Tag Archives: Policy and Advocacy

NYS OMH’s Multicultural Advisory Committee (MAC) meeting


I participated, together with other members of The Citywide Mental Health Project (Bert Coffman was wearing his many hats), in the MAC meeting (via phone conference) this last Tuesday. What follows is my personal take on the meeting discussions. These are the headings:

Who attended the meeting?

Where are the consumers?

Topics discussed

SH, crime in SH and licensing

Changes to the SH Guidelines = No CAB (consumer advisory boards)?

Who attended the meeting?

Ms. Moira Tashjian, Director of OMH’s Housing Development department attended the meeting by invitation of the committee, although I have the distinctive feeling that OMH wants her to be in this cultural committee, even though housing per se is not a ‘cultural’ issue directly. If I understood correctly, she will be attending the monthly MAC’s phone conferences. I welcome her participation and consider it a plus for us to be able to ask questions directly to officers of the OMH.

There were three (?) providers of supported housing (SH) services from different NY regions: Mr. Huygen from the NYC area, I didn’t get the names of the others, sorry.

Where are the consumers?

Apart from me and my group (Bert Coffman was wearing his many hats), there were no other recipients of services or their representatives. This is a salient point given that this ‘advisory’ committee, as all State and citywide mental health ‘consumers advisory boards’, are for the purpose of ‘giving recipients a voice in our mental health-policy-making system’. I’m sure you can guess why I put those words in curly marks. Read my document The elephant in the NY State mental health system if you can’t guess it.

The lack of consumers (I will call them ‘recipients’ from now on because ‘consumers’ does not describe what we are in this system) participation, in my view, make these boards de facto tools for the providers. Do they need these policy tools when they already have trade organizations and high paid lobbyers, and when they DIRECTLY help write many of the rules that affect us?

I know that Mrs. Frances PriesterMoss (coordinator) is trying to increase recipient’s participation in the committee. I have some ideas that would guarantee participation, but it requires for Ms. Tashjian to help us with the CABs in the programs. More on this below.

Topics discussed

SH, crime in SH and licensing

Ms. Tashjian informed us about all the new projects for housing for the mental health community. I believe her report will be made available soon for public information. She also went over what I call OMH’s SH ‘licensing’ scheme. As some of you know, I have asked her to explain to the public why more than three-quarters of housing are being privatized by un-licensing them, and to tell them that unlicensed means not regulated and no legal rights for the ‘tenants’ in it.

I didn’t get the answer I was awaiting from her. Actually, the whole enchilada about SH and unlicensed housing got more entangled when she discussed the issue of what level of ‘functioning’ is required for each category of housing.

Some of the providers brought the issue of recipients with history of violence been referred for SH. Ms. Tashjian alleges that a history of violence and low functioning are not impediment for acceptance into SH. I claim she is in the wrong there.

OMH is as explicit about levels of functioning requirement for each housing modality as its contradictory actual practice is. Just go online and read OMH’s RFP (request for proposal), each requests spells what type of ‘population’ a particular SH project is made for. This issue of housing people with severe mental health problems in SH, which is for people more ‘stabilized’ and able to function in the community with less supervision (that’s why OMH makes them ‘unlicensed’)  has been discussed in court many times, the last time was in the DAI v. NYS OMH case.

I didn’t want to raise the issue due to not enough time, but I did mention that this policy of housing people with violent history makes the CABs in the programs a necessity so that we can help the providers develop ways to cope with the situation.

I asked her if she was aware of the May incident where a recipient of SH in Brooklyn was murdered INSIDE the building by the woman’s also SH recipient lover. She said she ‘heard’ about it. Did anyone blink? Was the incident reported, as mandated,  to her for investigation on quality of services (could it have been prevented, etc.)?

Look, there is not enough housing to comply with OLMSTEAD, so OMH has been ‘dumping’ (excuse the expression) everybody everywhere. Just as it did when the people demanded to close the chambers-of-torture called psych hospitals of the 1970s; the state dumped the patients to the street. Now, they dump everybody in the few housing. OMH doesn’t care about the ‘unintended’ consequences of its policies. The courts tend to protect them.

There is not enough housing (money goes to ‘stupid wars’), it’s a policy issue. We NEED to discuss this policy as a community.

 Changes to the SH Guidelines = No CAB?

The SH Guidelines will be “updated”, according to Ms. Tashjian, (shall we say) ‘modernized’ to live up to the new millennium (my words). Are the current ‘guidelines’ that state that providers of SH must allow for consumers to participate, this is a direct quote, “in the policy making of the program” to be eliminated?

Ms. Moira brought this information about the changes when I asked her if she could help us to make providers comply with that guideline. She said that she needed to do more “research” about these CABs. I asked her directly to tell me if she was intending to eliminate that particular guideline; her answer was that she couldn’t answer at this point until she reads the guidelines.

When I asked her if she is mandated to inform the recipients about these changes or call for public comments before making the changes, she said that “the providers will be informed”. The context of the answer is that the “SH Guidelines” is for the providers. Whatever changes made will affect you without your consent or knowledge.

I think I also told her that I would consider eliminating the CAB provision to be a BETRAYAL to us recipients of mental health services. I may have used the word “BACKSTABBING”, I don’t remember which one I used. I was just blown away when she mentioned the changes to the guidelines. You can imagine.

None of the providers took a stands to protect the CABs.  I hope they were as blown away as I was and will stand with us if OMH tries to eliminate the CABs provision.

But, more than anything, I hope that Ms. Tashjian has the presence of mind to NOT take a step that will be construed as an attack on our right to have a voice in the programs.

In a time when we are been blamed for the violence in our society, we need to INCREASE our voice, NOT TO HAVE IT SILENCED.

The CABs inside the programs would allow us to reach out for the recipients that OMH supposedly wants to be integrated in the policy decision-making system; it would allow us also to spread information to them. With the problem of lack of housing and having to mix recipients with differing ‘functioning levels’ CABs make more sense as a tool to help maintain quality of services. Working with the providers, the CABs could save $$ to the state by using the rich human power energy and experience currently going to waste and untapped in these programs. Voluntarism can be organized through CABs to improve quality of services.

The only reason I can see for OMH to eliminate the CABs is if they are afraid that we will bring to light all the issues of abuse, disrespect and neglect in the SH programs of all types.

Should they do it, it will confirm my claims that our mental health system functions within a culture of abuse.

Let’s work together to stop the stigmatization and abuse of people with mental disabilities.

Take the rabbit, leave the mentally ill.


This Washington Post article (Watch him pull a USDA-mandated rabbit out of his hat) about how a children’s magician with a rabbit has been harassed by the federal government over a license required for the RABBIT, not for practicing magic tricks, shows what I have been trying to show to my fellow ‘consumers’ of mental health services: The administrative agencies, federal and states, are the centers that ENACT the oppression the people are feeling. I’ll explain in a moment.

Take the rabbit, leave the “doofus”. That was the WaPo calling that sweet-looking man a “doofus”. ts ts ts ts

About the magician, they DEMAND that the poor man concoct a 20 plus pages EMERGENCY escape PLAN for the RABBIT, you know, in case the rabbit is caught in the middle of a man-made terrorist act or a nature-made terrorist act. (Now, it is POSSIBLE, given the insanity of our federal and states bureaucrats, that they are awakening to the realization that MOTHER NATURE is…gulp…a TERRORIST. We NEED our bureaucrats to protect us from HER. I would love to see them arresting her for down-pouring on a summer Sunday, interrupting our family plans. Well, they are coming close. except that they started with a human:  Oregon Resident, Sentenced To Jail For Stockpiling Rainwater !!! CAN ANYONE GIVE THESE PEOPLE SOME THORAZINE!?)

 

The WaPo article analyses the insanity of the bureaucrats attitude and says this is about how the laws are enacted in this nation:

The story behind it illustrates the reality of how American laws get made. First Congress passes a bill, laying out the broad strokes. Then bureaucrats write regulations to execute those intentions.

And then, often, they keep on writing them. And writing them.

“Regulations are issued and enforced by the Agency.”

That’s the peril of the administrative agencies, that they are given DISCRETIONARY powers to INTERPRET the law handed down to them and apply it at will, and then they become the monkey on our backs.

The NY State Office of Mental Health (OMH) is MASTERFUL at interpreting the laws to HURT THE MENTALLY ILL. That agency does not pass a law that protects the people they are supposed to care for unless the courts or the legislators pass a law to CORRECT the abusive rulings of the agency. Then OMH claims that they are doing a good work because, well, the people are NOT aware of how the courts chastise the agency, in many occasions. They protect the PROVIDERS, including the abusive ones.

For examples of what I have just said, see some of my posts in the OMH category:

magician

Side-by-side: SAFE ACT and ‘illegal’ OMH Guidelines enacting the ACT

NY Safe Act: gun law gives Office of Mental Health power to see the future [wink]

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

Our community needs to awaken to the realization that the actions and rules of the OMH show that there is no reason for us to trust that the agency is looking for our interests. We need to participate in the policy-making process of this agency, we can’t leave it to them to distort the laws meant to protect us.

That’s my personal feeling about this agency.

BASTILLE DAY: OMH on the guillotine, metaphorically speaking.


The Citywide Mental Health Project is pleased to announce our support for this activity. We encourage other consumers to participate and attend the activities. See you there.

Please, pass along to friends.

bastille

FOR IMMEDIATE RELEASE June 17, 2013
Mental Patients Liberation Alliance (The Alliance)
George Ebert 1-800-654-7227
georgeebert@yahoo.com
______________________________________________________________________________
The Mental Patients Liberation Alliance (The Alliance) will host its 33rd Annual Bastille Day event to celebrate the human spirit and break the silence about psychiatric oppression on July 12, 13, 14 and 15 (Friday through Monday noon) in Albany.

A peaceful educational vigil will begin at the New York State Office of Mental Health, 44 Holland Avenue, Albany, at noon on Friday. A focus will be on the mental illness industries’ devastating “medical modelthat exclusively relies on – solely allows and most often forces – invasive dehumanizing, disabling, and potentially deadly drugs and Electro-Convulsive (ECT- Shock) treatments to address what are termed “mental illness” and “mental health issues” – on countless children, young people, and adults.

Kristin Woodlock, Acting Commissioner of the New York State Office of Mental Health, will publish the Regional Centers of Excellence Plan on July 8, 2013, that will “strategically position the mental health system for the future”. The position of we, the people, who have been stigmatized, treated, and dehumanized will be a focus of the 2013 Bastille Day. The Highlander Statement of Concern and Call to Action (March 2000) states, in part: “We call upon all people committed to human rights to work together to build a mental health system that is based upon the principle of self-determination, on a belief in our ability to recover, and on our right to define what recovery is and how best to achieve it”. In the spirit of The Highlander, the Centers of Excellence Plan will be one focal point of Bastille Day 2013.

A general members’ meeting will be held on Sunday, July 15 at 11:00 a.m. during the vigil on Holland Avenue. All meetings are open to the public.
The Alliance – established in 1972 – is a self help, mutual support, and human rights organization of, by, and for people labeled as “mentally ill”. Alliance members, their supporters, and concerned community members are connected to an international liberation movement. The Alliance can be contacted at http://www.TheAlliance.org or toll free at 1-800-654-7227.
….

NY Safe Act: gun law gives Office of Mental Health power to see the future [wink]


Children 11 years old automatically placed in the gun registry, all people admitted to inpatient psych hospitals and all people DISCHARGED from psych hospitals, all their names in the registry AUTOMATICALLY…sorry but it is NOT in fascist Germany. Is it the Office of Mental Health (OMH)? We must act against this outrage, but keep reading.

According to testimony of a Mr. Wolkenbreit, counsel to the New York State Conference of Local Mental Hygiene Directors, Inc. and other mental health providers and civil libertarians at a state Assembly committee hearing  about the mental health provisions of the NY SAFE Act (watch the video at the end of this post):

1) Everybody already admitted, even before the passing of the Safe Act, and everybody admitted to a psych hospital after its passing have been placed in the gun registry, AND at DISCHARGE TOO:

“the state took the position that ALL persons admitted to a state psychiatric hospital met the criteria of 9.46 simply by virtue of their admission...”

“based on POTENTIAL risk standards, hospital administration or counsel have RECOMMENDED or REQUIRED that ALL persons admitted with mental illness diagnosis  be reported…”

“because of amount of reports [received], DCJS is forced to accept them as VALID.”

“OMH wants reporting on discharge and admission…[this is] beyond the scope or reasonable or useful”. Mr. Stein

2) names of  all CHILDREN 11 YEARS OLD and up are been put in the registry automatically, and the absurd reason to include their names:

“OMH is requiring ALL mental health hospitals to report admissions of ALL 11 years old children or older…”

because it is possible that a 16 years old be admitted to the military with parental consent and be discharged at 16 years old and apply for a gun permit

Based on that ‘reasoning’, it is impossible not to sense  paranoia in the attitude of OMH’s administrators who ordered these procedures. They are now engaged in predicting the future: let’s ‘convict’ 11 years old kids NOW since surely they (boys and girls) will be enrolled in the army and surely will come out as  ‘terrorists’. Geez!

3) I mentioned in this blog, when the gun law was passed, that the gun law is NOT  a mandate to gun sellers to do a background check. A Mr. Stein (lawyer, I think) came to a similar conclusion during the hearing:

” Safe Act looks like a mandate but it isn’t…it is not an ‘authorization’ nor a ‘mandate’…[because it doesn’t have] mandate language like 33.13″

“it is NOT a mandate because it doesn’t have a ‘must’, [there are] no penalties.”

3) And, as I have been saying ALL along in this blog, Ms. Haroules of the NY Civil Liberties Union said that these laws:

“protect the providers, not the recipients.”

She also said, paraphrasing, that the way in which this gun law was passed, without input from consumers, made a mockery of the legislative process and the system. I said that too before.

That is in a nut shell what transpired in that hearing. In my view, this ought to be in the mainstream media. OMH has, once again, betrayed the people it is mandated to protect.

The political consequences of all this hanky panky with the gun law is hard to ignore. It is like a virus running across the US: dossiers being made of every citizen, classified in this or that category, all by a nation gripped by paranoia.

I have left out comments about stigma and repression and other problems, mostly because I’m focusing here on the political aspect of the issue: the power of the government to control our lives and the police state. I have mentioned all this in other posts. So…

We shall overcome, it will take time, but we shall overcome.

The only way to bring OMH to ‘task’ is by consumers regaining their collective voice and marching in front of OMH with their denunciations: CLEAN THAT REGISTRY! TAKE ALL THOSE NAME OUT!

That’s what the Citywide Mental Health Project is planning to do.The Tea Party and gun lovers had their rally this past weekend in Albany against this registry and law. Over a thousand people attended. WHAT ABOUT US?!

If you are interested in helping us organize a rally in front of OMH, contact us at:

citywidementalhealthproject@live.com

Links:

[2] http://www.nysenate.gov/committee/mental-health-and-developmental-disabilities

[4] http://www.youtube.com/watch?v=xSae–ouoGE

the Protection and Advocacy redesignation public hearings: our testimony


What follows is the statement I read yesterday at the state’s video-conference  on the proposed re-designation of the P&A system.

Our group were the only ones there speaking up for our community and representing the metro area.

This my  first experience for I have never been to these ‘video-conferences’ given that I’m ‘new’ to doing activism within the mental health system. It was quite an experience.

For one, we were amazed at the third-world level of the system! WOW. I’m sure in Nicaragua there would have been less problems in televising the thing. You could not see the people making the presentations, the audio went on and off…disgraceful. The workers tried the best they could with the equipment they get from yard-sales and the extra slow internet speed we have in the US, as compared to Europe’s.

As for the statements:

Look, our community is AWARE that the government IS part of the problem when it comes to abuses. Consumers from other areas of the state made direct comments about that.

Personally, I got from the conference that consumers don’t have  much hope in that the new P&A system will make a difference in protecting us. GOOD! Now we take the BULL BY THE HORNS.

I’m inviting anyone reading this in our community (consumers) to attend our group’s meeting on Friday April 26 to help us plan a meeting to call for the creation of a coalition to deal exclusively with the problem of physical and psychological abuses of consumers in the NY mental health system.

Please, read the testimony I presented yesterday at the video conference. Comments are more than welcome. There’s Word doc copy at the Our Documents tab.

Testimony of The Citywide Mental Health Project at thePublic Hearing on the proposed redesignation of the New York Protection and Advocacy(P&A) System and Client Assistance Program (CAP) for people with disabilities.

April 9, 2013.

Every 10-15 years, since Willowbrook, a new form of P&A is created as a result of reports about how the state ignores or is part of the culture of abuse of people with all types of disabilities in its system.

Today’s P&A ‘redesignation’, and the new Justice Center, is the continuation in the new millennium of this 10-15 years pattern.

It is the response, not to consumers’ denunciations, but to the Federal ADM of Developmental Disability’ scorching 2011 report based on the NY Times investigation of abuses in the state’s mental health system.

It concluded that the state’s CQCA[Commission on Quality of Care and Advocacy]  had failed (to put it mildly) to protect the disabled, that consumers were excluded from its P&A board, and that the commission had violated the DD Act [Developmental Disability Act]. The system was part of the problem, it had to be torn down and rebuild once again.

And yet, these mental health agencies always report that over 90% of consumers rate quality of care as excellent, even people in places where reports of abuses are rampant. That’s because it is taboo to discuss abuses in our system.

As a response to the report, Section 2 of the Protection of people with special needs Act repealed Art 45 CQCAPD. But it designated these same agencies and the JC as official oversight agencies keeping the same licensed and unlicensed rules that give legal cover to abusive providers, and leaving us still mute in the system.

And this notice of redesignation does not acknowledge nor mentions how the new P&A will correct the violations relating to the exclusion of consumers from the board, which led to the redesignation in the first place.

The definition of insanity is doing the same old things and expecting different results.

As long as the system continues to deny us a voice, as long as there is no official mechanism for us to bring from the programs in which we are up to the agencies our reports of quality of services, as long as token consumer councils continue rubber- stamping policies giving the impression that our community consent to them while we are actually been left out, this redesignation and the JC will continue the culture of ignoring our cries for help.

The Citywide Mental Health Project is calling on our peers to form a coalition of consumers to deal exclusively with this issue of abuses, which moved to our community when state’s institutions were forced to close, so that we can be heard loud and clear about the meaningful policies we want to see enacted.

We cannot continue hoping that good willed professionals will change this system, and wait for the next round of 10-15 years pattern of reports about abuses in the NY Times.

Thank you.

Lourdes Cintron

Founder of The Citywide Mental Health Project

(718)561-8415

Email: citywidementalhealthproject@live.com

Address: 480 East 188th St. Apt. 7M

Bronx, NY 10458

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.

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.

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.

experimentation

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.

THE LIBERAL IMPULSES vs THE OTHER IMPULSES

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.

Look, whatever you do, DON’T GO BACK TO WILLOWBROOK, DON’T GO BACK TO FORCE INSTITUTIONALIZATION.

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.

Outline of the origins of the mental health Consumer Advisory Board


This is how I understand the historical development of the consumer advisory board (CAB):

Two events mark the origin and background of CAB:
a) the beginnings of our Federal public mental health policy system (‘mhp’ from here on) and
b) the Willowbrook Consent Decree.

Part I:
A: Beginnings of Federal Public Mental Health Policy System
1) No FEDERAL mental health policy existed before the 1960s because:
a) States controlled mental health services up to that time and
1.  their focus was on funding psych hospitals as the only place for treating the mentally ill.
2. support was for the  psychiatric profession only.
b) because Americans distrusted the federal gov dictating the states what to do. Sounds familiar?

2)  Pres. Kennedy credited with initiating the Fed mental health policy system.
a) started with address to Congress Feb 5, 1963.
b) the process he used was typical of the policy making
process: he ordered a study/research about the situation of the mentally ill in the nation, created a committee to advice him on solution, and presented to Congress his decision on how to try to solve the problem.
c) his focus was on:
1- De-institutionalization of psychiatric in-patients
2- moving them and services for them to the community
3- Prevention
4- assigning funds for those services. By assigning funds, he committed the government to his plan to solving the problem of mental illness.

That same year (1963) Congress passed his Community Mental Health Act: In that way started the federal public mental health policy.

3) His policy consisted in:
a) offering money to the states to participate in his policy, but the money came with a catch:
b) in exchange for the money, States must create an Advisory Council that would:
1. advice the states on what services the mentally ill needed and
2. include protection and advocacy as part of services.
3. be composed of, among others, consumer reps. This is the first federally mandated state mental health advisory council.

In this way WE got into the newly formed Fed mental health policy system.

4) Nine years later came the Willowbrook court case (1972). The
Consent Decree (agreement) stated:
1. This Board [CAB] shall participate in the development of Willowbrook’s philosophy, goals and long term plans, advice the director on a regular basis…”
2. Membership shall include…residents or former residents.”

This CAB was not a mandate to other institutions but served as a model to our nation’s efforts to recover from the haunting history of state-run houses of horror for the mentally ill.

Summary:
These two events (fed mental health policy and Willowbrook) show how:
a) WE were called to participate at both levels of the nation’s new public mental health policy system: at the state and at the facility (program) levels.
b) the background behind the push to create CAB was:
1. Abuses at state’s facilities (policy of states’ ignoring the abuses).
2. Creation of fed mhp as a response to those abuses.
3. A recognition (implied in the laws) that without PARTICIPATION, the mentally ill were doomed to be oppressed by the same mental health institutions/facilities created to serve them.

This new federal policy and CAB were created for US, NOT for the PROVIDERS. There is no language there referring to CAB as an ‘ancillary’ organism in the policy system; CAB is an INTEGRAL PART of our mental health policy because it was meant to be used by us to coordinate with the providers the program’s policies to prevent abuses of power by providers (private and government).

Part II: THE PROMISE CONTINUED
This promise of participation of the mentally ill in the mental health system continued with almost the same language, with all the other Congressional acts that followed Kennedy’s and Willowbrook. For example:

1- McKinney Act: [July 22, 1987]

-Section 11386: “BY REGULATION each provider must provide PARTICIPATION  of…homeless or former homeless…INCLUDING on the BOARD OF DIRECTORS or other EQUIVALENT POLICY MAKING entity of the  PROVIDER…[no money to the provider] “unless provider agrees – to involve the individuals and families THROUGH  employment or volunteer services in the CONSTRUCTING,          MAINTAINING and OPERATING THE PROJECT.”

[How many of you have participated in the “constructing or operating” of your supported housing?]

2- OMH Supported Housing Guidelines (Appendix Goal 4) says that providers must provide us with “formal input into program and policy decisions”.

Thus, de-institutionalization brought the services to the community and we were promised a place at the TABLE! a VOICE in the system to be heard and to make decisions on matters that affects us.

We have even being given the MECHANISM to do that:
a) the state advisory council
b) and the CAB!! But not allowed to use it as intended.

Instead:
– Willowbrook’s CAB turned into end-of-life decision-making
body for these people. NY State passed this bill:

“authorize the CAB to make end-of-life decisions… [for people] who lack the capacity to make their own health care decisions.” NYS-S3169 Feb 10, 2011

That bill shows how important and the extent to which CAB can be used: Consumers together making important decisions. [We wouldn’t use it to make “end-of-life decisions”, though. We don’t need death panels.] But this mechanism is being hidden from us, maybe because it is too powerful a tool to leave in the hands of the ‘loony’? We can ‘decide’ euthanasia for someone else but not how to devise a grievance procedure for us in our programs?

Part III: Policy systems

Definition of POLICY:
1. An informed CHOICE
a) in response to some problem in the agenda of government or organization.
b) includes all DECISIONS /NON-DECISIONS to do something
about the problem: it‘s a conscious decision. As when the federal and state governments chose to do nothing at the beginning of the AIDS crisis, or how states did nothing to protect those being tortured in psychiatric hospitals up to Willowbrook and even today are examples of policy: doing nothing or policy of inaction.

2. The IMPACTS of those decisions are part of the study of the policy intentions; they are FEEDBACK! Always part of policy analysis because of:
a) POTENTIAL FOR INFRINGEMENT OF INDIVIDUAL’S RIGHTS by the policy enacted.
b) CAB are part of that feedback to the policy system’s process. THAT’S WHY WE MUST PARTICIPATE on them.

Part IV: The CORE FUNCTIONS OF PUBLIC POLICY

There are three: Assess, policy development, and assurance. These functions will be used by the City-wide Mental Health Project to assess how CAB in our programs are fulfilling the purpose for which they were created.

Not all of the essential services under each function will be used because we do not have the capacity at this time.

A: Assessments
1. Establish goals to solve problems we identified in prog.
2. Test those solutions
3. Assess the impact
4. Use the results

B: Policy development
5. Inform, educate & EMPOWER our people about the
problems we confront in the program.
6. Mobilize our community/create partnership with
others
7. Develop/plan intervention strategies and support
for our efforts.

C: Assurance
8. Enforce laws and regulations
9. Link people to services needed/GOVERNMENT
10. Evaluate the effect, accessibility and quality of services.
11. INNOVATIVE SOLUTIONS.

This outline and plans to empower our CAB will be reviewed and further developed through out this month.