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November 3, 2006GREAT TIME HAD BY ALL WHO ATTENDED MHANYS AWARDS DINNER AND CONFERENCE: Those who attended MHANYS Awards Dinner and MHANYS Annual Conference last Thursday and Friday witnessed the best of what comprises the Mental Health Association movement – dedication, emotion, and passion for the mental well-being of people throughout our society. MHANYS was honored that Senator Thomas Morahan, Assemblymember Paul Tonko and CQCAPD Chair Gary O’Brien joined us for Thursday evening’s events. In addition, we were so pleased to be joined by so many friends and colleagues from the Governor’s Office, NYS Assembly, NYS Senate, Office of Mental Health, Division of the Budget, Commission on Quality of Care and Advocacy for Persons with Disabilities, and the numerous colleague organizations with whom we work on a daily basis. These are the people who make it possible for us to continue with our good work. MHANYS was particularly pleased to see such a huge turnout from MHA affiliates from throughout the state, representing nearly 75% of the entire MHA network in NYS. All in all, nearly double the number of people who attended the Awards Dinner last year joined us this year. Thursday’s Awards Dinner highlighted outstanding accomplishments of people working to assist those with mental health needs in New York State, including: •
Michael B. Friedman, Director of the Center for
Policy and Advocacy of the Mental Health Associations of New York
City and Westchester – recipient of MHANYS’
CEO’s Award •
Mary Jean Coleman, in recognition for her 25+ years
working toward the prevention of suicide – recipient
of the MHANYS’ Leila Salmon Award, named in recognition
of Leila’s outstanding work in the mental health field as
the Director of MHANYS from the 1980’s to the mid-1990’s.
After the Awards Dinner on Thursday night, comedian Paul Jones addressed the crowd with his refreshingly frank and forthright performance that consists primarily of discussion of mental health issues. Speaking from his personal perspective, including his own 20+ year battle with Bipolar Disorder, Paul described very difficult events in his life, finding humor in all of them, including his own suicide attempt. The humor was interspersed with very emotional moments, like when he turned to his friend, Tom O’Clair, and expressed his desire to let Tom borrow “just one moment” in the hopes that “just one moment” might have made the difference for Tom’s son, Timothy, who took his life at the tender age of 12 in 2001. We thank Paul for sharing with us his perspective on the serious issues we all deal with each and every day. Friday’s
Conference: MHANYS wants to thank all of the presenters for their excellent work in making our Conference such a success. MHANYS would also like to thank Joshua Wolf Shenk for his noontime presentation on President Abraham Lincoln and his lifelong struggle with mental illness. The packed lunch room on Friday seemed riveted by Mr. Shenk’s obvious extensive knowledge and understanding of Lincoln, which he used to help others gain a perspective on Lincoln’s greatness, both as an individual and then later as President. Look for pictures from last week’s wonderful events on our website, www.mhanys.org, soon.
SATURDAY, NOVEMBER 18TH IS THE 8TH ANNUAL NATIONAL SURVIVORS OF SUICIDE DAY: This day, sponsored by the American Foundation for Suicide Prevention, will include local healing conferences for survivors of suicide loss will take place in over 100 cities throughout the country -- connecting survivors within their own communities and across the nation. For those who don't live near a conference site or who find it difficult to attend in person, the program will also be broadcast live on the web, followed by a live online chat. Conference
sites in New York State will include: For more information or to register to watch the live webcast, visit www.afsp.org. MHANYS’ CONSUMER AND BUSINESS OUTREACH PROGRAM HIGHLIGHTED BY US DEPARTMENT OF HEALTH AND HUMAN SERVICES’ SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION (SAMHSA) - http://www.stopstigma.samhsa.gov/topics_materials/consumerBusinesssOutreach.htm
Brief Description NYSOMH
ANNOUNCES CREATIVE NEW APPROACH TO EMPLOYMENT FOR PEOPLE WITH PSYCHIATRIC
DISABILIITES – PARTNERSHIP WITH NYSID WILL RESULT IN NEW COMPETITIVE
EMPLOYMENT OPPORTUNITIES The
New York State Office of Mental Health (OMH) today announced that
it is taking a new and creative approach to cultivating competitive
employment opportunities for New Yorkers with psychiatric disabilities.
OMH is entering a partnership with the New York State Industries
for the Disabled, Inc., (NYSID) that will create competitive, private
sector employment opportunities for individuals with a history of
receiving mental health services, and at the same time address OMH’s
record storage problem.
NYS ASSEMBLY TO HOLD HEARINGS ON WOMEN AND SUICIDE TO EXPLORE THE HIGH RATES OF SUICIDE AMONG WOMEN IN NEW YORK AND IDENTIFY SUCCESSFUL SUICIDE PREVENTION INITIATIVES:
ASSEMBLY STANDING COMMITTEE ON MENTAL HEALTH, MENTAL RETARDATION
AND DEVELOPMENTAL DISABILITIES NOTICE OF PUBLIC HEARING SUBJECT: Women and Suicide PURPOSE: Explore the high rates of suicide among women in New York and identify successful suicide prevention initiatives. New York City Thursday According to the National Center for Injury Prevention and Control, women attempt suicide during their lifetime about three times as often as men. Further, certain subgroups of women, notably young Hispanic and Asian American women, are at even higher risk for suicide. The Centers for Disease Control (CDC) reports that high school age Hispanic females report more feelings of sadness or hopelessness and of suicidal ideation and attempt, compared with their white or black non-Hispanic counterparts. Similarly, the CDC reports that Asian American women have the highest suicide rate of all women over 65, and according to the American Psychological Association Asian American girls have the highest rates of depressive symptoms of all racial groups and the highest rate of suicide among all women age 15 to 24. Several suicide prevention documents currently are available to assist New Yorkers, including a Suicide Prevention Education Awareness Kit that is available from the Office of Mental Health in Spanish and Chinese. While research over recent decades has uncovered information on the causes of suicide and the strategies to prevent it, much more needs to be understood about how gender, ethnic, cultural and generational differences may lead to increased rates of suicide. The Committee on Mental Health, Mental Retardation and Developmental Disabilities, the Puerto Rican/Hispanic Task Force and the Task Force on Women’s Issues is holding a hearing to gather information about women and suicide, particularly focusing on young Hispanic women and Asian American women. The Committee and Task Forces are also seeking information about suicide programs currently in place in New York State and input about ways in which to further decrease the risk of suicide and prevent suicide attempts for these vulnerable populations as well as all New Yorkers who may be at risk of suicide. Please see the reverse side for a list of subjects to which witnesses may direct their testimony, and for a description of the bills which will be discussed at the hearing. Persons wishing to present pertinent testimony to the Committee and Task Forces at the above hearing should complete and return the enclosed reply form as soon as possible. It is important that the reply form be fully completed and returned so that persons may be notified in the event of emergency postponement or cancellation. Oral testimony will be limited to 10 minutes’ duration. In preparing the order of witnesses, the Committee will attempt to accommodate individual requests to speak at particular times in view of special circumstances. These requests should be made on the attached reply form or communicated to Committee staff as early as possible. In the absence of a request, witnesses will be scheduled in the order in which reply forms are postmarked. Ten copies of any prepared testimony should be submitted at the hearing registration desk. The Committee would appreciate advance receipt of prepared statements. In order to further publicize these hearings, please inform interested parties and organizations of the Committee’s interest in hearing testimony from all sources. In order to meet the needs of those who may have a disability, the Assembly, in accordance with its policy of non-discrimination on the basis of disability, as well as the 1990 Americans with Disabilities Act (ADA), has made its facilities and services available to all individuals with disabilities. For individuals with disabilities, accommodations will be provided, upon reasonable request, to afford such individuals access and admission to Assembly facilities and activities. Peter
M. Rivera
1) What are the primary factors leading to the unusually high rates
of suicide among women in New York? For additional information and to obtain a copy of the Public Hearing Reply Form, contact Elana Marton at martone@assembly.state.ny.us or 518-455-4371. IN THE NEWS: Psychiatrists
Resist Changes at CDPHP - Doctors say insurer's pick for mental
health coverage is known for rejecting claims. By Alan
Wechsler ALBANY -- A dispute between local psychiatrists and Capital District Physicians' Health Plan could leave hundreds without mental health care. The fight is centered on CDPHP's attempt to turn psychiatric coverage over to United Behavioral Health, also known as UBH. Local psychiatrists say San Francisco-based UBH is known among doctors for rejecting reimbursement claims. The protesting doctors -- all are in private practice in Albany County -- say they hope the situation can be resolved before they have to stop seeing CDPHP patients. The patients are being treated for such illnesses as depression, bipolar disorders and panic attacks. Dr. James Nalbone of Albany said he has accepted UBH patients before, and his staff has had difficulty reaching a company agent or getting claims paid. "They still owe me money," he said. "Little things like that make me hesitant to turn half my practice over to these kinds of people." For years, CDPHP has contracted with a separate company to handle psychological care reimbursement. But psychiatrists -- medical doctors who treat mentally ill patients with both therapy and drugs -- always contracted directly with CDPHP. Earlier this year, CDPHP decided to switch its mental health contract to UBH, a subsidiary of the giant UnitedHealth Group of Minnesota. At the time, CDPHP decided to include psychiatrists in the contract, which takes effect next year. While CDPHP says the dispute involves only a few doctors, local psychiatrists say the change will reduce the number of psychiatrists in Albany County available to CDPHP patients from 60 to eight. Robert Hinckley, senior vice president and spokesman at CDPHP, said the idea was to join with a national company that could, for instance, ensure mental health coverage for college students who study out of state. It's a common theme in health care these days -- as health insurance companies continue to merge and grow -- that insurers say they need a nationwide presence to remain competitive. Hinckley also said reimbursement under UBH would be as good or better than under CDPHP. "This is all about providing higher-quality care," he said, indicating UBH workers would handle claims out of CDPHP's Albany offices. "We have a small cabal of psychiatrists in Albany County who are using their patients as pawns for their self-serving need," he said. While Hinckley said UBH should not be confused with its parent company, UnitedHealth, local psychiatrists were not so willing to make that distinction. Last month, the Buffalo News reported UnitedHealth was under attack in New York and other states over negotiating tactics and its willingness to drop major hospitals from its network. It also has been banned from selling certain products in New York state due to its practices, according to the News. A UnitedHealth spokeswoman, contacted Wednesday, did not respond to questions by press time. Dr. Ron Wolner, an Albany psychiatrist, said he was afraid of joining the UBH network because his practice could suffer if claims were unfairly rejected. In the meantime, he has been breaking the news to patients. "What we tell them is we've been terminated, and that they're trying to come up with some sort of transition plan," he said. "Beyond that, we don't know what to tell them." Wolner said about 40 percent of his 400 patients are covered by CDPHP. Wolner said he requested a special meeting Nov. 27 with CDPHP to discuss the issue. Unless the matter is resolved, he and other psychiatrists will have to stop seeing CDPHP patients after March 31. Dr. Norman Dovberg, who practices in Slingerlands, said he can't understand why CDPHP won't just continue with the system that has worked well for so many years. "I think CDPHP is paying a game of chicken," he said. "They want to intimidate us into going along with their plan."
The Lackawanna City Court Mental Health Treatment Court, which begins operations this week, is the latest of the state system's courts dealing with nonviolent individuals. Lackawanna Chief Judge Frederick J. Marrano said the court will provided supervised community-based treatment for individuals with mental illnesses. It is a program of the successful Lackawanna Drug Treatment Court, which was established in 1996. Marrano said a grand opening ceremony is scheduled at 4 p.m. Thursday in Lackawanna City Hall, 714 Ridge Road. The new program will involve court oversight of the mentally ill undergoing treatment for their conditions, the judge said. The court is designed to reduce crime and recidivism and improve safety and the well-being of people with mental illnesses, Marrano said.
CAMP PENDLETON, Calif. — Chris Packley returned from Fallujah in 2004 a top marksman on a sniper team showcased in the Marine Corps Times for its 22 kills. "I was exceptionally proud of that Marine," says Gunnery Sgt. Scott Guise, his former team leader. He also came home with flashbacks — memories of his friend, Lance Cpl. Michael Blake Wafford, 20, dying on the battlefield. Packley says he smoked marijuana to try to escape the images. He also left the base without permission. "I wanted out," Packley says. Last year he got his wish and was expelled from the Marine Corps. As a consequence, he lost access to the free counseling and medication he needed to treat the mental wounds left from combat, according to Packley, his former defense lawyer and documents from the Department of Veterans Affairs. Scores of combat veterans like Packley are being dismissed from the Marines without the medical benefits needed to treat combat stress, says Lt. Col. Colby Vokey, who supervises the legal defense of Marines in the western USA, including here at Camp Pendleton. When classic symptoms of post-traumatic stress disorder (PTSD) arise — including alcoholism and drug abuse — the veterans are punished for the behavior, Vokey says. Their less-than-honorable discharges can lead to a denial of VA benefits. Vokey calls it a Catch-22, referring to the no-win situation showcased in Joseph Heller's 1961 satirical war novel Catch-22. "The Marine Corps has created these mental health issues" in combat veterans, Vokey says, "and then we just kind of kick them out into the streets." Characters in Catch-22 were caught in a contradiction. They could be relieved of dangerous flying missions if crazy. But if they claimed to be crazy, they were deemed sane for trying to avoid danger and had to keep flying. In Iraq, Marines who perform well in combat can be lauded for it. But if they develop PTSD, they can be punished for stress-related misconduct, kicked out of the military and denied treatment for their illness. In recent months, the Marine Corps has begun investigating the matter, identifying 1,019 Marines who may fall into this group since the war in Iraq began. All served at least one year in the Marines and one tour overseas before being discharged for misconduct. "We're digging down into the data sources we have to try and come up with answers," says Navy Capt. William Nash, who coordinates the Marine Corps' combat stress programs. "That it happens at all is obviously not ideal." He says each case will be examined to learn whether the Marine suffered combat stress and whether that might have contributed to the misconduct. The results could help the Marine Corps flag combat-stressed Marines and help them avoid getting into trouble, Nash says. MORE
AGGRESSIVE ABOUT PTSD A 2004 Army study showed that about 17% of combat troops suffer PTSD, a rate comparable with Vietnam-era stress among such troops, says Joseph Boscarino, a senior investigator with the Geisinger Center for Health Research in Danville, Pa., who has conducted extensive PTSD research on Vietnam veterans. Vokey and his lawyers say they are convinced, based on reviews of medical records, that combat stress was a major factor in the misconduct cases. They argue that either the Pentagon or VA should revise its policies so that these combat veterans are not stripped of the medical care they need to get better. "People would be appalled if the guy came back and he had lost a leg, lost a limb, and then we say, 'Oh, you had a DUI (driving under the influence), so you're going to have to give your prosthetic back,' " says Marine Capt. James Weirick, a former member of Vokey's staff. "But to a great extent, we're doing that with these people." Packley, 24, received an other-than-honorable discharge. According to a VA document Packley's mother, Patricia, shared with USA TODAY, the department acknowledges he has PTSD but denied him benefits in July. "You go to war and they can't even help you with the problems you get from it," says Packley, who now does state highway construction in Joliet, Ill. He says he has been off anti-anxiety, anti-depression and sleep medications for months because he cannot afford it. "I'm just so stressed," he says. "It doesn't take much to get me almost panic-stricken anymore." HEROES
IN TROUBLE "You have guys coming in this building who are, no question about it, heroes in everything that they have done in the past," Studenka says. "You have them saying, 'I just need to get out. I want out.' That breaks your heart." The Marine Corps says post-traumatic stress disorder is no legal defense to misconduct and that discipline must be maintained. "PTSD does not force anyone to do an illegal act," Nash says. "The consequences to the Marine Corps of not upholding those standards of behavior would be a much greater tragedy. It would dishonor all those Marines who have been injured by the stress of war but who have not broken the rules." Marines, sailors, soldiers and airmen who get in trouble can receive one of four discharges. The lightest is a general discharge, often described as "under honorable conditions," in which recipients remain eligible for most VA benefits. More serious misconduct can lead to an other-than-honorable discharge or, worse, a bad conduct discharge. A serious felony results in a dishonorable discharge. The law prohibits a veteran from receiving the full spectrum of VA benefits — such things as health care, insurance and home loans — in certain cases, such as those involving deserters, conscientious objectors or those who receive dishonorable discharges. But the VA has discretion to grant full benefits in other-than-honorable or bad conduct discharge cases. It can still deny them if the agency decides the underlying misconduct was "willful and persistent," a largely subjective decision, VA official Jack McCoy says. Statistics from 1990 through September show that about eight out of 10 veterans who received bad-conduct discharges were turned down when they sought benefits, McCoy says. FEW
EXCEPTIONS The VA offers temporary counseling, but no medication, for veterans who are appealing their discharges. Counseling ends if the appeal fails. Vokey argues that the VA could relax its practices and treat veterans who are discharged for PTSD-related misconduct. Mental health experts say this problem almost certainly occurred in prior wars. But combat-induced mental disorders and how they may contribute to bad behavior were not as well understood. The issue exists today in the Army but to a lesser degree, says Army Lt. Col. John Wells, a former supervising defense lawyer. Combat-stress cases involving misconduct are handled in informal ways that often do not lead to a loss of benefits, Wells says. The Marine Corps, by comparison, prides itself on its strict standards. "We take discipline infraction very seriously," says Lt. Col. Scott Fazekas, a Marine Corps spokesman. It prosecutes about the same number of troops as the Army each year for misconduct, though it is only one-third the Army's size. The Marine Corps also does a disproportionate share of fighting and dying in Iraq, making up 20% of U.S. ground forces while suffering 30% of the casualties. More than 10% of American troops who died in Iraq were Marines from Camp Pendleton, which has lost almost 300, more than any other military base. Marine Corps statistics, though incomplete, show PTSD cases doubled from about 250 in 2003 to 596 in 2004, and then doubled again to 1,229 in 2005. Although Marine Corps officials say the service has come a long way in recognizing and treating PTSD, they acknowledge that it still struggles to provide treatment resources and to overcome the stigma against those who suffer mental health problems. "There might be some commanders out there who aren't really willing to accept that there is such a thing as post-traumatic stress syndrome," says Marine Col. Hank Donegan, a military intelligence officer at Pendleton. Vokey and his staff agree that many troubled Marines should leave the Marine Corps, for their sake and that of the Corps. To strip them of benefits is wrong, they say. "It seems to me our country has bought that problem and we ought to fix it as best we can," says Melissa Epstein, a Los Angeles lawyer and former Marine captain on Vokey's staff. A
MEDAL WINNER'S TRAUMA The citation described five separate episodes of valor, including one morning in February 2005 when Birrell organized the defense of a fog-shrouded observation post in Husaybah that came under multiple attacks by insurgents and suicide car-bombers. A wounded Birrell rallied his troops, tended to casualties and directed fire, often while exposed to enemy gunfire. "Sgt. Birrell reflected great credit upon himself and upheld the highest tradition of the Marine Corps," his citation reads. After coming home, Birrell took an assignment earlier this year as a drill instructor at the Marine Corps Recruit Depot in San Diego, and his life began to fall apart. Diagnosed with PTSD, he suddenly demanded a divorce from his wife, abused alcohol and methamphetamine and left his base without permission, say Birrell and Weirick, then his lawyer. Kicked out of the Marine Corps with an other-than-honorable discharge, he lived in Tijuana, Mexico, for months, often homeless. "What brought me down there was how the streets were kind of like being in Iraq — that kind of turmoil-type stuff," Birrell says now. Birrell says that in Tijuana, he could fill his head with thoughts of where to find food or shelter. Growing tired of that life, he finally called his parents and they brought him to their home in Las Vegas last month. "Life is great," says his mother, Kim Lukas, who says she's ecstatic to have him home again. For Birrell, who now lives in Torrance, Calif., insomnia is back. "When I do sleep," he says, "I'm constantly waking up from dreams, constantly tired throughout the day." His nightmares are of war. He visited VA offices Tuesday asking for benefits despite his other-than-honorable discharge. Birrell says he needs treatment for his PTSD. Weirick fears they will turn him down regardless of his battlefield heroism. Lukas says that makes her angry. "He's done two tours over there, and God knows how many lives he's saved," she says. "He's going to need the care."
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