide.” An estimated 12 percent of the overall prison population in New York is seriously mentally ill, and those who are disruptive and placed in these housing units become even more so. From 1998 to 2004, hundreds of mentally ill prisoners have tried to kill themselves, and at least 52 of those who were in solitary confinement succeeded. The Urban Justice Center, an advocacy group, estimates that today there are 700 mentally ill prisoners in solitary confinement in New York State, many of whom have been incarcerated for nonviolent, drug-related crimes. One does not have to be a trained penologist or psychiatrist to know that a mentally ill person should not be treated this way. Not only is such internment uncivilized, it is also counterproductive. Most of these inmates will one day return to the streets in a worse state than they were when they were arrested. There is a solution. Psychiatrists or medical professionals should oversee mentally ill inmates, not prison guards. The guards themselves realize this. In fact, the New York State Correctional Officers and the Police Benevolent Association supported the bill that Mr. Pataki vetoed to allow for alternative confinement for disruptive mentally ill prisoners. This bill, which also said that mentally ill inmates should be given treatment in secure hospital wards, was passed, almost unanimously, by both the State Senate and the Assembly. And several states, including California, Connecticut, Florida, New Jersey and Texas have passed similar legislation. In vetoing the legislation, Governor Pataki said, among other things, that putting mentally ill prisoners in separate hospital wards would cost too much. When I was on the Court of Appeals, I wrote a decision for the court in which I observed: “Merely confining an inmate in a segregated cell does not constitute cruel and unusual punishment. There are, of course, some cells that are so subhuman as to constitute such punishment even for a very brief confinement. One day in some cells might be constitutionally intolerable.” When I wrote those words I never dreamed that I would discover such a cell by living in one. No mentally ill person should have to endure that kind of suffering. Sol Wachtler, a former chief judge of the New York State Court of Appeals, is the author of “After the Madness,” a memoir.
Supporters of Timothy’s Law are now waiting to see if the Assembly will reconvene for a special session to pass a mental health insurance parity bill recently adopted by the Senate. “The Assembly is committed to passing the Timothy legislation as soon as it can, when it can,” said Bryan Franke, spokesman for Assembly Speaker Sheldon Silver, D-Manhattan, when asked if the Assembly would be called back for a special session. While Silver has not announced a special session, Franke made it very clear the Assembly had “every intention to pass that law.” The Senate and Assembly reached a compromise on Timothy’s Law on the last day of the 2006 regular legislative session that would provide parity in insurance coverage for adults and children suffering from mental health illnesses. That compromise was the basis for the bill passed by the Senate on Sept. 15. Matt Beebe, a spokesman for Assemblyman Paul Tonko, D-Amsterdam, who is sponsoring the legislation, said that the compromise bill was not everything the Assembly had hoped for. The Assembly had hoped to include provisions for treating alcohol and drug abuse as mental health care needs. Beebe also commented on the possibility of the Assembly coming back for a special session to pass Timothy’s Law in 2006, saying, “Probably — but we just don’t know yet.” After the suicide of 12-year-old Timothy O’Clair on March 16, 2001, Timothy’s parents, Tom and Donna O’Clair, became strong advocates to end discrimination against mental health patients by the health care insurance industry. Timothy’s Law has been passed repeatedly by the Assembly since the boy’s death. But the bill, due to what Timothy’s Law supporters call “legislative gridlock,” has never made it to the governor’s desk. The bill also faced opposition from the insurance industry, which warned the legislation would result in increased rates for all. “Today is a landmark day for New Yorkers suffering with mental illness and disorders,” said Tom O’Clair, at a press conference on Sept. 15, the day the Senate passed Timothy’s Law. “It’s a wonderful testament to what the Legislature can accomplish when they work together and a heartfelt tribute to Timothy. I thank the Senate and look forward to the Assembly’s return so they can pass it as well.” Paige Pierce, executive director of Families Together and a co-chair of the Timothy’s Law Campaign, said she is confident the Assembly will return to session this year and pass the law. “We view the Assembly as our allies,” she said. “We have a lot of faith they’re going to come back this year and get it done.” The legislation would mandate all insurance companies provide at least 30 inpatient days and 20 outpatient visits for mental health care. Co-payments for mental heath services will also be the same as co-payments for physical health needs. The O’Clair’s health insurance, like many Americans’, only covered 20 outpatient visits a year for a psychologist and psychiatrist combined. Their physical and mental health co-payments began at $10 a visit; the mental health care co-pay increased to $35 every visit. According to the National Institute of Mental Health, more than 50 million American Adults suffer from a mental disorder; and one in five children suffer from behavioral, emotional or mental health problems. If adopted, the law would be effective from Jan. 1, 2007 until Dec. 31, 2009, at which time the law could be amended and improved if necessary.
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