Tag Archives: mental health policy

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)

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.

When is ‘minimum’ the same as ‘high’? When NYS OMH says so. Part 3

Yesterday we talked about how both the Department of Mental Health (DOMH) and OMH go to courts to argue against consumers in need of protection that there is no right to sue under NYS’ mental health laws and that they are not mandated to provide ANY levels of quality of services. (Every time I write that I have to laugh; it’s a laughter of irony.)

Today I want you to see, side by side, these two agencies license rules and the NYS MH law giving the mandate to them, and compare them and come to your own conclusion, which I hope is mine too.

law blog

omh side

Again, the state speaks of

  • mentally ill persons
  •  high quality of services
  • Protection of rights
  • OMH must regulate and control the services

And how do these two agencies interpret that? They say, in Part 70.01 that the certificate “is intended”, as in ‘meant’ but doesn’t have to necessarily be the case, that a provider has met, not ‘complied’, with MINIMUM standards of care. MINIMUM.

Question: Since when is ‘minimum’ the equivalent of ‘high’?

I’m thinking, thinking….

The NYS law says “high quality of services”. These agencies downgraded to “minimum”. Thus, according to their “intention”, EVERY single program ought to be ‘certified’ because they ALL provide  the bare “minimum” quality of services, the LEAST quantity or amount possible, which is the definition of “minimum”.scrooge

Not only that: the certification is for the benefit of the provider, meant to hold him accountable ONLY to those minimum standards.  It’s a protection measure for the provider. Don’t hold him up to ‘higher’ standards of care, don’t be cruel, baby.

You think it doesn’t matter? From where do you think they got the court arguments we saw yesterday? “MHL does not impose a duty on OMH to provide any particular level of care for specific individuals”. That was their interpretation.

But this is nothing compared with what I’ll show you tomorrow.Then, after that, we’ll see the privatization of our public mental health system in action. Let me give you a teaser of why OMH told our legislators that  it’s ok to privatize our system”:

“…15% of case managers were performing psychotherapy”

“[licensure]…would not provide any meaningful measure of increased safety or quality to our citizens as reflected by the survey results.”

Whaaat!? My psychotherapist is a case manager!? That’s psycho!

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.


Guns and Mental Illness and the “liberal impulses”. [revised]

Yet another interesting article in the NY Times on our favorite topics, guns and mental illness. This one was  written by  JOE NOCERA, appropriately titled ‘Guns and Mental Illness’. See https://www.nytimes.com/2012/12/29/opinion/nocera-guns-and-mental-illness.html?hp&_r=0

I mean, is the best way guns are discussed now a days, as associated to mental illness. Hey, they go together like arroz y habichuelas, rice and beans for you monolinguals out there.

No pun intended with this image. Do you get it?

No pun intended with this image. Do you get it?

I don’t know if  I’m getting over-sensitive about the topic of mental illness or that these journalists are just plain  insensitive. It could be both…nah, they are really way  too detached and insensitive. The case is that the blame-the-mentally-ill-and-lock-’em-up is getting to be nauseating.

The first thing that strikes me about Mr. Nocera’s article is the use of the label “liberal”, a word associated in good ol’ USA with everything…not conservative, let’s say. You know, if you feel that the poor must be left to die at the entrance of the emergency room because they don’t have money or health insurance, you are NOT a liberal, which is a good thing according to the not-liberals. So, Mr. Nocera uses a word that conveys this to America:

Liberals are viewed as against the USA, unpatriotic people.

Liberals are viewed as against the USA, unpatriotic people.

Thus, he pretends to write an ‘impartial’ article  about the topic of mental illness while at the same time using an  emotionally loaded political word, “liberals”, to invalidate the political stands of the advocates for the protection of people with mental illness.

From the outset, the tone of the article is that those who advocate for the mentally ill are wrong because they are liberals. Not only that they are “liberals”, but they suffer from “liberal impulses”:

Ultimately, the article I wrote was about how the “deinstitutionalization movement” of the 1960s and early 1970s — a movement prompted by the same liberal impulses that gave us civil rights and women’s rights — had become a national disgrace.

Is he trying to equate the struggles against oppression to some kind of mental illness?

When he mentioned “a national disgrace”, Mr. Nocera was not referring to “The last disgrace”, the title of Geraldo Rivera’s documentay in 1972 about Willowbrook and the atrocities committed in these institutions. That’s the background for the “deinstitutionalization movement” to which  Mr. Nocera refers, but conveniently he skips that background.


He talked about “over medication” in hospitals  as the problem. Sure, sure. “Over-medication” was what those children got when subjected to medical experimentation in the ‘institutions’ for the mentally ill and the ‘retarded’, as they were then called. That topic of torture in States’ psych hospitals is tabu for these journalists. But, that’s the mental health policy they are selling to you, to go back to the houses of horrors.


What would he call the racist society of the 60s and 70s? He didn’t talk about the ‘racists impulses’ that caused the Blacks to organize the civil rights movement as a self-defense movement. Nor did he talk about the ‘sexist impulses’ that motivated women to unite against them. I wonder if  Mr. Nocera would consider today’s women’s movement in India against rape-as-tradition   a ‘liberal impulse’, not as a movement for self-defense.

What I want the reader to notice is the consistent and persistent  omission by these ‘impartial’ journalists of the details about  the atrocities committed in those ‘institutions of healing’. No mention that people were involuntarily committed just for being ‘different’ or politically ‘liberal’. Nooo.

Mr. Nocera talks about how throwing the mentally ill out of the ‘institutions’ into the communities was worse than what they were suffering in the hospitals. He neglects to tell you that these ‘liberals’ wanted the services in the community and that it was the States that refused to provide them.

"Liberal impulses" in action. Mr. Nocera says liberals demands  are a disgrace.

“Liberal impulses” in action. Mr. Nocera says liberals demands are a disgrace.

If today you have housing for the mentally ill, less homeless mentally ill, it is thanks to those ‘liberals’. Of course, the ‘liberals’ are losing the battle today against corporate greed and, as a consequence, you  will see the same problems you see when our political leaders suck your money out of the communities and into permanent wars and for Wall Street profit.

‘Bad liberals’ demanding no budget cuts
on mental health services. Go figure.

The pro-institutionalization stance in these articles is so subtle that you find yourself at the end wanting it as a remedy to today’s problems.

With the mentally ill rarely institutionalized for any length of time — on the theory that their lives will be better if they are not confined in a hospital — other institutions have sprung up to take their place.

He is alluding to that article the other day http://www.nytimes.com/2012/12/27/nyregion/new-yorks-mental-health-system-thrashed-by-services-lost-to-storm.html?smid=pl-share about how the situation for the mentally ill have worsen since storm Sandy. Funny that he refers to that article because  it shows that the problems with institutionalization are alive and well:

“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.”

Today, as yesterdays, we have reports of abuses in state-run home care institutions, or in those private ones contracted by the state. There’s no way you can claim that locking people up is good practice. Historically, State-run institutions are places for experimentation and abuse. We have a Center for the Protection of People with Special Needs because you can’t protect them not even in the new millennium. The Center was created THIS YEAR as a result of continued abuses for the last 12 years.


It’s all about money. You take the money away and you have to use repression as your ‘best practice’.

And Liberals, beware. They want to label you ‘crazy’ and lobotomize you.

It’s all coming back at gun point, pun intended.

What to do? I will give my suggestion soon.

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.


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?!


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.


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?


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.


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.


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.


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




Here we are again in a painfully too familiar situation. You can blame the NRA or the mentally ill  for this latest installment of collective pain.

But, what we are witnessing is a society falling apart at the seams since the very beginning of this millennium. It’s not the fault of the mentally ill, on the contrary, our personal, and ultimately collective mental illness, is the outcome of a society rapidly decomposing since the last 12 years.

This horror we just witnessed didn’t happen in a social vacuum nor are our reactions to this horror, impulsive and emotional as they may be, unrelated to this social decomposing we are experiencing.

The first automatic explanation for these killings  is ‘this is the act of a deranged, mentally disturbed maniac. We need to lock them all up and throw the key away.’ There’s your mental health policy.

That’s a problem because that’s a knee-jerk reaction. It blames not the problem but the consequence created by the problem. The problem is our decomposing society and the consequence is the collective and personal mental illness which outcome is self-inflicted pain and suffering, collective and personal pain and suffering.


It’s not difficult to see how our social political decisions are to be blamed for this horror. These social policies we enact (economical, health, prison and legal systems) have an impact not only on our health, but on the safety of our children.

Take for example the fact floated around for a while now, that the USA is in the #37 spot of nations’ quality of health  (according to the UN). This could contribute an angle to explain  why 20 children were massacred in the USA by a citizen, not by a an Islamist terrorist. Our nation’s low position compared to other nations’ health system happens because of our own health policies decisions. We think we are ahead when in reality we are falling way behind the Western nations. It’s not welfare nor Social Security nor Medicaid nor the ‘free loaders’ the ones to be blamed.

We vote for politicians that feed from the NRA and the Pharma and the big Health Insurance industry and Wall Street…those with the capital letters are the ones that make the laws that the lawmakers sign blindly and  that will control how inaccessible and useless the health services available will be. Oh, and how stereotyping those services will be: ‘you receive mental health services? Then you are a potential mass murderer. We must take your civil and personal rights away.’

Social Security and ‘the free loader’ and the mentally ill are not the cause of our pains.


Look for the connections between this latest horror and our policies in the status of our ‘social contract’.

Do you think that the recent HSBC bank corruption case, where not one from that bank set a foot in a court to face the charges of laundering billions of dollars for the drug cartels, has no impact on our mental health and our social fabric?

I think it does; it may be too subtle for you to notice in your daily hustle and bustle,  but it’s impact is there.

When the laws are unfair and the few can evade them with impunity and with the help of our ‘leaders’, they act as an acid that eats into our trust of our government. Remember, the government is supposed to represent us. If it is corrupt, it means that we as a people are corrupted. We act accordingly.


We have been living in a state of war since the beginning of this millennium. Do you think that has no impact on our personal and collective mental health? Give it a thought.

These connections have been weaved together for the last 20 years, at a minimum, and for the last 12 for sure. There is now a fiscal cliff  for you to jump off. Funny the metaphor used by our leaders: a cliff.

Our leaders in Congress and the White House are about to push you off a cliff and you still can not make the connection between the Connecticut shooting and the fiscal cliff. You will go down the cliff blaming the mentally ill for the push.

Already people are complaining about the new health regulations making access to treatment more difficult. You can’t be with the devil and expect goodness to come out from  him. The devil is our nation’s financial system. They control just about  everything. What caused the Connecticut shooting?


Maybe this kid who committed this crime  had no connections with the system.  Maybe it was simply that he was truly ‘crazy’. But, unless he was kept in a closet without contacts with humanity, he was a product of our society.

You must have had some experience with the system when it comes to mental health, at least  80% of Americans have, according to statistics.

Don’t tell me you think the system is reliable.  I won’t believe you believe so.

I feel sorry for those kids and their parents. One must be an insensitive jerk to not feel the pain. But, after the grieving, we must look at where we have arrived. And start making drastic changes to our political system.

Take the nation back from  the hands of the big financial hands.

Peace and mental health to all.

Nothing About Us Without Us!

what have we learned from the history of abuse of with mental illness?

This is from a short powerpoint test I made. See it in full screen. It has sound half way into the vid, so control your speakers.