Things that need fixing in our mental health system

Things that need fixing in our mental health system:

1. Certification

The NYS Mental Health Law mandates OMH to certify all providers. Certification provides the legal covers that allows our public legal advocates to bring cases of abusive providers to courts. But, totally against the mandate, OMH has established since the 1990s, together with our State’s DOH, a policy of DECERTIFYING providers. At least half of providers and services are not licensed in NYS.

This decertification scheme has provided judges who are less friendly to the mentally ill in our State’s highest courts the ammunition to allow the continued abuse of the disabled and the mentally ill in not-for-profit agencies. The state knows it; it participates in the abuses and defends these practices in courts.

Refer to the DAI case. Ask yourself: why, in the new millennium, we are still struggling with Willowbrookesque cases; why did we need to create a Center for The Protection of People with Special Needs this year, not 20 years ago?

2. ‘Best Practice’: no monitoring of providers needed.

Without certification, monitoring is just a word among the many used to describe something that is not happening in our mental health system. In other words, ‘monitoring of providers’ is a delusion of our mental health system. NYS courts have decided many times that legal advocates can’t monitor the safety of their clients in places where complains were logged, because these places are not ‘certified’.

Quality of services is a mandate. There is no point in giving money away to ‘providers’ who will pocket the money and dish out substandard mental health treatment. But you can’t have quality of services because our DOH and OMH says that monitoring is not necessary for people who can “defend themselves” from bad providers.  This is actually in their ‘license’ rules. Since you can’t monitor or be defended in court, quality of services becomes an unenforceable fantasy.

3. No Consumer participation.

This is the ‘pet peeve’ of the Citywide Mental Health Project. Please, read our Vision and Mission.

Federal and state laws provide for our participation in the programs, to the policy level of the programs. These provisions are there for us to protect ourselves from the history of abuse, to prevent more abuses.  It’s part of a policy system that requires the feedback of those receiving the benefits of the policy.

If you can buy a ticket to the moon then we consumers can give feedback to our not-for-profit servers.

Our bureaucrats are mis-managing our mental health system. Look, we adore the corporate system, even our bureaucrats use that model.  Just as you find CEOs that destroy their own companies and still get bonuses, we have the corporate model in OMH. They mismanage the system and still get praised.

Meanwhile, down here in the communities, you are raking your minds about why we have Erika Menendez in the streets. You are asking the wrong question. Ask why  OMH so often the defendant in cases of abuse; why is our public system been privatized by a decertification scheme that leaves the troubled people without quality of services. Why are the families so often complaining that the ‘system’ has left them alone with their troubled child?

Don’t look for quick fixes. Forced hospitalization as a remedy to the problem is a delusion you are suffering.

Erika Menendez, and the “impossible dream”.

I confess: I rather spend New Years Eve writing about this than freezing my touchy in Time Square. Eh, there are other reasons, let’s leave it at that.

OK. look: mental health, it’s not only a state of mind. It’s also a state of political priorities. There will for ever be people with mental issues, just as there will forever be poor people and wars.  So, how do we deal with those issues? We put most of our money on wars-for-profit.

Historically, we deal with mental health problems as in a spring: up and down turns, never going back to the same place…supposedly.

up and down, but never up in the beginning.

I have an ‘outline’ of  the history of our nation’s mental health system policy here, written in the summer. I keep writing about that past because it is TOTALLY relevant to today’s problems. The point is that dealing with ‘disruptive’ citizens is not new. Historically we lump the mentally ill and the ‘feeble’, the petty thieves and the communists/anarchists/socialist and feminists in prison and psych hospitals. Yes, even the political  prisoners wind-up in psych ‘treatment’.

Our less critical citizens tend to display knee-jerk reactions and solutions to every problem the news papers talk about. Today the issue is so-called mentally ill people running berserk, unmedicated, killing civilians. Hit me in the knee for a solution, please:

How solutions for social problems are really made.

OK, let’s round-up anyone who shows anger at anything, real or imagined, commit them involuntary, and forget about them in the hospitals. Just as we did until…this year! Read about the NY Center for the Protection of People with Special Needs. Check my post about this here.

That’s exactly what we do: we ignore their problems, we forget about them in the hospitals until one day good ol’ New York Times reports about the abuses in the hospitals (reports for the next 12 or 20 years) and one day we say ‘fine, open the hospitals; throw them to the streets.’ That’s your knee-jerk mental health policy process in action. No planning, no priority.

I have written in this blog many times about this. We have a plan. Please, read our ‘Vision” in the page up there.

How do you solve this problem? You can’t. You can only pablum it because you don’t want to spend the money it takes to provide the quality of services that would prevent this from happening. It’s not just services, it’s QUALITY of services that we need. Forced-medicate a person could be necessary ONCE; the problem is when you get used to force-medicate and it becomes a power-tool in your hands to use when you feel like doing it. And you know nobody is watching over you. It’s like those cops who abuse their power and you see them in the news beating unarmed civilians. Or when you WITHHOLD the services and meds because of carelessness and neglect. Same thing.

Erika Menendez does not lives in outer space, in a vacuum. You can point at her history and say ‘she was a problem’. Fine. If you neglect to see how and why the mental health system dealt with her, you become part of the problem.

Here in the NY Times an article about how mental health services are being reduced after the hurricane Sandy (here)

“I cried when I saw her,” Ms. Rosa said. “I found her in horrible conditions. She was lying in her own feces, she had a fractured leg and the provider could not explain how her leg was fractured.”

That has happened since BEFORE the hurricane, is common practice; you just didn’t want to know about it. Be honest, you still don’t care about how that woman is been treated in our house of ‘healing’.  What about those reports for over 10 years in the NY Times about abuses in adult home care run by the state? Willowbrook is alive and well! And your solution is still  to open that house of horrors as mental health policy again?! How is that a solution? How is ignoring that our bureaucrats are  doing a lousy job at managing our public mental health system a conscientious citizenry practice?

Our Office of Mental Health (OMH) doesn’t want to spend the money on monitoring abusive providers. For that reason, I guess, they have renegaded  the mandate to certify and monitor  every program (public). Interestingly enough,  pretty often OMH ends up being one of the DEFENDANTS in some of the most abject cases of abuse on the elderly, the mentally ill and the physically disabled. OMH has decertified more than half of programs that serves the mentally ill. I wrote about that here in this blog too. I’m still waiting for OMH to correct me on this. (Patience, I will get there.)

It is YOU who should be asking  OMH why have they decertified so many programs. YOU who should be asking OMH why is it that THEY so often end up as DEFENDANTS in those court cases about abuse to those who can’t protect themselves.

We, consumers, are fighting the budget cuts that not only cut spending but, inevitably, cut the quality of  services too. And we keep losing cases in courts about abusive providers and State.

Now, you tell me: If your budget cuts in mental health bring reduced quality of services, how do you think that may affect YOU? And, who wants to go WILLINGLY to psych hospitals or state-run adult home care (“assisted living”) housing to be abused?

FORCED HOSPITALIZATION:

As a consumer that I am, I tell you that I wouldn’t mind being carted away if I start to ‘lose it’…BUT NOT IN THIS SYSTEM. I have been hospitalized three times in the last 12 years, always ‘voluntarily’. The fear and terror I feel every time is not funny. I want to be treated, NOT MISTREATED. In psych hospitals, you bump into a tired worker and BAM, next you find yourself tied up to a bed and being ECTed. This didn’t happen to me, I witnessed it, though.

The abuses I have received in the hands of providers in the community is enough to make me distrust the system.

I used to work, and after I got ‘sick’, I wanted treatment and return to work. Thanks to my provider, NOT MY ILLNESS, my dream became an impossible dream. I had to fight, to get the services I needed, FOR FIVE years. It was only when I went to court PRO SE (without lawyer) that I saw some change. I lost the case, of course. A long story.

The mental health system and its policies needs monitoring by the citizenry. The consumers have no voice. No one listens to our screams, only when one of us succumbs to the neglect and the mistreatment.

LISTEN TO US, PLEASE. Let’s engage in a public conversation with us as HUMAN BEINGS, don’t talk about us in the third person.

You can’t cut funds and not monitor the system and then pretend that the sick people will get better by magic.

Forced hospitalization is a remedy for your convenience, so you don’t have to think about the problem. It does not to fix the problem.

HAPPY NEW YEAR.