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February 26, 2007
MHANYS
Legislative Conference on March 14th from 9:30 to 12:00
Five Reasons Why You Don’t Want to Miss This Event
We have had some recent successes in mental health advocacy. Passage of Timothy’s Law and a budget that provided over 2,000 units of new housing, more funding for alternatives to the SHUs and several other positive initiatives have come about largely through your advocacy and that of the other stakeholders in the mental health community. Only through the collective voices of many people fighting for the same agenda will we be able to affect real change. That is why we urge you to come to Albany on March 14th and be part of the grassroots efforts that will help shape the funding and priorities for the future of mental health in New York. IN THE NEWS Committing
to a Quick Fix Mental-health experts caution against moving ahead with the civil confinement of sex offenders Eliot Spitzer last year as a candidate and this year as governor has expressed his resolve to enact a civil-commitment law,” said Christine Pritchard, a spokeswoman for the governor’s office. He made this resolve very clear in his first budget by allocating $46 million to the state Office of Mental Health to civilly confine in its facilities violent sex offenders. While this budgetary move is sure to be a popular one, there are many people in the mental-health community who regard it with concern. “This is something that has been proposed in the past, creating these units in mental-health facilities geared toward holding sexual offenders,” said Glenn Liebman, CEO of the Mental Health Association of New York State. “But it is something that we have fought for several years, on several fronts. We just don’t think that this is good public policy.” “The mental-health system should not be identified as the resource for sexual offenders,” he added. “I think it is absolutely detrimental to mental-health patients.” Liebman’s reasons are threefold. First, there is a safety issue. People with mental illness, he said, are 12 times more likely to have been abused in their lives than the average individual. Placing a predatory criminal into a vulnerable population could be disastrous. Second, he continued, there is already a stigma attached to mental illness. In using mental-health facilities to confine sex offenders, there is a latent equating of the mentally ill with sexual offenders, which is incorrect and dangerous. “It sets us back years,” he said. The third major issue is funding. Though Spitzer’s budget is an improvement on past budgets, mental-health funding is not spectacular, he said. “With funding in the mental-health budget to house sexual offenders, we fear there will eventually be less money to house people with mental illness,” Liebman said. “You look at the people who will be housed as sexual offenders, and that number will likely increase, not decrease.” With this increased number, he said, the mental-health community at large could see its vital resources depleted as money shifts to the specific needs of housing sex offenders. “I have not seen one study that shows that civil commitment is effective in reducing the number of sexual assaults in our communities,” said Richard Hamill, president of the Alliance of Sex Offender Service Providers. “It has a negligible effect.” In fact, he said, the majority of states don’t use civil commitment, and two of the states that do are working now to dismantle the systems that they have set up. The No. 1 reason that states abandon civil commitment is cost. Due to the unique legal requirements of civil commitment, which include 31 hours a week of treatment, the cost of holding violent offenders is roughly $250,000 per person per year. And in a system that only 1 to 3 percent of the people committed to ever leave, the costs quickly become overwhelming. “All of us who work in the field have come across someone we don’t feel should be in the community,” Hamill said. “There are some really dangerous sex offenders. Our hope is that they would be kept in corrections facilities where they cost $30,000 [per person] as opposed to the mental-health facilities that cost a quarter-million.” What experts in the field of sexual offenses are suggesting, Hamill said, is that the justice system do a better job evaluating sex offenders prior to sentencing and give the most dangerous much longer sentences, including lifelong probation after release. “What I am hoping the governor will do is draw together a task force to take a look at this and then to craft a much broader kind of bill that would address sex-offender management. We need to take a look at all of the components that ought to be put in place.” The governor and the lawmakers, he said, need to take a look at the comprehensive picture of dealing with sex offense. From prevention and education programs in the schools, to assisting investigations, to what can be done for victims, the issues surrounding sex offenses are complex and intertwined. “I am afraid that we will create a system that will be very hard to undo,” Hamill said, “and that we are going to be fashioning all the other sex-offender-management strategies in the state around [civil commitment]. It will become more of an obstacle than something positive.”
Parity
for Mental Health One of the state Legislature's singular achievements last year was the passage of Timothy's Law, which requires insurers to cover mental illnesses on par with the coverage they provide for physical ailments. In a Sept. 14 editorial on this page, we urged the Senate to pass Timothy's Law legislation -- which it did and which then-Gov. Pataki later signed -- and ended with this observation: "But until there is a national parity bill, the states -- including New York -- must do the right thing and take the lead." Now, at last, comes news that Congress might be about to do the right thing, too, and pass a federal parity bill. Last Wednesday, the Mental Health Parity Act of 2007 was voted out of the Senate Health, Education, Labor and Pensions Committee and sent to the full Senate for a vote. Meanwhile, Rep. Patrick Kennedy, D-R.I., plans to hold hearings on a mental health parity bill that could go to the House floor this spring. If either the Senate or House version, or, more likely, a conference bill, ultimately passes Congress and becomes law, insurers that offer mental health coverage will have to provide it at the same levels as they do for such physical illnesses as heart disease, diabetes or asthma, Sen. Pete Domenici, R-New Mexico, a sponsor of the legislation, told Reuters. Despite the lack of a federal law, the nation's 9 million federal workers have received parity coverage for some time, under a directive signed by President Clinton in 1998. In a sense, these workers became an experiment that has proved wrong the opponents who warned that parity coverage would dramatically increase health care premiums. In fact, there has been no such escalation at the federal level. The same result was noted in California, which adopted parity in 2000, and the 35 other states that had parity coverage laws on the books as of 2006. Ironically, the response to a federal parity bill is quite different from the reaction in New York. For years, employers -- mainly those with small work forces, and health insurance organizations -- resisted Timothy's Law as an expensive government mandate. But the legislation that passed the U.S. Senate committee last week has wide support among employers and insurers. President Bush has long supported the concept of parity. And now it seems that after watching 36 states taking the lead on mental health parity, Congress may have finally gotten the message. Finally.
Military
Mental Health Services Seen Lacking NEW YORK (Reuters Health) - The psychological needs of U.S. military personnel and their families are straining the current mental health services of the military, concludes an American Psychological Association (APA) Task Force charged with looking into the issue. "The military is doing a lot of things to take care of the mental health services of the active duty service members and their families and children," Dr. Ronald S. Palomares told Reuters Health, "but there is definitely room for improvement." Many military families are going without needed mental health services because of the limited availability of such care, according to Palomares, a psychologist on the APA staff and a Task Force member, who has served active duty in the Air Force and Army National Guard. "What we found is that one military installation may have a really good mental health program but due to a number of factors, the quality and quantity of programs really varies across the military," Palomares said. The APA Task Force recommends developing centralized leadership across the army, air force, and navy to better coordinate mental health services. Barriers to accessing appropriate mental health care also need to be addressed. "We need to increase education of the military leadership about the value of mental health services," according to Palomares. "Stigma about mental health services in general and about seeking mental health assistance continues to be a barrier in the military. Military leaders need to be educated to reduce that stigma and encourage service members to seek mental health services when they need it." A shortage of psychologists in the military is another problem. "In the army and navy, approximately 40% of positions for uniformed psychologists are empty at this time," Palomares reported. "With fewer providers, there are more demands on those providers that are there, and many are being deployed themselves to provide mental health services on the frontlines so there are fewer stateside." Another concern is the lack of up-to-date research on mental health issues of modern active duty personnel. "As we tried to pull our report together, we found a lot of research about mental health issues and services for Vietnam veterans," Palomares said. "But with the global war on terror, the mental health issues of active duty soldiers are new and unique," Palomares noted, particularly the stress of multiple deployments. For female soldiers, Palomares said "there is no good research about women in combat and their mental health needs. What is the effect on children of their parents being deployed two, three, four times - we don't know." Addressing many of these issues ultimately comes down to funding, Palomares said, noting that the Task Force recommends additional funds be earmarked specifically for mental health services for military personnel and the families. |
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