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February 1, 2008
MHANYS Legislative Day on March 12th---please contact John Richter at jrichter@mhanys.org for more information and to sign up. Confirmed speakers include Mental Health Commissioner Michael Hogan, Assembly Mental Health Chair Peter Rivera and Commission on Quality of Care Chair, Gary O’Brien
Governor
Spitzer Signs SHU Bill Into Law — As we mentioned in yesterday’s update, earlier this week Governor Spitzer signed the SHU bill into law. Last week, we mentioned the strong leadership of Assemblyman Aubry and Senator Nozzolio. We would like to add the leadership of Governor Spitzer on this issue. He and his staff (including former MHANY S Public Policy Director, Michael Seereiter) worked tirelessly on a compromise that will ultimately ban the practice of putting people in prison who have a psychiatric disability in solitary confinement and instead provide alternate services in mental health treatment units. This is an historic commitment from the state on this issue. This is not a sexy issue and there are a not a lot of votes to be won by signing this bill but it is the right thing to do and Governor Spitzer deserves a great deal of credit for signing this bill. This bill is a testament to the people in the Mental Health Alternatives to Solitary Confinement (MHASC) Coalition, many of who were either directly effected or had a family member effected by the SHU, who courageously told their stories and are responsible for a dramatic change that will have an impact for years to come. Congratulations to all of the members of MHASC. We would also like to thank our colleague and friend Harvey Rosenthal of NYAPRS as well as the Governor’s staff for the opportunity to meet with Governor Spitzer. Listed below is an update on the bill put together by Bob Corliss, the MHANYS Director of Forensics Services, and one of the many unsung advocates who dedicated great time and effort to the success of the SHU bill. The Governor’s press release is also attached.
Governor Spitzer Heralds “Boot the SHU” Legislation as Historic As expected, Governor Spitzer signed the “Boot the SHU” legislation on Monday, January 28, and followed up on that with a reception for consumers, family members and advocates on Tuesday, January 29 at the state capitol. In addressing the gathering, the Governor called the SHU bill “historic legislation which demonstrates New York State’s commitment to providing mental health treatment for inmates with a serious psychiatric disorder.” After speaking, Governor Spitzer moved amiably about those present talking to many persons on an individual basis and posing for photographs. Both Glenn Liebman and Bob Corliss represented MHANYS. Governor Spitzer’s action formalizes the state’s decision to ban the use of solitary confinement for inmates with a serious mental illness who violate prison rules. Instead, these inmates will be placed in a residential mental health treatment unit where they will receive intensive psychiatric and behavioral treatment in a therapeutic setting. The state’s Commission on Quality of Care and Advocacy for Persons with Disabilities is also authorized to oversee and monitor the implementation of this legislation. The proposed state budget includes $12 million to begin implementation in this budget year. All told, the state is given four years to comply with all provisions of the legislation. Governor Spitzer’s signature on this legislation culminates over five years of grassroots advocacy by a coalition of consumers, family members, mental health advocates and providers, correction advocates and human rights activists all committed to ending the toxic practice of long term solitary confinement of persons with serious psychiatric disorders. At the Governor’s reception, both the New York Association of Psychiatric Rehabilitation Services (NYAPRS), which held its legislative lobby day on Tuesday, and the Mental Health Alternatives to Solitary Confinement (MHASC) coalition, of which MHANYS is a charter member, presented plaques to Governor Spitzer expressing appreciation for his leadership on this issue. (Governor Spitzer’s press release)
Governor
Spitzer Signs Legislation to Enhance the Governor Eliot Spitzer today announced the signing of legislation that will enhance the care and treatment of prisoners with serious mental illness by limiting the instances in which these inmates can be placed in segregated confinement. The legislation formalizes the administration’s commitment to removing prisoners with serious mental illness from what are commonly known as “special housing units” – where inmates who have committed disciplinary infractions are segregated from the rest of the prison population. The legislation would also implement a more sensitive approach to the treatment of prisoners with psychiatric disorders while meeting prison safety and security standards. Those inmates with serious mental illness who are not removed from segregated confinement will be offered a heightened level of care, including additional out-of-cell treatment and programming. Mental health clinicians will also conduct periodic mental health assessments of all inmates who remain in segregated confinement. “This is historic legislation that demonstrates New York’s commitment to providing mental health treatment for inmates with serious psychiatric disorders,” said Governor Spitzer. “The legislation also recognizes the need to provide a safe and secure prison environment where inmates and staff will be protected from harm. It strikes an appropriate balance between safety and security concerns and the needs of inmates with serious mental illness." Lieutenant Governor David A. Paterson said: “This groundbreaking legislation demonstrates New York’s leadership in ensuring that the mental health needs of prisoners are addressed. It will ensure that all inmates, including those with serious mental illness, receive appropriate treatment while in prison - enhancing their ability to make a successful transition into communities once they’re released.” Senator Michael F. Nozzolio, Chairman of the Senate Crime Victims, Crime and Corrections Committee, said: “This historic agreement is the result of years of hard work. I commend Governor Spitzer for his efforts in ensuring this legislation would be signed into New York State law. The New York State Senate has led the fight to enhance support for our correction officers and staff and I am extremely pleased that our prisons will now be more humane and safer for both inmates and the brave men and women who work there. The Senate remains committed to ensuring that New York State continues to promote and advance initiatives that make our State prison system the best in the country.” Assemblymember Jeffrion L. Aubry, Chairman of the Assembly Corrections Committee, said: “This legislation improves the way the state of New York treats inmates who are afflicted with serious mental illnesses. It advances treatment over punishment and better prepares correction officers who interact with such inmates, thereby enhancing safety of not only inmates and staff but of the public as well." Inmates with serious mental illness who are diverted or removed from segregated confinement will be housed in residential mental health treatment units that are jointly operated by the Department of Correctional Services and the Office of Mental Health. In these units, inmates will receive out-of-cell therapeutic programming and mental health treatment. A formal review process involving the input of mental health clinicians will decrease the likelihood that inmates will cycle back into segregated confinement. A number of these new mental health treatment beds already exist and many more are in development. The new legislation authorizes the Commission on Quality of Care and Advocacy for Persons with Disabilities to monitor the quality of mental health care provided to inmates and make recommendations about necessary improvements. The legislation Governor Spitzer announced today builds on the State's ongoing efforts to enhance treatment and programming for mentally ill inmates. Giants Beat Patriots 31—28 to Win Super Bowl I usually don’t inject my love of sports into the mental health updates but how often are the Giants in the Super Bowl. I am going out on the line and making this prediction. Hopefully I won’t be eating a lot of crow on Monday morning and instead will be celebrating the Giants third Super bowl victory. Go Giants!!!
In the News Officer’s
Slaying Leaves New Orleans Asking Why NEW ORLEANS — On Monday morning, in a bleak shopping strip almost under the Pontchartrain Expressway, Bernel P. Johnson wrestled the gun away from a young police officer and shot her dead. When backup officers arrived, he handed them the weapon. Weeks after being released from a mental institution, Bernel P. Johnson shot and killed a police officer. But Mr. Johnson, 44, who had a long history of psychiatric problems, was not supposed to be anywhere near that street or any other. Just three weeks earlier, on Jan. 4, the police “observed him to be mentally ill and dangerous to others,” said Dr. Jeffrey Rouse, the chief deputy coroner, who signed the papers committing Mr. Johnson to involuntary treatment. He was sent to a state mental institution, to be confined until he was no longer a danger to himself or others. Somehow, for reasons that remain unclear, the institution released him before the shooting. Because of privacy laws, state officials are not saying which institution it was, or how the decision was made. But the mental health system has been in chaos since Hurricane Katrina, and questions over these kinds of releases are adding to waves of grief, anger and fear that have swept over many in the city, even as it celebrates Mardi Gras. James Arey, a psychologist and the commander of the Police Department’s crisis negotiation team, worked closely with the slain officer, Nicola Cotton, 24. He said Mr. Johnson appeared to have been improperly released from state care, even though he had allegedly threatened to kill police officers. “The State of Louisiana had ample time to figure out this guy,” he said. “And because they weren’t doing their job, this officer, my friend, is dead.” Police officers are furious over what they see as a shortage of acute-care psychiatric beds at the remaining public hospital in the city and a lack of follow-up treatment. A prominent judge says the parish jail has become a de-facto replacement for closed psychiatric wards, and the sheriff who runs the prison agrees. State officials contend that they are struggling to rebuild the system, even as more people here are uninsured and so do not have access to other treatment. Doctors warn that the stress of living in a deeply damaged city, often without family and friends, is pushing people over the edge. And some also say that since Hurricane Katrina, the city has been attracting transients with mental health problems, who end up homeless and troubled on the streets. Or, as Dr. Rouse puts it, “It’s almost as if New Orleans has become a magnet for chaos.” In 2004, a mental patient shot LaToya Johnson, the first female officer to be killed here. Since then, Dr. Arey said, there have been seven deaths directly involving deranged people, “where there were gunfights with the police and we had to kill them, or they killed other people.” He said he did not think that, proportionately, there had been an increase in the number of dangerous mentally ill people on the streets, but others, including Dr. Rouse, disagree. Certainly, the number of mentally ill jail inmates has risen, said Marlin N. Gusman, the criminal sheriff for Orleans Parish. He said that after the flooding shut down Charity Hospital and other treatment alternatives, families who were worried about disturbed relatives would end up calling the police. “The lack of alternatives makes us the provider of first resort,” he said. Even before Katrina hit, mental health services for the poor in New Orleans were often criticized as inadequate — as they are in many big cities with large indigent populations. The police brought obviously disturbed people to the main public hospital, known as Big Charity, which had a floor devoted to short-term and long-term psychiatric care, including 97 acute-care beds. According to the state, there were 555 public and private inpatient psychiatric beds in and around the city, as well as out-patient clinics and supervised living programs. Louisiana State University, which ran Charity, contends that it was too badly damaged to reopen. The university did open an emergency room in nearby University Hospital and has been slowly adding beds for seriously ill patients, along with the state, bringing the total to 268. The state has added 133 beds elsewhere in Louisiana to help, said Dr. Kathleen Crapanzano, medical director of the state Office of Mental Health. But beds are not the only issue, Dr. Crapanzano said. Clinics are opening, but not necessarily full time. None of the private psychiatric facilities has returned. Insurance coverage is down, and stress is up. “We are slowly but surely rebuilding and adding services,” she said. “But the need is still great.” The family of Bernel Johnson could not be reached for comment Wednesday. But a brother and sister told The Times-Picayune of New Orleans this week that he was a paranoid schizophrenic who had threatened to harm people and once shot himself in the chest. The family’s efforts to have him treated or confined had all failed, they said. “This is a dangerous situation,” said Judge Arthur Hunter Jr., a former police officer who now presides over a special court dealing with mentally ill nonviolent Soldier
Suicides Reach Record Level, Study Shows Vets’ Battle with
Depression Reveals Effects of Long Tours, Lack of Resources Lt. Elizabeth Whiteside, a psychiatric outpatient at Walter Reed Army Medical Center who was waiting for the Army to decide whether to court-martial her for endangering another soldier and turning a gun on herself last year in Iraq, attempted to kill herself Monday evening. In so doing, the 25-year-old Army reservist joined a record number of soldiers who have committed or tried to commit suicide after serving in Iraq or Afghanistan. "I'm very disappointed with the Army," Whiteside wrote in a note before swallowing dozens of antidepressants and other pills. "Hopefully this will help other soldiers." She was taken to the emergency room early Tuesday. Whiteside, who is now in stable physical condition, learned yesterday that the charges against her had been dismissed. Whiteside's personal tragedy is part of an alarming phenomenon in the Army's ranks: Suicides among active-duty soldiers in 2007 reached their highest level since the Army began keeping such records in 1980, according to a draft internal study obtained by The Washington Post. Last year, 121 soldiers took their own lives, nearly 20 percent more than in 2006. At the same time, the number of attempted suicides or self-inflicted injuries in the Army has jumped sixfold since the Iraq war began. Last year, about 2,100 soldiers injured themselves or attempted suicide, compared with about 350 in 2002, according to the U.S. Army Medical Command Suicide Prevention Action Plan. Wars
lasting longer than planned The conflicts in Iraq and Afghanistan have placed severe stress on the Army, caused in part by repeated and lengthened deployments. Historically, suicide rates tend to decrease when soldiers are in conflicts overseas, but that trend has reversed in recent years. From a suicide rate of 9.8 per 100,000 active-duty soldiers in 2001 -- the lowest rate on record -- the Army reached an all-time high of 17.5 suicides per 100,000 active-duty soldiers in 2006. Last year, twice as many soldier suicides occurred in the United States than in Iraq and Afghanistan. Common
factors emerge Ritchie's team conducted more than 200 interviews in the United States and overseas and found that the common factors in suicides and attempted suicides include failed personal relationships; legal, financial or occupational problems; and the frequency and length of overseas deployments. She said the Army must do a better job of making sure that soldiers in distress receive mental health services. "We need to know what to do when we're concerned about one of our fellows." The study, which the Army's top personnel chief ordered six months ago, acknowledges that the Army still does not know how to adequately assess, monitor and treat soldiers with psychological problems. In fact, it says that "the current Army Suicide Prevention Program was not originally designed for a combat/deployment environment." Staff Sgt. Gladys Santos, an Army medic who attempted suicide after three tours in Iraq, said the Army urgently needs to hire more psychiatrists and psychologists who have an understanding of war. "They gave me an 800 number to call if I needed help," she said. "When I come to feeling overwhelmed, I don't care about the 800 number. I want a one-on-one talk with a trained psychiatrist who's either been to war or understands war." Santos, who is being treated at Walter Reed, said the only effective therapy she has received there in the past year have been the one-on-one sessions with her psychiatrist, not the group sessions in which soldiers are told "Don't hit your wife, don't hit your kids" or the other groups where they play bingo or learn how to properly set a table. Army
moves to address problem Increasing suicides raise "real questions about whether you can have an Army this size with multiple deployments," said David Rudd, a former Army psychologist and chairman of the psychology department at Texas Tech University. On Monday night, as President Bush delivered his State of the Union address and asked Congress to "improve the system of care for our wounded warriors and help them build lives of hope and promise and dignity," Whiteside was dozing off from the effects of her drug overdose. Her case highlights the Army's continuing struggles to remove the stigma surrounding mental illness and to make it easier for soldiers and officers to seek psychological help. Whiteside, who was the subject of a Washington Post article in December, was a high-achieving University of Virginia graduate, and she earned top scores from her Army raters. But as a medic in charge of a small prison team in Iraq, she was repeatedly harassed by one of her commanders, which disturbed her greatly, according to an Army investigation. On Jan. 1, 2007, weary from helping to quell riots in the prison after the execution of Saddam Hussein, Whiteside had a mental breakdown, according to an Army sanity board investigation. She pointed a gun at a superior, fired two shots into the ceiling and then turned the weapon on herself, piercing several organs. She has been at Walter Reed ever since. ‘Demonstrably
severe depression’ Her case hinged in part on whether her mental illness prompted her actions, as Walter Reed psychiatrists testified last month, or whether it was "an excuse" for her actions, as her company commander wrote when he proffered the original charges against her in April. Those charges included assault on a superior commissioned officer, aggravated assault, kidnapping, reckless endangerment, wrongful discharge of a firearm, communication of a threat and two attempts of intentional self-injury without intent to avoid service. An Army hearing officer cited "Army values" and the need to do "what is right, legally and morally" when he recommended last month that Whiteside not face court-martial or other administration punishment, but that she be discharged and receive the medical benefits "she will desperately need for the remainder of her life." Whiteside decided to speak publicly about her case only after a soldier she had befriended at the hospital's psychiatric ward hanged herself after she was discharged without benefits. But the U.S. Army Military District of Washington, which has ultimate legal jurisdiction over the case, declined for weeks to tell Whiteside whether others in her chain of command have concurred or differed with the hearing officer, said Matthew MacLean, Whiteside's civilian attorney and a former military lawyer. MacLean and Whiteside's father, Thomas Whiteside, said the uncertainty took its toll on the young officer's mental state. "I've never seen anything like this. It's just so far off the page," said Thomas Whiteside, his voice cracking with emotion. "I told her, 'If you check out of here, you're not going to be able to help other soldiers.' " Trying
to move forward, stumbling back She swallowed her pills there. A soldier and his wife, who live next door, came to her room and, after a while, noticed that she was becoming groggy, Thomas Whiteside said. When they returned later and she would not open the door, they called hospital authorities. Yesterday, after having spent two nights in the intensive care unit, he said, his daughter was transferred to the psychiatric ward. Whiteside left two notes, one titled "Business," in which her top concern was the fate of her dog. "Appointment for the Vetenarian is in my blue book. Additional paperwork on Chewy is in the closet at the apartment in a folder." On her second note, she penned a postscript: "Sorry to do this to my family + friends. I love you." Staff
writer Anne Hull contributed to this report. |
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