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June 18, 2007End of Session Advocacy With only a few days remaining in this year’s Legislative Session, there are still several issues of importance to MHANYS being debated including the SHU Bill and Expansion of Timothy’s Law. SHU
Bill: Status: Actions:
Timothy
Law Expansion: Status: Action: In the News: N.Y.
Advocates Urge Governor to Support SHU Legislation As New York legislators approach an end to their current session this week, mental health and disability rights advocates are pressing hard for Gov. Eliot Spitzer to support legislation to prevent people with psychiatric disabilities from being placed in solitary confinement in New York State prisons. Advocates said they were encouraged by the recent settlement to increase treatment and housing programs for prisoners with mental illness in New York State prisons, but said much more is needed. The settlement followed a 2002 lawsuit, Disability Advocates, Inc. v. New York State Office of Mental Health and Department of Correctional Services, filed in federal court in New York City. The settlement in April requires that prisoners with serious illness confined in a Special Housing Unit (SHU) will receive a minimum of two hours per day of out-of-cell treatment. It also provides improved suicide prevention assessments, which are now required upon admission to SHU. Meanwhile, both the state Assembly and the Senate have passed legislation (S.333/A.4870) to ban the use of solitary confinement for state prisoners with psychiatric disabilities. The bills also provide for residential mental health treatment programs and rehabilitation for inmates. Additionally, the legislation establishes oversight responsibilities of the New York State commission on quality care and advocacy for people with disabilities. Although the legislation has passed both the state Assembly and overwhelmingly in the Senate, the legislation has been sent back for revisions to clarify language regarding the scope and cost of initiatives outlined in the legislation, said Harvey Rosenthal, executive director of the New York Association of Psychiatric Rehabilitation (NYAPRS). “We expect the amended bills to pass,” Rosenthal told MHW. Rosenthal said he is also encouraged by the editorials by New York media on behalf of the legislation. The Times Union in its editorial called for a stop to this ‘inhumane practice,’ he said. Advocates had also planned a rally last week in New York City outside the governor’s office. Spitzer has added about $60 million in its mental health and corrections budget, said Rosenthal. “We appreciate the steps the governor has taken so far,” Rosenthal said. “However, we still have to go one more very important mile,” to ban the ‘SHU box,’ as it otherwise referred to, he noted. The settlement does provide some advances in the way prisoners are treated, but it is not enough, said Rosenthal. It reduces the number of hours prisoner serve in solitary confinement, from 23 hours to 21, he said. “It still doesn’t end the practice we are dedicated to end,” said Rosenthal. If the SHU bill is passed, New York will join many other states, including California, Connecticut, Florida, New Jersey, and Texas in keeping people with serious mental illness out of solitary confinement. Pressuring the Governor “We’ve been doing everything in our power to get legislators to pass a strong bill and put pressure on the governor to sign it into law,” Glenn Liebman, chief executive of the Mental Health Association in New York State, told MHW. “We think the settlement is a good first step, but it does not address oversight or training issues,” he noted. “We wouldn’t be satisfied until SHU was completely eliminated for people with psychiatric disabilities.” According to the New York State Office of Mental Health, people with mental illness account for 12 percent of the overall state correctional facility population, said Liebman. Not all of them are in SHU, however, he noted. “We need to take much more comprehensive approach to this issue,” said Liebman. The legislation calls for more training of correctional staff, he said. “The key component is to reform the system,” Liebman said. “We’re looking for a comprehensive response and this legislation provides that response to this issue.” “Solitary confinement for persons with SMI is tantamount to torture,” Jeff Keller, deputy director of the National Alliance on Mental Illness-New York State (NAMI-NYS), told MHW. “This is something you can’t do halfway,” he noted. “While the recent settlement allows for a lot more accountability in how people are treated, they [prisoners with mental illness] are still being tortured. We do not support torture with counseling.” “Going forward, we support legislation than bans people with mental illness from being put in solitary confinement,” he said. Prisons
Lose Sight Of Justice For Mentally Ill "Reliance on the cold mercy of custodial isolation will be supplanted by the open warmth of community concern and capability." President John F. Kennedy spoke those words 44 years ago, when he signed the Community Mental Health Centers Act. Its intent was to close the psychiatric hospitals and provide community mental heath centers for the mentally ill. The unintended effect of this law was to close the asylums and make the prisons the nation's repository for our mentally ill. According to the federal Justice Department, roughly 16 percent of the inmates in American prisons have serious psychiatric illnesses. They are not in prison because they are mentally ill, but rather because they violated the law. If their crime is the result of their mental illness, efforts should be made through mental health courts to divert them from prison. But for the mentally ill who are sentenced to prison, there must be a recognition of their desperate need for help. This recognition was absent when it came to the incarceration of thousands of mentally ill veterans returning from Vietnam who, because of drug and related crimes, ended up in prison. We cannot let it happen to those veterans returning from Afghanistan and Iraq who, because of the high incidence of mental disorders, may become involved with the criminal justice system. As we treat prisoners who suffer physical disabilities, so too should we concern ourselves with the treatment of prisoners who suffer from mental illness. Winston Churchill once observed that one of the most unfailing tests of a civilization is how a country treats its criminals. How much more telling is the way a country treats its mentally ill prisoners. Five years ago, Disabilities Advocates Inc. brought a lawsuit against the state Office of Mental Health and Department of Correctional Services. It sought to eliminate the destructive practice of placing mentally ill prisoners in punitive segregation known as The Box, a 6-by-8-foot cell where the prisoner is locked down for 23 hours a day. The suit also addressed another aspect of New York's shame: The Loaf. If a mentally ill prisoner becomes disruptive or acts out in response to voices only he can hear, he is put in The Box. If, while in The Box, he continues to be obstreperous or demonstrate other manifestations of mental illness, he is punished by being fed The Loaf. It's a dense, binding one- pound loaf of bread consisting of potatoes and flour with a side portion of raw cabbage. That lawsuit was settled, and although the settlement will lead to some improvements, it doesn't come close to resolving the problems presented by our abuse of the imprisoned mentally ill. For example, as part of the lawsuit settlement, The Loaf may no longer be fed to the inmate for more than seven consecutive days, but it still may be used as a punishment. And the 23 hours a day of lockdown will be reduced to 21 hours a day. This has been heralded as a meaningful concession, but it is far from that. For most inmates, the extra hour a day, if he is returned to The Box, is useless. When you are caged like an animal in a cell not much larger than a bathroom, losing all sense of time, beset by noises and smells that defy description, being told that you can spend an extra hour or two in an isolated outdoor cage subject to cat calls from other inmates is not beneficial. Being returned to the hole in isolation makes the drill counterproductive and the prisoner even more dysfunctional. My observations in this regard are not premised on academic theory. I spent more than a month in solitary confinement in a mental health prison unit. I can tell you from that tortured and mind-bending experience that psychiatrists or medical professionals, not prison guards, should oversee mentally ill inmates, and that no severely mentally ill prisoner should ever be put in The Box. As The Correctional Association of New York recently reported: "On nearly every site visit, we encountered at least one or two individuals in disciplinary lockdown who were active psychotic, delusional or immobilized by depression ... who mutilated their own flesh, who hadn't left their cell in months and repeatedly attempted suicide." One such diagnosed schizophrenic, covered with scars from attempted suicides, "has spent 13 of his 15 years of incarceration in solitary confinement." Earlier this month, the state Senate unanimously passed legislation that would eliminate solitary confinement for prisoners who are seriously mentally ill. The Assembly is in the process of passing the same legislation. This legislation will allow New York to join the many states, including New Jersey, Connecticut, California, Texas and Florida in keeping the seriously mentally ill out of solitary confinement. Similar legislation was passed last year but vetoed by Gov. George Pataki. Gov. Eliot Spitzer has already shown his concern for this problem by committing substantial funding for psychiatric services for prisoners. Those who have studied the proposed legislation, which will keep seriously mentally ill prisoners out of solitary confinement, are in agreement that the funds the governor has already committed for the care of mentally ill prisoners would cover the costs of this necessary reform. It is the earnest prayer of those who abhor the mistreatment of the mentally ill that Spitzer sign the legislation. We have seen the return of the "cold mercy of custodial isolation" in our criminalizing of mental illness. You don't have to be a trained penologist or psychiatrist to know that a mentally ill person should not be put in solitary confinement. Not only is such internment uncivilized, it is also counterproductive. Most of the inmates will one day return to the streets in a worse state than they were when arrested. Sol Wachtler is the former chief judge of New York. Profile
on Michael Hogan Commissioner,
Office of Mental Health Personal: Married to Barbara Stoutenburg Hogan, a Syracuse native; she is in Ohio, winding down her job in administration of early childhood education. They have three grown sons. What he does: Leads the state's mental health department, which licenses more than 2,000 mental health agencies, operates more than two dozen hospitals and serves more than 500,000 patients annually. The budget is close to $5 billion. How he got there: Graduated from Niskayuna High School and Cornell University. Received a master's degree in education administration from State University College at Brockport and earned a doctorate in administration of special education from Syracuse University. Interned at the state Department of Mental Hygiene, and then worked in various jobs at the Massachusetts Department of Mental Health, including a stint as supervisor of Northampton State Hospital. Became commissioner of Connecticut Department of Mental Health and then director of Ohio Department of Mental Health, where he served for 16 years. In 2002, President Bill Clinton (NYAPRS Note: actually it was President George W. Bush) named him chairman of the President's New Freedom Commission on Mental Health. Salary: $136,000 Why did you choose this career path? "Every extended family is touched by these illnesses; mine is as well. Both from that perspective and from the perspective of working with so many people over the years that are struggling to find their path to recovery, it's an area that is very challenging and can be very rewarding. I'm fortunate enough to have my career span the time when this country has finally started to come to grips with mental illness and what to do about it in a reasonable way." What was it like serving on the President's Commission? "It was an incredible experience. ... They assembled a really talented group of people, consumers, family members, advocates, clinicians. They really gave us a lot of support. They did not censor our work at all. We traveled around the country and listened to people's concerns and suggestions. We heard stories that would break your heart and others that would make you sing, they were so inspiring." Did anything come out of the commission's recommendations that you are proud of? "Today, we understand that any person can recover. That really is a sea change, and we understand it partly because of research and partly from movies like 'A Beautiful Mind.' We have a deeper understanding in this country now that it's possible for any individual, even when their condition seems helpless, to get better. Just articulating that, I think, was really the first public document of the United States government that said this." What is your philosophy for caring for the mentally ill? "I would think of people as people first, that everybody is an individual with their own sets of strengths, with their own history, their own family and with their own hopes and aspirations. ... there is something about the people themselves that is the most important factor in their recovery. What are the major issues facing the NY mental health system? "Although there's more talent in New York than I've seen anyplace else, there's also more bickering in the mental health world. The challenge is to see if all those talented and committed people can find a common ground." What are your goals for OMH? "We should manage prudently. We should expand an agenda that is collaborative among all of the players and as we find that common agenda we should try to work together to raise our sights to what is possible. "The psychiatric research institutions are unparalleled, and New York state formally supports several of these: the psychiatric institute at Columbia and the Nathan Kline Institute at NYU. We have not always found a way to have the research priorities as well as the results of the research to really be informed by practice. "We have terrific energetic leadership at both of those places so we should be building bridges between what the needs are in the field and what the researchers can tell us about what works, and then we should put it to practice. That's one of those areas where if we work together we have great potential." -- Cathleen F. Crowley |
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