Tag Archives: Justice Center

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

Was the Connecticut shooter acting in self defense?


Yahoo news published an article [ “Sandy hook shooting: Was Adam Lanza lashing out against treatment?”] stating that the mainstream media, particularly Fox News, is circulating the rumor  that the Connecticut shooter acted out his fear at the possibility that his mother was about to commit him involuntarily to a psych hospital, implying that he ‘snapped’ and went on a shooting rampage because he didn’t want to be hospitalized.

If ‘forced hospitalization’ means against your will, if you know or have heard that people are forced to take drugs, forced into electroshock, treated as a lab subject  and other psychiatric beauties, could a person be so traumatized about involuntary commitment as to ‘lose it’?

What that kid did was unspeakable. You can’t look for logic there. But he was the product of our society. If you say that he was terrified of the idea of forced hospitalization, think: why would he be so terrified about it? If the system is fine, the treatment fine, you shouldn’t  fear it, should you?

I believe that the psychiatric profession and the mental health system should be indicted for the crimes they commit, the abuses in the name of ‘for your healing’, but I would not consider the evils that they (and the pharma) do as a reason to go killing and call it ‘self defense’. That is not what happened  here.

Nonetheless,that indictment will never happen either.

THE TRUTH ABOUT THE MENTAL HEALTH SYSTEM

This is a highly repressive and brutal system, all behind the curtains because you don’t want to deal with it. Read the reports.

Go ask  any person who receives mental health services what  they think of the mental health system. Let them speak FREELY. Most of them will tell you that the experience in this system can be terrifying. Ah, but you don’t want to hear it from them. So, they fear that if they tell you the truth, the hidden label they carry (oppositional personality or borderline personality  or anger management or confrontational disorder) will be used against them. Everything is honkydory. Uhm.

You need to deal with the system, the psychiatric profession. Repression is not the answer. Sending the mentally ill to fill the prisons and continue the torture there is not the answer.

We are closing hospitals, not because we have solved the problem of mental illness, but because WE CAN’T SOLVE IT. We claim there’s no money, so we close them and send your loved ones to the emergency room and from there, if they survive, possibly to prison. Prisons are our new psych hospitals. Somebody is benefiting from having a dysfunctional  mental health system and that somebody is NOT the one who receives  the services.

I can imagine, on the other hand, the emotional reaction of the public to those ‘news’ about the possible cause of the tragedy. There must be anger at the mentally ill who do not accept ‘treatment’, who refuses to be hospitalized, because, after all, the ONLY reason for refusing treatment must be an irrational reason. How dare you refuse treatment and go on a killing spree?!

DID WE LOSE THE ARGUMENT AGAINST INVOLUNTARY COMMITMENT

For the people who receive mental health services, this public conversation about involuntary commitment is a lost battle from the outset.

First because the conversation is between ‘experts’ and the ‘advocates’ of the mentally ill, together with a lay public who understands very little about mental illness or about the experience inside those great institutions of ‘healing’.

The public’s understanding about mental illness is basically wrapped in stereotypes, prejudices and in the information coming to them  from ‘experts’ who benefit from the  ‘crazy people’ who populate their profits. Think the pharma and health insurance, non for profit, researchers, prison owners among others. They are all invested in having mentally ill people. The worse the problem, the more you need them, isn’t that the case?

Those receiving mental health services are not included in the conversation about what to do with people like Adam, and yet, they are the ones who have the data about what needs fixing in the mental health system because they suffer those problems in their own skin.

Quality of services are always measured WITHOUT the input of those who receive it. I may be your co-worker, but what right do I have to tell others how bad you keep your house? Only you can talk about your home. Same here: EVERYBODY talks about the mental health system except those who use it.

WHAT MUST WE DO WITH THE TERRORISTS?

And the second reason why we have lost the battle is  because this conversation is taking place in a TOTALLY emotional context: a mentally “deranged”  kid killed 20 children.  The outrage is collective. No one wants to hear you if you have a ‘diagnosis’. The moment you open your mouth to say something they tell you must trust your psychiatrists and take your pills.

Take as evidence of the emotional tone this week’s article in the NY Times equating the mentally ill with middle eastern terrorists [“What moves suicidal mass killers”]. [See my previous post.]

From there on you can only go down; there’s no redeeming quality in those afflicted with emotional problems: they are ALL terrorists because they can ALL snap at any moment. What must we do with the terrorists? Hmm?

PROGRESS IN THE NEW MILLENNIUM: POLICE KILLING UNARMED MENTALLY ILL PEOPLE

But no body talks about the continued history of abuses in psych hospitals, home care institutions (both on the physically and the  mentally disabled) and community housing for the mentally ill. Nor about the fact that the chances that your unarmed loved one will be ‘assassinated’ by the police in ‘self defense’ while trying to violently take him or her to involuntary commitment are extremely high. Well, at least here in NYC.

In the new millennium, the  NYS Governor, Mr. Cuomo, had to create this year [not 20 years ago] a Center for the Protection of People with Special needs. That center came out, first,  of the 10+ years that the NY Times was reporting abuses to the mentally ill and “people with special needs”, including rapes and physical and psychological abuses, with no one in the bureaucracy doing something about it.

Secondly, the Center came on the heels of  a court decision in NYS overturning a lower court ruling that the Office of Mental Health (OMH) and some non for profit home care contractor were abusing the residents. On appeal, the higher court decided that OMH was right in arguing that the advocacy lawyers HIRED BY THE AGENCY ITSELF  (OMH) had no right to protect the residents because, among other reasons, the residence was unlicensed and the residents didn’t vote to have the advocacy group represent them.  Now, that’s ‘crazy’, isn’t it? I’m not making this up nor misinterpreting. The case is Disability Advocates Inc. v Paterson, decided this past April. So, those people are still been abused in the hands of their care takers. Nothing changed for them.

NOSTALGIA FOR THE LOBOTOMY IN THE ’50s and ’60s

You see, I can understand the frustration of those in favor of involuntary commitment about seeking help. We have those frustrations too. We ask for services which are denied or withheld by those who feel powerful over us. Then, when the consequences of withholding services manifest, the system forces the services on you.  It’s INSANE.

The problem with those in favor of involuntary commitments start when they start messing up with our civil liberties and privacy.

There are other modalities for help, it doesn’t have to be forced commitment. Historically, forced commitment has led only to abuses.  Get on with the new millennium.

But nooooo. That guy, Ferguson, in the article is nostalgic for the psychiatric modality of the 1950s:

But even if people are willing to be committed, it’s not easy to get such treatment, because the US moved away from the asylum system in the 1950s and ’60s, Ferguson says.

Basically, the article speak about the mentally ill from the point of view of those who are not mentally ill. The reference to them  is in the third person. And there’s no mention whatsoever about the harm, the  prejudices and stereotypes against the mentally ill in the article.

BIG BROTHER AND SISTER TO THE RESCUE

Nothing good for our society is going to come out of this ‘conversation’ as long as you keep the focus only on the mentally ill. We are in times of political and economical turmoil. You have to keep in line or else…

Our NYPD has already started to act on that image of the mentally ill as terrorists. Take a look at my previous post, here is a quote from the NYPD:

“Mr. Kelly said the technique was similar to those being used to spot terrorists’ chatter online. The new searches would target “apolitical or deranged killers before they become active shooters,” he said. [Highlights by me]

We have to change now how we speak online. ‘Say something’ but be careful not to get tagged as terrorist by using the wrong words to do the report.

Out of fear and ignorance, the public is going backwards for ‘protection’. They want to go back to forced institutionalization.

Been there, done that. It was horrific.Think Willowbrook. It happened in NYS again in the late 1990s. You didn’t hear about it. That’s the problem: you don’t hear about it until the damage is done.

Just remember this: your irrational remedies, they will all come back to bite you.

AGAIN:

You need to deal with the system, the psychiatric profession. Repression is not the answer.

LISTEN TO US.

The situation out there


Chasing the money

It seems that our community has been forced into a tug of war by our government -state, federal and city- to protect our services from being decimated under the excuse of ‘economic crisis’. More money has been lost yearly in financial corruption than what is needed to keep small programs running: the recent CityTimes’ scandal in our city is an example.

This is the game we are forced into by the powers that be: stay focused on trying to keep programs open: low quality of services, abuses and mistreatment, our lack of meaningful participation in shaping our so-called public mental health system and programs policies, these issues are perennially moved to the back burner.

And our justice system seems unavailable for us too.

THE JUSTICE SYSTEM: hmmm.

Despite so many laws supposedly there to protect us, few cases brought to courts by legal advocates denouncing discrimination and physical and mental abuses in state and private institutions are actually won. Then many are overturned on appeal. Example, DAI v OMH (among other defendants), a case about abuse and discrimination of people with disabilities won in 2010 but over turned in April 2012 on technical legal grounds: OMH argued successfully that the non-for-profit legal group it itself hired to advocate for these people had no right to do their job! Go figure.

There is no expectation that the mentally ill will find in courts relief from abuse. The long arm of cultural stereotypes and prejudice about the mentally ill reaches our courts. The actual reason for the new 2008 ADA amendment was precisely that our nation’s court, all the way up to the SCOTUS, had been circumventing the ADA 1990 to deny relief from abuse to people with disabilities. In the “findings and purpose” of the amendment, it states, among other things: “(4) the holdings of the Supreme Court in Sutton v. United Air Lines, Inc., 527 U.S. 471 (1999) and its companion cases have narrowed the broad scope of protection intended to be afforded by the ADA [1990], thus eliminating protection for many individuals whom Congress intended to protect;”. To remedy this legal abuse, the amendment relaxed the definition of disability, among other things.

Many judges have done the ‘homework’ and have been allies of the mentally ill/disabled, but there are still a few who betray that culture of stereotypes. It shows in uncompassionate rulings.

The operating stereotype is still that the mentally ill must be mentally deficient and simple-minded,  a dependent  child-adult, not a citizen with political and human rights capable of thinking and standing for himself; otherwise, he or she must be a faker. Or, the interests of a whole group of people being physically abused (as in the case above) must be relegated to the interests of the ‘non for profit’ business or to protect legal technicalities.

We must carry our labels everywhere we go and have our social worth measured against them.

If you think that the new Justice Center for the Protection of People with Special Needs will change this, you are up for a rude awakening, again. But that’s topic for another time.

POLICY MAKING and citizenry

I have been speaking recently to some of my peers in the community about how they rate their participation in their programs.  The message I’ve been getting is pretty much generalized: they feel voiceless in their programs and treated in undignified manner. It seems to me that my peers suffer not only from chronic mental illness, but from a chronic lack of political power, they are treated as less than full-fledge citizens.

The ‘public’ mental health system in our state (and federal) is based on a carefully studied and planned mental health policy. Ingrained in all policies is, or ought to be, a mechanism for those directly affected by it to provide feedback about how efficient these policies have been in achieving their goals. Hell, even Staples asks for consumer feedback. So, our mental health policy gives us the Consumer Advisory Boards (CAB) or councils at state, city and program levels. These CAB are tools we have gain through years of struggles to participate in the system to have a voice, not ‘gifts’ from a benevolent state. But few consumers know about ‘policy’ or about CABs.

WE ARE NOT ALLOWED TO TALK ABOUT IT

The efficiency of  a legal or mental health system is measured, in part, on how good or bad YOU are being treated by  it or in it, how it feels on your skin,  not on the ‘quantity’ of laws and services tabulated. If our feedback is being heeded then it should reflect at least in superior quality of services or on how we are not been abused. Take note of these facts, though:

  • The Medicaid Redesign Team described our mental health system as “fragmented”. Imagine that, they gave it a thumb down. Evidently our “feedback” has not been heeded.  A “fragmented” system is by nature unaccountable and insensitive to the needs of those it’s supposed to serve.
  • The new Justice Center for the Protection of People     with Special Needs comes about as a result of all those articles in the NY Times since at least 2002 denouncing  Willowbrookesque houses of horror for the mentally ill in our state.  In the new millennium of technological advances, of cellphones and surveillance cameras under our noses, we are still facing the inhumane treatment behind closed doors of the mentally ill in the hands of those paid to protect them.
  • There are hardly any CABs in the programs we attend; the few out there are totally inefficient to collect our feedback and help us make the system and providers more sensitive  to our needs and humanity.

Overall, there is a pretty wide cloud of consumer dissatisfaction with our mental health system, its quality of services and the lack of true participation in the system. We are just not allowed to talk about it.

Let’s face reality:

·   The system is in dire need of repair

·   Our consumers’ movement has been  mainstreamed, forced to focus on the financial aspects of the system.

·   The system has given us the first salvo signaling the end of the ‘benevolent’ mental health system: the unprecedented arrest of ADAPT activists in DC this year (April) where they were denied legal access to their lawyers. Read in ADAPT’s website the information and updates.

·   Incidents of police killing people with mental  illness in distress are rising.

It’s time for us to start speaking up about these things which are taboo now-a-days. I would suggest opening the discussion via some consumers’ conference in the city. I invite my peers to open this discussion soon, for our nation is turning into a surveillance state in an effort to keep everybody ‘normal’ and ‘safe’ from people like you and me. After the current Colorado killings, people are commenting “we need crazy control, not gun control”.

Be ready. Be very ready.

Kafka’s “Before the Law” and the new Justice Center for the Protection of People with SPECIAL Needs


I don’t know why I thought about this part of Kafka’s The Trial after I read the news about the agreement between our state’s legislators and our governor on the new law for the Justice Center for the Protection of People with “Special Needs”, as they euphemistically call the disabled and the mentally ill. That part is ‘Before the Law’, on chapter 9.

One thing that called my attention about it was the POWER that the guard had over K. I call it the power of the State-delegated-powers.  Of course, the part is only a song to existentialism, it has NOTHING to do with Cuomo, nor with our political leaders nor with the new Justice Center. The point is, among others, how powerful these ‘security guards’ (our bureaucrats, really) become when they get all those ‘delegated powers’ from a higher authority. And even more interesting: how we fear them, to the point of  giving up our free-will, OUR POWER to act and confront the injustice in the law.

The new Center for the Protection…is nothing but more bureaucracy on top of old bureaucracy. It protects the perpetrator but you are told is the other way around. Read the new bill. I invite you to read it and mull over it.

And now, without further delay….Here’s Kafka:

BEFORE THE LAW

“In front of the law there is a doorkeeper. A man from the countryside comes up to the door and asks for entry. But the doorkeeper says he can’t let him in to the law right now. The man thinks about this, and then he asks if he’ll be able to go in later on. ‘That’s possible,’ says the doorkeeper, ‘but not now’. The gateway to the law is open as it always is, and the doorkeeper has stepped to one side, so the man bends over to try and see in. When the doorkeeper notices this he laughs and says, ‘If you’re tempted give it a try, try and go in even though I say you can’t. Careful though: I’m powerful. And I’m only the lowliest of all the doormen. But there’s a doorkeeper for each of the rooms and each of them is more powerful than the last. It’s more than I can stand just to look at the third one.’ The man from the country had not expected difficulties like this, the law was supposed to be accessible for anyone at any time, he thinks, but now he looks more closely at the doorkeeper in his fur coat, sees his big hooked nose, his long thin tartar-beard, and he decides it’s better to wait until he has permission to enter. The doorkeeper gives him a stool and lets him sit down to one side of the gate. He sits there for days and years. He tries to be allowed in time and again and tires the doorkeeper with his requests. The doorkeeper often questions him, asking about where he’s from and many other things, but these are disinterested questions such as great men ask, and he always ends up by telling him he still can’t let him in. The man had come well equipped for his journey, and uses everything, however valuable, to bribe the doorkeeper. He accepts everything, but as he does so he says, ‘I’ll only accept this so that you don’t think there’s anything you’ve failed to do’. Over many years, the man watches the doorkeeper almost without a break. He forgets about the other doormen, and begins to think this one is the only thing stopping him from gaining access to the law. Over the first few years he curses his unhappy condition out loud, but later, as he becomes old, he just grumbles to himself. He becomes senile, and as he has come to know even the fleas in the doorkeeper’s fur collar over the years that he has been studying him he even asks them to help him and change the doorkeeper’s mind. Finally his eyes grow dim, and he no longer knows whether it’s really getting darker or just his eyes that are deceiving him. But he seems now to see an inextinguishable light begin to shine from the darkness behind the door. He doesn’t have long to live now. Just before he dies, he brings together all his experience from all this time into one question which he has still never put to the doorkeeper. He beckons to him, as he’s no longer able to raise his stiff body. The doorkeeper has to bend over deeply as the difference in their sizes has changed very much to the disadvantage of the man. ‘What is it you want to know now?’ asks the doorkeeper, ‘You’re insatiable.’ ‘Everyone wants access to the law,’ says the man, ‘how come, over all these years, no-one but me has asked to be let in?’ The doorkeeper can see the man’s come to his end, his hearing has faded, and so, so that he can be heard, he shouts to him: ‘Nobody else could have got in this way, as this entrance was meant only for you. Now I’ll go and close it’.”

Cool, isn’t it?!