Category Archives: nation’s laws and mental health

The NYT got it wrong in ‘When the Mentally Ill Own Guns’


Ok. Look, it’s December 29. I’m not in the mood for fancy arse commentaries here today. After all, year-in-year out only a handful of internet pedestrians walk by this site, so I can expect less visitors at this time, the end of the year.

So, the only comment I have about that NYT’s editorial, to which readers are not allowed to comment, is the following:

If this is true…

Most mentally ill persons are not violent, though The Times’s analysis of 180 confiscation cases in Connecticut (dealing with people posing an imminent risk of injury to themselves or others) found that close to 40 percent of those cases involved people with serious mental illness.

then logic dictates that it is the other 60%, the ‘sane’ ones, whom you need to deal with. Those are the ones on whom you need to focus to confiscate their guns if any guns are going to be taken away. Why focus on the minority? The 60% sane ones are a “threat to themselves or others”, that’s more than the 40% who are non-violent mentally ill.

There, I said it.

Happy New Years to all the crazies. Let’s make it our new year resolution to  scare the hell out of the politicians this new year.

 

Under cover of law: Extortion as punishment and the high cost of stigmatizing the mentally ill


From the Washington Post

D.C. woman’s number of 911 calls prompt city to request that she be given a guardian

At stake in this case is that the state (D.C.) wants to take the money (SSD checks) of this person and the only way to do it is by stripping her of her civil rights. The excuse for this atrocity is that she calls 911 “too frequently”.

The ´disability´in mental disability is in how society perceives the illness and the person bearing it, it is not the actual symptoms or manifestations of the illness that matters. You are not accepted as a functioning member of society if you are perceived as ´disabled´.  The disabilities movement have tried to show that if you put ramps, for example, they are not a ´burden’ to society  and can function and work like any other person. Clearly, the refusal to put a ramp was what caused these people to be ‘disabled’.

The same with mental illness, well, they don’t need a ramp. What I mean is that, portraying the mentally ill as a ‘burden’ is stigmatizing and it is what causes them to be ‘disabled’. We have to thank our States’ mental health system for their  good work at impressing that stigma in the public.

In this post I try to show, with this article,  how the process of stigmatizing is achieved by our government, nation-wide.

Anatomy of a stigma

The issues or problems stated by the D.C. officials in the article are:

1) Repeat callers to 911

2) …well, there’s no #2 nor 3 or 4 for that matter.

Unburdening society of the burden of people with mental disabilities: make them non citizens.

The only real issue that the officials can present in this case is the frequent 911 calls by one person. They have to deal with it as with any other situation.

The rest of their ‘reports’ constitute only unfounded accusations using mental illness as the basis to legally punish and extort money from Mrs. Rigsby by declaring her incompetent. Her crime: being mentally disabled.

This is also, and very important, a test case to be applied in the future, if they succeed, to other people with or without mental disabilities: using guardianship to punish people who use services “too frequently”. All they have to do, if you are not mentally ill,  is tag a label of a a mental illness with the help of psychiatrists, who are always at hand for the job.

I can see nothing more stigmatizing than the officialdom and the psychiatric and mental health systems abusing their powers to conjure a lie using mental illness as the legal basis to deprive people of their civil rights. In order to do all that, they have to paint the mentally ill as a burden to society. That’s EXACTLY what these people are doing here. Just see how many times the word “burden” was used by them in the article.

The article states that there are “concerns from D.C. officials about the impact of one woman’s troubles on public-health and safety resources” and “repeat 911 callers have long been identified as burdens on the health system and a drain on public-safety resources.”

Shared delusions of Impending doom

As stated in the article, there have been NO research AT ALL about how ANY repeat callers, let alone this woman in particular, has an impact on the resources. That explains the fact that D.C. official speaks ONLY of a “concern”: “concern that if [a supposition, it hasn’t happen yet in all those years] if crews are tending to Rigsby, the next 911 caller with an emergency might [another supposition, hasn’t happen yet either]get a paramedic from a farther distance, said Miramontes, the medical director…“There will come a time [another supposition, that time has not come yet] when one of these [frequent 911 callers] will call and they will [nope, not yet] cost someone else their life,”

These are all words meant to portray the mentally disabled as a ‘burden’. There’s no concrete EVIDENCE they can show that would cause them to have the concern that, if they don’t take this woman’s civil rights away, the system is about to collapse…unless they share with Mrs. Rigsby the delusion of “impending doom”, as the psychiatrist thought she may have.

But, no, they are not delusional. They are simply conspiring to abuse the power given to them by the citizens and commit the crime of extortion under cover of law.

 

First lie: it’s all in her mind

They allege “that Rigsby, 58, has bipolar and borderline personality disorders and does not have the mental capacity to handle her medical affairs.”

The implication all along the article is that her illness is in her mind, except that “About 40 percent of the time, she dials 911 on her own. Other times, she’s out in the District when passersby see her fall and call for help, the testimony indicated.”

So, 60% of the times “passersby” make the call because they see her fall; clearly, it’s not in her mind for other people have witnessed her problem.

This case is a hands-on experience on How to Stigmatize People with Mental Disabilities.

Second lie: she uses the services EVERYTIME she calls 911.

In the article we find that “About 55 percent of the time, she refuses to be transported in an ambulance and signs a waiver allowing emergency responders to leave.” Clearly, less than half of the call-events end up in her being transported, this shows that the officials are exaggerating and lying about her.

Third lie: they are trying to save the city money (by spending millions)

That’s a good one. Hundreds of thousands of $$ will be spend on a court case, the city will be spending thousands on a neurologist for an expensive neurological test to prove she’s crazy, thousands on a psychiatrist and other “mental health experts” hired to lie in court on behalf of the city…she only ‘owes’ $61 grand after so MANY years, for crying out loud!

In addition, a guardian cost money to the city too because she doesn’t have enough $$ to pay for care at home. If they send her to a home…

Fourth lie: Mrs. Rigsby, not the system, is a burden to the city.

Well, if more than half the times she calls (55% of the times) she REFUSES to be carted away, that means that she is CONSCIOUSLY trying to NOT burden the system, but that’s not what you get from the article.

What they don’t elaborate in the article is that she REFUSES to be carried by the EMS, that’s the word they used, REFUSES. That means that they TRIED to take her just because they showed up, even though she is refusing. We don’t know whether she offered to go on her own, must likely, but it is clear she REFUSED to be taken by ambulance. Why are they making her look like an unreasonable person?

Well, without the unreasonableness, without the ‘crazy’ there’s no stigma and no stigma means no power over her because the truth that it’s all an abuse would be clear to all. Ergo, she must be made to look crazy, unreasonable and a burden.

When you read the comments posted for the article, EVERYBODY is taking as true that she is mentally ill and a burden to the system simply because the ‘officials’ say so. Her words don’t count.

It’s not about the money; it’s about the civil rights

“If the District’s petition is successful, the medical guardian could take responsibilities for such things as hiring a home health aide, filling prescriptions and proposing a different living environment. But it would still be possible for Rigsby to dial 911 because the guardian would not be a live-in caregiver.”

The issue of ‘repeat calls’ will not change. The problem is one of quality of services.

Cutting funds and leaving the communities dependent on punitive measures to squeeze money for services, or to cut expenses by criminalizing the poor and the mentally ill is the correct way to break our society apart.

We spend trillions on wars. That’s all I have to say.

Important news in the media about people with mental disabilities.


The information in the first headline below is disturbing. It’s another attempt at depriving people with mental disabilities of their civil rights.

The other two are news about how politicians of both parties continue to use people with mental disabilities as pawn for their personal and parties’ political gains. Well, that’s my interpretation of the information in the articles. If you believe what the government wants you to believe, that parity has been achieved…I don’t know what to tell you.

D.C. woman’s number of 911 calls prompt city to request that she be given a guardian

Equal Coverage for the Mentally Ill

Rules to Require Equal Coverage for Mental Ills

Man sets himself on fire on the Mall


Man is critically injured after setting himself on fire on the Mall

WARNING! Image that may be considered disturbing by some people is included in this post.

In the USA, contrary to Europe and the Middle East, the  visible evidence of the consequences of the war on the working class unleashed by their elected law-breakers…um…I meant to say law-maker’s policies, is not the working class seen in the streets fighting their corrupted elected politicians and their police-state. No. In the USA, the visible evidence of that class war is the disintegration of the public mental health in the form of self-immolation, increase in suicide rates, increase in ‘mass shootings’. It’s not ‘chemical imbalance’, it’s mental illness due to political imbalance. Mental illness  in healthy societies is very low and not a problem to that society.

This  evidence of the  increased mental deterioration of our people is what our president callously referred to as that pesky

ritual that we go through every three or four months

I know you don’t like to hear this but, our president’s and law-breakers (in both houses of Congress and both parties) laws redistribute our wealth up to the billionaire elite of Wall Street, to the war-mongering arms dealers and builders, the health insurance industry’s CEOs, the pharma and to the surveillance industry’s CEOs (among other privileged elitists) through trillions of dollars spent in contracts. This leaves the public safety-net destroyed when we need it the most.

The ignored-by-the-media epidemic increase in homelessness, usurious loan interest rates that guarantee the debt will be unpaid by an unemployed working class, the trillions in student loan debt that guarantee the students will not have a living-salary because the interest is prohibitive, veterans returning home without health and mental health services, all of this and more can have ONE guaranteed result: trauma to the mental health, individually and collectively.

But there are TWO public expressions of this problem: class struggle in the streets, as in Europe and the Middle East, or collective and individual depression expressed in self-directed violence and/or spontaneous, unplanned violence against the society. This last one is the one the law-breakers fear because they know it can turn into class struggle in the streets with THEM as the target.

Soo, before that happens, they and their media have DISCONNECTED from the public view the chain that ties  the INCREASE in ‘mental health issues’ to the economic and political war on the working class, and put the blame on mental illness as a threat to society, with the mentally ill turned in the public eye into a ‘terrorist’.

http://thoughtcatalog.files.wordpress.com/2011/01/pavss.jpeg?w=584

Famous photo of Vietnam era Tibetan monk protesting the war.

Self-immolation has got to be the most extreme form of political statement. The Tibetan monks used it to protest the Vietnam war and even today. We have yet to see why that man in the mall here in the US set himself on fire but, whatever the reason, it’s a bad omen of the extreme effect this ‘economical crisis’ is having on our people.

These laws taking away the civil rights of people with ‘mental illness’ are NOT created for your protection. They have been created for the protection of the elected officials and the banking and financial elite AFRAID of what may happen to them when we finally wake up.

People, the medicine we need is ‘the people united’ putting the fear in the elite’s heart.

Psychiatric Profiling as Blood Libel | Mad In America


This is Tina Minkowitz’ post at Mad in America. It presents interesting questions to our mental health advocacy community about what is to be done with the current political state of our nation’s mental health system and the prejudism against mentally ill people. Please, take a look at it. Thanks.

Psychiatric Profiling as Blood Libel | Mad In America.

Americans Fault Mental Health System Most for Gun Violence


Interesting Gallup poll.

One thing: according to the poll, Americans have NOT change at all, since 2011, in their believe that the “failure of the mental health system to identify individuals who are a danger  to others” is the MAIN cause of mass shootings (48%). But, there was a REDUCTION of 6% since 2011 to 2013 in the amount of people who believe that guns are the culprit. The question is Where did those 6% put the blame now? Evidently their change in perception is NOT reflected as an increase in the category of people who believe that the mental health system is to be blamed.

Surprisingly enough, Democrats are MORE likely to believe that guns are NOT the main culprit (51%), which brings the question: Why is the Dem Party so intent in ramming down our throats gun control laws as a panacea to this problem? As I showed in my previous post, Obama stated that the MAIN reason we have ‘ritualistic mass shootings’  is because “we” (the public) refuse to adopt “firm background checks”, a sad and absurd statement from the president of “hope and change”.

“Independents” are MORE inclined to blame guns than republicans themselves (44 vs 49% respectively).

This all leads me to believe that the Democratic Party PREFERS to blame guns so it doesn’t have to explain Why are they cutting funds for mental health services while the American people understands that bad quality of mental health services is the main cause of mass shootings.

If we were to accept that Gallop poll as valid, then these would be some points for the mental health advocacy community to consider:

1. Is the NRA succeeding in its message that guns are not to be blamed for mass shootings?

2. Is blaming the ‘mental health system’ equivalent to blaming the mentally ill individuals? That would be disastrous for us.

3. How can the mental health advocacy community take ‘advantage’ of the believe that the mental health system is the main cause of mass shootings? This point ought to be ‘exploited’: demand REAL reform in the mental health system NOW. While mental illness is NOT the ONLY reason for mass shootings (wars, national economy, environment of police-state, home foreclosures by Wall Street, joblessness, homelessness and many other social issues are part of the problem of mass shootings),  we could focus on QUALITY of services as much as on QUANTITY as a response to mass shootings.

We must battle against ALL background checks that stigmatize the mentally ill. Background checks are NOT the answer, not even enough to accept them TEMPORARILY because, once the legal damage is done, we can’t fight it for the next 50 years.

I’m a skeptic when it comes to polls, but, given that Americans tend to ‘buy’ them,  it would make sense to take advantage of this one.

 

Obama predicts shooting in 3 months


Obama made some remarks yesterday (Sept 17) in the Spanish tv station Univision which I consider APPALLING. I bring them for your consideration here because, hopefully, I misunderstood said remarks, and you can clarify them to me. Feel free to post your comment.

This is my transcript, you can hear him directly  in the video below. Highlights are by me and my comments follow below the vid.

“The fact that we don’t have a firm enough background check system is something that makes us more vulnerable to this kind of mass shooting…uhm…I do get concerned that this becomes a ritual that we go through every three or four months where we have these horrific mass shootings and yet we are not willing to take some basic actions we know can make a differenceUltimately, this is something Congress is gonna have to act on. I have now, in the wake of Newtown, initiated a whole range of executive actions, we put in place every executive action that I proposed right after Newtown happened. So I’ve taken steps that are within my control. The next phase is for Congress to go ahead and move.”

Now, my reactions to each of his ‘compassionate’ statements.

1. Obama says that the reason we go through this “mass killing every three or four months” is because background check system is not “firm enough”. That’s it. That’s all that needs to be fixed, our background check system. Even George W. Bush was more useful to the mentally ill people than this president we have now. After all, it was W who gave us the New Freedom Commission on Mental Health and the super important ADA Amendment Act of 2008.

I challenge ANYONE to tell me how has Obama gone above and beyond what W did for the mentally ill people. FYI, I’m not a republican (rather die)  nor do I support nor sympathize with W. But, to Caesar what belongs to Caesar

2. Also, Obama says that we are more “vulnerable to this kind of shooting” because of lax background checks. The implications: mentally ill people make this nation “more vulnerable”, and mentally ill people MUST be ‘firmly’ checked.

Given the path our government has taken, since Obama came to power, towards a surveillance state branding every citizen or group that it considers ‘subversive or dissenting’, these ‘background checks’ are bound to apply soon to any mentally ill person, whether or not applying for guns. NYS Office of Mental Health has started the trend already. See my post ‘NY Safe Act:…

3. The “ritual”. Now THAT was interesting. Was that scripted? Or was it ad lib’ed? Wow. Is he talking about mentally ill people having a ‘compulsion’ towards mass killing? Is he EXPECTING a mass shooting by,er, December or January 2014?

Funny thing is that, IF that’s what he meant, that mentally ill people have a RECURRENT death wish, why can’t he prevent the shootings? Evidently he expects them to happen consistently every three or four months. Does he expect that this compulsion and RITUALISTIC behavior can be stopped with “firm background checks”? HELLO. IS ANYBODY AT HOME!?

4. Who is “we” in that “and yet we are not willing to take some basic actions we know can make a difference.”? Is he blaming the public because they don’t want laws that are clearly oppressive and fascist? Or is he blaming the NRA supporters? It could help if he were more CLEAR. I think he is blaming BOTH. The “basic actions” entails depriving people who visit a psychiatrist of their civil rights, just to protect “we”.

5. And then there was the throwing of the towel. He is basically saying that he ‘tried’ to do something but, because “we are not willing to take some basic actions” he can do no more. It’s “up to Congress to move”.

That is THROWING THE TOWEL. He’s doing it because you voted against his gun law this year. He doesn’t care anymore, is what he’s saying. ‘Deal with it’ is what he’s saying.

Well, I’m going now to prepare my post for December’s mass shooting.

See you later.

The D.C. shooter and the other victims: the mentally ill people


OK. Keep moving; there’s nothing else to see here: it’s only dead people killed by an irrational mentally ill person.

I withheld my tongue when this incident was reported, waiting to see how long it would take the ‘officials’ to determine that it was just another case of an armed lunatic roaming free among us.

Until today, they were at a loss, running around like headless chicken trying to figure this incident out. Was it a terrorist plot? Was there more than one lone shooter? RUN! STOP THE PLANES FROM FLYING OVER D.C.!!

This is what happens when you don’t have ‘accurate’ gun listing profiles, I mean, reports; you can’t control the loonies. That’s the focus now, again.

Two things stand out (in my view) about this case: 1) the use of mental illness as an argument to justify policies in favor of arming/dis-arming citizens and 2) the stigmatizing of mental illness as a simple explanation to a problem that clearly has to do with the failure of the nation to provide QUALITY mental health  services, especially to veterans. I will discuss these now.

1) The use of mental illness as an argument to justify against or pro-gun rights policies.

The knee jerk reactions are the usual: we need guns because there are too many armed crazy people out there (NRA and Republican Party preferred argument), or we need to ban guns for the same reason (Democratic Party preferred argument). Either way you cut it, the mentally ill is the culprit.

In other words, the mentally ill is a political token to be used to settle a political issue: Constitutional gun rights. Our society can’t possibly engage in this issue using ANY other type of arguments. Not moral arguments, or about compassion, or about the economy, or about the crimes of the arms dealer and builders industry…no. It has to be settled by trampling on the rights of ALL the mentally ill persons in this nation, by vilifying a whole class of people who suffer neglect and powerlessness just because they are mentally ill.

This man, who committed this crime, seems to had been a walking ticking bomb for many years; that’s the impression that NOW the media and the police want you to stick in your mind. Based on the info that we are now receiving, he may had been ill, but NO ONE ever did anything to HELP him, not to punish or ostracize him, but to help him get services. That’s the payment we give to our soldiers when they come home. We let them boil in their PTSD and wait for them to do what EVERYBODY knows is going to happen. We do it because the national debt forces us to pay to Wall Street and cut mental health services. But no one talks about that NOW. NOoo. It’s the loonies that need to be thrown in a modern psych hospital (our prison system) and be forgotten there.

2) How easy is to explain this mass murder once you stick the label of ‘mental patient’ to the incident. NOW they understand.

You see, the Washington Post did its usual manipulation of info to help you arrive easily to the necessary conclusion. First, it described Alexis having a clearly paranoid episode, which happened long time ago, and then followed it immediately with this quote, which was made before we knew about Alexis’ mental illness:

“What caused this individual to kill so many innocent men and women?” Ronald C. Machen Jr., U.S. attorney for the District of Columbia, asked at an afternoon news conference outside the local FBI field office.”

It doesn’t take a rocket scientist to answer that question using the previous paragraph describing the paranoid episode. And THAT, ladies and gentlemen, is how the mainstream media practices the art of opinion shaping through EMOTIONAL MANIPULATION.

But that’s not all. The mainstream media is in a ‘damage infusion’ mode, forcing us to conclude that Alexis was a lunatic DESPITE him having also had a history of good deeds. It’s the process of enforcing the stigma rule.  For example:

a) his military achievements and recognitions are devalued in order to keep him stigmatized as a mentally ill person, unworthy of any recognitions:

“He received the Global War on Terrorism Service Medal and the National Defense Service Medal, awards of minor distinction”

“the Navy mistakenly said he had received a general discharge, a less-desirable category that would have indicated to future employers that there was something amiss with his performance.”

 Notice in the second quote how a dishonorable discharge is surreptitiously  equated with mental illness, and in the process implies that mentally ill people should NOT be hired.

b) other people’s good opinion about him become less important, and bad opinions AFTER THE FACTS become more prophetic:

“Those who knew Alexis in recent years describe him as a “sweet and intelligent guy” (a regular customer at the Thai restaurant where he had been a waiter) and “a good boy” (his landlord), but also as “very aggressive,” someone who seemed as though he might one day kill himself (a lay worker at the Buddhist temple where Alexis worshiped).”

c) and other people’s abuses pass as ‘insignificant’ and not contributing to Alexis’ losing it:

“The woman told police that Alexis had complained several times that she was too loud. She said he had confronted her a few days earlier in the complex’s parking lot “about making too much noise,” according to a police report.”

I’m sure that if you live in NYC, you know how ‘maddening’ a loud tenant above you can be. But we don’t question how disruptive that woman was, how did she contribute to him ‘losing it’.

d) and finally, how the system ignores the people’s need for mental health service to later blame mental illness itself as the problem. Mental illness is NO problem to society when we stop pretending that we are servicing people and actually put the money where the politicians mouths are.If we treat the people when they need it, we don’t have mass killings. And if we keep people employed we don’t have mass killing either. Neither if we stop spending money in “stupid wars” for the benefit of arms mongers, oil barons and Wall Street banksters.

We know that our politicians reward our veterans with homelessness and lack of medical and psychiatric services. Alex was a veteran. The signs where there but, as usual, no one did anything about it:

 “and it was unclear whether the Navy had sufficient cause to push forward. So when Alexis applied on his own to leave the Navy in early 2011 with an honorable discharge, the service granted his request, the official said.”

They had the opportunity to deal with him BEFORE he lost it. But they didn’t.

“Alexis also had an angry streak that flared often enough to create an arrest record in three states.”

Idem.

“Alexis’s father told detectives then that his son “had experienced anger management problems that the family believed was associated with PTSD,”

“He did not like to be close with anybody, like a soldier who has been at war.”

And the verdict:

 “Nobody could have done anything to prevent this except Aaron Alexis,” he said. “Maybe he snapped. I don’t know.”

This will not stop. Our society has failed to face the reality that mental illness is the product, not only of any physical disturbance, but of how our society is ordered, how we prioritize the use of our public wealth and resources.

Given that we prefer to pay big banksters for usurious loans instead of putting the money where it belongs (in the public service) we will have to continue blaming mental illness as the number one mass killer in the USA.

Prevention is incompatible with paying the debt. You gotta make your priorities.

See you in the next episode.

My sympathies for the relatives of the victims, as always.

I blame our government for this new social pain.

Cuomo Agrees to Plan for Housing Mentally Ill, Ending Legal Battle


This is breaking news in the NY Times. Cuomo Agrees to Plan for Housing Mentally Ill, Ending Legal Battle

This is an agreement to ´right´the wrongs committed by many NYS adult homes providers and that NYS judge that made that appalling decision in the case DIA v NYS-OMH etc in April last year. This agreement is a step forwards towards moving the people in those ‘homes’ of horrors to the community.

Am I personally happy and satisfied with this? I don’t go jumping with joy without first taking a quick glance to the text of the so-call ‘agreements’ and new laws to ‘protect’ people with disabilities of all kind. Why? Because one thing are the sound bites we get in the media about how great a new law is, another is the TEXT and the IMPLEMENTATION.

Now, with this agreement, everybody relaxes and forget about it. Just like with the Justice Center, we will assume that the government is looking to protect us. Nothing happens unless you threaten the government. Not even this agreement, the result of years of court battle with the state.

OK. I will NOT sour your joy. IT IS A STEP in the right direction.

I will tell you where we must put caution in this agreement.  You can read the agreement on your own here courtesy of Judge David L. Bazelon Center for Mental Health.

Suffice it say that the agreement WARNS those Adult Homes providers previously caught abusing the mentally ill that they should not interfere with their residents in this process of moving them out, or they ‘will be punished’. Adult Homes are going to lose $$ and they want to keep their houses of horror filled. That there is a NEED for a warning to them should tell you a LOT. (See page 8, part 4 in the agreement.)

First quick notes:

From “definitions” (pages 4 and 5):

1. You have to be 65 years old or under to qualify for the benefit of the agreement.

2. The agreement MAY take 4 or 5 years to be completed. If you are 62 now and you HAVEN’T been relocated within the next two years, you may not qualify anymore. Or at least the agreement doesn’t clarify that. This is a question that those of you in Adult Homes (AH) MUST ask the people involved in this agreement.

3. As usual, the agreement applies to AH that are LICENSED, per Social Services Law Article 7. If you are in an unlicensed one, you may have problem qualifying for the agreement. YOU MUST SEEK CLARIFICATION ABOUT THIS.

4.  AH with LESS than 80 beds do not qualify for the agreement. It (“transitional AH”) has to have 80+ beds AND  a “mental health census” of 25%. If you are in a small AH, you may want to confirm that it qualifies for the agreement.

5. “Impacted” AH are those in NYC with 120 beds or more AND a mental health “census” of 25%  of the population of the AH.

MENTAL HEALTH STATUS: Not so fast baby.

To qualify, a mental health evaluation to measure your level of functioning will be implemented. This is where the ENACTING may go astray, leaving people who are not dysfunctional ‘enough’.

1. Must have a mental diagnosis based on THE MOST RECENT DSM book.  I would say, tread with caution here.

  • ‘what if I my diagnosis is not in the book anymore? They removed some and added new ones.’ See my point?

2.  Excluded from the agreement are people with developmental disabilities, mental illness due to brain damage, and “SOCIAL CONDITION”. I’m as lost as you are on that last one. Looks like a loophole to keep people in. Must check the DSM bible for clarification.

3. “Must have a  SUBSTANTIAL FUNCTIONAL disability WITHIN the PREVIOUS 24 MONTHS before the date of the agreement.” Do you know what a “substantial”  functioning disability means? I suggest you look it up if you want to get out of there. Plus, it is ‘within’ the last 24 months of the agreement. Better check it out how that may affect you too.

4. Who will determine your disability, your substantial functional levels that will ALLOW them to put you in a supported housing?

  • a determination by SSA that you receive benefits due to mental illness will not be enough.
  • A “Health Home agency” AND a  MLTCP (managed long-term care Plan) will be in charge of the process of evaluating your qualification for the agreement. Even if SSA says you are disabled, these people may determine that you are not ‘substantially‘ dysfunctional and may disqualify you. See #5, subsections (b) i and ii on page 5.

So don’t assume that you automatically qualify to be relocated out of the AH just because you are there.

“PERSON-CENTERED PLAN”. Where have I heard that before??

Right, those of us in Supported Housing (SH) are struggling with “person centered support”. Welcome to our struggle. But, I will NOT deny that chances are that, if you make it to a SH, you may be better off than there. Just don’t come here thinking ‘wow, I made it. I’m out of danger’. Nope.

Now, I couldn’t find the dates for the agreement. If any of you find that info, please, forward it. It’s important to you, if you are in one of those homes,  because of the transition schedules. You don’t want to be left out.

My take about this:

1. This is a good step forward.

2. ALL THESE PEOPLE who are coming to the community are going to face the reality of what we have here: SH is over 80% unlicensed. This means, you have NO LEGAL PROTECTIONS there. People centered treatment does not exist. It’s a craps shoot.

3. the ‘culture of abuse’ that exists in those AH will relocate in the community, following our new ‘freed’ peers, with those workers who will get jobs from there to here.

4. TODAY MORE THAN EVER  we need to ORGANIZE our people. For ‘people centered ‘ services we NEED TO BUILD THOSE CABs.

5. Never has the state given ANYTHING without a fight. The NYS WILL BE crying ‘BROKE’ to avoid completing this agreement and creating housing for them. If you want to trust them 100% despite what history shows us, fine.

This is my first reaction to the agreement. Sorry if I sour your joy. I doubt it, though.

CONGRATULATIONS TO THE FORMER DIA.

GOOD WORK.

Welcome And good luck for those of you moving here to the community ‘with us’.

Like we used to say in the ’60s: the struggle continues.

Madness at OMH: Thousands of mentally ill New Yorkers listed [illegally] in SAFE Act registry


Wow! This is ‘snafu’ in all its glory.

One thing at play here: The seemingly ‘purposely’ releasing of private information about, apparently, ALL people committed voluntarily or not in our psych hospitals. I expect that there will be an investigation into this seemingly wide-spread contagion of forgetfulness about patients privacy rights. This is serious, though.

RELEASING THE LIST OF PSYCHIATRIC IN-PATIENTS

If this doesn’t have ‘conspiracy’ written all over it, its definition must be reviewed.

a) “More than nine out of ten reports so far have come from hospitals or state psychiatric centers — including hundreds [how many hundreds?]of reports filed in a single day in late April by state psychiatric hospitals. [“hundreds’ “in a single day” is too much for it to be a ‘mistake’.]

b) “Yet some reports, testified Wolkenbreit, are being filed by someone other than the mental health provider seeing the patient, and many appear to be computer generated, based on existing patient files.[If only mental health providers can file, who violated the rule and why?]

c) “Benjamin Rosen, a spokesperson for the state Office of Mental Health, acknowledged in an email statement that this spring many [how many is “many”?] psychiatric patients [not in-patients included?] were automatically referred [by who?]to county officials.” 

d) “From March 16, 2013 to May 6, 2013, while OMH was building a reporting portal for state psychiatric hospitals [hmm], reports were initiated [from where and by whom?] based on admissions to state psychiatric hospitals [all people admitted from March 16 to May 6? From All psych hospitals?], although mental health professionals had the ability to prevent reports from being forwarded for those persons who did not meet NY SAFE Act criteria,” said Rosen,…[who are they who did not prevent the reports from being forwarded?]

e) “In many cases [again, how many?] mental health providers listed on the documents, when contacted by community services directors for review, either said that they had not filed the reports… according to Wolkenbreit.” 

So, WHO filed the reports and why? Is the DCS or OMH investigating these ‘false’ reports of people “who did not meet the Safe Act criteria”? Did the psych hospitals receive orders from anyone, in the hospitals or by someone in OMH, to file the reports en mass? What are the chances that all those people working at state psych hospitals could have, at unison almost, made the same mistake of breaking a privacy law they ought to know by heart? How come other institutions, private, did not commit the ‘mistake’?

Did the Department of Community Services forwarded ALL of the names in the report to the NYPD?

“Of the 6,000 reports that have been filed, 11 have been acted upon,” testified Jed Wolkenbreit, counsel to the New York State Conference of Local Mental Hygiene Directors, Inc., citing figures from the state Office of Mental Health.

What does “acted upon” means? That 11 were forwarded to the NYPD or to the Department of Criminal Justice? How many, if any, were sent to the NYPD or to the DCJ?

This is a debacle. This is beyond stigma and violations to HIPPA. Evidently HIPPA is there to protect privacy. It’s PRIVACY and rights that are at stake here.

I’m sure that the NYPD is happy if this ‘error’ provided them with info about who is in mental treatment. The surveillance state has being feverish at work trying to compile a data base of EVERYBODY officially diagnosed as mentally ill. Sure, it’s to ‘protect’ you from yourself and others.

With stigma or without it, our police wants to have a dossier of everyone whom it considers a threat to the establishment, a ‘potential terrorist’. It’s our collective liberty what is at stake here. We, as people with disabilities, are just ONE of the many groups being labeled for ‘security’ purposes.

Everyone ought to stand by us in this debacle. It will happen to you next.

Comment by Lourdes C.

Source: http://www.thenewyorkworld.com/2013/06/03/safe-act-registry/#comment-327403

The IRS scandal: three degrees of separation from NYS Office of Mental Health


“An administrative agency does not have the power to change the plain meaning of the law and make a disaster happen and that’s what’s happened here.” Rep. Eleanor Holmes Norton  on the IRS’ interpretation of the words “exclusively” and “primarily” in the statue. May 23, 2013

This is relevant to the issue of how NY State’s Office of Mental Health (OMH) and other mental health agencies have ‘interpreted’ the mandate given to them by both the state and federal governments to protect the mentally ill from abuses and bad quality of services.

I discussed this problem in my post When is ‘minimum’ the same as ‘high’? When NYS OMH says so. I wrote it in February this year. There, I exposed how OMH changed the words “high quality of services”  mandated by the state mental health law, to make the providers accountable only to ‘minimum’ levels of care.  Mrs. Norton has validated the point I made there.

DISCLAIMER:

I am NOT supporting ANY politician of ANY of the two parties nor supporting ANY position in favor or against this IRS ‘controversy’. I use this controversy in this post ONLY as an example to ILLUSTRATE problems of statutory law in OMH’s regulations. These are my opinions and do not represent the opinions of other people who are part of the grass-roots group called The Citywide Mental Health Project. End of disclaimer.

THE BACKGROUND: Statutory vs. Regulatory laws and powers

The big issue and controversy is this: statutory law vs. regulatory laws. It’s about the process of making laws and how administrative agencies enact those laws.

1. Law-makers, whether state or Congressional (senate included), pass a law about any issue, be it mental health or IRS etc. It is called STATUTORY law because it is created by elected officials, not by a court or judge.

2. The law-makers delegate the enacting of the law to the commissioner of the administrative agency in charge of the issue for which the law was passed.

3. They give a BLUE PRINT to the agency which tells the agency what GOALS   the REGULATIONS it creates must achieve. The statutory law is a MANDATE to the agency. The regulation is to enact the mandate but carries the force of law and the backing of the police powers to enforce the regulation.

discretionary4. The law-makers give the commissioner of the  agency  DISCRETIONARY POWERS to enact the mandate. This means that the law-makers don’t care what regulations the agency creates, only that the MANDATE is enacted LEGALLY. The agency can create ANY regulation with ANY language as long as the PURPOSE of the regulation is to achieve the MANDATE.

5. But the DISCRETIONARY powers are LIMITED. The commissioner of the agency can pass any regulation as long as it is LEGAL and doesn’t violate the ‘spirit of the mandate nor state or federal laws.

spirit

The ‘spirit of the law’ as seen by some law-makers.

6. This means that an administrative agency is a LAW-MAKING body: Because it MUST pass REGULATIONS to bring the MANDATE into life, an administrative agency is considered a ‘law making’ system.

7. But the COMMISSIONERS of  these administrative agencies with  ‘law-making’ functions are NOT elected. STATUTORY law makers (meaning those we elect to state senate and assemblies and Congress) are, supposedly, accountable to us. Commissioners ARE NOT accountable to us, they are so only to state and federal law-makers.

All of the above is what is called POLICY-MAKING SYSTEM. This is important because:

  • the commissioners of the administrative agencies are NOT ELECTED and not accountable to the public, and
  • Because they have DISCRETIONARY POWERS to create NEW LAWS to control the public’s behavior through these regulations.

Because of all of this, there is a thing called FEEDBACK  built into that policy decision-making  system. It is there so that we can INFLUENCE those COMMISSIONERS into enacting or correcting REGULATIONS that had the unintended outcome of HURTING the people who was supposed to be protected by the regulations.

WORDS HAVE MEANING AND ‘FEELINGS’

words

OK. That was the background. Now, Mrs. Norton did exactly what I did in my document about OMH”s Supported Housing rules: she put the mandate and the agency’s rules side by side to illustrate how the agency DISTORTED the meaning of the mandate. The following is from MSNBC (bold and link by me):

Section 501(c)(4) of the Internal Revenue Code which defines social welfare organizations for tax-exempt purposes defines them this way:  “Civic leagues or organizations not organized for profit but operated exclusively for the promotion of social welfare.”

Then, the IRS code does a magic trick and changes the meaning of the word exclusively:

“To be operated exclusively to promote social welfare, an organization must operate primarily to further the common good and general welfare of the people of the community.”

http://tv.msnbc.com/2013/05/23/exclusively-vs-primarily-irs-law-a-disaster-waiting-to-happen/

The distortion of words in the mandates by these agencies have the consequence of stripping the SPIRIT out of the law, the PURPOSE FOR WHICH the statutory MANDATE was created in the first place.

There is always a ‘context‘ behind every law. Judges refer to them in many cases, they look at the ‘history of the statute” because words without context have no importance nor usefulness. That’s why writing policy and statutes is an ‘art’: there are specific rules about how to write them.

lawsIt is an art to prevent that the meaning of  “exclusively” be INTERPRETED as “primarily”, two words with DIFFERENT meanings. One, ‘exclusively’, CLOSES the door to anything that is NOT contained in the ‘universe’ described in the law. The other, “primarily” has a TENTATIVE meaning, it leaves the door open for things not envisioned and even EXCLUDED in the original description. “Exclusively” says ‘no way Jose’ to anything outside the boundaries; the other, “primarily”, says ‘yeah right, whatever’. One says “men only club’, the other says ‘primarily men only club’. Go figure. Bad examples? I think they are grrreat!

I stand by my claim that OMH’s so-called licensing rules violate  state and federal mandates. The problem is that, once these agencies write their rules, it is as if they were written in stone.

Remember how difficult it was to remove the administrative  rule that ordered Black people and other minorities to seat in the back of the bus in the South?

Just because it is a law or rule or written in stone doesn’t make it right nor are we obligated to obey unjust rules.

On Failed gun-control laws and ‘ROBBANRA’: it could have been worse.


Look people, you should appreciate and thank our sold-out ‘law makers’ for NOT passing the law.

First, it should be clear by now that the description ‘law makers‘ applied to our Congress is an anachronism. Keep up with the times, people! Congress should be known as ‘ROBBANRA‘, the Congressional ROBBANRA. Yeap, that’s more like it.

And…what was that? What is ROBBANRA?. Oh, I forgot to ‘splain’. It means the ‘Rubber-stampers of bankers, billionaires and the NRA’.

As I was saying, be thankful. Congress could had, after all, PASSED a  bill more appropriately named THE BILL OF LIES ABOUT GUN-CONTROL. Like our NY State Gun Control Law.

It would have been filled, like ours, with, not only loopholes, but with concessions and fictional ‘mandates’. And with provisions to control YOU, mental health consumers, or even users of the banking industry instead of the gun industry because, as we know, many bills passed by ROBBANRA (and many states also) are an opportunity to slide-in controls on issues un-related to the bill been discussed.

Like ours here in NY, where the gun bill was used to amend the Assisted Out Patient Treatment (AOT) law, extending the time a person can be held involuntarily and giving psychiatrists and RN nurses (for they now can commit people without approval of a psychiatrist) the power to guess when a person will flip and then commit him or her. AOT was not part of the gun-control discussion.

But that was not the only misrepresentation of the bill.

BIG ‘NY STATE GUN CONTROL BILL’ LIE

Our Congress could have passed a law with all the goodies for the NRA and then tell you that YOU WON. Like in NY State, because one thing is what they TELL you, another is what the new law says.

In NY State,  people were told that the new gun law mandates gun sellers to do background checks before selling guns. A LIE.

The bill’s Art 39, Section 898, sub 2  it clearly says that doing a criminal background check  is a CHOICE, not a mandate for the seller :

2. Before any sale, exchange or disposal pursuant to this article, a national instant criminal background check must be completed by a dealer WHO CONSENTS TO CONDUCT SUCH A CHECK, (caps by me)

I couldn’t find other ways to highlight that qualifier. That’s the masterful art of writing laws: use ‘must’ to give the impression that a mandate was stated, but then add the loophole ‘consent’ which is actually the only thing that matters in that line. ‘If you CONSENT to do it, you MUST do it right’ or else don’t do it.

I have to laugh.

You see. By Congress not passing the gun control bill, you were spared lies, fictional mandates and loopholes…but then, you would have go on living happily thinking that something positive was done.

Oh, well. Don’t worry, our Congressional ROBBANRA will give you more peace of mind with bills like the Homeland Security Law.

Gov. Cuomo’s ‘Intent to redesignate the Protection and Advocacy Systems’ proposal


For those of you interested on this, there’s a copy of the proposal on  ‘Our documents’ tab up there for you to download.

The Citywide Mental Health Project will, hopefully, make a testimony on this proposal on April 9.

Happy readings.  (smile)

Bloomy’s rights v. yours: he and the elite can (and will) infringe on your freedoms


“I do think there are certain times we should infringe on your freedom”

'nough said. Make sure you take your meds today or else....

‘nough said. Make sure you take your meds today or else “we” will infringe on your freedom….’

But YOU can’t infringe on “theirs”. You are the slaves of the elite.

Never was the elite more frank and public with their true fascists nature. Wow.

 

 

 

 

The Citywide Mental Health Project’s presentation at the NY City Council hearings on budget cuts to Mental Health services.


Below is the statement I read at the NY City Council. I would say    that the audience had a good response to this, most of them. There were some ‘uuuh’ at the part about the ASPCA, and a lot of laughter (intended) when I mentioned Dr. Evil  at the end.  The purpose of   this presentation was actually to have the providers and their          representatives there  hear us and our message. I think they did.

 Testimony presented by Lourdes Cintron for the Citywide Mental Health Project

At a Public Hearing on Thursday, March 21, 2013

14th Floor Committee Room

Presented to: New York City Council Mental Health Committee

Good afternoon. My name is Lourdes Cintron, the founder of The Citywide Mental Health Project, still a grassroots group of consumers of mental health services and their friends and relatives opening to public discussions the roots of our lack of voice in our mental health system and ideas on how to regain our voices in that system.

We, consumers, are grateful to you for trying to prevent more cuts in funding for programs, and to the highly professional service providers represented by these people here today for their efforts to keep these programs open.

But, after the money is allocated and everybody disperses to focus on the next threat to programs in the agenda, who keeps an eye on how are these funds been used in the programs?

Let’s be realistic: There is no meaningful follow up on accountability and what quality of services that money is buying. The CABs, [Consumer Advisory Board] the tool in place for us to partner with providers at the point of service to design policies that will deliver services effectively and without causing harm to us, are virtually nonexistent.

Unwittingly you continue to fund some providers who shouldn’t be in the business of social work, and your funds pay the salaries of some unprofessional directors and supervisors whom the ASPCA wouldn’t hire to service their dogs.

  • At a time when the mentally ill is been blamed and penalized for the violence and degradation of the social network  that comes with budget cuts
  • when privatization and decentralization of the functions of our government is almost complete (see the governor’ SAGE report),
  • when soon the quality and goals of our mental health services will be directly determined by how much profit they generate to Goldman Sachs and Wall Street in their new investment scheme called ‘pay for success’, in these times our role shouldn’t be limited to be consumers.

 

According to the SAGE report, the State spends 16 BILLIONS in contracts with NFP [not-for-profit] but there are few, and meaningless at that, CABs in those programs and no meaningful grievance procedures.

Instead we are given councils and advisory boards created by OMH and the DOHMH where we are forbidden to talk about the ‘A’ word: abuses.

They decide the agendas and do all the work; we just have to show up. So what happens when they decide to take the resources and change the structures of these boards?

The best illustration of the institutionalized mentality of disrespect and disempowerment of consumers is the so-called NYC “Federation” of Mental Health Consumer Advisory Board. I know because I was there and had to leave immediately to protect what is left of my sanity.

As you all know, the commissioner, without notifying or consulting the consumers who are there to ‘advice’ him, expelled the providers out from the old federation, kept the consumers because – well, you just can’t have a federally mandated consumer board without consumers – removed the resources from the MHC [Mental Health Committee] in the 5 boros [boroughs] and left the consumers with a shell of a ‘council’. He simply left us without a voice in the system.

That’s how OMH and the city have trained consumers to be helpless and disempowered.

In view of all these problems and realities, we are asking you to, as Dr. Evil said in Austin Powers, “throw me a freaking bone here”

We need MEANINGFUL CABs at the point of service, organized by consumers themselves to collect and bring to you our feedback about how the services you are paying for are been delivered.

That’s what the Citywide Mental Health Project is trying to do.

The least you can do for us is to help us organize a Town Hall meeting to listen to what the consumers at the point of service have to say about how they are receiving the services.

Maybe from there we can come up with more creative ideas to protect us other than building a whole bureaucratic structure around one phone call to report abuses.

Unmasking “Pay for Success”: Wall Street betting on poverty.


This post is based on a reading of “Counter(Imp)acting Austerity: The global trend of government support for impact investment, a research paper done by a Yasemin Saltuk for JP Morgan: “J.P. Morgan (“JPM”) is the global brand name for J.P. Morgan Securities LLC (“JPMS”) and its affiliates worldwide.” It describes the growth and projections of this ‘new’ form of capital investment ‘initiatives’ or ‘ventures’ aimed at directly profiting from the same social problems created precisely by JP and its equals. Basically, they invest, privatize and control those social services delivery systems which they deem profitable, with the government taking the “risk” of the venture. Yes, you will see in the report that the government will assume the ‘risk’, the rules are still been drawn.

There are many names for this new investing ‘trend’. Here in good ol’ USA it’s known as “pay for success initiatives”.

After reading the document, I too came with different names for this ‘initiative’: ‘Voltaire’s ‘social contract’ on steroids’; ‘Your road to wealth starts with the squeegee guy’; ‘The wolves feeding the sheep’; ‘Betting on poverty’…well, you get my drift.

When, as you will see, even the US State Department involved in this “pay for success” business (that’s exactly what it is), you know something fishy is there. And when JP Morgan works diligently in this report, you know that this is in the hands of big government and central banking systems. This ‘approach’ is the result of big lobbying, not the result of social workers finding ways to cope with the impact of budget cuts in the lives of the under-served. RIP ‘not-for-profit’ social services industry. Although it was a looong time ago since they stopped being ‘not for profit’.

And forget about “best practices”. If it ain’t increasing profits, it ain’t best practice.

Let me share with you what I found in that report. I’ll do this  in two different posts, the second will discuss how ‘pay for success’ will work and how it will be financed.

1. Origen of the new millennium’s “pay for success”: coping with debt with more debt

This ‘impact investments’ (“those intended to create positive social or environmental impact alongside financial return”) is not new. The report mentions that in France, for example, this idea is at least 100 years old. It was previously known as “social economy” in the form of ‘credit cooperatives’ with ‘social outcomes’ goals at its heart. This bank is the oldest in that tradition, supposedly:

Crédit Coopératif is a co-operative bank…” http://www.credit-cooperatif.coop/menu-bas/english-presentation/

But today’s ‘impact investments’ ideas are the direct result of the economic crisis created by the central banks:

“As governments across the developed world grapple with austerity, many are faced with the reality of reduced public spending at a time when economies struggle to grow…”

“In a global trend, governments are increasingly turning to domestic impact investment as they balance the need for fiscal consolidation with the demand for investment in economies struggling to grow.”

“As such, this period of fiscal consolidation has been an opportunity for impact investments”

“Whether or not the motivating factor is directly caused by fiscal consolidation [they don’t care] the coincident trend is clear: governments across developed markets are increasingly turning to the impact investment sector for delivery of domestic social services as they cut spending” [yeehaaa!]

Mind you, “fiscal consolidation” means “a policy intended to reduce deficits and the accumulation of debt.”  Reduce deficits means reduced social spending in order to pay the central banks, and reduce the accumulation of debt, well, in an economical system based on debt, reducing debt is impermissible and unacceptable. You will see how the report confirms that creation of debt is at the heart of this “pay for success” capital venture.

Anyway, this “pay for success” is the central banks’ medicine to the problems THEY have created with their debt collections and bailouts.

2. Why are JP Morgan  and the big banking systems interested in “pay for success”?

The language of WS and central bankers gives you a huge hint:

“[to] attract private investment capital, to take a more significant role in delivering social services”

“we show the consolidation required …”

“Fiscal consolidation is insufficient, coincident investment in growth is critical” [market growth, that is]

directed financing towards intentionally impactful and financially sustainable business – what we will refer to as “impact businesses”

“to deliver better returns”

encourage faster market growth”

allow businesses to improve their market position

opportunities for strategic investment

We believe this makes the market for impact investmentsthe investments that finance impact businesses –a key recipient of government support today and in the future.”

There can be no doubt about the nature of this ‘pay for success’ model: it is a profit-seeking, global financial market investment business. It has been thought out aaaaaall the way up there, where none of us can see or influence it. It deals with nations’ “consolidation” policies, “market growth”…This is NOT a GRASSROOTS movement.

In addition, these bankers DEMAND “fiscal consolidation” in order to participate in the shark feeding frenzy : the consolidation required”, “Fiscal consolidation is insufficient”.

And more ‘egregious’ is this:

“a key recipient of government support today and in the future.”

I thought that capitalists didn’t want the government to meddle in their business, that this ‘pay for success’ was about BIG BUSINESSES HELPING the ‘salt of the earth’, the downtrodden. But now I find here that it is about THE GOVERNMENT supporting the market! And to rub it in our face, they will finally, FINALLY take official and in-the-public’s face control of  how we receive services, if any and in whatever shape they decide it will happen:

to take a more significant role in delivering social services.”

And here we are, gingerly and happily CONSENTING to this total corporation appropriation of our lives, of how ‘recovery’ will be defined in terms of how much profit your pain gives them.

3. First ‘moral  implications’ question: profiteering from poverty

How safe it is for us to entrust the repair of the damages done by that global market and the global banking industries to our society into the hands of those same people?

Is it moral to devise a system of big stock  buying and investing and subject  our health services to the ups and downs of the market? As you will see later in the report, these people are aware that, in order to reap the most profit, the most sick and difficult to help due to mental illness will be left behind, those who can’t be shaped into some profit-drawn box of ‘behavioral outcomes’ will be left unserviced.

If, as even they acknowledge, this is the result of the financial and austerity crisis, isn’t there ANY way to solve the problem other than surrendering our lives to the global markets? And why does it have to be PERMANENT? Today they are only finessing the TRANSFER of our lives to their hands, drawing the rules they will use to make US PAY for that too,

“today and in the future.”

Tomorrow I will post the rest of the report. It will deal with the actual rules of how they will finance ‘pay for success’.

Lourdes C.

Of medical experimentation and privatization: OMH’s licensing rules. Part 4


Ok. So far we have seen that the state’s Department of Mental Health (DOMH)  and the Office of Mental Health (OMH) have downgraded the high quality of the services that the law mandated these agencies to assure, to the bare “minimum” (definition of minimum is ‘the least amount possible’) standards we can  tolerate without screaming.

We saw also that the rule protects the providers by stating the they will be held “accountable” only to those minimum standards; and that these agencies use this finely crafted rule  in courts to protect themselves and providers from any efforts to hold them to any higher standards.

Now, let’s see how the consumers fair in that licensing rule. Is there anything good for them there? A crumb? But of course NOT! It actually EXCLUDES you from its protection.

NYS MH LAW BASIS FOR ISSUING AN OPERATING CERTIFICATE

It says that the certificate will be given based on OMH finding that the following is working properly:

a) premises
b) equipment
c) personnel
d) records
e) and program
 

Seems reasonable to me. Does it says that it will be based on how ‘crazy’ you are, or on how your illness compares to other people with the same illness? Or based on whether you are ‘more’ physically disabled than mentally disabled?

Hmmm.

Hmmm.

Now compare it with this:

part 70

“Not intended to be include” was mentioned three times. This rule was written to exclude you and to deny services, all services, not to clarify how programs, equipment, etc must function, as described by section 31.05. Let’s break it to see who is excluded.

1. “on the same basis as others not so handicapped“. That’s a comparison. Nowhere in the state’s law you see that language.

A violation of ADA and other statutes?

This from the Supreme Court of the USA about violations to the ADA:

“Section 12132 can be understood to deem as irrational, and to prohibit, distinctions by which a class of disabled persons, or some within that class, [compering disabled people with each other]  are, by reason of their disabilityexposed by a state entity to more onerous treatment than a comparison group in the provision of services or the administration of existing programs, or indeed entirely excluded from state programs or facilities.”

That’s exactly what that Part 70.01 is doing, in my view. It denies services- “nor those services…” – based on how disabled or mentally ill you are and as compared to others. How is OMH going to make that comparison, it doesn’t say.

2. Who are the “not so handicapped”? How can an agency created to help eliminate stigma and stereotypes about mental illness write  with such an undefined and unprofessional language? The owner of the bodega on the corner of my street in the Bronx uses that language, “not so disabled”.

3. And who are those whose “disability is PRIMARILY other than mental” and not meant to be included? If it is not ‘mental’ then it most be physical. Thus, if you are physically disabled AND mentally ill, you are EXCLUDED from mental health services unless…you can measure which one is your biggest problem and come up with mental illness as the ‘big winner’. No wonder our mental health system is ‘fragmented’: it’s been run by car mechanics.

MECH

4. What are these “activities”, which “however well intended” [no compassion is allowed] , are “free of risk”!? Of course, they don’t say; go figure it out on your own. But this much I can tell you: if you think that human medical experimentation is considered by OMH as “above minimum risk” activity, think again. Consider this description and tell me that it is activity “free of risk”:

“These studies involve, inter alia, the administration of both FDA approved and experimental antipsychotic and psychotropic drugs, which are capable of causing permanent harmful or even fatal side effects *fn1and/or highly invasive painful testing procedures on subjects with no benefit or only the possibility of a beneficial effect expected from their participation. Moreover, several of the studies involve a medication free or placebo phase in which subjects, who are being successfully treated with approved drugs, are taken off the medication for a period of time before the experimental medication is introduced, during which time they may relapse and suffer the adverse symptoms of their particular illnesses or disorders.”

That is from the not-so-far- ago (1996) case T.D. v. New York State Office of Mental Health:

“The issues presented for determination in this matter concern the validity of regulations promulgated by the defendant New York State Office of Mental Health (OMH) codified at 14 NYCRR 527.10. The regulations, promulgated on November 7, 1990, state that their purpose is to “seek to ensure the protection of patients who participate in research while, at the same time, facilitating research into the very disorders from which they suffer and which underlie their impairment” (14 NYCRR 527.10[b]). Contained in the regulations are provisions which set out procedures for, and thereby sanction, the participation of adults and children, who are patients or residents of OMH operated and licensed facilities deemed incapable of giving consent, in so called “more than minimal risk” non-therapeutic and possibly therapeutic experiments.

That case was 20 years after Willowbrook! OMH was created in 1977, five years after Willowbrook and precisely to prevent another Willowbrook! But these activities were going on for a while before 1996 until the public lawyers brought that lawsuit. That case was not solved until 2010. Up to that date OMH argued, SUCCESSFULLY (in  Hirschfield v. Teller, related to the above case) that the public lawyers do not have the right to protect those people because it (OMH) didn’t see fit to require an operating certificate from the ‘facilities’ and, therefore, the lawyers don’t have access to clients in unlicensed facilities. But neither in licensed facilities, as we saw in the case above.

One has to ask oneself: for whom is OMH and the DOMH working?

And to close this part of this ‘series’, this is the last piece of the masterfully crafted rule Part 70.01 that leaves unprotected people in both licensed and unlicensed ‘facilities’:

final

That’s right: you can protect yourselves. Don’t bother these people. Who was it that said “HEAL YOURSELVES!!!”? Oh, right…JC.

So, OMH says that they expect you to be able to compare yourself to other people, come out short in terms of ‘health’, choose between either mental disability or physical disability and…be able protect yourself from abusive providers in licensed and unlicensed ‘facilities’.

A violation of ADA and other statutes, again?

(iv) Provide different or separate aids, benefits, or services to individuals with disabilities or to any class of individuals with disabilities than is provided to others…28 CFR 35.130 – General prohibitions against discrimination.

These agencies assume that you can do all these things and, based on that assumption, discriminate against you. These ‘experts’ on mental disabilities think that your illness is continuous or not, that you don’t go through ups and downs and relapses.

I have no problem with making sure that those who need the services are the ones receiving it. But this licensing rule has NOTHING to do with that. Otherwise, why use it to downgrade quality of services and protect the providers?

Next: Privatization

Privatizing NYS public mental health system, one rule at a time. Part 1


This is the first of a series about NYS OMH’s and the Department of Mental Health’s licensing policies. This is intended for my ‘peers’, to share what I have learned in my dealings with the mental health system. It took me a long long time to understand and put this together. Thus, I want to save the time to others.

Note: I am not a lawyer or paralegal. This information can’t be taken as legal advice (better believe it) nor as reliable for any legal purposes. In other words, I’m not responsible for the misuse of the information on this post.

Some topics I will cover this week  are: ‘best practices’, OMH report last year advocating using unlicensed workers (case managers) to provide the equivalent of psychotherapy, and the SAGE report. Let’s start.

NYS Mental Hygiene Law (MHL)
Title E, Article 31: Regulation and quality control of services for the mentally disabled

Section 31.02 Operating certificate required.

Some judges in our State’s courts have alluded to the simplicity of the title of that section 31.02: ‘operating certificate required’ (op cert here on). It flaunts purpose and determination: ‘op cert required, period.’  It is a declaration of State policy. It is a mandate. So why has OMH de-certified more than half of our mental health programs and providers, basically privatizing our public system?

According to the New York State Consolidated Budget and Claiming Manual there are a total of 90 types of mental health programs under OMH. Of those, 22 are licensed and 68 are unlicensed. OMH reported in 2012 that of a total of 6759 programs, 4646 were unlicensed and 2113 licensed.

Source: “Reports on the Workforce From State Agencies”   (OMH”s report)                                    March 2012

Source: “Reports on the Workforce From State Agencies” (OMH”s report)  
  March 2012

Do these figures matter to the consumers and to the public, who may one day find itself tagged as ‘client’? Let’s take a look at what a licensing policy accomplishes.

By the way: do you know how many license categories OMH has?

1. Licensed
2. Unlicensed
3. Not-licensed(!)
4. Certified
5. Operated by OMH
6. Regulated by OMH
7. Approved by OMH
8. Funded
9. By auspice
(From various sources, including the New York State Consolidated Budget and Claiming Manual)
 

Putting licensing policies in perspective:

safetynetA State’s licensing system reflects  its policy towards the issue it is licensing; it is part of the policy system.

Policy is the decisions and actions taken by the state:

  • to fix a social problem,
  • to protect and
  • to offer a better quality of life for its citizens.

The golden rule of all policies is ‘first, DO no harm’. It is so golden that it is alluded to in OMH’s ‘Rule 501.3 Waiver’:

(2) The commissioner may grant a waiver of a regulatory requirement…if he/she determines that:

(i) the rights, health and safety of clients would not be diminished; (The commissioner’s discretionary powers can’t be used if they  cause harm. Well, at least in theory.)

All policy systems have a feedback mechanism for those who receive the benefits of the policy. Through it they let the policy-makers know how effectively and efficiently it is working. Our state’s mental health policy is in NY Code – Mental Hygiene, Title B MENTAL HEALTH ACT. Consumer advisory boards (CAB) are the feedback mechanism, including for feedback to providers in the programs where the consumer is receiving the services.

The three characteristics and purpose of a licensing system:

  • To protect the public from dishonest practices and bad quality of services, and from violations of consumers’’ rights.
  • To regulate the profession or business in question. In our case, it regulates the (mental) health services industry. As a regulatory tool, it has the state’s police-power behind it: violators can be arrested and prosecuted.
  • It is a mandatory credentialing process that prohibits anyone not licensed to practice the profession or business in question.

We see all this in: “NYS Mental Hygiene Law, Article 31: Regulation and quality control [to protect] of services Section 31.02 Operating certificate required [the mandate].

Without its licensing policy, the state can’t protect, regulate or monitor its system. And the courts know it:

Hirschfeld v. Teller, NY 2010

Here, OMH decided that licensure was not required. Because only OMH is authorized to determine whether a facility is required to have an operating certificate and MHLS’s jurisdiction is expressly limited to licensed facilities…defendant it's the lawnursing homes are entitled to summary judgment dismissing the complaint.

And our state legislators, who are aware of the problem of licensing un-compliance, stated in law bill  S4858A-2011:

Lack of progress on licensure has a direct consumer impact. Without full implementation of the law, New York’s seniors cannot age in place and cannot take advantage of the numerous protections and disclosures contained in the statute.

That’s why it says “op cert required”. Once you choose to practice a regulated profession or business you can’t choose to be or not to be regulated, or both.

 But wait a minute!! With OMH you CAN be BOTH!

In a Q&A about request to run a business for housing for the mentally ill, the question was whether OMH would accept unlicensed units in a licensed program. But of course, why not? Hey, it’s not like the tenants care that you misrepresented the program as licensed but they are actually in de-regulated ‘units’. ‘It’s all about funding requirements, don’t worry, be happy. Trust me.’

And you can also report, with OMH,  as unlicensed a licensed program, and the other way around. For example, in the State’s Consolidated Budget Report, OMH’s:

1510 – School Program Co-located with Clinic Treatment Program (Non-Licensed Program if reported under this code) This program cannot be used to report expenses or revenues associated with services provided by the licensed Clinic Treatment Program (2100). [Parenthesis from the quote, highlight by me.]

2600 – CPEP Crisis Beds (Non-Licensed Program) This program is one of four program components which, when provided together, form the OMH licensed Comprehensive Psychiatric Emergency Program (CPEP). [Which is a licensed program.]

Tomorrow I will comment on the license policies of both the Department of Mental Health and of OMH.

Trying a ‘meeting of the minds’ with the Office of Mental Health


Yesterday’s MAC-OMH Town Hall meeting on licensed and unlicensed housing can be described as interesting, intense and illuminating: everything in it.

No other than Mrs. Moira Tashjian, OMH Director of Housing Development and Support came down from Albany to answer…er…field questions would be a more appropriate description, about that topic.

The attendance was a bit below expected, probably due to the freezing cold. By the way, there’s a flu going around. At least three people I know have come down with it and were unable to attend the meeting. I call that flu the “sequester threat”. They may be related, after all.

Back to the reporting. Mrs. Tashjian was open and honest in answering the tough questions from the audience; when she did not know the answer to a question, she would say so and not try to evade the situation. At least that’s how I saw it. She also promised to corroborate information and bring it back to us.

The meeting was interesting because of the different points of views on the topic. The issue of licensing was discussed by Mrs. Tashjian from the perspective of services and funding, the audience was more focused on protections and accountability of providers.

It was intense because, well, that’s what happens when ‘the meeting of the minds’ is incomplete. More on that later.

And the meeting was illuminating because it showed what was known and unknown by both the audience and the director of housing about the issue, the conflicting understanding (among everybody) about it, the levels of cooperation that can be achieved between her department and the consumers in the audience, and the steely resolve of the consumers-advocates in pursuing answers and clarity on the issue.

I’ll talk about the final outcome of the meeting at the end of this post. I want to focus now on the problem of reaching an understanding between administrators and the consumers.

‘Why would you want that?’

The question posed by Mrs. Tashjian at some point in the middle of the discussion that sticks the most in my mind is “why would you [the audience] want licensed housing?” She explained that licensed housing is the type where more restrictions are imposed on the resident because, as far as I understood her, it is for consumers still in lower levels of functioning (she didn’t use those words, I just did). I think that is where ‘the meeting of the minds’ broke, at least for me. I think that the question itself shows where the disconnect is.

First, most of us there don’t understand ‘licensed’ housing in the way she described it. For us, the issue is regulation and accountability of providers. She saw the issue as one of what services are provided in one or the other. While some people came looking for information about that, the majority of us went there to find information about the legal distinctions between licensed and unlicensed housing and programs.

That’s the issue Mrs. Tashjian had the most difficulty understanding, that we were not looking for services but to find out what protections each one affords. She was able to address everything else efficiently except that, at least in my view. We are not always looking for services, sometimes we want to know where to go when the service is being denied.

She was pressed to address the issue and pointed at the field offices to go for complaints and the grievance procedures that must be in place in the programs. That’s one of the problems with the unlicensed issue: we are not informed of options, providers are not held accountable for blocking access and, as Mrs. Tashjian said, their field office is made of only two staff members to cover thousands of residents. Come on!

‘He who has an ear…’

I don’t doubt Mrs. Tashjian commitment to helping us and her interest in listening and understanding what our concerns are. Yet, there is a disconnect between what the ‘system’ thinks we need and what we actually need, and it blocks the ability of administrators and providers to listen to us.

Despite all the words about ‘personalized treatment’ and all the committees and consumers’ councils to ‘listen’ to us, the mentality in the mental health system still is that we are this ‘needy’ people that don’t know any better, and ungrateful at that  too because we don’t appreciate all that is ‘given’ to us. It’s not a ‘conscious’ believe; it’s like everything in a culture: ingrained and unquestioned, until that believe is shaken. It’s always painful to have our culture questioned. Usually, something good comes out of the questioning.

This is what I would like them to hear:

First, we are grateful and appreciate the services and the work of those providers who can rightfully be proud of their professional interventions. But don’t forget: we also fought for those services we now have and are a source of job for so many.

Second, we do ‘know better’. We know that the system is ‘broken’ (as stated in the MRT report) because we experience it. Some people pay with their lives or that of others for the ‘benefit’ of getting supported housing because, once they get in, they get abused by unprofessional providers to the point of breaking, or neglected to the point of abject hopelessness.

We want you to hear that getting a service, getting housing is not the end of our path; it should be a new beginning.  For some of us, it has become the end of that path.

We want you to hear that the goal of the State’s mental health system policy is to help us ‘liberate’ ourselves from the shackles of mental illness, not to tied us and make us dependent on that system.

Granted, and the audience agreed with Mrs. Tashjian, there are some people who makes it difficult to help them. But those are, probably, the ones who are either in the midst of ‘episodes’ or maybe the sickest one. Unfortunately, those are usually the ones who, out of making the job more difficult, ankles the work-culture to paternalism, stereotypes and stigma. Hey, we all suffer from those problems, it’s not personal. We can only confront ourselves on those matters.

The big secret

It amazes me how difficult it is for our administrators and providers to internalize that abuses and neglect is the element referred to in the maxim ‘first, do no harm’. For some reason, despite past and present history, despite it having been the reason for the dismantling by Governor Cuomo of the Commission on Quality of Care and Advocacy and his creation of the Justice Center, despite reports in our mainstream media about abuses, no one in the system wants to talk about it; no one wants to acknowledge it. It is as if we were shouting at someone who has no ears.

And the outcome

The outcome of the meeting was that more answers are needed. I think Mrs. Tashjian said she would find more information about the legal difference between licensed and unlicensed housing; also, that she would look into the OMH’s website to see what errors there can be corrected.

I would like for her to look specifically at the fact that the only distinction between licensed and unlicensed housing (“community residence”) is that in unlicensed “there is no rental assistance”. As I told her, the majority of these housing provide such assistance and yet they are classified as unlicensed. Not only that, there is no reference to the fact that regulation and monitoring is not included in unlicensed.

I’m convinced that trying to clarify the difference between licensed and unlicensed is going to show how convoluted these distinctions are; that clarification is near impossible due to the many funding sources requirements. But more important, because OMH doesn’t want us to know that its policies try to unburden the providers from accountability and the only way of doing that is unlicensing. De-regulating the system is the way to unburden the providers. But then, we are left carrying the burden.

Mrs. Tashjian has nothing to do with that, I think. She doesn’t make policy, does she? I think she is going to find things she was not expecting to find, nor wanted to find, if she looks seriously at the issue of licensed and unlicensed housing. It’s an ugly bureaucracy out there.

I wonder if she would be as open with us, as she was yesterday, were her to find out the nasty truth about license and unlicensed.

More to come this week end  on this topic.

Lourdes

“For families struggling with mental illness…” and How to save a life


As I was reading this interesting new article in the New York Times about lawyers for families with mental illness, this video came to my mind. Most of you know this song; it’s sad (it’s about suicide)  but there’s hope in it.  It’s called ‘How to save a life’  by The Frey. I’m pasting here the lyrics and way down some info from  wikipedia about the song. The link to the NY Times article is here.

“How To Save A Life”

Step one you say we need to talk
He walks you say sit down it’s just a talk
He smiles politely back at you
You stare politely right on through
Some sort of window to your right
As he goes left and you stay right
Between the lines of fear and blame
And you begin to wonder why you cameWhere did I go wrong, I lost a friend
Somewhere along in the bitterness
And I would have stayed up with you all night
Had I known how to save a lifeLet him know that you know best
Cause after all you do know best
Try to slip past his defense
Without granting innocence
Lay down a list of what is wrong
The things you’ve told him all along
And pray to God, he hears you
And I pray to God, he hears you

Where did I go wrong, I lost a friend
Somewhere along in the bitterness
And I would have stayed up with you all night
Had I known how to save a life

As he begins to raise his voice
You lower yours and grant him one last choice
Drive until you lose the road
Or break with the ones you’ve followed
He will do one of two things
He will admit to everything
Or he’ll say he’s just not the same
And you’ll begin to wonder why you came

Where did I go wrong, I lost a friend
Somewhere along in the bitterness
And I would have stayed up with you all night
Had I known how to save a life

Where did I go wrong, I lost a friend
Somewhere along in the bitterness
And I would have stayed up with you all night
Had I known how to save a life

How to save a life

How to save a life

Where did I go wrong, I lost a friend
Somewhere along in the bitterness
And I would have stayed up with you all night
Had I known how to save a life

Where did I go wrong, I lost a friend
Somewhere along in the bitterness
And I would have stayed up with you all night
Had I known how to save a life
How to save a life

From wiki:

According to lead singer, pianist and songwriter Isaac Slade, the song was composed and influenced by his experience while working as a mentor at a camp for troubled teens:

One of the youngsters I was paired up with was a musician. Here I was, a protected suburbanite, and he was just 17 and had all these problems. And no one could write a manual on how to save him.

Slade claims that the song is about all of the people that tried to reach out to the boy but were unsuccessful. As Slade says in an interview, the boy’s friends and family approached him by saying, “Quit taking drugs and cutting yourself or I won’t talk to you again,” but all he needed was some support. The boy was losing friends and going through depression. He lost his best friend and could not deal with it. The verses of the song describe an attempt by an adult to confront a troubled teen. In the chorus, the singer laments that he himself was unable to save a friend because he did not know how.

While this was the original intent of the song, the band has opened the song to interpretation. They created a website where fans were welcome to submit music videos they had made for the song. This arose from the response that Slade got from the song:[3]

I got a lot of e-mails about it (…) One boy died in a car accident, and I guess it had been the last song he downloaded from his computer. They played it at his funeral, and some of his friends got Save a life tattooed on their arms. The response has been overwhelming.

From an interview with Slade by Bob Wilson in Sauce, Slade was asked, “‘How to Save a Life’, was apparently inspired by an experience you had as a mentor to a boy who had a drug problem. What’s the story behind that?” Slade answered:[4]

Well there’s a group home here in Denver called Shelterwood, and it takes in teens who’ve had a tough time; their parents don’t want to send them to jail, but they can’t keep track of them themselves… A friend of mine was actually the president for that particular school, so he asked Joe and I to come up for one of their weekend retreats… I was paired up with one boy in particular. His story was just amazing – all the relationships that he had put at risk because of the decisions he made, and eventually losing the relationships… the cost of his lifestyle and his choices, and kind of relating them to my own life and my own stories; seeing all the relationships I’ve threatened for one reason or another. It was a really inspiring weekend.